DEC 2009 / JAN 2010 SUMMARY: LIPS

January 19, 2010: Prednisone 5mg every other day four times weekly. Azathioprine 50mg every alternate day. Niacinamide 500mg twice daily. Prednisolone Acetate 1% twice daily. Veterinary Immune Tabs daily. No other supplements. Had switched food from Royal Canin duck/potato (made stools too soft and Corky lost weight because he didn't like it) to Taste of the Wild salmon/sweet potato (stools became firm and he regained his normal weight).

January 19, 2010

January 19, 2010

Janaury 9, 2010

December 28, 2009: Prednisone 10mg four days weekly alternated with Azathioprine 50mg three days weekly, niacinamide 500mg twice daily, Doxycycline 200mg twice daily, Prednisolone Acetate 1% eyedrops three times daily until Jan 4th then applied twice daily. Veterinary Immune Tabs daily. Fed Royal Canin duck/potato limited ingredients.

December 28, 2009

December 28, 2009

December 20, 2009: Prednisone 10mg once daily four days weekly. Azathioprine 50mg once daily. Niacinamide 500mg twice daily. Doxycycline 200mg twice daily. Prednisolone Acetate 1% eyedrops three times daily. Vet Immune Tabs daily.

December 20, 2009

December 13, 2009

December 8, 2009: Prednisone 30mg twice daily for two days. Doxycycline 250mg twice daily. Niacinamide 500mg twice daily. Prednisolone Acetate 1% FOUR times daily. After two days Dec 10th oral Prednisone was reduced to 20mg twice daily. Azathioprine 50mg was added once daily. Oral Pred was reduced to 20mg once daily Dec 12th. Fed Royal Canin duck/potato limited ingredients. Veterinary Immune Tabs daily.

UPDATE

The postings below document the course of events from the start of symptoms in late September 2009 through the turning point after the correct diagnosis December 8, 2009.
I am preparing to document the results and events after that date up until today.

SUMMARY: EYES

December 8, 2009: Day of correct diagnoses. Uveitus detected but with retina in tact (right photo). Corky's eyes were on the edge of going blind. He was treated with Prednisone injected under the eyelids then started a course of oral Pred 30mg twice daily along with Niacinamide 500mg twice daily as an antiiflammatory. Prednisolone Acetate 1% was applied 4 x's daily. Also Doxycycline twice daily. (see "lip
summary" below for details.



November 26, 2009: Continued


Cephalexin. Preparing for biopsy which was December 1st

November 15, 2009: Continued

Cephalexin and treating like

allergy. Debating about when to

schedule biopsy with his massive

histamine condition still active.

October 17, 2009: The right

eye corner is starting to fade

as the nose pigment returns.

October 11, 2009: Eye pigment looks

normal while nose pigment is faded.

August 2009: This is how he

normally looked (bottom right).

SUMMARY: NOSE BRIDGE

December 8, 2009: Biopsy was taken Dec 1st from the nose bridge (right) and lip margin (see "lip summary). Corky had remained in a state of massive histamine release making him unstable for the biopsy sedation. The sneezing continued and pigment fading waivered during November but by the last week it became more aggressive. Waiting for the correct diagnoses from three different pathologists posed great risks but the disease was confirmed December 8th as uveodermatological syndrome (see "nostril summary" for further report and treatment).

Lower bottom photo taken October 7, 2009: The pigment fading as a band across his nose bridge began late September and continued along with some flaking of the pigmented skin. The symptoms matched those of discoid lupus in which case their is no real cure. However I started him on a homeopathic for discoid lupus utilizing sulphur 30x and A. Triphyllum. We did suspect allergies and discontinued all nutritional supplements including fish oil, vit E, ester C, and Cosequin. We continued his holistic diet of Orijen Adult formula.

October 26, 2009: The vet wanted us to keep things very simple in case the problem was allergy related so we stopped the homeopathic remedy along with the supplements mid October. Corky's entire body was in a state of a massive histamine release and wasn't fit to undergo sedation for a biopsy. To our relief, the nose pigment returned by late October but only to decieve us.
November 2, 2009: The pigment began to wane again. By this point he had only been fed his usual diet with no supplementation. His stools were always a too soft and we suspected possibly a chicken protein allergy. On November 5th I switched his diet to Taste of the Wild salmon and sweet potato. His stools were perfect from then on.

UPDATES COMMING SOON!

June 8, 2010

I am organizing a summary of Corky's progress along with detailed photos. As of today we've been trying to put Corky's disease back into remission after a recent relapse, probably because we had cut down his dosage of meds too low. We are now making progress but not as fast as before. Meantime, he is still enjoying life with high energy and his eyes checked out fine. If you need information faster please leave a comment. I am now checking this blog regularly.

SUMMARY: NOSTRILS

Top left photo November 15, 2009: pigment loss and sneezing caused by disease attacking mucuos membranes inside nostrils although we assumed the cause was allergies or possible discoid lupus.



Top right photo December 8, 2009: Biopsy taken Dec 1st from nose bridge (see blue stitches)Diagnosis not confirmed until Dec 8th after awaiting results from 3 different pathologists.

Lower bottom photo taken October 2, 2009: guessing allergies or discoid lupus. Began homeopathic remedy as stated under "lip summary."

Because we saw nice improvement by October 18 (lower right photo) we were deceptively convinced this was discoid lupus and/or allergies. You can see the cobblestone texture returning along with black pigment. We had held off on the biopsy since his entire body was in a state of a massive histamine release we assumed was an allergic response to either an external or food allergen. I thought the residual from the homeopathics were kicking in.

By November 2nd he started to take a turn.

SUMMARY: LIPS

The photos below are listed latest to earliest, the bottom one dated October 2, 2009:

December 4, 2009: Biopsy was
taken Dec 1st but we had to wait for correct diagnoses from three separate pathologists. Since the disease attacks the margins where mucuos membranes meet hairlines such as the nose bridge, lips, eyerims, anus, and toe edges, samples were taken from the lip corner (see blue stitches at right photo) and nose bridge. Diagnoses was confirmed Dec 8th after the opthamology exam and we began treatment. Waiting so long for the biopsy results posed great risk and at this point Corky almost went blind. Prednisone was injected under eyelids then Prednisolone acetate 1%eyedrops was continued 4 x's daily along with oral Pred 30mg twice daily for 2 days tapered to 20mg 2 x's daily while starting Azathioprine 50mg daily. He was also given 500mg Niacinamide twice daily as an antiinflammatory. On December 5th I had also started him on Veterinary Immune Tabs Professional strength as found on Dr. Ramaekers website of Ramaekers Nutrition which I've continued ever since (rotating with the maintenance formula). We were able to taper the Pred a week later down to 10mg daily along with 50mg Azathioprine and gradually alternate days with 4 days weekly of Prednisone and 3 days of Azathioprine. The Niacinamide was continued every day. Corky's response was remarkable as the next series of photos will show.
Nov 15, 2009: Unable to perform a biopsy as Corky was still having a massive histamine release
Nov 2, 2009: The unknown disease was attacking the lip margins as well as the nose and eyerim pigment.

Oct 18, 2009: Per doctors advice we had stopped all supplements including fish oil, vit E, vit C, Cosequin and the homeopathics. Deceiving to us the pigment was returning so we thought he was improving
Oct 2, 2009: We assumed this was an allergy or discoid lupus. Continued the holistic Orijen Adult Formula kibble and started a homeopathic remedy for discoid lupus utilizing Sulphur 30x and A. Triphyllum.





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