Charleston offers your pets the best from the veterinary and human medical fields
“Why didn’t you become a real doctor?” This is often the first follow up question I hear after I tell people I am a veterinary neurosurgeon. While many people do not realize what they are suggesting with that statement, I think there is a general feeling among much of the public that we are NOT “real doctors”, or RD’s as we like to call them. Surprisingly, when I interact with an “RD”, they are always so interested to learn about what we do as veterinarians and I very rarely see an air of superiority from them. This interest has allowed much collaboration in research and clinical cases between the human medical and veterinary medical fields.
Fortunately, the local medical professionals are more than happy to discuss cases with us. Tam Tam is an 11 year old, Siamese cat. I saw Tam Tam in October 2012 for a sudden inability to use any of his limbs. A similar episode had occurred 8 months prior but resolved on its own. Examination of Tam Tam demonstrated a problem affecting his cervical spinal cord (in his neck). In order to determine the cause an MRI was performed and demonstrated a fibrocartilaginous embolism (FCE; essentially a spinal cord stroke).
No underlying cause was found for the FCE and Tam Tam made a good recovery and was able to walk again within a few weeks. At that time, however, he developed some unusual movements while he slept. Tam’s owner told me there was some “twitching”, but I was surprised to see how dramatic the episodes were, sometimes even falling off of the bed, when I saw the video.
Here is a link to the video on my Facebook page: https://www.facebook.com/photo.php?v=464074526996531&set=vb.100001819627696&type=2&theater
Further description of the episodes by Tam Tam’s owner suggested this was NOT a seizure. If his owner would wake him up as the milder movements started, the more severe movements would be prevented and then he would fall back asleep and they would start again. This would be consistent with a group of conditions known as abnormal sleep movements. Movement disorders are uncommon in veterinary neurology, and I personally had never seen a case such as this one. Fortunately, I have had the pleasure of interacting with the epilepsy department at MUSC in Charleston. We have enjoyed discussing the similarities and differences between our patients, the conditions we treat, and how we diagnose them. They invited me to be a guest speaker at their lunch-time rounds so they could see what a day in the life of a veterinary neurologist is like and there was a huge turnout. This relationship has also allowed me access to a great resource for unusual cases such as this, and I have been helped tremendously by their insight and comparison to human conditions. I sent this video to the department members and their suggestion was to consider a condition called REM Sleep Behavior Disorder. While people and animals are in REM sleep there are centers within the brain that inhibit the movements elicited from brain activity that occurs while dreaming. It is suspected that the pathway of these inhibitory signals was injured in the spinal cord from the stroke, resulting in uninhibited movements while Tam Tam was sleeping. We are currently trying to treat Tam Tam’s sleep movements with Melatonin, and we may also consider Clonazepam. The pets in Charleston are very fortunate to have so many great veterinarians available to help care for them. They are also fortunate that the medical professionals in the area are so interested in helping us as colleagues to help care for your pets as well.