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Posts Tagged ‘pemphigus foliaceus’

Vet visit on November 16th.

Everything is good, fewer and fewer Pemphigus lesions with each visit.

Doc says we can reduce steroid if everything stays consistent.  Crossing fingers we can get to 4 pills every other day.

We’re taking less pictures these days since things are looking better.

Still on Triamcinolone, Azathioprine and Cyclosporine.  Not seeing much improvement after adding Cyclo but being patient.

Otis is eating like a pig but still not gaining much weight. Steroids do make him hungry allllll the time.

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Follow up

Infection gone

Started him on Cyclosporine in hopes that we could eventually replace the steroid. Expensive med and hard to find but we’ll make it work, additionally it takes time to make it into system so we have to wait to see if we get any results.

Reducing steroids to 5 and 2.5 on alternating days.

Starting to get cold and a dog with limited hair might need a coat. 🙂

Things looking good!

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Had a tiny setback, infection popped back up but this time put on a weaker antibiotic Clavamox.

Still taking Triamcinolone and Azathioprine.

Things seem on track and everyone is happy.

 

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What the hell happened….

Woke up in the morning and Otis would not eat or drink. He went outside to potty and came straight back in to his bed. He would shiver and whine, breathing was strange and he just was miserable. He was also acting really strange. This in itself was not that off, Pemphigus can wax and wane.  Some days are good, others are bad.

Sometime in the afternoon he went outside and wandered like he was unaware of where he was, he tried to got potty about 15 times in a row so we tried to reach our derma vet and could not get in touch.

We contacted our regular vet and took him to the office, he took one look at him and could tell he was not well.  Got him started on IV fluids and took some blood to determine what was wrong, he decided to keep him in the office overnight.

My heart sank, we were right back to that horrible place again. That place of no hope. There were lots of tears and no sleep.

We went up the next morning to visit him, liver and pancreas levels were through the roof but he was hydrated again and feeling a little better.  Vet wanted to keep him all day and said we could pick him up that night if things were still going well.

Around 7pm on Sunday we picked him up, I noticed he seemed a little week in back legs but we thought it might have been from sleeping in a weird kennel. At home he had some trouble getting up the stairs and when he would sit/lay it seemed like he went down pretty hard.

The next morning when we woke he couldn’t stand on his own, I had to boost up his back legs. His legs were crossed in the back and he was weak walking. He couldn’t manage stairs at all and he nearly fell over when trying to sit/lay. More tears and a call to the vet. More bloodwork. Nothing in the bloodwork so took him home. More tears. Doc said steroid dosage could have been masking this all along and now that we were decreasing it was showing up. Maybe the Chloram was causing it?

A long debate with doctor and my husband on if it was time to end this, had it come to that point?

We had fought so hard and so long… I wasn’t ready.

September 21st he woke up and stood up on his own, weakly but on his own. By the end of the day he was getting stronger. The next day stronger and soon like he never had this problem. We’ve never figured out what it was, and probably never will but he was better and that’s all that mattered.

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Otis was doing really well at this point.

Still a bit of bacteria so kept on Chloramphenicol, still on steroids, still on immuno suppressor. Bathing twice a week and using betagen spray and neopredef powder when needed.

He was eating well and some personality coming back. And hair was starting to grow, which was a good sign on such a high steroid dose.

We were in a good spot.

 

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Follow up blood work, things starting to turn around.  Infection was almost gone and he was really drying out.

Otis looked pretty wicked. He had dried up and all of the skin where hair was lost had turned an ugly gray. We got some fun reactions in the car on way to the vet or at the vets office, needless to say people would move to the other side of the room.

He also had lost close to 20 pounds at this point, and being a Boxer that was all muscle. He looked pretty scrawny and sickly but he was feeling better. He was eating again and had some life back.

We also started him on a medication called Azithioprine, an immuno suppressor.

We were on the road to hopefully reducing steroids.

Possibly the first really positive vet visit.

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Staph bacteria was resistant to Clindamycin so we switched to Chloramphenicol but of course the Chloram was really potent and could have all kinds of wicked side affects so we had to watch him closely for any weakness in back legs.

It was also determined that the Clindamycin was most likely causing the swollen feet. And as per life about this time Chloram was expensive, toxic to handle and the pills were huge. It was around then that we figured out Otis would eat anything wrapped in bread and slathered in peanut butter.

Thank you universe for peanut butter, I love you Skippy.

We felt some renewed hope, positive again that NOW things would be on the right track.

I just wanted my friend back.

 

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After several calls to the vet we stopped the Pentoxifylline due to the feet swelling, Otis now looked like he had baby bear paws they were so large. It was painful for him to walk.  The swelling did not go down and in fact had spread up his leg.  Scheduled a return visit to vet on August 10th.

At that time we did a culture test again to determine if his Staph infection was resistant to the antibiotic, he still had infection present in his skin scrapes. He was still not eating very well and was generally feeling rotten.

My happy dog who would run and snooze in the sun and jump up to cuddle with me in the bed could no longer do these things.  He was too weak to jump anywhere and sun is off limits to dogs with Pemphigus.

Every day I questioned still if I was doing the right thing… was this the life he would want…would he ever get better…were we delaying the inevitable?

Our house was covered in sheets because every time he would shake blood would fly. Bathing him looked like a murder scene and I would cry each time. We hardly left him. We had to prop his legs apart when he slept because around this time his groin area was sticking together the skin was so raw.  We did find out that Gold Bond powder is a life saver for that. It was rough.

But we pressed on.

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Confirmed Pemphigus, those words made me feel like hell after everything I had read.

We continued on the medication and at some point a few days later Otis started acting like it hurt to walk. We noticed his paws looked a bit swollen and called vet, nothing to be concerned with yet.

It was also around this time that he started to almost refuse to eat.  With a dog talking almost 12 pills a day, food was the only way to get meds into him.  Forcing so many pills down his throat was nearly impossible.  It resulted in alot of tears, both out of frustration and from back of the jaw bites to the hand.

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On the way to the visit my stomach was in knots, afraid of what news we would get.  In all fairness to the clinic this is the same place we took our first Boxer for a neurology visit to find out she had a tumor that the told us was untreatable, it had a stigma.

The doctor told us that it believed it was Pemphigus but that a biopsy would need to be done to rule out anything else and confirm.

He was sedated and biopsied, some Pemphigus could be drug induced with Cephalosporines as the culprit so his meds were changed.

He was placed on Ciprofloxacin, a medicine called Pentoxifylline to increase blood flow to limbs and Triamcinolone as the steroid. It was also suspected he had a staph infection as well.

We went home to await the biopsy and hoped this would be what we were waiting for…

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