Veterinarians In Ne Pa That Can Treat Chronic Erlichiosis

[cometdust1]

Hi, My greyhound Jax has been recently Dx'd with erlichiosis and my vet referred my to valley central in the lehigh valley area for long term treatment plan.I would like to know if anyone in my area can tell me their experience with their dog having this and what vet they see for treatment.Any thoughts are greatly appreciated.

 

Thanks,

Linda

[Guest AmberGusDad]

I don't know about erlichiosis but I take my greys to Exeter Animal Hospital (Drs Barbara & Debra Dymond) in Exeter, PA. They are great with my greys and are always honest re their knowledge of various ailments. They could at least advise on local resources. Their number is 570-655-4536.

 

Ed

[Guest BrianRke]

Diamond has tested positive for Erlichia. When she was first diagnosed, the vet put her on a course of Doxycycline and said that was pretty much it. She has never shown any symptoms. The vet also told me they can test positive for a very long time, even after treatment.

[Batmom]

Any vet should be able to treat. You would normally give a course of doxycycline and then manage symptoms as needed.

 

 

ETA: What leads you/vet to believe the dog has chronic Ehrlichiosis rather than an acute case? If pup has been treated properly once, note that a high titer may not drop even though the disease is gone; the dog can get another tick bite and contract the disease again; and, the dog can have something else entirely (a different tick disease, or another type of disease). If he's been treated with doxy already, you could do a PCR to follow up.

Edited June 16, 2012 by Batmom

[cometdust1]

I brought Jax to a different vet in march because he had a persistant cough, his eyes constantly had discharge he seemed to me to breathe too fast and was always panting, even at rest. He took a chest x-ray which he said was negative,said he thought his eyes looked perfect and told me that his dog pants a lot and felt there was nothing wrong, but maybe he had some allergies that were making him cough and to try some benadryl.So,i figured maybe I was overreacting because my other greyhound died suddenly of massive internal hemmhoraging with no previous symtoms.Even when I took him to the vet the day he died they sent him home thinking it was a virus.On the way back home he collapsed after having bloody diahhrea in the car and by the time we got back to the vet he was almost dead and beyond saving so we euthanized him.Anyway, the cough did eventually go away but not the eye discharge.I forgot, when I took him for the cough I had his yearly heartworm check done which was negative.Everything else seemed fine with him until the last 3 to 4 weeks we started noticing him slowing down more and more, then he started eating less, his eyes got worse and when I noticed that his face looked drawn and he was losing muscle tone. I took him to a different vet that my local rescue group uses.I told him the symptoms and he tested him for erlichia with the heartworm test and it came back positive.He then sent bloodwork out for testing and he called me today to tell me that his blood levels support the erlichia dx.Jax has been on doxy for 4 days now and I think he looks even worse.I'm afraid he's going to die like my other one.He's still eating and drinking but he looks terrible,just sleeps all the time and doesn't want to open his eyes much.He's still losing muscle and weight. The place he referred me to is not open until monday, except for emergencies, so I'll make an appt. on Monday.I've heard they are very good with orthopaedics but I don't know about anything else.The name of the place is Valley central Veterinary Referral service.Oh, my vet that dx'ed him felt that it was chronic because erlichia is not found in PA.Since searching out info. on it, I now know thats not true, it's just not that common.So I don't know if it's acute or chronic and thats why I'm trying to find a vet that I know is current on erlichia symptoms, diagnosis and treatment.

[Hubcitypam]

Lots of greyhounds have Eherlicha. Many vets in the NE that don't see a lot of it often don't treat with a long enough course of doxy. Four days may not be enough to make the turn even if he has more days of treatment ahead. Don't let your mind get away from you before Monday.

Hugs to you and your guy. Hope he feels a bit better in the morning. Don't let your stress stress him out.

Edited June 17, 2012 by Hubcitypam

[Guest FullMetalFrank]

Sending prayers; I lost my sweet little girl to this very thing earlier this year.

[sweetdogs]

In people, treatment for tick borne diseases makes symptoms worse before they get better, especially in chronic cases. Your best bet will be to do as much research yourself as you can. I'd start with the Tick-l. I'll see if I can find an address for you. They have lots of knowledge & will be able to help you navigate your way through treatment. I hope your boy is feeling better today.

 

eta: here is the login page for the tick-L: http://apple.ease.lsoft.com/scripts/wa-PLUTO.exe?A0=TICK-L

and here are some links to get you started on your reading: http://saluqi.home.netcom.com/ticklinks.htm

You may also want to PM burpdog - she's had some experience with TBD's in GH's

 

Another thought I had was has his heart been tested? Some of his symptoms sound like heart disease (I might consider an ultrasound).

 

Good luck with everything & let us know how you make out tomorrow.

Edited June 17, 2012 by sweetdogs

[cometdust1]

I just brought Jax to the valley central ER because he didn't eat this morning and when i took him out in the yard to go he just laid down, Ihad to walk him on leash no get him to go.She admitted him because his platelets are low enough that she is concerned that if they go much lower he could spontaneously bleed out.His platelets were 77 and normal range are 148-484.the rbc was 4.31 with norm. should be 5.65-8.87. HCT was26.6 with norm val.range 37.3-61.7.HGB was 9.5 normally 13.1-20.5.I called back and left a message for her to call me.I want to know what his prognosis is because if it is very poor than I don't know whether I want to put him through all this.If his platelets drop much lower she is considering a blood transfusion.I've had 2 other greyhounds die from bleeding problems for different reasons and I just feel that in the end Jax will die too.I'd rather he was home with us.I really did not want to leave him there because they don't come home.I am so sad right now it's beyond words.Thanks for your kind words.I just spoke to to the doctor about his prognosis and she said as long as it's only in the mature blood cells and not the marrow the prognosis is good.I'm going to speak to the internist tomorrow about testing the bone marrow.

[sweetdogs]

Can you contact Dr. Couto at OSU? Here is the info. Obviously it's Sunday, but I don't think "the program" ever sleeps. Let them know that he's critical & follow up with them tomorrow. Use the consultation form (the second link below). The service is free & they will get back to you as soon as they can. Their specialties are oncology & hematology & everything greyhound. They will consult with you & your vet & can give you a second opinion without having to move Jax. If you have copies of his test results, email those too. I'll be thinking of your boy & you too.

 

For those interesting in contacting OSU for a consult, second opinion, appointment, or amputation:

 

Greyhound Health and Wellness Program

Ohio State University College of Veterinary Medicine

601 Vernon Tharp Street

Columbus, Ohio 43210

Phone: (614) 247-6757 or (614) 247-8490

Email: greyosu@osu.edu

Website: http://www.vet.ohio-state.edu/GHWP.htm (registration and fee now required to get full access to this site)

 

For a consultation, you must use the online consultation service found here. Do NOT contact Dr. Couto directly or you will not receive a timely response.

[Batmom]

Oh my. I'm so sorry your boy is worse and in hospital.

 

I'm not understanding what the bone marrow tests would be for?

 

If he stabilizes, it really would be worth consulting with OSU. They might be able to suggest what additional testing (such as for babesia, etc.) would be most helpful.

 

77,000 isn't dangerously low for greyhound platelets. Of concern, yes, but not that low.

 

Sending prayers.

[HoundHeavenAZ]

If I had it to do over differently ( oh, if only I did ), I wish I'd had the knowledge to contact OSU for a second consult as Batmom recommends.

 

Please know that you and Jax will be in my thoughts.

[cometdust1]

the bone marrow test would be to see if the erlichia has gotten into the bone marrow blood cells.I spoke to the doctor tonite and he ate very well for them which is good.The pressure in his eyes was a little low so they started him on steroid eye drops

[Burpdog]

They need to give him a shot of doxy and start oral doxy at 5mg/# of body weight twice a day. Also I shot of pred.

[Batmom]

Diane is right.

 

AFAIK a bone marrow test won't buy you anything. It's of academic interest but I believe not relevant to treatment decisions.

[tbhounds]

Folks- the attending vet is most likely being very cautious- you don't want to start pred (suppressing the immune system) if there's an underlying tbd.

I'm sure what the Dr is checking is the retic count (immature red cells)- if the hound is generating retic cells then the body is making blood cells (healthy marrow) With a good regenerative retic count and anemia present that leads you to believe the body is destroying them- (immune mediated disease) or something like a tbd is the culprit.

A platelet count of 77,000 isn't low enough where you should start seeing clotting problems.

Don't discount Bartonella.

FWIF- I lost my absolute heart hound to immune mediated pancytopenia- she was under Dr Couto and Dr Urie's care at OSU. Despite all of their efforts she couldn't be saved-- she was treated for about a little less than a year before I needed to release her to the heavens. PM me if I can answer any questions you may have.

One more thought- if you're in PA I would highly suggest to you to make the trip to Ohio State. Your hound seems stable enough to make the trip but, of course you need to clear that with your current vet.

If you decided to go I would be glad to "talk" you through it (directions, hotels etc...)

Edited June 18, 2012 by tbhounds

[Batmom]

I'm sure what the Dr is checking is the retic count (immature red cells)- if the hound is generating retic cells then the body is making blood cells (healthy marrow) With a good regenerative retic count and anemia present that leads you to believe the body is destroying them- (immune mediated disease) or something like a tbd is the culprit.

 

Ah, didn't think of that. Have never heard it referred to quite that way but that would make sense. I had unfortunate visions of a bone marrow aspirate .....

 

Continued prayers for your pupper.

[Guest LindsaySF]

I wouldn't give pred if a TBD is suspected. It might take a bit for the Doxy to kick in and do its job. Can your vet give injectable Doxy?

 

Ticks in the Northeast carry all sorts of TBD's now that they didn't used to. Your pup was likely infected in PA, if prior tick tests were negative. Some vets just don't realize that the local ticks carry bugs that they didn't used to carry.

 

While the numbers you mentioned are low, they don't sound bad enough to me to warrant a transfusion. Good that they are monitoring him, and hopefully they can get some more Doxy into him to kick the Ehrlichia's butt. I hope your boy improves.

[Hubcitypam]

I had unfortunate visions of a bone marrow aspirate .....

I have had two friends that had bone marrow aspirate done on their dogs. Both said they would never do it again.

Hope Jax is better soon.

[Guest FullMetalFrank]

Sending more prayers. At 26.6 the HCT is very low, greyhound "normal" is at the high end of the scale, 55-65. It's good he's at the vet where he can get supportive care; I hope tomorrow brings some better news.

[cometdust1]

Thanks so much everyone for your information! Icalled to see how he made it through the night.The nurse said he was fine and resting until about 10:00, then he got up and was whining and pacing in the cage so she took him out and realized he was reacting to some fireworks being set off at the stadium.He HATES them! Not too good to have near a vet hospital!He did settle back down a while after they stopped and he slept through the nite and ate this morning.She said his eyes were really bothering him so they put a numbing drop in them along with the steroid drop and tear production drop he's been getting.I forgot ,the ER vet said she believes he developed uveitis from the erlichia.They run 2 practices out of the hospital, the ER and the regular referral practice.They will be the ones who determine his treatment plan today after reviewing the test results from the ER and from my vet on last Tuesday's draw. They should be contacting me around 10:00 today.I'll keep you posted and when I have all the info I plan on forwarding it to Ohio State for review.

[cometdust1]

I wanted to mention that I had asked the vet what his prognosis was for getting better. She told me that if at this point, if the erlichia is only attacking the mature cells, he has a very good chance at beating this.If, however, the bacteria has gotten into the bone marrow, He can't produce healthy cells, the antibiotics can't destroy the erlichia within the marrow, so the prognosis is very poor.I was the one who brought up the bone marrow testing,there has been no definate discussion about it yet, she just said that it is possible butthat would be a discussion to have with the internist today.I want to know if it is in the marrow because if it is, I don't want to put my dog through an extended hospital stay and endure the stress of being away from home if he can't get better.I went down this route once before, and I live with the guilt everyday that my dog spent the last 21/2 weeks in the hospital scared and stressed,had fever, siezures, the last of which dislocated his hip, lived for another day and a half with the pain of that hip because the owner of the practice would not listen to her vet tech and x-ray the dog to check for it , she insisted it was a thrown clot.Finally, the tech, who I know personally, took it upon herself to x-ray him for me to prove to this arrogant jerk of a vet that it was dislocated.He was in such a poor, unstable state by this time,he had bleeding problems that could not be stabilized and would't survive surgery that he was euthanized.Sorry, I wasn't going to go on a tangent about it but once I started I needed to get it out because I still hurt and cry about it after 3 years. He didn't deserve that and I hate that woman from the bottom of my heart for letting him suffer like that due to her own pride and not accepting the suggestion of "a lowly tech", who's only had over 10 yrs of ER experience.Anyway, thanks for listening, this current issue is just bringing me right back to the bad places of the past and talking it out gets rid of some of the stress of it so that I don't let it cloud my decisions with Jax.On the plus side, all this typing sure is improving my 2 finger typing skills since I don't usually type and never text or use the internet!

[sweetdogs]

Hugs to you. We don't mind listening. :-)

[cometdust1]

I just spoke to Jax's internist. It looks pretty grim. He did an ultrasound which shows an enlarged liver and spleen and some fluid in his chest and abdomen. He feels that the erlichia dx is an incidental finding and his suspicion is cancer. he's doing a biopsy of the bone marrow and/or the liver and spleen to find out. He can't do the liver or spleen if the platelets are still low so he has to check that first. I pretty much have come to the conclusion that he cannot be helped.I just can't do this anymore! this is my 3rd greyhound in a row that has gone in a traumatic way before his time and although I love this breed to death I can't keep putting myself through this. I just want one dog to live out his life and die of old age related things.My other grey just died in January at 41/2 of spontaneous massive internal hemmhoraging and I my heart is just so hurt I can't stand it.

[sweetdogs]