Have a 7 year girl that has been on Prednisone for about 5 weeks. She was dx'd as having autoimmune disease. We have been slowly decreasing her doseage but I noticed tonight that she is developing blisters on her eyelids. Is this or could this be a side effect from the drug? We obviously will call the vet Monday morning but thought I would ask here what your thoughts are.

TIA

What sort of autoimmune disease does she have? what were her symptoms before the start of Prednisone? Blisters on eyes can be a sign of strangles. That is very old for strangles however. Are her lymph nodes under her jaw(neck area) swollen? Any blisters inside her ears, or on her vulva? Incidentally, I am hearing a lot more about strange autoimmune illnesses this late winter and early spring...all Labradors and all ages.

The first symptoms that she had were swollen joints, couldn't stand on her feet nor could she lay down. High temp. She was put on antibiotics and prednisone. Did blood work and her WCB was high, tapped a joint, fluid was murky in color and results came back as autoimmune disease. Did a follow up of blood work two weeks ago and her WCB came back normal but her red blood cells have tanked. Not enough to warrent a transfusion but is borderline. She lost 4.5kg.(about 10 lbs.) in two weeks as well. She has lost the pigment in her face, muscle loss and looks like an old dog now. I realize that these are many signs of the side effects of the drug but the blisters are a bit concerning.

Wow. I suppose they tested her for Lyme Disease and ruled that out. Those are troubling symptoms to be sure. Yes, the pred does wreak havoc and it happens rather quickly unfortunately. Are her eyes tearing at all? Have you checked her temp. today? How long ago did you start weaning off the pred and is she taking significantly less now? I would definitely have her checked out Monday. In the meantime I'd be watching for any new blisters appearing in those areas I already asked about, and in and around the muzzle area and lips.

Diane,

I'm so sorry to hear that your girl is so sick. As for the "blister type" lesions, sounds like possibley "Pemphigus" which is an auto-imune disease.Pemphigus appears as blisters around the eye rims, nose and lips and ears, but can show up of other areas of the body. It can be diagnosed via skin biopsy which can be done with a local anesthetic. Best of luck getting your girl well.....Please let us know how she's doing.

Diane, I'm so sorry about your girl's symptoms. I'm so glad that you are getting the help of a vet and getting repeated tests. Autoimmune diseases can be really difficult to diagnose. And it may take several tests to sort out things. It might even take a specialist in internal medicine.

Did the vet test your dog's platelets? Did the vet do an antinuclear antibodies (ANA) test? Coombs test? Urinalysis? Does your dog have an enlarged liver, spleen, or lymph nodes?

With many many swollen joints, skin lesions, and anemia I would be wondering about lupus, but that can be a difficult and unusual diagnosis. So you really do need a thorough workup.

Again, so sorry to hear about your girl and your worry. You are doing the right thing to call the vet tomorrow.

Was she tested for Addisons Disease. Sounds like it to me. Strongly suggest to your Vet , for the specific test, or you will loose her.

I could certainly be wrong, but I don't think that Addison's disease would present with swollen joints and anemia.

You are wrong Kate ! I have Addisons Disease .

We tested for Lymne disease (negative) and her liver is enlarged but was told that can happen when you give a dog such a high dosage of pred. Vet felt we had to hit it hard in the beginning as she was in so much pain from the joint inflammation. Will take her back in on Monday, I think the next set of bloodwork I'll ask about the Addison's and Cushings tests as well. Also am thinking it may be time to take her for a full body ultrasound. Maybe it will put some of the pieces together for us. Vet felt 3 weeks ago that maybe doing the ultrasound might be premature until something else presented itself. Thank you all for your comments and suggestions. I fully intend to investigate all avenues to help her feel better.

Hi Diane,

I have an Addisonian dog. His symptoms krept up on him over the course of a year or so. His blood counts were slightly off but nothing serious until suddenly his kidney values were off. Then he got better for a bit and then one day he went off his food. Within a day he went into a full blown "Addisonian Crisis" His sodium levels dropped and his potassium was through the roof. He was painful in his limbs and shivering. I ran an ACTH Stim test and had him ultrasounded....sure enough he had Addison's. During his crash he lost 11 lbs. in one week. I thought I was going to lose him at 6 & 1/2 years old. Luckily he responded very quickly to the Percortin and steroids and a week on IV sodium Chloride. ( he never had any sort of skin lesions ) Here we are...one year later and he's doing great (knocking on wood)At present time he gets a Percortin injection every 25 days and is also getting a very low dosage of Prednisone once weekly. He had surgery on Friday for a growth on his eye and did very well post-op with a little extra supportive care. Again Diane...my boy had no skin lesions. Best of luck with your girlie! I'll be thinking good thoughts for you both!

BTW Diane..how are your girl's kidney & sodium and potassium levels? Is she getting IV or Sub-Q fluids? If your Vet is even suspecting Addison's your girl should be getting Sodium Chloride at least Sub-Q but IV would be best. The slang name for Addison's is the "Great Imitator" because it imitates so many other diseases. The thing that throws me off is the skin lesions?? JMO...please keep us informed.

Me too. Those skin lesions. I sure hope you can get to the bottom of it. If it were my dog I would get a culture and sensitivity on those lesions. Send out to independent lab. The steroids may have made her susceptible to an infection. You may have a frustrating road ahead until you and your vets figure this out. I wish your dog the best. Hang in there.

Certainly possible that I am wrong. Also possible that you are wrong. It's just always dangerous to speculate about a diagnosis with as little information as Diane presented. Autoimmune disorders, especially the ones that have systemic symptoms, can be really difficult to diagnose. The symptoms overlap.

I'm presuming that Diane's vet may have done more testing than Diane presented and have ideas about possible specific autoimmune disorders. She's doing the right thing to call the vet tomorrow, but I do understand the desire to speed the process of diagnosis, which can seem agonizingly slow and scary when you just want to help your dog get better. I hope the vet gets to the bottom of the problem soon and that a treatment is available.

Yes, and the depigmentation of the face and the immune complexes in the synovial fluid.

Diane,

We can all speculate as to what your girls health issue may be...all hoping for the best for your girl. I think that it may help to jot things down as people try to share their own experiences with you with hope of "hitting the nail on the head" It wouldn't hurt to bring a list of these ideas to your vet, you never know, some of this infomation may help. Best wishes for a quick diagnosis and speedy recovery!

What about a staph infection? Ask to have eye lesions cultured.

Also, keep in mind that at the anti-inflammatory dose of prednisone, the immune system is very suppressed. The high dose of pred is neccessary because an auto-immune disease is an "overactive" immune system, and the pred suppresses that.
One of the pitfalls of suppressing the immune system is that opportunistic infections that the dog's body normally wards off, can gain a foothold.
So it's entirely possible that the skin problem can be a bacterial dermatitis, in which case it would be treated with antibiotics.
Or it could be a further manifestation of whatever auto-immune problem the dog has. You did not give a diagnosis (and maybe it's premature for your vet to give you one), but pemphigus is an auto-immune disease that causes skin lesions primarily on the face, as others have posted.
Sounds like you and your vet are taking this health issue very seriously and are doing the right things to get it under control. Keep working with your vet, this is not the first time he has seen an autoimmune disease and hitting it hard with pred right away is the usual protocol.
If the pred didn't work, there are other immune-suppressing drugs he can try.
Good luck, and like Melody said, keep us posted, so we all learn!

Thank you all! I am writting down all of the suggestions here and will be seeing her tomorrow hopefully if I can get in to see her. I will keep you all posted and once again THANK-YOU all!!

Good luck Diane! I'll be thinking of you. I'll run your girl's symptoms by the Docs at work tomorrow and see if they have any suggestions.

I have an Addisonian dog diagnosed at 4 years old who is now 12 y.o. and I don't think this sounds like Addisons at all. If your vet thought it was Addisons he would not have just put her on 5 weeks of prednisone and nothing more. If addisons was suspected an ACTH stimulation test would have been done for sure (already) because it's highly diagnostic and inexpensive, this is a serious disesase that needs immediate attention to treatment.

Do a search for these diseases in dogs, Auto Immune Hemolytic Anemia (AIHA) or Systemic Lupus Erythematosus (SLE). Good luck.

Here's a good description of SLE:

http://www.petmd.com/dog/conditions/endocrine/c_dg_lupus_erythematosus

Hey Diane...

How did you make out with your girl today?