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Collie Cyclic
Neutropenia
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Collie
Cyclic Neutropenia - Tessie the Border Collie
Report
for the Border Collie Society
Tessie the
Border Collie -29.05 05 - 01.04.08
A Sufferer
from Collie Cyclic Neutropenia & the only UK Border
Collie Recipient of Lentivirus-mediated Gene Therapy as a Treatment.
Tessie was purchased
on July 11th 2005 from an experienced breeder on a farm in mid-England.
She was small, pot-bellied & had one blue eye & one
brown but otherwise appeared healthy. However, the night after she was
first vaccinated her first characteristic symptoms appeared of high
fever, joint pain that made her lame & cry out if you picked
her up, upset stomach & other eye, mouth & chest
infections.
This was able
to be alleviated by pain control, but antibiotics did not
seem to help much, it was as though she got herself better with time,
so long as she was given highly supportive veterinary care &
home-nursing. This continued in a puzzling pattern of good health
& high activity followed by crashes of severely ill health. She
gained & lost weight, could not eat for several days at a time,
listless yet still wanted to interact if at all possible.
Blood tests
were regularly taken until a diagnosis of Collie Cyclic
Neutropenia was made in November 05. It was made on the basis of the
cyclic nature of the presence or absence of neutrophils in her blood.
With Tessie, this was about a 3 week cycle, though often it is a 10-12
day cycle. Without sufficient, mobilised, neutrophils in the
bloodstream, it is impossible to fight infection adequately. Therefore,
illness would follow about 5 days after her low point of neutrophils,
which would last about 5 days, then she would become bright &
energetic again; then the cycle would start all over again, although
sometimes there were longer or shorter gaps between illness &
good health.
She evidenced
many phobias during this time with fears of electronic
beeps, metal gates clanging, pouring of dry food - that she had
encountered while hospitalised. We learnt that her morale was vital in
her care & several young people became crucial to her ability
to eat, take medication, in that she allowed them to encourage her to
eat etc, while she trusted less those of us who had to be involved in
her personal care of cleaning, injections etc. She developed a
trademark 'shiver' of greeting for those she particularly trusted.
After
changing veterinary practice, it was recommended that Tessie
spent the Christmas of 2005 in a local veterinary hospital; Tessie was
afflicted with such severe mouth ulcers that it had caused previous
local vets to reach an impasse and so recommend ending her life.
However we had also begun correspondence with a paediatrician,
Professor Dr W Osborne in Seattle, who had spent his life developing a
cure for CN in the children in his care. He generously offered his
treatment, of gene therapy, which he had perfected in North American
Gray Collies (referred to here as "Lassie collies") & therefore
we decided that far from ending her life, along with the continued
support of our new local vet, who took Tessie under his devoted care,
Tessie should be given this potentially-lifesaving opportunity.
She responded
well to IV treatment at the veterinary hospital &
came home. We then continued her weekly blood tests, which she
withstood most stoically and gently. Her health however was still
failing in the continued fluctuating manner, and the programme for gene
therapy was initiated despite lack of time in mapping her own exact
gene sequences from bloods sent earlier to the USA. The STC from the
Veterinary Medicines Directorate was fast tracked by a lot of wonderful
people in the GMO Regulatory Authority, aided by Professor Dr. Osborne
and the VMD Staff. As soon as the lentivirus-vectored c-GCSF was
received in the UK under the STC, the strict, established procedure for
treatment was swung into action by Tessie's vet under the personal
guidance by Dr Osborne in the second half of 2006.
There was no
immediate improvement & indeed she further
developed a problem with her over-production of saliva, that caused
swallowing problems & frequent regurgitation of food. We learnt
to feed her from a high plate & to puree her food, on the
advice of a speech therapist friend. Then a local shepherd suggested
this might be a fish allergy, which seemed to help.
Then within 4
months, to our joy, we realised that we were no longer
visiting her vet to deal with her high fevers etc. She began to gain
weight, going from 10kgs to 17 Kg in 6 months. She became jaunty, ate
well - at least 2 chicken breasts a day, played a lot & became
a part of farm life.
We run a
centre for young people with autism to learn countryside
skills. Our animals are all part of this; Tessie took her place with
the girls with Asperger's syndrome, who had helped to look after her
when she was ill & now became her trusted companions out on the
farm. While she was too scared to mix with the noisier boys, she could
go anywhere with the girls, relaxed & confident together. There
were many walks & cuddles together.
Dr Osborne
visited her in the Summer of 07 & examined the blood
test charts that had been exhaustively prepared by a scientist
colleague, from the original practice blood sample results. He could
see that, although the cyclic pattern persisted , the lowest point (
nadir ) that her neutrophils reached was no longer as low as before
treatment. From his experience, Dr. Osborne knew that this meant that
Tessie was now able to deal with the everyday infections that had
previously assailed her. It was a very happy day. But because he needed
to use Lassie collie DNA to urgently create her treatment rather than
using her own precisely-targeted gene therapy, Dr. Osborne knew that he
had only been able to give her a close-targeted gene therapy treatment,
but at least & amazingly this had raised her neutrophil levels
above critical, so giving her the chance for growth and development,
and real quality of life.
Tessie
continued in good health apart from a cough & an
occasion of shortness of breath. This seemed to be contained by
treatment & we continued to have a happy & exuberant
little dog who joined in all farm activities with great joy. She also
brought great joy to us all, as we watched her experience all the
things her illness had prevented; splashing in floods to create ripples
to bark at, developing her herding instinct by following piglets
& hens ; chasing squeaky balls & balancing them on my
father's wheelchair arm so that he just had to throw it again -
& again, to both of their delights.
We had just
got used to having her without worry, when very sadly this
January her cough increased & she became very short of breath.
She was hospitalised again & diagnosed with pneumonia via
radiography. She again responded to IV treatment & came home,
but suddenly the infection spread to her other lung & she was
hospitalised again. This time there seemed to be no antibiotic
combination able to help her fight this virulent infection, which
created reactive fluid in the pleural cavity & we brought her
home to hospice-nurse her amongst her familiar things, smells, sounds
& particularly her friends.
Most sadly
but most peacefully, she was allowed to pass on by elective
euthanasia on April 1st, valiant to the end in trying to overcome her
body's damage, still walking outside just hours before she died. Her
spirit will never be forgotten, & many tears have been shed at
the loss of this extraordinary little dog whose fortitude &
joyfulness created such a special place in so many people's lives. And
above all the love that she created all around her, as people became so
selfless in their care for her, & to which she reciprocated
with such trust & devotion.
But this was
a devastating illness, which has caused so very much
suffering to her & all her friends & family. It would
surely be a fitting memorial if it became possible for this disease to
be eradicated from the breed, by careful selection & screening
for unaffected dogs for breeding, & the prevention of
inbreeding which can be the unwitting cause of such Collie Cyclic
Neutropenia.
Lydia Otter,
Pennyhooks Farm.
Tel 01793-782436
pennyhooks dot farm at virgin.net
www.pennyhooks.com
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