Opinions wanted

[2 Devils]

I know that nothing can be diagnosed over the internet so I am just asking for some opinions. Charlotte has been seeing the vet and we are just waiting on numerous blood results again.

 

I have a bc/mix (probably spaniel) that is 3 1/2 years old. We adopted her when she was a young pup after Brookcove2 (Rebecca) held a gun to my head and made me adopt her

 

Sorry in advance for the length of the post.

 

Over the last 2 years or so she has had bouts of lethargy, vomiting, vomiting bile, aggression, overheating easily and just not being herself. She is also a dog that does not drink much water. The vets do notice the difference in her when I bring her in. When she was spayed at 6 months her electrolytes were very low and have been on the low side of normal off and on since then. Last Sunday she could not keep anything down. So Monday off to the vet we went and she had to spend the day. The vets did more bloodwork. This time her electrolytes were very normal BUT her WBC's were low. Almost 2 years ago she was tested for tick born disease and that was normal. She was also tested Monday for addison's disease but that came back normal (very high normal but normal). She came home that Monday and was given anti-vomiting medicine. We gave that for a couple days and she was able to keep everything down. We were also told to give her pepcid a couple hours after the other meds to help with her vomiting bile (did not seem to help much). She went back for bloodwork yesterday and her WBC's were still low and they are sending the bloodwork onto an oncologist for review They also sent bloodwork off to Michigan State for a thyroid scan. Charlotte does not seem to be having any issues at the moment but they always come back.

 

Does anyone have any ideas of what could be wrong? The vets are stumped, all her different symptoms don't point to anyone thing. The vets even consulted an outside internist and nutritionist. Thyroid disease would be welcome at this point. And no she has not had the Proheart 6 shot.

 

Thanks in advance

[Rave]

Kim,

When I was looking for answers to some of Casey's questions, it was suggested I send her bloodwork results to a specialist who was apparently very good at interpreting any trends. She's very well-known, but I can't remember her name. I'll look for the info I was sent and forward it on to you.

 

-Laura

[2 Devils]

Thanks Laura

[Rave]

OK, the vet's name is Jean Dodds and people fax her their dog's test results for interpretation. Here's a website with a little more info: http://www.volhard.com/holistic/vteam/bloodwork.htm

 

There's also a Volhard list on yahoogroups that you might want to join and ask their opinions. They helped me out.

 

-Laura

 

p.s...I have Volhard's book (the one mentioned on the website above) that explains blood tests and what to look for, I can let you borrow it this weekend if you want.

[AK dog doc]

Kim

You mention the test for Addison's disease but not which test - there are basic screens which look for electrolyte abnormailities, and an ACTH stimulation test which is the definitive test. If it was an electrolyte screen, there is a chance that you could have an atypical Addisonian on your hands - a dog with normal electrolytes which still has the disease. These are very rare, but they exist. Just on the description, it does sound very suspicious for Addison's.

 

You also mention the low white count but not the proportions of cells - the pattern of different types of white cells within the whole can sometimes be illuminating. Also, is there an anemia? Has she lost weight? And do you know what her heart rate is at rest while she's feeling "off"? (This can be checked by placing your hand over her heart on the left side of the body behind her front leg... pulses can be difficult to find on some dogs, but the femoral pulse inside the upper thigh would also be a place to count heart rates). Dogs commonly have a regular irregularity of their heart rythm, so if she does, don't worry about that, though you might mention it to your vet just in case.

 

Has she been on heartworm preventative, or tested for it? Has any cardiac workup been done (ECG or echocardiography)? There are some fairly rare cardiac diseases wherein the dog will have episodic bouts of arrythmias. Sometimes these are intermittent enough that you'd have to be awfully lucky to have the stethoscope on her chest at the same time as the arrythmia, but they can be detected by 24-hour cardiac monitoring (there's a harness device the dog can wear to detect these.) There can also be abnormailites of electrical conduction that don't cause arrythmias, as well as disorders of the cardiac muscle itself.

 

Another thing that occurs to me is autoimmune disease - it can mimic practically anything, just as Addison's can. They might want to run an ANA test (stands for "antinuclear antibodies"), or whichever test their lab likes for this.

 

Those are the places I'd go first, though if the ACTH stim test for Addison's hasn't been run yet I'd put that high on the list... if it is a case of atypical Addison's, the most immediately life-threatening part is the very high potassium levels, so if those are okay, you may have a little wiggle room, but they can have a crisis at any time.

 

Good luck... I'll be watching the thread to see how it goes.

[2 Devils]

AK Doc Dog,

 

Thank you for responding.

 

Charlotte was given the ACTH test so we know it is not addison's. The vet said she was normal but on the very high end of normal. The vet said it is not cushing's either. Our vet was almost positive she was an addisonian when I brought her in... he was happy when they found out she was not but that still leaves everything up in the air.

 

About 2 years ago Charlotte's WBC's were 6.3 or 6.7 (can't remember). The last 2 tests were 4.3 and 4.6 respectively. Not extremely low so he does not think cancer but low enough that he is concerned. He sent the blood work off to the oncologist to let them run the blood.

 

I just heard from Charlotte's sister's owners and they say that she has low, but in normal range, platelets. She had a bout of very low platelets almost 2 years ago which may have been a result of a nasty bruise or the bruise was so nasty because the platelets were so low. The vets did not come up with anything. The owners have her tested yearly so they have a basis to go on now and the dog seems healthy. After I heard that, I am thinking that autoimmune disease could be a problem. Can that be hereditary? I will be calling our vet tomorrow.

 

Charlotte was just tested for heartworm, is on preventative (sentinel) and was checked for other parasites. They also did a urinalysis.

 

One thing I did not mention was that a few months back I put all 3 dogs on missing link plus. I only gave half the recommended dose. During this time, Charlotte was EXTREMELY energetic and hyper. She was bouncing off the walls. We took her off because she was getting to the point of being almost uncontrollable. I gave the vets the ingredient list and that is why he consulted a nutritionist. Neither could figure out what in the stuff made her so energetic and feeling like a puppy again.

 

Hope this gives some more info.

[StillTerry]

What is missing links plus?

[2 Devils]

Missing Link Plus is a powder supplement that you can add to your dogs food. You can go on some of the sites that carry dogfood and get a list of the ingredients and stuff.

[AK dog doc]

Well, glad to hear it's not Addison's - a very treatable disease, but it can be a bit spendy, and it carries some risks. Ditto Cushing's. Whatever it is, though, it's a zebra (you hear hoofbeats, you look for horses. This is a definite zebra.)

 

There is still the possiblity of some immune-system disorder, and yes, they are very often hereditary. But so can some other things be... it's possible that it's not autoimmune but another problem with the bone marrow. (Bone marow can be injured by immune system disorders - as can any other tissue that the immune sysetm can reach - but other things can interfere as well.) However, I'd agree that it isn't ringing a big bell for me in the oncology arena. Doubtful, but it should still be checked - it sounds like your vet is very thorough, BTW.

 

Individual animals may have unusual nutritional needs compared to the next dog over; I'm wondering if the Missing Link made her wild because she felt healthier on it. I can't think of anything in it that would make her hyper in and of itself, but I'd have to go back and check the label. Many of my clients use it as a supplement and none has ever reported hyperactivity to me - although that doesn't mean none has ever had it happen.

 

When you say she as overheating, what was her temp? and was it associated with any specific activity? Also, what kind of agression was she showing? Is she spayed?

 

I'm not coming up with anything specific right now; however, a bone marrow biopsy might be in order. However, that'll have to be done under anesthesia, so if she's stable right now you might wait til the thyroid results and consults are in. There are conditions where a particular line of progenitor cells fails in the marrow, or all of them get crowded out by scar tissue (that's called myelopthisis, but it's rare.) However, I'd expect an anemia if that were the case.

 

I'll keep my fngers crossed that some nice fixable thing pops out of the tests that are still pending, and I'll keep an eye on the thread.

[2 Devils]

Overheating: We don't actually check her temp but you can tell by how she is acting. There was a time when she was 6 months old that after 5 minutes of playing ball she started the wobbles (it was only 50 degrees). Once we cooled her down, she was fine. I know by how she is acting that I need to back off the exercise. Just a mile long walk in 40 degree weather can cause her to start showing signs but playing flyball she is fine, most times. We make sure she gets cooled down right after racing. She also is at the point that she will finally quit ball/frisbee play when she gets overly warm. It can also take her a lot of time to cool down after exercise... I explained this stuff to the vet and they said to just always keep on eye on her. Too many stories to write on the internet.

 

In many ways it is hard to explain the way she acts when she overheats.

 

With the aggression: She has always been a dominant dog. She also has always been somewhat growly towards other dogs (male or female). She is spayed. Over time it has gotten worse. We always blamed her increased aggression on the fact that she has been attacked by other dogs on a couple occasions or that it is just the way she is. If a dog gets anywhere near her, her hackles go up and she starts growling and at times will snap. Needless to say I keep her away from other dogs except during flyball. She is able to control herself on the racing lanes.

 

She is a great dog but she has her issues. We deal with them and go about our business. I may put her back on the missing link plus after the vets are finished testing her. See what kind of changes become apparent.

 

I think our vets are a great group. They always seem to be pretty up on things. They also take what I say seriously which is nice. I had vets in the past that kind of ignored what I said and then it was too late. There are 6 vets in this practice and I can actually say that I trust them all.

[HerdinGal]

Has she ever had an endoscopy to look down into her throat and stomach? Bouts of vomiting, lethargy, not feeling well (and badly enough to be put out enough to be considered aggressive) all sound like her stomach hurts.

I know with my human patients that the above symptoms usuall warrent a scope, and electroyltes can be way off d/t screwed up absorption and eating habits.

[AK dog doc]

I'm glad you have access to such capable medical help!

 

The agression thing sounds to me like it's a separate issue (although there again your vet can better advise you, having met the dog in person). However, if she's generally inclined to rearranging her environment to suit her - by bossing other dogs or what have you - she may be more inclined to do so if she doesn't feel well. That may just be warning the other dogs that she isn't in the mood to be messed with and to cut her a wider berth. She may have fear and/or dominance issues, but these are usually manageable with appropriate training (and the fact that she CAN control herself, since she does so at the flyball lanes, indicates to me that she is not suffering from some kind of organic mental disorder that would be unmanageable). So I have every confidence that that part of the picture can be worked out.

 

It is quite odd that going for a mile long walk in 40 degree weather (we're talking Farenheit, here, right, not centigrade?) is enough to overheat her. Particularly considering that she can compete at a fast-and-furious sport without overheating, and that in itself suggests she's pretty fit. Hmmmm.... May have to give this some thought. Does her tongue seem dry or sticky when she's doing the overheating thing? Since dogs can only sweat on their foot pads and primarily cool themselves by panting, they need a wet tongue for evaporative cooling. It almost sounds like she DOES have electrolyte issues (even if they're not Addsionian)... there's a condition in horses that is vaguely reiniscent; it's hereditary, but so far as I know it's never been reported in dogs.

 

Hmmm. Well. At any rate, it might be interesting to see what her temp actually IS when she's overheating - 100 to 102.5 F is normal. And, if she's having trouble cooling off, you can cold pack (not ice pack, unless she's extremely hot and likely to suffer injury if her temp doesn't come down FAST) the large vessels where they run near the surface of the skin... so inside the thighs where the femoral arteries run, as well as under the abdomen and the front legs (the "armpit" area). Plain cold water from a hose is fine, or cold wet towels. Wetting the pads with cold water can also help; cold water works not just by directly applying cold to the body, but also by evaporative cooling. Just a handly thing to know for general first aid with heat srtoke.

 

I'll mull this over and see if I can come up with anything else.... this has my curiosity piqued.

[Rebecca, Irena Farm]

I'm the one who held a gun to Kim's head.

 

There's a local phenomenom that involves young dogs who don't seem to be able to handle stress, no matter what the temp, or level of actual physical activity. Has more to do with stress levels.

 

So an excited dog just learning a sport or being restrained on a walk is actually at higher risk than a dog playing flyball or herding sheep. Also, they seem to grow out of it.

 

Symptoms are ataxia, wobblyness in the butt, collapse, panting, staring (but responsive), trembling. Looks like heatstroke - but NO rise in body temp!

 

I have a friend who had to retire a dog from training due to this, who calls it Bad breedin' Wobble Butt. They couldn't figure out anything about it, except that haunting electolyte problem. He didn't have a WBC problem. Since then I've collected anecdotal information here and there and I fear it may be a rising problem in the breed. Once upon a time these dogs would have been culled out in their puppyhood.

[Rebecca, Irena Farm]

PS, I really hope you find some answers. I found some puppy pics and I'll bring them to the tourney this weekend.

[2 Devils]

I spoke with my vet a few minutes ago and cancer seems a definite no, YAY...

 

Still waiting on other results...

[Denise Wall]

Kim,

 

There is a condition described in Labs called exercise induced collapse that sounds very much like the stamina problems I've seen in a number border collies. The link to read more about this problem in Labs and maybe print out a copy for your vets is:

 

http://thelabradorclub.com/library/eicstudy.html

 

Hope your dog feels better soon.

 

Denise

[2 Devils]

I heard about this before but Charlotte has never gone through a full work up to be tested for it. The vets always said to just be careful when exercising (they say she could be afflicted). I found it interesting that when you read the part about what type of exercise may cause it to act up that it specifically mentions that many dogs with this don't have problems during agility or flyball. Sounds very much like Charlotte.

 

We are still waiting on her thyroid tests to come back. I know it sounds bad but it would be ok with me if she has a thyroid problem. That can be treated with meds.

 

It seems there is a chance that there could be an auto-immune problem going on, in which case The Missing Link plus could be our short term medicine and then we will have more bloodwork taken to see what her WBC's are like.

 

Maybe in the next 2 weeks I will have some answers...