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Dr. Deb
Dr. Deb, Dog Veterinarian
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Experience:  I have been a practicing veterinarian for over 30 years.
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Dog been unwell, seen vet had blood test and urine test all

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Dog been unwell, seen vet had blood test and urine test all normal, has temp of 40 is restless can't get comfortable,won't eat .do you think emergency vet ?
Submitted: 1 year ago.
Category: Dog
Expert:  Dr. Deb replied 1 year ago.
Hello, I'm Dr. Deb and will do my best to help you today. I'm sorry for this concern for Tess; I can understand why you'd be so worried about her. When a patient presents with a fever and the origin can't be determined (no obvious wounds or evidence of pain or lameness/stiffness, blood work and x-rays are normal, etc), this can be a frustrating and challenging problem for both the owner and vet alike.Possible causes for a fever of unknown origin include1. bacterial infections which is why most of these dogs are placed on broad spectrum antibiotics in the hopes that they will respond.2. viral infections which aren't always easy to identify3. rickettsial or spirochete infections (such as are seen with tick diseases) and would respond to tetracycline-based drugs (Doxycycline or Minocycline).4. toxoplasmosis or neosporosis which are bacterial infections which typically respond to Clindamycin (which often isn't the first choice of antibiotics in these situations) or5. fungal infections, depending on where you live.6. cancer, I'm sad to say (although there are usually other signs such as weight loss or appetite issues)In many cases, there will be additional symptoms which might help point in one direction or another but when there's only a fever present, then often additional testing is required to narrow down the list (see below).Another option is to start treatment with tetracycline-based drugs to rule out a tick disease; if the patient doesn't show improvement within a few days (usually 72 hours), then this is less likely to be the problem.The additional testing which might be considered in these cases include:urine cultureabdominal ultrasound with aspirates of liver/spleenPCR/serology testing for rickettesial diseasespossibly joint taps and/or spinal tapspossible fungal testing (if common in your area).If this were my case, I'd probably dispense broad spectrum antibiotics as well as an also an anti-inflammatory drug. If there's no response and additional testing is not practical (for whatever reason), then I'd try a course of Doxycycline or Minocycline to rule out a tick disease.We do have tests for many of these diseases, but we are often testing for antibodies, not the organism itself, in most cases. If antibodies are not being produced (for whatever reason) then the tests could be negative and yet this is still the underlying problem. And with PCR and serology testing, there can be false negatives.I've also come to believe that there are tick diseases that we haven't even been able to identify yet and thus would not have tests for all of them. Unless Tess is currently taking antibiotics (and perhaps even if she is), then an ER visit would be prudent since she's not eating; she's not likely to improve on her own at home, unfortunately.I hope this helps. Deb
Dr. Deb, Dog Veterinarian
Category: Dog
Satisfied Customers: 9777
Experience: I have been a practicing veterinarian for over 30 years.
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Expert:  Dr. Deb replied 1 year ago.
Thanks for the rating; it's greatly appreciated. And, best of luck with Tess. I'll be hoping that this isn't anything too serious. Kind regards, Deb

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