She started overweight, so she is actually only about 10 pounds under her normal weight. Yes, her head/face could be from age and weight loss. Could be related to changes due to her poisoning a year or her tick disease. Or TMJ disease. The problem with normal is the change combined with the extreme jaw pain and being unable to drink water, is not normal.

To follow up on today.
Nothing was found unusual with the x-rays. No ear problems. Again visually
everything looks good. The vet was able to easily open Blaze's mouth all the
way under anesthesia. We also talked about maybe seeing an oral surgeon to
check her teeth and for TMJ disorders which could involve x-ray of teeth and
MRI for TMJ issues and related.

Our options given by the vet as she see's it.

1. We see an oral surgeon, look for teeth and TMJ problems. Only two are in
the area and it will be expensive especially if we go with the MRI of her
jaw.

and/or

2. We go forward with a muscle biopsy to continue to look for or rule out
the MMM.

3. It was also suggested to us by the Vet. If we are getting tapped out on
funds considering we are still paying a home equity loan on Blaze's
poisoning a year ago, and the sum of what we have covered on this new ordeal
is going to top that total. We skip the biopsy completely and just treat
with steroids to be proactive. There would be complications to monitor and
harder on Blazy by giving the steroids along with the current doxy for the
Ehrlichiosis. The ehrlichia canis will not like the steroids. But it would
be the cheapest way.

or

4. We do nothing for now and give it some time. Continue the fluid therapy
and hope the jaw problem is only related to the tick disease and improves.
We would wait to see if there is more better improvement and if she starts
drinking water sufficiently on her own. If not we go back to 1,2,or 3.

What my wife and I have decided to do is have the vet make the
referral/appointment with the oral surgeon as it would be hard to get in
otherwise. That will still give us 5 or 6 days until then to watch Blaze
for any improvement with her jaw problem. If we start seeing positive
change with her and she starts drinking again, we can always cancel.
If not, we make the visit to consult with the oral surgeon. and make the
next decision from there.

I've followed this thread and never replied, because I don't have a clue. I have a friend in Dallas who had a similar problem, or maybe I should say similar symptoms with a female pointer named Sugar. We first noticed it after a hunt on the Spade ranch. I tried the classic hand under the chin lift to put her in the dog box. She yelped!! It got worse. It was diagnosed with everything from Lyme disease to Rocky mountain whatever. She finally came out of it and hunted several more years. I don't pray, but my heart goes out to you.

Poor girl. I hope she gets well soon. Hang in there.

Sniper John,
You get a GOLD STAR from me and all of us here for your tireless efforts to save Blaze. As a veterinarian of 36 years, I would give my left cajone for clients as dedicated as you.
Also receiving a Gold Star is your veterinarian; she seems to be matching your determination every step of the way. It sounds to me that she is in consultation with specialists, and that can only help you and Blaze (and her).
Simply put, the Ehrlichia pathogen doesn't play fair. In many dogs, it causes no sickness at all. In others, the disease is easily treated with a course of doxycycline; Blaze gets well, and she never looks back. But in a few individuals, the disease is persistent and waxes and wanes, requiring multiple treatments as it flares, sorta like malaria. And sadly, in a few patients, they don't get well, ever.
Another poster and dog lover here on the forum, known henceforth as PINHEAD by my irascible Longhorn/Aggie wife, PM'd me regarding Blaze's plight. I remembered reading about her early in her disease time-line, but had not gotten up to speed with the recent developments. So, I read through the thread again this evening.
Again, I'm struck almost dumb by the herculean effort you and your vet are bringing forth. You are following the standard treatment protocol that will cure over 95% of the cases of Ehrlichia. It just seems to me that it may be time to cross your fingers, say a prayer, and try something else. Now, I'm a general practitioner and not a specialist. I am not there with you, your vet, and your dog to give a hands-on impression. And you will not hurt my feelings if you shout me off the stage; I've been the target of many thrown tomatoes over the years.
I personally would start the steroids. If the strange MMM-like development is an autoimmune complication of the Ehrlichiosis (sh!t happens), she might improve dramatically. It would also temporarily help a TMJ issue. It will not help the doxy treat the Ehrlichia, for sure, and may in fact make her worse. You will have to understand and accept this slight possibility, and your vet may ask you to sign a liability release as well.
Another approach would be to take Blaze to a specialist at A&M or elsewhere (if she were a person, this would have already happened). But from the sound of things, I think your vet is up to speed, is consulting with the appropriate internists, and is doing everything possible. My gut feeling is that referral will gain you little and will force you to take out a second mortgage.
My wife, HOLTVET here, has gone to bed already. She is a retired vet, graduated #1 in her class, and is the smartest person I've ever known. She has ZERO bedside manner and does not bandy words, but I think she would tell you to start the steroids immediately. (And if you're in range, she might give you a kick in the backside for emphasis). But I will bring this thread to her attention tomorrow and she may add something herself, after she tomatoes me first.
Good Luck to you, your vet, and to your beloved dog. Such is why I chose this most honorable of professions.

Thank you sir, Going ahead with the steroids has weighed heavy on me
and still is a possibility, but for now I am still going to wait before
I make any decisions. I'm giving Blaze a few days and then see where we
are at. We still have an appointment set with a veterinarian oral surgeon
in a week, but the idea was that we would cancel if we start seeing any
significant improvement before then. And I have also been offered free
services with a breeder in Louisiana who happens to be an oral surgeon.
I am predicting tonight we will cancel on Monday.

I did up blaze's doxy to 200mg twice a day with my vet's blessing, so its
400mg a day now. That is more than the standard by the book, but less than
the aggresive dose of 600mg a day recommended by some non vet "experts".
I don't want to risk any GI upset problems by uping her dose any
more than that since we had so much trouble with her eating before now.
That will be followed by a probiotic 2 hours after each dose.

Blaze had her best day yet today. Those two bad days had probably got us
into a "ready...fire...aim" mode for a moment, so for the next week we are just
going to hold the course steady as she goes even if we have a bad day or
two. I am learning it is an insidious disease and normal to have the ups and
downs as she recovers.

Blaze today. Barked at a squirrel. Drank or Ate with her food 4 cups of
water poured into the bowl with her canned food, so no hydration therapy
tonight. I also was able to throw a couple handfulls of dry food into that
and let it soften a little first and she ate that too. So she has had 4 cans
of Blue dog food, about a half cup of dry food, and counting the water
content of the canned food, maybe 5 cups of water total. She snuck over to
the table and got a lick into my chinese food when I was not looking
tonight. She growled and showed her teeth to me when I patted my wife
on the leg, She gave herself a lick bath. And she is now greeting at the
door again everyone that comes by the house. So we truly had a great day.

She still can't pick anything up and I can tell it hurts her to try. And she
will not drink water outright from her water bowl. But she will take water
in her food. It makes no sense on the water. But things are improving. Let's
hope that continues.
John

I just knew you and the wife were very good at what you do, so thought I would make you aware. I am pinhead with a heart.

I wish I had more help than this, but I will say that steroids and antibiotics finally healed my girl's foot. It was to the point they were talking about doing exploratory surgery and then amputating her toe if they didnt find anything. In order to prepare for the surgery she started taking anitbiotics and steroids (small doeses) and over 2-3 months it healed itself up.

With that said, the whole ordeal changed her personality to a degree, but she was still young when it happened and was ongoing for 6 months I believe. She used to be outgoing and had no unreasonable fear but now shes a scaredy cat. Its frustrating at times but she is still my fishing buddy.

Great news to share. Blaze has been on the doxycycline for her ehrlichiosis now for a little under 2 weeks.
Friday though not a lot of change, was a great day same as Thursday with no setbacks with her so that was a good thing.

But yesterday a wonderful day. Blaze was almost the same dog she was before all this started. Blaze had all her energy back and was more like an energetic puppy than a 7 year old. The morning started with her dragging her toys off a table and testing herself for pain with her jaw now than then. It was really cool to watch her work it out and build her confidence as the day went on. By evening she was carrying her toys around the house trying to get people to throw them to retrieve or to play tug a war with her.

Though she almost seems to be scared of her water, she did drink some water last night, so I think she will come back around on that eventually. Therefore we are still pouring water into her canned food to keep her hydrated. I have been adding dry food to it with no problem as well.

I can see a bit of wince of pain if she trys to make a full yawn, but that mouth gets wider every day. So at this point we are seeing a rapid recovery rate and the pain subsiding with her jaw. She did seem to have some slight jaw pain when she went to bed, but we have cut back on the pain medication from three times a day to only once or twice in a day and only if we think she needs it from overdoing herself like she did last night.

At this point I do believe what muscle loss she has in her head is related to the tick disease. Because the pain is sibsiding and use of her jaw returning, the common sense feeling would be that this is ending. She is also starting to gain weight back instead of losing it now.

I think we are going to beat this. Last night, I had the best night of sleep I have had in two weeks.

Great to hear John. We will keep praying for best .

Way to go Blaze. She's not going to let some little tick keep her down. Your going to have to start calling her The Ten Thousand Dollar Dog.

Great to hear she is doing better.

That's good news. Won't be long until she is back at em. Look forward to the future adventure stories.

Thats great. Always good to hear positive news. I understand what its like. Earlier last year it took me two weeks to find out my male had bone cancer. 2 months after that my 14 yr old female quit eating. Ive been watching this tread closely hoping for good news.
This thread has also made me aware that I need to do something to try to protect against ticks. I have pulled 4 or 5 off my pup in the last few weeks alone. Never had to deal with many ticks up north but they seem to be fairly common down here. This is a wake up call for me about the tick disease.

Sniper John,

I just want to say that I am sorry about Blaze's health issues, my prayers go out to you and her. I also wanted to tell you that I have read many of your road trip post and you have been an inspiration to me. After seeing your post and great pictures, you have given me the inspiration to get out there and hit the open roads with my dogs. Next year I will be making a road trip from North TX up to OK and KS and hunting all along the way. I would probably never have done this without first seeing your post, but after seeing the great times and great pictures I said WOW, I have to do that at least once in my life. So I want to thank you for sharing with all of us. I hope Blaze is out in the fields soon. Good Luck and Thank You!!

Great to hear. We'll continue to keep your family in our prayers.

Man, sorry to hear all this. Prayers up for all of y'all!

Sniper I am pleased to hear about the good news. It's amazing what we do as owners when it comes to our pets. I am thankful that Blaze has such loving owners like you and your wife. God Bless ya.

Continued good thoughts and prayers from all of us here at Cappy's house.

Everything with Blaze is still doing great. She is drinking water as normal and her bottomless pit of a stomach has returned. She is eating dry food again. She is able to pick up her larger toys now. We still does not have that full gap of her mouth when she yawns and for all we know that may never return due to scar tissue. Some minor atrophy to her face may remain with her for life, but at her age it will not be noticeable to most.

Now, I of course am not a veterinarian, but I have tried my best to educate myself when this started, so I will do my best to explain what we believe the underlying cause of the masticatory myositis was and explain how this can happen. As explained earlier the Masticatory Muscle Myositis that our veterinarians where almost sure Blaze had in addition to the Erlichiosis and subsequently tested negative for, is an autoimmune disorder where the immune system turns on itself and attacks the muscles of the head and chewing. We do believe it was actually caused by the tick disease. To best explain it I am going to quote from this website.
https://sites.google.com/site/tickbornediseaseindogs/immunesystem

"The mechanism whereby E. canis contributes to the development of "autoimmune" disorders is not simply prolonged "overstimulation" of the immune system. A generally accepted explanation is that some of the proteins with which E. canis "clothes" itself are a near match in composition and structure to proteins that are a normal integral component of the dogs own self in various cells/tissues. After prolonged exposure to these E. canis proteins the immune system sometimes begins to mistakenly identify the quite similar self proteins as foreign and mount attacks against them."

Now my next worry with Blaze is that once this autoimmune process was started, that it may not simply stop from just killing the Ehrlichia Canis with antibiotic therapy. But considering the use of her jaw and chewing has returned rather than get worse, she is no longer in pain, and she is now rapidly gaining weight almost as fast as he lost it, I do feel at this time that we have turned this around. So at this point I have no plans of putting Blaze on the steroid Prednizone unless something changes.

The next step will be finishing the antibiotic therapy and blood work to be sure the disease is gone and that there are no other underlying issues.

There are two schools of thought on the antibiotic therapy. By the book with normal protocol of 28 days. Or by what some vets who frequently work with tick diseases prefer. Being 6 to 8 weeks. I have done enough research on it that I will feel more comfortable with a longer duration provided we do not see any problems with her blood work. I will be discussing with my veterinarian about going with at least an additional 2 weeks of antibiotic therapy.

This is a really good site for anyone wanting to educate themselves on dog tick diseases and includes a great page on prevention.
https://sites.google.com/site/tickbornediseaseindogs/

Another titled Ehrlichiosis A Silent and Deadly Killer
http://home.earthlink.net/~hawkeye87/Ehrlichiosis Page.htm

Though we might not quite be out of the forest yet, it is headlights on the highway. I feel safe saying in advance at this point, barring any future relapse of the disease we have this beat. So one last time, thanks everyone for the kind words, prayers, suggestions, and shared experiences that my family received both publicly and privately. Blaze will be hunting another day.
John

Just saw this, and I'm glad to see she's doing better. I thoroughly enjoy the stories and pictures of Blaze.

Goods news! Glad to see she is back to normal. Also I learned something.

Glad to hear she is bouncing back. Hopefully it'll be a full and permanent recovery.

I had a male rottie years ago that contracted Erlichiosis (sp?). It took trips to three different vets before they pinned it down. Weighing almost 140lbs, it took massive amount of Keflex to bring him around. But it worked, for about 8months to 1yr at a time, then he'd relapse. Every time it happened the vet would give him another round of Keflex and he'd come back around. He lived another 4yrs, and died at 11yrs old, fairly old for a rottie.

My point here is not to discourage you. Just to let you know what you probably already know....Keep a close eye on her in the future, and have the starter round of antibiotics on hand for if/when she relapses. Our experience was, when we caught it within about 24-36hrs he would turn around rather quickly. Every case will be different though. hopefully you and Blaze are one and done.

Glad it's going y'alls way!

Very good to hear Blaze is on the road of recovery!

Yes, Blaze is going to be fine. As of yesterday she is eating all dry food again and with the rapid weight gain, only two meals a day now. As posted relapses are not unheard of and is the reason I would like to go against normal protocol by doing a longer duration on her antibiotic. Some vets that have worked with several cases of ehrlichiosis prefer this. I see no harm in it unless we see something screwy with her bloodwork.