Jeffie’s Neurologist

SidCorn-6

We popped down to the Queen’s Veterinary Hospital at Cambridge University yesterday to see Jeffie’s neurologist, Paul Freeman. We didn’t take Jeffie along because we were only going to view the scans and x-rays which had been taken when he was seen there, but which for some reason we didn’t get to see at the time.

It felt strange walking into reception without a dog, and knowing we weren’t even there to collect one. I almost felt like a fraud. So I buried myself in my Which Digital Camera? magazine, because another thing we were going to do was visit the Campkins photography shop to see if we could get me a new camera.

And the time went by. I read all the latest reviews and discovered that since I last bought a one, something called a Compact System Camera had appeared in large numbers, and that I wanted one.

We were given some tokens by the receptionist for a hot drink from the machine, and passed a minute or two selecting and following instructions after which we drank the strangest cappuccino either of us have ever tasted1.

More time passed. Canon and Nikon were metaphorically ditched, and I learned that Sony cameras were well respected and that Olympus were not only still being made but were strong contenders. I also learned that something mysterious called the Micro Four Thirds systems was raising the game.

And eventually, OH said: ‘Do you know we’ve been here nearly an hour?’

QueensFeb2015-Web

I went up to the desk and relayed this information to the receptionist in a polite ‘how much longer?’ kind of way and she checked our appointment time and who we were here to see, and looked horrified that we hadn’t been seen yet and rang through to find out what was going on, and a few minutes later the neurologist came through apologetically and ushered us into a consulting room. It seems he was just about to ring us to find out if we were coming or not, because his pager had fallen off somewhere and he’d never got the message that we had arrived.

Ah well. There then followed a most interesting session with him showing us the x-rays and MRI scans and explaining what all the things we could see thereupon actually meant.

My eye was immediately drawn to a bulging disc, but in fact it was an old problem, quite calcified and unlikely to be causing his symptoms because a) he doesn’t appear to be in pain judging by the way he throws himself about and leaps into the car like Zebedee, and b) it isn’t compressing anything. This was in the cauda equina2 area, but most of the bulging is in the safest position, which is downwards, and the nerves are not being pinched. We discussed his demeanour, his playfulness, and lack of any obvious signs of pain, plus the fact that he is in fact on anti-inflammatories as a kind of empirical ‘he’s nearly thirteen years old, he must hurt somewhere‘ solution. Personally, I haven’t seen any sign of any difference in him since he’s been on them, but I’m willing to trust my vet on that one.

There are also a few bone spurs, most noticeable in the thoracic region, but again, not of a type to cause a problem, and not in a place where they might cause a problem. ‘It’s something you see in old dogs’ he said. Fair enough.

I wish I’d thought to ask if I could snap a couple of pictures off the screen to show you, but the sad fact is that I didn’t, so you’ll have to make do with some random pictures.

JeffieCambridgeNov2014Web

Anyway. It was lovely of Mr Freeman to give us an appointment just to go and see the scans and to make time to explain everything thoroughly for us. I have to say that our experiences so far with the Cambridge vet school have been outstanding, and this afternoon gave us a new appreciation for exactly why the cost of an MRI is so high. Not only do the machines themselves cost an absolute fortune3, and animals need to be anaesthetised while inside them, but because the area they cover at any one time is so small, it can take a long time to get the information you need. You have to first determine which area is worth looking at by clinical examination, then take some x-rays to narrow it down, then set up your MRI to make ‘slices’ at predetermined intervals through the tissues. Each slice examines a two-dimensional area, so that, for instance, to examine a short section of spine properly4, you might need about fifteen slices – which all take time, both to produce and to analyse.

For Jeffie, today’s visit will make absolutely no difference at all. For us, it was reassuring to know that we had done, and were doing, all that was reasonable. He is an old dog – thirteen years old in a few months – and there is a limit to what one should do, I think, if the benefit does not outweight the risks and stresses involved. What we hope for Jeffie is that he will continue to enjoy life in his own idiosyncratic way, despite his ‘Dogzheimer’s Syndrome’ and his wobble issues, right up to the day we find that he has peacefully slipped away from us in his sleep. It’s a rare thing, but when it happens to an oldie whose issues are known and are being addressed, it’s a real blessing.

1 It must have been cappuccino because it said so on the pod. Tell me: why do coffee machine manufacturers assume that anyone who wants cappuccino or hot chocolate also wants to compromise their pancreas and rot their teeth? What is wrong with being allowed to add sugar by choice?

2 Cauda Equina literally means ‘horse’s tail’ and refers to a section of spinal cord with nerve roots branching out all over the place.

3 Pet Plan insurance is our friend.

4 In the ‘through the tube’ direction, not with the animal flat on his side.