Lucy (shown here on a fun day last summer) had a really bad couple of days this past week. She started having seizures Tuesday afternoon at some point while we were at work, and had a total of about 15 more seizures over the next 18 hours. After seizures approximately every 90 minutes overnight and several doses of valium that didn’t help (and no sleep for anyone), we took her to see her best friend (her veterinarian) at Eastern Animal Hospital first thing Wednesday morning. She continued to have seizures even though they were giving her phenobarbital and valium intraveneously. This is the first time she has not responded to that level of medication. They finally gave her an anesthesia drug to get them to stop.
Our vet wanted us to take her to Dogs & Cats Veterinary Referral in Bowie, because they have a neurologist on staff. She suggested that they would probably want to do an MRI to see if anything was happening in her brain to cause the seizures. We already knew that she has had epilepsy for years, pre-dating any of her other issues. However, they wanted to look for a tumor in the pituitary gland. Apparently this is pretty common in dogs with Cushing’s disease, and if it got big enough, it could cause seizures independent of epilepsy. Treatment of a tumor would be surgery or possibly radiation.
So, we picked her up from Eastern on Wednesday evening. We had an uneventful ride to Bowie, although Lucy was really out of it and trying to climb over anything (this is very unusual for her – she usually curls up and settles in for a car ride).
She did fine overnight – no more seizures. The neurologist did suggest an MRI. Craig and I thought long and hard about it, and we know, frankly, that these seizures are just one aspect of Lucy’s “issues”. We decided that, even if there was a tumor, we would not be pursuing any treatment of it. Her quality of life is surely in jeopardy, and putting her through those treatments would be too much. Plus, if the tumor were removed, we would still have underlying epilepsy, chronic lung disease, thyroid problems, recurring UTIs, and Cushing’s. So, if we were looking for a tumor on the MRI, and we knew we wouldn’t do anything to treat it, we didn’t see a reason to do the test. I asked the doctor what they would do without an MRI, and he said that we would continue to treat the epilepsy, and obviously we would adjust her meds. I then talked with our vet and she was 100% supportive of our decision to forego the MRI. (The neurologist was very cool with it too – we were a bit afraid that he would insist on the MRI and treatment, but he was very reasonable and understanding, given the laundry list of medical issues Lucy faces on a daily basis.) Our goal is to now keep her happy and comfortable until this happens again. And it will almost definitely happen again – it could be next week, in a few months, or it could be in a year or two. When that happens, we will know that we need to help her to let go and find that rainbow bridge to a more peaceful place. We certainly know that Lucy is resilient, but she can’t handle much more of this. Our vet told me that they were quite certain that she would have died if they had not intervened and stopped the seizures.
We brought Lucy home Thursday evening and endured another sleepless night as she was still in the post-ictal phase of the seizures; her brain was not yet back to normal. She paced and circled and had to keep moving all night long. Slowly throughout the day on Friday she began to calm down, and by Saturday we could really see she was essentially back to normal. Her phenobarb dose has been increased, so we are seeing more drinking and peeing, but we knew to expect that.
We’re going to keep an eye on our sweet girl and make sure she’s happy for as long as we can, but this episode certainly let us know that we can’t let her go through this again. It’s just too much.