Hello again to all of you -long time no post
Some of you may or may not remember my previous posts about Vito -his immune mediated vasculitis,nose bleeds, demodex, cruciate problems.
General unwellness. After NUMEROUS financially crippling visits to my vet and TWO referrals to University Vet Hospital, we have a definitive diagnosis. Leishmaniasis.
To say I am devastated is the understatement of the millennium. We were at the UVHosp last July and we saw the specialist dermatologist who diagnosed immune mediated vasculitis - treatment plan was a long course of antibiotics and prednisolone. The pred has been on and off since.When we saw the dermatologist it was 4 months after a cruciate repair on both legs. They were not healing properly. The op had to be repeated, again on both legs. This was also unsuccessful,apparently due to the high dose of pred he was taking daily.
I am LIVID that the derm, knowing Vitos history and all the clinical signs, did not consider the possibility of Leishmaniasis and did not test for it. I understand that his symptoms are many, but after doing my own research, quite frankly there is nothing else it could possibly have been.
Fast forward to two months ago -Vitos knees creak very loudly, he is in pain, can hardly walk still on pred so I can't give him metacam, one leg is constantly held up, just a bloody nightmare. I had to wait for an appointment for the Uni and went last Monday where I saw the ortho vet -he took x-rays and Vito's knees are totally shot -bone on bone. Massive swelling around the joints. He aspirated some of the fluid and said he was testing for infection with a view to *flushing * the joints, said it would ease his pain a little. I was given Atopica and Tramadol for pain.
The following night he called me and gave me the diagnosis. Back up there the next day for more x-rays, skin biopsies, fluid from the rest of his joints need to be tested. He said that he had never come across a case of it before.It is the cause of each and every one of Vito's problems. Poly arthritis, skin lesions, muscle wasting at the temples, nosebleeds, everything.
I am honestly in total shock -I can hardly BELIEVE that this poor dog has been suffering for nearly TWO YEARS and it was all due to a bite from a sand fly. Even worse, that it was not picked up on by anyone until now.
I am trying to find out as much as I possibly can, I am in Ireland and the drugs used to treat it are actually not available here! I am waiting to hear back from UVHosp tomorrow for treatment plan.
i am so very sorry you are going through this...i have had really bad results from doctors ''practicing medicine'' myself, so it is unfortunately a pretty common phenomenon, not just a veterinarian thing.
what is the current prognosis? is this poor animal EVER going to have any actual QUALITY of life [by which i mean, happily running, playing, and so forth, not just ''controlled pain/symptoms''].
I'm sorry you and Vito have had such a struggle -- and hope you begin getting better results.
I've had problems with physicians and vets, too. I'm happy with my current internist (for me) and for Puff we go to Kansas State's CollVetMed Tchng Hospl where, I feel, we get great diagnostic and treatment services.
Puff [YF, AKC field line (from competing HT/FT breeder) 62 lbs, dob: 8-'01]
Bess [BF, AKC bench line (from competing show breeder) 55 lbs., 1967-1981] "Poor Bess, the Wonder Dog":
Thanks this whole journey has been a complete , total and utter nightmare.
I spoke to the vet again today and I now have to wait as it is the first documented case of it here in Ireland(only one other, but post mortem therefore untreated) and they have to obtain a special license in order to import the drugs he needs. I am so anxious it is unbearable.
The treatment plan is daily injections of a drug called Glucantime for 40 days(which more than likely I will have to administer) with combined Allopurinol tablets, probably for life . This will improve his clinical symptoms but the poly arthritis is obviously irreversible and his knees are screwed :'( :'( :'( :'( :'(
I know it is HIGHLY unlikely, but does anyone have any experience of this?? I only know that it is endemic in only certain parts of the U.S and I cannot find anyone else to talk to about it :'( :'(
I remember your original posts. All I can say is that I'm glad you at last have a diagnosis. Do you have any idea how Vito caught the disease? I would think, with it being so rare, that it's not an easy thing to catch. I hope all goes well (and quickly) with getting the medications he needs.
Won't someone please feed me!
I just wanted to say how sorry I am that he is in pain. I pray that you find something to help him.
"Each is a creature of Earth and is entitled to reside on it with dignity"
Thanks so much - I can only assume Vito was bitten by a sandfly between the ages of 5 and 11 months when we were living in Italy. He showed no sign of a bite, no scratching, swelling, NOTHING.When he was about 2 1/2 he had a small surgery to remove a fatty lump under his jaw -a few weeks after that we started with the hair loss, dandruff,sore ear tips and tail, anemia, nosebleeds, and a myriad of other symptoms. My vet obviously had NO idea what was going on and Vito was treated for demodex with no results.Originally Posted by mattgusmum
Then he ruptured both cruciates and had two ops, both unsuccessful. Very bad arthritis, skin sores,deformed claws, I could go on and on.
I appreciate that my own vet was stumped but I feel that the Hospital dermatologist, having all our history and the poor dog having a nosebleed in his presence,, should have considered the possibility and had him tested.Multiple skin biopsies were done and the diagnosis this time last year was immune mediated vasculitis, cause unknown.
I did question the vet I saw this time at the hospital, and his explanation was(I don't actually believe this) that the skin biopsies taken last year showed no evidence of leishmania as he had not yet started prednisolone therapy.I am still waiting on a call to tell me the drugs are available. I know that they will only resolve some of the problems -his joints(only the stifles thank god)are shot,I'm not sure yet whether they might improve the pain levels in his knees, the only option is a knee replacement, and it is not viable for dogs. I have to think very long and hard.
i realize you have a lot of financial, and more importantly, emotional investment in this animal.
however, IMO there comes a time when we, as responsible 'parents' need to look at things in a way that will hurt US. if this dog, after years of pain, [''unsuccessful surgery'' among other major things] is not going to ever be pain-free, i believe i personally would be seriously thinking about a merciful helping hand to the Rainbow Bridge.
i find the suffering of animals to be particularly hard to deal with because one cannot explain to them what is happening, most importantly, that there may be a brighter future to look forward to [as can be done in humans--the hope of 'better things'' can carry one through a multitude of hurt!].
i also feel that many times, an animal that is in pain feels somehow like it is being punished for some nebulous thing...how could they not?
i certainly do not think i know you or your dog's particular circumstances.
i DO know that with every single one of our dogs, [happily living into old age] we have felt, with hindsight, that we waited too long, their lives would have been better had we NOT waited 'just that little longer''...that we waited that longer time for US, not the dog.
At the moment he is on Tramadol for pain which seems to be working better than anything he had before and the pred has been reduced to 10mgs every other day in preparation for the treatment- I spoke to the vet again today -there is a possibility of a further surgery at least on one knee depending on how this drug treatment works -now is out of the question due to the high risk of infection as his immune system is very precarious. I will have to evaluate the benefit of another surgery.
Believe you me, I have fluctuated nearly daily from deciding its time, to not yet, and back again. I am emotionally exhausted from it all. I do know that if his pain can be controlled and he can enjoy being a dog, then I will go for it. If not, it will absolutely break my heart, but I just couldn't put him through any more. I would have to think very carefully about even another surgery. I can't hold on to him at any cost if it means he will have a miserable and sad life. I love him too much for that.
Well I have just spoken to the Hosptal Vet agin this evening and it is not good news -he feels it is unlikely that he will be able to obtain the special licence in order to import the drug that Vito needs -it is not readily available here as it is only ever used to treat Leishmaniasis, and it has not ever been treated here before. He is trying but it doesn't look good.And apparently it is the ONLY drug possible to treat it.
I just dont understand if it is readily available in the rest of Europe(where it is endemic in a good many countries) and the US why the Dept of Agriculture might deny the import. I feel I'm going mad!