My Poor Rudy

[ShantisMom]

Here is a link to the website Lene'. It has all their contact information on it.

 

http://www.vet.ohio-state.edu/4366.htm

[brandimom]

I have no advice but prayers and good thoughts for you and Rudy.

[Guest Annie]

Sending prayers for you and Rudy!

[Guest tammara]

Prayers for handsome Rudy :hope

[greyhndz]

Argolola, I just caught up with this thread. I agree with confirming that a thorough TBD evaluation has been done. This not only includes the usual suspects, but often one of the TBD lab gurus will be able to test for specific strains endemic to the areas where Rudy has lived. Running appropriate PCRs at NCSU is also crucial, as is re-testing to see if the titres are going up (indicating acute infection).

 

Unless this proves to be babesia, I'd have expected Lyme, anaplasma, many of the ehrlichia strains, to have responded early on. I get the sense from your post that he may not appear to be improving significantly, meaning he's never returned to his baseline. Or are his symptoms waxing and waning, meaning improving, and then relapsing?

 

As far as testing for autoimmune disease, labwork can be notoriously unreliable: a positive ANA, canine rheumatoid factor and/or elevated sedimentation rate may raise suspicions. Elevated ESR is non-specific, however, and can be found with any type of systemic inflammation or infection. However, normal labwork does NOT exclude an underlying autoimmune disease.

 

Besides the fever, can you elaborate more on his symptoms? Does he show signs of joint pain? Does it always involve the same joint, or does it migrate to various joints at different times? Do the joints visibly swell? Has your vet ever been able to get a sample of the joint fluid to send for testing?

 

Jordan

[Guest argolola]

Thank you all.

 

Jordan, to answer some of your questions, he doesn't seem to have any joint pain. We first thought he was depressed, as he was staying in his cage all the time. He got little sores, was almost bald, trembled much of the time, afraid of everything, excessive thirst, potty accidents, fever, etc. The Doxy would stop the fevers at first, but now the fevers are back even while on Doxy. His interest in food comes and goes. Last month he lost weight, but is gaining back with Ensure.

 

I explained to the vet today, he just isn't "right." My husband saw the episode of The Family Guy with the horse that just stood there, and said, "There's Rudy." It was him to a tee. He just stands and stares. He isn't interested in anything. He WILL NOT go out for a walk under any circumstances. Often times, it takes 2 of us to get him out in the back yard to use the restroom.

 

When I come home from work, he greets me at the door and gets excited and "smiles" at me. Then back to his cage he goes. If we close the door on the cage, he gets very upset.

 

Thank you.

[Guest ProudGreyMom]

Oh no, poor Rudy, he has had such a rough start.

 

I think you did say that you had trouble getting weight on him, plus all the wee accidents. Those two things could be some kind of clue.

 

Please give him kisses from Jake, Andy and Molly.

[pokealong]

Sending prayers to Rudy. What Rudy's weight. The pred may make him eat a lot and lose weight quickly. It just sneaks up on you, so pay attention to that. The pred may need to be adjusted. By potty pads, as he will need to go out often and make sure there is lots of water.

 

My Peaches has IMT, she lost 20 pounds in a week. Every bad side affect the pred can give she got. Her pred has been cut to 1/4 of the original, but she is also on cyclosporin, not to mention the hypothyroid. Now it is just blood test to ensure the platelets don't dropt again.

 

Keep us posted on Rudy.

[Guest Pipi5]

Lene' if you're not sure your vet is correct, perhaps you should get a second opinion.

I'll keep you all in my prayers.

[greyhndz]

I'm not clear on what basis the vet has started steroids. He's not exhibited a specific pain pattern, though some of his behaviors may actually be his way of manifesting pain. He hasn't had swollen joints, just, if I understand correctly, depression, new fearfulness, poor appetite.... these symptoms make me think of something metabolic -- i.e., Addison's, Cushing's, thyroid disease, a problem with the pituitary gland or hypothalamus in the brain....

 

Prednisone is "the great imposter" and cause give you a false sense of security because the dog may initially become more animated, eat better, engage better, but this may just be side effects of pred. I would be very hesitant to put a dog onto steroids until I had clear, objective evidence of an inflamatory or autoimmune disease; if I were sure there was no chance of undiagnosed underlying infection; if I had ruled out any other possible metabolic cause for his behavioral changes. I'd even give thought to this being a neurologic issue. But IMHO, the correct sequence would be to narrow down the diagnosis before putting a dog on steroids, which could easily mask symptoms and potentially set fire to any underlying "smoldering" infection.

 

In human medicine, persistent "fever of unknown origin" is a very challenging diagnostic workup, but basically you think about infection, autoimmune or inflammatory process, or neoplasm (cancer). OR - something metabolic (such as hyperthyroidism).

 

I think a wise move to make, ASAP, would be to consult an internal medicine vet for a comprehensive workup. And unless there's a specific reason for doing so, I'd ask your vet to stop the pred before it interferes with the IM workup and masks symptoms. Pred will likely mask fever and may skew cultures and other labwork.

 

This is what I'd tell my human patients, and what I'd expect from my vet were this one of my pups (and indeed it was, a year ago, with the ultimate diagnosis of immune mediated polyarthritis).

 

Hugs to both of you, and I'll be anxious to hear pupdates. Feel free to PM anytime.

 

Jordan

[Guest argolola]

Thanks again all.

 

Just to be clear, he has been to 6 vets at 3 different practices in 2 different cities.

 

The bottom line is that we are BROKE. Between DH's surgery, property taxes, income tax, back child support and all the other requlars, the vet bills have maxed out the credit cards. My job is considering a 5% pay cut and also asking us to absorb more of our insurance costs. I would love to take him to a specialist, but I don't know how I would pay for it. I had a meltdown in DH's doctor's office when they told me it would be $25 for his FMLA papers.

 

The good news is that day 2 of pred=no fever today!!!

[Batmom]

From earlier posts, I'm pretty sure Lene has already gotten Rudy a pretty full range of tests, some of them more than once IIRC. I suspect the PCR was either Antech's, which tests for just about everything and then some, or else NCSU's.

 

I think your current course is reasonable. Seems like every time he's on antibiotics, he gets a bit better. Here's hoping this combo gets him all the way better.

 

Sending hugs and prayers.

[VinnieAndRexsMom]

I agree with Batmom. Lene has covered all the bases with numerous vets and tests. Since she has had two days of doxy with the pred added and no fever, I would stay that course to see how Rudy responds.

Hugs to Rudy and Lene

[JedsMom]

When Jed was having an especially bad ehrlichia flair, sometimes it took a round of pred added to his doxy to get him on the road to recovery. All of his flairs were stress related, and sometimes it was a vicious cycle of his flair stressing him out and causing him to be worse. The pred would help him feel better, which would allow him to relax and get better. Maybe Rudy will have a similar reaction.

[Guest ProudGreyMom]

I am just hoping Rudy feels better!! He is too sweet to be sick.

[RobinM]

How much pred is he on? For how long? Beau went from 40 to 50mg with imuran and now he is on 30mg. I would love to get him off of it soon.

 

How much pred is he on? For how long? Beau went from 40 to 50mg with imuran and now he is on 30mg. I would love to get him off of it soon.

[duncan41]

Sending more prayers for Rudy. Hoping for improvement every minute of every hour of each day.

[Guest argolola]

How much pred is he on? For how long? Beau went from 40 to 50mg with imuran and now he is on 30mg. I would love to get him off of it soon.

 

How much pred is he on? For how long? Beau went from 40 to 50mg with imuran and now he is on 30mg. I would love to get him off of it soon.

 

He is on 20 mg x 2 day until Tuesday then 20 mg day. Total of 2 weeks only so far.

[Guest FullMetalFrank]

I have no advice but just want to add my prayers... Get well, Rudy!