On lepto -- it is fairly widespread across the US (and most places) including city parks etc. Someone here posted a while back about someone with a cavalier in a suburb that got it and died and had only been just on normal street walks. :( So may be worth checking. Ticks also can be picked up almost anywhere. Our pyrenees used to get them from who knows where when I lived in a California central valley town. So not just rural areas pose a risk. Both might may be worth exploring as a cause.
So glad she is doing so much better!! You must be so relieved.
I am cautiously relieved but can't relax just yet. Sadie goes in on Saturday for another blood test so we should get that back on Monday or Tuesday. I will bring up lepto and TBD and see about testing for that as well as the pancreas test just to cover any other possibilities. Thanks everyone for your help!
I received Sadie's latest blood tests and after one week, her liver values have improved! Yay! They're not back to normal, but they have turned around and made significant improvement so I am very encouraged. We stopped the Cyclosporin so it looks like it was the right thing to do. Her abdomen is normal and no fluid buildup, eyes are still white, gums still pink. So far so good. As of yesterday, they have now taken away the Lactulose Syrup so I'm watching to make sure she stays alert and doesn't get foggy and lethargic again. One new thing popped up on her blood test, she is slightly anemic. They have added in a B-12 shot once a week. Sadie also is getting tired of that prescription food so I am looking into making her food, the internist gave me some guidelines for the white diet, but its a bit confusing to make sure she gets all the nutrients she needs without causing new problems that will make things worse for her.
Here's a comparison of her test results from a week ago and now:
TP: was 4.7 (normal 5.4-7.6); now 5.3 Close!
Albumin: was 1.8 (normal 2.3-4.0); now 2.5 Yay!
ALP: was 1201 (normal 10-84); now 1432 (vet said not unusual to increase due to increasing the prednisone when took off the cyclosporin)
GGT: was 388 (normal 0-10); now 152
ALT: was 276 (normal 5-65); now 175
AST: was 162 (normal 16-60); now 86
Cholesterol: was 516 (normal 150-275); now 325
Bilirubin, Total: was .6 (normal 0-.5); now .3 Yay!
HCT:was 44.7 (normal 37.0-55.0); now 31.1 Oops!
WBT: was 23.0 (normal 6.0-17.0); 21.5
So far she is back to acting close to normal. She is just a bit tired, and sometimes she has trouble getting her foot up and over the lip in the dog door, and she is still choosing her crate to sleep over curling up in one of the floor beds or going up the two steps up to the sofa where she usually hangs out during the daytime. But other than that, she is alert, seems happy, wags her tail, checks Joey's dish for any tiny morsel he may have left behind, and loves her treats. Poo's are soft but formed so that has improved as well. As long as things go along well, she will have another blood test again on Saturday. Hoping the numbers will be back to normal, or at least very close.
Thank you all so much for your help and support through this very stressful time!
It all sounds very promising, Teri.
What are the rest of the numbers on the CBC that reflect anemia - hemoglobin, RBCs? You may need to do another (cheap) test to see if this is regenerative or nonregenerative anemia if the anemia turns out to be chronic. The B-12 injections sting - so be prepared. B-12 generally won't do anything to improve chronic anemia; I've been down that road with lots of dogs with kidney failure (which causes nonregenerative anemia), although I did give B vitamins in subq fluid (made me feel better, anyway).
WBC is still high - is she still on antibiotics? What kind of what dosage and what does she weigh? What do they say about her still fighting infection? What other meds is she taking still?
Forgot to ask earlier - is she taking liver supplements such as a product with milk thistle and SAM-e? That would be something that could be very helpful and certainly won't hurt. Google Jean Dodds and read about liver diet and liver supplements.
I would def homecook a "white diet." It is really pretty easy and you shouldn't stress about it being perfectly "balanced" at this point. Dogs with chronic illness can do fine on an "unbalanced" diet - I have been feeding a 15 year old a kidney diet for years, and she is doing well on an "unbalanced" diet. You often can't do "complete and balanced" for a dog with a chronic illness such as liver or kidney disease, and it doesn't matter short term anyway.
I have the nagging feeling that something (infection?) caused this and that there is no chronic IBD or PLE or primary liver disease.
The RBC is now 4.26 (normal 5.50-8.50)
HGB: 10.6 (normal is 12.0-18.0)
They did an additional test:
Absolute Reticulocyte: 221,520/ul
Because it is greater than 150,000/ul the anemia is considered regenerative.
Vet said it is possibly from the IBD/lymphangiectasia and hoping that the anemia is short-term.
Yes, she is still on antibiotics. She was on Amoxicillin but it is difficult to get here so after the one week supply ran out they switched her to Clavamox tabs for another week. The tabs are 125mg tablets, 1 tablet by mouth every 12 hrs. She weighs around 10 lbs. They said they are suspecting that she has an infection.
Other meds she is on:
Prednisone: 7.5mg daily
Metronidazole (50mg tab): 1-1/2 tabs daily
Clavamox (mentioned above)
Vitamin B-12: 0.5 ml injected sub-q once a week for 5 weeks
plus her SM drugs.
No, she is not currently taking liver supplements. I asked about milk thistle and SAM-e, and while they were open to it and do use it for liver issues, they felt they had so much going on right now that they wanted to hold off on that for now. Sounded like they didn't want any more variables involved right now as they figured this out, but were certainly open to adding in the supplements soon.
White diet. They gave me a piece of paper and said I need to choose a protein source (choice of chicken, turkey, fish, low or non-fat cottage cheese, egg whites) and a carbohydrate (rice, potato, low fat plain pasta). Also calcium and vitamins should be added such as a Tum's per day and a dog multi-vitamin. Also recommends adding Fortiflora (probiotic supplement). When I look at the Fortiflora (sold at the vets) it comes in box full of little packets. Instructions just say to give a packet a day with no regard to size of dog. Seems wrong to me that I'd give the same amount of that and the Tum's to my 10 lb dog as to a 100 lb dog! Also, the multi-vitamin that I got (Canine Plus chews) has calcium in it, so not sure if that was taken into account or if I will end up giving her too much. Also, I was told to stay away from fish since that was the protein she was on when she first got sick, they wonder if she has a sensitivity to fish, and I should choose a protein that she has never had before. Maybe I'm just overthinking it, but she has come through so much I don't want to mess it up for her. They were hoping that I wouldn't have to switch to a home-cooked diet until she was stable as it is another new variable they will have to take into account if there are any more problems.
Yes, the vets are thinking that the liver disease isn't permanent yet and can be reversed once the cause is known. Possibly due to the Cyclosporin. Although they seem to stand by their initial diagnosis of Primary IBD and secondary intestinal lymphangiectasia. But we'll see how this all plays out. I am hopeful that her liver is turning around and will be normal or very close to normal in another week, and that the IBD and lymphangiectasia is stabilizing. Pat, I hope your nagging feeling is true and we get to the bottom of it soon!