Another French Bulldog with calcinosis cutis

RE: Another French Bulldog with calcinosis cutis

Ian Ramsey — Mon, 11 Mar 2019 12:57:46 GMT

Like the photos and the progression is clear.

Best wishes

Ian

RE: Another French Bulldog with calcinosis cutis

Lene Boysen — Mon, 11 Mar 2019 12:44:41 GMT

Hi Ian,

Thanks for reply.

Mila is back on track, has recovered over the weekend and Vetoryl will be started again.

Here three photos of the development of her skin changes.

As a dermatologist I find it interesting to see, how the skin improves during time. Often the skin is the major concern of our clients :)

The first one (top) is from December when Mila (25 kg) was on 60 mg Vetoryl per day.

The second from February when she still was on 60 mg per day.

The third picture from March after 14 days on 120 mg per day.

Maybe it is not that clear, but the skin has become less thick and more hair are present on the last photo.

It is not satisfying to leave the skin like this, but of course we need to find a lower level of Vetoryl as maintenance dosage. So, maybe during some months the skin will normalize, we hope so.

Thank you for all your inputs.

Kindest, Lene

RE: Another French Bulldog with calcinosis cutis

Ian Ramsey — Sat, 09 Mar 2019 19:51:10 GMT

I would stop the Vetoryl for a few days (until dog is brighter) then restart at 30 mg BID and recheck in 1 month.

Good to see that the Pre-Vetoryl cortisol agreed with the clinical overdose signs. We don't have that many dogs that have done this so your case is interesting

Thanks for sharing this

Ian

RE: Another French Bulldog with calcinosis cutis

Lene Boysen — Sat, 09 Mar 2019 08:44:41 GMT

Hi Ian,

The dog has had 2 x 60 mg Vetoryl for 14 days and has become increasingly lethargic. The dog will not eat much. The skin is however improved.

We took a prevetoryl cortisol sample Wednesday and I got the result yesterday. It is way below 27 nmol/L .

How would you proceed?

Kindest, Lene

RE: Another French Bulldog with calcinosis cutis

Ian Ramsey — Fri, 15 Feb 2019 09:20:51 GMT

Is the dog pruritic still? If not then I would stop the oclacitinib. The pruritis of calcinosis cutis is because of a foreign body reaction and secondary infection (perhaps) and I would suggest that once you have got through the worse of it that no special measures are required.

I have seen this twitching of hind limbs in quite a few old dogs with HAC - not sure of the cause but it does not hurt them.

You say the symptoms are under control 7/2 and 15/1 and the PVC = 95 - I am therefore unclear why an increase in dose is needed.

If I have mis-understood and actually you think the symptoms are NOT under control then going from 60 mg once daily to 90 mg divided in 2 (i.e 45 mg q12h) sounds very expensive ! I would be braver and go from 60 mg once daily to 60 mg twice daily - or if you are not that brave then 30 mg 3 times daily. What I don't like doing is 30 mg in the morning and 60 mg in the evening - but if that is all that the owner will do then we have to live with it (and I would do the smaller dose in the AM and the larger dose at night as that is closer to normal diurnal variation and the PVC then measures the effect of the larger dose.

Hope this helps

Ian