Fever of Unknown Origin - Update #2

[BG and Gavin]

So here I sit; I took the day off work.  Gavin started losing energy on Thursday night.  He went downhill to the point that we took him to the vet on an after hours call on Sunday.  He was totally lethargic, lying on his side, unresponsive.  He has a temp of 104.2 and his white blood cell count was elevated, but all other tests came back fine.  Urine test was fine.  Fever of unknown origin was the diagnosis.  The vet was troubled because the exact same thing happened last August with him. He is a bit stumped.  So treatment is Rimadyl (anti-inflammatory) and Clavaceptin (anti-biotic).  Gavin perked up right away on the meds, short bursts of acting normal (grabbing his ball, wanting to play, a short walk) followed by more than usual sleep. 

 

However, this morning I had to get his up and assist him outside again.  He would not do the stair steps or make eye contact or eat, just stood and stared at the floor, almost trance-like.  I called the vet again.  He said maybe the n-said was worn off and the fever was returning.  He wants to test for the white blood cells again when the meds are done. If they remain elevated, his next thought is an autoimmune disease, which is treated with a 2-3 month round of steroids when it flares up.  As we sit now, Gavin is bringing me his ball to throw and I just got him to eat some canned food with cut up chicken heated and mixed in.  Guess the n-said kicked in. 

 

Apologies for the long post but it’s been a stressful week. I am worried sick about Gavin, I have an important presentation to give at the College tomorrow, my 24 year job ends in a week and we are supposed to be looking after Mylie doodle for two weeks but have her farmed out while Gavin recovers.  Oh these doodles!

 

Any advice or similar experiences? Or a limerick for me??

 

UPDATE:  Gavin went to the vet today:  temperature perfect, negative on lymes, heartworm and two other things, auto-immune issue ruled out, white blood count still high (even a bit higher than when we were there 10 days ago).   He says he is a bit stumped.  The only thing he could think of is that the first blood test caught the count on the way up and it has not made its way all the way back down yet.  He is going to consult a pathologist about Gavin's case and get back to us next week.  He kept blood back from both visits for further analysis if necessary.  He gave us some Rymadyl to have on hand in case the fever returns so that we can begin to deal with it quickly.  I dunno?  He seems normal.  Any ideas?

 

UPDATE #2:  I just got the following email from my vet: 

I had a lengthy conversation with a pathologist at the animal health laboratory at the University of Guelph about Gavin.  She was saying that the effect of the WBC count going higher is not uncommon because the bone marrow is not shut off right away so  you can get a higher count before you get a decline.  She was very perplexed on why he was having these febrile episodes.  What she suggested to do is to do another CBC and urinanalyis in 60 days when he is apparently “normal”.  Immune disease does not fit here since he has recovered again in such a short period of time with NSAIDs and Antibiotics.   As well, we have ruled out Addison's disease via the normal Biochemistry profile and electrolytes.  We were thinking possibly a glomerulonephritis that is why we want to see urine again to monitor the protein level.  So if it is possible to get him back in probably the first part of June with a first morning urine sample and we can run a follow-up CBC that would be great. 

So the big word is a type of kidney disease.  I guess we will see.  He seems great now.

Update March 2013 Well this was two years ago.  We went on a session of 6 weeks of anti-biotics.  The only thing they could think of was a lingering kidney infection that was knocked down the first time in August, but never was really cured.  After the 6 weeks, white blood count was back to where it was supposed to be and urine was good.  That being said, about every 3-4 months Gavin has a mini-episode of lethargy reminiscent of the febrile episodes.  Usually he comes out of them on his own within a day.  If he does not come around right away, I give him a rymadol and it snaps him right out of it.  I have gotten pretty handy with the rectal thermometer though ;)

Update December 2013 - it has been almost a year since Gavin has any type of fever or period of lethargy.  Touching wood as I type, but I think we maybe out of the woods for good.

[Laurie, Fudge, and Vern]

BG, I hope Gavin feels better and someone can figure out what is causing the fever. Fudge and Vern send hugs his way.

 

We hate when Gavin feels tired and bad

It sure does make Fudge and Vern sad

We are sending hugs your way

Hope you feel better today

And that fever better take off, don't make us mad

 

Not very good, but I am out of practice :) Feel better soon!

[BG and Gavin]

Thanks Laurie - this helps to cheer me up :)

[Joan, Louie and Mila]

I hope your Gavin feels better soon...Was he checked for Lymes ? Louie was very very sick when he had Lymes...I live in deer tick infested Pennsylvania but when Louie crashed, I was in North Carolina. The vet there wasn't going to check for lymes until I mentioned it since they don't see a lot of it there.My vet when I got home also explained that it can be dormant for 6 months or more so he could have been infected as a puppy before he was started on Frontline Plus.

Hope you get the answer soon...

[BG and Gavin]

Funny you should say this - the vet did mention that he was sorry that he did not do a test for Lymes when we were there Sunday; he only thought of it when he was contemplating the case yesterday.  He said 3 cases have been reported in our county.  He is doing this test combined with the heartworm test this year for all of his patients.  We will have it done when we bring Gavin in for the second blood test.  Thanks Joan.

[Karen, Jasper and Jackdoodle]

It sounds like you are doing everything you can for Gavin. If an autoimmune disease is diagnosed down the road, I would find try to find a specialist at that point; on-going, long-term steroid use carries its own risks, and sometimes, a general practice vet is not aware of all the treatment options that may be available for immune-related diseases. That was my experience with Jack's illness. For now, you're doing everything right.

I'm so sorry poor Gavin is ill. I know it's useless to tell you not to worry, I've been there myself. But try to have a positive outlook and know that we are all here to help in any way we can, even if it's just for moral support.

[Laurie, Fudge, and Vern]

Here is another one. Keep us updated about Gavin. I hope it is nothing.

 

There once was a dog named Gavin

A fever he did keep havin'

His mom was worried sick

That it could be a tick

But we are hoping she'll soon be laughin'

[Suzann, Rosey & Bandit]

many many hugs being sent to you and poor Gavin.  I have no similar experiences  but would be out of my mind with worry too.  It sounds like you are doing all the right things and unfortunately will have to wait it out a bit.  Keep us posted;:):)

[Allyson, Peri & Taquito]

No doodle really likes to be hot

It makes your playtimes shot

I know it will break

No need to fake

At least you know mom loves you a lot!

 

Keep us posted - thinking of you.  Let us know what the tests say...

 

 

[BG and Gavin]

Limerick therapy - you guys are great!

[Donna K & Quincy]

BG, We really hope Gavin is feeling better soon. The Nsaid brings down his fever which makes him feel better, if it is Lyme disease he will need a different antibiotic. If he is not feeling better in another day or so I would take him back to the vet and have him tested. The Nsaid may only be masking symptoms. Now I know I haven't made you feel one bit better but I am a big worrier and Fever of Unknown Origin is not a diagnosis I am willing to accept. If there's a fever there's a reason, they just have to find it.  Doodle hugs and kisses from myself and Quincy. Have you googled Lyme disease to see if the symptoms fit? If it's any comfort you now have me worrying with you.

[Karen, Jasper and Jackdoodle]

Ditto to everything Donna said.

 

[BG and Gavin]

Thanks Donna.  Good information.  The vet is committed and not giving up on finding the cause.  He basically said everything that you did to me.  With only 3 doses of the anti-biotics under his belt, if they were to erradicate whatever was ailing him, they would not have had time to work yet, thus the reappearance of the fever.  I looked up the symptoms of lymes and he questioned me extensively today about them (I now realize).  He felt Gav over for nearly 45 minutes on Sunday and could not find anything tender, stiff or swollen, including his glands.  Despite all the fur he said that Gavin does not have much to him so its easy to feel around and find things.