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 Latte - Dehydration & Neurological symptoms

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PostSubject: Latte - Dehydration & Neurological symptoms   Mon Dec 28, 2009 10:05 pm

LATTE

I am going to do my very best to try to explain this all in the order it happened and without leaving out any important details. Those of you who have spoken with me and supported me along the way are welcome to fill in any blanks I left when I am done (as I'm sure there will be some).


Latte is a rescued female that came to me after she was no longer useful in her home. She was a breeder, and had many, many babies in her day, but had not had any in over 2 years, so she was being given up, along with her cage mate, who had a medical condition. Latte is now 11 years old. Before this started, she weighed in at 136 grams.



On Nov. 12, I found Latte in her cage looking very ill. Here is a picture I took of her at that time.

Her ears were droopy, eyes were dull and her nose was purple.

I drove to Tulsa to see Dr. Walsh with her on the 13th. She was dehydrated in the office, presented with the same signs as above, but was in respiratory distress upon arrival at his office. She was treated with a shot of Convenia, sub-Q fluids and nebulized fluids. No x-rays were performed because Dr. Walsh is cautious about anesthetizing an animal already in respiratory distress. He could hear crackles in her lungs and she presented as an animal with pneumonia, so that is the diagnosis he prescribed. She was also prescribed oral amoxicillin for 10 days.

We returned home, and I placed Latte in a hospital cage. She was weak, but still crabby and nippy. This was her normal behavior, so I was hopeful. After 3 days of treatment and rest, Latte's energy level had returned to normal, her strength presented as normal, her ears were perky, eyes were bright, and she was eating full servings of all of her foods. I returned her to her cage with Laslo and continued her oral antibiotics.

Antibiotics ended on Nov. 24.

I was out of town on Nov. 29 when my mom called me to tell me that she thought Latte was dying and I needed to get home right away. I flew home as fast as I could. At that time, Latte was dehydrated again. My loving mother let me talk her through giving sub-Q fluids to Latte TWICE before I returned home. When I got home, Latte looked to be in her final moments of life. She was non-responsive, eyes were dull & lifeless, ears were droopy, she was cold and she was severely dehydrated. I gave her sub-Q fluids again and tried to administer some more oral antibiotics, but could not get her to swallow. She then had one seizure. I was sure it was a death seizure. So, I got her warmed up and settled in for her to pass away. Here she is as she appeared when I arrived home:


After the sub-Q fluids, Latte began to grip with one hand. This was all the purposeful movement she exhibited. I stayed up with her all night (save a 2 hour nap), expecting that each moment might be her last, and hoping that it wasn't. I kept telling her that it was OK to go. I let her have a little time with Laslo. He loved on her and kissed her and then left her. I thought that he knew that she was going to pass as well.

She was still alive the next morning. She had not peed or pooped all night. She was still dehydrated. I administered sub-Q fluids again that morning and then put her in my bra and took her to work with me. I did not want her to be alone if she were to pass. At 10:00 that morning, she crawled out of my bra and began to look around!!! I offered her water and she drank about 1/4 teaspoon then curled up in my hand and went back to sleep. At noon, she drank another 1/4 teaspoon of water and then peed and pooped!

So, I took her to see Dr. Pearson after work. She was still dehydrated, but was now alert and trying to move around. Her symptoms were VERY STRANGE.
* She continues to be dehydrated - severely.
* She cannot or won't use her front limbs at all. She just drags them behind her, with her chin on the surface she is walking on.
* She does not use her back legs in a normal gait, she just pushes off with them like she is hopping. She would also flail her back legs like gliders do when they are on a slick surface and can't get their legs under them - this she would do on ANY surface.
* This is UNLESS I put her on my arm, then she would shimmy up it like we might a telephone pole - with one arm and one leg on each side of my arm.
* Ears are still droopy
* Eyes are not lifeless, but not bright
* She has had significant weight loss (about 65 grams)
* Latte was normally a crabby glider - she did not make a single sound ever. None.
* She was VERY weak - her grasp and her gross movements were very weak. She did not possess the strength to eat any solid foods - chewing was out of the question. The front half of her body (head, arms) seemed to be much weaker than the back half (tail, feet).
* She fatigued very easily. One or two minutes of movement, and then she would just collapse where she was and go to sleep
* She has stopped grooming herself.

Dr. Pearson gave her another shot of Convenia and consulted with Dr. Walsh over the phone. They both agreed (as did I) that given her age and her symptoms, the only other thing they might do was some blood work. I said I might do so when I went to Tulsa a few days later, but declined that day. Dr. Pearson and I discussed euthanasia, but since she was improving, I felt there was hope and could not have her euthanized. Latte was also given Clavamox as an oral antibiotic.

I took Latte home and placed her in an incubator to encourage her to sleep deeply and undisturbed. She still was not regulating her own body temperature. The next 10 days were unusual and exciting.

Tuesday, Dec. 1 - Latte continues to exhibit the unusual gait issues, the weakness, the fatigue, and the dehydration. administered sub-Q fluids 3X. She ate about 1/8 teaspoon of my staple mix!!!

Wed. Dec 2 - No change in symptoms. Sub-Q 3X. Ate one pine nut, licked guts of one mealie and drank a little pedialyte. Still in incubator. Still has not made any glider sounds.


Thursday, Dec. 3
- off to Tulsa we go! Latte's bursts of energy are now about 3 minutes long. She continues to not use her front legs much, but will pull them under her now. She does not even posses the strength to walk over a pen that I put in her way. :(

She ate about 10 pine nuts and 1/2 teaspoon of yogurt. Ears are no longer as droopy. Everything else the same - including need to sub-q several times each day.

Friday, Dec. 4 - only change in symptoms from before is she made one "calling out" sound to the boy gliders in the hotel room with us. Otherwise the same. Dr. Walsh says she presents like she has had a stroke. Her mobility is very difficult to describe, and is very unusual. I decided that she has had enough poking and prodding, so I declined the blood work. Looking back, I think I would have made the same decision. Sometimes in life answers are not as important as the quality of the life the glider lives TODAY. I chose not to run any more tests, to continue with the antibiotics and see if she got better. I chose to let her be happy TODAY. If she did not get better, I would euthanize and have answers through a necropsy. Some may not agree with this decision, but it was mine to make and it is the one I made for her. She was given sub-Q fluids in the office.

Friday night, after the long drive home from Tulsa, Latte woke up and was WALKING normally. It was a slow gait, but it was normal. She was using her front legs again. She walked around on my bed for about 7 minutes. She ate 1/2 of a serving of my staple food that was pretty melted. She drank some gatorade and peed and pooped normally. Still, she was not regulating her body temperature, so she spent this night in an incubator also. She has not made any other glider sounds. I gave fluids (sub-Q) once more that night.

Saturday, Dec. 6 - Latte slept all day like a normal glider. She awoke at about 6:00 and walked on my bed for about 10 minutes. She is unsteady on her feet, but is walking. She ate yogurt, staple food, a mealie and 3 pine nuts. Pine nuts are her all-time favorite, so I'm very happy to see her able to eat them easily. Then she started calling out - only the second time that she has made a sound since this started.
I decided that she might want to visit with her cage mate. I put her in the cage and Laslo climbed in the pouch with her and clicked and chirped and wrapped her in a bear hug and they fell asleep.
Several hours later, Latte crawled out of her pouch and sat on the hammock directly in front of her pouch. She just watched Laslo run around the cage. Laslo came over and gave her a kiss, then ran off and got a blueberry and brought it and dropped it at her feet. She ate the WHOLE thing!!! I couldn't get Laslo to bring her more food, but in the end I had to give her 2 more blueberries and 1 piece of corn. She ate all of it and then drank water from the water bottle. However, she would not (or could not) hold the food with her hands. I left her with Laslo that night, but put their pouch on the floor of the cage. She was given sub-Q fluids only once today. No glider sounds today.


Sunday, Dec. 7
- Latte is more active than last night. She is having trouble walking on the bars at the bottom of the cage, so I put hammocks on the bottom of the cage. This makes a huge difference. She is climbing up and down the bars of the cage and is interacting with Laslo, but when walking flat, she still does not use her hands. For the first time, she goes to the food dish and eats a bit of everything!!! Still, though, she does not hold any of the food.

Latte still does not have the energy she used to have, but she is staying up for about 20 minutes. She is maintaining her own body heat now. Required sub-Q fluids once today.
Still no glider sounds.

Throughout the next 10 days, Latte progressively and SLOWLY gets a little better each day.


Thursday, Dec. 17
- Latte is up sitting on edge of food bowl eating normally. She eats full portions of all foods. She is walking and climbing normally. She is noted to be running in the wheel for the first time. This, too, is normal. Her ears are perky and her eyes are bright. Her only remaining symptom is that she still makes no glider sounds.

December 18-24 - Latte seems to be fully recovered, activity wise. I keep saying she is a miracle and I have no explanation for her recovery. She has finished her antibiotics and returned to normal life. She even tried to bite me once, which was more cute than annoying. She still makes no other glider noises.

I felt she had recovered and I would live with a diagnosis of stroke, even though it was not confirmed. I figured that when she passed away I could get some answers on necropsy.


December 25 - 4:30 a.m.
- doing checks on the gliders and I don't see Latte. I find her in her pouch, severely dehydrated, ears droopy, eyes dull and lifeless, only moving one hand & blinking, but no other movements, and cold.
I push sub-Q fluids once per hour until 7:30. She is not improving and pretty non-responsive. At 8:00 I place a call to the emergency clinic in Amarillo, but get no answer. I leave a message and ask for a call back. At 8:20, Latte begins to crash. At 8:37 the seizures begin. She passes away shortly before 9:00

It was a terrible Christmas day for me, but a perfect healing for Latte and a wonderful birthday gift for Jesus.


Necropsy results show that she had an abscess on her brain - at the brain stem where the cranial nerves enter the brain.

This leaves me with many more questions than answers. I will be asking these questions of pathologists, vets and glider owners in the coming months. I hope that we can all learn a bit from this. I know that I have taken so much away from my time with Latte and from the diagnosis of brain abscess.

I put this here in the mystery forum as I await histopathology results and because we were not able to diagnose until after her death.

-----------♥♥♥♥♥♥♥♥-----------
~*~ Val ~*~
Passionate = one step down from crazy

We can only be said to be alive in those moments when our hearts are conscious of our treasures - Thornton Wilder

We are what we are, no matter what we might wish to be, or pretend to be. - Dean Koontz in The Face

My favorite color is orange - I'm the normal one.


Last edited by Something_To_Believe_In on Tue Dec 29, 2009 8:11 am; edited 1 time in total
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BindiAndScrubbie

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PostSubject: Re: Latte - Dehydration & Neurological symptoms   Mon Dec 28, 2009 10:16 pm

:cry: I'm very sorry, such a sad loss. Perhaps out of it all, something new can be learned to help gliders in the future. Sweet little Latte.
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Chris R

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PostSubject: Re: Latte - Dehydration & Neurological symptoms   Mon Dec 28, 2009 11:33 pm

Val....I am sooo sorry for your loss...

I have never seen this in a glider....but, I did see this exact thing ...brain abcess found on necropsy...on a rat terrier once....same exact symptoms....seizures, lethargy, weight loss, inability to move limbs at times etc, dehydration etc...he went from diagnosis of stroke to possible cancer (after ruling out distemper etc) before it was all said and done. his lab values showed a definate immune response but liver, kidney etc functions were within norms

I believe it was found that the abcess was made of a strep bacteria (hmm on second thought it might have been staph) that had started as a ear infection and went to the brain from there
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PostSubject: Re: Latte - Dehydration & Neurological symptoms   Tue Dec 29, 2009 12:46 am

I'm so sorry about the loss of Latte. I was reading this story and was so excited about the good news and then read of her passing. It sounds like you made her last days wonderful and formed a wonderful lasting memory and bond to hold close to your heart forever. R.I.P. dear Latte and you will be missed very much.
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PostSubject: Re: Latte - Dehydration & Neurological symptoms   Tue Dec 29, 2009 7:54 am

Chris R wrote:

I believe it was found that the abcess was made of a strep bacteria (hmm on second thought it might have been staph) that had started as a ear infection and went to the brain from there

Dr. Trybus, the pathologist, said this is what they normally see. However, he said he examined her ears and sinuses very carefully and could see no evidence that she ever had any infection. It's possible that she did, of course. She never had any symptoms of an ear infection, but we KNOW she had an infection - knew it in November when she was diagnosed with pneumonia.

It will be interesting to see what the histo results say. I'm lucky that i don't have to wait weeks and weeks since the lab is right here in Amarillo. Thank God.

-----------♥♥♥♥♥♥♥♥-----------
~*~ Val ~*~
Passionate = one step down from crazy

We can only be said to be alive in those moments when our hearts are conscious of our treasures - Thornton Wilder

We are what we are, no matter what we might wish to be, or pretend to be. - Dean Koontz in The Face

My favorite color is orange - I'm the normal one.
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PostSubject: Re: Latte - Dehydration & Neurological symptoms   Tue Dec 29, 2009 7:57 am

First let me say that I am sorry for your loss. I know how heart breaking it can be when these little ones get sick. And I would like to Thank you for giving such a detailed account because this gives me some idea of what I need to look for when I have a sick glider and how to document things.

Wouldn’t you know that the story of Latte would be the first story that I would read? As I read this, I just held my breath. Partly because I wanted so much for Latte to make it and partly because it was like you were describing exactly what happened to my Krabs who got sick around Thanksgiving. The symptoms were the same. All of it, and I wish that I’d had access to this information then. The only difference is that Krabs was bloated. Thank you for putting this site together and for trying to educate us. I want to learn more! I don’t even know if they looked at her brain during the necropsy. I think they just opened her up and looked at the organs. Thanks again.
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PostSubject: Re: Latte - Dehydration & Neurological symptoms   Tue Dec 29, 2009 8:52 am

Val......because she was on a long course of antibiotics you may never know where the infection started because the antibiotics cleared up the initial infection.....I'm very interested in those histo results though and cant wait for you to post them

Anita....Im sorry for your loss...lots of vets dont take the time to look at the brain even when there are neuro issues. Its sad that the brain is often overlooked and many issues go undiagnosed because of it...bloating could have been an "after" result of something like an abcess in the brain ie...brain didnt have the ability to send out signals for one of the organs to function properly thus causing fluid retention OR the fluid retention was a immune response ie....the brain is one of the hardest areas to fight infection, so gliders body overproduced white blood cells to try to fight it which also needs serum to carry those cells thus producing a bloat effect.......Guess we will never know but, those are possibilities and sometimes just knowing those mechanisims helps to "quell" some of the guilt we feel {{{{{{{huggs}}}}}}}
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PostSubject: Re: Latte - Dehydration & Neurological symptoms   Tue Dec 29, 2009 10:52 am

Val, you know you have my hugs and prayers.

I talked with Tim about this, he asked for you to pass along the results when you get them as he has never heard of a case like this in a glider, but is one reason he always says that we should have the brain analyzed if everything else looks good or if there are ever ANY reasons we may even think there is a neuro problem.

Know that Latte got the BEST care in the world when she was with you. She was VERY luck to have you as a mommy.

Also, I would like to THANK YOU in a BIG WAY for such a detailed report. Really it is what we ALL should be doing on our gliders all the time. I know it is something I will be doing as soon as I get moved. It will take some time to get it all set up and going, but it is much better to have this kind of information (eating normally, healthy coats, ears, eyes, weight, etc) to help us acknowledge things quickly.
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PostSubject: Re: Latte - Dehydration & Neurological symptoms   Tue Dec 29, 2009 7:01 pm

Thank you so much for sharing this with us.
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PostSubject: Re: Latte - Dehydration & Neurological symptoms   Sat Jan 02, 2010 9:38 pm

I received Latte's necropsy and histopathology report today. (Given the holiday, that would be less than a week turn around. FANTASTIC!)

The spot he thought he saw on her heart turned out to be nothing.

The abscess on her brain was described as
"Expanding and segmentally effacing the meninges at the level of the midbrain and cerebellum is a severe suppurative inflammatory response. The inflammation multifocally extends into the neuropil."

So, yea, large, severe, pus filled brain infection.

She was also dehydrated and very thin. This we knew - I described it above. It is just sad to see it in print: dehydrated, thin, brain abscess. Poor Latte. :(

"Diagnosis: Meningoencephalitis, Suppurative, Subacute, Severe"

In Summary:
"The central nervous system inflammatory response is considered the cause of death of this animal. The character of the infiltrate (suppurative) is consistent with a bacterial etiology."


[for those wondering, "suppurative" is just a big word for pus . ]

-----------♥♥♥♥♥♥♥♥-----------
~*~ Val ~*~
Passionate = one step down from crazy

We can only be said to be alive in those moments when our hearts are conscious of our treasures - Thornton Wilder

We are what we are, no matter what we might wish to be, or pretend to be. - Dean Koontz in The Face

My favorite color is orange - I'm the normal one.
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PostSubject: Re: Latte - Dehydration & Neurological symptoms   Sat Jan 02, 2010 9:45 pm

Poor Latte. Do they say what can cause something like this to happen? Is it just a random luck of the draw thing?
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PostSubject: Re: Latte - Dehydration & Neurological symptoms   Sun Jan 03, 2010 1:39 am

So would that possibly be listeriosis? If so, it's not that uncommon a bacteria.
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PostSubject: Re: Latte - Dehydration & Neurological symptoms   Sun Jan 03, 2010 5:23 pm

It is possible. Another thing that I learned: Try to anticipate everything. LOL

I did not request or pay for a culture of the infection/pus because I really did not anticipate this. I wish I had asked. Next time, I will know to do so.

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~*~ Val ~*~
Passionate = one step down from crazy

We can only be said to be alive in those moments when our hearts are conscious of our treasures - Thornton Wilder

We are what we are, no matter what we might wish to be, or pretend to be. - Dean Koontz in The Face

My favorite color is orange - I'm the normal one.
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PostSubject: Re: Latte - Dehydration & Neurological symptoms   Tue Jan 12, 2010 9:03 pm

for your loss Val.

It sounds like the antibiotics helped some.
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PostSubject: Re: Latte - Dehydration & Neurological symptoms   Wed Jan 13, 2010 10:51 am

Just read this. I'm sorry for your loss and Laslo's loss. RIP Latte.
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PostSubject: Re: Latte - Dehydration & Neurological symptoms   Wed Jan 13, 2010 11:45 am

How is Laslo doing?
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