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It was a normal Saturday morning in the McKee household. Dora, an 8 year old Collie, was wandering around the home keeping her owner, Theresa McKee, company. It was an hour later that Theresa knew something was wrong with her beloved companion.
“I was in another room when I heard Dora whimpering, so I went to see what was wrong,” said McKee. “When I found Dora she was thrashing on floor, unable to stand, her head was tilted to the side and her eyes were rolling. I was very scared and knew she needed immediate attention.”
McKee and her husband loaded Dora into the car and rushed her to their regular veterinarian. After a complete physical examine, it was determined that Dora needed to see a neurologist and she was referred to the Animal Neurology, Rehab and ER Center to see Dr. Michael Wolf, Diplomate ACVIM (Neurology), a board-certified neurologist.
The Animal Neurology, Rehabilitation & ER Center prides itself on being three facilities under one roof. Through the course of treatment Dora experienced all three departments. Upon arrival Dora was triaged by one of the clinics highly skilled emergency doctor and technicians to make sure that she was stable and did not require immediate medical intervention. Dora then had a consultation with Dr Wolf. And at that time it was determined that Dora would need an MRI in order to diagnose what was causing her problem.
“Dr Wolf told us that we would need to do an MRI in order to know how to treat Dora and give her the best chance for recovery,” said McKee.
Dora’s MRI revealed a cerebellar infarction (stroke) that was consistent with the central vestibular syndrome symptoms that she was exhibiting. With the MRI complete Dr. Wolf began to work on a treatment plan for Dora. The owners now had a diagnosis but there was nothing that could be done surgically to aid in Dora’s recovery. It was going to be a good deal of time with intensive nursing care to get Dora through this ordeal.
MRI played an important role in Dora’s diagnosis. Many people do not know that MRI is available to our pets. Without MRI, we would not have been able to make a proper diagnosis and treatment protocol. Patients can present with symptoms that are non-specific in many cases, fortunately MRI is able to help make the diagnosis, showing images of the brain that you cannot see on an x-ray.
“Dr Wolf called us after the MRI was complete and discussed his findings with us,” said McKee. “He then also discussed the need for intensive nursing care for Dora. It was easy for us to see how concerned Dr Wolf was for Dora. He was very compassionate as he explained what would be required for Dora’s full recovery.”
The Animal Neurology, Rehab and ER Center is a 24 hour facility with a doctor and licensed technician in the building at all times. This means that Dora could be hospitalized and have all of her nursing care needs met around the clock. For Dora that meant IV fluid therapy to keep her hydrated because she was still too dizzy to eat, it also meant bladder management because Dora was not able to walk outside.
“It was a relief to have everything she needed all under one roof” said McKee. “We didn’t have to worry about trying to transport her to another facility.”
Along with Dora’s other symptoms came a huge hurdle for both pet and owner. Following her stroke Dora was unable to walk. In fact, it was difficult for Dora to even get herself into an upright position. Dr Wolf knew that if Dora stood any chance of making a full recovery she would need to start intensive rehabilitation. So, Dr Wolf then brought Dr Laurie Tyrrell, CCRT, CVA in on the case. Dr Tyrrell’s job was to create and initiate a custom rehabilitation plan for Dora.
According to Dr. Tyrrell, “Human studies suggest that rehabilitation therapy is a critical component in the recovery process following a stroke and without it little progress will be made. It should be no different in our canine patients. They must relearn lost functions. Additionally, inactivity will only accelerate muscle memory loss, disuse atrophy, and certainly has a detrimental mental effect on the dog. Rehabilitation therapy is about restoring function. The more quickly we intervene, the faster and more completely we can restore normal functions for the patient. After all, a dog needs to be a dog!”
Our vestibular rehabilitation program allows our staff to help medically control the dizziness and nausea while we work to rehabilitate the system. In hospital rehabilitation helps maintain muscle mass and prevent against secondary injuries that can occur in a non-ambulatory pet. Staff at the Animal neurology Rehab and ER center was able to make sure that Dora was being rotated every four hours to prevent bed sores and received passive range of motion to help keep her muscles and joints healthy.
“Dora had severe left sided deficits following her stroke, in addition to pretty severe vestibular signs (vertigo), which made even the most basic functions for a dog, like holding herself up in a sternal laying position, impossible in the beginning. As her equilibrium problems began to stabilize, we could be more aggressive in working with her relearning these basic functions; which included righting herself from a side lying position, maintaining a sit, standing up, standing without falling to the left – even controlling her head movement to reach for the food bowl or a treat. She needed to relearn all of these things.” said Dr. Tyrrell.
Our rehabilitation department works closely with owners to create both in hospital and at home treatment plans. These plans allow the owners to be hands on with their pets care and recovery while at home, but also include using a variety of modalities here in the hospital. While participating in the program Dora received acupuncture, electrical stimulation, joint mobilization, massage and underwater treadmill. In order to provide continuity of care the McKee’s were taught how to do passive range and other exercises at home with Dora as well.
A unique aspect of Dora’s case is how different specialties worked together with the family veterinarian and family to help Dora make a full recovery. Dora presented to her family veterinarian, who referred her to our neurology center. She was admitted through our emergency department due to the time of her presentation and then transferred to our neurology department. Once a diagnosis was made, Dr. Wolf knew we needed the help of our rehabilitation department.
“Dora is such a very important part of our lives that we knew we had to do everything we could to help her,” said McKee.
“Dora’s owners were a huge factor in her progress as well, as they diligently performed home exercises and techniques to facilitate her recovery on a daily basis following her discharge, and continued to bring her for in clinic sessions twice a week,” stated Dr. Tyrrell. “When owners are motivated to work with their pets at home it can significantly add to what we are simultaneously accomplishing in the clinic. Her recovery has been really extraordinary to witness.”
Like so many of the stories at the Animal Neurology Rehab and ER Center, Dora’s story has a happy ending. Dora made a full recovery. She is now able to go for walks again, she is no longer dizzy or falling over and the McKee’s have their beloved companion back.
“We were so impressed with the care and attention that Dora received through this entire experience that we highly recommend anyone use this facility when their pet is in need,” said McKee.