# Perianal Fistulas...help :(



## Runswithdogs (May 8, 2010)

Our rescue GSD, Regen, started having issues with what we initially thought was her anal gland back in March/April. However, after treatment and recurrence and a vet switch, she was diagnosed with perianal fistulas. 

We are currently doing prednisone (she was on 20 mg/day, recently decreased to 10 mg/day), plus nightly cleaning of the area with Vetricyn and epsom salt soaks, and keeping it shaved. The vet switched her onto Hills z/d from her Taste of the Wild. This seemed to be helping and the last fistula had closed up, but 3 weeks after tapering her pred dose down, two new holes have opened up. 

We are kind of at our wits end. We already had to change to a much more expensive food that is well over $100 a month, and can't swing another $150-300 a month in meds when we are expecting our first baby in 6 weeks and therefore losing an income for the next 6 months. 

Does anyone have thoughts about where we may be able to get assistance for trying her on Atopica/cyclosporin or thoughts on other treatments that have worked?
I had asked the vet about tacrolimus ointment and he seemed unfamiliar with it, but it was one of the things I read about that seemed promising.

This totally sucks, she's been a really healthy dog up until this year, and since we have stayed on top of maintenance, she's not really seeming to be uncomfortable, but seeing new holes open up is disheartening, and she hates having to wear her cone at night.


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## NancyJ (Jun 15, 2003)

It has been awhile since I have had a dog with these so I don't have much helpful advice for today. This group helped me a LOT when I was going through it so, in addition to posters here, maybe they could help you.

https://groups.yahoo.com/neo/groups/PF-L/info


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## Runswithdogs (May 8, 2010)

jocoyn said:


> It has been awhile since I have had a dog with these so I don't have much helpful advice for today. This group helped me a LOT when I was going through it so, in addition to posters here, maybe they could help you.
> 
> https://groups.yahoo.com/neo/groups/PF-L/info


Thanks, I will check that out. Hopefully we can find something that will help her!


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## Heidigsd (Sep 4, 2004)

*Runswithdogs:* Sorry to hear about Regen's issues. Nikki has her share so I feel your pain.

When Nikki's dermatologist suspected she may have PF's the first thing she did was put her on Protopic ointment and also recommended a diet change. 

If you PM me your e-mail I can send you Nikki's report from her dermatologist at Texas A&M so you can share it with your vet. 

Here are some interesting articles:
Case Studies | Animal Dermatology Clinic - Bristish Columbia
Medical management of perianal fistula
http://www.cliniciansbrief.com/site...liniciansbrief.com/files/08_Jan_article_3.pdf


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## qbchottu (Jul 10, 2011)

I would go ahead and get the dog on cyclosporin/ketokonazole regimen. It worked well for my dog that had perianal fistulas. I had him on the medication for about a year and then weaned him off - he's been in remission since. I recommend you don't vaccinate him anymore because vaccinations have been linked to triggering exaggerated immune responses in genetically prone dogs. 

Wipe him with a Huggies wet wipe after each bowel movement. Apply a thin layer of desitin creme. Clip the hair around the perianal area and keep it short - hair traps bacteria. Let the area air out and dry as much as possible. 

An inflatable neck collar as an alternative to a traditional cone works well to stop the dog from licking or biting the area. Make sure to keep the dog on a single protein from a novel source. Earthborn grain free fish coastal catch, natural balance fish and potato, Orijen fish, etc type foods are good for PF dogs. Give only fish or novel protein based grain free treats also. Don't give anything else that could trigger a reaction. 

Keep the dog low stress. Moderate exercise. Limit excitement. Adding pumpkin and fish/coconut oil with a multivitamin is good to help keep condition up during treatment. It'll be tough and some side effects really suck, but it's worth healing your dog. I've had the treatment work well and would recommend it in cases like yours. 

You can email or msg me anytime for more info. Shop around for the best prices - you can get it fairly cheap at some bulk club stores for example. Goodrx is a good site to compare prices.


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## qbchottu (Jul 10, 2011)

I agree with you - it really sucks having your dog go through this disease. I can clearly remember how much it made my heart sink to my stomach whenever I saw a new hole or lack of progress. I spent about a year and a half looking at my dog's butt 5-10x a day! I completely agree with you about it not being fair and sucking. 

BUT there is hope and I think you should try out the cyclosporine/Keto treatment. It's the only thing that worked for my dog and not every dog has to be on it forever - my dog isn't anymore - and the dogs that are on maintenance doses can be tapered down to relatively symptom side effect free doses. 

ask the vet if he has any complementary intial doses or coupons. Check around for the best price and try out the treatment. PF only emerge to the surface after the internal tracts have erupted - meaning the surface damage is only a fraction of what needs to be healed from within as well. It will take time and the setbacks stink but I'm glad I did it because it gave my dog a second chance and without treatment he would have continued to go downhill quickly. 

Another tip - add a good digestive enzyme prebiotic probiotic supplement to the dog's diet. Since her GI system is lacking and under attack right now - she needs help properly breaking down food and digesting properly.


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## qbchottu (Jul 10, 2011)

Treatment and the disease itself can sometimes make appetite go down. You can help this by adding canned food to the diet - natural balance fish is good - there is a wellness grain free salmon 95% canned food - a few spoons mixed into dry food can help. 

You can also add ground novel raw proteins to the diet - say the trigger is chicken and beef - ground lamb or venison would be a nice way to add to the diet if the dog is refusing food. 

You can also boil some bones with water and make a rich broth to add to the kibble - lamb bones for example and that can help the dog eat also. Don't do too much at once though - if the dog has an adverse reaction to any diet change, hold back and eliminate the change.


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## NancyJ (Jun 15, 2003)

Years ago, my dog with fistulas did best on a fish based diet.


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## JakodaCD OA (May 14, 2000)

for right now, since your low on funds, get some Desitin, as in baby diaper rash creme. Put some on a q tip and put it IN AND AROUND the fistula holes twice a day...

I also highly recommend joining the email group from the page listed above..Many very pf savvy people on there that can offer advice, suggestions and support.


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## Mary Jane (Mar 3, 2006)

This worked for us: I really did not want to use a heavy-duty immune suppressant like cyclosporine systemically when Mars developed PF, so we changed his protein source and used cyclosporine ointment (tacrolimus) topically. There are online compounding pharmacies that sell it for a much lower price than our local drug store. After a few months, he healed completely, and several months later has not had a flare. I really hope that tacrolimus will work for Regen.

MJ


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## Magwart (Jul 8, 2012)

I can't help with the disease, but I do know good, reliable compounding pharmacies to save money on pricey pet meds:

Have your vet get pricing from Wedgewood in NJ -- our rescue gets other specialty (= expensive) meds from them through our vet, and their pricing is excellent. They mail out meds pretty quickly too:
Veterinary Pharmacy, Wedgewood Pet RX

They won't give consumers pricing. Your vet has to call, but it's totally worth asking--it could save you a lot of money.


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## LuvShepherds (May 27, 2012)

We cured our rescue of this by switching to single protein source, grain free food and creating a calm environment. We didn't push him in anything that caused anxiety or stress. One day, they were gone. It took a few years. Our vet never prescribed meds, and now I wonder if that would have helped him get over it faster.


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## Quinnj63 (Aug 23, 2018)

Hi friends!

I just wanted to chime in on this post because my 3yo GSD has been suffering from PAF for about a year now. 
We treated at first with antibiotics from my primary vet to get rid of the secondary infection. The one tunnel she had got a little smaller but then a few months later opened back up.

Visited a specialist back the end of June, and he put her on regimen of Cyclosporine 100mg 2x a day (she is about 65-70lb).
She was developing a second tunnel which opened up fully st the start of the regimen. After almost 2 months on the cyclosporine rhere was not much improvement... I was displeased.

Originally I had asked the specialist about Tacrolimus ointment because I would have liked to try that first and not start with the oral route, and he said he sees the most success with Cyclosporine. But After seeing no substantial improvement I brought it up again and he agreed it couldn’t hurt and was worth a shot.

On 8/15 she started 0.1% Tacrolimus ointment 2x a day topically to the area and after just over a week I am amazed to say that the tunnels are about 85% better!! They are almost totally closed up. Once they are totally closed I will discuss with the vet to take her off the oral cyclosporine and stay on the ointment for a while until we can try and taper off or move to a low dosage at least.

Another side note, I also changed the protein source in her diet because I read that the immune response could be triggered by an allergy. She was on a salmon based food since she was a puppy but I’ve now switched her to a Bison based food. Not sure if this had much aid in her recovery but I am pleased and just happy they are almost gone!!

I wanted to share my experience because hopefully it can help a pup with a similar condition!!


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## abishop (Aug 24, 2018)

Thank you so much for sharing your experience in treating perianal fistulas. My GSD female has just developed this disease at age 8. I will ask my vet about using the ointment you mentioned, along with changing her diet to a novel protein source.


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## Annmariern (Aug 25, 2020)

NancyJ said:


> It has been awhile since I have had a dog with these so I don't have much helpful advice for today. This group helped me a LOT when I was going through it so, in addition to posters here, maybe they could help you.
> 
> Yahoo! Groups


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## Annmariern (Aug 25, 2020)

Just joined and I’m so glad that I did. Lots of information from this group. Thank you for sharing your stories. My 6 year old shepherd was recently diagnosed with peri anal fissures. She had a course of Flagyl and amoxicillin. Now, she’s on amoxicillin and Rumsfeld, which just ran out. The Tacromilus is prohibitively expensive. Just switched her diet again to a novel protein diet. Still no better. Has anyone ever used Silvadene cream on the lesions? Going to call the vet again to discuss since my poor dog is not showing any improvement. Has anyone else’s dog demonstrated difficulty evacuating the bowels? Mine is frequently hunched over and travels as she tries to defecate. Stool is soft, like an oatmeal consistency. She has no blockages


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## Annmariern (Aug 25, 2020)

Annmariern said:


> Just joined and I’m so glad that I did. Lots of information from this group. Thank you for sharing your stories. My 6 year old shepherd was recently diagnosed with peri anal fissures. She had a course of Flagyl and amoxicillin. Now, she’s on amoxicillin and Rimadyl, which just ran out. The Tacromilus is prohibitively expensive. Just switched her diet again to a novel protein diet. Still no better. Has anyone ever used Silvadene cream on the lesions? Going to call the vet again to discuss since my poor dog is not showing any improvement. Has anyone else’s dog demonstrated difficulty evacuating the bowels? Mine is frequently hunched over and travels as she tries to defecate. Stool is soft, like an oatmeal consistency. She has no blockages


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## Heidigsd (Sep 4, 2004)

Annmariern said:


> Just joined and I’m so glad that I did. Lots of information from this group. Thank you for sharing your stories. My 6 year old shepherd was recently diagnosed with peri anal fissures. She had a course of Flagyl and amoxicillin. Now, she’s on amoxicillin and Rumsfeld, which just ran out. The Tacromilus is prohibitively expensive. Just switched her diet again to a novel protein diet. Still no better. Has anyone ever used Silvadene cream on the lesions? Going to call the vet again to discuss since my poor dog is not showing any improvement. Has anyone else’s dog demonstrated difficulty evacuating the bowels? Mine is frequently hunched over and travels as she tries to defecate. Stool is soft, like an oatmeal consistency. She has no blockages


The generic Tacromilus costs us about $50 dollars for 30 grams and it lasts a few months. Have you tried her on Prednisone, that's what we are using with Nikki because we know that she would stop eating if we put her on the Cyclosporine.


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