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  #61  
Old April 26th, 2012, 07:10 AM
will2power will2power is offline
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Skye's having another good morning. I was just speaking with her vet by phone and we've made a few changes to her meds. We'll drop the Benedryl back to 25mg b.i.d. (from 50mg) since we no longer see signs of urticaria. Her Baytril runs out tomorrow morning, but the vet wants her to go one more week, so we'll pick that up at the clinic later today. All other meds will stay the same until she has her blood work repeated in one week. I don't think I've mentioned it here before, but Skye also has some pinnal vasculitis. Both pinnae seem affected, with a pea-sized sore at the tip of each ear. Her lips, pads, tail and nails look fine. We've been keeping it clean and applying a little polysporin (as per the vet's recommendation). These are my latest worry.

Robyn, it was her neutrophils and monocytes that were elevated. The neutrophils were not unexpected, given her prednisone dosage. It's the monocytes that are a concern.

And Marty, Skye loved the moose meat. Now if I could just get the stink out of my house! lol
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Old April 26th, 2012, 09:45 AM
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Monocytes are 'mobilized' in inflammatory responses, aren't they? I believe they're also stored mainly in the spleen. Has the vet checked her spleen, by any chance? (I'll fully admit I've had no experience with this so basically that's just an out-of-the-blue brain fart. There may be absolutely no merit to it...)

Glad to hear she's still doing so well, give or take some ear tip lesions...

Moose meat! Who knew? LOL Stinky but delish!
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Old April 26th, 2012, 09:47 AM
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coming your way for skye and you

you could light a candle to remove the smell just a thought
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  #64  
Old April 26th, 2012, 10:53 AM
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Originally Posted by will2power View Post
Skye's having another good morning. I was just speaking with her vet by phone and we've made a few changes to her meds. We'll drop the Benedryl back to 25mg b.i.d. (from 50mg) since we no longer see signs of urticaria. Her Baytril runs out tomorrow morning, but the vet wants her to go one more week, so we'll pick that up at the clinic later today. All other meds will stay the same until she has her blood work repeated in one week. I don't think I've mentioned it here before, but Skye also has some pinnal vasculitis. Both pinnae seem affected, with a pea-sized sore at the tip of each ear. Her lips, pads, tail and nails look fine. We've been keeping it clean and applying a little polysporin (as per the vet's recommendation). These are my latest worry.

Robyn, it was her neutrophils and monocytes that were elevated. The neutrophils were not unexpected, given her prednisone dosage. It's the monocytes that are a concern.

And Marty, Skye loved the moose meat. Now if I could just get the stink out of my house! lol
Glad to hear Skye is still on the mend!!!
Sorry I didn't post yesterday, we were very busy at work, so not much time. One thing you want to make sure of is that when they take Skye off the pred, they wean her slowly. The first vet that actually wanted to help us instead of telling us to put Nookie down was a wonderful lady. But one thing she didn't know is that the pred needs to be weaned down slowly. She took him off it pretty fast and after too short of time, so it didn't have time to take care of the meningo and the seizures became pretty severe. She spoke with a friend of hers who is an internal specialist, and got the proper protocol (we ended up seeing that specialist for a few months before the holistic vet). She wasn't a bad vet, she just had never dealt with any issues like Nookies. At least she took ownership and told us what happened, apologized and corrected it

I'll go through all the links today and post them for you. They are mostly links on dogs with auto-immune disorders (possibles causes, symptoms and treatments). For now, this is a good link. It has some good info on vaccine protocols and also breaks down canine blood tests and helps you read and understand them, which I found very helpful with Nookie. It gave me an arsenal of questions to ask so I didn't feel so "in the dark" with everything that was happening:

http://www.acreaturecomfort.com/caninebloodwork.htm

And I just realized that I never answered the question regarding spherocytes! It is a specific test that requires a smear and checking specifically for spherocytes. The reticulocytes, I believe, can be seen in a regular CBC. Reticulocytes are just baby red blood cells.

Monocytes are typically indicative of infection, and being that she has been on Baytril for quite some time, you would expect that they would be coming down (though the neutrophils may remain high until she is off the pred). There are auto-immune disorders which can cause high monocytes, but also tick diseases, which I am not too familiar with. There is one girl here who is a wealth of knowledge when it comes to tick-borne diseases, and they can really wreak havoc. I'll PM her and hopefully she has gets an email when someone PM's her. This is one link I had favorited when we were trying to figure out Nookies symptoms, but, even though it is multisystemic, it didn't really fit with him. Maybe some of it will strike a chord with you:

http://www.vet.uga.edu/vpp/clerk/Bockino/

With everything poor Skye has going on, I'd be very surprised if this isn't an auto-immune response to the vaccines (or could possibly be tick-borne as well ). I'm glad to hear that you and DH are considering titres instead, especially since northern breed dogs are so prone to immune mediated illnesses.

You said you wonder if Nookie and Skye are related
With the amount of issues, you would think so... maybe they are soul-twins

One option for you may be to do what I did, and that's contact Dr. Jean Dodds directly. She's very accessible by email. She had me email her all of Nookies test results, then told me what she thought his issue was (Vaccinosis), and referred me to Dr. Steve Marsden. She also has a company where you can send in blood and she will analyze it specific for the breed/age. What may be normal for one breed can be abnormal for another. She's brilliant

This is her website:

www.hemopet.org

If you want copies of Nookies test results (bloodwork, CSF etc), let me know. It might be interesting to compare and if there are similarities, maybe your vet can take a look at them also (though we don't really have a "diagnosis", so to speak).

And you think you talk a lot!

Take care and continued prayers for Skye, and of course, you, DH and Sirius!

Robyn
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  #65  
Old April 27th, 2012, 11:57 AM
will2power will2power is offline
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Thought I'd give another Skye Baby update. We're having another good day. I'm watching her closely and she seems to be very happy and content. I just wish she'd play a little bit with me or Sirius. She has energy, but she just doesn't seem up to playing yet. Her Nan came to visit a little while ago and she got really excited, jumping and wagging her tail. She's still taking the same meds. I don't think I mentioned it in my last post, but the vet wants her to stay on 50mg of prednisone b.i.d. for another week. We were supposed to drop down to 50mg once a day today. She'll also stay on the Metronidazole for another week at the same dose (in addition to extending the Baytril for one more week). We dropped her Benedryl down to 25mg b.i.d. yesterday and that seems to be working fine. She even seems to have a bit more energy today (probably because of the reduced dosage). Her ears look about the same, but we're still using the polysporin. Hopefully that will heal soon. All in all, she seems like she was before all hell broke loose. She just doesn't play much yet.

HRP, she hasn't had her spleen checked, to my knowledge, but I'll bring this up during my next discussion with the vet. And breeze, the candle was a good idea. I got a vanilla scented candle last holiday and it helped. I'll probably need to use it again today, because I'm cooking more moose.

Robyn, thanks so much for all your help. You really are a treasure trove of information! Regarding Skye's prednisone, the plan is to taper her down very gradually. My instructions are to go from 50mg b.i.d. to 50mg once daily for one week, then 25mg once daily for one week, then 12.5mg daily for one week and finally 12.5mg every second day. Does that look about right based on your experience?

I loved the blood values website! It's put together in a nice format, explaining blood components and the table with normal values will definitely come in handy.

I'll discuss the spherocytes with the vet next time we talk to see if she's actually done any digging around for them on Skye's smears. She hasn't mentioned it to me, so I'm thinking she hasn't.

You mentioned tick diseases. This is something I know she considered and ruled out. It was a very long shot to begin with, but she did assess her for it. The website you gave on canine Ehrlichiosis was interesting. Except for the associated thrombocytopenia, the symptoms sound very close to what Skye experienced. This is going to really show how naive I am...but I really didn't know we had ticks in Newfoundland. I just looked on the provincial government website and see that we have several varieties (some permanent and some transient). Hmmm. Just thinking about the fact that we've had an increase in coyote populations lately. Coyotes are hosts for the brown dog tick, which is responsible for canine monocytic ehrlichiosis. AND it appears that some dogs develop a secondary immune-mediated hemolytic anemia (IMHA)! This is certainly worth another discussion with the vet.

I'm a bit hesitant to contact other vets right now, only because I don't have the money to spend. I had to buy another week's supply of Baytril yesterday (another $92.82) and right now I'm trying to scrape enough money together to have her urinalysis, CBC, chemistry profile and electrolytes rechecked next week (which will be close to another $200). We're getting near the $4000 mark now and we're already down to paying/buying only absolute necessities. She's worth every penny and more, though. I'll start selling off my assets if I have to!

As for Skye's lab results, I don't even have a copy of them. Should they have been provided to me? I asked for them when I emailed the clinic yesterday with some other questions. They responded to the questions but never mentioned my request for a copy of all her labs. When I see the vet next week I'm going to ask for them again. They have to give them if I ask, right? Then we can compare Skye and Nookie (though I know every situation is unique).

Whew! That's about it for now. I've been really busy today trying to get as much dog hair out of the house as possible. Skye's really shedding something fierce. It's a sunny day here (about 17C right now), so my windows and doors are open. As an interesting aside, I'm also watching Skye for signs of urticaria now that the sun is shining so brightly. The hives went away a few days ago, just about the same time that the weather here changed. Until today, it's been cloudy with drizzle/rain. I wonder if she's got a photosensitivity.

I hope you're all having a great day. So far so good in the Skye household.
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Old April 27th, 2012, 02:01 PM
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Thought I'd give another Skye Baby update. We're having another good day. I'm watching her closely and she seems to be very happy and content. I just wish she'd play a little bit with me or Sirius. She has energy, but she just doesn't seem up to playing yet. Her Nan came to visit a little while ago and she got really excited, jumping and wagging her tail. She's still taking the same meds. I don't think I mentioned it in my last post, but the vet wants her to stay on 50mg of prednisone b.i.d. for another week. We were supposed to drop down to 50mg once a day today. She'll also stay on the Metronidazole for another week at the same dose (in addition to extending the Baytril for one more week). We dropped her Benedryl down to 25mg b.i.d. yesterday and that seems to be working fine. She even seems to have a bit more energy today (probably because of the reduced dosage). Her ears look about the same, but we're still using the polysporin. Hopefully that will heal soon. All in all, she seems like she was before all hell broke loose. She just doesn't play much yet.

HRP, she hasn't had her spleen checked, to my knowledge, but I'll bring this up during my next discussion with the vet. And breeze, the candle was a good idea. I got a vanilla scented candle last holiday and it helped. I'll probably need to use it again today, because I'm cooking more moose.

Robyn, thanks so much for all your help. You really are a treasure trove of information!

Hopefully some of it will help you to figure out what's going on with Skye
I wish I could say I have no information on any of this (for my sake, not yours!), but I've been there lol


Regarding Skye's prednisone, the plan is to taper her down very gradually. My instructions are to go from 50mg b.i.d. to 50mg once daily for one week, then 25mg once daily for one week, then 12.5mg daily for one week and finally 12.5mg every second day. Does that look about right based on your experience?


As far as reducing the pred, that's similar to what our vet did initially, reduced it by 50% each week, which was far too fast, at least for Nookie. But the protocol, once she spoke with the specialist, was that it should be reduced by 25%, not 50%, each time. And ours ended up being a 25% reduction every 2 weeks instead of weekly (and if his symptoms returned after lowering the dose, she would bump it back up for another 2 weeks, then try tapering again), then towards the end, on the very small doses, it was every other day until he was off it.



I loved the blood values website! It's put together in a nice format, explaining blood components and the table with normal values will definitely come in handy.


I was so thankful for that site. It made deciphering his results so much easier and put my mind at ease on a few things




I'll discuss the spherocytes with the vet next time we talk to see if she's actually done any digging around for them on Skye's smears. She hasn't mentioned it to me, so I'm thinking she hasn't.

You mentioned tick diseases. This is something I know she considered and ruled out. It was a very long shot to begin with, but she did assess her for it. The website you gave on canine Ehrlichiosis was interesting. Except for the associated thrombocytopenia, the symptoms sound very close to what Skye experienced. This is going to really show how naive I am...but I really didn't know we had ticks in Newfoundland. I just looked on the provincial government website and see that we have several varieties (some permanent and some transient). Hmmm. Just thinking about the fact that we've had an increase in coyote populations lately. Coyotes are hosts for the brown dog tick, which is responsible for canine monocytic ehrlichiosis. AND it appears that some dogs develop a secondary immune-mediated hemolytic anemia (IMHA)! This is certainly worth another discussion with the vet.

There have been a few people here who were told by their vets that tick disease didn't exist in their province and dismissed it, or that it wasn't prevalent etc. One is a really nice lady named SuperWanda. I'll try to find her posts and link them. But when they insisted on the blood tests, they came back positive. The girl who is very knowledgeable is Maxalisa. Hopefully she will log on and give you some info. I remember a few of hers saying that even if the tick tests come back negative (which I guess is somewhat common), to treat anyway and if the symptoms subside and the dog recovers, then you are on the right path. Hazelrun Pack is also knows a lot about tick borne illnesses, which is why I think she had orignially asked if you had been to a warmer climate? I could be wrong though!

I'm a bit hesitant to contact other vets right now, only because I don't have the money to spend. I had to buy another week's supply of Baytril yesterday (another $92.82) and right now I'm trying to scrape enough money together to have her urinalysis, CBC, chemistry profile and electrolytes rechecked next week (which will be close to another $200). We're getting near the $4000 mark now and we're already down to paying/buying only absolute necessities. She's worth every penny and more, though. I'll start selling off my assets if I have to!

I can relate!! If anyone had told me 3 yrs ago that we would have spent as much as we have on our furboys, I would have said they were nuts lol. Between Nookie and our sweet boy Thorin, they have cost us a small fortune. We had to renegotiate our mortgage, increase our credit line twice and maxed out all of our credit cards. I even had my car for sale at one point, but hubby got a nice Christmas bonus, so I didn't have to
As for Skye's lab results, I don't even have a copy of them. Should they have been provided to me? I asked for them when I emailed the clinic yesterday with some other questions. They responded to the questions but never mentioned my request for a copy of all her labs. When I see the vet next week I'm going to ask for them again. They have to give them if I ask, right? Then we can compare Skye and Nookie (though I know every situation is unique).

They can't deny you copies of the reports. If they try, I'd be telling them to give me her entire file and go to another vet.


Whew! That's about it for now. I've been really busy today trying to get as much dog hair out of the house as possible. Skye's really shedding something fierce. It's a sunny day here (about 17C right now), so my windows and doors are open. As an interesting aside, I'm also watching Skye for signs of urticaria now that the sun is shining so brightly. The hives went away a few days ago, just about the same time that the weather here changed. Until today, it's been cloudy with drizzle/rain. I wonder if she's got a photosensitivity.

I hope you're all having a great day. So far so good in the Skye household.
I'm glad she still seems to be on the mend
I wouldn't worry too much about her playing or being overly active. When Nookie was on the pred he would have some "crazy" moments, but for the most part, he would drink, lay around and sleep. His personality was so masked by it. He slept about 80% of the time, and he was a puppy

One thing that scared the hell out of us was something that is quite common with high doses of pred, but the vets we were dealing with knew nothing about it. Nookie starting losing muscle in his head/face. He looked like a skeleton. We had taken him in to the new clinic we had started going to, but our vet wasn't in. It was an older man who owned the clinic. He took one look at Nookie and said "Your dog has masticatory muscle myositis!" and was very worried. We had never even heard of that and were horrified as he explained what it was and what we could expect to start happening. I was just in tears! He almost had us convinced to let him put Nookie under and take a muscle biopsy from his head down to his skull (which would have relapsed the meningitis at that point)!! We decided to call the specialiast before allowing him to do anything, and I'm SO glad we did. She kinda laughed when I told her what happened and said don't let anyone put him under, and that she was pretty positive he didn't have MMM. What he did have was something called "pred-head". Prednisone will waste the muscles in the head/face and make them look like they're starving (like skeleton heads), and can make the rest of the body bloat up. Nookie looked like a little cow with a skeleton head... it was horrible! We look back at some of his pictures and giggle now, but it was so scary back then.

I'll dig up some of the old links to posts with tick diseases

Take care, Honna!!
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  #67  
Old April 27th, 2012, 02:24 PM
will2power will2power is offline
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Wow! Just a quickie post as I'm trying to fix dinner...the vet thought Skye might have had masticatory muscle myositis! This was when they were trying to give her oral meds when she was hospitalized. Turned out she was just being stubborn. I'll review your other points in greater detail later this evening.

A bit of an oddity...the babes instinctively know when DH is coming home from work (he's predictable that way). He should be home in a few minutes. They always run to the window at this time of day and whine for him. For the past two days when they do this, Skye "mounts" Sirius. Weird. Guess she's trying to assert some kind of dominance? lol
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Old April 27th, 2012, 02:29 PM
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Wow! Just a quickie post as I'm trying to fix dinner...the vet thought Skye might have had masticatory muscle myositis! This was when they were trying to give her oral meds when she was hospitalized. Turned out she was just being stubborn. I'll review your other points in greater detail later this evening.

A bit of an oddity...the babes instinctively know when DH is coming home from work (he's predictable that way). He should be home in a few minutes. They always run to the window at this time of day and whine for him. For the past two days when they do this, Skye "mounts" Sirius. Weird. Guess she's trying to assert some kind of dominance? lol
LoL sorry, I hope I'm not overwhelming you. I always seem to be too detailed. I try to cut my posts down, then struggle with what to leave out and end up posting a novel
If it is too much for you, please don't be afraid to tell me!!

Nookie has actually been doing that to Montana (our rescue puppy) the last few days! When he does it, he gets this crazy look in his eyes, then he gets the zoomies and is way over stimulated. We have to make him lay down and have quite time. We're pretty sure his episodes are neurological though. It could be dominance with Skye, but if she's never done it before, I would consider that a bit odd.
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Old April 27th, 2012, 03:40 PM
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Ok, found the thread. It is quite lengthy, heartbreaking at times, but a VERY happy ending

That's a lot of info here and maybe you will find something that might help. Again, keep in mind that not all dogs get all the symptoms. If there are some similarities, it's worth checking out. If your vet doesn't thinking you need to, find another one


http://www.pets.ca/forum/showthread.php?t=73066

The dog in this thread is Timber, who, like Skye and Nookie, was a complete mystery.
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Old April 27th, 2012, 10:11 PM
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Yep, part of the question about the warmer climes was to see if there had been tick exposure. I didn't realize there were ticks in Newfoundland but if there's a growing coyote population, there could well be the chance of infection in Skye. There are screening tests for the tick-borne diseases. Idexx Labs puts out a fairly inexpensive one that tests for Ehrlichiosis, anaplasmosis and Lyme's, but if it's not available the vet may decide to run titers, which will be more expensive. However, even in humans, the tests may miss up to 30% of the cases, and last time I went in with symptoms after a tick bite, the doctor didn't even bother to test because of it--she just put me on a course of doxycycline. In fact, a common course of action here (both in human and veterinary medicine) is to treat if there is exposure and any symptoms at all, regardless of what the test results are. As Robyn said, if the patient responds, then you're on the right track...

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A bit of an oddity...the babes instinctively know when DH is coming home from work (he's predictable that way). He should be home in a few minutes. They always run to the window at this time of day and whine for him. For the past two days when they do this, Skye "mounts" Sirius. Weird. Guess she's trying to assert some kind of dominance? lol
I suspect she's feeling better and that's how she's burning off her excess energy!
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Old April 28th, 2012, 04:35 PM
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If someone can help me I'd give the world! The vet just called with Skye's lab results. She said she's very, very, very worried. Skye's slightly anaemic and her white cell count is through the roof (about 5X normal high values). She said a normal high for her would be 16. While she was in hospital last week they were running about 32. Today they're 56. And she's been getting two very powerful antibiotics for the past 8 days now! Her bilirubin is up a bit and her albumin levels are creeping back down again, so we may see the limb edema start soon. I'm taking her back again at 3:45 so they can try to aspirate one of the small hives on her head to see if that answers anything, but barring this, she says we've exhausted all our avenues in Newfoundland. She mentioned that they could do further testing in PEI or Guelph, but that's not even a remote possibility for us. I spent another $200 so far today and now she has to have the aspiration this afternoon. That's about $3500 in 7 days. They're completely baffled by her. No one seems to know what's going on! Her glucose is up slightly, but she's not concerned about diabetes. She also said her pancreatic values are down a bit and her liver values are slightly elevated. DOES ANYONE HAVE SUGGESTIONS FOR US? I don't even know if this post makes sense, because I'm crying so hard I can barely see the screen. Skye seems to be feeling better. So why are these results so horribly bad??? Help me if you can, please. I know you will, because you're all such wonderful people. ANY suggestions as to the possible cause of this would be appreciated! She's my baby and I need her.
Just a few thoughts at this point.

I would try beef and no poultry. Have had lots of poultry issues on some of the forums lately.

This sounds seriously infection induced. Some of that red skin is probably from seriously dilated blood vessels, which can also leak stuff into the body that's not supposed to be there.

Many of these infections emit things that cause an allergic response, so there are many fires to put out at the same time.

For any infection like this, I would want doxycycline added as one of the antibiotics, at the aggressive dose of 10 mg/kg (roughly 5mg/lb) twice a day - no other abx can do what doxy can do in these cases. I would want to slowly wean off the steroids and keep the abx the same until the blood picture starts looking better. If this were all immune based, the pred would be increasing the RBCs. This sounds like infection of the lining of the blood vessels and the bone marrow. This may or may not be related to tick disease, but it's behaving like one.

BTW, tick diseases, or this type of infection can cause IMHA, but the important thing is to make the main treatments the abx, with support from the steroids, rather than the other way around. I'm pretty convinced that the vaccines triggered something that the body was able to previously keep in check.

Just for future reference, benadryl can lower platelets if that ever becomes a problem. You can use vitamin C and bioflavanoids and particularly quercitin to fight the histamine releases if you want to. Yucca is supposed to be good for dealing with endotoxins from infection.

The vasculitis, to me, is a huge indication that aggressive doxy is warranted. Infection of monocytes, and neutrophils, particularly monocytes, screams one of the rickettsia infections, like ehrlichia or anaplasma. There are some local strains that do not show up on current tests however, so I would just treat. You don't have the low platelets, but that could be from the pred. If this dog is not on doxy, it is understandable that the monocytes are not coming down.

And a final somber note. I've seen a lot of vets treat the test results and not the patient. This is an area, where, if the vet doesn't feel the importance of treating with *aggressive dose* doxy, then I would use OTC doxy if this were my dog. This is what I had to do with my boy, which bought him about 8 more months until the infection of the blood vessels turned to cancer of the blood vessels.

Thank you for fighting so hard for Skye!
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Old April 28th, 2012, 08:29 PM
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Prednisone will waste the muscles in the head/face and make them look like they're starving (like skeleton heads), and can make the rest of the body bloat up. Nookie looked like a little cow with a skeleton head... it was horrible! We look back at some of his pictures and giggle now, but it was so scary back then.
Robyn, I think it is Prednisone that can cause Cushingoid symptoms, and a skeletal head is a Cushings symptom. Another to look for, funnily enough, is blackheads all over their bellies. I've seen it in both a genuine Cushing's patient(adrenal tumour) and in a dog that had cortisone induced symptoms.
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Old April 28th, 2012, 08:42 PM
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Robyn, I think it is Prednisone that can cause Cushingoid symptoms, and a skeletal head is a Cushings symptom. Another to look for, funnily enough, is blackheads all over their bellies. I've seen it in both a genuine Cushing's patient(adrenal tumour) and in a dog that had cortisone induced symptoms.
Wow... blackheads? I don't think I've ever seen a blackhead on a dog! Thanks, I'll keep that in mind in case I ever seen any on him! And yes, pred can cause Cushing symptoms as well. They were actually thinking he had Cushings at one point because of the muscle wasting, excess drinking and something else, but I don't remember just what it was. But they ended up saying those were just side effects of the pred. "Pred-head" is fairly common from what our specialist said, when an animal or a person is on high doses. Once he came off the pred, it took a good 2-3 months, but the muscle did come back.
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Old April 28th, 2012, 09:01 PM
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I know how awful Nookie must have looked. Sugar, who had the adrenal tumour, had the skeletal head and I kept looking at her and thinking 'Gee, your head is not as good as it was when you were younger' , but as with a lot of other Cushings symptoms, you put it down to age. The blackheads were so profuse that I thought she just had a filthy tummy, I even tried to wash the 'dirt' off.
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Old May 1st, 2012, 12:10 PM
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Dear All. Thank you for the replies, advice, prayers, etc. I know I haven't posted an update since Friday and there's a reason for that. I took Saturday for a cleaning day, Sunday we realized that in all the chaos we hadn't filed our taxes with only one day before the deadline (glad CRA has netfile) and yesterday my son had a car accident. No one was hurt and the car was insured, of course. But he did write it off and it was our only car. Sigh. What else can go wrong? I think our house has a curse on it.

Okay. Back to Skye. She continues to do very well with her eating, drinking, sleeping and bathroom breaks. We had her to the vet again this morning and did another UA, CBC, chemistry profile and lytes. The pinnal vasculitis is looking much better and her skin looks good. I got a copy of all her labs dating back to April 16th (the day she was hospitalized), including her values for today. Her UA looked good with everything in the negative to normal range. Her specific gravity was 1.018, but that may be because she's been drinking so much water (prednisone).

Her blood work is still very concerning, though. RBCs and platelets are fine. Her WBC count came down a little bit to 46.48 (down from 56.45 on April 23). On the differential, neutrophils are still high at 38.18 (but down from 50.38 on April 23) and her monocytes have gone up! They're now at 4.35 (up from 3.19 on April 23). This scares me because she's been receiving antibiotics for 16 days now! Her chemistry panel has some worrying results, too. Her urea is slightly high at 10.9 (and up from 5.0 on April 23) and creatinine is on the borderline of low at 44 (down from 68 on April 23). ALT is high at 335 (up from 46 on April 23) as is her ALKP at >2000. Her GGT is very high at 206 (up from 23 on April 23) and her AMYL is low at 215 (though it is up from 164 on April 23). Bilirubin looks great and her lytes all look good.

We're still stymied as to what's going on with her. When I left the vet was having the technician do a blood smear to investigate further. She was also going to share these latest results with her colleagues today and ask for their input. She's still digging for answers.

She's thinking that some of the chemistries may be elevated because of the prednisone she's been taking for the past 2+ weeks. She wants us to start reducing that this evening, with instruction on what to watch for in terms of how Skye reacts to the lower dose.

The plan now is to stay the course with her antibiotics (375mg Metronidazole b.i.d. and 150mg Baytril b.i.d.) and her nutraceutical (300mg Zentonil b.i.d.). Her prednisone will be reduced to 25mg b.i.d. starting this evening. We'll also continue with the Benedryl 25mg b.i.d.

I just don't understand what's going on with her. On the surface, she looks like she's back to her old self again. Except for the places where she had some hair shaved (for IVs and her Fentanyl patch), she looks/acts like she did before she got sick. Financially, this is really taking a heavy toll on us. I had to pay another $440.89 today for her tests and med refills. That's not going to stop us from doing whatever it takes it get her better, but it has made it hard to sleep at night.

Sigh. I just don't understand. Why so many monoctyes? On April 16 they were 1.89, on April 17 they were 3.93, on April 23 they were 3.19 and today they're 4.35. That's 9.4%. I just don't see how this could be an infection. She isn't even displaying symptoms of illness. It has to be immune-mediated, no?

I'm going to take some time and read over your latest posts above. I do appreciate the time that you've put into helping my baby girl. This is such a stressful time for us.
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Old May 1st, 2012, 12:21 PM
will2power will2power is offline
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LoL sorry, I hope I'm not overwhelming you. I always seem to be too detailed. I try to cut my posts down, then struggle with what to leave out and end up posting a novel
If it is too much for you, please don't be afraid to tell me!!
You're posts are perfect, Robyn. You have no idea how much it means to me that you've given so much of your time and knowledge to help Skye. We think you're wonderful.

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Nookie has actually been doing that to Montana (our rescue puppy) the last few days! When he does it, he gets this crazy look in his eyes, then he gets the zoomies and is way over stimulated. We have to make him lay down and have quite time. We're pretty sure his episodes are neurological though. It could be dominance with Skye, but if she's never done it before, I would consider that a bit odd.
Oh, Skye's done it before. It just strikes me as bizarre to see a spayed female trying to mount a neutered male. He's done it to her, too, always in a playful sort of way. My babes are just weird. lol
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Old May 1st, 2012, 01:17 PM
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Just a few thoughts at this point.

I would try beef and no poultry. Have had lots of poultry issues on some of the forums lately.
We've switched her to things like beef and moose and she seems to be doing really well with it (and likes it, too).

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Many of these infections emit things that cause an allergic response, so there are many fires to put out at the same time.
That's for sure! There were definitely a multitude of things happening all at once with her.

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For any infection like this, I would want doxycycline added as one of the antibiotics
Is this a drug that's more powerful than she's already receiving, or is it more specific to treating other likely causes of her symptoms?

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If this were all immune based, the pred would be increasing the RBCs.
Her RBCs started out high on April 16 at 9.26 (reference interval 5.65 - 8.87), but today they're at 5.82.

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This sounds like infection of the lining of the blood vessels and the bone marrow. This may or may not be related to tick disease, but it's behaving like one.
I mentioned tick-borne disease to the vet again today, but she feels this is highly unlikely. It's not something we see around here.

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I'm pretty convinced that the vaccines triggered something that the body was able to previously keep in check.
Hubby and I think there's a connection, too.

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Just for future reference, benadryl can lower platelets if that ever becomes a problem.
Her platelets have remained normal to slightly below normal. But it's good to know how Benedryl can affect her count.


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Originally Posted by MaxaLisa View Post
The vasculitis, to me, is a huge indication that aggressive doxy is warranted. Infection of monocytes, and neutrophils, particularly monocytes, screams one of the rickettsia infections, like ehrlichia or anaplasma.
It sounds like you know an awful lot about this and I'm grateful that you're willing to share that knowledge with me. If the vet is convinced that this is not one of the rickettsia infections, can you think of other possibilities?

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Originally Posted by MaxaLisa View Post
If this dog is not on doxy, it is understandable that the monocytes are not coming down.
So, in your opinion, the Baytril and Metronidazole wouldn't do much good?

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Originally Posted by MaxaLisa View Post
I've seen a lot of vets treat the test results and not the patient. This is an area, where, if the vet doesn't feel the importance of treating with *aggressive dose* doxy, then I would use OTC doxy if this were my dog.
I thought doxycycline was available by prescription only.

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This is what I had to do with my boy, which bought him about 8 more months until the infection of the blood vessels turned to cancer of the blood vessels.
I'm so sorry! Your boy did not survive?

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Thank you for fighting so hard for Skye!
To infinity and beyond! She's our little girl and we'd do anything for her. I appreciate all your help. So much.
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Old May 1st, 2012, 01:37 PM
will2power will2power is offline
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And yes, pred can cause Cushing symptoms as well. They were actually thinking he had Cushings at one point because of the muscle wasting, excess drinking and something else, but I don't remember just what it was. But they ended up saying those were just side effects of the pred.
We discussed this at the vet's today, too. She mentioned that Skye had lost some muscle mass (I've noticed it primarily in the shoulder area). We talked about the excessive drinking/urination and she thinks this is all attributable to the prednisone. Her head looks fine and we haven't seen any blackheads, either.

I'm glad Nookie got his muscle mass back.
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Old May 1st, 2012, 01:55 PM
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I didn't realize there were ticks in Newfoundland but if there's a growing coyote population, there could well be the chance of infection in Skye.
I didn't know we had them, either. But because this has been nagging at me, I did some more research via our university resources. Apparently, they're very rare and I think there's only been 2 cases of Lyme disease ever found in dogs on the island (one in 2004 and one in 2006, both on the west coast...I live on the east coast). I need to research this more, though. I was thinking that I might send an email off to the province's Chief Veterinary Officer. It couldn't hurt to ask.
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Old May 1st, 2012, 04:09 PM
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will2power,I have not said a word,because I have no advice to give,just wanted to commend you for doing everything possible for Skye and I hope she'll keep improving
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Old May 1st, 2012, 09:25 PM
MaxaLisa MaxaLisa is offline
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I can't quote quoted quotes, but a few thoughts...

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Is this a drug that's more powerful than she's already receiving, or is it more specific to treating other likely causes of her symptoms?

Her RBCs started out high on April 16 at 9.26 (reference interval 5.65 - 8.87), but today they're at 5.82.

I mentioned tick-borne disease to the vet again today, but she feels this is highly unlikely. It's not something we see around here.

Her platelets have remained normal to slightly below normal.

It sounds like you know an awful lot about this and I'm grateful that you're willing to share that knowledge with me. If the vet is convinced that this is not one of the rickettsia infections, can you think of other possibilities?

So, in your opinion, the Baytril and Metronidazole wouldn't do much good?

I thought doxycycline was available by prescription only.

Elevated monocytes, struggling platelets, call for doxycycline as part of the protocol, as it can do some things that other abx cannot do. Not that it's necessarily stronger, just that the other things might not work, or work well, without all the right pieces of the puzzle. The RBC's, also being abnormal and on the way down is pointing in this direction.

Most vets are not well versed in tick disease. Wanda's Timber is a very good example of this, which was linked to earlier. Vets and specialists often, IMNSHO, get this wrong frequently.

There are some tick diseases that require multiple antibiotics. I believe that Timber was on doxy with a round of metro. The metro can get at forms of some bacteria. For example, lyme, when hit with effective abx, can change into a cyst form that metro is effective against. So, it's not really clear what the right protocol is - gotta treat the patient and not the test. The protocol that my boy did best on was amoxicillin, cipro, and aggressive doxycycline (5mg/lb BID), and pulsed metro 3-5 days at the beginning of each month. He was very sick for many years, and he did well on this protocol and continued to get better. It was only when I backed off on the doxy after many many months that the cancer took over. Doxy is OTC as Bird Biotic.

I can think of no other possibilities - it's clear this is an infection and when I hear elevated monocytes, low end rbc, struggling platelets, that calls for doxy as a first line defense, regardless of what the actual organism is. I believe that a lot of these dogs will not survive without aggressive doxy, and I think it's almost criminal that vets are so afraid of doing this that I think many times it puts the dog in danger, and we have seen this often on the tick list. There are other things can make a dog this sick, but doxy is also anti-inflammatory (often allowing for lower dose pred), and it has a couple of different anti-cancer actions, so, unless the dog has some weird disease (like myasthenia gravis which shouldn't have acetylcholine inhibitors), there is almost no loss in trying an aggressive round, particularly in such serious situations. It's really a game of odds, and I know which option I would pick.

There are other more aggressive drugs that can be used, but if a vet isn't going to consider doxy, they aren't going to consider the drugs that might fight an infection of the monocytes.
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Old May 1st, 2012, 09:29 PM
MaxaLisa MaxaLisa is offline
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You know, recently in the Minnesota, and/or Wisconsin area, they have found new strains of Ehrlichia which aren't tested for on any of the standard tests. In Southern USA, there is a form of Ehrlichia that is very common that is usually not tested for in dogs (soon there will be a new Idexx 4Dx Plus that will include one this one). So, there are a lot of sick dogs out there, that test negative, and don't get treated.

In tick testing, negative results mean very little, unfortunately.
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  #83  
Old May 2nd, 2012, 08:33 AM
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We've had at least one dog that has had one of the new strains. Luckily (or is that unluckily), living in WI, we and the vets are well-versed in the symptoms and started treatment with doxycycline. The dog recovered but never tested positive for the known strains. Testing for tick-borne diseases is a tricky thing under any circumstances--last time I went in for symptoms after a tick bite, the doctor didn't even bother to test. He told me that they're finding that in humans, the tests miss up to 30% of the cases! So he just started treatment with doxycycline and skipped the test.

In an area where tick disease is emergent, many vets and doctors just don't have the expertise to recognize or detect the cases that do occur. Adding doxy might do a world of good. Typically the results are fairly quick, and if the doxy doesn't seem to be doing any good, it's easy enough to discontinue it after a few weeks... Might be worth a try in your dog's case!
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Old May 3rd, 2012, 09:39 AM
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Good morning, Honna! Just checking in on Skye to see how she's doing, and of course, you, DH and Sirius! Hopefully, she's still continuing to improve.

I would have to agree with Hazel and MaxaLisa about the potential for tick-borne illness, especially if you continue to see an increase in the Monocytes and a decrease in the RBC. As both have said, the majority of vets will insist that it's not common, or not even a risk in a particular area. But, as one of our forum members found out, they can be very wrong, and the cost could be your baby's life. I find the ones who insist that's not what it is and refuse to treat for it, even though the symptoms are there, extremely arrogant. I don't know if you read the thread I posted re: SuperWanda and her baby Timber, but if not, I think you will find some similarities.

One thing my hubby and I have found is that you have to be persistent, and not afraid to disagree with your vet. If they're good, they will consider what you have said and act. If not, they probably aren't worth seeing.

Let us know how you are all doing!! And a few more pics wouldn't hurt
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