Mystery Illness

[kingfisher7151]

Hi everyone, I apologize, I already know this is going to be a long post.

 

3 weeks ago we "adopted" Trooper, a 9 month old BC. He's doing MUCH better emotionally, but he's shown that he's pretty sick in many different ways and nobody has an answer why.

 

He's been to the vet twice in the 3 weeks, once for his initial checkup and again when he was acting quite sick. $500 dollars worth of blood work has come up as completely normal. We're still in contact with the vet and are trying to figure out what on earth could be going on here. So don't worry, this isn't a replacement for a vet visit! I'm just wondering if anyone has ever experienced anything like this.

 

The first sign of anything being amiss was that he was SO incredibly tired. We assumed it was due to a new environment and getting much more exercise than he was used to. While those things are true, he definitely is exceptionally lethargic. He'll go away to his bed in the bedroom at 6 PM and is absolutely passed out until 7 AM the next morning. Even during the day he's still very lethargic. He perks up when the other dogs are playing, but otherwise he does a ton of sleeping.

 

The next sign was that he has a HORRIBLE appetite. While he needed to lose some weight, he has dropped it more quickly than we wanted. There are some days where he literally has nothing more than a treat or two that we've shoved down his throat.

 

Sign number three is a gross one, but he definitely had some bloody discharge coming from his penis. It could be blood tinged urine, but it seemed to leak out in a weird way. We've also found spots of the pinkish fluid on the floor after he walks around.

 

Then today he was stricken with some horrible vomiting. He couldn't keep anything down. No diarrhea, but big stomach upset. He won't even consider eating the bad-for-you-but-delicious treats we keep for special occasions.

 

When he went to the vet the second time he had a fever of 105. He had been acting nearly normally, just a bit sluggish. We don't have a thermometer on hand, unfortunately so I can't see his current temperature. He was at the vet because...

 

He had goopy, green eyes. They were watery from the time we brought him home, but within a week they definitely had gotten infected. His sclera is still quite inflamed.

 

He overall just isn't in great condition. His coat is shiny, but he has eye discharge and coughs after he "barks" (which is waaay more like a yodel scream), and just looks dull I suppose. He has a bit of a potbelly and poor muscle tone. He's just bipolar, surely due to whatever it is that he's fighting. He's either the happiest dog you've ever seen, or he's fast asleep. It doesn't seem like a "happy" sleep, it seems like a "I feel like crap" sleep.

 

He was put on antibiotics for his goopy eyes, and the vet said that they would also treat any UTI that was brewing. They did a fecal exam and he came up positive for whipworms. He hasn't been treated for those yet, the medication they gave us was a powder which is hard to get down when the dog won't eat anything. But today we picked up both a pill version which he'll receive tonight. The breeder did say that they have had confirmed cases of coccidiosis on the ranch, when we asked about it the vet said the tests had come back negative, but there's a good chance the tests missed it. Everyone we've talked to thinks he's immunodeficient, which I think is highly likely. It seems to me that the stress of switching homes has brought on all of his illnesses. When we got him he was "healthy" - just watery eyes and a bit overweight.

 

He had an injury to his wrist as a young pup, which we definitely saw bothered him when he first got home. After laying down he'd have a prominent limp. But now that he's more active and has lost a good bit of weight we've hardly seen him limp at all. So I guess there's some positive here!

 

Despite my concerns when he first came into the house, he really fits in marvelously. The commotion doesn't bother him at all anymore. But there are times when he just really seems unhappy, and perhaps I'm reading into it, but it seems much more like a sick unhappy rather than a stressed unhappy.

 

And here's a picture of the little guy, the poor thing.

 

[gcv-border]

Awww. He looks so sweet.

 

I don't have any answers/suggestions, but did want to say kudos to you for taking such good care of him. I hate mystery illnesses and hope that you get some answers, or at least that he does improve with the antibiotics.

[Cody & Duchess]

My observation is going to sound like I am contradicting myself. (1) follow your gut feeling and keep on digging....if you feel something is wrong really good chance it is buttttt (2) the pic of the puppy...that pose - one of my dogs does to show she is highly content and life is good. Wish I could be more helpful, good luck.

[Tess's Girl]

I'm not a vet by any means but the eye goop and cough immediately made me think: blastomycosis I don't know if it occurs in the area you live in but I would look it up and maybe even ask your vet to test for it just in case.

 

It's been worse in my area this year than it has been before. I had a friend who noticed her lab had more of it second eyelid showing than normal. That was her only warning. Almost a year later the dog is still recovering. After knowing that case I've become paranoid about it.

 

When I first brought Tess home she was sick within a matter of days. I took her to the vet, she was tested for everything, it all came back negative. She remained sick, took her back to the vet again and this time she tested positive for coccidia. So it is possible something was missed the first time. If symptoms don't improve, I would test for things like coccidia and giardia again.

 

Hopefully it turns out to be something simple and a combination of a new home. Good luck figuring it out, I hope he gets well soon.

 

Edit: Here's a informative link on blastomycosis. http://www.vcahospitals.com/main/pet-health-information/article/animal-health/blastomycosis-in-dogs/437

[aschlemm]

I've been a Veterinary Technician for more years than I care to mention so I'm going to put in my two cents. I'd buy a rectal thermometer and start checking his temperature. Normally a dog's temp runs 100F-102.5F. I'd check it three times a day. If he's running a fever I'd call the Vet and ask them what the next step is. They may need to repeat bloodwork- CBC to check for systemic infection and perhaps recheck kidney values. Maybe they'd want to look at his urine too. If he continues to vomit don't keep trying to feed him, call your Vet for the next step. Maybe the antibiotic is making him vomit.

Coccidia isn't always shed in every stool (I had a pup I was SURE has coccidia but the Vet I was working for didn't want to treat unless I could prove it, FIVE negative stools later I had a positive one that was wall to wall coccidia.) But, usually with coccidia they have bloody/mucusy/frequent stools, if he's polluted it could put off his appetite. Giardia is also very difficult to find and requires special testing, usually dogs with giardia have diarrhea. The Vet I work for currently just treats for it if she is suspicious. I'm not sure how prevelent Lyme disease (and tick borne diseases in general) are in your area but the Vets in my area have an Idexx SNAP test that (in office with three drops of blood) will test for exposure to Heartworm disease, Lyme disease, Ehrlichia and Anaplasma. He's a little young but some signs of tick borne diseases are lameness, fever, loss of appetite and lethargy.

My area does not have blastomycosis but maybe he'd need a chest x-ray to identify the reason for the cough.

I'm sorry to say repeat bloodwork when you already spent so much but perhaps things were just starting at that point and are no longer normal now. Eye discharge can just be a sign of poor health. I would imagine that several things are going on (maybe coccidia, giardia, a urinary tract infection) and the stress of a lifestyle change brought it out into the open.

You didn't say what antibiotic he is on. Hopefully it is something broad spectrum and he will improve after it kicks in. You can try hamburger/rice or chicken/rice to temp his appetite (if he's not vomiting) or what we use at my office sometimes is Gerber (stage 2) Chicken (or lamb) baby food.

Good luck with him, he's a real cutie. I'm sorry you've had such problems with him and don't have an answer. Keep posting with updates!

[GentleLake]

I don't have anything helpful to offer, but do want to wish you well figuring it out.

 

Trooper's a very lucky boy to have landed with you. Thanks for taking such great care of him, and for caring for him.

[kingfisher7151]

Update:

 

Trooper went to the vet again today. Basically, she has no idea what's going on and has us referred to a specialist that we'll see tomorrow morning.

 

He still had a temperature of 103, but the vomiting did stop. The antibiotics should have treated any infections (UTI, eye infection, Lyme disease, etc.) and yet he still has nearly all of the symptoms. At this point the vet believes that he has something autoimmune. However there's still a decent chance that he has something fungal, viral, or bacterial. That narrows it down, huh?

 

Basically we're down to these current symptoms:

 

-Fever

-Bleeding from mucous membranes (gums and penis)

-General mouth inflammation, drooling, bad breath, bleeding

-Inflammation and slight swelling of his penis, along with bleeding

-Joint pain, lameness, and stiffness (mostly in the right wrist, but I believe the lameness is shifting and affects other parts of his body as well)

-Eye goop (not greenish anymore, likely just a sign of poor health. His eyes are also fairly reflective and dilated.)

-Lethargy

-Poor appetite

 

I also should mention that we think this is something that is either congenital or has affected him for nearly his entire life. We are gathering this from the fact that he has physical attributes that are not necessarily abnormal, but odd. I saw his father, mother, and littermate when we picked him up and they all look very normal. Trooper has very short legs, a fairly severe underbite, undersized testicles, and small eyes with a very long and narrow head. The rest of his family were very healthy looking dogs with plenty of leg and average looking faces. Of course this could just be the way he is put together, but we all feel that whatever he has been afflicted with has caused his growth pattern to shift.

 

When he was returned to the breeder he had a very swollen, hot, and painful wrist. He also had a very poor condition overall with similar symptoms to the ones he's presenting with now. Underweight, goopy eyes, fever, the works. He also came down with very similar symptoms when he was 6 months old, 3 months after having been returned to the breeder. We don't know if the bleeding problems were present. I suspect they were, he lived outside and likely never was in a position where they would have noticed such a problem.

 

We're so incredibly hopeful that the specialist has an idea of what this could be. We absolutely don't skimp when it comes to our dogs, but this stuff gets so expensive so quickly!

 

We just need him to be out of pain. The vet expressed concern about the possibility of him bleeding out if this is a blood problem. I just get this feeling that if we don't find the answer to this soon there will be severe, lifelong consequences and damage caused by it.

[GentleLake]

I wish I had more to offer than well wishes . . . and Reiki, which I'm sending.

[juliepoudrier]

Test for ehrlichia (now called neorikettsia) and immune-mediated hemolytic anemia. If not already on doxycycline, I'd start a round just to be safe. If symptoms improve relatively quickly many vets will take that as positive evidence of tick disease.

 

Praying for all of you. And please keep us posted.

 

J.

[kingfisher7151]

Thank you all for the advice and well wishes.

Julie, we'll be sure to have him tested for both. When he did the initial bloodwork 10 days ago they checked for all tick-borne diseases and all came back negative. But, I'm that obnoxious dog owner who does excessive amounts of research, and I think he is definitely at risk of giving a false positive. I've strongly suspected Lyme disease.

He was given Doxycyline when we was sick at around 6 months old and they definitely saw improvement and relief from symptoms then. He has currently been on Minocycline for the past 10 days and we haven't seen any improvement other than his eyes. Our vet said that it would have treated any tick-borne diseases. We absolutely won't rule anything out though.

I hadn't heard of immune-mediated hemolytic anemia, but after doing some research that does sound very similar to his symptoms. He definitely has some hemorrhaging going on, we've noticed bruising of his gums along with the bleeding. Perhaps this could have been triggered by something.

We'll certainly know more tomorrow after meeting with the specialist.

 

Edit: Oh, and the initial bloodwork didn't show any signs of anemia, but much has transpired between now and then and the vet thinks he definitely could test positive for it now.

[aschlemm]

Glad to hear you are going to a specialist. I am praying that it is a tick borne disease (they can also mimic signs of Autoimmune diseases) because that is more fixable. Maybe Rocky Mountain Spotted Fever? I've heard that typically hits them harder than Lyme, Ehrlichia is worse than Lyme usually. An autoimmune disease or just simply being a "poor doer" is much harder to resolve.

Good Luck!!!

[Liz P]

Keep in mind that doxycycline has effects on the immune system and can cause a relief in symptoms from autoimmune diseases, even cancers of the immune system.

[kingfisher7151]

We just have no idea what could be affecting him so profoundly that also didn't show up in the initial testing. Most of the conditions I've read about have caused a rapid onset of symptoms, not ones that reoccur over the past 7 months. Of course the test results could have been wrong, but literally everything was normal. Platelets, antibodies, white blood cells, it all came up normal.

 

I knew the dreaded "C" word would come up at some point. We're just going to pretend that couldn't be a possibility until we hear otherwise. 9 months certainly isn't unheard of for this to occur, but we'll just say ignorance is bliss and look for other possibilities.

 

It's a horrible feeling knowing your dog is quite sick, and yet nobody knows why.

[Liz P]

I've seen autoimmune diseases wax and wane over many months before a diagnosis is made. I happen to really enjoy diagnosing them and seem to end up catching them in lots of pets that come to me for a second opinion.

[gcv-border]

Ehrlichia is worse than Lyme usually.

Sorry to go off-topic, but ... in my experience - which consists of a couple of Lyme cases and a few Ehrlichia cases* - the symptoms from Lyme were more serious (appetite off, swollen joints, lethargy [not really wanting to go on walks and sleeping more], occasional limping), whereas the only symptoms I noticed when I suspected Ehrlichia were a slower eating pattern and a bit of tiredness (a slower pace on walks). The vet did not detect swollen joints in my dogs with Ehrlichia.

 

*Note: I do use either an anti-tick collar or a spot treatment on my dogs, but in my area the tick pressure is extremely high.

[Hooper]

I'll throw systemic lupus into the mix of possibilities to consider. It's one of those autoimmune conditions with different symptoms in different individuals, all of which overlap with other conditions, so it is hard to diagnose definitively. But, it would be something to think about if your dog isn't improving after a couple courses of different antibiotics. I know you've already spent a lot on blood tests, but the ANA (anti nuclear antibody) test is used as one indication of lupus. I had a dog who was diagnosed with it when he was about 4 years old. He had always been a poor eater with lots of digestive upsets, and then one day he came up lame for no apparent reason. To my shock, he was running a temperature of 104, and continued to bounce between 104 and 105 for about 4 days as the vet tried different antibiotics. Within hours of putting him on prednisone his temp was back to normal and he was up and wagging his tail and wanting to play. He was on a low dose of pred for the rest of his life. But, other than having frequent hot spots for the last year or so of his life he lived a good quality of life for 7 years, and then declined very rapidly just after his 11th birthday.

Good luck figuring out what your pup's problem(s) is/are. It's soooo frustrating to watch them feel awful and not know how to help them.

[amc]

I would DNA-test him for IGS (Vitamin B12 malabsorption syndrome). Many of Trooper's symptoms are consistent with B12 deficiency, and the test is now readily available through Paw Print Genetics and other laboratories at reasonable cost. You can submit carefully collected saliva swabs yourself, or have the vet draw blood.

 

Good luck and best wishes for Trooper. Please keep us posted.

 

Amy

[Sue R]

Amy makes a very good suggestion.

 

Obvious symptoms of IGS include diarrhea and susceptibility to infections. I assumed that since you had had extensive bloodwork done (my assumption based on your posts) that if this had been the problem, the bloodwork would have shown it. If this is indeed the problem, it is generally something that is readily managed (not cured) through regular injections of Vitamin B12. Not treated, it usually results in death within a few years of age. I lost a young dog (three years old) to this because it was not diagnosed in time to save him. Now there is a DNA test, as Amy mentioned, and it is something that is much more widely recognized than it was even just a few years ago.

 

It would be worth mentioning this to you vet and running the appropriate blood test or DNA test to find out if it is the problem in your dog's case.

 

Very best wishes!

[kingfisher7151]

Hi everyone, I'm here with an update.

 

Trooper's appointment didn't go too well today. We still have absolutely no idea what's wrong with him. The specialist wants to run THOUSANDS of dollars worth of tests before doing anything. We were pretty uncomfortable with her, so we have another appointment with a new vet tomorrow for a second opinion. We're really not skeptical people, but we just want to go elsewhere.

 

She has a protocol that she usually follows with his condition, which she is calling "fever of unknown origin". The order of business is as follows:

 

-Aspirate the lymph nodes in his neck which are slightly swollen, checking for lymphoma and a few infectious diseases ($400)

-Chest X-Rays and Ultrasound searching for possible lung problems (infectious diseases in particular) or foreign bodies or infected intestines, etc. ($2000+)

-Test joint fluid from various joints ($700)

-If all else fails, put him on high dose prednisone and assume it's an autoimmune disorder

 

We TOTALLY understand the value of testing. However, as much as we'd like to, we can't afford to put thousands of dollars into our dogs. Especially when those thousands are just on the tests, not the treatment. It makes us feel like *horrible* owners, and the vet was particularly good at giving us that impression. While she said she would be willing to do whatever procedures we wanted, she essentially told us that either we follow through with these procedures in that order or we give him high dose prednisone off the bat and he either lives if it's autoimmune or it kills him if it's not.

 

Call us crazy, but we just absolutely are not willing to do anything at this point that could kill him. We may not be able to afford such testing, but we aren't ready to take that step yet. She even said she thinks he's too young to have an autoimmune disease (although not impossible). That would basically mean we'd kill him on the medication.

 

What we're hoping is that the vet tomorrow is able to meet somewhere in the middle. I hope it doesn't sound like we don't care for our animals, we just need something reasonable. At this point we know there are a few things we cannot afford. We won't put him through chemo if he comes up with cancer. She said there are some fungal infections that cost over a thousand dollars to treat. We just have a limit. He has about $1000 into him at this point, we pretty much know what we have about $1000 more to spend on him before we're out of options.

 

I'm at the point where I'm going to do whatever cost effective things I can. I'm going to call vets in Oklahoma to see if there's any particular infectious agents that are common in the area that would be possible to treat. I also will definitely suggest the IGS to the vet tomorrow.

 

We just have to talk to the vet to see what our options are. We don't know if it's best to treat blindly for whatever seems to be most likely, or if it's best to just test and test and hope we get lucky.

 

The good news is that today we suddenly have a MUCH happier dog. He did have diarrhea overnight, but all of a sudden he's eating much, much better. He finished his last dose of antibiotic yesterday, so we suspect that it was part of his inappetence. He ate a good bit of chicken and preprepared raw food, then after we got back from the vet he ate a ton more with gusto (as long as it was covered in chicken goo of course). We ran errands for about an hour and came back to find him WAY more energetic than he has been for several weeks. He had a blast playing outside, and even after coming in he sat down with a buffalo horn and started chewing away. So at least there's some good news! He's still bleeding from his penis and is lethargic at times, but he's having an "up" day.

 

We just can't do any treatment that would endanger his life. Not before we have exhausted other avenues. It's just a struggle when those avenues are SO horribly expensive.

 

I'll let you all know how the appointment goes tomorrow afternoon. Thank you so much for the support!

[GentleLake]

Sorry you're not getting better results at this point.

 

I've got to say that $2000 sounds like an awful lot for chest x-rays and ultrasound. I just recently had 2 ultrasounds done on Bodhi, thoracic and abdominal. My vet was great checking around to find me better prices than they could offer (they've just purchased an ultrasound machine and also wanted to get more experience with it before trying it on a particularly puzzling case).

 

Cornell wanted $500 for the 2 views. Another imaging specialist (retired from Cornell) was asking for $250 for both views, so half the price. Then he kindly took $50 off because Bodhi was such a good patient. (He commented several times that he wished all his patients were so well behaved and accommodating.) I did have to drive about an hour to get to him, but he was just outside of Ithaca, NY, where Cornell's located, so no added time or expense there.

 

Anyway, one place was half the cost of the other, and both of them were far less expensive than what this vet was quoting you. Adding in a chest x-ray shouldn't even bring it up anywhere close to that estimate.

 

So it might be worth checking around to see if you can get the imaging done more reasonably, even if you'd have to travel a bit to do it.

 

Again, I wish you the very best figuring out what's going on with Trooper. I think many of us can understand not having unlimited funds while still wanting to do what's best for the dog.

 

And I'm happy to hear Trooper had a better day today. Dang therapeutic consultations. (In our case, it was a therapeutic ultrasound. )

[juliepoudrier]

Don't feel bad about having spending limits. Many people love their dogs dearly but can't throw thousands and thousands at diagnosis and treatment. I will third the suggestion to check for IGS (also known as cobalamin deficiency). You could try vitamin B12 injections--if he improves that can be considered a positive diagnosis. It's certainly worth asking the vet about.

 

When you speak with the second vet, be sure to ask what diagnostics are essential and what can be delayed or skipped altogether. For example, when one of my dogs was being treated for mast cell cancer, the oncologist wanted to do an ultrasound. I was newly unemployed and so asked if the US would change our treatment approach. The answer was "no," so I opted not to do it.

 

As Roxanne points out, different practices charge different amounts for the same services, and specialists do (in general) tend to be more expensive in my experience. For example, when I finally did get an ultrasound on Willow (later on when she became quite ill under treatment and I wanted to see if the cancer had spread internally), it cost me $700 at the oncologist. My regular vet would have charged less than half that (and yes, there can be an advantage to have the specialist doing the testing, BUT if the choice is not doing it or doing it at the regular vet, then I see nothing wrong with opting for the less expensive route, especially when you're just "fishing" for a diagnosis).

 

Last, I got a Care Credit card. Some people are very anti-credit card, and with good reason, but it could give you some flexibility in the amount you spend. I found it helpful to have 6 months to a year interest free to pay off vet bills. You just have to be careful how you manage it, because if you don't pay off the bill during the grace period, then Care Credit will add the accumulated interest to your bill and of course that can significantly increase your expenses.

 

Best of luck and please keep us updated.

[Shetlander]

I just wanted to say I am sorry for what you and your boy are going through. Don't feel bad for knowing what your financial limits are. I think most of us have a line we won't cross, either because we do not have the money or can not justify the expenditure. That doesn't mean you don't love your dog. It is obvious that you do and are going to considerable lengths to help him.

 

I hope tomorrow's visit goes better and that proposed costs will be more reasonable.

[Tess's Girl]

I learned the hard way that I should have listened to my gut when it comes to testing. When Crow was 10 weeks old he suddenly got bloody diarrhea and wouldn't eat or drink. My first thought was parvo and off to the emergency vet we went (of course this happened an hour after my regular vet closed).

 

The vet listed a whole gamut of tests to run. Parvo, fecal, x rays to check for obstruction, etc. For a split second I thought about asking her to do one at a time, but then I though, "vet knows best, right?" I was in panic mode and had almost convinced myself that my 10 week old pup was dying. So I signed off on all of them.

 

Turns out it was coccidia. Tess had coccidia when she first moved to my apartment complex so I should have thought of that as a possible culprit.

 

I the end I should have requested they do the tests one at a time and I would pay for them that way. It would have been more inconvenient for the staff, but it would easily have saved me about $800. After the parvo test came back negative, it would have been a fecal, and then bam I would have been done.

 

Go with your gut. If you're unhappy about the way things are going do not feel guilty about getting a second opinion. And if a vet wants to make you feel guilty about something like that then I wouldn't go to them anyway.

 

Prayers for you all and Trooper. I hope you get it figured out soon.

[Liz P]

Sometimes, (almost always because of communication error) people don't mesh with a vet. It's ok. Take a deep breath. The plan actually sounds great to me if money is off the table. As you said though, reality often doesn't match ideal situation.

 

Once you have had a chance to decompress, have a chat with that vet or another about your budget and goals. Decide on a plan that will work for you.

[Maralynn]

My jaw kinda dropped at the 2k price tag for u/s and xrays. I've paid anywhere from $60-$280 for u/s. Most people don't have unlimited finances when it comes to treating pets - it's just life. Most vets get this and can help you plan a course of action within your constraints if one is possible. I'm glad Trooper is feeling better today. I hope the visit tomorrow can bring some answers or at least give you a plan of action.