Saturday, July 16, 2011

Definition repeat from older post:

Uveodermatological Syndrome:

Uveodermatological Syndrome (UDS) is an immune-mediated canine disease characterized by inflammation of the eye, depigmentation of skin and whitening of hair. Morbidity is related primarily to the eye inflammation, which can result in secondary ophthalmological disorders that lead to blindness. Treatment involves both topical and systemic immunosuppression. It is believed that UDS results from a genetic flaw, and as yet there is no cure.

Uveodermatological Syndrome is similar to the human Vogt-Koyanagi-Haradi Syndrome (VKH), was first described in 1977. Human VKH is characterized by uveitis (inflammation of the eye), poliosis (whitening of hair), vitiligo (depigmentation of skin) and a variety of neurological symptoms. Unlike VKH, however, UDS does not usually present with neurological symptoms. Because of the similarity of the two entities, UDS is sometimes referred to as VKH-like Syndrome or simply VKH. Although generally considered to be more common in Northern breeds, such as Akitas, Siberians and Samoyeds, there have been reports of the disease in a wide range of breeds, including the Australian Shepherd, Dachshund, Brazilian Fila dog.

Clinical Relevance: Some breeds in which uveodermatologic syndrome has been reported (eg, Siberian Huskies, Old English Sheepdogs, Australian Shepherds, and Shetland Sheepdogs) often have heterochromia irides. This case highlights the fact that dogs with asymmetric uveal pigmentation may have unilateral ocular changes; therefore, uveodermatologic syndrome should not be excluded as a differential diagnosis on the basis of unilateral clinical signs.

Here are links to good documentations of dogs with the disease:

Friday, July 8, 2011

July 6, 2011 CORKY TURNS 8!!!

Corky remains stable and happy and we have been enjoying a long remission of the disease... however the symptoms do try to sneak up at times and then I will increase the dosage of pred a bit following a gradual tapering until we are back to the EOD (every other day) routine. I watch for symptoms mainly of pigment recession around the eyerims, nose, and mouth and also for any squinting. When the black pigment starts to fade to pink, usually at the eye corners, I increase the dosage to 20mg prednisone for one day then decrease it to 15mg for the next two or three along with all the other meds until we get back to the EOD schedule.
Last eye exams were good and improved since we switched from regular prednisolone acetate drops to pred mild drops every other day. He only has to see the opthamologist every 4 months now. Cork's recent full body lab results showed normal ranges in all organs except now the liver is showing some steroids. This did not surprise the doctor but he had expected to see this kind of result many months ago as Corky has been under steroid therapy for 19 months. The doctor was simply amazed. I wondered if Cork's success can be credited to the long term use of the Veterinary Immune Tabs that have Transfer Factors and medicinal mushroom extracts. At any rate his thyroid is doing fine and overall Corky looks fantastic! His coat is thick and healthy, the black pigment around his face looks great, his musculature is great, paw pads have greatly improved, and even the limp is gone. As for the liver, we have added "SAMe" s-adenosyl 225mg/ milk thistle to his routine in order to protect the liver.
Here is Corky's current meds: Azathioprine 50mg once daily, niacinamide 500mg & doxycycline 100mg & SAMe 225mg & thyroxine .4mg twice daily. Prednisone 10mg or 12.5mg once every other day. Prednisolone mild acetate 12% eyedrops in both eyes once every other day. Genteal mild eyedrops twice daily. Veterinary Immune Tabs professional strength 2 tabs 4 times weekly. Taste of the Wild salmon/sweet potato kibble and spoonfuls of Naturals fish/sweet potato canned and/or fresh salmon, carrots, apple, treats. Also, to support his thyroid he gets 1 tsp organic kelp powder daily. Most important ingredient of all: unconditional endless LOVE!
During Corky's rehab for his front leg limp he swam many laps in the pool. The limp lasted about 6 months. Finally I restricted his daily walks to absolute minimum with no running but increased his swimming sessions. One day he suddenly stopped limping and hasn't limped since. Here he is going for a swim... fetching the ball in the long lap pool:


Wednesday, February 9, 2011

February 9, 2011 CORKY IS A SUCCESS CASE!

It has been well over a year since Corky's official diagnosis of UVD and today he is looking and feeling great. His hair has mostly all grown back and it feels healthy and soft as it had drastically thinned back in September when his thyroid level dropped too low due to medication side effects. The pigment around his eyes, nose, and lips have stayed normal black for almost four months now.

We must be reminded of how serious and extreme Corky's symptoms were back in December 2009 (scroll down to earlier posts) and the long rollercoaster ride it took to finally get the disease into a sustained remission. Looking back we have endured two minor flareups and one major flareup in July 2010 which took a dreaded extended course of high dosage prednisone to bring the disease back under control. In addition to the numerous side effects from this episode, including hairloss and lowered thyroid, Corky had to undergo a major dental surgery in early October due to a deceptive cracked tooth which led to an abscessed carnasial molar that had be removed. This of course triggered his autoimmune UVD syndrome symptoms but after the surgery it calmed down and, to our great relief, has stayed in remmission ever since. His recent lab results came back healthy normal aside from his T-4 which seems to be oscillating between 1.7 and .5 so we have increased the thyroxine to .4mg twice daily. In addition to the thyroxine he is on a maintenance of prednisone every other day at 10mg alternated with 15mg EOD with a day of no pred inbetween. Niacinamide 500mg and Doxycycline 100mg twice daily. Azathioprine 50mg once daily. Prednisolone Acetate eyedrops twice daily. Other supplements include organic kelp powder and Veterinary Immune Tabs (professional strength) two tabs daily four times weekly. Taste of the Wild salmon/sweet potato grain free kibble and canned wet food for med adminstrating.

The good news is that Corky is happy and enjoying life as we are thoroughly enjoying him. Although his drama will always continue... he had developed a slight limp in his left front leg a couple months ago which he is still struggling with. The vet thinks he might have injured a shoulder ligament and since we are very cautious about using anesthesia for diagnosis we are not doing xrays at this time. Instead we have restricted his activities and giving it time to heal, expecting the healing to be slowed because of the pred usage. In fact, it may have been the pred that weakened his muscles making him more prone to injuries. It is a fine line any way you see it. Now since he is banned from chasing balls and frisbees which help with muscle tone, he is confined to walking only. He has gained a couple pounds putting more weight on the injured leg even though I've cut down on his calories. Then just when I think we're making a little progress he manages to gobble up a WHOLE LOAF of banana bread behind my back... aaaagggghhhh... so you get the picture...

One more new issue we are dealing with... he now has a ulcer in his left eye. Stopped pred acetate in that eye and are administrating two new serums and antibiotics... to be continued...

Meantime, a few recent photos of our beautiful Corkster:

a good looking eye:

a good looking nose:

Corky and Lulu... best buddies: