no blasto? Tests come back negative

[amy_in_mna]

Vet called with Brooke's test results-
The serum ID antibody test came back negative and the vet was told that Brooke's urine antigen test was negative as well.  I have asked if she would please get the actual result (number) as it seems that a zero would be an actual negative in this case vs. a 2 or something.  If I remember correctly anything under a 4 is considered negative? But I think Comet had something under 2 and was still infected with blasto.

Well, I am confused, relieved but not.  Blasto was really our last hope for this girl as I know we dont have the big money it would take for her to go down to the university of minnesota.  It would cost us 150.00 just to get into the door, they like to repeat all tests (dont like to take the vets results) - it would run us into the thousands.

She is doing okay on medications and vet said we could go ahead and keep her on and see what happens.  She would like me to log her temps daily so we can see if her ups and downs correspond to her fever.  She felt that Brooke really shouldn't spike a fever if it is blasto while on the itra.  Your thoughts on this?  Would this be true?

Brooke doesn't have any lesions to sample.  She has lumps but after a week or two they seem to go away (burst?)
Her symptoms when she is feeling poorly:
lethargy, lack of appetite, fever (105+), drooling, swollen lymph nodes,weight loss, limp/painful looking walk, lumps, her eyes get real droopy and mucosa gets red.  She does have a sore in her mouth that remains WAY back there, she has had other mouth sores (but they have since resolved - no more boil-like look to them)  She has had a cyst aspirated- our vet looked under microscope and thought she saw yeast, reaspirated and sent to a pathologist and patho said no to blasto.

Any thoughts?  Could this be blasto?  Should I continue treating with the itra?  I know that someone's dog was tested a number of times until there was a positive result... maybe it was Marge.

Not sure what to do.

Amy and Brooke the lab

[amy_in_mna]

Brookes urine antigen results are 0.32- so basically negative.

I should be cheering and part of me will be very glad if she is not going through this horrid blasto... but at least we had an answer.

Amy and Brooke

[Wilson3]

Wilson's fever DID change  ( up and down ) when on treatment his fever stayed for a total of 5 month once on treatment for 3 months swelling went down in legs fever was gone for good we stopped pain meds.

did they test for other things? what results?
How long already on this treatment ? and what are they using right now?
If the antibiotics have not worked I would start the itra but that's me
once blasto or any fungal really takes hold it could be to late

sometimes if you explain your situation to the universities they will treat the patient as a learning fro the vets to be so fees are much less if not free the experienced vets are right there watch but letting the student first look

I would call them also

I so hope you find an answer so
Wilson3

[amy_in_mna]

Thanks for the reply Wilson 

I was pretty sure I had read that fevers remained or fluxed during treatment for some dogs.  While on the phone with the vet, I didn't know for sure, but she (vet) sounded like the fever would diminish during treatment.

Brooke has been sick on and off since mid-november or earlier.  She hunted several areas in Minnesota this fall/early winter.

Brooke's CBC's have been unremarkable aside from a couple low platelet readings- but in the 4 CBC's she's had, platelets were normal twice.
Blood chemistry is unremarkable.

Brookie was on Keto for a couple days (started 1/18) and once our compounded Itra arrived (1/20) we switched over.  She seems to be tolerating it okay.  She was not on any medication at the time of urine and serum collection.

Brooke was negative for snap 4Dx (heartworm,lyme, E.canis and A phagocytophilum) but was treated on Doxycycline for close 26 days since vet thought we were dealing with anaplasmosis.  No change in symptoms while on treatment, which kind of rules out a tick borne disease- those almost always respond quickly to doxy.  The thing that keeps tugging at me is the cyst Brooke had - vet aspirated and felt she saw yeast- sounded really concerned on the phone when she called about it (this was a month ago) another sample was sent to a pathologist who saw nothing.

Brooke is going back in on Tuesday- doing a tick panel as well as chest and abd xrays.  We will continue on the Itra I guess until I have a definite diagnosis of something else- and not sure we will ever get that.  Vet is calling this FUO- a fever of unknown origin. 

Thanks for the tip about calling the U of M and talking to them about possible lower costs if Brooke were kind of a case study for students.  I will look into that     I hate giving up on her.  It has been a hard year and a half here- hubby has been without work since November of 2008- if the U was willing to give us a break...
Thanks again for your support, Wilson
Amy and Brookie the lab

[evayola]

I'm so sorry amy that you don't know yet for sure what this. I definitely think its worth a shot calling the university. When Marge first had symptoms of something we were in your same shoes. We were given antibiotics over and over again. When Marges toe swelled up to triple the size we had no choice but to amputate it before the infection spread higher up her leg. We sent the whole dinosaur sized toe to miravista labs and they came back with osteomylitis and nothing else. It was very discouraging. Months went by and the limping started. One vet finally suggested a chest xray which confirmed it was blasto. Her miravista antigen test came back really high and we started treatment. Marge was on pills for one year and then the miravista test finally came back negative (less than one) so we stopped treatment. Marge started licking her other paw like crazy and you could smell the yeast coming from it. We xrayed the bone and even radiologists didn't want to confirm blasto in there without a biopsy. Marge has had 2 negative miravistas since then but the blasto was there still lodged deeply in her bone. Is Brooke limping on just one leg? Is it possible you can get an xray of that leg? I really am praying that you find out just what this is. I know just like so many others here how heartbreaking it is watching your poor baby suffer.
Eva

[Wilson3]

didn't Joyce's ,gunner, take a really long time before they did find it to be blasto?
how did she finally get the right answer?

I am wondering "IF" it is possible that Brooke just doesn't have a high enough count to show up in the tests and each dog handles pain and illness/not feeling them selves different
all have something different going on yet a lot the same

wilson favored his one leg off and on for 6 months before things started to get worse I just thought he had ran to hard or jumped to high that day (playing frisbee) and was better within 24 hrs so I blew it off
Barnie had it they think for at least a yr before he had really started showing more signs his was just going potty lots hence he had blasto in his prostate(sp?) and now it is failing even though the blasto is gone from it but they just thought he had a weak bladder

okay so brooke has been on an antifungal for 4 days ,what dose? and what weight is brooke?
Has brooke started to act any different ?more sick? since you started treatment?
the cysts once open did they heal up? Have they ruled out cancer?

do call the un though poor your heart out to them...  stay positive and believe in brooke getting better see it in your heart and soul truly believe it!


wasn't there a guy on here that had Irish wolf hounds that had something like blasto ?
 to late not thinking well sorry...
I sooo feel bad for you guys that feeling of not nowing os the worse...
wilson3

[Jen]

Yes, Gunner went for almost a year before being diagnosed properly.  She had the cysts and the lumps etc.

[amy_in_mna]

Thanks for all of the replies! 

Wilson, you asked:
okay so brooke has been on an antifungal for 4 days ,what dose? and what weight is brooke?
Has brooke started to act any different ?more sick? since you started treatment?
the cysts once open did they heal up? Have they ruled out cancer?

Brooke was on Keto (200 mg 2xday) for 3 full days and now on Itra 140 mg 2xday.  Brooke weighs 55 but may have gained a bit back from last weight (couple pounds).  Brooke's illness comes and goes.  When she started the Keto she was just on the end of feeling quite poorly.  She is now eating okay (though I have to cook for her and make it extra yummy right now for her to eat... and she stands there and acts like she is waiting for something different - I just sit down with her until she eats.  Feeding several small meals a day.  So, she started Keto on a rebound period... I don't think she is feeling better than "almost okay"- she seems a little more down/tired than she would normally during a "good" time... but it is hard to say for sure.
Brooke has not had an open lesion outside of her mouth.  She gets lumps (she has had many) small/pencil eraser sized to quarter sized lumps that stay for a week or longer and then just disappear.  She did have some lesions in her mouth- kind of large pimplish/boil kind of deals.  In her mouth now there is the remains of those lesions but nothing fresh.  They don't appear to be draining anything- more like they are in the healing process.
Cancer is a possiblity and has not been ruled out- it would certainly be on the list of things to rule out if we scrape together the funds to get to the university. 
On tuesday we have an appt. with vet for a series of xrays (chest/abd) and we will talk again about doing more Tick born illness testing (though I think we have pretty much ruled that out).  I am also going to talk to her about going down to the university.  My big question for the vet about that is: "Do they want to see Brooke when she is feeling badly?  Makes the most sense to me! And if so, how do we go about scheduling that?  Once we have the xray appt, and learn what we can from that, I plan to call the U and find out what kind of costs they have/could Brooke be a guinea pig kind of patient etc.

I also talked with Ted's mom (Jen) and learned that Ted was neg for blasto on his urine as was Jen's niece... Jen's hubby tested 0.65 (which is considered negative) but based on symptoms  was treated/is being treated for blasto... It is all so confusing.

I wonder if anyone knows what 0.32 means... (aside from being negative) if there is SOME antigen/enough to generate a 0.32, is there not reason to believe there is/could be SOME infection with blasto?  How does one have any antigen without some of the blasto inside?? 
I wonder if I should have another cyst aspirated?   If so, what should be done with the aspirated fluid?   (First cyst aspirated the vet thought she saw yeast, another sample taken and sent off to a pathologist and pathologist said no blasto)
AAAAHHHHH!
Vet has mentioned this could Addisons- many similar symptoms aside from the fever (105+) and come and go cysts all over her.
Thanks for reading and for caring about us- it is much appreciated!
Amy and Brooke the lab

[Wilson3]

How is Brooke doing today? Any news?
It sounds like you have really been trying so hard for Brooke ...  you have really covered a lot already
It is such a tough call.. I am so glad you talked with Teddy's mom
my gut says to treat for blasto
you know her the best go with your gut feeling trust it!
do be careful with such high dose that can make her very sick also usually they treat very high for only 7 days to jump start it then back off some

keep doing what your doing  I wish I had better advise
wilson3

[Kash-]

Kinda a late reply, but just jumping in late because I have a dog with Addisons.

Yeah, lucky me Addisons and Blasto in the same family.  MY dog Mocha never had lumps an bumps or lesions during her Dx for addisons.

If her adrenal's are acting up, either hypo- or hyper-adrenal corticism, then a pretty simple blood test comparing Na / K (that's sodium vs. Potassium) should reveal this, or at least confirm it.  Unless your dog as been on any steroids like prednisone.  Hypo-adrenalcorticism is addison's and left untreated will result in death due to high levels of potassium poisoning the heart muscle.  Sure, there are plenty of other symptoms too that will vary, but my dog included anorexia, intestinal bleeds, polydipsia, incontinence, and funny pigmentation of the skin.  Pred will reduce the symptoms, but if it's addison's then the dog needs DOCP to regulate their blood correctly. 

There is an actual test for addison's, it's some kind of steroid tolerance test, that involves taking several blood samples over a course of a few hours.  However the dog must not have had any pred for a week or two for it to work correctly.  If your dog is off pred, and their blood chemistry doesn't include a wonky Na/K ratio, then don't look to addisons.

Or so says the "not a vet, hundreds of miles away, never seen your dog" advice guy.

[mhitesman]

Comet's initial reading was something like 1.25 on the miravista urine antingen test.  He was lethargic and in great pain as his right eye was infected (and later ruptured/removed).  He ran a fever of 106.  I, too, was surprised that anything under 1.0 was considered negative, and it surprised me that his low number was diagnosed as WEAK POSITIVE.  It surely did not seem weak to me or to him, but I guess we were very lucky, compared to many others.  In any case, I have never seen a good explanation for why not ZERO be the negative, but I think it might be that the body always has some yeast in it and that although the test is very sensitive, it is less specific and likely to detect other yeast in the body, some of which is normal?  My guess anyway.

Comet has had about a dozen tests since diagnosis in 2007.  They continue to go down.  I think his last one was .14. 

It seems, to me, that you are having some success with itra...sores and lumps drying up or going away, general energy improvement, etc?  If this is so, I guess I would continue the itra until I knew it was the wrong path.  I am sorry I cannot be more helpful or insightful.

[mhitesman]

One more thing.  I think the miravista labs urine antigen test has very high numbers for detecting presence of blasto (sensitivity).  Something like 96%.  A POSTIVE is re-tested at the lab, immediately, with the same urine sample.  A negative is not.  This is a very high percentage of blasto detection, obviously, but it is not 100%.  It could be blasto.  If you are seeing improvement on the itra and you do not have another diagnosis, I would persist with this treatment and certainly avoid any steroids, like prednisone, as steroids feed the yeast in the body.

At some point you may have to give up, but you are not there at least at this time.  I hate writing those words.  I just want you to know that everyone here loves their dogs very much and understands that you love your dog as much, and you will not be judged here.  We all have different limits imposed upon us even though we don't like to think about them.  If whatever you do is with love and caring for your dog, then it will be the right thing.