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Idiopathic thrombocytopenia in dogs

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SuperWanda
October 12th, 2010, 10:51 AM
I have a 10 year old husky cross who was having some weakness in her back due to discospondylosis but her appetite was low so we took her for x-rays and blood work. The x-rays showed that her spine condition had progressed and her blood work showed a low platelet count. We were given metacam to help her back but two days later her nose started to bleed and so we rushed her to the emergency clinic. At that time her platelets were only 1 per oil field and they stared her on 50 mg prednisone alternating with 2.5ml sulcrate to prevent an ulcer. The next day her platelets were up to 3 per oil field (around 54 when put through the counter) we had a few more x-rays done and they were normal, a ultrasound which was normal -- no tumors in spleen, liver, no noticeable ulcers or bleeding. We tried a vincristine treatment to hopefully boost her platelet counts but that has not resulted in a higher count which remains steady at 2-3 per oil field. She was on no medication before this which apparently can trigger this condition and suspect it is immune mediated. Our vet is putting her case onto some North American e-mail to see if a specialist somewhere has any more suggestions with regards to medication. I was reading about this condition in humans and not sure if this is a shot in the dark but new research has shown that when Heliobacter pylori present in digestive tract is treated with antibiotics that some had a dramatic increase in platelets. Not sure if this would be something to try in dogs? I know they have different species of Heliobacter in their guts but thought it wouldn't hurt to try? Sounds like this is most often a immune mediated problem but can possibly result from pathogens like Heliobacter, blood parasites from ticks or possibly a virus however I think there is little information on what the cause may be.

Just wondering if anyone else has information about this condition -- I know that if her platelets drop further she is at risk for a catastrophic bleed.

Goldfields
October 12th, 2010, 06:27 PM
SuperWanda, this is one of the two conditions that afflicted a sheltie I bred and sold 7 years ago or more. Combined with immune- mediated hemolytic anaemia it's called Evan's syndrome, which is what Arie had. Very sick dog with a wonderful owner, it has cost him over $7,000 but they have finally nearly weaned her off all drugs. I'm sure if you Google it you'll find there are a lot of possible causes.

rainbow
October 15th, 2010, 02:58 PM
How is Timber doing? :fingerscr :goodvibes: :grouphug:

Did your vet find any more answers for you? I have sent a pm to Dr Lee with a link to your thread and he will add his expertise next time he logs on.

Dr Lee
October 16th, 2010, 12:34 AM
I am sorry to hear about everything that your pet has been going through. This is always so difficult and low platelets can be so scary.

I assume that we have suspended metacam use while on prednisone? Other pain medications like tramadol may be safer with concurrent use of prednisone, if we need pain medications.

Autoimmune disorders can lead to low platelets - ITP Immune Thrombocytopenia is not uncommon. Steroids or other immune suppressives like azothioprine are often used. Other tests like radiographs and ultrasounds are important to rule out other underlying diseases. Also blood tests if indicated may also be helpful to rule out diseases like Ehrlichia which can also lead to ITP. So far I have not heard that helicobacter is a causative agent for thrombocytopenia in dogs.

I would recommend regular platelet checks until we are 1) out of a danger zone and 2) are on an upward trend.

I hope that this helps.

SuperWanda
October 17th, 2010, 08:40 PM
Thank you Goldsfield, Rainbow and Dr. Lee for your concern!

Yes -- no more metacam. Her platelets were low and they gave her metacam for her back. She was only on it for two days and then the nose bleed happened. My vet thinks maybe her platelets were already low and the metacam just pushed it down further.

Basically we have had 2 abdominal and 2 chest x-rays. Both showed nothing. We went for an abdominal ultrasound and there were no tumors, bleeding or any ulcers that he could see. All looked good so we continue with the prednisone and have platelet smears (# per oil field) done almost every day with no noticeable change (2-3 per oil field). The vet put her case on an e-mail database and some internal medicine vet replied and he said to stay on prednisone that it can take 3-7 days and to get an actual platelet count because a smear is not as accurate so her count was 73, I think, on Friday 15th. Still low so we are to keep giving the prednisone and my vet recommends trying the Imuran or azothioprine, that you mentioned Dr. Lee. I am starting tomorrow but am a little worried about it and the side effects but hopefully all will be okay.

Ticks were addressed as well. Here in Manitoba we have Lyme and Anaplasmosis. Less than 5% of the deer ticks here test positive for Anaplasma phagocytophilum. !0-12% for Borrelia burgdorferi so very rare chance but that was ruled out.

Blood tests also showed her to be slightly anemic so hopefully she is not developing the hemolytic anemia as well?

I have no idea what has caused this but it sounds like it can be a multitude of things from viruses, bacteria, toxins, medication genetics etc. I guess we'll never know.

Right now she is at home and seems to be improving slowly but her blood tests don't show any significant change for the better.

Thank you for your posts! I am very worried and just hope that her counts rise and she will get through this. I know she is 10 years old but hope that her age does not prevent her from recovering!

rainbow
October 18th, 2010, 02:32 PM
Glad to hear the ultrasound showed no tumours, bleeding or ulcers. :thumbs up

Is Timber eating well? Ask your vet about giving her supplements to help her immune system.

I hope the pred and Imuran are able to bring her blood count back up soon. :fingerscr :goodvibes:

SuperWanda
October 19th, 2010, 09:51 AM
Thank you -- I am just confused about the Imuran. Basically I have two groups of vets with different opinions about using it for just the low platelets.

My regular vet and the vet that did the ultasound are recommending it. They have also asked other vet's opinions and they agree.

The emergency clinic where we took her is not recommending it. They said there is nothing in the literature that says you should use it for treating just the low platelets. They said they would e-mail the internal medicine vet and see what he thinks.

So, this is really confusing me and I don't know if I am doing the right thing now???:shrug:

Yes -- she is eating very well -- I think they said that the prednisone increases your appetite so no problem with that. I also have some vitamins called vi-sorbits which I am adding to the beef and chicken stews that I am cooking. She is back to eating the Orijen dog food as well.

SuperWanda
October 19th, 2010, 11:20 AM
Just thought I would mention something I just found out. Last week her platelet count was 54 but the machine was calibrated that 150 is normal so the second test her count was 73 but that was a different machine where 200 is normal so basically her platelet count is about the same if you look at the ratio.

Let's just make this a little more confusing :wall:

rainbow
October 19th, 2010, 12:49 PM
It is so frustrating when you get two different opinions about what you should do. :grouphug:

Did you ask the emerg vet if her prednisone dosage would be higher if she was not taking the Imuran? I have never had a dog that required steroids but it is my understanding that if Imuran is given then they can give lower doses of prednisone. :shrug:

Hopefully, Dr Lee will reply soon with his opinion. :fingerscr

Glad her appetite is good :goodvibes: and sending you lots of :pray: :fingerscr :goodvibes: as well. :grouphug:

SuperWanda
October 20th, 2010, 02:04 PM
Yes -- I guess if the Imuran works they can start slowly lowering the Prednisone. Right now she drinks so much (no accidents yet) and pants from the prednisone. She is also lethargic -- not sure if that is a symptom of her illness or the prednisone?

I worry when I have to take any kind of minor drug myself so having to give her this stuff really makes me nervous. Because the Imuran is such a strong immunosuppressive, they recommend not even touching it with your bare hands and here I am giving this to her and hoping for the best. :eek:

Thanks for all your well wishes!

rainbow
October 22nd, 2010, 12:09 AM
How is Timber doing? :fingerscr

SuperWanda
October 25th, 2010, 08:36 PM
Have been on the Imuran now for 7 days and just got the blood results back. Unfortunately it wasn't great news. Her platelets were down to 66, red cells down a little more (4.82) and white blood cells now up from 6 to 17.2.

My regular vet is trying to contact our only internal medicine vet in the city who is on holidays so is trying another vet to see what he thinks.

All I know is when the white cell count is going up that has me concerned. And why is it just starting to go up now?

She had a little fresh blood in her stool today so I just picked up some antibiotics and zantac. My regular vet is concerned about the high level of prednisone if it is not an immune mediated problem.

I'm worried about a bone marrow cancer but this is all speculation from what I have been reading online.

Otherwise -- she still doesn't seem to be any worse -- still lethargic but eating well and drinking excessively due to the prednisone more than anything. I guess we'll just take this one day at a time.

Thanks for asking about her! I was really feeling positive about today so the results have left me feeling anxious again. Remind myself to just take it one day at a time.

rainbow
October 25th, 2010, 11:28 PM
I am so sorry to hear that Timber's blood count has not improved. :grouphug:

I'll be keeping you in my thoughts and prayers and hope that the vets can find some answers for you soon. :pray: :fingerscr :goodvibes:

SuperWanda
October 26th, 2010, 12:31 PM
Thank you. I was really hoping for some improvement.

I also hope it isn't the anemia problem (IMHA) that sometimes goes with the ITP.

Gosh, I followed the story posted by SwaysBodyguard a few years back that I'm sure you remember as well. Sway had IMHA and that was so difficult and heartbreaking. I have been reading about these diseases and it's just more than I can handle right now.

I am also sleep deprived so that doesn't help. Feeling very discouraged with the unknown :(

rainbow
October 26th, 2010, 01:52 PM
My heart goes out to you :grouphug: but try not to do so much reading until you get a diagnosis. I know it's hard when it's one of our furbabies but we always tend to think the worst and sometimes there is no need to. :grouphug:

Hopefully Dr Lee will have some further input when he logs on again and your vet finds some answers for you soon. :pray: :fingerscr :grouphug:

hazelrunpack
October 26th, 2010, 06:50 PM
No advice for you, SuperWanda, but I wanted you to know that I'm thinking of you and Timber and sending :goodvibes:! I hope you get a diagnosis soon! :grouphug:

Dr Lee
October 26th, 2010, 10:14 PM
I'm worried about a bone marrow cancer but this is all speculation from what I have been reading online.

With the high doses of pred and not seeing a positive response, I would agree that this would be a concern. A bone marrow sample might help further evaluate this. In general immune mediated diseases (such as IMHA and ITP (when combined they are often called Evan's Syndrome)), respond fairly well to aggressive immunosuppresives.

I am glad that so far she is not getting worse.

A note on IMHA. When you have an immune mediated destruction of platelets (ITP), and there is also a dramatic anemia, then IMHA is also assumed unless another clear cause of anemia can be determined (such as a dramatic blood loss from the ITP, such as a GI bleed). However ITP and IMHA are diseases that involve destruction of platelets and RBC. If they are not being made from a bone marrow disease, then ITP and IMHA are not accurate terms.

I hope that this helps. I wish I could help more.

Myka
October 26th, 2010, 10:46 PM
I also have no advice, but want you to know I am also following Timber's progress, and thinking about her everyday.

:goodvibes: and :fingerscr

SuperWanda
October 27th, 2010, 10:39 AM
Thank you hazelrunpack, Dr. Lee and Myka for your thoughts and advice,

She has been on the prednisone since Oct 1 and the Imuran for a second week now (but I give the Imuran every other day now). I think my regular vet is concerned so she is the one that is trying to get more information.

She's also the one who gave us the prescription for the antibiotic and zantac so this morning her stool was more formed with no mucous or blood that I could see so that is good.

Not sure what is going on but it worries me have her on these immune suppressing drugs if it is something else.

As far as the numbers for the anemia, her last RBC was 4.82 so would that be considered dramatic anemia or only slight?

I will ask more questions but it seems to me that a diagnosis of ITP is basically a guess as other things are ruled out. We had x-rays and ultrasounds and blood work for tick pathogens but not a bone marrow test -- although when this all began her white cell count was not at all elevated. Perhaps the Imuran is stimulating that or a possible infection? Who knows but I hope my vet finds some more information soon!

Thanks again for your support and I'll keep you posted on what happens.

rainbow
October 27th, 2010, 02:15 PM
Still thinking of you and Timber and hoping for a good outcome. :pray: :fingerscr :goodvibes: :grouphug:

2sheltiesmom
October 27th, 2010, 03:03 PM
I really hope your precious Timber is doing better. My 5 year old Sheltie "Bobby" had a G.I. bleed in the summer of 2009 from Metacam in combination with an antibiotic! He was hospitalized and was I SCARED. Thankfully we had a wonderful vet and staff who took the best care of him. Among other things they gave him "Diarsanyl" which is an oral paste for dogs (I'm copying it straight from the box). It is made by Vetoquinol and is a "Nutritional Supplement as an aid in coating the Inestinal Mucosa". One thing I learned from the vet during this episode is to use as little medicine/supplements/vitamins as possible. IMO:2cents: you should ask your vet about the Visorbits, it might be a good idea to not give her anything other than her 'scrips, lots of TLC and :sleepy:

SuperWanda
October 29th, 2010, 01:20 PM
Thank you rainbow and 2sheltiesmom,

My regular vet is working so hard to try and figure this out so I really appreciate that! She's been brainstorming with other vets and the suggestion now is to test her blood again this Monday. If there is no change we will start reducing the prednisone by half. I am fine with that because that is what is making her feel so unlike herself. She thinks that if the immune system was attacking the platelets that we should have seen improvement by now. She's been on the Prednisone for almost the entire month and the Imuran for two weeks now.

The other thing to consider is the bleeding and mucous from the rectum which has since subsided since I started antibiotics. She wonders about a growth and perhaps a colonoscopy would be the next step if we still see no improvement with the blood work. She did have an ultrasound but it sounds like it is hard to see every part of the bowel.

We could also consider a bone marrow test under sedation to determine if it is that type of cancer but I would think her white cell count would be really high and it only started to elevate after starting on the Imuran.

If there is a tumor, it would be risky to remove because her platelets are so low but I guess there are platelet transfusions available. I guess we'll cross that bridge if we get to it.

I am just glad to start reducing the meds because I want her to feel a little better. I struggle with everything that is going on -- I do want her to get well but at the same time it is difficult to drug her up and see her without much happiness if we are possibly nearing the end of her life. But, I also want to be optimistic and hope for a happy outcome (even though she is 10) although I don't want to be naive either -- I know many pets that have not made it to their 10th birthday.

I guess we'll continue to take this day by day.

Thank you all for you're kind words and advice! :)

Myka
October 30th, 2010, 12:22 PM
I am just glad to start reducing the meds because I want her to feel a little better. I struggle with everything that is going on -- I do want her to get well but at the same time it is difficult to drug her up and see her without much happiness if we are possibly nearing the end of her life. But, I also want to be optimistic and hope for a happy outcome (even though she is 10) although I don't want to be naive either -- I know many pets that have not made it to their 10th birthday.

Optimism is always good, and quality of life should always take precedence over quantity of life in my opinion. It is a tough thing to think about, but you show you are a responsible and sensible pet owner by thinking about it. I have been thinking about Timber everyday, and hoping that you can find some answers. It is tough when your buddy is sick. :pawprint:

rainbow
October 30th, 2010, 04:51 PM
Sounds like you've got a good vet there that is really trying to help Timber. :thumbs up

Good luck with the blood test on Monday. :pray: :fingerscr :goodvibes: :grouphug:

SuperWanda
November 2nd, 2010, 10:29 AM
Just an update about Timber:

Her platelets have dropped again from 66 (last week) to 55. Her red blood cells are a little lower but not much (4.5) and her white blood cells are down from 16 (last week) to 10.4. I guess the antibiotics might be helping with the white cells?

Still no idea on how to proceed.

Our only internal medicine vet returns on Monday so my regular vet is setting up an appointment to see her.

Still on the same doses of Prednisone and Imuran for now. Her liver enzymes are elevated now due to these drugs but I guess that's expected.

:shrug:

SuperWanda
November 2nd, 2010, 10:42 AM
I just wanted to add some current thoughts:

Is this an immune-mediated problem? We are not sure -- because we are not seeing any improvement with the drug therapy but in some cases you don't. So wondering about trying other drugs -- vincristine shot(s) again?

Could there be bleeding somewhere else in the body. We did have normal chest and abdominal x-rays as well as an ultrasound but I guess those can miss something. She did have some blood and mucous in her poop that has since subsided on antibiotics but I guess there are different types of colitis including cancer-related types? Her nose was also bleeding when her platelets really dropped the first time so was that a symptom of the thrombocytopenia or was there another reason for that?

I never realized how difficult it would be to figure out the cause of this. I'd like to take her to a human hospital and give her an MRI or a CT Scan!

rainbow
November 2nd, 2010, 02:08 PM
Has your vet consulted with Dr Dodds? She is the expert on auto-immune diseases like IMHA.

This must be so hard on you :grouphug: .....I'm still keeping Timber in my thoughts and sending lots of :pray: :fingerscr :goodvibes: for a good outcome. :grouphug:

SuperWanda
November 2nd, 2010, 06:13 PM
No -- is Dr. Dodds the one in California?

I also told my vet I would drive her to the Saskatchewan Vet Hospital if there was a test that would be better at determining the problem.


Yes, it has been stressful. I've always had a multitude of pets growing up but these are the first two where I am their Mom so haven't had to make those tough decisions you face when they get sick. I always knew it would be difficult but I never imagined it would be this complicated. For whatever reason it's really hit me hard. Just seemed like my whole life and routine has changed and I wasn't expecting it to happen so fast.

I guess when their lives are so short an illness can come on quickly. And although that's what happened, I also look back and wonder if there was anything else I could have done to anticipate it sooner. She's always been slower than my other dog (who is two years older) because of arthritis and had been lagging behind on walks. Sometimes I would worry but other times I would just think she's probably just stiff today. I feel I am fairly observant and in tune with any subtle change when it's come to their health so it really bothers me that this is happening.

I do know it's not my fault and that there are many factors that could be playing into her illness. I also know they are getting to that age where they will start having potential problems, but I think I really thought that I could somehow avoid or at least lessen the chance of them getting some terrible disease by keeping them as healthy as possible.

Myka
November 2nd, 2010, 06:48 PM
Yes, Dr Dodds is in California.

I work in Alberta, but live in Saskatoon. If you end up taking Timber to the Saskatchewan University Veterinary Center let me know if there is anything I can do to help. Do you have family/friends in Saskatoon?

Goldfields
November 4th, 2010, 03:56 AM
Super Wanda, don't beat yourself up because you didn't see this coming. When Arie got sick it was her groomer that noticed haemorrhages in her skin on her belly and elsewhere and fortunately for Arie's owner that woman had been a Vet in her own country. He would not have realised what was wrong, whereas she took one look and phoned him to tell him to collect her and get her to the vet immediately. Arie had been fine prior to that.

SuperWanda
November 4th, 2010, 09:29 AM
Thank you for offering to help Myka! I was fortunate to get in with the specialist this Monday so that will be the next step.

My regular vet said if I had to wait any longer she was considering sending me to Calgary. I do have many relatives there but not in Saskatoon.


Thank you Goldfields. When something like this happens you always think back and wonder if there is anything more you could have done. I have two dogs and Timber is more difficult to read -- she's very laid back and is not as emotional or sensitive as our older one. It also sounds like you don't have many symptoms with low platelets until they are at a very low level as you mentioned when you begin to see spontaneous bleeding.


I'll let you all know how our appointment goes! :fingerscr:fingerscr:fingerscr

hazelrunpack
November 4th, 2010, 04:46 PM
Sending :goodvibes: for your appt on Monday! I hope you get some answers! :fingerscr

rainbow
November 5th, 2010, 02:18 PM
Good luck with the specialist on Monday. :grouphug: :fingerscr :goodvibes:

rainbow
November 8th, 2010, 10:42 PM
How did the appt with the specialist go? :fingerscr :goodvibes:

Goldfields
November 9th, 2010, 12:43 AM
SuperWanda, I hope you have a diagnosis by now. Decisions would be easier if you know what you are dealing with. It must be so frustrating and worrying.

I am posting a photo of Arie's belly. His groomer took one look and knew what she was seeing , but how unfortunate are we Aussies that her qualifications aren't enough here? She shouldn't be wasting her talent as a dog groomer. I know the owner paid a huge price and was determined to save his precious dog, but really that vet/groomer probably saved her just by alerting him. Scandalous that she can't practice here.
Fingers crossed for Timber, whatever ails her.

SuperWanda
November 9th, 2010, 01:19 PM
Thank you all for your thoughts and well wishes for Timber!

Thanks for the picture Goldfields -- it's good to know what the bleeding under the skin may look like. She has a shaved belly right now from her ultrasound but otherwise I don't know how you'd ever detect that on a husky!

I'm not sure how much has really changed in the end but I'm glad we talked to a specialist about it.

Basically we stay on the same track with a few modifications. From the blood work she doesn't like her response to the prednisone (not a strong enough reaction) so we switch her to another steroid and keep her on the Imuran.

We also switch her antibiotic to another potent one just in case she has some weird strain of e-coli that they can't test for. When this all started she had some loose stool so a sample has been sent off today to look for parasites and other possible infections. Although I think these things are rare but I guess it's good to rule them out as well. I have always given heartworm med so they do get de-wormed every month but I guess you never know.

She was fairly upfront that it is hard to know absolutely what is going on and all though we have tried to rule out the possibility of a tumor or cancer it can be missed. There may be something that is difficult to see on x-ray or ultrasound so we treat what we know is true which is the low platelets. That would be a diagnosis of the ITP (Immune-mediated Thrombocytopenia Purpera) and the cause for this is unknown. Some dogs respond to treatment and some do not.

We get her on the new meds and test in a week to see if there are any positive changes in her blood work.

I'm still having a really hard time with this. I am questioning everything just because I think about us possibly nearing the end of her life and I don't want to be making that more difficult for her. That being said, if it is only her immune system and the treatment can increase her platelet counts and she starts feeling better than it would be worth it to me!

This is, however just a guess right now, and that makes me pretty uncomfortable. I like to know all the answers as it makes me feel more in control of the situation and with all the unknowns I feel completely lost and worried but I suppose that is life really. There are no absolutes and I guess we just continue and hope for the best.

SuperWanda
November 9th, 2010, 06:18 PM
Goldfields -- How old was Arie when he was afflicted with this? Did they ever learn the cause? Does he remain on medication for the rest of his life?

I was told that if Timber does recover -- no more vaccinations, no heartworm meds, anything that might trigger a relapse.

rainbow
November 9th, 2010, 11:04 PM
I hope the adjustments to Timber's medications are what she needs to turn everything around for her immune system. :fingerscr :goodvibes:

Did you ask your vet or the specialist about contacting Dr Dodds? Glad to hear that they agree about the no more vaccinations for her. :thumbs up

Sending lots of :pray: :fingerscr :goodvibes: for her next blood test. :grouphug:

Goldfields
November 9th, 2010, 11:45 PM
Arie is 7 and she also is allowed no further vaccinations. They can't possibly know what caused it but she was not de-sexed and here is one good reason for speying females, folks, just coming in season can trigger this. However, there is a big list of things that cause it, so who knows. She is now speyed, off all her meds and they are very pleased with her blood results. It wasn't easy to come this far though, it has cost him $8,200 worth of dedication(he keeps track of the cost) - he refers to her as his child though and just adores her. When she was 8 weeks old I knocked back two other very keen potential buyers for her, so what do you think, did I pick the right one? :)

I do have a sheltie breeder/ dog Judge friend who lost her top dog(male) to IMHA and in that case they were blaming the Parvo Vaccination.

MaxaLisa
November 10th, 2010, 03:05 AM
I was doing a search regarding low platelets and metacam, since that drug seems to be causing my GSD's nose to bleed and gums to go pale, when I came across your thread.

PLEASE treat your dog for an ehrlichia/anaplasmosa-like organism. Doxycycline at 10 mg/kg (roughly 5 mg/lb), twice a day is the aggressive dose, perhaps even IV doxy initially, though I don't have experience with doxy in that form.

Tick tests often have false negatives, assuming that we have a test for the right organism. The immune supressant drugs are driving the infection deeper. You won't have the benefit of titers to determine response, you'll have to look at cbc numbers to monitor. Sometimes you will also see changes in the blood count differential. It's important to use antibiotics that are effective against the ehrlichias for this. If that is not effective, then look to drugs that are effective for Babesia.

Good luck, hoping for the best for your Husky!

MaxaLisa
November 10th, 2010, 03:41 AM
Afterthought, I think low zinc can affect platelets. If your Husky mix is showing other signs of low zinc (often seen in the nose of Huskies), maybe some additional zinc is helpful for support, I dunno?

SuperWanda
November 10th, 2010, 06:21 PM
Rainbow -- thank you -- yes, I would still like ask her about Dr. Dodds but haven't yet. Are first apt. was so long as she was trying to go through all the tests results and get herself up to speed with all that has gone on but we will be talking again after the blood test in a week so that is one question I will ask.

Goldfields -- I'm glad Arie is doing so well! it sounds like it is very difficult to find a cause unless you know for sure your dog was exposed to a toxin or just had a vaccination. I can see how the costs start to add up because you have to continually monitor so it's wonderful he was able to persist and see good results.

MaxaLisa -- thanks for your posts -- does your GSD have low platelets from metacam. Was he treated for those tick-borne blood parasites as well?

We are in Manitoba, Canada so don't have Ehrlichiosis here. Anaplasmosis is found in less than 5% of only one species of tick here (Ixodes scapularis) and although that makes it fairly unlikely, we did have her red cells analyzed for Anaplasma phagocytophilum and none were seen.

Thanks for the zinc info as well. I'll look into that. Are there any foods high in zinc? Oysters come to mind but not sure about feeding that to a dog? We have been giving liver because she is slightly anemic.

Hoping for good results next week! :thumbs up

SuperWanda
November 11th, 2010, 10:53 AM
Goldfields -- also wondered if Arie lost weight through his ordeal?

We are feeding Timber more but she still looks thin -- her hips and spine are becoming more apparent. She has lost weight so that makes me worry about some type of cancer. Not sure if it is a symptom for just low platelets as well but her appetite is better now -- I think that is mostly from the steroid use.

MaxaLisa
November 11th, 2010, 06:00 PM
MaxaLisa -- thanks for your posts -- does your GSD have low platelets from metacam. Was he treated for those tick-borne blood parasites as well?

We are in Manitoba, Canada so don't have Ehrlichiosis here. Anaplasmosis is found in less than 5% of only one species of tick here (Ixodes scapularis) and although that makes it fairly unlikely, we did have her red cells analyzed for Anaplasma phagocytophilum and none were seen.

Hi SuperWanda,

My GSD has an infection of unknown origin, all tests are negative.

The metacam has been making his mucous membranes go pale - grey to sometimes white. I'm told that's not a platelet sign, but the last time this happened, it was in response to the antibiotic azithromycin and his platelets had dropped quite low when tested. So out of curiousity the other night I just did a search for metacam and platelets to see what came up, and found your thread.

My boy has an ongoing "low end" platelet issue which gets worse on some meds. So far, the red blood cell count is staying in the low normal range. He does have a "generous" spleen, but nothing out of the ordinary showed up on ultrasound.

Because of my other dog, I've been on the K9 tick list for about the last 10 years - seen lots of dogs and blood profiles go through that list. I've also seen a lot of dogs not make it because they were treated too long with steroids and no antibiotic - often the dog initially responds to the steroids, which seems to confirm it's the right treatment, but then continues to go downhill. These dogs typically do start to respond when doxycycline is finally started, but often it's too late. . Absolutely heartbreaking.

Because of the list, I recognized the signs in my GSD. He responds to doxy treatment used for tick diseases.

In your dog, with the red blood cell problem, and the platelet problem, white blood cell counts, it would be prudent to be using an appropriate "tick antibiotic" along with the steroids. Steroids only in your dog's situation, would scare me. The first rule about tick diseases is that our tests for tick diseases aren't infallible, and we haven't yet learned of all the diseases that they can transmit. It wasn't that long ago that the research was saying that dogs don't get Anaplasmosa. California has a strain of lyme that doesn't show up on some tests. Many things are possible, so remember that those statistics and negative blood results aren't absolutes.

Had someone on another board in a similar situation, but their dog had been bit by a coyote 6 months earlier. All tick tests negative. Platelets finally started turning around after doxy started.

I don't know about the foods and zinc. My friend with the Husky and zinc issue has to give regular supplements, she uses the condition of his nose to determine optimal therapeutic dosage. There's a recommended starting dose for this Husky problem. I think that liver from red meat sources will help with both the anemia and zinc issue?

I am hoping for good news for your girl on the next round of tests!

SuperWanda
November 11th, 2010, 08:50 PM
Thanks MaxaLisa -- I'll certainly look into that.

We currently have her on Baytril for 10 days just in case she has a strain of e-coli that they can't test for.

Did you try any other antibiotics before the Doxy?

What were the results of using the Doxy with your GSD? What are his platelet counts? Have you just started the treatment?

Goldfields
November 11th, 2010, 09:08 PM
Goldfields -- also wondered if Arie lost weight through his ordeal?



He said she was currently 10kgs and they want her down to 9kgs. I'd need to ask him did she lose some initially though. I'll try and get him on the phone tonight.

MaxaLisa
November 12th, 2010, 05:16 AM
SW, my boy has a number of issues, low end platelets is just one. Doxy is his primary abx. He gets better on other abx, but he also has some secondary Staph issues, eye issues, nasal issues, skeletal issues, perianal fistula, the list goes on. His platelets aren't given the opportunity to drop too low - I run regular bloodwork and pulse with antibiotics when they start to get too low. They have only been scary low once with the azithromycin. He doesn't get bloodwork until next week. When my Max was on Baytril, he did improve, but he also developed a delibilitating back problem that I'm still dealing with a year later. I had him on a doxy and low dose baytril regimine, used to treat the ehrlichias and coinfections like Bartonella.

I think what my boy has and what your girl has are probably different to a large degree, or at least manifest in the body differently. The important thing to me is that the blood profile you have is pretty textbook, and I would hate to see a missed opportunity when the stakes are so high.

There is one vet that used to be on the tick list that believes that it takes about 5 yrs for the chronic form of an ehrlichia type disease to develop into a chronic disease that shows in bloodwork. If this is the case, I guess anywhere your girl has been in the last 5 yrs is suspect, and depending on her age, parental exposure is also relevant.

Goldfields
November 12th, 2010, 06:53 AM
SuperWanda, you wrote in one of your posts ....

She did have some blood and mucous in her poop that has since subsided on antibiotics but I guess there are different types of colitis including cancer-related types? Her nose was also bleeding when her platelets really dropped the first time so was that a symptom of the thrombocytopenia or was there another reason for that?

Arie's owner said to tell you that when she had been on Imuran for a week(or 9 days?) , twice daily, she had blood in her droppings too, so they got him to halve the dose and she was okay then in that respect.
Now, some of this I didn't know. Apart from those haemorrhages you can see in that photo, she also had like blood blisters under her tongue and her gums were white. She was very close to dying, with platelets down to 2, 35 RBC count, which dropped to 27, to 23, down to 17, by which time platelets were at 4, but then she started to improve, RBCs up to 120 and he said at 160 they let him take her home. She was still confined for a month and a half though , cage rest you may as well say. Her illness lasted from December last year till August, that's when she was totally weaned off those drugs, and of the total price you would have to deduct $1,000 for a major consultation with a specialist, plus the cost of de-sexing her.
I smile as I say that her owner has only just discovered how nice it is to let a dog sleep on the bed. We could have all told him it's nice, couldn't we? :D Shelties just love being with their owners.

SuperWanda
November 12th, 2010, 09:44 AM
Thanks for that info Goldfields. I really hope that we have the same outcome as Arie did!

MaxaLisa -- It sounds like you have really struggled with your boy's health. I see that you are in California so understand that tick illness can be much more common there.

We haven't been anywhere with our dogs but here. Our dog is 10 years old now. But I will still look into the doxy treatment as I understand not everything can be explained or understood.

rainbow
November 12th, 2010, 01:36 PM
Hoping you find some answers soon. :pray: :fingerscr :goodvibes: :grouphug:

Myka
November 12th, 2010, 10:32 PM
On the tick subject, our little guy Peewee got 4 ticks last year, so they are definitely in my area, but I suppose Winnipeg isn't all that near to me! When I got titers and yearly blood work done on my older girl (RIP), I always got the Idexx 4Dx SNAP test done which tests Dirofilaria immitis antigen, as well as antibodies to Borrelia burgdorferi, Anaplasma phagocytophilum and Ehrlichia canis. I lived in BC at that time with her, and ticks are a more significant threat there I believe. It only costs $50 on top of any blood work panel which I think is worth the stress relief. I'm not sure if the medications Timber is on would inhibit the test...?

Thank you for offering to help Myka! I was fortunate to get in with the specialist this Monday so that will be the next step.

My regular vet said if I had to wait any longer she was considering sending me to Calgary. I do have many relatives there but not in Saskatoon.

You're very welcome. If you do end up needing my help PM me as I'm not always able to check the forums, but will see a PM through email that I usually check everyday. If you need, I am home (Saskatoon) now until Tuesday morning.

SuperWanda
November 16th, 2010, 11:04 AM
Thank MaxaLisa for looking into the anaplasmosis again. Vet's just don't consider it here -- very few documented cases in Canada but that doesn't mean it's not possible. I'd rather hope for something than nothing.

We have started the doxycycline. Not sure what will happen but I can only hope that what might be an unlikely chance will turn into something positive -- I really want to believe it but it is also very hard and I worry that time is taking it's toll on her.

Blood sample was taken but does look thin.

Not sure I believe in miracles but I am sure hoping for one at this point.

Thanks to everyone for keeping Timber in your thoughts.

Myka
November 16th, 2010, 12:12 PM
Weirder things have happened Wanda! Let's hope Timber is another one of these rare cases. :fingerscr

MaxaLisa
November 16th, 2010, 07:58 PM
I'm happy to hear about the doxy.

Hopefully the blood results will bring some good news - will be checking back to see.

It might not be Anaplasmosa, but something that has the same disease profile. Doesn't matter what it's called, as long as you can find something to fight it.

Hoping for the best...

hazelrunpack
November 16th, 2010, 09:49 PM
Sending good wishes and some :goodvibes: for an improvement in the next few days, SW! Give Timber a hug from hazel, please.

SuperWanda
November 18th, 2010, 10:24 AM
Our blood work is not good. At first I thought it was good because all this time we were hoping for the platelets to go up and they are 141. Two weeks ago they were 54. But she said the red blood cells are down to 2.2 and the white are very high at 41.6.

In her opinion it looks like a cancer in the body that was never found.

Yesterday she lost her appetite -- might have been with the start of the doxcycline but she will only eat cheese, milk and bread. She is very weak and is sleeping a lot but appears to be comfortable.

Just trying to digest this now as I was hoping for some small miracle just in case we were dealing with something treatable.

Thank you to everyone for your advice and thoughts for Timber. It really helped!

MaxaLisa
November 18th, 2010, 10:50 AM
I'm so sorry that the news isn't better.

Yes, this could be cancer, but it still could be infection, considering how much pred has been given.

Btw, doxy might be helpful in cancers such as hemangiosarcoma and lymphoma and others (osteosarcoma, etc.)

Here is a "shoulda, coulda, woulda" thread. The dog should have made it (anaplasmosa). The striking thing is how well the dog did on doxy as the pred was weaned. Unfortunately, due to the vasculitis/edema, they kept going back to the pred. I don't know if it will be helpful or not, but the dramatic improvement is worth noting.
http://www.germanshepherds.com/forum/preparing-say-good-bye/142129-my-dear-friend.html

Doxy can cause a lot of stomach upset - I don't have problems with it here if I use the capsules. Some folks use probiotics, pepcid, and/or l-glutamine between doses.

Still wishing for the best for you guys :hugs:

hazelrunpack
November 18th, 2010, 12:06 PM
I'm so sorry to hear about the new diagnosis, SW :2huggers: Don't totally give up hope, though. Although the low RBC count is disturbing, the platelets increasing is a good thing and the WBC count could just indicate a response to an infection.

My heart goes out to you :grouphug: I know how difficult it is to care for a sick furbaby, especially when you're not sure exactly what's going on! If she's comfortable that's good. Treasure every minute and love her up!

You're both in my thoughts and prayers. I hope you can find something tasty to tempt her appetite!

SuperWanda
November 18th, 2010, 12:15 PM
If you have any suggestions please send them our way.

I am still reducing the dexamethasone (not prednisone). Just cut the morning dose in half so she gets 2mg in the morning and 2 mg in the evening. I was told to cut 25% back every 7 days.

She gets 50mg Imuran every other day and was suppose to give it yesterday but didn't. Wasn't sure if I should taper it or if I should just stop it or keep giving it? The vet said to keep giving it because it may keep her comfortable.

I was giving Doxy (100mg tablets) at 10mg/kg of body weight (2.5 tablets twice a day - 250 mg twice a day) but cut that back to 1.5 tablets twice a day because of the loss of appetite.

That is all the meds she is taking. She is very weak but is still drinking goats milk and eating bread and cheese -- has no appetite for any meat product it seems.

SuperWanda
November 18th, 2010, 12:41 PM
I think I'll call MaxaLisa a "thread vet" because I just read her post and my mind is spinning.

As I was crying with the thought of letting Timber go -- I just want to do the right thing. Really don't know what that is right now.

hazelrunpack
November 18th, 2010, 01:06 PM
Since you really don't know what you're dealing with, about the only thing you can do is deal with it a day at a time :grouphug: Evaluate how Timber is feeling from day to day and make your decisions when they become necessary. :2huggers:

I was just looking for information on Imuran since I'm unfamiliar with it. Not sure what I'd do about it--but I'd for sure check with the vet and see if it's something that requires weaning.

I wish I had more advice for you, SW! :grouphug:

SuperWanda
November 18th, 2010, 01:18 PM
Imuran is aka azathioprine and is a chemotherapy drug. We were using it as a strong immuno-suppressant, not as a cancer fighter.

This would be the 5th week we have been using it. Started out giving 1 tablet every day for 7 days and now every other day.

My vet wants us to stay on it but I don't know if I should.

hazelrunpack
November 18th, 2010, 01:22 PM
Did he have a compelling reason to keep her on it? If not, it can't hurt to ask him how to discontinue it. Ethically, if you tell him you want her off it, he should tell you how to do it safely. And he may have a specific reason for leaving her on it...

SuperWanda
November 18th, 2010, 01:32 PM
All I could find on the net is that you could stop without tapering because it is not like steroids in that it leaves your body slowly over time just as it takes awhile to take effect.

SuperWanda
November 18th, 2010, 02:00 PM
I can call and ask -- she just said that it has an ant-inflammatory effect and it would make her feel better. She is thinking in terms of this being a cancer now.

...just talked with the pharmacist about this and she said to taper the steroids but you can just stop the Imuran. It may take a long time though to get that drug out of her system.

Timber just ate a bowl of cherrios and milk and had a vitamin. (I know this is not ideal but it is something)

Any other thoughts as to what a dog could eat if they don't like the smell of meat?

MaxaLisa
November 18th, 2010, 02:24 PM
SW, I've just seen a lot of these cases on the tick list - mostly tick diseases, some cancers, some autoimmune in the mixed, and some with all three.

In "the real world", I'm actually a mathematics professor, so I'm constantly evaluating the odds and tendency and the logic of treatment. For example, how long has your dog been on immune suppressants primarily, what has gotten better, what hasn't?

I also have dogs which have complicated medical issues, where things don't show up on tests well. I actually think we have strains in California that they don't have the right tests for.

My Max has a history of perianal fistulas (mostly seen in GSDs). Treatment for that is pred, cyclosporin, or Imuran, so I am familiar with those meds. On the PF list, those are predominantly the meds that dogs respond to. They made it worse for Max. I stopped all the regular meds, and put him on a doxycycline/niacinamide protocol and he started getting better. I searched the blog of a lyme MD and found a multi-antibiotic protocol that he uses for coinfections, and I put my dog on a protocol to mimic that. It took a combination of three different antibiotics to get him better and healed up. In some sense, it flies in the face of common sense and everything conventional. (Btw, I was working with a dermatologist through this, but I started the drug regimines on my own.) Oddly, I am in an area where they say that we don't really have tick diseases.

And the bottom line, is that it might not be a tick disease, for either your dog or mine. But if there is a lack of satisfactory response to the current treatment, and a high likelihood that there is another treatment to try that will not make things worse, then you gotta go in that direction.

Seems to me that pure autoimmune has been ruled out, and you are down to cancer and/or infection, neither of which respond favorably to immune suppression (though a few cancers do seem to respond to pred, which doesn't seem to be happening here).

Have you tried different types of proteins when feeding?

I'm a big fan of vanilla or unflavored whey protein (with no artificial sweeteners), mixed in a favorite liquid. For my girl, it used to be apple juice (and the natural sugars are good when they are not eating). For Max, he loves the green barley drinks, but will also drink the apple juice. The whey protein gives them lots of nutrients, and it's also a cancer fighter.

Did you see anyt of the digestive stuff get better with the decrease in doxy? If not, you might have to add some probiotics, or anti-acids, or l-glutamine for the stomach to tolerate it. All these drugs are hard on the body - all of them.

When Max was on cyclosporine for his fistula, similar to Imuran, I did stop it completely at once, though he was not on it long. He felt a little bit better each day, but it took about a couple of weeks for the antibiotics to start undoing the damage that was done by the suppression.

Do you know which white blood cells are increasing? Neutrophils? Bands? Monocytes? etc?

SuperWanda
November 18th, 2010, 03:03 PM
No, I don't know which blood cells are increasing but I could find out.

I haven't seen too much increase in her appetite since reducing the doxy but it's only been reduced for the last two doses.

I just gave her some Bio-K (probiotic acidophilus liquid) and I will try those different protein suggestions.

Still off the smell of meat and eggs so she just has some yogurt with the probiotic, toast with butter and goats milk.

I tried rice but for whatever reason that was not appealing.

She is on dexamethasone (a brother of prednisone). She started 50mg of pred on October 5 and switched straight to 8mg dex on November 8. I didn't realize but when our regular vet came to take blood she said she was probably experiencing withdrawl symptoms because of the switch but the internist never told us that. She just said to replace one with the other because they are brother medications. She has been on the Imuran since Oct 18.

BTW, how old is your dog Max?

MaxaLisa
November 18th, 2010, 03:58 PM
I'm just curious about the white blood cells. I don't think there is a specific pattern, but sometimes they can give you some clues.

Beef, chicken, liver, vegetables, minced olives, edible mushrooms, etc, try everything!

Max is 9 1/2 years. He's had issues all his life, they are progressing, only slowly when on abx though. In the end, it will probably take him, or turn cancerous, if it hasn't already. He is a work in progress :)

SuperWanda
November 18th, 2010, 08:33 PM
I guess I just don't understand why the vet is not happy with the jump in platelets? They were 54 and now 141. That seems significant and to me something must be helping that.

Maybe that doesn't mean anything if the RBC are 2.2 and WBC are 41.6 though?

hazelrunpack
November 18th, 2010, 08:44 PM
I agree about the platelets. Something is helping in that regard.

Anemia (decrease in RBCs) can be caused by internal bleeding or by destruction of red blood cells. My guess is that the vet is thinking there's a hidden cancer that's causing internal bleeding :shrug:

How far out of norm is the WBC count? White blood cells come in a number of varieties--some WBCs are more commonly seen when the body is fighting a parasite, some when there is a bacterial infection, some when there is allergy-related inflammation, some when the body is fighting cancer, etc. As MaxLisa mentioned, sometimes the pattern of WBC activity can tell you something about what the problem is...

Your vet should be willing to sit down and talk to you (or talk over the phone) about what his suspicions are and why he thinks that way.

Did Timber eat anything tonight? :fingerscr

MaxaLisa
November 18th, 2010, 09:23 PM
I think you answered your own question. If they had the right treatment, all parameters would be getting better. The platelets are getting better, but there is an increasing problem with the red and white blood cells, which basically tells them they don't have the right diagnosis :(

SuperWanda
November 18th, 2010, 09:44 PM
Yes, Timber had some of my chicken sausage and toast with liver pate even though she won't touch any chicken or liver that I make for her. I'm thinking she likes things with spices that disguises the smell of the meat? If that is the case I may end up buying her some hot dogs. I know that is not healthy but some "all beefs" would give her a little iron maybe?

I was also wondering if the Imuran is decreasing the red cells but not sure why it would increase the platelets at the same time???

I think the trouble is the vet does not know. It didn't seem like she thought the platelets going up a good sign since the RBC were low and the WBC were high? I don't know what a normal RBC is? I think we started out at 4.8 or 5. Apparently Timber was a little low 2 years ago with the RBC so when she was slightly anemic it wasn't a big issue. I'm not sure what a normal WBC count is either. I know the only time the WBC count went down a little was when we were on the metronidazole antibiotic. After that we switched to Baytril and now WBC is high but I'd have to get another test to see what the doxycycline is doing.

The results should be sent to the internist as well so I'd be interested to get her opinion.

However, at this point, I feel it has been long enough and she continues to get worse in some respects so I don't know if I'm right to get her off the meds or not but that's the thing -- no one seems to know. If they suspect cancer now but they also want me to continue meds, I just don't feel comfortable with it anymore. Why didn't I go to medical school? :wall:

MaxaLisa
November 19th, 2010, 05:07 AM
I hope that you will be able to mix some of the tempting things with some more healthy things to get some nutrition in her - I know how difficult it is!

I was also wondering if the Imuran is decreasing the red cells but not sure why it would increase the platelets at the same time???

I think this is the way it goes.....the drug regimen with the Imuran is bringing the platelets up, but there is another process that is destroying the red blood cells. That other process is either infection or cancer :( The Imuran itself should not damage the RBC, but it can make things like infection or cancer worse, which can increase the RBC destruction and increase the WBC.


I think the trouble is the vet does not know.

I think that right now there is no way for anyone to really know.


I don't know what a normal RBC is? I think we started out at 4.8 or 5. Apparently Timber was a little low 2 years ago with the RBC so when she was slightly anemic it wasn't a big issue. I'm not sure what a normal WBC count is either. I know the only time the WBC count went down a little was when we were on the metronidazole antibiotic. After that we switched to Baytril and now WBC is high but I'd have to get another test to see what the doxycycline is doing.

Labs have different normals. Idexx normal for RBC is 5.5-8.5 and WBC is 5.7-16.3, I don't know if those numbers apply for the test that you have. Platelet normals are 164-510, at that lab at least.

Diseases like ehrlichia or babesia can take years to settle in and cause this type of damage. I'm willing to bet that 2 years ago, this disease process was present.

Baytril is not a good tick disease antibiotic, I'm not surprised that it hasn't helped. I think it might help a bit with Bartonella, but that's not a disease where you are going to see this blood profile. The metronidazole is sometimes used to get at lyme cysts, but is also used in the treatment of babesia, which can do exactly what you are seeing in Timber:
http://www.gopetsamerica.com/dog-health/babesiosis.aspx


However, at this point, I feel it has been long enough and she continues to get worse in some respects so I don't know if I'm right to get her off the meds or not but that's the thing -- no one seems to know. If they suspect cancer now but they also want me to continue meds, I just don't feel comfortable with it anymore. Why didn't I go to medical school? :wall:

Yes, it's very confusing and frustrating. In my mind, it seems you should be ramping down the immune suppressants, and ramping up antibiotics that fight ehrlichia and babesia. I'm throwing in babesia here, because of the response to metro.

SuperWanda
November 19th, 2010, 09:10 AM
She is very weak and struggles to get up and walk. The only way to get in and out of our house is with stairs so we have a ramp for her but she doesn't have the strength to go up and down herself. She uses all her strength just to pee and collapses in the snow to recover before needing help back inside. She is still drinking excessively so we are up through out the night, getting our jackets and boots on and trying to help her in and out. We are both extremely tired and this whole situation has taken it's toll on our entire family.

MaxaLisa
November 19th, 2010, 09:36 AM
I see several options, none of which are the clear winner.

Continue what you are doing. It seems to me that you will see a continued decline.

Decide that she is too sick, and you do not want her to suffer anymore :(

Stop as much of the immune suppression stuff that you can, taper the others, and try a doxycyxline, clindamycin, metronidazole protocol, or at least the first and the last of those three. Mind you, I dislike metro a lot because some dogs get neuro side effects, but her history indicates there was improvement on this.

I am so sorry Timber and your family are facing this :2huggers:

SuperWanda
November 19th, 2010, 10:33 AM
Thanks MaxaLisa,

Do you know if it does happen to be some kind of infection and you are getting a destruction of platelets and/or red blood cells -- is that caused by the infection itself or by the immune system? I ask this because if the immune system is causing the destruction don't you want to stop that by suppression with the steroids? or once you stop the infection does the immune system stop the destruction of the cells?

I hope that question makes sense -- I basically want to know if the infection is causing the immune system to attack the cells or if the infection is directly attacking the cells?

MaxaLisa
November 19th, 2010, 12:05 PM
I hope that question makes sense -- I basically want to know if the infection is causing the immune system to attack the cells or if the infection is directly attacking the cells?

I can't say with certainty, I think either can be true. It is true that infection causes inflammatory processes in the body that can cause this.

I have seen treatment with doxy raise both platelets and red blood cells. The general wisdom is to use the immune suppressing drugs only if the platelets get at a life threatening low level. In general, steroids will interfere with the doxy treatment.

In a few dogs, though not the general case, this has turned into an ongoing inflammatory/autoimmune process, thought to be separate from the infection, though originally caused by the infection (if that makes sense).

I don't know if you have seen this, but he's the only dog known on the tick list to have beaten ehrlichia risticii, an ehrlichia transmitted typically by drinking water and not by ticks: http://www.vintagegoldens.com/jasperstory.html There are many success stories of other types of ehrlichias, including anaplasmosa!

I have started to put some tick links together here:
http://www.germanshepherdhome.net/forum/ubbthreads.php/topics/1594/Ticks_and_Tick_Diseases.html#Post1594
The diseases that you would want to look at would be the ehrlichias, anaplasmosa, babesia.

hazelrunpack
November 19th, 2010, 12:31 PM
SW, I'm sorry this isn't getting any easier for you and Timber. :grouphug: No advice, just wanted to let you know I'm thinking of you. :2huggers:

SuperWanda
November 19th, 2010, 04:34 PM
Thank you MaxaLisa, Hazel,

The internist called. She thought that based on the white cells - both neutrophils and bands are increasing that it's not likely an infection but a cancer.

We will monitor her over the weekend but no improvement has been seen with her appetite and she is very, very weak.

Thanks to everyone here for their support and concern for our Timber.

MaxaLisa
November 19th, 2010, 06:08 PM
Thank you MaxaLisa, Hazel,

The internist called. She thought that based on the white cells - both neutrophils and bands are increasing that it's not likely an infection but a cancer.

That's the same thing that the university vet said about my dog before she passed away. However, hers was a very different situation than this, although I believe that she had an infection that had spread to her brain.

I should add, that when my mother had an acute infection that she lost her entire colon to, it was the neutrophils and bands that increased, which ultimately resolved. This textbook discusses the same blood profile as an indication of infection:
http://books.google.com/books?id=3PJVLH1NmQAC&pg=PA819&lpg=PA819&dq=%22neutrophil+bands%22+infection&source=bl&ots=trux2_JMiV&sig=d6_5LsQVoIogjn5Wgkv5FNTEX-s&hl=en&ei=FA7nTL6QOoOR4gb21d34Ag&sa=X&oi=book_result&ct=result&resnum=2&sqi=2&ved=0CBsQ6AEwAQ#v=onepage&q=%22neutrophil%20bands%22%20infection&f=false

"The most commonly encountered reason for neutrophilia is an acute bacterial infection."
http://www.msdlatinamerica.com/ebooks/ClinicalLaboratoryMedicine/sid673577.html

I'm so sorry that you have reached this point with Timber, I will be thinking of you..... :2huggers:

SuperWanda
November 20th, 2010, 10:08 AM
Still pretty slow and weak here but we have discovered that she really likes hot dogs.

We have been on the doxy for 4 days now and I am not noticing any changes.

If she did have an infection wouldn't she have a fever???

I know we have a tentative diagnosis of cancer but it really bothers me to not know for sure.

I guess we have to put away the diagnosis and just judge based on how comfortable she is. This has been going on since the end of September/beginning of October so that's a long time to feel so lethargic and depressed.

MaxaLisa
November 20th, 2010, 02:38 PM
The fever is iffy, depends on the status of the immune system. My girl's temperature was going up a 1/2 a degree every so many days as her neutrophils were rising, still not enough to technically be called a fever. Previously, with all her infections, she never ran a fever.

If you're still giving any immune suppressants, response to doxy may be depressed. But after about a week and no response whatsoever, that's really not a good sign.

Since doxy can be a cancer fighter, at least this is not something that is hurting her.

Sept/Oct is a long time to be in this position, it is not looking good, but I always hope for the long shot, and then in the end, you know you really did try everything.

I am so sorry that she isn't turning around. I am very glad though that she likes hot dogs - something that she will eat :2huggers:

Goldfields
November 20th, 2010, 07:49 PM
I guess we have to put away the diagnosis and just judge based on how comfortable she is. This has been going on since the end of September/beginning of October so that's a long time to feel so lethargic and depressed.

Good idea seeing the diagnosis isn't definite, and don't forget that with Arie it took her 8 months to beat Evans Syndrome. If Timber doesn't have that, neither might she have what MaxaLisa thinks she has. I'd suggest having a bit of faith in your Vet who probably needs to go through a process of elimination to reach the right conclusion. You could always go to another Vet for a second opinion.

hazelrunpack
November 21st, 2010, 01:17 PM
She any better today, SW? :fingerscr :goodvibes: :grouphug:

SuperWanda
November 21st, 2010, 04:50 PM
No, not really any better. Still very, very weak and sleeping a lot.

Her gums are very pale and to feel better I think she would need a blood transfusion at this point. Very anemic and hardly any appetite.

Still struggling with a decision because do you get a transfusion to buy you more time to treat a illness that you may not even have. She may improve a little but then have to go through this all again if it is some kind of cancer and that would be very hard.

Again, it is so hard when you still have unanswered questions but maybe there is no wrong answer here. I don't know.

MaxaLisa
November 21st, 2010, 05:00 PM
I am so sorry...

Even if it's infection, it may be too advanced now, and may have done too much damage.

My thoughts are with you in this *very* difficult decision.

Rgeurts
November 22nd, 2010, 05:39 PM
No, not really any better. Still very, very weak and sleeping a lot.

Her gums are very pale and to feel better I think she would need a blood transfusion at this point. Very anemic and hardly any appetite.

Still struggling with a decision because do you get a transfusion to buy you more time to treat a illness that you may not even have. She may improve a little but then have to go through this all again if it is some kind of cancer and that would be very hard.

Again, it is so hard when you still have unanswered questions but maybe there is no wrong answer here. I don't know.

I'm so sorry to hear about Timber. I feel horrible, but I haven't kept up with this thread. I sincerely hope you get some answers. Just to let you know, we are going through similar issues with our baby. His is immune-mediated. He was also put on Azathioprine 5 weeks ago. Aftet the second week he showed very minor anemia. 3 weeks later he is in the hospital having a transfusion (just this past Saturday evening). The Azathioprine and Prednisone caused internal bleeding (they think, but do not know for sure) and the Azathioprine stopped him from effectively regenerating new blood cells. His RBC was down to 8.8%. Our vet was completely amazed that he was still with us. They immediately called in a donor and gave him a transfusion. The day before, we had been at the holistic vet for the same reason (black stools, lethargy). The holistic vet gave us an herb to help stop the bleeding and reduce inflammation. Our vet said we would most likely be back in on Monday for another transfusion. Our vet did reccomend stopping the azathioprine and so did the holistic vet. Our vet then said to wean him down instead as he could not live through a seizure. So we cut the dose by 33%. The next day she said to stop it completely. I'm very happy to say that today was a good day. Hubby took him in, they ran a blood count. He's still only at 14%, but they said he's generating new red cells "like mad". So a transfusion was not needed. The bleeding has stopped and he is hopefully now on the mend. Sorry for the length of this post, but I wanted you to know that we are going through something similar with the same drugs. The holistic treatment may help yours as well. If you would like the name, let me know. It also helps to rebuild the blood. Our baby went downhill SO fast on Azathioprine and it was terrifying. My heart (and prayers) go out to you and Timber :grouphug::grouphug:

Nanook had the same symptoms from the anemia: loss of appetite, pale gums, nose and tongue, unable to lift himself at all (hubby had to carry him) and could barely open his little eyes. Our vet did not expect him to make it long and was preparing us for the worst. After the holistic treatment, transfusion and a couple of tummy meds combined with removing the azahtioprine, he is now eating, walking and giving hubby and I "high fives" expecting his treats :)

SuperWanda
November 23rd, 2010, 10:53 AM
Rgeurts, I have sent you a pm. Thank you for the information and I hope your two continue to improve! I have been reading about Nanook and hoping he makes a full recovery. I'm so sorry you are going through this. It is very difficult.

Timber is eating a little better -- I don't want to be overly optimistic so we continue to take it one day at a time. Her gums are still pale and she is still very week. Sleeping a lot but as I continue to wean the steroid dose down she seems to be sleeping better. The weather here is giving her something to be happy about as she often lies out on the deck and loves to eat the snow.

I am still hoping for a miracle but am worried her anemia may be due to a hidden cancer and if so, will continue to drop.

I haven't given and azothiroprine since Friday -- not sure how long it stays in your system. If her RBC started to go up after discontinuation of that drug I would be very encouraged. I know that it can cause low platelets and white blood cells but wasn't sure about the RBC, is that what your vet thought?

SuperWanda
November 23rd, 2010, 10:58 AM
Also, did you just cut the dose of the azathioprine down to 33% for just one day before you completely stopped it? and no seizures.

I got nervous after stopping mine last Monday so gave her one on Friday but haven't given any since.

Rgeurts
November 23rd, 2010, 11:39 AM
Also, did you just cut the dose of the azathioprine down to 33% for just one day before you completely stopped it? and no seizures.

I got nervous after stopping mine last Monday so gave her one on Friday but haven't given any since.

Hi SuperWanda,

We cut the dose for the one day, then stopped it all together. So far, so good. It's more the prednisone that worries them. It has done so well in controlling the meningoencephalitis, but has just wreaked havoc on his poor little body. He isn't doing too well today. He has lost his appetite and is very lethargic again, though not as bad as he was. The Azathioprine can inhibit the production of bone marrow, and in turn, can stop the production of red blood cells, which is why they had us stop. Since we stopped, he is generating new blood cells, but we are not sure if they are able to mature. We will find that out on Friday. The herbs did help to stop the bleeding. His liver enzymes were also severely spiked which our regular vet and specialist said was to be expected and there was nothing really to do except monitor it.
The holistic vet disagreed, gave him a holistic powder and his liver is back to normal after only 5 days on the powder :fingerscr, so there must be something to it. I will reply to your pm :grouphug:

SuperWanda
November 23rd, 2010, 01:23 PM
Thanks for the info -- yes, the steroids are unsettling to use. Great if they are helping the problem but it is upsetting to see the side-effects they cause.

After almost two months on steroids Timber has just wasted away. Lost so much muscle and her sides look bloated. I'm hoping that as we reduce the amount it will make her feel more comfortable -- especially if she is battling another issue here.

It reminds me of how she looked when we first adopted her from the humane society. She was just skin and bones, had a bad cold and smelt like garbage. I couldn't believe that they were going to send her home so soon. They wanted to wait a week to spay her and even then, I felt the surgery would be hard on her and it was. She sure has come a long way since then.

Good luck with your guy -- I will be thinking of you as well.

SuperWanda
November 26th, 2010, 11:31 AM
We feel that Timber is improving. She is eating much better now and she seems stronger in her hind legs and back.

We did notice though that her nose is starting to sound stuffy again -- this is what happened when her platelets dropped the first time and her nose started to bleed. I am worried that stopping the Imuran and cutting the dexamethasone back too much may be allowing her immune system to attack the platelets again???

I would like to find a balance between the antibiotic therapy and immune suppressive therapy but really don't know enough about it.

Am trying to get the vets involved again so we can do another blood test to see where we are at.

hazelrunpack
November 26th, 2010, 12:49 PM
That's good news, SuperWanda!!! When is she scheduled for another check with the vet? I think if I were worried about the platelets based on her symptoms, I'd follow up right away, too. I often take ours in for weird symptoms that the vets are surprised actually turn out to be somethings instead of flukes.... As they put it, they'll never discount an owner's concerns about symptoms, however subtle, because the owners know their dogs better than the vets ever can. So if you have a worry because of the stuffiness, I'd have the do the next blood check early!

MaxaLisa
November 26th, 2010, 12:55 PM
Cautiously optimistic, so glad to hear some good news!

I hope you can get a vet to team up with you now that you are seeing some nudging in the right direction - something to be thankful for!

SuperWanda
November 26th, 2010, 02:01 PM
Thanks Hazelrunpack and MaxaLisa!

MaxaLisa -- You'll be especially interested to know that they are now want to do a tick panel.

I have read that it is more accurate before you start the antibiotic so not sure what this means???

Also read that an antibody test as well as a Polymerase Chain Reaction Test should both be performed, but again, am worried about the antibiotic interference.

Trying to get an appointment now for another CBC and figure out where to send the tick tests. She said Toronto but I was online looking at North Carolina State University.

I'm also being cautiously optimistic because I heard that, although the acute form of tick disease has a good prognosis, the chronic form does not.

She said to increase the dexamethasone a little over the weekend if her nose seems stuffy or we see blood.

She also wondered about some kind of fungal infection in the nose but I feel that the nose problem comes from low platelets. :shrug:

We are at least sleeping better here -- Timber sleeps through the night now on less steroid -- is eating a regular amount of food -- doesn't have diarrhea -- and is not as wobbly in her back. If we can just get the lethargy and weakness resolved that would be amazing!

Rgeurts
November 26th, 2010, 02:35 PM
I'm SO glad to see Timber is eating again and regaining a bit of strength!! I was almost afraid to open the post. I hope you get a diagnoses soon :pray:. As for the fungals, we have to worry about that with Nanook as well. He aspirated with one of his seizures and had a transtracheal wash (they flush the lungs with saline, draw it out and send it in for cultures) which indicated Aspergillius, which is a form of fungus. It can definitely cause the symptoms that Timber has and affects dogs with immune related issues. Below is a link to Aspergillius in dogs:

http://www.gopetsamerica.com/dog-health/aspergillosis.aspx

They believe that in Nanooks case it was just a contaminant and he hasn't shown any real symptoms except the runny nose and occasional respistory infection. As the specialist said, if he did have it, he would be a lot sicker than he is.

I will continue to keep you and Timber in my thoughts and :pray: :grouphug:

MaxaLisa
November 26th, 2010, 07:42 PM
So now they want to do a tick panel....I would be concerned, only because if they get negatives everywhere, they will be inclined to state there is no tick disease, when you really won't know. As you say, she has been on antibiotics. On the slim chance there is a positive, it's nice to know what you are fighting. Tough situation!

You're right about an antibody test (looks for immune system response) versus PCR (looks for fragments of the disease itself) - both have their problems, and both can give the dreaded false negative :frustrated:

The problem with this low platelet stuff is that you might be looking at ehrlichia, anaplasmosa, babesia, and I think even bartonella or other mycoplasms. You can actually call NCSU or probably even Toronto and sometimes they will talk to you. I spoke with someone at NCSU before I sent a sample there for their bartonella testing (which, of course, was negative!)

Nasal issues are tough. They can be fungal (aspergillus, yes!), or tick related (bartonella produces lots of nasal issues), or probably other things. I never thought about the nose bleed and platelet issue. My boy has nose issues - the insides are red and inflamed and often he cannot breath. The "leather" part peels and bleeds. It's not autoimmune. I am still searching for some answers. I am hoping perhaps thought that there are some allergies.

I hope that you don't have to increase the suppressants. I think that yo-yo stuff makes the antibiotics less effective. I am a big believe in using cetyl myristoleate to dampen inflammatory processes by the immune system. My favorite is the Jarrow True CMO product.

I am just happy to have some good news!

SuperWanda
November 26th, 2010, 09:45 PM
Our vet will come on Monday for bloodwork. We are keeping the steroid at the same dose through the weekend so won't increase it.

Yes, a little worried about the tick tests now. Doesn't seem like it is very accurate.

That is interesting about the aspergillius. Timber has always had a runny nose ever since she was youngbut we've never noticed any pus or any discharge that lookedinfected. It has always been clear mucus.

The only reason I thought low platelets = nose bleeds was what the emergency vet said about seeing bleeding in the nose as a first indication because that is where the vessels are close to the surface. :shrug:

MaxaLisa
November 27th, 2010, 09:50 AM
I see what you are saying about the nose and the platelets. If the discharge is completely clear, hopefully there isn't an issue with the platelets.

Maybe the nose is just more inflamed because the immune suppressants were keeping that down better when at a higher dose. With Max, his is inflamed - don't know why though. Immune suppressants will reduce just about any type of inflammation?

Hope Timber is still doing a bit better this morning.

SuperWanda
November 27th, 2010, 11:31 AM
Thanks everyone!

I just hope we can all get our doggies to feel better.

Timber is still okay thismorning. I am very happy with her appetite and she had a little walk around the yard even though it seemed tough.

Just really sleepy and weak.

I'm a little nervous about the CBC on Monday. I just want some good results and I especially don't want to see that her red blood cells have dropped. She has been getting dog vitamins, liver and had some eggs with spinach. Trying to give her good iron rich foods.

MaxaLisa - picked up some whey protein and l-gutamine today so will see if I can mix that in with some yogurt or wet food today.

MaxaLisa
November 27th, 2010, 12:55 PM
You are doing such a great job with Timber, thank you for giving her a fighting chance when it seems that the vets wrote her off!

Blood tests at this point are scary things, I hope that this one brings some better news too :fingerscro

I hope that she doesn't have any issues with the glutamine or whey. Glutamine is very well tolerated, I've never known it not to do anything but help. Whey, in general, is just a good source of amino acids to support the body in times like this. The only time I've seen an issue with it, is when there is a severe dairy intolerance. Even my girl, she could not tolerate a lot of dairy, but she could tolerate whey. Max, the GSD, has a pretty bad dairy allergy, so he can't have whey.

All the good iron rich foods have to be helping, and, with the abx, I bet are part of the reason that she is able to get up and around, to the extent that that is possible for her right now.

I am nervous for Monday too!

SuperWanda
November 27th, 2010, 09:24 PM
Thanks MaxaLisa,

No problems with Timber and dairy. It's one of the food groups she loves.

I actually think it was goat's milk that saved her last week because that was one of the only things she liked.

Thank goodness she's back to eating meat!

hazelrunpack
November 27th, 2010, 09:48 PM
Crossin' all our fingers and paws here for good results on Monday, SW. :fingerscr :pawprint:

MaxaLisa
November 27th, 2010, 10:57 PM
Crossin' all our fingers and paws here for good results on Monday, SW. :fingerscr :pawprint:

ditto here! :fingerscr

SuperWanda
November 29th, 2010, 01:24 PM
Thank you Hazel, MaxaLisa,

Might not get any results back until tomorrow because my vet is a mobile vet and the samples go to the university here.

When her blood was taken it was very dark compared to a few weeks ago when it was thin and light colored. Hopefully that means better results :fingerscr

Tick testing to Toronto but just antibody testing for the common ones in Canada. Not for Bartonella or Babesia and it sounds like the specialist doesn't believe we get these diseases here even though I talked to someone from North Carolina State Testing Lab and they have a few cases in their database. The thing is, they just don't have a lot of data from Canada. How can we say something isn't here if we don't test for it? I know it might be rare but think it would be good to rule out especially if they require different antibiotics for treatment.

That's to say IF she has a tick disease I guess. I asked if her RBC came up would that mean it wasn't cancer? It would have to remain elevated and not drop back down.

Still a mystery I guess so one day at a time.

MaxaLisa
November 30th, 2010, 03:53 PM
http://www.germanshepherdhome.net/forum/images/graemlins/default/impatient.gif

So hoping for good news?????

:fingerscr

SuperWanda
November 30th, 2010, 04:05 PM
Finally some good news!!!! :thumbs up

Timbers platelets are up to 184. Her WBC down from 41.6 to 18.4. RBC up from 2.2 to 2.8 and PCV up from 15 to 23.4 (I don't even know what that is but has something to do with the transfusion range which she was previously in).

Does anyone know if it takes awhile to produce red blood cells. I really thought it would be higher but am not complaining because at least it is going up!

So, now we just see what the tick testing says. Not sure if antibiotics will affect the antibody test???

If they are negative I'd like to send to North Carolina for Babesia and Bartonella since they don't test for those in Canada.

My regular vet is happy and supportive of us looking at this as a rare case. I hope that the internal vet also sees that something positive is happening and wants to investigate further.

Rgeurts
November 30th, 2010, 04:22 PM
Finally some good news!!!! :thumbs up

Timbers platelets are up to 184. Her WBC down from 41.6 to 18.4. RBC up from 2.2 to 2.8 and PCV up from 15 to 23.4 (I don't even know what that is but has something to do with the transfusion range which she was previously in).

Does anyone know if it takes awhile to produce red blood cells. I really thought it would be higher but am not complaining because at least it is going up!

So, now we just see what the tick testing says. Not sure if antibiotics will affect the antibody test???

If they are negative I'd like to send to North Carolina for Babesia and Bartonella since they don't test for those in Canada.

My regular vet is happy and supportive of us looking at this as a rare case. I hope that the internal vet also sees that something positive is happening and wants to investigate further.

Yay Timber!!!! :thumbs up :highfive: :D
Even though the RBC isn't a huge jump, it's going in the right direction!!
This link may help you understand a bit more about the CBC. I found it so I would know what everything meant with Nanooks:

http://www.peteducation.com/article.cfm?c=0+1302+1473&aid=987

PCV=Hemocrit

I :pray: her results continue to get better with each test!! :grouphug:

MaxaLisa
November 30th, 2010, 04:49 PM
I cannot express how completely relieved I am to see this! I am also glad that it sounds like you have your regular vet in your corner. Do you think your reg vet will continue with the treatment that you have been giving? This may take months, and like mine, may have to be on doxy for a very very long time....

Antibiotics have a great potential to affect antibody tests, and I suspect PCR tests to some degree. While PCR tests, if positive, are definitive, negatives aren't. I keep hearing though that antibodies take a long time to decrease, so if they have the right test, it's possible you could get a positive. If they don't test for the right organism, then back to square one.

I know that the full Bartonella testing at NCSU is expensive. They told me that antibiotics like amoxi and doxy will keep the organism in check (and may skew the test results), but they can't eliminate it. They use azithromycin, the same abx that dropped Max's platelets.

SuperWanda
December 1st, 2010, 09:01 AM
Thanks for the link Rgeurts.

MaxaLisa -- for now we stay on the doxy. I have finished the metronidazole so I will be interested to see what happens because for the past few months, when she was not on the metro, she had diarrhea but when she was taking the metro, she didn't.

I am still confused as to what is increasing the platelets. She was only on doxy for two doses before she had a reading of 141 -- not sure if it you would get an increase that fast. And now it is 184.

I also hope that her RBC will continue to rise and it's not just up because of my vitamin and liver supplementation.

We get another blood test in two weeks so I'll be interested to see where we are at that point.

For now, she is off the Imuran and I have the dexamethasone down to 1mg in the morning and 1 mg at night.

I was also thinking about the time I was 24 years old and got mononucleosis. I was extremely ill and had to drop out of University. Could barely get out of bed or eat for a month. My spleen was enlarged and I was jaundice. It took at least a couple of years after that before the fatigue subsided.

Not saying my dog has mono but is it possible there are viruses that cause these types of symptoms in dogs and that, eventually, they will run their course???

MaxaLisa
December 1st, 2010, 10:37 AM
Just some rambling thoughts...

Great questions to which you may never have satisfactory answers!

Seems to me that Timber is in the chronic stage of *something*. The immune suppressants I am sure played a major role in bringing the platelets up. However, without the addition of the abx, they were also making her sicker in other ways.

The abx, I'm pretty sure, are what brought the WBC down. Whether it was the metro or doxy (or the combination, which is often important).

RBC, at thie point, I bet is anyone's guess.

Your "mono" question, that opens the door to a whole new school of thought, to which a number of folks subscribe to - all the subclinical type of infections that we harbor that make us ill on a grander scale. Knowing the things that different people have done to get better, I could see a ciral component, though I strongly believe that it's a blood infection. I think with viral, perhaps a different type white cell is elevated?

I would be nervous taking the metro off, but since you're watching closely and will be testing, it will be interesting to see how the immune system responds.

hazelrunpack
December 1st, 2010, 12:31 PM
Seems like a lot of positive news since last I logged on :thumbs up Hurrah!!!!

Sending :goodvibes: that the trends continue!!

SuperWanda
December 2nd, 2010, 09:16 AM
Thanks everyone,

Timber is also going to continue with the metronidazole. It seems like she is developing some runny stool after only a few day off. This seems to be an ongoing thing with her the past few months -- she's been on it for 10 days at least three times now and whenever we stop her bowels have trouble.

Maybe I should also up the probiotics. I am only giving 1 capsule between doses of the antibiotic but maybe she needs more.

She is still eating well. I feel if we can get her blood results back to normal it will still take some time to get her strength up again. At least she is showing interest in taking walks again - :thumbs up - she just can't go very far.

Myka
December 2nd, 2010, 12:02 PM
Sorry I haven't logged in in a long time. Timber has still been in my thoughts. I just read everything to catch up, and I was very worried for awhile there! I'm happy to hear Timber is improving, and I have my fingers crossed that you get some answers or at least you continue with improvement. Good for you! And please give Timber a pat for me, what a tough girl!

MaxaLisa
December 2nd, 2010, 08:43 PM
Has Timber ever had issues with ongoing Giardia? If so, maybe panacur would help? I wonder what the deal with the stools are - if they are related to all the other stuff, or something else.

My Max here has stool issues - I've found some digestive enzymes really help, others not so much.

It wouldn't hurt to play around with the probiotics. I recently found that Max is allergic to dairy, so he has to have a non-dairy probiotic, and I've had to take the yogurt out of the diet. Since Timber's problems seem to resolve with metro, it certainly sounds infectious.

So glad to see Timber still doing well!

MaxaLisa
December 3rd, 2010, 02:42 AM
Just ran across this info in humans:

"Chronic Babesia infects only about 1% of RBCs so it isn't all that easy to find."
From here: http://lymemd.blogspot.com/2008/09/babesia-i-hope.html

That means that a PCR test, that looks for fragments of DNA and such, sounds like it is looking like a needle in the haystack. NCSU may have better information.

SuperWanda
December 3rd, 2010, 08:58 AM
Thanks Myka --Yes, we thought she wasn't going to make it. She is still sick but showing improvement. We have another blood test on the 14th.


MaxaLisa -- Both my dogs have been on and off metro for boughts diarrhea with mucus. (Probably my fault for allowing them to live a dogs life and swim and drink stinky river and pond water). I'm not sure about giardia in the past but Timber's stool came back clean just recently when it was tested for parasites. I would think that would include giardia???

My vet was wondering about some kind of systemic colitis? I don't know.

Today I read that you shouldn't give probiotics while taking steroids so she has about a week left on the dexamethasone. After that I thought I'd get serious with the probiotics. There is one product called Bio-K that I have used myself and it comes in non-dairy (might be good for your Max) http://www.biokplus.com/ They only use two strains -- this is from their website:

Why does Bio-K+ CL1285 contain only two different strains of bacteria?
Scientific articles show that if there are too many different bacteria in the digestive system, they can compete against one other, limiting the concentration of the most effective strains1. There is a natural synergy that occurs with L. acidophilus CL1285 and L. casei LBC80R which is particularly effective against pathogenic micro-organisms. The result is a dual efficiency, with each Lactobacillus strain complementing the other.

Now, this is for humans but when I contacted them they said they have had some good results when it has been used with other animals as well.

It is been used in hospitals to treat C-diff and has gone through a number of clinical trials. Also helpful for treating colitis. I'm going to give it a try and see if I can't get her immune system strengthened because I'm sure with all these meds it's been severely compromised.

rainbow
December 4th, 2010, 02:20 PM
I haven't logged on here for awhile but am very glad to hear that Timber is doing better. I did answer your pm about zinc deficiency but after reading your last post I would really check into a diagnosis for giardiasis.

Both my dogs have been on and off metro for boughts diarrhea with mucus. (Probably my fault for allowing them to live a dogs life and swim and drink stinky river and pond water). I'm not sure about giardia in the past but Timber's stool came back clean just recently when it was tested for parasites. I would think that would include giardia???


Giardia is very difficult to detect and you have to have several stool samples checked as it is not always shed in every one. I think there is a specific test they have to do and I'm pretty sure if left untreated it can cause mild anemia as well.

rainbow
December 4th, 2010, 02:41 PM
Here's some info on Giardia I just found .....

From http://ezinearticles.com/?Symptoms-of-Giardia-in-Dogs-(Giardiasis-in-Dogs)&id=2524242

There are some clear factors of infection like a big number of white cells or anemia in the blood test. These are quite clear signs of infestation.



From http://www.canismajor.com/dog/giardia.html

If the dog is healthy, the trophozoites may live in the lower digestive tract for years. If the dog has an immature or overburdened immune system, the trophozoites continue to multiply by dividing and can cause the debilitating disease.

Blood tests appear normal with the possible exception of an increase in a type of white blood cells and mild anemia.

rainbow
December 4th, 2010, 02:52 PM
Here is some more info on Giardia ....


http://priory.com/vet/giardia.htm


http://www.beaglesunlimited.com/health/giardiasis-diagnosis-treatment-and-prevention

SuperWanda
December 4th, 2010, 04:42 PM
Thank you so much Rainbow and to everyone for their support!

I am in shock because I have just found out today that Timber has tested positive for anaplasmosis!

A huge Thank you to MaxaLisa for getting me back into thinking about the anaplasmosis again. If it wasn't for you Timber would be dead right now.

We continue to wean her off the steroids and obviously keep her on the doxycycline. She has lost so much muscle from the steroids and I have just made an apt with a vet here that does acupuncture/ rehab/ chiropractic and massage / Chinese medicine. They are booked until January so for now we continue to keep her eating well and going for very small walks to try and get her strength up.

I would also like to send blood to North Carolina to see if she tests positive for Batonella or Babesia because, as MaxaLisa has said, possibility of co-infections.

I just can't believe we got a positive result after months on steroids and antibiotics.

rainbow
December 4th, 2010, 06:46 PM
SW, I'm so glad that you finally got a diagnosis. :thumbs up :grouphug:

Hazelrunpack's dogs get anasplasmosis every year and I'm sure she will give you lots of info when she sees your post. The vets in Canada as well as our doctors need to get their heads out of the sand as tick disease is becoming more frequent here over the last few years.

Hopefully Timber will now be on the road to recovery. :fingerscr :goodvibes:

MaxaLisa
December 4th, 2010, 07:15 PM
Wow. After all that. A positive. Thank goodness. It actually brought tears to my eyes, how weird is that? I am so happy we got her through this crisis, and now you have a legitimate test to help you with the vets and continued treatment.

Will post more later when I get to my laptop - the server for this site was too busy to log on last night.

Wondering where the metro now fits in...also wondering if the steroids didn't ramp up a latent giardia problem.

You've done a great job getting her to this point SW, please give her some extra hugs from me!

SuperWanda
December 4th, 2010, 07:32 PM
Thank you rainbow, MaxaLisa,

Like I said, I would have given up if it wasn't for everyone's support here.

... and again, a huge Thank you to MaxaLisa! Timber is alive because of you!

I'm sure this news will spread to all the vets here and I hope her case will spark some changes in diagnosing these things and what to watch for.

I agree, rainbow, we need to be more aware of this -- doctors and vets.

rainbow
December 4th, 2010, 10:07 PM
...also wondering if the steroids didn't ramp up a latent giardia problem.


I agree and since that is very possible I would pursue it as well and also have your other dog tested.



I'm sure this news will spread to all the vets here and I hope her case will spark some changes in diagnosing these things and what to watch for.

I agree, rainbow, we need to be more aware of this -- doctors and vets.

Ask your vet if he/she would help to make other vets in Canada aware of this. There have been previous cases in BC that did make the news but obviously that hasn't helped much. :(

Myka
December 5th, 2010, 12:33 AM
Oh wow!!! This the such a breakthrough for Timber! Now, having this diagnosis, what does her future hold? How treatable is the infection?

SuperWanda
December 5th, 2010, 08:43 AM
Yes -- I will look into the Giardia. I am just wondering though if it is even possible since she basically took metronidazole for at least a month. I wouldn't think the Giardia would have survived.

I am going to start adding more probiotics now that the steroid is low (down to 1mg of dexamethasone) and see if that helps. I know that the metronidazole can be hard on the liver and with all the steroids she's had, I can't imagine that is helping.

Side effects of the doxy can be diarrhea as well. She is on about 7mg/kg body weight which is between the 5-10 they recommend.

Interestingly, I was also just given this information. In May she had heartworm and Lyme test (this is usual for us and we test every second year). My vet didn't realize that that also included testing for Anaplasmosis and Ehrlichiosis so she was negative just this past May! So, was she exposed between May and October -- that would mean a more recent infection or was the organism eluding her immune system and she tested negative anyways. I am hoping that it is a more recent infection and she can make a full recovery. It obviously didn't help to have her on all the steroids, azathioprine and other medications like the vincristine treatment when her poor body was trying to fight this infection.

This has certainly been a crazy past two months! I'm surprised I haven't had a heart attack!

Love4himies
December 5th, 2010, 10:24 AM
I am so glad you finally have a diagnosis and it does seem to fit with her symptoms, including the nosebleeds. :grouphug:

I know with humans, they sometimes have to be on doxy for quite a while to clear up lymes disease, at least a month for suspected cases. Doxy in many people can cause severe tummy upset, so could be causing her to not eat. It should only be given on a full tummy. I know, very difficult to do when she won't eat :frustrated:.

Sending lots and lots of :goodvibes::goodvibes: Timber's way and hoping that the Doxy will do the trick and get her healthy again :grouphug:

MaxaLisa
December 5th, 2010, 06:34 PM
About the probiotics and steroids - I don't really understand that. I know that many protocols use them together, say for Crohn's disease? I wonder if they just put that there to cover themselves for liability purposes?

The giardia. I know some have said that it never cleared with metro, and they had to switch to panacur. Luckily, that is one thing that I haven't had experience with.

So curious, what type of tick test was it that showed positive. Was it a PCR test?

I don't know if I posted it before, but this is the liver support product that folks on the tick list have had very good response to, including mine. It seems to help the kidneys a slight bit too.

I am told that the SNAP test is not very sensitive for anaplasmosa and/or ehrlichlia - a number of folks on the tick list will have dogs with negative SNAPs and positive titers. It is supposed to be much more sensitive for lyme.

I would hope that this is an acute infection, but that anemia a couple of years ago has me questioning that. It is thought that it takes a long time for the disease to start causing platelet and blood cell problems, but I also think that there is a lot that we don't know. It would be really nice if this were dealt with and there weren't ongoing issues. With Max, he will probably be on doxy for most of the rest of his life, unless I can figure out something creative.

Still, all in all, a very happy turn of events, and a HUGE relief! :dog:

Goldfields
December 5th, 2010, 06:48 PM
Congratulations, SW, your perseverance paid off. Big hugs for the patient, Timber, who I hope will feel a whole lot better now that you know what it is. MaxaLisa is owed a big licking by Timber right about now. I will have to do some Googling, some of your problems there may not be found in Oz. We have a paralysis tick but doubt if you have that particular nasty, and we sure wouldn't want the ticks you have.

MaxaLisa
December 5th, 2010, 07:11 PM
MaxaLisa is owed a big licking by Timber right about now.

http://i47.photobucket.com/albums/f179/other95/smileys/blush.gif I will happily accept those, happy Timber is here to give them!!

I hate to say that Timber is not out of the woods yet. Hopefully she will continue to respond to doxy only, and there aren't any other weird things that will complicate that. Treatment will have to be extended, and hopefully she will tolerate that. I have a cyber friend that treats no less than 3 months. Then, the next step will be if she will be able to handle life with no doxy at all. Lots of unknowns, but I think Timber and SW make such a great team, they will find their way through this!

hazelrunpack
December 5th, 2010, 07:32 PM
Thank dawg you finally got a diagnosis, SW!!! :grouphug:

Doxy can be very hard on the intestines so if you can work in probiotics, so much the better. Giving the antibiotic with food helps, too, but avoid giving it with dairy.

We've found in the past with stubborn cases that treatment with doxy followed by 2 wks of amoxicillin can turn things around. If she was exposed after May, she may not be chronic--this might still be the acute phase of the disease. It may be, however, that she was exposed earlier and the anaplasmosis was still 'under the radar' at the time of the first test. As I understand it, false negatives are more common than false positives.

I hope Timber has turned the corner and makes a full recovery now! :grouphug:

MaxaLisa
December 5th, 2010, 07:49 PM
...We've found in the past with stubborn cases that treatment with doxy followed by 2 wks of amoxicillin can turn things around. ....

That's really interesting, since both antibiotics seemed to help both of my dogs. In theory, amoxi is not effective against ehrlichia/anaplasmosa. I've been curious about this, and now more curious with the experience that you have!

SuperWanda
December 6th, 2010, 09:41 AM
Love4himis -- Thank you -- yes, I initially gave the doxy on an empty tummy but am now giving it with food so her appetite has improved. In fact, she actually seems to be very hungry lately which is a good sign. I think she has a lot to re-build!

MaxaLisa -- As for probiotics and steroids -- not sure why Bio-K has that on their website either because, like you, I have been reading about giving them together as well.

So, I guess that SNAP test is the one vet's have "in house". I will find out if that is the test she had in May??? or did they send it away???

I know it wasn't PCR she had just recently -- they sent to Toronto and it was antibody testing but I would think it would be different than the SNAP??? I was hoping that the Toronto testing was more accurate? I will get the details.

Thank you Goldfields! We are heading in the right direction now at least! I actually use to find ticks interesting but now I feel a little tick-phobic!

Hazelrunpack -- what is the reason for giving the amoxicillin at the end of the doxy? Because I was told she was negative in May -- I am also wondering if that is very accurate. I guess we'll never know. I just hope that when treatment is finished that she remains healthy -- I still want to look into the US testing at NCSU. They cover more diseases and I would feel better sending another sample there.

There are still many questions to ask and I will also look into the panacur. I have been giving probiotics regularly now two hours after her antibiotics (twice daily). I thought maybe this morning her stool was a little more formed :fingerscr Still soft but formed so hopefully this will help but I will ask about the panacur if the metronidazole isn't the best to clear an infection.

Love4himies
December 6th, 2010, 10:07 AM
Superwanda, it is my understanding that there are different phases of this disease as HRP mentioned. Normally there it can start as a severe form (acute as she mentioned) and can come back cyclically which may not be as severe.

http://veterinarymedicine.dvm360.com/vetmed/article/articleDetail.jsp?id=506867

Clinical and laboratory findings

Clinical disease in dogs is most often associated with the acute, bacteremic phase of infection. The duration and severity of the clinical findings during the acute phase of the disease can vary greatly and can last from one to several days.5

Chronic, subclinical, persistent infections have been documented for more than five-and-a-half months in dogs experimentally inoculated with a Swedish isolate of A. phagocytophilum and for almost one year in dogs inoculated with a human isolate from New York (NY18).6,7 However, no confirmed reports of clinical disease occurring in animals known to be chronic carriers exist. It is unknown whether a chronic carrier state can later result in chronic disease.

SuperWanda
December 6th, 2010, 10:39 AM
Thanks Love4himies -- yes, I'm not sure if she has the initial acute form or if we are seeing the later chronic form here.

She did test negative in May so if that is accurate, most likely she was exposed this fall season. I'm hoping this is the case because the acute form responds to antibiotics quite well.

If the test in May was not accurate (which is very possible), she may have the chronic form. Not sure how long it may have been eluding her immune system and can be more difficult to cure.

PCR testing will tell you if the animal has a current infection but I'm not sure if that would tell us if it is recent or not???

With Timber, she has a history of mobility issues so if she had the acute form years ago, I may have not even noticed. We are also just starting to learn more about Lyme -- if you mention anaplasmosis here, most people haven't even heard of it.

Very frustrating!

SuperWanda
December 6th, 2010, 11:41 AM
Poor Timber -- I was just thinking about all she's been through. Many of you might remember that it was Timber who was diagnosed with a cancerous sarcoma on her leg. The tumor was removed with plenty of tissue and it was a long recovery because it was right by her knee so she hardly has any muscle there. After it was removed it was sent for testing and it ended up being a benign fibroma. Pathologists can be wrong.

Our other dog is the one that had the mast cell tumor removed from her nose but no sign of any regrowth -- it has now been 1.5 years! We were told there was a 50% chance that it might come back after 3 years so we are half way there.

Just reflecting on their lives to date. Make me a little teary :cry:

They are such great dogs and are essentially my kids as we have no human children. When your pets are ill you just really reflect on the time you have with them and how much joy they have brought to your lives :)

hazelrunpack
December 6th, 2010, 09:00 PM
That's really interesting, since both antibiotics seemed to help both of my dogs. In theory, amoxi is not effective against ehrlichia/anaplasmosa. I've been curious about this, and now more curious with the experience that you have!

Hazelrunpack -- what is the reason for giving the amoxicillin at the end of the doxy? Because I was told she was negative in May -- I am also wondering if that is very accurate. I guess we'll never know. I just hope that when treatment is finished that she remains healthy -- I still want to look into the US testing at NCSU. They cover more diseases and I would feel better sending another sample there.


Interestingly, we discovered the doxy/amoxi trick by accident. Lepto seems endemic here and every fall at least a few of the dogs come down with it. Sometimes the anaplas masks the lepto, in that once we get the anaplas positive result, we don't bother to test for the lepto. So if we have a dog that doesn't seem to bounce back completely on the doxy, we then switch to a 2-wk course of amoxi to finish off treatment (which is the protocol for lepto), assuming that the reason for the continued symptoms is an undetected case of lepto. HOWEVER, we've had dogs test positive for anaplas that turned around on the doxy/amoxi combo without the lepto titers converting during treatment--which indicates that if lepto was present, it wasn't one of the strains that they test for. Our suspicion is that in those cases, lepto was not involved but there was still something in that antibiotic combination that worked against the anaplas better than doxy alone. But we haven't a clue as to why it works. :shrug: :o

Sending more :goodvibes: for Timber's continued improvement!!!

Myka
December 6th, 2010, 11:51 PM
I tried calling in to Dr Shawn the Natural Vet on the Sirius Radio lastnight, but he was so busy I couldn't get through. I bet I tried 180 times in an hour! I wanted to see if he had any ideas to help Timber out with the Anaplasmosis, but also ideas to combat the affects of the previous drugs she has taken. It's a bit heartbreaking to know she didn't need those powerful drugs, but hindsight is usually 20/20 right? There is a bright side to every cloud though, and at least she is on a more promising road this week.

How is she eating now? Is she still on hotdogs and spinach? Have you tried feeding canned green tripe? I use Tripett brand, the dogs go ravenous for it, and I would think it would be nice of Timber's stomach provided you don't give very much as it's quite rich. Green tripe has lots of digestive benefits, could help her out.

SuperWanda
December 7th, 2010, 10:09 AM
Thanks for that info Hazelrunpack and thank you Myka! That's so nice of you to give up your time like that to try and get her some help :)

I've really been concerned about her liver because of all these medications so I want that to be part of the next blood test. I am seeing an alternative healing vet here on Jan 4. She does things like Chinese medicine/acupuncture/rehab so I'm hoping that will help. Rgeurts has seem good results with Nanook if you have been following her post so I thought i would give it a try.

Timber is eating very well. She is always hungry now and I think that is a good sign. I have always given Orijen and she is also getting some canned dog food as well as the foods I add to their diet like liver, eggs, veggies, meats, fish etc.

I'm also doing what MaxaLisa suggested and giving the whey protein powder.

I am taking her for small walks now but she can't go too far. She hasn't had any exercise for two months so that, in combination with the meds has really weakened her. But, she does want to go out for walks now so it might just take awhile to get her endurance up. She still sleeps a lot but she has a lot of healing to do.

Her skull has been so apparent under her fur because of the muscle loss The bone around her eyes is really apparent and on top of her head. My parents came over and thought that she was looking better so maybe it is coming back a little :pray:

Myka
December 7th, 2010, 11:04 AM
Oh, it wasn't a big deal. I was just driving on my way home and hitting the redial button. Personally, I would be just as careful with an alternative therapy vet as with a regular vet. There are bad apples in every bunch, and there are some very powerful "alternatives"! :D

I'm glad to hear Timber is back to her normal diet. I thought she still had a depressed appetite.

Love4himies
December 7th, 2010, 12:07 PM
Sounds like Timber is coming around :thumbs up. Sending lots of :goodvibes: that the Doxy will clear up Timber's illness.

rainbow
December 7th, 2010, 01:36 PM
Glad to hear that Timber is continuing to do well and back to eating normally again. :goodvibes: :grouphug:

I also agree that green tripe would be excellent to feed. There are a few brands but Tripett (http://www.tripett.com/Home.html) is the only canned one I would feed. :thumbs up

Milk thistle is a good supplement to support the liver. From http://www.liversupport.com/wordpress/2008/08/can-milk-thistle-help-your-pet/


Although the conditions milk thistle is used for varies widely in pets, ailments requiring liver support seem to benefit the most. Since the liver is an important component of digestion and detoxification, any illness involving these two are likely to benefit from milk thistle (especially silybin phytosome) supplementation. Whether you or your pet need hepatic support, milk thistle is a time-honored, well-researched and widely praised therapeutic option for increasing the resiliency, re-growth and recovery of this vital organ.

MaxaLisa
December 7th, 2010, 10:38 PM
I don't know if I posted it before, but this is the liver support product that folks on the tick list have had very good response to, including mine. It seems to help the kidneys a slight bit too......

Did I forget to post the link, or are they not allowed here?
http://www.iherb.com/country-life-biochem-liver-support-factors-100-tablets/1670?at=0

SW, I saw that on 11/2 Timber's liver enzymes were elevated. Have they been tested since? Are they changing in either direction?

I am so glad that she is wanting to go for walks, that's huge progress :)

MaxaLisa
December 7th, 2010, 10:40 PM
Interestingly, we discovered the doxy/amoxi trick by accident. Lepto seems endemic here and every fall at least a few of the dogs come down with it. Sometimes the anaplas masks the lepto, in that once we get the anaplas positive result, we don't bother to test for the lepto. So if we have a dog that doesn't seem to bounce back completely on the doxy, we then switch to a 2-wk course of amoxi to finish off treatment (which is the protocol for lepto), assuming that the reason for the continued symptoms is an undetected case of lepto. HOWEVER, we've had dogs test positive for anaplas that turned around on the doxy/amoxi combo without the lepto titers converting during treatment--which indicates that if lepto was present, it wasn't one of the strains that they test for. Our suspicion is that in those cases, lepto was not involved but there was still something in that antibiotic combination that worked against the anaplas better than doxy alone. But we haven't a clue as to why it works. :shrug: :o

I guess it doesn't matter why, in the long run, as long as you have a protocol that works! I will remember this, thank you :)

SuperWanda
December 8th, 2010, 05:41 PM
Thanks again everyone for the thoughts and advice -- why do I even need a vet???

I've added all of you as contacts so if you click on "SuperWanda" you should be able to view my albums if you are interested in seeing pictures of our :dog:'s.

Rgeurts
December 8th, 2010, 05:56 PM
I've really been concerned about her liver because of all these medications so I want that to be part of the next blood test. I am seeing an alternative healing vet here on Jan 4. She does things like Chinese medicine/acupuncture/rehab so I'm hoping that will help. Rgeurts has seem good results with Nanook if you have been following her post so I thought i would give it a try.

Yes... Nanooks liver was completely healed and back in the normal range :thumbs up

Our vet and specialist told us there was nothing we could do and at the rate of damage he may live to about 4 yrs. He started the herbal combo on a Monday and the following Friday his liver was normal :D
Timber is eating very well. She is always hungry now and I think that is a good sign. I have always given Orijen and she is also getting some canned dog food as well as the foods I add to their diet like liver, eggs, veggies, meats, fish etc.

I'm SO glad she is eating again!! :D

Her skull has been so apparent under her fur because of the muscle loss The bone around her eyes is really apparent and on top of her head. My parents came over and thought that she was looking better so maybe it is coming back a little :pray:

Nanook looked like a walking skeleton. It was heartbreaking :cry:
His little eyes were so sunken and he had atrophy. His cheeks were hollowed out, his head was pointy due to the loss of muscle around his skull(he looked like a little conehead :eek:)... he just looked like death. After just reducing the pred for the last 3 weeks, his head is already filling out. He's looking great :)
I'm sure Timber will start to fill out again too :pray:

Myka
December 9th, 2010, 12:06 AM
Hi Superwanda, I got through on the line to Dr Shawn lastnight. Sorry I forgot to post about it! He didn't say anything too exciting seeing as I guess he doesn't deal with Anaplasmosis where he is. He did suggest using any of the liver support and antioxidant supplements on his website. He also suggested that you could set up a phone consultation with him. I believe it is your vet that would talk to him, not you, but I am not totally sure. He said to email if you want to set that up.

http://www.petcarenaturally.com/

http://www.petcarenaturally.com/supplements.php

hazelrunpack
December 9th, 2010, 10:02 AM
omd, SW, your albums are so beautiful!!! Timber and Shiloh are absolutely gorgeous!

Is Timber still improving? :fingerscr :goodvibes:

SuperWanda
December 9th, 2010, 05:17 PM
Rgeurts -- Timber has that same pointy head, sunken eyes and no cheeks :eek: Terrible! Did your Nanook's nose ever change color on the meds? Timber use to have pink in the middle of her nose but now it is all black. Not sure if it will change back once she is off the meds or not?

Thank you Myka! I haven't heard of Dr. Shawn -- is that the Martha Stewart vet? I will certainly look into that. I wonder if they ship to Canada? Or maybe the alternative vet here will have a similar product for liver support?

Thanks Hazelrunpack -- now you can see why they may have some problems with Giardia -- all that stinky green water :eek: They have had fun despite the risks although this experience has scared me now. I may be investing in a tick collar and excluding the swimming :(

MaxaLisa
December 9th, 2010, 09:08 PM
Timber and Shiloh are great looking dogs!

Sure hope that you can get her past that "pointy head" issue soon.

hazelrunpack
December 10th, 2010, 07:10 PM
I may be investing in a tick collar...

Tick collars aren't very good...topicals are much better protection and even they aren't 100% (though they're pretty close) :thumbs up

rainbow
December 10th, 2010, 10:43 PM
I love the pics you posted in your albums ....Timber and Shiloh are two beautiful puppers. :lovestruck:

Is Timber still doing well? :fingerscr :goodvibes:

MaxaLisa
December 11th, 2010, 01:59 AM
I've actually had very good luck with the Preventic Tick collar. I've found ticks crawling on my girl with that when I used to use it exclusively, but I never found one attached. That was not true when I was using Frontline. They aren't a good option if you have dogs that bite each other's neck.

From what I'm hearing on the boards, response to Frontline is regional, some places it seems to work better than others. Some believe that the Frontline Top Spot is more effective than the Frontline Plus. I think that was my experience.

Love4himies
December 11th, 2010, 06:17 AM
Oh, your pups are beautiful :cloud9::lovestruck:

Is Timber still getting progressively better :pray:?

SuperWanda
December 11th, 2010, 05:24 PM
Thanks everyone!

Yes, I think every day she is doing a little better. The one thing I wish would improve is her energy level. She is really slow on walks and can't go very far. Hopefully that will improve with time.

Her appetite is still great so that is a good sign.

Our vet is coming on Tuesday for another blood test. She is going to bring some Panacure so hopefully that will settle the loose stool which I am still dealing with.

I'm guessing that her platelets will be higher but not sure about the white cells or red cells -- if there is a Giardia infection and I haven't had her on the metronidazole, I'm wondering if the white cells have increased again? Her gums are nice and pink now so wondering if she's not as anemic.

hazelrunpack
December 11th, 2010, 06:27 PM
Pink gums are a good sign! :thumbs up I hope the Tuesday blood test gives you nothing but good results!! :goodvibes:

rainbow
December 11th, 2010, 06:46 PM
Yep, pink gums are a really good sign. :thumbs up

Glad to hear that she is still eating well and I'm sure her energy level will improve with time. Good luck with the blood test on Tuesday. :fingerscr :goodvibes:

Love4himies
December 12th, 2010, 06:42 AM
Yup, pink gums and good appetite are all good signs :thumbs up. As for the energy, just like humans after getting over such a serious illness, it takes time for the muscles to regenerate itself.

Lots of rest and sleep is better for her now anyways :grouphug:

Sending lots and lots of :goodvibes:

Myka
December 14th, 2010, 01:45 AM
Thank you Myka! I haven't heard of Dr. Shawn -- is that the Martha Stewart vet? I will certainly look into that. I wonder if they ship to Canada? Or maybe the alternative vet here will have a similar product for liver support?

You're very welcome! Ya, Dr Shawn (the Natural Vet) is one of the vets on the Martha Stewart radio channel on Sirius. Another vet she has on is Dr Marty (Ask Martha's Vet) who also practices integrated veterinary care. I think Dr Marty would probably give better advice in your case. He was on lastnight, but I didn't have any cell reception to try to call.

I'm sure you could find a similar product in Canada or get it shipped.

SuperWanda
December 14th, 2010, 04:01 PM
Dr. Marty -- yes, he is the one I am familiar with. Thanks for that info Myka!

Had some great news today -- Timber's blood was almost normal! Her platelets are 287, WBC are 6 and RBC are 4.8 (still a little low but much higher than last time).

We are also going forward with further testing for Bartonella and Babesia and that will be sent to North Carolina State University.

I am really happy about that. Not sure if we will find out anything further but it may bring some peace of mind after everything that has happened.

Just took the dogs for a walk and we went a little further today. Before this all started, Timber did have some spinal weakness (discospondylosis) so not sure if I am seeing that or the effects of the anaplasmosis or both problems? She does sometimes stumble still and we went down a bit if a snowy incline and she fell down so doesn't have good control or strength back. I hope that it is just from muscle loss and not permanent damage. She really wants to participate in things now so I am happy she is enjoying life again!

Myka
December 15th, 2010, 04:51 AM
Great news SuperWanda! Go Timber Go!!

hazelrunpack
December 15th, 2010, 09:18 PM
Great update on the bloodwork, SW! :highfive:

MaxaLisa
December 15th, 2010, 10:15 PM
Great update :) so glad her bloodwork is responding so well.

I hope her strength and stability continue to improve and a steady pace. there are so many variables at play here, but she sounds so much happier and stronger, and that just makes my day!

rainbow
December 16th, 2010, 12:43 PM
Awesome news :highfive: and I hope Timber continues to improve. :fingerscr :goodvibes: :grouphug:

SuperWanda
December 16th, 2010, 04:55 PM
Yes -- things are really looking up. I feel a huge weight has been lifted from our shoulders. When I look back now I really can't believe it. Especially after the cancer diagnosis when she was in transfusion range, hardly able to walk or eat.

I am very thankful for everyone's support here! I really appreciate the time you took to wish us well, offer advice or answer my questions -- it really helped me take care of her when she was so ill.

MaxaLisa's determined e-mails trying to get us to consider the possibility of tick disease again -- pretty amazing considering we are on the internet and in an area where anaplasmosis is not that common.

Thank you so much to everyone and I hope you all enjoy a wonderful holiday with your loved ones (furry or not so furry)!

MaxaLisa
December 16th, 2010, 07:13 PM
After your update on the 14th, I was thinking about you (SW) and Timber as I was driving on the way to work...just the way that everything happened and everyone seemed to be in the right place to help Timber through. I have to give great kudos to you for asking a lot of questions, and following through on your instincts once you gathered the info you needed to make your decision. Nothing at all was clear, but it was all about the best treatment considering the odds.

Very surreal in some aspects, and I bet you will be processing it a bit for awhile. Curious if you've had this conversation with your vet, and what your vet thinks of all this.

I lost my heart dog on 10/2. She had the high neutrophil pattern too. I think she had a raging infection that got to her brainstem. I couldn't save her, and I had to fight with the vets and never really had a chance to treat her for what I think she had. I think she was probably too far gone, even if I could have got her the right treatment. I like to think that she was helping us out with Timber.

Myka
December 20th, 2010, 12:18 AM
That'sd a nice thought MaxaLisa. :)

MaxaLisa
December 21st, 2010, 03:59 AM
Thank you Myka :)

Myka
December 23rd, 2010, 08:37 PM
How is Timber doing these days SuperWanda?

MaxaLisa
December 24th, 2010, 04:22 AM
I've been wondering the same thing?

Myka
December 24th, 2010, 12:07 PM
She's probably busy with the holidays. I hope Timber is continuing to do better everyday.

SuperWanda
December 24th, 2010, 12:15 PM
Hi MaxaLisa, Myka,

Timber is doing very well! She is still not back to where she was before this all happened but I think I see a little improvement every day. She has gained a lot of the weight back now so is looking quite a bit better.

Still weak in her hind end and seems to have a chronic limp but hopefully we can get that settled down with our visit to the alternate healing vet here.

She is off all steroids and I just stopped the doxy -- really watching her now. I was just talking with someone who's dog had Lyme and had to go through 3 rounds of doxy before symptoms subsided.

MaxaLisa -- Thank you so much for your thoughts! I am so sorry about your loss. Do you think that she had the same illness as Max? How is he doing? Is he still improving?

As for what all the vets think about this -- haven't heard anything from the internal medicine specialist -- she was the one that finally sent the blood to Toronto for tick testing but got our regular vet to deliver the positive results. She knew our regular vet had prescribed the doxycycline but the last time we spoke, she thought it would be a miracle if she responded -- and then the results came back positive so I would think she would have been very surprised but really don't know.

I did call and leave messages with receptionists about what Timber had with the first clinic we visited and the emergency clinic. I wanted the emergency vet to call me back but she never did so I just left the information with the receptionist.

Overall I'm a little upset that the vet's I dealt with haven't really expressed anything over the situation. It makes me think that they don't care or are even happy that we found the right answers. I don't know...

I do appreciate that our regular vet is the one that is still sticking with us now. She is the one that got us going on the doxy and has helped us get the blood to North Carolina for further testing -- just got those results back and Timber is negative for all other tick disease. I know that isn't 100% but it makes me feel better for now.

Happy Holidays everyone!

MaxaLisa
December 24th, 2010, 01:27 PM
Glad to hear that she is still doing well!

I am *really* concerned to hear that the doxy has been stopped. She was so sick, and not off the steroids for very long, and this is chronic, probably going back to that anemia a couple of years ago - the bugs are deeply rooted in her. I know that you will be watching carefully and frequently testing those blood counts.

Even after a year on doxy (also used for treating his fistula), it only took a month for Max's platelets to start dropping and for the red blood cells to start looking not normal. He is now back on his abx regimen, but at least he is still here and not in crisis. It will probably eventually win, whatever he has, but with luck, it won't be for a long time.

Do keep an eye on the limp, if it starts getting worse, back on that doxy!

It is disappointing that you haven't really heard back from some of the vets. I would have hoped they would have showed more professional interest, if not personal interest :(

Myka
December 24th, 2010, 01:36 PM
Overall I'm a little upset that the vet's I dealt with haven't really expressed anything over the situation. It makes me think that they don't care or are even happy that we found the right answers. I don't know...


Hmm...that is rather frustrating. :frustrated: I think it would be in all vet's and all dog owners' interest to be aware that tick diseases are a concern in the prairies! I don't understand why the vets don't think this is significant!

I'm happy to hear Timber is continuing to improve. I was also under the impression that the Doxy would need to be continued for quite some time.

SuperWanda
December 31st, 2010, 10:22 AM
We are getting some more doxycycline and are having a blood re-count next Thursday. Next week is also our appointment with the alternative therapy vet.

She is still doing well but seems to have some limping that comes and goes. Not sure if that is from the muscle weakness and everything she's been through or still signs of the disease itself so she will get some more doxy as a precaution.

I hope the next blood test shows that her platelets and RBC are still going up!

hazelrunpack
December 31st, 2010, 12:26 PM
Oh, good! I'm a fan of keeping them on the doxy until all the bloodwork is normal and the symptoms are totally a thing of the past! Hope Thursday's blood results show continued improvement!!! :fingerscr

rainbow
December 31st, 2010, 01:15 PM
SW, I've been thinking of Timber often so thanks for updating us. :thumbs up

Glad to hear that she is still doing well :goodvibes: and hoping for a good report on the blood test. :fingerscr

Myka
January 1st, 2011, 09:46 PM
Thanks for the update SW! Fingers crossed for Timber's Thursday blood test!

MaxaLisa
January 2nd, 2011, 03:06 PM
Relieved to hear about the doxy! I too like to keep them on it until all is normal, and then just a bit longer, particularly when they have been so sick.

I'll be very interested in the bloodwork! Very happy to hear that she is still doing better. That limp, if it doesn't improve with antibiotics, might be a chiropractor thing, I dunno.

MaxaLisa
January 7th, 2011, 05:56 PM
Fingers crossed for good bloodwork results....

rainbow
January 7th, 2011, 06:27 PM
Hope Timber's blood test results are improving. :fingerscr :goodvibes:

MaxaLisa
January 11th, 2011, 10:57 AM
Update?????

hazelrunpack
January 11th, 2011, 01:02 PM
I was hoping for one, too! :o

:goodvibes:

rainbow
January 11th, 2011, 01:04 PM
That makes three of us. :fingerscr :goodvibes:

MaxaLisa
January 11th, 2011, 01:10 PM
Hopefully no news is good news :fingerscr

SuperWanda
January 12th, 2011, 04:58 PM
Hi everyone.

I wonder why they moved this thread to senior dogs since younger dogs can be afflicted with the same condition???

Sorry to keep you waiting. I just got the results back yesterday. Not sure why they took so long but maybe because we were right upon the weekend.

The results aren't too bad but her platelets have dropped from 287 (Dec 14) to 191. Her red blood cells are normal (5.74) and her white count has dropped from 6 to 5.4 so that is good.

As you know she is on the doxy treatment again (started Jan 1). I did contact the fellow who was co-author of the journals in which anaplasmosis was studied in Minnesota and in the 3 cases in Saskatoon. He use to work at North Carolina State U but now teaches. He gave me some really great advice and he told me that in their studies, anaplasmosis does not become chronic so once you treat it it should be cleared from the body. That being said, because Timber's immune system was suppressed an additional treatment in her case is needed because the antibiotic kills the multiplying bacteria but it is the dogs immune system that takes care of the rest. So we can't be sure she was able to get rid of the entire infection. He also said that The only tick-borne diseases that can be in a sub-clinical phase ("hidden") and come back after stress or other immunosuppression episodes are Lyme disease, Ehrlichia, and Bartonella.

After getting these results my vet suggested putting Timber back on low dose steroids. I certainly felt worried about doing that but I guess she just wasn't sure if we weaned her off too quickly or not and wondered if that was why her platelets had dropped. Again, I contacted this fellow for advice and his suggestion was not to introduce the steroid again --- in his words:

At this point the big question is: did your dog develop immunomediated thrombocytopenia (ITP)? And if yes, did he develop before, during, or after Anaplasma infection? It is not an easy question, because both diseases cause decrease in platelets. There is no specific test to diagnose ITP, and we normally need to rule out other diseases first (especially tick-transmitted diseases). Therefore, I would not reintroduce dexamethasone at this point, so you can be sure that doxycycline would be efficient and infection is not part of your problem anymore.

You should not be so worried about the platelet numbers, because it naturally varies a little bit within the normal range. For some labs, >180,000 is normal, for others >200,000. If it takes too long for the sample to arrive in the lab, platelets clump together, and the machine artificially reads less platelets in the sample. Always ask for a blood slide review, so the pathologist will tell you if there is an adequate number of platelets or if there are clumps. Platelets also adhere to glass surfaces (including blood tubes!) if they are not analyzed within few hours after the collection.Your dog should not experience any bleeding disorder if platelets are >50,000.

Finally, corticoid therapy increases platelet production even in healthy dogs. Dogs with abnormally high values of endogenous corticoid (due to an adrenal tumor for example) normally have very high platelet numbers. So I would expect a slight decrease in platelet number after you stop dexamethazone.

If you had stopped dexamethazone too fast, your dog would be really really sick by now (vomiting, diarrhea, etc). I dont believe this is the case.

I would repeat a blood cell count by the end of the doxycycline treatment, or if the dog gets sick before it. Lets hope that everything goes well this time.


So, it is always good to ask questions and I think after all that has gone on, I seem to be questioning everything now.

As for the patient, she is doing great. I think she is almost back to her old self, gaining more weight and howling all the time. She has gained back 10 pounds so looks much better! We have a second appointment for acupuncture and some chiropractic adjustments. I'm not sure if I noticed a difference but we only had one visit to date so we will wait and see what happens. Her spine and pelvis area are very stiff and her legs are still weak. She still limps but I believe this might be an injury from so much muscle wasting and weakness. She had a burst of energy and was digging a hole in the snow but right after that caused her to limp again so that's why I think she may have some kind of chronic injury.

Good news overall! :D

Love4himies
January 13th, 2011, 08:01 AM
That is great news :thumbs up. I am so glad you contacted the researcher, I would be listening to his advice, for sure!

If he is indeed correct about the immune system needed to fight the existing bacteria, then for sure, your dog should not be put on steriods :frustrated:, that is only common sense.:frustrated::frustrated:

Now of course we do need pics of the patient so we can evaluate for cuteness :cloud9::lovestruck: :D

rainbow
January 13th, 2011, 12:40 PM
SW, that is wonderful news. :goodvibes:

I too am glad that you contacted the researcher ....without his advise, poor Timber would be back on steroids again so kudos to you for checking things out so thoroughly. :thumbs up

Has your vet shown any more interest in getting information out there that tick disease does happen in Canada? Perhaps, if you could get a newspaper to publish Timber's story just to make the public more aware to get help if they suspect it with any of their pets.

Sending more :pray: :fingerscr :goodvibes: for Timber's recovery and yes, I'd love to see new pics too. :goodvibes:

hazelrunpack
January 13th, 2011, 02:22 PM
Wonderful update, SW! :goodvibes: So glad that Timber seems to be on the road to recovery now!!!

Myka
January 14th, 2011, 12:32 PM
Interesting update! Very interesting to hear what the researcher had to say.

SuperWanda
January 14th, 2011, 05:17 PM
Thanks everyone!

I also wanted to ask your opinions on the panacur for giardia. I haven't given it yet because I wanted to wait until Timber was off the doxycycline and feeling better.

I received it in a liquid form and am to give 13.7 ml once a day for three days. Has anyone else used the liquid? Seems like a lot to give and so I'm wondering how I will manage disguising it. :shrug:

Rgeurts
January 14th, 2011, 08:10 PM
Thanks everyone!

I also wanted to ask your opinions on the panacur for giardia. I haven't given it yet because I wanted to wait until Timber was off the doxycycline and feeling better.

I received it in a liquid form and am to give 13.7 ml once a day for three days. Has anyone else used the liquid? Seems like a lot to give and so I'm wondering how I will manage disguising it. :shrug:


So glad to see things are looking up and Timber is slowly getting back to normal :lovestruck:

As for the liquid version of the panacur, I used it for both Thorin and Nanook a few months ago. We REALLY struggled for the first day and a half... until I figured out how to do it :lightbulb: lol. Ours wouldn't take it in food or water, and you have to be very careful just shooting it into the mouth as they could inhale it. We fought (literally) with Nookie trying to get his mouth open enough to get the syringe in. That is, until, hubby held him and I just pulled his bottom lip out and squirted it (very slowly) between his back molars and cheek. We did the same for Thorin and it worked well :D

Neither one seemed to mind that... but try to pry their mouths open... forget it:laughing:

SuperWanda
January 18th, 2011, 02:35 PM
Thanks for the tip Rgeurts! Seems like a challenge but I will try your suggestion when the time comes.

I was just reading your thread and hope all is well with Nanook. Poor guy, however, if it turns out to be thyroid, at least you have some options.

MaxaLisa
January 19th, 2011, 12:41 AM
Wow, lots of news!! So glad that Timber is still doing well overall. Seems like those blood tests took forever :o

To be honest, when I heard that she was off the doxy, I expected the platelets to drop. Same thing happens with Max. Great that the RBC is holding and the WBC has come down (is it normal now?).
I am absolutely shocked that the vet would want to put Timber back on steroids. She just doesn't "get it" http://i47.photobucket.com/albums/f179/other95/smileys/gaah.gif

This entire process really is life changing, and very likely changes how you look at a lot of this medical stuff.

I think it's great that you contacted the researcher. I've been thinking about the meaning of "chronic". We have seen these chronic disease states on the tick list from dogs treated for anaplasmosis. So I guess the question really is, whether the infection is really cleared, and that makes sense to me. I think the disagreement may lie in how "easy" it is to eliminate the organisms throughout the body.

I think any disease process that the immune system is responsible for keeping in check will flare when the body is stressed, no matter what. He seems to make a distinction between anaplasmosa and ehrlichia, interesting, perhaps a lot more to learn there!

And the most important thing, so glad that Timber is doing so well. With the weight gain and vocalization, how great to have her back http://i47.photobucket.com/albums/f179/other95/smileys/wub.gif

I hope that the limp gets better, but in the grand scheme of things, Timber with a limp is soooooooooooo much better than no Timber at all. I was getting really worried when we hadn't heard from you. Often that's terrible news. What a relief!

SuperWanda
January 24th, 2011, 03:45 PM
Has your vet shown any more interest in getting information out there that tick disease does happen in Canada? Perhaps, if you could get a newspaper to publish Timber's story just to make the public more aware to get help if they suspect it with any of their pets.


No, not really. I did ask if this was a reportable disease and apparently it is not one that needs to be reported to the CDC. That really surprised me considering humans can also get this disease and Lyme is on that list :shrug: I meant to go to our MB government website and find out why.

SuperWanda
January 24th, 2011, 03:48 PM
Thanks MaxaLisa,

We will test again on Feb 6 (that would be a month since the last blood test and after another 30 days on doxycycline).

Still has a chronic limp but seems happy overall :)

Has anyone tried a product called Recovery SA? I might try it with Timber.

http://www.recoverysa.com/

Rgeurts
January 24th, 2011, 04:29 PM
We have Nookie on Recovery SA. Dr. Marsden put him on it about 6 weeks ago. I don't know if it's helping a lot. Nookie still has a pretty bad limp. But he doesn't seem to be hurting as bad, so who knows :shrug:

We were getting it through the vet at $33.00 per 100 grams :eek: :eek:(which only lasts a little over a week at Nookies size). pbpatti told me to check Tailblazers. I did and we now get a 350 gram jar for $42.00 (thank you patti!! :D). Once they get the 2.2 lb container back in stock, I will be buying it that way for $79.00.

I'm very glad to see Timber is still doing well, overall!! :lovestruck:

Chris21711
January 24th, 2011, 05:45 PM
Has anyone tried a product called Recovery SA? I might try it with Timber.

http://www.recoverysa.com/

I use it for Skippy, more as a maintenance supplement, he has a bit of a tricky back leg and is 11 1/2 years old. I think without it he could develop problems.

I also used it on Cocoa before she passed on, she went from having senior difficulties to jumping in 3 weeks.

They now have Recovery Extra Strength which is suppose to be better http://www.purica.com/recovery.htm......When we finish the tub we have I will then go to the Extra Strength formula.

Rguerts you say you go through 100grms in 1 week, is that the dosage that Dr. Marsden suggested you use?

Rgeurts
January 24th, 2011, 06:16 PM
Rguerts you say you go through 100grms in 1 week, is that the dosage that Dr. Marsden suggested you use?

It is. We give Nookie 3 tsps a day. Seems like a lot, but when I calculated the dose from the label, it's only 1/2 tsp more than what the label says :shrug:

Chris21711
January 24th, 2011, 06:19 PM
It is. We give Nookie 3 tsps a day. Seems like a lot, but when I calculated the dose from the label, it's only 1/2 tsp more than what the label says :shrug:

According to the label, doesn't it say to lower the dose after the first few weeks and keep them on a maintenance dose.....you might find the Ex Strength is better for Nookie...that doesn't come in the 1 kilo tub though, not yet.

Rgeurts
January 24th, 2011, 06:33 PM
According to the label, doesn't it say to lower the dose after the first few weeks and keep them on a maintenance dose.....you might find the Ex Strength is better for Nookie...that doesn't come in the 1 kilo tub though, not yet.

On mine, it says to start at a lower dose and work your way up, but nothing about lowering it (not that I remember reading, anyway). I was thinking of using the extra strength and plan on asking Dr. Marsden on Friday when we see him. I don't mind if it isn't in the 1kg tub. I'm sure it's still cheaper than getting it from the vet! :)

Between that, his herbs, pancrease-V and meds we are spending about $500a month. That's not including his food and vet visits :eek: :yell:

Chris21711
January 24th, 2011, 06:45 PM
On mine, it says to start at a lower dose and work your way up, but nothing about lowering it (not that I remember reading, anyway). I was thinking of using the extra strength and plan on asking Dr. Marsden on Friday when we see him. I don't mind if it isn't in the 1kg tub. I'm sure it's still cheaper than getting it from the vet! :)

I'm gonna have to read the label again :cool:

Between that, his herbs, pancrease-V and meds we are spending about $500a month. That's not including his food and vet visits :eek: :yell:

You're still young and have time to recoup :)

:sorry: Super Wanda for hi-jacking :o

Rgeurts
January 25th, 2011, 09:43 AM
You're still young and have time to recoup :)

:sorry: Super Wanda for hi-jacking :o

LoL, yes. Money is made to be spent :D

And I did read the label. It does say around 60 days you may be able to lower the dose and have it be effective. I'm sure Dr. Marsden will let me know when to lower it (if ever).

And sorry from me to Wanda! :sorry:

Chris21711
January 25th, 2011, 11:33 AM
LoL, yes. Money is made to be spent :D

That's why I have none :laughing:

And I did read the label. It does say around 60 days you may be able to lower the dose and have it be effective. I'm sure Dr. Marsden will let me know when to lower it (if ever).

Me too, I boobed on it :D

And sorry from me to Wanda! :sorry:

Ditto Wanda :o

SuperWanda
January 25th, 2011, 05:46 PM
No troubles.

I noticed that the purica website has a list of suggested retailers so I am going to look through and see who has the best price (and free shipping if possible).

We only have one store that carries it and they don't have the best prices.

Rgeurts -- I think you mentioned before that Nanook has a limp from the steroids??? Timbers limp is, I believe, the right front leg and I wonder if it is coming from the shoulder/spinal area but hard to tell. I was told by the natural healing rehab vet to not stop exercising however I am finding that exercise seems to make it worse. :shrug:

Rgeurts
January 25th, 2011, 06:27 PM
Rgeurts -- I think you mentioned before that Nanook has a limp from the steroids??? Timbers limp is, I believe, the right front leg and I wonder if it is coming from the shoulder/spinal area but hard to tell. I was told by the natural healing rehab vet to not stop exercising however I am finding that exercise seems to make it worse. :shrug:

Nanooks is the left front leg, shoulder and paw. They believe the reason for his limp is that the steroids cause loss of muscle and the tendons become "loose". In some of his pictures you can see that instead of standing upright on the paw, his little leg from the ankle down was actually laying flat on the ground. It has corrected quite a bit, but he still has a bad limp. I don't think it hurts him most of the time, but once in awhile he will step and just scream... it tears my heart out :cry:

Dr. Marsden and Dr. Milan both told us not to exercise him too much. They said to take him for very short walks and slowly work our way up to 15 minutes max. He can play at daycare but has to be with only 1 dog at a time and it can't be with a hyper puppy. He also has to take a lot of breaks in between. Nanook is insanely intelligent and gets bored so easy so Dr. Milan also suggested setting up a small obstacle course with chairs and different items and walk him through figure 8's etc to give him a good mental workout and it will also excersice him, but won't overdo it. Someone reccomended hydro-therapy. I'll be talking to Dr. Marsden about that on Friday. I can say that when we overdo it, I notice his limp gets much worse and he has more pain.

MaxaLisa
January 29th, 2011, 11:04 PM
SW, Max gets a limp on his front leg and it does come from his neck. He's be lost without his chiropractor! Occasionally his shoulder also has to get adjusted.

SuperWanda
January 30th, 2011, 01:41 PM
Poor Nanook -- perhaps as he grows he will be able to get over some of the damage caused by the steroids. We have also been doing a few exercises. Lifting up one leg for 10 seconds so that it forces her to balance. She also said to try to make her walk backwards -- this is not easy. We try to create a narrow passage by putting the coffee table beside the couch and forcing her go back to get out but she usually just stands there and doesn't know what to do.

MaxaLisa -- The natural healing vet said that Timber's neck is very tight as well. It's funny because we have been giving Timber massages at home to try and stimulate healing and circulation, she is getting very accustomed to these treatments and paws and grumbles at us as if to say, "Okay people, time for my massage"

rainbow
January 30th, 2011, 02:05 PM
She also said to try to make her walk backwards -- this is not easy. We try to create a narrow passage by putting the coffee table beside the couch and forcing her go back to get out but she usually just stands there and doesn't know what to do.


Have you tried it with a treat in your hand? I was told that walking backwards would be good for our lab as a recovery exercise after his tplo operation. I started doing it when feeding his meals and walking towards him with his food dish held up and he automatically would walk backwards. Hope it works for you. :fingerscr :goodvibes:

hazelrunpack
January 31st, 2011, 10:00 AM
Sounds like Timber is doing really well, SW! :highfive: Albeit getting a little demanding about her daily massages! :laughing: But how wonderful that she feels well enough to get demanding!!!

If you're not already trying to turn the backward walk into a cued behavior, have you considered teaching her to back up on command? It's one of our staple training commands here--comes in handy if they have me trapped against a door or are crowding one of our (infrequent and very adventurous :D) guests. Choose a command, then walk forward till she steps back out of your way. If you have to, bend over the guide her gently backward by the waist. Reward when you get so much as a step back to start with and work from there. Eventually, she'll catch on. Especially when she realizes that this is a rewardable activity! :dog:

MaxaLisa
February 4th, 2011, 01:48 AM
I was giving Max a loading dose of Adequan - my vet had me give it SubQ twice weekly for a month it made a HUGE difference in his neck. Of course he still needs the chiro!

I believe in Canada you have carprofen injections for the joint? I always get the name mixed up with the name for Rimadyl, so I hope I got the name right.the one you guys have that we don't I have heard is supposed to be better than Adequan.

rainbow
February 6th, 2011, 07:27 PM
SW, how is Timber doing? :fingerscr :goodvibes:




I believe in Canada you have carprofen injections for the joint? I always get the name mixed up with the name for Rimadyl, so I hope I got the name right.the one you guys have that we don't I have heard is supposed to be better than Adequan.

That would be Cartrophen :thumbs up .....

http://www.arthritis.au.com/DMOAD.2006.FINAL.pdf

MaxaLisa
February 6th, 2011, 09:54 PM
That would be Cartrophen :thumbs up .....

http://www.arthritis.au.com/DMOAD.2006.FINAL.pdf

That's it! Thank you :)

SuperWanda
February 7th, 2011, 02:18 PM
Thanks for the tips,

Timber does know the "back-up" command -- when they are in the car I use it before I close the hatch. Training using that command along with a treat might just do the trick.

I haven't heard of Cartrophen. I'll look into that. Problem is I don't know if they know why she's limping -- is it coming from joint, muscle, shoulder, spine??? It's really hard to say. As the holistic vet was doing her acupuncture/chiropractic/massage stuff, she did say that she could feel heat in certain areas. When I have been massaging her, I also notice areas that are warm -- between her shoulders and back near her pelvis.

I think she should be on some kind of arthritis supplement again -- she's previously been on and off of glucosamine. I am getting confused with all the supplements available -- am currently looking at Recovery SA or Sashas Blend. Also, a company called the Honest Kitchen (San Diego) make a herbal product called Lithe Tea. Don't ask me how you get a dog to drink tea :laughing:

Timber had blood taken today so I'll let you know where we're at. Just hoping there hasn't been another decrease in platelets. It is my understanding now that sometimes tick disease can trigger ITP (low platelets) and I'm really hoping that is not the case because steroids would be the recommended treatment. The holistsic vet we see also has some blood boosting herbs so I would consider that as an option.

One more bit of info... my vet said today that our province is considering making Anaplasmosis a reportable disease now so that is a big step forward.

SuperWanda
February 7th, 2011, 03:12 PM
Also wanted to ask if anyone has tried the green lipped mussel from the health food store? It seems less expensive than the pet formulas so wondered about adding it with a glucosamine product?

rainbow
February 7th, 2011, 06:29 PM
WOO HOO ....great to hear that Manitoba is considering to make Anaplasmosis a reportable disease. :thumbs up I hope they follow through with it and other provinces follow suit. :fingerscr

I checked into the green lipped mussel but we haven't tried it for Chase. He is doing well enough on Glucosamine/Chondroitin (and sometimes with MSM) supplements right now. There are so many different choices out there and I think some things work for some dogs and some things work for others.

Have you read the dogaware website on all the supplements and treatments for arthritis? It has a lot of information and a lot more if you click on the blue highlighted info .....

http://www.dogaware.com/health/arthritis.html

Good luck with Timber's blood test .....I hope his platelets have increased or at least remained steady. :fingerscr :goodvibes: :grouphug:

hazelrunpack
February 7th, 2011, 06:59 PM
That would be wonderful if they made anaplasmosis reportable, SW! Then Lyme's and ehrlichiosis, as well! Sure would make it easier to diagnose--vets would have the evidence that it's in the area right in front of them!

:fingerscr for good results on the platelet level. When will you hear?

SuperWanda
February 8th, 2011, 05:17 PM
The results are in and I am happy to report the good news! :D

Timber's platelets are back up to 245 (last month they had dropped to 191). Her RBC is now normal at 6.56 and WBC is 6.6. Packed cell volume is 42% (not even sure what that is but I am told this is good).

She is off the antibiotic so we'll see if that changes anything but I feel very positive about her progress and hope we are now 100% in recovery mode.

Just got back for a walk and she seemed like she had good energy today. She did start to limp a little at the end but overall, I think that may be improving as well :fingerscr

She has started to shed like crazy -- don't know if she's making up for lost time or maybe it is just the natural cycle now that the days are getting longer but maybe all of her shaved spots from the ultrasound and blood tests will finally fill in. One guy asked me if she swallowed a cell phone so I guess it looks like she's had some kind of major operation.

Rgeurts
February 8th, 2011, 05:25 PM
The results are in and I am happy to report the good news! :D

Timber's platelets are back up to 245 (last month they had dropped to 191). Her RBC is now normal at 6.56 and WBC is 6.6. Packed cell volume is 42% (not even sure what that is but I am told this is good).

Yay!! That is very good!! Nookie was down to 8% when he had his transfusion. We were told PCV is the overall red blood count and 42% is great :)

She is off the antibiotic so we'll see if that changes anything but I feel very positive about her progress and hope we are now 100% in recovery mode.

:highfive:

She has started to shed like crazy -- don't know if she's making up for lost time or maybe it is just the natural cycle now that the days are getting longer but maybe all of her shaved spots from the ultrasound and blood tests will finally fill in. One guy asked me if she swallowed a cell phone so I guess it looks like she's had some kind of major operation.

Nookie was shedding like mad as well. They thought at first it was just because of his illness and all the meds, but they did a full thyroid panel and sent it to Dr. Dodds. Turns out he has hypothyroidism. The drugs that he (and Timber) were on can cause onset, so if she continues to shed and it doesn't seem "normal", you may want to have a panel run. Nookies shaved spots FINALLY grew in!! It took a good couple of months being off the pred. One spot was shaved in June of last year and the others between July and Sept. He has such a cute, furry little tummy now :D :laughing:
It just grew in about 3 weeks ago. I'm SO happy that Timber is recovering. You both deserve a huge break SW :grouphug: :grouphug:

rainbow
February 8th, 2011, 10:46 PM
Awesome news. :highfive:

The normal PCV range is 37% to 55% so she is doing great. :thumbs up Sending lots of :pray: :fingerscr :goodvibes: for her continued recovery. :grouphug:

SuperWanda
February 9th, 2011, 09:02 AM
Thank you Rainbow, Rgeurts!

I never thought to connect the steroids to a thyroid problem but that makes sense so I'll watch the shedding for sure. Right now she seems normal in every other way (maybe a little more talkative) but I take that as a good sign!

hazelrunpack
February 9th, 2011, 03:38 PM
Great test results, SW!! Nice to hear she has some energy, too! :D Does the vet want to monitor via blood tests for a while now that she's off the antibiotics? Sometimes it takes multiple courses of antibiotics to get anaplasmosis under control, so we always monitor carefully for a few months after treatment, just to make sure...

SuperWanda
February 10th, 2011, 09:36 AM
Our vet said to wait until spring but I think that might be too long. You can be sure I'll be watching her very closely!

SuperWanda
February 10th, 2011, 01:04 PM
Oh, and I wanted to ask you hazelrunpack,

I know you've had to deal with tick issues so wondered if you use a tick preventative like Frontline? I have never used anything like this before but am now considering it. But, at the same time, it is insecticide that you are putting on your dog so that made me feel a little uncomfortable. Mind you, if it's safe, I'm sure it's a better alternative than the disease itself. I guess you apply it in the middle of the shoulder blades where it can't be licked off.

hazelrunpack
February 10th, 2011, 04:47 PM
Yes, we use Frontline Plus one month out of three if the temps are above freezing. The other two months of a three-month cycle we use Frontline (doesn't have as much flea protection, but the flea protection of the Plus lasts for three months). I've heard that it was deemed safe enough to use as an anti-louse treatment on German school children, but I've never investigated if that story is true or not... We've never had any bad reactions to it.

Goldfields
February 10th, 2011, 07:29 PM
SuperWanda, you asked about Sasha's Blend. When I popped into the vet the other day I found they are not selling it anymore. They told me that Pernaease, at around $50 a tub, has exactly the same ingredients and quantities as SB, which they now want $90 for. :eek: So, I've had Perkins on Pernaease for quite a while now as I told you, so now we are changing his diet, he is on Hills Science Diet JD and loving it. I can only give it a trial, for as long as a small bag lasts, because they are having trouble getting it into the country, he'll go onto a different brand but similar feed after that. I think he already is improving but early days yet.

Rgeurts, does Nookie have to be on thyroid treatment all his life now, or is he okay off the cortisone? I know it can cause Cushingoid symptoms too, the hypothyroidism bit I must have missed.

hazelrunpack
February 11th, 2011, 10:04 AM
I forgot to add that even if you do go with Frontline, you'll still need to check Timber periodically for ticks. Although the stuff is very effective, nothing is 100%...

SuperWanda
February 11th, 2011, 01:11 PM
Thanks Hazelrunpack -- that's what I was wondering because I know ticks tend to go for the neck area but I imagine they could still not come in contact with the medication.

I wonder if there is a mesh/net bodysuit available for dogs :laughing: Hey, I should invent something like that, I could probably make a fortune if I had the right infomercial :laughing:


Thank you Goldsfield -- that is expensive. When I contacted the company it was $96 and that was without shipping. I've decided to try a product I found at a local pet store called Esperanza super arthritic formula. It doesn't have the green lipped mussel but contains shark cartilage with glucosamine, msm, kelp and alfalfa. One of the reasons I liked Sashas was because they harvest their shark using sustainable methods and use conservation standards to harvest non-endangered species. That's the same for the Esperanza. Sharks are having a tough time these days because they are in such high demand, not to mention the degradation of the world's oceans so that is the only way I'd purchase a shark based product. I figure I could just add the green lipped mussel separately, but for now, I'll try this and see if I notice a change.

hazelrunpack
February 12th, 2011, 12:01 PM
Thanks Hazelrunpack -- that's what I was wondering because I know ticks tend to go for the neck area but I imagine they could still not come in contact with the medication.

I wonder if there is a mesh/net bodysuit available for dogs :laughing: Hey, I should invent something like that, I could probably make a fortune if I had the right infomercial :laughing:

The oil spreads out over the skin so the whole dog is protected after a few hours--we're as likely to find the resistant ticks in the fur on the neck or around the ears as in the feathers behind the leg. Just depends on where the tick attaches... But there are only a very few that live to attach--and most of those die within 24 hours and so (theoretically) don't transfer disease.

I do remember seeing a mesh anti-tick suit for dogs! Looked ridiculous and was expensive...the idea didn't seem to catch on, so I wonder if there were issues with fabric tears and overheating, or something like that... :shrug:

dbg10
February 13th, 2011, 12:52 PM
@Goldfields I am not sure where you live but there is an online site in Canada that will ship Sasha's Blend.
Sasha's Blend Powder (http://well.ca/index.php?main_page=product_info&products_id=24817)
I am not sure what you have been paying for it but the 100g size is $46.77 Cdn. and the 250g size $97.59 Cdn. Hope this helps :)

MaxaLisa
February 26th, 2011, 01:24 AM
The results are in and I am happy to report the good news! :D

Timber's platelets are back up to 245 (last month they had dropped to 191). Her RBC is now normal at 6.56 and WBC is 6.6. Packed cell volume is 42% (not even sure what that is but I am told this is good).

She is off the antibiotic so we'll see if that changes anything but I feel very positive about her progress and hope we are now 100% in recovery mode.

I'm a little late to the party, but great news!!!

I sure hope that she will be able to stay off the abx, but since she was so sick, she might be one of those dogs that needs a low dose. I hope that's not the case.

Frontline hasn't been very effective here, have switched to Advantix, since it also repels mosquitos, but it is more toxic, so I'm playing with sprays of essential oils. toying around with using a preventic collar, since fleas really aren't an issue here. Gosh, I wish there were a better way to fight against these blasted ticks!!

The joint stuff is tough. I've been using Cosequin and synthetic hyaluronic acid because my boy is an allergy boy. With my girl, I really liked using a bit of Cosequin combined with some glycoflex.

So glad to come back and hear that Wanda is doing well!

SuperWanda
March 6th, 2011, 02:50 PM
Thank you MaxaLisa!

I'm really happy with her progress. I would say that things continue to improve. I only notice a small limp now after walks. She use to lie down and really have trouble getting up with stiffness but now she seems to recover more quickly after exercise.

Her legs still quiver during walks and sometimes when lying down at home. I still don't know if that was from the muscle wasting and will just take some time to build up strength again.

The one thing I'm a little worried about is a thyroid problem after what Rgeurts mentioned happened to Nanook after high dose steroid use.

We are approaching Spring and Timber is still shedding like crazy. I have been brushing and most of the undercoat is out now. You can see new hair growing in (about 1/2 inch long now) where she had shaved spots but she looks terrible. Her tail is so thin and her coat is dull with a lot of dandruff. I have never noticed her to get so much flaky skin during past shedding periods so this is why I am paranoid about the thyroid. I don't know. Next blood test I'll ask for thyroid just to ease my mind.

Rainbow -- you are a long time husky owner -- did your guys ever have dull, flaky coat during the "blow-out" period?

Otherwise, she doesn't show any other symptoms of hypothyroid -- she has good energy and is a good weight. She seems energetic on walks and doesn't seem to be drinking excessively so maybe it is just a extreme shedding period for her -- out with the old, in with the new!

hazelrunpack
March 6th, 2011, 05:45 PM
Sometimes stress, including illness, will cause dogs to blow their coats more severely than usual, too, SW. I hope that's all it is!

At least if it's thyroid, it's easy enough to treat. We have a couple of hypothyroid dogs and give them the chewable thyroxine replacement--works well and they love it.

When will Timber be seeing the vet again?

rainbow
March 6th, 2011, 06:54 PM
Rainbow -- you are a long time husky owner -- did your guys ever have dull, flaky coat during the "blow-out" period?

Otherwise, she doesn't show any other symptoms of hypothyroid -- she has good energy and is a good weight. She seems energetic on walks and doesn't seem to be drinking excessively so maybe it is just a extreme shedding period for her -- out with the old, in with the new!


SW, I've had 3 sibes and none of them had a dull flaky coat during shedding season. One of them did have hypothyroidism and didn't show any of the normal symptoms. The only thing we noticed was she held her tail down most of the time. We got the vet to take a look at her and he took an xray but it showed nothing and he just shrugged it off. We changed vets and mentioned it to her and she was the one that thought it could be thyroid related and just a very subtle sign of low energy. Sure enough when the blood test came back she tested positive.

I would get the test done just to make sure. It is nothing to worry about and is easily controlled with medication that is not expensive.

SuperWanda
March 7th, 2011, 12:12 PM
Thanks hazelrunpack, rainbow,

I am due for a spring apt soon so thought I would test platelet counts at that time and ask for a thyroid test.

Thyroid disease seems very common in dogs so it wouldn't surprise me if she had some issues especially after all the stress and medication however let's hope it is just a spring shed-post tick disease renewal period.

I am also wondering about vaccinations now. They are due for 3 year rabies and 2 year DA2PP but now that they are 10 and 12, I wonder about getting titers instead. I have always been good about getting shots but especially for Timber, the thought of stimulating her immune system with a vaccine when she still might be recovering from a tick disease has me thinking about skipping them.

The one thing I am 100% sure of is heart worm since we are the mosquito capital and have a great looking flood forecast :eek:

hazelrunpack
March 7th, 2011, 02:04 PM
Frankly, I'd go with the titer. If they've been current with vaccines all their lives, they're probably going to have adequate immunity to the rabies and distemper family diseases. Generally, the viral disease vaccines tend to confer a pretty long-lasting immunity to their targets. Unfortunately, it's not the same for bacterial disease vaccines (like the ones for lepto and lyme's) which do fall off in efficacy pretty quickly...

MaxaLisa
March 21st, 2011, 01:29 AM
There is absolutely no reason to vaccinate a senior dog that has regularly received vaccines. I wouldn't even titer. http://germanshepherdhome.net/forum/ubbthreads.php/topics/1598/Vaccination.html#Post1598

Hope she is still doing well!

SamIam
March 21st, 2011, 02:04 AM
There is absolutely no reason to vaccinate a senior dog that has regularly received vaccines. I wouldn't even titer. http://germanshepherdhome.net/forum/ubbthreads.php/topics/1598/Vaccination.html#Post1598

Hope she is still doing well!

14 year old dog, belongs to a family member. Received all vaccines on schedule until last year. Last year titered instead, titer adequate. This year inadequate.

In areas where parvo and distemper were formerly thought gone, shortly after the trend of 3-year vaccines instead of annual, both diseases have popped up. It is true that some dogs after having received puppy shots and vaccines until the age of 2-3 years proceed to pass their titers up to 7 years past their last vaccination and beyond. It is also true that they may fail them as little as 12 month past their last regular vaccine, and at that point they are susceptible to the diseases.

The distemper/parvo vaccine titer is a moderate expense, and if your dog tests as inadequate, a decision can be made whether to risk a vaccine or keep the dog carefully isolated from possible exposure. The rabies vaccine is another story altogether; the vaccine titer is expensive, and legal and travel regulations may or may not accept a titer certificate in lieu of a vaccine cert.

MaxaLisa
March 21st, 2011, 05:40 AM
As we all know, titers being low does not mean that the dog is not protected, since the memory cells are very likely still trained. And in a dog that just received vaccinations 2 years ago, and just battled a near death battle and will be suffering chronic disease from this, this is not about expense, this about protecting the health of the immune system. And I certainly wouldn't base these decisions on the experience of one dog, when, on the health forums, we haven't seen such a trend.

I would like to see some substantiation that these diseases are making a comback. In the last 3 years, the only cases of distemper that I have seen were in recently vaccinated dogs, and one unvaxed dog in India. Of course that's a small sample that I see, but I've seen no reference to a distemper comeback in dogs following the three year protocol. As for parvo, there is the new strain of parvo which no vaccine is licensed to protect from, though anecdotally one vax is thought to be better than the other.

Certainly she can titer, and if the titers are low, I still say that this spring is too early for any vaccine with what Timber has gone through. The rabies, well, that's another legal story. I can only say I've seen dogs flair with disease after their rabies vax. I had an expemption for my girl the last 12 years of her life.

Rgeurts
March 21st, 2011, 12:06 PM
I agree completely with MaxaLisa. Timber has been through way too much, there is no need to put undue stress on her immune system. I, for one, will be getting titers for Nookie and will avoid the rabies vaccine (and any others we can) at all costs. We're quite sure that is what has sparked his terrible immune related disorders and have no plans to put his life at risk for something he may not need. Their lives are well worth the cost of the titers.

I'm so glad to see Timber is doing well!! Big hugs to you both :)

SamIam
March 21st, 2011, 01:58 PM
And I certainly wouldn't base these decisions on the experience of one dog, when, on the health forums, we haven't seen such a trend. I would like to see some substantiation that these diseases are making a comback.

The info is from my vet, who attends conferences. Somewhere out there be the paperwork, may or may not be published publicly on the internet.

SamIam
March 21st, 2011, 02:07 PM
I, for one, will be getting titers for Nookie and will avoid the rabies vaccine (and any others we can) at all costs. We're quite sure that is what has sparked his terrible immune related disorders and have no plans to put his life at risk for something he may not need. Their lives are well worth the cost of the titers.

:thumbs up:thumbs up
I got titers this year for my two "old" girls. Was very nervous as last time (~3 years ago) both tested as inadequate, but due to their age it was time to try again. Very pleased that both came back as good.
Hopefully you get good news when Nookie's are done, so there will be no worry of putting him through vaccines, and no worry of being susceptible to the illnesses, either.

MaxaLisa
March 21st, 2011, 02:47 PM
**The info is from my vet, who attends conferences. Somewhere out there be the paperwork, may or may not be published publicly on the internet.**


Vets say a lot of things, often they say incorrect things too. Been there.


Remember, the only way to determine immunity is through challenge - titers only measure circulating antibodies, which may be low in spite of the dog being protected. We have no way to actually measure if the dog is protected except by exposing them to the disease. Titers are the next best thing, but still inadequate. In dogs that are not around other dogs or dog events, I actually would expect titers to be low.


Keeping the dog's immune system up and primed for certain diseases (like parvo, not life threatening in adult dogs), can prevent it from serveilling for other diseases, like cancer or tick disease. In my mind, those are bigger risks in our senior dogs which may or may not be exposed to these other diseases and most like have the memory cells to protect them.


But owners will make the decisions that they re comfortable with, these can be very individual decisions.

Sorry SW, didn't mean to hijack!

Blackbear
March 21st, 2011, 05:10 PM
Please keep replies on topic and civil. PMs are available for personal exchanges.

marko
March 21st, 2011, 06:16 PM
100% agree - These types of exchanges wreck threads needlessly, please take them to PM and let's get the thread back on course civilly.

Thx
Marko
Admin

MaxaLisa
March 21st, 2011, 11:24 PM
I so agree, so sorry!

SW, don't know if I mentioned it before, but thyroid disease is common in tick diseases, and some dogs respond to low thyroid not only with coat issues, but some dogs will get a droppy eye, or even get shaky or stumbly. I agree that a thyroid check would be a good thing.

SuperWanda
March 22nd, 2011, 10:16 AM
Thanks everyone!

No worries about the posts -- I'm the one that asked about vaccines and titers. Thanks for all the advice!

I am certainly very protective now over her health and well being so don't feel comfortable with vaccines this year with everything that has happened and with their ages as well.

A thyroid check will be included for sure.

Everything is still going well. The dandruff is subsiding and her bald patches have now grown in about an inch but her coat still looks a little dull. I'm anxious to get test results since it has been almost two months -- the longest we've ever gone without testing but she really has continued to improve so I'm hoping everything is normal.

hazelrunpack
March 22nd, 2011, 12:47 PM
Glad to hear her coat is filling in some! Might just take her a little longer to get good coat condition back after being ill for so long!

Good luck with the tests! :goodvibes:

SamIam
March 22nd, 2011, 12:52 PM
Thanks everyone!
No worries about the posts -- I'm the one that asked about vaccines and titers. Thanks for all the advice!
I am certainly very protective now over her health and well being so don't feel comfortable with vaccines this year with everything that has happened and with their ages as well.
A thyroid check will be included for sure.

Thanks for saying so SuperWanda. I hope your titers and thyroid tests all come back with good news.:fingerscr