CIMDA

Canine Immune Mediated Disease => Auto immune disease in the dog - start here if you aren't sure. => Topic started by: Coco on October 30, 2017, 09:42:35 AM

Title: Autoimmune poli arthritis cocker spaniel
Post by: Coco on October 30, 2017, 09:42:35 AM
Hi everyone,
I'm Italian and I'm sorry for my bad English,
My sweet Coco, English Cocker, 5 years old, has an autoimmune arthritis. Her medications is deflazacort ,6 mg every 48 and ranitidine 8 mg per day, I start one year ago with deltacortene but 4 months ago I change the Therapy and start with deflazacort because of a terrible dermatitis she started to soffer of. The skin was really dry and flaked , offen bloody, and I was really worried about that. With deflazacort it seems to go better,
But the skin is still dry and I don't know what to do. The symptoms of arthritis are in remission, but I would like to have some help for the skin. I make ones a week a bath with clorexidina shampoo, that help her in some way, but I think its not enough, and my Vet does'nt help me in any way.
I need also help for the best food or for vitamins or other medications that could help her. I need Your support!!!!!
Can u help me???
Thanks in advance, Francesca

Title: Re: Autoimmune poli arthritis cocker spaniel
Post by: Jo CIMDA on October 30, 2017, 10:45:18 PM
Hi Francesca

I am sorry about your Coco.  It is good that her autoimmune arthritis is in remission.    What do you think is causing her skin problem?  Has she always had a skin problem or do you think it has been caused by the use of deltacortene? Has your vet identified the kind of skin problem that she is suffering from?  Is it an AI skin problem, allergic reaction, a deficiency etc......?  If it is bloody then she must have lesions.  Where are the lesions?   How is she in herself now?

I am sorry for all the questions.

The causes of skin lesions and dryness etc., are numerous and it can be very difficult to diagnose a problem without biopsies, skin scrapes etc. If you are lucky then treating speculatively with shampoos and ointments can resolve the problem but sometimes a confirmed diagnosis is essential to target the correct treatment. Take a look at this link.  It illustrates many different skin complaints and their treatments.

http://www.skinvet.org/downloads/32354/Immune+mediated+2010%28s%29.pdf

If the dry skin and sores are due to her being on high doses of steroids (which can happen) then I suggest you add essential fatty acids eg., evening primrose oil and fish oil to her diet.  EFA's can also act as an anti-inflammatory.

Also, Natural Vitamin E (therapeutic dose: 400iu twice a day, Ref: Clinical immunology of the Dog and Cat By Michael J Day). It encourages new cell growth but it has to be the natural form of vitamin E because the synthetic form has very little effect. 

It will take about 2 months of EFA's to make a difference but you might see some improvement after one month. Take a look at these links: 

https://www.thehonestkitchen.com/articles/essential-fatty-acids-for-cats-and-dogs/
http://www.peteducation.com/article.cfm?c=2+1659&aid=666

https://www.decodedscience.org/vitamin-e-another-tool-help-treat-canine-atopic-dermatitis/52103

If you think Coco's skin problem is an immune mediated skin disease then you might consider asking your vet to put her on a course of doxycycline (or tetracycline) and niacinamide and lots of different supplements as mentioned above.

There are also topical steroid ointments such as Tacrolimus (Protopic) or fuciderm that can be prescribed and they are very effective.

https://www.vetuk.co.uk/pet-meds-prescription-only-fuciderm-c-21_735/isaderm-fuciderm-gel-p-141

Check out the information above and have a chat with your vet about the next step for Coco.  If you go with a few suggestions he may prescribe something that will resolve Coco's skin problem.

Jo

PS. Your English is excellent!
Title: Re: Autoimmune poli arthritis cocker spaniel
Post by: Coco on November 01, 2017, 07:37:53 AM
Hi! Thank's for replaying so soon! Unfortunately my vet doesn't tell me something useful for skin problem of Coco, I think she doesn't know how to help me and she's not skilled for that immune mediated pathology.  I think it is a corticosteroids related skin problem, because the more the dose of cortisone is lowered the less are skin problem. The lesions are often on the top of the head, sometimes on the legs, but with clorexidina bath it goes better. I put Gentamicin cream on the lesions to resolve acute problems, and it seems to work good. Your suggestions for other medications are precious for me, and I'll start it as soon as possible. I made in the last 8 days  a course of amoxicillin, and it seems the skin is better.
I forgot to say that I am a medical doctor , anesthesiologist, so that I'm skilled about medications. I found the right dose of corticosteroid by my self, because I didn't found a good vet until now that can really help me in this situation.
Please tell me if you have other suggestions for my lovely coco, she' so cute and my little girl Sofia love her so much, they are so close...

Francesca
Title: Re: Autoimmune poli arthritis cocker spaniel
Post by: Jo CIMDA on November 03, 2017, 06:20:24 AM
Hi Francesca

Skin problems are common when a dog has iatrogenic Cushing's syndrome, so it is very likely that Coco's problem will resolve as you lower the preds and wean her off.  Even giving prednisolone (or other corticosteroids)  on an every other day basis will help.   

The other thing you have to watch out for is the mite, demodicosis.  When the immune system is compromised it can no longer keep this common parasite under control and this can show in the form of skin lesions.  If Coco's lesions do not resolve, and especially if they get worse, then a skin scrape might be worth doing just to rule this out because without specific treatment you won't be able to control demodex.

In addition to the cause of the skin problem, secondary infections are common but the amoxicillin should address this.

I hope you see an improvement very soon.  I know it is tough seeing Coco like this.  It does get better though.

Jo