New to Calcinosis Cutis

[bella0521]

Hi there,

I have a 4 year old 75lb American bulldog with huge calcinosis cutis lesions on her back. Here is some of her history:

Bella has had severe allergies for years. We adopted her last January 2014 from a rescue-- at the time she had ear infections, scabs all over from itching, hot spot, etc. Since adopting her (and maybe even before that), she has been taking prednisone daily. We have tried to decrease it, but we could not get her lower than 10mg/day without her tearing up her skin and being miserable (and even with 10mg/day she still is itchy and pink skinned all the time). Since we have adopted her, she has always eaten a lot, drank a lot of water, peed a lot (which we always attributed to her prednisone). Starting in the summer, I noticed she started losing her hair. Now her legs are bald, her tummy, part of her chest, the top of her head and parts of her face. Again, we attributed this to her prednisone (we did a bunch of skin scrapings and other tests to rule out mange, skin mites, etc. but nothing came back positive). Another thing to note, the skin on her feet/hind legs often gets cut and bleeds easily. I always assumed it is because she plays hard outside and skids to a stop, but perhaps her skin is thinning.

In short, Bella has had skin problems for a long time.

In December, I noticed that the hair on her back between her shoulders was standing up but didn't think anything of it. In January, I finally took a peek and noticed it was bright red underneath and her hair was coming out in chunks from that area. I took her to the vet and she thought they were hot spots, so they shaved/scraped the areas and gave us 2 weeks of antibiotics and some steroid spray to squirt on top. After the vet, the spots were bright red/bleeding and wet from the scraping. After the 2 weeks, the spots had scabbed/hardened up and there was no more wetness or bleeding, but were still bright pink and warm. When we went back to the vet after the antibiotics ran out, she said that these were not hot spots (they should've improved by now) and she didn't know what they were. So, she took a picture of it and sent it to a dermatologist who then replied that it looked like Calcinosis Cutis. We were told that this is probably a result of her being on prednisone for so long + the steroid spray that we were spraying on top of it.

Our goal is to get Bella off of prednisone to see if the CC clears up. We found another vet who had access to a new allergy med (Apoquel), so we are trying that and are going to slowly reduce Bella's prednisone and wean her off of it. So far, on the Apoquel her skin is not too pink and she is not itching so much (other than her CC spots), so I have high hopes that we will be able to get her off of prednisone. Unfortunately, even though the rest of her skin seems to be doing better on Apoquel, her CC spots are getting worse. They are thick, red, and now are cracking and bleeding. They are also spreading down her back and she is losing her hair in chunks. Some spots are even crusty brown.

Phew, that was a long story. Sorry. Anyways, both of our vets seem a bit clueless about CC so that is why I am doing some research here (even though technically Bella has not been diagnosed with Cushings nor have either of the vets mentioned it). Her symptoms that we have always attributed to allergies/prednisone do worry me now that I am reading about Cushings...

I guess at this point my question for you is: how to we go about treating her CC spots other than reducing her prednisone? (I want to be informed and be able to suggest things to our vet next time we see her.)

Should the hair above her CC spots be shaved? Or do we just wait until the hair falls out?

Is there anything we can put on top of her spots (that is not a steroid spray)? We do have a medicated shampoo right now that we are using on her back.

Do you think that Cushings might be the root of her symptoms? Or could all of this really just be a result of her long-term prednisone use?

Thank you for your help and support!!! I hate seeing Bella like this-- she has always had problems but this is just gruesome:( She looks like a zombie. I just want to know what I can do to make her better!

[Harley PoMMom]

Hi and welcome to you and Bella!

Gosh I am sorry that your sweet girl is going through so much. We do have members that are dealing with that calcinous cutis and I am sure they will be along soon to offer their advice. That CC does get worse before it gets better.

If Bella has been taking prednisone for a long time it may take a while for her adrenals to function properly again, so the tapering of the prednisone is very important. And I do believe the CC is caused by the prednisone. Prednisone is like a double edge sword, it helps with so many health issues but take it too long and those adverse effects pop up. Hopefully the new allergy med, Apoquel, will work for her and she can go off the prednisone or it can given at a lower dose.

Renee is our resident expert on CC, which I will provide a link to her thread so that in the meantime you can read it, and I am sure she will stop by soon.

http://www.k9cushings.com/forum/showthread.php?t=5908&highlight=Calcinosis+Cutis

If you have any questions please do not hesitate to ask them and know we are here to help in any way we can. ;)

Hugs, Lori

[Robert]

Hi I had a Maltese that had an autoimmune disease and they treated that with pred. She was very sensitive to the pred and developed CC within a few months. The veT advised it is connected and prescribed DMSO which definitely helped her but didn't completely cure it. Cheers

[bella0521]

Thank you for your help. I really appreciate it! I have heard of DSMO and mentioned it to the vet on the phone, but she thinks we should wait 2 weeks on a lower dose of prednisone to see what happens. If Bella's lesions keep opening up and bleeding then DSMO might be our next step. She says it is powerful stuff, though, and you have to wear gloves to use it. Yikes.

[Robert]

Potent stuff indeed....hope your lilt friend heals enough you don't need it. But from memory no nasty effect on dogs just healing. Cheers

[Renee]

Hi there,

Just checking in to share with you my experience and knowledge on CC.

I am sorry your girl is suffering so bad. I can truly relate, as my girl had lesions all the way down her back before we got things controlled.

Firstly - there is no cure for CC, other than lowering the cortisol. What I am unsure about with your girl, since her's is induced by pred rather than traditional cushings, is how low her cortisol needs to go. In a normal dog suffering from traditional cushings, the cortisol needs to come into therapeutic range of below 5 ug/dl and stay that way long-term. In a dog that has CC induced by pred, assuming traditional cushings is not at play, I would make a best guess that just getting off the prednisone will lower her into the appropriate range her body would naturally be at.

There are many different ideas about what may help or not help with CC. My personal opinion, through trial and error, is that DMSO is a complete waste of time. It smells horrific and I found absolutely no significant improvement that made it's use worthwhile.

Instead of DMSO, I would suggest a combination of tea compresses on the lesions, tramadol for pain (if that is an issue), and adding probiotics to her meals. You'll probably need to run a course of abx on occasion, as the lesions are highly susceptible to secondary infection. There is also a topical spray some have used, but I cannot think of the name off the top of my head.

Some people have used medicated weekly baths, but I felt that too much moisture was actually detrimental, and I never bathed my girl until she healed up somewhat. The lesions will crack, bleed, ooze, look raw and angry. Getting them wet is the last thing they need. You'll know you are heading in the right direction when they begin to dry out and flake, rather than ooze and be angry.

Keep in mind, even as you wean her off the pred, the lesions that are below the surface will continue to come up and break through. It will go through many stages. It will take months for the lesions to run their course and heal up, and that is only if you get her cortisol into proper range.

I see I've typed a lot, so I hope this can help you for now and gives you some hope.

[Robert]

Hi I suggest you take vets advice re DMSO - it didn't help the lst poster but in my. Case it changed red ugly sore type situation to a nit quite normal pink colour. Cheers

[Renee]

Hi I suggest you take vets advice re DMSO - it didn't help the lst poster but in my. Case it changed red ugly sore type situation to a nit quite normal pink colour. Cheers

I'm interested to know if you continued using pred while concurrently using DMSO, or if you were tapering off the pred and using the DMSO?

[Renee]

It won't hurt to try out the DMSO, so please don't think that you would be doing wrong by either trying it or not trying it. As I said, there is no cure for CC other than lowering cortisol, so you won't be causing or preventing it by using or not using the DMSO.

[Robert]

I'm interested to know if you continued using pred while concurrently using DMSO, or if you were tapering off the pred and using the DMSO?
Hi Renee Yer had no choice. Tammy had autoimmune haemolytic anaemia and would have died without the pred. Dose was being reduced over months but vet saId she wasn't on a big dose to start with and she must have been super sensitive to steroids. She was being reduced but Before she could come off pred she developed cardiomyopathy and I had to let her go within two months of being diagnosed with the heart condition.she had so much to cope with athe end poor little tyke. Sorry the DMSO didn't work for your bub- not everything works all the time I guess. And like I said her dose wasn't a big one to start with so maybe that helped. Oatmeal shampoo also used but that was all. Cheers

[bella0521]

Thank you both for all of your help and information. Luckily for Bella, it sounds like her CC might not be as bad as others. Although it is all over shoulders/spreading down to her hips and is bright pink, at least it is fairly dry and scabby. It doesn't crack/bleed often and it has never been wet or oozy (other than after the vet scraped her spots back when she thought they were hot spots). Also, she doesn't seem to be in pain-- when I touch the spots, she might look at me to see what I am doing, but she doesn't cry or wince or anything-- so that is very good. She itches her back by rolling on the ground a few times a day, but she has always been an itchy girl so perhaps the CC itchiness is not bothering her too much. Or at least that is my hope. We will see if this all changes, though, as she progresses through the stages of her CC lesions...

She is now down to 5mg prednisone a day and doing well, so there's another good thing! Her spots continue to be bright pink and spread, but as you said they've got to run through their course before they get better. I am trying to stay positive, if you can't tell:)

Here's a question for both of you: did you ever shave the CC lesion spots or did you just let the hair fall out naturally? When we start to apply DMSO/tea compresses/topical spray (whatever we end up using), would it be more effective if the hair is removed so the medicine is applied directly to the lesions? Just wondering.

Thanks again!

[Renee]

Sounds like her CC may be mild, and that could be because they are induced by pred, rather than traditional cushings. I do hope that with her tapering off the pred, her sores will get better and you won't have to deal with this.

[Robert]

Yer here's hoping with reduction cc will cure itself. A lot of Tammy cc was on belly and never shaved her or anything like that.

[pansywags]

Bella, Pansy's cc was also a fairly dry case, not a lot of oozing or general wetness, just occasional cracking. The vets at UC Davis recommended a light misting of trizchlor spray to reduce the chances of infection when a lesion did crack open. You can order it from amazon.

It's easy to apply and smells nice.