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Immune-mediated polyarthropy


MrRipley
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My 8 year old bc Ripley suddenly fell ill a few weeks ago and was hospitalized for nearly 3 days with a fever of unknown origin. The only symptoms he showed at home was lethargy and loss of appetite. (Lesson learned -- do NOT attempt to determine if your border collie should go to the vet or not by asking him if he wants to play frisbee!) Before bedtime I realized something was very wrong and I didn't feel comfortable waiting till the morning, so off to the emergency room we went.

 

Bloodwork all normal other than having a low platelet count. Negative for all tick diseases, including RMSF and babesia. Negative for lepto. Chest x-ray normal. Abdominal ultrasound normal. Spinal x-ray normal. His joints were not visibly inflamed, but because his fever was still high and he still seemed uncomfortable, a joint tap revealed inflammation and he was diagnosed with immune-mediated polyarthropy. I was told this is a common secondary condition to a primary infection, but without a definitive diagnosis of a "primary condition," they can't be sure if the immune condition is primary or secondary, or whether it will go away, or relapse.

 

He was retested a week later for all tick diseases and they were still negative. Regardless, he is being treated with 4 week course of doxy.

 

He has been on prednisone (5mg 2x/day) for 3 weeks, and yesterday we started dropping it to once a day, which I am both very happy and nervous about.

 

[Edited to add:] His CBC was normal, including platelet counts, at the 1-week recheck.

 

The vet kept asking me if he showed any lameness leading up to this, but he didn't. There was a weird thing that happened a couple of days before. On Sunday, he was swimming at a pool and running around like a nut and he wore two of his paw pads off. I doubt this had anything to do with the illness, but obviously he was limping and in some discomfort due to that. By Tuesday night we were in the ER. This dog has never been sick and barely been hurt a day in his life.

He's been feeling good now for nearly 2 weeks, despite losing a lot of muscle mass, unfortunately. Possibly side effects of the pred.
Has anyone had experience with anything like this?
Thanks,
Heather
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Despite the negative tests--TBD. They will often have symptoms and respond positively to Doxy even though the tests say negative. The best source for info on this is a group called Tick-L that you should be able to find online. Keep up the doxy.

A

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Lepto? I wonder about retesting/ Then I wonder about swimming. Was this a pond or pool? Any farm visits? Park outings close to wildlife? Did they culture the joint tap and do a sensativity? There can be lots of nasty stuff living in water from algea to bugs.

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Oooh! Pick me! I have a dog with this!

 

He started showing symptoms at 3 months old, and was officially diagnosed at 10 months. We didn't do a joint tap, but based on his symptoms we were pretty positive about the diagnosis.

 

His symptoms were similar:

-fever of unknown origin

-major lethargy

-intermittent lameness in both front legs

-poor appetite

-bloody discharge from his penis (this had us baffled)

-general poor-doing

 

We are also now highly suspicious that he has chronic pancreatitis as well. What caused what? We'll never know.

 

It was SCARY watching him go through this. There were days where we thought we would lose him. He was returned to the breeder at 3 months when he went lame. He had a couple recurring problems at the breeder's home, but after multiple vet trips they still came up with nothing. We adopted him at 9 months. Stress is a MAJOR factor in Trooper's condition, and I believe the move from OK to CO was what caused the big spike in his symptoms.

 

I'll link you to my original thread during his diagnosis. http://www.bordercollie.org/boards/index.php?showtopic=37763.

 

And here is the thread I started a couple days ago with an update: http://www.bordercollie.org/boards/index.php?s=c90f90a6693908e6c58d3763d39f29be&showtopic=38415

 

I wish you the best of luck, this can be a very frustrating road. Feel free to PM me with any questions! Or make them public, you never know who might see this information and need it!

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Thanks everyone for your comments.

 

Despite the negative tests--TBD. They will often have symptoms and respond positively to Doxy even though the tests say negative. The best source for info on this is a group called Tick-L that you should be able to find online. Keep up the doxy.

A

 

His last dose of doxy is this Thursday. Someone else had told me about that TickL group, I will check it out.

 

 

Lepto? I wonder about retesting/ Then I wonder about swimming. Was this a pond or pool? Any farm visits? Park outings close to wildlife? Did they culture the joint tap and do a sensativity? There can be lots of nasty stuff living in water from algea to bugs.

 

 

It was a chlorinated pool he was swimming in, but the yard is partially wooded, so sure, there could have been wildlife residue around. We hadn't been to a farm in weeks. I'm actually not sure if they cultured the joint tap, or just examined it and saw cloudiness? I will ask when I go back to the vet.

 

Kingfisher, I read through both of your threads, wow! I am so glad your guy is doing better. Ripley did not have any of the GI symptoms other than inappetence, and did not have any discharge or ulcers.

 

As of today, Ripley has been on the 5mg of prednisone 1x/day for 4 days now and is doing great.

We have a re-check on Thursday so I will post another update after that. I don't know if we'll redo the tick tests again, as badly as I want a solid diagnosis/reason for this, we're already $5000 in. Crazy I know. It's one of those fancy specialty animal hospitals.

 

Another thing I'm going to have to start looking into is getting a rabies vaccine exemption for him, because I'm terrified that a vaccine may trigger more autoimmune issues. Exemptions are allowed in PA.

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Tommy had auto immune polyarthrits. She just had one round and has been fine since. I get her shots every 3 years and she is on Trifexis. Has not had any problems. I did wait to spay her until she was 3 but it didn't bother her. I still watch her closely. I was warned that she might get arthritis after all the inflammation but she hasn't so far. She was on pred but she was also on an auto immune med and that made a huge difference once it kicked in. And I think she was on Tramadol for pain. She was really sick and limped for weeks but never stopped eating. She' been fine now for 5 years.

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Tommy had auto immune polyarthrits. She just had one round and has been fine since. I get her shots every 3 years and she is on Trifexis. Has not had any problems. I did wait to spay her until she was 3 but it didn't bother her. I still watch her closely. I was warned that she might get arthritis after all the inflammation but she hasn't so far. She was on pred but she was also on an auto immune med and that made a huge difference once it kicked in. And I think she was on Tramadol for pain. She was really sick and limped for weeks but never stopped eating. She' been fine now for 5 years.

 

Is she on any meds at all now to prevent recurrence?

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No. She's just fine.

 

One thing to watch for tho. When she was taking so much pred she really got a bad urinary tract infection. I didn't realize it at first because she had to pee so much anyway. And then she picked up mange in one of the vet clinics and we had to treat for that. She was on meds from Sept thru about April, I think.

 

She started with a sore jaw. Then she started limping on her right front ankle. And then she started to really feel awful. I think I took her to the ER a couple of times before we realized what was really going on. Then she stayed over nite at the vets and he ran blood tests and checked the fluid in her bad ankle. It was full of white blood cells. He also put her on fluids and she felt a lot better after that.

 

Her protocol which both my vet and our ER vet followed was Doxy for 10 days just in case it was a tick thing. And pred and the immune system meds plus pain meds.

 

While her immune system was down I had to be really careful not to take her anywhere that there might be sick dogs so she basically stayed homed and in our back yard for months.

 

But she got well. When I checked the prognosis for that illness is good but there is a 50% chance of it coming back. So far she is just fine. No arthritis in any of the inflamed joints so far.

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