Pemphigus Foliaceous

[kolarik1]

Well, Pop went to MSU today...student vet saw him (since when are vets cute?), then the resident vet...then they took him to see the professor!

 

They ended up not doing allergy testing as there *may* be an underlying food allergy, but they definitely don't suspect an environmental allergy...they too were puzzled with the fact that he got better on the Dog Chow, but think maybe it's because he was off of his meds...they biopsied him & ran some cultures, so I have to wait 5 - 10 days for the results...however, the resident vet & professor are thinking Pemphigus Foliaceous...

 

I've already searched the forum & see some others have had their hounds diagnosed with this as well.

 

For now, Pop is not to receive any medication (not even thyroid meds) until the results are back...I just have to soak his paws in this solution which I can get at any pharmacy and to remain on the Dog Chow. Part of me is hoping it is Pemphigus just so that I will have an actual, correct diagnosis and I can treat it.

 

Currently Pop is crashed on the bed after eating some food when he got home. I love my big goofy boy who was thrilled to see Zelda & I...but the look he gave me this morning while the vets were discussing his case. I thought for sure he was going to come home and poop/pee on all of my things...he gave me some major stink eye!

[Guest june]

Stink eye is so much better than lethargy and depression. Hang in there. Sending prayers and good thoughts your way.

june

[Guest mcsheltie]

I understand wanting to KNOW what he has. But don't wish for that one. Let's hope for something else.

[Chicocat]

Pemphigus Foliaceous and food allergy can look very much alike. When Cutie was tested the results came back inconclusive. She was treated with medications for immune disorders and while they helped didn't solve the problem. That's when we tried the diet for food allergies.

 

She was also taken off Soloxine. They didn't want to put her back on it for a while and when she had a dental they had a lot of trouble getting the bleeding stopped from an extraction. Not being on her thyroid medication could have contributed to that. She's back on Soloxine now and did just fine in her recent dental.

[EllenEveBaz]

Sending all sorts of good wishes to Pop.

[fsugrad]

Stacey, these threads have pictures of Robin's pemphigus ordeal from last year.

You may want to compare the pics to what you're seeing on Pop.

Best wishes, and lots of hugs, to both of you. Rita

 

When it first started happening:

http://forum.greytalk.com/index.php/topic/260532-robin-is-a-total-mess-our-poor-baby/page__hl__pemphigus

 

When it was diagnosed:

http://forum.greytalk.com/index.php/topic/262504-the-robin-update-pemphigus-treatment-new-pics/page__p__4714878__hl__pemphigus__fromsearch__1#entry4714878

 

The ICU stay when his leg swelled.

http://forum.greytalk.com/index.php/topic/262833-robin-is-home-from-the-hospital/page__p__4721721__hl__pemphigus__fromsearch__1#entry4721721

[kolarik1]

I understand wanting to KNOW what he has. But don't wish for that one. Let's hope for something else.

 

Trust me, I really don't want it to be Pemphigus...I just want to know WHAT it is...Pop is so beat up looking right now and his paws are bothering him, it sucks to see him like this. DBF is very protective (almost over protective) of Pop as he thinks of Pop as 'his boy' and those 2 do bond well together...might explain why Pop was all over the student vet (male) but hid behind me when the resident vet (female) came in the room. DBF is so good with both pups but is very protective of 'his boy.'

 

I don't know if you or your DH have seen Pop fully broken out, but it's not good by any means. I'm going to take some pictures tonight of his face and try some pictures of his paws, altho those will be much harder to get a good picture of. It's very hard for me to trim his nails as his paws are so tender and I feel like an ogre when I do it, but I know I have to so his nails are much longer than they should be.

 

Pemphigus Foliaceous and food allergy can look very much alike. When Cutie was tested the results came back inconclusive. She was treated with medications for immune disorders and while they helped didn't solve the problem. That's when we tried the diet for food allergies.

 

She was also taken off Soloxine. They didn't want to put her back on it for a while and when she had a dental they had a lot of trouble getting the bleeding stopped from an extraction. Not being on her thyroid medication could have contributed to that. She's back on Soloxine now and did just fine in her recent dental.

 

I actually asked the resident vet 'what if this biopsy comes back like the other 2 and says severe allergic dermatitis? How will we treat it then?' and she wanted us to wait until the results came back before determining a course of action

Edited March 17, 2011 by kolarik1

[kolarik1]

This is what Pop looks like right now...the paw picture isn't the greatest, but you can see the pink on his paw...his front paws are the worst, but all 4 paws are affected.

 

 

[fsugrad]

Oh, poor Pop! I hurt for him just looking at that picture.

Robin didn't have any spots as moist looking as Pop's---his were more of the red, raised, bumpy, crusty variety.

It sure looks like it could be some sort of pemphigus (to my untrained eye anyway). There are several different types of pemphigus. I know they told me that pemphigus foliaceus was the most common.

Sending lots of prayers that this is diagnosed soon, and that he's on the road to recovery asap.

[Guest mcsheltie]

Last time I saw Pop he did not look like that!

 

My experience with this is only with cats and there are some differences. But basics are the same, an auto-immune disease with a strong genetic component. Penicillin (including Amoxi) Cepha drugs and Trim/Sulfa should be avoided because they can trigger it. As can ultraviolet light.

 

Steroids like Pred are used at first. Often with topical hydro cortisone. This disease can wax and wane so when it goes into remission you need to be vigilant for the first sign of an outbreak and start (or increase if you are tapering) treatment again.

 

There are a number of other drugs that are immuno surpressive and can be used either by themselves or with Pred. Azathioprine and Tetracycline with Niacinamide are usually the next things tried with dogs. But I have not worked with either as they are not given to cats.

[fsugrad]

Just checking in on sweet Pop today.

[kolarik1]

Well the resident vet called today as they had the biopsy results, but not the culture results...those are due next week.

 

Her exact words 'lupus like disease'...so definitely not pemphigus, but I think they are still trying to figure out which type of lupus, the skin (discoid) or systemic...and what is weird is last fall my normal vet had mentioned discoid lupus and started having me give Pop Vit E and Niacin (pharmacist said it was the same as niacinimide), but it didn't seem to keep the outbreaks at bay. We talked for a bit on the phone & she was saying based on his history, the looks of him and what they had learned from me it didn't appear systemic, but they still need to do a urinalysis because they couldn't get enough urine when he was there...so I have to take him in the beginning of this next week for a urinalysis...but he has been consuming more water lately (and of course urinating more)...when I told her that she sounded a little worried that it may be affecting his kidneys, which as she basically said 'are essential for a dog.'

 

The cultures are to see exactly what type of bacteria he has so we know what type of meds will help kick the infections...and he'll have to start on immunosuppressant therapy. She called around 4:30 while I was at work, so I hung up the phone and cried at my desk...good thing there are 5' walls around and most people are gone by that time on a Friday. My supervisor is really nice so I'm sure she'll have no problem with me going to pick Pop up some time during the day this next week.

 

So it's still Dog Chow for now, no meds at all and I am trying to find this solution (which they say is OTC @ any pharmacy) to soak Pop's paws in.

 

ETA his blood work came back good, so besides possibly affecting the kidneys the rest of his organs appear to be unharmed (for now)

 

It just breaks my heart that he has this as I lost Mousey in December to cancer and my paternal grandmother died from complications of Lupus when I was 3 months old, after suffering with it for approx. 20 years.

Edited March 19, 2011 by kolarik1

[fsugrad]

I believe there are a few GT'ers whose hounds have lupus and their hounds lead happy lives.

I know with Robin, he has pemphigus, and he will always have pemphigus, but he is in remission, and we know what to look for and how to treat it if/when symptoms recur.

I think that is how lupus can be as well.

Edited March 20, 2011 by fsugrad

[Greylover97]

Niacin is not the same as niacinimide. Carolina takes niacinimide for pemphigus. It really helps her.

[kolarik1]

Niacin is not the same as niacinimide. Carolina takes niacinimide for pemphigus. It really helps her.

 

Then the pharmacist was lying to me...I read the label and didn't think it was the same, but since the pharmacist *told* me it was the same and they go to school for this very thing, I believed him/her. That really irks me...I took a pharmacology course in college, so I guess I'll have to pull my nifty reference book out...

 

Meanwhile Zelda is acting weird...I think it's because she knows I'm upset about Pop, but not sure.

[Chicocat]

Cutie was on Niacinamide for a while. I could have the pharmacy at WalMart special order it in tablet form, but I found a source online in capsule form that was much better. If the vet recommends it for Pop, here is the source:

 

Vita Cost - Niacinamide

 

Cutie was on a combination of Tetracycline and Niacinamide. We tried Pred early on but it caused too much muscle loss in Cutie.

 

I just saw Pop's picture in this thread and Cutie's reaction was nothing like that. She did have hair loss on her ears and spots on her legs and torso but Pop looks more like a type of pemphigus. In Cutie, her body was attacking the basal cells because of the food allergies. It took a year to figure this out with a good dermatology vet. :-(

 

Hope you find the right combination for Pop and get everything under control.

[kolarik1]

Cutie was on Niacinamide for a while. I could have the pharmacy at WalMart special order it in tablet form, but I found a source online in capsule form that was much better. If the vet recommends it for Pop, here is the source:

 

Vita Cost - Niacinamide

 

Cutie was on a combination of Tetracycline and Niacinamide. We tried Pred early on but it caused too much muscle loss in Cutie.

 

I just saw Pop's picture in this thread and Cutie's reaction was nothing like that. She did have hair loss on her ears and spots on her legs and torso but Pop looks more like a type of pemphigus. In Cutie, her body was attacking the basal cells because of the food allergies. It took a year to figure this out with a good dermatology vet. :-(

 

Hope you find the right combination for Pop and get everything under control.

 

Thanks for the link! I am still just hurting knowing that Pop has Lupus. I know that we all die sometime, but just knowing that with him it could be a lot sooner is really hitting home...I am truly hoping I have a few more years with him...he is 8 1/2, but I would love to see him hit the double digits.

Edited March 19, 2011 by kolarik1

[Chicocat]

You should have the benefit of good dermatology vets at MSU. My vet said the most important thing was getting it under control before it could involve any internal organs. The vets work hard to prevent that - they will take good care of your boy!

[kolarik1]

You should have the benefit of good dermatology vets at MSU. My vet said the most important thing was getting it under control before it could involve any internal organs. The vets work hard to prevent that - they will take good care of your boy!

 

The only issue is, he's been breaking out like this for almost 5 1/2 years now...the past biopsies have said 'severe allergic dermatitis' but from the previous biopsies the vets have never told me they have been able to find pustules to biopsy...the MSU derm vets did find the pustules, which is how they came up with the diagnosis. So....my thing is, I don't know how long he has truly had the Lupus...but his bloodwork came back good, so that's a huge plus...BUT, we still have to wait on the urinalysis...so I'm praying that his kidneys are either completely ok or not in too bad of a shape that they can be managed.