Ataxic, inappetant GSD.

Re: Ataxic, inappetant GSD.

ms1083 — Sun, 11 Jul 2010 10:00:14 GMT

would bile acid stim test help- or just fasting bile if cant get to eat? any chance of hepatic encephalopathy.

Re: Ataxic, inappetant GSD.

Michael Macfarlane — Thu, 08 Jul 2010 23:20:16 GMT

thanks for replying.

protein was 42 and pyrexia has never been a feature. dex was given on tuesay, and no improvement was seen until friday, we assumed that the gap was too long to be a steroid related response. is that a reasonable assumption?

currently he is deteriorating neurologically, still inappetant and with a mildly elevated bun and creat.... interestingly, he was painful on neck manipulation for the first time today.

will ring the pathologist tomorrow.

thanks again, and to the above posters also!

Re: Ataxic, inappetant GSD.

Ian Battersby — Thu, 08 Jul 2010 09:47:37 GMT

Hi Micheal

I would be inclined at the moment to consider that the renal and CNS disease may be seperate entities.

I am presuming the biochem was normal pre GA. So this could be an acute renal failure that occured during the GA , was a urine SG taken ? , however given the persistance of the azotemia following your fluids renal dysnfunction is likely. Out of date oxytetracycline has been associated with ARF. But you cannot exclude any potential idosyncratic reaction.

The CNS disease -

as withdrawl reflexes ok neuromuscular disease unlikely I am presuming placing ( and therefore propriorecption) is on all four linmb. Implying cervical or brain as a neurolocalisation.and this would fit with the inflammatory CSF you have described.

How elevated was the proteins and it would be interesting to know if the dog was initally pyrexic. It may be worth while having chat with your pathologists.

your description would imply CNS inflammation ( infectious /sterile ( e.g. GME) or secondary to neoplasia) . it may be that the dogs CNS disease originally responded to the cortisone hence the improvement and now deterioration as the effects wane.

Infection could link the two areas , but dogs with disemminated toxo i have seen have multi organ failure ( jaundice and pneumonias etc) not just renal and CNS disease. Neospora is possible but they also tend to have alot of muscular involvement. I guess you could have CNS neoplasia and a paraneoplastic effect causing renal dysfunction. But that is normal assocaited with a hypercalceamia.

In an ideal world - ultrasound the kidneys - check they are morphologically ok . This dog could have subclinical chronic renal disease that got worse under GA. this is more of a test to try and assess prognosis of renal disease

continue with your fluids.

have a chat with your pathologist re they take on the CSF changes

Certainly nothing wrong with checking Toxo/neospora

Check no travel history

Then MRI - probably brain first - obviously renal disease makes this more challenging.

All the best

Ian

Re: Ataxic, inappetant GSD.

Emily Nightingale — Wed, 07 Jul 2010 18:25:31 GMT

Hi there.

Sounds like a baffling case.

Have you considered doing a toxo or a neospora test?? Might not explain renal parameters but might help r/o cause of ataxia??

Good luck though! Let us know how you do with the case!

Emily

Re: Ataxic, inappetant GSD.

Bob Russell — Wed, 07 Jul 2010 17:32:17 GMT

I have always understood both amoxycillin and oxytet are very safe - my main concern is the renal side of things. Sky high BUN/Crea makes for a very guarded prognosis irrspective of cause.

Any access to toxins? Adders in your area? Strikes will make them very depressed and occasionally do serious damage to kidneys.

I have not seen renal failure associated with GME but immune mediated disease could link the two.

Hopefully one of the specialist members will have a look at the history and have suggestions!

Re: Ataxic, inappetant GSD.

Michael Woodhouse — Wed, 07 Jul 2010 00:57:24 GMT

[quote user="Michael Macfarlane"]He was treated with 10mls of colvasone[/quote]

Gosh - what a big dog

You've been very thorough! Really it's looking like MRI of brain/cervical spine.

Not to go O/T but amoxycillin and oxtet? I never use static/cidal together as was taught one can stop the other from working.

Lymphoma? GME?

Was there pyrexia?