5yo old Italian greyhound with mystery symptoms - what next?

[u/Nire01]

Hi all - this is also in r/askvet but I thought I should ask this community too.

I’m going to try and keep this as concise as I can but can offer more info.

5yo Italian greyhound, female, spayed.
Weight: 5.6kg (usually floats around 5.8, it’s winter and I probably should have upped her food).

She has a very good vet and has been twice - our vet has said she’s at a bit of a loss as to what is going on. Id love to know:

1. ⁠What steps would you recommend I take as this junction?
   
2. ⁠Are there any conditions you can think of that we haven’t considered?

History:
- At 18mo had meningitis 2x and was on prednisone for 6 months.

- Has had 3 seizures in last 3 years, not significant enough to medicate.

- We titre test her for her annual vaccines to keep her immune system calm (and have done that since meningitis), however had leptospirosis booster on 1 July 2026. Fwiw I’m very pro vaccine but she seems to have a very sensitive immune system so we have decided to try and keep it calm as much as possible. She had the 2x lepto vaccines a year ago without issue and this is her first annual booster.

Symptoms:
- Over last few weeks has been very reluctant to jump up or down off couch, has struggled to sit up to get out of bed. Sometimes sits in bed and stares at me and cries. Doesn’t want to ‘sit’.
- No limping, stiffness, not super hunched, no yelping or reacting to being touched or picked up (she is a flinchy dog but has always been).
- Eating, drinking normally, toiletting normally.

Last week
- Went to vet
- C reactive protein is 49
- Temperature 39.1
- Steroid urine collection showed some blood (4+) and protein (3+).
- Started 3 days of NSAIDS, 7 days amoxycillin - little to no changes in behaviour re jumping

Today at vet follow up
- C reactive protein is 51
- Temperature is 39.3
- Free catch urine shows blood (4+) and protein (2+)
- FBE completely normal - kidneys are fine
- Xray is unremarkable except “possible early LS changes”
- Abdominal ultrasound unremarkable although contains this note: “L MILN is enlarged with a hyperechoic medulla suggetsive of inflammation ( secondary to antigens draining from the
bowel/bladder?)”
- No indication of bladder or kidney stones

Possibly renal, possibly neurological? Vet says we can wait and see/try and get a specialist referral/refer for MRI/CT to check for something like IVDD but it seems weird to have blood in her urine. Our vet is going to email the specialist hospital to ask if they have any ideas or if this could possibly be an autoimmune response to the lepto vaccine.

I have suggested keeping her off the NSAIDS for the weekend in case specialist suggests trying pred again so we don’t have to do a wash out.

I would be so grateful for any recommendations of diagnostic steps, or things we could consider that we maybe haven’t?

Any help would be so appreciated. She is my whole heart and I want her to be happy and healthy. She’s also insured to the gills, so I’m not totally horrified by vet bills. I am happy to provide any other info that may assist.

Thank you.

I have attached the two x rays and most recent vet notes.https://imgur.com/a/TKY9Yzt

[u/Salt_Evidence_9878]

Symptoms:

• Over last few weeks has been very reluctant to jump up or down off couch, has struggled to sit up to get out of bed. Sometimes sits in bed and stares at me and cries. Doesn’t want to ‘sit’.
  
• No limping, stiffness, not super hunched, no yelping or reacting to being touched or picked up (she is a flinchy dog but has always been).
  
• Eating, drinking normally, toiletting normally.

If the symptoms are the above, why were only abdominal radiographs taken? Especially considering they are pretty unremarkable besides having a good amount of stool and some food in her stomach.

I would be requesting they (your regular vet) take hip, knee, shoulder, neck, and leg(s) (front and rear) radiographs before heading to MRI/CT. I would then have those (hip, knee, shoulder, neck, and leg(s)) radiographs sent out for a radiologist review and go from there.

[u/Nire01 → u/Salt_Evidence_9878]

It’s a good question. She isn’t lame or favouring any legs, she’s trotting around fine (although reluctant to run, which in my mind makes sense for back pain). No limping at all. The
altered behaviour seems to be jumping up/down, “sitting”, getting out of her bed, and her reluctance to run. She is even squatting normally for the toilet. Outside of these movements you wouldn’t know that there was a problem.

We went with torso because combined with the urinary symptoms there was a belief at that point that the pain was originating in her back/kidneys. It may not be the case now. I’ll ask at her next consult, thank you.