4/14/23 – Please welcome Kassius! Kassius was turned over to us by his owner because she could no longer care for him. Apparently, he has had recurring infections over the last year, but the vet does not seem to know why, they would get better with treatment but then return. After reviewing his previous vet records, we believe he has a draining track from his tail pocket but no tail pocket infection. We have decided to try a more aggressive approach to clear up this infection.
5/2/23 – Kassius had surgery today and all went well. He was neutered, had his palate shortened, his tonsils removed, his nares widened, and his teeth cleaned. It appears that all of his infections are gone at the moment. We will monitor for the time being and go from there.
5/9/23 – Unfortunately, the infection is back. We are continuing treatment while we wait to see the specialist for tail amputation.
6/13/23 – Kassius saw the specialist today and we will be moving forward with tail amputation but first he needs to have a CT scan, so the vet knows the best way to approach his surgery. At this time, he has multiple draining tracks with infection.
6/16/23 – Kassius has tail amputation surgery today and all went well. The specialist said this was one of the most complex tail amputation surgeries he has done. Kassius will have a drain for a few days but gets to go back to his foster home for recovery.
7/1/23 – Kassius has a new issue now; his fur is coming off in clumps and he has open wounds. They are spreading quicker than we can keep up with but we are consulting with the dermatologist.
8/4/23 – Kassius saw the dermatologist today and went ahead and did a skin biopsy today. We are treating his infection topically and with oral medications until we have the biopsy results.
8/17/23 – The skin biopsy results were consistent with calcinosis cutis with secondary bacterial infection. We suspect that the calcinosis cutis is a result of long term steroid use to treat his infections. We will start tapering him off the steroids today and hope this resolves his issue. We are still treating with oral antibiotics to clear up the bacteria infection as well as medicated baths and topical medicated cream to treat the calcinosis cutis. We are hopeful he will make a full recovery and be feeling better in a few weeks. We have also started him on prescription allergy medication.
12/12/23 – Kassius saw the dermatologist today and other than a few remaining spots and a new ear infection, he is doing well! His skin will probably never be perfect but he is going to be ok!
3/1/24 – Kassius is doing great but he is still looking for his forever home!
9/1/24 – Kassius is doing great in his foster home but he is still searching for his perfect forever home! He would do great in a home with no kids.
11/6/24 – We noticed Kassius’s gate was a bit off recently, rear leg weakness and ataxia, so we started him on arthritis medication. That did not improve the situation so we had a consultation with the orthopedic specialist a few weeks ago while then turned into a consultation with the neurologist and we decided to move forward with an MRI to determine all what going on with him.
TREATMENT/RECOMMENDATIONS: The neurological examination revealed moderate rear limb ataxia, mild weakness moreso in the left pelvic limb, and delayed proprioception in the left pelvic limb. These signs were consistent with an issue in the mid back (T3-L3 spinal segment). We also know Kassius has concurrent diffuse osteoarthritis. Possible causes for the signs include IVDD (acute vs. chronic, compressive vs. non compressive) vs. mass/tumor vs. subarachnoid diverticulum (or other cystic spinal lesion) vs. inflammation (immune vs. infectious) vs. less likely trauma/ vascular event.
Routine labwork was unremarkable. Preliminary radiographs showed narrowing of the T12-L1 disc spaces, along with some congenital vertebral abnormalities. The MRI did not reveal an obvious mass or tumor, and did not reveal an acute disc herniation. The primary finding was a subarachnoid diverticulum noted from T8-T10. We also noted hyperintensity/ brightness within the spinal cord in this area, that we are concerned may be edema/ swelling or a syrinx (dilation of central canal). We also noted several degenerative discs throughout the thoracolumbar spine, but they did not appear to be causing significant compression of the spinal cord at this time. Kassius also had likely incidental, abnormalities in his lumbosacral spine including a degenerative LS disc space and multiple synovial cysts from L6-L7, left sided.
Subarachnoid diverticula (SAD), typically occur in the dorsal subarachnoid space (like this one) and the caudal thoracic spine is a common location in older, small breeds and brachycephalic (Pugs, English/French Bulldogs). This may be a congenital problem (ie something that Kassius was born with) or it could be acquired from a past spinal insult like a trauma, disc herniation or inflammation.
The treatment considerations for a subarachnoid diverticulum include:
- A conservative approach with medication (gabapentin, +/- cyclosporine trial, as steroids have not been well tolerated in the past) and rehabilitation/ PT, or
- A more aggressive approach with surgery with some uncertainty about outlook/ recovery, and associated surgical risks
For now, I recommend we start with a continued conservative approach with consistent rehab/PT, and medication trials with Cyclosporine and possible Omeprazole as outlined below. Some patients respond to therapy, some only to a degree, and some worsen despite treatment. My hope is that Kassius can be maintained with medications, rehab, but I also want him monitored closely for worsening (pain, dragging of the limbs, not being able to get up on his own, etc.).
3/27/25 – Unfortunately Kassius had to have knee surgery. This is a sperate issue from his neurological issues. The surgery went well! This poor fella cant seem to catch a break.
10/1/25 – Kassius is doing well now but he struggled for a while after surgery. He ended up getting an infection so his recovery took a bit longer then expected. He is doing well with his at home therapy and medications. He is enjoying playing with the young male dog in his foster home!
approximate age: 8 – DOB 9/12/17
approximate weight: 61
likes dogs: yes
likes cats: yes
likes kids: we have not seen him around kids regularly, but he is a bit strong so he will not be place in a home with small kids
food: Taste Of The Wild, Pacific Stream
lifelong medications: carprofen, cyclosporine pills, joint supplements, fish oil supplements, topicals to keep up with this calcinosis cutis
likes: food, soft squeaky toys
dislikes: wet grass, nail trims, when his humans are eating without him, and being told no
ideal home: he needs a home with no small kids and someone that will work on manners (he gets a little worked up and mouthy) and his at home therapy
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