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perianal fistulas - scared for skye

Posted By: PositiveDog

perianal fistulas - scared for skye - 03/14/10 04:31 AM

As part of the GSD boards for some time, I have always made it a point to read the posts in the health sections daily. That's why Skye was diagnosed very early with an eye specialist when she developed pannus.

Pannus is fairly easily managed with Skye - ointment in her eye once or twice day depending on the brightness of the light or snow.

This time, Skye may not be so lucky. I already know almost 100% in my brain, but not in my heart, that she has perianal fistulas.

First it was just excessive licking for no known reason - not even red looking. Then she did look a little red, then the area all around her anus became very swollen. I am talking probably a half an inch or more high all around.

But hey - nothing else, right? And the swelling went down. Home free?

Yesterday she had sort of red spots and 'weeping' and today it is worse. I was hoping to take her this Friday when I am off work to MedVet in Columbus where the specialists are. I don't think I can wait that long.

I will contact them in the morning to see if I can get her in earlier.

I hope I am wrong.

Poor Skye - she is a rescue and poorly bred, but such a sweet wonderful dog. She visits kids in the library and people at mental health group sessions. She demos obedience classes for me and is a steady calm dog in every situation (except for having to bark back all those animals into TV so they don't get me.)

Lisa - thank you for the words of wisdom and hope on my PM last week. I don't think we are going to be lucky on this one.

Sorry this is so long - I am so sad and scared and feel so helpless. Our dogs don't deserve things like this.
Posted By: Braverhund

Re: perianal fistulas - scared for skye - 03/14/10 04:38 AM

Oh, Bonnie.. I know this is scary. Skye and you both deserve the very best, so may your suspicions not be true on this one! When will you have her examined? It may also be that she began a lick-lick-lick cycle, and the skin there is swollen and inflamed, and you can get weepiness with irritated skin. She may also have impacted glands (though I know you would know to look for anal gland issues too). I am hoping that this is NOT fistulas. If it is, the yahoo groups and PF forums may offer iseas and support. Lisa will surely weigh in and add her advice! I will be sending positiv, healing e thoughts and vibes for Skye, and really hope for an encouraging update!
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 03/14/10 04:40 AM

teary I'm so sorry Bonnie hugging My heart aches to read this post.

For now, soaking in warm compress soaked in Epsom salt water will help her feel better.

Many vets are not up on the most recent research. Some dogs (like Max), don't fall in line with the most recent research.

The first step, recommended in nearly all cases, is for a change to a single (novel) protein, single carb/starch food, no corn, no wheat.

This is so not what I wanted to read hugging

edit: just read Patti's post - maybe it's the glands????? maybe we can hold out hope for that...is it in the same general area as the pic Lauri posted in her thread?
Posted By: Doggonefool

Re: perianal fistulas - scared for skye - 03/14/10 04:46 AM

I am so sorry to read about the difficulties that you are having with Skye. The education that we find on this board, especially in the health section, are both a comfort and a worry. I find that the more that I learn, the more that I worry. But the more that I know, the quicker and better I am able to recognize and help.

Our dogs, our pets, are everything to us. Wishing you nothing but the best for your.
Posted By: Elmos Mom

Re: perianal fistulas - scared for skye - 03/14/10 04:53 AM

Bonnie, you're right. Our dogs don't deserve some of the things they go through. Skye sounds like an absolute sweetheart. The poor baby. It's difficult because they can't tell us their symptoms so we're relying on their queues and symptoms to figure out how serious something may be.

Please let us know what the vet says tomorrow. Sending lots of good thoughts.
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 03/14/10 04:57 AM

I don't believe it is the glands (but that would be wonderful) - I have been through that with my late german shorthair some years ago. Hers often had had to be cared for at the vets and one time did get impacted. This just does not look the same.

On a good note, because both Buddy and Skye have had an itchy winter, I put the dogs on Orijen 6 fish, which is, of course grain free. I was hoping for better coats and (for Buddy) fewer hot spots.

I am glad after what I have read here and other places. They have been on it less than a week. Their prior food was also grain free (CORE) but not single protein.

I chose Orijen 6 Fish over CORE Ocean because Orijen does not use Ethoxyquin as in USA fish.

Hopefully, this will be a good start if Skye is diagnosed.

Thank you for your fast responses. You are both so great to help us.

I will get epsom salt in the morning and begin using compresses.
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 03/14/10 05:00 AM

Max's almost closed with antibiotics. I will hope that Skye is one of the lucky ones.

Other than the pannus, are there other issues? Food allergies (can she tolerate beef?), anything else?
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 03/14/10 05:13 AM

It's been a long time since she had a beef based food. She was on EVO for a long time which is chicken and then I changed to CORE (still chicken.)

She has allergies to dust mites and mold. No food allergies turned up on her HESKA tests.
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 03/14/10 05:30 AM

It is thought that fistulas are related to a condition similar to Crohn's disease, which is what is true in people. In people, they operate. If your vet, any vet, talks about a surgical solution to a PF, time to walk out the door.

Back to my train of thought....I believe that fistulas are related to chronic inflammation. There is a genetic component for most, but not all cases. In some dogs, the inflammation is of an autoimmune nature and these dogs respond to the serious immune suppressive drugs (prednisone, cyclosporine, etc.), in others, like I suspect is true for my Max, it is due to chronic immune malfunction triggered by a chronic infection (in his case, from most likely a tick) and these dogs better respond to things like antibiotics, antifungals. I believe that Max's pannus meds contributed to suppressing his immune function. What are you using to control Skye's eyes?

I have a supplement that I really like for immune system inflammation that does not boost the immune system, it has saved Indy's life many times over. It is beef based, so Max can't take it, which is very frustrating. It might be something worth considering if this turns out to be a fistula. After about three days on it, Max starts chewing his paws to pieces, but for those three days, his eyes sure get better.

I am hopeful about the herb mix that I have started him on, originally recommended by Patti. It's too soon for you to decide what you want to do, you'll want to figure out a first step in conjunction with your vet, but there are things to try....a frequent first step is antibiotics, with metronidazole (we use tylan, Max stumbles on metro).

Until you get an appointment and a plan of action, using some Desitin zinc based ointment can help. For some, it's a huge lifesaver. If there is pain, some on the list use aspirin or apply orajel to the site. I started with the ointment, and then changed to the Burt's Bees version which is their diaper rash version. I went to Walmart and got their Large boxer shorts and put them on backwards (the tail fits through the hole), using a safety bobby pin for infants so that he doesn't lick the area.

The good news is that it can be managed, it's not a death sentence, and you are not alone hugging
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 03/14/10 06:38 AM

Thank you, Lisa. I will add the Desitin zinc based ointment to my shopping list.

Skye takes cyclosporine for her eyes.

I have also read about the surgery and don't see it as an option - glad to hear you hear you say that. But - a surgery site did have some of the best pictures I have seen. From beginning stages to chronic.

Graphic warning to others. Figure 5 which is supposed to be mild looks worse than Skye does right now.

http://www.docstoc.com/docs/17836754/Perianal-sinus-A-medical-disease

I am glad to hear the Desitin is OK - I am sure that she would not be licking if it was not painful and she seems sad and quiet.

Although - not quiet enough that it kept her from wanting to play toss the stuffed fishy in the middle of the night.

Speaking of the middle of the night - it is late and I need to stop worrying for a few hours. Off to sleep.
Posted By: FurKids

Re: perianal fistulas - scared for skye - 03/14/10 09:52 AM

The photo looks horrible, very painful is my thought. I know you hope like heck that you are wrong and I hope you are, too. Please let us know how it goes after your vet visit.
Posted By: Braverhund

Re: perianal fistulas - scared for skye - 03/14/10 06:51 PM

I'm just popping in again to offer words of encouragement and support for you and Skye, and to let you know that I continue to send positive, healing energy for Skye. I know just how scary the idea of PFs is. I went through it with my last senior dog. May this turn out to be something different, and more easily manageable than you suspect.
You and Skye together have brought so much joy to those who are ailing. May Skye's diagnosis and treatment be much better than you anticipate. Sending positive vibes for a smooth recovery and much better condition for her back end. Positive energy is on the way!
Posted By: BowWowMeow

Re: perianal fistulas - scared for skye - 03/14/10 07:04 PM

Hi Bonnie,

I don't have any advice but do want to offer you lots of support and a big hug! I hope it is something else but if it is pf then I hope you get it under control quickly! hugging
Posted By: Ruthie

Re: perianal fistulas - scared for skye - 03/14/10 07:15 PM

hugging

Sending good thoughts your way. I went though this with my Gator.
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 03/14/10 07:19 PM

G'morning Bonnie, just checking in. How are you two this morning?

I have no idea if the cyclosporin is implicated in this at all. For Max it is, doesn't seem to be true for other dogs, but I was curious.

That surgical paper is kinda old, 1998, and from a surgical perspective, so there are some things in there that are not right.

She'll key off a lot of your attitude too, so remember to play with that fishy!!
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 03/14/10 08:49 PM

Oh - I just attached the link for the pictures, not the information.

Unfortunately, except for emergencies both MedVet and StonyRidge are closed until tomorrow. I will all then to get an appointment. I know I can get right into Stonyridge - MedVet may take longer.

I am leaning toward StonyRidge hoping to get in Wednesday right after work.

I could also go to my regular vet - but I am not as comfortable with them for things out of the ordinary.
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 03/14/10 09:12 PM

You're doing the food change, and starting on the zinc ointment, so that's a start in treatment.

Some folks will use cortisone cream if it seems really itchy or inflamed. I tend to favor Preparation H for inflammation and discomfort, but Max's aren't red externally, his have holes where you can see the tunnel inside, it's a bit different.

This really sucks.
Posted By: BowWowMeow

Re: perianal fistulas - scared for skye - 03/14/10 09:17 PM

Try this stuff: http://www.nelsonshomeopathy.com/shop-online/H+care-Haemorrhoid-Relief-Cream-30g_prod1543.aspx

It is very soothing and healing.
Posted By: Natalie559

Re: perianal fistulas - scared for skye - 03/15/10 09:39 PM

No advice, just support! Let us know how the appt goes.
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 03/16/10 03:00 AM

Bonnie, were you able to get an appt soon?

Thinking of you two today!
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 03/16/10 11:43 PM

We are going to Stonyridge tomorrow (Wednesday) evening at 5:30. (I had to take my Mom to an eye doctor out of town for her macular degeneration or it would have been tonight)

I called and the Dr I take Buddy to for his back called us back - talked about 10 minutes and she seemed up to speed on everything.

She said in all her practice she has ONLY seen GSDs with this. Makes sense as what I have read said about 70% of all dogs with PF are our sheps.

She is talking cyclosporin and possibly , at first, also a topical ointment until it is under control (if this is what we are dealing with.)

Lisa - I should have written it down - I can't remember the name of the topical. We talked about Skye's pannus and she is going to do some research before we come in tomorrow.

I feel comfortable with this vet after speaking with her. But I still hope it something simpler.

Oh - and before she hung she said 'I'm glad you read up on these things.' Refreshing.

(Someone here had information about the scripts and Walmart - does anyone remember, or have the link?)

Thanks for the good thoughts, friends. Skye is uncomfortable, but is OK with the compresses. She still wants to play and be a goofy girl so that is good.
Posted By: LJsMom

Re: perianal fistulas - scared for skye - 03/16/10 11:51 PM

Originally Posted By: PositiveDog
Someone here had information about the scripts and Walmart - does anyone remember, or have the link?


That's LisaT: http://www.germanshepherdhome.net/forum/...=true#Post12006

hugging to you and Skye
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 03/16/10 11:59 PM

Thank you so much! I will look that up in case I need to be erady.

Also - I found the name of the topical ointment the dr mentioned in one of Lisa's links. It is Tacrolimus cream.

Yes - that is the link I needed! I will also ask about the ketocomaszole (sp?)
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 03/17/10 03:58 AM

You know - I just looked back and it was just 3 days ago I began posting about this - it seems so much longer. That means that other than the licking, it has been less than a week ago that Skye displayed any real symptoms, beginning with being swollen around the rectum.

Today, she looks so much worse I could cry for her. Sores all around the area, very red, damp and angry looking. Such a change in so little time.

Of all the weird things, I keep thinking about dogs that are not well cared for or dog's with families that do not think of health issues. How fast could a problem spread and how long before some dogs might get some relief? What if they are just yelled at to "stop licking" or ignored.

What if someone has the dog and does care, but can't afford the vet and treatment costs? In today's world, that could be any one of us. Businesses close, families break up, budgets barely buy groceries and gas.

I don't know why I am on this rant - I guess because I feel so helpless for my own dog tonight. By this time tomorrow night I will know where we stand and I can only hope Skye will get some relief.

On a lighter note - when Skye sees I have the flashlight, she lies quietly while I check her for changes. I guess anything can become a routine.
Posted By: BowWowMeow

Re: perianal fistulas - scared for skye - 03/17/10 04:58 AM

Hugs to you, Bonnie. I hope that things go well tomorrow for Skye.

I think about this stuff all of the time b/c of Cleo's health. I've nursed her through so much this past year and I know so many others would have just let her go or wouldn't have spent the money. But we're lucky to have these animals in our lives, aren't we? wub
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 03/17/10 06:23 AM

Bonnie, you are so right, there are so many out there that don't have the care and attention that our furkids have, and it's heartbreaking. Many of those dogs don't make it. Ruth, with Cleo, and so many others on our board, are an inspiration.

PF treatment can be expensive, and many can't afford it. I just sent my left-over cyclosporine to someone that lost their job.

I have cried for Max on occasion, and probably will in the future too. It's a dreaded disease. For those that don't reach remission, it does become a chronic disease that becomes a "new normal", that you all adapt to (like that darn flashlight), and many dogs will still be happy and goofy and play and run. There might be times when you yet again feel so helpless, but then you figure something out, and it will get better.

Thanks Joanne for posting that link. Yep, Walgreen's is the best price so far for the generic (modified) cyclosporine. The tacrolimus ointment is usually ordered from Roadrunner pharmacy, I think it's 30gm for about $66 (will last several months), though someone on the list just said they found it cheaper. Vets seem to know and trust Roadrunner though.

The ketoconazole, an antifungal, I think is a good idea for two reasons. It means that you can use lower doses of cyclosporine, always a good idea. Also, cyclo is an immune suppressant and will further make the dogs susceptible to bacterial and fungal infections. GSDs are already susceptible to fungal infections, so I think this is just a bit more insurance. If Skye tends to get yeasty ears, then I think it's even a better idea!

I'm looking forward to hearing what the doc has to say tomorrow, wishing you good luck, and lots of hugs to Skye.

Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 03/18/10 12:30 AM

OK - we're back from the vet's office and Skye was, as always, a trooper. Other than leaving enough hair to cover our friend Spike on this board, she did everything asked.

After taking a history, the DR checked Skye over in general, not wanting to start right away where she hurt the most. she was glad to hear I had chosen titers this year and said she really should not have annual vacs.

She did mention that Sky's spleen is large - not swollen feeling, but large. She said it may just be that it seems that way since Skye is slender with a tucked, small tummy. Nothing to worry about.

Down to business, she dimmed the lights in the room and put a bright light on Skye's rectum. The drs first words were, 'yes, I believe you are right and we are dealing with PF here.'

Then, while checking her internally, she found her anal glands were full - she expressed them and said they were clean - no puss or blood, so not infected.

Skye is 6 1/2 and has never had problems with her anal glands and no scooting or anything. Someone mentioned anal glands and I was surprised to hear they needed to be emptied.

She said that although it could be that the glands made Skye uncomfortable, making her lick a lot and that caused what we were seeing she did not believe that is the case.

It is probable it is the other way around and they have become full since she started having problems.

She wants to treat her for PF and watch the glands in the mean time.

She is OK with the cyclosporin for Skye's eyes or to use locally, she doesn't want to put her on that orally.

We are starting with Ciprofloxin as an antibiotic for about two weeks - 250 mg every 12 hours.

Then we ordered tacrolimus in cream form to apply topically. It is $68 where she orders and I told her to go ahead and do that.

I take Skye back in two weeks, unless there are problems and by then it should be more apparent what we have for certainty.

So there is still a chance it is not PF.

Lisa and others with experience - does this sound like a good start to you?

( I was happy to hear that pred is not a first choice for her - it is usually cyclosporin, but not for Skye.)
Posted By: JeanKBBMMMAAN

Re: perianal fistulas - scared for skye - 03/18/10 12:50 AM

crossedfingers
It would be really nice if it was not.

So wishing you the best in the next couple of weeks and a clean bill of health then.

If not...thankful she is with you.
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 03/18/10 04:16 AM

What a good girl Skye is wub

About the anal glands. On the PF list, they say there are two kinds fistulas. Those that will resolve when the anal gland issue is resolved, and those that are independent of the anal glands. In the former, they recommend removal of the anal glands. I have no experience with this, but I think that Jakoda (Diane) had this experience.

Interesting about the vet think that the fistula may be the cause of the anal gland problem rather than the other way around. I had never thought of that, and it certainly seems reasonable to me. I am increasingly wondering about Max's anal gland on that side.

I like that your doc is not jumping to the cyclo. Max's Derm says that about 50% of her PF dogs require cyclo. Max's PF got a lot better on Baytril/Cipro (similar drugs, Cipro much cheaper, thought not to be as effective).

The first vet that Max saw for this, was a fill-in vet, and she said that antibiotics for gland issues often require long term treatment, like 6 weeks. Of course this is different. I might put Skye on some hyaluronic acid, only because Baytril/Cipro can be hard on ligaments and tendons, and HA is the only thing I can think of that might help counter that, though I don't know for sure.

I think your vet is right on, from what I know, and hopefully Skye will be quickly on her way to healing crossedfingers
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 03/22/10 10:10 PM

OK, folks. Finally, Skye's cream is here - tracrolimus. I really want to be sure this stays on her and not IN her. I have tried different things on her, boys briefs, etc. I don't think they would remain on long if I am not here.

What do you think about the pants they make for dogs in heat? I have never bought those - do they stay on good with the velcro tabs?

She is to get this on her bum 2X a day.

She has been on the cipro since last Thursday night. She looks extremely sore, so I don't know if it is helping, but I am sure it is by at least not allowing infection.

Skye's spirits seem good and she has been very playful. Maybe the med and her new food, Orijen 6 fish.

Another question. My sister keeps her dog on 4 life transfer factor, classic. She swears by it and thinks this is why her aussie is still with us in spite of an anemia problem.

http://transferfactor-4-life.com/4lifetransferfactorclassic90capsules.aspx

I bought a bottle and have it today. But now - would I be upsetting things if I bump up her immune system since her problems are auto immune related? I am so confused!

We go back for a follow up on the 30th.
Posted By: JakodaCD OA

Re: perianal fistulas - scared for skye - 03/22/10 11:30 PM

just saw this post, sorry you are going thru this:(( It sounds like Skye is a trooper tho!

I do find it interesting they think the fistula is causing the gland problem as lisa said..It IS usually the other way around, and maybe at a later point, the vet may change her mind.

My first PF dog, had an infected gland, resulted in pf's, so not "true" pf disease. His was cleared up with cryosurgery, they removed the glands and all the pf tracts, not a pretty site, but did the trick.

My second one, blew his gland, (most likely due to infection) resulting in pf's, I treated him with oral cyclo , again, not "true" Pf disease, he had a couple of reoccurrances, I used the desitin which cleared them right up. I would not have hesitated with gland removal if the cyclo didn't work.

Most "true" Pf dogs have other issues as well, I see Skye has pannus:(( I personally don't think I'd use the transferfactor at this point. I'd wait and see if the Cipro /tacro helps first.

I haven't been on the pf email list lately, but at one point, even tho vets were prescribing using the tacro twice a day, I believe it was the concensus that using it ONCE a day and the other time (am & pm) use the desitin. Something about to much tacro wasn't as good as less?? Lisa is probably more 'up" on that suggestion if it's changed.

When I applied the desitin (and I imagine you could do the same with the tacro) I put it on a Q tip and put it IN the tracts as well as around them..

The biggest indicator,if there are no others, is the licking, when it starts to subside, things are 'good':))

Good luck with your journey, I hope Skye feels better soon:))
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 03/23/10 12:58 AM

Thank you for your reply to this and your kind thoughts for Skye.

I think I must have worded it incorrectly since it is being taken that my vet thinks the fistulas 'caused' the gland problem. Partly due to my state of mind last week.

It is more accurate to say that she did not think the glands ALONE were causing the sores she was seeing - meaning it was not just irritation from licking and only an anal gland problem. Instead, the sores were most probably fistulas and cleaning the glands alone would not stop the problem.

At that time, you could see into the sores - but at this time it does appear there are openings. She wanted to go ahead with treating for PF.

I hope that makes more sense - I don't want to put words in my vets mouth.

When I go back on the 30th I will ask about swapping out the desitin for one of the doses. I hope it looks much better than it does now.

By the way - at the moment, Skye is wearing bvds with her tail though the opening. She does NOT think it is cute, but she has decided to leave them on for the time being.

She looks pitiful and does not appreciate boy shorts.

The transferfactor was not for this issue, but for her immune system in general. Do you feel it could cause harm?

I did sign up on the pf email list, but now I can't find my way back. lol
Posted By: Wisc.Tiger_Val

Re: perianal fistulas - scared for skye - 03/23/10 02:49 AM

I have the Bitches Britches for Raya when I took her to training. The place I trained said she could come while she was in season, she just had to wear the britches (this was agility).

She didn't seem to mind them too much, lol better looking than boys shorts.
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 03/23/10 03:40 AM

Well, if the britches stay on during agility, they should stay on Skye lounging around the house.

I'll pick her up a pair or two tomorrow.

Thanks!
Posted By: SeanRescueMom

Re: perianal fistulas - scared for skye - 03/23/10 04:08 AM

Originally Posted By: JakodaCD OA
just saw this post, sorry you are going thru this:(( It sounds like Skye is a trooper tho!


Oh Bonnie, I just saw this post too. I'm so sorry I didn't see it earlier. I will check more regularly and for what it's worth, Sean sends gentle hugs to Skye. wub
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 03/23/10 04:32 AM

I will have to get a pic of Max in only his boxers. We have a pretty good routine now, and it only falls off if I don't attach it tight enough. Here's a pic when I first started - I tried using a shirt to hold them on, but soon realized that I didn't need the shirt: http://i47.photobucket.com/albums/f179/other95/medical/IMG00116.jpg (ignore the dirty socks on the floor please....) After I put the tail through the hole in the boxers, I pin it above the waist with a safety pin. It stays on while he's crated during the day, and also at night when he sleeps. If he hasn't been licking, I will leave it off at night.

Here's the link to the pf group: http://pets.groups.yahoo.com/group/PF-L/ It's always in the Health Index if you lose it. It's a fairly high volume list.

It is said that the tacrolimus is too harsh to use twice a day, and they don't recommend using it this way on the list. I never used it twice a day - I was using the tacro during the day, and then the zinc ointment at night. Now I just use the zinc ointment.

I would be very hesitant with the transfer factor. There are some folks that believe TF is good for autoimmune conditions. I don't believe that that's the case. What I believe is that it is immune stimulating, but at the same time you are trying to suppress with the cyclo, so I think they will fight against each other. I wouldn't use it.

It's possible that for some dogs, there is immune suppression, which is probably what is happening with Max. That's not the norm though. I'm wondering how kutzro's dog is doing....

Diane, I was wondering how long it would take you to check in!!

Bonnie, I'm glad that it seems like Skye is feeling playful. I think after the PF's break through, they feel better for a bit - I think when it's blistering and festering inside without an outlet, it's very uncomfortable.
Posted By: BowWowMeow

Re: perianal fistulas - scared for skye - 03/23/10 06:40 AM

Sending healing thoughts to Skye and hugs to you, Bonnie!
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 03/24/10 01:29 AM

Thank you, everyone for you good wishes and your advise.

Skye had a bad day today and is clingy tonight. I could tell her fistulas were painful - she kept twitching when I put the ointment on her with the q-tip. I try to be careful, but I want to be sure it is the 'nooks and crannies.'

She just looks so sore. Does this seem to get worse before it gets better?

She has been on the cipro for a week today and and got the trac ointment last night and tonight. As suggested, I am using desitin with zinc in the mornings. I will be so relieved to see her look better.

I feel more helpless with this than the pannus. At least I know her eyes are under control and not painful. But this - it makes me cry because I can tell she is not well and don't know how much the meds are helping.

She does still play, but for short bursts.

Funny story though - she romped with Buddy and her boy shorts got twisted. She came over to me and whined and turned around so I could help her. Silly dog.
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 03/24/10 01:45 AM

You will feel more helpless with this, it's big league, and it's scary.

With Max, many of the things that were supposed to help made it worse. You have to learn to follow your instincts on what is "better" and what is "worse".

Sometimes they will open up and ooze more when they start healing. But if they start really spreading, or getting worse otherwise, I would check in with your vet. If you want to experiment with some homeopathic remedies to help with the discomfort, I can suggest a few.

I put together the main part of Max's protocol, it's not standard. Instead of Cipro, I put Max on amoxicillin and doxycycline; when was initially put on Cipro, I switched it to doxycycline and half dose Cipro because that's a protocol for Bartonella. There's an article somewhere about the treatment for one of the tick diseases (Babesia) being effective for PF, so I went that route because of Max's previous issues.

If the Cipro doesn't work, I believe that the standard protocol is either pred or cyclo/keto.

Stick with it, but follow your intuition. On the PF list, they will use orajel on the fistula to numb the pain, or low dose aspirin for the pain, with Benadryl.
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 03/24/10 01:55 AM

Thank you, Lisa. I was just on the yahoo group - my member status is still pending, but I could look at some links. I will continue to study there and most likely will be bugging you more.

I intend to talk to my vet about not using the trac 2X a day. She seems open to new information.

The cyclo scares me with her other problems - we are afraid it could open a whole new world of problems.

I will look more into the keto (I know the full name is spelled out here in the link and will back track to it.)

I so appreciate your help and everyone's understanding. I think I have been fortunate with my dogs. Not so much right now.
Posted By: BowWowMeow

Re: perianal fistulas - scared for skye - 03/27/10 06:37 AM

How is Skye doing?
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 03/27/10 08:51 AM

I've been wondering too.....
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 03/27/10 01:39 PM

Thank you for asking. Skye goes back to see her vet Tuesday evening. While she is playful and cuddly, she is not doing well.

Her sores look bad and she is in pain. She is in some distress when she has to poop - sometimes jumps after starting to, before she finishes.

I am faithfully doing the desitin in the morning and tacrolimus in the evening and the cipro, but I don't know if it isn't working or if it is too early.

When I first took Skye it was more redness and swelling - my gut tells me the fistulas had to open on the surface before the med could do it's thing. I hope that is correct, because that is what it appears to have done.

Lisa - you told me to get hydraluronic acid (I am sure I spelled that wrong) and I have not. Last night I could see Skye was limping so it is my fault. I have to find some today.

I am hoping the vet can give me more insight.

Interesting side note:

Yesterday I took the day off work and went to the Pet expo in Columbus. There I had a free consultation with a pet communicator. I gave him Skye's picture (her therapy dog business card) with no comments.

He thought for awhile and said 'Skye is having some difficulties.' "yes' It seems to be in her back legs or joints.' I said no - then last night she was limping. Hmmm. He also said Skye was very proud of her work and does not want to stop.

Then - I met some people selling joint compounds and stopped because the one I get is going to be harder to get around here. Not only is their product completely natural and has no chicken base, it contains HA. She asked if I knew what that was talked about it with me for some time.

I will post that contact later so you can take a look at it.

Amazing coincidences, right?

Thanks for reading all this.
Posted By: JeanKBBMMMAAN

Re: perianal fistulas - scared for skye - 03/27/10 01:51 PM

hugging

Hoping things get better.
Posted By: kutzro357

Re: perianal fistulas - scared for skye - 03/27/10 03:04 PM

Hope Skye improves. What I think you`re finding is there are lot`s of things out there but how do you discern fact from fiction and real treatments from wishful treatments.
For me, I trust my vet. We make one change at a time and see what happens, we then either change it or sometimes we try a combo. I had stopped the cyclo and keta but when Lisa turned me on to Walgreen's script plan we`re back on at 1/2 dose.
My vet doesn`t like antibiotics or vaccinations with PF dogs as you already have an immune system that`s attacking the do and then you introduce antibiotics and vaccines that stimulate it more.

For me, I will keep Ruger as comfortable as possible but when it gets too bad for him we will say good-bye. Hopefully we have a number of years left.
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 03/27/10 05:37 PM

Kutro; If Skye would do good on cyclo I would get it and already looked into Walgreens. However, because she has other autoimmune problems, we (both the vet and I) are hesitant to use a systematic immune suppresant. Skey does get cyclo in her eyes for Pannus, but that is topical.

I stopped Skye's vaccines before all this and this vet was glad to hear that.

We have just started this journey and I hope it gets better. All or you have been great help to me - the support alone is priceless.

I am learning more every day - one of things I have learned is that there is no "one treatment fits all" for this illness.

Skye is tough - we will find what works best for her and live each great day together.

Thank you.
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 03/27/10 06:10 PM

kutzro, I hope your boy is responding to treatment?

Bonnie, it's funny the reasoning why not to use the cyclosporine, since that's the same reasoning that my Derm and vet said to use it! They thought that since he had more systemic immune dysfunction, that the systemic cyclosporine would work very well for him. It made sense to me actually.

Max's did respond to antibiotics, but then again, I use doxy, which has a lot of anti-inflammatory effects. Max's inflammation responds to Doxy and Rimadyl (used after a tooth extraction), but not to Metacam or cyclosporine - he makes no sense to me. High dose doxy and low dose Cipro was working very well for Max, but the Derm was nervous about using cipro at a low dose and creating restistance, so I switched to doxy and amoxi, which is still working to hold things, so far, I think, I hope.

I'm really sorry to hear that Skye is so painful. It's one thing to be uncomfortable, and another to be in outright pain. I gather the fistula(s) have opened up and look terrible frown I hate that. If they continue to open, then you know that the treatment is not working. Once they open, that should allow them to heal. I've got a spot on Max I'm watching very carefully, not sure if it's a new bubble or irritation from him when he gets at it.

If you go the cyclo route, the next step if the cipro doesn't work, I would definitely add the ketoconazole. Not only does it allow less cyclo to be used, but with the GSD susceptibility for fungus, it's added insurance.'

It sounds like you found a good product to try. You will have to give us an update on how it works out. I like all the standard joint stuff, but I think that the HA adds something.

Hugs to you and Skye, you're both such troopers!
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 03/28/10 12:24 AM

Lisa;

I found HA at Vitamin world - it is 50 mg. Is that too much to give Skye a day?

I am going to have to write all these things down for my vet - I wonder if I am confused or she is? I think the more I read, the more confused I become. thinking

My understanding is that it is good to suppress the immune system where needed for things like Skye's eyes, it would not be good to suppress her total system. Is that not right??

I may have to follow up Skye's visit Tuesday with the dermatologist with MedVet. I took Skye to their office in Columbus for her eyes, but I thought my vet in Troy would work out. I still believe in her - will see what Tuesday brings.

Here is the new joint product I found that sounds good to me. They used this initially for horses and created one for dogs.

If is in a cookie form, just taking two a day. Skye and Buddy sampled one and liked the taste. It has the HA in it (10 mg per treat.)

http://www.majestys.com/bb_flex.php

I also saw this one, but would have to continue the HA separately. It is powder form, like the one I currently use:

http://www.hiltonherbs.com/products/mobility-support/210

Your thoughts?
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 03/28/10 04:58 AM

For the HA, 50 mg is not too much. I don't know what the dose for a GSD should be, but for right now, I have Max on 100mg per day, and Indy on 50 mg per day. I am taking less than that myself to keep costs down.....darn dogs!

The first product contains all the things for the health of the joint, that you would use to prevent or slow further deterioration: glucosamine, chondroitin, msm, vit C, HA.

The second product, with msm and bamboo, looks like they have some nutrients that are good for the joints (the bamboo looks like it might contain silica and a few other things, I don't know much about it). The other ingredients are primarily antiinflammatories, which help keep the joints moving, but don't help as much with the structure of the joint as the other product.

The first one is more about the health of the joints. For a dog that is showing joint symptoms, I don't know if that alone will do the trick. You might have to add another product.

Okay, about the cyclosporin and systemic suppression. I went back and was reading one of the genetic papers on PF. There are two major things to note. The first is that they have noted a lot of Staph bacteria with most PF's. (I'm glad I read that, because I was hoping to stop the Tylan for Max, but that is effective against Staph, so probably not a good idea.)

The second thing is the genetic component to PF's. I have a student with Crohn's disease, that has tested positive for a gene that makes him susceptible to that disease, but also to a disease that causes a lot of spine problems, and I think there might also be something else that i can't remember.

They think that they have found a genetic link to PF's, and I think it may be similar to the crohn's disease issue. Although a PF is right in that anal region, it is not a disease of just that area. It is about the immune system as a whole. So treating with the cyclo really may be treating the whole body with something that might benefit it in the long run.

Now, the problem with this is that immune suppression as a whole, invites other infections, invites cancer, and the serious drugs also have implications for the liver, which processes the drug. You don't want to use the Cipro for the long term either though.

I held off as long as I could to try the cyclo, but I did when it was clear he needed help (I was very disappointed when it didn't work for him). Sean Rescue Mom has had Sean on cyclo and also doxy/niacinamide and other stuff in treating Sean for his very serious autoimmune condition, he is doing great. Sometimes their bodies require this.

How old is Skye?
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 03/28/10 05:10 PM

This great information. Lisa. Where is the magic wonder drug that helps everything, tho. hammer

Skye will be 7 in October. Not quite a senior and behaves more like 3. She is tall, 26 1/2 inches and her weight stays between 58 and 60 all the time. She is a long slender dog.

I am going to give her just 1 HA capsule, 50mg, a day for now - opening it and putting it in her food. Up to now, her joint health has been good and I have used a daily joint powder as preventative.

I will be changing her daily one (due to no longer being available) and I keep going back and forth on the two products I mentioned.


I love to see the 'Sean' updates - he is a special dog and Marlene takes such great care of him.

Thanks again - I am taking a lot of notes.
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 03/28/10 06:17 PM

Don't obsess too much, I know it's hard wink

If Skye were younger, then most likely she would have a different genetic link. Being her age, the genetics are just a bit different. But that's not useful info though, just a side note.

Max's PF first showed at 8.

Are Skye's stools always good?
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 03/28/10 08:02 PM

Bonnie, does Skye tolerate beef based supplements?
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 03/28/10 11:55 PM

Skye's stools are probably 99% good. She has soft stools rarely.

I don't know the last time I gave her anything with beef base, except for bones once in awhile - no problems with those.
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 03/29/10 12:07 AM

I was asking about the digestive system because so many of these PF dogs have food issues. Forgot that I think you recently changed foods.

If I were to give one supplement to try to modulate the immune system, I would try this particular one: http://www.vitacost.com/Jarrow-Formulas-True-CMO-Cetyl-Myristoleate

It's beef-based, so I can't use it on Max frown , but it has helped Indy quite a bit.

You've got a lot on your plate right now, but I thought I'd throw this out there.
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 03/29/10 12:18 AM

Buddy and Skye were on EVO for some time. I wanted to try something different and after a couple of trials, ended up with Orijen 6 Fish.

I am glad now due to what I have learned here and other sources about single protein sources not eaten before and dealing with pf.

Both dogs like it and are doing well on it.

The supplement you listed is for the immune system, not joints?
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 03/29/10 12:28 AM

Good about the food thumbup

The CMO is actually great for the immune system & joints...it is one of the very few supplements that is good for BOTH osteoarthritis AND rheumatoid arthritis, which is what caught my eye when I first started using it. Indy's joint issues are mostly categorized as polyarthritis, which is much like RA. Of course induced by her lyme vaccine though.

There's a thread on the old board about folks that have used CM for joint issues for their dogs - I think it's under supplements in the health sticky.
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 03/31/10 08:35 AM

Thinking of you and Skye hugging
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 03/31/10 11:41 PM

Thank you! Sorry I did not post last night - I was helping to evaluate some dogs in the current therapy animal class and got home late.

We were back at the vet for follow up last night. I am not sure about this, but I guess time will tell. thinking

After I told her the history of the break outs, infection and swelling the past 2 weeks, we both agreed that the sores seemed to have peaked and now were getting a little better. Skye is not as swollen on the bottom of the anal area, but the top is still pretty puffy, red and fiery looking. She almost looks as if the surface of the skin was just shaved off.

You can see that the skin is trying to heal over and there is no infection showing now.

Here Dr talked again about wanting to stay away cyclo if at all possible. She took her off the cipro since the area looks painful, but clean. She wants to see if Skye's lethargy is from the cipro. She sleeps so much and only plays with Buddy in short bursts.

In two weeks with no changes in diet, Skye gained 5 pounds. blush

She put her on prednisone, but just 2X a day for three days. She also asked me to keep using the tacralimus 2X a day, not just one.

But - she is going to do more research to see what she finds about the tac being very harsh and people being advised to go once a day on it.

So right now, just pred and the ointment. She is scheduled back in two weeks but said to call if I saw any sign of infection or negative changes in Skye.

She likes the supplements she is on (joint compound and hyaluronic acid.)

She also mentioned the orajel for pain, or a spray like people use for sunburn to soothe her. So more good ideas here.

I would like to use a more natural anti-inflammatory after the pred is done.

Does this all sound OK?
Posted By: SeanRescueMom

Re: perianal fistulas - scared for skye - 04/01/10 03:01 AM

Originally Posted By: PositiveDog
I love to see the 'Sean' updates - he is a special dog and Marlene takes such great care of him.


Aw shucks, Lisa and you are 2 of my biggest fans. blush Bonnie, I'm so sorry to hear that Skye is having this problem. My heart goes out to you. If for any reason your vet decides to prescribe cyclo. and/or ketoconazole please don't hesitate to contact me. Hugs and healing thoughts to Skye. hug
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 04/01/10 07:45 AM

Originally Posted By: PositiveDog
Thank you! Sorry I did not post last night - I was helping to evaluate some dogs in the current therapy animal class and got home late.


I figured that you had a life, and stuff to do wink I knew you would update when you were ready or had time!



Quote:
After I told her the history of the break outs, infection and swelling the past 2 weeks, we both agreed that the sores seemed to have peaked and now were getting a little better. .....

You can see that the skin is trying to heal over and there is no infection showing now.


Super news that there is improvement. Watch carefully, if you see any backsliding, back on the antibiotics!

Quote:
Here Dr talked again about wanting to stay away cyclo if at all possible. She took her off the cipro since the area looks painful, but clean. She wants to see if Skye's lethargy is from the cipro. She sleeps so much and only plays with Buddy in short bursts.

She put her on prednisone, but just 2X a day for three days.


Hmmm, wonder if it is from the Cipro? That is a pretty high powered antibiotic.

On the PF list, seems that some dogs respond to pred, some to cyclo, some need both.

Interesting the 2x per day for 3 days, but then what until your next check up? Nothing for the remaining two weeks, other than the protopic? That makes me nervous. The rule I wish I would have followed, is don't change anything as long as the PF is improving. I understand changing the Cipro if it's causing lethargy, but nothing other than the tac after three days????

Curious, what dosage is being used for the pred?

Quote:
In two weeks with no changes in diet, Skye gained 5 pounds. blush


Wonder if there was some SIBO and the weight gain was from the probiotics? Max gained weight with the antibiotics, moreso recently, maybe from food change, maybe other things. If Skye gained from the antibiotics, then I would consider treating with abx longer....of course I'm a big fan of doxy for both SIBO and the PF here.


Quote:
But - she is going to do more research to see what she finds about the tac being very harsh and people being advised to go once a day on it.


She probably won't find anything, it's one of those client experience things. I don't know how many dogs it's true for though.


I'm hoping that you made a typo about the pred for three days, and then nothing?????
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 04/01/10 10:43 AM

The more I think about it, the more concerned I am about the protocol your vet wants to use.

With PF, you ramp up the meds, you don't take away and leave with nothing.

Yahoo groups will by down most/all of 4/1, but if you haven't already, you probably should read Cecelia's primer that is listed in the Files section of the PF list.

They also have a pred protocol, it lasts for about a week, starting at 20mg and then tapers down, that is for a flair up. For initial treatment it would be different - one successful one I read started with 20 mg for the first week, I didn't pay attention after that.

I'm not a fan of pred, I'm not a fan of cyclo, but it really sounds like your vet is under-treating this. She might be in over her head??? Heck, Max shows no signs of infection, but he blows up off of abx and is healing with the current protocol. She sounds conservative and unsure, and under-estimates the nastiness of this disease perhaps?

Max's Derm had us try to taper of meds when he was in the middle of improving, and it was bad news each time. Treat until healed, and then one month longer. Taper either during that month, or the next.

What are your instincts here Bonnie?
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 04/02/10 10:55 PM

Ok - I have been trying to keep an open mind, but I am concerned that as you said we are too conservative with Skye.

Her 3 days on prednisone (no typo) are 2X a day and only 5 mg. Her last pill will be tonight, although I got extra in case she needs them. Is that even enough to do anything for a 67 pound dog?

Is there a good natural anti-inflammatory?

That and the trac 2X a day. I am also continuing the HA for her - 50mg morning and night.

No antibiotic - she has amazing energy so the cypro must have been hard on her. But - does she still need it? Who knows?

I have to say she does look like she is continuing to heal, but I wonder what is perculating under the surface? I will be watching carefully and go back with her immediately if I see any negative change. (We are scheduled for back in 2 weeks.)

On a good note, her shedding is almost done and her coat has come back to it's old softness after a few weeks on the Orijen 6 fish, so I think the food agrees with her. She eats eagerly.

Some of you have dealt with this for months - Skye and I for just over a month. Do you get discouraged? Tired? This was becoming the house of stress, so I am back to massages for the dogs which also relaxes me.

That's where we are now.
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 04/03/10 09:41 AM

Bonnie,

It is stressful, discouraging, and tiring. And every day it wears you down a bit more. On the PF list, they say that you adjust, learn to think of it as a chronic disease, a marathon and not a race. That being said, I haven't completely made that adjustment yet.

Even though we've been dealing with this here since August, I am still trying to figure it out, and I'm still pushing for remission, and not just steady state.

I'm glad that she is feeling much better after the Cipro, that's good news!

I'm glad that she is still getting better. It could be leftover from the antibiotics, could be from the pred. I can say that whenever I have backed off on the meds, on day 4 it was clear that bad things were happening. But that's Max, he marches to his own drummer wink

For Indy, as an anti-inflammatory, I use that cetyl myristoleate product that I link somewhere above. For Max, I am using a different CM product, but it's not as effective as Indy's, but it's a compromise because of his food sensitivities. I am also using a chinese herb mixture for max. Doxycycline is an anti-inflammatory, so I am killing two birds with one stone with that one. I would love to use that CM product above on Max, too bad I can't.

I guess we see what happens with Skye.

I keep forgetting to mention, you should take some pictures, so you have some comparisons now, and down the road.

I sure hope that she continues to improve crossedfingers
Posted By: SeanRescueMom

Re: perianal fistulas - scared for skye - 04/03/10 05:03 PM

Originally Posted By: MaxaLisa
I sure hope that she continues to improve crossedfingers


Same here, fingers, toes and even paws crossed for Skye. paw Just out of curiosity, have you considered taking her to another vet or specialist?
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 04/03/10 07:49 PM

This vet is actually not her regular vet and is a little more knowledgeable and open to new things.

However, if I continue to be shaky on this treatment or if Skye backtracks, I will probably take her to MedVet in Columbus - they have all kinds of specialists.

Ia am not sure what this would fall under as a specialty(?)

Thanks again for all the support. thanks
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 04/03/10 08:44 PM

Dermatology? Just don't go to a surgeon!
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 04/08/10 12:08 AM

A quick update after a week - Skye seems to be doing OK. She is initiating play with Buddy and Kodi (vacationing here for a week.)

Her bum seems to be slowly looking better, but she is still flinching when I apply the tacrolimus with the q-tip - which I am only doing 1X a day even tho the vet said two.

I am concerned about what may be going on inside, since she flinches, but the swelling almost gone, so.....

I am continuing the HA and her regular joint compound.

I dreamed the other night that I drove through a red light. I am taking that as 'slow down and be watchful - don't miss anything.'

Just wanted to let you know how she is today. paw
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 04/08/10 12:23 AM

The insides take a lot longer to heal....I'm glad that she is continuing to improve, that's a huge relief.

LOL, just make sure you don't run any red lights in real life, particularly at those intersections that have cameras wink

Good to hear that the news is pawsitive laugh
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 04/14/10 01:07 AM

OK - another two weeks into this (about 6 weeks total) and Skye had another follow up visit today.

Skye has continued to heal and act like she feels better. For about 1 1/2 weeks she has just been on the tacrolimus. I was told 2X a day, but I have only been using it 1 time a day.

Most of her skin has healed over, she has one spot still sore and tender.

For now we are to do 1X a day on the ointment (as I have been, but did not tell the vet) and after 2 weeks if there is no flare up go to every other day for 2 weeks. If she is still OK by then, it will be watch her for flare ups.

I am to put her back on the pred and call if she shows any relapse at all.

Skye has been energetic and very active this past week. I am hoping we caught this quickly and she will be free of the fistulas for some time. If not, I will just go from there.

Meantime I will continue to follow up on this disease and try to keep her on good food and supplements.

Thanks all who have been following Skye's journey into PF (and pannus.) I hope my girl will have some good times for awhile.
Posted By: LJsMom

Re: perianal fistulas - scared for skye - 04/14/10 01:16 AM

crossedfingers
Posted By: BowWowMeow

Re: perianal fistulas - scared for skye - 04/14/10 02:10 AM

Bonnie,

I am so glad to hear that Skye is doing better. I hope she continues to improve!
Posted By: Wisc.Tiger_Val

Re: perianal fistulas - scared for skye - 04/14/10 02:13 AM

Bonnie that is good news, positive thoughts that Skye keeps healing.

Val
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 04/14/10 04:01 AM

outstanding news, I am so happy to hear this.... crossedfingers that it continues!
Posted By: Braverhund

Re: perianal fistulas - scared for skye - 04/14/10 04:11 AM

Yes!! Bonnie, wishing you strength, wishing Skye continued improvement! You've been through so much together. Lots of positive thoughts your way and Skye's!
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 04/15/10 12:50 AM

Thank you everyone. The support and knowledge here made a world of difference. hugging to my cyber family!
Posted By: SeanRescueMom

Re: perianal fistulas - scared for skye - 04/16/10 02:08 AM

Bonnie, wonderful news about Skye. Jumping for joy! groovy
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 04/23/10 12:18 AM

Been thinking of Skye lately and hoping that the improvement is continuing.

How are you two doing?
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 04/23/10 02:13 AM

How nice of you to ask - I was just thinking today that I should post an update.

Skye continues to do well. Her bum appears to be almost 100% healed and she rarely licks anymore.

I am still using the ointment 1X a day and will go to every other day next week. I'll stop if she continues to stay 'clean.'

She has gained a total of about 8 pounds since she started getting better - after years of staying the same weight no matter what. I think that feeling good and the new single protein food, Orijen 6 Fish have agreed with her. She is still slender, but not so spiney and ribby. (She is still only 68 pounds.)

Also her energy has been very good - she is playful and acts happy if you know what I mean.

I hope that if/when Skye has a flare up it will be as easily treatable. Skye will be back at work as a therapy and demo dog next week after staying home and mending for about 6 weeks.

Oddly, her pannus has flared up - I think she is bored and spends a lot of time looking out the window while I am at work. It has been very bright out - I have upped her optimune to 2X a day again for awhile.

I wish all of your dogs with more difficult battles could have some of the relief Skye has had.
Posted By: SeanRescueMom

Re: perianal fistulas - scared for skye - 04/23/10 02:42 AM

Originally Posted By: PositiveDog
Skye continues to do well. Her bum appears to be almost 100% healed and she rarely licks anymore.


Great news and glad to hear she will be back to her therapy work next week. thumbup
Posted By: AgilePaws

Re: perianal fistulas - scared for skye - 04/23/10 02:59 AM

I just saw this, otherwise I would have responded sooner. Tacrolimus (aka Protopic) is also what we used to treat Starine for PF. My vet also did not want to go the cyclosporine route until we exhausted all other optins. The Tacrolimus worked for Star, and as I recall, it was about the same time frame as Skye. She healed completely and after I took her off of it several months later, it never came back. It's been six years. In retrospect, the only thing I would have done differently would have been to discontinue it sooner because the black box warning on it came out a few years afterward. I was following my vet's instructions at the time and no one could have anticipated the black box warning which came out while I was using it for my exczema. But I wouldn't be too concerned about it because neither Star or myself have had any long-term side effects.
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 04/23/10 05:30 AM

I am really really really happy to hear your update!! This is just great laugh even better that she gets to return to "work" smile

Max was healing until I tried to back off on one of his meds, and he took a few steps back, but we are on the right track again.

It's a bit scary what the wrong food and a goofy immune system can do when they are combined. I'm glad that a whole bunch of things are getting better for Skye.

Bummer about the pannus, thank goodness that's fairly controllable.

I'm not sure if this is a hijack, but, Sandy, if you read this, about the tac, are you talking about the immune supression inviting cancer risk? I haven't seen the warning, but I'm guessing it's similar to cyclosporine? I use the tac for Max's pannus, and, although it's working very well for his eyes, I think it might have some systemic effects for him.
Posted By: AgilePaws

Re: perianal fistulas - scared for skye - 04/23/10 05:47 AM

Originally Posted By: MaxaLisa


I'm not sure if this is a hijack, but, Sandy, if you read this, about the tac, are you talking about the immune supression inviting cancer risk? I haven't seen the warning, but I'm guessing it's similar to cyclosporine? I use the tac for Max's pannus, and, although it's working very well for his eyes, I think it might have some systemic effects for him.


The FDA put a black box warning on Tacrolimus several years back regarding potential cancer risks, at the time I was using it and it was after Star had used it and it did scare me back then. I haven't followed it much recently, until now when I did a quick google. Sounds like the FDA is backing off a bit: http://www.fda.gov/Safety/MedWatch/Safet...s/ucm151161.htm
Posted By: MaxaLisa

Re: perianal fistulas - scared for skye - 04/23/10 07:42 AM

Thanks Sandy, I appreciate the info.

I think that all of these drugs are powerful and in the longterm always have the potential to cause problems, though it seems very rare in these fistula uses.
Posted By: PositiveDog

Re: perianal fistulas - scared for skye - 04/23/10 11:26 AM

Hey, Lisa - not a hijack. Anything we can get into this thread about PF and meds is great. I also was interested to read what Sandy had to say.

Thanks all!
Posted By: JakodaCD OA

Re: perianal fistulas - scared for skye - 04/23/10 12:48 PM

good news for Skye!!
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