Other drug options, if your initial choice doesn't work, can include:
(Chlorambocyl, Gold salts, Pentoxifylline, Retinoids, Azathioprine, Atopica)
• Pain Relief especially in the early stages or after surgery may be necessary, eg. Tramadol.
• Essential Fatty Acids (EFA's) are given in therapeutic doses, regardless of which primary treatment regime is used. High doses of EFA's play an `active' role in the treatment of skin diseases and should be included in the treatment regimen and in low maintenance doses after remission. EFA's are known to be `steroid sparing' in high doses. This means that they have anti-inflammatory properties which may ultimately, lead to a lower dose of steroids being used and this is especially useful in dogs that remain dependant on steroids. However it is not easy to find a specified dose that is consistently used. Examples below:
EFA Ratio/Supplements
The 'therapeutic' dose of recommended supplements, in the treatment of autoimmune skin disease, often varies from one clinician to another. Below are some examples with their references.
Quote: "Research is being performed to determine the optimal ratio of omega-6 to omega-3 fatty acids that should be consumed. Previously, it was thought that the ratio should be approximately 15:1. Current recommendations are for ratios of 10:1 to 5:1." (Omega fatty Acids: sources, Effects, and Therapeutic uses in Dogs, Veterinary Services Department, Drs Foster & Smith, Inc. Holly Nash, DVM, MS)
Example Therapeutic Dose: Essential Fatty Acids
Quote: "Effect appears to be dose related and optimum doses and the most effective combinations of these oils have not yet been determined. Daily doses of Evening Primrose oil 172mg/kg/day, and Fish oil @ 44mg/kg/day, have been used in dogs over a one year period without ill effects". (Ref: The Veterinary Formulary by Yolande M Bishop)
• EFA dose should start at a high level until a response is seen. This can take up to 12 weeks. EFA's can cause loose stools. If this occurs, start on a lower dose and build up to the highest dose over a couple of weeks. Avoid using Evening Primrose Oil in dogs with epilepsy. Always follow manufacturer's dosing recommendations.
Manual of Skin Diseases of the Dog and Cat by Sue Paterson – Drug therapies for onychodystrophy
Essential Fatty Acid Dosage differs with individuals
EPA 400mg/10kg (Omega 3 - e.g., fish oil etc.)
GLA 100mg/10kg (Omega 6 – e.g., evening primrose oil etc.)
Biotin 2.5mg/dog once a day
• Natural Vitamin E (400-800iu/12hrs) encourages new cell growth. (Ref: Clinical Immunology of the Dog and Cat by Michael J Day).
• Chinese herbs are also noted as being effective but the owner should consult a vet who practices in natural treatments.
Biotin (5mg/kg/day: Ref: Muller, Kirks Small Animal Dermatology)
• Improves the quality of the nails but it can be difficult to obtain. Some dogs with SLO have shown to be deficient in biotin. This may be due to their diet. Foods with a relatively high biotin content include cooked eggs, liver, chicken livers, kidneys, some vegetables eg., boiled broad beans, raw or canned tomatoes, raw cauliflower, dried skimmed or whole milk, fresh milk, bran, yeast and raw egg yolk.
Note: Do not give raw egg white as it contains a substance called avidin which binds to biotin and prevents its absorption. This does not apply to cooked egg whites as the cooking process deactivates avidin.
• Gelatine – 10 grains (one capsule) every 12 hours. Ref: Muller, Kirks Small Animal Dermatology. Some owners give 1-2 cubes of jelly every day.
• Good quality high protein diet in case of nutritional deficiencies.
• Antibiotics if secondary infection is present
• Topical acrylic nail cement applied externally to permanent nail deformities, which suffer from re infection. Nails could be strengthened and protected by this application.
I have not known a dog to have external acrylic nail cement treatment but reference to this can be found in Muller, Kirks Small Animal Dermatology.
• Removal of loose nails Loose nails may have to be removed, usually under anaesthesia. As you can imagine, recovery from this procedure is likely to be very painful and prolonged, especially if nails on several different feet are affected. Clipping, cleansing, removal of the fractured portion of claws may be necessary even after treatment is well under way. Understandably, most dogs with SLO become very sensitive to their feet being touched.
Topical shampoos, Antiseptic soaks (Salt or Epsom Salt foot baths, Hibiscrub etc.) Initially it may be necessary to bathe your dog's feet to keep them clean and to wash off the blood etc., but once they are dry and healing it seems better practice to try to keep their feet dry. Antiseptic soaks or salt soaks will help to soothe and clean. Epsom salt soaks are reported to be very soothing when the dog has pain. When the feet are sore and weeping, you can use socks and boots (or strong plastic bags tied with string) to offer protection when out
(Chlorambocyl, Gold salts, Pentoxifylline, Retinoids, Azathioprine, Atopica)
• Pain Relief especially in the early stages or after surgery may be necessary, eg. Tramadol.
• Essential Fatty Acids (EFA's) are given in therapeutic doses, regardless of which primary treatment regime is used. High doses of EFA's play an `active' role in the treatment of skin diseases and should be included in the treatment regimen and in low maintenance doses after remission. EFA's are known to be `steroid sparing' in high doses. This means that they have anti-inflammatory properties which may ultimately, lead to a lower dose of steroids being used and this is especially useful in dogs that remain dependant on steroids. However it is not easy to find a specified dose that is consistently used. Examples below:
EFA Ratio/Supplements
The 'therapeutic' dose of recommended supplements, in the treatment of autoimmune skin disease, often varies from one clinician to another. Below are some examples with their references.
Quote: "Research is being performed to determine the optimal ratio of omega-6 to omega-3 fatty acids that should be consumed. Previously, it was thought that the ratio should be approximately 15:1. Current recommendations are for ratios of 10:1 to 5:1." (Omega fatty Acids: sources, Effects, and Therapeutic uses in Dogs, Veterinary Services Department, Drs Foster & Smith, Inc. Holly Nash, DVM, MS)
Example Therapeutic Dose: Essential Fatty Acids
Quote: "Effect appears to be dose related and optimum doses and the most effective combinations of these oils have not yet been determined. Daily doses of Evening Primrose oil 172mg/kg/day, and Fish oil @ 44mg/kg/day, have been used in dogs over a one year period without ill effects". (Ref: The Veterinary Formulary by Yolande M Bishop)
• EFA dose should start at a high level until a response is seen. This can take up to 12 weeks. EFA's can cause loose stools. If this occurs, start on a lower dose and build up to the highest dose over a couple of weeks. Avoid using Evening Primrose Oil in dogs with epilepsy. Always follow manufacturer's dosing recommendations.
Manual of Skin Diseases of the Dog and Cat by Sue Paterson – Drug therapies for onychodystrophy
Essential Fatty Acid Dosage differs with individuals
EPA 400mg/10kg (Omega 3 - e.g., fish oil etc.)
GLA 100mg/10kg (Omega 6 – e.g., evening primrose oil etc.)
Biotin 2.5mg/dog once a day
• Natural Vitamin E (400-800iu/12hrs) encourages new cell growth. (Ref: Clinical Immunology of the Dog and Cat by Michael J Day).
• Chinese herbs are also noted as being effective but the owner should consult a vet who practices in natural treatments.
Biotin (5mg/kg/day: Ref: Muller, Kirks Small Animal Dermatology)
• Improves the quality of the nails but it can be difficult to obtain. Some dogs with SLO have shown to be deficient in biotin. This may be due to their diet. Foods with a relatively high biotin content include cooked eggs, liver, chicken livers, kidneys, some vegetables eg., boiled broad beans, raw or canned tomatoes, raw cauliflower, dried skimmed or whole milk, fresh milk, bran, yeast and raw egg yolk.
Note: Do not give raw egg white as it contains a substance called avidin which binds to biotin and prevents its absorption. This does not apply to cooked egg whites as the cooking process deactivates avidin.
• Gelatine – 10 grains (one capsule) every 12 hours. Ref: Muller, Kirks Small Animal Dermatology. Some owners give 1-2 cubes of jelly every day.
• Good quality high protein diet in case of nutritional deficiencies.
• Antibiotics if secondary infection is present
• Topical acrylic nail cement applied externally to permanent nail deformities, which suffer from re infection. Nails could be strengthened and protected by this application.
I have not known a dog to have external acrylic nail cement treatment but reference to this can be found in Muller, Kirks Small Animal Dermatology.
• Removal of loose nails Loose nails may have to be removed, usually under anaesthesia. As you can imagine, recovery from this procedure is likely to be very painful and prolonged, especially if nails on several different feet are affected. Clipping, cleansing, removal of the fractured portion of claws may be necessary even after treatment is well under way. Understandably, most dogs with SLO become very sensitive to their feet being touched.
Topical shampoos, Antiseptic soaks (Salt or Epsom Salt foot baths, Hibiscrub etc.) Initially it may be necessary to bathe your dog's feet to keep them clean and to wash off the blood etc., but once they are dry and healing it seems better practice to try to keep their feet dry. Antiseptic soaks or salt soaks will help to soothe and clean. Epsom salt soaks are reported to be very soothing when the dog has pain. When the feet are sore and weeping, you can use socks and boots (or strong plastic bags tied with string) to offer protection when out