TANNER'S STORY - VALLEY FEVER - 1 Jan 11, '08 12:19 PM
by Lorraine D Iervolino

TANNER'S STORY
And
VALLEY FEVER


VALLEY FEVER
I am writing this because if I can save one owner and Yorkie this heartache, it is worth it. Tanner's owners feel the same.
I sold a Yorkie to this couple two years ago. It has taken two years for the proper diagnosis to show up. I have permission from his owners to post this and, since I am the breeder, I gave permission to myself.
It is so important to find the best owners you can for your pups. Another couple may have stopped looking for answers and Tanner may have suffered til the day he died.
Tanner and his owners live in West Texas. What follows is Tanner's new mom's personal diary and correspondance between us both. With each new doctor, I personally did a follow up call. This may take two or three postings, so please bear with me and read the whole story. I think it's important to see the agony a breeder and the owners go through when something is not right with a pup.



Hi Lorraine,
Feel free to use whatever you want from this. I do think it would be only right to use initials in place of the vet's names as you suggested. I included vet's names because the Dallas vet and these vets went to school together I think. I bold-printed what I felt was really important for him to see...should have bold-printed the coughing episodes! I included those because he had had Prednisone then and responded in a "normal" way...eating and drinking more...not so with the recent Prednisone treatments.
Gotta run...Me
Tanner Boy Moore born March 4, 1999

6-10-99 We got Tanner

6-11-99 Dr. B first checked him

7-7-99 Tanner has started to jump into the recliner, my lap, and onto the couch. I had been concerned about what I saw as a right hind leg limp so asked Dr. B to check it. He watched him walk and said he is doing it with both hind legs, one a little more quickly than the other. He said he probably has "loose knee caps" but would do nothing about it at this time. He doesn't seem to have pain. I didn't ask but wonder if his size has anything to do with it. It seems his legs have grown longer in a hurry! Dr.B said let him continue his usual activities of running and walking, etc. I hope the activity will help strengthen the muscles, tendons, and ligaments so he will not have trouble in the future from it. He used me for an "on-ramp" to the couch this morning! I was sitting in front of it as usual to play with him. All of a sudden he came charging and before I knew it he ran up the front of me, over my left shoulder and onto the couch! Once there, he checked out the top of the cushion where I keep his leash!

7-10-99 What a handsome stance Tanner has when he walks. He stands tall and looks so confident

7-26-99 Tanner is getting really good about stepping right along on our morning walks...slows down for the evening ones!

8-18-99 Dr. B checked Tanner over, clipped his nails, etc., he made a discovery about Tanner's right rear foot. He is apparently double-jointed in his outer toe. That means he can't "push off" with that foot the same as he can with the other. That probably also answers why I saw that limp earlier! Dr. B showed me the different ways Tanner puts pressure on his left foot and his right foot...he kind of "grips" with his toes when his left foot is set down and pressure brought to bear. He lets his right foot "hang loose" in comparison. Dr. B checked his knees and seemed to feel there is no problem at this time.

9-8-99 Tanner was neutered.

11-15-99 Given "Orbax" (22.7mg) that Tanner took 1/2 tablet daily for 10 days. At the same time Dr. B gave Tanner "Temeril-P" that Tanner took 1 tablet twice a day for two days, then 1/2 tablet twice daily. That didn't seem to make a lot of difference except to make him restless all night for a few nights. I knew he was eating more and drinking more as a result of the medication so I didn't want him to have to go out and be made to stay in! We went out lots of times that night! Dr. B did hear congestion in his lungs on that visit and we can hear it pretty often as he breathes.

11-30-99 Tanner is still dealing with that very dry cough. I may have to take him back to Dr. B. Thankfully, he doesn't cough very often so he may be better off dealing with it than having to take more medicine. It was windy and very dusty today.

12-3-99 We will be taking him back to see the vet soon since the cough lingers and gets worse when he doesn't have the medication.

12-4-99 Dr. B says it is allergies and so has put him on a stronger dosage of Prednisone.

4-4-00 I took Tanner to Dr. B because he was limping pitifully...left hind leg. A physical exam didn't determine any specific cause but we tried Rimadyl (25 mg chewable) for 10 days...a half tablet twice each day. He responded almost immediately with favorable results...seemed to have no problem whatsoever. Four days after the finish of the medication, the limp started again. We did the ten days, same treatment, followed with the same results, even to the start of the limp again four days following the end of the treatment.

4-17-0 10 more Rimadyl (25mg chewable)

4-26-00 5 more Rimadyl (25 mg chewable)

5-3-00 Today Tanner was radiographed by Dr. B. The x-ray was done without anesthesia and Tanner twisted. This made it look like his left hip was a little bit out of the socket. Dr. B explained it is probably a stretched ligament, that Tanner is a very active dog. He could not tell from the x-ray but the Rimadyl treatment and limited activity is the treatment for now. I specifically asked him about Tanner’s walking because of the way he pulls hard against the leash and Dr. B said to walk him. We will try the 1/2 of the 25 mg Rimadyl once each day for a couple of months then have another x-ray if he continues and/or develops the limp again following that. (Since Tanner had had the coughing a few months back…mid-November, ’99…and now had the lameness, his breeder was concerned with Lyme Disease. Dr. B indicated that was not a problem here.) Bought 30 Rimadyl (25mg chewable) today.

1-15-01 Combing Tanner, started at head and back as he stood on the carpet, then turned him and laid him onto his right side. He lifted his head with a little yelp. I quickly but gently pushed his head back towards the floor and he jumped up making a ki-yi-yi sound and holding his right front paw off the floor. We thought his shoulder must be dislocated the way he acted but a check by Dr. B revealed no apparent problem. By the time we got to the vet’s, Tanner had stopped limping. Dr. B thought it must be a bit like when we hit our “funny-bone”.

Sometime in mid-February Tanner took off after a cat and when he curved quickly around a sharp corner, his body twisted like a person’s would when turning an ankle.

2-26-01 Tanner was limping again so I took him to Dr. B who suggested that since we were simply controlling the pain we should see Dr. T H to determine what the problem is.

2-27-01 Dr. H did radiographs (used anesthesia) and told us that Tanner has 8 lumbar vertebrae instead of the normal 7. He told us it is “hemivertebrae” and showed us the x-radiographs as he explained. He told us Tanner would be sore that night from the positioning they had put him through in order to do the radiographs.

3-19-01 He has been in pain since the radiographs were done 3 weeks ago (stands like an old horse, head and tail end down, definitely favors left hind leg, won't lay down without help, walks slowly, has difficulty squatting for bowel movement, does not lift either hind leg to urinate). His treatment at present is 1/2 of a 5mg Prednisone daily (1/2 every other day did not effectively control the pain except for the first 12-14 hours).
I called Dr. B to tell him we had to do something better to help Tanner. He had so much trouble lying down that I had to force him (gently of course) and he'd act so relieved once he was down and could rest. Then, when he'd have his Prednisone he'd be a different doggie for the first few hours...could and would lay himself down. I asked Dr. B, "Do you want to hear what I think?" He said, "Yes, I want to hear what you think," in a manner that indicated to me he was perplexed to decide how best to continue. I told him I felt that Tanner would do well to try the 1/2 Prednisone dailv...that was no more than the original prescribed amount of one whole one every other day. (The whole one seemed to bring all-over-the-body tremors at 6AM following the first evening dose given at 8:30PM, so Dr. B said to cut the dosage in half.) So, beginning yesterday around noon Tanner got 1/2 and today he has had the second 1/2. He definitely does better this way...at least for now. My real hope and prayer is that by doing this, we get him enough help that eventually he'll get back to being as he was before he took that running curve! ( Some good has come out of it...he won't even try to jump to our low couches.. .he sits facing the couch where his little flat pillows are (one he leans his chin on, the other he leans against)and groans at us until we pay attention and help him up there! Then, when he wants to get down, if we don't notice, he groans at us some more! Today he was resting comfortably on the couch and I leaned back in my recliner. Right away he started to make little groany noises and I'd talk to him each time. Finally, I got up, went to the couch, and asked, "Do you want me to hold you in my lap?" Well, of course that's what he wanted! So we rested together a while! I figure he is really better off on the couch since that is a more stable flat source than my lap but we both take comfort from holding each other! So, for now, we will try the Prednisone daily. Dr. B said there is another medication (not a steroid) that can be given with the Prednisone but that has a tendency to make them sick so we'll avoid that of we can. I cannot believe that retching would help relieve Tanner's discomfort!

The side effects to Prednisone were classic the first time Tanner took it (when he had the allergies that first fall).. .he ate more, drank more, and needed to go out more. This time it has not increased his appetite but he has taken a bit more water. I did notice yesterday that he ate about 2 hours after he took the med and the same today. I will watch that he not overeat because he does not need more weight. His little haunches look quite pitiful...I know that the male is slimmer through his hips than the female but his hipbones and spine protrude and feel so rough and bumpy.. .more than they did a few months ago.

I did make a point of letting Dr. B know that the effects of the positioning for the radiograph seem to have been definitely detrimental. Dr. H had said that Tanner would probably be more lame that night because of the positioning but this is now 3 weeks later...not just one night.

10:29PM Since his medication started working mid-day he has had much relaxation and I'd say relief. After I worked at my desk earlier this evening I walked around in front of the desk and saw that not only was he relaxing on the floor, but he had laid on his tummy with his front feet straight out ahead of his body, nose tucked between his paws, and his back feet straight out behind him. He used to do that often but had not done it for a while.

11:11 PM He has just been outside and did a few "big dog digs" after he finished what he went out to do! That is another thing he has not done in along time. I will try to keep him from getting too exuberant but it surely is good to see him seeming to feel more like he should.

3-21-01 He has slowed somewhat in his comfort again this AM but before long it will be time for his pain med again.

3-24-01 Weight 10.1# Took Tanner to Dr. B to ask him to feel the prominent bony structure that has evolved in Tanner’s spine and hips. Explained that pain reoccurs once the Prednisone has been in his system 16-18 hours. Tanner has lost 1.5-pounds since this started even though he seems to be eating and drinking quite well. Dr. B said he feels it is time to have him checked in Dallas.

The following are letters between us.
Dear Lorraine,
Our vet thinks that Tanner is a "keeper"! He has now had his rabies
vaccine and is set up for his follow-up shots in the next weeks.
Tanner didn't wake me so much as I woke him last night I think! When I
put him in the kennel, he whimpered a little, so I lightly tapped he top and
told him, "Tut!" in that voice that says this is not acceptable behavior. He
didn't need to be told twice! He tried the same attention-getter later when
he had been just put in the kennel, too, so got the same attention again! He
and I have to come to a quick understanding of the fact that outside is not
just for a place to play! I am sure he and I will soon understand his body
language better so he will get out before he decides puddling is urgent! He
has eaten well and drank water well, too. His little eyes are so bright and
he thinks it is fun to get as close to our feet as possible...when we are
walking is not the wisest time for his attacks, but the most likely time for
them to occur! He is most happy with his pull rope toy but chewed a little
on the hard rubber ones just enough to let us know he appreciates having
them! He does like to cuddle some...especially when we took him to that
strange place...the vet's...this AM!
Did I understand correctly that you had called him "Big Boy"? He
responds so quickly to the "boy" part so I told J. I think we can just
incorporate the name you had and we chose so he can be Tanner Boy of Westwind
House. Is that okay with you? (Westwind House is what I have chosen to name
our house here since Westwind was part of Tray's name based on our having
lived on Westwind Drive when we got her. When we moved here we found that
the west wind surely blows with such frequency that we felt we could, as they
do in the land of the Yorkies origination, name our house. That is why the
Westwind House is added to Tanner's official name.)
When we went out to get into the car, our neighbors across the back alley
were just coming out. We introduced them to our new baby and they were
delighted with him. The young woman said her mom needs a puppy, has had two
poodles but will be looking for a different breed. Our neighbor thought a
Yorkie might be just the thing, said she would being her mom over to meet
Tanner next time she visits, and indicated they, too, would be willing to
drive to Corsicana. I plan to share the phone numbers for you and Jean if
they want them. I had printed off the pictures that Jean had sent, so will
be sure they see those as well...how could anyone resist after seeing the
puppy "in person" and the pictures?
I am glad you have your e-mail back! I miss my friends when they are not
able to communicate so freely.
Tanner said to tell you he sends his love and that he thinks we are
"keepers" too.
Thank you so much for your caring and concern...for us as well as for our
puppy.

First signs of trouble:
Dear Lorraine,
I took Tanner for his 4-months combo shot today. He really clung to me
to stay away from that guy with the needle! He does eat well but he is also taking the
once-to-twice daily walks plus the running he does inside and out so he is
getting more muscular.
I had been concerned about what I saw as a right hind leg limp so asked
the vet to check it. He watched him walk and said he is doing it with both
hind legs, one a little more quickly than the other. He said he probably has
"loose knee caps" but would do nothing about it at this time. He doesn't
seem to have pain. We will keep you informed about this...not because there
is any question about our plan to keep and care for Tanner, but because you,
as a breeder would probably want to know. ......

Tanner does not seem to have any discomfort that I can see. We will keep you
informed...the next vet visit will be in about 6 weeks for a Parvo shot, the
the neutering to follow that. I am praying that his daily walking exercises
will help him gain strength in his muscles, tendons, and ligaments so to help
hold him all together the way he needs! We will try to limit the jumping,
and thank you for the advice...makes sense to me that he not "jounce" those
long legs of his. (We are taking pictures regularly and when we get the film
developed, I'll be sure you get to see some via e-mail at least! It takes a
while to use up the 24-shot film, but once the grandkids come to spend next
week, we'll take more for their memory books, too.)
Tanner grows dearer day by day! He is a most affectionate little guy. .........

Tanner went for his 4th Parvo shot this AM.
As the vet checked him over, clipped his nails, etc., he made a discovery
about Tanner's right rear foot. He is apparently double-jointed in his outer
toe. That means he can't "push off" with that foot the same as he can with
the other. That probably also answers why I saw that limp earlier! Dr.
B showed me the different ways Tanner puts pressure on his left foot
and his right foot...he kind of "grips" with his toes when his left foot is
set down and pressure brought to bear. He lets his right foot "hang loose"
in comparison. I am really relieved that it's apparently not his knees!

Hi Lorraine,
The website I sent to you explained some about this occurring in people but didn't mention spina bifida.
I understand about not staying on the computer too long in a thunderstorm. When I hear thunder, everything to do with my computer gets shut down...usually in very short order!
The comment about giving him enough pain med to lessen the pain but not enough to delete it makes very good sense to me, too. It also makes it a little easier to see him stepping more slowly, etc. He has been restless since having the work done Tuesday. I am sure the stretching that was done Monday and Tuesday in order to make a diagnosis left "reminders" for a while. He really wants me to hold him a whole lot. I hope it is helping, not hurting him more. I try to position him so he can stretch if he wants. He stiffens when I first pick him up and until he has settled in a more comfortable position. Then he will snooze for hours! We slept in my recliner for several hours early this morning! I asked the vet on Tuesday aboiut picking him up and he seemed to agree that if it hurt, Tanner would let me know. I guess Tanner feels it's worth a bit of discomfort to get to where he is comfortable being held.


Tanner is pretty uncomfortable still...on Prednisone now. That started Monday with one 5-mg tablet about 8:30 PM. The following AM he asked to go out around 6 and when he came in I thought he was going into a seizure because he was shaking so. Off to the Internet I went...checked side effects and found tremors a possibility, called the vet and he cut the dosage to 1/2 tablet for that night and Wednesday night. Now we are on the every-other-night schedule until he shows improvement. Tanner seldom lays down by himself except when the Prednisone takes effect. He follows wherever I am most of the time, stands like an old horse with his head and his butt hanging low, then his hind legs start to quiver. After a while, I pick him up and hold him for a period of time (he then relaxes and sleeps) but I feel it is necessary for him to use his own power or he will become a complete invalid! When I have household duties that just won't wait, I lay him on the low couch and he settles there for a little while as a general rule. At this point I do not know what else to do other than to wait a kittle longer to see if the Prednisone will take more effect for a longer time than just overnight. I checked with Dr. B about hydrotherapy and he said it couldn't hurt. Tanner's legs are so long that the water won't rise far enough in the tub to get him off his feet! Anyway he got a good bath that day we tried!

Another diagnosis: Letter from Vet - Hemivertebrae is a shortened or misshapen vertebrae that occurs because of malformation during development in utero. Pain is due to nerve compression (spinal cord and other nerves..."pinched nerves"). Your veterinarians have undoubtedly first chosen to treat this condition conservatively since your dog has apparently lived with this condition for the first two years of life; they have correctly told you that surgery is an option in more severe cases. Surgery is used to correct the vertebral defect, stabilize the vertebral column and reduce spinal cord and other nerve compression (reduce pain) Usually a myelogram is done prior to surgery to evaulaute the degree of nerve compression and to evaluate if surgery will really help. Glucosamine will not remedy the structural defect of hemivertebrae.

Response to my letter after this diagnosis:
Dear Lorraine,
Money doesn't solve every problem and it wouldn't change Tanner. I try to keep you informed knowing that you care not only about him but for future Yorkies. I am not asking for money back. I always remember the words in a message from Carl Trehus, that he sent to us following my letting him know we had gotten Tanner from you. (He led us to you, you know.) He said, "If you got one of Lorraine's dogs, you got a good one."
Tanner is a very special part of us. Our hearts are much saddened for the discomfort he does have but we are thankful we can help him find relief. I am thankful this was not a malignant tumor and my understanding is that one could have shown up in a similar manner.
Since his medication started working mid-day he has had much relaxation and I'd say relief. After I worked at my desk earlier this evening I walked around in front of the desk and saw that not only was he relaxing on the floor, but he had laid on his tummy with his front feet straight out ahead of his body, nose tucked between his paws, and his back feet straight out behind him. He used to do that often but had not done it for a while. Maybe we had better look on it as a good sign and keep a happy spirit to help him feel encouraged, too! Right now he is on the couch and keeps an eye on me when I walk by! He probably wishes I'd go to bed so he would not feel he has to stay up to keep me company! Not often, but once in a great while, he will go to the bedroom to his quilt pad on the floor by our bed before we go in to go to bed. That's when I know for a fact that we have stayed up way too late!
I'll plan to keep you updated on how the treatment is going.


Dear Ones,
Our hearts have been relieved! We received word
early this morning that Tanner's problem is a fungal
infection that can be treated with medication for about
6 months. The fungal infection came about by our living in West Texas and Tanner's breathing the air! Our vet
will need to do intermittent blood tests to be sure
there is no liver damage. He will also need to do some
x-rays to be sure the bone is healing. The Dallas vet
has already called our vet here with the report and is
sending a written copy to him.
Thank you for your support of prayerful, loving
concern. Tanner is very special to us...but then, you
already knew that!
Love, Us

Hi Lorraine,
Just thought you'd find it interesting that in October of 99 we took Tanner to the vet several times for a very dry cough...were told it was allergies and he was treated off and on for about a month (some Prednisone) before it finally quit. At the time you asked if the doctor had checked for lyme disease and he assured me it was not a problem here. He was pretty surprised when he learned that tanner has Coccidiomycosis (Valley Fever)...he said, "...if he were a ranch dog..." Well, he's not and has never been; however there is a tremendous amount of building in our neighborhood (all around us and within a city block and more) and often very windy days that brings that dust right down over our houses in this neighborhood. The interesting this is that Dr. B lives within the same blockage area! Perhaps this will save some other dog from having to go through the same problems for so long. I felt you'd want this info to keep in mind for anyone else if you ever hear of "dry cough" and lameness again, too
Tanner started the ketonazole last evening and is supposed to have it for 6 months. He is to have a blood test every two months during this time to be sure the liver is not being harmed and more x-rays at some poinbt.
He gets the stitches out (Tanner had to have a bone biopsy) Saturday. He was really upset at the bandaged leg at first but more upset when I removed the bandage when its usefulness had passed. His little hind quarter has been shaved bare and the vet said, "His friends will probably make fun of him."! (Tanner was upset that the bandage was hot neon pink...he thought he should have had brilliant blue instead!) He looks so scrawny and it will be a huge relief for him to regain his weight.
I need to get along for now.
Lovingly...Us and T

I am so happy that you have finally found a reason for Tanner's pain. Now there is hope for a cure. I will pray every night that the medicine works quickly for Tanner.
I was just talking to L. (a fellow Yorkie breeder and a good friend) about Tanner's condition last night and that he was said to have a fungal infection of the bones and she mentioned Valley Fever to me. So, seeing the words this morning was not such a shock to me. If I have your permission, I would like to post Tanner's whole story on a Yorkie list I am on, which would include your letters to me. I will remove your names and information and the vet's names will just have a first letter, Like Dr. B to designate the difference. if by doing this, we can save some Yorkie and their owners all this pain, it will be worth the effort.
My hugs to you and a big hug to Tanner. Thank God you are his owners and would not take any answer given by a vet as the cause for his problems and followed through with all testing. God Bless you both.
With love always,
Lorraine Iervolino

Hi again,
J. and I have no problem with your telling Tanner's story. As a matter of fact...please do! When we lived inTucson we were told that dogs could get Valley Fever but we never heard about it in this area. We were also told at that time that we should try to avoid any new construction sites, etc. We were very particular about Tray during those years. Interesting, huh? Well, now we know and we do know that x-rays and blood tests can be done to determine the problems. We were told in Dallas that it can take up to 1-2 years to find it in the bones...that is why he had the radioactive x-rays. As it was it showed up as very difficult to see spots but that vet put two and two together and recommended the biopsy. We were so thankful it was not a tumor and you know we will be sure to keep a close eye on his progress once he feels better. Right now he likes us to pamper him and I think he deserves it! He lays around a lot of the time and rests well at night. If he starts to whimper or make little moans I check to see whether or not he needs to go out. He really has no desire to go outside unless he really has to go. That is not normal for him. He has loved being out and checking the perimeter. Maybe he heard the diagnosis and decided he'd not sniff the ground so much anymore!
Well, supper is not fixing itself...wish it would...so I had better be at it.
Lovingly....Us with The Pampered Pup

So, if any of you have a Yorkie that runs a dry cough and then seems to be in pain a few months later, PLEASE have them checked for VALLEY FEVER. I pray that Tanner will make a full recovery.





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UPDATES ON TANNER

April 17, 01 I took Tanner to the vet on Saturday to have the stitches removed. He was getting around better that morning and thoroughly enjoyed his visit to the vet. He heard other dogs barking so started his own version of calling the pack. I spoke to him about it so he kept grumbling under his breath but let a little bark slip out every so often. The vet came into the treatment room and asked, "What's going on?" I said, "He wants to know who let the dogs out!" The stitch removal went quickly and I filled Dr. B in about Tanner's weight...9.8#. His top was 12.6 and he had seemed to settle at 11.6. Dr. B said that should be taken care of shortly since Tanner is on the medication. I asked about giving him per vitamins and Dr. B felt that was perhaps a good idea. When I asked about glucosamine, he said it is for joints but that might also be a good thought. We have started the Petvites but not the glucosamine. I hesitated to start too many things at once particularly since we plan to be away a while. When I got Tanner out of the car at home, as usual, it was a bit awkward since he uses his front paws as boxing gloves, and he let out a little yip. (He used to put his front paws on my chest as I would scoop him into my arms from the car seat, but he cannot use his back legs securely now.) Following that he was obviously uncomfortable again. By mid-afternoon I gave him 1/2 of a 25mg Rimadyl and held him for most of 5-6 hours through the remainder of the afternoon and early evening.
On Sunday morning Tanner seemed to feel much more comfortable and when we came in after church he grabbed a sock toy and greeted me with his old time "Hello-o-o-o!" In the evening when we had been out for about 90 minutes he again ran for one of his toys and greeted me with it. He obviously felt better all day long. He has to favor that left hind leg because it is weak and spindly. He is using it though so it should heal.
The info on the prescribed medication indicates it is absorbed better when taken with food. So-o-o, the Pampered Pup is now being encouraged to eat from my hand since he thinks that is such a fun thing to do. He eats some without the game, too. I found that he really appreciates the pill being wrapped in bits of leftover baked potato! I had been using small amounts of cheese which he loved but the vet said something that made me think the medication does not absorb well with fat. It's no problem keeping baked potato on hand.
He sleeps very well all night long and once he has had one outdoor trip in the morning he likes to rest in my arms in "our" recliner for a while longer. His little feet seem cool more than I used to notice so I wonder about his circulation. And, of course, today the high temperature is supposed to be 58 (after yesterday's low 80's!) so that may be a factor!
12:30 AM April 18: He is showing much more interest in life! Just now he checked the entire perimeter of the back yard, stopping to sniff about every 3-4 steps! It was chilly out there but it was good to see him behaving like he is beginning to enjoy life again!
We are very much encouraged that he is showing as much improvement as he is so soon!
Guess this about catches you up for now.