What came first: Diarrhoea or Anal Furunculosis?

Re: What came first: Diarrhoea or Anal Furunculosis?

taliab — Thu, 10 Apr 2014 22:21:17 GMT

[quote user="Thomas Johnson"]

Another hijack of the thread. I'm treating a 6yo F(N) GSD with anal furunculosis which is showing a reasonable response to steroids. However it has also developed ulcerated areas of skin just distal to both its hocks, and on its left fore accessory pad. Could this be part of the same disease process as the anal furunculosis?

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I also saw a GSD x dog today who has a small ulcerated area above his anus about 1cm diameter that he has had for about 1 month....had 1 week cephalosporins then never came back for re-exam until today and has area of hair loss and wet dermatitis/ulcerated on lateral hock . Its a much bigger area about 5cm long and owner reports appeared suddenly but i was wondering if it could be related.

Re: What came first: Diarrhoea or Anal Furunculosis?

Anthony Todd — Tue, 08 Apr 2014 16:12:56 GMT

[quote user="Tim Browning"]

I would GA and examine properly, remove any diseased anal glands and possibly resect some fistulae. Sounds like furunculosis and if atopica not an option steroids should be given on welfare grounds. It is very painful and QOL can be markedly improved by steroids at reasonable doses. Worrying about side effects of steroids should not prevent palliative usage.

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Even I am somewhat surprised at the suggestion of steroids for this.

I would have thought surgically exposing the fistula, local ABs and hygiene would be the plan in these days of steroidophobia.

Lavage with a big old syringe and mild antiseptic helps too; real bad ones you can do with the garden hose too.[outside, not in the bath pleeeeze]

Re: What came first: Diarrhoea or Anal Furunculosis?

Anthony Todd — Tue, 08 Apr 2014 16:09:21 GMT

[quote user="Thomas Johnson"]Could this be part of the same disease process as the anal furunculosis?[/quote]

I always supposed the animal was just trying to get as close as it could to the irritation, and once the area is eroded it becomes a secondary irritation.....

Re: What came first: Diarrhoea or Anal Furunculosis?

Thomas Johnson — Tue, 08 Apr 2014 14:40:51 GMT

Re: What came first: Diarrhoea or Anal Furunculosis?

Tim Browning — Tue, 08 Apr 2014 13:31:34 GMT

Re: What came first: Diarrhoea or Anal Furunculosis?

Anthony Todd — Mon, 07 Apr 2014 22:11:04 GMT

Often it pays to have a look at the anal glands. If the content is purulent and/or watery packing them with your favourite antibiotic ear prep or intramammary is a good idea although I'm not suggesting it is in any way curative or causative.

Re: What came first: Diarrhoea or Anal Furunculosis?

shanley barber — Mon, 07 Apr 2014 21:37:12 GMT

Just because this is may be the one chance my client's Gsd will ever have , what dose of Trim/sulph did you use? I have a 8 yo intact female GSD currently on Carprofen for hip dysphasia, so I am pretty stuck for choices for her furunculosis. Steroids-> gut ulceration +/- pyrometra but Atopica too expensive!

Re: What came first: Diarrhoea or Anal Furunculosis?

Andrew Mellor — Thu, 20 Feb 2014 14:03:06 GMT

i have always used atropica ( and human 100mg capsules prior to these being licenced) with these but is hugely expensive and used nizoral in addition which keeps the atopica in the body up to 10 times longer , I have just posted on the Nizoral thread re this as I do not know what to do now that Nizoral has disappeared.

I have also apparently cured one on trim/sulph tablets was started on for another reason and when there was a dramatic difference to the furunculosis lesions we exteended the course to about 6 or 8 weeks and 2 years on it has never recurred.

Re: What came first: Diarrhoea or Anal Furunculosis?

Julian Earl — Thu, 20 Feb 2014 13:55:32 GMT

Having been down the surgical route with these, I now use novel/sensitivity diet/high dose steroids, and metronidazole and have achieved dramatic success with this approach. It was the referral surgeon to advised me not to refer these to him anymore but to use immunosuppressive therapy as first-line and it seems to work well.

In answer to the original question, I think the diarrhoea comes first and obviously the novel diet targets an underlying dietary sensitivity. I think it begars belief that steroids are appropriate for the severe ulcerative lesion that furunculosis involves but they are first-line and the theory of hypersensirivity being the underlying aetiology of these cases seems borne out by the response.

Re: What came first: Diarrhoea or Anal Furunculosis?

Anthony Dennison — Thu, 20 Feb 2014 11:09:01 GMT

[quote user="Gillian Mostyn"]We've had good success with atopica - if the owner/insurance can afford it. Otherwise you're looking at steroids +antibiosis for long enough to be able to do a good examination......[/quote]

No insurance, and the dog isn't eating too well at the moment which is why I went for Voren over oral steroids. I agree with the general consensus, but would like to investigate why the abdomen was tender caudally. Will try and book in for abdominal rads next week and inspect the anus at the same time to see what the damage is

Re: What came first: Diarrhoea or Anal Furunculosis?

Michael Woodhouse — Thu, 20 Feb 2014 00:39:07 GMT

Personally I'd be heavily sedating/GAing the dog to have a good look at that backside..............

Re: What came first: Diarrhoea or Anal Furunculosis?

Mark Hedberg — Wed, 19 Feb 2014 19:11:19 GMT

[quote user="Gillian Mostyn"]

I've seen chronic diarrhoea with anal furunculosis- they seem to have constant faecal tenesmus and I'd guess that the faeces simply doesn't stay in the colon long enough to become formed. We've had good success with atopica - if the owner/insurance can afford it. Otherwise you're looking at steroids +antibiosis for long enough to be able to do a good examination......

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Seconded. Also, fenbendazole not a bad idea either; lots of inflamed gut in there and i wouldn't put it past a parasite to set up shop!

Re: What came first: Diarrhoea or Anal Furunculosis?

Gillian Mostyn — Wed, 19 Feb 2014 19:07:12 GMT

[quote user="Anthony Dennison"]Going anywhere near her perineum caused her to scream and turn towards me.[/quote]

Before doing anything I'd want to be giving her some very good analgesia. I find this condition seems to be extremely painful.

Re: What came first: Diarrhoea or Anal Furunculosis?

Thomas Johnson — Wed, 19 Feb 2014 18:57:05 GMT

[quote user="Anthony Dennison"]

Where do I go from here? Just wait and see how the dog responds to antibiotics, or push for abdominal imaging?

[/quote]

As it's a GSD I'd want to run a TLI before doing anything else.