Vixen

[dom]

Hello

I originally joined the Yahoo groups but had difficultly working it all out 

Vixen is a 6 year old cross breed (probably collie x brittany) and came to me directly from the pound aged somewhere between 6-9 months of age. On arrivial she had the following:

- severe ulceration of the mouth (hard and soft tissue, roof of the mouth, tongue, back of her throat - she constantly pants and drinks)
- broken nails on all feet
- skin lesions (lower ears, neck, inner thighs, tail and belly button)
- unable to eat any dry food and wet food has to have liquid added to also added lactolose as she was unable to do a poo without screaming in agony
- urine leakage

Auto-immune was mentioned by the vets quite early on but we discovered that Vixen was pregnant so no treatment was started. Once pups were weaned Vixen was spayed and all skin lesions removed for testing (apart from ears and her tail was removed before we realised she was pregnant as it was constantly bleeding).

We started pred (looks like a maintenance dose after reading through on here) for about a 18 months and she started to suffer from depression so moved her onto medrone. She managed about 15 months on that before the depression returned. Switched her back onto pred. She had 2 incidents with a spider biting her and both times her face/neck swelled extensive, she lost her fur and recovery was about 6 months on continually antibiotics (she has permanent scarring from both incidents). She has had 2 incidents of reduced oxygen and her tongue went blue, she saw a heart specialist and her heart is fine.

Two years ago I managed to get some money together to take her to Willows in Solihull, where we withdrew her from the pred to make her mouth ulceration as bad as possible to take biopsies. She was also tested for cushings as she was displaying a lot of the symptoms at this stage (negative result) and a anti-necular test (also negative result). Kirsty the vet was very certain that Vixen has SLE and was surprised at the negative result. However, with all of the symptoms her vet is continuing to treat her as though she has SLE.

Vixen was put on atopica but the side effects were a nightmare. So she is now on a mix of atopica and pred (both maintenance doses).

Current additional issues (the ones mentioned above from when she arrived are still an issue)
- spinal discomfort (going in for x-rays in 2 weeks)
- abdominal pain after meals (she is now having 4 smaller meals rather than 2 normal sized ones)
- Facial and right front leg spasms
- increased isolation from the rest of us (I see her for maybe an hour a day, the rest of the time she is under the computer desk or in the garden)

Unfortunately, Vixen's insurance doesn't cover anything as she came with this condition. I am maxed out on credit cards on her vets bill (7k) so I am pretty much stuck now.

[Jo CIMDA]

Hi and welcome,

Poor Vixen has been throught he mill, hasn't she?  And you haven't had a picnic either.

Preds will induce drug induced Cushing's  but the symptoms will subside as you lower the dose. Atopica is very expensive. A much cheaper combination of drugs is pred and azathioprine.  Perhaps you can ask your vet to swap the Atopica for Azathioprine.  Never be afraid to say you can't afford it.  You may be surprised (or not) just how many procedures are recommended or expensive drugs prescribed when it is not necessary and by saying that you can't afford it the attitude of the vet changes and they happily offer an alternative.  Vets don't always consider the cost to the owner.

Vixen may have SLE.  A positive ANA test is not diagnostic of SLE and a negative result doesn't rule it out. A diagnosis of SLE is based on clinical signs and these are broken down into major and minor signs.  (Canine Medicine and Therapeutics by Neil Gorman)

Major signs include:
shifting lameness,
proteinuria - glomerulonephropathy (kidney)
skin lesions,
blood abnormalities such as anaemia, thrombocytopenia (platelet reduction) etc.

Minor signs include:
polymyositis (muscles)
pericarditis/myocarditis (heart)
Pleuritis (lungs)
generalised lymphadenopathy (lymph nodes)
Central nervous system signs such as behaviour changes, seizures, ataxia
gastrointestinal signs (vomiting, diarrhoea)

Definite SLE =
positive ANA plus two major signs
positive ANA plus one major and two minor signs

Probable ANA =
positive ANA and one major sign
negative ANA and two major signs.

I wonder if the episodes of her tongue going blue was due to her oesophagus not working properly or perhaps she is anaemic and she does not have enough red blood cells to carry the oxygen to the brain.

Have the drugs brought her into remission? Is she having a gastroprotectant?  The drugs she is on can cause stomach problems but this can be sorted with rantitidine or Antepsin.

She certainly has her fair share of problems.  I hope they can sort her out soon. I'm sorry your insurance won't cover it. That's an added worry.

best wishes
jo

[Penel CIMDA moderator]

Hi Dom,
glad to see you made it here, hopefully you'll find this new forum easier.
I know you've had such a hard time with Vixen.  It definitely sounds like SLE to me - as you know, Saffy had it from aged 3 - 5 when sadly she died from it.  She was always on a combo of Azathioprine and pred.   I totally agree with Jo about telling the vets you can't afford the drugs - and also if Vixen has never been on Aza then it might be the time to try it instead of Atopica.
Saffy had several negative anti nuclear antibody tests but she most definitely had SLE.

[dom]

Thank you both for replying 

Vixen had her x-rays and she has arthritis in her left hip but nothing else was spotted. Her neurological problems have increased and she is loosing coordination. She is spinning (to the left only) much more than normal, struggling to work out how to climb the stairs (it was never a problem previously), experiencing more spasms and her general behaviour is odder than normal. Forgot to add, the vet was also concerned about her gait when she went in for the xrays as she over steps and she has now started to splay her back legs and over step with her front.

But, she doesn't seem overly bothered by any of this. She is enjoying her walks but has gone off her food (I have put her on some very smelly wet dog food instead which she seems to want!) I am still waiting to see if Axa are going to treat this as a different condition and if so I can arrange for a MRI to see if there are any changes in her brain.

[gschellinger]

Hi Dom,

Poor Vixen has really had much more than her share. I wonder about an auto-immune brain problem. My Lola was originally diagnosed with immune mediated brain inflammation. Turns out she has something completely different. The over-stepping you describe reminds me of Lola. She has hereditary cerebellar ataxia, and it affected her rear legs mostly for the last four years, but now is also affecting her front legs. She oversteps in the front. All four legs have a wide stance to balance. She is also very uncoordinated.  Is there any dragging of the back legs. It could be so many things. When Lola first started with her symptoms I did a lot of research and had a huge list of conditions it 'could' be. It took a long time for me to find what it actually was
I hope you get answers.
gail.

[Jo CIMDA]

Hi Dom

Gail has a lot of experience in this area.  I presume you have had thyroid tests done.  There are some diseases that affect co-ordination and brain activity and also some drugs can do the same.  A neurological specialist would be ideal for Vixen.  I do hope the insurance pays up for a specialist and an MRI scan.  It so good that she is not that phased by all this, but it must be traumatic for you to watch.

Good luck

Jo