Friday, January 20, 2012

Nick's Diagnosis, the Official Version


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I got the report from Dr. Richardson, detailing his opinion of Nick to my vet. Here's what he said:

"He does appear to have some mild expression of Transitional Vertebral Segmentation as evidenced by what I believe is a small vestige of soft tissue at the juncture of S1 and S2. The LS (lumbosacral) Spondylosis is also evident and I would correlate that early development to this transitional aspect of the L-S anatomy. Consequently, ruling out the hips as you have his radiographs and my evaluating his knees by physical exam, we are left with a clinical diagnosis of Cauda Equina, with episodic expression by his bursts of activity.

I have informed Ms Atwater that this will likely worsen in time and thereby prepared her for possible surgical intervention when deemed necessary. I have had more success than not in helping such patients by dorsal decompression, guided by an in house CT scanning immediately before entering the OR. Many of our law enforcement dogs have returned to work, and I would expect an athletic outcome for Nick, providing neurologic damage does not ensue before decompression."

So ... it looks like he's saying that the early onset of the spondylosis is due to the TVS in his sacrum, and that Nick's physical exertions (he uses himself like an Abrams tank!) trigger his painful physical symptoms. And apparently he feels surgery will halt the whole nasty mess.

It's going to take time to get money set aside for any operation, and in the meanwhile ... I guess I'm just going to keep an eye on Nick. He's still laid off of work for at least 2 more weeks, so he'll have had a minimum of 1 month off at home. I'm kind of curious to see if the lay-off will make any difference in the recurrences of his symptoms, or not. Sounds like I should expect "not," though.

Here's an article that makes me feel a little better about Nick's situation:
http://www.acvim.org/websites/acvim/index.php?p=197

It's kind of hard to tell, from reading Dr. Richardson's note, if I should expect Nick to collapse or ruin himself at any moment, or if this is a vague sort of condition that could manifest over months or years. Anyhow, I'm going to get another set of x-rays and another opinion, just for my peace of mind.

Speaking of which, think I'll have a glass of wine to chase my cookies. I want to SLEEP, tonight. :-/

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