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Author Topic: Starting on Doxy...... unfortunately  (Read 4193 times)

Deeinnz

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Starting on Doxy...... unfortunately
« on: May 18, 2012, 03:42:16 AM »

Hi all,

As some people may know my boy Bossdin has had SLO for about 2 years now. I have managed to get his nails back to a pretty 'normal' state by just using the Fish Oil pills, antibiotics only twice and pain pills only when needed (not very often). And plenty of swimming in the ocean.

Today unfortunately that has changed. Over the last year or so Bossdin has had what I have called 'funny sores' that come and go, don't get infected and don't seem to bother him at all. Yesterday, while he was lying down in the sun I saw a red, raw looking sore on the underside of his foot, right beside the big pad. I immediately hoped it might just be mange, but was pretty sure it wouldn't be. I was already aware of yet another 'funny sore' on the top of one of his claws, around the nail bed, that I had been monitoring carefully for the last week or so. It didn't seem to be bothering him at all.

On further examination I found the beginnings of other 'blisters' around the big pads of his feet, and tried not to panic. Today the vet confirmed that he thinks it is Pemphigus Foliaceous. And with the other issues Bossdin has had we are hoping he just has DLE as opposed to SLE. SLE has been mentioned because of some shifting lameness Boss had earlier in the year (which I spoke to Jo about).

So my vet has started Bossdin on a course of Doxy. I have two weeks supply and have to get another two weeks if the Doxy makes some improvement in his condition. I also have to give him Rimadyl for 3 days to help with inflammation .

I'm just hoping this is just a minor flare up of his auto-immune issues, that this time his body has decided to attack the skin instead of his nails. His nails, like I've said look pretty good, almost normal.

What side effects should I look out for if he's going to be on Doxy for a month??
Thanks in advance,

Dee
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Dee and Bossdin (SLO, DLE, Pemphigus, BCC)
New Zealand

Jo CIMDA

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Re: Starting on Doxy...... unfortunately
« Reply #1 on: May 18, 2012, 11:40:16 AM »

Hi Dee

I'm sorry Bossdin is having more problems.  Your vet must check that the sores you describe aren't due to demodex mite.  It is very important because the treatment is different.  I would have expected pemphigus F to have shown on other areas of the body.  If it is PF then I doubt doxycycline will be enough.  PF is usually treated with immunosuppressive doses of steroids. It can take upto a month or more for Doxy to take effect. Is your vet going to include niacinamide?  Doxy is usually very well tolerated, so I doubt you will see any noticable side effects.

Good luck and I hope it goes well.

Jo
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Deeinnz

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Re: Starting on Doxy...... unfortunately
« Reply #2 on: May 18, 2012, 10:51:22 PM »

Hi Jo,

Thanks for your reply.

My vet took one look at the sores and said it wasn't mange (which is the demodex mite isn't it? ). And over the last year or so Boss has had other 'weird sores' . I did post some photos of them (very small sores that they were) on the yahoo site. He's had sores (or perhaps a better term is blister) in the past around his lips, eyes, and nose. And now around his foot pads. All these blisters have in the past just gone away on their own. But I notice now that it seems a couple are coming back on the edges of his lips.

My vet didn't say anything about the niacinamide, and I didn't suggest it as I thought it was used to increase blood flow, hence being good for the nails??? Would it help with P F as well? We (vet and I) are both hoping that the Doxy will help and that we won't have to go down the steroid path. But, if I have too I will.

When using steroids is the liver enzymes you have to keep an eye on?? I know there is something you have to monitor but can't remember what it is??

Dee
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Dee and Bossdin (SLO, DLE, Pemphigus, BCC)
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Jo CIMDA

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Re: Starting on Doxy...... unfortunately
« Reply #3 on: May 23, 2012, 10:55:46 PM »

Hi Dee

If you go into the section for SLO you will see my seminar notes.  This has most of the information you need.  The treatment is always a combination of doxy and niacinamide.  I also hope you don't have to go down the steroid route.  It is worth trying Doxy but it will take a while for any good results to be seen. 

Yes, liver enzymes rise when a dog is on steroids, but there are many other things too.  There should be an article in the files  called 'what to expect when you dog is on steroids'. 

I hope he is feeling a bit better.

Jo
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Deeinnz

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Re: Starting on Doxy...... unfortunately
« Reply #4 on: May 24, 2012, 07:28:05 AM »

Thanks Jo,

Will go into your notes shortly.

I"m thinking I will call my vet tomorrow to have a chat about his treatment plan. Bossdin is happy as larry and is feeling fine, no problems there.  It is me who panics when I see the small blisters he gets, they don't seem to worry him at all.

From what you told me on the old Yahoo site about the definition of 'remission' I"m wondering if that is the angle my vet is coming from, hoping that being on Doxy for a month will put Bossdin into total remission of all his Auto-Immune issues??  We didn't discuss it like that when I was there last Friday.  And of course I"m hearing what you and others have said in that, it will most probably take a lot more than one month of Doxy to put him into a full remission state. If that was the case, (needing to be on Doxy for months) I would struggle to afford it, as I am unable to work due to my own chronic health issues.

Bossdin was prescribed a 50mg Doxy pill and I had to give him 3 at once and then 1 1/2 pills every morning. (as well as the small blister things near his pads, the vet reckoned the scab he had above one nail indicated a nail bed infection), the actual nail was fine. He weighs 27.60 Kg.   23 pills (for two weeks) cost me $61 (no idea what that is in pounds). And I'm meant to ring up and get another two weeks worth before this lot run out.

I'm thinking (at this stage anyway) I might be better to just treat the symptoms as they crop up...... like now. Rather than try to get him into a full state of 'remission', considering the drugs possible side effects and the costs. I've also realised, once again, I need to take him to the sea more often. The clean sea water just seems to work miracles.

Dee
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Jo CIMDA

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Re: Starting on Doxy...... unfortunately
« Reply #5 on: May 24, 2012, 09:54:20 AM »

Hi Dee

I'm sure sea water will help enormously, if nothing else it will help any potential secondary infection.  SLO was known, in beardies anyway, as nail bed infection but in fact it is not a nail bed infection but an immune destruction of the nail and surrounding tissue inside the foot, well below the area of an exposed toe.  SLO does not cause lesions to the skin around the nail, but secondary infection can. Leisons on the pads is more likely to be DLE.  If it was SLE he would be very ill indeed and many more body systems would be involved. So that is good.

Don't underestimate the power of essential fatty acids when dealing with skin diseases. Money can be a problem and that is a worry for you.

Jo
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Penel CIMDA moderator

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Re: Starting on Doxy...... unfortunately
« Reply #6 on: May 24, 2012, 10:31:17 AM »



Don't underestimate the power of essential fatty acids when dealing with skin diseases

agreed.  I know a lady who runs a large greyhound rescue - she uses Evening Primrose oil at high doses for SLO, with really great results. 
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Deeinnz

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Re: Starting on Doxy...... unfortunately
« Reply #7 on: May 25, 2012, 01:44:49 AM »

Thanks Pen and Jo,

I've given Bossdin fish oil pills, every day,  right from the very beginning of this disease, back in May 2010.
I realise he will be on these for life.  Whenever something else flares up, like now, I just up his dose (normally I give him 4 pills a day, at the moment I'm giving him 6).

Do you think it may be beneficial to add Evening Primrose Oil as well??

On a different note, each time I log in here it tells me that I never have any new replies to this thread, that there are no new messages for me to read. Yet when I go into the actual thread I see the messages from you guys???

Dee  :D
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Jo CIMDA

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Re: Starting on Doxy...... unfortunately
« Reply #8 on: May 25, 2012, 12:53:49 PM »

Hi Dee

I'm sorry about the message thingy.  Unfortunately Penel is the one to answer that part of your post.

As for essential fatty acids.  Including evening primrose oil or another source of omega 6 is very important and the ratio is important too. 

Below is an extract from an article I have on my computer but unfortunately I don't have the source but it is referenced so that should be sufficient.

Jo


   Research shows that an optimal ratio of Omega-6 to Omega-3 fatty acids should be consumed for maximum positive benefits. Current recommendations are for ratios of 10:1 to 5:1 in the dog's daily diet.


Fatty Acids for Dogs - Sources
Fish oil, such as salmon oil, cod liver oil, and sardine oil, is rich in Omega-3 fatty acids (DHA and EPA).
Flaxseed oil, hempseed oil, and soybean oil are rich in Omega-3 too, but in the form of ALA. As mentioned above, ALA needs to be converted to EPA and DHA to be of nutritional benefit.
Evening primrose, borage, pumpkin seed, and sunflower oil are rich in Omega-6 fatty acids.

Pitcairn and Pitcairn, Dr. Pitcairn's Complete Guide to Natural Health for Dogs and Cats (Rodale, 2005).
A.D. Shojai, New Choices in Natural Healing for Dogs and Cats (Rodale Press, Inc., 1999).[/i]
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Deeinnz

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Re: Starting on Doxy...... unfortunately
« Reply #9 on: May 26, 2012, 01:00:31 AM »

"Research shows that an optimal ratio of Omega-6 to Omega-3 fatty acids should be consumed for maximum positive benefits. Current recommendations are for ratios of 10:1 to 5:1 in the dog's daily diet."

Sorry to be a dunce here Jo but does that means Bossdin should be getting at least 5 times as much omega 6 as the omega 3 ???

The fish oil pills I have only supply the omega 3 and a small amount of Vit E

Dee
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Jo CIMDA

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Re: Starting on Doxy...... unfortunately
« Reply #10 on: May 26, 2012, 10:58:57 AM »

Hi Dee
 
Yes it does mean that and you may find in some articles the ratio is even higher.   

Considering many articles will say that the correct ratio is very important, it is very hard to find recommended doses for essential fatty acids. Apparently the jury is out as to the actual ratio to use.  No one seems to want to lay down therapeutic doses.  Perhaps this is because they haven't done controlled clinical trials and different sources (eg flaxseed, EPO, salmon, cod etc.,) carry different values,  but it is known and accepted that EFA's are 'steroid sparing' meaning that when EFA's have been given for a period of 2-3 months it allows the steroids to be lowered more successfully. They do play an active part in building a protective barrier between the damaging infiltrating immune cells and the outer layer of the skin. Also the effect seems to be relative to the dose, so a low dose won't really have the desired effect. Therapeutic doses are needed for immune mediated skin disease.  If you look in the files at the SLO article it will have some guidelines for you.  If your vet isn't aware of therapeutic doses then you have to do your own research and find a dose you are happy with.  Introduce oils gradually because they can make the stools loose.

Example: I knew a beardie with DLE who was seen by a conventional veterinary specialist and in addition to the steroids (the more common treatment for AI skin disease at that time) She was on 3000mg (3 gramms) of evening primrose oil a day.  I had a dog with DLE and she was not treated with steroids but I put her on 3000mg of EPO and it did resolve her inflamed nose and crusty lips etc.  Natural Vit E 400iu twice a day is also given in skin diseases as this encourages new cell growth.

It shouldn't be left up to us but unfortunately it is where EFA's are concerned.
Jo

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Deeinnz

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Re: Starting on Doxy...... unfortunately
« Reply #11 on: May 30, 2012, 06:13:26 AM »

Thanks Jo,

I went to the vet yesterday to get the next lot of doxy and showed my vet your last message. He agreed saying it is very hard to work out the correct dose etc,  given we don't know how much omega's he is getting in the food I give him. Nothing on the labels of his food show the exact amounts of the omegas etc, it just says they are in there.

I"ve decided not to stress (wow, a biggie for me, ha ha) about what the levels may be in his food and will just carry on as I have been, using the SLO guidelines (for his weight he gets 6 fish oil pills a day). I've also now got some 1000mg Evening Primrose Oil capsules and am starting him on two of them a day.

It was a very good visit and I was encouraged because we discussed the amount of doxy prescribed and why (not to try to put Boss into total remission, just to get the Pemphigus under control). Already things are looking much better so clearly it's working.

The other hugely encouraging thing was, I told my vet I couldn't afford to have Boss on the doxy for months at a time and he said that I shouldn't worry about that as there is away around it. Apparently he can apply to somewhere (not sure where) to have Bossdin put on the human Doxy, which is much, much cheaper. For the initial stages Bossdin has to have the proper animal version, but if it turns out he will have to be on it for a long time my vet can make a case, based on the costs involved, to put him on the human version.  He then explained to me the difference in the two and that with the human one you have to be very careful that it is swallowed completely and doesn't get stuck in the gullet.

So, that is a big sigh of relief!

Thanks for all your support,

Dee  :)
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Jo CIMDA

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Re: Starting on Doxy...... unfortunately
« Reply #12 on: May 30, 2012, 10:39:14 AM »

Hi Dee

That sounds like a very positive meeting with your vet.  It is a real 'feel good' factor when that happens. And knowing that the treatment is more affordable to you know must be a huge weight off your mind. He sounds a nice chap and someone you can work with - that is so important.

I do hope all the EFA's will start to show some good effect - it should do.  You can't do anymore.

Jo

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