米氏春秋

前陣子阿樂有點不舒服

現在狀況比較穩定了

請不要擔心

這是我自己的小紀錄

希望阿樂可以盡快恢復原來的賤賤貌!

 前庭神經炎

0509

下午大概兩點半回家，發現有挫賽，很明顯是阿樂

踩的到處是

還兔了兩三陀

阿樂一直在閃有賽的地方，還窩在門口的角落

我先把小鬼兩隻遷到浴室綁住 

阿樂很虛的樣子 

滴清耳液都不甩，洗澡都一直躺著，洗頭也不像平常會閃，洗完叫他抖斗甩水他也很吃力 

一抖就要摔跤的樣子 

我趕緊大概吹一吹 帶去醫院  

這時很明顯全身無力，眼皮一直斗，眼睛無神，看起來很蒼白，下樓梯的時候幾乎要滾下去的感覺

上車也很吃力

從停車場走道醫院也很吃力

還一直走歪歪，很像喝醉酒

醫生一開始是懷疑突發性的前庭異常導致暈眩，所以才兔，走路沒力（因為很暈）

我說昨天吃了比平常多的地瓜葉，而且我還很雞婆用Blendtec打成泥，有腸胃到症狀，懷疑是地瓜葉中毒

醫生打去榮總毒物科問地瓜葉的毒性

這時間血檢結果出來

腎指數CRE略高，醫師建議應該要少吃一點肉

肝功能也略高 ，大概一百零幾

沒發燒，大便也沒蟲，血球數值也正常

後來榮總回電

地瓜葉裡有一種毒素（我再去確認名稱）會跟氧競爭 ，造成缺氧

 阿樂的血氧驗出來有略低，大概在90-95之間

血液抹片中有部分紅血球型態不太正常，看來空空的，跟地瓜葉毒性的症狀吻合

阿樂是雙側眼球震顫上下，眼上下皮跳，左側比較嚴重，頭也一直偏左

是單純的地瓜業中毒還是有合併中樞神經的病變還不知道

打了將近2000cc的液體，

開了兩天類固醇（預防中樞神經的病症），B12, Alinamin,腸胃方面的藥

如果是地瓜葉，一兩天排完了應該就沒事

如果是中樞神經（懷疑是急性前庭異常），通常一禮拜左右會慢慢自己好，只需要支持療法，也不會有啥後遺症

打完點滴感覺阿樂精神有比較好

雖然走路還是沒啥力，很像喝醉酒歪來歪去

上樓梯也要我頂著他的屁股幫忙

因為血氧低，這幾天先多靜養

不過阿羅就體重比例的話，他們倆吃的地瓜葉量應該差不多 ，他就整隻活跳跳.....

反正阿羅也一起禁食觀察....

在醫院待了差不多四小時，回家阿樂就睡著了

晚上只有帶阿羅一個人去散步. 阿樂看我們要出門一點反應都沒有

今日醫藥費4800

今天體重53.7左右,打點滴前量的

0510

早上餵了第一顆類固醇和其他藥, 抗生素和止瀉的除外

阿羅已經餓到快暴動了

下午去新竹, 大概四五個小時不在家

回家的時候也只有阿羅來迎接,阿樂還是躺著.旁邊有兩攤尿

晚餐阿羅有減量, 阿樂一開始用餵的,餵一餵他有自己吃幾口.

大概只有平常的八分之ㄧ不到.

晚上一起吹冷氣睡覺, 阿樂有想自己跳到床上,但是前腳搭著床,後腳就像軟腳一樣,

我把他抱上去,沒多久他又自己跳下來.看起來前腿的力量比較好,後腿變的比較沒力.

半夜阿樂又挫尿,自己趕快抓門說要出去,開了門他就往廁所跑.

眼球振顫有比較好一點

0511

早上又要用硬餵的.

約了碩聯林中惠醫師做神經內科檢查

下班衝回家的時候又發現阿樂挫了兩泡尿.

今天走樓梯有比較好一點

檢查結果,各種反射都正常,林醫師覺得眼球上下動跟前庭異常的動法不一樣

(後來證明是我記錯了,林醫師對不起!!)

懷疑是更接近CNS的問題.

步態檢查上後腿的步距有縮短,站姿時後腿的角度也變開開的,的確後肢的力量有變弱

阿樂今天看起來瘦很多.眼睛下都凹了.臉型看起來也變比較長.

偏頭的狀況有改善. 眼球振顫已經消失 .

CNS disorder? Muscular disorder?

林醫師建議先觀察他肌肉活力的回復狀況, 如果持續惡化,兩三天後先照CT.

今天體重52.75

晚餐用餵的,(禮拜天晚上煮的)羊腱肉煮熟打泥跟鮭魚泥比較愛吃

塞雞胸肉就一直兔出來.

阿羅虎視眈眈的等著要撿去吃,阿樂也不跟他生氣,真是不習慣.

晚上一樣餵藥,幫阿樂清耳朵.

今日醫藥費 610 (含神經理學檢查200,耳劑)

0512

早上位阿樂吃ㄧ點東西,發現阿樂會不自覺躺著尿尿,

他發現自己尿尿了還很驚嚇的彈開來..

帶他來上班

下樓梯有比較穩一點,牽著走路還是覺得他沒啥力

阿樂在休息室裡一直睡覺,傍晚出去散步一下,大小便都還正常

晚上九點要下班的時候有忍不住挫尿一次

路上遇到附近髮型室的古代要跟他玩阿樂也不裡人家.

回家換帶阿羅去散步,阿樂有一點想要跟的樣子

不曉得是不是有出門心情好,今天胃口有好一點,

晚上餵一餵願意自己從碗裡面吃飯了

要睡覺的時候會自己跑到臥室等著我開冷氣

晚上睡的很好,到早上才說要出去上廁所

阿羅身體燙燙的,一直抓癢,不曉得是不是要發急性濕疹

0513

阿羅果然是發急性濕疹

0514

0515

下午去接了阿羅阿樂來上晚班,

宗親揪甘心還特別過來幫阿樂做了一個小時的能量治療

下班後特別約了跑跑團出去跑跑

希望阿樂玩一玩胃口比較好

結果小鬼一直吃綠茶媽發的零食，跟Kenken玩

最後還被fimo父子檔修理

回到家一樣，塞幾塊羊肉以後又不吃了

今天會跑會玩，雖然體力不好，很快就累，也算有進步吧

今天晚班是阿羅阿樂第一次一起去上班～

0516

下午去長青回診

CRE 2.0 (上禮拜六是1.7)

沒力也變的比較沒膽

被路邊的阿黑阿黃一兇就嚇屬了

今天P麻送了超讚的羊肉棒跟鮭魚棒

阿樂現在變的不太愛鮭魚味

但是羊肉棒會咬在嘴裡,咬半天帶來帶去的才開始吃

今日醫藥費....忘記了

0518

晚上回家阿樂有到門口迎接

還像以前一樣咬了我的拖鞋跑到客廳

很可以確定這小鬼好很多

晚上有吃多一點

但是這小鬼不知道拿什麼翹，

一定要我拿到客廳他邊吹冷氣邊要我拿到手上餵他

他自己在碗裡舔一舔好像咬不到啥東西....

如果被我發現這小鬼是ㄍㄟ掰要人餵他就死定了！！

晚上帶阿羅散步，阿樂也說要跟

一起出去，走路比較穩

也用左後腳站，抬腳尿尿好幾次

回家弄了冰水，小鬼還知道把阿羅擠走自己獨佔

真的是個死孩子！！

雖然才走不到20分鐘，回來也很累的睡著了

0519

阿樂願意自己吃東西了!! 喔耶~

終於可以不必再每天花一個小時塞小鬼吃飯

也會想跳到床上跟媽媽睡上下舖,不過後腳上不來,要媽媽幫忙搬上來~

 0520

有吃多一點點

經過昨天的激勵,

到了睡覺時間就自己抓臥房的門要跳到床上

而且會躺在媽媽身上一直討摸摸

現在尿尿也很正常,回到準確的尿尿盆的模式!

喝水也會自己去開水龍頭

不過站著的時候還會頭歪左邊,有時候剛剛起身時走路會不穩

0521

現在阿樂拿翹不吃飯我就把飯收起來,

過個15分鐘再放出來

阿羅的飯第一輪就吃完了,看到阿樂的飯會一直差差跳要偷吃!!

阿樂會低吼阿羅不給他偷吃

不知何時會再進步到會跟阿羅打架玩的程度

現在睡覺前超愛摸摸的,要摸很久,摸一摸還會換邊翻肚要繼續摸

0523 

長青回診

CRE 1.8

驗尿除了比重偏低其餘正常

體重51.7-52,這禮拜又瘦一公斤了

今日醫藥費350

0526

 http://www.vetspecialists.co.uk/06_Animal_Welfare/Neurology_Facts/Vestibular_Syndrome.html

Vestibular syndrome
Vestibular syndrome refers to a group of diseases that affect the balance system also known as vestibular system. Common signs of vestibular syndrome include loss of balance, falling, rolling over, abnormal flickering of the eyes and general wobbliness.

What is the vestibular system?
The vestibular system controls balance and tries to prevent the animal falling over. Like the other senses, the balance system consists of sensors (deep inside the ear (inner ear)) and a specialised control centre (at the back of the brain).

Control of balance requires tiny changes in the position and movement of the body and the eyes depending on the position and movement of the head.

The balance sensors detect the position of the head in space while the animal is standing at rest or when it is moving. The information on the position of the head is converted into electrical signals which are sent to the brain. The balance control centre in the brain processes this information and sends messages to the rest of the body to keep the animal upright. Messages are also sent to the muscles controlling movement of the eyes to change the position of the eyes according to the position of the head.

What are the signs of vestibular syndrome?
Common signs of vestibular syndrome include falling, head tilt (rotation of the head with one ear held lower than the other), flickering of the eyeball from side-to-side or up and down (nystagmus), general wobbliness (often with the animal drifting to one side as he moves around) and/or circling. The balance centre is very close to the area of the brain that controls vomiting and so animals with disturbances to the vestibular system may feel nauseous or be sick.

The balance sensors are close to the hearing sensors in the ear and the nerves controlling the movement of the eyelids, lips and ears. This means that diseases affecting the vestibular system may also cause loss of hearing and a drooping of the muscles in the face (facial paralysis) [see specific fact sheet - facial paralysis]. Similarly, diseases affecting the balance centre in the brain can also affect other parts of the brain causing seizures, weakness, loss of vision, or difficulty eating and drinking.

What can cause vestibular syndrome?
Vestibular syndrome can be caused by a disease affecting any part of the system (sensors within the ear, the nerve connecting the ear and brain, or the control centre in the brain).
Diseases affecting the ear include deep ear infections (otitis), ear tumours or polyps, damage to the skull such as caused by a road traffic accident or a bad fall.

Diseases affecting the vestibular nerve include nerve tumours, nerve inflammation (neuritis) or an under-active thyroid gland. The brain can be affected by a tumour, inflammation or infection (encephalitis), stroke, head trauma, some vitamin deficiencies (thiamine deficiency) or a malformation of the brain such as a cyst. Some antibiotic treatments can also cause vestibular syndrome in a small number of "sensitive" dogs. Some animals (particularly aged dogs or cats) develop vestibular syndrome and yet no cause can be detected, despite extensive investigations. This is called idiopathic vestibular disease.

How will my vet know what is wrong with my pet?
Your vet may suspect that your pet has vestibular syndrome from your description of the signs. However, there are several other diseases that can cause similar signs so it is important to try to confirm the presence of a vestibular syndrome and then to identify its cause in individual patients. Your vet will perform a neurological examination [see specific fact sheet - neurological examination] to determine if the problem is more likely to be within the ear or the brain.

The ear should be examined with a scope and a swab taken if an infection is suspected. Many dogs have vestibular syndrome with no typical signs of ear inflammation such as head shaking, scratching of the ear, inflamed ear canal or inflamed eardrum. Other investigations such as X-rays, CT scans, or best of all MRI scans [see specific fact sheet - neuro investigation] can help to detect disease located behind the eardrum such as a deep ear infection or a tumour. CT and MRI scans of the brain are also useful for detection of brain disease. Your vet may also want to collect a sample of the fluid that bathes the brain and spinal cord (CSF) [see specific fact sheet - neuro investigation] for further tests.

How can vestibular syndrome be treated?
If an underlying cause can be identified and treated the signs of vestibular disease should get better. If irreversible damage to the balance sensors had occurred head tilt and/or an intermittent loss of balance may persist despite adequate treatment. In animals with significant nausea and loss of balance drugs used to control motion sickness may help reduce signs, but treatment of the underlying condition is also required.

If my dog has vestibular disease will he get better?
The outlook for dogs in which a cause of the vestibular syndrome is identified depends on what the underlying cause is. Some infections can be controlled quite easily whilst others are more serious, the outlook is worse for animals in which a tumour is discovered.

In most cases where no underlying cause is found animals will recover without any treatment. This recovery may take months and in some cases the animal may be left with a permanent head tilt.

If you are concerned about the health of your pet you should contact your veterinary surgeon.