Pancho is ill: please HELP!

Hi everybody,

Pancho is a 1.5 y/o Jack Russell Terrier. He's been vaccinated when he was a puppy with Nobivac DHPPi and Nobivac Lepto 2. He never had any particular health complaints a part for a ring worm infection (treated, but left a rounded scar on his front leg) and a minor infection which solved itself quickly with some generic antibiotics.

His diet should be pretty good: we cook for him every 4-5 days mainly brown rice or brown pasta mixed with cooked meat (chicken or beef) and plenty of vegs, both cooked and row. Sometimes we put some olive oil and primrose oil in his food. He also took some pro/pre-biotics on and off. His treats are dry sausages.

He has always been a very active, muscular dog. He gets plenty of activity and he's very bright. He goes hunting for bunnies and foxes and other animals in the bushes in Scotland. He's very sociable and of good nature.

About 10 days ago we notice he's not the usual himself. First thing we notice he shakes. A visible tremor occurs, looks like it happens when he inhales. He's becomes quieter and quieter, he doesn't want to go out when normally he always wants to shoot outside the door. Sometimes he asks to go out but when out he just either sits just outside the door or he wants to come back home straight away. He seems to pee and poo normally, but we noticed that when he lifts his leg he's unstable in his balance. At home he doesn't seem to follow his usual rest/activity patterns. He sits on the floor looking numb and he lays down, but he doesn't really go to sleep in his bed.

His appetite is 40-50% than normal. He drinks water, maybe a little bit more than normal.

We take him to the vet and she finds his temperature to be really high. She finds his glands swollen. She gives him an injection of generic antibiotic and anti-inflammatory and she asks us to continue with antibiotics at home and to keep an eye on him. On that evening he seems to be a little bit more active and brighter, he takes a small walk and he seems to be more bouncy and energetic.

Overnight same story. He doesn't come to bed with us as usual and he seems just to stay there, awake, looking at us from the floor. He wakes us up around 4am moaning but after a while he quiets down again. He's still shaking.

The day after we take him back to the vet and she decides to take blood and urine samples. She injects him with more antibiotic. She takes x-rays of abdomen and chest. The results don't show anything abnormal and she decides to refer us to the hospital vet. Once there a deeper, full examination and more tests are performed, including a neurological test. They confirm the swollen glands and he seems to have some complaints fully bending his neck downward, left and right. The blood test results show a worrying low level of platelets, to the extent that they are near to zero and spontaneous internal bleeding is feared. He doesn't show any signs of internal or external bleeding. They ask us to leave him there for observation and to get more tests done.

It's 4 days he's there. They phone us everyday updating us on the situation. Pancho seems to be quite bright and active, but once back indoor he quiets down, shakes and literally sleeps on his feet, even if it appears to happen with less intensity than before. He eats plenty.

They took a sample from his glands and the results are negative.

They put him from day 1 on a different, more specific antibiotic as they suspect a systemic infection.

The platelets are still near to zero and they don't show any sign of improvement.

Tomorrow or after tomorrow they should receive the results for the bug culture (I apologise for my poor terminology) to see if it's the case of a bacterial infection.

They might want to send us to the vet hospital in Glasgow to perform him some deeper neurological tests.

Reading a little on the internet I came across thrombocytopenia as a possibility.

I'm posting here to hope some owner or vet can give me their opinion based on a similar experience or specific knowledge.

Please help. We're experiencing some dreadful time and we're dead worried.

This is a photo of Pancho:
http://paquito.my-expressions.com/ar...0756206/328335

He's our special one.

Many thanks
Paolo

How worrying for you, I really hope that he picks up and they find the cause for you.

Oh you poor thing, you must be so very, very worried about little Pancho, but he's in good, safe hands, they'll do their very best for him I'm sure.

I'm no vet, but having read all those symptoms it would point to something neurological, even though those platelets are still zero. All I know is, when the white count is very high, then that means a severe infection, but you don't seem to have that, you have a zero count of platelets and I really don't know what that could point to, you'll have to leave that side of it up to your vets, because if you start searching and stabbing at different ailments, you could drive yourself nuts, I know, I've done that myself, and you've got enough worries on your plate.

I think the best thing you can do is to think back, deep and hard, think about the time this first started happening, where you went on a walk, or what could have happened to him, what could he have eaten, did he disappear into the bushes on a certain afternoon and seem to act differently that same night? Think hard about that side of things, and you might just come up with an incident that could have caused this sudden change in him and it could help out the vets, because just like you, they must be quite mystified themselves after having done so many tests and are still none the wiser.

Good luck, I'll have everything crossed for you that they can at least come up with a diagnosis which they can treat, and in the meantime, just think back and see what you can remember.

Hi Paolo, I'm so sorry that Pancho is so ill. He's a little darling! So cute! I'm not a vet but I am a vet nurse and it sounds like Pancho is in the best hands right now and they are doing everything to try and figure this out.

I think you are right on with Thrombocytapenia as a source of his low platelets. The question is, what it? Usually its caused by an autoimmune reaction, which means his body is literally attacking itself. Autoimmune responses can be caused by anything from vaccines, to onion ingestion to just a fluke of nature. Unfortunatly it can happen to any dog of any age or health status.

What is his hematocrit? White cell count? Any bruising anywhere on his body?

I don't know what protocol is in the UK, but typically IMT (Immune mediated thrombocytopenia) is treated with platelet transfusion where needed, whole blood transfusion in the face of a low hematocrit with low platelets. Antibiotics and steroids or immune suppressants. The antibiotic most commonly used here is Doxycycline. Then we would use Prenisone, or Immuran, or something similar to suppress the immune response.

The thing with auto immune disorders is they are likely to re-occur even if they appear cured on the outset unfortunately.

This is all purely speculation of course, based on what you've told us.

I really hope the vets get to the bottom of Panchos problems ASAP and he gets better and is home chasing rabbits again soon!

Wishing Pancho a speedy recovery and that he is soon home chasing rabbits and enjoying his life again xx

Hello and thank you very much for your kind opinion.

What you've described is certainly a strong possibility at this stage. Today we should get the test results from the lab to see if it's a systemic infection caused by a bug.

If the results will be negative I think we've narrowed down quite a lot the possibilities and surely we're going toward the diagnosis of Thrombocytapenia.

I'll keep you posted. Thank you so much

paolo

Hi,

so sorry to hear about your troubles!!!

Have you thought of contacting your breeders to see if they have any experience with this in their line? Just to rule out a genetic problem..... May be worth a shot...

good luck!

So sorry to hear about Pancho.I can offer no advice I'm sorry to say but can wish him a speedy recovery

Yes I did it, I'm just waiting for a reply.

Good advice thanks.

Hello,

Pancho is back home and he's well!

We had a phone call from the hospital saying that his platelets count is increasing, still very low but increasing. IT was 14 when normal range is 200-500, no it's 44. On Thursday he's going to have new tests to monitor this.

He looks so much better, full of life and very bright. He doesn't shake anymore and he doesn't sleep on his feet anymore either.

They are still waiting for the results to see if it was a tick born infection or something else. They told us they're seeing an increasing number of these cases in the Edinburgh area but they don't know the cause.

He responded well to the antibiotic Ronaxan.

You can imagine how happy we are.

I'd like to thank everybody here, it has been an amazing support in these horrible days. Please don't refrain from contacting me if in need of more info about his condition.

Cheers
Paolo