Breed: French Bulldog
Location: Anna Texas
About John Merrick:
He’s only 10 months old, he has a severe cleft lip and in addition his face and his ears are consumed with what I’m just not sure. We were told it was hyperkeratosis but if it is, it’s not like any hyperkeratosis I’ve ever seen before. Dr. Reno says we can’t rule out demodex that’s out of control, it could be fungal, or something else altogether.
Julie and I took him to the tub and began soaking and scrubbing and got a lot of it off but there is still much more where that came from. He has nothing on any other part of his body, it’s all on his face and his ears.
John Merrick went off to see the dermatologist yesterday and she got me on the phone while he was there with Julie. First thing she said was oooooh this is an interesting one and she took him off to go show all the other dermatologists in the office.
There’s a few things that we might be looking at but the one thing they are leaning towards the most is an abnormality in zinc absorption, they have seen this before and most of the dogs that have this do recover with zinc supplements. The second thing it could be is severe food allergy and the third is a problem with vitamin A.
They asked if they could take punch biopsies of a couple of places on his ears where they could send those off. The biopsies will take 7 to 10 business days to come back but if it is either one of those deficiencies ( zinc or vitamin A) it will show in the biopsy. If those are negative we would be looking at an odd food allergy so to start with we will be doing everything, the biopsies were done yesterday and he has been put on a hydrolyzed protein diet that will basically be different than anything he’s ever eaten. If the biopsies come back positive then we know its not food related and he will return to eating a normal diet. A zinc supplement will be started right away to see if it helps while we wait.
I asked if anything can be done for him in the meantime and she has put him on steroids and antibiotics for the secondary infection that he still has from all of this crust. She said we could try soaking it soft and removing it just like we have been but you need to know that it will always come back until we get to the root of what is causing it. The good news is if it’s the abnormality in zinc absorption they typically have good results with treating it so we are certainly hoping for that to be thee culprit.
Okay, let’s have a long conversation about John Merrick. He returned to the dermatologist to be examined. Dr. Crow was his dermatologist today and I spoke with him over the phone as Karla had driven him for his exam.
He explained to me that even though JM tested positive with a biopsy for zinc insufficiency he wasn’t convinced that is what it is. He offered to try and up his dose and give it a couple more months but he really felt we were looking at ILVEN which is inflammatory linear verrucous epidermal nevus.
We discussed the question if he was painful or not and honestly it was hard to answer that question because JM has been scrubbed of this crust and he was then very painful so is the condition painful or is the scrubbing making him painful. I stopped anyone from scrubbing him about 10 days ago and Dr. Crow agreed that no scrubbing of this crust is to take place again. The ILVEN does have pain associated with it and Dr. Crow honestly feels like even though he might have zinc insufficiency he truly believes this is ILVEN and one of the big reasons is because JM has a cleft palate and the condition of ILVEN is associated as a birth defect.
Dr. Crow and I both agreed to stop with the zinc and to move into the direction of treating ILVEN and that will require a compound pharmacy to make him in capsule for Accutane. Once this drug comes in he will be started on it and we will not soak or scrub his crust again and see what happens. He also informed me that this is not a curable condition and instead would be controlled. JM will always be on medication for the rest of his life and he will never be a normal dog with normal skin, how clear willit get? only time will tell.
I would like to address a few people who spoke up and were sure that this condition John has is Pemphigus, Dr. Crow said it absolutely 100% is not
Pemphigus..I just wanted to clear that up. Also lots of people want to put things on it, lotions, oils, and potions..none of those things are the answer.
This is a very rare disorder and one of the reasons we utilize highly specialized veterinarians, this condition is not something that is diagnosed by general practitioners and Dr. Crow is a very highly sought after dermatologist.
I’ve included the clinical summary of John Merrick for those of you who like to read and understand what exactly is being said by Dr. Crow.
I will update as we move forward but I would expect this crusty face to worsen before it gets better. John Merrick is just a pup and he’s pretty weary at the sanctuary, thankfully Karla and Neil have offered to take this little man home and foster him and we are very grateful as we know that’s just what he needs. In addition John Merrick doesn’t have an adopter waiting for him, we hope that there is someone out there who will accept him and love him regardless of this condition and we are sure if there is one the village will find them…