Just before Memorial Day weekend, Fozzie, our 2 year 9-month-old golden doodle (micromini) stopped eating and drinking and also wouldn’t move out of bed.   After a visit to a vet, they gave him NSAIDS and GABA.  He didn’t get better after two days, so we took him back (we had to water and feed him via syringe directly to his mouth).  They sent us to the Emergency 24 Hour hospital.  After x-rays, and labs, they believed he had Non Erosive Immune Mediated Poly Arthritis.   We were told that he would need to stop the NSAIDS for 4 days before he could start steroids (prednisone).  Rough long weekend.  On the Tuesday night after the long weekend, we gave him his first dose of 10 mg of Prednisone.  3 hours later he was much better.  could drink on his own, but not eat.  He also still was visibility in distress.   Continued the steroids at the same dose for almost a week, and then took him to an internal medicine vet group in Tustin CA.  She ran more blood tests and referred us to a neurologist.  The referral neurologist wasn’t able to see him for a few days, so we got an immediate Sunday appointment with the neurologist at VCA West Coast Specialty Hospital.   She recommended a joint tap (three joints), an MRI and a spinal tap.   I am a physician, so I understood the reasoning for the taps of the joints and the spinal tap...the MRI made no sense.  When I challenged back and asked what specifically they were looking for in the MRI, they backed off.   (I have to say the docs at VCA were very good, the billing and logic for it was intellectually dishonest.  It felt like they were more interested in exploratory testing then using their brains.  I learned in school that history and physical exam are 90%, and labs are just confirmatory.  I get the patient here can’t speak, but neither do infants).   So, all three joint taps came back positive for immune mediated poly arthritis.  The spinal tap came back negative for anything like meningitis or encephalitis).  So the vet increased the does to 15 mg twice a day.  Within a day he was improving.  every day since it has been slowing getting better.  We kept him on doxycycline until the tick PCR came back, to rule out that as a trigger for the immune response.  It came back negative.   Today I met with the VCA internist who wants to taper the dose of steroid down and start Cyclosporine.    I was wondering if any of you have any experience with Cyclosporine and what your thoughts are?  Also, something in the back of my mind is bothering me.  This all started less than 48 hours after I gave Fozzie a dose of Brevecto.   Has anyone else heard of this being linked as a trigger???  Any help appreciated. 

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  • I'm sorry to hear this.
    Bravecto and the other isoxyzoline flea/tick prevents have been shown to cause seizure disorders in some dogs. I have not heard of it causing autoimmune diseases. Those seem to be genetic, and I think every one of them has affected doodles belonging to members of this website. 
    I hope your pup does well with treatment. 

    • The critical care vet said that "personally" she would not give Fozzie a three year rabies (one year only), no heartworm preventive, and space and no kennel caugh vaccine (but bring a groomer into house).  No day care.  She said she feels that Brevecto is too immunologically aggressive for a dog that really doesnt have exposure to ticks.  She said topicals can be better tolerated.   It made sense.

       

      • A one-year rabies vaccine makes absolutely no sense. IT IS THE EXACT SAME DOSAGE AS THE THREE YEAR VERSION, ONLY THE LABELLING IS DIFFERENT. Why on earth would you stimulate the immune system every year when it could be done only once every three years, when the dosage is exactly the same???
        My labradoodle had two different immune-mediated diseases and was under the care of several veterinary specialists, including an internist, a neurologist, and a dermatologist. All of them recommended the three year vaccine for rabies and titer testing for DAP. Frontline topical for flea/ticks, heartgard for HW. (Heartgard is ivermectin. It's so safe it's used as a dewormer for tiny puppies.) NO Lyme or Lepto vaccines. Bordatella done intranasally. And not more than one vaccine on any given day. 
        Jack was not on cyclosporine, I declined it, but he was on prednisone for many years. He did fine with the above protocol, and also did fine at the groomer's, although we had in-and-out appointments so he did not sit around there.

  • My heart goes out to you and Fozzie.  It is tough to see your dog so sad and hurting.  I will be following this discussion as we are going through a similar journey with Murphy who is also in distress. Posted previously about it in early to mid March.  She is still on prednisone and Leflonimide and unfortunately still poorly.  All flea and tic medications and rabies, bortadella withheld. Closest dose would have been Feb1 flea and tic - which previously she has had no reaction to.  So no involvement there.

    She had, however, been continuosly exposed to my daughter and sister in law who had just returned from the democratic primary in New Hampshire.  Both were ill with flu-like symptoms,deep coughing and fevers.? Wondering if the VCA you went to was in Santa Monica, that is where Murphy went and stayed two days.  Initial diagnosis atypical pneumonia, continuing diangosis rheumatoid arthritis brought on by severe atypical pneumonia.

    Hoping Fozzie's journey is shorter than Murphy's  She is not having fun, 

    • Maryann, I am so sorry Murphy is still not doing well.  Sending hugs to her and you.

      I am so sorry about Fozzie. I am glad you are  a physician because your expertise will help with diagnosis and treatments.

       

      Both Murphy and Fozzie are so young. We never expect our young dogs to have such serious problems.

  • After two weeks how is Fozzie doing.

    Just to give you a sense of timeline - Murphy first began auto immune treatment mid March.  Mid June I think she has really turned a corner and will get better.  It took the Leflonimide about a month to build up enough to give her some relief.. Now we have to slowly withdraw the prednisone. It has been a long difficult trip, so hard to see you pup so sore and sad.  My heart is with you.

     

    • I'm so glad that Murphy is improving and hope to see her at a romp when we resume them.

    • Fozzie is progressing well.  Sorry for the delay in updating everyone.  We kept him on the 15 mg of Prednisone for a few more days.  He is now on 10mg twice a day with the 50mg frozen cyclosporin also twice a day.  It will be two weeks on Friday (June 26).   At that point I assume they will lower his prednisone to 10mg a day for 2 weeks and then to 10 mg every other day, and so on.  

      He seems to be progressing well.  He still isn’t as playful as he was.  Longer walks are being tolerated.  He is still drinking more water that I thought was possible for a 19 lb micro mini doodle (over a gallon a day) and seems to always be hungry....I realize this will likely subside after the prednisone is tapered off...but geeze.   Something interesting I noticed is that today was the first time he stretched in downward dog pose since before his symptoms.   I could tell it was a struggle, but he seemed to enjoy it.   He also started having bad diarrhea about a week into the cyclosporine.  The freezing of the pill was meant to mitigate that, but I am struggling to contain it.  I moved him to boiled chicken and rice with pumpkin.   It firmed up but still very soft and wet.   I am moving him back to his ZIWI Lamb/Tripe diet with pumpkin today….crossing my fingers.   Any suggestions welcomed.

      He struggles to jump up onto the bench in the back yard.  I think this is more psychological and will improve as his confidence improves.   I don’t know if that is real or not…I can’t palpate any soreness anywhere.

      During the last visit, I brought up the correlation between the vaccines/Bravecto with the symptoms with the vet.   He just was silent.  He said he wasn’t aware of any studies.  But said “between us, there is one company that controls all the specialty vet facilities in the US, and they aren’t willing to do any studies on this link”.    I found that pretty revealing.

      • I'd ask the vet if Fozzie can have a good probiotic. That might help with the diarrhea. 

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