Perianal Fistulas (PFs) a Continuing Fight
By DJ Hensch

(continued from Page 1) I had heard there was a new vet in the area and decided to meet her after she began sending clients to me for behavioral help and training. Upon meeting her I liked her instantly and in the midst of our conversation I told her about my problem with PFs in my dogs. She was currently treating 2 PF dogs. I decided to bring Lance to her and get her input on his condition.

By this time I had been with the PF support group for two years and the PF-L online support group from its beginning on October 25, 1998. Long enough to establish that the treatments of choice to heal PFs were Cyclosporin (which I couldn't afford) and a combination of Prednisone with Sulfasalazine (which met my budget and Lance's needs). I learned that the 2 PF cases (littermate brothers) this vet was treating were on the Pred/Sulfa and showing improvements.

It was agreed that we would try this route with Lance and see what happened. By this time Lance had been battling PFs for nearly 2 years. Upon examination her exclamation of, "Oh my! This is the worst case of PFs I've seen yet!" my heart sank.

On February 26, 1999 Lance was put on 50 mgs of Prednisone once a day and 1500 mg of Sulfasalazine twice a day, although the plan of choice is 1000 mg given 3 times a day, which my work schedule wouldn't permit.

Remarkably within a very short two weeks I saw considerable improvements and although Lance was showing side effects from the Prednisone I knew we had to continue with this course of treatment.

Prednisone, a steroid immune system suppressor, given to dogs will cause rapid heart beat, heavy panting, very increased thirst, sometimes ravenous appetite and either give the dog more energy or make the dog sluggish, depending on the individual dog's side effects. Lance's panting was not only heavy, it made reading or hearing a TV difficult if in the same area / room. At least we knew this was a sure sign that the prednisone was working.

After a month of this treatment the PFs were gone and all that remained were small areas of gray where the fistulas had been. On March 29, 1999 Lance was officially declared to be PF-Free at last. He had fought this dreadful disease for nearly two full years. Although guarded we celebrated our victory. Lance had now been on the prednisone/sulfasalazine for four weeks so the prednisone dosage was cut in half to 25 mgs once a day. The sulfasalazine dosage would remain the same for a total of three months after which time he'd be taken off of it but Lance had to be weaned off the prednisone gradually to allow his immune system to begin functioning on its own again.

Lance had won his battle against PFs but the winner of the war still remains unclear.

Lance continues his weaning process off the prednisone. Treatment began with four weeks at 50 mg a day. Then dropping down to four weeks at 25 mg a day. Then dropping down to four weeks at 12.5 mg a day. Then dropping down to four weeks at 12.5 mg given every other day after which he'd be taken off the prednisone entirely. He will be entirely off the prednisone July 12, 1999. After that we hold our breath and wait.

The prednisone/sulfasalazine left its marks on Lance. He lost a good deal of the muscle tone in his head due to the prednisone making him look very much older than his five years. The vet assures me that over time he will gain it back and fill out again. His eyes have a very sunken in look from the sulfasalazine attesting to the horrendousness of his battle. We are grateful to have Lance and Teddy still with us and hopefully do our best to keep it that way until we lose them naturally to old age.

Important Information Pertaining to PFs