CIMDA

Hello again Catherine and Jo!

I am so sorry to come back on here bothering you again. But sadly, I have another question about our 10-year-old Whippet Woody.

You will probably have forgotten by now but back in 2020 Woody started with Autoimmune disease of unknown type. The symptoms were lumps on his legs that came and went, pain on getting up from laid position and on sitting down from stood position. Added into this he lost his bark and seemed to have a sore throat, eating seemed to hurt him 50 percent of the time. Our vets did several tests, and Autoimmune disease was confirmed. SLE was then ruled out by further tests, and our vets consulted specialists in Liverpool who said they could do yet more tests in Liverpool to find out the exact type of Autoimmune disease concerned but there wasn't any point as the treatment is the same (Steroids!). We did all this with your help as until I contacted you, I didn't know the questions to ask. Woody then went on a course of steroids and we made sure it was the course you recommended. Again, we relayed your advice to our vets, they checked with Liverpool and Liverpool advised the same as you did. At this point I would like to thank you again for your advice, it was truly fantastic to have this. I would also like to say that thanks to you I have learned about so many more things such as vaccinations etc that I really wished I'd known before but I'm now able to spread the word to other owners (always with vets advice obviously). 

HOWEVER we think the Autoimmune disease is coming back now. Early this year Woody was diagnosed with heart disease – (Mitral valve disease (leaking heart valve) with marked heart enlargement. Mild subaortic stenosis (narrow outlet from the heart), with some leaking through the aortic valve. Possibly reduced systolic function (strength of contraction. Grade 5 heart murmur)
Woody was put on heart meds – Cardisure ¾ of a 5mg tablet twice daily. So as I understand it the heart disease is quite bad but he is stable now.
We were just coming to terms with the heart bombshell, when we noticed that Woody was starting to have a sore throat again and lose his bark, also drooling a tiny bit from the left side of his mouth. Also, his left-hand salivary gland was swollen. Our vet tested for salivary gland cancer by taking a sample from the gland. At the time one of the vet's assistants said it was quite likely that it could be salivary gland cancer and I remember saying to her that I'd noticed his face had become thinner and he was starting to have hollows under his cheeks. Then the tests for the cancer came back as negative which was a huge relief!  However, his face stayed thin, and his sore throat and lack of bark seems to come and go.

I feel sure this is his Autoimmune disease back again and talked to my vet about it. I wanted to investigate further and get him on another dose of steroids ASAP if needed.
But the problem is that my vet said because Woody is on heart meds he cannot go on steroids, she checked, and Woody's Cardiologist agreed. Also, our vet says she doesn't really want Woody to have a GA again if possible, so that would rule out some types of further testing. She has therefore had him on Metacam for a few weeks to see if that will help with the pain, which I am not happy about as it isn't getting to the root of the problem, however I am torn as I totally understand her advice about no GA and not having steroids.

I would have gone along with her advice, but I was looking at him last night and for the first time I was suddenly struck by the thought that his thin face couldn't just be a result of his heart disease or a sign that he is getting on a bit (he is 10) He has hollows under his cheekbones and muscles on top of his head are disappearing. I just suddenly thought that something isn't right. So I googled it and found that his appearance is quickly becoming very like a dog with Masticatory muscle myositis. He doesn't seem to have all the symptoms of this (he can open his mouth fine) but the muscle disappearance on his head is now becoming more marked. His face is starting to look sort of caved in looking. This coupled with the fact that he cannot bark, still gets pain when eating 50 percent of the time makes me think that continuing to mask the pain may not be a good way forward.

I am going straight back to the vets because of this but would greatly appreciate your advice on:
A) Do you know anything about giving dogs steroids that are on heart meds? Are there any ways round it?
B) Do you think we should try and sort this out? Our vet seems to think that we should essentially make him comfortable because of his heart problems and I agreed at first but now I am questioning this and would value your opinion.
C) Maybe I am panicking unduly but do you think he may have Masticatory muscle myositis, or something like it?

All the best and
Thank you once again
Elaine

Hello! And thank you for letting us join!

We have two rescue whippets, Woody and Sansa.
We adopted Sansa was from a rescue (the EGLR} and we took Woody in because he was a neglected pet and needed a good home urgently at the time.
Woody is nearly 8 years old, we adopted him at 2.5 years old.

I am trying to keep this brief, but Woody has many health issues – he has corns, also epilepsy (especially triggered by anaesthetic). He is on Trental to thin his blood because he has Idiopathic Vasculitis. (He had been getting scabs on the outer bits of his ears which then dropped off and left a little gap).
Also, he has had a pancarpal arthrodesis on his left wrist because the joint just conked out on him when he was running one day. Our vet suspects connective tissue issues.
So, the recent problem is that over December 2019 – January 2020 lumps developed on all 4 of his legs, all along the tendons, he got a sore throat and he started to struggle a little with his back left leg. He could walk fine but was a little reluctant to sit and get up from a laid position. I got a full blood test done at my local vets and a cell test on one of the lumps. Nothing unusual was found and my vet said, 'give it time'. I was still worried so took Woody to see his Dermatologist. She also ran full blood tests, said his lymph nodes were swollen so tested them. She then called to say the blood tests were all OK, slightly elevated liver but fine. The Lymph nodes were reactive, there were extra cells but no cancer, she thinks it is all immune mediated. Inflammatory cells were mentioned quite a bit. The dermatologist said Woody could be put on steroids. If the lumps clear up then that's a definite indication that it's his immune system. Then the steroids should be decreased until he is on the lowest possible dose. I asked if no steroids are an option. She said 'yes' and if it were her dog this is what she would do to start with.
We did that, but within days we noticed a large puffy looking swelling between his front legs and I contacted the dermatologist and he started on the steroids. The dermatologist has confirmed that she thinks Woody has some sort of Autoimmune disease.

Woody is now on steroids (Prednisolone) He's started on 2 a day, going down to one a day and the ultimate goal is to get him onto as low a dose as possible. He is now much better, all lumps gone, bark back to normal and barely any joint pain. These are the medications he is on now:

Prednisolone 5mg once a day
Trental 400mg half twice a day to help with his Vasculitis

I have joined the Whippet Health Issues FB group and asked questions there, so am starting to understand a little more about the disease, however I have specific questions that I am hoping someone can help me with:
1.   Does anyone know of an Autoimmune specialist in the Yorkshire area of the UK?
2.   What sort of Autoimmune disease could Woody have? The dermatologist said it is a complex area and she is not sure (hence my request about a specialist) I am so glad she has diagnosed this, she has been wonderful and I greatly appreciate her help but think I need someone more specialist now. Am I right?
3.   The dermatologist said I could flea and worm as normal with Bravecto and Milpro but I have NOT done this, I have read that I must not do this, is this right? If so, are there any natural products that are effective. I am worried about ticks, should I start to avoid walks that may be more prone to ticks?
4.   What about his Parvo booster? His booster is due in April, everyone on the Whippet Health Issues FB group have said we need to do a Titer test instead, is this right? Also what if the Titer test shows that he does need to be vaccinated, what then?

Apologies for the length of this! and thank you again for letting me join.

Elaine