Nov 24, 2009

Lucie Update

Today we took Lucie to the Animal Dermatology Referral Clinic in Dallas. Dr. Crow was wonderful! Dr. Johnson had spoken with him prior to us coming. He had also reviewed her medical history so he was ready to go when when it was time for our appointment. Dr. Crow sat on the floor with her and gave her lots of belly rubs so they could get to know each other better. 

We recapped what she has been going through. Since she has been on meds for a bit, Dr. Crow was not able to see her symptoms in full swing. The rimadyl has helped a lot with the joint pain. Her bumps are still on her ears. They are better than they were but not gone. He asked a lot of questions and examined her.  He does not believe that the bumps on her ears are related to vasculitis.

A brief overview of her symptoms are joint pain (related to trouble getting up or sitting), lack of energy, bumps on her ears with crusting skin and licking her front legs. While he was examining her he found a lump on her right back leg located on her tendon.

He didn't believe that any additional testing was needed at this point. We have caught and started treating her symptoms early. Dr. Crow agreed with Dr. Johnson's choice on her starting meds.

At this point Dr. Crow's primary clinical concern is Systemic Histiocytosis which is a Reactive Histiocytic Disorder. His physical findings match up best with this but since she did not display enough clinical symptoms at the appointment he could not arrive at a definitive diagnosis. Typically by the time he see's a patient with this it is clearly evident by the large nodules (plaques) visible on the animal. We could take her off all meds and see if her lumps worsen to be able to make an exact diagnosis but since she has been experiencing joint pain and lack of energy associated with this he did not want to go that route. He has changed her meds to Tetracycline and Niacinamide. We will continue to give her rimadyl as needed for pain.

So, what is a Reactive Histiocytic Disorder?
It almost invariably involves the skin where it is associated with nodules that form in the dermis and subcutis. These nodules are most commonly seen on the face (muzzle, nose and eyelids), scrotum, and trunk, but can occur in any location. The nodules may ulcerate and ooze. This pattern is typical of cutaneous and systemic histiocytosis. In systemic histiocytosis, there will be some additional evidence of spread beyond the skin. This is most easily recognized when there is involvement of the ocular and nasal mucous membranes. Reddening and swelling of the conjunctiva, corneal edema, and corneal vascularization may be seen. Nasal discharge and snoring respiration, which indicate nasal mucosal infiltration by histiocytes, may also be seen. Dogs with cutaneous histiocytosis are often bright, alert and outwardly unaffected by their disease. In contrast, dogs with systemic histiocytosis, are often anorexic and lose weight; they may be clinically depressed as well. This reflects the more aggressive and widespread tissue involvement in systemic histiocytosis. (Info from http://www.histiocytosis.ucdavis.edu/faq.html#Question_1)


I have been researching this subject since we got back from our appointment. Some sites that I came across state that this is cancer but Dr. Crow stated that it is cancer like but hardly ever results in cancer. This disorder is very rare.

What's next?
We will give her these meds for 2 months and then take her back to Dr. Crow for a check up. If we find any plaques or nodules we are to let him know so that he can examine them. He wants her to set the pace. She can do as she wishes, no restrictions. We will treat any pain with rimadyl. I wish this was more cut and dry. It still feels like a wait and see type game but at least we have a better idea now of what is most likely going on with her. We are to continue with the same food but no dairy with her meds.

In keeping with the doctors orders, Lucie decided to join us for a walk this afternoon. She also enjoyed lots of snuggle time with Hailey. Hailey always knows when to play with Lucie and when to just snuggle.






Thank you to all of our friends for your well wishes and prayers. We are truly blessed! Keep them coming. We will get her through this one way or the other!



25 Treats:

Khyra The Siberian Husky And Sometimes Her Mom said...

Well it seems like you've found a gem of a special vet!

It also seems like maybe you have finally found what it is khausing Lucie her diskhomfort...

Paws khrossed fur all!

Hugz&Khysses,
Khyra

Cocorue said...

he sounds experienced and cares about Lucie......she's not just another patient

our paws are crossed that she's on the mend.....

chikisses

The OP Pack said...

It sounds like you have found the right person to help you through this mystery. We are so hoping she continues to improve and that you can get even more definitive answers. Poor Lucie needs to feel better. And little Hailey - isn't she just a sweetheart.

Hugs to all of you, the OP Pack

The Army of Four said...

We will keep her in our prayers!
Love,
Ammy

Lorenza said...

I still have my paws crossed for Lucie!
Sure I hope he helps here to get better soon!
Kisses and hugs
Lorenza

Chef ·˙ ۛ ♥ said...

I agree - it sounds like Lucie is in very good hands with this vet, which should give you some peace of mind. I'm feeling reassured that he will help you manage this very well and help Lucie a great deal.

Amazing how Hailey knows when to play and when to just cuddle with Lucie. Dogs are so sensitive and smart!

Hugs to all the girls and special kisses for Lucie.

xox
Chef

The Other End Of The Leash said...

I can only speak re: undiagnosed bumps, but... if it is any consolation, for the past year and half, Kiva has what started as bumps inside her ear flaps and have progressed to crusty ulcerations that just never seem to resolve. These bumps have not been able to be diagnosed despite numerous trips to various specialists (including a canine dermatologist) in addition to her usual veterinarian. I believe they are either another symptom of the auto-immune disease that affects her eyes or a side-effect of the medication for that disease. At any rate, I've finally accepted that they definitely bother me more than they bother her!

Hang in there, you are doing all you can do and please keep us posted! :)

Emma Rose said...

We are keeping Lucie in our prayers. I agree that the new vet sounds like a very good one. Thank you for keeping us posted.

Kisses,
Emma Rose

chicamom85 said...

Lucie, I am continue to keep my paws crossed for you and Mommy is praying. It sounds like your new Vet Person is pretty good. You deserve the best in the world. I hope you keep getting better and have a Happy Thanksgiving.

licks and sniffs, Sasha

Tom, Tama-Chan, Sei-Chan, Yuu-Chan said...

Thank you for keeping us updated. It sounds like the specialist vet is really excellent. We are sorry that both you and Lucie are going through this, but she is lucky to be so loved and well looked after, both by her humans and her sisters. We are crossing all our paws that the situation will resolve itself.

MONA AND MOMMY TOO!! said...

Staci,

Having confidence in your vet is very important and really special, the way Dr Ruth was with Samantha.

You know Lucie has our thoughts and prayers. Hailey is so sweet with Lucie and I know you are very proud of her.

Have a wonderful Thanksgiving.

Love Sarah & Mona

Samantha ~ Holly and Zac ~ said...

I have heard of little dogs being service dogs to people. They can tell when they are ill and can warn them somehow when the people have certain conditions.

It sounds like sweet little Hailey is doing that for Lucie, what a truly wonderful relationship those two have. It is so touching looking at them sleeping together like that.

It does sound like you have a wonderful pair of vets looking after Lucie. We hope and pray that she starts to feel better soon.

Holly & Zac

Dina ... UK said...

Those photos are what i would call precious moments....so very sweet.

Sending good vibes, for the new meds to kick in and Lucie shows signs of getting back to normal......xxxx

pam said...

Thank God for good doctors. Maybe you could send one our way.

We're all praying these are the meds for Lucie.

Oh and another thing to send us -- Hailey. We need a cuddle bug.

Bobo, Meja and Mommy

Rusty and Bandit said...

Aww, poor Lucie. We'll be keeping you in our prayers. Adorable pictures!
Anna Marie and Rusty

Dory and the Mama said...

We have our paws crossed that things only get better!!!

Those are a couple of cute snuggle buddies!!

Smileys!
Dory and Bilbo

Sagira said...

I hope Lucie feels better soon. Poor baby.

Huffle Mawson said...

Sounds like this Dr Crow might know a thing or two!

River said...

We are sad that she must suffer. My mom really appreciates the information about it. We hope and pray that maybe as she gets older it will go away. What a treasure and a blessing Hailey is!

love & wags,
River

Clive said...

Keeping our paws crossed for you Lucie!

take care
Clive

caboval said...

Hi Lucie! We are keeping our paws crossed for you! We have never heard of such a thing! Our mommy was thinking it was what Kealani had, juvenile panosteitis, but it does sound different. Keep hanging in there and know that we love you! We check on you everyday and we hope you have a Happy Thanksgiving and get some turkey!!!! You are in our hearts here Lucie! Hugs JOey and Kealani

Maggie and Mitch said...

Our paws are SO crossed for you, Lucie!

Love ya lots
Maggie and Mitch

BJ Roan said...

I have a good friend in Dallas who has a Shelty with health problems. Dr.Crow consulted. I hear he is great, so sounds like Lucie is in good hands. Continued prayers here.

Canine Crusader said...

Glad to hear you found Dr. Crow. So sorry to hear about Lucie's setback. At least you know the Rimadyl works for her. Prayers for Lucie and Happy Thanksgiving to you and yours.

Biggie-Z said...

I have been lurking and reading about Lucie and I'm so sorry you've all been going through this. We hope Lucie feels better soon.

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