Morgan...Zombie Skin (CC): Need help w/ DMSO

[skinnybonedog]

Hi Everyone.....sad that I have to be here and have read so many of the "stories" here and some make me hopeful, some break my heart.
So my situation I hope involves iatrogenic hyperadrenocorticism. My 8 year old female French Bulldog has been on Temaril-P for years and I know the dangers of steroids but I thought that since it was such a low does it would not cause issues. She was put on it for chronic itchy skin. Well about a month ago she got into a fight with her sister and I thought she has gotten the skin on her shoulder pinched in the fight. But then about a week after it was not healing, and then got bigger and turned into a hard area about 2 inches in diameter. I was set to go on vacation with the dogs for a week and did that and it got worse. Was not able to get an appointment with my vet for 2 weeks and in that time it all got worse and came up on the other shoulder in the same place. My partner took her to the vet and he mentioned "CANCER" and/or possible issues from the long term steroid use. My hope is that this is Calcinosis brought on my the Temaril. I am tapering her off that and she is down to between 1/4 and 1/2 pill every other day in the am. Her energy is good, stools good, hair coat great except in the patches of what I am calling zombie skin. I have her on Cell Advance, melatonin, Adrenal jump start from Gaia herbs, Vetriscience BD, a liver support supplement, zinc, chia seeds and she is has been on a raw diet her whole life. I am devastated that I may have caused this and I should have known better. So my questions are what should my next step be? I am waiting for a call from the vet as he put her on antibiotics in hopes this was just a pyoderma infection but it is showing no change from that. Her next appointment is Monday. I am not even sure I should bother with a biopsy because it is pretty clear what this is (unless I am in denial and it is cancer). My hope is this was all caused by the Temaril and she will be ok, she is the most amazing dog. But I can't run any test until the steroid is completely out of her system right?? How long should that be after the last pill? And should I start DMSO on the zombie patches or just wait? There is no discharge, just torched looking, bumpy hard nodules. It does itch but does not seem painful and I put various things on it to help with the itch and her wash her in Duoxo every 3-4 days. Happy to have ya all to "talk to" about this. Thanks for any thoughts. I do not see a way to post an image unless it is already hosted....is that because I am new??

[labblab]

Hello and welcome! I just checked, and you are a fully registered member. Therefore, there shouldn't be any problem for you to create a personal photo album and upload pictures of your choice. Once you log in again, click on the "User CP" title on the upper left-hand corner of any page. That will take you to your control panel, and creation of a photo album will be one of the options available to you from the menu bar. Let us know if you continue to have problems, OK?

It doesn't sound as though your girl is exhibiting any other outward symptoms associated with Cushing's. So in terms of testing, probably the most useful thing would be to have a skin biopsy performed on one of the patches. We've been told that skin scrapings are not sufficient to diagnose Calcinosis Cutis -- that an actual punch biopsy is required. There would be no need to wait for a biopsy, if you choose to proceed. However, since you are already tapering your dog off the steroid, you may prefer to just give it some time in order to see whether the areas start healing now.

Since the skin issue is the only symptom consistent with Cushing's, I would not bother with specifically targeted blood testing. Even if she were to test positive for Iatrogenic Cushing's, your remedy would be unchanged: tapering her off the steroid. So let's first start off with taking a look at some photos of those lesions. Once again, let us know if you have trouble setting up your album.

Marianne

[labblab]

Oh good! I just your new photos of Morgan in your album. She sure is a beauty! :) :)

Now that you've got your album started, go ahead and take some photos of the lesions, OK?

Marianne

[skinnybonedog]

Here is my beautiful dog. I will take some shots of what I believe to be CC. I just talked to her vet and he said biopsy was next still leaning toward cancer. So I point blank repeated that the same thing is on both shoulders (but when he saw he, the right shoulder was way worse) and if it is bi-lateral and literally all appeared in the span of a month, did he still think cancer and he said no, most likely not. Said to keep her on the antibiotic until he sees her on Monday. Said he has not seen a case of CC in a dog on that low dose of steroid but is not saying it is not possible. I am thinking might be a good idea to catch her first pee Monday morning and take that with for a cortisol check or is that pointless given that she is still being tapered off the Temaril??http://www.k9cushings.com/forum/picture.php?albumid=1180&pictureid=8839

[labblab]

Hi again, for the reasons stated above, I really wouldn't bother with either blood or urine testing specific to Cushing's at the moment. The central issue is finding out the actual cellular nature of the lesions, so I'd be putting my money towards a biopsy.

Marianne

[skinnybonedog]

HI Marianne, I think our posts crossed. I was leaning as you said, just wait this out to see what happens when the Temaril is out of her system. The vet asked me how sure I was of "my diagnosis" and he was not being a jerk....I told him I had been doing alot of my own investigating and do not claim to be a vet but was a tech for a short time. He said he is just worried if I am wrong. I think he forgot she has an appt with him on Monday. So I told him he sees her Monday and he can decide what her things with how it looks now. Yes, will take photos of the lesions tonight. My wonderful Zombie girl....I just am so afraid I am in denial and the steroids are masking some other issues that I will find once they are stopped.

[skinnybonedog]

Ok, then I will have him do the biopsy because a confirmation of CC is better than worrying it could be cancer and I did not follow through. Does she have to be knocked out for the biopsy?

[labblab]

I'm sure the area would need to be numbed up, but I doubt that actual sedation would be necessary. But I truly don't know about that since I've not had that procedure done.

Depending on where you live, you might prefer to ask for a referral to a canine dermatologist. He/she would undoubtedly be able to give you a more educated guess just based on the appearance alone. Given Morgan's steroid history and the appearance of the lesions, they might not push for a biopsy.

But let us take a look at some photos, since we've seen quite a few cases here. We're definitely not vets, but we've probably "seen" more cases of CC than many actual vets have!

[skinnybonedog]

I am generally a cat person but this dog and stolen my heart 10 times over! I am obsessing over this whole thing. I am so sorry for those of you who have lost the battle with this condition/disease.

http://www.k9cushings.com/forum/picture.php?albumid=1180&pictureid=8841

[labblab]

Trust me, I totally understand about obsessing!!! :o :o ;)

We totally understand how worried you're feeling, and that's why I'm thinking a biopsy would give you the fastest, most accurate answer. But taking the time to see a dermatologist might give you some added peace of mind, just because he/she would know exactly which diagnostics are really necessary. But I realize a specialist may not be readily available to you.

[skinnybonedog]

I did email a local dermatology clinic yesterday asking them if they have vets with experience with CC and they do. My vet has only seen her once for this and he is a brachycephalic specialist, owns Frenchies and I don't think I have ever been in his office when there was not an English Bulldog there. I do have confidence in him and generally love him. It did not sound like he was going to push for a biopsy after I reminded him that it is bilateral. I think he was worried about a cancerous lesion because it does look horrible. I hope I am right about all this. I will post detailed photo when I get home tonight. It is so hard to go into work with her having this. She seems none the worse truly, a bouncy, playful, ball loving zombie dog...lol...when I walk in the door at the end of the day I worry if something bad will have happened while I was at work....uggg.

[skinnybonedog]

I am in San Diego and I do have that access luckily....and I will take her there if my vet does not feel he has the ability to deal with this. But I do feel the biopsy might give me some peace of mind that it is not cancer.

[labblab]

Yes, the bilateral nature makes me doubt cancer, too. CC can truly look horrible, no doubt about it!

[Joan2517]

Welcome from me too...she is so pretty! No wonder she has stolen your heart, she looks like a happy girl.

[skinnybonedog]

Yup, hence how she got the nickname "zombie dog" and teasing about belonging on the set of The Walking Dead. Other than it being somewhat itchy, she does not seem bothered by it that is until mom starts pulling at the skin to see how plaque-like it still is. Initially it was a 2" chunk of flesh with less defined lumps.....since going lower on the Temaril the skin has softened some and I can roll the skin again and the lumps are more defined but hard like rocks, not squishy at all.

[Harley PoMMom]

Hi and welcome to you and your girl from me as well!

I'm not sure how long a biopsy result will take to get back and if it's longer than a week another option would be to have an ACTH stimulation test performed. if the results from the ACTH stimulation test are low-normal or blunted than the diagnosis would be Iatrogenic Cushing’s,

Lori

[skinnybonedog]

I love her so much.....trying hard to not cry sitting here at my desk at work where I so do not want to be. Don't even want to eat my lunch.

[Joan2517]

We all cry at our desks on this forum. My coworker knows to stay out of my office when she hears sniffling, which is quite frequent.

[skinnybonedog]

Hi Lori, but wouldn't the results not be accurate being that she is still on the Temaril. I just took her down to 1/4 pill every other day. I thought I might be tapering too fast but the vet said to keep her on 1/4 pill every other day for 2 weeks and then stop. The dose of prednisilone is only 2mg per tab.....so she has been on a really low dose of 1 tab/day but every day for probably 5 years!!!

[skinnybonedog]

Lunch is over, I will post photos of the lesions when I get home. Thanks for the welcome!

[Harley PoMMom]

Dogs with spontaneous Cushing's will have an exaggerated response from the ACTH stimulation test, dogs with Iatrogenic will have a low-normal or blunted response.

[labblab]

Awwwww...we understand, but chin up! (I know, easier said than done :rolleyes:). But from your description, I'm willing to bet it's indeed CC, and that should normalize over time once the steroids are out of her system. From what you're describing, otherwise she'll be just fine!

As for the ACTH, you could go ahead and request one now and as Lori says, the pattern might indicate Iatrogenic Cushing's even now. However, if it was me, I'd still forego the blood testing for the moment. I'm obsessive, too, and I know that regardless of the blood testing, I'd still want to know the exact nature of the lesions. If they are confirmed CC, then I think you can basically assume that the steroids (even low level, and regardless how an ACTH might turn out) caused them. But that's just how I'd approach it myself.

[skinnybonedog]

Posted photos in her album...

[labblab]

I don't know whether you'll consider this to be good or bad news, but those photos strongly appear to be CC to me. In order to help you compare, I'll come back later today or tomorrow to post links to some other members' photos of confirmed CC.

[skinnybonedog]

Well, I would rather it be CC than cancer although I have read there is a CC form considered to be cancer.

[skinnybonedog]

Here a link....I was having trouble on my iPad getting it to copy a link

http://www.k9cushings.com/forum/picture.php?albumid=1180&pictureid=8842

[Harley PoMMom]

Renee, one our members here, took pictures of her Tobey at various stages of CC, you can check them out here: http://www.k9cushings.com/forum/album.php?albumid=805

And, with your girl it looks like CC to me too.

[labblab]

Thanks, Lori!

Here's another link:

http://www.k9cushings.com/forum/album.php?albumid=995

[skinnybonedog]

Yup, looks very similar. Only thing I notice is Morgan's lumps do not seem to be breaking open....not sure if that is good or bad. I would think if things were progressing, they would open but it has all kinda sat there for days looking the same. A few new small bumps have shown on on her read end between her anus and her girl bits....these seem more itchy to her than the giant patch of crusts.

[skinnybonedog]

So after seeing photos of the lesions and knowing they are on both sides in the exact same location, would you all still recommend a biopsy or is her situation and symptoms pretty clear to be CC complications from iatragenic cushings? Of course I will see what the vet has to say next week and I already have the connection with the derm clinic. My vet said he has never used dmso on the lesions and that when the condition causing them was dealt with, they eventually resolved. I also worry about the calcium resorption being sped up by dmso could cause hypercalemia. It is suggested to blood test calcium levels when using dmso.

[Harley PoMMom]

I still do highly recommend that a biopsy be done as this is the only way to confirm that it is CC.

I can't remember if our other members that were dealing with CC monitored their dog's calcium levels but that probably would be a good idea.

Renee, a member here, is our resident expert when it comes to CC, she and her sweet Tobey have had a couple rounds treating that CC. I'm including a reply she posted to another member who was also dealing with CC:


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.


And when you have some time on your hands, I'm providing a link to her thread: http://www.k9cushings.com/forum/showthread.php?t=5908&highlight=calcinosis+cutis

Also, another link to an article where they had success in treating the CC with minocycline: https://www.researchgate.net/publication/264167484_Minocycline_as_a_treatment_of_dog_with_c alcinosis_cutis

Hugs, Lori

[skinnybonedog]

Thank you Lori, I will read those links. I would rather avoid the whole dmso thing and let things heal more slowly. I did make up a gel and a spray for her that I actually use on my face with all kinds of skin healing ingredients. It seems to really help with the itchy-ness of the patches. I also put vetricyn on the patches as well.

[labblab]

Your photos really, really, really look like CC to me. Lori is absolutely correct that a biopsy is the only way to know for certain. However, as I wrote earlier, I honestly don't know how involved a biopsy in this situation would be. For instance, I don't know how large a skin sample is needed, and whether there are any issues with healing from a biopsy taken from an inflamed area such as this.

Even as obsessive as I am, if I were in your shoes, I might hold tight and just monitor the lesions now that Morgan is coming off the steroid. I probably would not use the DMSO at this point, either. As your vet says, once the steroid is out of the picture, the condition ought to spontaneously resolve over time.

If the spots do break open and start oozing, however, you start running the risk of developing secondary infection. At that point, using antiseptic/antifungal rinses or treatments may become important.

It's good that you have the derm vet as an option. If you have doubts as to the best path forward -- even in terms of a biopsy -- you can always request a consultation before making a final decision.

Marianne

[labblab]

Just wanted to also add that, from our experience here, it really seems as though boxers and bulldogs are especially vulnerable to developing CC. This is just my anecdotal impression and not based on any research. I have no idea why this would be the case, but those breeds seem to be over-represented among our CC patients.

[skinnybonedog]

I guess when she goes to the vet I will ask him if there is any reason to suspect a cancerous situation now that it is totally clear this issue is bi-lateral and if he feels a wait and see approach is a safe option (he was worried initially, that if cancer, waiting of course would not be good)....I would rather not subject her to needing to heal a wound from a biopsy at the same time as having to repair her skin, heal her adrenals etc. Everything else about her appears fine....she does not act sick in any way and I obsess about how she behaves so have always been very cognizant of her moods and behaviors. I have seen English Bulldogs with this in my research, less in Frenchies but have seen a few examples. Bulldogs and Frenchies just seem to be more sensitive to stuff, have tons of allergy issues, skin issues etc....all the breeding done to make them small, smashed and cute has not done them good for sure....

[skinnybonedog]

Has anyone dealing with CC tried minocycline and what were the results? I will push my vet to give her that if anyone has had positive results. Her lesions do not appear infects but she is on atbx right now so I am worried when she goes off of them in a week, if she will have more issues with the lesions.

[skinnybonedog]

In doing more research on this, I came across this article which seems to indicate that regardless of the reason for the development, CC is a cancerous/metastatic issue. Other things I have read indicated it could be one of four types with cancer being one of those.

https://vcahospitals.com/know-your-pet/calcinosis-circumscripta-and-cutis

[labblab]

I had never before heard of it being regarded as "cancer," but I do see some references now that I am searching for them. However, it sounds to me as though that determination may depend upon the underlying cause of the lesions, as you'll see from the quote I'm including below. Regardless of terminology or classification, I don't think you need to worry about CC being a malignancy in a sinister sense. Aside from appearance, I think the major issues remain the potential for discomfort and development of secondary infection.


Calcinosis cutis is classified based upon the cause. Metastatic CC occurs when calcium salts precipitate within normal uninjured tissues. Hypercalcemia and hyperphosphatemia are the cause and are the result of underlying systemic calcium or phosphorous imbalance/metabolism in which the extracellular calcium overwhelms the cells ability to regulate intracellular calcium. It occurs with impaired kidney function and other inflammatory conditions that impair calcium metabolism. Iatrogenic CC occurs from the injection of calcium containing products into the skin(IV administration of calcium chloride and gluconate) with material getting outside the vessel, skin absorption of calcium containing landscape products, or some medications. Idiopathic CC has no underlying cause and will resolve on its own within 12 months. Dystrophic CC is the most common type and caused by iatrogenic hyperadrenocorticism or spontaneous hyperadrenocorticism (pituitary or adrenal dependent). It also may occur with inflammatory skin conditions or diabetes mellitus. How dystrophic CC occurs is unclear, but gluconeogenic and protein catabolic activity in the skin involve cortisol. Cortisol is the body’s own steroid hormone produced in excess in these conditions. For dystrophic CC to occur there must be cation and anion deposition in to tissues and changes in collagen. Collagen changes occur from tissue injury and damage to cell membranes and result in transformation of minerals from dissolved ions in to solid phase. This causes an influx of calcium in to cells that lowers the extracellular pH and impairs mineralization inhibitors. With more calcium flowing in to the cells, there is a rearrangement of the molecular structure of proteins and a formation of an organic matrix that attracts and binds the calcium. The result is mineralization of skin.
Lesions in CC are characterized by erythematous papules, plaques and nodules that are typically ulcerated and secondarily infected. Lesions are often found on the top of the trunk and head, as well as the axillae, ventrum, elbows, hocks, and oral cavity. Soft tissue organs such as the spleen and kidneys may also show mineralization. Calcinosis cutis usually resolves with removal of the underlying cause. It is important to treat all secondary infections. Frequent bathing in medicated shampoos and hydrotherapy are helpful. Sometimes, surgical removal of isolated lesions may be recommended if the surgeon feels wound healing would be successful in the individual patient. Recently, the use of minocycline for treatment of CC was reported. Though minocycline is an antibiotic, it chelates calcium and directly inhibits collagenolytic enzymes. Treatment with DMSO gel may hasten resolution of lesions. A thin film is applied 1-2 times a day. If glucocorticoids are being used and are the cause they must be tapered and discontinued. Resolution is not immediate and takes time. The skin often looks worse before it looks better.

http://www.nevetdermatology.com/calcinosis-cutis-in-dogs/

Marianne

[skinnybonedog]

Marianne, yes, I had seen similar references but that link I posted was the first I had seen where it was pretty much a blanket statement that CC was cancer.....and I guess being that my girl has what looks to be CC despite the underlying cause, the singular "C" word upset me. I was going to hold off on getting the biopsy done at her appointment next week but I think I will get it to confirm CC and no other process going on in the lesions.

[labblab]

I totally understand -- "cancer" is a scary word, for sure. But in all my time here, I've never heard any vet express concern about CC in that regard. So I hope you'll be able to release some of your worry about that aspect of things.

Also bear in mind that all the biopsy may tell you is that the lesions are truly CC. In other words, I don't think the biopsy will reveal the underlying cause of the CC. In Morgan's case, though, her long term steroid use is the obvious and most likely culprit.

[skinnybonedog]

Thanks Marianne, I had seen references to it as a metastatic condition and my vet also thought cancer until he was reminded it was bilateral and popped up really quickly....just that one article kinda made me wonder if I am in denial over the issue. Thanks for trying to ease my worry :)...I am just seeing no change in the CC since tapering down the Temaril. Not good, not bad, it just sits there and clearly is really itchy. I did just order Duoxo spot-on and it arrives today so I hope that helps lessen the itch. No change at all in her behavior, she is totally being her wonderful self, all systems appear good, just the skin issue.

[molly muffin]

I think Bubs the boxer was taking minocycline

Also I know we linked this to another member about using minocycline with cc

https://www.researchgate.net/publication/264167484_Minocycline_as_a_treatment_of_dog_with_c alcinosis_cutis

[skinnybonedog]

Thanks, I am going to print that out to give to my vet next week

[Squirt's Mom]

I have taken the liberty of merging your post and the following comments on that post into Morgan's original thread. We like to keep al info about each pup in one thread. That way it is easier to look back thru the history if needed. Thanks!

[skinnybonedog]

No problem....I will keep posting just in the original thread.

[skinnybonedog]

No news to report on Morgan. Her zombie patches are a little less inflamed but no progress either way. I did get the Duoxo spot-on last night so she is getting her Duoxo bath tonight and then the spot-on to see how that compares to what I have been putting on the zombie patches mainly to help her be less itchy. Vet appointment is Wed. Her other mom wants to have an xray done to see if other things are calcified internally, I lean toward not wanting to know and staying in denial unless something changes with her health and then addressing that issue then....I hope that does not sound neglectful, it is just something that I can not do anything about, but will worry and obsess on even more than I already am, waiting for something to happen.

[skinnybonedog]

And opinions welcome....my thinking is, if I am going to ask the vet for minocycline for the CC, I need to wait to give it to Morgan until she is completely weaned off the Temaril-P...otherwise I am kinda one step forward, two back each time she get the Temaril-P during the weaning off phase which goes on until the end of next week. And if after she is off the Temaril what would be the best test to run to see that her adrenals have not sustained permanent damage for the steroid use? Would a morning fasting urine cortisol test give me that piece of mind?

[labblab]

As you can see, I'm always happy to offer opinions...;)

As far as the minocycline, I'm not exactly understanding your worry about waiting until the Temaril is finished. Since minocycline is an antibiotic, it is a totally different class of medication. So tapering the steroid really shouldn't have any effect on the timing of starting the antibiotic, as far as I would know.

In terms of adrenal function issues, the worry about long term steroid use is that the adrenals may shut down their natural production of cortisol in the face of the supplemental steroid. So if the adrenals are slow to resume their normal production, an Addisonian condition can result. The ACTH stimulation blood test is once again the preferred method for evaluating adrenal function in relation to cortisol (both over-production and under-production). However, if Morgan's behavior remains totally normal at the conclusion of the taper, I don't think you have much to worry about in terms of an Addisonian issue. Dogs with abnormally low cortisol levels can exhibit many overlapping symptoms with Cushing's: excessive thirst, urination, lethargy, loss of appetite, etc. But again, if Morgan remains totally OK aside from the skin issues, you've probably dodged any other bullet.

Marianne

[skinnybonedog]

Marianne, opinions are good, thank you. My reasoning for the delay of the minocycline is the CC, I hope, is there only because of the Temaril-P usage so I feel the doses of Temaril-P she is still getting are contributing to the CC not starting to resolve if it is going to (and I do get that it could take a long time to get better). So getting her off the steroids first would give a better indication of whether the minocycline has any effect (I am not talking about for infection but the report of it helping with the calcium resporption from the lesions).....as in they counteract each other in a way....if she is still on the Temaril concurently, how would I know if it was or was not working. She is currently on a different antibiotic so she has no issues with infection at the moment. She stays on those until she see the vet next Wed.

[skinnybonedog]

Posted some photos of Morgan's zombie skin taken a few minutes ago. They seem a little less angry and the skin between each swelling is less inflamed and the swellings themselves are a little more shrunken and dry.

http://www.k9cushings.com/forum/picture.php?albumid=1180&pictureid=8852

[labblab]

That's great that they seem better! Don't panic, though, if the lumps end up cracking open (in which case, things will look temporarily worse). As I understand it, those calcium lumps typically have to work their way to the surface and burst open in order to finally heal. I haven't personally witnessed it, but that's what's been reported to us.

By the way, just wanted to mention that I'm a big fan of Douxo's shampoos and skincare products. I have a nonCush Lab girl who suffered from recurrent staph infections on her skin for months. Oral antibiotics temporarily healed things, but the staph always recurred. I wanted to get her out of the antibiotic loop, and truly the thing that finally seemed to cure her was frequent bathing with Douxo's chlorhexidine shampoo. I also used their chlorhexidine spray, as well. I've used other products of theirs, too, and been similarly pleased with the results. So I hope you'll have good luck with them, too.

Marianne

[skinnybonedog]

Have been a fan of Duoxo products for years and they do work. She is getting a bath 2 times per week in the shampoo, sometimes the spray and now the drops....I used the drops yesterday and really liked the effect...she was much less itchy and the patches were softer and appeared reduced. So yes, really happy with Duoxo and always recommend it to people.

[skinnybonedog]

Morgan was just left at the vets office this morning. Full blood panel, 2 punch biopsies, one on each shoulder. Vet of course said highly likely to be CC from the steroids even though rare (which we knew) but biopsy will confirm or deny. Took the study on Minocycline and he found that good info enough to give an rx for the mino. Said next to try Zyrtec for the allergies if the clemastine is not working well enough. She has one more 1/4 pill dose of temaril-p on Friday am and then if the biopsy does come back CC and her blood work is fine, we will just watch to make sure everything returns to normal. If not, then he recommends further testing to see if her adrenals have permanent damage. So my baby is at the vets and I go get her today at 3. :(

[Joan2517]

Awww...I hate leaving them at the vet's. The day drags until we get them back.

[molly muffin]

Ask about a Cytopoint injection for the allergies. It's a new drug and so far we've had one person I'm aware of it try and it had good luck. If the other one doesn't work that is.

[skinnybonedog]

My vet did mention Cytopoint but I have big concerns with the fact that it came to market after only a 7 month safety study on 36 lab beagles!

Morgan is home, her blood panel showed some levels slightly elevated consistent with cushings...her platet count was slightly elevated (have read that blood clots can occur with cushings) ALKP slight elevation as well as cholesterol. Her ALT though was normal and her Ca and phos were both normal which is good as I was worried about issues from the possible CC. Vet was more sure it is CC after seeing it again but biopsy will show that. I am not going to give her last dose of temaril p....so now we wait and watch, and if she continues to behave normally, to get another blood panel in a few month to verify the elevated level have gone down.

[skinnybonedog]

This is the article that got me thinking about whether Cytopoint is really a good idea....messing with an immune system that is already challenged seems like a big gamble....not one I will take right now while Morgan is healing from all this. I will have to weigh risks and benefits should I not be able to control her allergies without the temaril-p on board. There is a french bulldog blog I am following with a frenchie on Cytopoint now, three shots so far, no negative issues, but also not total resolution of allergy issues either. Clearly my girl is super sensitive generally if she is breaking out with CC having been on such a low low does of steroid (2mg or less per day....not per pound)

http://vitalanimal.com/cytopoint-answer-itch/

[skinnybonedog]

Got the call from my vet today. Calcinosis cutis with osteoma complications....ie: more dense than "standard" calcinosis and areas turning to bone...uggg. He is consulting with a dermatologist and will call if the derm has any suggestions. At least we have a dx for sure.

[Cindyandroxie]

Is the duoxo spot on helping with the itching? And is it the douxo seborrhea spot on you are using?

[Cindyandroxie]

Also what do you mean areas turning to bone? Can you elaborate? Thank you so much. I'm learning a lot on this thread

[skinnybonedog]

HI Cindy, Yes, it is the douxo seborrhea spot on....it does not seem to relieve the itch for very long unfortunately. And it is only supposed to be used 1x per week but I do use it after each bath which is 2x per week. The main thing I am using is a gel and spray I made myself and that seems to help the most. I will post the list of what is in it when I get home tonight. The areas that are osteoma are even more dense than standard clacinosis and he is saying those areas are actually so dense in composition to be considered bone. So I am not sure if they will ever resolve but to my eye, ALL of the lesions look to be shrinking but I could be seeing what I want to see....lol....as I want them to go away just like you do.

[Cindyandroxie]

Oh please please post what you are using. Your home made. I ordered the spot on. I am using dmso also. She also had a cytopoint injection which does work but not on her back and ear where the calcinosis is worst. Her feet are not pink anymore so regular allergies yes but not something this intense I don't think . I. Following this thread closely. It has been very helpful. I'm most curious about the hard shield. I'm pretty sure you are speaking of the same thing Roxie has. A solid plate that is hard and calcified. Not crusty:eek: I'm so glad I found this site and feel so bad for these pups with such a horrible disease. God bless all of you and thank you again for any help you can give

[skinnybonedog]

Hi Cindy,

This is what I make for Morgan. This came from a serum I make for my face....I just left out the ingredient that turns it more lotion-like. You can google the ingredients to see what they bring to the mix and see if it is something you want to make.


76% distilled water
4% niacinamide (powder)
4% n-acetyl glucosamine
4% aloe 200x
3% panthenol (powder)
3% sea kelp bioferment
2% chamomile extract (liquid)
1% allantoin
0.5% sodium lactate (powder)
0.5% liquid Germall Plus

[molly muffin]

I think you were asking about pictures and I am thinking that Buttercup probably had some of the worse cc and some that was calcified so much as to be bone like.

http://www.k9cushings.com/forum/album.php?albumid=786&pictureid=5980

This was from a few years back and she had a macro tumor, so not the same cause but the same result due to calcium deposits.

[Cindyandroxie]

Hi molly. Thank you for that link. Yes that is exactly like Roxie's. I can see the hard plate from the angle of one of the photos. Her back and neck is covered just as Roxie's.

Do you know if it finally resolved on its own or what was used to make it to go away? Or if it ever did?

I really need to know. Says day 59. I think we around 65 or 70. Any info is really helpful to me.

[Cindyandroxie]

I'm going to take a look at these ingredients. Does it really relieve the itch? I gave Roxie another bath tonight to get some skin and hair off of her. She is sleeping peacefully now so I feel a bit better as she is not scratching. The post surgery onzie I bought her helps also. Thank you so much

[skinnybonedog]

Cindy,

It helps and she loves when I put it on her, for me to rub her skin while rubbing in the spray or gel....i just put it on again and she is sitting on the floor not scratching. I would say it helps for about an hour or so. If I can not watch her I put her inflatable collar on and she sleeps in a shirt. Roxie has a much more wide spread area covered than Morgan does so she must go crazy with how badly this seems to itch. I sent you a private message.

Tammy

[Cindyandroxie]

The itchiness is the one in her ear. :(

[Cindyandroxie]

Sharlene. Do you know what buttercups made m used for the itch and if the hard calcium ever cleared up?

[molly muffin]

I'm going through Buttercups thread now looking to see what she tried. I know she did chamomile tea compresses and left them on for as long as possible.

I'm going to copy a few things that she used:




she saw derma , did skin test only found normal amounts of bacteria on hind end, other wise no major infections, she's back on a mild AB to help prevent any skin infection, upped her pain meds to better control the head aches and ease discomfort from the CC. 2 new topicals for the CC, trizchlor spray conditioner(smells nice) and mupirocin ointment for spots that crack open.


The spray is really helping with the her skin and odor , so I have not had to put her through the stress of getting a shower and having the CC break open in the process, which of course we all know is very stressful for our babies

Dawn, tried several things. One of the keys from what she posted was limiting baths, so as to keep the skin dry as possible. She used the spray quite a bit and told others it was very helpful. (you can order it on amazon.com)

The plaque did start to finally come off after a more than a few months. it was a very long battle with the cc

[skinnybonedog]

Morgan in her pj's....not scratching for a change.

http://www.k9cushings.com/forum/picture.php?albumid=1180&pictureid=8864

[judymaggie]

Morgan is just precious -- so sorry that you are both dealing with CC. I have been away from the forum for a bit but wanted to touch base.

[skinnybonedog]

Thanks Judy, she is a cutie....just feel so bad she is so miserable. The CC is starting to resolve. I have her on the Minocycline but of course no way to really know if that is having helping or it is just getting her off the steroids. Has anyone here ever tried Nutriscan saliva testing for food sensitivities? I see both good and not so good things about.

[skinnybonedog]

I just updated here CC photos in her album.

[skinnybonedog]

Vet called after speaking with a dermatologist. Recommended 99% DMSO gel for sure, said the non ossified lumps will go away in 4-6 weeks but the osteomas will remain permanently. Said she is still concerned that underlying cushings could be an issue despite being off the Temaril-p. So good and bad news. The worst thing right now is the terrible itchy-ness of the CC areas and now her rear right leg is having issues which could be arthritis that had been masked by the steroids or it could be she is chewing her feet or it could be her leg is sore from attempting to scratch herself.....I am just not sure. After she has been laying down she has trouble walking but if I give her her favorite ball she has no trouble "killing it" for hours. So I guess I will give it some time and then get her tested but I am unsure which is the best test to run.....advice. Would a urine cortisol test give enough of a view on what is going on? Or would she need the full ACTH testing done?

[Cindyandroxie]

Thank you so much sharlene. I've tried various duoxo sprays for Roxie. I love duoxo sprays but reall can't find any that really stop her itch. I will order a bottle of the trizchlor 4 spray. I'm assumiming it's not the hc? Duoxo mousse is what I put on her lesions. What a mess they are. Oozy and bloody.
The onzie is very help full and I have found since bandaids and gauze won't stick I put a femine pad and stick it to the inside of her onzie over her lesion so it wicks away the moisture and keeps them clean.

My baby will get surgery next week to remove a baseball size mast cell tumor from her inside thigh. It won't cure her as she is terminal but will make her more comfortable so she can play. This cc put a damper on a lot of things and I thank all of you for your help.

[labblab]

...Said she is still concerned that underlying cushings could be an issue despite being off the Temaril-p...So I guess I will give it some time and then get her tested but I am unsure which is the best test to run.....advice. Would a urine cortisol test give enough of a view on what is going on? Or would she need the full ACTH testing done?
I do understand why your vet entertains the possibility that Morgan may be naturally Cushinoid. A urinary creatinine:cortisol test will give you certain information, but not the whole picture. It can only tell you whether Morgan's natural cortisol production is excessively high, and even if so, factors other than Cushing's may be the cause. So an elevated reading on the UC:CR would force you to advance to a blood test -- either a LDDS or ACTH.

In Morgan's case, you're also feeling worried about long term effects of the supplemental prednisone: has it resulted in the reverse problem of oversuppression of the adrenals. The ACTH is the test of choice in terms of diagnosing either Addison's or Iatrogenic Cushing's.

If Morgan was otherwise behaving totally normally and the only thing I was interested in was ruling out elevated cortisol, then the UC:CR would seem to be a reasonable gateway step. But in your specific circumstances, rather than spending money on a UC:CR which can only give you certain info at best, I'd personally prefer to put that money towards the expense of an ACTH, which can provide info about all three questions.

Marianne

[skinnybonedog]

Marianne, thank you for your thoughts and details on which test would be best. If she were naturally Cushinoid not relating to the steroids, wouldn't she still be displaying symptoms? That is why I am confused that the derm vet told my vet she thinks this. The blood values that were elevated were only slightly out of range and easily could be from the steroids which was why my thought was to blood test her in another few months to see if they went back within range. Other than the CC all the symptoms that were pointing to Cushings have disappeared and she has been off the Temaril now for 2 weeks on Thursday so if she was going to have an Addison's crisis, wouldn't that have already happened and she would be acting sick, lethargic, not eating etc. Plus the CC itself is actually shrinking and less angry. None of the lesions ever break open and bleed, they are just slowly getting smaller in diameter and flatter, absorbing from within. I would think if she was still Cushinoid, the CC would still be raging and spreading. I give her her favorite ball alot to distract her from her itchy-ness and she will kill and attack that ball for hours, still loves her food and is her usual happy self except for the itching. Am I just in denial?

[labblab]

No, I don't think you're in denial and I'm sorry if the way I worded things are prompting new worries for you! I should have elaborated by saying that I can understand that a derm vet might puzzle over the fact that such a low dose of steroid seemed to create a bona fide case of CC. I also knew that you have worried, yourself, about the natural function of Morgan's adrenals. So in order to more definitively put all those worries to final rest, the ACTH would seemingly be the most precise test.

But none of this changes our earlier discussions, and I agree with you in thinking that the worst is now hopefully behind you guys. I think it is entirely reasonable right now to be optimistic!

Marianne

[skinnybonedog]

Marianne, thank you....no, it was just that you said you understood why the derm vet might think she has actual cushings and I was just wondering why you thought that. The whole thing has me so upset....that I caused this current set of issues. Yes, there could be underlying issues for sure...frenchies are certainly not the healthiest of breeds! I really do not want to use the Apoquel due to its action on the immune system....it seems so counterproductive and with an already overactive situation and the lack of long term studies, that it terrifies me of what else I could cause in her in a few years! But at the same time she is so miserable now that she is off the Temaril and I am not sure if that has more to do with the CC being so itchy or it is just all of her is now itchy.

[Cindyandroxie]

Tammy.
I had to put Roxie on apoquel for the itch it seemed to help during loading dose but when it was backed down her itching got worse again. I too was worried about the immune system. Now we are on cytopoint and off the apoquel but I have it as a back up for when the shot wears off if I need it. We have had no adverse reactions from it. And no side effects near as bad as prednisone either.
The duoxo orange seems to be helping us. And the onzie I have her wearing to protect her skin from scratching it open and keeping it cleaner. I uploaded current pics of her lesions that have popped up.
She is not near as itchy today so I'm hoping we are at another stage. We also used 70% dmso and 30% aloe gel which seemed to help the inflammation of the cc

[molly muffin]

Hi, glad to hear that the itch is a bit better, but I think itching flares up as the cc flares.
I don't know which spray was used by Buttercup. I'd think without hydro cortisone in it, but I don't know for sure.

Her cc doesn't look nearly as red and angry as it use to look, so I'm hopefully that you are on your way. :)

[skinnybonedog]

Quick question on the DMSO....got it yesterday and it is 99% which is what the vet told me to use. I am not seeing any irritation, redness from that percentage and she is less itchy after I put it on. What I am unsure of is how often I should or can use it on her CC areas? Is it a once a day kinda situation or can I do it morning and night?

[skinnybonedog]

HI, posting a new thread because I wanted this specific question addressed. For those using DMSO, how often are you using it? I just got the gel yesterday and used it once last night, and then again this morning and it really seems to lessen the itch of her calcinosis lesions but the effect seems to wear off 5 or so hours later. I have read online references stating that it can be used 3-4 times per day on dogs and horses or every 6 hours. I have not seen any reaction to her skin from it other than the CC lesions are really going down but they had already started resolving. This is the 99.995% gel form and I apply it with a Q-tip. My vet's consult with the dermatology vet resulted in me being told to use this strength.

[Squirt's Mom]

MODERATOR NOTE: I have merged your post concerning the amount of DMSO to use into Morgan's original thread. We like to keep ALL inf about each pup in one thread. That way it is easier to look back thru the history if needed and it prevents posts/replies that may contain pertinent info from getting lost in the shuffle. ;) Thanks!

[labblab]

Sorry nobody's gotten back with you about the DMSO, but in honesty, not many folks here have had experience with using it. If I were you, I'd abide by whatever recommendations have been given by the derm vet because he/she will be the most familiar with any relevant research results.

How are you guys doing this weekend?
Marianne

[skinnybonedog]

Marianne, that was why I wanted to post a new thread about the dmso ? because some people using it might now be following Morgan's thread to see the question. I was out of town the past two days but while I was gone, Morgan's other mom talked to the vet abd we are going to pick up the Apoquel today to give it a try. I really do not want to do it but not sure what else I can do.

[labblab]

I understand your concern, so I've edited your original thread title in a manner that I hope will be helpful. We've now got Morgan's name in there, as well as CC and the request for help with DMSO. So hopefully this will cover all the bases now. I think this will be a better approach than starting a new thread, because as Leslie says, all the info about Morgan will remain consolidated in one spot. ;)

[molly muffin]

I think the dermatology vet should know the best strength and how often to use it since that is their specialty. so I'd go with that and see how it works.

[skinnybonedog]

We did not actually see the derm vet. My vet consulted with a derm vet. My vet is so so busy it is hard to get him on the phone so we really did not get a dosing schedual. I can call and leave a message for him on Mon. But now Morgan's has gone off food...no more steroids and her appetite is less frantic and she is more discerning and knows that mom has put all kinds of pills in her food. She bit open her adrenal supplement which must taste nasty....now she does not want her food. She will eat cheese or other things not her usually raw food so it is not that she is inappetant she just KNOWS her food is poisoned and even if I do not put a single pill in, she is like, "nope, could be poisoned" so will be cooking her some chicken tomorrow...sigh. Had her 1st dose of apoquel this afternoon....already less itchy....

[Cindyandroxie]

About the dmso. Our vet told us 70% dmso and 30% aloe and use it once a day and not on all of her areas at once. Roxie cc is all over her body and the dmso isn't just used for inflammation but is used to help the body reabsorb the calcium. If used on large areas at once it's too much for her body to process.
We are post pining the ap right now. Roxie just had her surgery and will start it back up in several days. We we were also prescribed doxicyline as it will help to chelate the calcium

[skinnybonedog]

So has anyone had to resort to appetite stimulents to get your dog to eat? I am at a loss at this turn with her not wanting to eating. If the lack of eating and the rear leg issue is a potential sign she actually does have cushings then how is it possible that the calcinosis cutis is so much better? Those two things can not be possible. Her CC would continue to be bad and should be getting worse. I am stumped.

[labblab]

Loss of appetite is not typical of Cushing's -- in fact, it's the reverse: low cortisol is more commonly associated with inappetance. Is Morgan still taking an oral antibiotic (or other oral medications or NSAIDS for that matter)? If so, that could be the culprit by upsetting her stomach.

Also, if she's having leg pain, that may be the result of arthritic issues being "unmasked" after discontinuing the supplemental prednisone (again, the issue being less circulating steroid as opposed to a cortisol level that is too high). Mobility issues for untreated Cushpups are more typically associated with hind-end muscle wasting rather than frank pain.

So if she's taking an antibiotic just as a prophylactic, I might first try stopping that to see if it helps. If not and if she develops greater lethargy or mobility issues, I might move up the timing for an ACTH stimulation test in order to make sure that adequate natural cortisol production has resumed. In summary, from what you're describing, if she continues to worsen I'd be more concerned about a cortisol level that is too low rather than too high.

Marianne

[skinnybonedog]

Thanks Marianna,

So if this were a low cortisol issue, wouldn't she be really lethargic, less playful and more depressed or sickly. From what I have read with Addison's situations it is very clear there is an issue. She played with her ball for hours yesterday. The rear leg issue very well could be arthritis that had been masked as it is worse when she first gets up from laying down or in the morning but once she gets moving she appears to feel better. The leg issue had not shown up yet when she physically saw the vet but it is not atrophy, her bulldog legs are as beefy as ever. She is still on minocycline just to help resolve the CC, not for any active infection and since she has been on it for over 10 days, I will take her off of it to see if removing it has an impact of her appetite. She wants to eat and is hungry, I can tell but is now just so suspicious because of all the pills she was getting...mostly immune supplements, adrenal support, things that taste bad. Now all I am trying to get into her is the mino, the apoquel and pepcid.

[labblab]

I actually doubt that Morgan's cortisol is too low, either, especially hearing this additional info. I was mainly wanting to reassure you that the problems you are noting are not typical of high cortisol which seemed to be your worry. Overall, it sounds as though things are moving forward for you girls, and that's a good thing!

[skinnybonedog]

Ok, thanks....I was able to see last night that her ankle appears swollen on the leg she is having the most issues with so that explains that. The eating or lack of really seems to be the pills in the food issue. This is so hard as this is a dog that would have tried to eat a bowl of rocks she was so ravenous from the temaril.

[Cindyandroxie]

Tammy. Are you seeing any improvement of Morgan's cc using the mylocycline? My vet prescribed doxycycline to us. I haven't started it yet as I have noticed a lot of calcium coming to the surface. What are your thoughts as to what's working?

[skinnybonedog]

Cindy,

I took her off of everything as she stopped eating anything but chicken so getting pills into has been really difficult. Was not sure if maybe the mino was upsetting her stomach. Oddly though, seems almost everyone whose dog has CC has had the calcium break through the skin....Morgan's CC has never done that. Her nodules are just slowly shrinking over time, never breaking open.

Tammy

[Cindyandroxie]

Biopsies are done with a local. Usually a small punch biopsy. Roxie needed 2 stitches. Les than a 10 minute visit. They send to lab for analysis results come back in a couple of days.
Hope this helps tammie. Roxie has had several do to mast cell tumors.

[Cindyandroxie]

Oh and as far as nodials breaking through the skin. Roxie has had several pop up but most of hers has not.

[skinnybonedog]

Morgan's appetite had come back and she was eating really well for the past few days but not knowing whether it was the minocycline or the dmso causing her to not want to eat, I added back the dmso, one application yesterday, she still ate fine....another application this morning, now tonight she is not eating again and has horrible diarrhea so now I know the dmso is the problem....so no more of that. Uggggg.

[molly muffin]

At least you figured out what was causing the problem. Is she back to eating again since discontinuing the DSMO?

[skinnybonedog]

Yes, she has her appetite back again. Weird the DMSO caused such a reaction....also caused horrible diarrhea. I thought maybe both were being caused by the Apoquel but once there is no DMSO in her system both those issues resolve so it has to be the DMSO which is a bummer because it was helping to shrink the CC. Was not even a large amount as her CC patches are only less than 2" x 2" on each side.

[molly muffin]

Does it make a difference what strength of DMSO is used?

[skinnybonedog]

I only have the 99.? % pure and have not tried diluting it since she had such a reaction to it. I get so stressed when she goes off her food so I think for now I will just let things be for awhile. She goes off the loading dose of Apoquel this weekend so I am worried the itching it going to start up again and then I am not sure what we will do.

I did try the DMSO on my roommates sprained ankle last night and my plantar fasciitis today.....helped us both with inflamation and pain so at least it won't go to waste.

[Cindyandroxie]

Tammie. I have an unopened container of 70%dmso and 30%aloe gel. If you want me to send it let me know. Roxie passed away this morning from a mast cell tumor. I want to thank if all you for your ideas about the calcinosis cutis. I beleave the dmso helped with the inflammation the apoquel and cytopoint helped with itching. Ultimately it was time and diet. Bless you and your pups and thank you again

[skinnybonedog]

Oh Cindy, no words can express how sad I know you are feeling. i am so so sorry.....

[molly muffin]

I was very sorry to hear of Roxie passing. :(

Well that is interesting that the DMSO is working for You. LOL That's good it isn't a waste at least. :)