This is our miniature Labradoodle Sailor. In this photo she was about 7 months old. She was a happy, energetic, and very loving puppy. She started her life as black as midnight, but after her first trip to the groomer, we learned she would be a "silver." She is still in the transition stage. This blog is about Sailor's battle with SRMA or Steroid Responsive Meningitis Arteritis which began shortly after this photo was taken and continues as she is approaching 10 months of age.
Sailor was spayed in early February on a Monday, and also had an episioplasty (to help prevent UTI's) and had two "extra" canine teeth removed at the same time. She tolerated the procedures well and came home with the dreaded plastic collar. For the first couple of days she was quiet and adjusted to the collar pretty well. By the third day, she was back to her boisterous self and slammed into doorways, walls, and furniture with abandon. By the weekend she had become lethargic, had vomited once, and did not want much to eat. On Sunday, we made an emergency visit to the vet who thought she had a stomach upset and gave her a shot to help that. We had removed her collar and left it off until Tuesday at which time she started going after her stitches. The collar went back on. On Wednesday, she was back at the vet to have the stitches removed, which went fine. When the vet brought her out and we were talking, she yelped every once in awhile when she would raise her head to be petted. Seems she must have a sore neck, said the vet, so we decided to keep her on pain pills for a few more days. By Friday, she was again refusing food and only sleeping with her head resting on her dog bed. Whenever she changed positions, she would let out a little yelp of pain. Saturday morning we were back at the vet. Manipulating her neck would result in pain, but only in one particular direction. The vet fed her some canned dog food (normally she ate dry puppy chow) which she gobbled up as though starving, even though she wouldn't touch her dry food. The vet put her on different pain medication, one specifically for nerve pain, and also on an anti-inflammatory. She said to keep her calm and quiet through the weekend and call her on Monday. This vet was the second one who had seen Sailor during this illness - different from the vet that performed her surgery and had seen her for the emergency visit. However, they certainly were both aware of all visits that Sailor had made after surgery and her condition.
By Monday Sailor was some better - would eat some canned food and her pain didn't seem as severe, but she still would not put her head down and some neck positions brought the yelp back. After talking with the vet, we decided to continue her on the meds and give her a few more days. Our daily walks, which usually consisted of long brisk mile and a half treks, became short 1/4 mile strolls, with Sailor occasionally stumbling. That was odd, I thought. Coming back home on Wednesday, Sailor suddenly veered sideways, and I had to hold her up by her halter (we had ditched the collar) and help her back in the house. By Wednesday night her condition had deteriorated. When I took her out to relieve herself, she was in obvious pain, but she made it out and back inside. Taking off the halter sent her over the edge - she cried out and began shaking and turning in circles. I held her and comforted her the best I could, but it was obvious she was a very sick puppy. I stayed up with her and lay down next to her on the floor with her head resting on her dog bed. She slept some, but it was a long night marked with several bouts of pain and restlessness.
In the morning, we tried to get her up to go outside, and she could not stand - she was literally trying to crawl to go outside to relieve herself, but couldn't make it and urinated on the rug. We took her immediately to the vet - where the vet tech helped us carry her inside. She could not walk or stand. The vet who had performed her surgery was there. He gave her some type of shot to counteract the anti-inflammatory and then gave her a steroid. She had no fever, but obviously there was some kind of spinal problem. X-rays from the previous vet visit showed no disc problems. He wanted to keep Sailor there, and we agreed. Late that afternoon he called and said he didn't know what was causing Sailor's symptoms, but that she was seriously ill and deteriorating. He had called a veterinarian neurologist for a consult, but had not heard back from him. The prognosis was not good, and we really felt we were going to lose our beloved Sailor. Our vet wasn't too hopeful, and we spent a very gloomy evening visualizing our lives without our sweet puppy.
At around 7:30 I received another call from our vet. He had spoken with the neurologist who had, upon hearing Sailor's symptoms and condition, immediately diagnosed her with SRMA. Our vet had made the right call in administering steroids, and we now had some hope that Sailor might survive, though her condition remained critical. The next morning we paid her a visit. She lay on her side with an IV of fluids and meds, and was not very responsive though we did get a slight tail wag. On Saturday morning we once again went to see her and her condition remained the same. On Saturday afternoon, the vet tech who was tending to her when the clinic was closed called and said Sailor had attempted to get up and she had been able to take her out with support to relieve herself. At last, a positive reaction to the steroid treatment. On Sunday morning, a third vet in the practice who had come in to check her, called and said she was able to stand with help and go outside and was eating a little - mostly treats. She was optimistic that Sailor would be able to come home on Monday. The vet tech also called that afternoon and said the first thing she heard when she opened the clinic door was Sailor's tail thumping against her crate. What good news!
On late Monday afternoon, we arrived at the clinic to take our puppy home. She was able to walk, though very unsteadily, and was so happy to see us. The tech went over all of the medications that Sailor would need and suggested a spreadsheet like the one they used. Sailor was on three different antibiotics (in case the meningitis was possibly bacterial), steroids, pain pills, and two anti-inflammatory (one which was a slurry administered with a syringe). This was a total of 16 pills/meds per day, and I definitely needed that spreadsheet. Pill time (twice a day) was an ordeal, but I didn't care as long as Sailor was with us and getting better. Sailor had weighed in at 49 lbs. before her surgery, but she must have lost 10 pounds or more over the previous two weeks - the term "skin and bones" described her perfectly. One of the side effects of steroids is increased appetite and thirst. We were giving Sailor as much water as she wanted, which was a lot. The end result was that she had several "accidents" because we did not take her out often enough. The vet told us she could get by on lots less water, so we started restricting that, which solved that problem. The second problem was food. Evidently, she had some problems with her jaw and chewing. We elevated her food and water bowls because she did not want to bend her head down. She refused the puppy chow she had been eating (Purina One), so we began feeding her Beneful wet food, which she inhaled. She also was enamored of our cat's food, which was very small dry nuggets, but the vet said that would give her diarrhea, so we bought some Royal Canin very small nuggets which she was able to eat - expensive, but not considering our previous outlays. After two weeks on all the meds, she completed the antibiotic treatments, and we were able to discontinue the pain pills and slurry for her stomach. She is now down to 6 total pills per day - 2 steroids and 1 anti-inflammatory twice a day.
Progress is agonizingly slow, but there is progress. If Sailor trots when she walks (usually early morning) that is cause for celebration. Pre-SRMA, Sailor would run circles around me at top speed when I would let her off leash or run laps around the ottoman in our den when we returned from our morning walk. Sailor doesn't run anymore. But, when she sees her friends (she's more fond of people than other dogs), she can move pretty quickly to get some loving pats. When she goes to the vet's for check-ups, she will try to dash up the steps, only to stumble and fall, but she gets right back up to see everyone and to bark at the receptionist until she gets multiple treats. That's progress, as she did not bark at all for two weeks after her ordeal. My heart skips a beat every time she stumbles (especially when the terrain is uneven or thick) but she recovers. She was a great ball catcher, retriever, never tiring of the game, but now she will mouth the ball and occasionally slowly go after one slowly rolled away from her. It is wonderful if she shows interest in her squeaky toys. She is now back on her regular puppy chow, no longer has to have her food bowls elevated, and is back up to 45 lbs. She is a long way from the dog she once was, but we are hopeful of a full recovery. Something that has never changed is her sweetness and her intelligence.
I have done so many searches on the internet for SRMA, and while I find a good bit of information about the disease itself, there isn't much about what happens from the diagnosis to the recovery except to say that each dog's journey is different. My purpose in writing this blog is to take you along on Sailor's journey - the ups and downs - to, hopefully, complete remission. Sailor just went back to her groomer after 3 months, and she noted that Sailor definitely has some stability issues. We are about to begin stepping down the steroid dosage from 80 mg. per day to 60 mg. If there are no adverse effects, we may decrease the dosage in another month. This may go on for 10-20 months - we just don't know. While the literature says this is a well-documented disease, not one of the three vets in the practice we use (which has a combined history of 55 years of practice) had ever seen a case of this - Sailor was the first. Thankfully, the neurologist who diagnosed Sailor, and by doing so saved her life, did his doctorate on this disease. Of course, now our three vets have become well versed in the symptoms and treatment of SRMA. We don't know (nor probably ever will know) what caused this to happen. Was it the extensive surgery? the plastic collar? environment? immune system? a cruel twist of nature? But, the fact is that it did happen and now we will deal with it and are grateful for the treatment she has received from the vets who love her.
Next week, Sailor will accompany us on a week-long sailing trip. She is a boat dog and is aptly named. She will love the undivided attention she receives on the boat, but we will see if the motion on the water will affect her progress. Stay tuned for future updates on her progress. If you have a dog who is experiencing SRMA, you have my sympathy, and I 'll be more than happy to share any knowledge I have about dealing with it. As far as the disease itself, your veterinarian is your best resource.
By Monday Sailor was some better - would eat some canned food and her pain didn't seem as severe, but she still would not put her head down and some neck positions brought the yelp back. After talking with the vet, we decided to continue her on the meds and give her a few more days. Our daily walks, which usually consisted of long brisk mile and a half treks, became short 1/4 mile strolls, with Sailor occasionally stumbling. That was odd, I thought. Coming back home on Wednesday, Sailor suddenly veered sideways, and I had to hold her up by her halter (we had ditched the collar) and help her back in the house. By Wednesday night her condition had deteriorated. When I took her out to relieve herself, she was in obvious pain, but she made it out and back inside. Taking off the halter sent her over the edge - she cried out and began shaking and turning in circles. I held her and comforted her the best I could, but it was obvious she was a very sick puppy. I stayed up with her and lay down next to her on the floor with her head resting on her dog bed. She slept some, but it was a long night marked with several bouts of pain and restlessness.
In the morning, we tried to get her up to go outside, and she could not stand - she was literally trying to crawl to go outside to relieve herself, but couldn't make it and urinated on the rug. We took her immediately to the vet - where the vet tech helped us carry her inside. She could not walk or stand. The vet who had performed her surgery was there. He gave her some type of shot to counteract the anti-inflammatory and then gave her a steroid. She had no fever, but obviously there was some kind of spinal problem. X-rays from the previous vet visit showed no disc problems. He wanted to keep Sailor there, and we agreed. Late that afternoon he called and said he didn't know what was causing Sailor's symptoms, but that she was seriously ill and deteriorating. He had called a veterinarian neurologist for a consult, but had not heard back from him. The prognosis was not good, and we really felt we were going to lose our beloved Sailor. Our vet wasn't too hopeful, and we spent a very gloomy evening visualizing our lives without our sweet puppy.
At around 7:30 I received another call from our vet. He had spoken with the neurologist who had, upon hearing Sailor's symptoms and condition, immediately diagnosed her with SRMA. Our vet had made the right call in administering steroids, and we now had some hope that Sailor might survive, though her condition remained critical. The next morning we paid her a visit. She lay on her side with an IV of fluids and meds, and was not very responsive though we did get a slight tail wag. On Saturday morning we once again went to see her and her condition remained the same. On Saturday afternoon, the vet tech who was tending to her when the clinic was closed called and said Sailor had attempted to get up and she had been able to take her out with support to relieve herself. At last, a positive reaction to the steroid treatment. On Sunday morning, a third vet in the practice who had come in to check her, called and said she was able to stand with help and go outside and was eating a little - mostly treats. She was optimistic that Sailor would be able to come home on Monday. The vet tech also called that afternoon and said the first thing she heard when she opened the clinic door was Sailor's tail thumping against her crate. What good news!
On late Monday afternoon, we arrived at the clinic to take our puppy home. She was able to walk, though very unsteadily, and was so happy to see us. The tech went over all of the medications that Sailor would need and suggested a spreadsheet like the one they used. Sailor was on three different antibiotics (in case the meningitis was possibly bacterial), steroids, pain pills, and two anti-inflammatory (one which was a slurry administered with a syringe). This was a total of 16 pills/meds per day, and I definitely needed that spreadsheet. Pill time (twice a day) was an ordeal, but I didn't care as long as Sailor was with us and getting better. Sailor had weighed in at 49 lbs. before her surgery, but she must have lost 10 pounds or more over the previous two weeks - the term "skin and bones" described her perfectly. One of the side effects of steroids is increased appetite and thirst. We were giving Sailor as much water as she wanted, which was a lot. The end result was that she had several "accidents" because we did not take her out often enough. The vet told us she could get by on lots less water, so we started restricting that, which solved that problem. The second problem was food. Evidently, she had some problems with her jaw and chewing. We elevated her food and water bowls because she did not want to bend her head down. She refused the puppy chow she had been eating (Purina One), so we began feeding her Beneful wet food, which she inhaled. She also was enamored of our cat's food, which was very small dry nuggets, but the vet said that would give her diarrhea, so we bought some Royal Canin very small nuggets which she was able to eat - expensive, but not considering our previous outlays. After two weeks on all the meds, she completed the antibiotic treatments, and we were able to discontinue the pain pills and slurry for her stomach. She is now down to 6 total pills per day - 2 steroids and 1 anti-inflammatory twice a day.
Progress is agonizingly slow, but there is progress. If Sailor trots when she walks (usually early morning) that is cause for celebration. Pre-SRMA, Sailor would run circles around me at top speed when I would let her off leash or run laps around the ottoman in our den when we returned from our morning walk. Sailor doesn't run anymore. But, when she sees her friends (she's more fond of people than other dogs), she can move pretty quickly to get some loving pats. When she goes to the vet's for check-ups, she will try to dash up the steps, only to stumble and fall, but she gets right back up to see everyone and to bark at the receptionist until she gets multiple treats. That's progress, as she did not bark at all for two weeks after her ordeal. My heart skips a beat every time she stumbles (especially when the terrain is uneven or thick) but she recovers. She was a great ball catcher, retriever, never tiring of the game, but now she will mouth the ball and occasionally slowly go after one slowly rolled away from her. It is wonderful if she shows interest in her squeaky toys. She is now back on her regular puppy chow, no longer has to have her food bowls elevated, and is back up to 45 lbs. She is a long way from the dog she once was, but we are hopeful of a full recovery. Something that has never changed is her sweetness and her intelligence.
I have done so many searches on the internet for SRMA, and while I find a good bit of information about the disease itself, there isn't much about what happens from the diagnosis to the recovery except to say that each dog's journey is different. My purpose in writing this blog is to take you along on Sailor's journey - the ups and downs - to, hopefully, complete remission. Sailor just went back to her groomer after 3 months, and she noted that Sailor definitely has some stability issues. We are about to begin stepping down the steroid dosage from 80 mg. per day to 60 mg. If there are no adverse effects, we may decrease the dosage in another month. This may go on for 10-20 months - we just don't know. While the literature says this is a well-documented disease, not one of the three vets in the practice we use (which has a combined history of 55 years of practice) had ever seen a case of this - Sailor was the first. Thankfully, the neurologist who diagnosed Sailor, and by doing so saved her life, did his doctorate on this disease. Of course, now our three vets have become well versed in the symptoms and treatment of SRMA. We don't know (nor probably ever will know) what caused this to happen. Was it the extensive surgery? the plastic collar? environment? immune system? a cruel twist of nature? But, the fact is that it did happen and now we will deal with it and are grateful for the treatment she has received from the vets who love her.
Next week, Sailor will accompany us on a week-long sailing trip. She is a boat dog and is aptly named. She will love the undivided attention she receives on the boat, but we will see if the motion on the water will affect her progress. Stay tuned for future updates on her progress. If you have a dog who is experiencing SRMA, you have my sympathy, and I 'll be more than happy to share any knowledge I have about dealing with it. As far as the disease itself, your veterinarian is your best resource.
