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Old September 30th, 2008, 02:13 PM
buschgobbler buschgobbler is offline
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Neurological Problems

I have a one and a half old Australian Sheppard cross. She was a rescue dog from the states. We have had her for approx. 6 months now. She was always very healthy. About 2 weeks ago she started to limp (her back leg). It was not a bad limp and we did not think too much about it. Two days after the limping started it got worse so we took her to the vet. They x-rayed the leg and found nothing wrong. They tried a couple more tests (i.e. reflex test) and suggested that we visit a neurologist.

We went to the neurologist two days later. The limp was a lot worse (to the point where she could not walk well at all). The dr. noticed that her front leg was having problems as well. They thought that this could be a number of things -- potentially lymphoma or an autoimmune disease. They also mentioned that it could be some sort of US born virus -- although they did not really know. They conducted a number of tests (blood, urine, spinal tap, etc.) and gave us two sets of pills (one for the virus and one for the cancer). She has been on these for 4 days and has not gotten any better (although she has not gotten worse). She is in no pain (just frustration because she cannot really walk).

Does anyone have any idea what the problem could be (just suggestions) so that I can look into them. Someone mentioned lymes disease and we are now testing for that. Any help or comments would be appreciated.
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Old September 30th, 2008, 03:10 PM
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Did the neuro rule out any nonviral/immune issues...no problems in the spine itself? Sorry your family is dealing with something so scary.
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Old September 30th, 2008, 03:37 PM
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Where in the States did you rescue your dog from? Depending on the area, you should probably check not only for Lyme's but for the various ehrlichias and anaplasmosis--especially if your dog got into ticks or was in a place where ticks are common. There is a 4DX test put out by Idexx that tests for exposure to a common ehrlichia, Lyme's and anaplasmosis--it's a cheaper test that doing all the titers separately.

A CBC might hint at anaplasmosis--look for platelets and white blood cell counts lower than normal or even just on the low end of normal.

Good luck with your dog, buschgobbler--and thank you for rescuing her!
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Old September 30th, 2008, 05:05 PM
buschgobbler buschgobbler is offline
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We rescued the dog from Ohio. Thanks for the info, we will do some research on this. The neurologist is already testing for Lymes (we will get the results tomorrow) but they do not believe that this is the cause.
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Old October 3rd, 2008, 12:05 AM
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Quote:
Originally Posted by buschgobbler View Post
They thought that this could be a number of things -- potentially lymphoma or an autoimmune disease. They also mentioned that it could be some sort of US born virus -- although they did not really know. They conducted a number of tests (blood, urine, spinal tap, etc.) and gave us two sets of pills (one for the virus and one for the cancer). She has been on these for 4 days and has not gotten any better (although she has not gotten worse)... Someone mentioned lymes disease and we are now testing for that.
Before I get into an answer I would like to discuss lyme disease testing and anaplasmosis. I agree that a CBC might be helpful however I assume that this has already been run at least once by now. Hazelpackrun's recommendation about the 4Dx test is a great one. It looks at lyme/ehrlichia/anaplasmosis/heartworm in a simple snap test that takes about 15 minutes. Also reference laboratories like Antech and Idexx can do comprehensive rickettsial/protozoal screenings which can be helpful since 4Dx is not comprehensive and does not get all strains. Ask if the test was only for lyme or if it was a comprehensive test. Anaplasmosis is a disease that is often found when other tick borne diseases are diagnosed. Luckily whether it is diagnosed or not, when you treat for one tick disease, anaplasmosis is often covered. A therapeutic trial of doxycyline can also be beneficial. Doxycyline is usually well tolerated and very inexpensive.

My recommendation would be to go back to the neurologist. This sounds complex and I do not want to go guessing. The specialists are there to diagnose the complicated cases. Often they might try a therapeutic trial (such as the two medications - btw, what were they? Is one was prednisone?) Therapeutic trials are nice because they can not only solve the problem but safe you and your pet from more expensive and/or invasive diagnostics. Unfortunately if the therapeutic trials did not work then we might have to bite the proverbial bullet and proceed with further testing. Has an MRI or CT scan been performed? One of these might be very beneficial and every neurology specialist will have at least one of these test abilities.

Also if lymphoma (I am keeping out good thoughts that this is not the case) is of concern, then your regular veterinarian could perform lymph node aspirates which are fairly non-expensive (comparatively) and fairly non invasive (comparatively ).

Also how high is your pet's globulin level? Can you find out? It can sometimes be very helpful.

Wishing you all the best.
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Old October 3rd, 2008, 08:25 AM
buschgobbler buschgobbler is offline
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The tests

Thanks for the reply Dr. Lee.

I think they ran the 4Dx test -- it was a test the checked for three strains.

The test that they ran when we first took her in was for the virus -- this came back as a low positive. The Dr. said that he does not believe that Sienna has this virus but they put her on Clindamycin anyway. The Dr. said to leave her on the medicine anyway because it will not harm her (but we don't expect to see any results because of this).

A CBC was done.

They also put her on Prednisone (so she is currently on 50mg of Pednisone and she is also on Clindamycin). Today (Friday) has been her 5th day on Prednisone and we have not seen any results (the symptoms have not worsen but have not improved). Is it strange to have not seen any results? Initially the Dr. said we should see results within 24 hrs but now he is saying the it can sometimes take longer. We have another appointment on Tuesday where the Dr. will do another check up. Is there anything that we should ask the Dr. that maybe we have not asked?

They have not done an MRI or a CT yet. They did do a spinal tap and they found protein in the fluid. When they sent this off the get analyzed, the sample arrived broker. The Dr. hasn't suggested doing another one yet but he did suggest that the high protein means either lymphoma or an autoimmune disease -- so the prednisone would be the right treatment regardless. If it is lymphoma isn't it strange that we have seen no other symptoms? (i.e. not swollen lymph nodes). The Dr. said the only way to be sure is to do a biopsy of the affected leg but even this is no guarantee that they would be able to get the cells that have the lymphoma. It just seems weird that the thought could be lymphoma based on the protein in the fluid alone.

We had done some research and found a disease called polyradiculoneuritis (Coonhound Paralysis) and the symptoms seemed very similar. We ran this by the Dr. and he said that Sienna definitely does not have this.

One last thing I should mention is that almost 5 weeks ago Sienna was put on Stilbesterol for what the Vet thins is an incontinence issue. She started licking a lot, and leaking from the vaginal area -- not sure if it was urine. It was drops of clear liquid usually when she was sleeping or lying around. Anyway, about 2 weeks after she was on this the limping started. The Dr. said there is no connection but I thought I would mention this.
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Old October 3rd, 2008, 08:26 AM
buschgobbler buschgobbler is offline
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Type of Virus that they tested for

the viruses were toxoplasmosis and neospora -- but once again the Dr. does not think this is the cause.
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Old October 3rd, 2008, 10:38 AM
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I googled the stilbesterol, and side effects include joint and leg pain. It's a human hormone replacement drug. Is she still on this medication? I always hate when vets or doctors dismiss drug reactions out of hand - it seems like most any drug on the market anymore treats one thing and causes 10 things that are worse than the original condition.

I hope that you get the answers you need.
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Old October 3rd, 2008, 10:49 AM
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I agree with Kandy. I can tell you how frustrating it is to have the doctor dismiss side effects as something unrelated, only to find out later that they disappear when the meds are changed...usually after months of suffering. If there is any chance that it might be a reaction to the stilbesterol, changing her over to phenylpropanolamine would be an easy enough thing to do.

I don't know enough about the possible side effects, however, to know how many of the other symptoms the vet found could be caused by the hormone replacement.
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Old October 3rd, 2008, 10:00 PM
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Quote:
Originally Posted by buschgobbler View Post
the viruses were toxoplasmosis and neospora -
just for clarification....

Neither of these are viruses. Both organisms are protozoan life forms and both are treated with the antimicrobial drug clindamycin.
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Old October 3rd, 2008, 10:02 PM
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Maybe I missed this but was she taken off of the stilbesterol to see if the limping resolved?
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Old October 5th, 2008, 07:42 AM
buschgobbler buschgobbler is offline
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Yes

Yes, she has not taken the stilbesterol for a week now -- the vet wanted to give her this and actually wanted to increase her dose because she was leaking again.

I know that toxoplasmosis and neospora are not viruses -- the vet never gave us the name of the virus but he said that these were could have been caused by the virus. She is on clindamycin but once again the dr. does not think that she has this.
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Old October 6th, 2008, 11:21 AM
buschgobbler buschgobbler is offline
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Hi Dr. Lee

Thanks for all of your help with this.

Our dog has been on prednisone for a week now, and we still haven't seen any improvement. She is going in to see the neurologist again tomorrow, but I don't think he knows what he is going to do. I don't believe he is running any blood work or anything tomorrow, it is more of an assessment.

Do you know what would give the vet the conclusion that she may have lymphoma or an auto immune disorder? As far as I can tell, he is basing this on finding protein in the spinal fluid. As far as I know, her white blood count was just above normal, but nothing drastic.

Do you have any other suggestions, or questions I can ask the vet tomorrow? I don't want him to give up, but we don't know what else to do. He had suggested doing a biopsy of her leg, but that that may not even show any thing, and because it is invasive, there might not be any point.

It just seems weird to me that this is there next step. That they cant run any other tests to determine if it could be lymphoma or an autoimmune disease.

Also, what would it mean if the prednisone isn't working (she is on 50mg a day, given in 2 does (25 each dose).

Thanks!
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Old October 6th, 2008, 12:48 PM
akiley7 akiley7 is offline
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My dog has the exact same symptoms. He just had an mri today that revealed nothing. He also had a spinal tap done and the results are expected back tomorrow. Our neurologist also feels that it is a virus.
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Old October 6th, 2008, 12:53 PM
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At the risk of over-simplifying - has an orthopedic vet looked at her leg? The limp in the back end could've been due to a stifle (knee) or hip injury - and the lameness in the front leg could be an effect of the back leg being lame since dogs carry 60% of their body weight on their front legs, and even more so if they are compensating for not using a rear leg.

Perhaps before the neurologist starts taking biopsies of anything, and everyone prepares for the worst case scenario, you might have an ortho vet at least look at the xrays your normal vet took. The appearance of the limp after being on the drug could be a coincidence.

The prednisone should've taken away any inflammation if that's what was causing the limp, which kind of makes me think of an injury that just happened to be at the same time. But if the limp is due to an injury, it will remain.

Just throwing out an idea.

I certainly hope you can get to the bottom of this quickly!
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Old October 6th, 2008, 05:24 PM
buschgobbler buschgobbler is offline
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Hi Kandy,

Well interestingly enough, when we first brought her into the vet with a minor limp, the vet gave her an anti inflammatory to see if that would help. It didn't and it got worse, so we brought her back into the vet. The second time we brought her in, our dog (sienna) didn't have her pill, and the vet took xrays and saw no sign of inflammation. Not sure if that is due to the pills that she had been on for the 4 days before hand. She noticed nothing else wrong with the leg.

Sienna doesn't seem to be in any pain, and the vet was able to move her leg all around, and even checked it when they sedated her for the xray and didn't notice anything wrong.

She then checked her reflexes, and noticed none in her back leg. It wasn't until we took her to the neurologist and they did the one test (I forget what it is called) but it checks her reflexes, and they noticed virtually none in her back leg, and that her front was weakened.

I don't think they did an xray of the spine, and not sure if that is abnormal. It is one question that I will ask tomorrow when we go in.
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Old October 6th, 2008, 05:27 PM
buschgobbler buschgobbler is offline
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akiley7,

Very strange that your dog has the same symptoms. How old is your dog?
They did an mri already?
Is your dog able to walk right now?
My dog is able to hobble along, but tends to start to do the bunny hop. You can see her back knee push outward as she walks.
She seems to have a bit more stability, but not sure if that is just her adjusting to this. Don't think the prednisone is doing anything, as I would have thought to see more of a difference.

Is your dog on any meds right now?

What does your vet think is wrong?
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Old October 6th, 2008, 05:30 PM
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Just wondered if it had been considered since my newfie girl had a limp that was misdiagnosed for over a year, complete with xrays and physical exams. As it was explained to me, if your vet doesn't have a good knowledge of orthopedics, many problems will go unnoticed even with xrays and physical exams.

I'm glad that's been ruled out for you. I hope you get some results!
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Old October 10th, 2008, 08:32 AM
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possible lymphoma

I am new to this forum and have been researching lymphoma since that is the diagnosis my 6 yr old Lab has received. His also began with hind leg weakness and was misdiagnosed as lyme. He showed knuckling in the front leg and general cognitive impairment, ie. confusion, getting lost. The vet believes that the cancer has spead to his neurological system at this point. His lymph nodes are now enlarged, but I suspect that he had this disease for awhile. I hope it is not lymphoma.
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