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Dr. Deb
Dr. Deb, Dog Veterinarian
Category: Dog
Satisfied Customers: 6110
Experience:  I have bred dogs and shown dogs for 20 years.
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My dog Holly, a lab 7 years old was diagnosed with

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My dog Holly, a lab 7 years old was diagnosed with chronic lyme disease. she recently, within two weeks began to limp on and off. Her blood test revealed she has a creatinine level of 3.7. My doc has her on clavamox 250mg, twice a day, she is 75lbs. he said there was blood in her urine and was worried about a uti. my dog is not eating at this point and we have her on iv fluids at home. i worry that the clavamox dosage is not enough but don't want to question my vet. Holly seems to be breathing rather quickly when laying down but otherwise is good when she is standing. she doesnt appear to be in any pain.
Submitted: 8 months ago.
Category: Dog
Expert:  Candy replied 8 months ago.

Hello, My name is XXXXX XXXXX I have been a veterinary nurse for 26 years.Thank you for allowing me to assist you today.

I am sorry to hear that Holly is having some trouble. I would love to help I just have a few questions.

Is the lyme disease a new diagnosis and if not how was it treated and was she retested after treatment?

Did your vet send the urine out for testing or did they test it in the office?

Has she been tested for any other tick born illnesses?

When did she stop eating?

I may have additional questions as we go along.

Customer: replied 8 months ago.

No offense to you but I would rather speak to a DVM

Expert:  Candy replied 8 months ago.
Thats no problem and I am not offended in anyway. I will opt out and see if I can find a vet to help you. Please do not reply back or it will lock the vet out.

Best Wishes to you and Holly
Expert:  Dr. Deb replied 8 months ago.

Hi, I'm Dr. Deb, a licensed veterinarian with over 25 years of experience.

Candy referred your question to me about Holly and I'll do my best to help you today.

To address your specific question about Clavamox, there's a bit of a range for dosages, but 250 mg twice a day seems on the low side to me for a 75 lb dog.
I probably would have dispensed at least 375 or 500mg twice a day. I've been going on the higher end of the range since we're starting to see drug resistance. Of course, I typically advise owners to give this drug with food to avoid stomach upset which may be difficult if she's not eating well.

That's a pretty high Creatinine. I'd be concerned about lyme nephritis given her breed and previous lyme exposure.
You probably already know this but lyme nephritis is a fairly serious diagnosis.

I would probably have done a culture and sensitivity of the urine if a uti is suspected to ensure that the proper antibiotic has been prescribed. It still can be done but the results may be affected since she's already on antibiotics.

An ultrasound of the kidneys wouldn't be a bad idea either.

 

Leptospirosis (LINK) is another diagnosis to consider since it can affect the kidneys and also cause lameness. The treatment is Doxycycline and Amoxicillin although some vets only use Doxy (I prefer both).

I hope this helps, Deb

Customer: replied 8 months ago.

Thank you for the answer Dr, I also thought the dosage was very low but did not want to question our vet. Holly has not eaten in 6 days and we visited the vet today and he gave her IV fluids with vitamins. She threw up three times since.


 


I was actually thinking of taking her for acupuncture as our vet and I were thinking euthanization. Holly, who is 7, is still up and around and wagging her tail. Her mobility has improved. The whole downward spiral started about two weeks ago. I have read about the prognosis of LN and it made me very sad.


 


Can you tell me what you would do if she were your patient. Do you think acupuncture is an option, I read a few good results.


 


The botXXXXX XXXXXne is I dont want to put my girl through much more but if there is hope I will.


 


 

Expert:  Dr. Deb replied 8 months ago.
You're welcome but I'm so, so sorry that Holly is having these issues:(

I'm sad to say that I've never had a dog with Lyme Nephritis (or a dog who I suspected had this condition) live, unfortuantely.
And, while some dogs with Lepto can ultimately do well, there is mortality associated with this condition, too, especially if it causes irreversible damage to the kidneys.

I always think that alternative therapies are worthwhile but in all honesty, I don't know if I think they'll be effective in this situation. It certainly won't cause any harm and may make her feel better.

If this were my case, I'd have her on a high dose of Amoxicillin at least 1000 mg twice a day just on the off chance that this is Leptospirosis. Injectable Penicillin is another option if she's vomiting a lot.
If she were eating, I'd have her on Doxy as well but when this drug is given on an empty stomach, the dogs are guaranteed to vomit.

I'd be hospitalizing her with intravenous fluids around the clock if at all possible. I'd be treating her with Cerenia which is a potent anti-vomiting drug and also has appetite stimulant qualities.

I'd monitor her kidney values. If they continue to rise or don't decrease, then I would probably advise euthanasia although it saddens me greatly to say so.

I'm not sure that I'd give up on her just yet....maybe give her a few more days with the above medical management I mentioned.

Deb
Dr. Deb, Dog Veterinarian
Category: Dog
Satisfied Customers: 6110
Experience: I have bred dogs and shown dogs for 20 years.
Dr. Deb and other Dog Specialists are ready to help you
Customer: replied 8 months ago.

Thank you for your answer. I understand totally what you are saying. I may be back to ask you more advice later. You seem like a very compassionate vet.

Expert:  Dr. Deb replied 8 months ago.

Thank you for your kind words; they mean a lot to me. Thank you for the rating as well.

And, you're welcome although it seems odd to say so under the circumstances.

Please ask as many questions as you want about this. I'm on my computer multiple times through the day so I'll get back to you as soon as I can if I'm offline when you post another question.

Even though you've rated, we can continue to communicate at no additional charge to you.

Deb

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