MRI-Confirmed Hydrocephalus Diagnosis in Red fox kit | Reviewing Apple’s MRI findings w/ Dr. Scanlon

Added: 2026-06-01

[00:00:00]The video you guys are about to watch might arguably be the most significant, historically significant and educational video I have ever posted on our channels to date. And it's about this little feisty baby back there that you can see eating Apple the red fox kid who has hydrophilis. She actually just received her official diagnosis which is amazing and historical in itself. This is our third positive hydrophilis diagnosis via MRI in a live red pox. Hi, Apple. No.

[00:00:33]Huh? It's only made possible because of you guys. This is the only way that we can chase these deeper answers. I'm pretty confident there's also no video out there that exists that's going to be just like this one. So, buckle up. It's a long one. You're going to learn a lot.

[00:00:46]I tried my best to think of questions to ask that I know you guys, the majority of you will probably be wondering or you would want to know how it works. Even if you aren't invested personally in Apple the fox's case like our Arctic Fox s family is, if you just want to know more about what hydrophilis is and how it could possibly affect an animal, this is an excellent video to watch. I figured instead of trying to summarize something with a topic that I am not an expert on, I'm going to let Dr. Scandlin herself take it away. This is the vet, the neurosurgeon that we are working with and who is handling Apple's case. She's amazing. She's very kind. And as you can see, this video is over 15 minutes long.

[00:01:25]I actually cropped out probably a solid 10 minutes of filler stuff. So, a big thank you to Dr. Scanland. She's a very busy woman, and she took the time to make sure that we were able to get all the answers we wanted and needed when we went over this imaging for baby apple.

[00:01:40]Touch.

[00:01:42]Oh, hi.

[00:01:46]Oh, yeah. Are you a warrior now with all your crazy shape spots? Oh, she's a crazy girl. Ow. Ow. Why? Come on. We talk about this behavior in this video.

[00:01:55]Actually, enjoy. Guys, >> here back at the vets's office. We are just waiting to see Dr. Scan to go over Apple's MRI results. This is very big moment. A little bit nervous, not going to lie. Excited to go over these.

[00:02:09]My mom and my daughter are with me, by the way.

[00:02:13]They make a little road trip. Apple. And so essentially this gray is her brain tissue here.

[00:02:22]>> All of this all of this in here is fluid.

[00:02:26]>> Wow.

[00:02:27]>> And looking at it from the side view here, all this fluid in the middle of the brain, this is the midline. So you can see this is where we attach. So I'm seeing the middle attachment here of the brain. The brain stem is all there. It's all intact. The cerebellum is quite squished. So, it should be a perfect kind of round ball here, but you can see it's more of like a box. But when I go from side to side, you can see the brain essentially detaches from the skull wall here.

[00:02:54]>> It does. Okay.

[00:02:55]>> Mhm. And it's kind of more so just attached at the top and the bottom. The sides have zero attachment to the skull, which is why I brought up Sunshine cuz Sunshine was similar.

[00:03:05]>> Yeah, Sunshine was detached. Now, is that what it hees?

[00:03:09]>> That's what Sunshine did. Here's that blood clot from Sunshine.

[00:03:12]>> Okay. She doesn't have one of those that I saw. Um, so I don't think that hers was quite as abrupt of a detachment from the wall. I think that's why Sunshine had such a rapid decline.

[00:03:23]>> Gotcha.

[00:03:24]>> What's kind of interesting, this is called a flare image.

[00:03:29]On a flare image, it tells spinal fluid basically to be quiet or void. So this it should be as close to water as possible. No cells, no protein. This is normal spinal fluid because it's nice and black. Mhm.

[00:03:40]>> All of this on the outside must have a bunch of protein and cells in it for it to not be black.

[00:03:46]>> Really? Oh, wow.

[00:03:47]>> So, it makes me wonder if there's a bunch of protein, inflammatory cells.

[00:03:51]This is all angry fluid out here despite, you know, the normal looking fluid here.

[00:03:55]>> I didn't know that like color was even a thing with it. That's interesting.

[00:03:58]>> Sunshine voids a little better on the outside, but this still isn't like usually it's black like this when it's straight spinal fluid. So his didn't void perfectly but a little bit better on the outside than than apple. Anything to take away from that other than kind of g whiz >> situation.

[00:04:16]>> So usually I mean that just wouldn't be there because any cerebral spinal fluid would just be draining and it'd be new stuff going in ess. So this is just kind of the old stuff sitting there that's holding.

[00:04:25]>> Uh it's also probably new. So because it kind of resorbs and creates and resorbs and and creates. So it's either not draining or it's not absorbing appropriately. And if it's not draining, then the question is, is there inflammation clogging its flow somewhere? Is there infection? Which I thought it was kind of interesting here as well. Brain tissue itself doesn't have a whole lot of inflammation. So, it almost doesn't look like there's a profound encphylitis or inflammation of the brain tissue, but we might have this ring of menitis here.

[00:04:56]>> And so, what what do you what do you do with that information?

[00:04:59]>> Well, the thought would be is it >> infectious which So without knowing what the infection is, which we did toxopplasma testing on one or two of these guys already, which toxo is what we'd be treating with clintomy, >> betrol, I would have no idea. That's just a broadspectrum antibiotic treating some bacteria, >> which there's a lot of there's a lot of controversy about using it in red foxes actually, especially young ones. Yeah.

[00:05:21]>> Which sucks because like it's so such a nice >> It's a very broad spectrum antibiotic.

[00:05:25]Yes. Um I was thinking more along the side of dogs and we treat dogs with all the time, but yeah, I can say I've never treated I know >> and I have in the past and haven't seen anything but it's like who knows if the long-term effects that people talk about you know I don't I can't attest to that.

[00:05:41]>> Um Clavamox would be the other broadspectrum antibiotic which I didn't spinal tap apple because I thought it wasn't safe.

[00:05:49]>> Okay. So >> I wasn't I was going to ask you if we ended up doing that or not with her.

[00:05:52]>> No, I didn't think it was safe and I didn't want her to decline immediately after anesthesia. Um now that brings me to my discussion of shunting which >> yes the people are going to ask those gonna be one of my questions is so let's talk about you know really surgery in general it sounds like shunting would be our option that if we were to do surgery that is the direction we'd probably go but why is she right now not a candidate I'm sure people are going to ask >> yeah so with all of this fluid here this brain tissue is essentially just floating in the middle of this globe so in veterary medicine in general not just this scenario More often than not, we are using fixed flow shunts, which means it flows a very specific amount of fluid. We usually use low rate um shunts so that a minimal amount of fluid is shunted at a time.

[00:06:38]>> However, this will always be at risk for overshunting. So, if I pull too much of this fluid out of here, that brain tissue collapses and >> we don't have a great way to control that. a little uh shunt comes in. It lives in this ventricle here. It comes out of the tube out of the skull. It runs under their skin of their neck all the way down their chest into their abdomen. But usually most of those cases still have tissue attached to the cranium. Are there ever cases I guess even and this is kind of theoretical even with humans like where there is a detached brain from the skull that you can still do surgery on in this like is there anything you can do for the detachment? basically >> I don't know the answer to that. I don't think that it >> so if they were to improve significantly with a slight detachment I think eventually it can kind of like refuse and and the brain tissue actually can reexpand once we remove some of that compression because this assumption here is that it's high pressure and squishing the brain tissue.

[00:07:34]>> Um but you know I think that this is a very severe scenario. I I think it would be a little difficult for me to convince um my surgeon friend that does a lot of these to >> to experimentally do it in this severe of a case. I don't know if he would >> appreciate that it's ethically a good idea because it's so high risk and potential poor outcome. I'm happy to run the case by him and send it to him and see what he thinks. Actually, on that exact note, so the next question would be if she is this severe and if she's stayed aside from the last 24 hours, like pretty static, pretty stable for the most part, when do you reach the point where it's like, oh, she's really severe and the only option that probably would fix it is getting rid of some of that food with surgery and she might die from surgery essentially. Or it's not like they have the mentation of like sunshine where it was like yeah, that's not a quality of life. like if she stays funky, is there ever a point you reach where it is kind of worth the risk between the two options or is her age like a huge factor as well as far she's just so young and so severe, >> right? That's still a huge factor for me cuz last time I spoke to um my colleague out in Connecticut, we talked about 3 to four months being the ideal time frame >> and that's >> using more so like dogs and cats. You know, I think that foxes don't get much bigger, right, than like a medium-sized dog.

[00:08:55]>> Yeah. Like 10 pounds is like a solid sized fox. Yeah.

[00:08:58]>> So, I think we the idea being 3 to four months, hopefully there isn't massive amount of growth where they're pulling out the implant. So, the age plays a huge part >> for sure. Um, if this is also there's concern if there's infection, in no um, scenario is it in good conscience to place it if there's infection because you're just going to spread that infection through the shunt because there's never a scenario where they are worsening neurologically that we're like emergently we should do a shunt. That is not a scenario. It has to be they they need to be relatively stable to be put through that surgery.

[00:09:29]>> And I guess that's where I and it's kind of like a gray area. Huh, there's so much gray on the screen. um where it's like they probably need the surgery and they probably will decline long term without it. But then that sweet spot of >> kind of like are you good to make it through surgery is kind of okay.

[00:09:45]>> Interesting. Now with the infection part too if we can't find the cause like how we ran that infectious panel and nothing showed up positive but it looked like there was an infection is it worth kind of throwing antibiotics even though you don't usually want to do that unless you know what's the cause?

[00:10:00]What's your opinion on that? I don't have strong feelings on that because I certainly treat things prophylactically with antibiotics in families that are like, "Oh, we can't do the infectious testing or it's too small and we can't get enough blood to."

[00:10:11]>> So, we we do that. I don't have strong feelings against doing that. I think the challenge here becomes if we add in the acettoolamide 2 and she starts improving, then I'm going to be questioning why.

[00:10:21]>> Is she improving because of the antibiotics or is she improving because we added another diuretic?

[00:10:25]>> Okay. Yeah, that makes sense. When I treat a bacterial menitis, I treat them for anywhere from three to six months.

[00:10:32]>> Oh, really? Okay. Okay. I was going to say like if it's going to take a week and a half or to two weeks for the whatever the >> acetto acettoine. So, I like that word.

[00:10:41]Um, is it worth like if it was going to be a 10day or two week dose of antibiotics sort of thing? Like do we do that first? But that makes sense then if you're going to if we do it long term.

[00:10:49]>> Yeah. And we tapped who did we tap?

[00:10:52]>> We tapped Sharpie.

[00:10:55]>> Bring up Sharpie again. We did everything on Sharpie.

[00:10:58]>> We did Sharpie got it all. I really >> He had a PCR that was negative. He did have a mildly inflammatory spinal tap, but we did the PCR which was negative.

[00:11:08]We must have done toxo testing on peanut. Is it peanut?

[00:11:13]>> Yeah, we did. Cuz I I wanted to get into the hang of just doing toxo on everybody if we can get the blood. That's always the issue is they're so tiny.

[00:11:20]>> Yeah, so tiny. And probably Miss Apple would have to be sedated again, I think, to get >> I was going to say she zonked enough to get blood out, you think, or?

[00:11:29]>> Uh, no. Actually, we ended up pulling her catheter because she was squirreling on us. Um, so we pulled her catheter actually put her back in the carrier because she was losing her mind.

[00:11:38]>> Yeah. Yeah.

[00:11:39]>> Um, she will need blood work in a couple weeks on the acettoolamide. They could probably do both at her size now.

[00:11:45]>> Okay, cool. And just to check, you said kidneys, like look at kidneys and everything with it. Okay. kidney and the CBC. Make sure the white blood cells, platelets, all those are okay. I did that stuff today. Nothing to really write home about.

[00:11:59]>> Um, kidney values look fine in my opinion. She's still mildly anemic. Her um, where are you? Hematocrit is 33. It was 35 two months ago. That to me is a negligible difference.

[00:12:10]>> Okay.

[00:12:10]>> Um, but nothing really to write home about. I was most concerned about kidney values, which were were here. Um, let's see. Her creatine is.5. Great. B's 21.

[00:12:21]Perfect. I >> have an apple.

[00:12:22]>> You have an apple.

[00:12:24]>> So, with her circling that she's been doing the last couple days, she's been circling right. What part of the brain is affected that would cause that?

[00:12:31]>> Yeah. She circles. She has right four brain signs. So, she circles predominantly to the right side, which means the left side or the left world no longer exists in an appropriate fashion.

[00:12:41]So, they tend to circle towards the problem because it controls the opposite side of the world because that's the only thing that exists. Now, >> do you ever see that reverse >> if they improve with symptoms?

[00:12:51]Absolutely. Yeah.

[00:12:52]>> Okay, cool. So, that's not like, oh, once you've seen that decline, it's it's not going to get any better. Like, it could only get worse. I mean, theoretically, I know that could happen, but that's good to hear then that maybe >> if they improve with therapies, absolutely, it can get better. I would not be shocked if she permanently has four brain signs. And a lot of pets with hydrophilis do incessantly circle. They have worse on one side of their brain compared to the other. That's not that uncommon.

[00:13:18]>> Is there anything that we can do to help reverse that? Stop that. Like is there even a medication even like if they start spinning if they're really stressed? I don't know. Is there any thing you can ever prescribe to help that specifically or not?

[00:13:29]>> Just this I could sedate her. What's something like maybe that she just needs to calm down a little bit? She did that to us um today when she got really >> stressed with handling circles. We like had to let go of the leash >> front part of the brain is personality.

[00:13:41]Okay.

[00:13:42]>> So all of this is where her personality comes from. So all of this fluid affected area is forbrain. This is where personality comes from. The cerebellum's sole purpose in life is fine motor movement and balance. So your balance system um and fine motor movements come from the cerebellum. All of the cranial nerves um all of your facial sensation, your chewing muscles, your your uh facial expression muscles, your vestibular system, all of that. Although there's vestibular in the cerebellum as well, but a lot of those cranial nerves, they come from the brain stem.

[00:14:14]>> Wow.

[00:14:14]>> So the forebrain is very much personality and behavior.

[00:14:18]>> Okay. And that's also where the spinning the right forebrain. You said >> right.

[00:14:24]>> We can't see tight spinning with vestibular dysfunction. So the cerebellum usually they also have a head tilt and then a nestagmus or rapid eye movements.

[00:14:32]>> Yeah.

[00:14:32]>> So they usually like vertigo symptoms.

[00:14:34]So, oh, so that would actually kind of, am I understanding correctly that this would kind of rule rule out uh vestibular disease being the cause of the circling based on how this looks?

[00:14:46]Because I've had other foxes circle and you know, without an MRI, vets will just chalk it up to, oh yeah, she probably has vestibular disease. There's not really anything you can do. But is that not necessarily the case? If you're looking at her MRI and saying it's probably forbrain, >> I think based on her MRI, it's most likely forbrain. Her cerebellum is not normal. is squished, but her forebrain is so affected and she does kind of circle a little bit more wide at times and she doesn't have a head tilt, no nestagmus. So, I think it's forebrain.

[00:15:12]>> That's really interesting.

[00:15:13]>> She also has a little bit more of a lateral strabismas in the right eye. So, the right eye kind of tweaks a little bit more laterally. So, I think she's more affected on the right overall.

[00:15:21]>> And that's what you would also like sunset eyes is that okay.

[00:15:24]>> Um, and then which isn't that crazy how much better she looks than when she she was like half her eyes were white when she first came in.

[00:15:30]>> I noticed that. That's what I said this morning. I was like, "Oh, her right eye is still a little wonky there."

[00:15:34]>> So, looking at this, how much of the brain is damaged? I mean, you look at this and it's like, I mean, would you agree that's kind of crazy impressive that she's been doing as good as she is doing with what this looks like?

[00:15:44]>> Yeah, I don't know that I would um feel confident giving you a percentage of how much of the brain is infected, >> but like there's a hu it looks like there's a huge part of the brain that's >> very much so a large portion of the brain. And that is how like let's say she had was born with hydrophilis. This is what her brain looks like and there's no progression. and she doesn't have any worsening. She could live like this for the rest of her life, spinning, eating, all those things. We have hydrophalic dogs that don't have surgery, don't really need medicines. They just live like this because they were born this way.

[00:16:12]>> Um, you don't need a whole lot of brain tissue to function as an animal as long as you can eat and play and, you know, the circling is kind of cute, you know.

[00:16:21]So, but they can still function relatively well with very minimal brain tissue. It's actually impressive.

[00:16:27]>> I know. It's amazing. That's was talking to a human doctor the other day about that. It's like the >> the amount of our brain that we actually use is >> so small >> and we're not giving them IQ tests or anything. So it's different than people right because you would notice the learning disabilities and all the things all of the important life functions for like heart rate blood pressure all your cranial nerves swallowing eating those come from down here. So this part of the brain is still very much normal but this is all behavior personality.

[00:16:55]>> Okay.

[00:16:56]>> All right. Last thing I think I have to ask you would the fact I mean she's just a spicy young age anyway but it almost seems like she doesn't have bite control where when she wants to play bite the other day I was super impressed we actually she did play bite for a couple minutes and it didn't puncture me but would her kind of not knowing how to bite and not go full force come from that affected cerebellum right there?

[00:17:18]>> Yeah, I think they can have a reduced what's the word I'm looking for? like inhibition. Yeah.

[00:17:26]>> Um so even sometimes we scan animals because strictly they have had a behavior change. So they used to be really docile and now they're aggressive. That's a forebrain change.

[00:17:35]>> Okay. And her Okay. Cuz that would make sense then because forebrain I also say that these babies and apples obviously like this too. It's like they feel their feelings really big really fast but then they kind of get over it really quick too. So that again would make sense with the forebrain being the most effective.

[00:17:51]Right. Okay.

[00:17:52]>> Yeah. And your lyic system is your um emotional processing center which also lives kind of in the forebrain around the hippocampus. And so if all of those structures are squished and squeezed and not normal, you're not going to have the same um behavioral emotional control.

[00:18:08]>> Yeah. Thanks, Dr. Scan.