So sorry to hear about Fly! So she has lost weight, has a scaly, red skin with hair loss, she isn't eating well at all, and it looks like she is having liver issues. Any vomiting?
I'm most concerned about possible liver cancer (the high alkaline phosphatase and high bilirubin point to a liver issues, as does the low albumin). There is a condition called "paraneoplastic syndrome" which can occur with liver cancer and causes a severe skin reaction.
I definitely think an abdominal ultrasound is the first thing to do. An ultrasound will give your vet a much better idea what is going on with the liver. X-rays of the chest can look for tumor metastases, too.
If you have a medicated shampoo--something containing chlorhexiderm, that would be useful and might make Fly feel a little better. It would also be good to have your vet do a skin scrape to check for Demodex mites. If Fly's immune system is suppressed for whatever reason (cancer or something else), these mites (which are normally found in very small numbers in hair follicles) can start multiplying and causing hair loss and a secondary bacterial infection.
Re vomiting, she did bring back her smallish midday meal on two consecutive days last week. Never done this previously and hasn't done so since I have given her smaller midday meal and similar in evening. On both days I had squeezed the contents of two capsules of Nutramega on to food. I strongly suspect that the very strong fishy smell might have had an adverse effect as she has refused anything that has had the faintest smell of the oils since. Very fussy and wary of any tit-bit previously woofed down. I am currently giving her mainly roast chicken and rice and any tit-bit she will take. Previously she would sit by me and take anything on offer (meat, most fruits, vegs). I do sense that her problem is of internal origin rather than a result of her skin reacting to something she has been in contact with.
Shampoo (5 times so far) is Malaseb (Chlorhexidinedigluconate 20mg and miconazole nitrate 20 but it is not a pleasant experience for the dog being soaking wet for three or so hours before she is dry!
Yes, I can imagine a wet collie is no fun for anyone! Does she tolerate a blow dryer? When you bathe her with the Malaseb, do you let the lather sit on her fur for a good 10 min before rinsing?
probably minimum of 5 mins as she shivers. I was given Virbac Epi-soothe to create a better lather first but since I couldn't be certain that medication went all over I mixed the medication with the shampoo so I knew that the former had got wherever there was lather. I have patted her with towel (not rubbed her dry) to get the worst of the water off but left her to dry in the sun or indoors. I have tried hair drier but not well tolerated and will make another effort. May I keep you posted on the outcome in case it is of benefit to other dogs?
Yes, please, I'm anxious to hear what you find out.
When do you go back to the vet?
I am leaving Fly there tomorrow morning. The intention is to anaesthetise her, do a body scan and take a skin biopsy. I will also ask if other local practices have had similar, if the Bristol Vet School might have a view and whether blood and lesion bacteriology might give a clue as to the condition.
Dear Dr Scarlett,
Re: Fly ref:JACUSTOMER-j4qzhg2c 6/7/14 reddened skin and hair falling out.
My vet carried out an ultrasound scan of the abdomen and found nothing abnormal. Skin biopsies were taken and hair samples with skin flakes attached sent to Axiom Labs, Newton Abbott. These showed neoplastic lymphoid cells colonising the epidermis and residual adnexal epithelium.
Diagnosis - epitheliotropic lymphoma, high grade.
Treatment - 25mg Prednisolone twice a day and Amoxycare 250mg twice a day.
Fly's skin is a more normal colour apart from the various lesions. Skin clearly visible through much thinned coat, appetite back, probably having twice the amount, and drinking quite a lot of water. I feel she should have the increased food at this stage rather than cause her any unnecessary misery. She's enjoying her walks and hunting for voles but some weakness in back legs when jumping up into Freelander so now a combined effort! I shall keep her going so long as she is enjoying life and not showing any signs of distress.
Chemo could be available but I would not want to inflict the possible effects of this on her, nor indeed would I on myself on myself unless the benefits/side effects balance was very clearly in favour of the former.
I am grateful to you for your initial opinion. It prepared me for the possibility of liver cancer though it turned out to be a different type. It's difficult without being able to examine the animal too!
With my thanks,