Questions about seizures and MRI.

Dr. Marie replied:

Hi Mike and thank you so much for asking your question. It sounds like Boo Boo has an amazing family!

It is often hard to diagnose the cause of a seizure, especially in an older dog. However, unfortunately the most common reason to see an older dog seizure is because of a brain tumor. In some cases, a brain tumor can be removed by surgery if you have access to a veterinary teaching hospital. However, there are many brain tumors for which we have no good treatment.

If we take the cost of the MRI out of the picture, then I would not hestitate to administer an anesthetic in order to get a diagnosis.

We see problems with older animals under anesthetic when there is significant organ dysfunction. If this were the case we should be seeing more changes on her bloodwork. Do you know if she had her urine tested as well? If she had mildly elevated kidney enzymes, but her unine was ok then this would mean that her kidneys are totally ok. However, if her urine was showing that her kidneys were diluting the urine too much then it may mean that she has some mild kidney disease. If the urine is dilute and the enzymes are only mildly elevated then I would still consider her safe for anesthetic. The vets will have her on IV fluids to support her kidneys and they will also monitor her blood pressure and give medications if necessary in order to keep her pressure at a level that is safe for her kidneys.

The anesthetics that we use these days are extremely safe.

Knowing whether or not there is a tumor present will definitely help you in making decisions on how to treat her for the rest of her life. You should be able to know how serious the problem is and what to expect.

Pekes are wonderful little companions! I really hope that BooBoo does ok.

Let me know if you have more questions. I am online all evening.

Dr. Marie.


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Dr. Marie replied:

You're very welcome!

I love stories of rescued animals. I have a house full of them myself!

The worst case scenario sort of depends on what type of tumor she has (if indeed there is one there). The MRI should be able to tell us if a tumor is there but will not tell us if it is malignant or not. To do that we would need to do a biopsy and as you can imagine it is difficult to biopsy a brain tumor as it would entail invasive surgery.

If it is a tumor there are a few possible scenarios. First, it may be a benign tumor that is growing but is not spreading to her body. If this is the case then this should not be painful for her. However, as the tumor grows bigger it will affect her brain more and more. We may see more seizures and potentially some more neurological deficits such as difficulty walking. Neither of these conditions should be painful, but they may cause BooBoo to be a little frightened. If she is having very frequent or long seizures then this can cause her some discomfort. Your vet may talk to you about putting her on an anti-seizure medication such as Phenobarbitol or possibly a steroid such as prednisone to help to reduce the frequency of seizures.

If it is a tumor that is malignant then you will eventually see spread of the tumor to other parts of the body such as liver, spleen, lung or lymph nodes. This is usually not a painful thing, but it will make BooBoo feel generally unwell. I imagine it feels like having a bad flu. She will show you this by refusing to eat and becoming very lethargic. Again, your vet may prescribe medications to help and possibly to increase her appetite. But at some point if you feel that she is not enjoying life then some decisions on euthanasia may have to be broached.

As I mentioned before there are some veterinary colleges that are doing surgeries on brain tumors. The MRI should tell us if this is an operable cancer. If so, there is a possibility that she could completely recover.

I hope that info helps.

Dr. Marie.