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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Need help w/Toby's Skin Infection
| Have any of you had any success in treating a large skin infection (looks like a really huge hot spot)? We've been treating Toby's skin infection for almost two weeks with very little success -- probably because of the prednisone. His PCV has been rising slowly, but the infection looks horrible. He was on Baytril and Clavamox for one week, and then another week of Clavamox. Additionally, the prednisone is really starting to get to him. His his hind legs are getting very weak and he can no longer get into the car on his own. Please let me know if you have any suggestions. I'm not feeling very hopeful tonight......... Thank you, Karen Hoffmann |
| Karen H. Missouri |
| Karen, I am not sure if you have had a diagnosis from your vet or not. It's clear that they have prescribed Clavamox for a skin infection. What is not clear is if they have determined this is a staph infection or not. I can really sympathize with you about this. Chance had these infections, and everywhere he did, he lost his hair. It took a long time to grow back. It was a very sad time for me. Staph starts as a red spot that seems wet and oozes a light colored fluid, "weepy" is the best description. The hair comes out in chunks and the skin remains bald. Clavamox is used for staph infections and you are right, the high doses of the prednisone are suppressing the immune system enough that opportunistic infections are able to take hold. We all have staph germs on our skin, and we (and our dogs) are usually able to throw off any infection with our own immune system. However, in this case, Toby is unable to mount a defense. Chance had this too and he was also weak like this. So some general guidelines are: everybody in your house washes their hands before and after touching him. Keep his skin as clean as you can without overdoing it. Gentle soap. Do not expose him to other dogs (or animals) and reduce or eliminate visitors to your home. Most especially avoid exposing him to anyone who has a compromised immune system, this bacteria can cross both ways, human to dog and dog to human. There is a newer form of staph called MRSA, it's a drug resistant form. It is very difficult to control in both humans and dogs. Cornell University in NYS has done some research on treating this in dogs. One of the things they have found is this can actually transfer from the human to the dog! While it's very hard to treat, the vet in charge of this research at Cornell announced that they had determined how to treat it. The first thing you should do is talk to your vet and find out if this has been diagnosed as a staph infection. The second thing you need to know is if this is the MRSA variant. Your vet may not be aware of this and not familiar with how to treat it. That's when you can do some leg work by calling Cornell and getting some information from them about this treatment. I know they have successfully treated it in several dogs in our area. Then, if this were me I would talk to the vet about decreasing the prednisone dosage. If you are not using another immunosuppressive agent, this is the time to add one so you can get that pred dose decreased. Once the immune system becomes this suppressed, Toby is open to many more infections that will need to be treated with constant antibiotics. Chance was on antibiotics continuously from May until October last year. Some folks use cyclosporine and there are several other drugs that work well also. If you aren't seeing a specialist right now, it might be a good idea to get an appointment to see one for this kind of advanced treatment protocol. I am optimistic that you will be able to eliminate this condition very quickly. my best patrice |
| Patrice NYS |
| Patrice, thank you so much for your comments. I was hoping you would respond as I had read of Chance's skin infections in the archives. I don't know if this is a staph infection. No culture has been done - at least not that I am aware of. It is defintely red and oozy. Some of the skin has become necrotic. My vet and I discussed decreasing the prednisone. We started decreasing before the skin infection. When I took him in for the skin infection, we discovered that his hematocrit had dropped so the vet increased the prednisone again in an effort to keep it from dropping further. She's going to call some specialists today to discuss azathioprine and cyclosporine. I will pass your comments to her, especially regarding MRSA. Thank you so much for your help and encouragement. I'm so afraid that this is the breaking point for Toby. Karen H. |
| Karen H. Missouri |
| Our dog has that problem. We have used a pink scrub and blue rinse don't know the exact name, I have to ask my daughter, you can get it at the vets. followed by a spray Gentaspray gentamincin twice a day. now the spots are healing, also with the reduction of predisone. His skin has become dry so he has to have a bath twice a week with hexadene. plus he takes a fish oil pill once a day. this seems to help.I know these spots are awful looking. we had a skin biopsy which turned out to be strep infection so he is taking Bactryl. we haven't had any problems with the leision and our family and our other dogs, but if immune systems are compromise you will need to take precautions while cleaning the leisons, "gloves". It's all coming together after 7 months thing are looking up. this is an expensive process. my daughter works for a vet hospital so we do get discounts, but the cost now with discounts is $4000.00. If it wasn't for her stubborness we would have had to make him comfortable, cause we sure can't afford this medical bill. It funny that my husband has chrones and has taken the same meds fred has taken. now that my husband is doing better, fred has took a turn for the better also.... Makes you wonder? Let us know how this works for you.. your in my thoughts. beth |
| beth va |
| Blue stuff: "Nolvasan (chlorhexidine diacetate), the only EPA-registered chlorhexidine disinfectant, works against at least 60 different bacteria, fungi, yeasts, and viruses. Nolvasan is non-corrosive, has minimal to no skin irritation, and retains antimicrobial activity in the presence of organic matter. Nolvasan’s unique binding to skin proteins provides residual activity for as long as 2 days." See if your vet will give you a small pint bottle from their larger gallon containers. Dilute this according to their instructions. But generally, the water shouldn't be very blue when you are done mixing, if it is, you have way too much in there. I keep a gallon of it and use it frequently for many kinds of soaks on paws for instance. Excellent stuff to keep on hand. Can give more fish oil than one a day. Chance up to 3-6 a day for 100 lb. Try using omega 3 eggs, one or two a day, also. patrice |
| Patrice NYS |
| Thats it.... Thanks. I think thats why my dogs skin became dried out. It works well! Good health to you |
| beth va |
| Beth and Patrice, thank you for your advice. The vet gave me some gauze pads soaked with some type of scrub. I've been using that once a day. She also prescribed azathioprine which we started last night. The prednisone will be decreased next week after the azathioprine has had time to kick in. I'll try the fish oil, too. And, Toby will be THRILLED to have eggs added to his diet. Poor dog is always starving now that he's on prednisone. Thanks again. I sincerely appreciate your help. Karen |
| Karen H. Missouri |
| Karen, Since it can take at up to 6 weeks for azathioprine to start to work (reference: Veterinary Drug Handbook) you might want to visit with your vet about waiting more then a week to decrease the prednsione. We do see azathioprine start to work sooner in some dogs but in some dogs it can take the full 6 weeks to kick in. To learn more about Azathioprine, you might want to check out this Web page: http://www.marvistavet.com/html/azathioprine.html |
| Joanne MN |
This thread was discussed between 12/11/2008 and 14/11/2008
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