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Bella (mom = Fahreen)
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Hello fellow Maltese parents, we’ve had a strange week with Bella. She turns 2 in April, weighs about 6.5lbs and is generally spunky and happy. Since last Sunday, she’s demonstrating a fear of coming down the stairs. She’s acting cautious, won’t jump on/off the couch and generally has low energy. I have a suspicion that her right hind leg might be a bit lame. We’ve seen her topple a couple of times - as if she is struggling with balance? She seems to be walking around okay for the most part though. She had an episode of bladder & bowel control loss at two different times on Thursday morning in our bed (11:30pm & 3:30am!). She woke up whining and distressed. Took her in to see our primary care vet on Thurs pm; Bella was upbeat and curious walking around and friendly with the dr & staff! She examined Bella’s leg and knees and palpated her body. She observed Bella (commands, attitude, etc) and didn’t really think much was going on with the hind leg. I okayed for the dr to administer some laser tx around her back and hind legs and turns out, Bella was distressed when the laser hit her mid-back area. Dr. Lisa thinks there might be a back injury. No imaging was done. We’re sched to go back for another laser tx next week. BUT, yesterday, Bella was hiding all day under the office desk (isolated room), tail was down most of the day, lots of tremors, slept a lot, and was going this strange “looking up at the ceiling” motion. All of our orthopedic ER rooms were at capacity so I couldn’t get her in for an emergency exam. She still has good cognition - wanted her food, sweet potato, wanted to go outside and sit in the sun, had water, peeing and bowel movements are fine! I’ve been doing some reading online - I’m concerned it can be a spinal cord injury or Shaker Syndrome? Any thoughts? Any tips? Should I try to get an X-ray at an ER? I’m so confused as to what to do? Thank you all in advance for taking the time to read and respond 🙏
 

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Is there another specialty vet that can see her? I do not have experience with either issues, sorry. Hope you find the solution soon.
 

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I would agree that he needs a thorough exam ncluding xrays.

The symptoms, to a lay person such as me, might be consistent one by one with various conditions. But the issue of a spinal problem would need to be looked into.

An x-ray could show a herniated disk (one of my non-Maltese small dogs had a herniated disk at the mid-to-lower spine level due to a fall while trying to jump up on a chair) and shaking can be due to pain But the looking up at the ceiling might be another type of neurological problem. Or maybe just stretching the spine.

I would definitely pursue having x-ray imaging to see if there is a spinal/disk problem. Because if there is, the conservative treatment may be complete rest with anti-inflammatories/steroids and pain meds as needed. No stairs, no jumping around, etc., that could aggravate the problem

My Charlie, who screamed in pain with very little movement, had to be confined to a crate for 6 weeks except for leashed potty breaks, as I recall. It was difficult at first, but he recovered withouut the need for surgery. But he fell on his back again a couple years later and I about panicked! Fortunately he was okay! But he's not allowed near elevated furniture anymore. Fortunately we don't have stairs except 2 down to the yard.

Anyway, I would say definitely look into it more. I'm surprised your regular vet started treatments without an xray, but maybe she was concerned about the cost. I hope that is not a problem. If it is, maybe look into getting Care Credit if you don't already have it.
 

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Bella (mom = Fahreen)
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Discussion Starter · #6 ·
I would agree that he needs a thorough exam ncluding xrays.

The symptoms, to a lay person such as me, might be consistent one by one with various conditions. But the issue of a spinal problem would need to be looked into.

An x-ray could show a herniated disk (one of my non-Maltese small dogs had a herniated disk at the mid-to-lower spine level due to a fall while trying to jump up on a chair) and shaking can be due to pain But the looking up at the ceiling might be another type of neurological problem. Or maybe just stretching the spine.

I would definitely pursue having x-ray imaging to see if there is a spinal/disk problem. Because if there is, the conservative treatment may be complete rest with anti-inflammatories/steroids and pain meds as needed. No stairs, no jumping around, etc., that could aggravate the problem

My Charlie, who screamed in pain with very little movement, had to be confined to a crate for 6 weeks except for leashed potty breaks, as I recall. It was difficult at first, but he recovered withouut the need for surgery. But he fell on his back again a couple years later and I about panicked! Fortunately he was okay! But he's not allowed near elevated furniture anymore. Fortunately we don't have stairs except 2 down to the yard.

Anyway, I would say definitely look into it more. I'm surprised your regular vet started treatments without an xray, but maybe she was concerned about the cost. I hope that is not a problem. If it is, maybe look into getting Care Credit if you don't already have it.
I would agree that he needs a thorough exam ncluding xrays.

The symptoms, to a lay person such as me, might be consistent one by one with various conditions. But the issue of a spinal problem would need to be looked into.

An x-ray could show a herniated disk (one of my non-Maltese small dogs had a herniated disk at the mid-to-lower spine level due to a fall while trying to jump up on a chair) and shaking can be due to pain But the looking up at the ceiling might be another type of neurological problem. Or maybe just stretching the spine.

I would definitely pursue having x-ray imaging to see if there is a spinal/disk problem. Because if there is, the conservative treatment may be complete rest with anti-inflammatories/steroids and pain meds as needed. No stairs, no jumping around, etc., that could aggravate the problem

My Charlie, who screamed in pain with very little movement, had to be confined to a crate for 6 weeks except for leashed potty breaks, as I recall. It was difficult at first, but he recovered withouut the need for surgery. But he fell on his back again a couple years later and I about panicked! Fortunately he was okay! But he's not allowed near elevated furniture anymore. Fortunately we don't have stairs except 2 down to the yard.

Anyway, I would say definitely look into it more. I'm surprised your regular vet started treatments without an xray, but maybe she was concerned about the cost. I hope that is not a problem. If it is, maybe look into getting Care Credit if you don't already have it.
Thank you for all your thoughts and ideas. We’re so grateful that we can afford good care for Bella. I have an appt with our vet again tomorrow for bloodwork and hopefully some imaging. Bella def is showing deficiencies on her right side - weakness and toppling over. I think there might be a spine/disk issue. Will address that with our vet and get referrals right away if need be. She’s in good spirits overall though. Fingers crossed.
 

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Sandi-- w/Kitzel (Kitzi) & Lisel (Lisi)
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If all else is negative I would ask for a neurological work-up---just to be sure. Best wishes as you move forward. We are here!
 
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Hello fellow Maltese parents, we’ve had a strange week with Bella. She turns 2 in April, weighs about 6.5lbs and is generally spunky and happy. Since last Sunday, she’s demonstrating a fear of coming down the stairs. She’s acting cautious, won’t jump on/off the couch and generally has low energy. I have a suspicion that her right hind leg might be a bit lame. We’ve seen her topple a couple of times - as if she is struggling with balance? She seems to be walking around okay for the most part though. She had an episode of bladder & bowel control loss at two different times on Thursday morning in our bed (11:30pm & 3:30am!). She woke up whining and distressed. Took her in to see our primary care vet on Thurs pm; Bella was upbeat and curious walking around and friendly with the dr & staff! She examined Bella’s leg and knees and palpated her body. She observed Bella (commands, attitude, etc) and didn’t really think much was going on with the hind leg. I okayed for the dr to administer some laser tx around her back and hind legs and turns out, Bella was distressed when the laser hit her mid-back area. Dr. Lisa thinks there might be a back injury. No imaging was done. We’re sched to go back for another laser tx next week. BUT, yesterday, Bella was hiding all day under the office desk (isolated room), tail was down most of the day, lots of tremors, slept a lot, and was going this strange “looking up at the ceiling” motion. All of our orthopedic ER rooms were at capacity so I couldn’t get her in for an emergency exam. She still has good cognition - wanted her food, sweet potato, wanted to go outside and sit in the sun, had water, peeing and bowel movements are fine! I’ve been doing some reading online - I’m concerned it can be a spinal cord injury or Shaker Syndrome? Any thoughts? Any tips? Should I try to get an X-ray at an ER? I’m so confused as to what to do? Thank you all in advance for taking the time to read and respond 🙏
Hello fellow Maltese parents, we’ve had a strange week with Bella. She turns 2 in April, weighs about 6.5lbs and is generally spunky and happy. Since last Sunday, she’s demonstrating a fear of coming down the stairs. She’s acting cautious, won’t jump on/off the couch and generally has low energy. I have a suspicion that her right hind leg might be a bit lame. We’ve seen her topple a couple of times - as if she is struggling with balance? She seems to be walking around okay for the most part though. She had an episode of bladder & bowel control loss at two different times on Thursday morning in our bed (11:30pm & 3:30am!). She woke up whining and distressed. Took her in to see our primary care vet on Thurs pm; Bella was upbeat and curious walking around and friendly with the dr & staff! She examined Bella’s leg and knees and palpated her body. She observed Bella (commands, attitude, etc) and didn’t really think much was going on with the hind leg. I okayed for the dr to administer some laser tx around her back and hind legs and turns out, Bella was distressed when the laser hit her mid-back area. Dr. Lisa thinks there might be a back injury. No imaging was done. We’re sched to go back for another laser tx next week. BUT, yesterday, Bella was hiding all day under the office desk (isolated room), tail was down most of the day, lots of tremors, slept a lot, and was going this strange “looking up at the ceiling” motion. All of our orthopedic ER rooms were at capacity so I couldn’t get her in for an emergency exam. She still has good cognition - wanted her food, sweet potato, wanted to go outside and sit in the sun, had water, peeing and bowel movements are fine! I’ve been doing some reading online - I’m concerned it can be a spinal cord injury or Shaker Syndrome? Any thoughts? Any tips? Should I try to get an X-ray at an ER? I’m so confused as to what to do? Thank you all in advance for taking the time to read and respond 🙏
Did your vet suggest a neurologist for these symptoms- just a thought
 

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Bella (mom = Fahreen)
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Discussion Starter · #9 ·
I apologize in advance for this lengthy discussion fellow fur-parents. I wanted to update you all on Bella's status. It has been a rough tough week so far. Bella has been worsening in terms of the weakness on her right side. Yesterday, she woke up with her right hind leg pretty much paralyzed. Our vet got us into a specialty care ER right away. They admitted Bella and started all sorts of testing and bloodwork - all her bloodwork was wnl! Then came the neurology work-up. One of our best neurologists in the Pacific NW happened to be on rounds and saw her with a full exam - they followed up with an MRI and these are the findings. First issue is they discovered she has COMS or Chiari Malformation. I had never heard of this condition and apparently it is common in small breeds and esp the ones that are "made/bred cute" with smaller rounder heads. It is when their skulls are actually too small for their brain size and that leads to impingement into the brain stem and narrowing of the spinal cord (I hope I understand this all correctly?). Dr. Spoor said that there is significant narrowing of her spinal cord which is leading to spinal fluid build-up. Secondly, she is also showing in the MRI signs of GME - granulomatous meningoencephalomyelitis - which is a non-infectious meningitis in the brain. This is an autoimmune disorder that is quite common in small, white, female dogs. Wow! We are in shock! Utter utter shock! All this, out of the blue?!?! They have kept her in the hospital and started steroid therapy last night; I hope we can bring her home today. All I have been doing is crying and praying. We love her so much. We just want her to have a good recovery and healthy quality of life. She is barely 2! I need to have another conversation with the neurologist about the long term prognosis but I think he said that it can be good as long as its well managed with meds. If anyone has ANY thoughts on all of this, pls share! I am also wondering how I can bring this up with Bella's breeder ... should I? Bella has 2 brothers in her litter; I am curious if they are both healthy? Bella has had health issues almost all her life :( Of course, we are going to do everything to help her because she is our baby and I truly believe that her soul chose our family to be a part of. I am feeling a bit bitter about her health issues though .... pls don't judge me! Thank you for letting me pour my heart out; I am grateful for this community.
 

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I am so sorry to read this. To be honest, I've been actively involved with small dogs for over 30 years now and I'm aware of both of these conditions - and both of them came to mind when I read your earlier posts. I'm glad you've found a neurologist who has recognized them - many veterinarians are ignorant about these conditions.

There is a LOT of information available about both chiari malformation and GME online. I know of a few dogs who have been had their lives extended - with quality - when diagnosed early and treated aggressively. Wishing you all the best as you go through this with your fur-baby.
 

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Bella (mom = Fahreen)
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Discussion Starter · #13 ·
I am so sorry to read this. To be honest, I've been actively involved with small dogs for over 30 years now and I'm aware of both of these conditions - and both of them came to mind when I read your earlier posts. I'm glad you've found a neurologist who has recognized them - many veterinarians are ignorant about these conditions.

There is a LOT of information available about both chiari malformation and GME online. I know of a few dogs who have been had their lives extended - with quality - when diagnosed early and treated aggressively. Wishing you all the best as you go through this with your fur-baby.
Thank you! Bella is on aggressive prednisone doses right now. The goal is to bring all the primary inflammation down. And then we shall talk about long term mgmt of the conditions. I’m just so so shocked that one day she was perfect and the next, everything started to go downhill.
 

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I'm so sorry to hear the diagnosis. I was hoping, as I'm sure you were, that it was something more simple. I've heard or read about both those conditions but have had no personal experience with them. It sounds like her care is in good hands now. I hope for the best for you and little Bella. Whether to tell the breeder? Probably the specialists can tell you if these conditions are genetic, and if so, telling the breeder might be a good idea, for the sake of her other dogs and puppies.

I hope you'll keep us posted -- lots of sympathetic listeners here!
 

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Bella (mom = Fahreen)
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Discussion Starter · #15 ·
I'm so sorry to hear the diagnosis. I was hoping, as I'm sure you were, that it was something more simple. I've heard or read about both those conditions but have had no personal experience with them. It sounds like her care is in good hands now. I hope for the best for you and little Bella. Whether to tell the breeder? Probably the specialists can tell you if these conditions are genetic, and if so, telling the breeder might be a good idea, for the sake of her other dogs and puppies.

I hope you'll keep us posted -- lots of sympathetic listeners here!
Thank you … yes, am concerned about future litters from these parents. And I’m also curious of how many prior dogs from this couple have reported this health issue.
 

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Bella (mom = Fahreen)
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Discussion Starter · #16 ·
Thank you … yes, am concerned about future litters from these parents. And I’m also curious of how many prior dogs from this couple have reported this health issue.
Bella is on Day 5 of Prednisone today. Had developed a GI upset for sure. Last 24-hrs has been diarrhea and she’s not interested in eating anything today :( She’s hydrating and urinating as expected on these meds. Talked to the vet today and they asked me to add Pepcid. Started that tonight too. I’m concerned about her lethargy and not eating. We tried a bland diet with rice, her fav treats etc etc. but no go! Any tips or thoughts? Thank you in advance.
 

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I'm sorry to hear this. I think prednisone may make her sleepy. It might take a while for the Pepcid to help her digestion. But the condition she has deserves more expert advice than I have, so your vets or even an emergency vet would be the best source of advice. My only suggestion might be to take her temperature, if you can, to make sure nothing different is going on . {{{{{}}}}}
 

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Bella (mom = Fahreen)
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Discussion Starter · #18 ·
I'm sorry to hear this. I think prednisone may make her sleepy. It might take a while for the Pepcid to help her digestion. But the condition she has deserves more expert advice than I have, so your vets or even an emergency vet would be the best source of advice. My only suggestion might be to take her temperature, if you can, to make sure nothing different is going on . {{{{{}}}}}
Thank you … yeah, I think I might need to take her into the ER again tomorrow to get everything checked out.
 

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If her tummy is upset she may not want to eat and may be feeling sluggish. Your vet, ideally your specialist, is the best course of action at this point. Let us know how she's doing.
 

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LACIE, SUKI & LING LING ❤️❤️❤️
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I’m so sorry to read this. I hope you can find a really good neurologist. You can never have enough info when it comes to treatments. If whatever information your Vet gives you doesn’t seem right, move on. We are our fluffs only advocate, so fight hard to keep her well.
Here is an article from Dr. Alan Sisson from Angell hospital. He has since retired but people from all over the world flew to see him for their dogs GME. Sending positive prayers to Bella 🙏🏻
 
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