Cody’s been the star player in a two-year game of Stump the Vet. He’s see a variety of local vets, specialists in private practice, specialists at UGA veterinary teaching hospitals and Cold River Veterinary Center, a holistic specialist in Vermont (via distance consults). Symptoms presented have been chronic lameness, which seems to move about; periodic skin issues that flare up; and very high fevers of unknown origin.
We’re still waiting on the results of a variety of tests performed Wednesday at Georgia Veterinary Services (GVS) to determine if Cody really does have Lupus (Systemic Lupus Erythematosus (SLE)). SLE is the result of widespread immune complex deposition with multiple organ involvement. Joints, kidneys and skin are most commonly involved but almost any organ can be affected. It occurs in dogs, is rare in cats, and has been reported in large animals. This disease is know as the “Great Imitator” due to the multitude of clinic signs that may be seen. SLE is a chroni disease with alternating subacute periods and relapses. Unfortunately, over 40% of dogs diagnosed with SLE die within less than a year. Not good news.
It was suggested a couple weeks ago that we have an ANA test (antinuclear antibody) test done, which if positive, could mean that there’s an autoimmune disease involved. And because of his additional symptoms (chronic lameness, skin issues, and fevers), SLE is suspected. Results of Cody’s ANA test were positive. Preferring to treat with something other than the traditional prednisone therapy, we sought out an experienced veterinarian trained in both Western and Eastern (Traditional Chinese Veterinary Medicine), and selected Dr. Susan Wynn at GVS in Atlanta. She also suggested that Cody has “leaky gut syndrome“, which Dr. Kruesi of Cold River had also suggested. Dr. Wynn also helped us understand that in order to diagnose SLE, the dog must demonstrate supportive clinical signs, have at least 2 separate manifestations of autoimmunity and have a positive nuclear antibody test (ANA) test. So in addition to prescribing Chinese herbal supplements and creating a very specific home-cooked diet for Cody, she recommended accupuncture (which we’ll have done closer to home) and finally referred us to Dr. Alysa Cook, an internal medicine specialist at GVS for further consult.
Cody’s ANA test was positive, though it was determined that it was a very low positive. We’ve learned that an ANA titer isn’t always positive in cases of SLE as titers correlate with the severity and the stage of the disease and numerous other diseases can result in positive titers. So a few additional tests were needed: a new Complete Blood Count (CBC); a Urinalysis and Urine Protein Creatinine Ratio test, (protein in the urine is one of the markers for SLE) and a Arothcentisis (joint fluid analysis, done by needle injection and drawing of fluid from 3 of Cody’s four ankle joints, under anesthesia, of course), as well as an examination by an orthopaedic specialist to rule out any ortho issues. After giving us private time to discuss all of the above, we elected to have all of the tests performed.
We’re still waiting on two of the tests, but here’s what we know today: Cody’s blood work was normal. No issues there with kidneys or any other organs. Urinalysis did show some protein in the urine, so they’ll examine that again to determine just how much protein. Joint fluid test should have been back yesterday and we hope to receive results by end of day today. Thankfully, Dr. Cook called to touch base with us yesterday even though she didn’t have all the results. Nice.