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Digging and Popping since 2000

 

Lepto and how one scalawag became the greatest

 

 

Years ago I remember sitting on a bench at a playground and overhearing a conversation between two mothers. They were appalled at some baby sitter callously ignoring the child she was supposed to be watching. They went on describing the dangers the poor baby was facing while this monster of a person was not protecting the child. Slowly I began to realize that the baby they were describing sounded eerily similar to my own daughter.  As my brain kicked into a higher gear I knew instantly who the monster was. They were talking about me! I was the evil person allowing my vivacious 2-year old to climb freely on the monkey bars while the other toddlers were safely anchored by their mothers’ firm grips.

 

That memory came back to me when I was sitting at a waiting room of an Animal Emergency Hospital in West Caldwell, New Jersey.  I was waiting to be allowed to see my precious puppy Kate, who was fighting for her life with a help of a snaky I-V line pumping fluids and antibiotics into her. Kate had Lepto but nobody knew it yet.

 

She was my dream come true puppy, nice looking, smart and very driven. I had observed Battaglia protocol for early puppy stimulation with the litter she came from, and almost immediately it was obvious to me she would be my star. By week four, when I augmented the program with my own exercises, I was shaping my dream dog. She was fast, alert, sociable and incurably cute and mischievous. By week 12 she was as close to being my soul mate as a canine can be. And here I was, looking into the dark tunnel of the worst nightmare.  The possibility of losing her was more than I could bear! That was the moment when I started asking myself if I had been protective enough. My own daughter survived childhood with nothing more than a couple of bruises, to emerge with a tremendous self-esteem and uninhibited spirit that I attributed to her unrestrained, exuberant explorations.  My heart might have skipped a couple of beats now and then but I tried to never hold her back. I have employed the same principles with my dogs.

 

Kate was born mid May and enjoyed the early outdoor explorations in the gloriously balmy weather of June.  She was always on the go, forever eager to disappear into the woods and flowerbeds. She was the first pup to dig a formidable hole in the lawn. At a tender age of 10 weeks she helped her mother to catch a baby bunny. We named her Dignpop Scalawag Kate.

 

Kate’s high energy level and friendliness worked against her in the early stages of the deadly disease brewing inside her. She was more energetic than her siblings and so when that energy dropped down it was not noticeable.  She just behaved the same as the other pups. She might have already been infected with Leptospira interrogans when I took the entire litter for their Distemper complex shots at the age of 12 weeks. I will never know that for sure. What I do know is that vaccination’s effect on the immune system sent my Kate on a downward spiral.

 

A day after the immunizations, which did NOT include a Lepto vaccine, Kate exhibited first visible signs that something was amiss. I was the only one to notice a slight change in her demeanor.  She ate well, she played with the other pups but she just was not quite herself in my eyes. I dutifully took her back to see the vet, who just sent me back home, as mild reactions to vaccines are only too common. Usually there is no need for any intervention. With Kate, even a mild reaction was not obvious.  She was wagging her entire body, licking the vet’s face and being a playful little clown. I remember sheepishly explaining that Kate was really a bit subdued and not bouncing off the walls as usual. I got a gentle nod but there was zero conviction in it. 

 

Next day Kate did not finish her breakfast. Although she still played and ran around I took her back to see my vet.  It was a Saturday and I did not like the prospect of a weekend without access to him. I knew he was leaving for a horse show. In fact we learned he was already gone and so Kate was examined by his associate, who gave her a shot of Benadryl and sent us home again. Next day, Sunday, Kate was definitely sick.  She did not eat her breakfast at all. I brought her to a state-of the art emergency clinic. While waiting our turn to be seen Kate made friends with dozen techs. The vet who saw us suspected a possible obstruction so in addition to running basic blood CBC we had Kate x-rayed and took a sonogram of her belly.  On paper everything looked in order. 

 

In that moment I felt that I had landed in a twilight zone. Was I insane or was everyone else?  I was holding a puppy in my arms, and I knew she was sick.  I was speaking to a doctor of veterinary sciences who showed me a paper and a video telling me that my puppy was well.  I love reading tests.  I am a junky for statistics, charts and graphs but here I stood as a breeder, which meant a mother.  My gut told me the pup was sick.  It was not reassuring to see all those numbers aligning in a handbook order. That only meant we had not found the enemy yet.  It was lurking in there.  I could feel it!

 

Kate got some sub-Q fluids because she looked “slightly dehydrated” and we were sent back home.  Again! Now for the third time! My frustration was bad but my fears even worse.  I had spent a few hundred dollars in three days, saw three independent vets and in essence I had been told to take a chill pill. The problem was my pup was getting worse and nobody was taking it seriously, except my husband and me. Less than a half hour after we got back home Kate threw up.  I went to pick her up and she arched her back and cried in pain.

 

The next twenty minutes were stretched into some haunting trance and seemed never to end. My husband was speeding to the clinic while I was cradling Kate in my arms and crying loud. When we burst through the hospital doors nobody dared asking us to wait.  The same vet who had just sent us home a short hour earlier needed no more than a short glance at Kate to know she was in trouble. Kate was almost listless in my arms. The vet ran the full blood work and announced that Kate had renal failure. Her kidneys stopped working. Her blood showed the whooping 140 BUN, which indicated level of urea nitrogen in the blood. In the normally functioning body, kidneys filter all sorts of toxins and sent them on their merry way out. Next time you see a piddle on the carpet appreciate the nature’s wondrous way of expelling all the bad stuff. Kate’s kidneys quit their job and so the toxins were flowing right into her blood stream. This time the results on paper were helpful, however horrifying.  Instead of the normal range from 6 to 25 BUN we saw the monstrous 140.  What I did not know at the time was that the worst news was yet to be revealed a day later. The ghastly results were not accurate.  They were simply the uppermost numbers the hospital’s in-house lab could process.  Another blood sample, taken at the same time, was sent to Cornell for an additional analysis to come back with the crushing 199 BUN.  I will spare you other technical data (creatinine, albumin, billirubin, phosphorus ...) and just say there was no doubt Kate’s kidneys packed their bags and left the engine running unattended.

 

Talk about denial.  My brain could not even process the vet’s suggestion for euthanasia. I kept asking incessant questions of why and how. I totally refused to believe we were dealing with any congenital problem and focused on any possibilities of acute condition. Kate was hooked up to an I-V line and we started pouring fluids and antibiotics into her body.  Fluids to “thin” the concentration of toxins in her blood and antibiotics to zap any possible bacterial infections.

 

It is amazing how quickly I forgot about social graces and interrupted Sunday reprieve for many veterinarians that day. Like a broken record I would relate all the test results, clinical symptoms and Kate’s history to them. I will forever remember the string of numbers on the blood test I was quickly learning to interpret. I sent a mayday call to all Internet dog related groups I knew. I hired a highly recommended internist to take over Kate’s case and spent the rest of the night reading everything I could find online about renal failure in puppies.

 

One thing I simply could not bring myself to consider was euthanasia without a certainty that Kate could not recover. Most Internet sites dealing with renal failure in puppies refer to congenital defects.  None of it seemed right.  Kate had been a picture of health. Her current condition was of such an abrupt nature that nobody believed there had been a problem till the crisis was upon us. I was convinced it was something acute and I had to find what it was.

 

I implored the specialist who took over the case to consider Lepto.  He collected urine samples directly from Kate’s bladder and sent them along with blood samples for testing.  Meanwhile all the tests that could reveal congenital defects came back negative.  Kate’s kidneys were of proper size and shape and showed no visible problems under a sonogram examination.  I refused my consent for a kidney biopsy fearing any additional trauma.

 

Knowledge can be a dangerous thing. Little knowledge is even worse. I knew practically nothing about renal failure and had to make some monumental decisions.  The more I read the more conspicuous it seemed that Kate’s illness coincided with puppy shots. Soon I found enough horror stories about vaccinosis to fill the largest binder. I was wrongly convinced that Kate was suffering a reaction to a vaccine but I also did not abandon the thought that it could be Lepto. In either case I believed that my puppy could be saved.

 

Kate’s BUN kept hovering way above 150 for three straight days.  Three days of not sleeping.  Three days of crying, reading, talking on the phone to other breeders, to veterinarians from dozens of leading vet schools across the country, crying some more. Three days of fighting with vets not to give up. A couple of other Norwich terrier breeders told me of very similar experiences with their pups.  Both suffered renal failure within days of receiving immunization for Parvo and Distemper.  Both died.  The necropsy was inconclusive but suggested Leptospirosis.

 

So that was how I got to that moment in the waiting room thinking about my daughter climbing the monkey bars to a loud disapproval of other mothers in the playground. Was it wrong of me to vaccinate Kate with a combination vaccine? Was it wrong of me to let her roam in the woods of my fenced-in property?

 

It was day three of our ordeal. I was allowed to see her again for a short 10 minutes.  Kate was visibly better.  She wagged her little tail feebly when she saw me.  I was elated.  Two hours later, at midnight, I was allowed to see her again.  This time my husband was with me.  Kate was wagging her entire body when she saw us.  She was back.  She was so Kate: chewing her I-V line, trying to crawl from my hands to my husband’s as fast as her weak body let her.  We both thought that it was the Katest thing to do.  She was so great, in fact the greatest.  Soon we were calling friends from coast to coast.  Happy tears!

 

Next morning the internist in charge called me to say that Kate’s condition had not improved according to the latest blood test results and that I should be considering ending her suffering.  Dumbfounded I simply collapsed to a chair and hung up the phone.  Luckily, the phone rang again and it was a friend with more presence of mind than my sleep deprived brain allowed me.  She listened to my blabbering between loud sobs, and just asked: “Is he talking about today’s results or results from yesterday’s blood sample?” Friends are wonderful!

 

Kate improved so much over the next two days that we were allowed to take her home. She was coming back home thin as a rail but with all her spirits intact.  We decided that after all she is no scalawag.  We renamed her as Dignpop Katest the Greatest. Within just a week of coming back home Kate’s kidney values were back to normal, all of them, even the most weird sounding ones.  Looking at those clean charts I was thinking that if that was not happiness than I didn’t know what was.

 

Now onto the Lepto thing. Urine samples showed no signs of Leptospires.  The blood test took almost 4 weeks to come back and it was inconclusive. Meanwhile, after much research, I agreed with vets treating Kate that it was prudent to keep her on antibiotics for a month following her terrible episode. A month later we tested her again.  The result was positive. As I learned, typically the first test is inconclusive until a second titer is run between 2 & 4 weeks and shows a four-fold increase.

 

I might never know what role the combined vaccine played in Kate’s illness.  I might never find out why she got it while 5 other dogs in our household did not.  I am glad she did not shed any bacterium from her urine. I am glad we brought her for treatment so fast. I am glad she is here by my side as I am typing this, the greatest pup I could ever dream of.

 

People often ask me if I am going to vaccinate my dogs for Lepto from now on. My answer is no. The bottom line is that even after my harrowing experience and almost losing the most incredible puppy I would not vaccinate for Lepto.  The only 3 cases of Leptospirosis in Norwich I know of ,including Kate, involved  strains that were not a part of the vaccine. The species Leptospira interrogans has been classified into subtypes called serovars.  Over 200 serovars have been identified and named. Vaccination against Leptospira interrogans is only available for the serovars called canicola, grippotyphosa, pomona and icterohaemorragiae.   According to veterinarians I spoke to from Cornell University and University of Pennsylvania more than 95% of the reported Lepto cases involve serovars for which vaccine does not exist.

 

Lepto vaccine, on the other hand, has been documented to claim Norwich terrier lives. I don't know the Norfolk cases but I would suspect the dangers are the same.  Even if your dog does not have a bad reaction this particular vaccine is taxing the immune system tremendously. So in effect you would be vaccinating against miniscule possibility of contracting 4 out of 200 serovars.  Moreover if your dog is vaccinated and he does get infected with Lepto bacterium the diagnosis might be impossible because the tests measure the antibodies against Lepto, which a vaccinated dog will exhibit of course. Another point to make is that vaccinations reduce the severity of the disease but do not prevent the infected dogs from becoming carriers. 

 

Did I change my opinion about dogs exploring the dangerous world of woods, where Lepto, Parvo, Ehrlichosis and Lyme, to name just a few bogymen, are lurking? No, I did not. My heart will still skip a beat or two sometimes but I will let them grow their uninhibited spirit.

 

Magda Omansky

Originally published in Ups and Downs, a publication of The Chesapeake Norwich and Norfolk Terrier Club