38 replies to this topic

[Brad]

Fungal infections are NOT the only diseases that can involve all those body systems. I treated a dog with a TBD with almost the same presentation. The OP needs to speak with his vet about how to procede.

Liz, absolutely, I'm not going to just administer drugs I've left a msg for the vet to call me in the morning to discuss options. I'm pressed with a sense of urgency to do something, anything, but doing the wrong thing isn't going to help.

BTW, TBD is a what? Oh, got it, tick borne disease? We thought that, and treated with Doxy, which should have shown some improvement (I'm told). It did not, although it did seem to break the fever.

[Liz P]

There is a reason I asked about the dose of doxy used.

[Brad]

There is a reason I asked about the dose of doxy used.

Is my dosage off?

[juliepoudrier]

Brad,
Per the vets and experts on Tick-L the aggressive dose of doxy that SHOULD be used to treat TBDs is 5 mg/lb every 12 hours for 8 weeks. If your dog is getting 75 mg twice a day (and is 30 pounds), then she's getting about half the dose she should be getting.

Here's an excellent site on TBDs. I've linked to the treatment page. Read it and share it with your vet. I re-read your original posts, but don't remember whether she was tested for TBDs? If a small amount of doxy helped some, then I'd certainly consider upping the dose from the conservative level your vet is using to the aggressive level recommended on Tick-L. You have nothing to lose.

If you look around the site I linked above, you will see a general discussion of TBDs and what diseases you should test for. The testing is relatively cheap, and I'd certainly go ahead and do it (and contact Protatek and send the blood there for testing). If you check the testing page of the site above, you'll find a link to Dr. Cynthia Holland at Protatek.

At the very least, do consider increasing the doxy dose and see if it makes a difference.

J.

[Brad]

At the very least, do consider increasing the doxy dose and see if it makes a difference.

J.

Thanks Julie. After Liz's comments, I did some reading last night and have doubled the dosage on the doxy. As you say, I've nothing to lose at this point. I've got the vet calling me at 9am, so I'll discuss whether we've tested for TBD (we've tested so much I'm losing track) and specifically ruled out any possibility.

[WildFlower]

I have nothing helpful to add but just wanted to pass on my well wishes. I hope you and your vet are able to figure this out.

[bcnewe2]

I'm sending you all the MOJO we've got.

That and, make sure she's eaten something before giving the doxy, it can do a number on their tummy's. I used to feed Mick half his dinner then his pills then the rest of dinner. If he wasn't wanting to eat, I'd get out the good stuff (whatever that was) and at least get something in his belly. Otherwise he tended to throw up and you could see he was more uncomfortable.
And for what it's worth, Mick did not respond right away to the doxy. It took weeks to see any improvements and then way longer for him to be feeling better. Plus I had to argue with the vet to keep him on the doxy, she was ready to quit after a few weeks. I was not. Mick did not present with the usual symptoms of TBD's. He had them and then a ton more. I don't remember chest issues but it took 3 vets to get a diagnosis and none of them were thinking TBD's. It was the boards that suggested it and me doing tons of research.


Good luck and keep fighting...

[Brad]

Thanks Kristen! My vet is pretty good, so probably no issues continuing the meds, and worst case, I can just go to my doctor and get more doxy if I need it. You know, for malaria prevention
My concern is that I feel like I need to treat something now, not wait for all the tests to come back, I'm just not sure what to treat for! I'll keep the doxy going, and make sure she has something to eat. I understand it can be bad for the esophageal lining

[Liz P]

You really need to speak with your vet before increasing the dose.

[juliepoudrier]

If he's talking to his vet today at 9, then at most she would have one doubled dose--I don't think that's going to create a huge crisis.

J.

[Brad]

I did send an email to the vet for him to read before he calls me with what I've done, links to the clinical study I read describing that dosage, etc, but will discuss thoroughly with him when he calls. This dosage is also recommended on other sites I've reviewed, so feel confident that I'm not doing further harm (taking into consideration GI impacts of the medication).

[Jimmyd65]

is there any update on this dog?

[Brad]

Yes, sorry, a bit of an update. Still no definitive assessment, although a specialist came in and had a look, and we decided to treat for fungal infection with a new med (fluconazole). We also continued with the elevated dose of doxycycline. Over the last couple of weeks, she has shown substantial improvement in energy and appetite, eating now double what she ate before. Hopefully she adds her weight back.
Issues that continue, her left eye is still dialated and mostly unresponsive to light, and appears sunken in to the socket. My wife fears we'll lose the eye.
Also, her sense of smell may be off, or couple with incorrect vision, she can't target food very well. I'll offer a treat (I wrap her meds in a roll of deli meat) and she'll press her nose into it like she's trying to find it, but won't eat it. She will however smell around on the floor, or sniff at the dinner plate, etc, so I'm not sure what to think. I've sent an email to the Internalist, but she's out of town until next week.

Overall though, the dog appears happy and is playing with the other dogs, and tries to jump on my head whenever she gets a chance. If it is fungal, a much longer treatment term will be applied with the fluconazole, so hopefully we see further improvement. FWIW, we ran 2 panels for fungal, both came back negative.

[juliepoudrier]

Brad,
Refresh my memory: Was a full tick panel ever run? If not and all test for a fungal infection are coming back negative, I think I'd revisit the tick-borne disease issue and see if something shows up. Neurological symptoms can appear in chronic Lyme as well as some of the other TBDs.

J.

[Brad]

Julie, no, I think it was a time frame restriction, and the vet felt that any TBD would require doxy anyway, so we just treated accordingly, knowing that using the doxy wasn't harmful to the dog. However, after a month of doxy, we saw no improvement, so assumed that TBD was not at fault.
Honestly, not knowing exactly what to press the vet for kind of left me vulnerable to what he believed, rather than doing what needed doing. After many hundreds of dollars on fungal tests, I'm told that they aren't all that accurate anyway. Seriously?
So, working with the money available we tried to test for most likely and treat for TBD regardless of testing. Also, tick illnesses are kind of rare here, so it wasn't high on the list. My guess was blasto, which is also almost unheard of, but the specialist thought crypto more likely. I even suggested distemper, but the symptoms didn't follow closely enough, and with vaccines, almost unheard of also.
$2000 later I still don't know what it is or isn't, but the recent recovery is promising, my only long term concern being her eye.
Overall, I felt that the vet should have assigned more seriousness to the issue, we lost a lot of time with hmms and haws...some tests took 10 days to get back, etc
Just as this was setting in, she was supposed to go off to Martha McHardy for training, now I'm ot sure she'll ever get to chase woolies But, we were close to calling it done, and she started to come around, so even if she loses the eye, she's still here and happy again

[PSmitty]

Poor girlie. I sure hope she continues to show improvement.

[ShoresDog]

Poor girlie. I sure hope she continues to show improvement.

Me too. You all have had a lot to go through. I hope she can bounce back from this.

[Debbie Meier]

You may want to check out this discussion board Brad:

http://blastomycosis.../board,1.0.html

[Brad]

Thanks Debbie, that's a lot of reading I'm fairly certain that if it was in fact blasto, the lack of immediate treatment should have killed her long ago. And the test did come back negative, for whatever that's worth (apparently not a lot).
Overall she seems to be recovering well, although still a bit of nasal snorting and the eye thing. Looking at it tonight, I'm pretty sure she'll lose the eye. Not the end of the world, if the rest of her recovers properly. I'm torn with taking her back to the vet for the eye, since he didn't seem to really know what to do with the whole case. The specialist is away until the 13th, so I'm not sure waiting is a good plan either..