
The Mean Seeds
By Cathy Lewis
(copyright reserved to the
author 2008)
I am not a veterinarian, nor do I
represent myself as one on the internet. But I hope that my
experiences as a Springer lover might be helpful to someone else in
addressing grass awn symptoms in their working dog.
We have had four of our own dogs
suffer grass awn infections, one with two separate incidents. Jessie
and Tai have had surgeries for pyothorax, Tai and Roz have had
abscesses removed. When Tigger showed clear symptoms of a pyothorax
in 2007, we made the very difficult decision not to treat him
because his age and general health suggested that he would not have
a positive outcome. Actually, when I dig even further back in my
memory, we had two other dogs that were treated for localized
abscesses with drains and antibiotics (one later developed a
fullblown pyothorax). When the abscess issue first cropped up, this
seemed the more normal course of treatment, but perhaps this was
more a lack of knowledge of the full extent of the problem than a
different syndrome. Knowing what I know now, I’m not sure I would
feel that this approach was aggressive enough in light of our
subsequent experiences.
The increase in the number of
grass-awn related infections appears to coincide with the increase
in planting of Canada wild rye in conservation mixes in
approximately 2001. Seeds recovered from two dogs in Minnesota in
2007 were determined to be Canada wild rye. Several additional
samples recovered from dogs in Wisconsin were recently submitted for
identification.
I have provided details of symptoms
and treatments of our own dogs below. Here are the points that I
would stress to anyone who thinks their dog might be affected by a
grass awn. First, be aware that the symptoms of a grass awn
infection can be very vague and nonspecific. It’s very important
to be aware of your dog’s behavior, both when s/he is healthy and
when s/he is not. If you have concerns that your dog just isn’t him
or herself, consider a visit to your veterinarian and make sure that
your concerns are taken seriously.
These infections can go from
barely noticeable to critical in an extremely short period of time.
Many veterinarians, particularly those east of the
Mississippi that do not have exposure to foxtail infections on a
regular basis, or who do not have a lot of working dog clients, will
not have a grass awn infection high up on their diagnostic radar.
Your dog surviving a grass awn infection may well depend on you
being an observant and informed owner, and you may need to educate
your veterinarian. Refer him or her to the Grass Awn Project website
and/or print out one or more of the articles from the site to put in
your file, preferably before you have urgent need of that
information. 
Roz, 2008, Abscess:
Our most recent case of
grass awn infection involved Roz, Edwardiana Rhapsody of Beggarbush,
a 4 year old female. Roz ran a temperature of approximately 104
degrees at Thanksgiving, 2007, and showed discomfort in her back.
Roz usually likes to put her feet up on me to be petted, but she
began to avoid doing that and didn’t want to make the short jump
into the dog trailer to go training. At that point I believed that
Roz had not been exposed to grass awns, so we treated with
doxycycline and her symptoms resolved. She showed the same symptoms
in late January, 2008, so we did a full workup for a “fever of
unknown origin” and suspected a urinary tract infection. A Lyme’s
test was negative. With no other clues at that time, we again
treated with doxycycline, and once again the symptoms disappeared. I
found an abscess on Roz’ right side to the rear and at the base of
her ribcage the evening of April 14th. We had trained earlier that
evening and Roz ran enthusiastically. She did not have a fever nor
did she seem ill. At my request, the following day our vet referred
us to the University of Wisconsin, Madison veterinary school to
address the abscess. Roz’ abscess was in a similar area, but the
opposite side, from one that Tai had almost exactly a year previous,
which was also treated at UWM (more later). Roz had a CT scan prior
to her surgery that showed an “area of concern” in her back, along
with the abscess on her side. Her surgery involved removing a piece
of a back muscle (approximately 1”
x 3”) – a grass awn was found and removed in this area – and removal
of the abscess, which necessitated removal of two ribs and insertion
of a piece of mesh to close the abdominal wall.
Roz had surgery on Thursday, April
17th. She came home on Sunday evening, April 20th. She was wearing a
pain patch and was prescribed Rimadyl twice daily. Considering the
extent of her surgery, she was fairly bright when she came home, and
did well the next two days, eating with enthusiasm and happy enough
to take brief walks on lead. Some fluid was pooling on her side in
the area of her incisions. Per instructions I removed her pain patch
Tuesday night. Wednesday morning
Roz refused her breakfast. Her temperature remained normal. I took
her to my vet to have the fluid pocket checked. It was large and
heavy enough that it was dragging on the top staples closing her
larger incision and pulling them loose. My vet was reluctant to
attempt to drain the seratoma due to concerns about creating an
opening for infection to enter. The seratoma had increased in size
on Thursday and Roz was still not interested in food, so I took her
back to UWM to see her surgeon. Roz was reassessed and the fluid
pocket drained. We were concerned that her lack of appetite and
slight depression was due to pain, so the surgeon prescribed a new
pain patch and oral pain medication for 24 hours until the patch
took full effect. Roz seemed to feel much better after these
procedures, and resumed eating. Her recovery proceeded smoothly
after this. Culture results
of the tissue removed during Roz’ surgery showed
actinomyces
and bacteroides. Actinomyces is part
of the normal flora of the mouth, bacteroides of the intestinal
tract (see
http://microbewiki.kenyon.edu/index.php/Bacteroides,
particularly the pathology section). While these bacteria are normal
residents in various parts of the body, when they end up in other,
“foreign” places, they wreak havoc. Based on these culture results I
am suspicious that Roz may have swallowed the grass awn that caused
her infection by migrating out of the intestinal tract. Roz was
treated with Clavamox for two weeks post surgery, followed by two to
three weeks of metronidazole after the culture results came back.
Roz’ surgeon believes that Roz
should be able to return to trialing. Even with the loss of the two
ribs her major organs remain adequately protected, though we would
not want her to have any direct jabbing blows to that side. She’s
back to taking daily free runs in the field four weeks post surgery.
The suspensory ligament supporting the right ovary had to be cut and
reattached during her surgery to access the infection in her back
and remove the grass awn, so it remains to be seen whether she will
have any reproductive repercussions from her procedure.
Roz’ discharge and pathology
reports from UWM:
Roz_UWMdischarge0408_grassawn.pdf
Roz_pathology_report.pdf
Tai, 2004-2005,
Pyothorax: Tai had
bacterial pneumonia in his right lung in September (2004), but
apparently recovered well after antibiotic therapy. He resumed
running trials. On Thanksgiving evening, he presented with
an abscess low on his right side, about level with and just behind
his elbow. By the next morning when I got him to the clinic, the
abscess had flattened out against the chest wall, so there wasn't
much to do but watch it, and he took Clavamox for three weeks. As
luck would have it, we were supposed to leave that day to compete in
the National Open, and happily we did go to Kansas and Tai earned a
Certificate of Merit in the trial.
In January (2005) I noticed that
Tai had a small lump, about the size of a grape, that felt like it
was on the bottom of a rib bone, a few inches back from where he had
the abscess in November. On January 19th the lump was removed, and
sent for a biopsy and culture. Our vet did find a splinter of plant
material (more rigid than a grass seedhead, about 1/4 inch long)
embedded in the lump. He did not find evidence of migration around
the site, but was reluctant to do too much exploration for fear of
causing a pneumothorax. That culture grew both actinomyces and
nocardia. Tai was on Clavamox for several weeks, switching to three
weeks of doxycycline as that was thought to be more effective
against nocardia. Tai developed a hematoma/seratoma at the surgery
site, but that healed without apparent complication.
In mid-March (2005) Tai suddenly
presented with a fever (104.6 at the clinic) - this after training
normally the day before. He carried himself with
obvious discomfort, with his back
arched like a whippet and what seemed
like some vague lameness on his front feet. A chest x-ray was clear,
and blood work was normal, as was a Snap test to rule out Lyme's
disease. The vet sent us home with Clavamox again. It took about
four days for his temperature to come back to normal, even on the
antibiotics. No sign of external abscess with this episode. My
concerns about actinomycosis and the possibility that the lameness
might be osteomyolitis led me to request that the vet x-ray his left
front leg that Monday; those x-rays were clear.
I had Tai entered in Master at the
West Allis Training Kennel Club test Memorial Day weekend. He didn’t
seem entirely himself that morning, but when he thought we were
going training, he was happy enough to jump in the car. He didn’t
run at all like himself, though, and when I took him back to the car
I realized that his breathing was extremely labored. I immediately
called my vet clinic and got him over for examination. A chest x-ray
showed congestion in his chest, and our vet referred us to the
University of Wisconsin, Madison. Tai was diagnosed with and
successfully treated for a pyothorax, which included placing chest
drains and periodic flushing of his chest for several days. His
treatment notes from UWM are attached. Happily he made an apparent
full recovery and resumed his trial career.
Tai’s discharge reports from UWM:
Tai VMTH Discharge Papers.pdf
Tai VMTH Discharge Papers June 9 Visit.pdf
Tai,
2007, Abscess: I found a
lump on Tai's rib cage March 27. Roughly the size of half an egg but
flattened out more, on the lower part of the last ribs on his left
side. His previous abscess and lump were on the right side.
Temperature normal, and he trained well the previous night. No other
symptoms that I could observe. Lump slightly larger the next
morning, which wasn't surprising especially since I'd compressed it
the evening before and repeated that morning. The vet aspirated and
took some fluid, no bacteria observed, just lots of white blood
cells indicating infection. No indication that he had any chest
congestion, thankfully.
My vet suggested antibiotic therapy,
so we put Tai on clindamycin, which didn’t do much to change the
size of the mass. He was rechecked on April 11, and on April 26 when
his antibiotic was changed to Clavamox, which did seem to have some
effect in reducing the size of the lump. We took him to University
of Wisconsin, Madison on May 1. They took x-rays and did an
ultrasound, which showed that he actually had two masses. I had been
monitoring the one on the outside of the chest wall, but he had a
second one inside the abdominal wall in the same general area. From
the ultrasound it appeared that the masses were fairly encapsulated.
The two masses were on either side of his abdominal wall like a
sandwich around his ribs, so the bottom few inches of the last few
ribs were removed along with the masses on May 2. At the time this
seemed drastic to me - seems like those bones are where they are for
a reason. Imagine how I felt when I got the report on the complete
removal of two of Roz’ ribs a year later.
A grass awn was recovered from one of
the masses.
Tai was originally scheduled for
discharge on May 3rd, but his surgeon was concerned about the extent
of his pain level so opted to keep him another day. He was feeling
amazingly good by the time he came home on May 4th, but pain
medication was prescribed to be sure he was comfortable. His
activity was restricted for three weeks post surgery, and he was
more than ready to get back to work at that time.
I have found conflicting
information in my research as to whether it is prudent with these
abscess cases to do some antibiotic therapy prior to surgery to
attempt to reduce the abscess. I would discuss this thoroughly with
your veterinarian if your dog develops an abscess.
Tai VMTH Discharge Papers 5-07.pdf
This article
will be updated periodically, and I have two additional case
histories to write up once I’ve gathered the details . |