Read Luna's Story
Read Luna's Update
Read Sharkie's Story
Read Sharkie's Update
Read Sharkie's Update (November 2000)
Read Sharkie's Update (December 2001)
Read Chaser's Story
Read Chaser's Update
Read Chaser's Update (January 2002)
 

Three stories about Tollers with immune mediated polyarthritis follows.  The first story, Luna's, was written specifically for this website, the next two stories were originally published in "Toller Talk" the newsletter of the NSDTR Club of Canada. 

Luna's medical file is larger than all of our other pets together, but to look at her you would think she's a normal, fun-loving Toller - other than her perpetually shaved knees, that is.  It started in February 1997, when Luna was 22 months old. She became withdrawn and unwilling to play with our older dog, a four year old German Shepherd Dog, and our new Border Collie puppy - both of whom she adored. We thought she was suffering winter blues (who could blame her, it was the worst winter in years), but she started getting worse. She began to have trouble getting up to move around. Her rear legs were very stiff and we could see they  were difficult to bend.  She began to whine very softly to herself when lying down and standing caused tremors to pass through her body with the effort of supporting herself. There was no injury that we could recall, so naturally our fears were of hip dysplasia, although her sire and dam were both cleared at the time of breeding.  However, x-rays proved that her hips are in excellent condition. The next step was the drawing of joint fluids from front and rear knees under mild sedation to determine if it was an inflammation. Luna was quickly diagnosed with  immune-mediated poly-arthritis, or arthritis in more than one joint cased by a breakdown of her immune system.  We began an anti-inflammatory treatment using Prednisone, which produced remarkable results - she improved within hours. But with the cure came several unfortunate side-effects, namely extreme hunger and thirst, poor bladder control and insomnia. The latter two also caused a considerable amount of sleep deprivation on my part.  We didn't see a dramatic improvement in the next joint taps in two weeks, and in fact there was little improvement, so we started her on Azathiaprine to suppress her immune system and to make it easier to reduce the Prednisone dosage so we both  could sleep.

For the next two and a half years we continued on a program of regular joint taps and reductions in the Prednisone dosage until October 1999 when we celebrated normal levels and took her off the Prednisone altogether. She remained on the same dosage of Azathiaprine as a stabilizer, and we made plans to test her again in a few months.

All was going well and we saw definite improvements in every way until mid-February 2000.  One day, with no changes in routine, I noticed she was lame and my heart sunk. I watched, hoping against the odds that I was wrong, but after two days she was definitely getting worse so I called and made the appointment for joint taps. Then, a strange thing happened that evening - she vomited up her supper and immediately became more animated. We had no clue before this that she might be unwell, although our GSD had been sick with a short-lived bug two weeks earlier. She hadn't shown any of the earlier signs that he had when he was sick, so we were very surprised to realize she had the flu!

We went ahead with the test, but the results would be inconclusive based on the realization that she could be suffering from a virus that may cause temporary inflammation. The sample results returned abnormal - as we suspected they might, but now we need to determine if the inflammation was caused by a return of her earlier problem, or as a result of the virus. (I know how I feel when I get the flu - my joints are stiff and I ache all over. Is this what she had?) We're repeating joint taps in two weeks, and then we'll decided if she needs to return to the anti-inflammatories. Through this entire ordeal I've been very anxious about her health. It's very sad to see a vibrant, energetic and talented little dog be reduced to a depressed and lethargic lump as she did. And although our vet assured us the Prednisone wouldn't affect her behaviour, we definitely saw dramatic changes in her manner. Where she had been focused and dynamic, she became inattentive and listless. She had enjoyed training and learning, now she resisted and lost interest quickly. However, we saw these positive traits slowly return as we reduced the dosage level of Prednisone. In fact, within a week of a dosage reduction, we would see a long-lost behaviour return that we thought was gone forever. When we finally quit the Prednisone, we were shocked at how playful she became. Our GSD has had little rest since, but no one's complaining.  So we're waiting again.

We'll likely never know the exact cause of her immune system failure, but we have a couple of theories. Stress, hormones and genetics likely all play a part, but it's still all conjecture. I have recently learned that one of her littermates has been diagnosed as dysplastic, but others from the same litter are healthy. There seems to be little or no apparent pattern to these immune-mediated disorders, but maybe with time and documentation of this kind we'll begin to see a pattern developing.  I chose a Toller because I wanted to participate in competitive obedience and other  doggy sports. I also chose a Toller because the breed touches me in a way no other breed has.  Luna obtained her CD with three HIC and a HIT, and I'm hoping that we'll be seen in the competitive obedience ring again soon. So, here I am with the dog of my dreams and what do I do? We keep going - I'm not giving up yet.

I'll continue to chronicle Luna's journey with this disease on this site as information becomes available.

Luna's Update – March 2000

Now that Luna has had a couple of weeks to get over whatever virus was plaguing her, she returned to the vet clinic for more joint taps. We are very relieved to learn that her joint fluid is absolutely NORMAL. This was an excellent opportunity for us to see how easily a virus can affect her health. We'll definitely be on the lookout for flu symptoms the next time she looks stiff and sore.

Now, our long-term plan is to test her joint fluid every six to eight months to ensure no inflammation returns and hopefully in time we can eventually stop administering the Azathiaprine which supresses her immune system. I strongly support a long-term treatment plan for situations like Luna's. If we had decided that a treatment of only a few months was all she needed because she was no longer stiff or lame, we may have seen a dog with such severe joint deterioration that her life may have been drastically shortened due to chronic joint pain in a few years.

We all know our Tollers and their stoic constitutions - they will not complain until they can no longer deal with their discomfort. Just remember, just because your Toller chases a tennis ball, doesn't  mean she isn't in pain.

Debbie Unger and Luna (Westerlea's Misty Moon CD)

At the end of July, 1994 I sent Sharkie to Calgary with my good friend Debbie Kishineff for the Alberta Booster. The trip was long, 13 hours one way, she had two bitches in season and the weather in Calgary was extremely hot. Debbie reported that he’d appeared depressed, lethargic and off his food during the trip. The stress level for him was probably extremely high and that’s what we attributed his symptoms to. A couple of days after he arrived home I noticed he still wasn’t himself; he lay under the porch, refused to eat, seemed depressed and when I could coax him out from under the porch he moved slowly and stiffly with his spine hunched over. The final straw was when he showed absolutely no interest in his tennis ball. That was when I took him to our vet, Ed Marshall.

Ed first decided that Sharkie was suffering from some sort of intestinal inflammation, and prescribed an anti-inflammatory and steroid for one week. However ,he decided to do a blood panel, just in case. The results came back indicating mild anemia, low red cells and a higher than usual white cell count, confirming Ed’s suspicions. When the prescriptions ran out Sharkie “crashed” almost immediately. He was lame in the right front leg, then the right hind, depressed, lethargic and off his food again. Back we went.

This time we saw the other clinic vet, Nigel Bass, who thought that perhaps Sharkie had managed to pick up a case of Lyme disease, although Lyme isn’t an issue in North-Central BC. Nigel prescribed steroids again while we waited for the test results. There was immediate improvement again. The Lyme test came back negative, and Nigel’s brother (also a vet) suggested we consider auto-immune disease. Nigel read everything he could on systemic lupus erythemotosis (SLE) and immune-mediated poly-arthritis and lent me his textbooks so that I could read the same and we decided to start a course of prednisone that would hit Sharkie’s immune system fast and hard, followed by a gradual weaning off the drugs. We were advised by the lab at the Coast that we could not undertake to do joint taps or an anti-nuclear antibodies test while Sharkie was on the drug therapy.

In the meantime, I contacted Sharkie’s breeder, Lynda Martin to let her know what was happening. Until my conversation with Lynda, no one in the Toller world had ever mentioned auto-immune disease in Tollers to me. I was devastated by our conversation, terribly afraid that Sharkie was going to die. Lynda gave me the names of two other Toller owners who had dealt with the same problems and I contacted both. They were a wealth of information and a great comfort to me, although one had lost her dog during the battle, and the other subsequently lost hers as well. Due to the lack of information available I told Lynda that I would not be silent about Sharkie’s disease as there were likely to be other people in the Toller world who were dealing with the same problems, but were not aware of the prevalence of auto-immune diseases in Tollers. She was readily agreeable.

In January of 1995 I wrote a letter to Dr. Jean Dodds of Hemopet in California. Dr. Dodds is one of the leading authorities on auto-immune disease in dogs and I wanted her opinion. Imagine my surprise when Dr. Dodds herself called me one evening. During our conversation she determined that although Sharkie doesn’t suffer from full blown SLE, he more than likely has a naturally weak immune system that was severely compromised by the trip to Calgary and it’s associated stresses and that the stress triggered the crash.

Sharkie was 20 months at the time of his crash. He’s a 21 inch high dog, with good bone. At his worst, he weighed only 39 pounds, had lost most of his undercoat and looked like an abuse case. I started him on a home-cooked supplement, designed to boost immune systems and started gathering whatever information I could on Tollers and auto-immune disease. Whenever asked, I’ve shared general information with owners who have contacted me. Specific dogs, other than my own, I have not discussed. Up to 1993, Swedish club health records had recorded 17 cases of immune-mediated poly-arthritis, and there apparently seemed to be some indication of heredity. I feel that there may be a familial link.

Today, in January 2000, Sharkie weighs in at a well-muscled 52 pounds, has beautiful coat, and has been drug- and symptom-free since December of 1994. As we’ve never had a definitive diagnosis, I have a standing arrangement with the vet’s office that they will clear the decks to do joint taps if Sharkie should crash again. Since June of 1998, after he’s been lying down for any length of time, he’s exhibited lameness in the left front and x-rays on his front legs revealed a fuzziness on his left elbow, which the vets feel probably indicates arthritis. It is likely this is a result of the immune-mediated poly-arthritis.

Sharkie's Update – March 2000

Sharkie has been drug-free since December 18, 1994 and has remained in remission. He plays ball very hard in the yard, goes on every hike with us and is a great swimmer. The arthritis in his elbow continues to be a concern, but hopefully we'll hit on a combination that will give him relief.

Sharkie's Update – November 2000

In late September of this year I noticed that Sharkie’s mouth was bleeding.  That night all the dogs had been given moose leg bones to chew on, and I attributed the bleeding to that. However, a couple of nights later I noticed his mouth was still bleeding and I took a much closer look. What I found horrified me. He had small blisters all along his gumline and when I lifted his tongue I found two huge purple edemas under it. The next morning I called the vet’s office and arranged to take him in.

Given his past history the vet was very thorough, checked her text books, asked lots of questions and then said she thought Sharkie may have “pemphigus”  (http://www.canismajor.com/dog/autoimmn.html#Skin). This meant nothing to me. I spent the weekend doing internet searches for pemphigus and discovered that there are four forms of it, all are an auto-immune disorder. Pemphigus vulgaris is the worst of the lot, and this is what Sharkie’s mouth looked like.

I called the vet’s office Monday morning and made arrangements for him to go in the following morning for a biopsy to determine whether we were dealing with pemphigus and an anti-nuclear antibody test (ANA) to determine whether we were instead dealing with system lupus erythemotosis (SLE). The clinic was also concerned by the bloody foam now coming from his mouth and ordered a chem panel as well in case his liver was shutting down. In the meantime we were sent home to start another round of prednisone to suppress his immune system. The first week’s dosage was 100 mg/day, which is a huge amount. I noticed a very quick improvement in Sharkie’s mouth, the blisters disappeared, the edema under his tongue was going down and all we were left with was a fairly large ulcer above one canine tooth.

We waited a week for results from the lab in Ontario. Once again we are left without a solid diagnosis. The biopsy for pemphigus was negative, as was the ANA test and his chem panel was also fine. The “best guess” is auto-immune vasculitis.

In the past month Sharkie’s mouth has cleared up, to give his body a higher level of function I’ve switched him to the BARF raw diet, and we’ve begun the prednisone weaning process again. I’m hoping that we will be lucky and achieve another 6 years of remission.
 

Sharkie's Update – December 2001

Sharkie's story seems to be one small thing after another....over the spring and summer of this year we started to notice a gradual decrease in Sharkie's energy level, an increase in his weight and his coat was starting to look funny. Despite shortening his rations, his weight continued to rise to a high of 58 pounds. Right before we left for the National in Ontario we had our new vet clinic send a thyroid serum panel to Dr. Dodds at Hemopet as I was suspecting he was likely hypothyroid. This was confirmed and Sharkie was started on .3 mg/twice daily of Soloxine on September 5. I increased his daily amount of powdered kelp to help support his thyroid function and I try to keep his intake of cruciferous vegetables low or nil. We have since managed to pare his weight back down to 52.5 pounds and I'm hopeful I can get another 2-3 pounds off him in due time. His coat is looking normal again, he's as active as his arthritis lets him be and he's back to being his nosy, inquisitive self! He turned 9 years old on December 3.
 

Laura Norie and Sharkie (Ch. Colony's Sailor's Delight TD, CD)
 

In late June of 1998, our dog took a tumble on wet grass while retrieving. He didn’t seem to be affected by it at all. The next day we went to agility practice, and the day after that we went on a 5 km walk. The third day after the fall, he stiffened up. He had trouble getting up when lying down. That third day, he also had his annual vaccinations and rabies shots.

We rested Chaser for a week thinking he’d shake off the stiffness of the fall which had been aggravated by too much exercise. He seemed to be getting better, so the first weekend in July we participated in a scheduled weekend agility trial. Chaser stiffened up over that weekend and uncharacteristically knocked down jumps by the end of the second day. We gave him another week to heal up after all that exercise but he didn’t seem to get any better. We called our vet and she said to rest him for another week. We saw our vet a week after that. By our description and by what she saw, she said he seemed arthritic. Physical examination revealed nothing. He could gait properly and could lift either leg to urinate. He didn’t indicate lameness - just stiffness upon getting up when lying down. She called down to OFA to ask about Chaser’s hip x-rays. which were taken on June 1st of this year. OFA stated that there was no arthritis, no dysplasia -just a slight subluxation of his left hip. We asked our vet about possible causes of his stiffness - could it be a bone spur, a pinched nerve, a fracture, a disc problem, soft tissue damage (ie. a groin pull),...? Chaser was started on “Metacam,” a non-steroidal anti-inflammatory to relieve any inflammation.

Chaser’s condition took a noticeable downturn in early August when he started yipping going up 4 steps on our deck. He held up his left hind leg, then a few minutes later he could put his weight on it. He could not jump in and out of the car to go for his ever- shortening walks. Back at our vet’s. Auto-immune disease was mentioned. We knew Laura’s dog, Sharkie, had auto-immune problems. But Sharkie had had a very different onset of symptoms. His was a sudden onset with drastic symptoms, leaving him with no desire to retrieve or eat. Whatever was wrong with Chaser was a sudden onset with a gradual worsening of symptoms; but he still had a desire to play and eat. We had a Complete Blood Count, Blood Chemistry Panel, and Urinalysis done on Chaser to provide a baseline. The Urinalysis indicated that his protein was slightly elevated, otherwise all tests were normal. No auto-immune indications showed up in the bloodwork.

Chaser had been allowed to swim throughout all this up until one episode where he was very stiff a few hours later. The swim did not seem to alleviate his condition that time. In mid-August he then started limping in his right front leg, which gradually unstiffened as he walked it off. A few days later, he started limping in his left front leg which also unstiffened as he walked it off.

We went back to the vet’s. A second urine sample turned out to be normal. Chaser was then heavily sedated to see if he’d yelp on palpation when relaxed. He didn’t yelp. Then he was x-rayed in all of his joints. Nothing but the slight subluxation was seen on the x-rays in the left hip. There were no fractures and there was no arthritis. The vet saw his left front lameness in the clinic which wore off as he walked it off. The vet suggested that the front lameness could possibly be attributed to the dog compensating for the pain in his back end. Hip surgery was a possibility for a few weeks down the road if he did not get better. The vet had consulted with the senior vet in the clinic as well as with another vet in the Prince George area. However, a second opinion from an orthopedic specialist was recommended.

Dave and I had watched our dog go from an active, agile athlete to a toneless, progressively lame and stiff 3 1/2 year old male. He was now also limping either in the front or back end on an almost daily basis. We still hadn’t ruled out other causes such as soft tissue damage which could be diagnosed through ultrasound or centography. No such machines existed for dogs in our area. We decided to take him to the University of Saskatchewan’s Small Veterinary Clinic. We booked an appointment for the following week and drove there. Chaser worsened during the trip. On the morning of our appointment, Chaser had trouble moving his head sideways or up and down, and yipped when he moved. We were afraid to even pet him.

At the U. of S., the vet listened to Chaser’s case history, looked at the recent x-rays. gaited Chaser, tried to run up and down stairs with him, and performed various physical exams and various blood tests. They ruled out any neurological damage. The blood tests and urinalysis were normal. However, the vet said that Chaser’s neck lymph nodes were enlarged. He decided to do a joint tap test that day. The joint tap test indicated lots of thin (not viscous) liquid in all eight joints. The liquid was also red-tinged. (he later told us that the red-tinged color may have been due to the “Metacam” which we had taken Chaser off of the week before in case he needed surgery. “Metacam” is a blood thinner.) They needed the final results of the joint tap test and the cultures before making a diagnosis and would tell us the next day.

On day two at the U. of S., after 9 1/2 weeks of not knowing what was wrong with Chaser, we had a diagnosis. The results of Chaser’s joint tap test were consistent with immune-mediated polyarthritis. This condition occurred the day he received his annual shots and rabies in late June, three days after his witnessed fall. It is unknown whether the shots caused this disease or whether the shots triggered it. We will never know. There also is no test available to test for this disease before it surfaces. They also did a Lyme Disease test (negative) that day to rule that out.

We spoke with Karen and Lillian, Chaser’s breeders, and told them about Chaser. We said that other people should know about immune-mediated polyarthritis as it happened in our case, it could save them weeks of endless unknowns. They agreed. We’ve also started Chaser on a different dog food with more “natural” ingredients and a supplement.

Chaser is now on Prednisone which he will be weaned off of around Christmas. His prognosis is good. With gradual exercise to build up tone and stamina, he should be back to his usual active self by next year. Of particular note throughout this ordeal was Chaser’s attitude. It was very good from the outset and we know it will see him through to his recovery.

Chaser's Update – January 2000

Chaser is almost five years old now.  After three bouts of steroids, he has been steroid-free for seven weeks.  He’s still a little stiff, but he is steadily gaining back his muscle tone thanks to his new retrieving pal, Tracker.  A few months after Chaser’s diagnosis, we also discovered that he had hypothyroidism, so he is on soloxine every day.  He was neutered last year as well.  For the past few months,  Chaser has been on an even more natural diet:  chicken vegetable stew, a small portion of an excellent natural quality dog food, vitamins, flax seed oil, and a nutritional supplement from the sea.  Chaser’s healing is an ongoing process.

Chaser's Update – January 2002

Chaser is almost 7 years old. He still experiences his "bouts", but they are less severe and less frequent. He also has residual stiffness, and is still on thyroid medication.

On the upside, it's been 3.5 years since he was vaccinated. The toxins are dissipating out of his system. Chaser's also been under the care of a homeopathic vet for 21 months and he's also been on a 100% raw food diet for 12.5 months.

In the past 8-10 months, we've noticed a marked improvement in his comfort level, attitude, zest for life and agility. We tend to think it's the raw food, but we know all the above variables are at play to one degree or another.

Yvonne Weyer and Chaser (BISS Ch.Kylador's Genuine Chaser TD ADC)