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January 16, 2015
Taffy's illness started without any warning whatsoever. His symptoms appeared to point to more of a mechanical or physical problem and didn't really alert us to the severity of the underlying cause until it was almost too late. So the purpose of this blog and any subsequent updates about his progress, is to highlight the symptoms and effects of Taffy's autoimmune condition, in the hope that if just one person reads this and goes on to recognise similar symptoms in their dog which results in earlier diagnosis and treatment, then it will have been worth it!
We were up very early one Saturday morning at the end of July last year. I came downstairs and smiled as I looked at Taffy peacefully curled up in his bed. He never was a morning dog! Eventually he woke up and I watched as he appeared to stagger out of his bed. He followed me to the kitchen looking very peculiar and slightly disorientated. When I said: "Taffy! Are you OK?" He looked up me with his eyes and didn't lift his head. At the time I thought he looked really strange, but put it down to a bout of stiffness from being curled up asleep in a tight little ball due to his age (he's about 10 years old).
By Monday Taffy seemed no better. Still wobbly as his trotted along on our walks and reluctant to move his head very much. He would follow my movements with his eyes, but his head stayed very still. I took him in to his vet who examined his back and neck and decided on a treatment of painkillers and Metacam anti-inflammatory for a suspected neck injury. She thought he seemed stiff and tense in his neck muscles so suspected he had been injured in some rough and tumble with our other dog, Reina.
Within an hour of getting him home from the vet he was just like his old self - energetic, lively and loud! My old Taffy was back!
The course of Metacam finished the following weekend and then it was like Groundhog Day. Stiff, wobbly Taffy returned, but worse! His neck and shoulders seemed hunched and I thought I was imagining that his neck was swollen. He hung his head and couldn't move it from side to side. He didn't want to jump on my lap and struggled with the stairs. When I tried lifting him he winced with pain. But it was the vacant expression in his eyes that told me something was really wrong.
After rushing him back to the vet on Monday morning he spent the morning lying in the sunshine in the garden while we waited for a call from the specialist referral hospital to take him in. By lunchtime he could barely stand and was going downhill quickly. In the back of the car on our short journey to the hospital he cried with pain over every little lump and bump in the road. Once there, the neuro surgeon checked his reflexes and on his left side when he tried a paw flexion test, there was no reaction from Taffy. Then when his tested Taffy's eye reflexes, there was no blink or reaction here either. It wasn't a good sign.
They admitted Taffy immediately and he had an MRI and a sample of his spinal cord fluid removed while under general anesthetic. The following day I received a call with the news that Taffy had been diagnosed with multifocal myelitis GME (Granulomatous meningoencephalomyelitis), which is an acute, progressive inflammatory disease of the central nervous system. It wasn't something he had caught, it's not contagious or caused by a bacteria or virus. It is an autoimmune disease where basically the immune system fails, and not just fails, but starts to attack and reject other body systems. In Taffy's case, virtually his entire spinal cord was being affected by pockets of inflammation, resulting is semi-paralysis along his left side, his lack of reflexes and extreme pain. It affects dogs of all breeds and sex, but appears to be slightly more prevalent in middle aged dogs and small breeds like terriers and poodles.
Taffy spent the next 4 days in hospital until the veterinary team could find a painkiller that he would respond to. The treatment for his autoimmune disease initially was Predisone steroids and Cytarabine, which is a chemotherapy drug used to suppress the immune system. Without this drug, Taffy's immune system would continue to attack his own body and he wouldn't survive. When he came home covered in patches where he had been clipped for injections and tubes, he was truly exhausted.
Three months later Taffy finished taking the steroids which had been on a reducing dosage. Thank goodness because they had a terrible effect on his appetite and thirst. He was ravenous and begging for food constantly. However, the Cytarabine injections must continue and every 3 weeks we return to our vet for 4 injections, each roughly 12 hours apart, first thing and last thing on a Wednesday and then the same again on the following day. This will be, potentially, for the rest of his life! Although his prognosis is guarded so we have no idea how long this will be.
It's a huge commitment! But now, roughly 6 months after he was first diagnosed we are in the 3 weekly routine. Taffy himself is doing well. He looks normal, you wouldn't know from looking at him that he's gravely ill. He tires more quickly, can't manage great long walks and isn't quite as agile as he was. Occasionally he still winces if you don't pick him up quite right. He doesn't mind his regular visits to the vet for his injections and they're so quick that we're in and out in the blink of an eye. In another 6 months time the plan is to maybe start to increase the length of time between Cytarabine treatments from 3 weeks to 4 weeks, but there's a strong probability that he will relapse if this doesn't work.
So that's the story so far. We're in a little limbo at the moment. He won't get any better, he hasn't become any worse...but he's still with us!
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