Species: Dog Breed: mix pekinese and bor Age: 2-5 years
Hi.
I live in rural Peru. After many wrong diagnoses, a vet here diagnosed Diego with Canine Discoid Lupus and prescribed an oral steroid and it cleared it right up.
Diego has done this treatment twice in the last 8 months or so and both times it succeeded at clearing up his nose but it comes back after a month or two when he is not taking the steroids . The vet is recommending 15 days of steroids every two months, indefinitely. Does this sound right? What pill should I give him, in what dosage and what supplements might he need to offset the effects of long-term steroid use?
Please note that the vets here are not totally reliable. The one I mention above has been the only one who has correctly diagnosed him yet he is a big jerk. I would prefer to stay clear of him if possible. I do have two others dogs so I will probably be asking you other questions in the future.
Thanks, Susan
PS: Diego is cream color and while the cdl is primarily on his nose, he does have some pigment issues
Dr. Marie replied:
Thanks for providing a good picture of Diego's nose:
When a dog has an autoimmune condition like discoid lupus, usually the treatment needs to be lifelong. It is possible that the two months on-two months off treatment could work. If so, this may be a better option than just staying on steroids all the time.
I can't legally discuss dosages unfortunately.
There are other treatments that may work for discoid lupus. Sometimes a topical treatment works. A steroid cream may do the trick or a medication called tacrolimus on the nose can work as well. Actually, if you can get tacrolimus this is one of the preferred treatments. It is possible that these medicines are not that easy to come by in rural Peru perhaps.
There are also oral medications that aren't steroids that can be used to treat discoid lupus. The oral medicines doxycycline and niacinamide can often work. They would be long term medications. You can also ask your vet about supplementing with vitamin E and omega fatty acid solutions which may help as well.
I'm sorry that I can't discuss exact dosages. You can ask the vet about the availability of the above drugs. If the vet does not have information on using these treatments I am happy to email him and discuss the case if he is open to that.
Dr. Marie.
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Customer reply:
Thank you for your reply. Re: the vitamin E and omega fatty acid solutions - are those used to offset the effect of long term steroid use? Are those available at pet stores? Are they two separate solutions? Re: dosages - would it be within your legal limits to respond with a "that might work" or "that might be too much" sort of answer, if I share with you what this vet is prescribing? The thing is that I do not entirely trust him which is why I sought out additional counsel here. Anyhow, I thank you for your other suggestions.
Sincerely, Susan
Dr. Marie replied:
I understand your predicament, but I really can't advise at all on how much or even whether or not to give medications. The vitamin E and fatty acid solutions are separate and in Canada and the US are sold over the counter or in a pharmacy. We believe that they simply help the immune system. They on their own won't cure discoid lupus but they can help and possibly reduce the amount of steroids that need to be given.
Customer reply:
Ok, well that makes sense and I can totally empathize with your position. So I guess that it is a matter of me working with the steriods and then experimenting with some of the other remedies you mentioned and see what else works and/or allows me to give him less steriods. But am I understanding that generally speaking, keeping him on an on/off steriod program will not harm him. Correct? Thank you again for your time. You will hear from me again I am sure! Sincerely, Susan ps: Diego is cute, heh?! Ha! He has a twin brother who is black and is named Zorro. To die for the two of them! Plus their older sister, makes three. :-)
Dr. Marie replied:
I think the on/off steroid program should be ok as long as when you come off of the steroids they are tapered gradually. If you go from a high dose to suddenly stopping then this can be very hard on the adrenal glands.
Diego is definitely a cutie!
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Dr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.
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