7-year-old male pit/dachshund mix with recurrent high fevers and severe leukopenia/neutropenia.
This started several years ago after an episode of gastroenteritis. Since then, he has had intermittent flare-ups with lethargy, stomach gurgling, and sudden fevers as high as 105°F. During these episodes, his WBC count becomes nearly nonexistent. He also develops red, hive-like spots when feverish.
Over the past year, episodes have become much more frequent/severe. Antibiotics initially seem to help, but toward the end of treatment the fever returns, often requiring ER hospitalization. Most recently, he was hospitalized last week for a 105°F fever and extremely low WBC, improved enough to go home on antibiotics, then returned to the ER yesterday after another fever spike.
He has had extensive testing: bloodwork, ultrasound, stool testing, infectious disease testing, etc. Everything returns essentially normal once the episode resolves. A specialist previously discussed a bone marrow biopsy but felt it wasn't necessary because his bloodwork normalized.
He also has chronic skin allergies treated with Cytopoint/limited diet and a mildly enlarged heart.
We are desperate for ideas about what could cause recurrent 105°F fevers with profound WBC/neutrophil drops that completely resolve between episodes. Could this be immune-mediated/autoimmune disease, cyclic neutropenia, bone marrow dysfunction, or an underlying inflammatory disorder? Would bone marrow testing during an active episode be worthwhile?
He was supposed to see his internist yesterday, but unfortunately we had to cancel the appointment because he was admitted back into the ER with another fever.
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