Sunday, August 1, 2010

SUMMARY August 1, 2010


Below are photos showing a brief course of events since the onset back in 2009. Corky relapsed in March while on a low maintenance dosage of prednisone 5mg every other day alternated with azathioprine along with niacinamide and prednisolone eyedrops twice daily. We continued the Veterinary Immue Tabs daily.

As the disease became more aggressive we gradually increased the pred but as the disease continued to be aggressive we had to get aggressive with the medication. During the whole month of June he was given up to 60mg pred for 18 days then gradually tappered to 30mg daily until his eye exams improved. He had seen the opthomologist three times that month. By July the pigment continued to return and the pred was reduced to 20mg daily. By mid July we were able to skip a day and go every other day at 20mg. We are now down to 20mg of pred EOD alternated with 10mg EOD. All other medications remain the same: azathioprine 50mg daily, niacinamide and doxycycline twice daily, prednisolone acetate 1% eyedrops twice daily, tropicamide eyedrops three times weekly. Vetinerinary Immune Tabs daily.

Corky's complete blood analysis came back with good results showing very normal organ levels except the thyroid read .4 (normal is between 1 - 4). The vet said this is typical of an animal on high medication. However, Corky does not have any clinical signs of hypo-thyroid symptoms so we will not treat it at this time. Instead we are gradually lowering the prednisone and will recheck the thyroid in 6 weeks. Meantime, Corky is full of energy and enjoying life.

As for the side effects of prednisone at high doses for the extended period Corky had the typical excessive thirst and urination, ravenous appetite, and hyper energy. He developed moist dermatitus and a rash on his belly which we treated with hydrocortisone cream and a cone around his neck to prevent him from licking. He had to wear the cone for weeks even after the rash cleared up. His paws became so dry and cracked sometimes he limped. I applied a natural organic foot balm to his paw pads and wrapped them in socks at night. During the day on our hikes he wore boots and socks made by Ruff Wear, the best on the market. He could run and chase balls without the boots coming off and he actually seemed to like wearing them. Now he doesn't need to wear them anymore. It took continuous effort to soften his paws and at the same time exercise him enough in order to keep his muscles toned since the pred weakens muscles. In the long run we did notice muscle loss with a slight swayback. It would've been much worse if he didn't get adequate exercise but he hikes every day with us, chases balls and frisbees and swims in the lap pool.

The cracks at his nostrils bled occasionally during the drug therapy but once blood poured from his left nostril on a hot day. Luckily it didn't last long and didn't happen again. Because the pred thinned his skin he bleeds more easily. One day on our morning hike he rubbed himself hard against a nasty thorn bush which left deep scratches on top his head and along his back. Although these scratches bled more than normal we didn't notice them until the next day after they scabbed. The scabs dried up, he kept rolling on his back to relieve the itch, the scabs came off along with the hairs. To our horror, he ended up a patchwork of big bald spots all over his body. At this time I cannot bring myself to post the photos but when the hairs all grow back I'll show before and afters. To our relief the hairs are growing back nicely though we expected a very slow process due to the pred. Perhaps the Vet Immune Tabs made the difference. Corky now has a whole wardrobe of hats and cooling coats he must wear everyday when outside. Luckily he is a good sport and wears anything I put on him.

All in all we are on an uphill of the rollercoaster. The disease seems to be back in remission. Slowly we are decreasing the pred but will not go as low as before the second episode. Meantime, Corky is having a good life full of fun and lots of love.

Eyes summary

August 1, 2010:



June 28, 2010:


May 31, 2010:


March 20, 2010:



February 9, 2010:


January 19, 2010:


December 8, 2009:










Nosebridge summary

August 1, 2010:



June 28, 2010:


May 31, 2010:


February 9, 2010:


January 19, 2010:


December 8, 2009:








Thursday, July 29, 2010

Lips & nostrils summary

August 1, 2010: smoother with cobblestone texture. Full pigmentation.



June 28, 2010: loss of cobblestone texture, cracks around nostrils that often bled.

May 31, 2010:



February 9, 2010:


January 19, 2010:


December 8, 2009:






August 1, 2010: Complete return of pigmentation. Continued lowering of prednisone dosage. Every other day pred 20mg / skip a day / pred 10mg / skip / pred 20mg/ skip / pred 10 mg... Next step will be pred 15mg EOD then gradually 10mg EOD. All other meds and eyedrops remain the same.



June 28, 2010: After intense period of aggressive medication to put the disease back into remission. See earlier posts for medication routine.


May 31, 2010: at the start of the aggressive medication approach as the disease became more aggressive:




March 20, 2010: Relapse mid March. Increased pred from 5mg to 10mg for several weeks at no avail.



February 9, 2010: Continued improvement and stabilization with low doses of prednisone 5mg every other day alternated with azathioprine. Con't with niacinamide and Veterinary Immune Tabs daily. See earliest posts for complete medication program.


January 19, 2010: After several weeks of initial treatment and maintenance of 5mg pred every other day alternated with azathioprine. See earliest posts for complete med program.

December 8, 2009: Just biopsied and diagnosed as UVD. On the surface the disease attacks the margins at mucous membranes where pigment meets hairline; the lips, nose bridge, eyerims, paws, anus. Internally it also attacks the eye retina and nostrils and other mucous membranes. Here, prior correct treatment, Corky lost all black pigment on his lips:

Tuesday, July 6, 2010

JULY 6TH, 2010 HAPPY BIRTHDAY CORKY!

Today he turned 7! Isn't he gorgeous! Today is a good day!

Luckily you can't see the bald spots except for the one on his front leg. More on the pred side effects later. For now we are celebrating his happy day. Today he is full of life and loves his new birthday ball. Simple things...


Monday, July 5, 2010

July 5, 2010

Here is a quick update for now... photos before we started the intense therapy course and after. Scroll down to earlier posts for details of medication adjustments and more photos. We have tappered the prednisone down from 60mg for 18 days then 40mg 10 days, 30mg 10 days, and are now down to 20mg per day. All other meds remained the same. We are aiming to get him on an every other day maintenence schedule again. I will update after the next eye exam in a few days and also comment on the side effects of the high dosages. He is still full of energy and still has a great attitude. He is just the best sport ever. I hate to see him as the poster dog for this disease but if this blog could help someone else, here it is. We are thrilled to be able to celebrate his 7th birthday tomorrow. Today he had a fun hike along his favorite trail up Mt Lemmon with the family and tomorrow he'll get to party more... Every day is precious. Did I say how much I love him?...

More later, for now here's a comparison of the pigment changes since May 23:

July 5, 2010:

May 23, 2010:

July 5, 2010:

May 23, 2010:


July 5, 2010:
May 23, 2010:
July 5, 2010: Notice the hyperpigmentation in a place he never had pigment before. It is not consistent this time around:
May 23, 2010:

Wednesday, June 23, 2010

June 23, 2010 UPDATE

Today I am looking at my bright-eyed beautiful boy who is right now pestering me to throw the ball as I try to write. With great relief I notice that most of the pigmentation around his eyelids, nose and lips has returned. The white of his eyes are still a bit red but his eyes are full of life and he can see perfectly. His eye exam last week showed improvement and the eye pressure had even increased to a more normal level. At the start of this disease the eye pressure was dangerously low and measured 4 & 5 but now it is at a more normal level measuring 13 & 15.

This is a crucial time in the course of events as we are slowly decreasing the prednisone after a long period at a high dosage. He was on 30mg of pred twice daily for 18 days. Before that he was getting by on 5mg pred every other day alternated with azathioprine 25mg until the relapse late March when we gradually doubled and then tripled the amount but didn't get enough response. We had continued the niacinamide twice daily and eyedrops twice then 3 x's daily. I also continued the Veterinary Immune Tabs daily as always since December '09. I have not changed his food since his stools are consistently good: Taste of the Wild salmon/sweet potato.

When the disease seemed to be coming out of remission by late March we noticed some depigmentation around the face although this time at a slower rate as my photos will show. At this point since he now has some tolerance toward the drugs we had to get much more aggressive. Below I've documented the dosages given along with the photos. Earlier documentation is shown if you scroll down to older posts.

Since early December 2009 when Corky was diagnosed with uveodermatologic disease I started him on a nutritional supplement that I've continued ever since. I believe it has helped with his success. It is called Verterinary Immune Tabs found at Ramaekers Nutrition online ramaekersnutrition.com. You must talk to one of the website's veterinarians in order to purchase the professional strength tabs. The basis is made from Transfer Factors derived from colostrum which carry molecules that help balance the immune system. It also utilizes powerful mushroom extracts potent in the healing process along with omega 3's, amino acids, trace minerals, msm, and everything else good for a balanced immune system.

As for the side effects from the high dosages of pred, we have seen the typical raveneous thirst and appetite, hyperactivity, panting, excessive peeing. The skin rash and dry cracked paws and nostrils may be caused by the drugs if not the disease, or perhaps the extra dry air and allergens this time of year here in Tucson. I worry about the long term affects of the drugs but we really have no choice. This disease won't go away and can only be managed by drugs. The past ten months has been an emotional rollercoaster struggling to keep our beloved dog alive. If we can sustain him at low doses as we did in January through March, then he could still live a long quality life. As loyal as he is to me I remain dedicated in fighting this disease with all the persistance it takes. Meantime, Corky reminds us how every moment counts, none of us will be here for long. He's waiting for me to throw more balls so off I go. Today is all there is.

And oh, yes, I believe dogs do feel love.