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Pemphigus: The Story of Kuma

Monica Curtis
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Kuma was a male Akita and beloved family member.  When he was four years old, we noticed that something was wrong with his skin and coat.

His symptons were loss of pigmentation and hair, and small scabby bumps with some scaling of his skin.  Discoid lupus erythematosus was the first diagnosis from a punch biopsy.  His treatment plan was vitamin E, prednisone, tetracycline and niacinamide, using a topical flouroinated corticosteroid.  The topical corticosteroid was ommitted from his treatment plan after realising it was doing no good.  The dosages varied, yet the medication was consistent for approximately one year.  We were also warned to limit his exposure to sunlight as the lesions are exacerbated by sunlight.

There were changes in Kuma's condition during that year.  Little by little, the loss of hair and pigmentation grew larger.  There was more scaling, more scabs.  It seemed to begin to irritate him more, so he began itching more.  Kuma was an excellent dog and he quickly realised that itching made things worse.

Then the infection started to invade his eyes and ears.  I began to panic, recalling the first diagnosis of Vogt-Koyanagi-Harada syndrome (VKH).  Akitas appear to be predisposed to this disease, and a lot of questions are still unanswered,e.g., the immunopathogenesis of VKH is unknown.  Lack of skin and hair pigment, fever, nausea, and blindness are a few of the clinical signs.  You can understand my fear when the lesions began surrounding his eyes and ears.

The advice given was to increase the dosage of medications.  At this point we were still administering prednisone, tetracycline, niacinamide and vitamin E.  For aproximately six months Kuma did fantastic!  The lesions and symptoms were subsiding and his hair was growing back!  We wanted to take him off the high dosage of drugs to return him to his natural self.  For approximately three months Kuma wasn't getting any more symptoms or lesions.
Notice the lesions on Kuma's muzzle
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Then his condition seemed to worsen overnight.  Back on the medication, same as before, but adding azathioprine.  I was apprehensive about using this drug as the research has shown it to cause heart disease and blood problems.  Two weeks after starting the azathioprine, we had to rush him to the hospital.  He had a fever and a bad case of the shakes.  We came to the conclusion he had a bad reaction to the azathioprine, so we discontinued use.  After four long months of his condition worsening and spreading throughout his body and medications being increased, our vet started consulting with a dermatologist.  Three months later I was able to get a visit scheduled.  That's when the next four punch biopsies were completed and the results came back with pemphigus foliaceous.

Pemphigus Foliaceous is a cutaneous autoimmune disorder.  Treatment is often life-long, however some animals will go into remission.  Immunosuppressive therapy is required to control this disorder.  At this time, Kuma had lesions and hair loss all over his body.  His tail, the pads of his feet, his groin, his back and shoulders _ literally everywhere!  The option my vet was giving me was to administer Gold Salt injections into Kuma every week for as long as needed.  The side effects would be muscle and joint soreness and nausea for three to four days after each shot.  At this point Kuma had gone through too much irritation and pain to submit him to more.

I drastically changed Kuma's diet.  Although there is great contraversy about this, we switched him to an all-natural raw diet.  An article in the GRF Newsletter suggested using natural oils and gentle products to bath him with, so I thought it would be wise to shave Kuma so the application of topical treatments would be more effective.  I had an oil made specifically for Kuma.  So, our regime consisted of prednisone, fish oil, natural diet, soaking in Thalassotherapy bath salts and using "Kuma Oil" afterwards.  Once again, everything was going well.  Super, as a matter of fact!  He was once again himself.  He wanted to eat, he wanted to play and he wanted to be alive.

Kuma in the last stages of Pemphigus
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Four months later he plummeted so hard and so fast there was nothing we could do to help him but to put him to sleep.  Now I want to help others deal with this disease to honor Kuma.

Here are a few very important things I would consider if faced with this situation again:

1.  Early diagnosis is critical

2.  Use natural therapy and pharmaceuticals - a delicate balance yet effective

3.  do not push exercise when tired

4.  Try Eastern and Western methods.

In stages, pemphigus can be conquered.  Keep in mind that when it returns - and it will return - it will be stronger, more potent and much faster.  You may be able to conquer the next stage also.  Just be prepared. The velocity, strength and determination of the disease to stay alive is unbelievable.


Our thanks to Monica Curtis for sharing this painful story with us.  Our condolences go to Kuma's family.

Any article in this newsletter may be reprinted with attribution
http://www.cerebussamoyeds.com/WEB2001.pdf

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The above information is simply informational. It's intent is not to replace the advice of a veterinarian nor to assist you in making a diagnosis of your pet. Please consult with your own veterinarian for confirmation of any diagnosis. Your pets life may depend on it.