New and improved coat and nails!

About 2-1/2 months ago, I wrote a blog post about how Cooper’s coat and nails had gone to hell. His coat was woolly and thin, he had a bald patch on his back, and his nails seemed to be breaking one after another.

Cooper’s back looking down from mid-back toward the tail – December 3, 2012

Part of this can’t be helped. Cooper has Symmetrical Lupoid Onychodystrophy (SLO), and with his history of the disease, that means that his nails are going to break no matter what we do.

But they seemed to be breaking more severely and more often than they had been for several years, and plus, that coat! Terrible.

Skin and coat issues sometimes result from infection or inflammation, so we took him to the vet. Turned out he had a mild staph infection, which we treated with antibiotics and daily Murphy’s Oil Soap baths. Once that cleared up, his skin was better, but his coat was still crappy.

So the next suspect? Diet.

One common remedy for coat problems is adding Omega-3 fatty acids. But Cooper has no lack of Omega-3s. Ever since he was diagnosed with SLO, he’s gotten 6000 to 8000 mgs of fish oil every day.

So it had to be something else.

We got a lot of advice from other IWS owners, and we adopted quite a bit of it. (Thank you!)

First off, we changed his kibble. We can’t feed a raw meat diet, as many suggested, unless the meat has been immediately flash frozen, because of the danger that his compromised immune system would not be able to handle the organisms present in fresh raw meat. He had been eating Kirkland’s Nature’s Domain grain-free salmon kibble. Now we switched to Martha’s recommendion of NutriSource kibble, choosing the grain-free salmon version. Plus, we also kept up our practice of feeding flash-frozen chicken wings and Martyn’s vegetable dog soup.

In addition, Deb had mentioned that she gives zinc to her SLO dog. I’d been reading about the benefits of zinc methionine, a highly accessible kind of zinc. So we added two supplements from Nature’s Farmacy Dogzymes: Ultimate, multi-minerals and vitamins, and Gro-Hair, a source of zinc methionine. (I am not affiliated with this company at all.)

We also changed from his former SLO medication regimen to this:

• fish oil capsules, 4-1200 mg in the morning and 3-1200 mg in the evening
• vitamin E, 400 IU, 2x/day
• biotin, 2500 mcg, 1x/day
• vitamin B, super complex, 1x/day

If you’ve been reading regularly, you’ll see that we decided to drop the doxycycline and niacinimide. We just thought that all that antibiotic after so many years might not be needed anymore. (And about 6 months ago, months prior to the worst of the coat and nail issue, we had already started giving him a low dose of Soloxine, a thyroid supplement.)

So now it’s been over 2 months of the new diet and medication plan. What have been the results? Absolutely wonderful. Take a look:

Cooper’s back looking down from mid-back toward the tail – February 6, 2013

His coat is much thicker and curlier, the wooliness is just about gone, the bald patch has disappeared, and the tuft of coat at the base of his tail has even grown back in. By itself, that’s wonderful, but the incidence of broken nails has gone way down, too. Last Sunday, when I did his weekly nail filing, not one of his nails was broken or split.

I hope this improvement keeps up. Come this next weekend, we’re headed to one of our favorite training grounds where there will be some water retrieves. Cooper is happy to go into the water naked if it means he gets to retrieve something, but I’m much happier when he has a lush full coat to protect him.

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Skin, coat, and nails go to hell

Last week, I wrote to the IWS list on Yahoo groups that I had a mystery going on with Cooper’s coat.

He has a big bald patch (maybe 4″ long and 2′ wide) on the top of his back, between his hip bones, a few inches head-ward from his tail. The coat loss is also particularly noticeable on the shoulder patches and on his neck, but also on his chest and between the pads of his feet. Instead of thick, tight brown curls, his coat is thin and very wooly, particularly on his back and especially along his spine.

Plus, overall, the coat his body is much redder than before. And he’s lost his insulating undercoat — not good for a winter-time hunting dog. But his skin is not red, itchy, or warm. There is a little flakiness, but not much. He does not appear at all uncomfortable.

We went to the vet, thinking that this all might mean that he’s needing his thyroid medicine adjusted. But turns out not to be thyroid — Cooper has a staph infection on his skin.

Cooper’s back, top is mid-back, bottom is toward the tail

Then today, we noticed a particularly bad broken nail — one of those split and exploded nails that look like it should really hurt. But Cooper isn’t limping or crying, or even licking it excessively, so again, he does not appear uncomfortable. He just gently licks and chews at it from time to time, trying to get it off himself.

Left front index toe from top

Left front index toe, from side

He’s gone months without an exploded nail. And his coat hasn’t been this bad ever. And then there’s the bacterial infection he had in his right ear about a month ago. I don’t have a clue what’s going on.

At the same time, Cooper’s appetite has really improved. He’s always had an on-and-off again relationship with food. Now, he is eager to eat, and even works for treats (which he NEVER did before). Because of his SLO, he has a few food restrictions, including no grains and no raw meats except that which has been flash-frozen. So he eats fish-based kibble, a little blended vegetables, flash frozen raw chicken wings and, just recently we added frozen raw liver. And we just this week switched away from the Costco brand of grain-free foods, just on the advice of some other IWS owners.

He still gets his SLO regime of medications: 6 capsules per day of salmon oil, Vitamin E, doxycycline, and niacinimide plus biotin and Permaclear. And we’ve just started adding a food supplement with zinc methionine in it.

When we went to the vet last week, she suggested that we go back to the veterinary dermatologist to see if a change in his SLO regimen is warranted. His whole coat, skin, and nail system just doesn’t seem to be doing well at all.

But he seems happy. Tonight, while I was giving him his weekly nail-filing-and-TTouch session, he just lay there, letting me first file his nails and than run my finger tips in clockwise circles all over his body. He seemed confident, very relaxed, and not worried that I would touch his broken nail. Which I didn’t. I just looked at it and took these pictures. And sighed.

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Change in the SLO regimen

Cooper has been prescribed so many medicines and supplements to treat his SLO: tetracycline, niacinimide, fish oil, vitamin E, biotin. Plus, on the advice of some other owners of dogs with SLO, I also give him super vitamin B complex and biotin.

Now, the supplements won’t hurt him. In fact, lots of dog owners give their dogs fish oil for their omega-3 fatty acids, which are excellent for a dog’s coat. Though at 6 capsules per day, Cooper gets quite a bit of fish oil.

But the tetracycline — he’s been getting a 500 mg capsule of tetracycline, 3 times per day, for almost 3 years. That’s a lot. A lot.

And it hasn’t been trouble-free. It’s really inconvenient to space out 3 doses of tetracycline so that it’s given as close to every 8 hours as possible. Sometimes it makes him nauseated. And because calcium interferes with the body’s ability to absorb tetracycline, Cooper can’t get food with calcium in it within 2 hours either side of taking the tetracycline. At his dosing schedule, that means almost no dairy — no cheese, which he likes, and no yogurt, which he also likes and which would also help restore the healthy bacteria in his gut that the tetracycline kills.

I’ve been hoping for an alternative, but one that would not lead to a worsening of his SLO. Some inconvenience, a little nausea, and no dairy is nothing compared to the pain of SLO.

Fortunately, yesterday my vet has suggested that we switch to doxycycline. It’s a “semisynthetic” version of tetracycline with some definite advantages. It doesn’t bind with calcium like tetracycline, so the vet has given his OK to give Cooper yogurt. And best, of all, its half-life is 18-22 hours compared to tetracycline’s 6-11 hours, which means that he only needs to take it two times per day, instead of tetracycline’s 3 times per day. And if all goes well, we might be able to reduce it down to 1 time per day sometime in the future.

So we started the new regimen today:

• doxyclycline, 100 mg, 2x/day
• niacinimide, 500 mg, 3x/day
• fish oil capsules, 2-1000 mg, 3x/day
• vitamin E, 400 IU, 2x/day
• biotin, 2500 mcg, 1x/day
• vitamin B, super complex, 2x/day
• Perma-Clear, 1 capsule, 3x/day

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SLO check-in

Although it’s been awhile since I last wrote about Cooper’s SLO (symmetrical lupoid onychodystrophy), it’s never far from my mind.

Three times a day, Cooper gets medicines. Every day, I’m always on the look-out for another broken nail, another session of determined toe-licking, or non-accident related limping. And awhile back, when Cooper’s coat began to look dry, my first thought was not to wonder about the effects of weather or the need for a new diet.

Instead, it was, “Oh, I wonder if this is a signal for another flare-up of SLO.”

Cooper’s current SLO status

Since last March, when his two front “index” nails were so badly broken, there have not been any new breaks that were anywhere near that bad. He’s had a couple of nails sort of peel, like a banana, where an outside layer of hard nail tissue peels away.

Several nails look very beat-up and irregular. One of these, Cooper started to lick last night. This might mean it has split back under the cuticle and is causing discomfort. If that’s the case, I should see the nail split in the next several weeks.

But it’s not all horrible. Four nails (one on each foot) look beautiful, black, glossy, straight, and strong. And (thankfully, knock on wood, please God) nothing that makes him limp, cry, or bleed.

Medication regimen

We’ve changed his medicines a little bit. We’re still with

• 500 mg tetracycline, 3x day
• 500 mg niacinimide, 3x per day
• 400 IU vitamin E, 2x per day
• 2 1000 mg salmon oil, 3x per day
• 2 capsules Permaclear in the morning, 1 at midday, and 1 at night

To that, we’ve added

• super vitamin B caplet, ground up and added to his food, 2x per day

We’ve stopped (mostly because it got expensive)

• Si Wu Tang powder, 2x per day

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Horrified fascination

You know how you can’t help yourself when something horrible is happening? You have to watch: car wrecks on the road, scenes of destruction, videos of natural disasters and violence. That’s how I felt last night.

Last night, we noticed that Cooper had begun licking and chewing on one of his toes. That can mean only one thing — another nail is broken or about to break. I got down on the floor to watch. After he was done with that session, I belatedly wished I had had a video camera. It was horrible, and I was fascinated.

A nail had indeed split. But the quick must have died awhile ago because his licking and chewing didn’t seem to hurt. He even let me touch the nail briefly. But what was really, horribly fascinating was that he was trying to pull the nail completely off. He’d grab it and pull, but since the nail wouldn’t let go, the nail would pull out of his mouth and his foot hit the carpet with a thud. He did this, over, and over, and over.

There’s no video, but Russ did take some pictures. The badly broken nail is on the index toe of his left front foot. You can also see the nail next to it is is hollow and chipped at the tip, splitting along the bottom, and with a gray crumbly quick.

left front index and 2nd toe, from the front

left front index and 2nd toe, from the inside

I hate this disease SLO. He’s been doing so well for several months. And now this.

But is Cooper upset? Or wanting to change his routine? Or putting off the joys of today? No.

Put that mouse down, and throw the ball!

He’s a real inspiration, that boy.

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4 weeks of no broken nails

Since going back to the full regimen of medications for Cooper’s SLO, we’ve had no broken nails. That was on October 28 — more than a month ago.

Funny. I just realized that I wrote, “we’ve had no broken nails.” Not exactly true, but that’s exactly how it feels.

I know that Cooper is the one whose nails break, but whenever it happens, it feels like it happens to me, too. I don’t have the physical pain in my feet, but it hurts my heart. I just hate to see him suffer. And I hate knowing that we’ll be dealing with this his whole life.

But, given that SLO is with us to stay, all the alternatives are worse. So, I’ll just try to be grateful that I have my boy, that we have a vet and a treatment regimen that is working, and that right now we have time to enjoy together.

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abandoning our SLO experiment

Well, today we discovered a badly split nail. Looking back at our records, since starting our reduced-tetracycline-&-niacinimide experiment on Sept 15, I can see that Cooper has had 2 minor-ish splits and today’s 1 bad split. Prior to that, on the full dose of tetracyline-&-niacinimide, plus the herbs, we had 11 weeks of no split nails.

The badly split one is the same one that exploded so dramatically back on June 21st (see the middle picture of that post), but then seemed to grow out nice and solid. Then today, it split down the middle, all the way through, all the way back to the cuticle. Plus, one of the halves itself split into half.

I’m not willing to do this anymore. So, we’re going back to the full dose (500 mg ea. 3x/day) of tetracycline-&-niacinimide, plus the salmon oil, biotin, Permaclear, and Chinese herbs. That combo has seemed to give us the happiest results in the past. Let’s hope it does again in the future.

I’d post a picture, but Cooper won’t let me touch or hold the affected foot at the moment. Otherwise he doesn’t seem to be in any discomfort — he’s running around, chasing Tooey, and generally being his usual self.

I, however, am so sad.

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11 weeks of no broken nails, part 2

The vet was just as pleased as we were with the improvement in Cooper’s nails, so after consulting with the veterinary dermatologist, she agreed with our wish to reduce the amount of tetracylcine that we’re giving Cooper.

So now we have the same array of medicines, but just less of the tetracyline and the niacinimide:

• 1/2 tsp Biotin Concentrate 2X, 1x per day
• 500 mg tetracycline, 1x per day
• 500 mg niacinimide, 1x per day
• 3-1000 mg salmon oil capsules, 2x per day
• 2-Permaclear capsules, 2x day
• 3/4 tsp Si Wu Tang powder, 2x per day
• 400 IU Vitamin E, 2x day

It’s sort of an experiement to see if the Permaclear and the Si Wu Tang are really the agents that have led to Cooper’s improvement. We’ve seen significant improvement after he started them about 5 months ago, in contrast to almost no forward progress with having been on the tetracylcine and niacinimide since the beginning of treatment in February of 2009.

That’s a long time, over a year and a half, of being on tetracylcine and niacinimide. We’re hoping that reducing these medicines will not put back Cooper’s status with his nails, while maybe helping bring back his undercoat.

But I don’t like experimenting on my dog. I wish I had a medical crystal ball that could give me the answers I need.

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11 weeks of no broken nails

Halleluhia! I just realized that it’s been about 11 weeks since Cooper broke a nail.

Back on June 21st, three nails broke very badly, and we had to go to the vet to get them clipped and filed off. Since then, the surfaces of two nails have peeled back somewhat, but no nails have broken open, no quicks have been exposed, and he’s been in no pain.

The best part is that this is true despite Cooper’s being just as active and just as busy in field work as he’s ever been.

In a previous post, I listed out all the medicines that Cooper is taking for his SLO. That regimen has changed a bit since we started him on acupuncture and Chinese herbs. This is what we’re giving him now:

• 1/2 tsp Biotin Concentrate 2X, 1x per day
• 500 mg tetracycline, 3x per day
• 500 mg niacinimide, 3x per day
• 2-1000 mg salmon oil capsules, 3x per day
• 2-Permaclear capsules, 2x day
• 3/4 tsp Si Wu Tang powder, 2x per day
• 400 IU Vitamin E, 2x day

I also file his nails very gently, 2-3x per week, just to keep them short and to remove any snags or sharp edges.

I’m feeling hopeful that perhaps his SLO will go into some semblance of remission.

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SLO nails don’t break, they explode

When I say that Cooper’s nails “break” because of his SLO (Symmetrical Lupoid Onychodystrophy), that’s really misleading. It might make you think, “Oh, a broken nail. No big deal. Happens to dogs all the time.”

A much better way to describe it is “blow out” or “explode.” That’s what the nails really do. Picture a nice, smooth, solid popcorn seed exploding.

If the popcorn image doesn’t do it for you, maybe these photos will help:

Back right foot, outside nail

In the picture above, you can see how the top of the nail has lifted up and lifted away from the quick. The quick — the core part of the nail, just under where a green piece of grass is sitting — is already dead. You can see where the top of the nail has also split away from the side of the nail that’s on the other side of the quick. The section of nail on this side of the quick is already gone.

Front right foot, inside nail

In the picture above, you can see how the whole nail had lifted up and away from the quick and then blew apart. It’s separated into three parts: top and two sides. The quick in this one is dead already, too. You can see from this, too, that they nail had already been clipped pretty short before it blew apart. For dogs with SLO, it’s better to keep nails short, but that’s no guarantee that they won’t break.

Front right foot, outside nails

The nails in the picture above are what would be the pinkie (top left) and ring finger (bottom right) of the front right paw. The pinkie has already split into three parts, while the ring finger hasn’t blown out yet. On the ring finger, you can see the initial split along the bottom of the nail, and you can also see at the tip of the nail how the nail shell has begun to separate from the quick. This nail is going to blow apart soon.

Nails that have exploded like this are painful. They need to be trimmed or maybe even removed to prevent them from splitting further up and tearing the cuticle. If you’re very lucky, your dog will let you trim them, but I haven’t been this lucky. Sometimes, with less severe splits, Cooper has been able to chew off the hanging pieces himself, but the nails in these pictures required professional help.

If your dog consistently gets nails like this, get to a veterinary dermatologist as soon as you can. They will recognize SLO and can help you choose treatments that might control the disease. And consider joining the SLOdogs yahoo group for information and support. Or add a comment to this blog entry. If I can help you, I will.

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Surgery worse than the condition?

We got Cooper’s bandages off his feet, and hoped that all would be well. One of the two nails has healed up just fine, but sadly, he’s still limping.

This morning, he finally let us look at his feet. We noticed that on the foot that makes him limp, the vet cut the whole nail and quick all the way back to the toe. We can see a pink, moist center in the toe — that’s what’s left of the quick. Of course, it’s exposed, so naturally it’s uncomfortable. This surgery is much more extreme than he’s had before.

There’s a lot of debate on the SLODogs yahoo group list about surgery. Some people just give pain medications and let the nails eventually fall off or get bitten off by the dog. Others rush to the vet everytime a nail breaks.

We’re somewhere in the middle. We try to keep his nails short so they’re less likely to break. If he’ll let us clip a broken nail, we’ll do that. If he can bite it off himself, we let him do it. It’s just when the split goes so far up under the cuticle that we can’t clip it and he can’t bite it off that we go to the vet.

Dogs with SLO will have broken nails. Doing surgery every time a nail breaks just isn’t feasible or healthy. Every time there’s surgery, there’s at least a tranquilizer, and for future surgeries, the vet has told us that there will be anesthesia. This is really hard on a dog, but so are broken nails.

We’ll just have to see what the future holds and go from there.

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More broken nails

When you have a dog with SLO, you expect that nails will break. For Cooper, mostly a nail splits and he chews it off. It’s uncomfortable for a couple of days, but he gets the nail off, the quick underneath dries out, and we go on.

Last night though, when we got Cooper home from the boarding kennel, we noticed he was limping, holding his left front foot in the air. Once we got him to let us look at his feet, we could see that he had two split nails, one on the left front foot and the other on the right. And these were both bad splits, up to and under the cuticle.

These were the kind of split that, had he tried to take it off himself, he could easily have ripped the cuticles, inviting infection and more pain. So off to the vet we went.

Cooper home from the vet

They tranquilized him and removed the broken nails. Nasty, painful, and expensive. And they told us that next time this happens (and we know that there will be a next time), they will have to anesthetize him. The tranquilizer doesn’t kill pain; it just makes him immobile enough to allow the vet to remove the nails.

No matter what we do, Cooper’s nails will break. It doesn’t matter if we keep him quiet in the house or allow him to run in the field — the nails will break. In fact, by the time we see the splits, the nails have already broken at the nail bed.

The disease makes me so angry, and there is no one and nothing to be angry at. It makes me cry. And it has taught me in yet one more way that heartache is real, not just a metaphor.

We’ve been consulting a vet with expertise in acupuncture and Chinese medicine. It’s too soon to tell if the needles and herbs are helping his nails. We can see that it’s helping his digestion, and that may be, we hope, a path into helping his nails.

But here’s the thing. There was Cooper, limping, both front feet bandaged, and a little woozy from the tranquilizer. And what did he do? He came over to me, and dropped a tennis ball at my feet. “Throw the ball” is what that means. “I want to retrieve.”

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13 pills and some powder

That’s what Cooper gets every day to treat his SLO.

Cooper's daily regimen

My regular vet and dermatologist vet worked together to prescribe this regimin:

• Morning: 400 mg pentoxifylline, 3 salmon oil capsules (for 540 mg EPA and 360 mg DHA), and 400 UI vitamin E
• Afternoon: 500 mg tetracylcine, 500 mg niacinimide, and 2 salmon oil capsules
• Evening: 400 mg pentoxifylline, 3 salmon oil capsules, and 400 IU vitamin E, and 1/2 tsp biotin concentrate powder (for 2500 mcg of biotin — when we travel, I use a capsule instead)

If you read around about SLO, you’ll no doubt eventually find the most common recommendations, which are for niacinimide/tetracyline, plus the EPA and DHA. The amounts are based on the dog’s weight. Pentoxifylline is a more recent recommendation. Some vets also recommend steroids, which we are avoiding. If we are lucky, Cooper’s SLO will go into some kind of remission, which we’ll then be able to maintain with just the fish oils and vit E.

The purpose of the tetracyline is not for its antibiotic properties — it, plus the niacinimide, is intended to increase circulation to the feet and toes. At first, we had three doses of the niacinimide/tetracyline per day, but when the pentoxifylline was added, the tet/nia was reduced to once per day.

And it all takes so long to see if anything works. Nails take about 90 days to grow out, and the damage is done at the nailbed, before that part of the nailshell even emerges from the under the skin. So, if a nail has already been damaged, you won’t see if for months. And then it splits or breaks off, and you have to wait another 90 days to see if that nail will grow in healthy.

We are still waiting.

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Broken nails, broken hearts

After all these months of silence on the topic, I’m not sure what to say or how to start… How about with this:

This afternoon, Russ took Cooper into the vet to have a piece of broken nail trimmed off. It turned out to be more than the vet tech wanted to handle, so the tech called in the veterinarian. One thing led to another, and Cooper was lightly sedated so that the vet could remove the nail shell from one of his front toes.

Cooper after toenail surgery

This is just the latest chapter in a long story that has been going on since at least January 2009 when Cooper was almost 2. That’s when we discovered the first broken nail. The top of one nail on one of his front feet had split and lifted up. Picture the hood of a car lifted up — that’s what it looked like. But where the engine would be in a car, was the poor, pink, pulsing quick.

We thought it was just a broken nail, split one one of his romps. We got it trimmed off, and forgot it.

But then another nail split and then another one. Whole pieces of nail shell would hang on by a cuticle at the nail bed, and then Cooper would chew them off or, if he let us, we’d trim them off. Sometimes they split top from bottom; other times side from side.

It obviously hurt. And a new one would break every month or so. Earlier this week was the worst. One nail split, but the shell wouldn’t come off all the way, and he wouldn’t let us near it. He tried to lick it off himself, but every lick hurt. He lay on the bed, licked his toe and cried: lick, cry; lick, cry; lick, cry. Over and over again.

Cooper’s nails break, not because he’s romping and catching them on something, but because he has a disease, called Symmetrical Lupoid Onychodystrophy (SLO). It’s an auto-immune condition in which the immune system attacks the nails. It’s not known exactly what causes it — probably something genetic, triggered by something in the environment.

All breeds can get it, though greyhounds are noted for it. Mixed breed dogs get it, too. Raw-fed dogs get it just as as kibble-fed dogs do. Some say that hypothyroid might be implicated; others notice that dogs with perfectly normal thyroid function, like Cooper, get SLO. It’s not a bacterial, viral, or fungal infection, though a broken nail can become infected. There’s no clear link to vaccinations, other diseases, activity, or anything identifiable in the environment.

And the heredity factor isn’t even clear. Neither of Cooper’s parents suffered from it, and the owners of those dogs had not heard of the disease in any of Cooper’s fore-bearers, either.

I can’t get Cooper to let me take pictures of his feet when he has a broken nail, but another blogger has a more cooperative dog. If you want to see what it looks like, take a look at http://blackschutzhundshepherds.blogspot.com/2009/08/horrors-of-slo-symmetrical-lupoid.html. These pictures were taken after the quick has begun to shrivel, so you won’t see the pulsing pink quick under the freshly broken nail.

If you think your dog might have SLO, do at least these two things: join the SLOdogs Yahoo group and go see a veterinary dermatologist. The people on the yahoo group have a wealth of information and experience, and there’s a good chance your regular vet will never have seen SLO. I’d also suggest you talk to your dog’s breeder — I did that, and received wonderful support and help from both Rosemary and Tammy.

It’s heartbreaking to see my beloved boy suffer, and the more so because there’s nothing I can do to fix it. I have been mostly silent all this time. I kept hoping it would clear up or go into remission. But keeping quiet has kept me isolated from other people, and it’s made me feel like I’ve left out an important part of this blog about my life with Cooper.

Now I hope I’ll hear from some of you.

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