We see many interesting cases here at Best Friends, however, cases like James stand out in our memories.
James is a 10 year old, male, neutered, Akita/Malamute cross. He presented to Dr. Meg for a lameness evaluation, possible neck pain, and a decline in his eating and activity level. On exam James is a gorgeous, big guy weighing in at over 100 lbs. His exam in the room was relatively normal, but when taken outside to observe his walking he had a pronounced choppy gait in his front limbs (especially his right front). He also occasionally crossed his front limbs and his rear legs were slightly slow in placement. Unfortunately all of these findings pointed towards a potential brain lesion.
Diagnostics: Radiographs were taken of James head, neck and chest to rule out causes such as trauma or obvious bone disease. We also take chest radiographs in cases like James to look for metastasis (spread of cancer). No obvious lesions or disease processes were visible. We also ran bloodwork which was relatively normal. With James clinical signs and laboratory information, we were highly suspicious of a brain tumor or tumor growing off of the skull. These growths unfortunately cannot be visualized on radiographs alone.
Magnetic Resonance Imaging (MRI) is considered the best method to visualize lesions within the spinal column and brain. Luckily, we have access to MRI capabilities even for our pets. James scan revealed a large growth compressing his cerebellum (area of the brain that controls your gait and feet placement). See the white growth on the photos below? It was even causing brainstem deviation. In older animals (greater than 8 years of age) sudden onset of neurologic signs are often due to benign meningiomas (growing from the meningeal layers). Although benign, they unfortunately can still cause severe neurologic deficits due to their presence. Some dogs respond to oral steroids alone for awhile, however, this type of growth will cause worsening neurologic signs, pain, seizures and a poor quality of life as it grows. We have to imagine they have considerable headaches as well! The only cure is surgery…brain surgery!
Surgery: Beyond his mass, James was an incredibly healthy dog, and his owners wanted to give him as long and happy of a life as possible. After considerable consideration, the owners decided they’d like us to pursue surgery for James. We worked closely with Colorado State University’s Veterinary Hospital and neurology team to prepare James for a subocciptial craniectomy. The surgery went wonderfully, and the mass was indeed a benign menigioma. James had a right sided head tilt and strabismus (abormal eye movement) for a few days post operatively, but that resolved quickly. His head tilt resolved entirely after a couple months.
Followup: James is now back to being his 100% beautiful self and we’re happy to report we only see him for vaccines and regular deworming.