Mystery Illness

[BluegrassGrey]

Posting this for a friend with a 7yo retired racing greyhound (retired for 5 years). Little girl has not been eating since 12/15 and has had temperatures (up to 103.5F). She has lost a total of 10# (she did NOT have any weight to lose). Lives with 2 other greyhounds who are not sick. Currently under treatment of her vet. Looking for any other ideas from experienced greytalkers....... Sorry this is long, but to give a brief summary:

 

Tests done Results

1. CBC w/Chem blood tests: normal

2. Abdominal area Ultrasound: partial thickening of pancreas wall

3. Stomach scope: normal

4. Tick Bourne Disease titers drawn & sent: negative

 

Medications:

Cerenia (250mg 2x/day)

Rimadyl (75mg 1x/day)

Tylenol (250mg as needed)

Pepcid

Amoxicillin (500mg 2x daily)

Ursidiol (300mg 1x daily);

Metronidazole (500mg 1x day)

Probiotic 2 tablets daily

 

Have tried many foods, but she is refusing everything..... currently syringe feeding pureed cooked chicken breast.

 

[seeh2o]

I have no idea, but the Cerenia really caused a lot of problems for Ed's Boston Terrier. Where did she race? Here in the southwest Valley Fever is a concern for dogs who raced in AZ, Mexico. Blockage?

 

I hope they can figure this out soon, sending good thoughts for this little girl.

[Hawthorn]

I don't know either, but have autoimmune diseases been considered as these can involve fever and lack of appetite? She is on so many medications that you have to wonder if this might be contributing to her issues. Metronidazole, for example, very seriously affected my boy's appetite. I just looked up Ursidiol, too, and that also lists nausea as a possible side effect.

 

Sending good wishes.

[tbhounds]

I would consult with Dr Couto at this point

http://www.coutovetconsultants.com

[Batmom]

Consult is a good idea. She could send an email to Dr Couto's service today.

 

That is a lot of meds. What are the ursodiol, metronidazole, amoxicillin, and probiotics for? Have they considered pancreatitis?

 

Best luck.

[Guest normaandburrell]

 

 

Even without the presence of a high fat diet, an animal can have an occurrence of pancreatic inflammation after eating a large amount of fatty foods. This tends to occur around the holidays, when dogs are given table scraps that are not normally a part of their diets. Source: Pet MD

Did they do pancreatitic enzymes (amylase and lipase)?

[JohnF]

I'd be concerneed about abnormal cell growth in the Pancreas and want new enzyme tests too.

 

I'd also worry that long term Rimadyl use might have compromised blood flow in the Kidneys and led to CRF. (Easy to check blood and do an urinalysis)

 

I hope that poor dog can be helped soon.

[PatricksMom]

Do you know why she's on each of these medications? That's a lot, and the risk of a rare side effect or an unexpected negative interaction go way up with that many medications.

[Guest FordRacingRon]

Posting this for a friend with a 7yo retired racing greyhound (retired for 5 years). Little girl has not been eating since 12/15 and has had temperatures (up to 103.5F). She has lost a total of 10# (she did NOT have any weight to lose). Lives with 2 other greyhounds who are not sick. Currently under treatment of her vet. Looking for any other ideas from experienced greytalkers....... Sorry this is long, but to give a brief summary:

 

Tests done Results

1. CBC w/Chem blood tests: normal

2. Abdominal area Ultrasound: partial thickening of pancreas wall

3. Stomach scope: normal

4. Tick Bourne Disease titers drawn & sent: negative

 

Medications:

Cerenia (250mg 2x/day)

Rimadyl (75mg 1x/day)

Tylenol (250mg as needed)

Pepcid

Amoxicillin (500mg 2x daily)

Ursidiol (300mg 1x daily);

Metronidazole (500mg 1x day)

Probiotic 2 tablets daily

 

Have tried many foods, but she is refusing everything..... currently syringe feeding pureed cooked chicken breast.

 

Man that is a lot of meds. I am having sort of the same issues with Leia but it is thickening of an intestine wall. She too is not eating great but she at least eats enough to maintain her weight,,, but that is a LOT of meds. Leia is on the Amoxicillin, Metroidazole, Pepcid and a probiotic also. We have Rymadyl but not using it. She is being treated for IBS. Leia passed all the tests you listed also but her enlargement was diagnose with an Ultrasound and a stool test. All her blood tests are as your friend's, all passed.

 

Sometimes I think,,if it were me,,I too would hate to eat with a bad and sick stomach (which I do have as I have Crohn's disease). I can tell when Leia really feels bad and the only thing she will eat then is baby food (prefers the Gerber's chicken and gravy). I figure that must be easiest on the tummy,,,but it does "come out" much they way it went in.

[MaryJane]

Why on the Rimadyl and Tylenol? Those 2 make me nervous and if this was me, I would discontinue both of those ASAP.

 

Check thyroid - full panel. Not likely an issue but, just to rule out. And, also B12 and folate as I would expect those to be off given she is not eating well. You may need to supplement with B12 shots until the cause of this issue is discovered.

 

As others have noted, did she have an amylase as pancreatitis might be suspect.

 

Has a urinalysis been done .. if not, I suggest that you do one and if they see bacteria, I would recommend a culture.

 

Can you post exactly which tests have been done?

 

I might also change to a white fish and potato/rice diet as most dogs have not built up a reaction to these. Dr Dodds has one on line I believe. Note, Dr. Dodds also does thyroid tests but she is on the fringes of the medical etablishment.

 

Last thing, has your dog been eating any treats like rawhides that are either made, processed, or packaged in China?

[Houndtime]

I don't have advice, just think all those meds could make a person sick to their stomach, so, I assume it could do the same for a dog. When Fuzzy was sick two years ago with severe diarrhea, and he was on a differnet med every day, one day I just said, let's stop all this and go back to square one. I took him off of everything, weaned him off of pred and gave him the veterinarians potato diet. Within 12 hours his diarrhea stopped. I wish your friends all the best results for their dog.

[cometdust1]

dogs can take tylenol? I always thought it was bad for dogs. That is a lot of meds. Hope there is an answer found soon.

[BluegrassGrey]

Thank you everyone for your replies and good wishes...... Please keep it coming..... I will respond as best I can.... This family usually just feeds plain kibble........ definitely no table food, or rawhides/other items from China..... nothing given/snuck over holidays from family etc. She was bred/born in the South East US....... no official races.....

[tbhounds]

dogs can take tylenol? I always thought it was bad for dogs. That is a lot of meds. Hope there is an answer found soon.

They can but, it must be dosed very carefully.

[racindog]

My OPINION based on my experience. The Rimadyl and Tylenol would be stopped immediately period and probably the cerenia too. Way too many drugs. You give that much stuff to a healthy strong human and they will get sick too. The gut and its flora is sooo important to recovery and well being and it is being destroyed with all the antibiotics and drugs etc. Now my Bobber had a somewhat similar senario when she was 4. A high 104+ fever for over 2 weeks that the vet could not get down despite trying several different antibiotics-including IV- but thankfully not all at the same time. Turns out it was a systemic kidney infection and after accupuncture treatment to open up her little energy pathways and Fresh Factors-which she never had before but suddenly wanted them so I gave it to her- at that point the antibiotic we were trying at the time started to work! I still have that same bottle in the fridge at home so I would always know exactly what it was in case I needed it ever again. If you want to know its name PM me and I'll look when I go home. Anyway she did recover but ever since has had protein in her urine but it has caused her no problems and she is 9 now. She has been on my home kidney diet though all those years since the original sickness. Like John F above I'd be concerned with CRF-and of course taking all those drugs are just disasterous if that is in fact the case and could push her over the edge into it if she is in a nebulous zone so to speak.

Edited January 6, 2015 by racindog

[Burpdog]

Dogs are not suppose to take tylenol and I'm not surprised she is not eating with that medicine combination. The product insert on Rimadyl says if they stop eating, stop the med immediately. She could bleed out.

 

TBD panel that is negative doesn't mean anything. If they are in crisis they can be negative for erlichia.

 

 

WHY ALL THE CONCERN ABOUT EHRLICHIA

IN ADOPTED GREYHOUNDS?

 

 

Suzanne Stack, DVM

 

Studies have shown that it can take as long as 5-7 years following a bite from an Ehrlichiacarrying tick for a dog to show symptoms. By then, a greyhound is long gone from the tickinfested racing kennel or farm and possibly living in an area where Ehrlichia is unheard of. The greyhound may present with a variety of mysterious ailments, some of which can be serious and fatal if not treated. Veterinarians working with adopted greyhounds should maintain a high index of suspicion for Ehrlichia.

Ehrlichia canis is the most common Ehrlichia species infecting dogs, but there are others (E. platys, E. risticii, E. equi) and researchers suspect that there are many more. E. canis is a rickettsia (an organism somewhere between a bacteria and parasite) carried by the brown dog tick - a common if not universal problem in racing kennels. Greyhounds from all over the country mingle together sharing their ticks, making racing kennels a smorgasbord of tick-borne diseases.

Acute (first few weeks) signs of Ehrlichia, such as runny eyes/nose and cough (resembling distemper) would not be expected in adopted racers. Virtually all adopted greyhounds will be in the chronic stage. There may be vague signs such as lethargy, fever, anorexia, and weight loss. Greyhounds may have bleeding, bone marrow suppression, eye disease, neurologic signs, neck/spinal pain, polyarthritis, enlarged spleen, enlarged lymph nodes, or kidney disease. Bloodwork may show anemia, low white blood cell counts, low platelets, increased protein (hyperglobulinemia), and increased ALT/ALKP.

Ehrlichia testing is done with antibody titers. Titers measure the body’s immune response

to the bug, not the amount of bug in the dog’s body. Most labs titer from 1:20 to

:1,000,000 or more. In general, the more chronic the infection, the higher the titer. The

IDEXX in-office “combo” test (heartworm/Lyme/Ehrlichia) catches titers over 1:100.

 

While sick dogs usually test positive, they might not if:

 

1. They have a poor immune response (the reason why a very sick dog sometimes tests negative).

2. They carry an Ehrlichia strain other than the standard E. canis the lab tests for.

3. They have a titer <1:100 on the IDEXX test, or

4. There is variation between labs.

There is not necessarily a correlation between the severity of the disease and the titer number.

All positive titers should be treated.

Ehrlichia dogs respond dramatically and quickly (within days) to doxycycline dosed at 5 mg per pound twice daily. For this reason, greyhounds should be started on doxycycline as soon as Ehrlichia is suspected. If not immediately available at the veterinary office, all human pharmacies carry doxycycline (a tetracycline family antibiotic). Often patients are vastly improved by the time their titer results are back from the lab. This doxycycline trial can be as useful as the titer results in determining whether to continue with treatment. The standard regimen we use in Arizona where Ehrlichia is endemic is 5 mg per pound twice daily for 2 months. Doxycycline must always be given with food - otherwise it may upset the stomach. Alternatively, Ehrlichia can be treated (offlabel) with Imizol, an injectable drug approved for the treatment of Babesia, another tick-borne disease. The Imizol protocol is two injections two weeks apart.

There is a poor correlation between resolution of infection and serum antibody titers. In patients with high antibody titers, the antibody concentrations decline very slowly (over years) following effective therapy. In many patients, the antibody titers persist at high concentrations indefinitely. The PCR (polymerase chain reaction) test, which tests either positive or negative (no numeric value) for Ehrlichia DNA in the bloodstream, may be used for follow-up testing, but is not perfect either.

The most reliable indices of response to therapy are clinical signs, CBC changes (i.e. anemia, platelet counts), and serum globulin concentrations. A reasonable approach is to monitor recovered dogs with a CBC and titer at six-month intervals as long as the dog remains clinically normal. If clinical signs develop or the CBC becomes abnormal, re-treat, using Imizol if doxycycline was used the first time around. The majority of Ehrlichia dogs will require only one treatment course, but owner and veterinarian should remain watchful in order to recognize a relapse.

[Guest FordRacingRon]

I would like to add a PS,,although probably not related but off the list of meds you frined's dog is taking,,, my dog is on some of them as I mentioned in post #9 . She basically won't eat and has the "runs" all the time so we are treating her for IBS. She got pretty sick a couple of days ago and I , in my heart, believe it was too many meds in her, trying to get her IBS under control. I need to let my vet know,,but I stopped the Amoxicillin and cut the Metronidazole to the dosage your friends dog has. Kept up the probiotics and if I see her hip hurting give her a Rymadl.

 

I just two days she has perked up, is eating better and we are finally getting somewhere wit her diarrhea. I really be believe as RACINDOG noted that some of these meds are fighting each other and hindering what we are trying to fix.

 

Less is more I suppose.

[NeylasMom]

I don't understand the pain meds either, especially the Tylenol. Dogs can take it, but Tramadol and Gabapentin are much more common and likely less risky, although I'm not clear why this dog needs pain meds at all.

 

They definitely need to do a urinalysis if they haven't already. Urine can show early signs of kidney disease, which could affect appetite before blood work would.

[tbhounds]

My guess is the Tylenol is because the dog is febrile

[NeylasMom]

My guess is the Tylenol is because the dog is febrile

Oh duh, I totally glossed over that. Also not explained by kidney disease. So basically I have no clue.

[4My2Greys]

From what you've posted the known factors are

(1) partial thickening of pancreas wall, (2) fever, and (3) loss of appetite. Taking these into consideration I did some reading and wonder if she has a pancreatic abcess. The walls of the pancreas become inflamed during a bout of pancreatitis. I don't known, but would this appear as thickening of the wall? Pancreatic abcesses are a complication of pancreatitis. Signs of pancreatic abcesses may include vomiting, depression, abdominal pain loss of appetite, fever, diarrhea, and dehydration.

[BluegrassGrey]

Sadly their little girl went to the Bridge Monday 1/5 night...... She had begun Doxycycline on 1/4 (for suspected TBD despite neg. results as Burpdog mentioned could've been the case). She went down very quickly, and was hospitalized Monday morning and started on IV fluids etc..... No necropsy done, but vets are suspecting cancer, or a virus that triggered an uncontrollable autoimmune response.

[tbhounds]

Please forward my deepest sympathies. Sadly, I think cancer was most likely the culprit -Oh how I loathe cancer.

[macoduck]

Kathryn, if you PM me this little girl's name I will add her to the Bridge Angel list.

[NeylasMom]

I'm sorry.