Does this look like Calcinosis Cutis?
Submitted by MrsDowns on February 7, 2012 - 7:39amMy bulldog, Julio, has been on Prednisone (at varying doses) for about 2 years now. Initially to treat Masticatory Myositis and then as part of his chemotherapy protocol. In November he started developing lesions that looked like hot spots but they have now turned into crusty spots that seem to spread overnight. The fur just falls out in clumps and along his shoulders, his skin feels hard, like he's got a plate of armor under his fur. Could this be Calcinosis Cutis from extended Prednisone use and, if you've experienced this before, did you find it necessary to do a biopsy to confirm? Our oncologist has never seen this before and wants to do a biopsy to confirm but if I can, I'd like to spare him that pain/discomfort.
It doesn't seem to itch, but he seems uncomfortable. We have been weaning him off the prednisone for a couple of weeks now and it's hard to tell if it's helping or making it worse. He's down to 5mg every other day, the lowest dose he's ever been on.
Any thoughts??
[ mom of Julio - age 8, cutaneous lymphoma - and Cesar - age 8, just a wee bit tubby ]
What you are describing sounds like calcinosis cutis -
Your pictures do look similar to what our bulldog looked like in the initial stages and the description of skin developing hard shell like armor definitely describes calcinosis. Although we were told that the itch is similar to poison ivy times 10 our Rocky never really acted like he was itchy.
Rocky did have a skin biopsy but it was a very minor procedure that only required a local anesthetic however it was scheduled when our regular vet was out of town. When he returned he said the biopsy would probably not have been necessary as he recognized what it was as soon as he saw him.
In our experience it got a lot worse before we started seeing improvement. Important to wean off the prednisone as it is the cause of the Cushings/ calcinosis and continued use just makes it worse.
There are so many different skin issues it might be. Hoping it is not calcinosis as it is a very difficult condition to deal with and treat.
Lonna & Harley
Thanks for the info!!
I took him in to see his oncologist yesterday, because he just seemed so uncomfortable and not himself, and we have decided to skip the biopsy. She's only had three patients with calcinosis cutis but we both agree that, with his history, this is most likely what's going on. She prescribed Tramadol to help him with the pain and we are starting him on antibiotics since his white blood cell count was low and he does have a couple of open lesions that look moist.
He is down to 2mg of Prednisone and should be completely off of it by the end of the week. Did you notice an improvement with Rocky right away or is this only the beginning? Aside from cutting out the Prednisone, did any other treatment work for you? Dr. S mentioned creams we could try but said she didn't think they were very effective. So, right now, we're just weaning him off the prednisone and trying to make him comfortable.
[ mom of Julio - age 8, cutaneous lymphoma - and Cesar - age 8, just a wee bit tubby ]
A few suggestions for treatment
When we were dealing with this our vet was in GR Michigan. A veterinary dermatologist from Phizer in CA was coming to there clinic. We were asked to bring Rocky in to her for consult. She had us apply DMSO gel to his lesions twice daily. You can purchase it at most pharmacies. We were instructed to wear gloves when applying as it absorbs into skin very quickly. Rocky also was on antibiotics as with calcinosis the lesions often become infected.
One thing we discovered by accident that really seemed to help the most was bathing him with a good quality human medicated dandruff shampoo. Originally we were bathing him with Malaseb shampoo (with no real positive results) but when we ran out and could not get it we tried medicated dandruff shampoo that we had. Amazingly he looked much better the very next day! We discussed this with our vet who said that although there was no clinical proof it was very likely that the chemicals in dandruff shampoo helped soften and heal and if we saw that it was helping to continue using it. We continued the DMSO & the dandruff shampoo and although it took several months his skin and coat did return to pretty much normal. There were a few of the really hard spots on his back that had been especially large and hard that did not grow hair back but were really not noticeable to anyone but us. We were so pleased as Rocky's calcinosis at its worst had covered most of the top of his back and we had hoped to get it under control but never thought he would look as good as he did.
Try not to get too discouraged. We did. This is not a condition that dissapears quickly even with stopping the pred and treatment. It seemed after weaning him of the pred he actually got worse for awhile. But the good news is, he did start to gradually improve and eventually recovered almost completely.
If you have any other questions please don't hesitant to ask.
Lonna & Harley
Do you remember...
Thanks for the help! Do you remember what brand of shampoo you used?
My biggest concern right now is that he seems to be in pain or, at the very least, uncomfortable. I have been giving him Tramadol but he is not himself. He has become really picky about his food and would rather stay upstairs and nap than come down to eat or interact with the family. He seems depressed. :( Did Rocky go through that, too??
[ mom of Julio - age 8, cutaneous lymphoma - and Cesar - age 8, just a wee bit tubby ]
Yes, he did become more lethargic :(
Our Rocky was never a bundle of energy but unfortunately yes, he did become more lethargic. I attributed it mostly due to the withdrawal from the prednisone. It is really awful that prednisone sometimes is the only thing that can make them feel really good but using it (especially long term) can have such devestating concequences :(
We used men's L'Oreal medicated dandruff shampoo but I am not sure that it is still available. I think most quality dandruff shampoos use the same ingredients.
If you have more questions please feel free to ask. If you would like to call me to talk more send me a email or private message and I will send me phone #.
Lonna & Harley
To Shave or Not To Shave...
It's so nice to be able to talk to someone who has gone through this. Just like with the cancer, it's a little easier for us to handle if we know what to expect. It's difficult seeing him so low but it helps if I know this is normal and there is a light at the end of the tunnel... so thank you for that. :)
One more question... did you shave Rocky or let his fur fall out on it's own? I'd like to shave him so I can see what's going on with his skin but our oncologist (who doesn't have a whole lot of experience with this issue) seems to feel it would be painful or leave him exposed to infection. He has two large patches over his shoulders where it feels like his fur is almost matted down. I don't know if there's a huge scab under there or if his skin is just hard, if that makes sense.
[ mom of Julio - age 8, cutaneous lymphoma - and Cesar - age 8, just a wee bit tubby ]
We did not shave
and our vet did not suggest it. Rocky's hair fell out pretty quickly on its own :( Even with antibiotics his lesions would often become swollen and infected. Your explanation makes complete sense. It was amazing to us how hard Rocky's skin became in the areas effected but mostly on the top of his shoulders and back. It was explained to us that it was calcium deposits forming and then his body fighting with them causing the large hard areas. For people whom have never experenced this it is hard to understand how difficult this condition is to deal with and treat. Our Rocky was a trooper but we felt so bad for him.
I would have loved to have someone to talk to with experience when we were dealing with this. I had not yet discovered forums like this.
My best advice for anyone going through this is patience. We got very discouraged as it seemed he got worse quickly and then when we started treating him progress was slow. Also with Rocky although he did get better he never did return completely to his old self. We attributed some of that to his age but some to his body becoming dependent on the pred that he could not longer take.
We did learn a lesson from this. We are reluctant to even give prednisone short term but will never again allow any steriod base meds for our dogs long term.
Hope you start to see things turning a bit in the positive direction soon.
Lonna & Harley