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Dr. Ellie
Dr. Ellie, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 370
Experience:  emergency and critical care resident
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My dog is 16 on steroids for awhile now. She oftentimes had

Customer Question

My dog is 16 on steroids for awhile now. She oftentimes had small sores that would scab over that I would apply antibiotic ointment or hydrocortisone to and they would heal. Today I noticed a huge hard flat thing that almost looked like maybe her hair was knotted. When I went to cut it out as I came to the edge the knot or scab lifted up and I could see into her body. Red inner tissue and some white mucus looking stuff. I'm sure I opened her to infection so I will definitely get her into the vet tomorrow. It's not bleeding. Her calcium levels were very high at our last vet check and cancer is suspected. Could this be skin cancer?
JA: I'm sorry to hear that. Is your dog bleeding a lot?
Customer: Not at all
JA: Phew. What is the dog's name?
Customer: Ginger
JA: Is there anything else important you think the Veterinarian should know about Ginger?
Customer: She is on steroids and gabapentin, anti anxiety and pains meds.
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. Ellie replied 1 year ago.

I am sorry to hear about Ginger's recent troubles. The high calcium level makes me worried that she has a condition called caliconsis cutis. This where calcium deposits in the skin causing sores. The best treatment of to reduce the calcium levels and prevent calcium from being deposited in the skin. There are several potential causes of high calcium including renal disease (secondary hyperparathyroidism), primary hyperparathyroidism, fungal disease, and toxicity. Addison's disease is also a reported cause but not likely to be present as long as the dog is on steroids.

It sound like your dog needs to be worked up thoroughly for each of theses causes. Some can be ruled out with routine blood work while others require special testing. Your vet can send out a hypercalcamia panel to test for primary hyperparathyroidism as well as cancer related hypercalcemia. Other testing that should be pursued if you would like to get a more definitive answer may include an abdominal ultrasound (plus or minus fine needle aspirate of any abnormal organs), chest x-rays and a skin biopsy or FNA of the lymph nodes. Another thing that your dog should be evaluated for is the presence of an anal sac mass as this would suggest cancer of the anal sac gland and removal would be recommended.

How far you want to go to diagnose your dog's issue is up to you. Prednisone can cause calcium wasting but can also cause immune suppression which can predispose patients to infections.

If you would like to pursue additional testing but your vet is not able to to do all of these things you may also ask about a referral to the nearest internal medicine specialist. He or she can make the appropriate recommendations based on your dog's specific condition and you can decide together how you want to treat your dog.

Skin cancer does not usually cause hypercalcemia so this would not be my first suspicion. The most common cancers that cause hypercalcemia are lymphoma (T cell is more common than B cell to cause this), anal sac adenocarcinoma and multiple myeloma.

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