Granul – what?
Have you ever heard of this? Neither had I until September of 2008 when Desi was diagnosed with it.
I’ve posted information on this blog about Desi and I’ve discussed his diagnosis, treatment and recovery with many customers and friends. So much so that people have asked for more information. I am not a veterinarian nor a medical expert but I will be happy to share what I’ve learned. Please consult a veterinary neurologist who has experience treating GME if you suspect your pet is presenting similar symptoms.
Desi wasn’t eating regularly in mid August. We had all the routine exams and lab work done and when his appetite still wasn’t back to normal we had an ultrasound done. It wasn’t conclusive, but we suspected pancreatitis (chronic not acute) so we started him on fluids and with held food to give him a chance to heal. He wasn’t feeling better over the weekend so we did a second ultrasound on Monday morning. The second scan was more suggestive of pancreatitis so we started meds and continued fluids. By Monday evening he was very weak so we admitted him to a veterinary hospital for IV fluids. We aren’t certain what happened, but the vet on call in the hospital called and said he was showing signs of neuro issues. Desi had never had any neurological problems at all previously. In fact even though he hadn’t been feeling well, he was still spot on in his movements and all of his behaviors were appropriate. Fast forward a day or two and an MRI and spinal tap showed inflammation in his brain. By this time he wasn’t aware of his surroundings, was continually circling, was constantly crying out and had had seizures. It was heartbreaking and unimaginable that short of an awful accident, he could change so dramatically in a matter of thirty six hours.
There are several types of GME, Desi’s being multi focal or existing in several areas. You might want to search granulomatous meningoencephalomyelitis or GME, but be aware of the source of the article and before completely despairing that it isn’t treatable check if the author has much real experience with treatment. I learned that typically prednisone is used alone and often that is just not sufficient. I don’t want to suggest that Desi’s treatment is appropriate for all dogs, but for those who have asked or just want to learn more about what worked for him, he’s been on cytarabine which is a chemo drug, prednisone which he’s finally weaned off of which is a steroid, cyclosporin, phenobarbital for the seizures and he was also on Pepcid while taking the Prednisone.
The fall and winter were very difficult for Desi, myself and my husband. When Desi was first well enough to come home he calmed down considerable and was able to rest which he had not been able to do at the hospital. He recognized his name but could only focus briefly and on on person at a time. He slowly started to be able to follow me and in a few weeks he regained some strength. I worked with him twice daily for short rehab sessions every day until he was able to do most things as he’d done before. It’s unclear whether some of his abilities have returned due to recall or retraining. My guess though is that he has recalled most things. Now five months later, Desi is still not quite himself, but he functions well and he is enjoying life again. The differences that are apparent to me as the person closest to him are his emotions are just under the surface; in other words he is very easily excited.
He was never left alone for more than a few hours before he was sick because I can bring him to work with me and almost everywhere I go. Since he’s been sick, he’s never been left alone because he panics. Now that he is off of the prednisone we’ll start leaving him for a few minutes at a time to see how he does. We’ve not returned to agility although we’ve tried a few things that were typically very easy for Desi in the back yard and he’s been able to do them. I still don’t feel he’d be safe on higher contact equipment. I don’ t feel it would be safe just yet.
The neurologist assigned to Desi’s case was fortunately experienced in treating GME and was very diligent in treating him and giving us support over the phone after he was home. His chemo is now stretched to every five weeks and next we’ll work on weaning him off the other meds one at a time. We are very fortunate that he’s recovered to this point. It’s hard to believe that he was as bad as he was and now he’s happily resting while I work waiting for his afternoon walk – wearing his newest Goose Down Filled Dog Coat – sorry, I couldn’t resist. But truth be told, he minds the cold quite a bit since he’s been on chemo and cyclosporin. He wore his coats before he was sick when it was very cold, but now he shivers without them even at forty degrees.
Next time I’ll fill you in on what dietary changes we’ve made since he’s been sick. Desi’s dietary needs are what brought me to Dr. Harvey’s foods which will be on the site shortly. Thanks so much for caring about your animals and taking an interest in Desi.