Thursday, April 26, 2012

963. Follow up: GME? The circling Schnauzer

Mini Sch Male 12 years
Consulted Vet 1 two weeks ago but Vet 1 said no obvious problem but would require MRI and blood test.

I saw the dog on April 24, 2012. Dog was circling anti-clockwise in smaller and small circles. Collapsed on April 24, 2012 as she couldn't circle anymore as the circle was too tight. Continuous movement, whining. Loss of bladder control. Euthanasia not accepted by the young lady owner. Her colleague referred her to me.
Warded 2 days. Treated. Could look straight when sent home on April 25, 2012 with phenobarb 30 mg bid.

Friday April 27, 2012
Follow up:  Phoned lady owner today

1. Dog has excellent appetite, could control bladder and bowel movements
2. Head tilt to the left mainly but not permanently as prior to my treatment. Walk mainly anti-clockwise but can walk straight or turn right.
3. Head tilt to the right and left, like a pendulum sometimes. Therefore left and right turning possible, instead of permanently circling anti-clockwise befoe.
4. Can see
5. Looks at owner when called.
6. Not as restless as before treatment. No obsessive need to walk anti-clockwise and whine continuously.
7. "Is he dopey and sleepy?" I asked. "Not really," she said. I asked her to monitor the times of usage of phenobarb, now given twice a day by a family member.
 
Will phenobarb work? Much depends on owner's compliance with medication dosage and timing. There needs to be follow up by the owner.

Cause of this brain disease to be GME?  Granulomatous meningo-encephalitis?
Eosinophils and monocytes were higher than normal.

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