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Discussion Starter #1
I'm at a loss here and was curious if there might be some help out there.

I have a 9-year-old (almost 10) yellow lab, which as been an amazing companion since she has been a pup. A little background, she has always shown a bit of dehydration in her blood work since she was a puppy although has never had any issues drinking or eating her entire life. Two (2) years ago, she had a mass cell tumor removed which had Grade 2 cells. She has been getting follow up tests done to look at the area and other minor fatty bumps and so far all looks good. Last blood work + urine sample prior to incident was March 2018 - no issues, clean bill of health.

About 3-4 weeks ago, we noticed she was having some difficulty with the stairs. Thinking this was her hips bothering her, we didn't think too much of it. Then, she started having difficulty chewing her food, and not eating the entire bowl. We made an immediate vet appointment to have her teeth, hip, etc checked, plus she was due for blood work. She deteriorated rapidly over the next few days up until her vet appointment. Major lethargy, not drinking, and barely eating.

1st vet visit (vet 1): Blood work came back with a 10% loss of red blood cells since March of 2018, her creatinine numbers were a bit elevated but other kidney numbers normal, and she was showing slightly anemic. There was some nasal discharge which leaded the vet to want to run a chest x-ray. Nothing of course was found and a referral to the ER vet for Ultrasound was made given her history.

2nd vet visit: (ER – vet 2): She was admitted the same day for ultrasound as we were advised not to wait. The ultrasound of her kidneys, stomach, liver, and other internal abdomen looked good, in fact the vet advised that she looks better than most dogs of her age/size (whatever that means). They also did a small needle into the spleen to check for any abnormal cells again given her history. Nothing jumped out and all looked normal. This Vet has been with this facility for over 25+ years and has been in an ER setting for quite some time. Additional tests were urine test which came back concentrated and looked good (kidney functions good based on this). We live in a wooded area and our yellow lab had a tick embedded about 3 months prior to incident. Naturally, A SNAP 4D test was done testing for heartworm disease, Lyme disease, ehrlichiosis, and anaplasmosis. All came back negative. Since we are in a heavy wooded, highly infested animal area, the leptospirosis test was also conducted and came back negative. The though was this could still be leptospirosis and we should treat it accordingly. She was sent home with antibiotics (Amoxicilin to start) and once this is complete another called Doxycycline. Due to her dehydration, they also gave her 1000ML of fluids. On the way home and that evening, we noticed a slight enhancement to activity, but no where near 100% of normal.

3rd vet visit (vet 1): After the fluids, she drank a little water, but then nothing for almost 3 days straight. We were unable to give her fruits, food, or much of anything. We changed her to some wet food and water mixed in which she started eating but still had difficulties and was very slow. Water consumption was not much so back to the vet to receive additional fluids. I believe an additional 750ML was given to assist with the dehydration.

4th vet visit (vet 1): I went back on my own to receive additional fluids to administer at home as required.

5th vet visit (vet 3): New Vet, same practice. Went back to the vet again as she was getting worse. To the point of falling off couches, unable to walk down the ramp of the house to go outside, really not drinking anything, but surprisingly enough eating – just slowly. The new thing over the past few days was head twitching/shaking – almost like a seizure but only head. Was told this could possibly be neurological and recommendation to a neurologist for MRI. At this point, I told the Dr. that it would be far to risky to put her under anesthesia given her condition, but we would take the referral. Additional blood work was run since she has been on the antibiotics for 7 days. Blood work came back within 1% of original levels, so no improvements/possible decline. Again, sent home with no additional instruction other than continue with the antibiotics.

6th vet visit (vet 3): Dog was not doing well, to the point of where I thought we were at the end of the road. Took her back on one final attempt here to see if there is anything else we can do. A thyroid test was done at this point only because I’ve heard some symptoms but was told this is not likely in an older dog. Humor me, run the test. So it was done. In parallel to this, we started her on an immediate inflammatory steroid – she had a cortisone shot to start and then prednisone, 2 pills per day. I came home and administered 500 ml additional fluids due to dehydration. The next day, received a call that the thyroid test came in a little low, and that would be normal given her health status but nothing to be alarmed about. The great news, between the steroid injection and the fluids, she had bounced back more than we’ve seen for the past ten (10) days. She was up pacing around at 3AM, drinking a huge amount of water (side effect), and eating normal. The shaking of the head went away and a dramatic increase in everything including her eyes wide open. Unfortunately, the steroids do lead to more thirst and accidents in the house unless she is taken out every 3-4 hours. We wake up at night between 2AM-3AM to prevent this from happening.

We are now in day 6 of normal behavior, still not 100% but much better. The steroids defiantly make her more energetic, more panting, etc.

So we still don’t have an answer to what is going on. However, now receiving 2 different ideas on how to proceed.

Vet 2 (ER Vet with over 25+ years experience) – she and I talk over the phone at least once a week. She recommended to not start the Doxycycline as it could potentially have a severe side effect and make the dog sicker and prone to a decline. She also advised to watch and see how the dog reacts with the amoxicillin now depleted and make sure also no decline. Her last dose of amoxicillin was 24 hours ago as this is being written. So far, no decline, but it may take time. The other item she suggested is getting her slowly off the steroids to reduce accidents but referred me back to the veterinarian which prescribed this (normal action – no problem). Once completely off, she recommends a test for Addisons. I did some reach on this, and she most certainly has symptoms. However, she is 9 years old which is not typical from what I understand. The other possibility is that the mass cell is back somewhere else, or hiding. She thinks this would not be tick related since #1 antibiotics did not work and #2 we had immediate reaction with steroids.

Vet 3 (Vet, not my normal vet, but same practice) – he believes I should keep her on the Doxycycline because there still are possibilities of lepto and/or other tick related illness that are undiscovered. He also states we should continue on full steroids for the 2 weeks followed up by additional blood work to check the counts. He is *not* recommending any testing done for Addisons, rather to see where we are in another week or so.

I’ve asked Vet 1 (my original vet) to give me a call on her opinion.

So again, I’m at a loss here. We don’t have a diagnosis. I have difference of opinions of vets. I’m leaning toward getting her tested for Addisons, but wanted to see if anyone out there (vets or not) had other opinions, stories, or suggestions to share.

Any help please?
 

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I am very sorry that your dog is having such difficulties, that would worry me a lot too. I know that I would be doing just as much as you have if it were my nine-year-old retriever. While I don't have any experienced advice for you on which vet to listen to, I want to give you encouragement and hope that you discover what is wrong.

Have you heard from Vet 1 yet? And how is your pooch doing today? If I had to make the choice, knowing only what you have written so far, I would say Vet 2 is who I would listen to. But don't let that stop you from more independent research or second opinions. Keep us updated!
 

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Update... blood work showing drop in red blood cells 3% in 2 weeks even with steroids. Vet's thinking that if this was Addisons there would not be a decrease in red blood cell count. Going in for a Polymerase Chain Reaction (PCR) test this Friday. Perhaps this is a tick or other rare illness?

Now I'm reading out this grain free warning issued by the FDA... heart failure. Very scary stuff.
 

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PCR test came back negative. Referral back to Internal Medicine for a second go-round. Vet's say we could try the Doxycycline since we have it in hand. Here are the historical Red Blood Cell counts:

March 2018 - 47%
August 2018 - 33.6%
September 2018 - 30.9%
October 2018 - TBD in a few weeks
 
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