Cornell University Hospital for Animals

 

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Patient Spotlight: COWBOY

A rugged rascal since puppyhood, Cowboy had weathered many scuffs, but in spring 2012 his owner, Jay Phillips, noticed something very wrong. Though he had been fine the previous day, suddenly the Boston terrier was reluctant to move or eat and began crying late one night. He seemed limp and in the morning he was paralyzed from the neck down.

“It was terrifying,” said Phillips. “I raced him to Cornell University Hospital for Animals and they took samples for a bunch of tests.”

The doctors suspected Lyme disease, and proteinuria and hypoalbuminemia seen on blood work raised concern about the possibility of Lyme nephritis, a condition in which Lyme disease attacks the kidneys.

“Test results told us that Cowboy's kidneys were being damaged at two different locations, both at the glomerulus (or filtering apparatus) and the renal tubules (concentrating apparatus),” said Dr. Catherine Cortright, who oversaw the case. “The glomerular damage was causing protein to leak into Cowboy's urine. The tubular damage resulted in glucose remaining in the urine rather than being pumped back into the body and saved. It caused cells to be sloughed into the renal tubules and appear in the urine.”

Testing at the Animal Health Diagnostic Center revealed that Cowboy had chronic Lyme disease and was experiencing an acute flare up. Lyme disease can present two different clinical scenarios; an acute infection, or chronic disease. The acute form usually attacks the joints, causing an intermittent lameness that may move from one joint to another. The more chronic disease is the result of antibodies against the bacteria building up in the blood and blocking the filters of the kidney, causing extensive kidney damage that can be fatal.

“Most dogs that are Lyme positive in this area have no clinical signs, and just being exposed and testing positive is not a reason to treat,” said Cortright. “But Cowboy had developed severe clinical signs. It’s possible he had Lyme nephritis, a serious and life-threatening condition that is poorly researched in the dog. Many of the treatment options are in their infancy and there is not yet strong scientific support for any recommended treatments. Cowboy's kidneys had experienced extensive damage. Kidneys in general are not able to regenerate function. This means that every insult that they experience is irreversible, so waiting to treat aggressively could mean the loss of adequate kidney function in the future.”

The prognosis was grave, but Cortright prescribed a combination of medications that helped ease Cowboy back to functional kidney levels. Recent tests have revealed a more complex picture, suggesting that autoimmune disease, which can be sparked by Lyme disease, might also have played a role in Cowboy’s symptoms. Nevertheless, Cowboy’s symptoms have been managed through medication since he came to CUHA, and frequent rechecks show he continues to maintain the good health he restored.

“Initially they had estimated he had two months to live, but I took him home and had a serious talk with him, and years later he’s still thriving thanks to the care he gets at CUHA,” said Phillips. “He looks like a million and still has his spunky personality. I took him on a three mile walk yesterday and he came home and found a rope to play with. I owe Dr. Cortright everything, she was a rock star. She called me from her honeymoon to check in on him. It has been a very long road, but Cowboy has gotten better and better."

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