Harold's Mystery Illness

[macoduck]

Harold is 12, been with us for about 3 weeks, in previous home(s) he received no preventive care for years. He had a well-doggy checkup with my vet last week. Being treated for hookworms. Missing many teeth, most recently losing 4. Bloodwork normal but protein in urine 2+.

 

Three days ago I thought his right wrist looked different.

Two days ago it was a little swollen just above the wrist joint. No limp. no pain. No trauma. No bug bites. Called for a vet visit (booked for today).

Last night it looked bigger. It was soft and mushy.

This morning definitely bigger. Very slight limp.

When I got off work at noon I found the swollen area had just burst and was bleeding. Foot normal size but from wrist to elbow was slightly swollen. Immediately went to vet.

Xrays show no bony abnormality, only soft tissue swelling. Area was cleaned, drained and wrapped. Dressing is to be changed tomorrow.

Meds issued:

Ciprofloxacin 500mg give 1/2 tablet once every 24 hrs.

Cephalexin 500mg give 2 every 12 hrs.

Tramadol as needed

Blood test done and compared to last week's. Everything within normal range BUT when compared to greyhound normal:

Hgb was 18.4 (gh normal 19.0-21.5)

HCT/PCV was 52.3 (gh normal 55-65)

WBC was 6.73 (slightly gh high 3.5-6.5)

RBC was 7.7 (slightly gh low 7.4-9.0)

MCV was 75 (60-77 fL)

Total Protein was 5.7

Globulin was 3.1 (on high end of gh normal 2.1-3.2)

Creatinine was 1.3 (gh normal .8-1.6)

BUN was within normal range at 24 (7-27mg/dL).

T4 was 1.0 (gh normal .5-3.6)

Nothing seems to fit neatly into a catagory for tick disease or Valley Fever.

If I read correctly about glomerulonephritis, high would typically be > 3.0 protein. Harold's was "2+".

Thrombocytopenia was considered but his platelets are OK at 179 K/uL

Regarding his urine:

Specific gravity was low at 1.015 Urinalysis will be repeated tomorrow.

PH was 6.5

Protein was 2+ (200-300mg/dL) Can someone explain this result for me?

4DX lab test:

negative for heartworm, ehrlichia, lyme, anaplasma pha...

 

7/12 slight swelling above right wrist:

 

Today right after it burst, note leg is slightly swollen:

Harold asking for your opinion on what might be wrong with him:

Please give me some ideas on what to ask the vet tomorrow when we go for the repeat urinalysis and dressing change.

At this time they do not want to do any tick disease or Valley Fever tests. From what I've read, this seems correct according to the assorted lab values affected by those diseases.

Poor Harold.

Edited July 31, 2011 by macoduck

[Remolacha]

abscess? not very helpful, I know

 

Harold

 

I hope you get some (good) answers

[HopeForHounds]

Poor guy, that has to hurt now.

 

Did you get any history on his health prior to this? I wonder if he has had any previous swelling/s?

 

I don't know if you remember, but up until 18 months ago Jake had swellings similar to that (except for the bursting part) and his blood work was normal along with every other test we ran including joint taps. He also had negative tick testing. With him we had rotating leg swelling a lameness, with the episodes getting closer together. When we had two back legs in the same week in Dec 2009 my vet was totally at a loss. We decided to treat him as if he had tick disease and I'm so glad we did. Within a few weeks I had a new dog. Unfortunately we hadn't been aggressive enough and he had another episode 4 months later. We did treat aggressively then, and I'm thrilled to say that at 12 years old Jake spins and runs and is a total nut.

 

Praying you get to the bottom of this and Harold is feeling better quickly.

[macoduck]

Foxysmom:

I don't know much of his prior health history and won't be able to find out anything from previous owners. His canine teeth are ground down to nubs and he lost 4 other teeth the week before I got him.

When he came here he supposedly had severe SA, food aggression, urinary incontenence and daily diarrhea. We've seen none of that here.

He can't seem to hold his urine for more than 4-5 hours. He'll wake me up at night to go out and he wears a bellyband during the day when I'm at work (5.5 hrs). Sometimes it's wet, sometimes not.

 

The meds issued today were to treat this as a severe infection of unknown origin. The lump felt mushy like a seroma.

 

Did you treat Jake with doxy and how much for how long?

[Batmom]

The leg is almost certainly some type of infection/abscess. If it doesn't clear up promptly, I'd culture it.

 

As long as the red cell volume / size (MCV on your lab report) is normal, the HCT and RBC are fine.

 

I would want to investigate the protein in the urine. Did anybody spin it down and look at it under the microscope? Coupled with the low specific gravity, could be an infection going on there, could be some kidney insufficiency.

 

Do you know what BUN was? Anything other than what you've mentioned marked low or high on the labwork?

[greytpups]

No advice, just wanted to let you know I hope you find out it's nothing serious and easy to clear up. Sending scritches and for Harold...you can have a

 

Jan

[macoduck]

Jey:

The BUN was within normal range at 24 (7-27mg/dL).

Nothing else was out of whack.

Comment beside the urinalysis: "protein test is performed and confirmed by the sulfoaallcylic (spelling obscure on printout) acid test." and "non-crystalline debris present".

 

Is there a name to the "spin it down and look under a microscope test"? Would the current 2 antibiotics (for the skin infection) also be appropriate for any kidney infections?

 

MCV was 75 (60-77 fL)

 

All add those values to my main post above.

[MaryJane]

Could be an acute/chronic kidney issue that is causing protein to spill into the urine - the vet will likely suggest a food with %protein less than 20% (approx).

 

With a specific gravity of 1.015, you want to repeat the urinalysis again and make sure that you get a "first morning specimen".

 

They will likely need to do a culture on the urine to see if there is a UTI and if there is - it may or may not be sensitive to what he is currently on for antibiotics.

 

With an abscess like that I would worry whether there is some type of septicemia (blood infection) going on. If so, hopefully the antibiotics will address it.

 

Good Luck

[Guest Lynnada]

I don't have any advice either, just trying to learn anything I can pick up about greyhound health. My boy, Socks is 7 and has been having some intermittent limping, vet believes it's just some joint swelling from aging and wear and tear.

 

Feel better Harold and all the best that it's nothing serious and easy to clear up.

[Batmom]

If they noted debris, then somebody (or some machine -- they do that now) looked at it under a microscope. I'm suspecting a machine? or an outside lab, since the debris wasn't identified. The extra test does help to confirm that there really is protein in the urine and not something else (the first test is easier to fool and some normal substances can interfere with it). Protein 2+ in a highly concentrated urine (specific gravity > 1.030) is sometimes no big deal, but in a lower specific gravity like Harold's, it is significant and should be followed up. Not necessarily horrible -- could just be a matter of making some dietary changes, which could also help him go a bit longer without having to pee.

 

MCV is fine.

 

 

ETA: Which antibiotic is best really depends. Cipro is a "big guns" antibiotic for kidney/urinary things. There are bacteria that don't respond to it, but it's a good first choice. Cephalexin is a common go-to drug for skin infections.

Edited July 15, 2011 by Batmom

[tbhounds]

Forgive me as I really didn't read the other replies so, I hope I'm not repeating an answer. As far as the limb-it looks like an abscess that broke out--spiderbite??? Yes, you would want to culture the wound if it doesn't heal, however, you are already giving antibotics so that would alter your results. As far as the proteuria--with a SG of 1.015 +2 is something that should be followed up on. Glomerulonephritis is not all that uncommon with our GH's. After your hound is finshed with the round of antibotics you really should have the urine cultured to rule out an infection (I know you are currently giving antibotics but, they might not be the proper one to fight a specfic bladder infection). If it turns out were there's an not infection then you should run an urine protein creatinine ratio (UPC ratio). I would also check your hounds blood pressure. Most often GN is treated with a renal friendly diet and medications like low dose aspirin and enalapril. Also, you should check the SG on a first morning urine sample--the urine should be more concentrated at that point--ideally the SG should be around 1.030

The rest of your hounds bloodwork looks pretty good for an oldie Did I help or confuse?? Feel free to pm if I can help further.

[krissn333]

If the above doesn't get you anywhere, my next move (especially if the specific gravity continues to be low in spite of the specimen being a first thing in the morning catch - before he's had a chance to drink a bunch of water and dilute it) would be to get an ultrasound of the kidneys. Lauren (Gracegirl)'s boy Fenway was having similar issues in the pee department - blood work all normal but low specific gravity and peeing a lot. U/S of the kidney's showed some renal disease. Of course she can provide you with more details of what it took to get to that point.

 

As to the swelling on the leg, I've got nothin' there, but what Jey and others have said sounds good to me I would actually be kind of glad that it burst when it did - a pup from our group had a similar swelling that was about the size of a softball before it burst. It turned out to be something nefarious - hemangiosarcoma or some other -sarcoma that I don't know much about. My mind doesn't go there with a swelling like Harold's though (sorry, not trying to scare you or anything!). Hopefully it will just heal up and it can be chalked up to something to do with circulation/kidney stuff.

[HopeForHounds]

I'll have to check what the dosage was, but yes doxy. You can ask Diane, burpdog, she was who I asked to get the best dosage. Vet's here don't see tick so our vet was reluctant to use the really high dose. Diane told me at Sandy Paws that it would likely come back, and she was right. We were prepared though and my vet just asked "how much and for how long?" No idea at all if what Harold has is similar, but I also don't take negative tick tests at face value any more.

[HopeForHounds]

I'll have to check what the dosage was, but yes doxy. You can ask Diane, burpdog, she was who I asked to get the best dosage. Vet's here don't see tick so our vet was reluctant to use the really high dose. Diane told me at Sandy Paws that it would likely come back, and she was right. We were prepared though and my vet just asked "how much and for how long?" No idea at all if what Harold has is similar, but I also don't take negative tick tests at face value any more.

[Burpdog]

Nothing seems to fit neatly into a catagory for tick disease or Valley Fever

 

It never does. Keep an eye on his HCT and PLT

 

Looks like an abcess witch can be serious if it gets into the bone. Good thing you are having it treated!

 

I don't worry about elevated protein in the old ones. Almost all of my seniors have elevated protein and no effects from it.

[macoduck]

Nothing seems to fit neatly into a catagory for tick disease or Valley Fever

 

It never does. Keep an eye on his HCT and PLT

 

Looks like an abcess witch can be serious if it gets into the bone. Good thing you are having it treated!

 

I don't worry about elevated protein in the old ones. Almost all of my seniors have elevated protein and no effects from it.

 

 

Diane, by elevated protein, what kind of numbers are you seeing? Is Harold's "2+" number horrible?

 

In his previous life Harold was free-fed but he had to compete with 3 other big non-greys. What he could get for himself was Apex chicken & rice (Protein 26%/Fat 18%)

[tbhounds]

Nothing seems to fit neatly into a catagory for tick disease or Valley Fever

 

It never does. Keep an eye on his HCT and PLT

 

Looks like an abcess witch can be serious if it gets into the bone. Good thing you are having it treated!

 

I don't worry about elevated protein in the old ones. Almost all of my seniors have elevated protein and no effects from it.

You should worry about urine protein loss. Hounds that have PLN or GN are prone to a thombus event (blood clot)!! That is why Dr Couto starts these hounds on aspirin. Just ask packmom what just recently happened to her boy MC.

+2 protein an a dilute urine sample (1.015) is concerning and should not be overlooked.

[macoduck]

....... . As far as the limb-it looks like an abscess that broke out--spiderbite??? ........

 

We have a winner!

 

When Harold's dressing was changed today the first thing my vet said was, "brown recluse spider bite".

Yesterday there was no clear puncture or bite mark. Today it has a target appearance circled by necrotic tissue. Total wound size including the necrotic tissue is about the size of a quarter.

The swelling is nearly gone. We are to continue with daily dressing changes - lightly to allow some air to get to it. And - I almost fainted - he said to out a dab of honey on it! I've known about using honey from GT. Now my vets are finally catching on to it.

Regarding the protein in the urine issue, we sent another sample off for testing and results will be in next week. This time it is a fresh catch from this morning. We are not making any dramatic changes in food at this time.

Because of this boy's past, I think he needs a bit more time to level off, adjust and get used to our easy-going household. We will definitely re-visit the tick disease testing at next week's visit if this shows any signs of somehow not being the spider bite.

Provided there's no dramatic change found in today's urinalysis, and given that all other tests were OK, we'll still discuss a food plan. He needs to complete his antibiotics and have his system get back to normal........so we can find what might still be abnormal.

Thank you everyone for your suggestions and PMs. Harold is feeling much better and happier today.

[tbhounds]

Glad he's feeling better! Sounds like a great plan for Harold (love his name)-- one step at a time.

[45MPHK9]

Glad to read this good update for your Harold. That old doggie could not have ended up in a better home. You're the best, Ducky. Continued good wishes for Harold.

[Guest greybookends]

Ducky I'm glad Harold is on the mend.

[greytpups]

So glad to hear he's getting better.

[Newgreymom]

Glad to hear he's feeling better...Poor baby!

[Houndtime]

Yah Harold!!!

[Guest mbfilby]

I'm glad you figured it out. Keep a close eye on it though, brown recluse bites can be very nasty.