Billy Update......babesia Test Results

[Guest houndlover]

Billy had bloodwork done last Monday and it was sent out to test for babesia (per the specialist's suggestion). The results came back and the ratio is 1:80. I don't know much about babesia and did some research on line and he has a lot of the symptoms of chronic babesia but my understanding is that the ratio is possibly in the "untreatable" area b/c it is pretty low. My regular vet was going to do some research when I spoke to her on Saturday to see if it should be treated. She suggested that I still talk to the specialist that did Billy's ultrasound to see if I could get him in for a FNA (fine needle aspiration) of the spleen and lymph node that is inflamed.

 

I spoke with the specialist today and scheduled an appt for a FNA next Tuesday. I also filled her in on the test results. She was going to talk to some of her colleagues to see what their thoughts are about treating the babesia but the long and the short of it is that she in not completely convinced that what is going on with Billy is cancer (thank god). She said that is still a possibility but that there is a possibility that this could be from chronic babesia.

 

Billy still has on and off diarrhea and eats great one day and not so great the next. His spleen is enlarged, the lymph node near the spleen is enlarged, his liver is slightly enlarged but she thought that was from the pred and his kidneys showed some deterioration from the last ultrasound (I think she said nephrosis???).

 

Has anyone every experienced something like this? If so what did you do? I welcome any and all suggestions.

[Batmom]

Some babesia info for you:

 

http://www.cvm.ncsu.edu/vth/ticklab.html#babesia

http://www.cvm.ncsu.edu/vth/documents/Babesiosis.doc

 

[robinw]

i recommend that the vet actually look at a blood sample. Phoenix's ratio was low, also but those nasty babesia critters were visible in his blood.

[Guest houndlover]

i recommend that the vet actually look at a blood sample. Phoenix's ratio was low, also but those nasty babesia critters were visible in his blood.

 

 

That's very interesting. What did they end up doing for treatment and what type of symptoms did Phoenix have that made the vet think to test for babesia?

 

Some babesia info for you:

 

http://www.cvm.ncsu.edu/vth/ticklab.html#babesia

http://www.cvm.ncsu.edu/vth/documents/Babesiosis.doc

 

Thanks....I will definitely check these out.

[robinw]

i recommend that the vet actually look at a blood sample. Phoenix's ratio was low, also but those nasty babesia critters were visible in his blood.

 

That's very interesting. What did they end up doing for treatment and what type of symptoms did Phoenix have that made the vet think to test for babesia?

 

Some babesia info for you:

 

http://www.cvm.ncsu.edu/vth/ticklab.html#babesia

http://www.cvm.ncsu.edu/vth/documents/Babesiosis.doc

 

Thanks....I will definitely check these out.

he was treated with two shots of imizol injected several weeks apart. he seemed depressed, was limping and couldn't even walk across the street without needing to stop. what are billy's symptoms?

[Guest houndlover]

he was treated with two shots of imizol injected several weeks apart. he seemed depressed, was limping and couldn't even walk across the street without needing to stop. what are billy's symptoms?

 

Lethargic, diarrhea, weight loss, loss of appetite, depressed. His spleen is enlarged, the lymph node near the spleen is enlarged, his liver is slightly enlarged but she thought that was from the pred and his kidneys showed some deterioration from the last ultrasound.

[robinw]

Lethargic, diarrhea, weight loss, loss of appetite, depressed. His spleen is enlarged, the lymph node near the spleen is enlarged, his liver is slightly enlarged but she thought that was from the pred and his kidneys showed some deterioration from the last ultrasound.

a lot like phoenix except i don't remember having his spleen checked. i forgot to mention that he was very lethargic also.

[Guest mandm]

My greyhound was also low positive and we treated because he had symptoms, including falling platelets, lethargy, heat intolerance, random, unexplained lameness (he was 3 yrs old at the time & had no racing injuries), mild incontinence and poor digestion. All symptoms cleared after treatment, except the stomach problems, those did not resolve until I found a diet that was good for him. It seemed that within a few days of treatment he was a new dog. He had prevously acted like a grandpa greyhound and started acting young again, frisky, friendly and sometimes naughty, for a greyhound. For us, the treatment decision was a good one.

 

I did not fret much about the decision to treat. He was low positive and he was symptomatic, so I treated.

 

Treatment was the standard two Imizol injections spaced two weeks apart. My greyhound suffered no serious side effects other than pain at injection.

Edited May 19, 2009 by mandm

[ShantisMom]

Lethargic, diarrhea, weight loss, loss of appetite, depressed. His spleen is enlarged, the lymph node near the spleen is enlarged, his liver is slightly enlarged but she thought that was from the pred and his kidneys showed some deterioration from the last ultrasound.

a lot like phoenix except i don't remember having his spleen checked. i forgot to mention that he was very lethargic also.

 

 

Shanti was the same way. Her titer was also 1:80. We treated. Since then she has more energy, no more runs, eats like a champ now compared to before. Limp is still there, but that has more to do withher VF. Oh, and she no longer pees in the house after treatment...a added bonus.

[Burpdog]

Many don't treat that titre with NO symptoms. However, with symptoms I'd be treating!

 

If you do, make sure the vet changes the needle after the draw of Imicarb and alternates sides for the second injection.

[turbotaina]

Many don't treat that titre with NO symptoms. However, with symptoms I'd be treating!

 

If you do, make sure the vet changes the needle after the draw of Imicarb and alternates sides for the second injection.

 

Absolutely agree with Diane here.

[greyhead]

Wow, this sounds a lot like Shane. He has never been TBD tested, but that's gonna change. Thanks for all this info!

[Guest houndlover]

Many don't treat that titre with NO symptoms. However, with symptoms I'd be treating!

 

If you do, make sure the vet changes the needle after the draw of Imicarb and alternates sides for the second injection.

 

Absolutely agree with Diane here.

 

I wouldn't be opposed to treating for the babesia seeing as how he is symptomatic but wouldn't I want to wait until after I have the needle biopsy done next week and get the test results back from that? If the biopsy results come back that he has cancer would you still want to treat for babesia?

[Guest mandm]

How old is Billy?

[Guest houndlover]

How old is Billy?

 

He will be 12yrs old in June.

[Guest mandm]

The situtation appears very complicated. It's way over my head, but I'll respond because, if I were in your place, I would want some input. Again, I've got a little TBD experience, but am FAR from knowledgable.

 

For those of us with young greyhounds that are low positive but symptomatic, it seems like a no-brainer. I said I didn't fret the decision, but I did carefully consider it, as I'm sure the others did. Because your Billy isn't young, it's a lot more complicated. It's especially difficult when your vets have not dealt with Babesia. They read the Imizol precautions, which are l-o-n-g, and that scares them. So they hesitate.

 

Then you read about our young greyhounds that took the treatment without incident and magically transformed into healthy, robust dogs. It's confusing. I believe the treatment is well tolerated by young, otherwise healthy dogs. But it's hard on their system. Well worth it to clear the disease, but not something you'd want to try on a weak dog that may have other issues.

 

So I guess I'd want to clear up the cancer question first.

 

But if it's Babesia, the Imizol really is a miracle drug. You wouldn't want to hesitate.

 

Now about that titer, and again I'm no expert, just have a little bit of experience. It does not measure the amount of disease in the dog's body, but rather his immune response to an encounter with the disease. Normally, a high titer is evidence that the disease is/was there and should be treated. A low titer can mean the dog encountered the disease organism and fought it off. But a low titer can also mean the dog has the disease, but has not been able to produce adequate antibodies to fight it off. Pred suppresses immune response, so a dog might not produce adequate antibodies, resulting in a low titer.

 

I had another greyhound being treated with Pred and was told a TBD titer would not be accurate, because of the Pred. So we did a PCR instead, which is more accurate because it actually tests for disease organisms in the blood. But there is a long wait for results of a PCR, 2-4 weeks. And while a positive PCR will tell you that the disease is there for sure and you can go ahead and treat, a negative PCR could be false, because the particular blood sample sent in did not "catch" any of the disease organisms. So if the PCR came back negative, it probably is negative, but you'd want to do another PCR, just to be sure. And that means another 2-4 week wait. No problem for dogs without symptoms, but for those that have serious symptoms, the wait can be fatal.

 

Now again, I'm no expert, not even very knowledgeable, but I think RobinW's vet got lucky with Phoenix's blood sample when they were able to see actual disease on the slide. If I am understanding this correctly, the disease organism is not spread evenly throughout the blood, so it is unlikely that they can be found on a microscope slide at a vet's office. Same reson a PCR could show a false negative. But Phoenix demonstrates how a dog can have an active infection but still titer low.

 

I'm just trying to share what I know, which isn't real much. Since your situtation is so tricky, I'd take it to the Tick List.

http://saluqi.home.netcom.com/ticklinks.htm

 

I just want to add that I am not normally conservative when it comes to TBD treatment, but that's how my post sounds. I urge others to weigh in on this one.

Edited May 20, 2009 by mandm

[ShantisMom]

Many don't treat that titre with NO symptoms. However, with symptoms I'd be treating!

 

If you do, make sure the vet changes the needle after the draw of Imicarb and alternates sides for the second injection.

 

Absolutely agree with Diane here.

 

I wouldn't be opposed to treating for the babesia seeing as how he is symptomatic but wouldn't I want to wait until after I have the needle biopsy done next week and get the test results back from that? If the biopsy results come back that he has cancer would you still want to treat for babesia?

 

 

If it were me and my dog in your shoes, I would wait for the biopsy. If it is clean, treat. If not, heaven forbid, then you re-evaluate. Shanti was 3 when she was treated. Yes, the warnings scare the crud out of you. But she did fine and improved from it.

[Batmom]

Re PCRs: Should be able to get a PCR faster now -- IDEXX and Antech both have fast-pcr technology, believe turnaround there is a couple days, and NCSU tick lab will turn it around in 3 days for an extra fee.

 

I too would be on the fence about your pupper -- wouldn't want to treat with Imizol if he has something else, but would sure want test results as fast as I could get them.

 

Are you anywhere near a teaching hospital? When we went to UW Madison, we got cytology results same day.

[Guest houndlover]

Thanks for the info. I really appreciate it. I am in Western Mass and I am not that far from Tufts, which I believe is a teaching hospital

 

I am waiting for a call from my vet now to discuss what we should do. Billy had a bit of a set back overnite and I'm not quite sure what to do anymore. He stopped eating again on Monday, started with diarrhea Monday and is very weak. I took him to the vet last nite and he has lost 2 lbs again (he is 65lbs again). We put him on IV fluids, pepcid and all of his meds and he was up 6 times last nite with diarrhea and vomited bile at 3am. DD was home with him today until 10:45am and she said he was "fine" but her version of fine and my version of fine are usually completely different.

 

I always feel like I am overreacting to things that happen to Billy and that I call the vet way too much but I just don't know what to do or what to expect anymore.

[ShantisMom]

[Guest mandm]

Doesn't sound like you are overreacting to me. But maybe I'm an overreactor too.

 

I hope you can get some quick answers.

 

Those quick PCRs that Batmom mentioned sound like a real good next step. They weren't available last time I treated, about 3 years ago. I'm guessing they're not cheap. But depending on your funds availability, I would send off a fast PCR today and also have your vet order in the Imizol today. It might take a few days to get the drug. 3 years ago, a vial of Imizol cost about $60, so you may have to cover that cost if you decide against treatment. But if you go for treatment, you'll want the Imizol available, you won't want to wait.

 

[Guest houndlover]

I spoke with my vet earlier and she thinks that this is probably lymphoma b/c Billy initially got better on the pred and now he is not doing well again. She said that is generally what happens with dogs that have lymphoma. She then spoke with the specialist that did the ultrasound and the specialist is pretty sure that this is babesia b/c she said that from what she could see in the ultrasound everything looked more sicklical (I'm not really sure what she meant by this but she is the specialis, not me). So I guess that the next step is the PCR (thanks Batmom!) and then the biopsy on Tuesday. I will be taking Billy to the vet at 9:30 tomorrow morning for the blood draw, they will send the blood out right away and should have the results in 2 days. I am hoping that we have the results before we do the needle biopsy on Tuesday. Billy will also get the once over from my vet tomorrow morning, which will make me feel much better.

 

I know that I could probably have the PCR results quicker if I went to Tufts but I would much rather stick with my own vet if at all possible.

 

Thanks again for the suggestions. I will update as soon as I know more.

 

 

[Guest mandm]

I know that I could probably have the PCR results quicker if I went to Tufts but I would much rather stick with my own vet if at all possible.

 

Thanks again for the suggestions. I will update as soon as I know more.

Tufts probably sends out PCRs to the same place as your vet, so I bet you wouldn't have saved any time going there. Sometimes it's best to stay where you are comfortable.

 

Good luck.

[Guest houndlover]

Billy is at the vet. I took him to have blood drawn for the PCR and they admitted him to the hospital. He seemed okay last nite but this morning he couldn't walk and I had to carry him to the car. I cried all the way to the vet. The tech carried him into an exam room and my vet came in to take a look. Instead of just doing the scheduled blood work for today we ended up doing a chest x-ray b/c he was having trouble breathing. The x-ray had something on it but it was NOT cancer. My vet said that she was having a hard time seeing part of the x-ray b/c Billy is so "ribby" (he weighs about 62-63lbs now). They took his temp and it was 105. They are treating him with IV fluids, antibiotics and cool towels to try to get his temp down.

 

Please send good thoughts for my boy. It killed me to leave him today.

[Burpdog]

Sending lots of prayers. If they have not treated the babesia, he could be crashing.