Sterile nodular panniculitis?
Breed: Siberian Husky
Age: 11-15 years
My dog has a patch of nodules on his neck. I took him to our normal vet five times (~$1000, multiple series of antibiotics and one series of prednisone) and to a specialist vet for dermatology today. The specialist said it will cost $1600 more to run a set of labs to determine what it is. I don't have the money and I'm afraid of doing nothing. Would you please be willing to read a short description and comment?
Three months ago Kobi got a scratch on his back from an old nail. He chewed it and it got infected. The vet had him wear a cone. The infection healed but the cone scratched the skin on his neck. He scratched at this and it got infected. It healed, but then a couple days later a large soft bump developed under the skin. It burst a few days later (mix of blood and yellow liquid). Then on the same spot he developed a set of about 15 small nodules on the skin. These are now bursting once per day or so.
My on-line research found something called "Sterile nodular panniculitis"
This sounds like what he has. Two questions please: (1) is there some less expensive way to have this diagnosed?; and (2) if this is what he has what can I do without having to spend a lot more money?
ps. I see the note on this form about email photos. I'll try to do that.
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Dr. Marie replied:
Thank you for sending the photos of these red lumps on your dog's neck:
These are definitely not a "normal" case. I can understand why multiple tests are being recommended. I likely would have put this dog on antibiotics first in case this was a bad case of furunculosis which is a bad skin infection. But, it sounds like this was done and didn't help.
This is a really tough situation, especially if funds are limited. If there is sterile nodular panniculitis (and I think there is a good chance that this is), then the treatment is strong doses of immunosuppressive medications. And, in some cases these medications need to be given long term. These medications tend to be expensive.
The problem is, though, that if it is not sterile nodular panniculitis, and it is something infectious then immunosuppressive drugs will make it worse. It is possible that this is a serious fungal infection such as actinomyces, nocardia, or a mycobacterium. I definitely wouldn't want to give immunosuppressives to a dog with fungal disease.
In order to know how to treat this, it will be important to have tests done. Because this is not a common condition, the tests are unfortunately expensive.
I wish I had better options for you. It sounds like all of the inexpensive treatments that possibly could work have already been tried.
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