I've recently gone back to the vet with my weim daisy and asked for the results from
The lab for when she had biopsys and for them to explain every detail and suprise suprise it was stated on the results by a skin specialist that it is pemphigus he reckons it must have been re analyzed and added at a later date!
I just wanted to know of any non steroid medicine anyone might have been recommended for
Their dogs or of any medication they know of works that isn't so harsh on the dogs organs and not so much of a strain on her body. So what they offer me I'll know what it might be or I can ask for the best medication!
Thanks guys ,
Katie
Hi Katie
If the diagnosis is correct and Daisy has Pemphigus then she will probably have to be treated with immunosuppressive doses of steroids (see the Michael J Day protocol in the files) Some AI skin diseases such as Discoid lupus can be treated with Doxycycline and niacinamide and a variety of therapeutic supplements such as Vit E and Essential fatty acids.
Pemphigus is an umbrella heading for a variety of different pemphigus complex skin diseases, and there are about 5-6 different types that carry varying prognosis. The most common one is pemphigus Foliaceus and the prognosis is very good. If your vet treats Daisy with steroids then perhaps you should also ask about including all the supplements that have a really good effect. Natural Vit E and EFA's are used in combination with conventional medicine to treat these conditions. You should see improvement in her skin within a week or so.
Good luck with your discussion.
Jo
Pemphigus Foliaceus
Pemphigus is a group of autoimmune skin diseases. Pemphigus foliaceus is the most common in this group. Autoantibodies are directed against the epidermis, the outer layers of the skin. You may notice pustules or crusting on the muzzle, face, lips and ears before the disease slowly progresses to the dog's trunk. The footpads may become thickened and sometimes the surface layer of the pad will lift off. Diagnosis is obtained by several skin biopsies and immunoflourescent staining. Many skin conditions take on a similar appearance so it is very important for other conditions such as demodicosis, drug eruptions etc., to be excluded before treating with immunosuppressive drugs. Secondary infection may be present and this should be treated with antibiotics.
Treatments for Autoimmune Skin Disease
Unlike systemic autoimmune diseases, there are several treatment options for autoimmune skin disease, these include, topical ointments, steroids (prednisolone), cytotoxic drugs, azathioprine and Atopica (cyclosporine) and a combination of tetracycline or doxycycline and niacinamide (Vitamin B3) and 'steroid sparing' supplements such as essential fatty acids and natural Vitamin E in therapeutic doses.
If the use of steroids is appropriate, then the regime is the same as systemic autoimmune diseases, with or without a 'combination' drug.
There is a group of five antibiotics that go under the heading of 'Tetracyclines'. Two of these, tetracycline and doxycycline are indicated for the treatment of immune mediated skin disease having anti-inflammatory and immunomodulating effects, and the ability to suppress antibody production. Either one can be used in combination with niacinamide (vitamin B3) for the treatment of immune mediated skin diseases. It is more commonly used, and seems to be especially successful, for the treatment of SLO. It should be noted that food or dairy products can reduce the amount of tetracycline absorbed by 50% or more. To maximise bioavailability it is recommended to administer the drug two hours before or after food. Unlike tetracycline, doxycycline is not affected by food or dairy products to the same extent (no more than 20% reduction) and this is thought to be insignificant. Doxycycline is also more convenient to administer because it is given only once a day.
It takes 1-3 months before positive results are seen and treatment is likely to be continued for 6 months or more. Doxycycline or tetracycline with niacinamide seems to be a good treatment choice as it avoids the use of steroids and other stronger drugs.
A more recently licensed drug for atopic dermatitis in the dog is Atopica (cyclosporine), an immune modulating antibiotic. Since being licensed it is becoming very widely used for a variety of autoimmune diseases. Atopica is effective for immune mediated skin disease, but it is a very expensive drug and the cost is often prohibitive. Administration of grapefruit juice two hours before cyclosporine, however, leads to a significant increase of its bioavailability and the dose, and consequently the cost, of cyclosporine can be significantly reduced. (Reference: Effect of Grapefruit Juice on the Pharmacokinetics of cyclosporine in dogs. Veterinary Record Feb 7, 2004). This drug should not be given to dogs with hepatic or renal insufficiency and it is advised to check these functions before treatment starts. Atopica should not be given within two hours of food. For further details see the reference to cyclosporine in treatments for inflammatory/systemic autoimmune disease.
Essential fatty acids and natural Vitamin E also play an active role in the treatment of skin diseases and should be included in any treatment regime. Chinese herbs are also thought to be beneficial, and biotin in the treatment of SLO. It is always worth trying other treatment options before using immunosuppressive doses of steroids and azathioprine, and very expensive drugs such as Atopica, however some skin disease, such as those in the pemphigus group may need more aggressive treatment.
Shampoos or ointments such as fuciderm and Protopic (tacrolimus) can be useful in the treatment of skin disease. Protopic has been used successfully in the treatment of anal furunculosis.