I guess I should first introduce him and give a brief history on what we have done in the past to help control his skin allergies. Festus is his name and itching has been his unfortunate game. He has had ups and downs with his itching a lot of misdiagnosis along his road to recovery. Along with his skin allergies he is also Hypothyroid, basically his thyroid doesn't function on its own anymore (if it ever did).
Festus - July 2012
Festus' Thyroid history:
It all started roughly after Festus was a year old with some minimal hair loss on his neck, chalked it up to a new collar with a plastic buckle on it that he had a reaction to. Went back to using his other collars and it seemed to not get any worse but not get any better either.
Few more weeks went by a little more hair loss and a few bumps on his neck area (underside of neck), so I took him to the vet for the vet to have a look at it, we took a biopsy of it and sent it off to the lab. The lab came back with no real abnormalities other than inflammation. Treated with course of antibiotics (cefalexin) for 10 days and vanectyl-p no changes other than we realized he doesn't respond well to vanectyl-p or prednisone, he literally pees himself, so it is a drug we attempted to stay away from.
Few more vet visits to see what was going on, and everything was inconclusive. Neutered him at 18 months, he blew through the anaesthetic took a lot to get him down, and to keep him down thank goodness a neuter is a quick procedure. Before the neuter was done I had a full cbc/chem screen, clotting panel, Free T4, Total T4, everything was in normal ranges,thyroid was within the normal range although a low normal. If I knew then what I know now I would have had him started on a low dose of soloxine. We attributed the hair loss to hormones and snipped his precious jewels away. After his neuter his scrotal sac swelled up HUGE, we couldn't do a scrotal ablation as the gas was starting to wear off while he was still under. That became slightly infected, another round of cefalexin.
In the mean time his hair loss proceeded to get worse, he became more and more itchy and more and more ornery. He didn't want to listen or retain knowledge.I thought it was stubborn teenage dane age and brushed it off. He unlearned how to walk on a leash, and just seemed to not behave himself overall. We took him to two board certified dermatologists, a holistic vet, and two separate traditional medicine veterinarians. The dermatologists tested for thyroid (as did the other three), as well as did the allergy blood work and allergy skin testing. He has a myriad of allergens that he is sensitive to (cooked chicken being the absolute worst for him and mold).
Fast forward to April 2011 and thousands of dollars later. We tried shampoos, sprays, supplements, food changes you name it we’ve likely tried it. I took him back when he was really bad, last ditch effort on his blood work, told the vet to just run it we did another cbc/chem screen Free T4 and Total T4 through Idexx lab. FINALLY he showed to be hypothyroid. His level was 4.6 for the Free T4 (tested by equilibrium dialysis) normal range is 7.7 – 47.6. Total T4 was 10.1 and normal was 13.0 – 53 (one of the few copies of blood work I have). We put him on thyro-tab (generic soloxine) 0.3mg twice a day. This did help him out to get him comfortable and we noted some improvement. 6 weeks later we tested him and he was bumped back into ‘low normal’ range. This vet wanted him to stay on the 0.3 dose and continue there, I didn’t see the ranges that I wanted Festus to be at so I upped his dose to 0.45mg twice a day, he did a little better still. I talked to the vet he didn’t agree with my choice to up his dose as in his words “he is too young of a dog and shouldn’t be on thyroid meds”. So another switch in vets this time to a different holistic vet, more blood work and an increased dose to 0.6mg twice a day. We rechecked him put him on different supplements including zinc and B vitamins. Some changes but she kept on telling me his blood work was in normal range and we didn’t need to adjust it.
I had troubles not seeing further progress in him, trying her supplements so I switched vets again about 3 weeks ago and saw copies of his blood work, he was STILL in the low normal when the prior vet was testing him and telling me he was well within normal ranges. Just shows that you should be receiving and LOOKING at copies of their blood results. The new vet upped his dose to 0.9mg twice a day and has been more aggressive with his treatment which is what we have needed to get his thyroid stable. Since going to Dr. Johner at Northwest Veterinary Clinic we have seen some amazing progress with him still ups and downs though. We have done several rechecks on his thyroid and have him at a stable dose of 2.5mg of the brand name Soloxine twice a day and he is finally in the high normal range, which is where he should be for his age and breed.
Present day - December 12, 2012 - Atopica/Cyclosporine MOD Time!!
Now the main reason for the blog. I've started him on cyclosporine MOD (aka Atopica). After a long discussion with the vet we've decided to give him a three month trial on the cyclosporine to see how he does and cross our fingers that it works. For a dane this medication is quite expensive but if it works it is totally worth it for my handsome blue boy to be happy and to live itch free. His initial dose is 300mg once a day every day 2 hours before dinner time as it is to be given on an empty stomach. Well as empty as possible, he gets a small piece of deli meat just enough to wrap the three pills all together so that he will just gobble it right down the hatch. I also am giving him the cyclosporine separate from his Soloxine as to not give any stomach upset.
Now that his thyroid level is under control, we have moved onto the diagnosis that it isn't just the thyroid causing all his skin issues but accompanying it is Atopic Dermatitis. Hence the need for the cyclosporine MOD.
Now onto the photo documentation of the blog (the most important part) to hopefully see some visible improvements.
*All photos were taken this morning, he officially started on the cyclosporine last night.*
Festus - Neck close up - December 12, 2012
Festus looking all GQ - December 12, 2012
Festus - Body shot - December 12, 2012
Festus - Front leg/foot close up - December 12, 2012
Festus - belly/armpits - December 12, 2012
Festus - armpit area close up - December 12, 2012
This by far is his worst area on his body.
Festus - Hind foot close up - December 12, 2012
His favourite body part to suck and chew on.
Cookies to those who have made it through reading this first blog. I promise the rest of them will be much easier (aka shorter) to read through. I will be trying to update weekly. Likely I will be updating on the weekends though so the next update to come this weekend in only a few short days.
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