Zac Update

Zac is still feeling fine, happy and bouncy and bored and wanting to get back to working and playing. He keeps breaking into "puppy fits" when i take him out, even though he's still on crate rest. The tick titer came in late last week and the lepto titer came back today. Both are negative so we can rule those out. I'm really glad it's not lepto. Now the dogs can get back to enjoying the pond at the farm without me fretting about it.

Numbers

Good news on Zac today - his liver enzymes are down a lot from last week. Normal ALT is 10-100. Zac started at 722 on 7/18, then 1320 on 7/19, 1923 (!) last thursday and now 502 today. We're moving in the right direction, yay!

Just Cuz...

Zac has decided that if i'm going to force him to be quiet and spend all of his time indoors, that it's a perfectly good time to enjoy a second puppyhood. And every good puppyhood needs a perfect toy. So, after lanquishing around the house for months with nothing to do and no one to love him, Good Cuz has now been adopted. Zac loves Cuz! He's a great friend for tossing around, he bounces in all kinds of interesting ways, and he's got those terrific feet with which to be carried. So far, Zac has not figured out that Cuz has an industrial sort of squeaker in there (thank you!), though i'm sure it's just a matter of time. If this keeps up, we may have to invest in a Bad Cuz too, cause they're pretty cute with the little horns.

We're just waiting on tomorrow to repeat some bloodwork and that lepto titer. Zac-boy seems to be feeling pretty good though. I'm planning to keep him on heavy duty activity restriction for another 2 weeks minimum though, to see if we can get that skip to go away. In the meantime, Zac LOVES Cuz!

Another Update

Just talked to the internist - he got Gael's lepto titer. We can't be completely sure but it doesn't look like she had lepto. It's one of those things where we could have ruled it in for sure if something had been sky high, but not being sky high, we can just say *probably* not since we don't have a paired test to compare against. That's good since i don't want this to be lepto. Zac's second titer is still the answer-maker on that. In the meantime, we'll keep treating as if it's lepto and keep waiting until we can repeat that test at the end of next week.

The internist still really feels it's some sort of toxin. If we do rule out lepto (keep fingers crossed!) and tick-borne stuff (another week before that comes in) then we may never know what it was, though i have a couple of out-there theories and will keep trying to puzzle that out. Unless Zac gets more ill or another dog comes up with a problem, i'd rather not cut anyone open to do a liver biopsy.

Zac and Working dogs

We repeated Zac's bloodwork today and his liver enzymes are higher than they were on saturday. We'll repeat them next week and hope they start coming down. His kidney values are still fine. And he's feeling good, bouncing around playing with toys in the house. We're still waiting on his tick titer and Gael's lepto titer, neither came back today. I talked to the internist for a long time today about some different things and he's going to try to get up with a liver expert to discuss the cases. He still thinks it feels like some sort of toxin but we're still treating it like lepto.

It was such a gorgeous evening, i just had to work dogs a little bit. Billy was wonderful and put a big smile on my face. He's going to be a very good outrunner, checks in and casts perfectly. I sent him up the hill and he did a beautiful job. He seems to more or less know his flanks already. I also tried splitting the sheep and calling him through again and he was much better this time, way more enthusiastic about coming through than last time and he enjoyed holding the groups apart. We even did a bit of driving. He's a good little man and enjoys working *with* me. His 1st birthday was monday and now he's all grown up! Okay, maybe not, but he does seem to be maturing a bit. I feel like i've hardly even started training him since we just go out here and there and do a little work, but he seems to be coming along and getting trained somehow. It was like that with Jet too and Billy reminds me quite a bit of her in his work. There are worse dogs to take after, that's for sure! I finally have a recent picture of him to post. Every other one i've posted of him was 6 or more months old. I really like this one from last week.

Zac/Gael Update

Zac is feeling just fine though he's getting pretty bored. I'm limiting his contact with the other dogs somewhat, and he's not allowed to go out in the backyard to hang out for a while longer. I don't want the other dogs exposed to his urine since we don't know if he might have lepto, so he just gets quick trips out in the front yard for potty breaks. I already had him on restricted activity, trying to give his leg a real good rest, so i'm just going to go ahead and keep him very quiet for another 2-3 weeks and see if his leg ends up improving.

As for what the heck has caused his liver enzymes to shoot up, well, that's just not very clear. We're still waiting on test results and hopefully some answers will be found but it's a really complicated picture. It could end up being lepto, though he had been on a pretty high dose of dozycycline for 5 days when he got ill and doxy is usually what you use to ward off a lepto infection, and you would expect more actual symptoms with lepto. It could end up being a tick borne disease, but his blood work was normal. No clear picture emerges from the history and the lab work, that's for sure. The lepto titer came back yesterday but we need to repeat it in a week or two in order to interpret it - the changes in antibody titers (if they change) could provide an answer. The tick titer is still out but will hopefully be back by friday. I've also run across some (mostly anecdotal) evidence that doxycycline can elevate liver enzymes but that doesn't explain the severe dehydration and peeing problem. Yes, it's a very tangled web but hopefully with some time it can be sorted out. In the meantime, i'll be very careful about keeping his urine away from other dogs and cautious about potential sources of the initial infection.

In some good news, Gael's liver enzymes were measured yesterday and all is back to normal there! I had a lepto titer run on her as well, to see if her antibody levels are high, which would be some evidence that she had lepto. I wish titers had been run when she was sick but the internist didn't feel it was necessary. Apparently he didn't know how much i HATE a mystery. I had this lepto titer drawn in hopes it'll add another piece to the puzzle. It should be back in the next day or two.

Anyway, that's where we are now. No real answers but we're approaching this as if it's lepto, just to safe. And talk about lightning striking twice - what are the odds on 2 vaccinated dogs, one of them 5 days into a course of doxycycline, picking up lepto in 2 different states (probably) and presenting with non-typical symptoms and bloodwork?

Lightning...

....apparently does strike twice sometimes. Zac's been hooked up to an IV most of the time since friday morning with something that looks remarkably like whatever it was Gael had in mid-May. I noticed thursday evening that he was acting funny when he'd pee. He'd hike his leg like normal but when he tried to walk away from peeing, he'd hunch over with his tail hanging down and keep peeing, like he couldn't stop when he wanted, and his stream was kind of weak and dribbling. I called the vet and dropped him off friday morning, expecting to hear back that he had a UTI of some sort, something along those lines. Instead they called and said his ALT liver enzymes were very, very high, his urine specific gravity very low, and that he was severely dehydrated. They started IV fluids and IV antibiotics and sent out for a lepto titer and to culture his urine. I picked him up in the afternoon and dropped him off at the emergency vet to continue the fluids and antibiotics and to monitor him, and they sent off for a tick titer. He came home this afternoon and feels fine - he's felt just fine the whole time actually. Hopefully the titers will come back quickly and we can start getting some answers on what this is. I ran the other 4 dogs by the vet saturday to check liver and kidney values and they're all normal, and hopefully will stay that way. I just hope we can solve this mystery. Zac is now on the same feeding and supplement protocol Gael was on, and i'll talk to the vet tomorrow about the plan for monitoring him.

Keep an eye on your dogs, especially keep an eye on any increase in drinking and peeing. That was the first sign anything was wrong with Gael and Zac both, and the liver values were really high without either feeling bad at all. I didn't act as quickly as i probably should have with Gael since it was such a sneaky thing. I think i caught Zac pretty early.

Gael update

I took Gael in for her repeat bloodwork today and it looks good! Her alkaline phosphatase is still elevated at 589 (was over 6000 to start, then 4500, and 1542 two weeks ago) but everything else is back to normal. She'll stay on the liver support kibble, Sam-E, milk thistle and Actigall, and we'll do another blood draw in a month. Good news!

Now to put her on a diet. All the good spoiling she's been getting has made her fat. :-)

Latest Gael Lab tests

Good news! I just got the numbers on Gael as of this morning and her alkaline phosphatase is now 1542 (was over 6000 to start, then 4500 last week) and her ALT is now 463 (was 1528 to start, 1428 last week) and REALLY good news is her bilirubin is back in the normal range. So, she's still pretty high on the enzymes but they're moving in the right direction, YAY!!!! She'll stay on the drug and supplement regimen she's on and we'll test her again in 2 weeks. She feels really good and was practically bouncing off the walls last night. Whew!!!!

To celebrate, she and i went and test drove this (Gael looked extremely stylish in the back seat):

Another Gael update

I finally talked to the internal medicine specialist and thought i'd update everyone. We're still in wait-and-see mode but he was glad to see the enzymes coming down, though he'd rather they moved more quickly. Those enzymes have a pretty short half life so could drop very quickly - disappointing that they didn't drop more significantly (but they did drop). Also, Gael's bilirubin is back up a little, which is concerning as well. It started at 4.3, then dropped to normal, then went back to 1.1 and tuesday was at 1.5 (.9 is the top of the normal range). The good news is that she still feels good. I'm picking up a medication today that might or might not help (Actigall), and we'll repeat the blood work on tuesday. If the numbers aren't dropping we'll have to consider getting more aggressive and doing a surgical biopsy. Unfortunately, Gael's not the best candidate for surgery with compromised liver function - the liver needs to be able to handle clearing the anesthetic agents from her body.

So that's the latest...

Gael update

Here's the latest update on Gael --

I ran Gael by the emergency vet this morning for a
blood draw and the lab tech called later - the liver
enzymes have gone down a bit.  They're still in really
scary territory but going in the right direction. 
Alkaline phosphatase was 5888 thursday and is 4500
now ("high" is 200).  ALT was 1528 and is 1424 now. 
I'll talk to the internal medicine specialist on
wednesday or thursday about what the next steps are
but i suspect he'll suggest waiting and monitoring
her levels for a while, especially since she feels
okay.  She's getting very spoiled with all the
special treatment and attention (but she's worth it!).

Roller coasters

Well, the Shoofly Gang roller coaster continues. I noticed Monday after we got home from the Bluegrass that Gael seemed a little off. By the evening she was obviously feeling bad, lethargic and not wanting to move around much, gums pale with a tinge of yellow to them, a slight fever and then she refused most of her dinner. I was on the phone first thing tuesday morning with the vet and had her in the office when they opened. She was jaundiced and dehydrated, and they started fluids right away and began trying to figure out what was wrong. Her liver enzymes were literally "off the scale" - the number for her alkaline phosphatase was so high that the machine in the vet's office wouldn't read that high and the blood had to go to another lab. A usual high reading might be something like 200 and Gael's was over 6000. Most of her other lab values were okay, white and red counts normal, etc, just the liver enzymes completely out of whack and she was pretty dehydrated. She spent the day at the regular vet, then i took her to the emergency vet office for overnight care and she stayed there until late wednesday evening. She was feeling a little better after aggressive fluid therapy and antibiotics, her fever was gone and the jaundice cleared up, so she got to come home and sleep curled up in the bed with me. She spent thursday back at the emergency vet getting more IV antibiotics and fluid therapy, an ultrasound (everything looked normal) and having pre- and post-meal bile acid tests (sent out for results). She was feeling pretty normal, bouncy and happy and yapping at the folks at the vet's office. The internal medicine specialist who was running the case felt like she was doing well enough to take on the trip to Dr Ben's trial this weekend, though i wasn't convinced until friday morning, when she seemed to be her normal self and was tossing toys at me. Since there are hookups at this trial site and i knew Gael could hang out in a nice air conditioned camper all weekend, i decided to head on out, with plans to come right back home if she had any sign of not feeling well. About 3.5 hours into the 4 hour drive the internist called with the results of the bile acid tests and the numbers were scary high, as the enzymes had been. Normal pre-fasting on the bile acids test is < 10 and Gael was a 58. Normal post-fasting should be under 20 and Gael was well over 200. The internist said he'd only seen such high values on the enzymes and bile acids test once or twice in his career. He also really didn't know what the heck was going on, said she should be feeling pretty lousy, etc. with those numbers. I was really devastated at this news - i just knew those results would come back okay, or if not okay at least not horrible. I wished i'd gotten the news sooner and had stayed home with Gael, but since we were so close and had already dealt with the horrible holiday traffic, we went on to the trial with the same original plan. And Gael did fine, was perfectly happy sleeping curled up on my lap (or my pillow when i was out of the camper) in the A/C. We took naps between runs and even managed to play a little fetch in the camper and she was happy and upbeat, feeling fine. The current medical plan is to repeat the bloodwork tomorrow and hope the enzymes are coming down, deciding what to do from there, either wait and see if she gets better or needs a surgical biopsy or what. She feels fine, was just sleeping curled up next to me here on the couch and is now rolling around on the floor scratching her back happily. Please keep her in your thoughts and prayers and hope for those numbers to start down.

The NC State Trial at Ben and Emily Ousley's was pretty okay. I was distracted saturday, really just popping out to run the dogs and then back to the camper and Gael. The Open dogs and i didn't exactly burn up the trial field. Both ran decent but we couldn't seem to finish out a run for a good score. Sunday was much better in terms of being more focused. Spottie had a terrible run, missed everything. I can't really blame her with all the distraction of the last few days. Her group of sheep ran and ran. It was actually kind of funny even, how "not her day" the run was. I guess she gets to have a bad one now and again. :-) Zac had a really pretty run, very clean, finishing with a 91 and second place out of about 60 dogs. It's too bad saturday was so off, since he ended up only a couple of points out of the double lift finals. Moss ran Nursery friday evening and ran out the full Open length outrun very nicely, one of only a couple of the Nursery dogs to get out without much trouble. Unfortunately one of the 4 sheep doubled back just after the lift and he only brought 3 down the field, but he did it well. Sunday morning's Nursery run was decent as well, nice enough outrun with one redirect, and then i got some course training in with him as he wasn't flanking far enough to really turn the sheep online when asked on the fetch. His drive out was good, then the sheep bolted on the crossdrive, and then on his return leg he gave me that flank i'd schooled. The score wasn't anything but it was good to see him pick up that improved flank. I decided to go ahead and move him up to Ranch instead of running him in ProNovice since he was handling Nursery well enough. I was very, very pleased with his Ranch run. Again it wasn't very high scoring but the pieces are starting to come together. He had a beautiful fetch, giving good pace and flanking far enough to keep the sheep online, his nicest fetch at a trial yet. His drive away was really pretty as well - i got him to pace down more than i've been asking and he really had great contact and hold on his sheep. It was quite pretty in parts and very encouraging for the future.

So that's the latest on us here at Shoofly. Gael and i will be off to the vet first thing tomorrow, hoping for good news.