Calcinosis Cutis and Cushings Disease (Kiera has passed)

[claireabella]

Hi my name is Claire and I have an 8 year old Rottweiler called Kiera who we have had since she was 8 wks old.To give you a bit of background information about her she is a very loving dog ( habit like a cat really, only when she wants a cuddle). She has always been a very itchy dog, getting a lot of sores from scratching especially around her neck area, and licking and biting her feet and legs.we tried different things over the years, change of diet, allergy tablets, etc but nothing seemed to work. Approx 18 months ago the vet decided to put her on steroids to see if his helped with the itching..it did work with only the occasional scratching, over the months she started gaining a lot of weight, drinking a huge amount of water, constant panting, and her season stopped. The vet tried adapting the dose, but things carried on the same. Then one day I noticed a wet patch on the back of her neck, thinking it was a sore caused by scratching when I looked it was covered in pus and the smell was horendus, the vet said he had an infection and gave her antibiotics. Within a week her whole neck was infected and was starting down her back. The vet changed the antibiotics but to no avail, the smell was awful, we had to clean it constantly while chunks of her fur where just coming away. She was booked in for a biopsy by the vet which took 2 weeks for the results, during this time it continued to spread and now starts from behind her ears to her tail and down her back legs and cheek of her face, she has been on these new antibiotics for 4 weeks now and have stopped any more pus being formed, now it has all scabbed over and her fur is just coming out in clumps. The results of the biopsy was:- Calcinosis Cutis with Furnunculosis and suspected iatrogenic Cushings Disease...they wanted me to get her off the prednisolone quickly which I did and has been off them a week now and goes into vets for blood tests in 3 weeks when the prednisolone are out her system to see if she has Cushing's Disease. Since she has come of the steroids she is very miserable and will hardly eat anything. I am at my watts end worrying about her, trying to get her to eat, her fur is coming outas the the scabs are coming off and her skin cracks and bleeds, she has now started with chewing her feet again. If anyone could give me some advice I would greatly appreciate it, I am so worried . Many Thanks

[labblab]

Hello Claire, welcome to you and Kiera! I apologize in advance because I don't have long to be here right now, but I want to assure you that you will be hearing more from me and also our other members.

In terms of gaining control of Kiera's calcinosis cutis, indeed it seems critical to ultimately shift off the prednisolone. However, one worry I have is whether it may have been discontinued so abruptly that her adrenal glands did not have the chance to re-awaken enough to be producing enough natural cortisol to fulfill her daily needs (hence the low appetite, generally feeling poorly, etc.). It is a fine line to walk when titrating off a steroid supplement after an extended time on it. And of course, the other issue is how to gain the upper hand on Kiera's allergy issue once she's off the steroids.

In order to give you encouragement, though, we have folks who are dealing with all these same issues -- perhaps not all at once, but still, I think our group's experiences will be very helpful to you.

So I apologize again for signing off right now, but I will be back. In the meantime, can you please tell us the specifics of Kiera's discontinuation of prednisolone: dosing and timeframe. For overall functioning, it may be the case that she needs to come off the steroid a bit more gradually.

Marianne

[claireabella]

Thank you Marianne for your reply, i believe she came off them far to quick also, kiera was on 2 x 5mg prednisolone daily, because the vet wanted blood tests doing, she wanted her off them in a week, I did argue the fact it was too quick but she insisted she would be fine, I did it over 2 weeks which I know is far to quick, she has now been off them for 8 days,She is booked in at the vets again in morning, and due blood work on the 14th of October.

[labblab]

Hi again, Claire, and I'm sorry it's taken me so long to get back to you! I am hoping that you came away from yesterday's vet visit feeling a bit more encouraged, but yes, I have to agree with you that I would have wanted to take a longer time to bring Kiera off the prednisolone. So I do still worry that she may not yet be producing sufficient cortisol on her own, yet.

It is true, though, that lowering the steroid is the most important thing in terms of halting the progression of the calcinosis cutis. In the meantime, while you are still dealing with caring for the lesions that are already present, you may find some suggestions on this thread that may be a help to you:

http://www.k9cushings.com/forum/showthread.php?t=6093

Also, I know that the issue that prompted the prednisolone in the first place was Kiera's allergies. So another big question is: how to control that problem without the steroids? There are a couple of nonsteroidal medications that are now available for treatment of troublesome allergies in dogs who cannot tolerate steroids. The first is "Atopica" and has been around for about ten years. The second is a much newer drug, "Apoquel." During the past year, Apoquel has been in short supply. But apparently the manufacturer has recently released a larger supply. Both of these drugs do carry the risk of side effects, most seriously that they can leave a dog more vulnerable to infections. But apparently they have been very successful in treating allergies that don't respond to other options. Here is an article that discusses them both:

http://skinvetblog.com/2014/10/07/apoquel-vs-atopica-a-comparison-of-two-medications-to-control-atopic-dermatitis-in-dogs/

So I guess your challenges are threefold. First, to make sure that Kiera does have sufficient corticosteroid right now -- either via natural production or through a small supplemental "bridge" dose. Secondly, to care for the existing CC lesions (while hoping that the progression will be halted now that she's done with the large doses of prednisolone). And thirdly, finding alternative treatment for the allergies.

Please do let us know what you found out yesterday,
Marianne

[molly muffin]

Hello and welcome from me too.

It is hard to get them off the steroids and usually takes a very slow gradual process, so as Marianne said, the adrenal glands can start to produce on their own while being supplemented by smaller and smaller doses of the steroid.

The hope of course is that once her cortisol levels are back to normal that the cc will clear up. Just like with regular cushings though, it will take a while for the cc to clear up. Once her levels are normal and she isn't producing the excess, those calcium deposits still have to come up through the skin and no more be produced. This can take awhile (as in months).

We've had members, who if you can find it, have given very good reviews of the apoquel, so I'd ask the vet about that for her allergies. (marianne provided a good link for reading up on that).

What did the vet have to say?

I do hope she starts to get better soon. My sister had a Rottweiler who thought she was a lap dog her entire life, she just wanted to curl up like she did as a puppy and cuddle with you.

[claireabella]

Hello every one, and thank you all for your help, but sadly yesterday after her appointment at the vets it was clear that she was getting no better, the Calcinosis Cutis was increasingly getting worse, she was on the highest strength possible of antibiotics and they still weren't working, and due to the Cushing's she couldn't have any more prednisolone for her severe itching, the vets couldn't do any more for her, my husband and I spent the day with her doing her favourite things, and she was the happiest I've seen her for a while, she had a lovely walk, a ride in the car and her favourite meal fried steak, then at 5pm we finally said goodbye to her, our hearts are broken but we know we have done the right thing. As tears roll down my face as I write this, I would like to thank this forum for the information it gives and helps other pet owners with this disease. Thankyou

[labblab]

Oh Claire, I can't tell you how sorry I am to read this news, but thank you so much for telling us what has happened. I know what an excruciatingly hard decision this was for you and your husband. But you put Kiera's welfare above your own pain, and that was the most loving final gift that was within your power to grant. Please know that you remain always welcome to talk with us here, to let us know how you are doing and to share special memories and stories about your sweet girl.

If you ever wish to do so, you may start a tribute thread for Kiera on our "In Loving Memory" forum, and her name has now been added to our special memorial list of honor there:

http://www.k9cushings.com/forum/showthread.php?t=6879

Again, I am so sorry for your loss, but grateful that you found us. Even in this short time, you are both part of our family. Kiera will always be honored here, and you will always be welcomed back.

Sending many hugs in loving memory of your dear girl,
Marianne

[judymaggie]

My sincerest condolences to you during this difficult time. As Marianne said, you provided Kiera with the opportunity to be released from her pain and she can now run free with all of our pups who have preceded her to the rainbow bridge.

[molly muffin]

I am so very sorry. What a heart breaking time for you and your family.

My sincerest condolences

[mytil]

Oh Claire,

I am so very sorry - you both have my deepest condolences. Now your sweet girl is pain free. I know it is a hard decision and thank you for letting us know.

Please do stay with us as we all know what you are going through.
Always remembering your girl Kiera!
Terry

[Beaglelover]

Claire, I am deeply sorry to hear about Kiera. I know you are heartbroken, please find comfort in knowing you did everything possible to make Kiera comfortable in her life. Don't second guess anything you did. Time will heal your broken heart. My thoughts and prayers go out to you and your family. Tammy

[claireabella]

Thank you everyone for all your kind words and messages of support, we really do appreciate it. Its been a week now since we said goodbye to our baby girl, it has been such a long week while we wait for her ashes to be returned home to us, even though we have another dog called Diesel ( Staffordshire Bull Terrier) the house seems so empty without her, Diesel is very confused they had been together since they where 8 weeks old and even thought he wore the trousers he loved her very much always following her wherever she went. It breaks my heart loosing her, but he just be so confused why she hasn't come home.
When I feel stronger to write more, I would like if allowed on here to write more about keiras story, and if I am able to help anyone else who has a pet who has or is suffering with this I will help as much as I can. Thank you again everyone.xx

[molly muffin]

We have an In Loving Memory section, where you can start a thread and tell Kieras story and just stay in touch. Many of our members use this section once their beloved furbabies have passed. We would love to hear all about her. This is going to be a hard time for all of you including Diesel. Poor boy. I'm sure he can't figure out where she is and why she isn't there. They too can go through depression.

http://www.k9cushings.com/forum/forumdisplay.php?f=8