Labrador with terrible skin problem
 

I would like an opinion if anybody can help.......
We have been to see countless vets and a dermatology specialist -immune
mediated vasculitis, but prednisolone therapy is not working.
A link to photos :((

http://picasaweb.google.co.uk/gvrossi/VitoSkin

Labrador with terrible skin problem
 

In article ,
"Dushichka" wrote:

immune
mediated vasculitis

Google found this. Are your vets trying any other drugs?

Vasculitis is treated by withdrawal of offending drugs (if implicated in
the cause) or by immunosuppressive drug therapy. Glucocorticoids used
alone or in combination with other agents such as azathioprine or
cyclophosphamide are usually used to treat non-drug-induced cases. (See
also periarteritis nodosa, below.)

--
Janet Boss
www.bestfriendsdogobedience.com

Labrador with terrible skin problem
 

"Janet Boss" wrote in message
...
In article ,
"Dushichka" wrote:

immune
mediated vasculitis

Google found this. Are your vets trying any other drugs?


Janet -thanks. This has been an ongoing problem for a good year now. Vet
initially suspected demodex, but nothing made any difference. The problem is
also exacerbated by the fact he had torn cruciate ligaments in BOTH legs
which were operated on twice, one leg has not been successful and he is
still in pain. The pred he has been taking on and off has delayed
healing....if we come off the pred his skin flakes and falls off in
chunks -metacam hurts his stomach and doesn't really help. We have another
appointment at the University Vet College in two weeks but I want to go
armed with as much info as I can, they have not been terribly helpful so
far. My darling dog is in pain both from his leg and his skin, I am at my
wits end.

Labrador with terrible skin problem
 

In article ,
"Dushichka" wrote:

My darling dog is in pain both from his leg and his skin, I am at my
wits end.

I'm really sorry for you - it looks like a miserable condition. I hope
you find answers.

--
Janet Boss
www.bestfriendsdogobedience.com

Have you tried a homeopathic/holistic veterinarian? I would highly recommend getting a second opinion from one. You can do an online search for one near you at American Holistic Veterinary Medical Association AHVMA - American Holistic Veterinary Medical Association, Academy of Veterinary Homeopathy The Academy of Veterinary Homeopathy.

Also, I have a number of articles from the World Small Animal Veterinary Association on ischemic dermatopathy that I could e-mail you if you contact me privately at , perhaps they will help.

Ischemic Dermatopathy / Cutaneous vasculitis

A little known and often misdiagnosed reaction to the rabies vaccine in dogs, this problem may develop near or over the vaccine administration site and around the vaccine material that was injected, or as a more widespread reaction. Symptoms include ulcers, scabs, darkening of the skin, lumps at the vaccine site, and scarring with loss of hair. In addition to the vaccination site, lesions most often develop on the ear flaps (pinnae), on the elbows and hocks, in the center of the footpads and on the face. Scarring may be permanent. Dogs do not usually seem ill, but may develop fever. Symptoms may show up within weeks of vaccination, or may take months to develop noticeably.

Dogs with active lesion development and / or widespread disease may be treated with pentoxyfylline, a drug that is useful in small vessel vasculitis, or tacrolimus, an ointment that will help suppress the inflammation in the affected areas.

Owners and veterinarians of dogs who have developed this type of reaction should review the vaccination protocol critically and try to reduce future vaccinations to the extent medically and legally possible. At the very least, vaccines from the same manufacturer should be avoided. It is also recommended that the location in which future vaccinations are administered should be changed to the rear leg, as far down on the leg as possible and should be given in the muscle rather than under the skin.

Vaccination of dogs - Wikipedia, the free encyclopedia
--------------------------------------------------------------------------------

A retrospective study of canine and feline cutaneous vasculitis
Patrick R. Nichols**Animal Allergy and Dermatology Center of Central Texas, 4434 Frontier Trail, Austin, Texas 78745, USA
Daniel O. Morris††Department of Clinical Studies, Veterinary Hospital, University of Pennsylvania, 3850 Spruce St., Philadelphia, Pennsylvania 19104, USA and
Karin M. Beale‡‡Gulf Coast Veterinary Dermatology and Allergy, 1111 West Loop South, Suite 120, Houston, Texas 77027, USA
*Animal Allergy and Dermatology Center of Central Texas, 4434 Frontier Trail, Austin, Texas 78745, USA †Department of Clinical Studies, Veterinary Hospital, University of Pennsylvania, 3850 Spruce St., Philadelphia, Pennsylvania 19104, USA ‡Gulf Coast Veterinary Dermatology and Allergy, 1111 West Loop South, Suite 120, Houston, Texas 77027, USA
Correspondence: Daniel O. Morris, Department of Clinical Studies, Veterinary Hospital, University of Pennsylvania, 3850 Spruce St., Philadelphia, PA 19104, USA.
Abstract

Twenty-one cases of cutaneous vasculitis in small animals (dogs and cats) were reviewed, and cases were divided by clinical signs into five groups. An attempt was made to correlate clinical types of vasculitis with histological inflammatory patterns, response to therapeutic drugs and prognosis. Greater than 50% of the cases were idiopathic, whereas five were induced by rabies vaccine, two were associated with hypersensitivity to beef, one was associated with lymphosarcoma and two were associated with the administration of oral drugs (ivermectin and itraconazole). Only the cases of rabies vaccine-induced vasculitis in dogs had a consistent histological inflammatory pattern (mononuclear/nonleukocytoclastic) and were responsive to combination therapy with prednisone and pentoxifylline, or to prednisone alone. Most cases with neutrophilic or neutrophilic/eosinophilic inflammatory patterns histologically did not respond to pentoxifylline, but responded to sulfone/sulfonamide drugs, prednisone, or a combination of the two.

Blackwell Synergy - Vet Dermatol, Volume 12 Issue 5 Page 255-264, October 2001 (Article Abstract)
--------------------------------------------------------------------------------
Vitale, Gross, Magro (1999)
Vaccine-induced ischemic dermatopathy in the dog
Veterinary Dermatology 10 (2), 131–142.
doi:10.1046/j.1365-3164.1999.00131.x

Prev Article Next Article
Full Article
Vaccine-induced ischemic dermatopathy in the dog
Vitale,
Gross &
Magro
1Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California 95616, USA, 2IDDEX Veterinary Services, California Dermatopathology Service, 2825 KOVR Drive, West Sacramento, California 95605, USA, 3Department of Pathology, Beth Israel Hospital, Harvard Medical School, Pathology Services, Inc., 640 Memorial Drive, Cambridge, Massuchusetts 02139, USA
Correspondence to: Carlo B. Vitale
Present address: Encina Veterinary Hospital, 2803 Ygnacio Valley Road, Walnut Creek, California 94598, USA.
Abstract
Post-rabies vaccination alopecia associated with concurrent multifocal ischemic dermatopathy was identified in three unrelated dogs. All dogs received subcutaneous rabies vaccine dorsally between the scapulae several months prior to observation of the initial area of alopecia at the vaccination site. All three dogs developed multifocal cutaneous disease within 1–5 months after the appearance of the initial skin lesion. Cutaneous lesions were characterized clinically by variable alopecia, crusting, hyperpigmentation, erosions, and ulcers on the pinnal margins, periocular areas, skin overlying boney prominences, tip of the tail, and paw pads. Lingual erosions and ulcers were observed in two dogs. Histopathologic examination of the skin revealed moderate to severe follicular atrophy, hyalinization of collagen, vasculopathy, and cell-poor interface dermatitis and mural folliculitis. Hypovascularity was demonstrated by diminished Factor VIII staining of blood vessels. Nodular accumulations of lymphocytes, plasma cells, and histiocytes in the deep dermis and panniculus also were noted at the rabies vaccination site. An atrophic, ischemic myopathy paralleling the onset of skin disease was identified in two dogs. Histological examination of muscle biopsy specimens demonstrated perifascicular atrophy, perimysial fibrosis, and complement (C) 5b-9 (membrane attack complex) deposition in the microvasculature of both dogs with myopathy. Marked improvement of the skin disease was obtained with oral pentoxifylline and vitamin E.

Blackwell Synergy - Vet Dermatol, Volume 10 Issue 2 Page 131-142, June 1999 (Article Abstract)

--------------------------------------------------------------------------------
The Armed Forces Institute of Pathology
Department of Veterinary Pathology
WEDNESDAY SLIDE CONFERENCE
2002-2003

CONFERENCE 19
26 February 2003

Conference Moderator:
Dr. Michael Goldschmidt, MSc, BVMS, MRCVS Diplomate, ACVP
Professor, School of Veterinary Medicine
University of Pennsylvania
Philadelphia, PA 19104-6051

CASE II - 2513-02 (AFIP 2839301)

Signalment: 5-year-old, male, castrated, canine, Chihuahua
History: One by three cm lesion on the dorso-lateral neck
Gross Pathology: None
03WSC19 - 2 -
Laboratory Results: None

Contributor’s Morphologic Diagnosis: Post-rabies vaccination alopecia with injection site granuloma and panniculitis

Contributor’s Comment: The hair follicles are markedly atretic and their lower portions are replaced by an eosinophilic, hyaline stroma. The deeper dermis also has a cleft or seroma pocket that is partially lined by a thin layer of foamy macrophages and multinucleated giant cells with more peripheral lymphoid nodules with many scattered dermal macrophages, lymphocytes and plasma cells. Scattered melanin-laden macrophages (positive with Fontana-Masson melanin stain and negative for hemosiderin with a Prussian blue stain) are in the hyalinized lengths of the hair follicles with a few beneath the epidermal basement membrane (pigmentary incontinence).

This is post-rabies vaccination alopecia with an underlying injection site granuloma. Post-rabies vaccination alopecia is most commonly seen in toy or small breeds, especially Poodles, but Chihuahua cases have been reported. The lesion usually develops three to six months after vaccination.

Other reports describe mild to severe lymphocytic inflammation with macrophages in the superficial or deep dermis or scattered around hair follicle remnants. The dermis may have smudging of the collagen, especially around the hair follicles. Rabies vaccine antigen has been found in the hair follicle epithelium and in the walls of vessels in the area. One report of focal alopecia developing in all twelve of twelve inbred miniature Poodles injected with a killed rabies vaccine two months earlier suggest that there may be a familial predisposition to this apparently idiosyncratic, hypersensitivity reaction to the antigen.

WSC

(MORE ON NEXT POST)

(continued from above)


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Article entitled, ISCHEMIC SKIN DISEASE IN THE DOG by Dr. Peter J. Ihrke, VMD, DACVD
Professor of Dermatology, Chief, Dermatology Service, VMTH, Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California, Davis, CA, USA presented at the World Small Animal Veterinary Association 2006 Congress (article accessible at http://www.vin.com/proceedings/Proce...765&O=Generic).

The following are quotes from Dr. Ihrke's presentation:

3. Localized post-rabies vaccination panniculitis (Post-Rabies): A localized ischemic skin disease associated with a rabies vaccination site and temporal link with the vaccination.

4. Generalized vaccine-induced ischemic dermatopathy (GVIID): A generalized ischemic skin disease with a temporal linkage with rabies vaccination, but with more severe generalized post-rabies vaccination-associated disease.

2. Post-rabies vaccination associated disease is presumed to be due to an idiosyncratic immunologic reaction to rabies antigen that partially targets vessels. Rabies viral antigen can be documented in the walls of dermal blood vessels and in the epithelium of hair follicles via immunofluorescent testing. Since this syndrome is seen predominantly in very small dogs, it is tempting to speculate that the disease may be partially linked to increased antigenic load in comparison to the body size of the dog, since the same volume of rabies vaccine is given to all dogs subcutaneously.

Initial lesions--an alopecic macule or plaque develops at the site of prior subcutaneous rabies vaccine deposition. The time between vaccination and noting of the lesion usually is between one and three months.
__________________________________________________ ________________________
Cutaneous Vasculitis and Vasculopathy - WSAVA 2004 Congress

Cutaneous Vasculitis and Vasculopathy
Verena K. Affolter
School of Veterinary Medicine, University of California, Davis
Davis, CA, USA

" Immune-mediated vasculitis is typically triggered by an adverse drug reaction (antibiotics, nonsteroidal anti-inflammatory medications, vaccines,...."

"Vaccine-induced vasculitis is mainly seen in small breed dogs...."

"Acute vasculitis--Legs and feet, ears, lips, tip of the tail, scrotum, and oral mucosa are mostly affected. These areas are more vulnerable as their blood supply has limited collateral circulation. With cutaneous vasculitis erythema, ecchymoses, areas of necrosis, and well-demarcated, "punched out" ulcers, and occasionally hemorrhagic bullae and/or pustules are seen. Erythema caused by vasculitis does not blanche with diascopy because of extravasation of the red blood cells. Subcutaneous vasculitis presents as nodular lesions. Systemic vasculitis causes variable clinical signs depending on the organ systems involved: phasic pyrexia, lethargy, anorexia, myalgia, arthralgia, lymphadenopathy and nasal discharge are seen. Wide spread systemic vasculitis may progress into shock and disseminated intravascular coagulation.
Chronic vasculitis--Less severe or slowly progressive vasculitis results in low-grade ischemia. Clinically these cases become evident at a chronic stage. Patchy alopecia, scaling, erythema and hyperpigmentation are seen. Lesions typically involve the pinnae, face, feet and tip of the tail often occurring over pressure points."

__________________________________________________ __________________________________________________ ________________
Combination Vaccines, Multiple Shots--on Page 16 of the 2003 AAHA Guidelines under Immunological Factors Determining Vaccine Safety, it states that: "Although increasing the number of components in a vaccine may be more convenient for the practitioner or owner, the likelihood for adverse effects may increase. Also, interference can occur among the components. Care must be taken not to administer a product containing too many vaccines simultaneously if adverse events are to be avoided and optimal immune responses are sought. "
--------------------------------------------------------------------------------

Duration of Immunity to Canine Vaccines: What We Know and Don't Know, Dr. Ronald Schultz Duration of Immunity

What Everyone Needs to Know about Canine Vaccines, Dr. Ronald Schultz What Everyone Needs to Know About Canine Vaccines

World Small Animal Veterinary Association 2007 Vaccine Guidelines - WSAVA - Scientific Advisory Committee Scroll down to Vaccine Guidelines 2007 (PDF)

The 2003 American Animal Hospital Association's Canine Vaccine Guidelines are accessible online at Special Report .

The 2006 American Animal Hospital Association's Canine Vaccine Guidelines are downloadable in PDF format at About AAHA .

Veterinarian, Dr. Robert Rogers,has an excellent presentation on veterinary vaccines at Home

October 1, 2002 DVM Newsletter article entitled, AVMA, AAHA to Release Vaccine Positions, AVMA, AAHA to release vaccine positions - - DVM

July 1, 2003 DVM Newsletter article entitled, What Do We Tell Our Clients?, Developing thorough plan to educate staff on changing vaccine protocols essential for maintaining solid relationships with clients and ensuring quality care 'What do we tell our clients?' - Developing thorough plan to educate staff on changing vaccine protocols essential for maintaining solid relationships with clients and ensuring quality care - DVM

July 1, 2003, DVM Newsletter article, Developing Common Sense Strategies for Fiscal Responsibility: Using an interactive template to plan service protocol changes Developing common sense strategies for fiscal responsibility - Using an interactive template to plan service protocol changes - DVM

Animal Wellness Magazine Article Vol. 8 Issue 6, How Often Does he REALLY Need A Rabies Shot Animal Wellness Magazine - devoted to natural health in animals

The Rabies Challenge Animal Wise Radio Interview
Listen to Animal Wise (scroll down to The Rabies Challenge 12/9/07)

The Vaccine Challenge Animal Talk Naturally Online Radio Show » The Vaccine Challenge - Show #91

US Declared Canine-Rabies Free -- CDC Announces at Inaugural World Rabies Day Symposium CDC Press Release - September 7, 2007

Rabies Prevention -- United States, 1991 Recommendations of the Immunization Practices Advisory Committee (ACIP), Center for Disease Control's Morbidity and Mortality Weekly March 22, 1991 / 40(RR03);1-19 Rabies Prevention -- United States, 1991 Recommendations of the Immunization Practices Advisory Committee (ACIP) "A fully vaccinated dog or cat is unlikely to become infected with rabies, although rare cases have been reported (48). In a nationwide study of rabies among dogs and cats in 1988, only one dog and two cats that were vaccinated contracted rabies (49). All three of these animals had received only single doses of vaccine; no documented vaccine failures occurred among dogs or cats that had received two vaccinations. "

Labrador with terrible skin problem
 

On May 5, 8:56 am, "Dushichka" wrote:
"Janet Boss" wrote in message

...

In article ,
"Dushichka" wrote:

immune
mediated vasculitis

Google found this. Are your vets trying any other drugs?

Janet -thanks. This has been an ongoing problem for a good year now. Vet
initially suspected demodex, but nothing made any difference. The problem is
also exacerbated by the fact he had torn cruciate ligaments in BOTH legs
which were operated on twice, one leg has not been successful and he is
still in pain. The pred he has been taking on and off has delayed
healing....if we come off the pred his skin flakes and falls off in
chunks -metacam hurts his stomach and doesn't really help. We have another
appointment at the University Vet College in two weeks but I want to go
armed with as much info as I can, they have not been terribly helpful so
far. My darling dog is in pain both from his leg and his skin, I am at my
wits end.




Somewhat hard to tell from the photo just what is going on, but it
appears the skin is thin layered, but without large amounts of
granulation tissue.

If immune mediated is the diagnosis, then the specific type of immune
mediated may need to be determined. For example, looking at other
issues within the immune system, not just inflammatory cells. Looking
at other immune diseases such as lupus, or metabolic conditions such
as thyroid levels, or immune stimulation from surgical sutures or
adhesives, or ruling out other diseases that influence the immune
system such as Addisons, or Cushings disease.

Topical influences like licking at the wound, rubbing the wound on
carpets or bedding, or another pet licking the wound.

Additional drugs like cyclosporine, or levamisole, that influence the
immune systems' responses.

Labrador with terrible skin problem
 

"bruce" wrote in message
...
Somewhat hard to tell from the photo just what is going on, but it
appears the skin is thin layered, but without large amounts of
granulation tissue.

If immune mediated is the diagnosis, then the specific type of immune
mediated may need to be determined. For example, looking at other
issues within the immune system, not just inflammatory cells. Looking
at other immune diseases such as lupus, or metabolic conditions such
as thyroid levels, or immune stimulation from surgical sutures or
adhesives, or ruling out other diseases that influence the immune
system such as Addisons, or Cushings disease.





My dog has been suffering symptoms for over 18 months and it has only just
been picked up now.

The Vet from Uni Vet hospital has just rung me to give me a definite
diagnosis for Vitos skin and joint problems. Leishmaniosis. This from sample
of fluid from around the knee joints. My poor dog has been suffering for two
years and this is the diagnosis. I have to take him back first thing in the
morning for more tests and skin biopsies. I have not been told of a
treatment plan, if anyone has any links to info I would be very grateful. I
am googleing like mad -anybody have any experience of this?

Labrador with terrible skin problem - UPDATE- Leishmaniosis
 

My dog has been suffering symptoms for over 18 months and it has only just
been picked up now.

The Vet from Uni Vet hospital has just rung me to give me a definite
diagnosis for Vitos skin and joint problems. Leishmaniosis. This from
sample
of fluid from around the knee joints. My poor dog has been suffering for two
years and this is the diagnosis. I have to take him back first thing in the
morning for more tests and skin biopsies. I have not been told of a
treatment plan, if anyone has any links to info I would be very grateful. I
am googleing like mad -anybody have any experience of this?

Labrador with terrible skin problem - UPDATE- Leishmaniosis
 

To say I am devastated is the understatement of the millennium. We were at
the UVHosp last July and we saw the specialist dermatologist who diagnosed
immune mediated vasculitis - treatment plan was a long course of antibiotics
and prednisolone. The pred has been on and off since.When we saw the
dermatologist it was 4 months after a cruciate repair on both legs. They
were not healing properly. The op had to be repeated, again on both legs.
This was also unsuccessful,apparently due to the high dose of pred he was
taking daily.

I am LIVID that the derm, knowing my dogs history and all the clinical
signs, did not consider the possibility of Leishmaniasis and did not test
for it. I understand that his symptoms are many, but after doing my own
research, quite frankly there is nothing else it could possibly have been.

Fast forward to two months ago -poor dogs knees creak very loudly, he is in
pain, can hardly walk still on pred so I can't give him metacam, one leg is
constantly held up, just a bloody nightmare. I had to wait for an
appointment for the Uni and went last Monday where I saw the ortho vet -he
took x-rays and the knees are totally shot -bone on bone. Massive swelling
around the joints. He aspirated some of the fluid and said he was testing
for infection with a view to *flushing * the joints, said it would ease his
pain a little. I was given Atopica and Tramadol for pain.

The following night he called me and gave me the diagnosis. Back up there
the next day for more x-rays, skin biopsies, fluid from the rest of his
joints need to be tested. He said that he had never come across a case of it
before.It is the cause of each and every one of his problems. Poly
arthritis, skin lesions, muscle wasting at the temples, nosebleeds,
everything.

I am honestly in total shock -I can hardly BELIEVE that this poor dog has
been suffering for nearly TWO YEARS and it was all due to a bite from a sand
fly. Even worse, that it was not picked up on by anyone until now. I spoke
to the vet again today and I now have to wait as it is the first documented
case of it here in Ireland(only one other, but post mortem -it was
therefore untreated) and they have to obtain a special license in order to
import the drugs he needs. I am so anxious it is unbearable.

The treatment plan is daily injections of a drug called Glucantime for 40
days(which more than likely I will have to administer) with combined
Allopurinol tablets, probably for life . This will improve his clinical
symptoms but the poly arthritis is obviously irreversible and his knees are
screwed

I know it is HIGHLY unlikely, but does anyone have any experience of this??
I only know that it is endemic in only certain parts of the U.S and I cannot
find anyone else to talk to about it