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Stroke or brain tumor?

Species: Dog
Breed: Sheltie Mix
Age: 11-15 years
I have been doing a lot of searching on the internet over the weekend and am glad to have just found this forum. I hope that maybe I can get some experienced perspective on my Sheltie-mix's condition and what I feel was his untimely end. Max was a rescue dog so I'm not sure of his exact age, but he was roughly 12-13. Over the last two years or so he had begun to slow down a bit and act a little strangely. When I took him to the vet they said he just was getting old and had some mild arthritis, but now that I do more research I strongly believe he had canine cognitive dysfunction. He would occasionally splay out on our hardwood floors and we would have to pick him up, but once we steadied him he was fine. He would also occasionally jump into the wall when he would go up the stairs, but we also attributed this to his age. Four years ago he was diagnosed with kidney disease, but his blood work in early February showed his kidneys to be functioning fairly well. He had begun to exhibit incontinence more frequently, but it was not consistent. Max was wary around other people and for the most part only let me pick him and pet him, and I think he had been more stressed and confused as of late because we just had a baby in October and there were constantly family members and their more energetic dogs in his space. He still seemed to enjoy things most of the time, however, and he would eat and drink and occasionally enjoy being pet, although he seemed to sometimes get distracted and walk away.
On Thursday night my husband and I came home and found him splayed on the floor again next to a pile of his defecation. I thought at first that this was a normal episode of him slipping, and lately he had been defecating inside of the house even after I had just taken him outside, so I wasn't alarmed by it. When my husband went to try and pick him up, though, Max was snapping at him, so I had to do it. When I tried to steady him like always he wasn't able to stand at all and kept flailing, so I took him down the stairs to the backyard and steadied him. He stumbled around the yard in a drunken state, and he seemed very unlike himself. Both his back and front legs were stiff, his back legs more so than his front. He stumbled a few times so I finally went and picked him up and brought him back inside where he just collapsed on the floor. That night we kept him in our bedroom with us, and though he would stand occasionally and stumble in a couple of directions he would fall soon after. When he needed to pee he would stand up, but he ended up peeing on the carpet before I could get to him to take him outside. I gave him water throughout the night, holding it up to his head, but he was not interested in eating even a soft treat. The next morning I made him an appointment with the vet. When my husband carried him to the backyard he bent to defecate and did but ending up sitting down in it.
I was not at the vet's right when my husband got there with Max because I had to drop our baby off with my mom, but when I got to there the vet was performing a physical exam on Max. She showed me that when she bent his paws back (knuckling, I believe it's called) on all four legs he had no reaction whatsoever. She did a number of other physical tests that indicated to her that all four legs were somehow neurologically compromised, as well as his facial reflexes. She said she didn't think that he was in pain, but that he clearly had some sort of a neurological episode that was either a stroke or a brain tumor. When she finished the exam she didn't really say what our options were, I had to ask. She said blood work and x-rays wouldn't show much since the problem was neurological, and that an MRI or CT Scan could be done to determine the cause but because of his kidney disease those tests might harm him. She said given the extent of his lack of responses in all four legs and his age it was unlikely that he would recover his mobility, and if he did it would be months. She said we could just to take him or "it wouldn't be wrong to euthanize him." She said we had to consider his quality of life at this point. My husband and I cried and asked some more questions, but my husband thought it would be cruel for us to let him continue living this way. I agreed to it, and Max was euthanized while we held him on Friday morning.
Almost as soon as I got home on Friday, though, I immediately regretted this decision. I have been reading online all weekend about people whose dogs recovered from strokes, and I am angry that the vet or myself didn't think to at least wait the weekend out to see if Max would improve on his own. My husband is angry with me because he feels like we did the right thing, but I am devastated and feel like I killed my dog. Any similar experiences or feedback would be so much appreciated.


Online vet, Dr. Marie

Dr. Marie replied:

I'm so sorry to hear of your hard times with Max.

While we'll never know exactly what happened, from what you have written it really does sound like you've made the right decision. Please know that I don't make statements like that just to make people feel better. Whatever was happening with Max was very serious.

What you are describing really doesn't sound like cognitive dysfunction. Cognitive dysfunction is similar to alzheimers in people. It is quite common for dogs to get a degree of cognitive dysfunction as they get older where they forget their house training or are confused. However, there really aren't any physical symptoms that go along with this condition. The trouble standing and the neurological symptoms do not match at all.

I wonder if what you are thinking about is vestibular syndrome. This is a condition similar to a stroke where dogs will suddenly have balance issues and great difficulty walking. Dogs can indeed recover from vestibular syndrome on their own and quite often make a full recovery. But, the symptoms you are describing do not match vestibular syndrome either. Dogs with this condition do not have the neurological deficits that you are describing. The knuckling on all 4 legs does not match. Vestibular Syndrome affects a particular part of the brain that can cause the eyes to flicker back and forth and the dog to feel wobbly, but doesn't cause actual knuckling issues.

In order to have all 4 legs affected and the face, there had to be something very serious going on. I have never seen a stroke affect all of these nerves but I suppose it is possible. A stroke of that magnitude would not be something that would be easy if even possible to recover from. A brain tumor could possibly do this and is probably more likely than a stroke.

If this were my case I would have made the exact same recommendations. You could have had an MRI done but it entails an anesthetic which would have been risky and it is very expensive. Plus, an MRI is not going to solve the may just simply put a name on what the problem is.

I think that the chances that Max had something treatable that he could recover from are almost nothing.

Please know that you did the right thing. In my opinion, to try to treat this would not have been fair for Max and would have put him through more discomfort.

Please let me know if you have other questions.

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. 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 so much for your response. I considered having a post mortem done on Max to see if that would reveal what his problem was, but the vet said all they could was a superficial one that would not include the spinal cord or brain, which was most likely where the problem resided. It's just so difficult because last week up until his episode Thursday night that changed everything he was eating well and still looking out the front window like he enjoyed doing. I really do appreciate your time and input.

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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.

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