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ForumsGerman Shepherd Dog > Anal furunculosis/perianal fistulae......treatment n cost. (29 replies)
Anal furunculosis/perianal fistulae......treatment n cost. by noddi on 21 December 2011 - 19:46 |
| Anal furunculosis/perianal fistulae..... treatment/cost.i have today had my bitch of 9 years old diagnosed with a mild case of anal furunculosis.I live in the uk.My vet at the peoples dispensary for animals(PDSA...charity)has advised the use of cyclosoprin at a dose of 150gm.once daily to start with or(as the pdsa will not supply cyclosporine)the alternative is prednisolone at 70mg daily.I,m wondering if gsd peeps who have experienced this disease or are now experiencing it mind answering some questions.Thank u......1)which route would u take....cyclorsporine,prednisolone,or homeopathic methods......2)Dosage.....is this too low to start with......3)wot do u recommend for keeping the anus area clean n dry.....4)would u combine some natural treatments such as aloe gel drink,cream for external use....5)would u change diet.....i feed raw,obvious the raw bones would have to go but vet has recommended a prescription diet(Hills science diet,)......5)less important but would u continue to show her in veteran classes.......6)the most important one COST.......i have sourced 2 online vet prices her in uk....Canine chemists quoted £85.10 for 15 tablets @100gm n 15 @50gm.vet medics was £92.40.Just wondered if anyone here in the uk knows of anywhere i could purchase cyclorsporine cheaper.Thank you.Carole Spelman. |
by Wildmoor on 21 December 2011 - 20:07 |
I take it the bitch is 30kg going of the recommended dose of Atopica - a way to reduce cost is to add in Ketoconazole then you only need 1 to 2 mg per kg of Atopica instead of 5mg per kg, as the anti-fungal drug slows down the degradation of ciclosporin another immunosuppresive is Tacrolimus cream (Protopic) not sure of cost but if this is the first time she has had lessions and they are not deep it may be an alternative Keep her weight low, you could use malaseb spray on cotton wool for cleaning, again not sure if available in UK - options to discuss with the treating vet |
by DAWSY on 21 December 2011 - 22:01 |
Hi there, a friend of mine has had a similar problem with costs of medication for her dog which has quite a severe problem with furunculosis. She has taken the medication to a local pharmacist who is in the process of identifying the composition of the tablets with a view to the possibility of providing a cheaper alternative! ( My friend hasn't disclosed to the pharmacist the price she is currently paying the vet!) It might be worth considering this as an option. I will ask my friend to let me know how she gets on and keep you updated, |
by JakodaCD OA on 22 December 2011 - 00:24 |
| I have had two gsd's with fistula's, both were the result of anal gland infection/issues, so not "true" fistula's in my opinion. I did go the cyclo (atopica) route with my second one and it worked for him. To answer a couple of your questions with what I did. 1. cyclo 2. my male weighed 80lbs I started with 300 mgs per day, (split into two doses), for one month, second month I went to 200 mgs per day, by the end of the second month the fistulas were closed, third month dropped to 100 mgs per day, and for a maintenance month went to 50 mgs daily. 3. I kept the area shaved, daily keeping it clean and as dry as possible..I also used Desitin (with zinc),,I believe some in UK use I think it's called sudacream(sp)? I did not change diet as mine was not the result of other issues, (many pf dogs have other issues, allergies, ibd, sibo etc) I would encourage you to chek out the PF website and join their email group, alot of great advice http://perianal-fistulas.tripod.com/MainIndex.html |
by Spooks on 22 December 2011 - 10:49 |
| Pet Drugs Online appear to be cheaper for buying Atopica - 15 x 100mg for £39.78, a prescription is needed for them though. Hope it all goes well for you |
Spooks by Super Para on 22 December 2011 - 12:37 |
| Hi Carole, Some years ago I had a dog from a well known UK Breeder who developed this nasty disease at about 4 yrs old. Thankfully I had insurance and this covered the cost for Cyclo for the full period (cant remember how long) approx 1-2 months. It was a horrible time we were dreading the what was thought the worst!! Thankfully he made a full recovery and lived a normal healthy life up to 13yrs. The vet believed that because we caught it early it was treatable and hence did not have to have long term medication. I had never seen this horrible disease before but knew of it and I believe if you are giving the necessary care and husbandry and paying attention to your animals everyone should catch it early. What would we have done if I had not got the insurance? I would have paid no questions asked. If the dog had been old then that would have been a different matter. I do believe the disease is no longer a killer now we have cyclo (thank goodness). Good luck, hope the animal does well. |
by noddi on 22 December 2011 - 13:13 |
| thank yu very much,to all who have provided information ,i,m extremely grateful.I have decided that Chiki will be having the cyclo.even if i have to register with a private vet instead of the PDSA.I would prefer to stay with the PDSA,not because of only making a small donation for my dogs treatment which most do but not me.Everytime i,ve had to attend there i have waited to see how much my girls treatment has cost n then i mostly pay £50(donation)even if treatment was less.Lily (Chiki,s mum)had an open pyometra in feb.2010,cost approx.£305,which i paid over a period of time.One receptionist calls me a star,so i would hope they,d allow me the prescriptions(paid for of course)to obtain the cyclo.from an internet vet.pharmacy,thus allowing me to attend PDSA for follow ups n my contributions for her treatments.My only worry will be if she has to have surgery but i,ve a feeling the PDSA wont offer that either???.Chiki is fine in herself,looks very well,alert but looks a bit peed off with me as i keep examing her bum.Whathave u kind ppl.used to soothe the affected area n to keep it dry?Can i use baby wipes with aloe for cleansing affected area n wot do i use to keep it dry?The vet said it was a mild case but DID NOT DO AN INTERNAL EXAM,as i asked her ...how she knew it was AF.n she said she not examined internally as she didnt want to hurt her n that obviously i knew a lot about my breed n was observant enuf.to catch it in the early stages.I,m pondering whether i should get a 2nd opinion as a friend in another breed asked why antibotics werent being tried first or the anal glands removed if antibotics dont worked??Carole.S. |
by LilyDexter on 23 December 2011 - 01:25 |
| Hi Carole, So sorry to hear about Chiki, she was such a good gorl when I took her in for you at Maidstone, looked the picture of health. My Willow has this, and also my old Dexter's brother had it as well as a few other GSD's I know. Firstly I would not put her on the Prednisalone, GSD's do not do well on steroids in general & I would never give them to any of mine after what happened to Dexter & what i know about other dosg who have been on them. Apart from a few exemptions it's like signing a death warrant for your GSD. Cyclosporin is good & will work in that it holds it at bay. Willow started with puss around her bottm & small holes seeping this brown grainy fluid. The vet did an internal & diagnosed an abcess in her anus, but the minute I saw it I knew it was AF. She had strong antibiotics for a few weeks but then had to go to have the removed. The vet called after the op & said he could only remove one gland as her inside was in sucha bad condition, tracks going down as deep as he could find with this grainy fluis seeping through everything, he stictched her back up & told us in his op it was an aggressive tumour. The tests came back showing AF & deep seated infection. This was 18 mths ago. She was sput on 3 Antirobe antibiotics once a day for several months, and slowly weaned off them so that she now is on them for a week & off for 3 wks, but it has been a slow process. She was also put on 150mg of Atopica daily (she weighs 35kg)she was on this for a few mths & then reduced to everyo other day, then every 2 days, then 2 pw, then 1 pw. Sadly at this point it all flared up & so she started back up on the daily course. We droppped them back again slowly & got to one every three days before it started up again. She was put back on the full dose, then dropped abck again. But by the time she got to one dose every 3 days it flared up again. Unfortunately this seems to be the pattern for most dogs I know with it. I have found that if she gets too hot this can make it worse, so I try to keep the bedroom (where she sleeps of course) as cool as we can bear & also try to stop her getting to hot in the warmer weather or when the heating is on. So watch where she is sleeping.Also a change in routine or being stressed doesn't help with this. As for keeping the area clean, some vets prescribe hibiscrub bit I think this is too strong. I cleaned Willow's bum every evening when at it's worse, just with water or salt water on soft cotton wool & dried it off. Dermisol cream from Vetuk might help if there are sores & shaving foam (sensitive one) will break down any poo if it is crusty there. Usually dogs GSD get it from about 18 mths to 4 yrs so she seems late for onset. I think it is a sign of a compromised immune system, so if she has never suffered with anything along those lines, could there be a more serious health problem underlying? I doubt it though. I pay about £45 a pack for my Atopica (cyclsporin) at Newnham Court in Maidstone. Hopefully you will be able to keep it pretty much at bay as I have with Willow & i'm sure she will still get to a ripe old age if you can afford the meds, but they have finacially exhausted us even though we are insured because of the interest on the bills & all the excess fees Good luck with this Carol & hugs for poor Chiki |
by bazza on 23 December 2011 - 10:27 |
| Hi carole, hope you and Mr are well. So sorry to hear about Chiki, can't give you any advise but hope everything works out well for her. Have a Merry Christmas and a great New Year. |
by Doppelganger on 25 December 2011 - 20:05 |
| Hope you get it sorted Carole - I know how much she means to you. |
by hexe on 26 December 2011 - 08:09 |
| noddi, I've got a study from the Journal of the American Veterinary Medical Society on the subject of treatment success using the tacrolimus ointment, which in the States at least is less expensive than the cyclosporine. If you'll click on my user name and contact me @ the email address shown there, I'll be happy to send you a copy of it as a PDF for you and your vet to review. At 9 years of age, there is a good chance you may be able to successfully manage the condition so it does not have an adverse effect on her longevity--diet plays an important role in the disorder, also, so you'll want to carefully consider how you're presently feeding, and what sort of changes you can make to her diet to minimize the overstimulation of her autoimmune response. Additionally, breeders should be made aware that there is a now DNA test that can be done to identify whether a dog is clear of the allele associated with this disorder, is a carrier of the allele (has one copy of it), or is at risk for developing the condition (dog has two copies of the allele), similar to the way the DNA test does for degenerative myelopathy (CDRM to the folks in the UK). Like the DM test, the perianal fistula testing is done from a cheek swab, but as far as I've been able to find out, it is still only available through a lab in Finland--though OFA does now recognize the results for a charge of $15.00. (Source: http://germanshepherdhome.net/forum/ubbthreads.php/topics/1588/Perianal_Fistulas ) Here's the link to the lab's website, with info on what the test is looking for, what the results mean, and how to order a test kit: http://www.genoscoper.com/in_english2/gene_tests/gene_tests/anal-furunculosis-and-csk-dla-ri/ I believe that some GSD breeders in the UK have already started testing their stock using this test. According to this newsletter from June 2008, research was being done in the UK to try and develop a test to identify perianal fistula carriers and affected animals, so it might be worthwhile for you to contact the university mentioned and see if they've made any progress toward that, too: http://www.akcchf.org/news-events/library/articles/germanshepherdupdate0608.pdf As of last spring, at least one of the UK researchers was still actively involved in the study: http://www.rvc.ac.uk/Staff/bcatchpole.cfm Aaaannnnd--it turns out that the Finns also have a DNA test to determine whether a dog is carrying the genetic coding for *pannus* (Canine chronic superficial keratitis), too! THAT is something breeders ALSO need to become aware of, and start testing for as well--all three of these diseases for which DNA testing has recently become available have one primary factor in common: affected dogs generally don't show ANY clinical signs of the disease until they're already matured and well into the ages where they've likely already been bred and not only have offspring on the ground, but that offspring is ALSO reproducing...and passing the genetics along to sustain these diseases in our breed. I've always been willing to overlook pannus to a certain extent, since it typically doesn't show up until the dog is 6-7 years of age, and there's also the environmental factor that had to be factored in, but if there's now a way to identify which dogs are carriers and which are likely to become affected via a simple cheek swab *well before a dog reaches the age for consideration as breeding stock*, there's really no adequate justification for NOT doing the test, and for breeding dogs which are found to be at risk of developing the condition. By testing early for this condition, breeders could identify which pups should absolutely NOT be sold to homes located in areas where the environmental factors would only serve to exacerbate the condition, which would save those dogs a great deal of unnecessary discomfort later in their lives. |
by noddi on 26 December 2011 - 12:58 |
| thank u Hexe for your post.I beieve that yes,some breeders here are doing the allae test to determine whether their breeding stock carry/have the allaes.I know both the ladies here in the uk(one more personally than the other)who are working with the researchers into the genetic health diseases of the GSD.In fact one of them has asked on my behalf the advice of one of these researchers re my bitch.Both are not fully convinced it is AF,seeing as she has never suffered from any auto immune defect before and the late onset(ie at 9 yrs)Vet diagnosed from external exam,no internal as she considered it would cause her more distress as she was sore there.She didnt consider treating with prednisolone plus antibiotics to get inflammation down so an internal could be done,say in a wks time,as another experienced gsd person,s vet has done recently.This experienced breeder/show person has been in breed more yrs than me and she suspected AF but it was the anal glands,which the vet expressed n the infection cleared up with meds.I DO SUSPECT SHE HAS AF n a friend who,s bitch has it ,has had a look n confirms that it does look like she hasS |
by noddi on 26 December 2011 - 13:03 |
| continued ....AF.Advice from researcher is NO MORE BONES.....give veg and all bran daily.Road excercise for 15 mins.plus free running.Use sudacrem inside and out,giving child,s dose of vit c and zinc tablets for 2 wks.Carole S. |
by LilyDexter on 26 December 2011 - 14:03 |
So pleased that there is a DNA test for this. One of the main reasons I wouldn't get another GSD is because this illness seems so prevalent in GSD's at the moment & also because of the pain & distress it causes the dogs & the huge expense for the owner. My insurance has nearly run out & Willow's vet bills for it are around £200 per month just to hold it back, not to cure it. |
by hexe on 26 December 2011 - 14:28 |
| Carole, if your girl's problem IS AF, in addition to increasing the dog's fiber intake (hence the veg & all bran), the studies here in the States have shown it to be beneficial to change the dog's diet as far as the protein and carbohydrate sources, since the condition does have an autoimmune basis... Between her age and gender, your girl's situation is definitely not the normal presentation, BUT--it is also not unheard of for allergic responses to develop to things that formerly were well tolerated. This can especially be true in instances where a dog experiences a bout of a gastroenteritis that causes damage to the lining of the gastrointestinal tract, leaving the dog at risk of becoming sensitized to it's usual food as nutrients from the feed are introduced into the bloodstream before the digestive process has adequately broken them down to allow the cells to utilize them. Typically, dogs that are diagnosed with AF here are fed either a prescription diet that is processed by microhydrolization, (which reduces the proteins to the smallest possible level) or they are switched to a commercially available product that uses a protein source and a carbohydrate source that is novel to that particular dog (i.e., venison, fish, rabbit, duck or another protein source not typically used in dog foods, and a carb source not usually used such as oatmeal, potato, barley, millet, quinoa, etc.). Right now, if you're not confident with the diagnosis (of sorts) that you've gotten so far, it's most definitely time for a second opinion. An impacted anal sac can rupture externally and create one or more tracts that can mimic early stage AF, and I've had this occur as a consequence of a dog refusing to empty her bowels for 48 hours (she wanted to be at least 30 feet from anyone when she went, and we were traveling in an area where that simply wasn't possible for two days). We sedated her enough to be able to express the contents of both sacs and flush them out with a cleansing solution, packed them with an antibiotic ointment, and she was put on a round of antibiotics by mouth, a course of prednisone, and cleansing the area after each bowel movement, followed by application of antibiotic ointment using a hemorrhoid-cream nozzle. I also switched her to the microhydrolized diet, which also has increased fiber, and within three weeks or so she was fully healed and back to normal. |
by noddi on 26 December 2011 - 17:09 |
| hiya Hexe,hope yu are having a good xmas.Chiki has been fed raw(prey)for the past few years,approx.5/6 yrs.She has been getting various types of mince plus organ meat in the mornings and raw meaty bones of an evening.In addition i use probiotic yoghurt,eggs,cottage cheese.Treats are tripe sticks or fish4dogs treats as mine wont eat fish.Veg only added occasionally if i,d cooked too much for me and hubby.Dont use any type of biscuits.The mince is varied,beef/beef n heart/beef n liver/tripe/tripe n beef/tripe n chicken/tripe n oily fish/rabbit/venison/turkey/chicken./minced meats(mixture of meats)She wont eat the raw duck mince.i,ve only been feeding this mince for approx.3 mths.n wasnt aware that it contained 10%ground bone,so think i,ve more than likely over done the bone content by quite a way as both my girls were a little constipated.All RMB.have been dispensed with and both girls are going regulary(once a day as per normal)Stools are now softer as before they were on the hardish side bit not solid.Chiki is only objecting if i clean it with either hibiscrub/salt water,if its just warm clean water she,s ok and doesnt whine.The position of wot is being classed as the 2 fistulae is near to the top and very nearly in line on either side.In fact the area which is sore looking is just around the anus opening and its like there,s a small pinky red bubble just there(my sister,a state registered nurse wonders if she has piles?)She has never sufferred from any gastro infections n very rarely the yellow biley stuff one gets when they eat grass,which she regulary does,tho i try to stop her.Its not the normal short grass but long wide strands out in the overgrown fields.Carole. |
by Doppelganger on 26 December 2011 - 21:12 |
| Could it be a rectal polyp? I'd certainly get a second opinion before going ahead with treatment. |
by hexe on 27 December 2011 - 05:24 |
| Carole, dogs can and do get piles (hemorrhoids/polyps)...second opinion time, methinks. |
by noddi on 27 December 2011 - 10:12 |
I wish to thank everyone on here who has forwarded very helpful advice,especially Hexe.Thank u all very much.Will book Chiki in to be examined by a private vet tomoz.n cross my fingers that the PDSA vets diagnosis was incorrect.Thank yu all very much.Will keep yu all informed.Carole. |
by noddi on 28 December 2011 - 16:16 |
| Afternoon all.A quick update o Chiki,s condition.Have been to a private vet today n Chiki had impacted anal glands which have now been expressed.A Synulox n a rimadyl injection n rimadyl n synolux tabs.for next 10 days n a follow up at the vets in 2wks time for a quick internal n squeeze if needed.Thanks everyone for your input.Carole. |
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