o_rooly

The vet called in a round of doxycycline (200mg 2x daily for 20 days). I just gave his first dose with more ground bison and green beans. Aston had almost made it to the door to greet me when I got home. He hightailed it to the kitchen after me when he heard the refrigerator open, and proceeded to hound me for the food I was preparing. Cleaned his bowl, hopped out back, peed, then proceeded to hop over to his couch and rub his face all over it. :beatheart I (gently) manipulated the joint without a peep from him. I'll be lucky if I live to see my 33rd birthday.

My husband just messaged me to report that Aston cried when he tried to get up for his walk this morning after I left for work, and it was all he could do to go out back to pee. he can barely walk now. His condition hadn't changed when I checked on him and fed breakfast this morning -- he was on three legs, but chipper, and I could manipulate the joint without a peep. I've texted the vet. Don't know what to do. My husband has been very supportive in my care decisions for Aston up to this point -- has basically left it up to me, and has been there 100% to keep up with meds, soaks, icing, carrying -- but he is very distressed that Aston is suffering without answers (as am I... but it's so hard... he keeps rebounding, and there are still possibilities to explore... but our friend and charge faces a lot of suffering through it, ups and downs). I am going to leave work ASAP to check on him. My heart is falling apart.

I just read around (and of course, the internet is always right )... an immunosuppressive pred dose is 2-4mg/kg/day?, and Aston's ~66lb (has lost weight since we upped pred ) = a little under 30kg = minimal immunosuppressive dose. hrm. I think that right now, my vet is waiting on the rheumatoid-factor test results, which should come back any day now. Still waiting to hear Dr. Couto's input on the CBC/chem, too. If rheumatoid-factor results come back negative, I'll push for a mycoplasma culture. At least Aston seems to be in good spirits. He's getting better at being on three crappy legs. Goes out back to our wee backyard in the morning and tries to play-stretch, wags his tail, tries to do sillies, can't, stops, wags, looks at me.

60mg daily, along with 50mg azathioprine every other day.

I'm so, so sorry. There are no words.

I've sent Aston's CBC and blood chem results from Thursday to Dr.Couto, awaiting his response. He said that we may want to culture separately for mycoplasma, but it's likely not necessary if his symptoms don't return while he's on pred. The problem is, the symptoms haven't left -- Aston can only barely touch that foot to the ground. To top it off, we let him out back to pee before dinner, and a bee stung him in his only good leg. gave him benadryl, and thus far, no swelling, though he's newly uncomfortable. Bless this poor dog...

WHEW. Glad to hear that you were able to pinpoint what was happening, and that Truman is on the mend. That would have shaved a few years off of my life.

Good to hear that things are showing up well!! and yeah -- Aston's teeth sure aren't perfect right now, either. His prednisone's immunosuppressive properties cause tartar to build up REALLY quickly. I used to be able to give him raw turkey necks to keep things clean, but turkey's a no-no for him now. Will have to start brushing if I don't get more chewies on board!

I concur with the above suggestions for methocarbamol -- it's helped Aston quite a bit (at 500mg 2x/day). Aston was diagnosed with LS in April 2013. He was stable, but visibly getting gradually weaker as the year wore on, until he started suffering major bouts of weakness (as in barely able to walk due to his hind end falling into a near-squat) in late December. An acupuncturist issued B12 injections in many points along his hind end + legs, which stopped the major weakness bouts, and then he underwent a 4-week series of Adequan injections (2x/week). I believe the Adequan helped greatly -- his hind end no longer starts to sink immediately when he is standing in one place -- he can stand now for an extended duration, albeit eventually shakily. He is still okay if we keep him moving on walks. He has also been on gabapentin (300mg 2x/daily) and tramadol (100mg 2x/daily). I am not sure whether these have helped in general for LS, but I am afraid to try to take him off of them if they are not doing any harm otherwise. A hug for you, and scritches for your girl. It is so very hard.

Joint fluid was extracted on the swollen left hock in January and sent for cytology (marked neutrophilic inflammation and suppurative arthropathy noted; no infectious agents), culture (negative) and the tick panel (negative). I'm very paranoid about the immunosuppression in case there's an underlying infection. One note is that his lymph nodes have not been enlarged with either of these leg episodes (his popliteal node WAS huge when he was fighting the pseudomonas/staph infection in his left-hind in October, though, and he was on ~30mg of pred daily at the time). In terms of improvement -- he seemed close to pain-free on Friday, after 24hours of increased pred + azathioprine, but since then, it has been up/down. At worst, he will still get up on his own if encouraged with treats, but will walk, very hobbly (not nearly as bad as it was at its worst), and will turn into a statue if I try to turn him around early on our (already short -- ~3/8 mile) walks. I can also manipulate the joint now without pain, whereas I literally couldn't look at it without Aston crying before. I read over Willow's episode. That's incredibly frightening. I'm so glad to read that she was able to get back to normal, no small feat!! Going to pick up the most recent CBC results tomorrow (from Thurs) to send along to Dr. Couto. Batmom -- Will also contact NCSU once I get my act together with the backstory. Thank you for the heads-up!!

The clinic had Antech run T961:FastPanel® PCR Canine Tick Borne Profile with Lyme Serology..

My vet just responded to my text (which contained Dr. Couto's input) with: "We did all that." I asked her last night about putting him on a round of doxycycline just in case the tick panel was a false negative. She doesn't think any treatment is warranted if the test is negative. I've read around on various dog forums, and it appears that the Antech lab panel that was run (along with other PCR tests) doesn't really tell you anything if it comes back negative. My head is spinning. I'm considering pushing for another blood sample to be taken and sent to either Protatek (http://www.protatek.com/reflab/diag.html) or NCSU (http://www.cvm.ncsu.edu/vhc/csds/ticklab.html), but I also don't want to be at odds with my vet -- she's been great, answering my questions sometimes literally 24/7 via text. She is generally open to discussion and Dr. Couto's opinion, but in this case, I just want answers

Thanks for the trachea idea!! Unfortunately, duck is out, since we're on a single, novel protein for now (bison). However, I just searched for bison chewies on Amazon and found a company (Great Dog Co) that sells a full line of trachea/tendon/"pizzle" chews from bison. YAY! http://www.amazon.com/Great-Dog-Bison-Tubes-Sourced/dp/B00AEDY3HO/ref=sr_1_41?m=A35JA3B5HB628R&s=merchant-items&ie=UTF8&qid=1392570674&sr=1-41 I think I'd go for trachea first, since I'm sure the "pizzle" probably isn't the odor-free kind Guh. I just looked over at Aston's leg, it looks waaaay vascular compared to the others. I texted it to my vet (because I can't just leave the poor woman alone), and she thinks that it's just inflammation still, since I can manipulate his joint without complaint. Looks so weird, though. Want to fix.

Dr. Couto just responded: "It is unlikely to be rheumatoid arthritis, since the cartilage is fine; in RA, the cartilage is eroded. Hence, if it is inflammatory, it is what we call non-erosive polyarthritis, most of which are immune-mediated. They should do a joint tap for cytology and culture (including Mycoplasma). Also, a SNAP 4DX PLUS would help with some of the odd tick borne disease. Did they do lab work to check his platelets?" I've forwarded his response to my vet so that we can proceed. So, it looks like we may be back to almost square 1 on diagnostics. I looked back at the cytology for his left-hind limb swelling, and IMPA was indicated then (my addled brain forgot). I suppose I should be very glad that it's not erosive, either way.. but Aston's still not able to walk well this morning. One improvement is that I can now manipulate/poke/squish his wrist without a blink from him. The joint, while still warm and swollen relative to other unaffected joints, does still seem to be tapering off very slowly. He is scarfing his bison like a champ, and spending five extra minutes standing on three legs in order to lick his bowl SO SO CLEAN. He seems to be in good spirits. Won't be swayed from his normal routine of going upstairs after his morning meal and morning (mini-)walk so that he can get up on his favorite couch in the office. We don't let him go downstairs on his own, though, since he'd be forcing a lot of weight downward -- my husband carries him downstairs whenever needed. Wish I'd kept up with my sandbag training so that I could actually be functional in this aspect. Will head out today to buy some Nature's Balance Bison + Sweet Potato, and will go half/half kibble/bison to see how it goes. One thing I've noticed is that on straight bison, OMG his poops are so tiiiiiny. Makes me realize how much he couldn't get out of normal kibble -- if I tried to increase kibble amounts to put weight on him, it just sailed right through him. Have to find something else for him to chew/clean teeth on, though -- turkey necks are now out. I was looking at ordering bison tails from ElkUSA, but I'm worried about feeding him raw bones when he's on a lot of immunosuppressive medication. Anyone have any experience in feeding raw meat/RMBs to immunosuppressed dogs? Is it safe? I asked my vet about whether I'd need to change anything about Aston's care while he's on immunosuppressives, and she said no, and that it was fine for him to interact with other dogs as normal (well, medium/large dogs anyway ). This strikes me as odd, but she said that the immunosuppression here mostly affects bone marrow.

Odd-colored gums alone tend to send poor Aston to the vet (though my vet did note that pale gums can be due to cold -- not sure what suddenly-black gums might signify). I'd probably go for peace of mind. With Aston, panting in the absence of too-warm conditions usually means something is making him at least uncomfortable if not painful (unless he's on prednisone, which initially causes panting anyway). I've read that leptospirosis can cause dark red speckles on gums + shivering, but there are usually many more systemic symptoms, like fever and more gastric upset. A hug for you, and scritches for Cinnibuns. Edit: Aston also pants when he's anxious or excited. However, if he's panting at a quiet time in the absence of stressors, it's usually discomfort.

Sending good thoughts for your buddy.

Was the cause of Beanie's swelling ever pinpointed? I've sent an email to Dr. Couto to loop him in on the latest news. In happy news, I found Natural Balance Limited Ingredient Bison & Sweet Potato kibble in a local shop; Amazon also has 15-lb bags for $37.99. Otherwise, I scouted around today, and the cost of fresh or frozen bison around here is $6.80/lb at the cheapest (Costco). I think that if I used the NB kibble, I would still just use it to bulk/supplement the ground bison to bring costs down. I'm afraid to risk using too much of (or any of) anything that could cause a flare.

Thanks for the heads-up on this... We're waiting on results from a rheumatoid-factor test, and I'm reading that false results are somewhat common in this case, too (false positives as well as negatives). Has this been your experience? I'm worried that the test may not actually tell us anything, and loading up on a new treatment always worries me given the med load that Aston's currently dealing with -- though of course, I wouldn't want to restrict it if it should still help him. I can't thank everyone enough for the support.. .

It seems like it. But then, prednisone perks him up anyway... and we've just quadrupled the dose. The last time a joint randomly started to swell (with no cultured pathogens or oddball cytology present), it stayed at a low-grade, non-painful swelling for weeks, and then overnight ballooned and became incredibly painful. This was about a month ago. That's when fluid was extracted for testing, and then a compression wrap was applied, and the swelling reabsorbed within a day or two... it seems like it could have been another display of rheumatoid arthritis, but it resolved without having to up his prednisone at the time. So, Idunno

Continued good thoughts for Nell. What a sweet, lucky pair of hounds you have. Thank you SO MUCH for keeping us posted.

The hours following the vet visit yesterday were ugly. The mobility gained immediately following the cold-laser treatment was gone about an hour later, as his wrist started to swell anew: In the afternoon, Aston managed to hobble outside, laid down in the grass, and then refused to get up or respond to cookies. I texted back and forth with his vet, who said I could try icing the wrist, but Aston cried if I breathed on it. We ended up (hand-)feeding his dinner early in order to get more pred into him, and start the azathioprine. By nighttime, he was a bit more alert, but couldn't get up. My husband insisted on taking the night shift with him, and carried him in and out of the house to potty. ( ) I found ground bison at Costco, so started cooking his novel-protein meals last night. He didn't care about the smell of cooking meat last night, but when I reheated a portion for breakfast this morning -- haven't seen him lurch out of bed so quickly lately, injured or not! He absolutely scarfed his food and the heap of meds. Was putting a tiny bit of weight on his foot. Came home to check on him at lunch (husband and I staggered our work schedules to reduce Aston's alone time to 3hrs max), and he greeted me at the door Tonight, he greeted me at the door on all four feet, with a slight limp. We went for a short walk, and he was quite chipper. Scarfed his food and stood at his bowl to lick it for four minutes after eating, then limped over to the couch to rub his face all over it. His wrist tonight: If this is rheumatoid arthritis -- what a nasty, messed-up condition. Of course it could be worse, so I am counting my lucky stars!! but I didn't know what it was previously -- just thought that "arthritis is arthritis." It just seems a cruel trick for a condition to take a random joint out from under a dog, overnight!, when the poor thing is already weak. Nature, you scary.

I've had a few separate consults with Dr. Couto since October for Aston. Here was my experience when I first contacted him (taken from http://forum.greytalk.com/index.php/topic/301799-dr-couto-is-available-for-consults/page-2?hl=%2Bmnmdogs+%2Bo_rooly&do=findComment&comment=5606374, hope the formatting doesn't get too garbled): "I initially sent Dr. Couto the backstory on Aston's case, along with the path report + xrays and a blood culture report that were used in diagnosing his severe foot infection. He responded saying that he needed more information, and from there we had a few days of back-and-forth between him and me, and me and my vet. My vet was very cooperative with running updated bloodwork, a urinalysis, etc., even though she wasn't completely on-board with some of Dr. Couto's thoughts on greyhound blood markers (since Aston's high-for-a-greyhound globulin was well within the "normal dog" range). It felt pretty awkward to call my vet a few times a day with updates and further requests from a mystery oncologist on travel in Spain , but oh well. I'm sure that there are great oncologists locally, I don't mean to discount them at all. However, it's hard to beat getting to pick the brain of a leading researcher in how cancer presents in greyhounds. " With Aston's latest issue, my vet actually requested that I contact Dr. Couto again to double-check xrays. So, it feels a lot less awkward to keep getting a second opinion Dr. Couto has typically gotten back to me the same day, often within a few hours. I don't know how he does it! But I did also read that he's currently traveling. I send a new payment to Dr. Couto automatically if a consult is on a "new" issue (unfortunately, we've had many seemingly independent issues); otherwise, I have just updated him on ongoing issues if changes occur. Hope this helps!

In case it helps -- akin to what Newgreymom mentioned, my friend's horse had an ulcer on his eye that wouldn't heal, and they did end up taking him to a specialist who scraped his eye with a razorblade (or some surgical instrument close to it) in order to get fresh tissue exposed to heal, is my understanding. Prior to this, they had also spun down his plasma to use as direct treatment, and I think there was some success with this prior to the ulcer that wouldn't heal otherwise (the horse has a history of ulcers... he likes to rub his eyeballs on stuff He is currently ulcer-free; when he has an ulcer, he wears a mask that has a giant bubble that covers his ulcer-prone eye.

The arthritis test will take 5 days. In the meantime, I'm going to start cooking for him, and it needs to be a novel protein. Will be off to find some venison/rabbit/?? meat this afternoon. Cautiously optimistic after seeing that Aston can bear some weight on that leg after this morning's cold-laser treatment. Thanks again, everyone

At vet. No bone changes, rheumatoid arthritis suspected. Upping pred and adding another immunosuppressant. Aston's receiving a laser treatment to help with pain. Vet is calling their lab about testing.