Discoid Lupus

[Guest TriciasZoo]

Sam has to go in for a biopsy on his cute nose, to check for what we believe is Discoid Lupus. Has anyone else had any experience with this disease?

[Guest SoulsMom]

Soul has it, so far it is only cosmetic, affecting his nose. I'm still in the process of trial and error to keep it under control, but what has seemed to work best is keeping baby sunscreen on his nose any time he is outside. The vet said he could prescribe a topical steroid cream, but we both decided to try and control the symptoms naturally first to avoid any side affects from meds.

 

Occasionally Soul will get a bit of a "bloody nose", but so far the sunscreen is working really well. I also try to keep him indoors during the day when the sun is at it's highest.

Edited April 13, 2008 by SoulsMom

[Guest TriciasZoo]

Right now it's just Sam's nose too, but the progression the vet described was NOT good. He did remove all the scabs when he was last in, but they are already starting to form again, and I know how sensitive and painful his nose is. I try to keep Vit. E / Aloe ointment on it, but he HATES for it to be touched.

[Guest SoulsMom]

When Soul's was really peeling bad he hated to be touched too. Once he was diagnosed we started with the sunscreen, and changed his diet and added supplements. He's now grain free and gets two vitE caps a day. If he's starts to get "crusty" I use bag balm. He has his good days and bad, but nothing near what it was before he was diagnosed.

[Guest SoulsMom]

Right now it's just Sam's nose too, but the progression the vet described was NOT good.

 

What progression? My vet (who also consulted with several others) said there is only a 5% chance it will develop into SLE, and most likely it will only affect his nose for the rest of his life. Yet we did discuss monitoring Soul's kidneys to be on the safe said . . . .I'm curious about the progeression you vet described

 

[Guest MomofSweetPotatoes]

Usually a topical oitment like tacrolimus or an ear drop (synotic) used as a topical can help alleviate the symptoms.

We found that in the winter, it seems like the skin issues are more prevalent. (I wonder if it is the change in the angle of the

sun to the earth) We use chapstick with spf 30 to cover Yardman's nose to help protect his nose from the wind and the sun.

Signs that it may be affecting the feet is - extremely dry and cracked foot pads, hyperkeratosis of the pads, dry cracked nails, red or raw foot pads. Also, this could mean other pathologies too, but these are some things that have been in common with those I have chatted with over autoimmune disease in our greys.

 

Supplements like CoQ10, vitamin e, antioxidant formula, and Niacinamide (b vitamin), fish oil caps, flax oil, help alleviate the symptoms as well.

 

Avoiding foods with chemical preservatives will help to avoid flare ups. Definitely consider sunscreen (chapstick with SPF) for his nose. It will help the peelies.

 

Yardman actually has sytemic lupus with discoid on the nose. We've been treating his symptoms for years now and have been quite successful in keeping his symptoms at bay and keeping him comfortable. As far as progression, watch for extreme thirst, excessive urination. Lupus likes to affect the kidneys, so just watch for signs of kidney disease and do blood work (esp for kidneys) every 6 months. (JMHO on the blood work) and don't panic if there is a UTI.

 

I hope this information helps.

Edited April 13, 2008 by MomofSweetPotatoes

[Guest TriciasZoo]

Amoung the things I remember the vet saying is that the nose would eventually become disfigured, leading to breathing inhibitions, to start with. It would eventually affect other parts of the body, though I don't remember the details. He did say it can be extremely painful for the dog. And I see that already with Sam. He hates it when I put anything on it. Two vets have recommended oral meds. I'd have to hunt down the email I got from Shelley, a friend who's a vet, to see what she would prescribe. I know Tetracycline was one. My vet agreed with oral meds too. But first we have to have the 'official confirmation' via biopsy, and Sam had to get healthy after his hookworm ordeal before we could do that. I'm giving him one more week to recoup, then the biopsy.

[Guest MomofSweetPotatoes]

Ok, that's bizarre. But ok... Yardman has had Lupus since before I've had him and his nose has yet to become disfigured and he's 10.

I would really seek a second opinion before biopsy. Biopsy scars will take forever to heal if it is discoid lupus.

 

Personally I would try the tetracycline niacinimide combo (one won't work without the other really) Give it 8 weeks to see if there is an affect.

 

I would seek a 2nd consult. Start conditioning Sam to having his nose and face touched. He's going to need to get used to it.

 

Wishing the best for you and Sam.

[Guest SoulsMom]

Amoung the things I remember the vet saying is that the nose would eventually become disfigured, leading to breathing inhibitions, to start with. It would eventually affect other parts of the body, though I don't remember the details. He did say it can be extremely painful for the dog. And I see that already with Sam. He hates it when I put anything on it. Two vets have recommended oral meds. I'd have to hunt down the email I got from Shelley, a friend who's a vet, to see what she would prescribe. I know Tetracycline was one. My vet agreed with oral meds too. But first we have to have the 'official confirmation' via biopsy, and Sam had to get healthy after his hookworm ordeal before we could do that. I'm giving him one more week to recoup, then the biopsy.

 

That sounds like the progession of SLE, not Discoid Lupus.

 

I 2nd Kerri's thoughts about the biopsy. With Soul visual was enough for the vet to determine that it was Discoid Lupus, and he saw no need to put him under for a biopsy yet. If Soul didn't improve with diet and sunscreen, then we would have reconsidered the biopsy surgery. But he's done nothing but improve since we started with the supplements and sunscreen.

 

I also forgot to mention that sometimes his condition affects the delicate skin around his eyes, causing a few bumps from time to time.

 

Hope Sam is feeling better soon!

 

ETA: The only time Soul is in pain is when he has a flare up and I try Kerri's chapstick trick on his nose. He doesn't like that, so during those times I use the straight baby sunscreen from the bottle. Other than that he's happy and healthy.

Edited April 14, 2008 by SoulsMom

[Guest TriciasZoo]

Ok, that's bizarre. But ok... Yardman has had Lupus since before I've had him and his nose has yet to become disfigured and he's 10.

I would really seek a second opinion before biopsy. Biopsy scars will take forever to heal if it is discoid lupus.

 

Personally I would try the tetracycline niacinimide combo (one won't work without the other really) Give it 8 weeks to see if there is an affect.

 

I would seek a 2nd consult. Start conditioning Sam to having his nose and face touched. He's going to need to get used to it.

 

Wishing the best for you and Sam.

 

Yes, that's it. That's the combo! My vet won't start him on it w/o the biopsy. BUT I have the dosages from my friend so I could just order the meds and start him without my local vet. And yes, I've been working with him on getting more used to me touching it. I will ask Shelley her opinion on prognosis for my second opinion. She agrees with the diagnosis.

 

Thank you guys for helping me through this, guys!!!

[tbhounds]

I believe the medications are the same as if you were treating SLO--Tetracycline, niacidimide (B-3) and E.F.A's and plus or minus Pred (short-term just to reduce the inflammation). The medications are to suppress the immune system. Depending on the severity of the the disease you might just be able to use topicals and E.F.A's. (check the tip of his ears--sometimes you'll start to see crusting there too).

[Guest SoulsMom]

Kerri, I'm curious, what dosage of CoQ10 do you give?

[Greylover97]

Carolina has pemphigus. Her nose peels a lot during the winter months. The vet looked at her nose and said pemphigus, no biopsy needed. She was given a topical cream and prescribed niacinimide. She was diagnosed in the winter of 2004-2005. She has no issues with breathing. We carefully check the other areas where skin meets fur (eyes, toes, mouth, girl plumbing, etc.), since if it was to spread that is where it would go to. Knock on wood we haven't had any other issues.

 

Get a second opinion, I don't think a biopsy is necessary for a diagnoses. Niacinimide isn't going to hurt him, why not try and see what happens.

[Guest MomofSweetPotatoes]

Kerri, I'm curious, what dosage of CoQ10 do you give?

 

200 mg I started at 100mg and we've bumped up to 200mg over the course of a year or so.

[krissn333]

If you want to be ABSOLUTELY sure, you can do the biopsy...

 

Pinky was never biopsied, her nose, ears, and the area around her eyes, coupled with the hyperkeratosis of her paw pads and her brittle toenails said it all. When we (my group) took her from the track, the track vet said that she "just" has discoid lupus and that a little vitamin E ointment would be just fine. Poor thing was so miserable at the kennel I brought her home, that's when I really discovered her paw pads and her toenails. There is NO WAY that all she needed was vitamin E ointment. If that's how she was being cared for at the track, I am not surprised that it turned into SLO.

 

Pinky takes tetracycline (500 mg twice a day), Niacinamide (500 mg twice a day), Vitamin E (400 IU twice a day), and an Omega 3 fish oil caplet. This regimen keeps her at an even keel most of the time.

 

Recently she's had some flare ups so she's taken a burst and taper course of pred. She started the last one at 20 mg for 5 days and then tapered from there (10 mg for the next 5 days, and then 5 mg for a week or so). With the stress of having to go to the ER 2 weeks ago she's flaring a little again. Doc wants to try her on a low dose (5mg) of pred daily for a month and see how she does. If she's doing well we will drop to every other day and see if she flares again or if she can maintain. We are waiting until her stitches are removed this weekend before starting her on that though.

 

She's my little eeyore dog but when she's feeling good you can really tell...her "normal good" is still not as energetic as Ace and Fritz (I think that's just her personality), but there is something about her, I can tell when she's feeling better...the subtleties that moms pick up on And when her poor little nose is all flaky and cracked and bleeding I just feel awful for her. We've used Carmex on her nose with good results (it doesn't taste good at all so she won't lick it).

 

I have also used Preparation H on her nose and on her paw pads too, as recommended by our veterinarian...moisturizing but also does something with blood flow but I am not sure what it does. I try to use that or Bag Balm on her feet on Sundays, after they've come in from being outside I grease her up and put baby socks on her while she takes her afternoon nap

 

ETA: regarding the disfigurement...I have never read that but I would imagine it could happen if the nose went untreated for a very long time. For a long time I was not sure if Pinky could actually SMELL anything, the other dogs would be sniffing stuff and she would show now interest, like her smeller didn't work I still don't know if it WASN'T working when I got her but now that she's being treated it works again, or if she was just very timid when I got her and didn't take an interest in smellies ...nose function was something I worried about too though...

 

Kerri, I'm curious, what dosage of CoQ10 do you give?

 

200 mg I started at 100mg and we've bumped up to 200mg over the course of a year or so.

 

Do you just use the CoQ10 that can be bought at like Target or Walgreens in the supplements section?

Edited April 15, 2008 by krissn333

[Guest MomofSweetPotatoes]

Kerri, I'm curious, what dosage of CoQ10 do you give?

 

200 mg I started at 100mg and we've bumped up to 200mg over the course of a year or so.

 

Do you just use the CoQ10 that can be bought at like Target or Walgreens in the supplements section?

 

Yes, I just get mine at whole foods. But I am sure it's all the same. We've also started a B-complex too, because b2 and b5 help metabolize fats (helps the EFA's do their thing) and B-6 helps with the amino acids and deficiencies in B-6 can lead to skin disorders. So, it seems with the b complex we are seeing less flare ups skin wise. So, food for thought anyway.

Edited April 15, 2008 by MomofSweetPotatoes

[Guest SoulsMom]

Kerri, I'm curious, what dosage of CoQ10 do you give?

 

200 mg I started at 100mg and we've bumped up to 200mg over the course of a year or so.

 

Thanks Kerri! I have some in the house, I'm going to start Soul on it and see if we have any more improvement.

 

[Guest TriciasZoo]

This is the response I got from a friend/vet, when I asked if I should put him through the biopsy and told her what my vet gave me as a prognosis:

 

I can understand your frustration but think about it this way--if he starts treatment and it isn't discoid lupus and he has some sort of bad reaction to the meds or something then technically he is liable for that and you could charge him with malpractice. Unfortunately in this day and age, us vets have to worry about that too!! I couldn't imagine any type of bad reaction, the meds I gave you are safe (just vitamins and an antibiotic) so I think it should be fine. Yes, if it is untreated, it can get worse and cause other wounds in other places and it can become systemically painful.

[Guest SoulsMom]

This is the response I got from a friend/vet, when I asked if I should put him through the biopsy and told her what my vet gave me as a prognosis:

 

I can understand your frustration but think about it this way--if he starts treatment and it isn't discoid lupus and he has some sort of bad reaction to the meds or something then technically he is liable for that and you could charge him with malpractice. Unfortunately in this day and age, us vets have to worry about that too!! I couldn't imagine any type of bad reaction, the meds I gave you are safe (just vitamins and an antibiotic) so I think it should be fine. Yes, if it is untreated, it can get worse and cause other wounds in other places and it can become systemically painful.

 

Hmmm. See, I have not heard the Discoid Lupus can become systemically painful. SLE, yes. But not Discoid. However, that is just based on conversations with my vet and a handful of other people who have dealt with the disorder. And my experiences so far with Soul. As far as the vet being liable if he prescribes a steriod cream with out actual biopsy results My vet gave me the option of a biopsy, and I declined. He then gave me the option of the cream, and after disucssion we decided to try the natural way first.

 

Do you have pics of Sam's nose? Are his ears and eyes affected as well?

 

[Guest TriciasZoo]

Yes, I'll upload the pics of his nose. It's not affecting anything else. Neither vet I've talked to suggested a topical treatment only. Both talked about Niamiacide and Tetracyline. (Don't ask me if I can spell this early). I'll go upload the pictures.

 

 

 

 

 

At the last vet visit the vet removed all the scaling, but it's coming back less than two weeks later.

 

I admit I'm getting frustrated, not at anyone. So PLEASE don't take it that way. I'm just getting overwhelmed with everyone telling me something different. I'm afraid if I have to make the decision, which I do, that I have to go along with my vet in town, which does mean the biopsy, before he'll treat it, as it COULD possibly (unlikely) be something other than discoid Lupus. I know how sore his nose is already.

Edited April 15, 2008 by TriciasZoo

[Guest SoulsMom]

Yup, Soul's looked like that before we started the sunscreen and supplements. It's now soooooo much better.

 

Poor Sam, we know how he feels!

 

Edited to add: Since a biopsy requires him to "go under" and can be so painful in healing, maybe you could try the sunscreen and supplements first and then if there is no improvement after a few months do the biopsy and get the cream.

 

Here is what we do (and he doesn't need steroids):

 

Baby sunscreen every time he goes outside in the sun

Limited outdoor time during peak hours

Grain and additive free kibble (right now he's on Taste of the Wild)

Grizzly Salmon oil

800mg vit e/day

 

As for the scabs, Souls came off on their own as he healed. He hardly needs the bag balm anymore, only if I forget the sunscreen and he has a flare up.

Edited April 15, 2008 by SoulsMom

[Guest MomofSweetPotatoes]

Ok, don't remove the scaling anymore. Let it fall off on it's own.

 

That looks like Yardman's nose. I am not diagnosing. Talk to your vet. Ask him if you can trial basis do the tetracycline/niacinimide combo before doing the biopsy. The only reason I say this is - once those biopsy scars are there, they will take FOREVER to heal. Yardman's took over 1 year before normal flesh was on the scars, and the derm vet that did it, took the smallest nips possible.

 

If your vet is hesitant to let you try a less invasive procedure, I would really seek a second opinion. Changes to the body can be monitored by you and semi-annual bloodwork. I would really hate to see him have biopsy flesh removed for a less than definitive diagnosis and then have to deal with the biopsy scars lack of normal healing. It's really not fun.

 

Really try to get chapstick with spf on his nose before going out. The lack of sun on his nose will help.

 

I'm sorry you are so frustrated. It really is frustrating.

 

Also, remember, I am not a vet, so if you trust your vet, go with their recommendation. I'm just an online person, with experience in dealing with something similar to what you are dealing with and I've never stayed at a holiday inn express.

Edited April 15, 2008 by MomofSweetPotatoes

[Guest MomofSweetPotatoes]

Wanted to add, this is Yardman's nose almost 2 years post biopsy.

 

See the corners are still pink? The biopsy was in those locations, that's almost 2 years post biopsy.

Edited April 15, 2008 by MomofSweetPotatoes

[Guest TriciasZoo]

I've actually had three vets agree. I forgot about the day I took him or his leg x-ray, and saw the other vet, and she agreed. My vet won't treat it as DL without it. Yes, I could order those meds, as one vet gave me dosages for his weight, but Sam has already given me two potential cancer scares. So while this isn't cancer, I still want to be thorough, especially with as much pain as his nose is in. I'm not worried about a biopsy scar. I've got a top-notch vet who will do it well to minimize it as much as possible, and like all scars it will fade over time.

 

*sigh* I just feel pulled in so many directions. I had no idea there would be so many different opinions on this subject, never having heard of the disease until now.

 

Oh, and _I_ didn't remove the scaling. The vet did. while Sam was there overnight for the hookworm infestation.

[Guest MomofSweetPotatoes]

Oh, and _I_ didn't remove the scaling. The vet did. while Sam was there overnight for the hookworm infestation.

 

Ok, sorry, I read too fast and misread that. Removing the scaling can actually cause the scaling to come back faster. Hey, if 3 vets agree, then go with your gut. No need to have us keep hen-pecking you.

 

Sorry you have to deal with this. It's not fun

Edited April 15, 2008 by MomofSweetPotatoes