"Apollo" Norton spent an enjoyable day out in the country with his family, but when he returned, he was biting at his tail . His owner took him to the New York City Veterinary Specialists where they found a (Hot Spot). He opted to let them clean it up and came to us the next day to let us deal with it.

While we were disinfecting the lesion, suddenly and without provocation, Apollo screamed out in pain. We've heard animals in pain before, but even we were shocked by the intensity of the cries that were emanating from Apollo.We just didn't understand what happened. Even putting Apollo on the floor didn't stop the screaming....

We couldn't do anything but wait, and try to give what comfort we could to Apollo. But every time we touched him, he cringed in even more pain.

Soon (but not soon enough), he stopped screaming, and was just whimpering a bit. He received a complete physical examination, but we found nothing wrong. After consulting with his owner, we decided to take radiographs, as the most likely explanation for such intense pain would be an intraveterbral disc problem. The X-rays seemed normal to Dr Raclyn, but to be safe, he decided to send the radiographs to a radiologist for a second opinion.

While we awaited the results, Dr. Raclyn spoke with Apollo's owner, and he recounted that Apollo hadn't been himself recently. He'd been lethargic, and his appetite has been depressed for a while. This prompted Dr Raclyn to do a general blood panel with our in house laboratory. Nothing turned up abnormal though, and the blood went off to the laboratory for confirmation, together with a CBC request to check the White Blood Count and Red Blood cells.

He conducted a neurological exam, and if fact, he noted that there were "proprioception deficits". This means that Apollo was unable to tell that his paw had been knuckled, and was unable to right it. This is usually a sign of spinal problems, but sometimes it can also be because of weakness in the leg or pain (they know the paw needs to be righted, but can't do it). We suspected that there was truly a "slipped disc", even though the X-rays appeared normal, and the neurological exam supported this. But whatever the cause, we knew that Apollo was in pain, and we needed to do something about that. We started a course of anti-inflammatory drugs, and Chinese Herbs for pain and inflammation.

At the same time, remembering that Apollo had just been out in the "country" (New Jersey) we ran titers for the major Tick Borne illnesses (Lyme Disease, Anaplasmosis, Rocky Mountain Spotted Fever and Erhlichia Canis). It would take at least a day to get the results back from these tests. Since Apollo was showing Neurological signs, we decided to get the specialists involved in this puzzling case. We referred Apollo to a Veterinary Neurologist at New York City Veterinary Specialists. The neurologist conducted a much more involved neurological exam, and also saw problems, but was unable to figure out what the problem was. Sometimes, medicine is a mystery, and sometimes we never get answers. We were hoping this would not be one of those instances. We continued the anti-inflammatory medications, and the neurologist added on other medications for pain as well. But we were stymied. It felt like an episode of "House", with Dr Raclyn, Dr. Freedman, and Dr. Levitan (the neurologist) banging heads together trying to figure out what could be plaguing Apollo.

The medications were helping, but it was still obvious that Apollo was a sick little dog. We were waiting for tests to come back from the lab either confirming or denying the possibilty of Autoimmune Disease, Tick Borne Disease, Intravertebral Disc Disease, and even urological problems. But when the results finally arrived, we were very surprised.

The radiologist agreed with Dr Raclyn, in that she saw no evidence of a "slipped disc". The CBC came early back the next day, and revealed that the WBCs (White Blood Cells) were normal, indicating the liklihood of an infectious agent causing the problem was slight. But there was an abnormal amount of Bilirubin (a bile pigment) in the urine. This usually indicates either a problem with red blood cells being destroyed in abnormal quantities, or a liver problem. But the blood tests showed nothing of the sort. The tests for Autoimmune Disease came back negative.

Then ... later in the afternoon... the Tick Borne Disease tests came back. Lyme Disease is one of the most common infectious diseases we see in dogs. We've even been seeing it in dogs who never leave the city. But the the Lyme Disease test was negative. The Anaplasmosis test was negative and the Erhlichia Canis test was negative. But lo and behold, the titer for Rocky Mountain Spotted Fever was not the expected 1:64, but instead was a whopping 1:4096. Yikes, that was high. Clearly, Apollo was forming so many antibodies to RMSF in response to having been infected by a tick carrying the disease.

Antibiotic therapy was begun immediately, and we continued with the medications for pain. As of this writing, Apollo is slowly improving and we hope for a complete recovery.

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