sassy is relapsing.

[Alyssa]

Thank you Sheena. I’m willing to think that Sassy is okay – its just that I want to reduce her meds before I invite other things to happen, if we are keeping her on these high doses when these are really false readings! Her vet, however, is very hesitant to reduce anything with the white count still up. Thats why I’m getting so frantic. Do I do x-rays of her chest when she isn’t coughing? Do I do ultrasounds when she doesn’t have symptoms of anything? Do I just insist on reduction at this point & say no to those? I dont know what to do. Im praying her level comes back at 15 from idex tomorrow – then we might get the okay to lower.

Shes been on 80mg pred / 75mg aza a day for about 50 days now – shes been in normal PCV (above 37) for close to a month.

[Sheena]

Alyssa – you didn’t mention a cough before, I don’t remember if you did. A cough could mean infection.
Sheena x

[alyssa]

No, no! Sorry she isn’t coughing Sheena! That was my point. Her vet mentioned chest x-rays but she doesn’t have a cough, wheeze, or any breathing related issues. Then she said ultrasounds in addition. Basically if her white count isn’t down with index today (I haven’t gotten the call yet), I’ll have to go spend about $1200 to see if there is something where there are NO symptoms

[Sheena]

Hi Alyssa

Let’s see a copy of the latest test first before you go into further investigations. Logically, assuming neutrophils are high again, it is most likely to be infection, but you seem pretty convinced she’s not got anything wrong, plus your vets stopped the antiobiotics, she is acting fine so move onto the second most likely – the drugs. Lowering the prednisone is the only thing you can try – but only a 25-33% reduction (personally I would stick to 25% as she has relapsed, so play it safe). Then the usual retests & see what effect this has. If you think logically again, reducing the pred would not make an infection worse – quite the opposite.

Sometimes, it’s better not to read too many things Alyssa – it’s very easy to jump to the wrong conclusion or worst scenario without looking at the big picture! Let your vet do the thinking – ask the questions you ask on here & write down what they say, tell us, then we might have more of an idea of what they are thinking about. I hope so! I am worried about YOU worrying!

Love Sheena
xxxx

[Alyssa]

Okay, I don’t have the results to post as they came in really late and he called after they closed but it’s not the news we wanted-

their machine came back at 20 WBC, in-house it was 21. So the same, basically. PCV was 45, in house was 43. Basically all nuetrophils still.

This does mean it went from 16 to 20 in 2 weeks, after 2 weeks of Doxy.

The urine test I believe he said showed moderate bacteria, a few other things were said about it but I’ve forgotten. Non crystalline debris maybe?

The urine collected would have been extremely diluted – she drinks so much and her pee is already watery, in addition she had peed twice in an hr before that sample was collected. So, if there is moderate bacteria in such diluted urine, would that mean there could actually be a lot of bacteria in her?

We’re likely going to go back in the morning and do a sterile stick of the bladder in this case & culture what is there.

Just wondering if a UTI / bladder infection can exist for this long (over a month), without clinically getting worse? When she had a UTI last time there was blood at the end of her pee before I noticed it and tested her. Nothing like that this time.
She has started drinking a lot again and has to pee a lot again. I said before that it slowed down as she adjusted to Pred, and came back when all of this started. We did in-house urinalysis about 3 or 4 weeks ago and nothing was seen, which I requested due to the increased drinking/peeing.

[Sheena]

Hi again

Definitely need to do urine culture then – catch a mid-stream urine specimen first thing tomorrow or they can take a sample from her directly using a needle no problem – the best way actually.

UTIs can go on for ages, smouldering, so this could be the cause. They need to determine which antibiotic(s) are effective against the bacteria causing it.

Need sleep!

Sheena x

[Alyssa]

Thanks Sheena – okay, yes, I had already made the appointment for tomorrow to go ahead and do the sterile draw with the needle. I hope it isn’t too painful!

[Brigitte]

Alyssa,
I think the sterile draw is a good idea in Sassy’s case. It sounds awful, but is actually no big deal as long as they are not stressed out at the vet. Make sure Sassy has a fairly full bladder when you go. You probably know all that already, been there done that? I just wanted to be sure:)
Best wishes,
Brigitte