We were finally referred to ISU and their team of docs have tried so hard to box this up for us. We are on a path to an auto immune diagnosis or a possible cancerous process. Heidi's clinical signs don't present as "normal" and test results have been "insignificant" for the most part.

Lots of blood, tests,radio graphs, ct scans, aspirations, lymph node biopsy, and joint fluid tap.(No MRI and CSF tap, no scans of the head or tick panels). We still have some cultures out, but will take weeks. In the meantime, since Heidi limbs are swelling, a low dose of steroids may start Monday, even though fever is yet unknown.

Possible disc problem (no MRI or CSF tap has been done to rule out IVDD, meningitis, or DM) Mild degenreative valve. Possible vasculitis (noticed thickening of ear).Some dermatitis and a clostridia overgrowth. Enlarged neck lympph nodes-lots of plasma with an unidentified non staining rod architecture(in both). Regenerative anemia, midly low magnesium and continued mildy low albumin.

Aspergillosis and cancer-plasma cell tumor have moved down the list,as with DM. Despite low T-4, suspect Euthyroid Sick syndrome since clinical signs don't support "-thyroidism".

Heidi is taking Clavamox, Doxycyline, Famotidine, Tramadol and weekly B12 shots. She also has been put on a unique protien diet -Royal Canin Rabbit and potato. She has been taken off DES (no incontinence so far). 6-8 weeks "cage" rest.

Little vomiting, increased appetite,temp has leveled out.(101-102-no spikes of over 104). Intermittent improvement in ear redness (definite improvement in "thickness")Coordination/mobility has improved (still rear deficits but much less knuckling and shuffling, but still "stiff"). Heidi is more alert. Down side is additional symptoms of "stuffy" nose, occasional weird tail movements and heartbreaking "shivers"

What do you folks think? Could there be more going on with the ears? (Strange- initial ear infections presented more on the left side. Leg/lymph swelling more on the left side and knucking more on the left side). Is it possible to have a thyroid issue even though typical signs aren't there? Is a tick borne illness possible? Is bacterial/fungal infection still possible? I know- all the above. Not sure I want any of these to be, but not having a definitive answer or knowing it's cause is so hard to deal with!

I had no idea vet medicine was more of a rule out than a rule in. Frustrating. Anyway, just wanted to give an update and maybe get some info how to keep my girl as comfy as possible. We can't chase sticks, so maybe some mental stuff?

What are the shivers like? All-over shivering like she's cold?



"We can't chase sticks, so maybe some mental stuff?"

Do you know any nose games? Or "which hand," or rolling the ball to each other? Or "sticks in a bucket" where the dog picks up sticks that are spread out around her and deposits them into a container? (Have you shaped any behaviors with markers?)


I'll come back later too and see if I can find some of the other threads we've had on quiet games for recovering or crate-rest dogs.

I'm so sorry you are having so much frustrating lack-of-answer.

Hi Connie. Yes, shivers as if she were cold - but not all over-shoulders forward.

The only nose game we've played is "find it"...the ol' "hot or cold" game using "yes" or "no" looking for hidden hot dogs or cheese. This unique protein diet is rough. I have made some "cookies" using dry and canned, but it's just not cheese! I've even made "rabbit" gravy out of this stuff to entice her appetite. Needless to say, it's not super motivating stuff.

No marker training or rolling the ball. I've tried "catch" since she'd catch anything, but Heidi's not doing that anymore. But oh boy, sticks in a bucket.. we need to try that one.

Thank you, Connie!

How about rolling chilled canned food into little balls for rewards?

My understanding of Euthyroid sick syndrome is that it's concurrent with (and caused by) something else, and that the list of possibles is long. Let me see what I have saved about it.





ETA
Here;'s what I had saved:


http://www.ncbi.nlm.nih.gov/pubmed/16095165

http://www.everythinggolden.com/hypothyroidism.htm
Scroll to Euthyroid sick syndrome

http://www.ehow.com/about_5079729_euthyroid-sick-syndrome-dogs.html

http://www.jpma.org.pk/full_article_text.php?article_id=189


Edited by Connie Sutherland (04/14/2012 07:53 PM)
Edit reason: ETA added links

I saw some quiet "recuperating" type games once when I was looking up TPLO.

I'll try to find that page again.

"Quick" update in case anyone is interested. I do have some questions...not sure if I should ask them here or start new topic specific to the question.

As of ISU visit last Wed: Suspect Immune Mediated Polyarthritis;Suspected T3-L3 Myelopathy. Gastrointestinal disease secondary to immune disease.(Tick panels, MRI/CSF tap have not been done). Mild anemia has cleared. Fever and GI have cleared and increased appetite (which actually happened starting Clavamox/Doxy/Famotidine).Liver still up but not worrysome to the vet. Stuffy and "peeling" nose cleared up. Left paw dragging and knuckling are worse.

Just finished Doxyclycline(4 wks)so current meds are Famotidine, Tramadol and Predisone(30/mg/day started 2 wks ago)Oh, and of course the unique protien diet and weekly B12 shot.

Prednisone had immediate impact on attitude and movement (just as before) and decreased leg swelling dramtically in 2 days. Plan is to continue the low dose (30mg/day)with another joint tap in 3-4 wks. Same normal side effects as before,except: extremely dry skin, very noticeable on the outside of her ears,(now advised to add 4 pumps of omega 3) and losing muscle mass, quickly. (which I am sure is part due to a months rest as prescribed for initially suspected back "lesion")

So my questions, (though I will be calling the vet today) is: 1. Is it "typical" Pred would cause a loss of 10 lbs in 7 days for a resting dog? Vet answer:Pred is causing muscle wasting but now suggesting swimming(...ugghhh this is 1-1/2 hr one way, I'm in a river community, BUT it's too dang cold yet for that) 2. Is the Pred really causing the dry skin or is this diet related? 3. Should Heidi still be on some sort of antibiotic in addition?

Sucks..the vet I really liked, is now on a different rotation. "New" vet was not a personable and much more "hurried". Frustrating! The suspected T3-L3 "lesion", (now "myelopathy") was on day two, (when I could still afford and willing to do the MRI/CSF tap)Choices were made to do the joint taps, bone biopsy and lymph biopsy (which didn't provide any tissue). Not knowing if the spinal issues really are disc related or if it's DM related or even a combo.....Frustrating, mind and emotionally tangling, and scarey not knowing if what I am doing is the "right" thing - since from what I understand, polyarthritis is common with DM dogs, excercise and diet changes are necessary, stress kept at a min, which includes med procedures. Even if I could afford MRI and back surgery, would I do it? Should I let her walk when she wants or continue rest? Should I change her diet add meds/supplements to slow possible DM?

Wow, sorry, I knew I'd get off the "vomiting-Lack of appetite" topic! So hard to believe that's how we started....

Your dog is not presenting typical clinical signs of any one condition, therefore despite a ton of tests (and money spent) there is no clear answer. It sounds as though therapies are being tried to see if something will make her feel better. Ruling out disease is a huge part of diagnosis. I like the approach of spending your money on antibiotics that cure tick borne disease vs. the tick panel .
Pred muscle wasting occurs over weeks/mos not hours/days.
Fever causes rapid weight loss.
is ISU Iowa State University?
Antibiotics, vitamins and steroid together are a potent combo that allow the body to defeat many problems. In the end though, with all disease, the dogs body has to do the healing, the chemicals we add only give a push in the right direction.
As far as doing the "right" thing goes, it sounds as if the dog is better, so I would say you are on the right track.
Hoping for the best.

Yes Betty, exactly. "Rest" for possible self healing for the suspect IVDD type II, which doesn't seem to be helping, but I'm not real patient at this point either. BUT the antibotics and Pred beyond question have helped.

The neuro stuff is so disheartening. Now the quick weight loss topped off with my MRI/CSF concerns/issues...

Yes, Iowa State University.

I appreciate your response, Betty. Thank you very much!

Iowa State is a first rate organization, absolutely world class.


IMO if they thought an MRI/CSF tap was going to be something that gave valuable information which would lead to a cure they would have pushed you hard in that direction. It would not have been presented as "your choice or not".

There are people there on staff 24/7, ---if you have more questions like the ones that you asked here, I would call them up.

Heidi has rec'd the most amazing care at Iowa State beyond a doubt! My questions and comments here are absolutely not intended to question that! I am dedicated to going there....they are 3 hours one way for us....we we have spent 4 days in the last month and again in another couple of weeks.

I could've done the MRI/CSF tap early on and clearly voiced that. The push was for the other 3 days worth of testing and I do understand that.

I understand they are extremely busy there. My new attending has not called me back yet.

Again, ISU was definitetly the place for us to go!