Dr Dimitar Ivanov,
Veterinary surgeon, Neurology specialist
Dobro hrumvane veterinary clinics
Dog, Bleki, toy terrier, M, 5 yo.
Came in the clinic on 11.04.2017 with left circle movements, menace deficit on the left and no reaction when stimulating the nasal mucosa. On the right, spinal reflexes are decreased and there are no conscious proprioception.
Doubt for brainstem problem.
V – vascular – it’s with peracute onset
I – inflamatory – it’s possible but no changes in blood sample
T – toxic – The dog did not take any medication, fed the same food and was not seen taking unusual things, but it’s not unpossible
A – anomalous – тhe dog is 5 years old and it is unlikely that there will be any manifestation of these diseases
M – metabolic – there is no other clinical signs or any changes in blood samples.
I – idiopathic – there is no seizures and vestibular signs
N – neoplastic – it’s more possible
D- degenerative – the dog is too young for cognitive dysfunction and too old for other degenerative diseases.
We made MRI on 12.04. and found a lesion in the left mesencephalon.
The final diagnosis is neoplasia in left midbrain.
We started to prepare for surgery.
The antibiotic preoperative was Ceftriaxone 30 mg/kg i.v., Manitol 1 g/kg i.v. and Methylprednosolone 20 mg i.v.
The surgery was on 22.04.2017 and we made a left craniotomy and displacement of the temporal lobe dorsolaterally until the lesion was reached.
Bleki preoperative video:
The skull was open and we enlarged the hole with Kerrison rongeur (pic 1 and 2)
We aspirated the brain liquor and very slowly reverse the left temporal lobe.( Pic 3 and 4)
When we found the lesion we punctured the cyst formation and drew the liquid contents.( pic 5)
The reason to do this surgery was to try to reduce the pressure in the tissue and to improve the dog’s condition.
After surgery we continued the antibiotics in the same dose and methylprednisolone in the same dose for three days. After then the dose was reduce to 2 mg /kg. After few days the methylprednisolone was change with prednisolone and started to reduce the dose.
Until the methylprednisolone is reduced, the patient is better every day, improves motor activity, appetite, but fails to maintain a constant temperature. A corneal ulcer of the left eye appears – I guess the cause is a trauma to the left oculomotor nerve and reduced lacrimation.
On 28.04. we included one more antibiotic – amoxicillin with clavulonic acid.
On 29.04. the prednisolone was reduced to 0,5 mg/kg, the dog was with anisocoria (myosis on the right eye and mydriasis on the left). On 30.04. the circle movements on left started again.
We tried to find Lomustine for chimiotherapy but we couldn’t and increased the dose of the prednisolone to 2 mg/kg
Bleki 22 days after surgery:
Bleki 23 days after surgery
The dog is good, he walk normally but when he stops, he start to make circle movement on the left.