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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 28954
Experience:  University of California at Davis graduate veterinarian with 45 years of experience
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I have a 9 week old Maremma puppy who is currently at the

Customer Question

I have a 9 week old Maremma puppy who is currently at the vets with a very high temperature. I first noticed he was not well on Sunday morning (3 days ago now). The vet has performed blood tests, urine tests and xrays without any conclusive results. They feel like they have exhausted all avenues of getting to the root of the cause and are now advising I take him to a specialist (3 hours drive away) so they can conduct a spinal tap. This raises significant concerns for me and I am concerned that it will be evasive and uncomfortable for such a young dog, and that if they discover something terribly wrong it might not be able to be saved.
Can you offer advice on alternative treatments or management please?
Submitted: 9 months ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 9 months ago.

You're speaking with Dr. Michael Salkin. Welcome to JustAnswer. I'm currently typing up my reply. Please be patient. This may take a few minutes.

Expert:  Dr. Michael Salkin replied 9 months ago.

I'm sorry that your question wasn't answered in a timely manner and I'm sorry to hear of this with Monty. When the cause of a fever can't be confirmed with basic diagnostics and imaging, we call the condition a fever of unknown origin (FUO). Advanced testing might consist of the following:

1. Laboratory tests such as blood cultures to detect bacteremia associated with discospondylitis, endocarditis, or other foci of bacterial infection; cytology and cultures of cerebrospinal fluid or synovial (joint) fluid); cytology of lymph nodes or affected organs; serologic tests: antibody titers or antigen tests for specific infectious agents; PCR (DNA-based) testing for specific infectious agents; immune tests such as ANA, Coomb's, and serum protein electrophoresis

2. Imaging such as abdominal ultrasound to examine for evidence of pyelonephritis, prostatitis and to identify +/- aspirate enlarged abdominal organs or masses; echocardiogram; CT/MRI

3. Diagnostic procedures may include arthrocentesis looking for polyarthritis, CSF tap, muscle biopsy, abdominocentesis, transtracheal wash or bronchoalveolar lavage, laparoscopy, thorascopy, or exploratory surgery for biopsies.

Monty's age and clincial presentation will dictate which of the above should be considered. If there's evidence of altered mentation (mental status) such as disorientation, confusion, or ataxia ("drunken sailor") CSF tap would be reasonable. Please respond with further questions or concerns if you wish.

Expert:  Dr. Michael Salkin replied 9 months ago.
Hi Nicky,

I'm just following up on our conversation about Monty. How is everything going?

Dr. Michael Salkin

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