Hello, I'm Dr. Kara. I have over 20 years of experience as a veterinarian and I'd like to help with your concerns about Ching's swollen hock and fever.
The most likely cause of these symptoms given her good response to an anti-inflammatory medication only is a condition specific to the Shar Pei breed called Familial Shar Pei Fever. The concern is that this condition can also cause amyloid (a protein) being deposited in the kidneys, which eventually leads to kidney failure.
This disease is inherited and is related to the gene that allows increased levels of hyaluronan in the subcutaneous tissues which causes the breed's characteristic wrinkles and thick skin.
At this point the recommended therapy is Colchine at a dose of 0.025-0.03 mg/kg (2.2 pounds) twice daily, or less if the dog develops diarrhea. It is recommended dogs are started on a low dose once daily and then gradually increased to the maximum recommended amount (up to the calculated dose above), if they tolerate it without diarrhea, once or twice daily. For most Shar-Peis, that is one 0.6 mg tablet given twice daily. Colchicine is a potent drug but it accumulates in white blood cells (the desired target for treatment) and gastrointestinal signs occur long before other serious side-effects. Treatment is for life. There were problems obtaining the drug at a reasonable price but the drug company has decided to provide it at a reasonable price for Shar Pei owners as a compassionate measure.
Here is a link to read more about the disease if you would like:
There is also information about how to obtain Colchine from the only manufacturer still producing the drug in that article. But here is the information again in case you have trouble accessing the link:
"Currently, sale of colchicine has been restricted in the U.S.A. by the FDA to one manufacturer, URL Pharma, under the brand name "Colcrys®" with an exorbitant price increase. URL Pharma has instituted a Patient Assistance Program for Shar-Pei that is administered by NeedyMeds. There is an application for the program (income adjusted fee structure) on http://www.needymeds.org/ website HERE. Applicants must provide a valid Colcrys prescription from a licensed veterinarian, and must attest that Colcrys will be used solely for their Shar-Pei dog. Applicants who qualify for the program will be able to select a 30-day supply (60 tablets), 60-day supply (120 tablets) or 90-day supply (180 tablets) of Colcrys... "
Owners can also use nonsteroidal anti-inflammatories like Metacam to help with discomfort, swelling and the fever during the flare-ups.
There has been some speculation that using omega 3 fatty acids, which are natural anti-inflammatories, at a dose based on the EPA portion (eicosapentanoic acid) of the omega 3 of 20mg of EPA per pound of body weight every 24 hours. If we dose based upon the EPA portion the rest of the acids will be properly balanced and supplemented.
You should have your pup's morning urine tested frequently (yearly in young dogs and every 3 to 6 months in older dogs with no symptoms of kidney disease) for signs of increased levels of protein and decreased concentration. These are the first signs of kidney failure from amyloid being deposited in the kidneys.
Signs to watch for with her are hock swelling and fever as you have seen, especially fevers that don't respond to anti-inflammatory therapy, but also lethargy, decreased appetite, vomiting or diarrhea. These are red flags that your pup needs a veterinary examination and some testing.
Best of luck with your pup, please let me know if you have any further questions.
Thank you,we live in South Africa would Colchicine have a different name here? or is there a similar, I understand your resticted sale note
. When I took Ching for her injections the young Vet had not heard of Shai pei conditions, I would like to show him your reply.
I have started Ching glucosmine hydrochloride 500mg chrondroitin sulphate 400mg osteoarthitis support 60 tablets, for humans 3 tablets a day I give her one tablet, does this help her, I put olive oil on her food would suppliment be better omega three
Thanks for the reply.
Colchine is the generic drug name. I try to give that whenever possible as that makes it easier to find it then looking for trade names. Trade names of colcgine are Artrex, Colchily, Colchis, Colcine, Goutichine, Goutnil, Tolichine, and Reugot to name a few. It is used in people to treat gout so it may be possible to get it via a human pharmacy. I would try to contact the company that I gave you information for to see if they have a similar program in South Africa.
Glucosamine products are wonderful for arthritis and I would continue those as they cannot hurt an older dog. You can add the omega 3's to that as well. Omega 3's will be better for her then olive oil. Animal based oils are better absorbed and digested in dogs then plant oils, and omega 3's have a natural anti-inflammatory effect.
It is possible that your lines of Shar peis in South Africa are less likely to carry the genetics for Familial Shar Pei fever so your veterinarian may not see it much. Here in the States and in Canada we unfortunately do it see it a fair amount.
Let me know if you have any further questions.
As an aside, you have a very beautiful country. My family was fortunate enough to go on a Safari there about 5 years ago and none of us wanted to leave at the end. We met very kind people and of course the wildlife is amazing.
Thank you for your help. Shai Pei are still unusual here, hence prehaps lack of info. Breeder did mention Swollen Hock when I bought Ching but I was to much in love to comprehend the sadness , I love SA came on holiday 1982 but I never left .Have visited Kruger Park many times during my 31 years here
I will take your advice and contact URL Pharmacy
Nice talking to you
Dear Dr Kara,
My self and Ching have an appointment with a vet recommended by her breeder,Ching will be spayed on Wed 25th Sept 2013,plus she may need to have an eye lift as this is also a shai pei problem, I will also ask for her urine testing to check for increased protein as you advised I will also require her to read your medical opinion
I just hope she she keeps up to date on any progress with Shai Pei conditions
Once again thank you for your interest,pity you are not in Cape Town
Maureen, I'm sorry I missed your reply earlier.I think it is a great idea to check her urine before any procedure that requires an anesthetic. Knowing her history I would probably also want to run a mini blood panel on her before anesthetizing her. We want to make sure her kidneys are functioning well and can handle the anesthetic and surgery stress.
Entropian surgery is one many Shar peis require, and I'm sure that if this veterinarian knows the breeder then they are well aware of Familial Shar Pei Fever and proper techniques for entropian surgery.
It is a pity I am not in Cape Town, I would love to meet you and Ching.
I hope to visit South Africa again someday, the memories I have are all very good.
Take care, let me know how things progress for your girl, Dr. Kara.
Ching my Shai Pei bitch is now 14months old she was spayed after her first period in Oct 2013 plus had her eyelids readjusted, she recovered very well from this dual operation,but then I noticed she was losing fur in round patches all over her body mainly rib cage and under her neck and
her back legs became quiet bald, my Vet did various skin scrappins but could not diagnose the cause, decided it was a bacteria and put her on a course of 60 antibiotics. lasting two months plus I must shampoo twice weekly Sebba Derm a keratolytic fungical shampoo. Is this skin condition just another shei pai problem, or shock after her operation, it is now 1/2/2012 her fur growth seems to slightly better
Her swollen hocks are still there and it feels like jelly sac's can I massage them away. I have not yet started her on your suggested medcation as i did not want to confuse this currant problem with perhaps problems with new tablet regime
Hello Maureen, it is nice to hear from you again though I am sorry to hear that Ching is having skin problems.
Deep skin infections are quiet common in Shar Peis. The wrinkling of the skin gives bacteria and yeast a perfect warm, moist place to grow and the skin is so thick oral antibiotics have difficulty penetrating the skin layers. We must often treat them for several weeks to months to resolve infections. Topical therapy (shampoos) are a great supportive therapy and used once or twice weekly once the skin clears can prevent recurrence. Unfortunately expect lots of skin infections throughout your girl's lifetime.
Unfortunately Demodex mite infections are also very common in Shar Peis and they are difficult to pick up on skin scrapings because the skin is so thick. Sometimes we need to biopsy the skin to diagnose them. Demodex infections are more commonly seen after stressful events which weaken the immune system (like surgery). If she isn't getting better with antibiotic and shampoo therapy then either a skin biopsy or trying therapy for Demodex mites would be indicated.
As far as using omega 3 fatty acids along with antibiotics and skin conditions they will not interfere with each other and omega 3 fatty acids will be helpful for skin and coat health. I don't see a reason not to use them.
Colchicine, the medication for Shar Pei fever can interact with some antibiotics and antifungals. Some antibiotics (clarithromycin, erythromycin) and antifungals (fluconazole) slow metabolism of Colchicine and so the dose must be titrated down while taking those antibiotics. Colchicine can also cause nausea and so can many antibiotics and antifungals so you should be aware of that as well. They won't be harmful together you just need to adjust dosing and look for side effects like nausea.
Best of luck with your girl, please let me know how things go for her.
Wow, what a lovely surprise to find you and receive a caring reply.
My local vet told me Sha Pei are bad news for owners but good news for surgeries.
The responsibility seems to rest with me to explore on internet then take this info to the surgery for them to read maybe receive a prescription, pay and come back in two weeks.
The surgery is always busy so this is sour grapes from me . They agree Ching is a delightful pet but maybe not enough Shai Pei in Cape Town to take time on research. So to be able to communicate with someone who is interested and knowledgeable soothes my soul