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Thread: iatrogenic Calcinosis Cutis - Severe Condition (Andy crossed The Bridge 6/08)

  1. #1
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    Default iatrogenic Calcinosis Cutis - Severe Condition (Andy crossed The Bridge 6/08)

    I just joined this forum last week. Andy has Calcinosis Cutis (CC) d/t Dexamethasone use. He also has Degenerative Myelopathy (DM). He was put on the low dose dexa. last year as a last resort to helping with his severe inflammatory condition when nothing else worked and even Cephalexin no longer worked. The results were far better than expected. The Dexa. cleared up the inflammatory process and also helped him regain some disability he had from the DM. We enjoyed a full and fun summer.

    Sept. 2010
    , Andy had surgery on his R. Rear Paw. It took a while for that to heal, longer than normal. But before and after surgery, he was removed from the Dexa. Also the doc wanted to see him fully off of it to reevaluate his inflammatory problem. Much to our disappointment Andy's allergies were so bad again that we put him back on the low dose Dexa.

    Oct 2010, Degenerative Myelopathy (DM) Forum, posted the question: "Quality of Life Question: Should I give Andy the steroid Dexamethasone knowing it could shorten his life but provide him with a good Quality of Life that he doesn't have now?" The answers were an overwhelming response to choose steroid treatment to provide a Quality of Life. Feeling reassured we put Andy back on the steroid and everything got better again.

    Mid Mar 2011, Andy just didn't seem right to me. Nothing I could say but by end of Mar he started a wound on his nose that was a problem.

    End of March 2011, Vet gave Cipro for nose.

    Mid April 2011, back for a recheck. The Vet refers me to another because of the seriousness of it.

    Late April 2011, referral Vet throws his hands up and says it's out of his expertise. Now we need to see the Dermatologist. Andy had saw this Dermatologist when he was having Allergy testing and treatment. Great Doc.

    Dermatologist Appt May 5th 2011. Seeing Dermatologist. By then I was really concerned because in addition to his nose, a tiny bump broke open on his back. I figured Andy might need antifungals or something like that. The Dermatologist said Andy has CC d/t steroid use. Ok, so we have to take him slowly off the steroids. That didn't seem too bad. Then he precedes to explain the severity of his condition. So we went home with antibiotics, antifungals, pain medication, shampoo, and treatment instr. I still didn't have a real clue what all this meant.

    1st week after appt., with the Dermatologist, Andy developed these huge growths on top of his neck which were weeping copious amounts of fluid. That's when the Dermatologist explained everything.

    2nd week after appt., now over his shoulders and hard skin areas begin. I'm told there's no treatment. We have to get him off the steroids, which we were doing.

    3rd week after appt., Andy began losing hair down his back along with these same mounds. I saw Andys skin getting real lumpy from the calcium deposits. Seemed everything on him was inflamed. He lost his energy, alertness, and interest in almost everything. He acts odd. We had a recheck with the Dermatologist who shaved the remaining hair off his back and other areas that had were weeping really bad. Nothing seems to be slowing down this process.

    4th week after appt.., June 2, Recheck with Dermatologist. Andy was involved all the way to his anus and tail. His head is now nearly all involved. He doesn't look like my dog. The calcium deposits have closed over his right eye, so he can't see out of it. His right ear is so swollen shut he can't hear out of it. Sides of his face are hard. Of course there's a lot of infected areas that aren't healing. I'm doing all I can do to help Andy but it just doesn't seem enough.

    June 5th 2011, he is eating, drinking, pee, potty, but is having a lot of muscle wasting despite 6 lb weight gain. On special high protein cooked diet. The prognosis is POOR. His condition is serious but stable. Even if we get him off the steroids in time, we may face the fact that the Adrenals don't start functioning, that's Addison's Crisis then. And, we'll again face the severe inflammatory problem and Degenerative Myelopathy. I find my self saying it's not right to have him continue. My other side argues that he is still Andy and has life in him.

    Today I realized the life I refer to is his abilities to eat, poop, drink, walk a very small amount. He is not happy anymore. I know no one can make a decision for me, but I'd love to hear others comments, suggestions, encouragement if appropriate, on the situation. No dog should have to go through this. Pics will only be posted if requested.

    With lots of love for my boy Andy, 10yro Choco. Labrador Retriever

    Thank you for providing a forum where we can get our story down on paper, have support, etc. Andysmom
    Last edited by andysmom; 06-07-2011 at 08:34 AM.

  2. #2
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    Default Re: iatrogenic Calcinosis Cutis - Severe Condition

    Corky and I want to welcome you and Andy.

    I'm so sorry that Andy is having such a rough time.

    I don't have any experience with these issues, but our members have a wealth of knowledge, and are very caring and supportive. I'm sure others will be along that might have more knowledge with these issues.

    Terri

  3. #3
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    Default Re: iatrogenic Calcinosis Cutis - Severe Condition

    Dear Andysmom,

    I, too, am so very sorry for your boy's multiple problems. Although Calcinosis Cutis is not a common condition, we have had a few members whose Cushpups have been afflicted and treated. And fortunately, some of those with success. As a matter of fact, here is a recent thread posted by another member whose dog is currently undergoing treatment:

    http://www.k9cushings.com/forum/showthread.php?t=3387

    I do have to be honest with you, though, and tell you that for a case as severe as Andy's, I do not feel optimistic. Particularly because, as you already know, the really difficult aspect of his condition is that it appears as though he will suffer from such painful issues no matter whether his steroid treatment is continued or stopped. So you are really caught between a rock and a hard place.

    I am very sorry not to be able to offer you more encouragement. What are your dermatologist's thoughts at this point? Does he think that it is in Andy's best interest to proceed?

    The gift of a forum like this is that you will have the opportunity to gather differing thoughts from a number of people. And others may have some additional suggestions to offer to you. But from the way in which you have described Andy's poor body, I am thinking that the greatest gift that you may be able to give him at this point is release. I am so sorry to say this. And please know that whatever you decide, we'll be here to give you as much help and support as we possibly can.

    I am really grateful that you have found your way to us,
    Marianne

  4. #4
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    Default Re: iatrogenic Calcinosis Cutis - Severe Condition

    Thank you for reading Andy's story. And I appreciate your honesty which is what I'm looking for. Dogs don't die from this, they die from secondary infections. But the calcium deposits can also be so severe that they can prevent simple movement. Andy has 1 eye covered up right now so he can't see. His face continues to disfigure.

    He's wearing an E Collar now because of the infections on his head. Dogs have a hard enough time getting around with those anyway and with Andy blind in right eye, he's running into everything. I find all this upsetting. I'm afraid he won't get enough water because of the neck stiffness and him being too tired to try. I have it up so he can stick his head down in it. That worked really good last time. I'll hold it in my hands if necessary.

    The Vet says he has only seen one other case worse than Andy in his "whole career" and that is one he's treating now. He has been treating that dog for over 2 years fighting infections and so forth. He says the dogs calcinosis cutis has never resolved. This can be physically debilitating. Some owners just can't let go. I don't want Andy to suffer nor do I want our companionship to end anytime soon. I love my boy more than any other relationship.

    But Dr. Thomas said to me at our visit this past Thursday, "I will work with Andy as long as you want me to. I will never tell you when to quit. But it will get to a point where going further may not be feasible".

    Calcinosis cutis caused by steroid use has NO treatment. I'd be beside myself if Andy had the type that could be treated. The way to stop this from progressing is to be completely off the steroid, if we make it that far and infections don't take him first. Because of the rapid and severe nature we are dealing with we can only hold our breath and wait and see what happens at that point. Goal date June 25th.

    Andysmom

  5. #5
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    Default Re: iatrogenic Calcinosis Cutis - Severe Condition

    Has your vet discussed the possibility of using DMSO to aid in controlling the calcium deposits? I'm afraid I don't know any specifics, but you will find reference made to DMSO in Diva's link that I posted above.

    And do you mean that June 25th is the date by which you hope to have ceased all steroid use? I know this will be a tight-rope walk for you, hoping that Andy's other inflammatory issues do not flare during the steroid taper...

    Marianne

  6. #6
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    Default Re: iatrogenic Calcinosis Cutis - Severe Condition

    Will look into the DMSO and ask Vet too.

    Yes, the steroid will be completely out of his system by June 25th. And so we wait hoping all goes well till then.

  7. #7
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    Default Re: iatrogenic Calcinosis Cutis - Severe Condition

    Hello and welcome to the forum.

    Let me just say that I am so terribly sorry that Andy is having to deal with so, so much. I am also sorry that you are facing a decision that is the most selfless and gut wrenching you'll ever have to make. I've never had two legged children so my dogs are my children...they are my life and I'd take a bullet for any one of them. I can tell you right now that my love for them and my inability to fathom life without them clouds my judgment, which is why I've needed my vet to help me let go of my babies over the years. It saddens me that you don't seem to have a vet who is willing to do that for you. To assure you that he will never give up and will continue to do whatever you want him to do is simply not right. As a veterinarian he took an oath to relieve animal suffering, not prolong it because a pet owner cannot let go.

    I reread your post a number of times and failed to keep a dry eye every time. My heart hurts for your boy and based on what you have written, I can't imagine that his quality of life is remotely good or happy. My tears are not just for Andy but for my own dog, Jojo, whose quality of life is deteriorating. He still eats and poops but little else remains of his once happy life with me. I assess his quality of life on a daily basis and on his worst day, I don't think my description of his physical state will ever be as dire as Andy's is right now.

    You have laid everything out on the table for us, no candy coating, no soft pedaling. You have painted a dismal picture of a dog whose prognosis is poor and, in your own words is not happy and finds himself in a situation that no dog should have to endure. You admit that you are doing everything you can to help Andy but it isn't enough; you admit that you look at him and feel that it's not right to have him continue and you are aware that taking him off of steroids will most probably opens him up to the agony of infection and debilitating progression of DM. This in itself tears my heart out but to make matters worse, I know that if Andy is like every other dog we've seen with CC, if he ever sees relief from this CC, it will be a very long time and chances are that he will most likely be totally debilitated by his other conditions before that happens.

    Peeing, drinking and pooping are all things we with cushdogs can relate to because all of these things go into overdrive on steroids. Is it possible that this is still driving Andy's ability to perform these bodily functions? Even when steroids are a non issue, I believe that quality of life is much more than the ability to perform bodily functions that keep us alive.

    You came here soliciting opinions, so I'm going to give you mine. I don't ever recall a member describing their dog as being in such a horrid state as Andy. My heart breaks for you because I know how devastated you are to have to watch your baby be in so much pain; however, my heart is shattered for Andy. It is not my intention to diminish any hope you may have for Andy's ability to regain a good quality of life but I hope you can understand how vidid a picture you have painted. To get an idea of how I felt reading your post, perhaps you could reread your post and for a moment, pretend that Andy is not the dog involved. Would you believe that dog's quality of life is good and that with such a poor prognosis that it will ever get better?

    Since your derm vet has assured you that he will be taking his cue from you rather than Andy's well being, perhaps you might want to consider asking your gp vet or another veterinary professional you trust to advocate for Andy. Ask him/her to speak in Andy's best interest and to be brutally honest with you. Ask him what s/he would do if Andy was his/her dog, given Andy's apparent discomfort and poor prognosis.

  8. #8
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    Default Re: iatrogenic Calcinosis Cutis - Severe Condition

    My heart breaks for you and Andy. I will say prayers that you find your way for Andy's sake and for your own.

    I don't know that any of us could say for certainty what we would do if we were walking in your shoes. I do believe in quality of life verses just existing. I don't know that a dog's very essence of being can last long, just existing. Yet we all hope maybe if there were just a chance. But at what cost is that chance?

    Praying for you and sweet, sweet Andy.

    Love,
    Addy

  9. #9
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    Default Re: iatrogenic Calcinosis Cutis - Severe Condition

    Dear andysmom, your post is one of the saddest I have read. My heart breaks for you and Andy. I am not familiar with his disease, but it sounds like he is suffering. Only you can make the final decision and we support whatever you decide. Maybe it is a blessing that you found this site so that you can feel at peace if you decide to let him go. All I can say is that I think if he were my dog I would make the decision to let him go. I have read your post several times and cry each time, I am just so sorry for the position you are in. I will be praying for you and Andy that you are able to decide what to do for him.

    xoxo,
    Cindy, Alex and Bear

  10. #10
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    Default Re: iatrogenic Calcinosis Cutis - Severe Condition

    Dear mom of Andy,

    After reading your post, I was very impressed. Impressed by the difficult road Andy and you had to travel and especially impressed by your honesty in describing the road you and Andy have traveled so far, your honesty in telling us about your doubts and fears and the questions you have to strugle with...

    And of course, we don't know Andy (but I honestly can say that I already know for certain that his story will stay with me for the rest of my life) and therefore it's hard to comment but in a more general way, I can share my thoughts and feelings with you.

    I only lost one dog to "old age" at the age of 16. Another dog I had to let go due to several serious healthconditions when he was barely 5 years old and another dog I had to let go when he was only 18 months old...due to severe pain. It has always been my personal believe that when a dog no longer has a "dog worthy" life, we should let them go. During their entire lifetime, long or short, they are there for us. They makes us smile and laugh, they console us, lift our spirits, they are our constant companion and loyal friend during difficult times in our lives... So to me, it's my duty even to be there for them when their life gets difficult. It's my duty to them to do everything in my power to end their suffering or pain...with treatments, medications, therapy...anything. But when none of those offer a permanent improvement of their life, it's my duty to decide for them that enough has been enough. They have been there for me, their entire life, now I have to be there for them...at the end of their life and to make sure the final part of their life, wasn't one of unneccesary suffering. They never let us suffer....at the contratry, all they try to do is trying to make it better for us. We owe them the exact same thing and nothing less... But that's just my personal believe.

    Wishing you and Andy all our best and strength,

    Saskia and Yunah.

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