Seizures, wobbling head. What is up with our spaniel? [2]

This week Roo had her appointment with a Neurologist at Dick White Referrals. Due to covid, the consultation was carried out partly over the phone and also in person in the car park. We went through all of Roo's history with the vet on the phone, answering any questions she had before she came out to meet us and Roo. The vet then went through what would happen next, the tests they suggested and how we would like them to be done, either Roo staying overnight or bringing her back the following day for more tests.

We were informed that Roo's episodes did not present as typical seizures and appeared to be more tremor like in appearance. Lots of things were suggested that it could be; anomalous, metabolic, degenerative, inflammatory, infectious or neoplastic diseases. Basically, anything! It could be something to do with how her cells process or an organ function, it could be a build up of toxins or a brain function. But until the tests were ran, nothing was certain and even after they were, we still might not know.

We decided it would be better for them to just keep Roo in overnight and do everything they needed to. We didn't feel taking her home and bringing her back in again would do anything for her anxiety. Whatever we did, she would be stressed.

Roo then went off for a physical and neurological examination whilst we waited in the car park. The examination revealed that Roo had a slight irregularity of the skin on top of head, which we already knew about. We think she either had it when we got her, or possibly that the cat had scratched her head when we first got her. What we didn't know though was that just in front of that she has a slight compression of her skull which is soft. At the time, we weren't told about this. The vet came back out to the car park to tell us everything was fine and Roo had been put into kennels. The next steps would be to conducted a fasted blood test, feed her and then do another blood test. The following day she would undergo an MRI, Spinal Tap and Urine Testing.

Later that evening, the vets called to say that Roo was doing well, she had eaten and the results of the first blood tests had come back normal. All of the nurses looking after her wanted us to know that she was being a good girl.

In the morning we recieved a text from the vets to say that Roo again was fine and had eaten. Her MRI was scheduled for the morning and they would call later to update us.

Around midday the call came. The MRI had revealed that Roo has a small cyst on her brain, in front of the odd skin lump on her head. The cyst is directly below the soft spot on her skull, which is there because her skull never formed completely. The vet however didn't feel the cyst explained the episodes Roo had experienced and it was more of an accidental finding.

At the moment there wasn't anything they wanted to do about the cyst as brain surgery comes with a lot of risks and complications. There was however a small risk that Roo could get meningitis from the cyst if it is connected to her skin with a small opening (they couldn't see this on the MRI though but it could be less than a mm big). Further MRIs may be needed in the future to ensure the cyst is not growing or changing as well as more Spinals taps to check for signs of meningitis. It is however possible that the cyst or the trauma that may have caused the cyst could have caused some brain damage but more on that later.

Later that afternoon we were able to go and collect her. The vet came out to see us and showed us Roo's MRI. Going through all of the images taken. Showing us the cyst and gap in her skull, explaining what everything meant. Then came what to do next. Regarding her episodes one possibility could be gluten sensitvity dyskinesia (basically celliac disease), there had been studies into this with Border Terriers and we could submit Roo's blood work for testing. This would then invovle Roo going on a completely certified gluten free diet for a couple of months then being exposed to gluten to see if it triggered a reaction. We can also trial her on some anti-epileptic medication but the vets didn't want to change more than one thing at once so gluten sensitivity was to be investigated first.

Are we any closer to finding out what is causing Roo's episodes, not really but a few things have been ruled out. We cannot thank the team over at Dick White Referrals enough, the time the Neurologist spent going through things and making sure we understood it all was greatly appreciated. Too often you can feel rushed out the door but luckily this was not the case.