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View Full Version : Estrogen, Hyperestrinism, & Hair loss for our pups



StarDeb55
05-28-2009, 09:58 AM
As many of you know, I have an 8 yr. old Lhasa boy, Chewy, that I update you on from time to time. I sent an outside e-mail to Alison about a month ago concerning the recent discovery the Chewy appears to be suffering from allergies. Alison has encourage to me post the e-mail on the boards, due to comments that Dr. Lewis, my derm vet, made concerning hyperestrinism. I am copying the e-mail I sent to Alison, so you will have all of the information in context of Chewy's symptoms. I have bolded Dr. Lewis' comments.

last week the groomer alerted me that the hair down Chewy's back was terribly thin, & his skin seemed to be quite dry & flaky. He has always worked on his paws like there is no tomorrow, you look at his pads & they're just screaming red.

Chewy had a follow-up with the eye vet this morning & as I'm sitting there waiting, I'm taking a close look along the middle of Chewy's back, yes, his hair has thinned out considerably. I was stunned though when I flipped his tail back, & here's this big bald spot at the base of his tail, on his butt. I'm thinking, "Great, here's a $300 trip to Dr. Lewis in the derm clinic, as I'm not going to get on the "treadmill" that Barkley & I were on, with 3-4 severe ear infections a year for something like 3 years before the GP sent us to Dr. Lewis. I guess it was fate as the eye & derm clinics are in the same section of the speciality clinic, sharing the same reception desk. I finish checking out with the eye clinic, tell on of the derm clinic girls that I guess I'd better make an appointment to see Dr. Lewis ASAP. Guess what, Dr. Lewis had a cancellation at 230 this afternoon, so we went back down.

I took a copy of Chewy's labs that were done right before last Christmas which included the normal UCCR. Dr. Lewis agrees with me that in all likelihood, it's not Cushing's, nor a thyroid issue. He did skin scrapings, no demodex or anything else suspicious. His paws are pretty badly infected with bacteria. One ear does have a small amount of yeast, while the other, right now, is just an excess production of wax. Poor guy looks like he's got "allergy eyes", too. Derm Clinic is working with Pfizer on a trial allergy medication that Chewy would be an excellent candidate for except his use of Tacrolimus eye drops knocks him out of the trial immediately. Dr. Lewis feels that there is a distinct possibility it may be Alopecia X, or an overproduction of estrogen, but feels more strongly that it's allergy related, even though hair loss usually doesn't occur with allergies. My comment was that with hyperestrinism wouldn't that affect the liver function. He said not necessarily. He said it's more likely that the hair follicles are just extremely sensitive to estrogen, even at normal levels, & react by causing hair loss, so there's a possibility that lignans + melatonin may, also, be on the agenda.

lulusmom
05-29-2009, 06:16 PM
My comment was that with hyperestrinism wouldn't that affect the liver function. He said not necessarily. [/B]

Lulu's estradiol was hugely elevated and since I know that estradiol is the demon sex hormone (:D), I did a lot of research on it, including communications with Dr. Oliver. Estradiol is the estrogen that is elevated in cases of "hyperestrinism" and per Dr. O, by the time a dog is diagnosed with it, liver damage is almost always apparent with very elevated alkaline phosphatase, enlarged liver and the normal steroid hepatopathy and hyperechoic liver that you usually see via an ultrasound.

Sooo, your question was very appropriate but your derm vet's response is not in keeping with Dr. O's definition of hyperestrinism and it's impact on the liver. Having said all that, I will tell you that I was shocked that Lulu's liver enzymes were normal despite the hugely elevated estradiol. Good grief, do any of our pups read the book?

Please do keep us posted on what's going on with Cutie Chewy.

Glynda

AlisonandMia
05-29-2009, 06:21 PM
And it wasn't just estradiol that was elevated was it, with Lulu? It was the whole lot really and her cortisol was out of range too because she was "between treatments" at the time (??) and yet those liver enzymes were all "normal". Did you ever get that test repeated?

Alison

lulusmom
05-29-2009, 06:31 PM
Yes, all five intermediates were off the charts. I haven't done a new UTK panel because she hasn't stabilized on the lysodren yet. She is overdue but my mom has been my priority lately. I am comfortable that if the cortisol is within range on the next stim, everything else should be too; however, I may have her estradiol checked just to make sure. She's been on melatonin and purified lignans for over six months so if the estradiol is still elevated, I'm not sure what else we can do.

G.

Harley PoMMom
05-30-2009, 09:52 PM
Glynda,

I was just wondering if anyone has asked Dr O. about Treatment #10 listed on Treatment Option Considerations for hyperestrinism? It says:

10) Specific hyperestrinism treatment. ArimidexTM and AromasinTM. Indicated for treatment of hyperestrinism in dogs, but kinetic studies are lacking they inhibit aromatase enzyme.

Maybe we got lucky and more studies were done :)

Lori and Harley

lulusmom
05-31-2009, 10:48 AM
Lori,

I never asked Dr. Oliver about treatment option 10 because, 1) personally, I would rather stick to the tried and true treatments that have been tested for efficacy and 2) Lulu's IM and I are following Dr. O's recommendation to the letter. I don't recall that Dr. O has ever recommended that treatment so I wonder why it's on the treatment option page. Good question for Dr O huh?

Glynda

Wylie's Mom
05-31-2009, 08:24 PM
I thought I read that ArimidexTM and/or AromasinTM were cost prohibitive.

-Susy

Harley PoMMom
06-05-2009, 08:41 PM
I e-mailed DR.O about the ArimidexTM and/or AromasinTM and here was his response. My questions in blue, his answers in black.

Dear DR. Jack Oliver:
I was just wondering about Treatment #10 listed on Treatment Option Considerations for hyperestrinism? It says:
10) Specific hyperestrinism treatment. ArimidexTM and AromasinTM. Indicated for treatment of hyperestrinism in dogs, but kinetic studies are lacking they inhibit aromatase enzyme.
>>>These treatments are so expensive (human anti-cancer drugs) that they are prohibitive to use in dogs. Also, melatonin and lignan both inhibit the same enzymes as these two drugs, and are much more affordable.
As my Harley was diagnosed atypical via UTK panel case # EN 09-3017 (5/1/09) with Estradiol baseline of 129.4 pg/ml and post ACTH of 132.2 pg/ml.

>>>These estradiol levels are very elevated. But, you would still treat with melatonin and lignan as you are doing. Also, these high estradiol levels are sometimes seen when owners are using hormone creams, so if you might be doing this, consider being extra-careful with application as the hormones are readily absorbed across the skin of people and pets.

He is currently taking the Melatonin and the pressed flax hulls with lignans prescribed from the UTK option sheet.
>>>Give this treatment some time, as it may take several months for the estradiol levels to come down.

But if these do not bring his Estradiol down, I was wondering if the ArimidexTM or
AromasinTM could be an option for Harley.
>>>It's an option, but a very expensive option, with extremely limited experience in dogs. I only know of one dog that these drugs were used in (a bixhon that weighed 12 lbs) and it cost the owner about $250 per month, and took 6 months for estradiol levels to come down.

>>>Hope that is helpful. Regards, Jack.

I don't know, the $250 doesn't scare me as much as the "extremely limited experience in dogs." :eek:

Lori

StarDeb55
06-06-2009, 10:11 PM
Now for a Chewbacca update. Both dogs were groomed today. The mobile groomer I use had to shorten Chewy down further than either of us intended because the longer she worked on him, the more she discovered just how bad his hair loss is. Glynda, at the rate this going, Chewy is going to resemble Miss Lulus very shortly. I was literally stunned when I saw him. He has so much skin showing through what little hair he has left, he looks almost white. You can see from the pictures I've posted that his hair is a nice golden tan color. Guess, I'll be calling the derm clinic on Monday to try to get that follow-up moved up. It wasn't due until the end of the month, but "Holy Smokes", I'm afraid if I let the poor guy go that long, he will be totally "naked". I would be sorely tempted to start the lignans + melatonin without talking to Dr. Lewis first, but guess I better wait.

Debbie

gpgscott
06-06-2009, 10:39 PM
Deb, If I understand this right, there has not been a full adrenal panel for Chewy.

I do not think there is a downside to beginning melatonin and lignans but I think I would want the panel first.

Scott

StarDeb55
06-06-2009, 11:01 PM
No, there hasn't been. Dr. Lewis seemed fairly convinced we're dealing with allergies even though he did make the comment that hair loss is somewhat unusual with allergies. Now, that you mention it, I really had not given Atypical a thought when I had the negative UCCR done at Christmas time. In light of the skin/coat issues, perhaps a full panel might be warranted. All of us have to go to the GP on Tues., so I think I may just get the ball rolling through the GP as I know, I can get the UTK panel done cheaper through him.

Debbie