BauersMom

The 4 weeks is correct. However, that doesn't mean that we're going to stop giving him fluconazole at that point. The vet may want to move him to a different dose, change meds, etc. It just means that we are going to give him this dosing (200 mg 2x/day) for 4 weeks. We expect him to be on it for longer.

We called Roadrunner Pharmacy -$49 for the month!

Original thread is here. So a quick update and a few questions - he's been on the fluconazole for 4 days now, and he's "brighter" and interacting more. The toy box was raided today, so another good sign that he's feeling better. He's also put on 5 pounds in the last ~2 weeks. He's still limping and still has a fever, however. We did lung x-rays and his lungs are clear, but there was a lymph node on the x-ray that was abnormal - the vet explained that's common in a systemic fungal infection. He's set to be on the fluconazole for 4 weeks. When should we expect the remaining symptoms start to resolve? If we don't start seeing improvement in the limping and fever after a certain point, should we change meds/approach? Thanks

I will be calling a different pharmacy for sure. The local one said it will be $300 for a month.

Looks like he was raised on a farm in New Mexico!

I have no idea! I am trying to piece together his history and get a hold of his owner. It does explain a lot of his symptoms, from what I have read today.

The fungal test is back - he came back positive for antibodies to coccidiomycosis (valley fever).

I noticed some spots on him this morning - balding, crusty and looking a little red. One toe is nearly completely hairless now, and he has probably another 4-6 spots on him. Left over from the pyoderma? Related to some sort of immune issue?

So we're seeing some improvement. He shows moments of having no pain, like last night at 2am he was ready to walk around the house and investigate! This hadn't happened at all for the two weeks he's been here, so even though it was at an ungodly hour, I took it to be a good sign. He's subdued again tonight, but a few times today he seemed more perky. I'm encouraged. He's on doxy and deramaxx only at this point - not sure which is having the positive effect, but I'll take it!

I know about the backlog from the osteo thread. I haven't yet submitted anything though.

No steroids at this point, for sure. It's all been NSAIDs for pain relief. I'll check about the antibody panel, thanks for the suggestion. The vet we have been seeing is out until early next week - do you think it's worth doing a joint tap sooner rather than later? I could see about getting in with another one at the practice today or saturday.

The link works, and it sounds really possible. The only piece then is the GI/weight loss, which could be something unrelated. The vet mentioned doing a joint tap - he must have had something like this in mind. And yes, we're keeping him on the doxy for exactly that reason, foxysmom!

He turns 4 this year. I feel like the stress of the haul "triggered" something, however that's just a guess and the timing could also be coincidental. I don't know! Edit to add - is there a test for polyarthritis? Does it present with a fever, or is that something else, you think?

No films (yet). I believe it was an Idexx panel (PCR), not 100% sure, covering Anaplasma, Babesia, Bartonella, Ehrlichia, Hepatozoon, Leishmania, Neorickettsia risticii, Rocky Mountain spotted fever and Canine Hemotropic Mycoplasma and Lyme QuantC6 (from their website, and this matches up with what he read me today). He came right out of a racing kennel, and wasn't showing any issues at the time of the haul. In fact, I saw him right after he got here and he was a bouncy, happy dog. He's very subdued now. Everything was normal (well, except for everything wrong with him!) on physical exam (heart/lung sounds, etc). One other thing I've noticed is that he has two white spots on his nose...like he's losing pigment there? They are small, but definitely unusual and something I didn't notice on him two weeks ago...??

Good question about the other dogs - one other also came down with diarrhea/weight loss, but he rebounded pretty quickly. No other symptoms with that dog like fever, etc. And no other non-greys on this haul. I don't think they've tested for meningitis or septicemia, but I will check. Thanks

If anyone has any suggestions on what to look at next, I'm all ears. Here's the story of the last two weeks - Tex was hauled up from Florida a few weeks ago, so I don't have a ton of history on him. By all accounts, he came up looking and acting fine. He has a recurring fever, between 103-104 usually. But it's not a constant fever - it's periodically came out at a normal temp. But when he heats up, he's HOT - I can feel how hot he is. He had a bad bout of diarrhea for a week or so. It's better now, but not perfect. Fecal was negative. He's lost a lot of weight, like 8-10lbs. I am feeding him a ton of food (raw and kibble) and he hasn't gained a thing. He acts like an old dog (he's four this year). Getting up and getting down are clearly painful for him. He will limp on various legs, and shifts his weight frequently when standing. The vet called it a 'polyarthritis' type presentation. He had pyoderma. For meds, he was put on cephalexin for the pyoderma and flagyl for the diarrhea. Those helped. When the fever came back (while still on the ATBs) and the limping got more pronounced, they assumed it might be tick related, so we started him on doxy. His full tick panel has since come back totally clean. We're keeping him on the doxy still. Because he's clearly in pain of some sort, last night the vet gave him a shot of an anti-inflammatory. Definitely saw improvement in his desire to get up and walk around - he was still gimpy and stiff, but more spunky. We're putting him on deramaxx now to help with that. With the fever, the vet is narrowing it down to some sort of infection. Because of that we've sent out for a full fungal panel as the next step. Bloodwork is unremarkable except for an elevated ALT (220 u/L, I think, I don't have it in front of me). Annnd on top of all that, the poor dog has a bad case of happy tail. Any thoughts? Ideas??

I'm sorry to hear about Nadia. Glad you got the gabapentin upped, sounds like it helped.

Berkeley is a miserable patient and does horrible in new/unfamiliar situations and did decent (for him) through chemo. We had to rearrange things a bit and try to desensitize him a bit... and had some bad moments for sure... but I have no regrets going that route with him. Our post-chemo life is much happier though, that's for sure. Ironically, of all my pets past and present, Berkeley has been at the vet the most (even before the osteo dx!). Bloat, broken toes, hemorrhagic gastroenteritis, the random gashes and so on means Berkeley is in every e-vet's records within 30 miles from here.

Could you point us to evidence on improved efficacy for the Lyme vaccine?

We don't vaccinate for Lyme here, mostly for the reasons outlined in the ACVIM paper and by DunesMom. We do annual 4DX Snap tests, treat with Frontline and keep the yard tidy (much like recommended here: http://www.cdc.gov/ticks/avoid/in_the_yard.html). I don't think adding a somewhat-effective vaccine is worth it.

You got it, Kristin. It seems like the dxs come in 'waves'. The board will be quiet, and then a whole slew of new diagnoses. I dunno, maybe that's just my impression. Berkeley is gaining a little weight, so I think it's time to lay off the 'extra' cookies. How is everyone else doing?

Even though everything pointed to osteo in Berkeley's case, and everyone who read the x-rays said the same thing, it still stung when the biopsy came back. I don't know why, it should have been no surprise, but it still hit me hard. Hugs to you and Symbra.

Aww, poor Pinky. Hopefully, she's rebounded for next week!

Oh no. Fingers cross for some "good" news on Monday for you.

Things to consider if looking at amputation - cost is a big one. Amputation and the follow up chemo (even if you get it for free from OSU) will run anywhere from $5000-10,000 easily - depending on the cost of x-rays, bloodwork, complications, etc. After amputation care is not trivial in some cases. Can you stay home with them during the first week? How will you handle helping them around, if needed? Stuff like that should be considered. Another is logistics within your lifestyle. Berkeley can no longer do stairs (though MANY tripods do well with stairs, Berkeley does not)... so we've had to move our bedroom to the first floor. Thankfully, we have a first floor bedroom that was an office. We also have a ramp out to the yard. Can you manage a tripod for the next year, hopefully two/three years? The other thing to consider and realize is that amputation may not give you much more time over going the pain management route. It's a crap shoot, though like Jen said, there are dogs that make it a lot longer post-amp and diagnosis. Good luck with your decision. It took me a good week to really think it all through, it's a lot to take in.