February 17, 2009

FSF - Familial Shar-Pei Fever

I really wanted to do a write up on Shar Pei Fever. This is going to be long, maybe at times boring, but very informative. I know when Chloe first had symptoms of Shar Pei Fever - I went nuts. I DIDN'T know what to do, and I was panicked.
Luckily she has never had to go to the vet for her fevers, but we've been VERY close.

I will post all the links to informative sites right now, then talk.

This is Jeff Vidt's section on Shar Pei Fever - he is a Shar Pei medical specialist


Familial Shar-Pei Fever (FSF) is a hereditary inflammatory disorder seen in Shar-Pei. It is inherited as an autosomal recessive condition.

Clinical signs: Episodic fever is the most important and consistent clinical sign of this disorder. The temperature commonly is in the 105-107°F range. The fever is generally self-limiting lasting 12-36 hours. Another common clinical sign often accompanying the fever is swelling of a joint, usually the hock (tibiotarsal) joint and is known as Swollen Hock Syndrome (SHS). This painful, hot swelling can also involve the carpus (wrist) and the lips. Dogs with FSF are sick -- they are reluctant to move and when they do walk they have a characteristic "walking on eggs" gait. They often are painful in the abdomen and have a characteristic "roached" back.

Pathogenesis: What we do know about this disease is as follows:
Shar-Pei with FSF have increased levels of the cytokine Interleukin-6 (IL-6). IL-6 is involved with the fever response and and is an integral part of triggering the production of Acute Phase Reactant Proteins by the liver. IL-6 is also involved in the Systemic Inflammatory Response Syndrome (SIRS). Dysregulation of IL-6 is the cause of much of the disease in Shar-Pei with FSF. IL-6 also plays a major role in the body's stress response and serves to "prime" the immune system.


Shar-Pei with FSF are at risk from early death from systemic amyloidosis. About 25% of the FSF dogs will develop renal failure including renal amyloidosis -- a smaller percentage will develop hepatic amyloidosis. This is usually seen in Shar-Pei between the ages of 2-5 years of age. They also seem more susceptible to immune-mediated kidney disease such as membranous glomerulonephritis, protein-losing glomerulopathies, DIC, thromboembolic phenomena such as mesenteric, splenic and pulmonary embolism and Streptococcal Toxic Shock Syndrome (STSS).
FSF in Shar-Pei was hypothesized to be an animal model of Familial Mediterranean Fever (FMF) in humans. Recent work indicates this is not true, although FSF is very similar to FMF in man.


FSF is a heredofamilial disease with a genetic basis. It appears to be inherited as an autosomal recessive condition. Laboratory Findings:Unfortunately there are no blood test, etc. which are specific for FSF. During a fever episode there will often be an increased white blood cell count, an increase in liver enzyme levels and other non-specific findings. Work done by Dr. Gary Johnson at the University of Missouri College of Veterinary Medicine to develop a DNA blood test to screen for the disease was unsuccessful and the research effort will still continue.

Treatment: It is very important to monitor the temperature in this condition. Initially, fever can be treated using aspirin. Usually a regular strength adult aspirin is given every 6 hours for the first 24 hours and then twice a day for 3-5 day thereafter. In rare cases where aspirin doesn't work of for extremely high fevers, dipyrone is given. Some patients will require supportive care with intravenous fluid therapy and in extreme cases emergency treatment similar to heat stroke treatment. Antibiotics are not normally indicated in this condition.

Colchicine: Colchicine is a drug that has been in use in people with FMF to prevent amyloidosis. It is currently being recommended in Shar-Pei with FSF for the same purpose. No studies have been completed to determine if it is useful for this purpose in the Shar-Pei or not. The clinical impression is that it does help. Those dogs on colchicine seem to have fewer FSF episodes and less severe signs while on the drug. Side-effects appear to be minimal at this time and are primarily gastrointestinal such as vomiting, diarrhea, anorexia (decreased appetite), etc.

Prevention: Shar-Pei with FSF only show symptoms sporadically. It would appear that there are "triggers" involved in initiation of the FSF episodes. One of the major triggers appears to be stress. This may be a dog training class, a dog show, another illness, a dog in heat, excessive exercise, etc. If the owner can recognize these triggers and take steps to avoid them the number of FSF episodes can often be reduced. Diet does not appear to be helpful in prevention of FSF or kidney disease. Surely diet has a role in the management of the kidney disease once clinical signs are apparent. Low dose aspirin therapy may be useful in decreasing the incidence of FSF and its severity as well. Aspirin may also be useful as an adjunct therapy in the prevention of thromboembolism.
Monitoring: Monitoring for the complications which often accompany FSF is one of the major goals of the owner of an FSF dog. The primary and most consistent sequela to FSF is kidney failure either due to immune-mediated kidney disease or renal amyloidosis. I currently recommend monitoring a urinalysis every 3 months. The sample should be collected first thing in the morning after the water has been taken up overnight. I primarily look at the urine specific gravity which is a measure of the concentration of the urine and the protein levers in the urine. When the kidneys begin to fail the initial indication is a loss in the ability to produce a concentrated urine. This occurs before there are blood changed related to kidney failure. Increased water consumption, increased urination are the clinical signs associated with the loss of concentrating ability, but these signs are often not recognized. I also thing it is wise to do a blood panel every 6-12 months and certainly do one in the urinalysis is abnormal. Weighing your dog periodically is very important. We often don't recognize a significant weight loss because it is very subtle over a longer period of time. Water consumption and appetite are other important indicators to watch.

Complications of FSF: We have already discussed the kidney complications in this condition. Other Complications which have been documented include thromboembolism (mesenteric, splenic, pulmonary), DIC (disseminated intravascular coagulation), SIRS (systemic inflammatory response syndrome), MODS (multiple organ dysfunction syndrome), STSS (streptococcal toxic shock syndrome), hypertension associated with renal failure. Many of the deaths following an acute FSF episode are due to these complications. No FSF episode should be treated lightly!

Diagnosis: There is no specific diagnostic test for FSF at this time. Diagnosis is based on the clinical sign of episodic fever in a Shar-Pei. I think every Shar-Pei that dies should be autopsied to determine the cause of death, but this is even more critical in cases involving FSF. Renal amyloidosis can only be diagnosed based on kidney biopsy and staining with Congo Red stain. This stain is specific for the presence of amyloid. Amyloid has been found in other tissues in Shar-Pei as well so special staining should be requested on all tissues submitted for histopathology. Many dogs with FSF will not have amyloid in the tissues at the time the tissues were harvested -- this means the absence of amyloid in a biopsy specimen does not mean that dog will not or would not have gone on to develop amyloidosis at a later time. To further confuse the issue, not all Shar-Pei with amyloidosis have shown signs of FSF.

Future: Research is currently underway at the University of Missouri College of Veterinary Medicine by Dr. Gary Johnson to develop a DNA blood test. The gene for human FMF was sequenced in the Fall of 1997 and with that information Dr. Johnson had hoped to sequence the FSF gene. That information was applied by Dr. Gary Johnson to FSF in a research project founded by the CSPCA Charitable Trust. That project did determine that the mutations causing FMF in man do not exist in FSF in the Shar-Pei, hence they are two distinct, although similar diseases. There are other hereditary inflammatory fever disorders in man and Dr. Kastner ant the National Institutes of Health are looking at the disorder with information supplied by Dr. Tintle. Familial Hibernian Fever in man has also been ruled out as the cause of FSF by Dr. Johnson with information supplied by NIH. Work will continue to find the genetic mutation(s) responsible for FSF in Shar-Pei.As of this writing the mutation responsible for FSF has not been found. If a test can be developed, a screening program can be established to screen breeding stock and determine normal individuals, carriers and affected dogs. With this information Shar-Pei breeders can gradually eliminate this genetic disease from the breed. One of the major obstacles to research revolves around the unpredictable phenotype of FSF. There is no consistent age range when clinical signs develop, the clinical signs can be variable, some dogs develop amyloidosis, some don't, etc. This makes it very difficult to use genetic selection methods which are based on phenotype.

Recommendations: All Shar-Pei with FSF should be on colchicine and be regularly monitored via urine samples and blood work for development of complications. Dogs with FSF should not be used in breeding programs and should be neutered. Dogs with a family history of FSF should be on colchicine and monitored. Dogs with FSF should be maintained as stress-free as possible.





Linda Tintle's write up on FSF and Amyloidosis

An Article by Linda Tintle, DVM
Published in the July/August 1993 issue of The Barker

What is Amyloidosis?
A generic term for a collection of diseases that result in the abnormal deposition of amyloid protein throughout the body.


How is Amyloid Made?
When inflammation occurs, certain chemicals are produced and released into the blood. These chemicals of inflammation are called the Acute Phase Reactant Proteins (APP). After the inflammation has gone away, the APP are broken down by the body and excreted. Dogs (or people) with amyloidosis can't break these APP down into excretable form and instead turn it into Amyloid AA and dump it outside the cells but still within the body.


Why does the Amyloid make them sick?
Amyloid is constantly deposited outside the cells. It builds up like a garbage heap in an alley vay until it starts to squeeze the adjacent cell walls.
The compressed cells can't work properly. The damage or disease that results depends on what kinds of body cells are most severely damaged or killed.
Kidncys can't heal themselves by growing new kidney cells. If a kidney cell dies, it is gone for good and can't be replaced. This is why the amyloid protein usually causes kidney failure first.
tress commonly, the liver fails from amyloidosis.


What is FamiLiial Shar-Pei Fever (FSF)?
l Gave one or more bouts of unexplained fever, usually 103-107 degrees but rare cases may go h igher.
Fevers usually start when they are 18 months old but sometimes first attack is not until they are full grown. Fever episodes usually become less frequent with age.
Fevers last 24-36 hours in most cases without treatment.
Fever episodes may be accompanied by one or more of the following signs:
Swelling around a joint ("cellulitis") with or without inflammation of the joint itself ("synovitis"). One or more joints may be affected but most cases involve the tibiotarsal or "hock" joint... Swollen Hock Syndrome (SHS).
Sometimes a swollen, painful muzzle.
Abdominal pain, reluctance to move, "roached" back, mild vomiting or diarrhea, shallow rapid breathing.
Swollen hock syndrome was reported to be experienced by up to 53% of those dogs having fever episodes by owners responding to the 1991 National Specialty survey.


What is Familial Mediterranean Fever and What does FSF have in Common with FMF?
An inherited disorder of humans, reportedly as an autosomally recessive trait.
Recurrent bouts of [ever, usually starting in childllood.
Polyserositis, involving one or more of the following:1.Abdominal pain.2. Chest pain.3. Joint pain, usually involving one of the larger joints.4. Swelling/inflammation of skin about the ankle or top of foot.5. Free from symptoms between attacks.6. May develop amyloidosis. Before colchicine therapy, up to 30% of FMF patients died of amyloidosis.
FMF is accepted to be a disorder of the regulation of the immune system, specific defect unknown.


What Causes the Fevers in FSF?
We don't know exactly.


What we Do Know: Shar-Pei seem to have a problem regulating their immune system. The immune system:
Recognizes "self" from "non-self' and eliminates foreign invaders such as bacteria and removes cancer cells.
It does this with specialized cells and/or their chemical products.
It is miraculaously complex but is controlled in part by a vast communocation system involving chemical messengers called CYTOKINES.
Shar-Pei with FSF have abnormally high levels of a cytokine called Interleukin-6.
Interleukin-6 (IL-6) "turns on" various parts of the immune system. It is involved in contl-ol-ling the fever response and is a trigger, alone or with other cytokines, for the production of the APP... the precursors of Amyloid AA.


Shar-Pei with FSF:
Have excessively high levels of certain protective antibodies (immunoglobulins).
Have an exaggerated rate of division of their Iymphocytes... one of the immune system cells rcspollsilgle for fighting infection and mounting an antibody response...when grown in the laboratory and compared to normal dogs.
Why do some dogs with FSF get Amyloidosis and others don't?
Shar-Pei with FSF have an abnormal inflammatory response... the immune system's accelerator pedal, IL-6, is always being pushed, sometimgs a little, sometimes a lot and this probably varies with individuals.
Extra APP are produced chronically.
Some Shar-Pei can't properly excrete the APP and dump them within the body as amyloid.
In people with FMF, the fever disorder and the abnormal production of amyloid protein are believed to be different parts of the same or linked genes.


Patterns of Inheritance
we have submitted a paper which has been accepted by theJorunal of Heredity offering evidence that this disorder is inherited as an autosomally recessive gene. It will be published in late 1993.


My opinion:
Based on extensive pedigree analysis going back to originally imported foundation stock...
Heterozygous carriers, having one normal gene and one abnormal gene for the disorder, do not develop amyloidosis.
Only when doubled up on the abnormal gene... homozygous...do they deposit amyloid.
Normal X CarrierCarrier X CarrierCarrier X Amyloid-AffectedHeterozygous Carriers May:Experience the effects of abnormal immune system regulation including episodic fevers +/- Swollen Hock Syndrome .
May never experience a fever and be asymptomatic, silent carriers.
Have an increased risk for thromboembolic disease ("strokes" and abnormal blood clots causing disease or very rarely, sudden death).
Possibly have an increased risk for early death from certain cancers.
Live out relatively normal lifespans (eight years) without ever developing amyloidosis.
IL-6 has been shown to be a growth factor for malignant plasma cells (plasmacytomas and myelomas) and because IL-6 "turns on" the development of many cell types, it is not unlikely that it may "turn on" abnormal or malignant cell lines as well. This could explain the un- usual number of cancer cases in patients with FSF. I am looking into a study of this with veterinary cancer specialists.


Less commonly, signs of amyloidosis may precede outbreaks of fever or the patient may never experience or report any fever spisodes. This is called "Phenotype II" in FMF.
Amyloidosis...a Killer.
Deaths from amyloidosis have been reported to me as young as eight months of age and as old as 12 y ears.
Most die between three and five years of age.
Most Common Signs of Advanced Amyloidosis...
Unexplained Weight loss.
Increased thirst and frequency of urination.
Vomiting.
"Bad breath" as a result of uremia or the build-up of toxins/wastes in the bloodstream as the kidney +/or liver fails to process them. How is Amyloidosis Diagnosed?
Amyloidosis can only be diagnosed by examining specially stained tissue samples microscopi-cally ull(ler polarized light.
Tissues must be obtained by surgical biopsy or, after death, by necropsy. The veterinarian sublllittillg the sample requests that it be stained with "Congo Red" to detect the presence of amyloid .


Dr. Quimby and his graduate students are working on a blood test involving monoclorlal antibodies of serum amyloid A but this is in the early investigational stages.

How common is amyloidosis in Shar-Pei?
The precise incidence of amyloidosis in Shar-Pei is impossible to determine at this time. Survey Results 1991 National Specialty...23% w/fever of unknown origin. Even if everyone who did NOT return their survey had NO fevers...we would still have...ll+%. That's still a lot of dogs experienceing fever episodes. Private communication with some of the original breeders and importers of the foundation stock of our dogs has led me to believe that many of them were affected by the immune system dysregulation.


How is FSF Diagnosed?
No single test available.
Still a diagnosis of excluding the other possibilities.
Blood tests and cultures are usually negative/normal except elevated WBC with left shift is not uncommon.


What's All This About an IL-6 Test?
Dr. Ariel Rivas is working at the Diagnostic Laboratory of the New York State College of Veterinary Medicine at Cornell University to develop a blood test to measure IL-6 levels of dogs.
Because Shar-Pei with FSF have elevated levels of IL-6, we are hoping to use this as a screen-ing test for this disorder.
Before this, IL-6 levels could only be measured by growing special cell lines in tissue culture media...an elaborately expensive, time consuming and very complicated method.


Questions About The Test...
How old do they have to be to be tested?
How specific is it for this disorder?
Will it tell me if my dog will die from amyloidosis?
Will it be expensive?
How is FSF Treated?
Fever episodes are treated with anti-inflammatory medications, e.g. Dipyrone.
Extremely high fevers may require more aggressive treatment, similar to that of "heat stroke."
Colchicine
Experimental...use of the drug needs to be reviewed and treated cases compared to untreated cases before it can be widely accepted.
Used in FMF to reduce the severity and frequency of fever outbreaks and to block the development of amyloidosielil art rcsults in Shar-Pei ssrith FSF are encouraging.


How is Amyloidosis Treated?
Most patients don't show signs until disease is well-advanced and they are dying. Treatment is difficult if not impossible in most cases.
Treatment of advanced kidney and liver failure needs to be designed to fit the needs of each individual patient and should be left to your veterinarian or specialist she/he refers you to.
We have used colchicine along with more conventional therapies in somc, less advanced cases. Sorne arc still alive two years post-diagnosis. These are the EXCEPTIONS not the rule. More on Treatment and Diagnosis of Amyloidosis...


Dr. Jeff Vidt wrote an excellent article: "Plan of Action for Amyloidosis" in Nov/Dec 1992 issue of The Barker on signs to watch for and treatment of amyloidosis which covers the subject in depth.
I have a treatment protocol for FSF/amyloidosis that I will send to any veterinarian on request.


Does Every Shar-Pei that Dies of Kidney Failure Have Amyloidosis?
Lots of causes of kidney failure and some are related to FSF and some not.
Amyloidosis does, however, seem to be the OVERWHELMING cause of premature death from kidney failure in Shar-Pei but only histopathologic exam (biopsy or necropsy) will tell you for sure.
Glomerulonephritis
Shar-Pei with FSF may also develop membranous glomerulonephritis with or without amyloidosis as a result of immune complex deposition. Glomerulonephritis is common in imune-medicated diseases.
Glomemlonephritis forms as a result of the deposition of immune complexes along the glomerular capillary wall and ultimately results in the destruction of the glomeruli within the kidney, loss of protein in the urine and kidney failure.
Other related kidney disease...
Pyelonephritis (infection of the kidney) may occur commonly in FSF/amyloidosis patients.
They can also throw a clot to their kidneys...an "infarct."
These conditions may cause or contribute to kidney failure and are non-amyloid related kidney disease that may be triggered because of their immune system problems for FSF.
Therefore...
A Shar-Pei may die of kidney failure at an early age and be negative for amyloid.
The dog's kidney failure may OR MAY NOT have been related to FSF and at this time. It is impossible to determine any relationship with certainty.
These animals can only be classed as suspicious, unknown.


Currently available diagnostic tests
I recommend a minimum database of CBC with differential, semen chemistry panel, urinaly-sis and urine protein/creatinine ratio for my patients with FSF if the owner is willing. Lyme disease (Borreliosis) should be ruled out in endemic areas.
Immune panels, Immunoglobulin levels, cultures, radiographs and joint taps are sometimes needed .


Can I use urine protein levels to screen my dogs?
Most non-Shar-Pei that develop amyloidosis get a glomerular amyloidosis after nine years of age They spill a lot of protein in their urine.
Humans with FMF and amyloidosis spill a lot of protein in their urine.
Unfortunately, Shar-Pei (and Abyssinian cats with Familial Amyloidosis) most commonly get medullary amyloidosis and they may or may not spill protein in their urine. This makes the test worthwhile (because a positive may be significant and should be followed up with a urine pro-tein/creatinine ratio) but a negative doesn't mean you are safe.


Dr. Linda Tintle, 251 Sullivan Street, P.O. Box 906, Wurtsboro, New York 12790. (914) 888-4884.




Like I said, Chloe has FSF. Her first fever was spring/summer 08. She was almost 6 months old. I freaked. First thing I did was look on Shar Pei Forums for an answer. What do I do!?
Well take her temperatue! So out comes the themometer, (she doesn't like that part) and she had a temperature. Great! Now what? Well get an aspirin to help her with her fever. Aspirin given. Poor girl looked SO miserable. She wouldn't get up, she was shaking, and eventually when she did get up to go outside she wouldn't put any weight on her left leg. Her left hock was super swollen, and very warm. So to help with her fever I wet wash cloths and layed them on her to comfort her. Every so often I would get a syringe and give her water to drink. I also took her temperature ever 20 - 30 minutes. It is said that if the temperature goes above 106 degrees then it is time to go to the vet. Chloe's been to 106.2 before and I was JUST about ready to rush her to the vet, but it went down - thank goodness!
Chloe's fevers usually last before a few hours to three days. Shortest was a few hours, longest was three days (boy was that ever fun!)
After the first fever we (myself, and the breeder) weren't sure if it was FSF. So I didn't put her on Colchicine. After the second fever I put her right on Colchicine, and bought metacam. Metacam is to be given as soon as I spot a symptom of FSF. I find after using Colchicine she hasn't had a severe fever yet. All minor.
Pickles has yet to show any signs...I am hoping he is FSF free.
Chloe's triggers are usually stress and high excitment.
One time she got a fever after seeing a bunny rabbit and getting too excited.
Sometimes it is random as well.
It takes some getting used to, seeing her so miserable, shaking, hot, and uncomfortable. My heart breaks everytime I see her that way.

24 comments:

elle said...

your words are so helpful, I have a9week old girl called lily and on saturday night i was a woken by this heavy panting i didnt no what was happening so i rushed her straight to the vet, they said her temp was 104, but no swollen hock or mouth, she was eaten and drinking but the vet kept her in and they kept saying it could be shar-pei fever i was not convinced as no other symptons other than the high temp what do you think??

Anonymous said...

Cooper came to me from Oklahoma via van. It was a 24 hour ride for him. The second day he was home he did the same thing, rapid respirations, fever of 104, congestion. He had pneumonia. I'm not convinced he has FSF, he had no other sx either.

Alet said...

Alet
I came home last night and found our Shar-Pei Rusty just laying in his bed. He felt warm and didn't respond to us calling him. I noticed his lower left back foot was swollen and he was breathing short shallow breaths. I rushed him to the vet and he diagnosed him with FSF. Thank you for your information regarding this disease. It gave me a lot of insight regarding this illness. We'll just keep him comfortable and give him his meds. I just hope and pray he will be okay.

Anonymous said...

I am just learning about all this now after getting home from the emergency vet and them telling me that my little girl could have renal damage she is only 20 weeks so sad I am still crying like a baby. I am unsure what is the long term prognosis do I keep her going with all this does it get worse what to do I am totally confused. Big prayers tonight I think !!!

veronica said...

Veronica said...
My shar-pei lived with the SHS/FSF for 7 years and 7 months. He was on Prednisolone and Colchicine for the past 5 years. Only in his 7th year he developed slight damage to his liver. Ironically, it was not due to the Shar-Pei fever. He had a tumor of a size of small cabbage attached to his liver that the vet failed to notice!!!!!!! He had to be put to sleep.
Disgraceful!
There is a hope and good prognosis for dogs with FSF. Colchicine is a must, but make sure your dog has medical insurance so the cost of tablets can be covered. The tablets are very expensive. My dog had to take them every day.

shae acopian detar said...

My dog Crumbles died of SFS. It turned into Cellulitis and then Necrotizing fasciitis, and all of her organs shut down and she died. I had her in the hospital from the very beginning of her fever. Her fever was 104.5 and I took her to the doctor. Her belly and legs developed huge blisters and then the flesh began eating away. She died within 48 hours of her fever beginning.
It's the worst and scariest thing ever. I miss Crumbles more than you can know, she was like my child. Doctors are completely unfamiliar with this stuff, which is really frustrating.
I have anohter shar pei who last week had a 104.5 fever as well and the skin on his legs were bruising, and I knew immediately this was what Crumbles had. I rushed him to the vet and demanded they take it seriously and put him on the right meds. I made them look at Dr. Vidts website. Waylon, my 2 year old shar pei is fine now. We understood what we were dealing with and it made a huge difference. He is alive!
This post you have put up is so important for people to read. Not that many people are familiar with this..
Thanks for the post.

Sincerely,
Shae Acopian Detar
www.everythingstyle.com

shae acopian detar said...

ALSO, Colchicine did heo Crumbles. When she was alive...
she used to get fevers every 3 weeks until I started her on Colchicine twice a day...her fevers went from 3 weeks to 5 months...it was pretty good. I would suggest that if you think your shar pei has SFS get your doctor to put them on Colchicine permanately.

colchicine:
http://en.wikipedia.org/wiki/Colchicine

Shae Acopian Detar

Janie said...

Zimba was my dog for 5 great years he died 5/31/2010 of Kidney failure as he was red on his back leg and very swollen took him to the vet twice in May. She the Vet gave him shots for hocks {1} Predaisone {2}Vomiting
{3}Antibiotic
This was the last time we went to Vet 5/27/2010 he got so sick. I call the vet Sat like a crazy mother. All they could say is take him to the Hospital. So we go my Boy friend & I. Zima Let me remind you. My father died 12/22/2004 Zima was born 12/31/2004 & I got Zimba 2/14/2005 so. He was the one that help me throw all that and here I was living it twice again with Zimba sick and thinking about my Daddy, But then it hit me I was so mad. The Vet that he had Zimba since day one never check Temperature never because, I had just asked for his history and no where in his chart was one Temperature. So In Zimbas name Please check your dogs Temperature always. Zimbas mom

Anonymous said...

In July '09 I bought my I bought my little 6 week old pei girl - she had gotten her first round of "puppy shots" the day before from the breeders vet and right from the getgo she seemed rather "itchie " all over and suspected fleas and promptly gave her a bath w/Frontline the following day. Howver, this did't do the trick - I spoke with my vet.
She had 3 skin scapings due to development of small bald spots under elbows and hind legs - nothing was wrong. I put her on BENEDRYL, changed her diet to grain free/low allergy WELLNESS SIMPLE SOLUTIONS DUCK @ RICE and a medicated bath every 10 days and my baby seemed much better. 2 weeks after she got her Rabies vaccine suddenly in the evening she was sick: rached back, swollen lips, stopped eating and drinking, didn't sleep all night [ sat up all night], felt hot across her eyes and cried when I touched her.
In the morning my husband took her to the vet and he said " BEE STING " in the muzzle. I spoke to him on the phone and I said I think she has FSF - he did not agree. She had 2 other episodes - the third w/cellulitis of 1 hock. My vet then conceeded - FSF. She went on PREDnisone 1 every other day and has not had any episodes since. She was just spayed successfully. I love her so much but wouldn't want to go through this again - no more pei's for me.

Anonymous said...

Our 6 year old female sharpei seems to be in perfect health except for a swelling of her hock that has been evident for about a month. She is not lame, and doesnt seem to be worried by the swelling at all. I took her to the vet about 3 weeks ago. She took X Rays, bllod samples and a urine sample and pronounced that she had sharpei fever. I have been reading all your comments with great interest. Molly has never had a fever, and is not ill in any way. Her only sympton is the swelling. From reading your posts, it seems to me that the swelling usually accompanies a fever, and is temporary. I am going to seek a 2nd opinion, but would apreciate any advice

Anonymous said...

My Shar-pei was diagnosed with FSF about 9 months ago, when he was about 2 years old. He has been on Colchicine since the day he was diagnosed and has not had a fever episode since, only mild swelling in his back legs if he get to much exercise. I just found out today that the FDA has pulled Colchicine from pharmacies, and the only available option is Colcrys. I would not have an issue with this except for the fact that I would get a 90 day supply of Colchicine for $10, and now have to pay almost $500 for 90 day supply of Colcrys. I am going to look into medical insurance, but worry it is too late. Has anyone run into this problem with Colcrys?

richard keller said...

Re: colcrys. Our Shar Pei is now on this med . We filled the first prescription locally, $ 195 for 30 pills !!! After searching the internet we are now getting 200 pills for $ 95 from Canada , much better.

Anonymous said...

Amy
I have an 8 year old shar-pei in which we rescued when she was 4. I read up on this Fever when we got her but never thought anything of it until Sunday just gone, I walked into the room, to find her keep stretching her neck up, Shivering, & weak. She stood up & was really off balance then arched her back as if to stretch again, then just laid back down shivering. I rushed her straight to the vets in which they felt her all over & couldnt find a specific sore area, then took Temp which was 40, the vet gave a dose of anti inflammotry & a double dose of antibiotics & sent us home. She still hasnt got back to her 'Happy' self & is still rather weak & shivery. Does this sound/relate to FSF? as i know the vets around here arent very familiar with this condition. Her breathing is also very deep, as if she is taking deep breaths constantly. Any advice is much appreciated. Thank you!

Compostman said...

This is a copy of another posting.

I believe I may have discovered an effective treatment for FSF in place of pain killers. Keep in mind, it is yet to be long term time tested.

I have written to both Dr. Vidt and Tintle explaining the success iI have had in bringing FSF under control with my Shar-pei. The drug Allpurinol is used in the treatment of gout on humans, which I have personally used for years. It both reduce the production of uric acid, which is the cause of gout, and also helps to flush it's build up out of the system. A month ago I started my Sharpei on 150mg of Allpurinol daily and the results have been astounding.

I personally take 300 mg daily for my gout. It has stopped my gout attacks for over five years. It appears Allpurinol appears to be effective in also reducing hyaluronic acid (HA), the cause of FSF, plus flushing excess HA, as it does uric acid, out of the dogs system. HA is considered by most experts to be the cause of FSF. My 5 year old male SharPei has FSF and his attacks now occur three weeks and have become quite severe. He is virtually unable to walk when he gets an attack.

His almost immediate and positive response, the first week, to Allpurinol has been astounding. He is running, jumping, and playing like a puppy again, which when he did before often brought on an FSF bout.

Since taking Allpurinol his level of alertness now and response has gone from a scale of 4 to 10. He has had no signs of a FSF for going on a month of treatment. But as significant is the positive effect on his level of activity and look in his eyes. Allpurinol is a relatively safe drug, without any significant bad side effects. I felt it important to get this information our to Sharpei owners. I have personally lost a Sharpei to amyloidosis brought on by FSF, it isn't fair to yourself or the animal watch them die like that.

I recommend you contact you vet and discuss it with him before using Allpurinol.

Although is actually probably safer the using asprin or colchicine. I am not a Vet. I'm am only trying to help other Sharpei owners from experiencing the pain in watching your dog suffer from pain and high fever. Seeing that glassy pained look in a dogs eyes when the are experiencing the pain and high fever of FSF is a difficult experience. And knowing it can progress into amyloidosis and and see them die is even worse.

Keep in mind Allpurinol has not been long term tested or proven effective by anyone but me.

A few minutes ago Vino climbed onto my lap with a look of thank you.

GOOD LUCK

John Laurenson

Compostman said...

This is a copy of another posting.

I believe I may have discovered an effective treatment for FSF in place of pain killers. Keep in mind, it is yet to be long term time tested.

I have written to both Dr. Vidt and Tintle explaining the success iI have had in bringing FSF under control with my Shar-pei. The drug Allpurinol is used in the treatment of gout on humans, which I have personally used for years. It both reduce the production of uric acid, which is the cause of gout, and also helps to flush it's build up out of the system. A month ago I started my Sharpei on 150mg of Allpurinol daily and the results have been astounding.

I personally take 300 mg daily for my gout. It has stopped my gout attacks for over five years. It appears Allpurinol appears to be effective in also reducing hyaluronic acid (HA), the cause of FSF, plus flushing excess HA, as it does uric acid, out of the dogs system. HA is considered by most experts to be the cause of FSF. My 5 year old male SharPei has FSF and his attacks now occur three weeks and have become quite severe. He is virtually unable to walk when he gets an attack.

His almost immediate and positive response, the first week, to Allpurinol has been astounding. He is running, jumping, and playing like a puppy again, which when he did before often brought on an FSF bout.

Since taking Allpurinol his level of alertness now and response has gone from a scale of 4 to 10. He has had no signs of a FSF for going on a month of treatment. But as significant is the positive effect on his level of activity and look in his eyes. Allpurinol is a relatively safe drug, without any significant bad side effects. I felt it important to get this information our to Sharpei owners. I have personally lost a Sharpei to amyloidosis brought on by FSF, it isn't fair to yourself or the animal watch them die like that.

I recommend you contact you vet and discuss it with him before using Allpurinol.

Although is actually probably safer the using asprin or colchicine. I am not a Vet. I'm am only trying to help other Sharpei owners from experiencing the pain in watching your dog suffer from pain and high fever. Seeing that glassy pained look in a dogs eyes when the are experiencing the pain and high fever of FSF is a difficult experience. And knowing it can progress into amyloidosis and and see them die is even worse.

Keep in mind Allpurinol has not been long term tested or proven effective by anyone but me.

A few minutes ago Vino climbed onto my lap with a look of thank you.

GOOD LUCK

John Laurenson

davisp421 said...

I have a Sharpei mix. He has lost almost ten pounds, refuses to eat (I put food in his mouth,) has no life to him, heavy breathing...all of the symptoms mentioned in Sharpei Fever. His temp was 103 degrees today and could not walk on his back right leg. He had horrible diarrhea and was on meds which cleared up the heavy mucus. The doctor came up with Sharpei Fever today and did more blood work. He is on baby aspirin and we are waiting to hear. He is an orphan and I am his fourth (and last) home in four years. I will ask for some of the meds, especially the allpurinol mentioned. I will not put him through a biopsy. This has been so upsetting because he is such a sweet and good boy. I cannot bear the thought of losing him.

melgeo126 said...

This was Dr. Tintle's response to this on the Shar Pei Forums: http://www.sharpeiforums.com/viewtopic.php?f=4&t=18517


This gentleman wrote Dr. Vidt and I as well with his theory and experience. We have been looking at his claims for the drug but the reason allopurinol has not been looked at in the past is because:

1) Humans get gout because of uric acid build-up. It is a result of disordered purine metabolism. The crystals activate the inflammasome and cause autoinflammation. FSF and gout are both inflammasomopathies. With the exception of some Dalmatians, dogs do not have this problem. FSF and gout have different underlying causes of autoinflammation.
2) Allopurinol is a xanthine oxidase inhibitor that blocks the production of uric acid. It is a very specific drug that targets the excess uric acid. Shar-Pei do not have elevated levels of uric acid.
3) It is not without side effects (rare but in 2% of patients they can be life-threatening) and is very carefully dosed to achieve desired target levels of uric acid. I repeat, Shar-Pei do not have elevated uric acid levels.
4) I could find some reference in the literature to allopurinol stabilizing HA in the endothelial glycocalyx by blocking some reactive oxidative species (ROS) damage. Hence it may help with damage to blood vessels (vasculitis) due to its potent antioxidant action. The owner using the drug in his Shar-Pei may be seeing some benefit due to allopurinol's antioxidant effects.

I had not posted because I wanted to see if there was more data that might support the use of allopurinol in our dogs. I am still looking and maintaining an open mind but so far, I think the risks out-weigh the benefits. (There are also a great many drug interactions that need to be monitored with patients on allopurinol.)

There are other potent antioxidants that are safe that could achieve the same benefit. (Vitamin C, HyVitality, mixed tocopherols like natural Vitamin E, alpha lipoic acid, etc.) The correspondent had cut n paste some comments from a lay article that suggested allopurinol might have a role in HA metabolism/catabolism in the body and I am trying to find out where that statement originated.

I am very familiar with gout because I have been long aware of its similar underlying pathology (and I have a brother-in-law who suffers with it). I am a lurker on a gout forum for just this reason because I want to see what is working for them and allopurinol is commonly used. But I had not looked at it at all prior to this because I knew it was used to block the enzyme xanthine oxidase, something that should not be of any help to our Shar-Pei.

I will keep digging and if I find something beneficial, will post again.

I am very open to these kinds of suggestions from owners because this is how I found out that dipyrone works. I had an owner write me that his dog would spike to 108 degrees F on a regular basis and dipyrone was the only thing that would drop it consistently and reliably. He lived in So. Calif. and bought it OTC in Mexico as tablets. So if someone thinks they have something that works, please let me know.

Thanks. ~ Linda

_________________
Linda Tintle DVM
http://www.wvc.vetsuite.com

jasmyne said...

someone posted about mucus in the stool...my girl had tons in her stool on every type of diet. finally, "taste of the wild" salmon formula cleared this up 100% in just 3 feedings. it's both grain and chicken-free. for grain-free treats, i stick with baked potato, a spoon full of coconut oil, a wedge of grapefruit, or a peice of cooked broccoli smothered in olive oil.

Jana F. said...

Thank you so much; your article has helped a great deal in understanding our Brandy's illness. She is only half Shar Pei, which we think/hope is in her favor. The first attack wasn't until she was 3 years old, we'd never heard of FSF, and it was really severe and frightening. Of course, it was 11:30 pm on a Friday night, so we had to hunt down a 24-hr Emergency vet. They checked her temp--over 106--put her on IV fluids and into a cooling chamber where she responded quickly. Had to leave her over night, which was awful, and then to her regular vet on Monday. Everyone had to research the illness, since they had rarely seen it at either office. Now we keep meds on hand, and when it hits, we keep a close eye on her, lots of ice water close so she can drink it without moving, and the episodes have lasted from 3 hrs to a full day. Then she perks up and starts getting back to her normal, sweet self. She is 7 years old now, and doing pretty well. We try to keep the stress down (not always easy!) and just watch for any signs. I've read that a low-protein diet may help, but what she eats doesn't seem to contribute to the frequency or severity; also, our vet hasn't recommended we put her on any daily meds (aspirin or colchicine) but we do have antibiotics and Rimadyl ready; they seem to help. And when she's feeling so bad it's easy to give them to her! Her vet says she is doing well for her age, we just hope that she's with us for many more years. I periodically check to see where research is on either a cure or a prevention; now that the gene causing the illness is identified, that's definitly a hope, as well.

Anonymous said...

If someone could help I would really be greatfull. I have a 4 year old male shar pei. From day 1 he has has bother with his fur/ skin . I left alone he will eat away at his fur till it bleeds. I've been to loads of vets but none have solved my solution. I you have any solution drop me an email please
Nick_mccluskey@hotmail.co.uk thanks
Nick

Anonymous said...

If someone could help I would really be greatfull. I have a 4 year old male shar pei. From day 1 he has has bother with his fur/ skin . If left alone he will eat away at his fur till it bleeds. I've been to loads of vets but none have solved my solution. I you have any solution drop me an email please
Nick_mccluskey@hotmail.co.uk thanks
Nick

Andrea Krol said...

I have a shar-pei and she is 5. I believe her kidneys are now failing. Every where she sleeps, she gets up and there is urine left there. My dog is not eating much at all if anything at all. I have taken her to the vet many times and spent a fortune for a vet to have no answers except to tell me to let them run more tests. I know stress makes her worse and I'm not sure what we should do as the vet upsets my dog. We often will get up and our dog can't/won't get up she seems like she is in so much pain. Basically we are just trying to keep her happy and comfortable as we love her and she is a member of our family. I know the time is coming soon but figured she will let us know when it's time. I wish there was an answer to all of this. One more thing when this all began a few years ago and I called the breeder to talk about this, she hung up on me. I did try to call but I believe she blocked my number. How horrible if she is breeding sick dogs and knows she is. I am so disgusted by the lack of caring by the breeder, I didn't want anything from her just to talk about my dogs condition. Any advice for our beautiful shar-pei would be greatly appreciated.

Ashley Clemmensen said...

I had Shar Pei dumped on my property about a year about and she more or less adopted me I had never taken her to the vet seeing was how there were no health problems or anything well we recently moved in to the city and yesterday I could swear that she was running a fevor but I had no way to check her entire head was on fire I couldn't hardly touch her so I called the vet and.the soonest.they could.get her in was late the next afternoon so we went through a day of her being off food need having to force her to drink and her breath was so shallow it scared me well when we woke up the next morning she was fine it was.like none of it had happened and.the vet ran blood work and did the works but said she seemed fine. MY QUESTION IS will a vet not chatch it if this isn't what they are looking for or if the dog isn't having an episode because this sounds a little like what my what people lizzie when through contact me with info via aclemmensen2012@gmail.come thanks

Blacklily said...

Thanks, very informative. My boy is now 2.5 and he has FSF. His first episode was at 6 months and gfor the next 3 months was 1 a month and then for next year was 1 every 3 months and the last episode occured after 6 months, which I am hoping is a good sign. I notice that the first sign of his episode is diarhea, then slight limp. After diareah I get him to vet for a shot of metacam and he always has a temp of approx. 104 and this comes right down to normal (only after metacam) in 6 hours, plus we get something for his diarhea. If he seems in pain he has tramadyl for his swollen joints (more and more now where as the first couple of episodes he did not need this) and he has metacam for 2-3 days after the episode. I keep him on quite a controlled diet as he seems to have a sensitive tummy and a bout of diarhea always results in an episode.
Thanks Rachel