<p>Last Wednesday, my otherwise healthy 5 year old yellow Lab woke up hobbling around on 3 legs. I brought her into the vet, they drew some blood and she was diagnosed with Lyme disease. She was put on Doxycycline and Rimadyl, and after a day or so, seemed to be feeling much better. The bloodwork also shows a low Albumin level, so the vet asked that we bring in a urine sample the next day so they could check her kidney function. </p>
<p>The vet called this morning with the news that she thinks my dog has Lyme Nephritis. Her urine sample shows significant amounts of protein. I’m googling it and getting sadder and sadder by the minute. This does not sound good. I’m in absolute shock.</p>
<p>I have to bring her in this afternoon to have her blood pressure checked and plan to have (another) long talk with the vet about the treatment, and about the prognosis, both short- and long- term.</p>
<p>Dog experts - what else should I ask about? Specific things? Can anyone tell me about a successful outcome you’ve had with this diagnosis? </p>
<p>Please, I beg you, for now, I don’t need to hear about bad outcomes. I KNOW what might be in store. But I sure could use some positive thoughts or some good news.</p>
<p>JustAMom, I’m so sorry to hear about your dog and I don’t have any knowledge about this particular disease. I will say, though, that one of our dogs suddenly became ill one day and ended up in the ICU for a week, with a very poor prognosis. Every one of the vets at the specialty hospital gave us the worst case scenario. But alas! Our doggy was one of the fortunate ones, who beat the odds and now, almost a year and a half later, she’s doing well. She had hemolytic anemia and I did the same as you, searching the internet and making myself so crazy and sad. I share just so you know that even with a dire prognosis, there’s still the possibility of a good outcome. Hugs to you and your pup and good thoughts across the miles.</p>
<p>JustAMom, I don’t have any expertise to offer, but I do want to offer my sympathies, and my hope that your dog will recover. I have found (most recently when I panicked after accidentally serving my sons raw shrimp) that searching the internet yields much information on the most awful possible outcomes with no perspective on probabilities. I got the right information by calling the pediatrician’s office and speaking to a very knowledgable nurse, who told me to stay off the internet. Wait until you see your vet this afternoon.</p>
<p>Just a mom, so sorry to hear about your “baby”. You have some good things on your side, her age and the fact that she was not showing symptoms of renal failure. Stop researching at this point, it is a lot to take in. Try to take someone with you to take notes when you meet with the vet. They may order further tests, (ultrasound, X-ray and possibly a biopsy). Don’t be upset if they order IV’s or other meds and a diet low in phosphorous. Will be thinking of you and your family, best of luck.</p>
<p>The vet mentioned the possibility of doing an “ultrasound guided biopsy” when we spoke this morning. I hesitate because 1) the nearest place that does it is in New Haven, an hour and a half away, 2) the results wouldn’t be available for 3 weeks and therapy would need to start right away 3) her history suggests that it wouldn’t be anything BUT Lyme Nephritis. I can choose to do it if we want to, but I’m not sure how it would be valuable. Thoughts?</p>
<p>As I understand it, the therapy would consist of Doxycycline (which she started last wednesday), Omega-3 fish oil in pretty high doses, a low dose of aspirin, and immunosupressants (ie, steroids). That’ll begin as soon as possible.</p>
<p>Justamom, if the results are not going available for three weeks and the disease can progress rapidly without immediate treatment, I would seriously question the value of the diagnostic procedure. I would also begin the therapy right away, since it is the only viable option, IMO. When our cat got deathly ill, Mr B took her to the vet. The vet said that her illness could be caused by a virus (no treatment options, just prayers that her immune system would win) or a bacteria (antibiotics, $40). The tests cost $500 with the results coming in one week. It was no brainer to skip the tests and start the kitty on antibiotics to see if it would help (and yes, it did and the cat is purring on my lap as we speak). Hugs to you and your furry kiddo.</p>
<p>BB, that was my thought as well. They would begin the therapy immediately anyhow, regardless of our decision on the test. So I don’t really see the value doing in, only to get the results 3 weeks down the road (and, it’s around $1200).</p>
<p>I asked DIL who is a vet and she asked if your vet had given either 1. non-specific ELISA test or 2. C6 Antibody test.? In ELISA, it is very sensitive and cannot determine a response against a “live” case or response against the vaccine. Has your dog at anytime received the Lyme disease vaccination?</p>
<p>The c6 test can only be used in active infection, but it sounds like if that is what your pooch has, this test would be effective.</p>
<p>Did they ever find a tick or did you ever find a tick in last few months? She also added that with the protein high urine the vet my recommend a low protein diet and ACE inhibitor. (I have not idea what that is. Just copying an instant message…lol)</p>
<p>Edited to add that she did recommend that your dog get the vaccine even if she is Lyme positive. Natural response to Lyme cannot always fight it off like vaccine protection provides.</p>
<p>She had not been vaccinated for several years. (No lectures, please, I feel guilty enough already, although the vet says that I should not).</p>
<p>I had not found any ticks on her this year until Wednesday night when I was applying ice to her sore leg, I found a little one (ie, a deer tick) on her back. So I don’t have much doubt on the Lyme diagnosis.</p>
<p>They did a “Protein creatinine” test, I am not sure of what specific measurement she was talking about this morning, but some measure of protein loss in her urine that is supposed to be less than .1…hers was 9.4. </p>
<p>I will ask about the ACE inhibitor. I don’t know what it is either, but have seen it referenced many times on the internet (which I am trying my hardest to stay away from for the rest of the afternoon, except for CC)</p>
<p>JustaMom, I’m sorry about your girl. My mother’s dog developed Lyme disease but lived for several years after diagnosis. In our experience, an ACE inhibitor will be given to control blood pressure; high blood pressure and heart issues can often accompany the kidney failure. From what you’ve described, it sounds as if the diagnosis is definitive; I would not put my dog through the biopsy either. </p>
<p>Let us know how things go. This can be managed and I hope things look a bit brighter after this afternoon’s visit. Stay away from the internet! Your vet is your resource.</p>
<p>One of my retrievers started limping one day. The next day she was losing the other back leg. My vet was on vacation and I ran this dog around to 3 vets before I finally got a Lyme diagnosis. She was dying and quickly.</p>
<p>They treated the Lyme with major antibiotics and she was better. The vet said that the Lyme symptoms might come back in the same way. She was on antibiotics quite often.</p>
<p>The good part was she lived a long time after this and she lived to 16.</p>
<p>No guilt whatsoever about the vaccines, it just changes what tests can help or not. Like I stated the ELISA would do not good because it can’t separate antibodies from the shot versus the actual virus.</p>
<p>The Western Blot may also be advised. One reason for the biopsy is that there may be a concurrent organism and would require a different antibiotic.</p>
<p>Spent a good 45 minutes with the vet this afternoon. She took a BP reading which read high…but it’s hard to tell how much of that is due to all the excitement of a trip to the vet. We (H went too) didn’t get a lot of answers…unfortunately, I don’t think there ARE a lot of answers. Just start with the therapy and re-test in a week or so to see how she’s responding. Her treatment will include Doxycycline, Prednisone & Immuran (2 immunosupressants/steroids), Enalapil (to lower the BP), a high dose of Omega3 Fish Oil, and a small dose of baby aspirin. A low-protein special kidney food. And we’ll have her re-checked in a week to see if the protein levels have done what they need to do. She mentioned having an ultrasound performed on her abdomen (not a biopsy, just an ultrasound), just to rule out other things that would present there, that would call for a different treatment. We haven’t decided on whether or not to do that. It’s $450+. </p>
<p>In the meantime, it’s so frustrating because she is acting normally - walking, running, playing, like nothing’s wrong. Except that she’s not very hungry. She’ll eat maybe half a meal then lose interest. So how to I gauge whether or not she’s improving? I really can’t. I’ll just do what the vet wants, and cross my fingers… :(</p>
<p>In case your vet didn’t mention it (our vet did not), some of the common side effects of prednisone (which our pup experienced) are an increase in hunger, thirst, poop and urination (might need more frequent trips outside). YMMV, but I just wanted to share this, as it might be hard to know whether to attribute an increase in appetite to the pred. or overall improvement. </p>
<p>^^Yes, so true! Our furry girl is still on steroids after a year and a half and it definitely affects her appetite. Not fun, but it’s the price for still being here. </p>
<p>I’m sure your vet has also told you that once on steroids, the dog must be weaned off them and not to stop them suddenly.</p>
<p>Yes thanks all for the steroid warnings. We will discuss weaning off after a week (she’ll need to be weaned of BOTH the immunosupressants), and the vet’s discussed the potential side effects with us. Our earlier labs were prone to ear infections which we’d need to use pred to get under control so we’re sort of familiar to those effects. In this case the benefits greatly outweigh the risks.</p>
<p>Guess I’ll need to get a neighbor kid to let her out while we’re at work…</p>
<p>One of ours presented the same way and was diagnosed with Lyme a few years back. I let her out one morning and she hobbled then just fell over and couldn’t get herself back up. Scared the life out of me. She immediately went on Doxycycline, Prednisone and I think one other that I can’t remember. She responded pretty quickly and has been fine ever since. I believe the course of medication lasted several weeks, even after she appeared symptom free. I’ll keep a good thought!</p>
<p>We decided to go ahead with the ultrasound, there is an internist that will do it tomorrow. They really want to rule out everything they can before getting her on all those strong immunosupressants. Hoping for the best.</p>
<p>In the meantime, that bad little dog is acting like nothing’s wrong. Except she’s not too hungry.</p>
<p>My dog has had to be on steroids for skin issues. Everytime he goes on them he is excessively thirsty, needs to go out at night, inncontinent and has issues voiding, takes forever and goes in dribs and drabs. It resolves after he goes off them. We learned to not give him excessive water.</p>
