Saturday, December 18, 2010

Good thoughts for Winnie

Our poor little Pooh Bear has been fighting a strange mystery disease since Thanksgiving. Everything started with urinary tract signs (mostly frequent urination, peeing in the house, etc). She was started on an antibiotic and all those signs cleared up, but a couple of days later she developed a fever. That started us on a wild goose change through her abdomen looking for the cause- did a bladder infection ascend to her kidneys? Did she eat something inappropriate? We sent out a urine culture (negative), checked bloodwork (normal aside from an elevated white blood cell count), and checked for tick-borne diseases (negative, plus she's on monthly tick preventatives). Radiographs revealed an enlarged spleen, so she had an abdominal ultrasound. Aside from a slightly prominent spleen, no other abnormalities were noted. A splenic aspirate was sent out- nothing really significant there either.

Winnie's fever persisted, so the hunt moved from her abdomen to her chest. Thoracic radiographs revealed consolidation of her right cranial lung lobe. Suspecting pneumonia, we started her on some more antibiotics, but her fever didn't really respond... So off to the U of MN teaching hospital she went. Although they agreed it would be strange for a middle-aged otherwise healthy dog to suddenly develop pneumonia, the radiographs and bloodwork were all consistent with pneumonia and didn't revealed any potential underlying causes. We decided to give the antibiotics a little more time to work, and Winnie's fever disappeared for a couple of days. Unfortunately, it came back... so Winnie went back to the U for a transtracheal wash to try and collect some of the organisms causing her pneumonia and culture them out. After a few days of waiting, nothing grew on her cultures. She had another day or two of being fever-free, but then it all started again. Her doctor then performed a fine-needle aspirate of the affected lung lobe, hoping to find the organisms causing her disease, but the samples just showed inflammatory cells. We added one more antibiotic to her regimen as well as an anti-inflammatory to give her some relief from the fever... which worked great until the drug wore off and the fever came right back.

After 2 1/2 weeks of trying different medications, we finally decided that we needed to try something else. Based on Winnie's age and the focal nature of her pneumonia, we suspected that she might have a migrating foreign body (i.e. she inhaled a seed or bit of a plant, which was travelling through her lungs and wreaking havoc). Unfortunately, Winnie was too small for bronchoscopy to be an option to explore the problem lung lobe. We finally bit the bullet and decided to take her for a CT scan and, if everything was still limited to her right cranial lobe, proceed to a lung lobectomy. Her CT scan was Thursday, and (because nothing in her case has gone as expected) the images showed that the lung lobe that had been looking bad was looking better, but now several of the lobes on her left side were looking affected. Sigh. She wasn't doing great under anesthesia, so she was recovered and went home on Thursday night. She returned to the U yesterday for a lung biopsy, in the hopes that getting a piece of tissue would be more likely to grow organisms in culture or show us any other underlying problems with her lung itself. Cytology yesterday unfortunately just came back as "neutrophilic inflammation" with no evidence of organisms... so now we wait for histopathology results to come in.

Winnie has been in the ICU since her biopsy with a chest tube in place. She's doing well, and if everything goes according to plan, she'll be going home in the next day or two. For now, we are onto yet another class of antibiotics to see if whatever's in her lungs responds. Winnie is being a trooper, and even though she hates the hospital and being in a kennel all day, she is tolerating everything pretty well.

So, please keep our little Winnie girl in your thoughts. It is miserable to be so far away from her during this, but her vets in Minnesota have all been fantastic and she's in the best hands. All we want for Christmas is a healthy corgi, and some answers about why she's been so sick!