Mystery illness, prednisone more harm than good?

[GreytOwl]

Hi all,

We're very worried for our sweet 9r old, Lucas.  He wasn't eating beginning on Sun Jan 30 and on Monday wasn't responding much to my voice, his eyes were dull, and his breathing was rapid and shallow. No vomiting, no diarrhea. He had to really struggle when transitioning from standing to lying down and vice versa - very shaky back legs. First available appt was Tues afternoon. Couldn't get him to e-vet or urgent care on Monday - I called several facilities and all were either turning away patients or the wait was several hours sitting outside in the car.  After a scary afternoon and night, we went in Tues (Feb 1) and saw a different vet than we usually work with. Lucas's temp was 103.8. He had lost 5 lbs. His weight in August was 174, 170 at annual exam in Dec, 165 on Feb 1. Doc sent us home with doxycycline. Next day got test results:  bloodwork, abdominal and chest xrays - all fairly normal.  I was able to get him to eat by hand feeding him some home cooked turkey and soft pasta. We were bringing him water at his bed. He did seem to feel a bit better. Vet scheduled ultrasound on Friday.

His regular vet did the ultrasound. He'd lost another 2 lbs and his temp was now at 104.2. Nothing abnormal on the ultrasound. Vet recommended a high dose of prednisone for possible auto immune illness. 60mg/day, and to continue doxycycline. By Sat morning, Lucas was feeling better. He was moving comfortably and started eating more and drinking a bit more. Monday, I talked with the vet and we agreed to talk again Wed. I called and gave an update and asked about next steps but didn't get a call back. Lucas is definitely responding to the steroid - better ability to move, even some interest in going for short walks (which we've done and he walks extremely slowly whereas before he would trot for the first block and could walk at a normal pace for 1.5 miles daily. ) Fever is gone. He's eating some(still home cooked bland diet plus kibble is left out at all times, if he is interested in it - which he has been eating intermittently this week.) However, he's dropped even more weight and is all hips and ribs. The prednisone is causing the usual increased thirst and peeing. 

This morning, I found an open sore on his shoulder. It's about the size of a pea. The skin just looks like it melted open. Is this the prednisone? Some other strange symptom from whatever is going on?

I've left a message for the vet and sent photos of the lesion. 

GT folks, I'm at a complete loss for what to do. The steroid is helping (and hurting?!), the antibiotic is maybe helping? This open sore is really weird and worrisome - how do I prevent more infection?  Last Monday, I thought we were going to lose him. I could sure use your advice. Thanks, all.

[Time4ANap]

I can't say that we've been through anyhting like this with our seniors.  Although many of the symptoms are familiar, there was usually a reason that was found through testing. 

My suggestion if you continue to get no answers would be to do a consultaiton with Dr. Cuoto.  There is a fee for his consultation, but it is usually well worth it to get his eyes on the test results and get his input. He will consult with your vet as well   https://www.coutovetconsultants.com/  Many of us on this forum have used him when we weren't getting answers. He is extremely responsive and responds to emails rapidly. 

Hope your boy is feeling better soon, and please keep us posted here. 

 

[cleptogrey]

steroids are wonderful. they have been bad mouthed for abuse, but can do wonders. i agree w/ couto consult.

steroid responsive meninghitis? look it up, i know it happens in whippets, not sure about GH. it's pretty frustrating these days, unfortunately racing breeders only care about their dog's performance for a short period of time. so many things happen as they age, problems(osteo etc) are not a concern of the breeders.

talk to your vet and come up w/ a plan of action and a budget. it's essential, in today's world vets just look for the answer no matter what and test beyond our pocketbook's contents.

[GreytOwl]

Just got a call, and my vet wants to start a taper on the prednisone and change the doxycycline to an antibiotic that's more aimed toward skin infections. I'll head out soon to pick up that Rx.  He said we should talk again on Monday.

Thanks to you both. I've followed your stories and advice for years, even before acquiring our sweetie (who is a lovely brindle.) I've got some insurance - that will help. I've been thinking Dr. Couto, and I've got all the records, notes, bloodwork results, images that took place thus far. I think my vet would be willing to contact him for a consultation.  Dr. C is a GH hero.I've been scouring this forum topic for answers. This hound is the light of my life. 

[GreytOwl]

And I just looked up Steroid Responsive Meningitis.  Some of the symptoms really resonate. "The signs of SRMA include a moderate to high fever, spontaneously yelping out, unwillingness to move the neck and a short choppy gait in all 4 limbs. "

Lucas had a mild but strange episode over the holidays - seemed like there was neck pain: he couldn't do his usually down dog stretches and yelped when we were removing his raincoat over his head. He'd greet visitors with his usual happy hops but then would cry out and look so confused. His gait was indeed short and choppy as if walking was painful. He's a corn dog and has had intermittent limps since he came home with us. The corns have come and gone, always on one of his paws, sometimes two, and rarely but miserably on three. He's also arthritic and had been on carprofen. 

"The signs can wax and wane and interestingly, prior to presentation to a neurologist, many dogs had improved but not become normal on any antibiotic or NSAID." Lucas seemed to improve - we bumped up his NSAID to a normal dose when we'd been previously giving him half. 

Then on the 31st he really started getting desperately ill but with such different symptoms - thus "mystery illness". I'll ask my vet about SRM.

Thank you, Cleptogrey.

[GreyPoopon]

No advice--other than supporting the recommendation to consult with Dr. Couto--but best wishes to you and your boy.

FWIW, I do know that pred can cause drinking, peeing, and muscle loss. I had a non-grey on mega doses for months; she did not develop lesions but she had all the other side effects.

[cleptogrey]

your welcome! it's more than treatable. my first whippet presented symptoms similar to SRM and my vet first put him on Doxy- he responded well to the antibiotics. That was her test to see if it could be SRM. His symptoms presented itself again(not skin issues but soreness to joints/neck & fever) so we went the route of gabapentin and lots of testing to even rule out valley fever and some cat borne bacterial infections( we have a colony of feral cats who occasionally invade our property) and then some. eventually his glands popped and it was lymphoma(which we caught very early but it didn't matter). fingers crossed you don't have anything as dramatic. all of this transpired in 4 months leading to his ultimate demise.

[EllenEveBaz]

Sending all our brightest light for your brindle boy, and ditto'ing the recommendation for the Couto consult.  

[GreytOwl]

An update on Lucas: the new antibiotic is Simplicef. 200 mg tablet/1x daily.  We started it on Thursday evening, so he's had three as of right now. The open lesion has scabbed over, and Lucas is much more himself as of yesterday am. He's greeting us at the door with wags and bounces, he's eating with gusto, and we took a wonderful stroll along the sound. He's drinking an incredible amount of water (and peeing, peeing, peeing) thanks to the prednisone. He's so skinny, but his energy and engagement are back to his happy self. 

It's a tremendous relief to have him "back".  I'm not sure what the vet will want to do next - culture the lesion?  Continue to taper the prednisone? I hope to know more later tomorrow.

I'm waiting to do the Dr. C consultation for a bit to see if we are on the downside of this or having a temporary rebound. Thanks so much, all. 

[NeylasMom]

I'm sure it's coincidental, but the timing of this seems strange. I have ana acquaintance whose dog has been hospitalized with a mystery illness that included a fever. She was finally diagnosed with a type of pneumonia, but that doesn't seem to be her only issue. Doesn't sound like her symptoms are quite the same either, but it makes me go huh.

Anyway, I'm really glad your boy is doing so much better. Hope he's 100% very soon!

[BandM]

Pleased to hear it sounds like their is some progress being made. I can't offer much advice, but we have been in a similar boat for almost 12 months now, when our 6 yr old GH presented the exact same symptoms you describe in your opening paragraph, with the diagnosis being an autoimmune disease 

Long story short, there have been ups and downs the last year and we fully expected to lose her. We (discussion between vet and I) have since settled on her dosage of predinsone which has been tapered down and recently added paracetamol to help manage pain. This will be reviewed next week.

She has added and settled in bodyweight, though you wouldn't think so in her face, which looks gaunt and "boney". Walks are kept to a minimum, she really struggles after a few hundred metres, especially in colder weather. The feisty little character has certainly lost its edge, but you can see she is determined to do more, but body isn't willing. She does seem quite content with the lazy home life. Appetite is there, but she is now a slow eater. I have come to accept this is her life now, but she responds to us, wants for attention, has an appetite, all the signs are there that she is still with us, but physically she is limited. A broken humerus in September didn't help her cause, but she has remarkably made a full recovery from it.

Sorry to not much offer in the way of advice and to waffle on a little, just want to share my experience of managing a similar case this last year. It is something we have to manage on a daily basis, wishing you and Lucas all the best on the road to what will hopefully be a full recovery!

 

Edited February 13, 2022 by BandM
Grammar

[cleptogrey]

As per" culture the lesion"

Once antibiotics are administered you can't culture it until your dog is off the meds. Hopefully the drug will do the trick. If It's a bacteria that is drug resistant the leisuon won't heal. 

My daughter went thru this with her dog. That is how I acquired this info. 

Time will tell-fingers crossed!

[GreytOwl]

BandM, your love for your hound shines through your post. Thanks for sharing your story. As much as I'd like to get some sort of definitive diagnosis, I'll be happy with just helping him be happy and comfortable.  Like your girl, Lucas loves his lazy home life. And we're incredibly lucky that thus far his health has been pretty good.  Best of luck to you as you work toward good health for your greyhound girl. 

NeylasMom - friends in our neighborhood have a border collie/german shepherd mix who is suffering from similar symptoms as well. She is 13 and has had weight loss, difficulty moving, and is just 'out of it. Some symptoms are too general to point to the real culprit. When bloodwork and imaging can't pin anything down, it gets scary. We're with you on the 'huh'. 

We had a nice, but slowed down again, walk today. He is back to following me from room to room and is happy to remind me that he's going to starve if he can't have his dinner NOW!  I'm happy to serve.