Diagnosed with Perianal Fistulae - German Shepherd Dog Forums
 
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post #1 of 7 (permalink) Old 04-21-2019, 05:32 AM Thread Starter
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Diagnosed with Perianal Fistulae

About 2 months ago, I noticed Luna was obsessively beginning to lick her hind end. I had immediately taken her to the vet due to the fact it was causing reaction/swelling/moisture ulceration problems and she had been put on 2 weeks of prednisone and put in a cone. The pred helped a lot, but as soon as it was stopped, she went right back at it. Then the vet put her on apoquel to try to tame the itching while we considered that her food might be causing an allergy (we'd recently switched her to Fromm Whitefish & Potato from Fromm Gold as a way to lower fat content for her corneal dystrophy.)

Over several weeks, it just got worse though and I decided to get a second opinon, and the new veterinarian believes it to be the start of PF given the way it looks, the reaction to the meds, and her predisposition being a GSD.

She's now on cyclosporine and an antibiotic for a secondary infection that had just begun, we return in 2 weeks for a check up. Now, I don't mind the costs. For me, this dog is my world and it's not her fault she ended up so unlucky! Corneal dystrophy, pannus, and now PF. We also have had pet insurance since she was 5 months old, so we get most costs reimbursed including her treatments, so I'm very fortunate for that. I've read what I can, but it can be quite scary to read up on these and see the "worst case scenario" sides and possibilities. Since a lot of those conditions have potential autoimmune related causes, I wonder if they're all really linked to her autoimmune in particular?

Right now she is on Acana Singles Pork as we try to find a more hypoallergenic food. She doesn't have a great appetite since the PF started and while she does eat daily, she'll ignore her food some mornings. I'm not sure if she has no appetite due to the PF or if it's the food she's on now and being picky. Any recommendations where to go now for food options? We're starting to get lost on what to do.

I'm just hoping we get this under control and it doesn't resist treatment and she can live in comfort. I feel so bad for our girl, she's been unlucky but I'll do everything I can. Has anyone had a GSD with PF? What did you do to best help their situation?

Luna, Born 5/6/2017
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post #2 of 7 (permalink) Old 04-21-2019, 09:39 AM
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at the bottom of this page there's a list of "similar threads" worth reading if you haven't already.....


We have a senior who was diagnosed a few years back....he was prescribed tacrolimus which is basically a topical steroid which was applied after using a chlorhexidine wipe....it can have side effects with long term use--so some folks are dead set against it....so ask your own vet about it and most important IMO....Do your own homework on the drug.....JMO but many of the most effective drugs for animals and human alike ALSO come with risks and side effects........

Our dog did well on the tacrolimus--cleared up after two weeks and I stopped using it--he's had two flareups since and I used it for approx. a week each time until it cleared up........


Again this is JMO...but this really got started (could have been a coincidence ) after I jumped on the "grain free" bandwagon and started feeding TOTW grain free kibble....grain free kibble made his poop very hard and it was a struggle for him to poop I could see him strain .....as he's aged it's been a struggle to keep weight on him which was why I tried the TOTW grain free in the first place...he liked it pretty well...but the lack of grain was not good for him....getting him back on a kibble with grain (that he actually would eat ) softened his stool and has helped him as much as anything IMO.....
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post #3 of 7 (permalink) Old 04-21-2019, 09:51 AM
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There's a forum specially for PF. I think it's a Yahoo group. One person I know with a dog with this condition found that the "right" food helped a lot.
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post #4 of 7 (permalink) Old 04-21-2019, 11:29 AM
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Desinif, are you open to getting this dog off of kibble and feeding an alternative diet? I have one of these dogs who lost the genetic health lottery too, and I think getting the dog off kibble probably saved his GI tract.

Instead of fooling with other kibbles, I would try transitioning him to The Honest Kitchen's Preference (grain-free) base mix -- plus whatever kind of meat he does well on (raw or cooked). You can even use eggs for some of the protein.
https://www.thehonestkitchen.com/deh...eggie-base-mix

Since he's been on fish, maybe try beef or cook up some ground pork and pour off the fat if pork agrees with him. The base-mix is designed to make a complete meal with the addition of any fresh meat, so you have control. You can easily control the fat content through the meat if you need a lower-fat diet. The box tells you the ratio of base mix and meat for a given weight (though mine eats more than the box says to hold his weight).

I really believe that this particular food has an anti-inflammatory effect in the GI tract--I think it's possibly from the quercitin-containing fruit/veg, but the greens probably help too. It also produces HUGE (mega) poops -- and that's GOOD for dogs with anal issues because it empties everything out naturally. You'll sometimes see chunks of veg in them -- don't worry about it.

My dog had the constant butt licking, red, inflamed anus, impacted anal glands, and eventually progressed to bloody diarrhea. He was on multiple rounds of antibiotics. He had a surgery to remove polyps in the rectum caused by constant inflammation. His GI tract was "on fire." We had to apply topical meds to try to bring down the "heat," but it didn't help on the inside. He was miserable. Emptying his anal glands at the vet was incredibly painful for him because everything back there hurt. The vet thought we were headed to progression into PF, and possibly poor quality of life -- we had a very serious heart to heart about his concerns about the long-term prognosis. He had a hypothesis that the whole thing had a food allergy at its root -- if we could turn off the inflamed GI tract, everything else might calm down and then things might function normally again.

We tried a bunch of different Limited Ingredient foods, different brands and proteins for 6 weeks each -- it takes that long on each food to do an elimination diet. He got a little better on some, but never turned around completely. Something in all of the kibbles was still not working for him.

My last step out of desperation was to get him off kibble entirely and do something radical -- that was what led us to THK's Preference and beef. Within 2 weeks, the licking stopped, his anus went from red and irritated to pink and healthy, his poop firmed up, and his stinky anal gland smell went away because they were emptying naturally. I got my dog back.

We challenged him a year later with Acana singles beef kibble since it has ingredients that are similar to what he was eating and tolerating. We went right back to problems. I can't explain why -- I'm convinced this dog just can't eat kibble. The owner of a little independent pet food store I frequent has a Dane that's similar -- she has access to all the kibble in the world, and he gets sick eating all of them....the only thing he does well on is a raw diet.

I've tried other base mixes (including one much more expensive), and my guy doesn't do as well. There's something about the bulk of THK stools that really makes a big difference.

I add a Taurine capsule daily because THK has none added. It's especially important if you feed meat that has little in it naturally, but it's easy to supplement. We also add fish oil.

Glandex may help too. https://www.glandex.com/collections/glandex-for-dogs
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post #5 of 7 (permalink) Old 04-21-2019, 03:26 PM Thread Starter
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Quote:
Originally Posted by Shane'sDad View Post
at the bottom of this page there's a list of "similar threads" worth reading if you haven't already.....


We have a senior who was diagnosed a few years back....he was prescribed tacrolimus which is basically a topical steroid which was applied after using a chlorhexidine wipe....it can have side effects with long term use--so some folks are dead set against it....so ask your own vet about it and most important IMO....Do your own homework on the drug.....JMO but many of the most effective drugs for animals and human alike ALSO come with risks and side effects........

Our dog did well on the tacrolimus--cleared up after two weeks and I stopped using it--he's had two flareups since and I used it for approx. a week each time until it cleared up........


Again this is JMO...but this really got started (could have been a coincidence ) after I jumped on the "grain free" bandwagon and started feeding TOTW grain free kibble....grain free kibble made his poop very hard and it was a struggle for him to poop I could see him strain .....as he's aged it's been a struggle to keep weight on him which was why I tried the TOTW grain free in the first place...he liked it pretty well...but the lack of grain was not good for him....getting him back on a kibble with grain (that he actually would eat ) softened his stool and has helped him as much as anything IMO.....
Wow I've been using this site since I got Luna and I never noticed it shows similar threads! Thanks, I have read through a lot of posts from the search bar but hadn't seen much in the last few years - But I definitely still took in previous experiences.

The only medical treatment we really discussed so far is the cyclosporine, but said it could be months to see a good clear up for her... That's really concerning. We already use Tacrolimus for her pannus (paused during the treatment for her corneal dystrophy) and I'll consult with both my vet and the eye specialist (we have an eye appointment Thurs.) about treatment.

Quote:
Originally Posted by middleofnowhere View Post
There's a forum specially for PF. I think it's a Yahoo group. One person I know with a dog with this condition found that the "right" food helped a lot.
I found that from a previous post from a few years ago, I'll look into it and see if it's still active. Thank you.

Luna, Born 5/6/2017
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post #6 of 7 (permalink) Old 04-21-2019, 03:40 PM Thread Starter
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Quote:
Originally Posted by Magwart View Post
Desinif, are you open to getting this dog off of kibble and feeding an alternative diet? I have one of these dogs who lost the genetic health lottery too, and I think getting the dog off kibble probably saved his GI tract.

Instead of fooling with other kibbles, I would try transitioning him to The Honest Kitchen's Preference (grain-free) base mix -- plus whatever kind of meat he does well on (raw or cooked). You can even use eggs for some of the protein.
https://www.thehonestkitchen.com/deh...eggie-base-mix
Yes, I am absolutely open to it. I'm open to anything that can keep this from progressing or making her life miserable. I'll look into THK. It would be alright to find a lower allergenic protein via raw just switching up the meat if she doesn't do great on one?

Quote:
Originally Posted by Magwart View Post
My dog had the constant butt licking, red, inflamed anus, impacted anal glands, and eventually progressed to bloody diarrhea. He was on multiple rounds of antibiotics. He had a surgery to remove polyps in the rectum caused by constant inflammation. His GI tract was "on fire." We had to apply topical meds to try to bring down the "heat," but it didn't help on the inside. He was miserable. Emptying his anal glands at the vet was incredibly painful for him because everything back there hurt. The vet thought we were headed to progression into PF, and possibly poor quality of life -- we had a very serious heart to heart about his concerns about the long-term prognosis. He had a hypothesis that the whole thing had a food allergy at its root -- if we could turn off the inflamed GI tract, everything else might calm down and then things might function normally again.
I'd suspected an allergy fairly early on, she's been dealing with ear itching pretty consistently and itchy skin as well as some just other odd reactions (paw licking). Since we'd dealt with a behaviorist for Luna we thought a lot of the licking was related to her anxiety/obsessiveness but I'm starting to really think she was trying to tell us hey guys I'm really itchy! I hoped the switch to whitefish would help, but it was just downhill from there.

I really DON'T want her life to become failed meds and misery. It already looks painful. She is absolutely MISERABLE and shaking at the vet when they're back there clearing her glands already, and she hasn't developed tracts yet and the vet is optimistic, but I gotta admit that I'm a bit spooked from the websites/information posted in previous threads and even what I've read up online. I keeping reading on what a terrible, painful disease it is and how half the dogs with it end up with low quality of life. Even our vet said she had to admit, she's seen dogs euthanized for it because it wasn't able to get under control (because she said she didn't want to lie to me, it's something we do need to get under control and doesn't always have the best prognosis.)

It's really gotten me in the "anxious" state of mind. But I am open to try what we can for her diet, treatment, and lifestyle.

Quote:
Originally Posted by Magwart View Post
We challenged him a year later with Acana singles beef kibble since it has ingredients that are similar to what he was eating and tolerating. We went right back to problems. I can't explain why -- I'm convinced this dog just can't eat kibble. The owner of a little independent pet food store I frequent has a Dane that's similar -- she has access to all the kibble in the world, and he gets sick eating all of them....the only thing he does well on is a raw diet.
She hasn't done great on the Acana either - it's been a few weeks on it and almost a bag gone and she honestly has lost her appetite even more with this one. I'm starting to wonder if it's not a kibble problem as well as we've tried three different proteins at this point (chicken, fish, pork.)

Quote:
Originally Posted by Magwart View Post
I add a Taurine capsule daily because THK has none added. It's especially important if you feed meat that has little in it naturally, but it's easy to supplement. We also add fish oil.

Glandex may help too. https://www.glandex.com/collections/glandex-for-dogs
Thank you for taking the time to give me all this information. I will definitely look into it more and also revisit my vet & her eye specialist on adding these into her diet. I really appreciate it all.

Luna, Born 5/6/2017
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post #7 of 7 (permalink) Old 04-21-2019, 07:20 PM
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My dog Nitro also has the condition. The more you can find out about the condition the better. I suggest you keep a diary so you can accurately track how she's progressing. It's been very helpful (and at times embarrassing) having photos of Nitro's bum on my phone, to track the success of his treatment. What works for one dog may not work for another. I had him on natural therapies and a natural diet for 7 months with an awesome Holistic Vet. Nitro even had a faecal transplant. Unfortunately with my dog, despite our best efforts, his condition continued to deteriorate.


Nitro is currently on Cyclosporine and Ketoconazole.

"Ketoconazole administration allowed a dramatic reduction in cyclosporin dose (over 90% in 12 dogs and 80% in the other two) compared to previously reported cases treated with cyclosporin alone. CONCLUSION: The use of combined ketoconazole and cyclosporin provided an effective treatment for perianal fistulas."


https://www.ncbi.nlm.nih.gov/pubmed/12054282

He has been AF symptom free for quite a while and we are slowly reducing his dosage. By obtaining his meds from a compounding pharmacist, I save a lot of money. We see our vet monthly. Having a 'fresh set of eyes' each month means subtle changes I can miss are picked up.

One side effect Nitro has from the medication is Gingival Hyperplasia. His teeth were beautiful, prior to treatment.

https://wagwalking.com/condition/gingival-hyperplasia

I'm currently feeding Royal Canin Veterinary Diet Canine Sensitivity Control, formulated to assist dogs suffering from food allergies, food intolerances and food adverse reactions. It can also be used to help manage inflammatory bowel disease, diarrhoea and colitis. The main ingredients are duck and tapioca. If I don't pre soak the kibble in water, he gets constipated.
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