Leonardo’s Long, Scary Journey: From Diagnosis to Recovery

My nearly four-year-old Bernese mountain dog, Leonardo, has been coming to BluePearl since late July 2014 after having been evaluated by the orthopedic specialists at Ohio State Veterinary School regarding a hip replacement. Because of damage done to his hip and femur from a spider bite when he was six months old, it was determined that Leonardo will never be a candidate for any kind of hip surgery. In the beginning I was looking to increase Leonardo’s stamina, improve muscle tone, lose weight and make him as pain-free as possible. In a story posted to your site, I describe how difficult Leonardo had been and what a joy he was becoming. However, that was just the tip of the iceberg. Leonardo became the dog I have always wanted. With the expertise of Dr. Ruth Schmidtchen and her vet assistant, Danielle, and then April, Leonardo became a titled therapy dog for the young children at the local psychiatric hospital where he would visit weekly and do tricks for an hour; he became a tracking dog where he could walk nearly three miles in a practice session, he earned an obedience title and one leg toward a rally title. This was the dog I had always dreamed of owning…and then my world collapsed.

On the evening of December 3, 2015, Leonardo was perfectly fine at 6:00 PM. At 8:30 PM he was paralyzed in all four limbs. The next day, he was seen by my regular vet who did some preliminary tests and referred us to the other specialty veterinary center here in Louisville because they had a board-certified neurologist on staff who could see him that morning. The neurologist at the other veterinary center did see him…and misdiagnosed him with Wobblers. While I never was able to see her, I did speak with her by phone and I insisted her diagnosis could not be Wobblers for numerous reasons. I knew Leonardo’s pedigree inside and out, and there is not one dog or puppy produced on either his side or dam’s side that has Wobblers. There was no pain, and there were no symptoms leading up to the complete paralysis. This diagnosis was devastating to me because of the dog Leonardo had become. It would in all probability end everything we worked so hard to do as a team, and Leonardo is not a dog who is comfortable being a couch potato like my other two Berners.

The morning of December 5th, we had a water therapy session scheduled. So with a very heavy heart, it had been my intention for us to say goodbye to Dr. Schmidtchen and April and then later that day have my family vet give Leonardo wings. My neighbor helped me carry Leonardo in, and I could tell the entire reception staff was upset to see Leonardo in this condition, as they had gotten to know him and grown attached to him over the past 18 months. Dr. Ruth came out to the front where we were sitting with Leonardo on the floor.

Dr. Ruth did some preliminary testing in the waiting room, asked me an array of questions and then we brought him back to the rehab room for her to examine him further. She looked at me and said, “there is no way that Leonardo has Wobbler’s, he has had an FCE. I would have known, I would have seen the signs of Wobbler’s during all this time.” He CAN come back from this!” She very patiently explained what an FCE was; how it is called a stroke, that no one knows why it happens, it’s nothing I did, nothing Leonardo did, nothing genetic, and with rehab, he can make a full recovery. She asked if there had been X-rays taken at the other veterinary center, and when I said yes, I signed a form for the X-rays to be sent over so they could be sent off to a board-certified radiologist. After we all stopped crying, she asked if she could do an acupuncture treatment on him. She also asked if I would see Dr. Hodshon, the surgeon on staff whose sister-in-law is a neurologist at the University of Tennessee, that following Wednesday.

By the time we arrived on Wednesday, Leonardo had begun to make strides. He had acupuncture that day and was evaluated by Dr. Hodshon. After a lengthy physical exam, review of the records and discussion with me regarding him, she agreed with Dr. Schmidtchen’s diagnosis. She completely disagreed with the neurologist and recommended Leonardo do a fast withdrawal from the high dosage of prednisone he had been prescribed and doubled the doxycycline he was prescribed by the neurologist “because he was a tracking dog” without ever having done a tick panel. By that time, the X-rays came back and the radiologist diagnosed intervertebral disc disease (IVDD) which can be painful, and can require surgery and then rehab.
That afternoon following hours of being examined by various doctors, Leonardo and I returned home. He walked across the room on his own and ate his bowl of food that I had put on the floor, expecting to pick it up and take it to him and hand feed him. From that day on, I knew with Dr. Schmidtchen’s guidance my boy was going to be ok. I continued to bring Leonardo in for acupuncture and laser therapy through December, and on December 30th he got back into the treadmill. It may have only been seven minutes in the tank, but it was an AMAZING seven minutes!

Leonardo continued to improve, but I was posed with a dilemma; I had three diagnoses: wobbler’s, FCE, and IVDD, and all said that the only way to be completely certain was to have some kind of advanced imaging performed. While an MRI is available for four hours at a facility two hours away from me on Wednesdays, it is the neurologist who made the Wobbler’s diagnosis who would be performing the MRI. I needed to know if Leonardo had IVDD in addition to the FCE? I felt confident that the neurologist was completely wrong in her diagnosis, but there was that nagging “what if?” What if I go through all this rehab and get Leonardo back to where he can do the things he did before and he does have IVDD and he completely ruptures a disc requiring surgery and rehab all over again? He will be four at the beginning of May, and this breed’s average life span is only 6.8 years. I don’t have that kind of time. I needed to have an MRI done. I sought Dr. Schmidtchen’s opinion in the matter; was I being fatalist in believing I needed a complete answer, or would it be that Leonardo would never improve enough to be able to return to what he had been doing before and I needed to accept that his career as a therapy dog and versatility dog were over? Dr. Schmidtchen told me she expected Leonardo to make a COMPLETE recovery and absolutely understood why I would want to make sure that there wasn’t IVDD lurking in the background. So then question was “where?” I could return to Ohio State, where they had his records from the consultation regarding his hip, or to the University of Tennessee, where the other Dr. Hodshon was a Professor of Neurology, but more importantly had already been consulted by Dr. Becca Hodshon regarding Leonardo and so was familiar with his case.

The appointment for Leonardo to be seen at UT happened all at once. Dr. Schmidtchen was incredible with making sure that all of his records from BluePearl were faxed down to the Neurology Department at UT. She was excited we were going. Leonardo was seen at UT on January 13th, a full neuro evaluation was performed and then I was brought back in. Dr. Hodshon was positive, without a doubt, that Leonardo did not have Wobbler’s so that was checked off my list and finally put to rest. There was, however, a potential problem. Because of the length of time from when Leonardo went down and became completely paralyzed to then, it was very possible that the evidence of an FCE might not be visible even with an MRI. The best time to see an FCE with an MRI is 3-5 days following the episode, but because the neurologist in Louisville had misdiagnosed him and put him on doxycycline that had to be completed so his system was clear in the event they needed to do a spinal tap, I might have lost the window completely. What the MRI could do would be to tell if there was any IVDD. Then the question became did I still want to go through with it, and if so, what section(s) of his spine did I want to have done. I went through with it and, fortunately, the FCE was still very visible at C5-C6 and there was no sign of any intervertebral disc disease. That evening when I picked my boy up and we went over the results, I was told that there was no reason why he will not be able to make a complete recovery and return to doing all of the things he was doing prior to the FCE.

One might think that the story ends there, but it doesn’t. Leonardo has gone weekly for water therapy sessions, acupuncture treatment and laser treatment. At this point, if he was any other dog, he would be 98.5% recovered with just some additional work needed to build his strength. However, he isn’t just a regular dog so we have a long way to go. He has increased his time in the tank from seven minutes to 27.5 minutes, nearly the amount of time he had been at prior to his FCE, just at a slower speed. He has some areas of hypersensitivity that we are working on so that he can manage them in order to return to being a therapy dog. We are working on the other equipment in the department to build core strength so he can return to being a tracking dog and return to the obedience and rally rings.
With the help, knowledge and expertise of Dr. Schmidtchen and her staff, I was given the dog I had always dreamed of once. In December she literally saved his life and has given him back to me. The bond between him and me is closer than one can imagine.

The photo is of Leonardo and Dr. Ruth just before St. Patrick’s Day. She likes to see dogs in hats and Leonardo loves Dr. Ruth, so he was happy to oblige. He was wearing a bowler hat, shamrock sunglasses and a glittery bow tie in the waiting room.

Patricia Finley