Caring for a Three Legged Dog or Cat
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Thanks, Pam. Appreciate the info!
Micki
~ ~ Rio ~ ~ |
Hello, Sorry about the delay in my input. As far as I am aware there are very few causes of calcinosis cutis other than too much steroid. If the steroid is coming from his adrenal glands (Cushing's) or from prednisone its all the same. The best thing to do is to make sure there is not a secondary skin infection associated with the area as the calcium deposits can set them up for one. As far as the condition, you should speak with your oncologist and find out if it would be possible to stop the prednisone. That by itself may be enough to stop the progression. Ideally however if he has Cushing's the best thing to do is to treat it. Trilostain, which is a treatment for Cushing's Disease should not add any major risk to his cancer therapy, as it simply blocks the production of the hormone. I have treated a number of animals with chemotherapy who were concurrently on trilostain and have had no problems. Obviously, no medication has no risk but in a situation like this I would say the benefits would by far overshadow any risks. If he is a candidate or not for Triolostain is something entirely different. You should ask you oncologist or consider a consultation with an internal medicine specialist for the specifics.
As far as the DMSO. It is supposed to work by mobilizing the calcium in the skin. The biggest risk as I understand is mobilizing too much calcium at once and causing his blood calcium to go too high. I am not certain if this has ever happened or its just a risk. I asked our dermatologist if she has ever tried to use it to treat calcinosis cutis but she hasnt and neither have I. I hope this helps some.
Sincerely,
Johnny D. Chretin, DVM, DACVIM
VCA West Los Angeles Animal Hospital
Thank you Dr. Chretin!
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Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Thanks for the info on trilostain. My regular vet mentioned it as well when we went in for Rio's CBC this week. We decided not to use the DMSO and we switched out amoxicillin for cephalexin to head off any skin infections. We go back to the oncologist next week. There's an internal med specialist at the same office. I'm going to try and speak with her firsthand rather than just the oncologist, as I'm concerned about the long term issues with letting the cushings/calcinosis go untreated.
~ ~ Rio ~ ~ |
Dr Beth Herman is the Internist at Summit and she is very nice. I am sure she can give you lots of info on treating with trilostane versus mitotane. Trilostane is given once or twice daily and is now available in the USA as Vetoryl (we used to have to get it from Canada). It is not without side effects and still has to be monitored like mitotane (Lysodren).
Pam
Everything I'm reading says that the number of side effects with the Trilostane are much less severe and less common with it versus Lysodren. Finally, some good news.
Thanks everyone for the info and I'll keep you posted on what comes from our vet visit on Wednesday.
~ ~ Rio ~ ~ |
Just wanted to let everypawdy know that Rio has posted an update in her blog.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Hi, just wondering how Rio is doing now, ive noticed its been a while since the last blog post. My dog 'Jimmy' has cushings disease and has been kept under control perfectly by our vets in North Wales UK. He has Vetoryl every day and one day we noticed he had a bit of blood on his head. That wound opened up really big and we took him back to our vets and we just had the skin results back now and has this calcinosis cutis same as Rio. It is spreading all around his groin area and all the way down his back, Just wondering if Rio has improved at all? as I am very worried about Jimmy.
Stu said:
Hi, just wondering how Rio is doing now...
Welcome Stu! Check out Rio's blog for her latest updates, looks like she just posted yesterday. Consider registering so your posts publish without moderation and to take full advantage of these forums.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Thanks for asking! Rio is doing so much better since they put her on the Trilostane (US version of Vetoryl). Her hair has grown back, for the most part, except for where the worst of the calcinosis is. Even though her ACTH stimulation numbers are where the internist wants them, the calcinosis doesn't appear to be going away or even getting smaller yet, after 3 months of Trilostane. They told us, without the DMSO treatment, it would probably take a while (6 months or more) for it to go away.
Here in the US, the only real treatment for calcinosis is the DMSO, and we chose not to do it. It basically causes the calcium deposits to break up and release into the blood stream where they are eliminated through the liver. If you do it too quickly or over-treat with the DMSO, it can cause a whole 'nother set of problems: hypercalcemia, being the worst, but also kidney and bladder stones, etc. With everything else that Rio's been challenged with, I decided that we'd just let this one resolve on its own.
Stu, what I would be concerned about is the appearance of the calcinosis AFTER being on the medication. It makes me wonder that maybe the dosage isn't quite right. Depending on how long it's been since Jimmy's last ACTH stimulation test, you might want to consider having that done again, just to be certain that the numbers are where they are supposed to be.
While having the calcinosis is definitely not ideal, as it can get infected relatively easily and its not very aesthetic, I definitely consider it to be more of a nuisance than anything else. As long as Jimmy's blood numbers are where they are supposed to be, I wouldn't worry too much.
Good luck with your Jimmy-boy!
Rio's mom and Rio
~ ~ Rio ~ ~ |
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