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Juvenile Renal Dysplasia {previously Suppressed immune system}

Janice

Well-known member
While Reuben was away being neutered today, the vet rung to say that they had found ulcers under his tongue and she wanted to test one under a microscope and take a blood test as he might have a suppressed immune system.

We had saved up for a few months in a jar to get the £75 for the neutering, and then the blood test and ulcer test was to cost another £186!! :eek:


Luckily he is insured, so we paid the first £81 and the insurance pay the rest.

Has anyone had a dog with a suppressed immune system before? She seems to think it may have something to do with him being underweight.
 
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Yes!! Believe it or not I have a friend who just had this happen a while back with her girl. She was doing an odd mouth movement and took her to the vet (I went with her). It was really weird. The vet opened up her mouth and pointed out two ulcers on the roof of her mouth. This is what they call it
Eosinophilic Granuloma
And this is what they said about it

She has spontanious collection of cells which form ulcers. She will probably get them for the rest of her life.

She was put on prednisone (short term) and it is considered genetic.

Hope this helps.
 
I am running to a meeting and just have a moment, but google canine eosinophilic stomatitis - this is a less common genetic malady in Cavaliers - and is associated with a suppressed immune system. It is actually more common in cats than in dogs. These ulcers are generally found in the throat.

If you go to Cavalier Connection message board and do a search you will find several threads there discussing this condition as we've had several members whose Cavaliers have had this.

There are links posted there and I've typed verbatim there from vet textbooks. I can copy and paste later tonight if you can't find these threads on that site.

Pat
 
I copied and pasted what I wrote in the past on another board:



There is very little in the literature about this disease - it is much more common in cats than in dogs. Notice that it isn't even listed on cavalierhealth.org This is also found in Maltese.

There are a few paragraphs and a drug chart in Ettinger's Textbook of Veterinary Internal Medicine. I can scan this material tomorrow at work (my scanner is broken) and email to you if you send me your email address - [email protected] Corticosteroid drugs are used along with some antibiotics and antifungal drugs.

Did you see this abstract -

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1748-5827.2002.tb00026.x

Journal of Small Animal Practice
Volume 43 Issue 12 Page 533-538, December 2002

To cite this article: A. J. German, D. J. Holden, E. J. Hall, M. J. Day (2002) Eosinophilic diseases in two Cavalier King Charles spaniels
Journal of Small Animal Practice 43 (12) , 533–538 doi:10.1111/j.1748-5827.2002.tb00026.x


Prev Article Next Article
Abstract
Eosinophilic diseases in two Cavalier King Charles spaniels
A. J. German11Department of Clinical Veterinary Science, University of Bristol, Langford House, Bristol BS40 5DU1, D. J. Holden11Department of Clinical Veterinary Science, University of Bristol, Langford House, Bristol BS40 5DU, E. J. Hall11Department of Clinical Veterinary Science, University of Bristol, Langford House, Bristol BS40 5DU and M. J. Day**Department of Pathology and Microbiology, University of Bristol, Langford House, Bristol BS40 5DU1Department of Clinical Veterinary Science, University of Bristol, Langford House, Bristol BS40 5DU *Department of Pathology and Microbiology, University of Bristol, Langford House, Bristol BS40 5DU
1A. J. German's current address is Department of Veterinary Clinical Science, University of Liverpool, Crown Street, Liverpool L7 7EX

Abstract
This report describes the clinical presentation of two Cavalier King Charles spaniels with different eosinophilic diseases. The first case presented with dyspnoea and a non-productive cough, and investigations demonstrated eosinophilic bronchopneumonopathy. The second dog was referred for the investigation of haemorrhagic vomiting and diarrhoea and was eventually diagnosed with eosinophilic enteritis. Both dogs had concurrent eosinophilic stomatitis, and both responded completely to immunosuppressive glucocorticoid therapy. This report is the first to describe the concurrence of eosinophilic stomatitis and systemic eosinophilic disease in Cavalier King Charles spaniels, and suggest that this breed may be predisposed to eosinophilic syndromes.
--------------------------

Here's more

http://www.dentalvet.com/vets/oral_ulcerations.htm

Breed Predilections - Ulcerative eosinophilic stomatitis affecting three Cavalier King Charles spaniels have been described. The lesions are similar in gross appearance to palatine eosinophilic granulomas, but histologically they lack granuloma formation. Maltese are prone to oral ulceration caused by periodontal disease.

------------------
Here's another:

PubMed Citation
Articles by Joffe, D.
Articles by Allen, A.

Journal of the American Animal Hospital Association, Vol 31, Issue 1, 34-37
Copyright © 1995 by American Animal Hospital Association


--------------------------------------------------------------------------------

Articles

Ulcerative eosinophilic stomatitis in three Cavalier King Charles spaniels
DJ Joffe and AL Allen


Ulcerative eosinophilic stomatitis affecting three Cavalier King Charles spaniels is described. The lesions are similar in gross appearance to previously reported palatine eosinophilic granulomas, but histologically they lack granuloma formation. The cause of the lesions is not known. Treatment with corticosteroids led to the resolution of one case and partial resolution of a second. A third case resolved spontaneously without therapy.



Pat
 
Found something else that I posted in May of 2004 that I'll cut and paste below. Since I now have newer vet texts, I'll take a look tonight and see if I can find more current info:
----------------------------------------------------

I have done some research, and there is very little info in most of the veterinary texts about canine stomatitis. There is a lot of info about feline stomatitis as it is linked with some common feline immune mediated diseases, esp. FIV.

I couldn't find anything about canine stomatitis in several editions of Kirk's Current Veterinary Therapy. In Ettinger's "Textbook of Veterinary Internal Medicine" there is some brief info, including:

"Stomatitis is inflammation of the oral mucosa. Oral inflammatory lesions in dogs and cats have multiple causes, necessitating a consistent and logical diagnostic approach. A complete history and thorough physical examination are essential. Oral ulcerations occur in at least four different immune mediated diseases.......etc.......The many infectious diseases that are manifested by lesions in the oral cavity include......etc..." "Candidiasis (which is yeast) may cause severe stomatitis in dogs and cats." "Stomatitis may be described as idiopathic (means they don't know the cause) despite a thorough diagnostic evaluation." Then they talk about the condition in Maltese dogs. Goes on to say "It is appropriate to assume that there may be an immune mediated component to idiopathic stomatitis following negative diagnostic testing. A prudent treatment plan includes regular teeth cleaning, oral preventive medicine at home, and intermittent or chronic provocative corticosteroid therapy. Antimicrobial therapy (they list drugs, including metronidazole) emphasizing anaerobic pathogens may be administered on an intermittent, chronic basis." There is some similar info in Merck's Veterinary Manual.
---------------------------
0
 
My goodness... thanks Pat for all your info. However, reading all this has got me well confused!!! :eek:

is it something which can kill him or something which will clear up with the proper medicine as a one off or short treatment? or is it a rest of the life medicinal thing?

i know you cant say properly as we dont have the results yet.

im just hoping he has an ulcer because he has an ulcer (just like i get them sometimes) and that he is slim because he is a fussy eater.

Fingers crossed, I may know saturday night. :(
 
I'm not expert, but it sounds like something that will be treatable, but will continue to flair up now and again.

He may not be a picky eater, eating might just be painful for him.
 
I don't know if it is anything like esosinophilic disorders in humans, but I have a condition known as eosinophilic esophagitis. Eosinophils are a type of white blood cell so an eosinophilic disorder indicates that there is an abundance of eosinophils where they normally are not (in my case) or more than typical. In my condition, the eosinophils cause my esophagus to spasm and set up an inflammatory process that cuases food to get stuck.
I have had to have food surgically removed from my esophagus more than three times. Kids with this disorder lose weight because they are afraid to eat. (No such luck with me!). The current thinking is that it is an immune mediated response like Pat said, caused my an allergic response to something. Maybe it is the same in dogs. Since it is a fairly uncommon disorder in cavaliers, I don't know if the scientists have examined allergic responses in relation to eosinophilic stomatitis. What I do know is that my condition is treatable with proton pump inhibitors (like protonix) and a steroid spray into my esophagus. We are also examining food allergies. It is not life threatening. Like Soushiruiuma said, maybe it is too painful to eat and Reuben is thin because he has had these ulcers periodically during his life. Good luck figuring it out.
 
When Dylan was having his MRI scan done by Dr Clare Rusbridge she found he had 2 eosinophilic granulomas. She said it is a condition that cavaliers are prone to but that she hadn't seen a cavalier with it for some years. She said it may cause him to retch or cough and seem as if he has a sore throat but she didn't advise that he needed any treatment for it unless it becomes a problem. We have never noticed Dylan having any difficulties at all like this so far. He is extremely greedy and will eat anything in fact I struggle to keep his weight down! I tried to find some information about the condition but found hardly anything at all about it. I would be interested to know what your vet says about it Janice. Has Reuben shown any signs that the ulcers are causing him discomfort?
 
about it. I would be interested to know what your vet says about it Janice. Has Reuben shown any signs that the ulcers are causing him discomfort?

He has never gagged or coughed at all.

ALthough he is fussy, he WILL eat when he feels like it, hard food, soft food, chews all sorts, but not regularly.

To be honest I rather hope it is something to do with him being thin and it can be resolved and he may put on a bit of weight.

He is 12" high at the shoulder and 15" long down the back from shoulder to beginning of tail, but ony weighs 4.75kilos.

I do get some looks when people stroke him as you can feel all his spine.

i will certainly let you know what is said when the tests come back.

He was sick today.. 24 hrs after eating some peices of chicken, they came up completely undigested, hope its to do with the anaesthetic and not the other thing. :(
 
Oh Janice,
I hope Reuben is feeling better. I was thinking of him yesterday.
I might see you tonight at "The pump" if we make it through all the snow.

Give Reuben a hug from us anyway.

Mel
 
Dont think we are going to make it Mel, he is shivering indoors and it is just SOOOO cold out there... and with my husband not home from work Id rather sit with Reuben if thats ok.

Hope all goes well, I might open the front door and have a listen!!! b*n*n*
 
Just had some very bad news from the vet. :(

She rung me to say that they have found very high levels of something in his blood and he has a bad kidney disease :(

she said that he has to go in straight away tomorrow morning and stay in for 3 days while she flushes him out and does more tests and hopefully by monday they will see an improvement.

But, she said, dont think all will definitely well as it is a bad thing and he is so young, that is why he is thin and has bad breath and he may not make it.

All we can do is take him in and HOPE against hope he is ok.... he is only 10 months and he is the best dog we have ever had.

Even my husband and 2 teenage sons were crying tonight.

Please keep your fingers crossed and pray over the next few days, I have never felt quite this bad. :(
 
Janice- So sorry to hear this. I hope he gets better soon, keep us updated. Sending healing thoughts his way.
 
Oh, Janice, we all feel for you and your family and will hold little Reuben in our hearts especially tightly over the next few days. What a rotten thing to happen - and just before Christmas too.

Do let us know how you all get on. Our thoughts will be with you and I'm sure everyone will send healing vibes :l*v:
 
Oh Janice Im sooo sorry about Reuben x

He is such a sweet little thing and full of energy. You will be in all my prayers and please let us know how it all goes. It must be such a shock for you especially finding out all this when all you wanted was him neutered.
But thank goodness you did get him done otherwise you would never know any different.


Sending positive thoughts your way xx
 
I'm so sorry Janice. Thinking of you all and keeping everything crossed for little Reuben.:l*v:
 
Can you get the exact numbers for his creatinine, phosphorus and BUN? Those are the kidney values. At 10 months and since he has had "failure to thrive" this likely means that he has JRD - juvenile renal dysplasia. I've known a few Cavaliers to have this and a lot of shih tzu as it is common in the shih tzu breed. There is a genetic component in some breeds.

The term "azotemia" means that the kidneys are not properly filtering out the waste products - this causes poor appetite, nausea, vomiting, general feeling "yucky." Kidney failure also causes anemia. Treatment includes:

1. Hospitalization for IV flush to flush out the toxins. In the US, we give daily subcutaneous fluids (very easy, cheap and quick) to keep the blood kidney values down once out of the hospital. This is really the key to keeping a dog with kidney failure alive. Vets in the UK generally do not let clients do subq fluids at home - I have no idea why.

2. Diet - diet needs to be very low in phosphorus but still with a good amount of bioavailable protein (good quality protein like egg whites) esp. for a growing puppy. Most of us with dogs in kidney failure home cook as there is not a good commercial diet available. Hill's KD and Royal Canin and Purina make commercial kidney diets but they are really inferior to home prepared kidney diets. Most vets push low protein and don't understand that it is low PHOSPHORUS that is needed and protein is not the enemy per se.

3. Phosphorus binders are given with meals - generally aluminum hydroxide in capsules or liquid form - these bind to the phosphorus in the food eaten and it is carried out through the intestines (feces) without having the need for the kidneys to filter it out.

4. Supportive care like pepcid 30 minutes before a meal to reduce acid stomach, anti-nausea drugs like Reglan, certain supplements like omega 3 fish oils and CoQ-10, and drugs that coat the stomach such as sucralfate (carafate) to prevent ulcers. B-vitamins can be given for anemia. Omega 3 fish oils absolutely help reduce creatinine (studies out there to prove this).

5. For PLN (protein losing nephropathy) - dogs with JRD are often losing protein in their urine - sometimes ACE Inhibitors like benezapril or enalapril are given. These are the same drugs used for heart failure. They often help but they sometimes hurt so you must monitor effects with blood chemistry. The "old school" vet view is to reduce dietary protein with a PLN - the new vet research shows that protein should actually be increased (to help make up for the loss) as much as possible while still keeping low phosphorus. (I had a Maltese mix with a PLN kidney disease.)

I had a geriatric Cavalier who developed chronic kidney failure, and I learned everything that I know about how to take care of him through a yahoo group - K9kidneydiet. Many vets, esp. in the UK, either do not know or do not share with clients many of the basic facts outlined above about how to keep a dog with kidney failure alive. Many vets basically give their clients a bag of KD food and send their patients home to die and they don't try daily fluids at home, etc. For some reason, many vets WILL let clients do subq fluids at home for CATS but not for dogs - I have no idea why. Most dogs are euthanized because they will not eat, lose weight, become anemic and lethargic, feel terrible, etc. so it becomes a quality of life issue. The key most of us find is to keep the kidney values down (which gives good quality of life) with the daily fluids - almost like a "poor man's dialysis." For humans, of course, dialysis is used rather than an IV or subq fluid flush. Even if the IV flush gets the numbers down, daily fluids at home are needed to KEEP the numbers from rising again.

Below are links if you want to read the technical.

http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2003&PID=6602&O=Generic

http://www.vetprof.com/clientinfo/juvenilerenal.html

For anyone who wants to get serious about treating a dog with kidney failure, I cannot say enough good things about that yahoo group. What I learned there kept my dog alive and well compensated for a long time until he was euthanized for other reasons at 16 1/2. My GP vet and my cardiologist became believers when they saw what could be achieved and now send clients to me for information about home care.

It is EXTREMELY overwhelming at first to learn about diet, fluids, etc., but it becomes a part of daily life once you understand the basics.

As you can tell, I am passionate about this subject - this is because I have lived it and I know exactly how it is to feel powerless and hopeless. Above is a very basic primer - there is much more for anyone interested.

Pat
 
Janice try not to get too upset. Now that your vet knows whats wrong with Reuben she can start helping him with it. Sending positive thoughts and healing vibes to you and Reuben.
 
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