1.5 year old collie with lethargy

RE: 1.5 year old collie with lethargy

Beats — Fri, 21 Jan 2022 23:03:48 GMT

When increased to half a 60mg pyridostigmine (TEVA) twice a day was thought to be significantly improved, and at three-quarters of 60mg pyridostigmine (TEVA) twice a day is vastly improved and running around forests again etc. Sometimes still falls down on front legs and trips, and also increased frequency of urination has been noted, but no other side effects. Holding this dose for another couple of weeks, then might consider giving full 60mg tablet twice daily to see effect.

RE: 1.5 year old collie with lethargy

Julian Earl — Sun, 09 Jan 2022 13:41:19 GMT

The blood test is useful. No report of anisocytosis and Auto-immune Haemolytic Anaemia? This was my first thought on reading about ayoung to middle-aged lethargic order Collie. It seems to prefer his breed IME! Repeating the blood specifically to get this double-checked might be worthwhile? I have known cases only detected at a second haematological examination...

RE: 1.5 year old collie with lethargy

Beats — Sun, 19 Dec 2021 23:22:34 GMT

Negative ACh rec antibodies make MG much less likely, but don't exclude it entirely. I've started on a trial of pyridostigmine 60mg (TEVA) quarter of tablet twice daily as other than the negative test result it looks like a MG dog to me. (further reading: https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.16223 "While seronegative MG occurs in approximately 2% of dogs with the generalized form, false-positive results are rare.⁸ "; where "8" self-references to a review article from 2002 by the same author, who runs the lab doing the test)

CK = normal, T4 = normal, CRP=normal

Haven't done neospora or toxo titres (nor angiostrongylus serology).

Can do nothing at all conscious.

DNA test for sensory neuropathy pending, but does not look typical.

If not getting anywhere over next 3 weeks with increasing-dose pyridostigmine trial, then think maybe muscle and nerve biopsies (+/- repeating the ACh rec antibodies and suggested infectious disease serologies) next step.

RE: 1.5 year old collie with lethargy

Utlendigur — Sun, 19 Dec 2021 23:03:57 GMT

Video looks like a possible neuromuscular problem which would fit with the megoesophagus. Does the negative ACh rec antibodies completely rule out myasthenia? Creatine kinase to see if possible polymyositis, Neospora &Toxoplasmosis titres? T4 and cTSH for completeness. If aggressive it's probably not going to be possible to measure post exercise lactate or temperature, or check reflexes...

RE: 1.5 year old collie with lethargy

Beats — Sun, 19 Dec 2021 20:27:02 GMT

I think there is air in the esophagus. A conscious radiograph to confirm not a result of sedation will not be possible in this patient. On GA'ing and putting the endoscope down straight after the xrays the distal esophagus looked ballooned out to me. Feeding from height with tinned food, and exercising before feeding/giving water, has largely fixed coughing and pools of froth.

I've annotated where I think the esophageal walls maybe run on the last of the laterals.

RE: 1.5 year old collie with lethargy

Beats — Sun, 19 Dec 2021 17:33:26 GMT

pitch of bark has changed on questioning.

Ach Rec Antibodies negative.

General progression and worsening of signs, but day-to-day can vary quite a bit. 2 days ago wouldn't get out of bed was worst yet. Owner description not clear on whether worsens with exercise or not, but on taking to park for 20mins and observing did seem to tire noticeably as went (jaw dropping and wanting to lie down more).

RE: 1.5 year old collie with lethargy

Clive Ansell — Sun, 19 Dec 2021 14:48:25 GMT

Maybe worth testing for Angiostrongylus? serum or faecal flotation.

RE: 1.5 year old collie with lethargy

Allison Gleadhill — Sun, 19 Dec 2021 13:20:58 GMT

Myasthenia? Any change in pitch of bark? Can you exacerbate it by exercise. Could be worse the blood test.

there is also a border collie movement disorder. called descriptively border collie collapse syndrome which would also be made worse by exercise. Videos on line to compare it to.

RE: 1.5 year old collie with lethargy

Beats — Sun, 19 Dec 2021 11:48:31 GMT

RE: 1.5 year old collie with lethargy

Beats — Sun, 19 Dec 2021 11:17:03 GMT

[quote userid="8958" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30122/1-5-year-old-collie-with-lethargy/234581#234581"]Addisons[/quote][quote userid="8958" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30122/1-5-year-old-collie-with-lethargy/234581#234581"]Addisons[/quote]

Cortisol high enough to rule it out. Any other blood tests in specific you are interested in?

RE: 1.5 year old collie with lethargy

Neil Wheadon — Sun, 19 Dec 2021 10:58:24 GMT

I tend to look at radiographs as much ruling stuff out than in

The primary issue seems to be the cough? and it's a young dog.

1) Chest

The heart is normal on both views. The top radiograph is on inspiration so that helps

This leads to lung fields. The cranial fields look fine. The caudal look OK, but when you blow them up it's a bit fuzzy so tough to tell. There is an area of consolidation running caudally on the RHS.

Looking at the laterals there is almost hint of a megoesophagus line dorsally but not on the others

2) Neck/stumbling

These are always hard, but need to be centred on the vertebrae, so can't tell with these

3) Artifact

You've got horizontal banding on most of the plates

In conclusion this negates the heart, but I'd be looking at the lungs. Suggest blood sample including a biochemistry and try to get a sputum sample or even BAL. (I'm obsessed but never negate Addisons)

Neil

RE: 1.5 year old collie with lethargy

Julian Earl — Sun, 19 Dec 2021 09:01:01 GMT

[quote userid="12930" url="~/001/veterinary-clinical/small-animal/f/misc-clinical-discussions/30122/1-5-year-old-collie-with-lethargy/234578#234578"]The dog is unexaminably aggressive if try to do anything to it. No obvious neck pain observed though when moving free[/quote]

Thanks. The lack ofapparent paincould be good news though itmight explain the aggression? Good luck. Re-x-ray with contrast media in the spine? I have always been keen on identifying neck-pain in dogs! Seriously painful sometimes and Very difficult to diagnose a specific cause sometimes! Trial therapy with NSAIs perhaps. Might be a pointer if the dog responds?

Thanks for those radiographs by the way as well!

RE: 1.5 year old collie with lethargy

Beats — Sun, 19 Dec 2021 08:40:08 GMT

Sedated with high dose medetomidine/butorphanol.

RE: 1.5 year old collie with lethargy

Beats — Sun, 19 Dec 2021 07:36:30 GMT

The dog is unexaminably aggressive if try to do anything to it. No obvious neck pain observed though when moving freely.

RE: 1.5 year old collie with lethargy

Julian Earl — Sun, 19 Dec 2021 05:32:57 GMT

Any apparent neck pain, especially caudally?

RE: 1.5 year old collie with lethargy

Beats — Sat, 18 Dec 2021 19:52:11 GMT

no heart murmur. knuckles over on front legs sometimes and generally slow for a young collie and jaw drops as exercises and pants. video is not great anyway.

B12 level is healthy, not anemic.

RE: 1.5 year old collie with lethargy

Lucy Fleming — Sat, 18 Dec 2021 19:50:31 GMT

I can't make the video play, but any heart murmur?

What's that strange genetic B12 deficiency Border collies can get?