Panna's Unsolved Multiplying Health Mysteries

[chocolatecoffee]

I've posted a few times about the problems we've been having with Panna, yet since my last post it just seems like nothing is getting better...so I was hoping someone may have ideas on anything I could try.

Just a bit of background, Panna is a spayed female Maltese who just turned 7-years-old in October. We adopted her when she was 2-years-old and she didn't have any previous health problems at all. She's on a mixture of Orijen and homecooked food, and even through this all has maintained a good appetite (even getting a little overweight, but is now at a perfect weight) and drinks a fair amount of water as well.

In March of 2009, she started walking differently, seemed unstable, and it seemed to be focused on her back legs. We took her to the vet and they thought it could be Invertebral Disc Disease, and we tried Anafen and Meticam (at different times) with no improvement before realizing it couldn't be controlled using medication. In the span of a few weeks her condition suddenly declined rapidly and she went in for surgery in June at the specialist clinic and they discovered it wasn't a herniated disc, but rather a mass that was compressing her spine. However, they still expected the same recovery period (up to a year recovery with gradual improvement, they recommended rehabilitation therapy, etc.).

In the week following surgery, everything seemed to be fine except she seemed incontinent, which we were told was nothing to worry about. We took her in for a follow-up and she was walking much better, they took a urine sample to see if she had an infection, and while doing that she completely lost the use of her back legs so they wanted to keep her for tests. In the next few hours, her condition declined rapidly (developed a fever, had an extremely high heart rate, extremely elevated levels of potassium, and there was fluid in her abdomen with bacteria). They said she might not survive and they had to do another surgery to explore what could be wrong, but it could be anything from a hole in her urinary tract to failed kidneys.

Well, she survived the surgery and they found nothing wrong, and were completely puzzled. We've done countless tests as they suspected cancer, failed kidneys...anything, and everything comes back negative. After nearly $20,000 spent at that one vet in the span of a month with practically no answers, we decided to take her to therapy and see how she fairs.

Since that time her walking had been getting gradually better (though she'll still fall over, can't squat, etc., but the therapy centre has been impressed with her progress) and she seemed to be improving. She developed a urinary tract infection in late October, which cleared up with antibiotics (Clavamox). At the beginning of December, her walking was getting even better, she was in good spirits, and she was starting to wag her tail again which we hadn't seen for month

Suddenly in the past week she seemed to lose control of her bladder and bowels again, and just yesterday she started urinating blood. Suspecting another urinary tract infection we took her to the vet, however they couldn't get a culture because she's passing urine so frequently (and she doesn't get a steady stream of urine) her bladder seems to constantly be empty. She was prescribed the same antibiotics, then today she was passing even more blood. We took her back to the vet this afternoon and again they couldn't get a good urine sample, but got enough to examine under the microscope and found quite a few crystals. The pH of her urine was 6.5, which the vet said is indicative of a different type of crystal (I believe it was oxalate), which can't be controlled through changes in diet, though she recommended I switch from Orijen to a Hill's formula (which I'd like to avoid). For the next two days, we're going to see how she is continuing Clavamox and starting cranberry extract.

We also discovered today that she has a Grade 3 (of 6) heart murmur, which we were completely unaware of and puts her at high risk for anesthetic. She does have significant plaque build-up as well (we've given her chewies for years and she was scheduled for a teeth cleaning earlier in the year, but it was canceled in the interest of the other issues). She also has severe luxating patella, although she doesn't seem to be terribly bothered by it.

Through this all, she's been a relatively happy girl in high spirits. Even today, she's just happy to cuddle by the fire, perks up whenever she hears any sounds of food, and you can hardly tell she's in pain, so we don't believe her quality of life is such that would warrant euthanasia, and no vets have suggested it. However, it just seems that we can't figure out what's wrong and new issues keep coming up, and every vet we've been to (a total of 4 now) seems to have different ideas and opinions. I don't know if I should be trying another approach, trying a different diet...anything, we seem to have no answers. I'm still trying to make sense of everything but am at a loss (which is probably apparent by the rambling); any advice would be greatly appreciated!

[luckypenny]

Did they biopsy the mass that was compressing her spine?

I don't see any mention of blood tests done? If there were, what were the results?

[chocolatecoffee]

Sorry, I should have mentioned those things; all the information isn't very coherent in my mind right now.

The vet didn't have any concerns based on the biopsy results, and it indicated the mass wasn't cancerous.

The only major concern raised by her blood work was the high levels of potassium when she went in for her second surgery (on June 24th), which they couldn't find an explanation for and it has been normal since then.

Her blood work since July has consistently come back "normal" so that they can't draw any conclusions from it. Her white blood cell count has been on the lower end of the normal range at times, however at the time of her last blood work (at the beginning of November) everything, including the white blood cell count, was normal. The vet said these fluctuations could have even been attributed to stress, and wasn't concerned about them.

[hazelrunpack]

Were there ever any anomalous platelet counts? In particular, low platelets or even a count on the low end of normal?

[chocolatecoffee]

On June 24th, 25th, and 26th her platelet count was very close to the low end of the normal range, which coincided with the low white blood cell count. They suspected cancer at that point, but when both increased they ruled it out and said that stress could have caused the fluctuations, and two months ago both were well within the normal range.

On a better note, there seems to be much less blood in her urine tonight. She's tired from the day and is snoozing, but not so tired as to refuse any food or treats!

[hazelrunpack]

Okay, at the risk of sounding like I'm really really paranoid about ticks (although I am) and like I'm seeing ticks everywhere (although I do )...anaplasmosis (and, I believe, ehrlichiosis) can cause both low WBC and low platelet counts. Anomalous bleeding is not uncommon due to the low platelet counts. Anaplasmosis is a tick-borne disease that we have to treat the dogs for every fall. Both anaplasmosis and ehrlichiosis can cause intermittent lameness (for that matter, so can Lyme's), and neurological complications (like staggering and paralysis) can occur, especially in chronic cases. Our Belle has chronic Lyme's for years and gets periodic flare-ups--we just finished treating her again this past week for her most recent episode.

Do you have ticks in Calgary? Or has Panna been in tick territory? I can't believe it would be common there, since it doesn't seem to be much of a problem in Canada, but I thought I'd throw it out there as a possibility...

[luckypenny]

Originally Posted by hazelrunpack

Do you have ticks in Calgary? Or has Panna been in tick territory? I can't believe it would be common there, since it doesn't seem to be much of a problem in Canada, but I thought I'd throw it out there as a possibility...

The last time I spoke with one of our vets, she said she was both seeing and hearing of more cases of tick borne disease in Canada...especially in southern regions.

Chocolatecoffee, can you take your pup in for another blood test? Hazel, there's a specific test she can ask for isn't there?

[hazelrunpack]

There is a snap test put out by Idexx labs called the 4DX snap test. It checks for heartworm, Lyme's, anaplasmosis, and one variety of ehrlichiosis. A 4DX here runs about $36, I think. That's probably the cheapest option--alternative testing is running separate titers for each of the diseases and that gets pricey.