Leish - after treatment - count 4 times higher

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fyfin
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Leish - after treatment - count 4 times higher

Postby fyfin » Sat Aug 20, 2016 10:26 am

We have a rescue dog which was 2 years old when we got her with bloods completely clear as she was left at a rescue centre and never on the streets. We have had her for 2 years and she seemed very healthy and bouncy (small terrier type) and the same day she had her annual check up at the vets we took her to be groomed at a different veterinary practice who have an in house groomer. He did a great job as usual and then told me that I should get her to have a blood test as he could see potential signs of leish. He was referring to dry flaky skin on the joints of here legs. The vet who had just checked her over hadn't noticed and I wasn't aware that this could be a sign in any case.
We were really surprised as we had stupidly thought by using Scalibor collars and obviously not being out much int eh evenings with her that she was safe.
So we had the blood test and the count was 1/320 so treatment was suggested by the vet of milteforan and allopurinol which we administered according to the instructions. I didn't like doing the milteforan as it sounded a nasty medication chemotherapy and supposedly carcinogenic, but if it was going to help it would be worth it.
After 4 months I took her for another blood test and a check up at a different vets and he as very thorough and pronounced her as very healthy, so imagine my surprise when he phoned with the blood test results and told me the count was 4 times higher than the last one.

I really want to go and discuss this but as it is August they are closed for s couple of weeks but I just wondered if anyone had a similar experience or any idea what the explanation could be.

She still seems happy and healthy but knowing this count is now around 1 / 1300 is a worry and should I still keep giving her the allopurinol as the previous vet (also closed) said we could reduce to one tablet a week after 4 months.
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Gasman
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Re: Leish - after treatment - count 4 times higher

Postby Gasman » Mon Aug 22, 2016 6:37 pm

The treatment of choice, and more likely to guarantee a good result is Glucantime. Milteforan is usually only given when the dog already has kidney problems - which often indicates also that the form of Leishmania is the internal-organs-attacking variety. If a dog has kidney problems, it would have shown up on blood test but also with symptoms like nausea and vomiting.
You dog sounds like it had the external variety only affecting the skin - crusting and scabbing, especially round the joints and the ears, eyes and nose, and abnormal growth of the toe nails.
We have had two dogs with leish - both well cared for, but that damned sandfly/mossie seems to be able to get at one's mutt no matter what care one takes. Also from the first bite transmitting the disease to the dog, it can take at least 6 months, and even longer, before any symptoms start to show as the bug goes through its development cycles. Our dogs also had Scalibor and at that time we were not informed by the vets that it was only about 60% effective .... So, yes, your dog may well have got the disease. One of ours (pedigree GSD) was internally affected and had to have the Milteforan for the 28 day regime - recovered well AND the blood count went down and stayed down. The other one (mastin crossed with gos-knows-what) only had the long nails, dermatitis, crusting, and wasting of flesh on the head - he had the Glucantime injections for the 28 day regime and also recovered well, with also good blood recovery (though strangely he had never actually tested positive on BLOOD, only on the more expensive DNA test when it was obvious from his symptoms that he probably had it, even with negative blood test x 3 at the clinic).
The moral of the story is that,
yes she has probably had it,
yes the toiletteur was probably more vigilant than the vet,
that perhaps Glucantime may have been given if there were no kidney problems
but in any case the Milteforan should have done its work.

How is the dog now? Has the skin recovered? If she has not got further symptoms, don't panic. Get another check done when the clinic opens .... I seem to remember something about antibodies and antigens taking time to leave the body or settle down before the blood test could be trusted but you need to check with your vet about that.

Allopurinol is a very good enhancer of the body's immune system so boosts the dog's potential to save itself from any invading nasty. I would suggest you should continue on the Allopurinol full dose until the vet's clinic is open after the holidays. It will not do any harm and may well keep her going til you can sort out what is going on with the blood tests.
Incidentally if I remember rightly the DNA test which is definitive (the blood tests come up with all sort of false positives and false negatives!!) cost about 70 euros - may be more in Almeria - which you may find a bit much for a rescue dog? but hey, perhaps she is worth it?

For on-going care - the preventative measures have improved a lot over the last few years, so chat with the vet (and perhaps the toiletteur!) about what is recommended now? You don't want her to get it again!! ----- By the way, Allopurinol also helps to prevent recurrence of symptoms taken in the smaller doses over several months.

Our expert friend with the local rescue society would say that if she has very few mild symptoms, don't panic and go with the flow - some dogs have very high blood counts, but actually never develop symptoms!!!! It all depends on the actual dog and how its system fights off the invader! The important thing is to watch for symptoms and that will tell you that the body is out of control and needs help - that is the time for aggressive treatments.
Cheers - hope she is OK now - and thanks for rescuing her!

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Re: Leish - after treatment - count 4 times higher

Postby fyfin » Mon Aug 22, 2016 8:51 pm

Gasman, many many thanks - what a great detailed response. I don't actually have a lot of confidence in the previous vets and even less now after your comment. She is a lovely little dog and I'm not worried about spending money on her but I suspect I was given a one size fits all treatment and from what you are saying , it wasn't necessary probably ,or even effective. I'm going to call in the other vet's tomorrow and hopefully they will be open as I'm sure he mentioned something on the phone about proteins being good but I could have misheard. I didn't know about a dna test but if it would prove something I would certainly have it done.
The actual flaky skin has disappeared although we did rub some coconut oil on it as well (my wife is a great believer in the power of coconut oil) and to be honest she (the dog not my wife lol) has no real symptoms at all.
My surprise was that the count had increased so much after treatment so I will see what the vet has to say tomorrow.

Thank you again for taking the trouble to answer.
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Re: Leish - after treatment - count 4 times higher

Postby Gasman » Tue Aug 30, 2016 6:14 pm

So, Fyfin
How is the little dog and what did the vet say about the rise in the test result?
We also have come to know the benefits of coconut oil recently!
Cheers!

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Re: Leish - after treatment - count 4 times higher

Postby fyfin » Tue Apr 25, 2017 4:07 pm

Well Susie had another blood test last Friday and surprisingly it has doubled to 1/2560. I was told by the vet to bring her in again today for another blood test to check liver and kidneys. She still seems totally healthy with no symptoms whatsoever - could do with losing some weight. lol.
I am giving her 2 x 100mg tablets of allopurinol every day and the vet says there is nothing else we can do.
It is so annoying as I did everything I could to protect her when we got her from the rescue centre and she was completely clear at the time.
The vet we use now says not to worry as it depends how her body is dealing with it but I can't help but be concerned.
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Re: Leish - after treatment - count 4 times higher

Postby Gasman » Tue Apr 25, 2017 7:45 pm

I think this vet has it right, at any rate for the moment - watch and wait. There may come a time, perhaps an other infection, or heatwave, or something that sets it off, a moment when the immune system has to struggle with something else - and then you will get the symptoms. Remember that it takes at least 6 months, and often up to 4-6 years before the leishmania actually develops and takes hold- so she may even have had it while at the Rescue, or before, and it would not show up when you got her .
As long as she is fit and healthy, and NOT losing weight!!!, carry on but be watchful. The worst is if the internal organs, and Kidneys are usually first to show, get affected. Watch for sudden bursts of vomiting and excess drinking as first signs of the kidneys .... but HEY, she is doing well and giving you fun and love, so go with the flow ...

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Re: Leish - after treatment - count 4 times higher

Postby Gasman » Tue Apr 25, 2017 7:58 pm

An After-thought - our vet was telling us recently that studies have shown that the Milterforan may not have a 100 pc destroying history for the leishmania bug. It is used as a fall-back, and usually very effective means, when the internal organs are already affected, as Glucantime does have a history of increasing any problems that may exist in the liver and kidneys. Glucantime is the drug of choice where possible, as just about 100 pc effective when the course is followed properly. So perhaps when you get the blood tests this time, and if they are OK for the liver and kidneys, you might like to ask the vet about this potential problem - perhaps the milteforan has not killed them off, and Susie needs a course of Glucantime now .... but again, a sensible vet may well say that as long as Susie is well, leave well alone, till she has problems.

As to the DOUBLING - it is a strange way that the positive test is worked out - there is never just a few points of increase. If the titre goes up, it doubles each time! so the results get rather shocking!

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Re: Leish - after treatment - count 4 times higher

Postby fyfin » Wed May 17, 2017 11:48 pm

I just got back the results of the last blood test and it appears there is a potential problem with liver or kidneys. We are doing another one in 3 months to see if it has got worse before apparently starting some other medication.
I'll see if I can attach the results as I'm not really sure what they mean.
susiebloodtest.jpg
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Re: Leish - after treatment - count 4 times higher

Postby Lyric » Thu May 18, 2017 10:20 am

If you google GPT or ALB blood test you will get an explanation, probably won't understand it ! but it is there. I do it with my out of limit bits on my blood tests.

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Re: Leish - after treatment - count 4 times higher

Postby El Cid » Thu May 18, 2017 11:43 am

GPT is a liver test, but for kidneys, the Creatina level is the one to watch for but in this case it's normal (I'm assuming that CRE relates to Creatina.).

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Re: Leish - after treatment - count 4 times higher

Postby Gasman » Thu May 18, 2017 3:07 pm

You and the vet need to keep a watching brief ... if she is doing ok at present, that is fine, but you need to be aware in case things start to go downhill on the kidney and liver front. I am sure the vet would be happy to explain what each bit of the test means for Susie. The BUN is fine but the Albumin is high - could be relevant. And the GPT is high too.
As I said before - all is not lost!!! All you need is a good vet and the follow the advice. Watch for vomiting and excess drinking, watch for weight loss, crusting around nose and ears - if Susie is happy and coping, then dont panic and keep taking the Allopurinol.
The vet may want to put her on special kidney-tolerant diet if the blood results do show an on-going problem. Our GSD loved it, and after 6 months when her kidneys tests came back to normal, she was weaned off it and lived a happy life thereafter! The mastin mix has never looked back since his Glucantime course and is fighting-fit several years on.
The Leishmania seems to be like a barrometer for the state of the immune system of the infected dog - if the immune system is coping then the Leish. cannot get a hold and stays relatively dormant, but if there is an upset in the system it can crash rapidly if the Leish. takes on with a vengeance - so watch and wait and keep Susie active and healthy.

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Re: Leish - after treatment - count 4 times higher

Postby fyfin » Thu May 18, 2017 4:10 pm

Many thanks again for your advice and encouragement. There is no problem keeping her active - loves chasing and catching tennis balls and getting to be very good at it too. Keeps me active as well on our walks.
It's just annoying knowing she has a problem and we didn't manage to prevent it happening. Our friend's podenco roams all over the place night and day and was living rough for a few months before they got him and he's totally clear. Other people seem to have used milteforan with allopurinol and eventually they were able to stop the allopurinol, indeed this happened to one of our friend's dogs who tested positive.
But, like you say, she seems fine at the moment so we'll just keep a look out for any changes and see what happens at the next blood test.
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Re: Leish - after treatment - count 4 times higher

Postby Gasman » Fri May 19, 2017 1:33 pm

:thumbup:
:clap:

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Re: Leish - after treatment - count 4 times higher

Postby patricia » Fri Jun 09, 2017 8:57 pm

The bun and crea are within the normal range for kidneys so she has not got kidney problems. Yes Crea is creatina. The other numbers are just a little bit over. My cat had readings of high creatina and bun but I have reduced that to normal using Semintra.
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