We had one of those Sundays where an animal's health prompted a flurry of calls to our vet in Helena. Wobbly, blind Briggs had started showing slight tremors in the morning, so we took his temperature and found he was running a fever of 103°. Not very high, yet still a fever. But the tremors were unnerving, so we called our our clinic's emergency number and talked with our primary care vet, Dr. Brenda Culver. Because of the Rocky Mountain Spotted Fever he had for a long time before coming to us, Briggs' health can be a complicated affair. He continues to be on doxycycline for the spotted fever, even a year after Brenda diagnosed it as the root cause of his disabilities. The fact that he was on doxycycline and now running a fever again was also alarming.
Brenda explained that this can be one of the "legacy" issues of spotted fever, so she had us give him Baytril, a different type of antibiotic. After having us describe his tremors — slight trembling, like shivering — she concluded that might be because of the fever.
About 90 minutes later after giving him the Baytril, Briggs threw up. Another call to Brenda, who told us he would likely have absorbed most of the Baytril in that amount of time so it should still take effect. We should continue to monitor him for any changes.
A couple of hours later, his tremors suddenly became more pronounced. As he lay on the floor, he began rhythmically pulling his legs in towards his body and then flexing them out again. We didn't like the looks of that, so we called Brenda again. Since we're 70 miles from the clinic, we do quite a lot of "tele-medicine" with our vets and try to give them as much accurate information as possible so they can decide if we need to bring the animal in. Other than his tremors and fever, Briggs was otherwise what vets call BAR — bright, alert and responsive. We did some quick neuro assessments for Brenda — no dragging of paws, etc. So it didn't feel like we needed to rush him over to Helena, but clearly something was amiss with his tremors.
Brenda wanted to give him a steroid to "quiet" the tremors and give the Baytril a chance to kick in.
What next ensued is a conversation we've had many times with Brenda and with our equine vet, Dr. Erin Taylor. We have a well-stocked "pharmacy" here for scenarios exactly like this one, and while we don't always have the first medication they ask for, we usually have something in the same class of drugs.
Brenda: "Do you have any injectable prednisone?"
Me: "No. But I think we have Depo-Medrol. Let me go look."
(Sounds of Steve rummaging through the medical cabinet, shuffling bottles of this and that around.)
Me again: "Hey, wait, I just found some injectable Dexamethsone. But it's the SP type."
Brenda: "Perfect! That's just what we want. It's the 4 mg per ml version, right?"
Me: "Yes, it is. How much should I give him?"
(Sounds of Brenda doing the dosage/weight calculations in her head. This is why she went to vet school and I didn't.)
Brenda: "Let's give him 6 mls sub-Q (under the skin) and see how he does."
I thanked her for all her help and went off to find the syringe I needed. Alayne took the photo above of Briggs getting his injection.
A short while later, his tremors were gone. He got up off the cot, wobbled into the kitchen to drink from the water bowl, and suddenly seemed much spunkier.
Yesterday evening, he ate his dinner just fine and kept his second dose of Baytril down. Today he is much better — his temperature is normal, no tremors, and a happier boy all around!
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