our three year old German shepherd has anal furunculosis. he was prescripbed ciclosporin 200mg daily five months ago. Initially it seemed to improve but in the last week has got much much worse again. What else can be done. I have read that avoiding beef proteins and milk in diet can help but cannot find any specific dietary advice, can you give any more advice on this as we are desperately worried about him.
many thanks
karen

Hi, Karen,

Anal furunculosis in GSDs is extremely difficult to treat. I never found ANY medical treatment to be of any value.
I have never used cyclosporin, but cryosurgery carried out by an experienced surgeon, in my opinion, is the only form of treatment that has any hopes of success.
The immediate post-operative results look awful , but long term it is the best option.

Walter

The best results are often with cyclosporine, and I have seen a few cases clear up completely on it. The only thing I would say is that 200mg for a German Shepherd seems like an underdose (were you started off on this dose or a higher one?). You can start off on a higher dose and titrate down. Other options that help are keeping the tail trimmed to prevent the formation of a warm moist environment; some people recommend tail amputation, but I think this is a bit extreme; high doses of antibiotics to get rid of secondary infection if present; removal of the anal sacs if they are becoming blocked and abscessated; cryosurgery - is a help but often needs repeating every few months; radical excision surgery - successful in a percentage of cases; diet trial - a good idea as dietary allergy has been implicated in the condition worsening. I would also test for EPI and hypothyroidism as they may be associated with this condition and it sounds odd that the dog should have been doing well only for the furunculosis to return.

Even though Cyclosporine was hailed as the new wonder drug for furunculosis when it first started to be used; it is quite clear that some dogs do not respond to any treatment whatsoever. I hope your dog is not one of these and wish him a speedy recovery!

Hello,
He was started off on ciclosporin 200mg daily, after a month at his next checkup it had started to improve so the vet reduced it to 200mg every second day, it got worse within a week so the vet agreed to increase it to 200mg daily again and he has been on this dose ever since, it did seem to get better but has got worse. He was weighed before treatment the ciclosporin was started and was about 45 kilos ( he is large boned long haired german shepherd). What dose would you have recommended to start on and when would you reduce this? He hasn't had any other tests or blood tests, should renal function etc not be monitored as if in a human (I am a pharmacist so am a bit surprised that it is not monitored in an animal).
I found the advice in the two replies very informative and am very grateful to you both for taking the time to reply.
Many thanks and look forward to your reply with interest
karen

Over to you, James!
Walter

The BSAVA formulary lists the dose for ciclosporin as 5mg/kg and suggests a dose for anal furunculosis of 5mg/kg every 12-24 hours, so your dog has not been grossly underdosed although he is on the lower end of the dose range. I'm not sure whether any form of the drug is licensed for this condition, although "atopica" is licensed for skin hypersensitivity. Your dog may need a higher dose or a dose of increased frequency to begin with before gradually tapering down. Your dog is big enough for 225mg twice daily to begin with. However, in light of the fact he responded well at the start, your vet would be the best person to advise you of whether other diseases such as those previously mentioned might have developed in the meantime.

As to the question of renal impairment, it does not commonly occur with dogs on cyclosporin treatment compared to humans. You could ask your vet to check your dog's creatinine levels and urine specific gravity if you are concerned.

I hope this is of some help.

Sorry for "butting in" Walter!

Hi, James,

Thankyou for your contribition. You are clearly more up-to-date in treating this very intractable condition than am I!

Walter

once again many thanks for your very helpful replies.
karen

Dear Walter.
My six and a half year old german shepherd developed anul furunculosis last year,he was given tablets and cream for three months by a vet but got worse.
I contacted another vet and they referred me to Dick White referrals who operated on him it was expensive but after three weeks it looked really well again it has stayed like this for nearly five months now but when I did my daily check on him today I found his anal orifice red and raw looking I used some Fuciderm cream on him but does this mean he will slip backwards again to how he was before the operation.
Keeping fingers crossed for your advice
John

Hi, John,

Anal furunculosis is a very difficult condition to deal with, and does tend to recur when it has been treated, apparantly successfully.
Many vets think that it is caused by the dog's conformation and the way that GSDs carry their tails.
It may well be that cream will help in the very early stage before there is actually any broken skin, but once sinuses have formed topical treatment other than cryosurgery or actual surgery in my experience is useless, and the longer it is put off the worse the condition becomes and the more difficult it is to treat.
Carry on with the medication, but seek help quickly if the redness does not settle.

Walter

I have an 8 year old GSD who has had a "sore" around the anal gland site. My vet has prescribed 4 wks antibiotics as he felt it was more likely to be an anal gland problem. It has been 2 weeks since the antibiotics have finished and it has improved although he is still licking the area several times per day. I have read that anal gland probs often lead to af, does anyone know if this is true? My vet is keen to carry out a biopsy to check whats going on, is this the usual way to diagnose af does anyone know? I know he uses the cyclosporine route for af which he has said is very successful until it comes to weaning the dogs off it. Does anyone know of any side effect of cyclosporine as I am uncomfortable with it?

Any comment would be greatly appreciated.

Jenny

Hi, Jenny,
If you look back up this thtread you will see that Cyclosporin has been useful in several cases. Anal furunculosis in GSDs is very difficult to treat satisfactorily and often recurs even after what appears to have been successful tratment. Ask your vet why he wants to do a biopsy - clinical examination is usually sufficient to establish a diagnosis.
Walter

Hi,
I hope this helps but 1 of my dogs had Anal Furunculosis (perianal fistulas) and they treated her with antibiotics which were squirted via a tiny flexable nozzle through the rectum. She was also given pro-fibre to treat the blood streaked quite loose jelly poo. Which she still has a dessert spoon of every day on her dinner. The whole lot cleared up in 2 weeks and touch wood 6 months on she is still fab...

Hope this helps...

Vikkie

Hi, Xenatil,
I think that that it may have been fistulas of the anal sacs which your dog had, which does respond ell to the treatment you describe. It is not the same as para-anal fistulas which are frequently seen in German Shepherds, and which are much more difficult to treat successfully.
walter

Hi, we have a 3 year old GSD bitch who has recently been diagnosed with AF/PF. We joined the PF group & have had so much good advice from people experienced with AF/PF. We think it would set aside alot of your fears if you contacted them as they are so supportive & helpful. Here is the link
[groups.yahoo.com], hope you find them as useful as we have. All the best of luck with your furbaby.
Geri,John & Navidia (GSD)

Hello
Is this forum still alive?
My GSD has recently been diagnosed with anal furunculosis and has been perscribed atopica. But also nizoral - what effect will that have? I can only find dermatological applications for it.
Regars, Sarah

Hi, Yes, I am pleased to be able to tell you that this forum is alive and well. We changed the server recently, which caused a few problems, but now all is 100% OK.
Apart from cryosurgery, Cyclosporin appears to tbe the treatment of choice for anal furunculosis - see the correspondence above. I do not understand the reasons for prescribing Nizoral, which is indicated for fungal skin conditions.
Ask your vet to explain.
W

Hi,
We rescued a gsd bitch around october last year,our local vet have said she is around 6years old she is a really lovely girl, and we love her to bits.

About a week after we got her, we took her to our vets, she was diagnosed we anal furuculosis,at first she was percribed antibiotics and steriods, it seemed to get better for a while, then it really flared up, our vet told us it is one of the worst cases he had seen,bless her,

She is now on Atopica, 100mg twice a day,


What we really want to know is will it ever heal up?
We know that she might have to stay on a low dose maybe for the rest of her life, is there anything else you can advise us that we can do, dietery wise or medication to help with the healing process?

She had a really rough start in life, and we want to make her life now as healthy,fullfilled,with all the love and care we can possibly give her!

Hi, Jo,

Am I right in assuming that your dog is a German Shepherd (aka Alsatian)? it is rare to see anal furunculosis in other breed.

If you read some of the questions and answers earlier in this thread you will get some useful information. I do not thinkl that any form of mediaction ever 'cures' this condition. At the best, it helps control it.

Cryosurgery with or without Diathermy, followed by medical treatment seems to be the most successful approach, and you really need pet insurance for that unless you have deep pockets. You would not, of course, get insurance for a pre-existing condition.

W

Our 8 1/2 yr. old chocolate lab was diagnosed with perianal fistulas. This diagnoses came after having surgery to remove his left anal gland and close up the visible holes and tracts (leading back to the infected anal gland). At his post-op visit, additional small openings and red inflamned spots (beginnings of fistulas) were noted. He has been on Atopica (Cyclosporine) 100 mg - 2 capsules twice daily for 1 week now. The site has completely healed up. He will re-visit out vet. who will start lowering the dosage! So far I'm very impressed with the drug!

Hi,
This is very interesting. Anal furunculosis is relatively uncommon in labradors, and usually affects GSD. I am delighted to hear that cyclosporin has worked so well. The condition is very difficult to treat, and before the days of cyclosporin we had only surgical excision and cryosurgery, neither of which were totally reliable.
W

Hi My GSD was diagnosed with furunculosis at 3years of age and was given cyclosporine form . This certainly made the anus much better and after a few weeks we stopped the drug and he was clear of the disease for another few weeks but then it started to return.
We immediately put him back on to cyclosporine. This procedure went on for almost four years. Firstly we used tablets mixed with brussles pate and then we had to use the liquid cylclosporinte mixed with honey in order for him to take it down
On the 7/7/2007 my dog was so excited about going for a walk as usual he started to bark and then suddenly had a fit and fell to the ground . Within 5 minutes he was dead. I did look at his bottom before taking him to the vet and found his bottom was clear of the disease.
Does anyone know if his death was caused by a side effect of the drug Cyclosporine . I looked on the web and found one of the side effects was high blood pressure and wondered if this was the cause. Anyone out there have any other ideas as to why he died. thanks

Hi, Una,

I have checked the manufacturer's data sheet on cyclosporine but can find no reference to side effects which could lead to a sudden death like you describ, except, just possibly, in a diabetic dog whose condition has not been diagnosed.
Cause and effect are often difficult to link, and a comment I used to make when pet owners tried to link two events was 'Everyone dies sometime after their last meal, but necessarily as a result of it'

W

Hi Walter

Thank you for your comments much appreciated. I am sure one does try to link two events.

My GSD "Jerry Lee" named after K9 film (he was just like him mentally)is now sitting in a wooden box in the cabinet ashes only I mean not the dog .

thank you again for answering so promptly.

You certainly give better service than my local doctor ha ha

best wishes

una

Thank you for your comment. I am pleased my response helped.
W

Regarding the nizoral question earlier: This is added to the regime as it allows one to half the dose of cyclosporine, reducing the cost of treatment. (Nizoral (ketoconazole) intereferes with the breadown and excretion of cyclosporine fron the body, allowing a smaller oraldose to achieve the same blood levels.)

John Wrote:
-------------------------------------------------------
> Dear Walter.
> My six and a half year old german shepherd
> developed anul furunculosis last year,he was given
> tablets and cream for three months by a vet but
> got worse.
> I contacted another vet and they referred me
> to Dick White referrals who operated on him it was
> expensive but after three weeks it looked really
> well again it has stayed like this for nearly five
> months now but when I did my daily check on him
> today I found his anal orifice red and raw looking
> I used some Fuciderm cream on him but does this
> mean he will slip backwards again to how he was
> before the operation.
> Keeping fingers crossed for your
> advice
> John

Hi, John,

To the best of my knowledge the current treatment for anal furunculosis is Cyclosporine and ketoconazole - both given by mouth after surgical cleansing of the affected area.
Before these medicines were available surgical excision and cryosurgey (freezing) were the only treatments available and were not very satisfactory.

W

Hello I am very pleased to have found your site. I am glad but very sorry to find out I am not alone in trying to deal with this horrible illness.
My 10 yr old rescue GSD was diagnosed with AF last year. He is the worst case that the vet has seen. We suspect he had it for some time before he was diagnosed and was treated initially by one vet for infected anal glands only. As he got worse and a locum vet looked at him from across a table (because of being abused he is very distrustful), we took him to a vet recommended.) He has had 5 operations and has been on 3 50mg Atopica and 2 50mg Carprodyl a day. He did improve but in the last month one side has started to get worse again so the vet has started him on 2 200mg Nizoral a day as well. After 2 weeks on that he has showed a great improvement and so we go on. But there have been several times recently when I have wondered if I'm doing the right thing. Never minding the expense (we did not have jnsurance on him), is it right to keep the dog going like this when the likelihood is that he will never be totally cured but kept comfortable? But there are days when it is all worthwhile........

John Wrote:
-------------------------------------------------------
> Dear Walter.
> My six and a half year old german shepherd
> developed anul furunculosis last year,he was given
> tablets and cream for three months by a vet but
> got worse.
> I contacted another vet and they referred me
> to Dick White referrals who operated on him it was
> expensive but after three weeks it looked really
> well again it has stayed like this for nearly five
> months now but when I did my daily check on him
> today I found his anal orifice red and raw looking
> I used some Fuciderm cream on him but does this
> mean he will slip backwards again to how he was
> before the operation.
> Keeping fingers crossed for your
> advice
> John