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Desperate! Fever Of Unknown Origin


BBones
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Hi friends

Desperately seeking advice, suggestions and comfort!! My darling boy (18 month, Working Springer Spaniel), is now spending his fourth night, fifth day at the Animal Hospital with a FUO (fever of unknown origin).

Bit of background history. Puppy was admitted with a tick last Monday (I use Advantix), and was discharged after treatment on Tuesday. Wednesday I would say he was 75-80% back to normal. Thursday I noticed he was shivering (rang Vet, they just said to keep an eye on it). He wanted to sleep a lot and he took a lot of encouragement to go outside, which if you know spaniels - if VERY uncommon. He was only drinking small amounts and eating small amounts of soft food (is normally on BlackHawk).

Long story short, I took him back to hospital on Sunday, as he just wasn't himself. He had a temperature of 40.4. They admitted him, put him on IV antibiotics and fluids. And there he has remained.

They administer anti inflammatory's, which reduce the fever, but approx 8 hours later, his temp spikes back up again. This has been the pattern for the last four days. Blood work has been run, all clear except elevated white blood cells which show infection. Urine and stool are clear. X-rays last night are clear.

I am so worried for him. As the vet said today, he's sick - but he's not getting sicker, but he's not getting any better either!

Any advice or suggestions? We are all desperately missing our little man (basically my third child!). Just praying tomorrow brings a miracle.

What on earth could be causing this?? Vet believe it's unrelated to tick bite....

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Sounds like my cat!

This has happened to him twice now. Not sure why either.

The vet assumed maybe a cat bite originally, but it just didn't follow the patterns.

We did so many tests, bloods etc. and nothing came back. but he ended up getting better :)

So I am sorry i have no clue what it could be, but hopefully your springer is on the improve!

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I had a similar situation with a Whippet a couple of years back.

A week after teeth extracted. Temperature of 41. Drip, ABs. Only test that showed anything was an elevated white cell count.

And then gone. Didn't return.

Perhaps an infection from the tick. Perhaps a depressed immune system has allowed something else to take root.

All I can suggest if it continue is more bloodwork and a specialist consult.

I hope it passes.

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Have they considered changing to a different antibiotic? After 5 days with no response, it seems it's not working. If they still think bacterial infection is the probable cause, then possibly it's time to try another antibiotic.

Of course if it's viral, antibiotics won't work...

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Have they considered changing to a different antibiotic? After 5 days with no response, it seems it's not working. If they still think bacterial infection is the probable cause, then possibly it's time to try another antibiotic.

Of course if it's viral, antibiotics won't work...

..if it is Ehrlichiosis 'response to the drug may take one month'!

quote from the Wikipedia link:

'Supportive care must be provided to animals that have clinical signs. Subcutaneous or intravenous fluids are given to dehydrated animals, and severely anemic dogs may require a blood transfusion. Treatment for ehrlichiosis involves the use of antibiotics such as tetracycline or doxycycline for a period of at least six to eight weeks; response to the drugs may take one month. Treatment with antibiotics like Clarithromycin and Azithromycin is being studied. In addition, steroids may be indicated in severe cases in which the level of platelets is so low that the condition is life-threatening.'

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do you know what kind of tick it was? ...there a few diseases that are spread by brown dog ticks were the symptoms would tick most if not even all the boxes of your description, see brown dog tick and Ehrlichiosis.

Hi Willem, I'll run it by the vet. I don't think they ever found a tick originally, so not sure of the type.

Have they considered changing to a different antibiotic? After 5 days with no response, it seems it's not working. If they still think bacterial infection is the probable cause, then possibly it's time to try another antibiotic.

Of course if it's viral, antibiotics won't work...

Sorry, just to clarify - they started puppy on a third antibiotic today. Crossing everything that it starts helping overnight

His temp - although still high, has been resting at 39.2 & 39.4 this afternoon.

The vets are honest with their struggle on this one "he's a real mystery", they keep saying.

???? Please get better puppy

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The vets are honest with their struggle on this one "he's a real mystery", they keep saying....

...that (the mystery) is another 'ticked box':

quote form the Wikipedia link:

Diagnosis is achieved most commonly by serologic testing of the blood for the presence of antibodies against the ehrlichia organism. Many veterinarians routinely test for the disease, especially in enzootic areas. During the acute phase of infection, the test can be falsely negative because the body will not have had time to make antibodies to the infection. As such, the test should be repeated. A PCR (polymerase chain reaction) test can be performed during this stage to detect genetic material of the bacteria. The PCR test is more likely to yield a negative result during the subclinical and chronic disease phases.[2] In addition, blood tests may show abnormalities in the numbers of red blood cells, white blood cells, and most commonly platelets, if the disease is present. Uncommonly, a diagnosis can be made by looking under a microscope at a blood smear for the presence of the ehrlichia morulae, which sometimes can be seen as intracytoplasmic inclusion bodies within a white blood cell....

As you used Adventix, it is likely that the tick(s) have fallen off, so it is unlikely that a paralytic tick would have had enough time to inject enough venom; however, one bite from a brown tick - before it died - could have been enough to infect the dog with the Ehrlichia bacteria.

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Hi friends

Just a quick update on my puppy. The 3rd antibiotic seems to have done the trick overnight. His temperature has remained still slightly elevated but didn't spike overnight or in the wee hours this morning as it has for the past week. They said if he remains stable today that I can bring him home tonight (with a weeks course of all 3 AB's).

Still no idea to what has caused the infection - and perhaps we will never know, just SO happy puppy is fighting hard and hopefully home tonight. I guess time will tell what the long term prognosis is

Thank you all SO much for your kind words and suggestions

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An elevated white count indicates inflammation, rather than infection specifically (though is often due to infection). If there were no wounds or evidence of gastrointestinal obstruction then I would be considering immune mediated causes in my list of differentials - including things like meningitis or polyathritis but also considering the possibility of serum sickness given the recent treatment for a tick. It can cause non specific signs like fever, lethargy, joint and muscle pain.

Edited by Rappie
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