Sunday, July 3, 2016

Week 5 of Stella's Story. Rocky Mountain Spotted Fever that was and then wasn't: New diagnosis IMPA (Immune Mediated Polyartritis)

This has been a total roller coaster.  I have now seen a total of 3 vets with 3 different opinions.  Here is how the fifth week of this nightmare played out.

June 30th.  Called KSU at 8:01.  Got an appointment to see a specialist at 10 am.  Hurried up to my office to get all of my notes, and type up a good summary (was handwritten and very horrible).  Rushed back to Wamego, loaded up Stella, and headed back to Manhattan to KSU Vet Med.  Met my 4th year student, a very bright, wonderful young woman.  We went through EVERYTHING on my typed up time line, and she took lots of notes.  We waited another hour and a half for the resident to come in, but stella and I cuddled and caught up on work email.  Thank God for smart phones.  Found a penny when I took her out to potty.  I thought this had to be a good sign.  The resident felt like she had lupus and wanted to do some tests that would help rule lupus out.  We did an ANA test and a urinalysis.  The ANA test came back negative, but her urine was full of protein.  They decided to rule out lupus, but rule in some sort of autoimmune disease like poly-arthritis.  They also decided to go ahead with the endoscope friday morning (july 1), and do a joint tap to check out what is in her joints.  Before I left town, I got to go over, check in with the resident and student, ask a million questions, and share a bag of beef jerky with Stella.  She seemed way better, and performed all of her tricks for the student.  I am so ready to get this stupid bottle cap out.  I know we had to wait till she was stable enough, but now is the time.  I took out a loan from a family member to cover the cost of the KSU visit, and my other two vet visits.  I would rather have one payment than to have to pay three different bills.  It is what it is, and I am not going to stress about it.

July 1st:  Long night without my girl.  Very anxious watching the clock, knowing the timeline of things to come.  The student called me around 8 am to tell me she had a great night, and that she was doing really well, and in fact was very hard to examine because all she wanted to do was cuddle.  She was suppose to go into surgery around 11 am, and I would be called when she was in recovery.  True to form, the resident called around 12ish, and said she was in recovery and that the bottle cap was out.  It was very rusted, so hard to tell where it came from beer wise.  Her joints were tapped, and the fluid was cloudy.  They were waiting on path to tell them what the cloudiness was from.

In meeting with the resident and the student, we formed a plan forward.  We still haven't completely ruled out bacterial/tick borne in the form of Bartonella, so we are keeping the baytril in for that, and for the possibility of bacteria in joint fluid.  We are going back up to the high does of pred, hopefully just for 2 weeks.  We will have a recheck at KSU for blood values, pain management, and pred dose in 2 weeks.  Unfortunately, we will be on the pred for some time, with estimates being 3 months to 6 months.  The wean down will be very slow and very careful.
July 2nd: What a great day!  Now we are having issues keeping her quiet.  She wants to run, play, and not be quiet.  She has resumed many of her normal ways like sleeping in the bed with me, watching over andrew while he bathes, and being the boss of the boys.

July 3rd:  Much like the 2nd.  I think we may be officially done with this blog thread till her recheck, YIPEEEE!!!!  She really isn't having any issues being on the high does of pred or the codeine.  She is pretty much back to normal in all ways.  I will update when we get the joint fluid cultures back but other than that, it seems the nightmare may be over for now!!!!  Thanks for all the emails and calls and FB messages!  They have truly helped me get through this nightmare!

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