Post by Gary GI have a four year old female English Mastiff...Over the last 3 years
she has continued to develop sebaceous cysts all over her body...The
Vet drains them and has even removed the sac of a large on during an
office visit...The Vet feels removing them under anesthesia could be
dangerous...I also wonder what good would surgery be if others just
take their place...Does anyone have any ideas?...Thanks in
advance...GG
Elkhounds are famous for sebaceous cysts. Probably 50% of elkhounds will be
affected in their lives at some time or another.It's pretty much something
we live with.
I wish more vets would remove them locally, if they could.
I've known Elkhounds that have died when cysts became infected, burst
internally, and became systemic. Also have them tested to insure they are
not mast cell tumors.
When removing them, make sure that the hair follicles are removed along the
line of incision, or those will erupt into new sebaceous cysts as the
surgical site heals.
Those Elkhounds with recurring cysts, are often put on 25mg a day benedryl
for the rest of their lives, this seems to drastically reduce re-
occurrance.
Most owners also cleanse them with Stridex pads. With a few precautions, we
live with this problem with relatively little problems.Keep weight
management down, and fed lower fats inthe diet.
I am posting below, the collected wisdom of those of the breed who deal
with this on a regular basis,
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begin post
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1) Vets don't like to see cysts on tails as there is so very little skin
there.
2) If the blood coming out of the cyst is purple, this means thereis an
infection.
3) The vet can try to cauterize a burst cyst, an attempt to kill the
lining of the cyst.
4) Some cysts, even after bursting, cauterizing, and a course of
antibiotics, continue to manufacture the goop that cysts are made of. The
pressure of the goop building up once more makes the dog attack the site
again, bursting it, relieving the pressure until the cyst builds again.
This of course creats a never ending cycle.
5) These cysts will need to be removed surgically.
6) Have the vet put your dog on antibiotics for at least a week before
cyst surgery. The surgery may prove to not need operating, and if it does
need surgery, it makes a far smaller surgical site... ALWAYS.
7) Even on the vet's table, people will still remove those little tufts of
hair from shedding elkies! :D
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The above contribution by Nancy Millis-MacHaffie
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There are many kinds of cysts, one being the epidermoid or infundibular
cyst. Other
names are epidermal cyst or epidermal inclusion cyst. This just refers
to the type of cells found within the cyst. If the cell structure
includes hair follicle cells, it might be termed a follicular cyst. If
it includes a sebaceous (oil) gland), the cyst is a sebacous cyst. And
there can also be a pilar cyst and a colloquial term used for a type of
cyst called a wen.
But a infundibular cyst simply means the cells a epidermal cells. They
might be found in areas that are prone to acne in people, more common in
some locations on trunk the dog. They are nodular, doughy subcutaneous
lesions, normally pigmented or yellow or white in color. They are
uncommon prior to puberty and are generally considered secondary to
cystic degeneration of odontogenic embryonic stem cells or traumatic
inclusions of surface epithelium. So a dog that is cut when groomed
might have a cyst form comprised of epithelial cells.
Now multiple cysts may also occur - and quite commonly - as a result
when the dog has folliculitis and the healing includes epidermal cells -
cysts may form. And there is a variant of basal cell carcinoma
where a infundibular cyst appears.
So as far as plain old cysts, simple excision if they become irritating
and vicks doesnt work
OTOH, there is a genetic variation known to occur in people and mice.I
have only seen one dog that I think fits theis case - a Bouvier - but
since it is a genetic variation, it can occur at any time in any mammal
which has similar embryonic development. The gene in humans is the
chromosom five in a location known as the APC locus. A stands for
adenomatous, c is colon?, and p is polyposis. Again, the gene is
called that, but the gene controls more than the colon.
Three different "diseases" caused by translocations or truncations of
this sequence in humans (chromosome 18 in mice). One condition is
familial adenomatous polyopsis. One is known as Gardner's syndrome,
which fits this (I think) and the Bouvier. The third is Turcot's (she
mutters, not checking that one because I think this is Gardner's).
Gardner's can certainly have variable signs. And while it is caused by
a deviation at the APC locus, it certainly is found in human medicine
that some individuals have normal colons.
Epidermoid cysts of Gardner syndrome occur at an early age and in less
common locations that are not generally associated with trauma to the
epidermal layer. Cysts tend to be multiple and are present in the
multiple form in 50-65% of patients in people. Like normal infundibular
cysts, cysts in Gardner syndrome usually are not a significant problem,
but like normal infundibular cysts,they can become oozy or inflamed or
rupture.
Other associated problems are polyps in the colon, as many as 100 in
some cases. Osteomas - bony tumors, Extra teeth or unerupted teeth.
And the bad news is that the polyps that do occur associated with this
defect are 100% malignant - they will become malignant unless they are
removed. And then I get a little lost because this has something to do
with the inability to recognize the restriction enzyme (not a digestive
enzyme or food enzyme but enzyme like gene structure) and TaqI which has
to do with tumor suppression. And another result is the development of
infundibular cysts as a problem with normal matebolic housekeeping.
In humans (and in mice), Gardner's is considered autosomal dominant
because homozygotes die in utero. It may have multiple expressions
based on the exact place of truncation or translocation coding error.
So different allele variations may result in different errors in genetic
structure, which may vary according to date the coding turns on and is
expressed. In some humans, no polys are ever found - although most do
develop polyps (and evidence of early changes in the colon are generally
seen.)
My best recommendation is probably to check out most recent research
into Gardner's and recomemndations for people. If the infundibular
cysts are simply multiple cysts, I'm not sure there is generally
anything done except to keep the dog free of problems arising from the
cysts.
There are many breed people successfully treating cysts with Vicks VapoRub
or alternately Stridex medicated pads for acne - the alcohol-free until
they go away.
This was passed on to me by a friend in our breed with the experience:
CYSTS OR TUMORS?
There is often talk among Elkhound lovers about skin eruptions or cysts
that appear on their dogs occasionally, or, as the case with my Elkhound
Cookie, much more than occasionally. Often these eruptions or sores are
incorrectly diagnosed and referred to as sebaceous gland cysts when in
fact they are actually something quite different. After a number of years
of research, I have found out that it is a condition unknown to many
veterinarians and breeders, and though it can be seen in Old English
Sheepdogs, German Shepherds, and Collies, it is primarily seen in Norwegian
Elkhounds and Keeshonds. The condition is called Intracutaneous Cornifying
Epithilioma, formerly called Keratoacanthoma.
These tumors, as opposed to cysts, are much more complex and are thought
to start in the skin between the hair follicles. Since the word tumor
tends to scare, it is important to stress that they are benign and do not
metastasize or spread to other organs in the body. Much of the research
Ive read indicates that the condition occurs in dogs five and under and
most often in males but this is not a hard and fast rule as my Elkhound
first showed signs of the condition after age five and is female. (She
died at age 19)
There are two ways the condition can show up; most often, a single tumor
appears usually on the neck and/or shoulder area. A dog may have one or a
few of these over the course of many years that need to be removed
surgically or sometimes they can be drained and heal on their own. The
second pattern, more rare, is the generalized form of the disease which is
many recurrent tumors that appear in the skin at one time, in different
locations on the body and in various stages of development. These growths
can appear quite different, sometimes just a small lump under the skin that
can get to be bigger quite quickly or they may grow slowly over time.
Sometimes a hole forms on the outside of the lump and the cavity inside is
filled with a white/yellow grainy or tiny pearl like matter that is
actually keratin, the substance your hair and nails are made of. Often the
keratin forms and dries on the outside of the skin ranging from large
cauliflower like clumps to small nubs which act as plugs to the openings to
the cavities. I have also seen small hard lumps with a hole and no sign
of the keratin at all often located in the flank or ankle area. If these
are reachable, your dog may lick at these incessantly or not want them
touched, this is often an indication of a deep, multi chambered keratin
filled cavity which are difficult to drain. Whether your dog experiences
one or many tumors the treatment is largely the same, one of monitoring and
maintenance. With tenacity and some education for you and your vet, your
dogs quality of life shouldnt have to suffer. The most stubborn growths
will need to be removed through surgery. Some underlying tumors that dont
form an opening can often be left alone if they dont swell or fester.
Other than surgery there are treatments you can administer yourself which
can address the problem dramatically. If the growths have formed an
opening so that the medicines can get in and the keratin can get out you
will have the most luck. I have had great results with frequent baths
using a medicated shampoo called Sebolux. If you have many areas affected
with growths, even small nubs, a full bath is the best way to tackle
everything at once, or you can spot treat one or two growths if that is all
that you are dealing with. I have found that when my dogs coat and skin
begins to have a greasy texture, a good Sebolux bath can keep the growths
and lesions from blowing up. It is essential that the shampoo be lathered
vigorously for at least ten full minutes to the crusty dried keratin which
will break up and dissolve easily and wash away. By removing the plugs the
shampoo actually helps to draw out the keratin and keep the matter from
backing up inside. Even if the areas are raw or bloody, a gentle but
thorough lathering will clean them up and make them feel much better.
Elkhounds are notorious for hating baths but they can get used to the idea
(even you can, in time) if they are exposed to them more regularly. No one
likes to cut the beautiful fur of an Elkhound but it does grow back and a
little trimming around the sores can help a lot.
Keeping the fur from drying to the sores which hinders drainage and air
drying of the wound. It seems to me the condition always gets worse in the
hot weather months so extra baths at this time can be helpful and keep your
dog more comfortable in general.
I have used a non-sharp, large needled syringe that I fill with Hydrogen
Peroxide so that I can direct a stream of peroxide into the openings of
the cavity. Peroxide helps to bubble up some of the matter inside and to
keep the affected area clean. Sometimes a mixture of cortisone and
antibiotic cream can help to bring some healing to an inflamed area that
looks infected. A good mixture that comes in a tube with a pointed nozzle
is called Panalog which you can ask your vet to prescribe. A clean
washcloth soaked in water as hot as possible and applied as a compress for
five or ten minutes can help bring down the swelling of an inflamed lump
and sometimes allow you to express some of the keratin from inside. I have
drained and healed many tumors this way, which helps keep the vet visits
down.
In the generalized form of the disease where the tumors are high in
number, a relatively new drug treatment has shown some amazing success.
The drug, called Etretinate or brand name, Tegison is a retanoid or vitamin
A derivative. It is a people drug, (this is also a people disease) every
expensive $90.00 a month and though it has many serious side effects in
people, there seem to be few in dogs that outweigh the benefits. The drug
takes sometimes two months or so before results many be seen. In my
Elkhounds case it has improved her condition dramatically. Cookie has been
on the drug for over a year and the one time I tried taking her off, the
tumors all began reappearing in force within six weeks. She will remain on
the drug the rest of her life. (The dog lived until age 19) In the
research my veterinarian and I have done, no other drug treatment such as
prednisone, antibiotics or chemotherapy have shown to be at all effective.
Other than Etretinate and an antibiotic after a surgery, I would strongly
question any drug prescribed for this condition.
If your dog has had anything resembling what I have taken too long here to
describe, I urge you to show it to your veterinarian and take along the
name of this disease and ask that it be looked up. If either of you are in
doubt about any growths you find, ask your vet to do a biopsy to be certain
of what you are dealing with. My hope is that this may help anyone out
there who has been baffled by strange lumps and sores their dog may have
developed. I also feel strongly that it is important to bring this
information to the attention of breeders, some of whom I have found to be
woefully unaware of this genetically transmitted disease. Though the
disease is not in essence life threatening, there are many people who would
not and could not bear the time and expense this condition demands. Before
I thankfully stumbled upon a vet who took the care to help me research the
disease, my Elkhound went through years of countless surgeries, proddings,
lancings, infections and maybe worst of all, no one but her two closest
humans wanted to touch her. Cookie was finally sheared to her skin, except
for her head and tail, so we could aggressively tend to all her growths and
sores and started on the Etretinate. It wasnt until then that real
improvement began for her. No animal should go through this if it can be
avoided through genetic testing and responsible breeding. I would be
interested to hear from anyone who has experienced this disease, especially
the generalized form and would gladly offer any more information I can.
Below is the phone number for Tufts University Veterinarian Research
Library where I am still doing research on this. I recommend them for
gaining research materials on any health issue you might be facing in your
animals. For a reasonable fee and sometimes free, they will send or fax
you articles from their references. I cant close this without saying that
Cookie, my brave, 19 year old, rescued Elkhound has been worth every effort
and dollar spent.
The disease does get worse with age and I always found it to be much worse
in the summer. For bad cases the drug mentioned above has certainly
changed my Elkies life and the shampoo is a must for semi bad to occasional
cases...Someone mentioned a twig coming out of the side of their dog, this
is the dried keratin mentioned above. I have never noticed any particular
food connection, doesnt mean that there isnt one, but in my experience
changes in foods had no effect and I feel time can be better spent with
other avenues of treatment. Hope this helps some of you it is
disconcerting to see that this problem seems to be getting as more
Elkhounds are appearing. If I can be of further help to any of you I will
be glad to do what I can. Please post this wherever it might help anyone.
Good Luck
Nan Irwin
nkidesign _at_ earthlink.net
Tufts University Veterinarian Library, 607 chapel Street, New Haven Ct.
06510