My poor little Spencer is sick, and we can't figure out what's wrong with him. He has some very odd symptoms, and I wonder if anyone else has ever experienced anything like this or may be able to offer any kind of help. Opinions, thoughts, ideas– we're desperate and will gratefully accept them all! Spencer has been getting pickier and picker about eating and losing weight and muscle mass. We have been trying everything to fix that, but then three days ago, he woke up unresponsive, almost catatonic. I rushed him to the vet, and we have done just about every kind of test and x-rays imaginable. The only thing that is off is that his alk phosphate is 2000! Spencer is a Fanconi dog, so his alk phosphate value has always been high and tracking upward. That's not uncommon in an older Fanconi dog, and it was 900 in September. But the rest of his values are in line, so he is not in renal failure... or liver failure... it's not his gall bladder, it does not seem to be pancreatitis and there is no sign of cancer.
This is his third day on IVs, and he has perked back up and is acting almost normal except he can't eat or drink. It's not that he doesn't want to-- he doesn't know how. He puts his mouth down to the bowl and has figured out how to make slurping noises, but he can't seem to get his tongue out of his mouth. He's not paralyzed; he just can't figure out how to drink. He seems as puzzled about it as we are. The vet says it's possible he had a stroke, but he is a Velcro dog and I saw no signs of that. Still, it's possible. So has anybody every heard of anything like this-- or maybe have suggestions or thoughts that I can discuss with the vet? We're baffled. We're feeding him with a syringe, and he's getting IVs, but we can't do this forever. Thank you for any help-- any at all!
I am sorry I have no information to offer. However I would like to say that I hope poor little Spencer gets well soon! It's hard to see our little guys in pain or in trouble. My heart goes out to you and Spencer.
Thank you so much! Yes, it's hard. If we just knew what to do… My vet has called other vets, and they all say they have never seen anything quite like this.
Are you sure it is not a gall bladder problem? It could be a bile duct obstruction. Has an abdominal ultrasound been done? If you have had one done and it is normal then other things it might be is Cushing's or Hepatitis.
Has he been taking any medications that could cause the high Alk Phosphate-like steroids or anti-seizure medication?
My 13 year old Fanconi affected girl, Missy, has gall bladder problems-sluggish gall bladder diagnosed by an abdominal ultrasound and high liver values but she does not have liver problems nor gallstones. She is taking Urosodial for it. She was also diagnosed as having Atypical Cushings disease and is taking Melatonin for it. The blood test for the Atypical Cushings had to be sent to the Univ. of TN for diagnosis. Missy goes to an Internist-Dr. Beth McElrevy at the Cincinnati Care Center for this problem and Dr. Tracy Leonard, her regular vet for the Fanconi. The number for the Cincinnati Care Center is 513-530-0911 if your vet wants to call Dr. Beth McElrevy. Has your vet contacted Dr. Gonto regarding this problem?
I hope your boy gets better!
Jennifer
Thank you so much! Yes, it's hard. If we just knew what to do… My vet has called other vets, and they all say they have never seen anything quite like this.
Has your Vet contacted Dr. Gonto for his opinion? Have blood gases been done recently? Was he checked for Vestibular?
http://www.canine-epilepsy.com/vestibular.html
Thank you so much for your help and your questions! Yes to everything. This does not appear to be Fanconi-related, though you never know. Kidney values are fine– very good, actually-- for a Fanconi dog, except for the Alk Phos, but the other liver values are within normal range. Vet did a bile duct test, thyroid, urine analysis, fecal, x-rays, abdominal ultrasound, CBC, gases, electrolytes. Almost all of his values are very good for a senior. He doesn't have the head tilt, balance, gait or eye issues for Vestibular, and he doesn't have the weight gain or appetite with Cushings. And those values are normal. He has no jaundice, no signs of paralysis, no drooling, no eye issues and no sign of infection.
It seems to be his tongue. He can't use it. He wants to drink and makes smacking noises with his mouth, but he can't get his tongue out to lap or lick. We checked for a throat obstruction, dental issues, tongue lesions, ulcers, even a splinter. I'm taking him in right now for another IV with fluids and antibiotics-- have been doing this twice a day. He wants the food and water-- will take it gratefully through a syringe-- but can't get to it on his own. This is so weird. Please keep the ideas coming. We will try anything. He so wants to live, and of course, he is my baby!
Could it be a neurological problem? Would a fluoroscopy help? This is a test where they take pictures of the dog swallowing and eating food. It diagnoses trachael and esophagus problems. It looks like it can diagnose tongue problems like tumors or a foreign body stuck, etc. My boy had this test done several years ago at the Cincinnati Care Center when he had regurgitation problems and he has an esophagus motility problem.
Jennifer
That is very strange and I wish I had something helpful. As far as loss of muscle mass, I will say taking Digital (my 15yo brindlewonderkid) swimming once a week has helped with this, especially in the winter. In fact, my regular vet saw him last week for his yearly and asked about how I was keeping him so fit. I'm very lucky to have a wonderful hydrotherapy pool nearby. I've also noticed on the swim days, his appetite increases (as well as his water intake). This is directly related to exercise. I also do homemade muttloaf for my dogs. I started this because Digital was such a picky eater. I use it as a supplement to his regular evening kibble. (http://maryshouse.us/Recipes.htm)
of course none of this is very helpful for the immediate problem of him not being able to eat.
By process of elimination, the thinking is that it is some type of neurological problem. Spencer's tongue is curled under and he can't move it, and he does not want to open his mouth. He locks his jaws and snaps down on your fingers when you try to insert them in his mouth. There is obviously some mouth problem. He has never snapped before and usually is fine with his mouth and teeth being checked.
I have never heard of a fluoroscopy, Jennifer– thanks for mentioning it. Unfortunately, my vet has just about given up on him. I am going to try and find a neurologist, but I will have to wait until Monday at UT. I don't know if he'll make it until then. When he clamps his jaws down, like he has started to do, we are having a hard time getting food into him. He has some trouble swallowing. And he's just about had it with the catheter and the IVs-- he keeps pulling them out. The vet wants to do one more IV in the morning, then let him go if he doesn't start eating and drinking on his own. I don't sense that he's ready to go-- he just needs help that we do not seem to be able to give him. 
Spencer's ailment is truly unique, I would wonder about anesthethitizing him to get that mouth open and have a good look all around. Not being able to eat and drink is not a long term viable condition, I am afraid. Poor little guy, poor YOU, sometimes there just isn't a good solution. Hugs and hoping you find a good neurologist for him soon.
Maybe try a holistic vet also. My friends dog had some sort of neurological problem and they took him down to a holistic vet and that vet ended up saving his life. The vet here had just about given up on him too, said he wouldn't make it and they should put him to sleep. He has now been good for two years with no signs of the pre-existing problem. I am really hoping that you can find a solution and not have to let him go, especially if you don't think he is ready. I hope all is well soon.
I will say my holistic vet has been a key element in my old boyz health/happiness.
Also, looks like there are many hits if you put in "tongue paralysis in dogs" I don't know if any of them fit your situation, but I did notice one was linked to tick borne diseases.
Thank you so much for your responses. It is baffling and heartbreaking. He can only open his mouth slightly. He stands at his bowl and tries to smack his mouth at the water, then he keeps circling around and trying it again and again. He is desperate for water and starving, despite what we are able to get down him through the syringe and with the IVs. It isn't enough. He has lost 20% of his body weight in the last four days. He is exhausted and starting to give up. I can feel it. My vet has written him off. It is Saturday now, and I am unlikely to find a neurologist or holistic vet that will see him today. I'm pretty sure he won't make it until Monday without drastic improvement. It's just breaking my heart that I can't help him.
I have been researching online for hours. I did find something called Masticatory Muscle Myositis. I'm going to speak to the vet about it this morning when I take him in for the IV. We discussed Lyme disease and tick-releated illnesses the first day, and I believe some test ruled that out. I'll have to ask again. I will probably take him to the animal hospital today for another opinion, since my vet seems to have already decided that he is 14 and it's his time. If he were in kidney failure, I would agree, but the poor dog is desperate to eat and drink. He just can't physically do it.
Thanks for all the support. It's so much more than I'm getting from my vet.
Yes I would take him to a different vet…quickly. If your vet doesn't want to help him anymore I would find someone with some compassion to look at him. Just because he is sick your vet should not write him off that is ignorant. Do you have a special care clinic somewhere around you? Those places are usually very good as well.
This is heartbreaking. Can you get a large syringe, 20 or 30 ml? If so, also get some rubber or plastic tubing that will fit on the end of the syringe, cut about 4-6 inches long and fill syringe with ensure or some other nutrient rich liquid. Put the tip of the tubing as far back inside his cheek as you can back beside the molars, and slowly inject the Ensure. If he can swallow without choking he will get some nutrition. (I'm s nurse and we used to do this for baby's with oral surgery, in the recovery room) It may take a long time to get a can at a time of ensure down him, and it will be a lot of sugar (check for a diabetic-type supplement) but this is all I can think of to get something besides plain fluids into him, might keep him going till Monday if you think better vet care might be found then. My heart breaks for you and Spencer.
Can they do subQ fluids? That would last for a little while and you might be able to do that at home.
I have always done subQ myself. Pretty easy to do….
Thank you for all the advice and support. Spencer is in surgery right now, and he is very weak and fragile, so we're just waiting and hoping. The vet found painful lesions on the back of his tongue and they now suspect that he has something embedded in his throat or perhaps a mass that was not caught on the films. It almost sounds like strep throat, except the antibiotics should have been helping. Of course, this should have been caught the first day… or the second... or the third... when I kept insisting the problem was in his mouth or throat and everyone at the vet's office insisted that they had thoroughly checked that and it was fine. If you have any positive thoughts you could send our way, we would appreciate them. Give your Bs an extra big hug today!
Positive thoughts and heartfelt prayers going out for you and Spencer! Hugs to you both!
Terry
Hang in there Spencer, and Spencer's family! We're all hoping he makes it and will be around a few more years.
