Clinical Case Challenge
Second Opinion at Tufts Saves Shayla’s Life
They say big things come in small packages. Well, you can say the same for big diseases. Granulomatous meningoencephalomyelitis or GME is an inflammatory disease of the central nervous system, which effects many small breed dogs and one which very few people know anything about. When Veronica was asked to tell her story about Shayla, she jumped at the chance as this became a perfect opportunity to raise awareness of this little known and often fatal disease. Pet parents should always be vigilant for any unusual signs of illness in their pets. In cases of GME, Veronica Morrison would encourage you to be aware of signs or symptoms, such as stumbling, circling, torticollis (head turning) or an uneven gait. And Veronica is thrilled to report that with Tufts’ expert clinical services, Shayla was diagnosed early enough and her story has a happy ending.
Background: Veronica’s first experience with Tufts Foster Hospital for Small Animals at Cummings School of Veterinary Medicine occurred about twelve years ago. Since then she has sought out the services of Tufts VETS (Veterinary Emergency Treatment & Specialties), a specialty and emergency veterinary hospital located in Walpole that is affiliated with Tufts Foster Hospital for Small Animals with very positive results. So when her dog Alfred was first diagnosed with a brain tumor, and her groomer recommended she get a second opinion at Foster Hospital in North Grafton, she acted immediately. Alfred’s results were very positive back then, where upon referral to the Foster Hospital and subsequent brain surgery, Alfred was given the gift of another two years to live. Thereafter, Veronica would continue to use Tufts VETS’ services on a sporadic basis when she felt she needed a second opinion for her companion pets.
That second opinion on September 12, 2013 is what Veronica credits as a lifesaver for Shayla, her 7-year-old Westie. This time from Dr. Johanna Cooper, who had previously seen Veronica’s dog Ariella. Shayla had been being treated for an ear infection, but Veronica noted that things didn’t seem to be improving. She was having trouble going up and down stairs and could not walk in a straight line. It was as if she was inebriated. “If you don’t know what’s wrong with your pet, take them to someone you trust. I really liked Dr. Cooper and I knew she would know what to do next – either treat the problem or tell me who can,” said Veronica. She was given an appointment the very same day and upon exam, Dr. Cooper clearly witnessed unusual behavior. Shayla’s head was massively turned to the left, in what she called torticollis and when Shayla tried to walk in a straight line, she leaned to the left as if she was circling around in that direction. After further examination, Dr. Cooper found there to be no pain when she manipulated the neck and her ears were fine. The most worrisome thing was that according to Veronica, Shayla seemed to be getting progressively worse. The symptoms indicated signs of a brain issue and Dr. Cooper acted immediately by contacting the neurology team at Foster Hospital to make an emergent referral. Veronica left Walpole and went directly to North Grafton where she was seen by the emergency team.
Treatment: Shayla underwent x-rays, blood tests, an MRI and a spinal tap on the following day. After all the testing, Shayla was diagnosed with granulomatous meningoencephalitis (GME), an inflammatory disease of the brain that can be caused by an immune system issue or infection. Veronica recalls, “Dr. Kathryn Weiss explained the diagnosis to me and answered all my questions.” More testing was done to determine the best treatment protocol – to find out if it was tick-borne or fungal, but testing revealed that it instead was likely immune-mediated and she credits Dr. Weiss and Dr. Phillip March for putting an appropriate treatment protocol in place.
Outcome: Shayla returned home three days later and went into remission in October. “If Dr. Cooper did not recognize Shayla’s condition as a serious neurological condition, Shayla would have died,” says Veronica. “Today, she looks and acts like nothing was ever wrong with her! She needs to take medication and see the doctor for follow-up, but I am very pleased with her progress,” she continues. She frequents a dog park and meets up with her friends on a regular basis and everyone comments on how much energy she has.”
Shayla’s happy ending is a true testament to the insightful and expert diagnostic capabilities of the Foster Hospital for Small Animals team of doctors. Veronica is extremely grateful to the entire neurology team. She credits Dr. Cooper for recognizing it was a neurological problem and everyone in North Grafton – Dr. Phillip March, Dr. Michael Stone, Dr. Kathryn Weiss, and all the veterinary students – for what they have done to help Shayla. And because of the complicated nature of Shayla’s illness, Veronica has made a decision to make Foster Hospital her “go to” place for primary care veterinary services, where Shayla now sees Dr. Michael Stone. “The comprehensive services and the continuity of care among the specialists that is available is second to none and I want only the best for Shayla,” says Veronica.
- Cummings School