One problem after another.

[Two&Counting]

Our 10yo Sheltie, Aili, was diagnosed with rheumatoid arthritis last fall. Vet started her on pain meds first. Was not helping and went to Prednisone.

Fast forward about 5 months, and I noticed that my girl was scratching like crazy. I suspected start of Spring allergies, but when I was doing a tummy bath, she was losing hair and had a nasty looking rash on her tummy, hair loss and leathery looking skin on her elbows which showed signs of chewing, and hair loss and crusty skin on the edge of one ear. I immediately got her to the vet and they started weaning her off the Pred, started antibiotics for a secondary skin infection (rash), and started Azathioprine (immune suppressant).

1 month later, Pred has now been stopped, rash looks TONS better. She is still very itchy and has now been prescribed Apoqual. The entire edge of the ear has a nasty cracked-crusty look and the vet said it is just part of the same skin problem we have been fighting for almost 4 months now.

I am getting a bit frustrated, and feel terrible for my poor little pooch. I would love to find something topical that can aid the healing process.

Has anyone experienced this type of skin problems on their shelties? What treatments did you use and how long before you started seeing results? Is this just part of the aging process for my pup? I don't know what to think and am just waiting for the next problem to show up.

Aili is such a beautiful little girl and as you can imagine from all the skin problems is looking a bit rough. She has slowed down so much in the last year but for the most part seems very content. Still a major snuggly girl if I lift her onto the couch (can't get up on her own anymore).

So hard to see her struggle. Any advice from those in the community would be MOST welcome.

 

[ghggp]

I am so sorry your 10-year-old Aili is suffering.
While I have never experienced any skin issues as you describe... I do know some on the forum that have gone to doggie dermatologists.

It might be better at this point, due to her age, to get to the bottom of the cause as soon as possible.
It might be expensive but well worth the investment from a specialist.

Good luck to you and Aili... soft pats to you little girl!

 

[Caro]

Sorry to hear about Aili. I don't have experience with rheumatism, but do with auto-immune issues and skin problems and the drugs you are using so this is from my experience.

Let me start by saying - please be extremely careful with Apoquel. I would never give Apoquel and Azathioprine together. Combining an immuno-suppressant with a drug that can cause or exacerbate cancer (Apoquel) is extremely risky. At the specialist vet clinic I attend, the vet specialists will only prescribe Apoquel as a last resort because of the high risk of cancer and other immuno responses. It has been discussed on Sheltie Forums before. My general vet also prescibed it for Mr D, later I found out when specialist vets refused to use it it seems the company started pushing it with general vets, who just don't have access to the same material specialists do.

If you think your dog has seasonal allergies she probably does - you do know your dog best. A simple antihistamine is much better. My girl (Tully) is on Pred/Azathioprine and her Internal Medicine Specialist (IMS) vet advised to use Cetirizine (Zyrtec) for seasonal allergies. the IMS said to be most effective Zyrtec needs to be given every day during allergy season rather than on an ad hoc basis. My girl gets half a tablet.

You may also want to try a multi-vitamin. If she has an auto-immune condition (rheumatism) she may not be absorbing enough nutrients and that may contribute to her skin conditions. Mr D's skin was shocking until I put him on a multi (not just a skin/coat vitamin) and he had a big improvement. It was only later when I found out he had an autoimmune disease that the multivitamin helping made sense. Although for Aili it may just be the Pred. Tully lost a lot of coat when she was on the high dose of Pred (as well as other side effects), but it looks great now she's on alternate days of Pred/Azathioprine.

Also for the skin, the IMS recommended Essential-6 Spot on for skin. It contains the essential oils and spreads through the coat rather than them having to ingest something else. I use both the cat and dog one on Tully (the cat one was on sale and my cats hated it). The cat one less smelly!

I should have said from the outset - if you have not seen a specialist vet I would really, really recommend you go. My Mr D would still be alive if I had taken him. Tully now sees an IMS and it is saving me a fortune. Yes the initial outlay is higher, but I need to see the IMS a lot less (and he follows up and prescribes over the phone) so my vet visits have reduced at least four-fold.

Is she on a prescription diet? I would definitely be going for either limited ingredients or prescription diet. Despite some people criticising the contents, these diets have been scientifically developed, with nutritionists and tested over a long period to ensure their efficacy and safety. You are in the US so have lots of choices for prescription diets. The brands most often used on the IBD forums are Royal Canin, Hills and Purina Pro Plan.

Humans with RA often have IBD - auto-immune diseases often go hand in hand (IBD in dogs is an intestinal inflammatory disease). Mr D's skin was eventually linked to him having untreated IBD and not absorbing some nutrients. It was too late for Mr D and he died of IBD related cancer, but Tully was also diagnosed and we are managing her.

Have you done food trials? I would really recommend looking at her food intake, maybe going onto a limited ingredient with a novel protein - I think Purina Pro Plan has some good ones. Skin + arthritis just seems like something is happening with her immune system (if it's not just the Pred). And like I said, I would really, really recommend referral to an IMS to get a plan.

Hope that's not too long - happy to answer any more questions.

 

[take4roll10]

Sorry your dog is not doing well. I unfortunately, know the feeling. My dog has skin and fur issues. Her tail is almost completely bald.

Her skin and fur issues are from Cushing's disease. Other symptoms of Cushing's are excessive drinking and urinating, pot belly & extreme hunger. If you dog has any of this symptoms, you may want to consider a ACTH test to check her cortisol.

 

[Two&Counting]

Thank you all for your replies!
Take4 - we already tested for Cushings when Aili was first diagnosed with RA. All those tests came out really good.
Caro - I had not heard that about Apoquel! It has definitely helped the itching problem but I don't want other problems later (cancer) because of it. I had been contemplating a vitamin regime and will look again.
ghggp - Thank you for your well wishes!

I am hoping we have stared to turn the corner. I put some antibiotic salve on the edge of her ear (yucky sticky fur!) and within 48 hours the scabby looking flakes fell off and the edge of her ear looks almost normal again! Aili is much quieter again - my stoic little low-rider. Trip to the groomer tonight to do a bit of trimming and nice sudsy bath! With all the topical sprays and ointments we have been using since her skin broke out, she really needs it.


Thank you again for being a wonderful sounding board for all of us who love our Fur-Kids!