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Dementia? Very Worried. Looong Post...sorry.


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Misty is an 11 year old broodie with hypertension. Five weeks ago, she came in from the yard with a front limp. She was holding the foot up and panting by evening, and still limping in the morning, but not as much. However, she was pacing, panting, shaking, and had a drippy nose.. By the time we got to the vet later, she was no longer limping. The vet manipulated her all over and could not get a pain response. He explained that the shaking could be many things. Since she was due for blood pressure check in a week, we put off blood work, and just went with rimidyl.

She got worse a week before her appointment, so we went to the specialty hospital on an emergency basis. She was pacing, panting, nose dripping, shaking, and not eating. She would stand on her bed for over an hour, just shaking and not going down. Her blood pressure was high, so they increased her meds. She was seen by internal medicine and neurology, and did blood and urine testing. Nothing was found, lab work was perfect, and they suggested that she may get better with the increase in meds. My vet had already tested for TBD with negative results. She had lost 8 pounds in six months.

She has been on the higher dose of meds for a week now. She shakes almost all the time, sometimes she just vibrates. She has always been a shaker, but usually only one leg at a time. I stopped taking her to meet and greets because people would comment that she must be cold or scared. Her litter mate is also a shaker.

She continues to act confused and depressed. She pants and paces with her head down and tail tucked. I have to hand feed her, and she refuses most food she used to like. For the last two days, she has been standing in corners for an hour at a time. She has lost more weight and is miserable. She goes back to the hospital tomorrow. What should be the next step?

This seems to have all come about within the last couple of months. Before that, she did shake, and had been slowing down some, but now she is a mess. I have to put a bit of food between her lips and teeth to get her to eat most meals. Saturday and Sunday she probably ate less than a cup each day. Monday was less than that. Yesterday I got her to eat an egg and some peanut butter in the morning. At dinner, she actually ate from her sisters dish. She probably had close to two cups of food yesterday...her regular amount. Today she won't eat. She won't play, and no longer greets me when I come in. She has no life!

Suggestions?

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i went thru dementia with my late welsh terrier who until this started was a vivacious crazy terrier. his days and nights were mixed up, he was in a state of panic most of the time. marked his bed/crate every time he started to settle. we tried sedatives but we ended up with a very stoned dog fighting with himself in the crate. he was staring into corners and walls and finally i realized that it was a quality of life issue and his life was lacking quality. it was a most difficult decision.

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Onyx had what the doctor called "and old brain" It looked like the brain of a 12 yr old not 8 yr old (which she was at the time). She had several episodes that she seemed lost/dazed. Stood in the corner not knowing what to do.

Funny thing though. She was put under anesthesia for the MRI. Had Valium first.

 

She never had another episode. Obviously she had quite a few, enough for me to pay $3000 for an MRI. After that one anesthesia, she never had another one.

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What did they do for her? I don't want to put her under so they can tell me that her brain is old. I know that! I had an MRI for Suds, as well as a spinal tap, and they never did figure out what was wrong. I had to let him go because they couldn't control his pain. It's been over two years, but I still regret putting him through that. I spent $6000 and had no idea what was wrong with my dog! I'm hoping to try meds to reduce her anxiety. It's like she knows something is not right, and gets upset. Two or three times today I found her standing in the corner. I did get her to eat a little more today, but it was tough. She also forgets her routine. I call the dogs to go out, she comes with the others, walks out on the deck and comes back in. If she does go down in the yard, she sometimes just stands and shakes. I have to walk her around to get her to pee.

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Had her leg been x-rayed? If not, I would definitely do that.

 

While you're trying to figure this out, put her on l-theanine. Can't hurt, might help. Its a neutraceutical that is calming/helps reduce anxiety. You can find 100 mg capsules easily, make sure you don't buy ones that have Xylitol. Twice a day to start.

 

This article may also be helpful:http://www.whole-dog-journal.com/issues/11_12/features/Caring-For-An-Older-Dog_16086-1.html

 

I would say though if the onset is as sudden as you describe, I would keep digging for a medical issue.

Edited by NeylasMom

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Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

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Had her leg been x-rayed? If not, I would definitely do that.

While you're trying to figure this out, put her on l-theanine. Can't hurt, might help. Its a neutraceutical that is calming/helps reduce anxiety. You can find 100 mg capsules easily, make sure you don't buy ones that have Xylitol. Twice a day to start.

This article may also be helpful:http://www.whole-dog-journal.com/issues/11_12/features/Caring-For-An-Older-Dog_16086-1.html

I would say though if the onset is as sudden as you describe, I would keep digging for a medical issue.

Thanks!
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I think the next step is to run a brain and spinal MRI. You need to rule physical pathology before deeming this as behavior changes or mental dementia. Things to consider are tumors and IVDD or other chronic spinal changes. The lameness is concerning. The shaking may or may not even be a symptom of concern or it may be essential nerve tremors-a benign condition.

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Is it possible for you to take her blood pressure at home rather than at the vet's office? It could be the dose of bp meds is too high, which would lead to weakness, which would lead to trembling and feeling strange. Worth seeing if the vet would let you borrow the equipment overnight.

Star aka Starz Ovation (Ronco x Oneco Maggie*, litter #48538), Coco aka Low Key (Kiowa Mon Manny x Party Hardy, litter # 59881), and mom in Illinois
We miss Reko Batman (Trouper Zeke x Marque Louisiana), 11/15/95-6/29/06, Rocco the thistledown whippet, 04/29/93-10/14/08, Reko Zema (Mo Kick x Reko Princess), 8/16/98-4/18/10, the most beautiful girl in the whole USA, my good egg Joseph aka Won by a Nose (Oneco Cufflink x Buy Back), 09/22/2003-03/01/2013, and our gentle sweet Gidget (Digitizer, Dodgem by Design x Sobe Mulberry), 1/29/2006-11/22/2014, gone much too soon. Never forgetting CJC's Buckshot, 1/2/07-10/25/10.

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The blood pressure equipment is very expensive and quite sensitive. Her blood pressure was 220 last week before they increased the meds. The docs suggested that we could see an improvement n a few days if the high bp was the cause. They take into account that it could be higher at the hospital than at home. 220 there could be 200 at home. They also take three readings, and use the middle one. We bring her blanket from home and get her settled before they do it. They have also started using headphones because the noise of the equipment would sometimes scare her.

I had asked about having it taken by my local vet, but he doesn't have the doplar equipment.

Edited by Neighsayer
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I was able to take a rough BP at home for Pearl who's BP was never controlled well. I got the itty bitty infant cuff and put it on her front leg when she was laying down. I used the top leg. And I would watch the needle very carefully as I slowly let the air out of the cuff. When it started bouncing in rhythm to the heartbeat that was the systolic. It's not a great method, but if it's at 120, you KNOW it's not at 200. But it could be between 100-140. It worked well for me.

 

She was diagnosed with valvular disease at age 5, hypertension at age 6 and she succumbed to cancer at age 12. I always thought I'd lose her to a heart attack or CHF.

 

You can find a human infant cuff at most drug stores or online for about $20.

Edited by MP_the4pack
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The blood pressure equipment is very expensive and quite sensitive. Her blood pressure was 220 last week before they increased the meds. The docs suggested that we could see an improvement n a few days if the high bp was the cause. They take into account that it could be higher at the hospital than at home. 220 there could be 200 at home. They also take three readings, and use the middle one. We bring her blanket from home and get her settled before they do it. They have also started using headphones because the noise of the equipment would sometimes scare her.

I had asked about having it taken by my local vet, but he doesn't have the doplar equipment.

Just an FYI regarding the BP. We all know that our RR's can and do often have white coat syndrome. Just wanted to share my Shannon's BP numbers. Shannon was a very uptight nervous dog while in the hospital. She started tossing protein in her urine so I started watching her BP. I must admit it was easy for me as a technician because I could borrow the Doppler and bring it home with me. Her pressures at home were perfect--120. When I took her pressures in the clinic she topped at out 300! Even after waiting hours after she settled and she appeared to be relaxed the numbers still averaged above 200. Any chance either one of the clinics you see have a PetMap you can borrow? I find they aren't as accurate as a Doppler but, they are pretty close.
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My girl's was very high at the vet's. But, she had symptoms at home. For her, very low dose of meds relieved symptoms; higher dose made her weak and shaky. Low dose reduced bp at vet but it was still pretty high there.

Star aka Starz Ovation (Ronco x Oneco Maggie*, litter #48538), Coco aka Low Key (Kiowa Mon Manny x Party Hardy, litter # 59881), and mom in Illinois
We miss Reko Batman (Trouper Zeke x Marque Louisiana), 11/15/95-6/29/06, Rocco the thistledown whippet, 04/29/93-10/14/08, Reko Zema (Mo Kick x Reko Princess), 8/16/98-4/18/10, the most beautiful girl in the whole USA, my good egg Joseph aka Won by a Nose (Oneco Cufflink x Buy Back), 09/22/2003-03/01/2013, and our gentle sweet Gidget (Digitizer, Dodgem by Design x Sobe Mulberry), 1/29/2006-11/22/2014, gone much too soon. Never forgetting CJC's Buckshot, 1/2/07-10/25/10.

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Have they done an ultrasound of her belly, by chance? One of our greys used to stand instead of getting into bed, would pace and act like she just didn't want to sleep - but she would seem so exhausted (shaking, drooling, head down, eyes droopy, etc.). She also stopped eating most things and after numerous vet visits and so many tests, I asked for an ultrasound and they found "numerous" tumors. She was suffering from acute pancreatitis - thus why she didn't want to eat or lie down on her belly -- because it was just plain painful.

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The ultrasound might be the next step. They did an ammonia test today because those numbers could indicate liver issues. We are also going to increase her bp meds and try anipryl for a bit. She has lost five pounds since last week, but was a little more interested in food this morning and last night. I've started adding vanilla ensure to her dish when she starts eating on her own. She did eat last night, and probably ate close to her normal amount yesterday. I had to hand feed her on her bed this morning, but she ate a 5 ounce hamburger patty and some yogurt. She has been eating eggs scrambled with cheese, so I'm going to use ensure instead of milk in her egg tomorrow. I went out to lunch after her appointment today. I chopped up my leftover steak and combined it with mashed potatoes. Hope she will eat that.

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