Preliminary diagnostic report on Boltz – 25 November 2020

There were no significant findings on the nerve/muscle biopsy that was sent to the University of California- San Diego.  The brain and spine showed no lesions that would have caused the neurological condition. This confirms the information that we gained by doing the MRI and spinal tap, which in itself is a significant component of this case as Boltz was the first wolf in our history that had both procedures.  The pathologist final report is yet to arrive.   I would say we had the best diagnostic team possible, but if I go back to the original discussion about Degenerative Myelopathy, the idea was, that if we ruled everything else out, that’s the likely cause.  The DNA test that we ran on Boltz showed the lack of the mutated gene for DM.  What I didn’t know (and now I do), is that the lack of the mutated gene wasn’t a diagnosis for DM but was indicative of a an animal being a carrier, not whether an animal had DM.  Our loss of Boltz is still fresh in our hearts.  The passing of each wolf is hard, but the lack of knowledge on the cause makes this particularly hard for staff.

Today, we take the time to remember Boltz, his legacy of knowledge and medical diagnosis that was a first for any of our wolves.  We also take today to honor Luna, who lost her battle to cancer on November 26, 2019.

RIP to these two, it was an honor to be one of your many social companions.

Boltz Update – 12 November 2020

As you may have read in the Center’s press release, we euthanized Boltz at approximately 7 a.m. on Nov. 12, 2020. His condition really declined in the last week, not only physically, but behaviorally.

 

While the lack of mobility and swaying of his back legs didn’t seem to elicit a pain response, he began to fall more frequently, began dragging his feet and he started to struggle to get up.  Initially, his mobility would noticeably decline when stress would seem to exacerbate the condition.  So we modified the wolf yard access, cancelled programs and did whatever possible to keep him calm. Surveillance video was reviewed each morning to assess how long he rested and his posture upon rising in the morning.

 

In the last few days, we saw a decline in mobility that was independent with any external activity in the wolf yard that may trigger stress.  Our biggest concern was that he would seriously injure himself falling as the colder weather and snow on Tuesday created icy conditions.  The other concern that is equally important as the physical was the psychological.  This condition seemed to cause confusion and panic when he didn’t have the strength to support himself.  His struggles were heartbreaking and we were helpless to find him any relief.

 

Boltz deserved better than to struggle and panic through this decline.


Since this condition was first identified on Aug. 23, he had a Thoraco-lumbar and brain MRI, CerebroSpinal Fluid cytology, CerebroSpinal Fluid infectious disease assessment, protein tests, cancer cell tests, and a genetic screen for Degenerative Myelopathy and all were inconclusive. We assessed and used possible treatments in the absence of a diagnosis in hopes that we would see some response or improvement.  Despite our Veterinarians dedicated efforts, we had no improvement.  When the decision was made to go forward with the USDA Animal Welfare Act Euthanasia protocol, we consulted with the University of Minnesota pathologist to discuss all sampling that could be performed at the necropsy and made sure we did everything possible to find an answer.  We also sent nerve and muscle biopsies to a specialist at the University of California San Diego Neuromuscular Lab.  Their reputation has been described as: “…an international reference center dedicated to the diagnosis and study of spontaneous neuromuscular diseases in companion animals. Specialized testing performed in this laboratory includes evaluation of muscle and peripheral nerve biopsies by state-of-the-art methods, immunohistochemistry, immunofluorescence staining and immunoblotting for the diagnosis of various muscular dystrophies and other congenital myopathies.”

 

As is standard protocol for any wolf mortality at the International Wolf Center, we did allow all the remaining ambassador wolves to see and smell the body through the fence.  This has been a practice recommended by our Veterinarian years ago to help the other wolves process the loss of a pack member.  All the wolves showed interest, but Grayson had the strongest whining and licking response, and had a significant amount of bark howling throughout the day.  Staff spent time with Grayson to help calm him and also transitioned Grizzer and Denali into the Pack Holding Area where Boltz had been residing. Boltz’s body will be cremated at Pets Remembered in the Twin Cities and his ashes will be spread with his pup mate Luna’s, who succumbed to cancer on Nov. 26, 2019.

 

I am grateful to all of the people who emailed me with comments, suggestions and their own pet’s medical histories.  I wish we had more time to try every procedure, but without any diagnosis, we couldn’t let him suffer without any treatment nor continue with invasive procedures that had limited outcome.  We hope to learn of his condition through the final necropsy and tissue samples provided.  Boltz’s legacy will be to help us learn all that we can about his condition and serve the ambassador wolves to the best of our ability for generations to come.

 

– Lori Schmidt

10 November 2020

Despite an extensive amount of diagnostic testing, research and treatments, Boltz continues to decline from his neurological condition.  On his Monday morning vet check, the wolf care staff discussed quality of life issues and efforts are being made to keep him comfortable and calm as the next steps of the USDA Animal Welfare act protocol are addressed.

Boltz Update 6 November 2020

Boltz completes his treatment for Myasthenia Gravis on Sunday.  Unfortunately, there were no improvements seen in a week of treatment.  We are preparing the USDA quality of life assessment that includes a behavioral assessment of alertness, pain response, social engagement, willingness to take food, tolerance of ambient temperatures, lack of tolerance for environmental changes and climatic stresses, ability to rest and impact of medical condition to behavioral stress.  To accomplish this, we rely on our surveillance cameras, monitoring when he goes into the den at night, when he first rises in the morning and if there are instances where he rises during the night.  At this time, all video shows Boltz getting a good night’s rest, often entering the den by 10 pm and not rising until after 6 am.  Rest is certainly a beneficial component for his situation.  Weather today is causing a challenge for all the wolves.  The temperatures are expected to be record breaking in the high 70’s.  This is causing Boltz and even Denali a bit more agitated with the heat.

Boltz Update 2 November 2020

After seeing Boltz get excited about a deer leg on Saturday night, I was hopeful that the new treatment for Myasthenia Gravis was helping. However, today he continues to have issues with back leg strength and mobility.

We will continue five more days of treatment and monitor his activity closely to assess improvement. The veterinarian has prepared me for the gravity of this condition. We have exhausted all test options for treatable conditions. All that is left are some invasive biopsies that wouldn’t yield any treatment options, only a diagnosis. The recommendation from the veterinarian is that we don’t need to put him through more painful invasive procedures while knowing there is no knowledge to be gained that would help him. Under permit from the USDA Animal Welfare Act, we are accountable for Boltz’s quality of life including what he endures during medical treatments. We will be assessing quality-of-life standards, both in his social and behavioral health, as well as his medical condition to determine what is best for Boltz

Boltz update 31 October 2020

Boltz tested NORMAL for the mutated gene associated with Degenerative Myelopathy, meaning he does not have the mutation commonly known to cause the development of DM.  Our vet decided to start treating him for Myasthenia Gravis, and if that is the cause, we would expect to see improvement in a week.  Based on the extensive tests that have already been completed, the one remaining diagnosis being discussed is degenerative peripheral neuropathy which can be diagnosed by a nerve or muscle biopsy, but has no treatment.  Since this condition has no treatment, our local vets and the neurological specialists concur that this more more invasive test would not be recommended at this time.

22 October 2020 Updates

I don’t have anything to post on Boltz today, we are waiting for additional spinal tap test results to come in (if you recall, there were 3 tests). So, far everything has been negative and bloodwork is all in normal range. I have copied one of the reports here to see all the things that have been ruled out in this challenging time trying to get a diagnosis.  The Vet put him back on prednisone as his condition was declining since we weaned him off of the prednisone to do the spinal tap. Now, we are closely monitoring him by camera and visual checks to assess if prednisone is working. Staff are diligent in reducing any distractions in the wolf yard that might impact his ability to comfortably rest.   I hope to have more answers by the Monday Working for Wolves webinar at 5 pm Central time.  There are still spots available for this webinar if you would like to register check our our Programs – Webinar tab on the website at www.wolf.org.

Boltz update 19 October 2020

So far, the test results we are getting don’t show any abnormalities in the bloodwork.  As I said in previous logs, he is otherwise in good health and doesn’t appear to be having a pain response, but his strength in his back legs is compromised.  We received some preliminary results on the spinal tap and according to the lab report

” No obvious infectious etiologic (causing or contributing to the development of a disease or condition.) agents, malignant neoplastic cell populations (cells that could potentially invade and metastasize into cancer) , or atypical particulate matter are identified.  The critical thinking and waiting game on additional samples continues.

Boltz update 15 October 2020

Bolz did well through the procedure that started with a drugging at 3:50 and the reversal drug at 6:22 pm.  He will have 2 shave marks, the lumbar area didn’t yield clear enough fluids for a sample, so the vet needed to go  higher on the spine.  She successfully got enough samples to run all 3 tests – The Neurologic RealPCR, Fluid Analysis with Cytology, and Aerobic and Anaerobic cultures and we got enough bloodwork for a full panel, CBC and the Degenerative Myelopathy DNA test.  He got a good dose of Cefazolin antibiotic to reduce the risk of the spinal injection site getting infected.

He is remarkably healthy considering this odd neurological issue.  His heart rate during the whole procedure was between 52 and 56 and his respiration was between 12 – 16…these are the vitals of a good cardiovascular system.  He’s resting on some blankets and pillows in the Wolf Care Center, although he prefers the cooler floor.  He has a very thick winter coat already.  I will stay with him all night and will transition him outside later tomorrow.  We will not have the cameras on through the weekend as we suspect he will need some time to adjust.  If you watch the cameras closely, you may notice that the noise of the camera movement does impact the wolves, even Grizzer who is hard of hearing, will lift his head when I zoom the camera.  We want to keep Boltz calm, he’s had a rough day.

Boltz Update 12 October 2020

Boltz has been transitioned off of steroids so we can move forward with additional testing, including a spinal tap and bloodwork to be conducted on Thursday October 15th.  We will also draw enough blood to repeat a CBC, Full Blood Panel and complete the DNA test to determine if he has the mutated gene associated with Degenerative Myelopathy (DM) in dogs.  The Veterinarians required at least a week of no steroids before the spinal tap because of the tendency for steroids causing a higher white blood cell count.  But, transitioning off of steroids needs to be done slowly over time to reduce any additional side-effects.  Boltz had a bit of a challenge during the transition, but is now seeming to rest more comfortably.  This condition continues to be challenging to diagnose because he has moments where he has limited control over his back legs, then he has moments where he is mobile.  The symptoms don’t fit a clear diagnosis to point to one thing, which is why we are choosing to do the spinal tap.  We are going to concentrate on three tests, a Neurologic RealPCR, detecting any indication of one of the tick-borne organisms could be causing the neurological disorder. Even though we have tested for tick issues in bloodwork in the past, their presence may have been below the limits of detection in bloodwork but may be identified in spinal fluid.  The second test is Fluid Analysis with Cytology, which would provide details on proteins and more importantly cell types and appearance that could help identify cancer cells.  The last test is Aerobic and Anaerobic cultures, to indicate if there are other bacterial infections.  The procedure will require a full immobilization, so I will post after the procedure on Thursday to let you know how he did, but we don’t anticipate seeing any results until early next week.