Neurologist Dr. Parent also believes Ruby-Sue has a life-threatening intracellular parasite infection called neosporosis, which attacks her central nervous system. Monday, November 7th – Ruby-Sue had her big appointment with top nerologist, Dr. Joane Parent of the Faculté de Médecine Vétérinaire in Saint-Hyacinthe. We arrived at the clinic for our 1:30 appointment at 1:35, and finished our appointment at 6pm. Ruby-Sue had 3 Veterinarians on board for her appointment, Dr. Parent leading the team. A thorough neurological exam was done of Ruby-Sue, her x-rays taken perviously were looked over by radiologists on-site and a parasitologist was called-up for his two-cents. Ruby-Sue had a blast, she soaks up any attention she can get and returns it with relentless kisses – which she sure did. The team loved her, because she is so darn love-a-bul, and she was a star patient. As previously diagnosed by Dr. Altschuler (also the MTL-Dog-Blogger, ask-a-vet), Eleven Eleven’s trusted veterinarian – Dr. Parent and her team also believe Ruby-Sue has an infection called Neosporosis. A ‘rare’ infection according to Dr. Parent, that she has only seen 3 other cases of in her life. The infection is caused by an intra-cellular protozoan parasite called Neospora caninum, most commonly caught from eating uncooked infected tissue (meat), or given to pups through the mother’s placenta. Dogs can be infected without being symptomatic, in this case because Ruby-Sue is symptomatic she probably caught it from her asymptomatic mother transplacentally. The infection is causing continuous spasms in the muscles of her legs, which has caused her knees to invert. The neurological effects, clinically seen in her muscle spasms, are most-likely caused by damage done by the infection to the tissue of central nervous system. With her fast-growing body her tendons are remaining short due to the knee inversion, which even further reduces her ability to bend her knees. On the bright side – The radiologist saw no defects in her bones or in the configuration of her spine, knees, hips, and legs. We were concerned about cervical weakness, but the radiologist according to the x-rays ruled that out, one less thing to worry about. With effective antibiotic treatment for the parasite, hydrotherapy, massage therapy and regular stretching exercises (maybe some yoga) to lengthen her tendons, she has a chance to one day re-gain full use of her legs. Also – thanks to Dr. Altschuler’s quick diagnosis based on clinical signs of the infection, we had already stated Ruby-Sue on the nessicary antibitotics for the infection weeks ago which gives us that much more of an advantage. On the down side – Diagnostics alone will cost us a small fortune or about the same price as a decently used car, which we just don’t have. Because the infection is so rare, there is not much known, like what is the most effective treatment plan and how curable the infection really is. There is a chance even with treatment, the parasite could continue to infect her other limbs, lungs, heart, liver or brain, and ultimately kill her. On top of the fact it is a rarely diagnosed infection, it is even more-rarely actually treated as most owners opt to just euthanize and get another puppy instead. Anyone who has met Ruby-Sue or seen her videos, would agree, she is bursting at the seems with life and love. She has too much life, and most importantly – fight, in her for us to prematurely end to it. The estimate given to us by Dr. Parent for diagnostics, is around 1, 400$ on the low end. For treatment which will require months of specially order antibiotics, it could put us well over 2, 000$. The 1, 400$ estimate includes; an EMG, MRI, and Cerebrospinal fluid (CSF) collection plus analysis for infected cells to confirm diagnosis. Our plan of action; - First step (already done) – We sent out a blood test to measure her Creatine Kinase blood levels. CK levels in the blood rise when muscle or heart cells are injured, and will give us an idea of her level of muscle damage. - Second step – If those levels come back elevated, which we are expecting, we will move forward with an electromyogram (EMG) of her muscles to measure the level of activity and gather further information on her muscle damage. This test will also let us know if her front limbs are effected, but not yet showing clincal sings. Ruby-Sue will need an MRI to take a closer look at potential spine damage or lesions caused by the infection. The MRI and EMG require anaesthesia, to avoid risks associated with repeat anaesthesia we would like to do both at once, which would be around 600$ +. From there, depending on our available funds and the results of the tests, we will have to make a tough decision to pursue or humanely euthanize. - Third step – If we have the available funds to pursue with Ruby-Sue’s needs, we would need to do a Cerebrospinal fluid (CSF) collection and analysis for infected cells to