Killian's vet visit :(

[Pam]

Sue I was almost afraid to read this. As always you and Killian have my utmost admiration for the way you are both dealing with all of his medical issues. The most wonderful words in your post were "his quality of life is good." For that I am grateful and I know it is because of your good nursing and never-ending love for your boy. (((Hugs))) to you both.

[robinh]

Every time I see Killian's name in a post I hold my breath. You both have been through so much, but you just keep plugging away. When I feel down about all the problems I have with Max and his allergies, I think of the two of you. Your faith, joy and love for Killian is inspiring for not just me, but for many.

Give he and Shiloh a big hug for me. And one for you too.

[Sudilar]

Again, I want to thank everyone for your wonderful thoughts, prayers and encouragement. It means so much to me. Hugs to you all.

When I brought Killian into the vet yesterday, the techs and front desk told me that Killian was their favorite GSD. They told me that they remember the first time I brought him in. He was so skinny and rashy, but what a great personality he had! His vet told me that he was such a lucky boy to have us as his family. As long as he has quality of life (and he does), we will fight the good fight.

All of this seems to stem from autoimmune breakdown with liver disease as a big complication.

Thank you all so very very much. This is the best bb!!!!!!!

[Albea]

Oh, Sue, I'm so sorry Killian has yet one more problem! But your vet is right, the sweet boy couldn't have found a better, more caring mommy. For as long as his quality of life is good, that's all that counts.
I add my prayers to all the other ones for Killie's better health.
Hugs to you and the kids.

[wolf_Q]

Originally posted by Sudilar

When I brought Killian into the vet yesterday, the techs and front desk told me that Killian was their favorite GSD. They told me that they remember the first time I brought him in. He was so skinny and rashy, but what a great personality he had! His vet told me that he was such a lucky boy to have us as his family. As long as he has quality of life (and he does), we will fight the good fight.

Awwwwww how sweet!! He is definitely lucky to have you! I hope you will be able to figure out all of his medical problems. I'll keep you both in my thoughts.

[momoffuzzyfaces]

Originally posted by Cinder & Smoke
Hi God ~

We're not sure Who'z in charge of passin out da *challengez* fur
us guyz livin down here onna Big Durt Ball...

But kuld You check on whut's bein handed out
fur Killian an hiz Mom?

He'z been given a LOT of *challengez* -
an he an Mom are handlin em purdy well...

Kuld You ask em to *ease off* a bit?
Mebee jest let poor Killian *enjoy* hiz Senior Years?

'Preciate any Help You can give to this matter, God.

THANKS, God!

/s/ the Prayer Pups

Me and all my cats add a BIG AMEN!
to that!
Hang in there Killian and Sue!!!

[stacwase]

Poor Killian! I'll bet he's just being a trooper through it all, too. It's amazing how much they can go through and still be sweet and loving.

Afer reading your post, I'm doubly grateful for how well our visit went.

Kisses to Killian.

[dragondawg]

Sudilar

I recently ran into the subject of Pemphigus while corresponding with a puppy owner whose dog has a T-cell Lymphoma. I lost my 11 yr old puppy to Lymphoma last year so I keep in touch with the Lymphoma crowd. Anyway her dog apparently has as part of the cancer a wild T-cell line that attacks the skin which results in a condition known as Paraneoplastic pemphigus (PNP). It appears to now be under control with the use of Cytoxin.

You might try getting a reprint of a very recent article in the European Society of Veterinary Dermatology (2004 Vol 15, 90-98) titled Pemphigus: current therapy. It might be possible to get an address off the Internet somewhere. A couple of interesting snippets...

The author claims Pemphigus vulgaris (PV) is a very rare form of pemphigus accounting for less than 0.1% of the referral cases in a dermatology specialty practice... This form requires the most aggressive forms of combination therapy.

The big question with all the problems your dog has experienced is how agressive is "agressive"?

Per glucocorticoids such as Prednisone the author suggests if the Pemphigus can not be controlled by every other day or once per 72 hr maintenance then other immune suppression agents should be used.

As mentioned above the author gives Azathioprine (a transplant anti-rejection drug) as a preferred choice, but then goes on to listing possible liver damage as a side effect. He discusses the use of Mustard agents such as Leukeran (0.1-0.2 mg/kg every 24-48 hrs) . I have not been able to find any citations indicating liver damage as a possible effect of Leukeran. In fact it is used against cancer after it has spread to the liver. You need to ask questions about it. My puppy never received Leukeran, but instead Cytoxin another Mustard. I commonly gave both Metoclopromide, and Cimetidine as supportive drugs. Never had any GI problems with the Cytoxin. Leukeran would probably behave in the same manner.

BTW- I note you don't list a stomach acid blocker being used. If you are not using one, then get your puppy on Cimetidine or Rantidine as soon as possible to help heal the ulcerations the Prednisone is causing. I gave my 90 lb baby 200 mg Cimetidine 2X daily during Chemo and especially when on Prednisone. Check with your Vet for the dosage to give to your puppy.

An adjunct treatment the article lists is Tetracycline + Niacin. Only problem is that the Niacin might cause liver problems. Oops the Tetracycline can also cause liver shunting. So much for that therapy.

If you decide to discuss with your Vet the possibility of using Leukeran you will have to monitor the bone marrow function via blood tests. Given that the Prednisone has already suppressed the immune system, it's going to be a balancing act withdrawing from it, while switching to increasing doses of Leukeran. You'll definitely have to keep the puppy on the amoxicillin, and if you run into any infections before getting things stabilized have another antibiotic such as Baytril at the ready.

Hopefully you can get off the Prednisone while keeping the Pemphigus under control.

[KYS]

Dear Killian,

Always seding you good thoughts and lots of slurpey kisses.

[Sudilar]

dragondawg,

I am so very sorry for your great loss.

Killian is a 10 year old GSD presenting with liver disease for three years now. His liver is not in good enough shape to add more drugs. The last test (and we will not test again) told us that his liver is getting progressively worse (we know that).

Pred is keeping the pv just at bay at an every other day dosage.

We don't use an acid blocker. At the dosage he takes, we have no evidence of ulceration. At higher doses, he gets bloody stools, but we don't go that high anymore.

At this point, we are not doing anything but cutting back (a very little) on the pred. If more symptoms of Cushings show up, we will have to rethink the protocol. The problem is the condition of his liver, that limits us on what to use.

Thanks for all the info. I will pass it on to his vet.

[Sudilar]

I just spoke to our rescue's president and told her that I would not be fostering Buddy. Killian needs more of my attention and with a foster here, I would be taking away from Killian. The bad thing is that Buddy would have fit right in at our house. He is perfect for Shiloh. But, things happen for a reason, so...Killian comes first.

[tatsxxx11]

Oh Sue I lost internet connection for most of the day; I'll write more tomorrow. {{{HUGS}}} and of course, ;love to Killi and Shiloh.

[Cincy'sMom]

Poor Killian!! You guys hav ebeen trough so much!! It is always so obvious how much you love him and I admire the life you have given him. He's sucha strong boy!!

[ramanth]

Thoughts and prayers and lots of hugs for you and Killian.

[Kfamr]

I've kept up with Killi through reading, but I rarely post.. It's so sad that you, Shiloh, and especially Killi have to go through all of this. He sounds like he is a happy boy though.. and as long as his life is of quality (and I bet it is!)


{{Hugs to all of you}}.. and kisses to Killi and Shiloh.
Many many many well wishes headed your way.