1st RMSF and now Hypothyroidism - any advice

Oh man, this story sound WAY too familiar.  My Billy got bitten by a tick back in March -- like you about Mid-May I felt something wasn't 'right'.  and among other things (we thot we'd found the answer with an ear infection -- he's a cocker) but I also had a blood panel pulled.
 
He came back super anemic.  They tested for tick disease (Ehrlichea is big around here) and we actually got a light positive and began to treat him for that -- plus prednisone because there was the thot he might also have immune-mediated hemolytic anemia. 
 
Once they put him on the drug for the tick disease, he rapidly got MORE anemic.  The bottom line was, he really did NOT have tick disease at all -- but rather his body had actually formed antibodies to the tick disease but his immune system kept responding as if the blood had 'invaders' in it and eventually the immune system was attacking the blood itself.  Ultimately we've gotten him pretty well stabilized but it's taken months.
 
A couple of thots for you:
 
1.  hypo thyroid means LOW thyroid.  Was he on pred BEFORE the thyroid diagnosis??  Pred in the bloodstream will make a thyroid test read WAY off and way low.  Have your vet talk to the vets at Michigan State -- they JUST got done with a huge test study they have done on exactly that same thing.  We got the same reaction in Billy's thyroid test.
 
2.  a dog that is HYPO thyroid will **gain** weight, not lose it.    This just doesn't sound right.
 
3.  What's the pack cell volume (or hematacrit)??  ARe they having you keep a constant eye on it?
 
This sounds WAY too much like what Billy went thru.  Tick disease CAN trigger IMHA in a big way.  There's only so much pred that they can take -- but there are super steroids out there that are better tolerated by the body.  Billy is on both pred AND cyclosporine.
 
emotionally exhausted?  Trust me -- I UNDERSTAND. 
 
We finally began having success when my vet said to me "Look take Billy up to the U of Florida -- we aren't getting far enough and he needs better tests than I can run!"  -- and the vet at UF said that literally saved Billy's life.  When he went in his PCV had zoomed from 24 to 8 in two days.  With the pred we had finally gotten the PCV up to like 29 and thot he was responding and blam -- soon as we started that doxycycline it smacked him hard. 
 
Billy had SIX transfusions over 3 weeks.  Honestly no one thot he would truly make it -- and it's still day by day, but he's gained SO much ground. 
 
I hate to sound like the harbinger of doom but this sounds a whole lot like IMHA to me.  Is your dog eating?? That's the biggie -- you gotta keep them eating, even if you have to play dirty to do it.  They get so weak from blood loss that they don't want to eat and they GOTTA eat to tolerate the medicines. 
 
Please feel free to email me.  In fact I'm going to PM you my phone number.  I'll help any way I can.

Callie,
 
Thanks so much for your quick response...I can't believe I missed it, I must have gone to bed right when you were posting. 
 
"Jersey" has been a little anemic since we got her from the pound 5 years ago.  Other than that she has had no medical problems until April.  We went on the prednisone and the doxycycline as soon as we got the tick borne screen and she actually was doing really well (although not eating much) until about 2 months later.  She was on the prednisone when the Vet did her thyroid test, but he had told me that he just didn't want to waste the time to take her off the pred for the test.  He said he would have to read it cautiously and take into account the Pred.  (At the time she was acting like her little body was giving up...He and I were both afraid that she was...again...trying to die).  The thyroid test wasn't just low...it was abyssmal, so we started the thyroid pills.  He said we would do another blood and thyroid check after a month of the thyroid and pred. pills if I could get her to eat.  He also mentioned that he might do a transfusion if he didn't like the look of the tests.  I'm going to ask him about the IMHA, although I think he may be already considering that as I sort of remembering him mentioning it one day.  (It's so hard to remember everything when you've been to the vet almost every week for 4 months))
 
Well she is eating better, but she is still like hugging a skeleton.  I am doing everything I can to get her to eat...it's like pulling teeth sometimes.  She only wants to steal wet cat food when she can and eat the chicken and beef that I've been cooking for her.  I'vc tried every "healthy" recipe for dogs I can find...and she won't go near any of those either.  She is still unable to walk well or far, and cannot get up very well.  At night, when we are home she does better once she has been up and around a bit, but I know she spends the entire rest of the day just laying outside.  (under her own personal air conditioner) I just wish she felt like getting up and doing anything outside.  She has even lost her bark...when she tried recently it sounded all weak and hoarse. 
 
I really appreciate your post.  It does sound very similar and I'm thinking  I'm going to take her back earlier than expected and really ask about the IMHA and check on the PCV (now that I can get online and find out what that is and what it means).  Unfortunately, I know very little about all this medical stuff so when he shows me tests and tells me numbers, I'm just left saying, "Whatever we need to do....just do it."  I'm slowly learning much more about all of this than I had ever planned.  This is all so sad and scary.  I don't have children (human ones, that is) so I've never quite been in such a position of trying to take care of someone so sweet and helpless.  Thanks also for the #.  I didn't want to risk calling to late tonight (I'm a teacher, so I usually am in bed by 9) but I really wanted to write you back.  Thanks tons...
 
Karla
 
 
 
 
 

For a while I kept Billy eating ANY WAY I COULD.  Treats, ice cream, yogurt, etc. 
 
Things like beef heart are GOOD for the dog right now.  But if you have to offer goodies, do it.  Newman's Own treats have been Heaven sent!! 
 
Trust me -- Billy's has been going on equally as long - and if my vet visits were ONLY once a week I'd be doing cartwheels.  The round trips back and forth to Gainesville were killing me.  But heck -- we made PROGRESS!!!
 
The deep diagnosis was tough -- eventually they had to do a bone marrow draw because in Billy's case the immune system was killing his blood IN the bone marrow.  Reticulocites are the 'baby red blood cells' and they weren't making it out of the bone marrow (where they are formed) to *become* red blood cells.  So in Billy's case it was a matter of getting enough cyclosporine (plus the pred he was already on) IN him to get the level high enough in his body so the immune system would begin to chill back. 
 
But they had to transfuse Billy several times.  If the blood gets TOO low they will just die.  But the interesting thing is how much better they FEEL after the transfusion.  Man, new dog in a few hours!!   But for a little while with Billy as fast as we pumped blood IN him the body would 'kill' it.  But eventually we got the tide to turn. 
 
If you search for Billy's name you will find a zillion posts and the whole saga and all the updates I've given.  if it hadn't been for the folks on this board I would have lost my mind MONTHS ago.