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Experience with sterile nodular panniculitis? UPDATE

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  • Experience with sterile nodular panniculitis? UPDATE

    Just wanted to update and mention that the steroids seem to be working great, his bumps have gone down, almost gone and the oozing is gone! Now just hanging on to the hope that this is acute and not chronic

    So the vet thinks that this is what is wrong with my dog.

    back story, Easter weekend find two small lumps on his chest, we think maybe fatty tumors no biggie he will be 9 this fall, it happens

    two weeks after that we notice there are more and much bigger, then one appears to have opened and is oozing and then my husband accidently pops one next to the open one by touching to to eximine its consistency, thing shoots out at him like a zit on acid, hit his glasses and all over his arm

    take him to vet, they drain a cyst or two and look under microscope and says that it doesn't look like cancer but to be sure we need to do a biopsy for $$$ but he gets some antibiotics to keep the open things from getting an infection

    week after that, looks like he is on death's door, go to different vet for different opinion, tumors/cysts/whatever much bigger and much more numerous, one looks like a tennis ball on his hip and some on his ribs and more on the chest and some on his back and he looks like he lost weight

    2nd vet looks him and says he doesn't look good, he has lost 4 pounds, they quote a biopsy at half the cost and she thinks it is most likely either mast cell tumors, cancer, or a rare fungal case

    takes biopsy and fluid from cysts and sends for testing

    no cancer , no mast cell but still no result on fungal or maybe even bacterial

    few days later, goes in again to try for another biopsy but lumps not cooperating and only get fluid, also get two drainage tubes in for two large pockets of fluid, one being on the hip where the tennis ball busted all on its own and gets antibiotics to keep infection away due to several open things/sores

    current, new ones still poping up and busting, today one busted an you could tell it really hurt him, last few days he has been in an e-collar due to the tubes, call vet to get update and to update her and she says that the lab said no fungal, not sure what it is and its most likely sterile nodular panniculitis and she will need to research it as she has never diagnosed it

    we search it as well and well it seems there are no real answers and treatment is usually steroids

    so, sorry for the book but here we are

    ps. 2nd vet, now vet is mainly eastern not western medicine and would like to try herbs instead of steroids due to long term use complications, however dog appears to be getting worse again and long term may not be a problem

    pss. we have been taking him to work to keep an eye on him and he has totally won over the office and staff and clients alike love him (except for one who does not like dogs and we kept him away from her once we knew, he was totally out of signt)
    Last edited by Burbank; Jul. 8, 2011, 01:50 AM. Reason: update

  • #2
    Years ago I had a wolfhound diagnosed, (after much to-ing and fro-ing, and a referral to the dermatology dept at the vet school) with "Immune Mediated Panniculitis". It sounds like the same thing. She would get lumps like cysts, which then would burst and ooze and look awful. It was all up and down her back and sides and looked seriously gruesome.

    But the good news is that once we figured out what it was, prednisone cured it. I don't recall how long it took, maybe a couple of weeks. We just clipped the hair and topically treated the lesions so they wouldn't get a secondary bacterial infection. She was around a year of age, and it never recurred, and none of her descendents have had it. Let's see, that was six generation ago.

    It must be pretty uncommon, I've never heard of another dog that had it! Good luck with yours, hope and trust your outcome will be as good. It is certainly dreadful looking and I think our Chelsea may have had a fever...not sure about that but know she did not feel good and that had to hurt, as you say.

    I guess they have not learned too much more about it since 1987- I think that is when she had it.


    • Original Poster

      glad to hear that your dog cleared up and never had it happen again, sounds like an acute not chronic case.

      we have a vet appointment tomorrow and we are leaning to trying steroids for a few weeks (8 weeks max) to see if it clears up and with hope that will work and it won't be chronic and keep reoccuring.

      from looking online it seems to be a not well understood disease and not a common disease, lucky us maybe with these odds I need to buy a lottery ticket


      • #4
        Please please do not mess around with this disease and someone who does not know how to treat it. Find a veterinary dermatologist. I can't imagine one not having treated at least several in their lifetime.
        I have seen this disease progress to near whole body pretty quickly. Yes, you need to immuno-suppress them, these dogs are on steroids for a long time, or they recur. Just by saying "trying steroids for no more than 8 weeks" screams to me that the person is not experienced and i would find one who is.




        • #5
          Yep, we had in a wonderful cocker spaniel with this, however immune mediated. He was treated with pred, did well, but had a nasty relapse. Had to be treated with IV antibiotics (and with all his nodules, he developed them around the IV so his catheter had to be replaced every 12 hours). Fever on and off over 5-6 days, but did eventually overcome the hurdle and has been great ever since on a moderate dose of prednisone and he will likely need to stay on them for life. Hopefully your guy will respond to his meds well!


          • Original Poster

            idlemoon, the 8 weeks is me and my husband talking, we will discuss with our vet their thoughts ofcourse however I am also aware that long term steroids can have very serious side effects.

            just did a quick search on the website you posted and it looks like there is only one dermatoligist within 50 miles of us, we are in the middle of nowhere.

            is steroids the only answer for this or will chinese herbs be able to be used, I ask b/c our vet is very eastern in thinking, but she is very caring and concerned and has been researching this and sent the samples to two different labs, our regular vet who is very western in thinking just didn't seem to care as much and offered no ideas


            • Original Poster

              starting steroids tonight


              • #8
                A lot of homeopathic remedies can help, thats for sure. However, science stands behind what traditional vets recommend. try whichever route you feel comfortable with, lots of people do "both" as well. Depends on what your drugs are.

                Remember, a lot of our very valuable western drugs came from natural remedies - opoids, vincristine. However its the science behind them that makes the drugs that much more useful than the raw ingredient.

                Good luck with whichever route you choose.


                • #9
                  Wow, I guess we were really fortunate in that a) we finally got an accurate diagnosis from the dermatology department at a vet school....and it was not easy, like you we had several of the "cysts" biopsied by the local vet to no avail...I think Dr. Tommy Manning, formerly at Cornell but then at NC State, was able to arrive at the diagnosis by using milk to look at it!

                  And b) it sounds like we were so fortunate that the prednisone did clear it up. I do use alternative and eastern veterinary care when I can, but for some things, like this, I think the risks and dangers of steroid treatment are outweighed by the benefits. At least, I can tell you, with this particular bitch, a short term course of pred absolutely cured her. It does sound like she had the acute rather than chronic form.

                  Perhaps the Chinese herbs might be of even more benefit to help support your guy and maybe help with the side effects of pred? But if he were my dog, I would absolutely do the pred, even though I know you hate to, in this case I would go ahead with it.


                  • Original Poster

                    thanks squish and hound, he is on steroids and is being supplemented with vitamin e and two different herbs, the vitamin e was mentioned in the research as helping with the steroids and we figure the herbs can't hurt

                    I am very western in thought and our vet after discussing with other vets and researching decided that steroids were really the only answer for this disease/ disorder/ PITA


                    • Original Poster

                      update at the top


                      • #12
                        Excellent news!! Thanks for the update. Hopefully that will be the end of it, yay!!!!


                        • #13
                          Good update! ( but not surprising) Please be prepared for the long haul. Glad he is better!



                          • #14
                            Sterile nodular panniculitis

                            Thank you so much for sharing!!! Your post helped me feel a lot better! Our pet just got diagnosed with SNP yesterday and what relief! Finally feel hopeful after months of roller coaster of emotions. Feel like came back from hell !
                            started thankssgiving, actually looking back, it started 3 years ago... Occasionally he'd get sick, fever, diarrhea , not eating and then after antibiotics, he'd be back to normal. I've been told by my vet that he ate something wrong since all blood tests came back neg. watched my dog like hawk and cleared all suspicious toys he might ingest including his favorite furry small animal.My dog now is 4yrs old. He's part poodle which is one of the dog breed that's susceptible to SNP.
                            our vets all the tests to lab came back neg, no bacterial or viral or fungal etc, X-ray showed enlarged lymph glands around stomach
                            and no response to many different types of antibiotics. Refused to eat, still fed him water by dabbling with fingers, in pain,moaning groaning, rapid heartbeat, fever. Sent to special animal hospital emergency, they repeated all the tests including ultrasounds, came back neg and costed us over $3000!
                            We refused further testing that would cost additionally over $3600 including endoscopy and demanded our dog back,which they refused to release saying they need to stablize fever. Talked to our vet who called vet to release our dog, so they finally did after paying additional $1200! From couple of days of hospital stay! They still didn't get rid of fever!
                            My vet couldn't figure out why he still had fever until dog started limping and had cysts which oozed yellowish liquid. He thought it might be cancer or Lyme disease so got tests, which came back neg. but still anorexic and dog lost 3 lbs, all bony now until he got prednisone which improved in a week until vet decided to slowly reduce the dose and stopped it all together since he was eating ok and swelling on his belly went down almost disappearing and chests opened and almost all healed. He was worried about side effects of prednisone.
                            after we stopped, immediately within 2 days, every symptom came back with vengeance. He can't even walk like severe painful arthritis. He's so much in pain we decided to put him to sleep, until 1 hr before, I met with vets partner(our vet was gone) she explained she thought we should try prednisone tx.
                            she said its rare autoimmune and she's only seen one case in her career very similar to my dog and at this point, it wouldn't hurt to try. We agreed, so he's at the vet overnight from yesterday to get IV fluid and prednisone . Today I get him back.
                            Did research all night and not much is known and not much available. Very rare, and not much studies or research is done!
                            Cure is by prednisone tx 4-6weeks or more and some are complete cure some needs longer .
                            at this point I could hope but just wanted you to know
                            THANK YOU so much for posting!!!!! I almost put my most beloved pet to sleep!!!!! Now I can't wait to go pick him up today.
                            I'll update later but just wanted to thank you again.
                            hope this helps someone else out there too. Test results come back neg, rapid heart beat, painful joints, limping, anorexic, throws up, high fever like 104-105, high white blood cell count,
                            disinterest in food, depression, nodules, cysts with liquid puss, slimy stool, diarrhea, but still pees. These are some symptoms we noticed.
                            Last edited by Pie314; Feb. 15, 2014, 01:40 PM. Reason: Missed some details