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Questions about seizures and MRI.

Species: Dog
Breed: Pekingese
Age: 11-15 years
Dr.,
We are in a dilemma and don't know what to do. Our pet, BooBoo, our beatiful Peke (about 13 as we found her 8 years ago) had a seizure (we believe it was one) a couple of nights ago. She also had something similar about 6 months ago. She spent Sat-Sun in emergency and her tests showed nothing siginifant except some elevated kidney results which the vet did not believe was too crucial to her well being because of her age.

She is about 11.5 lbs (lost about 1.5 lbs recently) and walks aimlessly around the house. Besides her incontinence problem we are concerned for her well-being. She has been panting on and off and like to rub her snout against pillows and my open hands often as if to scratch. She also roams around all hours of the evening and we must "baby proof" the house so she doesnt get in trouble. Her appetite is now good although last week she had some eating problems.

This morning my wife and I took BooBoo to a Neurologist and she (Dr.) told us that she believes there may be neurological problems with her. That we can start her on some meds, which are steroidal and see if she improves but recommended an MRI to actually rule out brain tumor.

Although the MRI is $1750 we are not hesitating because of the funds. I will do anything to help her and will definitely not consider "putting her to sleep" unless she was in pain. Our concern is the anesthesia.

The Neurologist told us BooBoo would have general anesthesia and that is a concern for us as we dont want to lose her during the testing.

Any advice you can offer is greatly appreciated as we are pet owners (have another Peke as well) and don't believe in putting a pet "to sleep" just because they are old and costing us money.

She is the cutest little thing and we dont know what would be right. We can answer any questions you may have about her to help you formulate a proper response.

Thanks,
Mike


Online vet, Dr. Marie

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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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. AskAVetQuestion.com and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

Customer reply:

Thank you, Dr., for your detailed response.

The neurologist, who is board certified, Diplomate ACVIM (if this helps), believes that her chances of survival are as good as any other dog since her blood work is relatively good (unexciting, as she calls it). BooBoo did have a urine test performed this past Saturday and all was normal.

Dr., presuming the worst scenario, that she has a malignant tumor, what can we expect? I realized that her life will change significantly and probably rapidly but are there meds that can at least assist her?

We want to know if she is in pain. Although she is lyeing down very comfortably as we speak, I dont believe we can know if she is experiencing any type of pain? (or can I).

That is our concern....BooBoo suffering.

A quick scenario of BooBoo's life...my son found her in the street 8 years ago, she had to have an emergency hysterectomy immediately after we found her. She has never been what I would call a normal dog, always timid and shy. Unlike my other Peke who we got when he was a pup and is a tiger at age 14.

Thanks, Dr.

Mike



Online vet, Dr. Marie

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.



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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.