Fever

[skip11]

Ok so my pup got sick again a few days again. He was healed last friday, then a few days a go on Wednesday he got a fever again. The fever won't go down. We tried IV, gave him tolfedine for the fever med. It helps maybe for a few hours and fever is back again (ranging from 39.5C - 40.5C). I thought it was from the botulism creeping up again, so we gave neostigmine shots 2x. He doesn't seem "paralyzed" like he was before so maybe it's from another cause. The vets don't know what's causing it, only some sort of internal infection most likely. Anyone have experience with any of this? I might leave him at the vet for a few days so they can deal with the fever better. It's just unnerving sleeping at night not knowing if the fever will go up to 41C or not and the nearest 24 hour vet is 45 minutes away with no traffic.

[S_B]

Basically by my quick read on those 2 drugs they are just making him comfortable? What are they doing to treat the infection (causing fever)?

If this dog were mine I'd try this first.
http://www.vetbook.org/wiki/dog/index.php?title=Metronidazole

As well as get him on a good kibble, no more table food and good probiotics. If he still became symptomatic after that I'd put him down. Being constantly sick is no life for a pup.

I hope he recovers Skip, but it looks grim from my perspective.

Good luck,
S_B

[skip11]

Thanks for the advice. I just messaged the vet about the metronidazole. They don't know the exact cause of the infection so they can't treat it. They're just helping with the symptoms.

It's just frustrating because it's just not clear what causing it. Littermates were all fine, never sick and he was healthy when he was younger. I hope he recovers too, I have such high hopes for him =(.

[S_B]

I sure hope they give him the meds, it certainly can't hurt at this point. I have little trust in most vets these days, a truly good one is hard to find.

I sure hope he pulls through, he's a beauty. Please keep us updated.

S_B

[skip11]

Thanks S_B.

So they are giving him the metronidazole through IV for 3 days along with doxy for 3 weeks (just in case he has babesia or other blood parasite that's undetected or a false negative on his blood parasite tests). He's looking a lil fresher when I visited him and the fever is down. He's staying there till at least Monday and we'll see from there if he can go home or not. The neostigmine shots are not given anymore because he's already moving better and it's not needed anymore. Waiting on the lab report for his hematology, organ functions, and electrolytes (last time his leucocyte was abnormally high, CPK levels was also super high, and calcium level was a tiny bit low).

[S_B]

That sounds like a good deal on the meds Skip!

I'm very curious where the correlation to possible Babesiosis infection was made? Care to share?

If that is a real suspicion they need to administer a shot of Berenil as well.

S_B

[skip11]

They said because he has a history of ticks (he got like 1 or 3 when he was like 5 or 6 months but removed 1 right away, ticks were there maybe for only 1 day). After that he never got ticks, consistent tick meds (the drop behind the neck) every month.

Visited him and the fever got up again, sigh. I'm starting to think this is something else than botulism. Previously the fever never got this bad. This time the paralysis wasn't bad but the fever just never came down. Still waiting on the blood work from the lab to be more clear. This is a very strange case even for the vets and the fact that he got the best care possible from us makes it even weirder.

[skip11]

Ok so bloodwork and electrolyte came back and not looking good. I never know how to resize pics here because the allowed size is too small (150kb or something). Even with a resize site it doesn't work. But the gist is calcium is high at 14.96 (the last time he was sick it was a bit low). Leucocyte is at 33,3 (down from 51,6 when he was sick before this but still way high). Red blood cell is low = 5.23, haemoglobin is low = 11.7, hematocrit is low = 32.8, lymphocyte is high = 6.5, monocyte is high = 1.7, granulocyte is high = 24.6 (but down from 42.1), albumin is slightly low = 2.5, globulin is slightly high = 4.6, alkaline phospatase is high = 313. So yeah they're running a blood parasite check again and giving him something to help reduce the calcium.

So now I don't know, maybe it is botulism or maybe this time it's something else. The fever hasn't gone down but he's still on continuous IV, hopefully it'll come down by tomorrow.

[S_B]

It doesn't sound good Skip but don't give up just yet.

Interesting read: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2942055/

I'm betting the tick is coincidental, but it could have played a role in the dogs weakened immune system. Along with the topical drugs. I say that about topical drugs because what are these chemicals we are trusting to cover all of these things systemically? It just seems we really don't know all of the side effects yet.

However this turns out it's a learning lesson for us all. Please keep the updates coming.

S_B

[skip11]

So lookin better today. Fever has finally gone down to 38.8C, what a relief. He's still weak and lethargic but definitely moving around more and a lot better compared to yesterday. They're gonna run a PCR test for babesia. I have a feeling it's some sort of a blood parasite or something else other than botulism due to the anaemia. If it is a blood parasite (babesia or other tick borne disease), I'm curious if he has a chronic condition that goes undetected because the last time he has a tick was when he was 6 months old and has consistent tick med every month.

[S_B]

I'm glad to hear he's coming around Skip. It is very possible he was born with the Babesia parasite. Hopefully you'll get some answers soon.

Wouldn't hurt to read up on it though, good info here on this site as well as Merck and other sites.

S_B

[skip11]

Thanks. I really hope they can pin point the exact cause because it's just really weird. I don't think he's born with babesia because none of the dogs from the kennel ever had babesia. I will keep you guys updated.

[S_B]

Babesia is hard to find when a dog doesn't have symptoms. You can test every dog in a kennel and get false negatives. Stress one out and boom, there it is.

There is absolutely no way to know if a kennel is 100% babesia free. Babesia has been found in every red blood cell organism on earth.

He may not have it, but it wouldn't be surprising if he did.

S_B

[skip11]

Ya that's true, kinda hard to know if they don't show any symptoms. So we brought Achilles home. His fever has gone down and body temp has been stable for 2 days. He's still weak but moving around. Doxy is continued for another 2.5 weeks and metrodinazole for another 5 days. Also med to help increase his RBC. I hope he makes full recovery. Another blood work is coming up in 2 weeks, so let's hope his hematology is back to normal by then.

[S_B]

Did they run a Babesia test?

[skip11]

They're running a PCR and blood smear test right now. Just waiting on the results. Supposedly this will help confirm if he has babesia or any sort of blood parasite or not.

[skip11]

His Coombs' test is negative as well.

[skip11]

He's full of energy today. I know we're supposed to limit his activity but it's practically impossible with him being a house dog lol. Ended up taking him out for a short walk to empty. I will not be doing any intense exercises (springpole, jumping, etc.) with him for about 2-3 months or maybe less depending on his test results.

[S_B]

Sounds good Skip, glad to hear it. Keep your boy stress free, you don't want yet another relapse.

Let us know on that test. Keep up the good work!

S_B

[skip11]

Thanks! Yes I'm trying to give him just enough exercise so that he doesn't go crazy in the house but still low-ish intensity so he doesn't get any physical stress in the body. I figure if I just chain him up (he has a 4.5m chain from the backyard that reaches just the inside of the house), he'll get mentally stressed even more because he can't do anything. He's the type that doesn't do anything when he's chained up + he's the only dog right now so he'll get bored. When he's free in the house he's biting everything pillow, shoes, furnitures and humping the pillows too. You know how it is with these dogs when they're not tired.

[skip11]

PCR test came back. Negative for babesia. So I don't know what's causing the anemia, maybe the tests for the other blood parasite were false negative? Now I'm not sure if it's botulism that made him sick the very first time.

[BRICKFACE]

You get his liver enzymes checked with all the labs they took?

[skip11]

@BRICKFACE:

Those are ALT, AST and ALP right? If so, yes.

AST = 44 (normal)
ALT = 52 (normal)
ALP = 313 (way higher than the normal range)

[S_B]

From what I read on ALP values they can be elevated due to growth (bone) and drugs.

It's got to be frustrating not having a diagnosis.

S_B

[skip11]

It's very frustrating. So far the possible diagnosis are: botulism, electrolyte (calcium) imbalance due to supplement/diet, and blood parasite. I'm gonna get another hematology report next friday to see if everything is back to normal or not.

[Rainman]

Did they search for Leptospirosis..?

[skip11]

@Rainman: We don't have a test for leptopspirosis here but from the symptoms and the lab results it's not lepto.

[skip11]

So blood smear test came back. Did not found any blood parasite but showed that there is a possible genetic autoimmune disease (even though Coomb's test is negative) that has something to do with calcium receptors and parathyroid hormone. This gets even more confusing. First they say no autoimmune, now they say there is.

[skip11]

I was supplementing him with but I've stopped giving them now.
https://www.amazon.com/Vets-Best-Supplements-Chewable-Tablets/dp/B002RXHS8A

and

https://www.amazon.co.uk/d/Supplements-Vitamins-Dogs/Fortan-Cafortan-Concentrate-300-g-600-Piece/B000LXY6ZG

[S_B]

Interesting they're saying "auto immune" as Babesia has been many times mistaken for this. Can they explain why the red blood cell count was so low?

The hip and joint supplement shouldn't be an issue, although unless you're working him as a pup I wouldn't feel it's needed. Whatever that 2nd one is I wouldn't use myself, there's nothing in those ingredients that seem beneficial to me except the hemoglobin. I'd use a desiccated liver supplement a couple times a week for blood benefit, it's all natural vs the stuff you posted.

One thing with a weakened immune system is you don't want to use supplements that "boost" the immune system or over supplement. I've read that you want the immune system to repair itself and become stronger, not relying on supplementation.

What is the breeding on your dog if you don't mind sharing?

S_B

[skip11]

"Can they explain why the red blood cell count was so low?" Not sure, I'm going to the vet again on Friday to do hematology and what they call PTH test (to check parathyhroid hormone) as well as checking his calcium and phosporus levels again. I'll ask them again to explain the red blood cell count was low. He's acting normal now just not 100%.


Here's his ped. I can't add pics here because the size is still too big even after resizing.
http://www.thepitbullbible.com/forum/bulldog_dogs_profile.php?dog_id=57393

[skip11]

Oh and they're gonna check is albumin as well because it's always either 0.1 level lower than normal or just barely normal.

[skip11]

The joint supplement I've only recently used when he was 12 months old, so maybe only for about 2-3 weeks. I've always used multivitamin since he was a small pup. The Cafortan multivitamin (the 2nd link) I've only made the switch recently as well. Maybe when he's about 11 months old I think.

[S_B]

Ok Skip, just my 2 cents here. You can't tell me out of those 30 dogs in that ped you posted not one of them had Babesia!

It is VERY prevalent in these dogs, especially in active dogs. Often times dogs carry the parasite without symptoms.

I'm not real familiar with all of the new testing or the accuracy of them but I would imagine you can still test false negatives as not too long ago even DNA testing was producing false negatives.

I'd be willing to make a bet your dog became sick with the initial disease do to a weakened immune system from being Babesia positive.

Where did they pull the blood from when they sent in the babesia test?

S_B

[skip11]

"You can't tell me out of those 30 dogs in that ped you posted not one of them had Babesia!" That's true. Probably they had but no symptoms.

"Where did they pull the blood from when they sent in the babesia test?" I wasn't there because he was hospitalized but most likely from his front leg where his IV was. And since we don't have a test kit for babesia, they used PCR to confirm if he has babesia or not (not sure how it works, but the result is negative).

[skip11]

His hematology and electrolyte came back. All are normal, although RBC and hematocrit are on the cut off range but should improve. Just waiting on his parathyroid test result.

[S_B]

He's finished with the Metronidazole but is still on Doxycycline right? Did they prescribe anything else?

S_B

[skip11]

Yep that is correct. He's still on Fufang, a chinese herbal med for humans that helps with anemia. Doc said to finish it because it's working. It's in indo but here's a link http://www.mandjur.co.id/fufang-ejiao-jiang. Oh and another med for his muscle and nervous system from 3 weeks ago when he got sick again for the 2nd time and diagnosed with a recurring symptoms of botulism (doc gave 1 month worth of med, 1x/day).

[skip11]

Alright, so he's parathyroid test came back and it's normal. So after all this we still didn't know what causes him to be sick. Vet said probably some sort if unknown infection.

@S_B: I think you're probably right that he might've got some sort of chronic babesia that tested false negative which causes his immune system to weakened. I'm still not sure if the very first case was botulism or just electrolyte/calcium imbalance. The symptoms looks very much like botulism.

[S_B]

Skip I'm not in the least bit surprised. I think most vets misdiagnose Babesia for many other things unless they test specifically for it, which can also be difficult.

Babesia is a complex parasite/bacteria, it doesn't want to kill it's host because it wants to survive. This is why often times dogs will go through life and not show symptoms.

The symptoms you described initially can all be caused by Babesiosis, it's important we recognize these things so when we go to the vet we have a head start and possibly save time and money.

I have read recently it has been discovered the anti malaria drugs do not work as well on Babesia as thought. The parasite is elusive and likes to hide in tissues waiting for its opportunity (weakened immune system) to strike. Anthelmintics paired with combination antibiotics done intermittently seems to be the new option in treatment.

Glad to hear he's recovering Skip, if he were mine I'd make sure to Ivomec (Anthelmintic) him on a regular schedule.

S_B

[skip11]

Thanks for the advice S_B, I'll keep that in mind. It's a lil hard here to just buy meds like that here because most of the time you need the vet's note. I'll ask my vet about the Ivomec.

[SGC]

In the US one can buy Ivomec over the counter for cattle and you can figure the correct dosage on line or on this site. One can also buy Ivermectin on line from Australia if one does not want a large quantity such as the liquid Ivomec cattle wormer.

I have ordered it from this Australian web site and had it sent to me in the US pretty quickly --

http://www.pets-megastore.com.au/vetahearttablets-c-165_160_309.html

Not sure if they ship to Indonesia or not but you can check it out. With only one dog you would buy the tablets for the right weight for your dog and it gives the dosage size.

Hope he is doing better and continues to improve.

[S_B]

Great info SGC!

[skip11]

Cot dammit. He got sick again. This time they found hookworms eggs. So it is very likely that after all this time, the hookworms didn't get detected and it's the actual cause of his sickness. One of the vets has a similar case with a dog having fever and it's caused by hookworms. I worm him with Drontal Plus every 2 months usually. I'm worming him again right now with Cazitel for 3 days in a row and also Advocate spot on.

[S_B]

Ivomec would have helped you there also Skip. That poor fella, I'm sure you both are at your wits end! Hope that's the last of it.

S_B

[skip11]

I hope so too. I really hope that it's actually the hookworms that's causing all the problems so at least it's not that complicated and pretty easy to treat. Any experience with hookworms causing this kind of sickness?

His fever is actually going down when given Tolfedine this time (last time, fever won't go down even with the med, only went down after 3 days of IV), creeps back up again usually at night-morning. He's weak but it's not as bad as last time. He can still move, albeit very weak, and prefer to lie down. He can get up the stairs if he want to but can't jump up to sofa/bed and can't go down stairs or bed/sofa. Fingers crossed this will be the last.

[BRICKFACE]

Damn skip after all that freaking worms...at least you have a cause this time

[skip11]

@BRICKFACE: I know. I really hope it is the hookworms this time.

[evolutionkennels]

Take a 1000 ml bottle of panacur, add to it a tube of equimax. shake well, and give three days in a row. repeat again in 14 days. give your dogs monthly wormer with Ivomec every 28 day, not every month. Worm pups at 2 week intervals. 2,4,6, and 8 weeks. Worms have a 14 day cycle, so worming pups the first time at two weeks old kills almost all your worm problems. again at 4 6 and 8 is to kill anything remaining. Switch the wormers up. do panacur one month for 3 days, next month do pyrantel . Hook worms can kill your dog. Best not to have that problem.

[skip11]

Thanks for the advice Evo. What I meant by "I hope it's hookworms" is that so it's clear rather than unclear diagnoses and playing the guessing game. I will try to get individual ingredients as you described, see if anyone sells it here.

[evolutionkennels]

read my post on Tick diseases

[IWK]

Great info. Following this thread... Thanks to those sharing advice.

[skip11]

So he's been basically healthy since Saturday. He's just not at 100% strength right now but recovering real well. So still not sure what causes the sickness though the hookworm definitely contributed to the anemia. As far as the fever, we still don't know. His most recent hematology came back normal although the HCT is still on the low end of normal due to anemia; working on bringing it back up again. Vet said his weakness, tremors, hard to move/walk is a muscle injury. I have to disagree because when he's healthy he never showed those symptoms so I don't think it's muscle injury.

Anyways, just keeping him on short walks now and 2-3 min springpole sessions whenever he goes crazy in the house and start biting everything. Hopefully he doesn't get sick again now we got rid of the worms. Still waiting ont he 4DX kit (they ran out, still waiting for order to arrive) to test for heartworm, lyme disease, Ehrlichia canis, Ehrlichia ewingii, Anaplasma phagocytophilum and Anaplasma platys. I also asked for a full tick borne panel but vet insisted because the PCR for babesia was very sensitve/accurate and came out negative we don't need to do a full tick borne panel again (his E.Canis the most common one over here was also negative).

[S_B]

Damn Skip, are there any tests left? I'd be frustrated as hell!!! Glad to hear he's on the road to recovery! :-bd

S_B

[skip11]

4dx is the last one. I sent you a PM as well. This is the most mysterious disease ever because all the test came back negative.

[S_B]

4dx is the last one. I sent you a PM as well. This is the most mysterious disease ever because all the test came back negative.

Didn't get the pm. My box was overloaded, just cleared it out. You can try again.

S_B