Test For Tbd?

[Guest suzye]

I just don't know what to do anymore. Jazz went into kidney failure probably because of Deramaxx in October. I've posted a couple threads about that. Around Thanksgiving she stopped eating the Rx diet, just as well since I can do better cooking. She eats mostly boiled chicken breast, glutinous rice and scrambled egg whites with a little baby food and some 90/10 beef. THANK YOU from the bottom of my heart to whoever I found out about k9kidneydiet from! It's been mentioned a few times (I think I saw it when I did a search) so thank you, thank you, thank you!!!

 

I started subcutaneous fluids in early December. In late December she started coughing, not a ton, but noticeable. Sometimes it's productive, sometimes it's just like a little water almost wehnt down the wrong pipe. On Friday 1/18 they did a chest x-ray (they did abdomen too) and they found no problems (was worried about heart disease, fluid, who knows what else). Bloodwork showed high lipase of 2441 (200-1800). Everything else was "OK" considering her kidney failure. I've always thought it a little odd that her creatinine is constantly creeping up (now 4.0) while BUN not rising as much (52) and phosphorus ALWAYS normal (3.5-4.5). It just makes me wonder if something else was going on.

 

The vet didn't think anything of lipase and wasn't much help on the cough. This morning she threw up a little bile (and did a lot of gagging) so I took her to the e-vet for the CPL test. They didn't do the one I really wanted (where you get a number back) but did the SNAP CPL with positive or negative. She was negative (but is she borderline?). This vet thought the cough was a tracheal infection so we got Doxycycline. He was also concerned that her low platelets could be caused by tick disease. I know the figures really aren't low for a greyhound, but historically up until 12/13 she was always above 200,000. Below is her recent history.

 

01/18/08 = 162,000 (post subqs)

12/21/07 = 195,000 (post subqs)

12/13/07 = 153,000 (post subqs)

11/21/07 = 251,000 (pre subqs)

08/10/07 = 207,000 (pre renal)

05/21/07 = 228,000 (pre renal)

 

I'm trying not to write a novel here but give the most relevant info. Should we test for TBD? It seems so unreliable. I don't know how she could get a disease like that. Is North Carolina better than Protatek? It bothers me to give her fluids with her platelets low because sometimes a little blood comes out.

 

I'm just at my wits' end.... We all now how this is going to end up, but she's still happy a lot of the time, I think, so I'm fighting. BTW she is on Sucralfate and Benazepril twice daily, given away from the Doxy. Blood pressure has been an issue but the Benzepril is helping BP (and maybe hurting kidneys, who knows).

 

[robinw]

i would definitely test for TBD. at this point it can't hurt. Although Phoenix was tested at Protatek, I understand that North Carolina is more reliable now.

[Guest suzye]

Thank you for the feedback Robin. Can anyone tell me how much they paid, a ballpark figure? Does NC test for all the TBD possible? I think there are 5 or so.

[Greytlady94]

North Carolina State University School of Veterinary Medicine. This lab tests for the most strains of tick disease. The following is a link to their web site and if you scroll down it tells how the blood sample needs to be shipped.

http://www.cvm.ncsu.edu/docs/ticklab.html#shippingsamples

The next link is the form that should be printed and sent with the sample.

http://www.cvm.ncsu.edu/docs/PDFS/ticklab/...ples_9_2007.pdf

 

I don't know the cost but they would probably be able to tell you. Sending prayers for Jazz.

[Guest suzye]

North Carolina State University School of Veterinary Medicine. This lab tests for the most strains of tick disease. The following is a link to their web site and if you scroll down it tells how the blood sample needs to be shipped.

http://www.cvm.ncsu.edu/docs/ticklab.html#shippingsamples

The next link is the form that should be printed and sent with the sample.

http://www.cvm.ncsu.edu/docs/PDFS/ticklab/...ples_9_2007.pdf

 

I don't know the cost but they would probably be able to tell you. Sending prayers for Jazz.

Thanks Greytlady. The form actually had prices on it. It was pretty confusing for someone like me, but if I assume the part marked $20 was actually $20 per individual test, and I add everything up, it's $325. I'm simply not read to deal with a positive test result, especially if the chances of curing it aren't real good (e-vet said she might be in sub-clinical phase if she has it). My vet will probably think I'm crazy for asking for this.

[Guest MorganKonaAlex]

My Kona had kidney failure, was on SubQT fluids and had a minor cough. We had a consult with a renal specialist at Angell Memorial in Boston. He witnessed the cough. He didn't know what it was from, but he wasn't concerned about it.

[Guest suzye]

My Kona had kidney failure, was on SubQT fluids and had a minor cough. We had a consult with a renal specialist at Angell Memorial in Boston. He witnessed the cough. He didn't know what it was from, but he wasn't concerned about it.

Thanks Kris. That's a similar situation. I'm more concerned about the platelets at this point than the cough, but I don't like it when she gags (she's only done it bad a couple times so far).

[Batmom]

The form actually had prices on it. It was pretty confusing for someone like me, but if I assume the part marked $20 was actually $20 per individual test, and I add everything up, it's $325. I'm simply not read to deal with a positive test result, especially if the chances of curing it aren't real good (e-vet said she might be in sub-clinical phase if she has it). My vet will probably think I'm crazy for asking for this.

 

No, you'd probably want either the tick panel at $90 or the PCR panel at $125. Plus shipping and whatever your vet's fee is.

 

But, I would talk with your vet first about possible reasons for fluctuation in platelets. AFAIK, platelets aren't constant -- the value does fluctuate -- and 160K is still a very good reading for a greyhound.

 

Another thing to consider is how the platelet value is arrived at. If it's from a regular blood sample, it isn't that accurate. To get an accurate platelet count, the blood needs to be in a special tube with ?anticoagulant? -- separate from the blood used for the CBC. On a CBC, the platelets will be clumped and the value estimated from that.

[Guest vahoundlover]

I recently had a TBD done on Curly at NCSU, can't tell you the cost...my vet still hasn't billed me

 

I would recommend if you go that route to send the extra samples for the PCR test at that time, that way if a TBD does show positive they already have what they need to do the PCR test.

 

Sending prayers for Jazz.

Edited January 21, 2008 by vahoundlover

[Guest suzye]

No, you'd probably want either the tick panel at $90 or the PCR panel at $125. Plus shipping and whatever your vet's fee is.

 

But, I would talk with your vet first about possible reasons for fluctuation in platelets. AFAIK, platelets aren't constant -- the value does fluctuate -- and 160K is still a very good reading for a greyhound.

 

Another thing to consider is how the platelet value is arrived at. If it's from a regular blood sample, it isn't that accurate. To get an accurate platelet count, the blood needs to be in a special tube with ?anticoagulant? -- separate from the blood used for the CBC. On a CBC, the platelets will be clumped and the value estimated from that.

After looking closer at the list, it seems like the $90 panel plus 2 individuals (Babesia gibsoni and Leishmania infantum) would cover everything. If I'm going to all this trouble I want them to check everything. I sent my vet an email asking about the better platelet count. Maybe we can do that first. I just hate to put Jazz through all these blood draws over and over again!

 

I recently had a TBD done on Curly at NCSU, can't tell you the cost...my vet still hasn't billed me

 

I would recommend if you go that route to send the extra samples for the PCR test at that time, that way if a TBD does show positive they already have what they need to do the PCR test.

 

Sending prayers for Jazz.

Sounds like a good idea, we'll have them collect and send extra in case. I hope Curly was OK -- I haven't kept up with this board like I have the kidney group. Do people who've never seen a tick on their pet, and haven't been in a woodsy area, and whose dog is not fresh off track or some other situation with lots of unknowns, test for TBD? I've had Jazz for 7 years. It seems like such a stretch. I think I will try a better platelet count first, if my vet can do it.

 

It looks like I might be scheduling an ultrasound at a diagnostic imaging facility so we can really, really be sure about pancreatitis. She seemed interested in food today but only wants to eat chicken, no rice. She ate about half her lunch.

Edited January 21, 2008 by suzye

[feemandvm]

Asked to comment...

 

I don't find those platelet counts alarming at all. I really don't glance at platelet counts in Greyhounds unless they are <100,000. Batmom is exactly right... there can be a lot of fluctuation in platelet counts in a standard purple top associated with platelet clumping. TBD is a rule out for low platelets and for kidney disease so you can test... but I'd be hard pressed to think that is the cause even with a positive result based on teh history you provided. Still if you have the money, it couldn't hurt to test... just consider a PCR test if you get a positive titer.

 

What is her BP currently? Do you have her on fatty acid supplementation?

 

 

[Guest suzye]

Asked to comment...

 

I don't find those platelet counts alarming at all. I really don't glance at platelet counts in Greyhounds unless they are <100,000. Batmom is exactly right... there can be a lot of fluctuation in platelet counts in a standard purple top associated with platelet clumping. TBD is a rule out for low platelets and for kidney disease so you can test... but I'd be hard pressed to think that is the cause even with a positive result based on teh history you provided. Still if you have the money, it couldn't hurt to test... just consider a PCR test if you get a positive titer.

 

What is her BP currently? Do you have her on fatty acid supplementation?

Thanks Bill. Her last BP was 163/131. The top # is good for her (on Benazepril 10 mg twice daily), the lowest it's been since after kidney failure. I'm not sure that the bottom # is anything to worry about. Her first reading back in December was 203/154, very concerning. I was just a little worried since her platelets were consistently over 200, and then after the kidney problems they dropped.

 

She is on Doxy now for a cough (e-vet suspected tracheal infection) so I want to check her platelets on Saturday just to make sure the med isn't adversely affecting her. Her cough was better for a couple days, but then today it was a little worse, and she coughed up a little mucous (seemed clear when I wiped it on a paper towel). Overall, I'd say it's beter after starting Doxy.

 

Jazz gets omega 3 fish oil daily. I stopped it for a few days when I was worried about pancreatitis, but now we're ramping back up. Her recommended dose from what I hear is about 900mg EHA and aboout 600 DHA. An ultrasound on Tuesday showed her pancreas perfectly normal (kidneys of course wereanother story). She also gets CoQ10 although I don't know if I'm really giving her enough to make a difference.

 

Thank you for all the expertise!

Edited January 25, 2008 by suzye

[Guest suzye]

This morning at 5:30 AM she woke us up gagging and retching. She stood up, perhaps in anticipation of vomiting, but nothing else happened and I got her to lay back down. She coughed some after that. Yesterday she ate very well, and the gagging was 8 hours after her snack. I was expecting her not to feel well today, but she gobbled up her lunch. She eats beef (low fat) & rice better than chicken & rice, but beef costs so much more. As is I'm spending $3.50/day on her food. Anyway, I wish I knew what that gagging is. In the last 2 weeks she's had a clean chest film and clean abdominal ultrasound (except for kidneys). Only thing that hasn't been looked at is her throat.

Edited January 25, 2008 by suzye

[Burpdog]

Perhaps try some anti acid meds at bedtime and during the day.

 

 

[ShantisMom]

Thank you for the feedback Robin. Can anyone tell me how much they paid, a ballpark figure? Does NC test for all the TBD possible? I think there are 5 or so.

 

We tested in late November. It was about $250. We used Prototek.

[Guest suzye]

Thanks for the info ShantisMom.

Perhaps try some anti acid meds at bedtime and during the day.

OK. I will try giving her Pepcid before bed. Awhile back I quit giving it to her because I thought it might be causing vomiting, but the gagging stuff started awhile after. She now gets Pepcid before dinner and I can try giving it again before bedtime -- is 5 hours apart enough? I can't give it before lunch due to my work schedule. I'm extremely lucky I can come home at all. I shudder to think about this whole situation if my office was not so close to home (she won't eat in the morning).

[Guest suzye]

We sent out CBC for manual platelet count: 186 with normal range 164-510. However, her lymphoctyes were high: 44 with normal range 12-30. Ugh... is this more reason to check for TBD?

[Burpdog]

Protatek is around $70 to test for the standard: e canis, valley fever, rmsf, lyme and babesia.

 

Her platelets look fine, but it is possible to have a TBD without low platelets. Why not just do the tick panel?

[Guest suzye]

Protatek is around $70 to test for the standard: e canis, valley fever, rmsf, lyme and babesia.

 

Her platelets look fine, but it is possible to have a TBD without low platelets. Why not just do the tick panel?

The expense (was looking at North Carolina State) and the uncertainty. If the test comes out negative, she might still have it. I'll still be wondering.

 

Last Saturday when I took her to the vet, I had to CARRY her into the exam room. Good thing she only weighs 52 pounds! She is so upset about being at the vet. I hate to bring her back again already.

 

I thought I read on this forum that North Carolina is better? There was a thread on here about Protatek giving out 50% positive results. If we want to use Protatek, I'll have to do a search to find their form or whatever instructions on how to send it to them.

[Burpdog]

I thought I read on this forum that North Carolina is better? There was a thread on here about Protatek giving out 50% positive results

 

That is someone's opinion. Of all the dogs I know tested at Protatek, I can tell you it is no where near 50%. However, if the dogs tested are from Texas, I would not be surprised. I know of dogs tested at North Carolina and they said negative yet the dog got better on doxy. Does that mean North Carolina is not any good? Hardly! Either the tick disease the dog had was not tested for, or if you read Dr. Stack's writings, you will see it is possible for a sick dog to test negative and they are really positive.

[Guest LindsaySF]

No advice, just hoping for the best.

[Greytlady94]

I think it was Dr. Feeman who posted some time back about North Carolina, that is where I heard about it originally.

[feemandvm]

I'd personally only use NC State for tick testing. They really are the top TBD speicalists in the US IMHO and have PCR testing when indicated and have really been the researchers that discovered hte significance of Bartonella! Other labs may be less expensive but I would be less likely to believe the results so not sure that I would be any further ahead. : (

 

163 isn't bad for a GH blood pressure. That is where my GH's is currently and I am trying to decide if I should put her on an additional medication to lower it a little further. I'd love to see it around 140 if possible.

 

It isn't uncommon to see elevating kidney values without a rise of the phosphorous level beyond the normal range. At the vet conference I was just at... the specialists stated that the labs used normal ranges for phosphorous that were "way" too high and it is lulling owners and many vets into a false sense of security.

 

 

[Guest suzye]

Thank you for the replies. I may decide to send off for tick testing the next time we draw blood, I just can't bear to drag her back to the vet again just yet. I don't know why I'm being so indecisive on this problem.... I was really scared to do the ultrasound too but felt much better after we did it.