Saturday, November 21, 2015

Can you help us? I thought it was over; I was completely wrong!

** Although I've written many of the firsts posts in one day, they're all in chronological order and the wording is quite short. So, reading them from the first to the last makes the most sense. Thanks a lot and many dog hugs! **

Spring and then summer came and Cesar was so much better! Our vet, who had completely lost interest in our case, told me to lower the dosage and then stop the zinc supplement and things should be fine. Well, it wasn't!

I (since there was nobody else to seek help regarding medication :/ ) lowered the dosage by 25%, from 100 mg. to 75 mg. per day. I was also giving him some biotin.
There was a time at the beginning of summer when he was 90-95% healed. Some lesions on his ears were still present but I guess it was as low as 5% of how it was at its worst.
Then suddenly he got open wounds on his elbows.

We started our vet visits again and hearing the story, everyone seemed to think it was zinc responsive dermatosis. By everyone I mean all the vets who heard this disease from me, but they had no other idea, so would say "the elbow must be due to that as well."

I added a new supplement at this point, seaweed.
So from August - beginning of Nov 2015 (which is the date I'm writing it now) it was:
- 100 mg zinc picolinate in 2 doses
- 1.000 mg seaweed in 2 doses
- 10.000 mcg biotin in 2 doses
- 2.000 mg fish oil

Since November it is:
- 150 mg zinc picolinate in 2 doses
- 2.200 mg fish oil
- 20.000 mcg biotin in 2 doses

I increased zinc after reading a few scientific articles* on the issue.

In spite of all this zinc, the illness is rapidly returning and new bold spaces are opening in him. The elbows seemed to get better, but new areas opened up on his face, ears, legs. For the first time, his nose is losing the thick black skin. When it first started it was on top of the nose where there is fur. This time it is the actual black nose that is opening up and scarring.

All the photos are from the end of Nov. 2015.
I basically don't know how to supplement or what to do; hence, opened up this blog to seek help from people who are knowledgable about this illness - or whatever might be going on.
If you have any ideas, any tests you'd recommend me to get done (which I may or may not find in Turkey :/ ), just anything at all, please comment and/or contact me.
Thanks so much in advance.

Articles I've read and recommend on this (sorry, I'm just copying the info from the article rather than writing it in APA format since )

1. Veterinary Dermatology 2001, 12, 101±109
Zinc-responsive dermatosis in dogs: 41 cases and literature review
*Department of Medicine and Epidemiology, **Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, California 95616, USA, {Departement Pathologie Generale Infectieuse et Parasitaire, Ecole Nationale Ve te rinaire de Nantes BP 44307, Nantes Cedex 03, France, {Department of Clinical Sciences, ##Department of Pathology, {{Veterinary Teaching Hospital, School of Veterinary Medicine, #Department of Biology, {{Department of Statistics, Colorado State University, Fort Collins, Colorado 80523, USA, ***Koret Veterinary Teaching Hospital, School of Veterinary Medicine, The Hebrew University of Jerusalem, PO Box 12 Rehovot 70600, Israel and {{{Animal Dermatology and Allergy, Loomis, California 95650, USA
(Received 22 November 1999; accepted 4 May 2000) 

2. Jan Hall DiagnostiC Dermatology Can Vet J Volume 46, June 2005
3. Oxidative stress in the pathogenesis of canine zinc-responsive dermatosis
Mariarita Romanucci*, Laura Bongiovanni*, Anita Russo*, Silvia Capuccini, Luca Mechelli, Laura Ordeixand Leonardo Della Salda* a 2010 The Authors. Journal compilation a 2010 ESVD and ACVD, Veterinary Dermatology, 22, 31–38.

Some test results

** Although I've written many of the firsts posts in one day, they're all in chronological order and the wording is quite short. So, reading them from the first to the last makes the most sense. Thanks a lot and many dog hugs! **

He was tested for these four diseases and the results were all negative:
- lyme
- heart worm
- leishmaniasis
- ehrlichiosis

The skin biopsy says there's a possibility of an auto-immune disease that is causing the inflammation.

Friday, November 20, 2015

What it looks like during healing

** Although I've written many of the firsts posts in one day, they're all in chronological order and the wording is quite short. So, reading them from the first to the last makes the most sense. Thanks a lot and many dog hugs! **

Medicated baths every week for about 2 months plus all the supplements finally paid off. This is January 2015 when I was convinced that this time the treatment and the diagnosis was correct. Finally we had a cure and he was getting better!
You can see how hair started growing from the middle of the lesions.

At first things got worse with zinc supplements

** Although I've written many of the firsts posts in one day, they're all in chronological order and the wording is quite short. So, reading them from the first to the last makes the most sense. Thanks a lot and many dog hugs! **

The pictures below are from 2-3 weeks after we started the treatment for zinc responsive dermatosis. Since things were getting worse and we just had 4 months of wrong diagnosis, I was very hesitant about this one as well.

The most difficult thing about a metabolic disease with dermatological symptoms is that the reaction of the body can take a very long time. If you are doing something that helps or that is bad, it takes at least a few weeks before it shows up. This is what all those vets told me, those vets with irrelevant diagnoses. That's why and how we lost so much time because they kept telling me "just wait."
But it has also been my experience. As I said the skin leisures kept getting worse and worse for almost a month before things started to heal. We were 2-3 weeks into zinc responsive dermatosis treatment when these pictures were taken.
We used zinc oxide for a few weeks at first because that's what the vet prescribed. When I read about different types of zinc and absorption qualities, I switched to zinc picolinate.

After a medicated bath (every week) when the dead skin is scrubbed away

how it spread to the whole body

Skin lesions are not the best smelling things, but he's still me beloved dog son <3

Zinc Responsive Dermatosis Diagnosis in Nov. 2014

** Although I've written many of the firsts posts in one day, they're all in chronological order and the wording is quite short. So, reading them from the first to the last makes the most sense. Thanks a lot and many dog hugs! **

By the time he was diagnosed with zinc responsive dermatosis in Nov. 2014, I had sent these pictures to everyone I could think of who had some dermatology expertise. Nothing constructive and useful came out of that, but in Nov. 2014 a new vet we saw diagnosed him with zinc responsive dermatosis after he did some research.

When we went to this person I asked him to do every single medical test that can be done on dogs because I was feeling so desperate. Due to the lack of hair around his eyes, the skin around his eyes would stick to each other and he'd have a hard time opening his eyes after a nap. Some of the skin would bleed. It was really really bad. Due to Cesar's condition, I wasn't functioning as well in my normal (work and other things) life since I was continuously thinking about what I should do.

The diagnosis didn't come right away, first the vet said he didn't know what it was but that he thought it is a metabolic disease rather than a purely dermatological one, and that he'd research. A few days later he said it must be zinc responsive dermatosis.
Cesar is his first patient with this type of a disease that he has seen, so he didn't/still doesn't really have any experience or much of an idea regarding the dosage. And honestly by the time I'm writing this (a year later) he lost interest in this case and just says "keep doing what you are doing" when I ask him.

With the diagnosis we started:
- scrubbing and cleaning with a medical shampoo every week
- 100 mg. of zinc / day (he prescribed zinc oxide, I then switched to zinc picolinate after doing some research; asked him about the mg and he told me to give the same mg)
- biotin (about 3.000 mcg/day)
- some multivitamins that I sometimes give my dogs anyways, treat kind of stuff that's not high in dosage
- fish oil tablets - > I've always given all my dogs fish oil tablets, and I made sure that he gets plenty.

I also switched him from BARF to grain-free dog food at this time because for whatever reason he was always constipated when taking zinc supplements plus eating barf. Supplements plus dog food eliminated the constipation. The dog food I feed him (and my other dogs) since Nov. 2014 are one of these, I buy a different package every time:
- Orijen (a different one every time since they're all grain-free)
- Farmina N/D Grain-free
- Acana Pasifica

I don't feed any of my dogs any grain. I decided that when I first adopted dogs close to a decade ago after reading many books on dog nutrition. By the way I'm a vegan and don't personally enjoy this, but believe it is the best for them, that's just another story

Aside from the constipation, the other side effect of zinc was loss of appetite, which is to be expected from what I understood. I made sure that he got enough calories every single day, but that usually meant adding some meat or canned tuna fish to his food and putting it in front of him a few times. Sometimes I'd follow him around the house with his food bowl, which sounds crazy, I know, but it seemed to work to make sure that he didn't lose any weight.

I found out about Snowdog Guru around this time and highly recommend everyone to read her 3 part series on zinc deficiency and huskies. Here is the link:

Pictures are from November 20th-22nd 2014.

How it started.. A Patch is not always just a Patch!

In the summer of 2014, he got a tiny patch of bold space on his nose. When it comes to health, I'm pretty cautious, so we went to see a vet right away.
That's when our endless clinic visits started.

In the next 4 months he was diagnosed with
1. fungus
2. allergies
3. demodectic mange and
4. combination of these things
by many many  different veterinarians.

With every new diagnosis and treatment, he got worse, and the patches spread. For the first 3 months it was very slow, so I couldn't tell if it was getting worse or healing (and the vet would always say "it takes a long time for the treatment to cure, so be patient"), but then suddenly he started losing hair and thick flakes of skin from so many places on his face, and then some on his body. 
When it first started, you can see something is wrong on the nose.
I don't have skin lesion pictures of those 4 months mainly because I didn't know it was going to be such a serious and chronic illness.
It was more like the vet says "this is ... . I'm positive. Here is the medication, may take a month or two to heal, be patient, keep going with this treatment;" I believe it and apply the treatment, and then see someone else when it gets worse (usually at least a couple of vets working in the same clinic agreeing on the diagnosis), then believing that new treatment is actually the cure. Little did I know that we were wasting time and using unnecessary medication.

The weird thing is there has been times when two vets would interpret the very same test result completely differently.
One example was the skin test for fungus. The result report said something like "fungi spores were found". The interpretation of one vet was that this was a fungus case, the result was positive and she prescribed accordingly.
Cesar's reaction to this treatment was horrible, he got worse rapidly, so I took him to another clinic.
This time another vet looked at the same report by the lab and said "spores are always found on the skin, this test is actually negative for fungus. The previous vet interpreted it completely wrong!"
I'm not a vet, and just didn't know who to trust. I'm just a rescuer and a dog owner who is trying to treat sick dogs, be it stray or adopted by me.

and it is Suzie in front of him

Awesome 2,5 years!

Next 2,5 years, he was perfectly healthy. When I first adopted him, I gave him some supplements like Vitamin E, which I read could help with lead. Then I dropped them, he was on a BARF diet and fish oil supplements like the rest of my dogs and everything was great. I cut his hair short once or twice at the beginning to observe the lead pellets and some that were close to the skin actually left his body.

I used to write a dog blog in Turkish from Suzie's perspective, who happens to be one of my other rescued dogs. I got this domain, thinking that I could start blogging in English where Cesar tells the stories of us rescuing and fostering dogs, the walks we have, the places we visit, etc. Basically it would be the story of Cesar's life. I never got to do it because taking care of my dogs and rescue work took so much time, I just kept postponing writing the blog.
Anyways here are a few pictures from those times. By the way I did all the blood work every year and got with great results, he was very healthy.

Unicorns in my Living Room? Not Likely... I'll Adopt My Foster (again!)

My friend Eda, whose idea it was to go and get Cesar, named him. She said "Let's wish him luck from Cesar Millan and call him Cesar. He needs all the luck to find a new home now." We assumed that he was going to be renamed when adopted, but we weren't very optimistic about how long that would take. You see, when there are hundreds of thousands of homeless dogs, it really is difficult to rehome an adult, mix-breed dog, but as always we were going to do our best until it happens.

As Cesar started living with me, I realized some thick, hard, weird substances under his double-coated fur. I was afraid he could have already been shot, and got him x-rayed. Unfortunately it was correct, he had more than a 100 lead pellets under his skin, which could not be removed. Since he's carrying so much lead in his body, I was told that he'd need blood tests on a regular basis to make sure that he's not being poisoned by them. "Mix-breed, adult dog who needs blood tests on a regular basis looking for a home." Now the chances for finding a home for this lovely dog seemed like unicorns singing in my living room, and I think that's very unlikely. The name "Cesar" paid off for a quick rehoming, apparently he was already home! I decided to keep him when I saw the X-rays. Hello to my new boy! 

How we met

Let me make this first post about how our roads crossed with this gorgeous dog.

The very first look when we entered the house to drop the other dog and to take Cesar.
Cesar and I met on a facebook post on a cold February day in 2012. He was a stray and some people were threatening to shoot him dead, so this lady who used to feed him on the street posted his pictures online and asked for help. She said there is nowhere she can take him, and he can be killed any time. Cesar and the lady were in a different city about 500 km (310 miles) away from me, so all I could do when I saw the post was reposting to my followers and specifically asking for help from my friends in that city. I kept doing this for a few days in a row with no hope. The thing is we live in a country with a hugggeee stray animal population, and those of us who try to do something for them always have their hands full. Weirdly enough, there is not a single animal hotel in that city, so all my efforts to organize placing him in a safer place were inconclusive. Spending a lot of time on the phone trying to save this doggie did not pay off from a distance of 500 km.
Hellooo, I hear we're going to Istanbul, huh?
As always me and my friends had fosters, all those animals we rescued and looking for homes, some in clinics, etc. This happens to be the story of our lives. Given the situation, it just didn't make sense to go get him, but when my friend Eda suggested to do so, I said okay and we bought a dog box and plane tickets for the next day.

Walking before getting back on the plane. Our first of many walks.
Very same day, a dog residing in my city found a home in Izmir (where Cesar was), so we took the newly rehomed dog to Izmir and got Cesar from Izmir to Istanbul (where we live) to foster him and to keep him safe while looking for a home. The adopter of the dog we took to Izmir, with whom we are very close friends now, got Cesar from the street he was in (which was far away from the airport). So we went to Izmir on a plane, dropped off the rehomed dog to this lady, got Cesar from him and jumped back on the plane.

Same day, coming to Istanbul from Izmir with the Mr.