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Posts Tagged ‘SLO treatment’

Last December, almost exactly 7 months ago, Cooper had a really crummy coat and a bad nail break. After that, we changed his medication regime, and after about two months, both his coat and nails really improved.

So, it’s been awhile since the last bad breaks, but I guess SLO never goes away. It may get better, and it may even go into remission, but it’s always there, hiding deep in Cooper’s immune system and under the fold of skin on the toes where the nails start growing.

As you can see in the pictures below, a couple of Cooper’s nails are in bad shape again.

20130708-144139.jpg

Right rear foot, “ring” toe, fully split

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Front right foot, “index” toe, cracked but not yet split

His coat is a bit fuzzier and woolier than we’d like, and a touch thinner, but nothing like the horrible shape it was in back last December. And if I were to take a picture of it, you wouldn’t really see the difference between his coat now and how it was when in good shape last February. And fortunately, he still has coat between the pads on the underside of his feet. Back last fall, the coat there was so thin that the skin became raw and abraded from a day of hunting.

We’re still on the same regime as last February, and I don’t plan to change it unless things really get worse. So, here it is again, just for reference if you’re interested:

For the SLO:

  • 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

For the low thyroid:

  • Soloxine thyroid supplement, 4 mg, 2x/day

For his coat:

  • Nature’s Farmacy Dogzymes: Ultimate multi-minerals and vitamins, 1 tsp, 2x/day
  • Nature’s Farmacy Dogzymes: Gro-Hair, a source of zinc methionin, 1/2 tsp, 2x/day
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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

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_coat_2-13

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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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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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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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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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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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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