# Perianal fistula or ruptured gland?



## LisaT (Feb 7, 2005)

Can you believe it, I think Max has one (Perianal Fistula).

Can you just believe my luck right about now?

I just signed up for the yahoo group. Guess I better figure out a way to deal with this......

http://www.vetspecialists.co.uk/06_Animal_Welfare/Soft_Tissue_Facts/Perianal_Fistulae.html

http://www.theveterinarian.com.au/clinicalreview/article772.asp

http://vetblog.co.uk/vetblog/wp-content/uploads/2008/05/furunculosis.jpg (not Max, hopefully he doesn't get this bad)


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## BowWowMeow (May 7, 2007)

*Re: Perianal fistula*

OH NO!!!!! That's horrible. 

I know that Patti had total success with Chinese herbs to treat her last dog's pf. There are a bunch of threads on here with info too. 

Big hugs to you, Lisa. I guess you're being tested for some reason...and I understand exactly how you feel.


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

Thank you Ruth. 

I've read most of the threads as they've shown up here. I'll be interested to see what info Patti has. The conventional treatment for Max is not an option, for a number of reasons. (ETA: well, at least that's my first instinct.....I need to make sure it doesn't get out of control)

I honestly don't know how much more I can handle. I know you know what I mean!


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## Barb E (Jun 6, 2004)

*Re: Perianal fistula*

Ahhhhhh crap Lisa


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

What I wouldn't give for a hot spot right now.

Thank you Barb....


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## arycrest (Feb 28, 2006)

*Re: Perianal fistula*






















*Lisa & Max *


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## Brightelf (Sep 5, 2001)

*Re: Perianal fistula*

Lisa, good vibes and prayers coming atcha-- and Max, too! (((Hugs)))









Okay. My last GSD Chell got PFs, I think, when he was about 12. They came frequently then, about one new or re-opened draining tract every other month! We tried the usual conventional treatment, anibiotics, etc. (I would still reccomend the antibiotics, though) Nothing stopped the PFs from happening.

Then my vet asked me if she could try Chinese Traditional Med herbs, to rebalance Chell's system so he could fight them off himself. The alopathic normal treatment wasn't helping much, one PF would clear up, and 1 or 2 months later, the same would open again or a new draining tract would form.







So, I agreed we could try the woo-woo Chinese herbs thing-- even though I thought "How are a bunch of dried out plants gonna help?"














Chell had been her patient for years, but the Chinese Trad Med interview was FUNNY as heck-- "Does he dream?" "Does he prefer to lie in warm or cool places?" "By a door or window, or against a solid wall or corner?" "Do you feel he has headaches?" "Which of the following emotions seems to be dominant in him..." etc. But, the interview helped her get an idea of some other things as well. Funny too, she ended up guessing some things about him that I hadn't told her about his body and his habits/personality.

Anyway, I apologize for this, but there were 2 herbs perscribed, and I cannot remember which one was for the PFs and which was for his arthritis! A CTM vet will know which one was for the PFs!

One herb was: *Long Dan Xi Gan Tan *

and the other was *Xiao Chai Hu Tan*.

He, I think, never had another PF like he'd had before. He lived about 2 - 3 more years. This may not work on Max or on other dogs. Best bet-- go with BOTH alopathic and Chinese herbs. Do the antibiotics, the creams and salves reccomended by your vet and the Yahoo group. My only caveat might be-- run the dietary change ideas through your personal filters. If you reall feel the dietary changes suggested would help, you can try them. But, if Max is fed raw or homecooked, *he is getting more of what he needs to fight this and right hiw own system *than he would on a kibble the group may suggest. Try whatever seems to help though, just use your best judgement regarding quality of diet for Max.

Hang in there Lisa,





















I know you don't need this right now. It may just be getting Max's own system to do more of the work to protect itself against the PFs. Praying that this helps him!


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## JenM66 (Jul 28, 2005)

*Re: Perianal fistula*

Could you please catch a break right now?!!!!! I'll send you the butterfly net to catch it as it floats by, if that would help. No experience (thank goodness) so I'm just sending lots of










































and ear scritches your way.


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## Brightelf (Sep 5, 2001)

*Re: Perianal fistula*

After I typed all that, I remembered to mention-- be sure to get a really good look back there (not that ya want to...). It can also be a blown-out anal gland. We all know that they get impacted, but when they burst, it sure looks just like a PF!


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## LJsMom (Jan 6, 2008)

*Re: Perianal fistula*

OH NO!!! This all happened AFTER the new vet appointment? Poor Mr. Max.

Do you have Four Paws, Five Directions?


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

Thanks everyone. I spent most of the night napping and waking up to check on max, so he won't lick and dig into the site. I'm getting up to go t bed now. I am so bummed. 

Patti, thank you so much, I will have to reread tomorrow to get everything again. Also, didn't think about the anal gland. I wonder what abx they use. I pulled him off abx to have this blood culture done, and started them again tonight. Don't know if they are the right ones though. I've never heard his stomach so noisy. 

Joanne, right before the vet appt, he had pure liquid diarrhea come out. I thought he was reacting to the probiotics maybe. Then this. I have been trying rice the last many days, to try to get weight on both him and Indy. They've both been grain free forever. 

He's also been battling an ear infection triggered by herbs from the acupuncture vet. He doesn't do herbs well because of his allergies. 

I'm gonna go to sleep and feel sorry for all of us here for awhile. Guess I'll regroup tomorrow.

Guess I'll hope for a burst anal gland???


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

Oops, yes Joanne, I have 4 Paws, why?


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## LJsMom (Jan 6, 2008)

*Re: Perianal fistula*

That first Chinese herb that Patti is mentioned is in there - but not the second one.


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## LJsMom (Jan 6, 2008)

*Re: Perianal fistula*



> Originally Posted By: LisaT I have been trying rice the last many days, to try to get weight on both him and Indy. They've both been grain free forever.


Neither LJ nor Steel can eat rice. I use Quinoa.


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## Brightelf (Sep 5, 2001)

*Re: Perianal fistula*

Joanne, may I ask what happens to LJ and Steel when they eat rice? (sorry to highjack, Lisa!) Grimm doesn't do well on it either.

Wishing for an easy solution for Max-- may it just be a ruptured gland and nothing more serious.


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## JakodaCD OA (May 14, 2000)

*Re: Perianal fistula*

Lisa,,hey join the club(( altho right now I have no PF dogs.

What I would do right now,,shave his butt good, Definately have the glands checked out, sometimes pf results from an anal gland infection, (which both mine were from) vs true PF's.

Don't want to bum you out more, but since Max has alot of other issues, well, if pf's are gonna show up, you'll find it does on dogs with allergies, ibd, sibo, o ther issues ((

DESITIN! You can try it, alot of us "pf'er's' have had success in clearing up reoccurances with Desitin,,(the zinc oxide),,,I put it on a q tip and apply IN and around the area a couple times a day,,

Most importantly, you wanna keep that area clean and dry if possible...

Diet is important, (your doing good there),,pumpkin (canned) could help...

ask away,,definately join te PF group..hey whats one more email list?? Good luck
diane


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## LJsMom (Jan 6, 2008)

*Re: Perianal fistula*



> Originally Posted By: BrightelfJoanne, may I ask what happens to LJ and Steel when they eat rice? (sorry to highjack, Lisa!) Grimm doesn't do well on it either.
> 
> Wishing for an easy solution for Max-- may it just be a ruptured gland and nothing more serious.


Patti, I swear the diarrhea gets worse!


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

Thanks Joanne, will look it up. Patti, no problem$ with the highjack. 

Diane, I am very sorry to say this, but when I first thought of PF, I thought of you







what a thing to be remembered for, eh???

Max is one walking pile of inaflamed mucous membranes, so I know he is very susceptible to this stuff - he's set up for almost any of the bad things that GSDs get. 

The abcess is on the right side, pretty close to where the anal sac is, so maybe we will catch a break. I guess I'm hanging on to that thought right now. Last night I was cleaning it out with peroxide and it felt hard underneath. I don't feel the same thing this morning, so maybe that's a good sign. 

We have an appt in 3 hrs, with the same vet that did Max's bloat surgery. If it's the gland, I guess it needs to be cleaned out. He had anal gland problems about 2 or 3 yrs ago, but they've been fine since. Guess they haven't been checked in the last 6 months though. 

Well, I guess I will know more this afternoon.


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## LJsMom (Jan 6, 2008)

*Re: Perianal fistula*

I gotta give you guys credit - I don't even know where anal sacs are. I know they are "back there" somewhere.


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## srfd44-2 (May 20, 2004)

*Re: Perianal fistula*

If it is PF's, Lisa, the dog from the shelter, Hans was on a no grain and no meat diet. He was put on Wellness Fish & Sweet Potato food. He has been out of the shelter for about 4-5 months and doing great. Hope for Max does well.


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

Joanne,







that you don't have to learn!

Kathy, thank you. I'm wondering of the rice hurt or helped. He's been standing on his right hind leg funny for awhile, today clearly favoring it. This may have been impscted for awhile - lots of things went unnoticed this last term while halping Dad with chemo. So now I wonder, did the rice bring this to the front for a good reason or a bad?

He licks his hind are when he gets salmon or probiotics or digestive enzymes. Is that cuz they are bad for him, or because they help bring things to the head. Same question with that herb formula he was on. 

More questions than I have answers for. Guess the big question on what it is will be answered this afternoon. If he wants to put him on abx, hopefully we will find one that is also active agaisnt bartonella, just in case.


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## JenM66 (Jul 28, 2005)

*Re: Perianal fistula*

Good luck at the vet.







for good news.


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

It looks like good news!!

The vet that is looking at Max is a surgeon and a shepherd guy. He took a quick look and said it doesn't look like a fistula, but a gland abcess...Woo! Hoo!

They took him back to clip and clean out. The vet too was very relieved - he said when I said fistula or gland, he his heart stopped, because he knows how nasty that can be. I thought that was cool. 

I know one reason this happened. I strayed from basic principles. Because of pressures from STB-ex, I have become less proactive and more reactive in terms of the dog health. Because of being so involved with my parents' health care, I haven't had the time to connect with the dogs much at all either. 

So it will take a bit to get back on the right track with them. 

For now, I'm just greatly relieved.


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## Brightelf (Sep 5, 2001)

*Re: Perianal fistula*

Yay for the temporarily yucky gland and not a PF at all!!







Hooraaayyy!







Lisa, I am dancing with you for Max! This is super news!! Try not to feel too badly. Max has you, you have him, there is no PF, and his bunz will be feeling tip-top in no time! I have had a few things like Grimm getting icky ears or the runs from my lack of awareness after my DH died. You have had a LOT on your plate lately, with both parents, the divorce, Indy. Max and Indy are lucky to have you-- you DO connect with your fur-buddies, as much as you possibly can! Right now, give yourself a breather.







Max is going to be okay!


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

Thanks Patti! I guess I need to give myself permission to be human, eh???

I feel soooo much better than I did about 12 hours ago!


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## Brightelf (Sep 5, 2001)

*Re: Perianal fistula*

Goooood!







I perscribe more RockyRoad!


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

I've got some Haagen Dazs 5 Mint in there that I haven't tried yet. Lunch maybe?


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## LJsMom (Jan 6, 2008)

*Re: Perianal fistula*



> Originally Posted By: LisaTI've got some Haagen Dazs 5 Mint in there that I haven't tried yet. Lunch maybe?


I had that for dinner last week, followed by the Brown Sugar. I like the Mint better.

I am SO relieved. I was so worried earlier I had to go for a bike ride.


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## Barb E (Jun 6, 2004)

*Re: Perianal fistula*



> Originally Posted By: LisaTIt looks like good news!!


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

Hmmmm, they didn't have the Brown Sugar...chocolate is still my favorite I think!

Well LJsMom, we appreciate your worry, and am very impressed at how you respond to worry - very healthy! Me? Not so healthy nowadays. Guess I better get back to basics for me and the dogs. 

The vet said that he could be wrong, but the positioning of the hole, and also the other gland had some real firm gunk in there, he's pretty confident it's the gland. He sent us home with some Clavamox, which is cool. 

I guess now I have to figure out what to do with the glands. Clearly his diet isn't dealing with them properly. I don't like the idea of having to have them expressed regularly, but I guess that might have to be the solution. His glands I think are pretty deep and recessed - I remember them having troubles with them. 

Sure wish I knew if that rice was hurting or helping.


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## WiscTiger (Sep 25, 2002)

*Re: Perianal fistula*

Lisa try no rice. I found that Oat Bran is a good fiber source and really inexpensive. In the natural food section at the grocery store in bulk it is 99 cent a pound and a pound goes a L O N G way. 

Are you home cooking for Max. You might want to try Oatmeal instead of rice.

Val


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## Brightelf (Sep 5, 2001)

*Re: Perianal fistula*

I gotta agree with you, Lisa. the rice in the chix and rice bland diet, I think, DOES make the poops worse! I thought I was the only one who suspected this. Anyway, I love Val's idea of oatmeal. Ruth also uses Quinoa, can that help?

There's a "5 mint" flavor? I am coming back to The States SOON!!









I think with all you have to deal with, and all Max has to deal with, what about this: Just get him on a diet that makes him and you both feel good. If it makes the poops firm n bouncy, perfect! But, try not to worry too much about that. (would pumpkin help?) I know the best is if Max himself can empty his own glands. But if that is difficult because his poops are always a bit soft after fiddling with his diet, maybe let the vet show you how to gently, carefully express Max's glands into a papertowel on a regular basis. (I say maybe have the vet show you, because Max's glands may be deeper, lower, etc that other dog's? From what you said? Not sure!)

Sending happy-healthy-healing butt-butt vibes to adorable Max. Sending good heart vibes to Indy. Sending strong and healthy vibes to Dad recovering from treatments, and to Mom getting used to her ostomy and learning to be cool about it. Sending mondo mega boku vibes of totally awesome positive juju to Lisa for peace, serenity, calm, relaxation, oh heck, happiness, too! Have the 5 mint!!


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

**Sending mondo mega boku vibes of totally awesome positive juju to Lisa for peace, serenity, calm, relaxation, oh heck, happiness, too! Have the 5 mint!! ***


Hey, with all of that, how can I miss??? Thank you Patti







you are right, I may have to settle for soft stools and regular expression at the vets. I tried doing them myself before - I failed miserably and Max just got annoyed!

Pumpkin gives both mine loose stools after the first day, and oatmeal didn't work very well. But oat BRAN sounds like it might be a winner. Great suggestion Val. Never thought about trying that. I was just trying the rice because it's supposed to be so kidney friendly, but it's not meant to be. 

I will try to post a couple of pics when I get home tonight, if my DSL is up. I feel a bit silly for overreacting, but ever since Max had anal gland problems a couple of years ago, I've been worried about him getting a PF. In the grand scheme of things, not a terrible overreaction though!


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## JakodaCD OA (May 14, 2000)

*Re: Perianal fistula*

hey sounds like good news;, atleast better news !

How about metamucil? some of the pf'er's give that if pumpkin isn't an option..?? 

Yep, better to have an abscessed gland vs the other,,would you ever consider having them removed? (glands I mean) ,,I know when my first pf dog started, (infected anal glands),,I think expressing them all the time, made the whole situation worse and just exasperated (sp) everything,,ended up removing them, and never a problem...


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

Diane,

If I thought that he was headed for a PF, or if we continue having problems, I will at least look at that option. I guess a lot of it depends on what happens with him after this point. 

I too think that when he was regularly expressed before, , when it was infected a couple years back, it made it worse.


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## LJsMom (Jan 6, 2008)

*Re: Perianal fistula*

What have you decided to do about the rice?


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

Million dollar question Joanne. 

With Max's current ear infection, I think I'll stop anything that is new-ish, which means no rice. I did just pick up some oat bran though, and will try that. 

He's just hungry. He can't handle more meat, can't digest more fat, and is allergic to life essentially. I tried some of the EVO canned speciality meats, and his creatinine spiked up. I tried the other grains, and they didn't seem to do well. Potatoes worked until he got an ear infection.

So, I just dunno what to do with the skinny boy.


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## LJsMom (Jan 6, 2008)

*Re: Perianal fistula*

Poor Max. I'm sure there's an answer out there and you will find it. In the meantime, are you keeping a spreadsheet?


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

Don't tell Barb, but, uh, no. 

I never have the time to keep it updated


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## WiscTiger (Sep 25, 2002)

*Re: Perianal fistula*

Lisa are there any Veggies you could give Max. With his sugar problem I would say no carotts, but what about some green beans, yellow beans, lettuce. Those are also good fiber sources and gives some body to the food, AKA won't act like he is starving all the time.


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

Thank you Val, that's actually what I've been trying to do (great minds







). His base veggie is green beans. (I'm almost wondering if he couldn't be allergic to steamed green beans, is that possible?). 

I recently added the "normandy mix", mostly cauliflower, brocolli, some yellow squash, some carrots. Costco version has more cauliflower and brocolli, Sam's has waaaaay too many carrots!! 

In the morning, just this week I started adding celery and bell peppers (all steamed). He does so well on bell peppers. 

Geez, if only I ate so healthy! I guess maybe I should up the amount of veggies in the morning, just to see if that helps. 

It sure is tough to feed a dog that can't tolerate much! .


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## Brightelf (Sep 5, 2001)

*Re: Perianal fistula*

Lisa, Natalie who has Penny is usually really good for food ideas. maybe she might be able to think of veggies that might be well-tolerate by Max? Sending good vibes out your way.. to Max.. to Indy.. to Mom.. to Dad... to the icecream... etc.


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## LJsMom (Jan 6, 2008)

*Re: Perianal fistula*



> Originally Posted By: LisaT(I'm almost wondering if he couldn't be allergic to steamed green beans, is that possible?).


LJ says it's very possible. She tested allergic to peas. I have since discovered she can't have green beans or any bean.



> Originally Posted By: LisaT Sam's has waaaaay too many carrots!!


And what nasty carrots they are!


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## WiscTiger (Sep 25, 2002)

*Re: Perianal fistula*

Lisa how about some spaghetti squash with a little tomato sauce, lol going Italian marinara sauce.
http://lowcarbdiets.about.com/od/cooking/a/spagsquash.htm


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## Barb E (Jun 6, 2004)

*Re: Perianal fistula*



> Originally Posted By: LisaTDon't tell Barb, but, uh, no.














> Originally Posted By: LisaTI never have the time to keep it updated


Lisa - If you send me the info you want on it I'll make one up for you and then if you'll just send info at you have it I'll update it and send it back to you.
Won't be anything fancy


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## natalie559 (Feb 4, 2005)

*Re: Perianal fistula*

Hi Lisa, So sorry to hear about Max. Doesn't he know better than to get sick while his sister isn't well?! Hugs to your family


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

LOL, thank you Natalie! I haven't tried that angle with Max yet, I will have to let him know!!

Barb, that's a very generous offer! I will work on a list and amounts of the food. I'm curious how you setup your spreadsheet too. 


Max's anal area has a spot that is pretty swollen. I guess I need to make sure the abcess heals from the inside out. He is however, doing very well on the Clavamox.


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## LJsMom (Jan 6, 2008)

*Re: Perianal fistula*



> Originally Posted By: LisaTHe is however, doing very well on the Clavamox.


Lisa, is the Clavamox twice a day? Are you doing probiotics? If so, how are you spacing the two out. I'm just curious since LJ is on the same thing.


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

The Clavamox is 500 mg twice a day. I'm giving them just before Bfast and just before dinner, so maybe 20 minutes before he eats.

I haven't been giving the probiotics, but will start them as soon as I can remember.

It used to be that I could keep track of all this stuff, but I've been having great difficulty lately!

Did I know that LJ was on Clavamox? I don't remember why?


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## LJsMom (Jan 6, 2008)

*Re: Perianal fistula*

LJ is on the same dose - 6 more days till hit the maximum on Clavimox. It's for the staph on her belly.


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula was anal gland rupture/pics*

Here are a couple of pics. It's hard to keep him still, lift his tail, and move the skin in a way to show the abcess clearly, and not get a blurry picture -- I'm just not that talented, so these are the best I could do!


Here is a pic from the first night. He's laying on his side. His rectal area does have a black "spot" at the bottom normally. The red is blood coming out of the hole:











Here it is after they cleaned it up. He's been licking back there quite a bit, so it's kinda mucousy (is that a word? my spellchecker says no!)












Oh, and since I've posted pics of Max's behind, here are much more flattering pics:

http://www.germanshepherds.com/forum/ubbthreads.php?ubb=showflat&Number=1180232&page=0#Post1180232


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula*



> Originally Posted By: LJsMomLJ is on the same dose - 6 more days till hit the maximum on Clavimox. It's for the staph on her belly.


That darn Staph -- seems like she just can't get rid of it - Poor LJ


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## LJsMom (Jan 6, 2008)

*Re: Perianal fistula*

Eeew. It looks painful.


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## DancingCavy (Feb 19, 2001)

*Re: Perianal fistula*

Poor Max.







I hope, whatever it is, you're able to get it under control.


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

I've been following up with a different vet, my regular vet is still out, Max is still having issues. 

Glands seem fine, vet thinks it's a fistula...we're doing a last ditch modified effort of abscessed gland and PF treatment before going all out on the PF front


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## JakodaCD OA (May 14, 2000)

*Re: Perianal fistula*

is it still looking the same or have you noticed any closure??

Poor dude,,been there done that,,ain't fun(


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

It's closed, but a small drainage hole, and swelling. 

He has been licking at it, so there's a chance it's yeasty and irritated and itchy, and that actually is our last hope!


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## JakodaCD OA (May 14, 2000)

*Re: Perianal fistula*

yep, I noticed especially when they are drainy, the dog will definately lick more, (good indicator of something going on to much licking!) 

With the swelling, it very well may be an abscess getting ready to pop,,have you tried hot compresses on it?

The things we do for our dogs)


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

Post vet visit, looks like there is some blood coming out. I do notice occassionally some stuff was coming out, it's not yellow stuff anymore, the Clavamox must have taken care of that. She switched him to Baytril in case the Clavamox wasn't getting to something. Trial run on the baytril for 10 days. $$$

I will work on puttin a cone on when I leave the house, and externally apply something for yeast. Not sure what I have at home yet.


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

I haven't been doing the compress since it healed up - just happened that I'm back at work and trying to juggle too many things. 

I need to get on a schedule.


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## LJsMom (Jan 6, 2008)

*Re: Perianal fistula*



> Originally Posted By: LisaTTrial run on the baytril for 10 days. $$$


At least it wasn't 20 days of Baytril for a large dog.


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

LOL, it will be if the first 10 days is effective! So I guess that's what I should hope for?!?!?!?

Isn't this LJ's favorite abx?


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## LJsMom (Jan 6, 2008)

*Re: Perianal fistula*



> Originally Posted By: LisaTLOL, it will be if the first 10 days is effective! So I guess that's what I should hope for?!?!?!?
> 
> Isn't this LJ's favorite abx?


Yes. I feel your pain.


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

ouch.


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## Ruthie (Aug 25, 2009)

*Re: Perianal fistula*



> Originally Posted By: LisaTGlands seem fine, vet thinks it's a fistula...


Lisa,

I hate to say it, but the pic that you posted looks just like our Gator's fistulas. I am so sorry. That really sucks.


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

Ruthie, 

I guess I hate to hear it, but it's good to have a better idea of what we're dealing with. I just hate that we've wasted time goofing around with this. The vet that we saw that day is the same one that did Max's bloat surgery -- and I think he's the reason why Max has never done so well after that. Strike 2, I ain't giving him a 3rd opportunity......

What are you doing for treatment of Gator's fistulas? The vet said that this is the first time that she has seen one on just one side, though many of the pics I've seen online were only on one side.


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## Jazzstorm (Nov 29, 2005)

*Re: Perianal fistula*

<span style="color: #3333FF">UUgh Lisa I am so sory to hear about Max. That pic looks painful.

My Jazz had PF, luckily they have come along way in PF control since then.(early 90s) I was told to add fiber,( bran and metamucil) I cleaned(they recommended phisoderm) and dried the area 3x a day,antibiotics (can't for the life of me remember what it was, but it was VERY expensive 10$ a pill, I could only purchase it at a people pharm)

I am sure you will have many more options and a much better prognosis. {{{HUGS}}} </span>


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## Ruthie (Aug 25, 2009)

*Re: Perianal fistula*

Unfortunately, we lost Gator 3.5 years ago. It was basically bloat, but it was in his intestine. It was NOT related to the AF.

We did lot's of things for Gator and most of the time his quality of life we very good. During severe break outs, he was in pain and had periods of incontinence. It is a scary thing, but not the end of the world. As Jazzstorm said, there are a lot of treatment options. Rest assured that Max can still have a happy and comfortable life. It just might be a little more work for you with vet trips, meds, and accident clean up.

Here is what we did for Gator.

-	Switched diet to single source protein that he had not yet been exposed to. We did Duck and potato
-	Prednisone 2x per day
-	Cleaned area 2x per day and covered with cream. I can’t remember the name of it, but I think it was an anti-biotic cream.
-	We also tried the medication that Jazzstorm referred to. I also can not remember what it was called, but it is a human cancer medication. It was very expensive and had little success, so we stopped it.

The best advice I can give you is to go to a specialist. A local vet probably doesn’t see a lot of cases of AF and may not be up on the latest treatments. We have a very good vet hospital locally that is almost as large as a human hospital. They were great, but very expensive. We ended up going to Michigan State Animal Hospital and they were great there. Second opinions are good.


----------



## LadyHawk (Jan 19, 2005)

*Re: Perianal fistula*

ASK the vet if he can write a script for 2 tablets of Tacromilus 
It's an anti rejection med used in human patients with organ replacement. 
They had a local pharmacudical compounding company make it into a topical ointment when Gracie had them - they cleared within days and never returned. 


Tacromilus (TD) 0.1% gel


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula*



> Originally Posted By: Jazzstorm <span style="color: #3333FF">UUgh Lisa I am so sory to hear about Max. That pic looks painful.
> 
> My Jazz had PF, luckily they have come along way in PF control since then.(early 90s) I was told to add fiber,( bran and metamucil) I cleaned(they recommended phisoderm) and dried the area 3x a day,antibiotics (can't for the life of me remember what it was, but it was VERY expensive 10$ a pill, I could only purchase it at a people pharm)
> 
> I am sure you will have many more options and a much better prognosis. {{{HUGS}}} </span>


Jazzstorm,

Thank you.

Today there are three small openings, looking a bit like rips, so I'm sure it's a fistula









More fiber, rice in the diet, is what triggered this whole fiasco. It was probably just simmering under the surface though. He does get a lot of vegetable fiber.

Haven't heard of phisoderm in ages....that was good stuff.


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula*



> Originally Posted By: RuthieUnfortunately, we lost Gator 3.5 years ago. It was basically bloat, but it was in his intestine. It was NOT related to the AF.


I'm so sorry












> Quote:We did lot's of things for Gator and most of the time his quality of life we very good. During severe break outs, he was in pain and had periods of incontinence. .....
> 
> Here is what we did for Gator.
> 
> ...


Urinary incontinence? Funny, Max has periods of problems with urination.

That's helpful information. I guess I had better start scouring the PF list to read up on the different options, and also this site:
http://www.members.tripod.com/~perianal-fistulas/MainIndex.html

I will go to a specialist if Max fails to respond to treatment. The vet claims that they get about a 90% response rate for dogs treated the cyclosporin route, but I didn't ask her about relapse rate.....they use metronidazole with it ( http://www.ncbi.nlm.nih.gov/pubmed/6741906 ). Too bad that makes Max unstable in the hind end. She said sometimes they use Tylan too, both used for their anti-inflamatory effect. Tylan I can do.....She said there is also a human med they have to get from the human pharmacy...sounds very similar....

Thank you for the information!!


----------



## Sheppy (Nov 13, 2004)

*Re: Perianal fistula*

> tablets of Tacrolimus

The drug is also sold in an ointment form as Protopic. Still pretty pricy -- about $115/ 30 gram tube. That tube can last about three months. 

It's made by a Japanese company and like many other things, the weak dollar wreaks havoc on the pricing. 

The big gun on fistulas is cyclosporine.


----------



## LJsMom (Jan 6, 2008)

*Re: Perianal fistula*



> Originally Posted By: LisaTToday there are three small openings, looking a bit like rips, so I'm sure it's a fistula


Oh no. I'm so sorry.



> Originally Posted By: LisaTHaven't heard of phisoderm in ages....that was good stuff.


Like 30 years ago when we had pimples!


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula*



> Originally Posted By: LadyHawkASK the vet if he can write a script for 2 tablets of Tacromilus
> It's an anti rejection med used in human patients with organ replacement.
> They had a local pharmacudical compounding company make it into a topical ointment when Gracie had them - they cleared within days and never returned.
> 
> ...



Okay, here is my current plan.....

Baytril and tylan, twice a day with meals.

I have tacrilimus ointment for Max's eyes (pannus) that I get from a compuonding pharmacy (only 0.03% though). I never use up the tube before it expires. I'm going to refill early, and apply it internally, in the fistula, with a q-tip. Externally, in the area, apply Desitin for the zinc -- it also seems like he doesn't like the smell, so is less likely to sneak a lick when I have the collar off of him.

Maybe I should call the vet and see if she is willing to write a script for either some cyclosporin ointment or stronger tacrolimus ointment - any opinions on which might be more effective?

Twice a day?

When I can, warm compress once a day, red "laser" light acupuncture (which really isn't a laser).

Not much I can do with the diet, but don't give anything that might cause more of an allergic reaction I guess.


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula*



> Originally Posted By: Sheppy> tablets of Tacrolimus
> 
> The drug is also sold in an ointment form as Protopic. Still pretty pricy -- about $115/ 30 gram tube. That tube can last about three months.
> 
> ...


You would opt for the cyclosporine over the tacrolimus? I pay about $25 for a 5 gm tube of his eye meds.....

You don't happen to know the optimal strength if the ointment is used, do you?


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula*



> Originally Posted By: LJsMom
> 
> 
> > Originally Posted By: LisaTToday there are three small openings, looking a bit like rips, so I'm sure it's a fistula
> ...


Thanks LJsMom...poor Max, he's pretty miserable. But I suspect that this has been making him feel pretty crummy for awhile.

LOL....forgot about the pimples part -- you're right!


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

Found this interesting conversation, and wanted to leave the link here so I can access it later:

http://books.google.com/books?id=OxQU_cL...epage&q=&f=true


----------



## Barb E (Jun 6, 2004)

*Re: Perianal fistula*

Just wanted you to know that though I've not posted lately I read and keep up







x 1,000,000,000.50


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

Thank you Barb, I really appreciate it. 

Max does too.


----------



## JakodaCD OA (May 14, 2000)

*Re: Perianal fistula*

Lisa, also been keeping up here,,just wanted to add a few things.

Haven't checked out your link yet, (pressed for time will do it later).

ANyhoo,,On the pf site, there should be a listing of vets etc in your particular area that are more specialized in dealing with pf's,,may be an option for you.

I used the cyclo, oral, (didn't know it came in topical?) worked for Dodge, but again, he had no real underlying problems (which most pf dogs have), and his case I don't consider 'true' pF's, more the result of those rotten anal glands..

As for relapse on cyclo, dodge really didn't have any, once he had a small hole erupt, used the topical desitin and it vanished within a week.

MOST, on the list that use topical protopic, use it only ONCE a day (even tho vets advise twice),,and use the desitin once a day,,(one am, one pm)..

Also, I did not use metro in conjunction with the cyclo, in fact didnt use anything inconjunction with the cyclo. 

While the pics of Max DO look like a PF, in my opinion, it may not be a "true" PF< it's pretty far away from the gland area (or so it appears),,?? Did you ever consider a gland removal??? 

Ok, off will be back later to check


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

Diane, cost right now is the issue for gland removal, and also the question of whether that's a critical contributing factor. I guess it's taking some time to get my head wrapped around this in a way that I'm comfortable with. 

Part of that comfort level is where the abx fit in. The Baytril seems to be making him pee like crazy. I think I will try the doxyxyxline and niacinamide as an immune regulator, primarily because he alwyas does better on doxy and hasn't been on it since before summer. 

Appreciate the info on the dozing for the ointments - I was trying to figure out how ro do that - the tacrolimus will work better after cleaning the area and with no desitin. Someone on the PF list said not to put the tacrolimus inside the sore area - I'm trying to think why, might post and ask. 

I know he's been uncomfortable in the hind end for awhile, though it was skeletal, maybe it was this.


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

Walking and texting=lots of typos - oops!


----------



## JakodaCD OA (May 14, 2000)

*Re: Perianal fistula*

I hear ya on money, ( I'm not sure why they don't recommend putting the tacro inside the area, but must have reasoning for it.

I know I definately put the desitin inside and around the area, I was lucky, both dogs I had with PF's, were soooooo easy to work on. And I'm sure that it makes their back ends uncomfortable, even with movement !! It's gotta be real painful !

I know you'll get tons of advice off the pf list,,)


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

I haven't posted to the list yet, still just reading. Guess I'm just holding my breath to see how well things will work for Max. 

I called and asked the vet for a script for the stronger tacrolimus ointment, we'll see what she says. I looked at the list on the PF site, but no vet in this area.

What strikes me is how uncomfortable he has probably been -- I don't think I realized the extent. Now that I am putting "stuff" on it, he is so much calmer. Poor boy.


----------



## Sheppy (Nov 13, 2004)

*Re: Perianal fistula*



> Quote: _LisaT wrote ..._
> 
> ... cyclosporine over the tacrolimus? ...


Cyclosporine is more effective, potent, expensive and it potentially has more side effects. It's sold as Atopica for dogs. Depending on where you get it, the price will run about $4.50 to $6 per pill. You can get a generic cyclosporine for about $3/pill at CostCo. 

It's often dosed with Ketoconizal (sp?). The Keto reduces the ability of the liver to metabolize the cyclo and that results in higher levels of cyclosporine remaining in the bloodstream. This cuts the iniital dose rate from 2 pills/day to one. After the fistulas are under control, you can taper off to a lower dosing schedule. 

The Protopic ointment is the 0.1% version. Treatment is a pea-sized dollop rubbed around the anal area once or twice a day. You will need the area clean and dry and you will also need to keep the dog from licking that area for a while. Again, after the initial treatment course, the dosing rate can often be tapered back.

The Protopic is much cheaper to use than the cyclosporine. Vets will often try the Protopic first and then go to cyclosporine if there is not a good response. 

You are balancing the cost of surgery(s) against continuing medication. Even with the surgical option, many vets will run a course of cyclosporine to reduce the size of the fistulas prior to the operation.

It's best to get the condition under control early and keep it under control. That minimizes the damage to the anal structures.


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

Thank you Sheppy. 

I really don't want to go the oral cyclosporine route. This is a dog that excessively pees when given steroid eye drops, and too much of the cyclosporine ointment in his eyes cause them to start eroding. He gets wobbly on flagyl, and pees excessively on Baytril. Cyclosporine scares me.....ketaconizole, he can do!

Regarding the surgery - I guess I'm not completely convinced that he has the type that would resolve with removal. With his luck, he would have to go through the surgery, but would still have PF problems. Also, still hoping to see a minor miracle with a quick resolution -- I know, not likely.

Thank you for the information!


----------



## Sheppy (Nov 13, 2004)

*Re: Perianal fistula*

Unfortunately, the ketoconizal has no effect on fistulas by itself. It is primarily a drug to treat yeast infections. It's benefit in treating PF's is to extend the residence time of the cyclosporine in the blood stream. 

PF's are currently thought to be an autoimmune disease which is why the immune system modulators like tacrolimus and cyclosporine are effective. 

In any case, you need to hook up with a vet who has sucessfully treated this condition.


----------



## JakodaCD OA (May 14, 2000)

*Re: Perianal fistula*

Hey I see you are getting TONS of food for thought off the PF List,,
You and Max are in good hands on there,,so much information you could go into overload LOL..

Definately shave the butt area,,,I probably forgot to mention that earlier,,but glad someone did on the list )


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

What a great list!! As soon as I introduced myself, just tons of info









I did get a referral to a dermatologist that is not too far from me. I made an appointment for next Tuesday. I also got a script from the vet for the stronger tacrolimus ointment, AND my regular vet is back from her months long hiatus!! So, while my dogs aren't any better right now, I do feel better!

Now that I'm treating Max with some stuff, I can see symptoms that are related to the PF, that I thought were digestive issues. I feel so bad for missing all of that -- but when it's internal, who knew???

Can't say enough good things about the list though!


----------



## LJsMom (Jan 6, 2008)

*Re: Perianal fistula*








Things are looking up!


----------



## JakodaCD OA (May 14, 2000)

*Re: Perianal fistula*

I'm so glad, I knew they would give you lots of "food for thought" ))

Hang in there,


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

Lol, very cute Diane!

Thanks you two. Never did I imagine that I would have to take one of the dogs to a dermatologist:
http://www.adavet.com/
Figured I'd always come up with something. Oh well,







!


----------



## LJsMom (Jan 6, 2008)

*Re: Perianal fistula*

Looks expensive! I like the links on allergies.


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula*



> Originally Posted By: LJsMomLooks expensive!


I"m trying not to think about that part!

My thought, hopefully, is by spending now, I can avoid dragging this out any longer than it has to be, thus cheaper in the long run. 

I can pretend at least...


----------



## Ruthie (Aug 25, 2009)

*Re: Perianal fistula*



> Originally Posted By: LisaT
> 
> Urinary incontinence? Funny, Max has periods of problems with urination.


Just stoped in to get an update on Max and saw your question. No, Gator's wasn't urinary...it was the poopy kind. When he had outbreaks close to the rectum, he couldn't hold it. He had very runny stools. He did pee a lot though because of all the steriods.

It has been too long ago to join in the medicine conversation, but hearing some of the names, I recall that the topical we used was Protopic. It did seem to help alot.

I am glad to see that you are getting lots of help and advice. Seeing the derm vet...great! Max is blessed to have you. When Gator was going through his ordeal, I can't tell you how many people said, "Why do you put up with that. I would just put him down and get another dog." Can you believe that? 

So, what a blessing that Max ended up with you, who will love him and take care of him and do what is best for him.


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula*

Thanks Ruthie!

Yeah, I don't understand about these folks that consider dogs expendable either. My stb-ex husband was waiting until it was time to put Max down because he is so high maintenance. LOL, if I have anything to say about it, Max will be here at least twice as long as that marriage!

Thanks again for your support, it helps knowing that other folks have been through this, and the dogs have come out on the other end in a good or manageable way!


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula (pics)*

Some pics:



















tonight it's oozing reddish blood stuff


----------



## BowWowMeow (May 7, 2007)

*Re: Perianal fistula (pics)*

Owie!









Lisa, 

I am just catching up on this thread. I am so sorry Max is still going through this. I hope the dermatologist can help.


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula (pics)*

Thanks Ruth. It's a bit scary, cuz I think it could go either way.


----------



## Allie (Aug 7, 2008)

*Re: Perianal fistula (pics)*

Hi Lisa -
My Riley, rescue, age unknown, had PF. The Yahoo list is wonderful. I joined the group way back in the beginning in 1999 - and remained active with the group until Riley went to the Bridge, March 2001 due to a stroke. I tried everything for Riley - laser surgery, cyclosporine, antibiotics. then tacrolimus was discovered and Riley responded really well. Back then, I had to have a compounder make up the tacrolimus and used a fairly strong mixture. I would dry Riley with a betadine water mixture and then apply - I alway used surgical gloves when handling it. The tacrolimus really worked. I hope it works as well for Max. The Yahoo Group is good because they really keep up with the new treatments. 

Mary Lou, Murphy and Allie


----------



## Barb E (Jun 6, 2004)

*Re: Perianal fistula (pics)*

Owie


----------



## JeanKBBMMMAAN (May 11, 2005)

*Re: Perianal fistula (pics)*

Wow, Lisa, I've avoided this thread because I just didn't want to know for sure. (and was hoping not to see pictures-but am glad you posted them because I always wondered what they looked like because they scare me)

I am glad you have each other. He's a lucky boy. 

Wow, you are riding quite a wave there...time to come in to shore, Lisa!


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula (pics)*



> Originally Posted By: Allie512Hi Lisa -
> My Riley, rescue, age unknown, had PF. The Yahoo list is wonderful. I joined the group way back in the beginning in 1999 - and remained active with the group until Riley went to the Bridge, March 2001 due to a stroke. I tried everything for Riley - laser surgery, cyclosporine, antibiotics. then tacrolimus was discovered and Riley responded really well. Back then, I had to have a compounder make up the tacrolimus and used a fairly strong mixture. I would dry Riley with a betadine water mixture and then apply - I alway used surgical gloves when handling it. The tacrolimus really worked. I hope it works as well for Max. The Yahoo Group is good because they really keep up with the new treatments.
> 
> Mary Lou, Murphy and Allie


Thank you Mary Lou. I just sent off to a compounding pharmacy for my prescription, since I will be able to get that sooner than anything else. I'm so glad that it was a magic bullet for Riley, I'm hoping that the same will be true for Max. He's so sweet, he knows he's not supposed to lick, and when he can't stand it, he just looks at me, wanting me to do something for him









Hadn't thought about the bentadine - will ask the dermatologist about what best to wash him with.

Thank you!


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula (pics)*



> Originally Posted By: Barb E.Owie


Thanks Barb







I really hope that we can prevent it from enlarging, and get it healed up.


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula (pics)*



> Originally Posted By: JeanKBBMMMAANWow, Lisa, I've avoided this thread because I just didn't want to know for sure. (and was hoping not to see pictures-but am glad you posted them because I always wondered what they looked like because they scare me)
> 
> I am glad you have each other. He's a lucky boy.
> 
> Wow, you are riding quite a wave there...time to come in to shore, Lisa!


Oh geez, stop the ride, I **really** want to get off....

When the slits starting opening up, it was really weird, and then I could see the hollow inside. I'm afraid because I don't know exactly how hollow it is inside. I do know that there were pictures in the files on e PF list of dogs that were a lot worse, that got better. Some didn't.

Most of the pics online that I could find were pretty advanced. I think there should be more like Max's for folks to see. Then maybe some idiot vet wouldn't have wasted over a month of treatment.....(aaargh, please ignore the frustration and bitterness there!)


----------



## SunCzarina (Nov 24, 2000)

*Re: Perianal fistula (pics)*

Eek, the pictures. Poor Max. I've avoided this one figuring you had it under control and it's flashback topic for me. 

Rex had PF after he'd had his bowel obstruction - back in the early 90s before the internet and readily available information with pictures. 

They looked like what Max has. After cleaning his bum all summer, it's not an image one can forget. I cannot remember what the medication was for them - there was a topical and maybe a pill (maybe just a topical)

It took 4 or 6 months to get rid of them. Not a fun summer! The medication wasn't that expensive, I was in college and don't remember having to ask mom and dad for the money... I do remember buying lots of aloe baby wipes for him.

He also had trouble controlling his poop then. I always thought it was as a result of the bowel obstruction or his EPI or a combination of both. Maybe it was the PF too.


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula (pics)*

Hi Jenn, sorry for the flashbacks!!

I can imagine how much more difficult this would be without the information from the internet. 

Luckily, his bowel movements aren't too affected right now. Maybe he's had this for awhile, but i've kept it in check with his abx, but we just got behind. I dunno. 

I'm holding my breath a bit, hopefully in several weeks I'll have some better news.


----------



## LisaT (Feb 7, 2005)

*Re: PF/Dermatologist update*

We went to the dermatologist on Tuesday, I got the referral from someone on the PF list.

The vet here had put Max on Baytril, and she said that she sometimes uses flagyl for an anti-inflammatory, sometimes Tylan instead. So we put him on Baytril and Tylan. She said that the next step would probably be the standard oral cyclosporine and ketoconazole.

He peed like crazy on the Baytril.

So, reading that doxy and low dose cipro (baytril) is a treatment for bartonella (Max and his unknown ailment….who knows what it is?), and also reading that doxy and naicinamide is often used for immune regulation, and also with the help of things written here, I had him on the following:

Internally: Doxy, niacinamide, half-dose baytril, and tylan.

Topically: tacrolimus at a lower dose (.03%, cuz I have it here for his eyes), and the Desitin zinc ointment.

At the appointment, when we talked, I showed her the pics that I have posted here, from the initial blow and recently. So she was expecting it to look really bad upon examination. BUT, it has been healing a little bit each day, and she said that it looked great, healing nicely, and was very relieved.

She said that I almost have things right.

Max always does better with doxy, so we are going to stick with that, unless it stops working. If it stops working, then we will have to go to the oral cyclosporin. She wasn’t completely convinced that the niacinamide helps that much, so we will stick with that for awhile, though it’s not considered critical. We will also stick with the tylan.

She wants me to stop the Baytril, so I don’t create superbugs and in case we need the Baytril later. She added the antifungal ketoconazole, because most of these GSDs have an overgrowth of yeast. She had one GSD that eliminated the fistula with a diet change and an antifungal alone. Max does have signs of yeast overload.

She gave me a prescription for the .1% topical tacrolimus that I have to get ordered.

I was worried about overuse of abx, for the rest of his life, but I have also noticed that the doxy is a bit less effective each time I stop and started. She specifically asked about that, because, in her experience, each time you let the process start over again, it gets harder to control. 

She said that if this was just a mild inflammatory process, or his first, or his only one, she would aim to get him off meds. But with his eyes, persistent ear problems, losing a dew claw to an inflammatory process, his external nose, his nostrils, etc., I should resign myself that his GSD immune system will require modulation for the rest of his life. If we can manage him permanently with only doxy and the keta, then perhaps I should consider him lucky. She said that we hopefully will get the keta down to about 3 times a week, and the doxy to a lower maintenance dose. She did have a GSD in the foothills that managed her lifetime on doxy (they thought chronic lyme and inflammation).

She also thought that the topicals were better once things were under control, and that the oral stuff was the critical part at the initial steps. She was more concerned about him licking the Desitin zinc ointment than the tacrolimus. We also talked about the benefits of perhaps oral zinc supplementation, or oral vitamin A supplementation, thinking either might help, but not being sure.

Overall, I never thought I would be taking either dog to a dermatologist, but I am so glad that I did. And this particular one – you could tell that she loved dogs, and was very open, and overall I am just very pleased, with a sigh of relief


----------



## Barb E (Jun 6, 2004)

*Re: PF/Dermatologist update*

very glad to hear it went well Lisa!


----------



## LJsMom (Jan 6, 2008)

*Re: PF/Dermatologist update*

I'm glad Max is getting off the Baytril. LJ has taken so much of it, that now it doesn't work. 

Now if only you could find a regular vet that is as kind, knowledgeable, and open minded as this dermatologist!


----------



## LisaT (Feb 7, 2005)

*Re: PF/Dermatologist update*

Thank you Barb and Joanne









Joanne, my regular vet is just back from her extended time off -- she is about the best vet out there for me, so I guess I'm double lucky right about now!


----------



## Ruthie (Aug 25, 2009)

*Re: PF/Dermatologist update*

Glad to hear that you are getting some good help for Max. Keep us posted!


----------



## LisaT (Feb 7, 2005)

*Re: PF/Dermatologist update*

Thank you Ruthie, I am keeping my fingerscrossed.


----------



## JakodaCD OA (May 14, 2000)

*Re: PF/Dermatologist update*

also glad to hear your getting some good help/advice/suggestions for Max....It can be a long road, but so worth in the end (no pun intended!)


----------



## LisaT (Feb 7, 2005)

*Re: PF/Dermatologist update*

Ha, Ha!!

Actually, Max has started backsliding since the Derm appt







figuring out my next step now...


----------



## natalie559 (Feb 4, 2005)

*Re: PF/Dermatologist update*

Thinking of your pack today Lisa


----------



## Barb E (Jun 6, 2004)

*Re: PF/Dermatologist update*



> Originally Posted By: LisaTActually, Max has started backsliding since the Derm appt
> 
> 
> 
> ...


----------



## LJsMom (Jan 6, 2008)

*Re: PF/Dermatologist update*



> Originally Posted By: LisaTActually, Max has started backsliding since the Derm appt
> 
> 
> 
> ...


Oh no! Can you go back to whatever it was you were before? Poor Max!


----------



## LisaT (Feb 7, 2005)

*Re: PF/Dermatologist update*

Thanks you guys. Came home today and he was pretty bloody. 

Joanne, I am going to put back what the Derm had me take out. I just hope that I haven't lost too much ground


----------



## Ruthie (Aug 25, 2009)

That sucks.


----------



## LisaT (Feb 7, 2005)

Thanks Ruthie, it sure does. And I can tell he's pretty uncomfortable









Terrible things these PF's.


----------



## Daisy1986 (Jul 9, 2008)

Did a search for anal gland problems and saw this. Sorry to read this. Hope there is improvment soon.


----------



## LisaT (Feb 7, 2005)

Thank you Kelly, I am hoping for improvement soon too!


----------



## Allie (Aug 7, 2008)

Lisa -
I learned in treating Riley, that somethings just did not work. It was more trial and error. For example, Riley became very nausated on cyclosporine and though I used it for a period of time, I could see that it was just not working very well and I could not keep making Riley ill. I truly believe that each PF case is different as to treatment. Sorry that you are going thru this rough time with Max. Hope things improve. I check this thread ever few days, as I do know what you are going through.

Mary Lou


----------



## JakodaCD OA (May 14, 2000)

Allie is soooo right, and this is whats so frustrating about PF/anal gland problems,,what works for one doesn't work for another, and we unfortunately sometimes have to mess around with different things,,

I hope you can get max back on the right path , will be thinking of you both


----------



## BowWowMeow (May 7, 2007)

Just catching up here, Lisa. How is Max doing today?


----------



## LisaT (Feb 7, 2005)

Thanks you guys, this is so frustrating, and a bit scary.

He may have taken a turn for the better. I'm not sure, but I changed doxy from a capsule to a tablet, and the PF stopped healing and got worse. I have some capsules left and went back to those several days ago, and it looks like he might be healing again. I want to give it another couple of days before I can say anything for sure.

If it's the doxy, I am wondering if it's the magic of the capsules, or I need a higher dose for the tablets. Of course, when he ran out in the yard yesterday after I got home and promptly heaved in a couple of places, that worried me too







We are just finishing up the low-dose Baytril, and hoping that it's cuz I gave it too far away from food perhaps? Today he seems to be pretty calm. We got the new, stronger topical cyclosporin in the mail, so I'm using that now too.

I was thinking about his nose (in relation to Vinnie's post about Dalton's Discoid Lupus), and the pics on Vinnie's blog look exactly like Max's. On the doxy/niacinamide, it got a lot better. With the added antifungal, it might completely resolve. The dermatologist said (and I agree with this), that they really think that all these inflammatory conditions are the same thing in the GSD, but they manifest themselves differently in different individuals. That's a bit scary, because Max has been getting more out of control in systemic inflammatory "stuff" over the years, and I hate to think that the doxy/nia might not work and that we are heading to cyclosporin. I haven't been working with the homeopathic vet because I needed to save some $$$$ (divorce sucks), but maybe, I need to get back in touch with her -- homeopathic vet versus cyclosporin, just on the practical cost side, the homeopathic vet might win. In terms of longterm health, I know what the answer is there.

So, I'm holding my breath over here, and crossing fingers. I told Max to cross his paws, and he just stared at me. However, when Indy was laying down, I saw her paws crossed, so maybe she was sending good vibes for Maxie boy


----------



## JakodaCD OA (May 14, 2000)

well I'm sure we will all be crossing our paws and sending good vibes for Max,,hang in there, keep us updated


----------



## LisaT (Feb 7, 2005)

Thanks, and will do!


----------



## BowWowMeow (May 7, 2007)

Thanks for the update. I understand your worry.









I have been investigating some holistic anti-inflammatories for a friend's dog. Should I post them for you?


----------



## LisaT (Feb 7, 2005)

Thank you. It's a great thing to get better, it's another thing to just stay stable, but the potential for massive blowout is a genuine concern









Absolutely would be interested in what you've come up with!! Because of Max's sensitivities, the ones that I know of won't work very well. 

Curious about something. If I use a therapy that usually would give him an ear infection (he is notorious for yeasty ears), but now that he is on abx and an anti-fungal, would you consider using the therapy if there were no others? I hate these decisions...which is the lesser of the evils???


----------



## BowWowMeow (May 7, 2007)

Lisa,

I was most recently looking at this one: http://www.onlynaturalpet.com/products/Inflamzyme/106005.aspx

As for the ear infection, that's a tough call. Basu was terribly prone to yeast infections in his ear and they drove him crazy.


----------



## Brightelf (Sep 5, 2001)

Sending lots of good vibes for Max. You must feel so scared and frustrated, Lisa! I wish that I were closer, I wish that I could help somehow. And, I know with a dog with sensitivities, all our choices get weighed so carefully... ears vs PF vs anything else that may be affected. Could the Baytril, even though he's just finished it, or the doxy be causing a bit of heaving in the yard? I am sending mondo mego positive vibes for Max to heal the PF and really, really do well and be stable!


----------



## LisaT (Feb 7, 2005)

Thank you Patti, it's such a balancing act







I was thinking about the Baytril and the doxy too. Max is soaking up the good vibes









Ruth, on the Inflamzyme, interesting. Right now he has all of that in his diet, except the L-cysteine. I tried extra bromelain away from meals, and it makes him lick his butt excessively









Amount/Serving - %DV
Vitamin C (ascorbic acid) 100 mg - 167%
Magnesium (as magnesium carbonate) 25 mg - 6%
Bromelain (1,800 M.C.U./g) 125 mg - *
Quercetin 125 mg - *
Mixed Bioflavonoids (from citrus fruits) 100 mg - *
L-Cysteine (as L-cysteine HCl) 75 mg - * 

However, interesting about the cysteine:
http://www.sciencedaily.com/releases/2009/01/090119081346.htm
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1097751/

and for addiction (how weird)????
http://www.sciencedaily.com/releases/2007/09/070911120331.htm

Looks like something to add to the mix.


----------



## Daisy1986 (Jul 9, 2008)

Glad things are little a bit better. 

What did you decide? 

I think from the looks of the pics, I would risk an ear infection and try the option.


----------



## Brightelf (Sep 5, 2001)

Lisa, I understand, again, how very hard it is to balance supplements in a dog with sensitivities, when you have a goal for either curing or managing a condition like this. Max is so very lucky to have you for his Mom! How is Max feeling? How are you holding up? Just wanted you to know that while I haven't any fantastic ideas, that I am sending positive, healing vibes out Max's way!


----------



## LisaT (Feb 7, 2005)

Thank you Patti









Kelly, I think, when the time comes, since he will be on an antifungal, I will go with the herbal that might cause an ear infection.

I really can't believe it, but this boy is still on three different antibiotics (doxy, tylan and amoxi) and an anti-fungal. I've got him on some supplements (l-glutamine, DGL licorice, aloe gel internally and put in the fistula itself), and am trying to use some homeopathic remedies.

He is not getting worse, I don't think, and appears to be slowly improving. I think. He had those three slits and some open wound underneath, but when everything blew up, the slits got larger, and the tunnel for the open internal wound seemed like it got a lot bigger inside. I thought I might have seen some irritated tracts actually at the end of the rectum too.

There is still the one big slit, but the other ones seem to have healed externally, and I think underneath filled in with healed tissue. I think the one deep cavern is not as deep, but it's hard to see.

He will be on the doxy and the antifungal permanently - we will work down to a lowest possible dose, but keep him on it, because of his numerous inflammatory conditions. I would like to move him from some of the drugs though to some herbals. Too scared to do that right now, but I'm thinking longterm. The Derm said that the antifungal may end up being 3 times a week, if we are lucky.

Btw, the response to the antifungal is pretty amazing. His eyes are getting better, his nose is getting better, digestion had immediate improvement, and inside his ears are changing. I've had this fixation on GSDs and their apparent susceptibility to fungal infections like Aspergillus, thinking that it most likely is incredibly underdiagnosed. Not that I that I think that Max has Aspergillus, but I do think that he has been able to keep fungal infections in check less successfully than bacterial. When he came to live here, he had a raging ear infection that I battled for awhile. Yeast. Yeast that resolved by treatment with antibiotics...now in what world does that make sense?


----------



## LisaT (Feb 7, 2005)

I haven't updated this in a bit....so here goes....

Max is still on a variety of drugs....amoxicillin, doxycycline, tylan, niacminacide (for immune modulation), ketoconazole. Separately I have tried to take him off the amoxicillin and doxyclycine, and the pattern is the same. By the end of day 2, he is panting quite a bit. By the end of day 3, he starts oozing quite a bit of yellow-ish gunk, by the end of day 4, it is starting to turn blood tinged, and after that, a lot more blood. The same thing happened when I took him off Baytril, which is why I started the amoxicillin in the first place.

Removing the tylan seems to affect his nose the most, I didn't pay attention to the fistula during that trial, since that was the first one I played with and I wasn't paying close enough attention.

I've also found that doxy capsules work a lot better than the tablets, but the capsules are nowhere to be found nowadays.

Each of the trials of removing the abx has cause the fistula to become worse, and larger, so I have been spending time undoing the damage that all of that has caused. Maybe we lost about a month of treatment, maybe more, because of the trials.

For the past couple of weeks, I've been sticking to all of the drugs, and he is continuing to heal, ever so slowly! The Derm said that he still may need some low dose cyclosporin, but so far we have held off. I found one reference to fistulas going away after babesia (a tick disease) was treated, which scares me about the cyclosporin - what if this really is all infection based from those friggin' ticks. 

Have I mentioned lately that I hate ticks?

IF this thing heals, I am so very worried about how I am going to get him off all these drugs. I haven't found a probiotic that he can tolerate (how does that make sense), but I have found that he does pretty good on soil organisms (primal defense), if I'm around to give it to him. 

Can't wait until this work schedule changes (in a matter of a few days!). In the evenings I am applying tacrolimus ointment to the area, and then putting backwards boxers on him so that he doesn't lick. In the day, I put on some zinc ointment (been using Burt's Bee's stuff or Desitin), and he has to stay in his cone in the crate. Poor boy, that stupid cone is terrible for his neck. It's really an ordeal, and he's been a very good sport about everything. 

I will have some time off in the next month, so he'll get a reprieve from all that cone-time!


----------



## BowWowMeow (May 7, 2007)

Poor Max and poor you! This must be so stressful for both of you. You're doing a great job with him, Lisa!


----------



## LisaT (Feb 7, 2005)

Thanks Ruth. It is really stressful, moreso than I might have imagined. But we seem to be managing!


----------



## JakodaCD OA (May 14, 2000)

if it isn't one thing it's another,,darned if you do, darned if you don't.

Poor Max and poor you,,I know it can be stressful..I'll be thinking of you both!


----------



## Daisy1986 (Jul 9, 2008)

MAJOR







For all you and Max are going through. When I saw this I was hoping for nothing but good news. 

Which it is all things considered. He is healing, and you will have TIME off, so no cone!







Keep healing MAX!


----------



## LisaT (Feb 7, 2005)

Thank you Kelly









I guess all things considering, it is good news - it good be *much* worse!


----------



## Barb E (Jun 6, 2004)

x 1,000,000,000.50


----------



## LJsMom (Jan 6, 2008)

> Originally Posted By: Barb E.) x 1,000,000,000.50


Again, what Barb said! I think I'm out of words today.

Oh, still waiting on a photo of Mr. Max in this boxers...


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula/boxers pic*

Thank you both, hugs and support always help!!

Okay, I'm sure that Max doesn't want me sharing this, but here's a bad cellphone pic of when I was using a shirt to hold the boxers up - I will work on getting a better picture with just the boxers, now that I have it down to a fine art



















Yes, he does sleep with a pillow. I got tired of seeing his head hang over the side, so I put a pillow there!

And he is such a good boy. I forgot to take off his boxers when I let him out the other morning. I know he really had to pee, but when I brought him in, he was still dry. He must have thought it was some cruel joke!


----------



## LJsMom (Jan 6, 2008)

*Re: Perianal fistula/boxers pic*

Oh, poor Max! He has a gorgeous tail! Odd how they like to sleep with their head over the side!


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula/boxers pic*

He *will not* sleep with his head on the bed, it must be hanging over something. Guess LJ does the same thing?

LOL, his tail does look rather fluffy there doesn't it? Guess cuz we can't see anything else of him!


----------



## Barb E (Jun 6, 2004)

*Re: Perianal fistula/boxers pic*



> Originally Posted By: LisaT


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula/boxers pic*

I call it his _skater dude_ look


----------



## Barb E (Jun 6, 2004)

*Re: Perianal fistula/boxers pic*

The reason for the boxers make me sad, but the picture really made me go awwwwwwwwwwwwwwwwwwwwwwwwwwwwwwe


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula/boxers pic*








, I know exactly what you mean!


----------



## natalie559 (Feb 4, 2005)

*Re: Perianal fistula/boxers pic*

Sounds like your making the best of a tough situation. Give Max a hug from me.


----------



## Allie (Aug 7, 2008)

*Re: Perianal fistula/boxers pic*

Lisa - thank you for the update on Max. I think the boxer idea is great. Also applaud you for thinking of it - I never did when Riley was being treated for PF. Having gone thru this, I know how frustrating and hard it is. However, Max looks pretty happy on his bed with boxers and pillow and they always say that dogs live in the now. Take care. Woof to Max from Allie who now has perfect lips thanks to this board.


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula/boxers pic*

Thank you natalie, I gave Max a big hug from you









Allie, I can't take credit for the boxers, it was Jakoda's suggestion, which has worked very well. He's pretty tolerant of them.

LOL, glad to hear of the perfect lips, and woofs right back to Allie from Max!


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula/Sean Rescue Mom?*

Sean Rescue Mom,

I read in another thread that Sean is on the cylco and the doxy/niaminacide, along with other stuff. Thought instead of hijacking that thread, I would post here.

Max may be headed for cyclo in addition to the doxy/nia combo, in addition to his other meds.

Just curious, when you started the cyclo, did you try weaning off the doxy/nia, or did you stay on them, thinking to keep the cyclo at a lower dose? Is he also on ketoconazole?


----------



## JakodaCD OA (May 14, 2000)

*Re: Perianal fistula/Sean Rescue Mom?*

not seans mom here, but I'll tell you what we did with dodge when he went on cyclo, (and I know Max can only take certain stuff so this may not pertain to him at all but throwing it out here)

Dodge was on heavy doses of keflex prior to the cyclo, didn't work, put him on the cyclo only. Nothing else, and trough tested to make sure the dosage wasn't to low or high. 

I was REAL lucky, that Dodge was an experiment with my vet, since he hadn't had the opportunity to treat any PF dogs with cyclo, (cost) he gave them to me at 'his' cost which saved me alot of money.. 

I didn't use ketaconazole just straight cyclo. Dodge tolerated it very well.. the only side effect from it was major coat blow, and I mean MAJOR, and he turned into a poop eater)


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula/Sean Rescue Mom?*

Oh man, and Max's coat looks so good!

You don't remember the dosage, do you? Just curious. This thing waxes and wanes, and he's pretty miserable right now as it is starting to get worse for no reason that I can pinpoint.


----------



## Brightelf (Sep 5, 2001)

*Re: Perianal fistula/Sean Rescue Mom?*

Also not Sean's Mom here, but sending good vibes for sweetie Max to feel BETTER! When will you know if he'll be going on the cyclo? 

This may not be the way to go in Max's case, but, if you do consider trying a vet who does Traditional Chinese Veterinary Medicine, the herbal mix that made a huge difference for my last senior's recurrant PFs was either 

Long Dan Xi Gan Tan

or

Xiao Chai Hu Tan

Sending these for Max!


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula/Sean Rescue Mom?*

I don't know when Patti, I can't bring myself to call the Derm. 

The prima TCM vet here I can't work with, she's not a "team player" - at least that's the best way to put it. Though I'm afraid I will have to forge some kind of relationship with her. 

My primary vet, the one that has been giving Max his acupuncture and has taken very good care of us, is soon no longer going to be practicing. It's a devastating loss for us







the ramifications are pretty serious, considering the vaccine issue, etal. Guess it's one step at a time. 

I will have some time coming up very soon, will spend some time looking at those herbal combinations. I appreciate the reminder, thanks.


----------



## LJsMom (Jan 6, 2008)

*Re: Perianal fistula/Sean Rescue Mom?*



> Originally Posted By: LisaTMy primary vet, the one that has been giving Max his acupuncture and has taken very good care of us, is soon no longer going to be practicing.


Geez, that really sucks.


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula/Sean Rescue Mom?*

It really sucks.


----------



## Sean Rescue Mom (Jan 24, 2004)

*Re: Perianal fistula/Sean Rescue Mom?*



> Originally Posted By: LisaTSean Rescue Mom, I read in another thread that Sean is on the cylco and the doxy/niaminacide, along with other stuff. Thought instead of hijacking that thread, I would post here.
> Max may be headed for cyclo in addition to the doxy/nia combo, in addition to his other meds.
> Just curious, when you started the cyclo, did you try weaning off the doxy/nia, or did you stay on them, thinking to keep the cyclo at a lower dose? Is he also on ketoconazole?


Lisa, originally when Sean started cyclo. 8 yrs. ago he was not on the niacinamide/tetracycline/trental cocktail. He started out on 100 mg of cyclosporine and the ketoconazole was added purely to keep the cyclo. in his system longer. Yes, he is still on the ketoconazole and I space out the time between giving both meds. or he sometimes vomits. I also used trial and error to figure out what was the best time of day for him to get the cyclo. and ketaconazole. He has to have both on a full stomach so I start the cyclo. with dinner and give the keta. approx. 2 - 3 hrs. after. The research for his cocktail is out of the Univ. of Penn. and he has been doing well. Whenever we tried to lower the dose of cyclo. or the frequency he would start to flare so we have kept him on the same regimen. 

Hope that helps, if you have any other questions please feel free to ask. I'm more than glad to help.


----------



## JakodaCD OA (May 14, 2000)

*Re: Perianal fistula/Sean Rescue Mom?*

we 'experimented', but it worked,,the first month we did a dosage of 150 mgs per day,,the second month (since things were going well) dropped to 100 per day,,by the end of the 2nd month the fistula's were closed, so we did another month at 50 mgs..

VERY low doses compared to some I've seen. That was it, 
we had one 'slit' show up oh, about 6 mths after treatment, but I used desitin on it, and it closed within a couple weeks..

It kinda bothers me to read dogs that are "on it for life", It's a powerful drug, and I don't think leaving them on it for a long period of time can be good for them at all. If Dodge's had reappeared, I was going for radical surgery, but thank good ness they didn't.

Oh, and when he was done with the cyclo, his coat came back like you would not believe,,GORGEOUS and thicker than before !))


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula/Sean Rescue Mom?*

I have a call in to the Derm. Grit my teeth, and dialed the number. I keep thinking that, like his pannus meds that I only have to give every 3 or 4 days if he is on doxy, maybe we will get away with low doses of cyclo. 

Diane, I've been bad about apply the zinc ointment, wonder how much that is making a difference. My schedule has been terrible these past couple of weeks. 


SRM, what prompted the addition of the doxy/nia, symptoms or protocol?


----------



## Sean Rescue Mom (Jan 24, 2004)

*Re: Perianal fistula/Sean Rescue Mom?*



> Originally Posted By: LisaTSRM, what prompted the addition of the doxy/nia, symptoms or protocol?


No doxy, Lisa, just the niacinamide, tetracycline and trental. Remember this was to treat Reactive Hystiocytosis not P.F. so that's probably why the protocol is different. The research is always changing and the Univ. of PA had done an extensive study with promising results on this autoimmune illness.


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula/Sean Rescue Mom?*

Sorry about the tetra - I tend to use the tetracycline and doxy interchangeably since doxy is a tetracycline.

The Derm has a feeling that most of these conditions, at least in the GSD, stem from the same type of immune system malfunction, which makes sense why the treatments are so similar.

Interesting about the trental. Someone on the colon cancer forum had a fistula whose surgeon treated it with an ACE inhibitor in order to increase blood flow to the area.

There is some thought that Max got worse when we switched to doxy tablets instead of capsules. The manufacturer has been out of capules for awhile now, and I've been so frustrated. It never occurred to me that if I get a script, I might be able to get the caspules. After talking to the Derm, I will be picking up the new capsules on Thursday. You know it's bad when you are buying in bottles of 500......

And a testament to the Derm, she wants me to switch to the capsules, and keep doing what I am doing, and come in for a recheck in 6 weeks, rather than run in for a recheck. Of course call if things really start going South, but the hope is the switch back to the capsules will help. I also added more vitamin e to his daily regimen. 

So, at least for another week or so, for sure no cyclo. If he doesn't get worse, then we will hold out longer. I don't know if my nerves can take this, but he is such a good sport


----------



## Sean Rescue Mom (Jan 24, 2004)

*Re: Perianal fistula/Sean Rescue Mom?*



> Originally Posted By: LisaTThere is some thought that Max got worse when we switched to doxy tablets instead of capsules. The manufacturer has been out of capules for awhile now, and I've been so frustrated. It never occurred to me that if I get a script, I might be able to get the caspules.


Interesting observation about the tablets, Sean has always taken the tetracycline capsules, never been on tablets. You'll have to let me know if Max does better on capsules. Best of luck, please keep me posted.


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula/Sean Rescue Mom?*

Thanks SRM, I will be sure to post back. I will know in about a week if it's the form of the doxy.


----------



## Brightelf (Sep 5, 2001)

*Re: Perianal fistula/Sean Rescue Mom?*

Lisa, this has got to have you stretched so very thin.







My hope is that the switch in the doxy makes a real, noticeable difference, and that Max feels better. Also, I am glad that the derm spoke with you, and will re-check in 6 weeks, but be available for consult sooner if need be. Immune system stuff seems so tough to battle, the very meds we use are formed, held together, shaped using fillers that a normal dog's body won't react to, but can upset a sensitive dog. Maybe in a week, you'll start to really see some positive changes on the capsules. I am hoping that having others here who have been through something similar helps. My hope, too, is for a vet like your vet who'll no longer be practicing-- a vet with whom you again have a good rapport, who knows his/her stuff, can think outside the box, and who is just CRAZY about Max







and Indy







. Who wouldn't be?


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula/Sean Rescue Mom?*



> Originally Posted By: Brightelf....My hope, too, is for a vet like your vet who'll no longer be practicing-- a vet with whom you again have a good rapport, who knows his/her stuff, can think outside the box, and who is just CRAZY about Max
> 
> 
> 
> ...

















Thank you Patti









If the capsules work, I think that will be pretty amazing at the difference.


----------



## Brightelf (Sep 5, 2001)

*Re: Perianal fistula/Sean Rescue Mom?*

Lisa, I am sending positive vibes to sweetie-boy Max. And, I'm staying tuned







for GOOD news!


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula/Sean Rescue Mom?*

3 days on capsules only, and it has stopped getting worse. 








stay tuned....


----------



## Sean Rescue Mom (Jan 24, 2004)

*Re: Perianal fistula/Sean Rescue Mom?*



> Originally Posted By: LisaT3 days on capsules only, and it has stopped getting worse.


YAY!







Hope we get more good news, Lisa.


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula/Sean Rescue Mom?*

Thank you









I'm nervous about posting though, don't want to jinx it....


----------



## Brightelf (Sep 5, 2001)

*Re: Perianal fistula/Sean Rescue Mom?*








I understand your caution. But, YAY-- more positive healing energy for sweet Max! may the capsules be it for him!


----------



## LJsMom (Jan 6, 2008)

*Re: Perianal fistula/Sean Rescue Mom?*

Yippie!


----------



## BowWowMeow (May 7, 2007)

*Re: Perianal fistula/Sean Rescue Mom?*

Keeping my fingers crossed for sweet Max....


----------



## Barb E (Jun 6, 2004)

*Re: Perianal fistula/Sean Rescue Mom?*



> Originally Posted By: LisaTThank you
> 
> 
> 
> ...


Hey where's my post from last night?









Redoing the post









_*Crossing fingers and paws in the E house*_


----------



## JakodaCD OA (May 14, 2000)

*Re: Perianal fistula/Sean Rescue Mom?*

I won't mention it, so as not to jinx this,,but YIPEEE continued progress..))


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula/Sean Rescue Mom?*

A watched fistula never heals.......is that a saying? I'm trying really hard to only look at it every 2 or 3 days. I'm not being very patient with this!! But as long as we stay in the "no blood" category, that's a +++


----------



## Brightelf (Sep 5, 2001)

*Re: Perianal fistula/Sean Rescue Mom?*

That really IS good, Lisa! You're watching because.... I'd be watching, too.







But, tiny increments of healing are still increments of healing.







We all are waiting with you, for sweet Max!


----------



## Sean Rescue Mom (Jan 24, 2004)

*Re: Perianal fistula/Sean Rescue Mom?*



> Originally Posted By: LisaTA watched fistula never heals.......is that a saying?


It is now.









I've been gone this weekend picking my daughter up at college. Had to check in once we got back to see how Max is doing. Hope to hear more good news.


----------



## rjvamp (Aug 23, 2008)

*Re: Perianal fistula/Sean Rescue Mom?*

Glad to hear Max is doing some better! I hope he continues to do better.


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula/Sean Rescue Mom?*

Thanks guys, this dog is killing me...

A little blood last night, but I've decided not to freak out just yet. 

He came up lame last Thursday after we picked up meds and then went to the park. He refused to use the stairs I have for the car (ugh), jumped up, and immediately pulled up his right hind leg, same leg as the fistula side. 

He couldn't put any weight on it for awhile, then it got better, but it hurts him. It pulled up again after he tried to scruff his paws after marking the other night, and again after coming off the couch. 

Can't yet figure out if it's knee, hip, back, muscle pull, or some kind of pain from the fistula. We do have a chiro appt tomorrow, maybe some answers there. 

Can you say stress???

If it's knee, can they still do a perfect sit and appear comfortable? Knee is my biggest fear, I think. 

I'm home grading finals nowadays, so at least I get to be here, even if they are completely bored!!


----------



## Brightelf (Sep 5, 2001)

*Re: Perianal fistula/Sean Rescue Mom?*

Oh, my. Deep breaths, Lisa.







Max is keeping you on your toes. Could the doggy chiro very gently examine Max;s knee? Give you some input? I would be anxious about the blood too, but, it may be the fistula is still healing, and he may have moved funny, temporarily tweaking a healing edge. I am sending positive thoughts to you, and healing energy to Max!


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula/Sean Rescue Mom?*

Thanks patty, that's what I'm hoping on both accounts, the blood and the chiro. 

Sometimes , more than others, like now, I wish they had a better facility to speak to us. If I had spare bucks, I'd find a communicator. But if I had spare bucks, we have him in for acupuncture. I'm working on getting him in to acupuncture.


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula/Sean Rescue Mom?*

I just bit the bullet and made an acupuncture appt, but couldn't get it until the 28th. Since my normal vet is making some career changes, I don't know if there are many of those appts left


----------



## Brightelf (Sep 5, 2001)

*Re: Perianal fistula/Sean Rescue Mom?*

Lisa, you're going through this not knowing how much support you'll be able to get from your trusted, longtime vet. That's hard. I admire your courage. I am truly hoping that the accupuncture makes a real difference for him. Also, I am hoping that whatever vet is brought on board is a real surprise for you, in a GOOD way, someone who makes both you and Max feel supported and cared for, cared about. Praying for the BEST for Max!


----------



## LisaT (Feb 7, 2005)

*Re: Perianal fistula/Sean Rescue Mom?*

I know that the acupuncture will help. 


There is no one to replace this vet. Her practice has lots of vets and is now corporate run, her style of medicine is not their priority. Haven't quite figured out how I will go about finding another vet. Even the other acupuncture vet in town doesn't do primary vet med. I guess I will figure something out.


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## LJsMom (Jan 6, 2008)

*Re: Perianal fistula/Sean Rescue Mom?*

I'll ask my acupuncture vet if he knows of anyone good in your area. It's a long shot, but you never know...


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula/Sean Rescue Mom?*

Long shots pay off sometimes, wouldn't that be cool? Thanks LJsMom.


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## LJsMom (Jan 6, 2008)

*Re: Perianal fistula/Sean Rescue Mom?*

I asked him today. Naturally, he doesn't know anyone - however he said to search these websites (which you've probably already done):

http://www.holisticvetlist.com/

http://www.ivas.org/Members/VetSearch/tabid/124/Default.aspx

http://www.aava.org/


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula/Sean Rescue Mom?*

Hope LJ enjoyed her AP. Max really needed his chiro today - his spine and neck were a mess. She couldn't find anything wrong with his leg, we'll see if it continues to bother him.

Thanks Joanne, I double checked all the AP links -- I didn't have the third one, and there are a few folks on there that weren't there before. Most don't seem to have an office though, so I don't know if it's here or there. Sigh, I so don't want to go through this. Maybe my old vet will set up shop in her home? I can wish I guess. We see her next week.


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## Sean Rescue Mom (Jan 24, 2004)

*Re: Perianal fistula/Sean Rescue Mom?*

Lisa, how is Max doing on the capsules?


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula/Sean Rescue Mom?*

I'm kinda holding my breath at this point.

I _don't think_ it's getting worse. The holes seem to be closing a bit, but he almost looks a bit puffy in the area, and I've read all sorts of stories about these things blowing and becoming pretty nasty. So I'm hoping that he is just healing, and I am just imagining things. 

I often use his nasal passages as an indicator, and they are red and raw (I should get a picture, his nose is in terrible shape).

There was blood on his tail a couple of days ago, but I didn't see any yesterday or this morning, so there is hope.








(is there a smiley for holding one's breath, don't think that would come across well!)

Thank you for asking about the boy


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## Qyn (Jan 28, 2005)

*Re: Perianal fistula/Sean Rescue Mom?*



> Originally Posted By: LisaT......
> 
> 
> 
> ...



Oh Lisa, I only just saw this and have just finished reading it all.









I really hope he is on the mend this time.


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula/Sean Rescue Mom?*

Thank you Alison, it's been pretty stressful for the both of us. His current treatment is kinda a long shot it seems, but we are staying the course so far. Waiting for a treatment to start working is one thing, but wondering if the treatment will even work is another. 

BUT, we haven't lost ground in the last week, I don't think, so that's a huge a positive!!!


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## Brightelf (Sep 5, 2001)

*Re: Perianal fistula/Sean Rescue Mom?*

Lisa, I am off to bed, but please know that you and sweetie boy Max are warmly held in my prayers tonight. Not losing ground is HUGE when dealing with a PF. Really, may you start to see some real improvements back there. We're all keeping you and Max in our thoughts.


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## BowWowMeow (May 7, 2007)

*Re: Perianal fistula/Sean Rescue Mom?*

Lisa, 

I hope you see some improvement with Max. Have you tried the remedy Silicea? I read on several forums that it is indicated for pf.


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula/Sean Rescue Mom?*



> Originally Posted By: BrightelfLisa, I am off to bed, but please know that you and sweetie boy Max are warmly held in my prayers tonight. Not losing ground is HUGE when dealing with a PF. Really, may you start to see some real improvements back there. We're all keeping you and Max in our thoughts.


Thank you Patti, hope you are sleeping soundly! Have to say though, I'm not used to you being in a time zone that's a lot closer to mine nowadays. Funny how even on the internet one can get used to things like that


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula/Sean Rescue Mom?*



> Originally Posted By: BowWowMeowLisa,
> 
> I hope you see some improvement with Max. Have you tried the remedy Silicea? I read on several forums that it is indicated for pf.


Thanks Ruth.

I've been using Silicea, and also Arnica. I've been doing some reading up, hope to learn some more that might be helpful to move things along better.

Funny thing is when he gets Silicea, he kinda acts like a butthead....


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula/Sean Rescue Mom?*

Max's PF continues to get better now that we are back on the doxy capsules. I'm a little worried because the external hole is getting smaller, but I can still see a tunnel in there. I think it will be bad if it closes up before healing more inside.

The good news is that I haven't seen any blood in awhile







though he does still lick at it a lot. 

Still holding my breath, but taking a deep one once in awhile!


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## BowWowMeow (May 7, 2007)

*Re: Perianal fistula/Sean Rescue Mom?*

Good news!!!!!!!!!!!


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## LisaT (Feb 7, 2005)

*Re: Perianal fistula/Sean Rescue Mom?*

Thanks Ruth, I think we might finally be back to where we were a couple of months ago. Now we just keep chugging along!!


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## Mary Ward (Sep 11, 2010)

Hi,
My dog Ruppert has a similar looking opening. At first we thought it was a ruptured anal gland abcess but it hasn't healed (since 8/02/10) Our vet now thinks it may be a pf. We are going to try cyclosporin on monday. No pictures yet, any thoughts.
thanks
Mary


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## LisaT (Feb 7, 2005)

Below is the link to Max's follow-up thread (which badly needs to be updated), and also a link to PF info. I highly recommend you get on the PF yahho list. 

Perinal Fistula - GermanShepherdHome.net

Perianal Fistulas - GermanShepherdHome.net

Change of diet to a single protein, single carb/starch source if you haven't alreay done so. 

It took 8 months for me to get Max's closed, though I suspect now he should have his glands out - recommended whenever there is gland involvement.


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## LisaT (Feb 7, 2005)

Cyclo 100 mg, is cheapest, usually at Walgreen's, but only if you put your dog on the family plan. So sorry you two are going through this!


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## Mary Ward (Sep 11, 2010)

Thanks for the info. We're going one step at a time, trying the cyclo first for two weeks and if it doesn't work probably going for a look around. Diet change is tough because he has a hx of pancreatitis and had a flare with lamb biscuits. I am now on the pf yahoo site. Thanks 
No to a third collar to stop his persistantness.
Mary


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## Mary Ward (Sep 11, 2010)

that was a now to a third collar for rupp. It's been ordered. Someday we'll have a dog collar yard sale
Mary


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