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My dogs is a 13 year old maltese diagnosed with

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My dogs is a...

My dogs is a 13 year old maltese diagnosed with Syringolyelia at age 2, was treated with a protocol of 2.5mg prednisone every other day which has been discontinued as a result of cushing simptoms. He is experiencing severe Ataxia symptoms. any suggestions?

Veterinarian's Assistant: Do you have frequent headaches? Any issues with coordination or balance?

I am alking about my dog. He has severe issues of coordination and limb functionality

Veterinarian's Assistant: Anything else in your medical history you think the doctor should know?

Dear computer I am not the dog

Submitted: 4 months ago.Category: Dog Veterinary
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Answered in 8 hours by:
12/2/2017
Dog Veterinarian: Dr. Joey, Board Certified replied 4 months ago
Dr. Joey
Dr. Joey, Board Certified
Category: Dog Veterinary
Satisfied Customers: 4,943
Experience: 15 yrs in practice, specialist canine/feline medicine
Verified

Hello I am Dr. Joey. Thanks for asking your question and trusting me to help you and your pet today. I am a licensed veterinarian with over 17 years of experience. I am so sorry to hear your dog is going through this.

The number one sign of this condition is pain. Prednisone is not a pain relief medication. I didn't see that you mentioned you were giving him anything right now for this. Therefore, discussion with your vet about appropriate pain relief options is very important. However, treating pain will probably not resolve the ataxia or balance issues.

Was the diagnosis made via MRI scan as this seems to be the definitive way to diagnose this? If not, then I recommend you get a referral to a veterinary neurologist right away and get a diagnosis for exactly what is going on. Assuming it was a neurologist that did the initial diagnosis and a scan was done, typical treatment for this is surgery, although many opt not to pursue this. This can often improve many patients, although if not done and in some cases even when done many need lifelong medication in addition to this which involves 1)pain relief and 2)medication to reduce the overproduction of cerebrospinal fluid such as cimetidine or omeprazole or possibly diuretics such as furosemide and 3)corticosteroids.

As well, simple actions, for example raising the food bowl and removing neck collars, can also help relieve some pain. I assume you are already doing this.

The bad news upon examining some studies on this problem: The clinical signs are usually progressive. A recent study found that approximately 3/4 of this type of associated neuropathic pain will deteriorate on conservative treatment only.

I am at a point I need to know what questions you have. I hope that the information I provided has been helpful.

Please let me know if for any reason you need further clarification, have more questions, or were expecting a different type of answer.

If you received all the information you needed, then please take a moment to submit a rating.

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Customer reply replied 4 months ago
Dear Dr. Joey
Yes to all. To the extent that Gabriel was diagnosed with Cushing via ultrasound observing one enlarged subrenal gland my question was really not weather he has or not Chiari (MRI done at age 2 and diagnostic by Neurologist) but really if suffering from cushing (probable cause 10 years of corticosteroids) since that can also be cause by a pituitary disfunction (cancerous growth) but given that syringomielia impacts the same area weather the ataxia could be caused by Syringomielia while cushing by dysfunctional subrenal gland.???
Dog Veterinarian: Dr. Joey, Board Certified replied 4 months ago

This is most likely iatrogenic Cushing's, then, which means we caused it by the high dose of prednisone. This should be reversible upon a slow wean-down on the pred (never stop abruptly or the body will go into crisis). So, the signs of this should be reversed. If your vet thinks an immunosuppressive drug like pred is needed for continued treatment then consult with the neurologist on if an alternative might work.

However, we can only tell if this is iatrogenic versus the body developing natural Cushing's by stopping the pred, waiting a few weeks and then repeating one of the screening tests and/or repeating the ultrasound to look at the adrenals for measurement to see if we suspect a tumor on one of the adrenals. IT is important to try to differentiate this but it's going to take some time.

I do not understand that the syringomelia and pituitary affecting same area? A primary pituitary tumor is microscopic beneath the brain, and therefore doesn't cause any sort of mechanical problem. A solitary enlarged adrenal gland is near the kidney and does not impinge on the spinal cord in dogs. If it did, which is almost unheard of, then removal of this adrenal gland is indicated ASAP (never seen this to be a problem except in ferrets).

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Dog Veterinarian: Dr. Joey, Board Certified replied 4 months ago
Hi,

I'm just following up on our conversation about your pet. How is everything going?

Dr. Joey
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