Maltese Dogs Forum : Spoiled Maltese Forums banner
1 - 17 of 17 Posts

·
Registered
Bella (mom = Fahreen)
Joined
·
72 Posts
Discussion Starter · #1 ·
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 🙏
 

·
Registered
Bella (mom = Fahreen)
Joined
·
72 Posts
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.
 

·
Registered
Bella (mom = Fahreen)
Joined
·
72 Posts
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.
 

·
Registered
Bella (mom = Fahreen)
Joined
·
72 Posts
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.
 

·
Registered
Bella (mom = Fahreen)
Joined
·
72 Posts
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.
 

·
Registered
Bella (mom = Fahreen)
Joined
·
72 Posts
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.
 

·
Registered
Bella (mom = Fahreen)
Joined
·
72 Posts
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.
 

·
Registered
Bella (mom = Fahreen)
Joined
·
72 Posts
Discussion Starter · #21 ·
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 🙏🏻
Thank you so much for your kindness, prayers and for sharing the article. Very insightful. Bella is responding very well neurologically to an aggressive Prednisone protocol right now (although her tummy is suffering so much!). We have a follow up with her neurologist in a couple of weeks. We’re staying positive and determined to do whatever it takes to give her a good quality of life 🙏
 

·
Registered
Bella (mom = Fahreen)
Joined
·
72 Posts
Discussion Starter · #25 ·
I too have a Bella who was diagnosed last February with GME. She is 10 years old. I noticed her legs slipping and her walking up against things because of her difficulty walking. We were referred to a neurologist who diagnosed her. She is on prednisone and she gets 2 injections of chemo called cyterabean. ( I hope I spelt that right) monthly. She responded very well and they started to decrease her prednisone and spread out her chemo to 6 weeks a part. Unfortunately she relapsed. We have to keep her on Chemo every 4 weeks and prednisone for the rest of her life. We too love our precious Bella and will do whatever it takes to give her the best quality of life. She is our baby too.
One thing I am doing to help keep her liver enzymes down is giving her SameLQ 225 and it has really helped. You can get this from Chewy.com.
We also have another Maltese named Baylee who has PLE Protein Loosing Enteritis. She is now on chemo too. We are having a difficult time getting her blood albumin up past 1.8. She sees an internist and is on dexamethosone injections daily. We are so fortunate to have health insurance on these fur babies.
If they have not tried the chemo for your Bella you may want to mention it. It really is helping my Bella. My thoughts and prayers are with your precious Bella
Thank you to all of you who have responded to my queries and sent prayers and messages ... this is truly a wonderful place to belong and I am grateful to have found this forum. Well, we have had a couple of weeks now and I have updates! Our Bella had an extensive neuro re-eval and follow-up earlier this week. She is doing wonderfully so far and the neurologist has upped her Prednisone dose to the max (for her weight) in the hopes of completely suppressing her immune system and killing the active flare-up of GME completely. BTW, Bella has the MUE form of GME - Meningoencephalomyelitis of Unknown Origin (meaning, non-infectious and auto-immune related). Bella is tolerating the upped Prednisone dose just fine; she is drinking a ton of water and is very hungry all the time (hard for us to see her this way but we can't keep feeding her!). No other side effects so far - fingers tightly crossed! She will be on this dose for 3-weeks and then starts the Cytosar (Cytarabine) chemo infusion every 4-weeks. At this time, he will start the taper off the Prednisone. The Dr. says he thinks she should get at least 5 consistent months of the infusion before he will try to extend the time between infusions. The rest remains to be seen. ABSOLUTELY NO MORE IMMUNIZATIONS per the neuro - it is the one thing that has been proven over and over again to flare up GME episodes! We are staying hopeful and optimistic. Unfortunately, her Chiari-like malformation is the other major issue she is dealing with. That will need some management in the future also, but for now, we need to get the GME in remission. The chemo infusions run around $1200/month (!!!). I am really hoping that our medical insurance will help pay for it. I wonder if there is anyone here who has dealt with a Maltese with Chiari? Apparently, it is most common in Cavalier King Charles.

I am asking for any thoughts or tips on how to deal with a super immunosuppressed doggie .... any input is appreciated! I am being told to be careful of how she is exposed. No more dog parks for us! We have already made arrangements with our groomer who will come home and help us out. I am getting a doggie stroller so she can still go out and walk with us and we can pop her in when she is too tired to walk herself. And the Dr suggested we turn to cooked food now; Bella currently eats raw beef & lamb interchangeably from Small Batch. We have started giving her some fresh, steamed veggies for snacks (she is just so hungry all the time!), she loves blueberries, and sweet potato. I am changing her treats from raw to jerky style ones. I would really appreciate any help with cooking her food. I am happy to buy quality lamb and beef and cook it but am not sure how to make her food complete with all the nutrients she needs? Add a meal mixer? I heard that Fish Oils are good for the central nervous system so I will look into that supplement too. I know that her liver enzymes will be monitored so we may need to add the SameLQ (thank you Bella Maltese's mom!).

Thank you again for all your support!
Fahreen Xox
 

·
Registered
Bella (mom = Fahreen)
Joined
·
72 Posts
Discussion Starter · #28 ·
I am glad the prednisone is helping!

I did a search on this site for "Chiari" and "syringomyelia" -- I found there was one person who posted once, another who posted about her dog Kodie who had something similar, but that was a long time ago. I hope you find other advice here -- or elsewhere!

It sounds like you are very dedicated in the care of your Bella! ❤
Thank you!
 

·
Registered
Bella (mom = Fahreen)
Joined
·
72 Posts
Discussion Starter · #29 ·
I am so glad you are able to get your Bella the treatment that we are doing for our Bella. My Bella is doing great right now and I swear by the Same LQ supplement to help her liver enzymes. I would be interested what you are using to feed your Bella. I had to put my Bella on a special diet because she developed bladder stones on top of everything else. The new dog food actually worked to dissolve the badder stones so I have to keep her on it for now. The prednisone does make them very hungry and urinate a lot more. I give ours green beans as a snack. Are blueberries ok to give them. If so I will get her some. She would love it. I would be curious to know what the meal mixer is too. Continual prayers for your Bella.
Bella Maltese mom ( Lisa)
Thank you Lisa! I appreciate your support …
Blueberries are great for them! Try it. Our Bella loves lil chunks of strawberries too, although she’ll gobble up as many blueberries as we give her! I am happy to keep posting here as we tweak Bella’s diet. Or we can chat via private messaging too - if it becomes too much for everyone else - lol. I’ve been praying for both our Bellas … I’m glad your baby is stable.
 

·
Registered
Bella (mom = Fahreen)
Joined
·
72 Posts
Discussion Starter · #32 ·
Honest kitchen makes a base mix where you add the protein and it completes the meal. You wouldnt have to worry about supplementing etc. i added a link to their site.

Thank you for the link. I just heard about Dr. Harvey’s meal mixer too. I haven’t gotten around to researching my options yet. I will keep posting as we get more info … on food, on the Chiari condition as well as the treatments.
 

·
Registered
Bella (mom = Fahreen)
Joined
·
72 Posts
Discussion Starter · #34 ·
UPDATE - hello all! I have been meaning to post an update on our Bella and the management with GME/MUE & the Chiari treatments. So Bella is now going onto chemo infusion #4 next week in an effort to quieten her GME flareup. We work with a lovely team of neurologist/oncologist who have dialed in her her dosages and Bella seems to be tolerating the infusions quite well. She is going every 4weeks right now. She is also on a taper of the Prednisolone. We have managed to keep her weight under control quite well (7.2 lbs) with resorting to low calorie snacks like green beans and cauliflower. Thank goodness she loves all sorts of veggies - lol. I am feeding her a diet of lightly cooked food from Small Batch - interchange btwn turkey and beef. Her pre and post-infusion bloodwork has been coming back perfect. She’s full of energy and seems to be happy happy. Sounds like our specialist wants to give her about 7-8 infusions as Bella continues a slow Pred taper and then reassess her brain status with an MRI early next year. This will give us an idea of the status of the GME inflammation. They say about 2/3 of the small doggies end up responding very well to this tx course. We are super grateful and continue to have hope and faith that we’ll enjoy many more years together with our lil furball. My question is how do we manage vaccinations moving forward? I haven’t had this conversation with the neurologist yet. But I know that vaccinations are a no-no (they trigger the GME flareups instantly!). All of Bella’s titers so far are fine, so we know she doesn’t need any updates currently. I use Dr. Mercola’s natural flea/tick spray on her when we need to. She’s pretty much an indoor dog, and we play a lot indoors so she gets her exercise.
Also, any tips/feedback on how to manage Bella’s food addiction? It started when she went on Prednisolone and I am cognizant of the fact that she was very hungry all the time due to the meds. But now, she’s on half the dose with the taper but I think she’s built the habit of begging for food all the time! This girl LIVES FOR FOOD! It’s funny and it’s not. Any thoughts? Thank you all again - I’m truly grateful for this forum and all the support from the members. 🐶😍
 

·
Registered
Bella (mom = Fahreen)
Joined
·
72 Posts
Discussion Starter · #38 ·
Sue has a pup w/Chiara so hopefully she will see this & respond! I know he (Tyler) is on prednisone for seizures. Our Lisi has immune issues & had severe vasculitis some years ago (she is now 11 & has cancer). She is a fighter/trooper & has overcome some giant obstacles although she did lose one entire ear flap & part of another one when she had vasculitis.
It sounds like you have wonderful medical care for Bella~:)
Let us know how this goes!
Sandi, thank you … I am happy to connect with Sue if she has any questions about Chiari. Pls feel free to let her know if you know her personally and can PM her. I hope Tyler’s doing alright. I’ve learned a bit about this condition from our experience and personal research. I am also happy that your Lisi & Kitzi are doing well. These babies are such lil troopers! 😍
 

·
Registered
Bella (mom = Fahreen)
Joined
·
72 Posts
Discussion Starter · #40 ·
Thank you! Tyler has had this for a long time & Sue has done a great job of caring for him! She is not on SM much anymore as she is mainly on FB. She is the American Maltese Rescue Association co-ordinator for the northeast. She has been a valuable & knowledgable SM member for a long time so you two could interact well.
I’d love that! I bet she’s just chockfull of knowledge in this matter! Unfortunately, I don’t participate on any social media platforms.
 
1 - 17 of 17 Posts
Top