English springer AIHA Bone Marrow Aspiration – Page 10

Keymaster

Sara,
Actually, dogs with a predisposition to autoimmune atophy tend to express this early in their lives, around 2 or so. Chance did this. It was a sign that something else loomed in the future, his autoimmune bone marrow failure.

Chance’s allergies came on with a vengeance and we were just completely flummoxed. We did not have a clue in 2000 why this could be happening to a young puppy. We certainly wasted a lot of time dancing around the issue, a bit in denial. I tried so many over-the-counter things, but none of them worked. The vet suggested we see a veterinary dermatologist and we were very hesitant about that. It would be an expensive visit.

Finally, when our lives became upside down because of his allergies, we did relent and see the vet dermatologist specialist. There were two sets of tests, a blood test and a scratch test. The blood test is imperfect and she warned us it would not be very specific nor improve treatment. The scratch test was very specific and it showed a whole panel of things he was allergic to. From this, they eventually developed his own personal serum that became his allergy shots.

She also wanted us to do a elimination diet, but I was savvy enough, like you, to realize that he was only bothered during the spring and the fall, and much less the rest of the year. I did remove chicken from his diet because he had always refused to eat it anyway and I think he was allergic to it. I had fed him a raw diet, per the breeder, right from the start. For the bulk of his life after this he got raw meaty lamb bones or pork shoulders, no chicken.

So the dermatologist told us that the best treatment would be allergy shots. (This was long before Atopica came to market.) Boy were we reluctant about that! In the end, I knew I had to do it for him, his life was miserable. So this was wildly expensive and the schedule and dosing was very complicated and specific. She also told us it would take a year, possibly longer, for the shots to become effective. Until then we had to use other measures to control his symptoms.

She gave me a long list of approved antihistamines with their canine doses and insisted we use Malaseb shampoo. She also prescribed Temaril-P (Trimeprazine 5mg, Prednisolone 2mg) for us to use during the worst times. So for maybe 2-3 weeks in the spring and fall I would dose him with this to allow his skin to heal and to give him relief from the agony. This medication was a life saver. I still highly recommend it to owners whose dog’s allergies return after being in treatment for AIHA but have discontinued the prednisone, since the dose of prednisone is quite small.

He began to respond to the allergy shots the following year and from then on, he was virtually free of allergic symptoms other than a little eye gooping during the worst pollen season. We also continued the malaseb shampoo throughout his life which really improved his skin and coat. This shampoo fights bacteria but it also fights yeast. Dogs that work themselves raw significantly increase the growth of yeast on the skin and this burns terribly, making it a vicious cycle of destruction. So part of treatment had to include stopping the dog from licking and also treating the yeast with Malaseb about every 10 days which works great.

All this manipulation of his immune system was not a good idea, but that wasn’t understood as well back then. This specialist told me that dogs with serious allergies were sometimes even put down because their lives were so miserable. Seriously. So for us, shots were a choice we made for his comfort, not for his longevity.

Atopica came on the market around 2007. This was the year that he developed autoimmune bone marrow failure. A specialist was clueless about how to treat him and only prescribed prednisone. Over several months his health diminished on very high doses of prednisone. It was only when we contacted Dr. Dodds did she insist he be put on cyclosporine. I struggled trying to find any of this human medication locally. It wasn’t available. My vets were working with Dr. Dodds and offered “we have Atopica on the shelf, will that work?” She replied that this was a perfect solution. So this was probably the first time a dog being treated by Dr. Dodds used Atopica, packaged for canine atophy! The capsules were so easy to dose and I could get them right at the vets’ office.

You are correct, cyclosporine (Atopica) is prescribed now for dogs with atopic allergies, it was researched and tested for marketing for canine atophy, not for autoimmune diseases, but is now used, off label, for many different conditions other than allergies! It has saved many dog’s lives that would have been put down in 2000 for intractable allergies. Dosing is important with this drug. There is a ramp up period where the drug is dosed at a higher dose to “load” the system and then the vet will experiment with a lower maintenance dose to see what works well for the specific dog. The idea is to control the atophy at the lowest maintenance dose possible.

I also noticed with Chance taking high dose Atopica that he did develop what are called hyperplastic skin lesions. They looked pretty horrible but he never itched his skin or had any irritation from these growths. Many dogs do get these and similar skin conditions.

The action by which cyclosporine works (a fungus) is to disrupt the growth of rapidly growing cells, in this case the T-cell lymphocytes that are responsible for autoimmune attacks like allergies or AIHA. This disruption of fast growing cells is also directed at skin cells (epithelial) and thus you can see this abnormal growth not only on the skin but also on the gums and sometimes the pads of the paws. The skin’s genetic blueprint for making cells becomes altered and “skin” looks very different than what was planned.

“Hyperplastic skin lesions occasionally develop during treatment with cyclosporine A. Most of the lesions resemble those of psoriasiform lichenoid dermatosis, although papillomavirus can be detected in some instances.”

But here’s some specific and important information I found about Springer Spaniels and a hereditary condition Psoriasiform-lichenoid dermatosis.

“Psoriasiform-lichenoid dermatosis is a rare skin disease of Springer Spaniels characterized by symmetrical papules, plaques and nodules.
(see picture here: )
http://www.vetbook.org/wiki/dog/images/a/ab/Psoriasiform01.jpg

The marked breed predilection suggests heritability. The aetiology is not known but this disease may represent an atypical Staphylococcus pseudintermedius infection.

The condition is primarily observed in young dogs with lesions on the pinnae, ventral truncal region and genitals.

Over time, the lesions progress to hyperkeratotic lesions with adherent crust and keratinaceous debris. Follicular casts may be observed.

Chronic cases resemble severe seborrhea with malodor a definite part of the history and Staphylococcal pyoderma may be seen as a secondary factor.

Resolution may be achieved with prolonged courses of cephalexins such as Cefovecin. The use of cyclosporin, which is used for lichenoid keratoses in other breeds is usually unrewarding.”

So this resembles what you are describing and matches your breed. I think this is worthy of mentioning to your vet and perhaps a visit with a dermatologist specialist is called for. I think attempting to treat a condition like this with acupuncture is an unfortunate redirection away from medicine and proper clinical diagnosis.

Since this condition is considered relatively benign , and if they are causing no discomfort, then antibiotic treatment is optional. That is your choice after discussing it with your vet. There could still be some degree of atophy. The shampoos used about every 10 days may be enough to keep the itching under control.
my best
patrice

Details