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Author Topic: SLO Query  (Read 2310 times)

Nuala

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SLO Query
« on: September 13, 2013, 07:59:20 AM »

My Irish Terrier has been battling Polymyositis for about 15 months now and is currently doing very well on a combination of Prednsiolone and Azathioprine.  We are down to 0.5mg/kg/EOD of pred. with aza EOD as well and are going through a very slow reduction process.  Blood test results are all good and side effects considerably lessened with the EOD dosing.

My new query relates to the loss of 2 different toe nails in the last 3 months which have made me concerned about possible SLO as a secondary AI condition.  My girl is a very active youngster (just turned 4) and is ball manic!  Both nail loss incidents occurred when she was racing after her beloved ball and if it were not for the pre-existing AI condition, I would have put the loss down to trauma to the foot.  On both occasions, about 2/3 of the nail has been lost and with little or no bleeding.  The nail has regrown and there does not seem to be any deformity to her nails.  She has had no lameness or signs of any infection or anything else untoward.  Just wondering if I am being a bit paranoid in thinking of SLO?  Any advice would be most welcome.

Nuala

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Jo CIMDA

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Re: SLO Query
« Reply #1 on: September 13, 2013, 12:45:02 PM »

Hi Nuala

If a dog already has on AI disease then it is known that they are genetically predisposed and this means that it is possible they can get different AI disease.  If the damaged nails are on one foot and none of the others are affected then it could be a trauma.  Only time will tell because if it is SLO then others will appear and on different feet.  This can take months to show.  I'm not sure if the information below is in the files but I have pasted it here for convenience.  It's an extract from my seminar notes and I hope it is useful.

Jo


SLO comes under the heading of an autoimmune skin disease.

Definition:
Symmetrical:  Affecting corresponding parts simultaneously and similarly.
Lupoid:   Comes from the word lupus meaning any of a group of skin diseases in which the lesions are characteristically eroded.
Onychodystrophy:  Abnormal claw formation.
As previously stated, SLO can be `primary’ or `secondary’, meaning it can occur in isolation,  i.e. primary,  or it can be secondary to another autoimmune disease such as, pemphigus skin disease; or SLE, a multi-systemic autoimmune disease which is far more serious.
Unlike some autoimmune diseases primary SLO is not life threatening, but it is a very painful and miserable condition until correct treatment is well under way.  Primary SLO involves the nails and surrounding area of the feet only. Multiple nails on different feet are always affected but this can take many months to fully develop. Routine blood results are normal in a dog with primary SLO.  A dog with secondary SLO would show other signs of being unwell eg., footpads can be affected and other areas of skin involved, very high temperature, lameness, anaemia etc......
Differential Diagnoses
In addition to SLO being linked to other autoimmune diseases, nail disorders can be caused by:
•   Trauma  (very unlikely that all claws would be involved)
•   Infection – bacterial, fungal  (again, very unlikely that all claws would be involved)
•   Endocrine problems:  (eg., resulting from an underactive thyroid or Cushing’s syndrome)
•   Nutritional causes
If the reason for sloughing nails were due to any of the above, other than trauma or infection, it is likely that other clinical signs would be evident. 
Wrong Diagnosis
Initially only one or two nails are affected. It’s common, and not unreasonable, for the vet to assume a diagnosis of bacterial or fungal infection and treat accordingly. Treatment can go on for several months before both the vet and owner accept that the treatment is not working. The longer SLO is left without appropriate treatment the more nails will become affected. Secondary infection is very likely because the feet are in contact with the ground and the dog will naturally lick his sore feet which may also cause infection.
The first thing you may notice if your dog has a nail problem is when he cries out in pain and limps, or licks his foot. Nails can bleed profusely and this can be alarming to start with.  It is natural to think that he has caught his nail on something that perhaps has broken it and made it bleed.  It is probably not until a second and maybe a third nail becomes a problem that you might start to connect the two and wonder if this is more than just accidental damage of a couple of broken nails. Of course, one lost nail may be due to trauma or even an infection but if the problem extends to other nails on different feet then it could be SLO.   
Clinical signs of SLO can include:
•   Lameness, swollen toes.
•   Loss or partial loss of nails, licking of feet.
•   Bleeding and/or discharge from the nail or surrounding skin.
•   Deformity caused by abnormal growth.
•   Secondary infection.
•   The dog is generally well but may be depressed due to pain.
The disease is progressive and it can take months before all claws are affected. Blood tests will be unremarkable but a full blood test is essential to first rule out the possibility of an underlying disease.
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Nuala

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Re: SLO Query
« Reply #2 on: September 13, 2013, 02:14:08 PM »

Jo, thank you for replying so quickly.  The information you posted is very helpful.  At this stage, Brannagh's only symptom is the nail loss.  I think it is a case of wait and see with fingers firmly crossed that it is just trauma.

Nuala
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Jo CIMDA

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Re: SLO Query
« Reply #3 on: September 13, 2013, 06:33:23 PM »

Hi Nuala

I'm glad it useful.  I hope it doesn't progress further.  Has  Brannagh been on steroids and Aza for 15 months?  If so perhaps you should start to consider reducing the dose.  15 months is a long time and it would be nice to gradually get the dose of both drugs a bit lower with view to perhaps weaning her off altogether.  it's worth thinking about and having a chat with your vet.

Jo
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Nuala

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Re: SLO Query
« Reply #4 on: September 14, 2013, 10:43:25 AM »

Hi Jo,

Brannagh had a relapse in March of this year immediately after coming off all meds and we had to restart the pred. & add in the aza. at the immunosuppressive dose so this is our second round of treatment in 15 months.  We are keeping our fingers crossed that she continues to do well as we lower the dose slowly over the coming weeks. 

Nuala
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Jo CIMDA

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Re: SLO Query
« Reply #5 on: September 14, 2013, 08:29:21 PM »

That explains it Nuala.

Have a look at the Michael J Day reducing drug protocol in the files.  It is an excellent guide.

Jo
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