Seven years ago on this day Bailey had a very involved surgery. People told us to put him down- a 16 month old dog; we opted to save him. Today he is having the time of his life.
One Pomeranian’s Journey With Atlantoaxil Instability Luxation.
Pomeranians are called the heart break breed, but Pomeranians have hearts that won’t break.
You know when you have this feeling that there is something wrong, you call the vet, make an appointment and off you go. In a 16 month old pom you don’t expect the worst, but when the worst is what you get, you now have to deal with what that is.
It started in March 2010 as a disinterest in going for a walk. We would get to the corner and Bailey would want to turn around and go home. It wasn’t lethargy and he was not limping or eating differently so we thought it would pass. The only thing we noticed was a small sway in the head, like he had a kink in his neck from sleeping funny. A few more days passed and we were at advanced dog training. The trainer noticed the sway in the head and said, “Judy, I think Bailey needs to see a Neurologist”. “What?!” I was shocked. Here was a healthy vibrant young pom. I just couldn’t believe what I was hearing. Knowing that my trainer had tons of experience over the years with her own dogs health issues, clients dogs and me having 3 other pom’s at home, 2 with many of the terrible issues that face the breed, BSD, Thyroid, Collapsing Trachea, Cushing’s disease etc. (Yes my dogs have it all) I made the vet appointment the very next day. Once at the vet office I requested all the blood tests for various conditions and requested an X-ray. The vet felt that some of the blood tests were overkill, but agreed. When it came to the X-ray, she felt it was not necessary. I took her advice, although not willingly, and home I went with pain killers prescribed by the vet and an appointment with her canine Chiropractor. All the results of the blood work came back normal, so they suggested crate rest until the next appointment. He seemed better, but painkillers can mask an underlying problem. 2 weeks passed and we were in front of a certified canine Chiropractor. They are first certified for human Chiropractic, then for canine. She was very concerned as she looked at Bailey. His head would sway to one side and then the other. She did a mild adjustment and sent him home. Back to crate rest. The next day, he was crying when he stood up and was not interested in eating. Then all of a sudden he fell over screaming, the worst noise I have ever heard in my life. He was out of his crate to eat and stretch his legs when this happened. I got him calm but as the day progressed his pain increased. When I took him out of the crate to go outside, I would carry him and put him gently in the grass; he could not stand and would scream and his legs were curled under him. This had been going on now for a few hours and was getting worse, so we rushed him to the emergency hospital. The first Dr. that saw him felt it was a disc in the neck that needed surgery. They got him comfortable, but didn’t stabilize the neck. They didn’t know what his condition really was. He stayed there overnight and in the morning the Dr. on staff saw Bailey. Thank God he had the foresight to have an MRI done. After the MRI and his reading the report we got a call. Bailey had Atlantoaxil Instability Luxation. What is that? I asked, he explained it me over the phone and asked for my husband and me to come meet with him. Once at the emergency hospital they seated us in the mourning room, never a good sign. Dr Galingo came in and he had a book with him. He showed us the problem with Bailey’s neck based on a diagram in a medical book. He explained to us that he was born with a rare birth defect called Atlantoaxial Instability Luxation. It is a condition in which the first two cervical (neck) vertebrae are not firmly attached. Normally, the atlas (the first cervical vertebra) and the axis (the second cervical vertebra) are attached by a group of ligaments. They are further stabilized by a prominence on the axis called the dens that protrudes into a hole in the atlas. Atlantoaxial instability can lead to cervical spinal cord injury, the symptoms of which include: neck pain; a drunken, staggering gait; paralysis of all four legs; or sudden death. In Bailey’s case, he fell over and became paralyzed when the ligaments ripped. Basically, the ligaments were doing all the work that the dens bone wasn’t. He also explained to us that this happens at a young age, usually between the ages of 6 months and 18 months. Dr. Galingo then showed us the options for a type of surgery, very specialized that required a Neurologist. He wanted us to transfer Bailey to the VRC, Veterinary Referral Center and Emergency Services in Malvern, PA. About 1 hour trip from our house and a hospital that my 2 older pom’s went to all the time to see specialists in dermatology & internal medicine. The emergency center wrapped him up in multiple blankets and off we went. It was a Friday night and as we drove him down to the VRC, I couldn’t believe what was happening. Once there, they got Bailey comfortable and went over his condition again. They urged me to sign a DNR form, but I said no. He was not going to die from a DNR, I wanted them to try to save him if they could. We left the hospital that night very sad, confused and depressed. We stopped for a quick bite to eat and sat there just staring at our food. How could a young, healthy pomeranian from a well known breeder be in such a state of distress. Why was this condition never mentioned to Vets’s in medical school? So far, every Veterinarian we talked to had never heard of this condition. The following morning we had a phone conference with Dr. Avril Arendse, a Neurologist at the VRC. She said the plain x-rays of the cervical spine showed no luxation between the vertebrae, but noted that there was a larger than normal space between the dorsal spinous process of C2 and the dorsal laminae of C1. On ventrodorsal projection the cervical spine, the dense, appears to be hypoplastic. She said that this is consistent with injury to the dorsal ligment. Dr. Arendse had stabilized his neck with a custom fit heat molded plastic brace that was very secure and layered with padding and tape. She informed us that Bailey was currently paralyzed from the swelling on the spinal cord as a result of the injury. First, we had to try to get him feeling his paws again so that he could regain any or all movement to his limbs. Then he needed involved surgery and long term care to get him back to as normal as possible. He had a 70% chance of a 100% recovery. It was in his best interest to have the surgery at the U of Tenn, Vet Teaching Hospital in Knoxville, TN. Another shocking realization, this was not a surgery that your average surgeon can do. I was so confused by everything and I kept going back to the X-ray that I was denied at the beginning of all this. It would have shown the birth defect in the dens bone, Bailey still would have needed the surgery, but he wouldn’t have had the ligament damage. He would simply have needed the procedure to repair the neck. I was also stunned to learn that many dogs die from this condition and are found dead on the floor when the owner comes home. Only about 10% survive the catastrophic injury of the ligaments ripping away from the neck and of that small percent, very few are saved by their owners.