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Eye irritations, late heat cycles: plus, a puzzling case of muscle pain.

Q (Question) I have an issue with my three-year-old female German pointer. A few weeks ago, she suddenly developed tearing in both eyes. Her internal eyelids became very red, so I assumed she had inflammation of the conjunctiva. My local vet prescribed Neo-Poly-Bac ophthalmic ointment.

After a week on this treatment, she made no progress, so the vet prescribed a new ointment from a local human pharmacy. The new medicine was Gentak 3 MG/GM (gentamicin sulfate). After a week of this, the redness cleared up in both eyes. However, the tears have not stopped. The vet directed me to continue this ointment for as long as three weeks to see what happens.

She is still tearing. My vet's only other suggested procedure would require sedating her and surgically opening her tear ducts. He is stumped. There have been no new additions to the house. Laundry detergent has not been changed, there is no other animal contact, etc. It is the same environment she has lived in since day 49. Do you have any advice on how to go further from here, or anything else to try?--CB

A (Answer) I would try staining the cornea to see if there is an ulcer or abrasion that could not be seen by a direct ophthalmoscope exam. Also, if the vet is going to open the tear ducts under anesthesia, this would be a good time to look under the third eyelids for any foreign material that might be causing the irritation.

When I see both eyes inflamed and a clear discharge, I think of an irritant or allergy. Something to add to your treatment regimen might be flushes with physiological saline and steroid drops.

Q (Question) I purchased a German shorthaired pointer as a pup for breeding. She is in excellent health, but she is now 18 months old and has never come in season. My veterinarian said this could be a very dangerous situation, as she could become prone to uterine infections, which can be life-threatening.

She also said there was a specialist about 150 miles away who could make some recommendations. I would appreciate your opinions and options before I make a 300-mile trip.--MC

A (Answer) I like to let time take care of these cycling issues. There are some published drug protocols that have been used to alter heat cycles and begin a bitch cycling, but they can also be problematic. I had a Lab of my own that did not come in heat until she was 12 months old, and she went on to raise three litters of pups while only coming into heat once a year.

It is not the fact that the bitch does not come in heat that sets the uterus up for infection. Rather, over repeated heat cycles, progesterone is released by the corpus luteum formed at each ovulation site on the ovary, and this has a quieting effect on the musculature of the uterine wall. It allows bacteria to invade and set up an infection in the uterus (pyometra).

Q (Question) I have a chocolate male Lab named Bear who is two years old and 75 pounds. Starting in December 2009, Bear has started getting flare-ups, where he has a lot of difficulty getting up or sitting down, though he never cries out in pain. His muscles seem cither achy or weak for some reason. When attempting to go up stairs, he has had his legs give out, and he slides down the steps. Sometimes he'll stand like a scared cat with a highly arched back. The problem appears to be mostly affecting his hind legs.

This condition comes out of the blue. I call them flare-ups because the problem is not constant, but episodic. He's afflicted around once a week. He'll wake up with the condition when he went to bed fine, or he'll be fine when we put him in the crate before leaving for work, but when we come home he'll be afflicted.

We have a prescription for Deramaxx (75mg). Deramaxx does seem to knock him out of the episode: Say we came home at 6 p.m. and he's afflicted, He'll hardly be able to get up the stairs. I'll give him one 75mg Deramaxx and by 10:30 p.m. that same night, he'll be perfectly fine.

He'll then stay fine around a week or so until the next episode. Exercise does not seem to induce a flare-up. He doesn't have diarrhea, nor is he vomiting. He has a healthy appetite.

TREATMENT HISTORY

Nov. 25, 2009: Problem hasn't started yet. Found fully engorged tick. Took Bear to vet to have Lyme disease test and get Lyme shot. Test comes back negative.

Dec. 5, 2009: Bear gets second and final booster for Lyme vaccine.

Dec. 24, 2009: Bear suffers from first flare-up. We give him Deramaxx, which we happened to have. Flare-up disappears. Take him to vet and he gets another Lyme test. Test comes back negative again.

Mid-January 2010: It is becoming obvious that these flare-ups are not isolated incidents. We take Bear to the vet again and he gets a blood test. Vet thinks it could be Addison's disease. Blood test results show it isn't Addison's, as he is actually a very healthy dog.

Beginning February 2010: Vet thinks the problem could be hip dysplasia. Bear is sedated, and his hips are X-rayed. Results show that his hips have no skeletal dysfunction. Vet suggests giving Deramaxx daily to see if flare-ups disappear.

Mid-February 2010: After only the second Deramaxx pill. Bear develops explosive diarrhea and bloody stools. We take him to vet and he gets anti-ulcer drug and Metronidazole.

End of February 2010: Bear has a flare-up right after finishing Metronidazole. We don't give Deramaxx but do give Rimadyl. Rimadyl has no effect. After three days, the flare-up doesn't go away. In desperation, we give one Deramaxx that night. When we wake in the morning, Bear is fine.

My regular vet has conducted a slew of tests and still has no idea what is ailing our retriever. We can control the problem but have no idea what is causing it in the first place.--RB

A (Answer) I can believe that your vet is stumped. These neuromuscular-skeletal problems of retrievers are very complex and often require extensive testing as the veterinarian rules out several possibilities. First the cardiovascular, respiratory and other organ systems must be looked at to make sure there is no underlying problem that may be expressed as this muscular weakness. Examples of these diseases might be diabetes, liver disease, chronic renal disease, lung disease and heart problems.

Then begins the long road of investigating the nervous system, bones and muscles. It sounds like your veterinarian has already taken some radiographs and ruled out hip dysplasia, and may have looked at the spine. Myasthenia gravis does not seem to fit your dog's symptoms, and neither does exercise-induced collapse (EIC). Other inherited muscular disorders usually show up earlier in the pup's life.

One thing that sticks in my mind is some type of polymyositis. This condition is best appreciated as a group of clinical signs that have one trait in common: inflammation of multiple muscle groups of the dog's body. Often this inflammation is an immune-mediated response.

Some diagnostic tests that might help define the diagnosis more completely are a serum creatine kinase test, electromyography and muscle biopsy. The first test can be run with a serum sample taken in your veterinarian's office, but the other two would require a visit to a specialist. One suggestion I have for undergoing these tests is the University of Pennsylvania College of Veterinary Medicine.

One other thing that is in the back of my mind with this dog is the question of clinical signs arising shortly after vaccination for Lyme disease. Did these vaccinations (rigger some immune response, such as lupus or inflammatory muscle disease?

Questions may be sent to me at htholcombdvm@qwestoffice.net.

By Tom Holcomb, DVM
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Title Annotation:Veterinary Clinic
Author:Holcomb, Tom
Publication:Gun Dog
Geographic Code:1USA
Date:Aug 31, 2010
Words:1332
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