Continued from Part 2
Where we left off: An inter-digital cyst had been found on Billy the large dachshund’s left front paw, adding to the problem of the badly infected right front paw.
Dr. Mitelman: The good news is that Billy's front right paw was steadily improving. Islands of alopecic skin were steadily shrinking.
What hadn't changed was his desire to lick and chew the leg.
We brought the inter-digital cyst on the front left paw under control.
Then, wouldn't you know it, Billy diverted his attention to his rear legs.
Without the e collar (and even at times with it on) he would lick and chew. If given the opportunity to do so for long enough, he would probably chew his paws to the bone.
What brought this on?
Back at the hospital, Billy was examined. Again. There was a tiny red bump on the webbed skin between the toes of his right hind leg.
What came first?
Barbara: We were amazed to see the infection in the right front paw healing so well. At the same time we were distressed that the dog was so itchy. And the appearance of the sores on all of his other legs meant that we were now doing daily cleanings/treatments on all four paws.
It was crazy-making time for all of us. What was causing this? New floor cleaner or laundry soap? Something in the grass? What had changed? It was always in our thoughts and the topic of every dinner conversation.
Dr. Mitelman: We were on a hunt for answers. Barbara recalled that Billy had some warts (or papillomas) removed from the right side of his body at the other clinic.
Now the right front and back paws. The asymmetry piqued her curiosity and worries further.
(Billy wouldn't mind the middle name Dexter, right?)
It was time to consult with senior veterinarians. It was pointed out that the skin beneath Billy's armpits was also moist, dark, hairless and had a slight yeast odor. Another skin issue.
The path was now turning towards allergies.
But to what? And why now after all these years free from medical problems, save for a bout of intervertebral disc herniation in 2008 (that is for another blog).
A collective decision was made to treat the symptoms and get the itch under control. A routine medication consisted of a tablet containing both an anti-histamine and a steroid.
"This will take the itch away and make him more comfortable," I reassured Barbara. "Have him take two pills tonight, and call me in the morning.”
Barbara: I certainly did call the clinic in the morning. But not with the message everyone was expecting.
Billy, a normally exuberant, tail wagging bundle of energy, fell into a deep sleep shortly after taking the new medication. My first reaction was, "good, we will all get some sleep tonight".
My relief turned to panic when, 12 hours later, I could not wake the dog!
Billy became a little more active en route, but had a groggy appearance and was simply not himself. When the doctor commented on how calm Billy was, I knew something was wrong. This vet had never seen my very boisterous dog before.
Blood work was done. Everything looked fine, except Billy was a little dehydrated.
I was allowed to take him home with instructions to call with any changes.
Billy went back to sleep. After eating. I knew that was a good sign. I emailed Dr. Mitelman and spent the day listening to Billy snore.
Dr. Mitelman: I got Barbara's message late in the day after attending an out of town meeting. I checked with the clinic and called Barbara. We would monitor the situation through the night.
On the bright side, he wasn't chewing. He was, however, a zombie.
Billy slept well into the next day. A consult with the pharmacolgist was done. He couldn't offer an explanation for Billy's idiosyncratic response to the medication. This was a drug reaction with unexpected signs and of a lengthy duration.
On Monday, the drug company who manufactured the medication was called. They were willing to help since Billy's reaction was a first for them in well over 20 years of manufacturing and distributing the drug throughout North America.
The company graciously offered to cover the costs of blood tests, radiographs and ultrasounds in order to elucidate any cause and/or effect.
Barbara: Billy was himself again by Monday. Almost 48 hours of deep sleep. Dr Mitelman examined him and everything seemed fine. Tail wagging and happy again. I left Billy at the clinic for the tests requested by the drug company to be done.
I was looking forward to the answers I hope we would have.
Dr. Mitelman: Foreshadowing at its best, this was just the first drug in the line of medications to induce reactions in Billy. And to confuse and confound us.
When A Small Sore Turns Into A Catastrophe: Billy's Story (Part I)
Life-threatening Infection Resolves; All Is Good? Billy's Story (Part II)
What Is Going On With Billy's Skin? Billy's Story (Part III)
The Plot Thickens: Billy's Story (Part IV)
I've Never Seen That Before: Billy's Story (Part V)
Billy's Diagnosis Still Unknown: Billy's Story (Part VI)
Neuronal Ceroid Lipofuscinosis (NCL)? Billy's Story (Part VII)
Time To Make A New Plan: Billy's Story (Part VIII)
Atopic Dermatitis? Billy's Story (Part IX)
It Is Not Neuronal Ceroid Lipofuscinosis But What Is It Then? Billy's Story (Part X)
My Dog Has A Gut Of Steel, Doesn't He? Billy's Story (Part XI)
Feeling As Though Running Out Of Options: Billy's Story (Part XII)
Fighting Fire With Fire Backfires: Billy's Story (Part XIII)
A Second Endoscopy: Billy's Story (Part (XIV)
Staying The Course: Billy's Story (Part XV)
Fewer And Fewer Solutions Left: Billy's Story (Part XVI)