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Mystery Illness


kingfisher7151
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I'm so sorry to hear about Trooper's difficult case! A couple of things I wanted to suggest:

 

I would advise against feeding raw food to a dog who is sick and may even have an underlying immune disease. Cook the food or keep trying canned foods or toppers that may help entice him to eat.

 

Fevers of Unknown Origin (FUO) are incredibly frustrating for vets as well as owners. I have a dog who has had that happen not once, but twice in her life, and I had access to every possible diagnostic and medication. Both times she was severely ill but eventually got better with no answers as to what could have been the problem. It happens and it's so frustrating!

 

I work in a rural area where there are many clients who have to be smart about their finances. Some vets are not used to considering this and will provide you with the gold standard of diagnostics available and assume that you can follow that plan. If the client can not afford this (which is reality and not an indication of the love and commitment of the owner), it's the vet's job to keep costs down by being smarter with which diagnostics to run and in which order to run them.

 

Is there a way to find a reputable vet who understands working on a more limited budget? For example, clinics in more rural areas do have lower costs associated with their services...the key is to finding someone who knows what they're doing vs. "just a country vet". We have a lot of clients who have vacation homes here and use us for most of their vet work instead of the more expensive urban vets at their other residences.

 

I'd go for the diagnostics in stages. Ask the vet which test is most likely to give you an answer. In general, the lungs are one of the top places to look for a FUO, so the chest x-ray may be a good idea. Fungal infections can be quite nasty and I know a number of border collies who have gotten them. They are not always something many vets consider depending on what kinds of dogs they're used to seeing.

 

Now I certainly can't advise this without seeing the blood work or the dog, but I don't think it's a bad idea to try a dose of steroids in a lot of these cases. A couple days of steroids really shouldn't crash the immune system, but would give you a quick answer as to whether an immune disease is likely.

 

And a B12 injection is really cheap and also benign. You could give that to him before running the genetic screening, that would save money.

 

Sorry for the disjointed reply. Hope that you can get to the bottom of this soon!

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A blood test can certainly reveal an affected animal but a DNA test can reveal a carrier. Here is a webpage from one company that offers testing for this in their panels for both Border Collies and Beagles.

 

www.animalgenetics.us (sorry, my cut-and-paste is missing in action but you can go to "canine" and then to the proper page that lists the DNA test panels they offer.

 

And another is www.pawprintsgenetics.com, which also offers a panel that tests for multiple genetic conditions.

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A blood test can certainly reveal an affected animal but a DNA test can reveal a carrier.

 

I have to wonder at this point how important (IOW, is it important at all?) that Trooper be identified as a carrier? Right now Kingfisher just needs to find out if it could be what's causing the problem (maybe. Maybe the vets don't feel it's a real consideration) at the most reasonable cost.

 

Not trying to be argumentative at all here. At this moment in time, I'd just think affected status would be more important to determine than carrier status, and probably less costly to determine.

 

As an aside, I wonder . . . would an affected dog automatically be a carrier? If it's like CEA, for instance, there's no need to do a DNA test on an affected dog because being affected already answers that question. I don't know, just wondering out loud.

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Just want to add my voice to those who are supporting you in this, and to say that I wish you the very best in determining what is going on.

 

And I also want to second those who have suggested taking testing in stages. My vet always does testing in stages - test for the most likely thing first, and then if that is negative, go down the line of the others. This can sometimes save you a great deal of money.

 

I also want to encourage you, as have others, to go with your "gut" feelings. Obviously you love this dog and want to do the very best you can for him. Your gut feelings count. Listen to them, and listen to what your dog may be telling you as well. I am not being woo-woo here....what I mean is that you are with the dog more than the vet is, and your own intuitive feelings and observations, some of which may be subconscious, are valuable. Follow them and they are unlikely to lead you wrong. That has been my experience, and I have had a lot of it over the years.

 

I sure do with you luck, and will be following this thread.

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For some reason, my "quote" function doesn't want to work, either!

 

In this case, only knowing if the dog has the disease is all that is needed. Some people have questioned if carriers might also be subject to some effects but I don't think anyone knows at this point.

 

At least we know that there are blood tests and DNA tests available to those who want, need, or choose either. No argument here!

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Tommy Coyote, we're not far from Colorado State University, but when we asked our friends (who is 3 months away from being a licensed vet from that school) she said she hadn't heard of any situations where you can bring your dog in for students at a discounted price.

 

We are absolutely going to give him a B12 injection. It's not going to hurt him if it doesn't help, so there's no reason not to! We're super hopeful that it may be the answer. In case it is, my mom and I are divided on whether or not to do a DNA test. I want to, she doesn't see a reason to! We won't count our chickens before they hatch, though.

 

The "up" streak has continued and even gotten better today! Woohoo!! He is absolutely ravenous. We are essentially positive that the antibiotic was causing horrible nausea. He does have even worse diarrhea, but the diarrhea began when we got him on the wormer. It has gotten worse with every passing day of the 5 day treatment. It doesn't really surprise me, but we're just going to finish the treatment and wait it out. Then we get to do it again in 2 weeks. :blink: Maybe I'm just trying to fit a square peg into a round hole, but I wouldn't at all be surprised if he had ulcers consistent with IGS. He has had slight blood in his poop, and also has some minor ulceration in and around his mouth.

 

We still don't have an answer for why he has such recurring illnesses. We had an hour long conversation with the breeder trying to figure out more about his previous illnesses. From what we can tell, he has the exact same symptoms every time he has a flare up. She was surprised about the bloody discharge and never had seen that in him before, but it's really something you wouldn't notice unless you're looking for it. I only saw a tiny bit of pink tinging around his manhood leading me to check, and we find droplets on our hardwood floors. It's definitely not something I would have noticed if he were outside all the time. We're still looking at the possibility of tick-borne illnesses, even though the tests came back negative. The specialist said that it's possible he had an initial infection of Lyme disease or something similar and that the autoimmune reaction is still active. So we still don't know!

 

But we're having such hope that he's improving. We still have an illness certainly, but the cause may be much more simple than we were thinking. It would be a miracle if it were IGS. Whatever it is we're so happy to see him race down the driveway screaming at the other dogs while they play fetch. And when he comes inside he's begging for them to play more and hasn't tried to hide in his bed at all for the last 2 days. We'll work on behavior when the illness is better. :)

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I hope that Trooper's improvement continues. He sounds like he has made great leaps in the last 2 days.

 

With regard to going to a university vet school: great diagnostics, but I have never saved on my vet bills. Another downside, there have been a couple of instances when I felt I paid more for treatment because 'they' wanted to use the case as a teaching tool for the students. An upside - macabre as it is - when an animal has died while in hospital at the vet school, the necropsy is free.

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Glad to hear about the continued improvement!

 

 



Is there a way to find a reputable vet who understands working on a more limited budget? For example, clinics in more rural areas do have lower costs associated with their services...the key is to finding someone who knows what they're doing vs. "just a country vet". We have a lot of clients who have vacation homes here and use us for most of their vet work instead of the more expensive urban vets at their other residences.

 

I felt very fortunate to find a vet like this when Kipp was sick. Small town office but the vet was pretty up-to-date and had some contacts who were specialists. Because of this I was able to get diagnostic work and specialist opinions at a really reasonable cost.

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Swamplands Farm, he does have minor ulcerations in and around his mouth. His tongue looks normal, except that he does have a good notch in it on one side. I assumed from an injury, but it could be anything. We did notice his tongue is much more red compared to Keeper's pink tongue. The urine doesn't have a strong smell (that I know of), and it isn't really the urine that's pink. It's the discharge from the penis when he's not peeing that's pink.

 

We're off to the vet, cross your fingers, toes, and paws!!

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I had an experience where the vet school did save me a bunch of money. It was because they had better treatment methods available to them, so the issue was resolved quickly, whereas my vet treating the same problem led to all manner of complications. The biggest advantage of going to the vet school is that you often get specialists at close to regular vet prices for diagnostics. The disadvantage is that for an interesting case, they may really want to run every test under the sun.

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I'm back! The vet appointment went...well? We didn't do anything other than drawing blood for another CBC test. But, I did get much better feelings from this vet. She just seems way more realistic. I pushed a bit to do a B12 injection and she balked. I was a bit frustrated about that considering it wouldn't be harmful, but I understand that she doesn't want to give him anything yet until the bloodwork comes back. If it comes back normal I will absolutely request that we do the B12 before any other treatment. I was under the impression that she wasn't familiar with the condition, but as I understand it's very commonly misdiagnosed.

 

To make our reservations about our other vet (who we've been with for nearly 10 years) even more solidified, we found out on the fecal results that they forwarded to the new vet that Trooper is also positive for tapeworms. Too bad they never told us that!! They even had us buy $100 worth of wormer that doesn't even treat tapeworms. One $12 pill later from the new vet and he is set on his wormer. We also found out that he has a very abscessed tooth. I had seen that it looked bad and knew his breath smelled, but I couldn't really see the extent of the infection. She believes it was caused by a trauma. Considering it's on the same side as a missing top tooth and a split in his tongue it makes sense. We suspect he got clobbered during the many times he snuck in with the sheep and cattle back at the farm. It's just frustrating that the other two vets didn't notice it. And it's VERY obvious when you finally see far enough back with the light.

 

The new vet is also on the track of an autoimmune disease. More specifically, polyarthritis and meningitis. I'm still very curious about the possibility of IGS, however. We ultimately still don't know any more than we did when we started. But at least he's eating! He has put on a pound and a half in 2 days, if that's any idea of the degree of his starvation.

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Your new vet sounds much more on the ball.

 

I would imagine that a long- standing tooth abscess could cause many of Trooper's symptoms as it swelled, self-drained and then reformed yet again.

 

It may even account for many of his generalised symptoms including the joint problems and bloody discharge if if he had additional intermittent sepsis (systemic blood infection) +/- crossreacting autoantibodies that can occur after some bacterial and viral infections.

 

Good luck with getting him sorted..he certainly is in good hands.

 

ETA the autoimmune conditions I was thinking that may occur secondary to an infection could be something like the 'dog equivalent' to human Henoch Schonlëin Purpura (HSP). In human children, this condition is usually 'self limiting' and most get better on their own.

I don't know if the same sort of thing is described in dogs, but personally I'd be surprised if there was not something equivalent.

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I'm with Maxi, wondering how much this tooth infection might have been contributing to the symptoms you've seen. No matter what, fixing that issue should be helpful to him and I'm glad you got it found and it will be treated (along with the tapeworm treatment).

 

Sounds like a new vet was what the doctor ordered!

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Count me in . . . Sounds like the new vet is more on the ball. I doubt tapeworms were causing Trooper's problems, but simply the fact that they steal nutrients from the body wouldn't have helped him any and just made it harder for him. And if it were me, I'd be back at the other vet's office asking for a $100 refund for the wrong wormer. :P

 

It's quite possible that the abx he was on for his eyes also treated at least some of the infection from the tooth, explaining why he's feeling better now. But, yeah, a systemic infection like that can cause all sorts of problems. Add in worms to weaken him further, you've got at least some of your answers right there.

 

I agree that the IGS and cobalamin malabsorption (I'm not sure all cobalamin malabsorption is IGS, since it didn't show up in my dog until she was around 10) is often missed. 3 vets stood around for 7 hours trying to figure out Tilly's problem and missed it, and almost $900 later wanted to do exploratory surgery, while another vet looked at the test results, did another quick blood test and dxed it in a matter of minutes. So, yeah, it's something that goes under many vets' radars. But it sounds like this vet has a good reason to hold off on trying B 12, so I'd give her a chance to see if she can figure this out.

 

So very happy for the encouraging news. Keeping all finders and paws crossed here that things just keep getting better.

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I agree that the IGS and cobalamin malabsorption (I'm not sure all cobalamin malabsorption is IGS, since it didn't show up in my dog until she was around 10) is often missed.

So IGS always shows up when the dog is young? Quinn was a sickly youngster with chronic giardia and diagnosed with IBD at age two. When he started showing behavioral issues at nine, he was found to have low cobalamin, so we started shots. A test a few months later found ok cobalamin but low folate. So now he is also on folic acid and shots every other week. Both levels are good and his weight is back up.

 

Sorry for the derail. Many of Trooper's symptoms are different from Quinn's at ages two and nine.

 

It is so hard when your dog has a puzzling health condition. Hard to find the right vet sometimes. Hard to know when you need another opinion, even if your vet is great and working hard. Hard to choose from treatment options when it isn't fully clear what is going on.

 

I find you really need to be active in driving the treatment to some extent. Not that you are the expert by any stretch, though you can build a lot of knowledge. But you need to keep advocating for your dog, asking questions, doing research, and figuring out when to pursue exploring other options.

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I agree that the IGS and cobalamin malabsorption (I'm not sure all cobalamin malabsorption is IGS, since it didn't show up in my dog until she was around 10) is often missed.

 

As I understand it, cobalamin deficiency (vitamin B12 deficiency) can result from a number of causes, one of which is cobalamin malabsorption syndrome, which is hereditary and always (AFAIK) shows up young (though it may not be diagnosed until later). IGS (Imerslund-Grasbeck Syndrome) is the name given to cobalamin malabsorption in humans, but it is coming to be used for the disorder in dogs as well. I'd prefer to keep the term IGS for humans (just as I wouldn't call BSE [mad cow disease] CJD or vCJD [Creutzfeldt-Jakob Disease, its human version]), but the tide seems to be going the other way.

 

Of the various companies I know of in the US who offer DNA tests for it, Animal Genetics ($45) calls it IGS, VGL ($50) calls it IGS, VetGen ($65) calls it Cobalamin (B12) malabsorption, and PawPrint Genetics ($80) calls it Intestinal cobalamin malabsorption (Border Collie type).

 

Very glad to hear that Trooper is doing so much better.

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In humans, Imerslund-Grasbeck Syndrome is a specific form of juvenile megaloblastic aneamia (megaloblastic anaemia 1) that is caused by Vitamin B12 (cobalamin) deficiency and is often associated with proteinuria (protein in the urine).

 

It was originally described in 1959/1960 in several Finnish families by Grasbeck and in several Norwegian families by Imerslund. Subsequently, it has been found to be associated with mutations in 2 separate genes - CUBN (Finnish type) and AMN (Norwegian type). I think the disease caused by either gene is inherited as an autosomal recessive disorder.

 

For those interested, you can read more about it in OMIM (Online Medelian Inheritance in Man).

 

In humans, there are other forms of Vitamin B12 (cobalamin) deficiency/malabsorption that are not caused by IGS syndrome.

 

However, as Eileen says, it does seem that in the "dog world", different forms of cobalamin deficiency are sometimes being grouped together under the single "IGS" title

 

Apologies to the OP for hijacking the thread.

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