ahicks51
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Sad ending, so stop reading now if it'll be upsetting.
Speedy started to decline and was euthanized Monday despite vet neuro consult on Friday and some slight modifications to his meds. The pheno didn't seem to be causing his ataxia and other symptoms, or at least they didn't improve substantially even after we reduced the dose. The vet wasn't convinced Speedy was even having seizures; the (lousy) video we provided, along with our observations, suggested he had tremors or wobbling, versus a seizure. He sure as heck behaved post-ictal after his tremors, so I don't know what to think.
We would have let him go sooner but for how we held out hope it was valley fever with CNS involvement, and that the fluconazole might take hold in time. He remained a strong eater up until the end, although he had substantial difficulties in other parts of his life. I don't think there was much pain, but can't be certain. Ultimately, based on what we know, it could have been meningitis or encephalitis (which might have responded to the steroids), tick borne (he was negative for all TBDs and was also on doxy), valley fever (despite having been on fluconazole for 10 days, fluconazole doesn't get into the CNS very well), or a brain tumor. Vet neurologist determined symptoms and behavior when tested put the location of whatever problem (inflammation, tumor growth, etc.) at the base of the brain stem, suggesting it was a brain stem tumor which would be consistent with the slow, gradual changes in behavior we saw.
Six hours after putting him down, I asked the vet clinic if they'd do a CSF draw to send out for a valley fever titer (his bloods were negative, but the CSF can contain antibodies without systemic involvement), but there was some mumbo jumbo about how they couldn't vouch for how the body was stored and since I'd signed away any necropsy, they said they would refuse to do so. As if antibody levels would change in CSF in cold storage after euthing. As if even a false positive or a false negative would matter at this point. So, lesson learned- even if the euthing is an emergency, if the cause of the illness is unknown leave the option for testing open even if no full necropsy is done.
Since Speedy was a foster, we adopted him posthumously. It's devastating for all parties involved.
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The seizures are very mild and a secondary symptom. He has a blown right pupil and inflammation of the brain with negative bloods for infection and VF. It may be VF with CNS involvement such that there's a negative serum titer, but antibodies are present in the CSF. So, while treating with doxy (for an infection or latent TBD that's not showing up on a tick panel), prednisone (for the inflammation of the brain), fluconazole (for a potential VF infection), and phenobarbital for the seizures, I was hoping to find out whether or not 90 mg BID pheno is too much, and that seems to be the case.
He doesn't stop breathing during seizures, and he is often able to respond to his name while seizing. There is no rhabdo the next day, and his seizures are little more than head-nodding for a few minutes. While it is important that we control them, I find that drugging him to the point where he can't even move is excessive and the dosage seems high when compared to what others have used here.
We remain hopeful that the seizures are caused by VF since that can be treated, but the next step up is MRI- and, frankly, I don't know of any diagnosis via MRI that is going to be treatable.
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It's bad because we've had him since March and these are the first seizures we've seen; between this and other symptoms, if it's not valley fever, then it's likely he will not be with us very much longer. Even if it is VF, CNS involvement is quite serious and can required prolonged- even life-long- prescription anti-fungal meds.
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We're hopeful that a veterinary neurologist will not be necessary, because if it's not valley fever, the diagnosis is rather bleak; any additional diagnostic tests must be weighed against the costs to the adoption group and helping other dogs. If it *is* VF, then our hope is that the fluconazole will put it into remission, although CNS involvement with VF is quite serious. So I'm hoping to make the best with which we are given, and (first off) ensure the ataxia and other symptoms are from too much pheno (versus brain inflammation), and secondly to see if less pheno is an option.
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Speedy (5 yo male greyhound, ~75 pounds) was prescribed 90mg BID phenobarbital for seizures; his seizures- while sometimes prolonged- are quite mild. We suspect the underlying cause may be valley fever (coccidioidiomycosis); blood tests are negative, but apparently animals can have CNS involvement without antibodies in the blood.
By day 5, he was stumbling, having problems standing, ataxia, pacing. The vet was consulted, and he stated we should stay at that dosage. Vet has experience with greyhounds, and "inherited" a practice from a retiring vet with extensive greyhound experience.
Are greyhounds more sensitive to phenobarbital than other breeds? This poor guy won't get up because he doesn't have the hind-end coordination to do so, and then will pace for hours because he doesn't have the coordination to sit back down.
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Negative for TBDs, negative for Valley Fever. A bad combination.
The prednisone (and/or the doxycycline) seems to be doing something, and he was a bit better today. If he's fed when he wakes up at dawn, his whining becomes somewhat diminished, allowing The Lisa to get a bit more sleep. Another small seizure this afternoon. Added phenobarbital this evening.
Next steps include fluconazole (in the event the VF is a false negative), and play it by ear. CT or MRI would be on the agenda, but cost has to be measured by the adoption agency, as well as to what ends a scan might yield any long-term benefit for Speedy.
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All right. So, last evening was not a good night. There was languishing and anguish and discomfort, and... then a seizure. We've had him 10 months, and nothing of the sort previously. And it was a prolonged one- I'd call it status epilepticus, but for the fact that he was breathing the entire time, and there were no strong muscle contractions. Urine was normal this morning (no apparent rhabdo). Also noticed this morning his right pupil is dilated, doesn't respond to light. Didn't sleep well last night, average-to-slightly-more-whining-than-usual.
Came home for lunch to get some work done, and Speedy barely moved. Wouldn't leave his cushion.
The adoption group and The Lisa take him to the local vet, and... not good; there's presumably swelling of the brain. So, tickborne diseases are suspect, "infection," and... valley fever (coccidiomycosis), which hadn't even occurred to me. So, tests are in process (VF takes four days), a handful of pills have been doled out, and... came home from work, and Speedy is his usual self, knocking over everyone- and every thing- because he's excited. The Lisa decided to check the back gate lock, and Speedy comes careening over, thinking he's going on a walk. We start to prep their dinner an hour early, and Speedy is busy stepping on all the other dogs that are laying down, and knocking over the other dogs that are still standing. Like the dog he was six weeks ago, and we haven't even started the pills yet.
I'm at a loss. But at least the prognosis has some branches that I did not consider, ones that have a better path than the ones I was thinking of, anyway.
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Thanks everybody for the insights.
This evening was fun. I got home from work around 7, by which point in time the whining had hit a fever pitch- or so I thought. It managed to get *worse* and for a while I was ready to cart him off to the E-vet. He was actually whining to the point where there was some mild panting- he wouldn't settle down, and when he went outside, he refused to do anything except come back in.
I grabbed some kibble from the bag, and he ate from my hand- OK, no problems there, not hurting bad enough to not eat. We fed all the dogs, and he ate his meal, then laid down and went to sleep. Then it was more whining, more sleeping, a group roo (when I decided to join in on the whining- Speedy came running), and then sleeping. He started carrying on when he didn't get the cushion he wanted, but now that he's on the one he wants, there's no whining.
A vet visit is on the agenda through the adoption group; they're kept up-to-date with his issues. It's just a really weird situation.
He used to run to the side door when he was outside and saw me duck into the garage, thinking there was going to be a walk. He hasn't done that for weeks now.
Maybe we'll wean him off the Claritin to see if it makes a difference.
And hi, Pam.
If y'all miss me, back up and try again! -
We've fostered 30-40 hounds over the years; this one has been problematic for several reasons. We've had Speedy for ~8 months now, awaiting a home. He presents a difficult placement in that he's smart or aggressive (managed to open the latch on the back gate when a crazy ranting drifter walked by, causing all four dogs to spill out into the street- all recovered without injury), he's not cat safe, he's a big black dog, and he may have dominance issues with other breeds (dang near tore Tito's ear off- it's fine now).
First we weren't feeding him enough. He whined. We fixed that, and got sleep at night for a change.
Now that he's adequately fed, he's gone back to whining. Although the whining builds up to feeding time, he still whines even after he's fed, up until he slips into a food coma. No obvious signs of pain or injury. If it's a slab fracture, he hides it well.
He's become picky with his food- a slow eater- which is weird in light of how he whines before feeding time. Maybe he's bored with the bagged food, but we also add in cooked rice (flavored with meat juices), lettuce, etc. He also gets a generic Claritin daily for allergies, his only medication.
He doesn't like to leave his cushion. I have literally had to yank the cushion out from underneath him to get him to go outside. He slips off the cushion like a fried egg slides off the pan, and refuses to move- even if taken by the collar. Tonight he didn't even go on his walk, which he's never done before. A week or two ago, at a meet-and-greet, it was commented that he likes to lay down and just not move.
He is slow on walks all of a sudden. One mile walks, and by midway through, he starts walking very slowly. Normally I'd suspect joint pain (between the cushion and the walks) but he's young (about 4), and only had about 58 races. Plus, when he's out in the yard, he'll bolt back inside as if nothing is wrong.
He has started whining at night, and on Saturday he woke us so we let him out, only to have him start whining an hour later. He sometimes does this to get the cushion he wants when the other dogs get up to go out as well, but instead he really had to pee- so the second time, we called his bluff (figuring he had just gone outside an hour before) and he went into the crate and emptied his bladder. This happens now and again: he's let out, doesn't do any business, and then within a short period of time either HAS to go out again, or soils the carpet. (Fortunately, it's rare he soils the carpet.)
He and Tito got into a fight over an emptied dog bowl that didn't belong to either of them. Speedy would have killed Tito if he could have gotten through his super-thick fur. Tito's ear was bleeding and it hung on the side of his head for a week before it gradually went back to normal. We muzzled Speedy 24/7 except for feeding for several weeks after that.
I have no idea what to make of this dog. I'm not even sure what to do with him. He's a great dog, he's gorgeous, but I just can't parse his behavior. I'm not even sure I have a specific question other than what to do. He starts whining early in the morning, and neither The Lisa nor I are getting sleep like we should.
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Sileo may be a good option for him, but if he's generalizing to other sounds a longer acting anti-anxiety drug like Prozac might be needed. Unfortunately Ace is about the worst thing you can do for a dog with noise phobia.
We took him to the "usual" vet, but he was out and we got some guy that must've gotten his degree from the University of Transylvania. He just wasn't very useful, and instead of getting a benzodiazepine like I was hoping for, we got Ace. That was a mistake.
Hadn't heard of Sileo. Aside from the price and how it can't be stored for any length of time, it looks like another option that's better than Ace. I forgot to mention that Tito is now getting thunder-phobic, but it's been a miserable monsoon season here in Phoenix so there's not much thunder, really.
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All our dogs are greyhounds, except Tito, an 80-pound bucket of fur.
We've been fortunate that all of our dogs and fosters have been pretty much bulletproof when it comes to thunder and fireworks. But a few years back, Arizona legalized certain fireworks, and people took advantage of that and started using whatever the heck they could buy, and now twice a year Tito gets very upset.
And when an 80-pound dog that is pure muscle gets upset, he can tear a house apart. Crating doesn't help; he gets destructive, starts chewing the bars, and won't settle down. The past year or two, putting him in the spare bathroom helped, but then we decided- hey, let's get all chemical and Ace him (acepromazine) for New Years. Let's see if that helps.
It kind of helped. He was whacked out, and he recovered the next day. Fourth of July, same deal, except now he needed several treatments (including split pills for the "light" days that preceded and followed the 4th), and he was kind of whacked out but generally did OK.
After this past NYE, he didn't do so well. His storm-buddy, Minerva, is now gone; She Who Must Be Obeyed would vault out the dog door and bark at the sky- just once- when there was thunder. Nothing that girl back. She is gone as of her 13th birthday. Tito had his first Minerva-less NYE, and didn't do so well. And this 4th of July was even worse. I think the acepromazine has left him more stressed out from the experience, and now he acts even worse from the Ace alone. Most recently, he's started acting up and getting destructive even when the wind picks up. We tried putting him in the closet- he seeks refuge and will not settle down- and he completely tore the closet apart and tried to core out from the walls. The 4th of July fireworks seem to start earlier and stop later, and just a single "pop" will cause him to start looking for a place to hide, and turning the place upside down.
I've never tried a "storm shirt" or anything like that. I don't know how well it would work.
So, if anyone has any bright ideas, I'm all out of options. I think he was doing kind of OK, but the acepromazine made it much worse. Not having Minerva is part of it, but none of the other greyhounds get anxious so he's not cueing in on them.
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CoQ10 for fatigue and depression in MS.
The biotin study. 91.3% improved clinically- that's pretty remarkable.
I suspect both are just feel-good measures for me that have little effect on long-term decline in dogs, but- hey. We do what we think is best.
Rummaged up this old study in which dogs were fed HUGE doses of biotin, but they didn't look at toxicity. Plus, it was 3-5 weeks. But they were feeding 5,000 micrograms per 10 kg weight, which (for a 66-pound greyhound) would work out to 15,000 micrograms, or about 50% more than I'm feeding Minerva.
In a collaborative study with small-animal veterinary surgeons, dogs with fur and skin conditions were treated with biotin (approximately 5 mg biotin/10 kg body weight/day) for 3 to 5 weeks. In total 119 cases could be treated which were reported to show symptoms such as dull coat, brittle hair, loss of hair, scaly skin, pruritus or dermatitis. Cases requiring other treatments with e.g. glucocorticoids, were excluded from the study. In 60% of the cases all symptoms were reported to be cured after the biotin treatment and in a further 31% an improvement was noted; in only 9% no effect was recorded. All breeds responded but to a variable extent: e.g. in Poodles the response was lower (no response in 6 out of 11 cases) than in Alsatians where all improved and 14 out of 29 were completely cured. The results confirm the favourable effect of biotin for treatment of fur and skin conditions in dogs.
Linus Pauling went a little wonky in his later years, claiming high dose vitamin C would cure us of everything. Since then, the Pauling Institute has been a good source of exactly how much of any given vitamin you can take without overdosing. This is the site for biotin. Being a water-soluble B vitamin, overdose is very difficult in animals, and while biotin- present at thousands of micrograms in supplements- seems like it is at a high dose, it's still milligrams. The "Toxicity" section there may be of interest.
Plus, the quantity need not be the 10,000 micrograms we're providing. Maybe 1,000 ug would be plenty.
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Interesting! I'd love to see photos of her highness's fuzzy butt!
Her Royal Majesty's Royal Hiney:
And the underbelly in question:
Neither of us can remember her having a well-furred belly before. Plus, she's been shedding like crazy ever since we started the biotin.
Some notes on the hind end- the day after I first posted about this, The Lisa tells me she was play-fighting with Tito, rearing up on two legs and hopping over him. Again, probably 95% Rimadyl (which she has been on for almost a year), but hearing of her bounding over a large dog like Tito is pretty cool.
Biotin for humans with MS is supposed to take 8-10 months to kick in, so I'd be fooling myself to say any signs of improvement could be ascribed to biotin in the short time (~4 weeks) we've been using it on Minerva. But the fur...!
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Other than growing hair, have you as yet noticed any improvement in hind end weakness?
I'm not expecting improvement quite so much as I am hoping it will slow the progression.
She's also on CoQ10 based on an Iranian study showing that high doses of that compound work in MS, too. And she gets a slug of olive oil with dinner; "true" olive oil contains oleocanthal, which is an anti-inflammatory. If it burns the back of the throat (but not the tongue and the rest of the mouth) when slurped, it contains oleocanthal. Much of the Italian oils are fake, so I stick with Californian stuff as the labeling requirements are much more rigidly enforced. She's also on Rimadyl, which is probably 95% of any improvement we've seen.
Just a hunch, and I really don't have anything by which to compare it to so it would be pure speculation on my part. We've had Minerva 10 years this month, and she's our grande dame; not much experience with older greys. But I thought the biotin thing was interesting.
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We serendipitously discovered that Minerva (age 12-1/2) has grown remarkable butt fuzzies (longer and thicker than ever) and now has belly fur for the first time ever, having started her on high dose biotin (10,000 micrograms, or 10 milligrams) several weeks ago. Perhaps the two are unrelated, but if anyone wants to try it, we bought this stuff off of eBay. I have no financial affiliation with Natrol or any other vitamin supplier.
10 mg of biotin- particularly for a 60-70 pound greyhound- seems very high, and I suppose a lower dose would work just as well for most dogs for butt fuzzies. But the human dose in a recent MS trial ranged from 100 mg to 300 mg/day (!), so we're careful and watching for any potential adverse effects at 10 mg. We're trying to find out if perhaps the progression of hind-end weakness can be ameliorated the same way as MS symptoms were through use of high-dose biotin. Just a hunch.
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The latest news today:
Two more dogs came in on a recent haul from the same track, same kennel that had strikingly similar symptoms. This time, skin scrapings revealed hyphae; topical anti-fungal was prescribed.
Sparks, having been on the fix-what-ails-you topical described above, now has pink skin showing through the furry "window" between his shoulder blades, and the swelling of the sores on his throat are vastly improved. He's now on the OTC anti-fungal, which hopefully will finish what the clotrimazole started.
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Quick update: The scab between his shoulder blades is vastly improved after 2-3 days' treatment with compounded... goo from a local vet that we had in the freezer (gentamicin, betamethasone, clotrimazole, and tetracaine), applied daily after carefully trimming the area of all fur. Then we shampooed him- and the scab pretty much fell off; I had been applying the goo to the left side of the scab to look for any improvement, and although the entire area looked better, the left was much improved. So, now we're applying it to the entire wound, along with his throat.
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Better/worse- Yes, it improves cyclically; the scabs form, fall off (or are scratched off- he doesn't flip onto his back and rub, but She Who Must Be Obeyed claims she's seen him manage to scratch it with his rear legs), and it gets wet and re-scabs again. The size of the affected area has not changed. I have a topical (compounded by a vet) that I am trying on half of the affected area to look for any improvement; just started it last night.
Oddly, I do have some colloidal silver, but only as liquid. Need to figure out where it is- but I have the wherewithall to make more.
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Skin scraping- yes; nothing obviously wrong, as per vet.
Frontline- no data as to when it first started. Kennel he came from apparently treated with Frontline, but I have no data from them as to whether he had that same problem. Plus, I don't understand why he would have the patches behind his legs, behind his ears, and on his throat if it were direct contact from Frontline or other topical applied to his back.
CS- I think you mean MyoGesic-CS? Had to search for that name. I've wanted to try "EMT Gel" but my supply is exhausted. Haven't seen any "CS" product on the shelf locally.
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New foster- 2-1/2 yo neutered male, off the track for 2-3 months. Scabby areas behind his front legs and ears (minor), throat (rubbed bare), and between shoulder blades (scabby patch 2-3" across). Tried chlorphenamine maleate ("Chlor-Trimeton") as per vet, as well as "hot spot" spray (tea tree oil + rosemary). No dice.
It comes and goes in waves.
Dog has been treated with "Frontline," but in a stripe, i.e.: not everything between the shoulder blades. He's fed lamb and rice food (Hund and Flocken) due to suspicions he might have chicken sensitivity.
Any suggestions?
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I believe now that I got collars that perhaps hadn't been stored properly and had lost their effectiveness, because when I experienced the last infestation it took just a few days after putting the collars on and I wasn't finding any more ticks.
Our adoption group used Preventic collars in the kennel until they fell apart- using and re-using the same collar until embrittled so badly they had to be discarded. Apparently they remained effective for many months of use.
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We had ticks for the first time ever this year. Nothing got rid of them. We found tens of them. We would search before and after they used the yard, and they had no more coming in from the yard; they were coming from inside the house. We searched them 3x/day, put them in alcohol to kill them. There were more every time; the numbers never started to taper off.
We froze the beds overnight in the casket freezer after some experiments showed the ticks died after -20 in a jar in the freezer. We put ticks in a jar with diatomaceous earth (Safer's brand) and shook it up; they were still alive 5 days later. DE is apparently useless. The "Adams" brand stuff (methoprene + etofenprox, I think it is) was useless. We applied it, the ticks came out and asked if they could have some more, please.
At wit's end, we got collars from the adoption group: amitraz (Preventic). The ticks died faster than my 401(k) did circa 2008.
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Does diatomaceous earth work on ticks?
In an attempt to control a tick infestation here, we put several live ticks in a Mason jar with a spoonful of "Safer's" brand diatomaceous earth from Home Depot. We'd shake it up daily so they were constantly coated in the stuff. A week later, they were still alive, dusted- coated, crusted, swimming in DE- and showing no signs of weakening.
The only thing that worked were tick collars with amitraz, given to us by the local adoption group. We took ~200 ticks off of 4 dogs, checking them 3x/daily, and still had no idea where they were coming from- we'd check them before and after going into the yard, and they had no more coming in. Plus, it's Phoenix: ticks bake alive in 110F heat. The yards are separated by gravel and 6' tall concrete block walls. We figured one may have hatched out eggs in a dog bed, so we froze the dog beds >24 hours in a casket freezer at -20F.
The Preventic collars with amitraz were what did it. The Adams stuff (sold as Spot On Defense- same company, here in Phoenix, same ingredients) did absolutely nothing.
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We never had a biopsy done, but Coco had dermal hemangiosarcoma, as judged by a local greyhound vet with 30-40-some years of experience, just little black dots on the skin, maybe 2mm diameter. He removed them with local anesthesia, and were told to expect them to come back.
Something like 16 months later, I found another bump on him, and took him in. THAT wasn't it, but doc found one, right on the knee, that I'd missed. Also tiny. Doc noted it was highly unusual for it to take so long between hemangios, and I commented that Coco was on a zero-carb, BARF diet. He noted that *could* be one reason why it took so long.
The next time I took him in was over a year later- no skin bumps at all. We lost him this past September from an apparently unrelated issue, at about 10-1/2 years of age, with no apparent dermal lesions, 1-2 years after the last time we took him in for skin bumps.
So- the takeaway from this is 1) it may not have actually been dermal hemangio (no biopsy performed) and 2) the diet may have had absolutely nothing to do with it, and anecdotes are worth what you pay for. But I thought it was interesting.
You might look into low-dose chemo. And double-check with an oncologist as to whether there are any experimental treatments in the pipeline that might be options.
If y'all miss me, back up and try again!
Freezing While Walking In Traffic?
in Training and Behavior discussion
Posted
Sorry to drag up an old thread, but-
He was at Hemopet in California for three years? Or Texas?