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TANNER'S STORY

Valley Fever.... this courageous little Yorkshire Terrier named Tanner was afflicted with Coccidioidomycosis (Valley Fever).   Unfortunately, Tanner's disease was not diagnosed for a number of weeks and even after being seen by a number of veterinarians.  Eventually he was taken to Dallas, Texas where the correct diagnosis was made.  Tanner began a nine month ordeal of physical therapy and costly medication... but with good veterinary care and extraordinary perseverance by Tanner's owners, the little rascal has now regained almost all of his mobility.  Oh yes... his recovery was further hastened by the addition to the family of a second little Yorkie named Max.  With Max's prodding and Tanner's invincible spirit, the recovery and eventual happy ending to this case of Valley Fever was accomplished.  Congratulations to Tanner, Max and their human partners Marilyn Sue and John M.

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VALLEY FEVER IN A DOG... A CASE PRESENTATION

CASE HISTORY

9-8-99 Tanner was neutered.

11-15-99  Weight 11.3#  We wondered about Tanner's breathing because something didn't seem right.  Given "Orbax" (22.7mg)  that Tanner took 1/2 tablet daily for 10 days.  At the same time Dr. B gave Tanner "Temeril-P" that Tanner took 1 tablet twice a day for two days, then 1/2 tablet twice daily.  That didn't seem to make a lot of difference except to make him restless all night for a few nights.  I knew he was eating more and drinking more as a result of the medication so I didn't want him to have to go out and be made to stay in!  We went out lots of times that night!   Dr. B did hear congestion in his lungs on that visit and we can hear it pretty often as he breathes. 

11-30-99    Tanner is still dealing with that very dry cough.  I may have to take him back to Dr. B.  Thankfully, he doesn't cough very often so he may be better off dealing with it than having to take more medicine.  It was windy and very dusty today.  

12-4-99 Weight 11.2#  Dr. B says it is allergies and so has put him on a stronger dosage of Prednisone.

4-4-00  12.6#  I took Tanner to Dr. B  because he was limping pitifully... left hind leg.  A physical exam didn't determine any specific cause but we tried Rimadyl (25 mg chewable) for 10 days... a half tablet twice each day.  He responded almost immediately with favorable results... seemed to have no problem whatsoever.  Four days after the finish of the medication, the limp started again.  We did the ten days, same treatment, followed with the same results, even to the start of the limp again four days following the end of the treatment. 

4-17-0         10 more Rimadyl (25mg chewable)

4-26-00   5 more Rimadyl (25 mg chewable)

5-3-00    Weight 12.6#  Today Tanner was radiographed by Dr. B because of the persistent limp.  The x-ray was done without anesthesia and Tanner twisted.  This made it look like his left hip was a little bit out of the socket.  Dr. B explained it is probably a stretched ligament, that Tanner is a very active dog.  He could not tell from the x-ray but the Rimadyl treatment and limited activity is the treatment for now.    I specifically asked him about Tanner’s walking because of the way he pulls hard against the leash and Dr. B said to walk him.  We will try the 1/2 of the 25 mg Rimadyl once each day for a couple of months then have another x-ray if he continues and/or develops the limp again following that.   (Since Tanner had had the coughing a few months back…mid-November, ’99…and now had the lameness, his breeder was concerned with Lyme Disease.  Dr. B   indicated that was not a problem here.)    Bought 30 Rimadyl (25mg chewable) today.

11-10-00  Weight 11.6# 

1-15-01  Combing Tanner, started at head and back as he stood on the carpet, then turned him and laid him onto his right side.  He lifted his head with a little yelp.  I quickly but gently pushed his head back towards the floor and he jumped up making a ki-yi-yi sound and holding his right front paw off the floor.  We thought his shoulder must be dislocated the way he acted but a check by Dr. B revealed no apparent problem.  By the time we got to the vet’s, Tanner had stopped limping.  Dr. B thought it must be a bit like when we hit our “funny-bone”.

Sometime in mid-February Tanner took off after a cat and when he curved quickly around a sharp corner, his body twisted like a person’s would when turning an ankle.

2-26-01 Weight  11.6#  Tanner was limping again so I took him to Dr. B who suggested that since we were simply controlling the pain we should see Dr. H. to determine what the problem is. 

2-27-01  Dr. H did radiographs (used anesthesia) and told us that Tanner has 8 lumbar vertebrae instead of the normal 7.  He told us it is “hemivertebrae” and showed us the x-radiographs as he explained.  He told us Tanner would be sore that night from the positioning they had put him through in order to do the radiographs. 

3-19-01  He has been in pain since the radiographs were done 3 weeks ago (stands like an old horse, head and tail end down, definitely favors left hind leg, won't lay down without help, walks slowly, has difficulty squatting for bowel movement, does not lift either hind leg to urinate).  His treatment at present is 1/2 of a 5mg Prednisone daily (1/2 every other day did not effectively control the pain except for the first 12-14 hours).
I called Dr. B to tell him we had to do something better to help Tanner. He had so much trouble lying down that I had to force him (gently of course) and he'd act so relieved once he was down and could rest.  Then, when he'd have his Prednisone he'd be a different doggie for the first few hours... could and would lay himself down.  (Some good has come out of it... he won't even try to jump to our low couches... he sits facing the couch where his little flat pillows are (one he leans his chin on, the other he leans against) and groans at us until we pay attention and help him up there! Then, when he wants to get down, if we don't notice, he groans at us some more! Today he was resting comfortably on the couch and I leaned back in my recliner. Right away he started to make little groany noises and I'd talk to him each time. The side effects to Prednisone were classic the first time Tanner took it (when he had the allergies that first fall)... he ate more, drank more, and needed to go out more. This time it has not increased his appetite but he has taken a bit more water. I did notice yesterday that he ate about 2 hours after he took the med and the same today. I will watch that he not overeat because he does not need more weight.  His little haunches look quite pitiful... I know that the male is slimmer through his hips than the female but his hipbones and spine protrude and feel so rough and bumpy... more than they did a few months ago.

           I did make a point of letting Dr. B know that the effects of the positioning for the radiograph seem to have been definitely detrimental. Dr. H had said that Tanner would probably be more lame that night because of the positioning but this is now 3 weeks later...not just one night.

3-24-01  Weight 10.1#  Took Tanner to Dr. B to ask him to feel the prominent bony structure that has evolved in Tanner’s spine and hips.  Explained that pain reoccurs once the Prednisone has been in his system 16-18 hours.   Tanner has lost 1.5-pounds since this started even though he seems to be eating and drinking quite well.  Dr. B said he feels it is time to have him checked in Dallas.

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Tanner was taken to see Dr. W. in Dallas where the diagnosis of Valley Fever was made.  As follow up, Tanner's owners consulted with Dr. S., who specializes in Canine Valley Fever at the University of Arizona and the following is a letter to Marilyn Sue M. from Dr. S. 

Dear Ms. Moore, Sounds like your poor Tanner has been through the ringer. Fluconazole is an appropriate drug for your dog right now because of the possible neurologic involvement.  I do not know if surgery will improve the way he feels unless the bone lesions in his back are pressing on the spinal cord and they think they can relieve the pain that way.  In humans, they would perform this surgery, but they would put steel rods in the back to stabilize it.  I worked with a man who had this surgery done for Valley Fever in his back.  He had bone grafts and everything. Tanner may get well from the Valley Fever with long term medication, though his prognosis to be off medication in his life is not good.  There is another drug you can add to his treatment regimen that may help.  The drug is called Abelcet, and we have had about 50-60% success in dogs with severe Valley Fever.  Also, because of his size, Tanner should be on 50mg of Diflucan twice daily.  Because his disease has gotten so severe and is so widespread, Tanner should be on a full dose of his medication until the bone lesions have gone away on the x-rays, then on a half dose probably for the rest of his life. For dogs as sick as Tanner, the recurrence rate if the medication is stopped is high.  50 mg is a good dose for him. Best of luck to you and Tanner.  If your vet needs to ask me about the Abelcet, please pass the e-mail address on to him/her. Sincerely,  Dr. S.

Tanner's wheeled cart that allowed better mobility during his period of rear leg paralysis.

Tanner and Max playing King Of The Couch!

    On June 6, 2001, you were so prompt in answering our concerns about Tanner, a victim of long-undiagnosed Valley Fever that finally caused paralysis in his hind quarters.  Here's a happy update on Tanner!  You recommended the Fluconazole be given 50mg twice a day instead of the once a day prescribed in Dallas so we did.   

    Since that time, Tanner and Max have become the best of buddies and Tanner continues to show improvement!  He now walks all the time (unless he is in a terrific hurry to check out the back yard) but we still use the cart when we do the twice-daily block walks.   He does have a limp in his left hind leg but that is where all the trouble originally manifest itself and I have seen improvement even over the past few days.  His muscular structure is filling in beautifully again and his spine protrudes less and feels more sturdy.  He and Max play a lot and sleep a lot.   They are so good for one another and we are so thrilled with all that has occurred.

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Happily, almost a year after the onset of signs of Valley Fever, Tanner is nearly normal.  He romps and plays with his little pal Max.  John and Marilyn Sue are happy that the medication has helped Tanner defeat Valley Fever... and so are Max and Tanner.

See the article on DISEASES IN DISGUISE that discusses systemic fungal diseases and how they are often mistaken for other disorders.  This article by T. J. Dunn, Jr. DVM was published in Dog World Magazine and was inspired by Tanner's Story.