Mucocutaneous Pyoderma (Incl. Lip Fold Pyoderma / Dermatitis)

December 17, 2014

Hi Keely,

You wrote,
“I think Lupus is unlikely since the condition has been so responsive to the Allimed which is both strongly antibacterial and anti fungal. However I feel his immune system must surely be compromised in some way or else the condition would have resolved.”

As soon as I saw the photos of Murry, it made me very suspicious of an auto-immune disease. Not Lupus, but one of the Pemphigus complex diseases. The Allimed, (concentrated garlic), has helped 80% since Murry has bacteria and/or yeast in these skin lesions since the skin is not normal, and is essentially an open wound. He has a compromised immune system, either from genetics or secondary to ‘vaccinosis’ from over vaccination.

So, the Allimed has cleared up the secondary problem of the yeast/bacteria, but is unable to completely clear up his auto-immune problem.

You have helped him considerably with the RAW diet, as raw meat contains Vitamin C. Dogs are able to make their own Vitamin C, but in Murry’s case, he is probably deficient, due to his compromised immune system.

Avoiding future vaccinations is of paramount importance.

And keeping the lip folds and prepuce area clean is also a good idea. Hydrogen peroxide might be something you could try, that, hopefully, will not be too irritating.

Lastly, I suggest you try the homeopathic remedy, Silicea. It is available in health food stores, and I believe in England, it is over the counter in Pharmacies.

Start with 6C or 12C potency. Give Murry one pellet TWO times daily for the next 3 weeks.

This remedy came up at the top of the list in Dr Pitcairn’s New World Repertory, of symptoms:
1. Face, lips ulcerated
2. Ill effects from vaccination
3. Mucous membranes, affections of, ulceration

Two other remedies that may be useful, that came in second and third, are Sulphur and Thuya. Both are very important remedies for vaccinosis, and Thuya is a good remedy for growths, warts, and tumors. As you mentioned he has ‘lumps’ on his face and leg.

But at this time I would start with the Silicea. You can also dissolve one pellet into a 2oz glass dropper bottle, in Spring Water, (or filtered water) succuss, (or shake) the bottle 20 times by hitting it against the palm of your hand, prior to each dose. Give him 1/2 dropperful by mouth TWO times daily for the next 3 weeks.

If you wish to continue with the elimination diet, you can. But I do not think that will be necessary.

And, you might consider finding a holistic veterinarian in the UK, that could treat Murry:

Click here to find a holistic veterinarian in your area. Another resource for vets knowledgeable in homeopathy is AVH.org.

After three weeks on the Silicea, please send me an update, (or sooner if he is worse!).

Keep us posted by coming back to this page and clicking the ‘click here to add your own comments’ link below.

Take care,
Dr. Carol Jean Tillman

DISCLAIMER: The above should never replace the advice of your local veterinarian, as they have the ability to evaluate your dog in person.

Thanks so much for your reply Dr Tillman. I have ordered some Silicea 6C . I will report back when I have some more news.. Thanks again, Keely.

Dear Dr Tillman,

I would just like to update you on Murrys current condition etc..

I looked at lots of photos on the internet of dogs with Pemphigus complex diseases particularly those that effect the mucous membranes. I don’t feel that Murrys condition resembles any of the pictures I have looked at but I can see how you could think that from the ‘not very good photos’ I supplied you. I realise I could still be wrong but based on all the research I have done i don’t feel that he has that condition. Another thing is many months ago the Allimed capsules managed to clear up the lip fold infection on Murrys left side and the infection has not returned since and the skin looks normal there. I feel that if Murrys condition was autoimmune in nature then the infection would have returned on his left lip fold and yet it has required no treatment since and looks fine. Also why would the antibodies have stopped attacking his left lip fold and yet continue to attack his right lip fold and prepuce?

The photo at the vet website link below is a very accurate representation of how Murrys lip folds looked. He also had the infection starting to spread on his nose like the dog in the photo but the Allimed capsules cleared that up before it could worsen.

http://openi.nlm.nih.gov/detailedresult.php?img=3551225_vetrec-2012-101069f07&req=4

I stopped giving Murry Allicin (Allimed capsules) on December 29th.

For the past 3 weeks I have been giving him 1x silicea 6C pellet, 2x daily as well as a quarter of a pipet twice daily (consisting of 1 dissolved pellet in mineral water. I hope I have done what you recommended correctly.
I don’t think the Silicea has made any difference to Murrys condition. His prepuce infection is now worse than it was before I stopped the Allicin at the end of December.

Murrys right lip fold infection however is much improved since the 2nd January when I started applying Penaten cream to his right lip fold twice daily. Because the cream is very thick and did not adhere well to the infected area, I mixed it with a little E45 cream and it then adhered very well. The cream dramatically seemed to improve the condition. I believe it is the zinc in the cream that is so effective. I then switched to Sudocrem Cream because it is a thinner zinc based cream and I didn’t need to mix it with as much E45 cream to get it to adhere. This is proving to be very effective and the infection appears to be almost entirely gone under the lip fold now.
So I now know that the infection appears to be very susceptible to zinc. I try to make sure Murry doesn’t lick the cream as I read about zinc toxicity in dogs.

I know that zinc is antibacterial but do you think it may be possible that Murry could have ‘Zinc responsive dermatosis’. I read that German shepherds can be predisposed to that condition and that it can effect the mucous membranes inc lip and prepuce ..?

Since the zinc cream is so effective I was wondering if you might know of something zinc based that I could apply (preferably ‘spray’ on his prepuce as he won’t let me touch it but will let me spray it).

Dr Tillman any more help or suggestions to you could offer would be much appreciated. I would very much like to know your current thoughts on the matter. Also would you like me to try another homeopathic remedy now?

Many thanks again Dr Tillman,

Keely.

February 2, 2015

Hi Keely,
Regarding a ‘diagnosis’ for Murry, a biopsy of his lip fold area would be needed to say if he has an autoimmune condition or not. Fortunately, treating him homeopathically, it is not that important to obtain a specific diagnosis, just treat the symptoms.

The link to the photo of the German Shepherd dog with the lip fold ulcerations and erosions is really a severe case of mucocutaneous pyoderma. I hope that Murry is not that severe.

You wrote,
“I stopped giving Murry Allicin (Allimed capsules) on December 29th.”

You wrote,
“Murrys right lip fold… is much improved since the 2nd January when I started applying Penaten cream to his right lip fold twice daily.”

So, January 2 you started a Zinc oxide cream.

You wrote,
“For the past 3 weeks I have been giving him 1x silicea 6C pellet, 2x daily as well as a quarter of a pipet twice daily (consisting of 1 dissolved pellet in mineral water.”

Then January 11 (?) you started Silicea 6C. Actually, you only need to give him either the dry pellets OR the pellet dissolved in water, you do not have to give him BOTH.

You wrote,
“I don’t think the Silicea has made any difference to Murrys condition. His prepuce infection is now worse than it was before I stopped the Allicin at the end of December.”

So, you have been applying the Zinc oxide cream, (switched from Penaten to the Sudacrem cream)since Jan 2, to his lip folds, and giving him the Silicea 6C since Jan 11?

If the zinc oxide cream appears to be *improving* his condition, this also may be suppressing his symptoms on his lip fold, and causing the prepuce area to become worse. Using the Silicea at the same time, it is difficult to know whether he is able to respond to the Silicea, or not.

You wrote,
“I believe it is the zinc in the cream that is so effective. I then switched to Sudocrem Cream…This is proving to be very effective and the infection appears to be almost entirely gone under the lip fold now.”

The ingredients for the Sudocrem include Zinc Oxide, Benzyl alcohol, and Benzyl Benzoate. None of these ingredients are very safe to be taken by mouth. I could not find any precautions on their website, probably because a baby would be wearing a diaper, and it is unlikely that a baby would be able to lick their bottom.
Regarding Zinc-Responsive Dermatosis, I have not even seen a case in 35 years of practice. In Current Veterinary Therapy XIV, (page 1180-1181) there are two syndromes described. Syndrome 1, is a genetic condition in Huskies and Malamutes, so that is appears at a very young age. Zinc supplementation needs to be given for the rest of their life to treat the condition. Syndrome 2 appears in rapidly growing puppies that are being fed a poor quality dog food or are being over supplemented with calcium. Once they have a better quality diet, and given some zinc supplementation, they respond quickly, and therapy is not needed once they reach maturity.

At this point, I suggest you stop all topical applications of Zinc oxide, or any other cream, and continue with the oral Silicea 6C. (either dry pellet or the dissolved form TWO times daily, for the next 3 weeks.

Clean his preputial area with saline or warm tap water daily.

And in three weeks, please send an update.

Keep us posted by coming back to this page and clicking the ‘click here to add your own comments’ link below.

Take care,
Dr. Carol Jean Tillman

DISCLAIMER: The above should never replace the advice of your local veterinarian, as they have the ability to evaluate your dog in person.

Hi Dr Tillman,

Thanks for your reply. I will do as you suggest and I will stop all zinc cream and clean the lip fold and prepuce with saline water only.

I will put the saline water into a spray bottle and spray it onto the prepuce area since he won’t allow me to touch it so please let me know if you don’t think that is acceptable. I could also try taking him in the sea if that is Ok? .. I live near to the beach and this may be quite helpful in keeping it clean.

I will continue the Silicea twice daily for the next 3 weeks. He is much more accepting of the dissolved pellet in spring water so I shall continue with that method.

Can I please confirm with you that I am making the remedy correctly please.. I am dissolving one tiny 6C Silicea pellet in mineral water inside a little dropper bottle and giving Murry a little of the liquid via pipet twice daily. The dropper bottle I am using is half the size as the one you suggested so I am giving him a quarter of a pipet each time. Is that OK?

Thanks again Dr Tillman,

Keely.

February 2,2015

Hi Keely,
Yes, you are making the Silicea dissolved in water correctly. Spring Water is best. I am not sure if your mineral water is the same?

Is Murry’s prepuce painful? Does he try to bite if you attempt to clean it? Are the lip fold areas also that painful?

A spray bottle with saline would work fine. But if he is that painful I would just let the Silicea act, and if he is responding well, you will see that he is less painful. Ocean water would leave his entire cost salty, requiring a bath every day. It would be best either to use saline or nothing.

Keep us posted! And come back to this page and click the ‘click here to add your own comments’ link below.

Take care,
Dr. Carol Jean Tillman

DISCLAIMER: The above should never replace the advice of your local veterinarian, as they have the ability to evaluate your dog in person.

Apparently in the UK to be called either mineral or spring water both must come from a natural spring but mineral water must be much more highly regulated with regards to pollutants and must meet the minimum amount of naturally occurring dissolved minerals from the rocks of which it flows through.
So I will continue with mineral water for the Silicea unless you advise otherwise..?

Murrys prepuce doesn’t appear to be painful of such but could be tender to the touch. I think its more the case that he is protective over that part of his body. I regularly watch him to make sure that its not causing him any discomfort when he urinates but it doesn’t seem to be bothering him in that way. He does lick the area for a while fairly regularly though because of the infection.

His lip fold is not particularly painful I don’t think. I clean it regularly with a saline solution and he is fine with it..
His lip fold can be itchy however and he does try to rub his mouth/chin on the carpet, sofa etc.. I won’t apply anything to the area though unless you recommend that I do so.

Thanks again Dr Tillman,

Keely.

February 4, 2015

Hi Keely,
You wrote,
“I will continue with mineral water for the Silicea unless you advise otherwise..?”

That sounds fine to me!

You wrote,
“Murrys prepuce doesn’t appear to be painful of such but could be tender to the touch….His lip fold is not particularly painful…. I clean it regularly with a saline solution and he is fine with it.”

Ok. Some German Shepherd Dogs can be very irritated, or short tempered if they have pain. And might snap, or try to bite, if the painful area were handled. If that were the case, I might decide on a remedy different than Silicea. But since he seems ‘accepting’ of you treating him, then Silicea fits his constitution better.

Continue with the 6C Silicea for another 3 weeks, without any other topical treatment that might ‘confuse’ the picture, so we can observe if Murry is responding to the remedy.

Please keep us posted by coming back to this page and clicking the ‘click here to add your own comments’ link below.

Take care,
Dr. Carol Jean Tillman

DISCLAIMER: The above should never replace the advice of your local veterinarian, as they have the ability to evaluate your dog in person.

Murry doesn’t try to bite when I treat him but he doesn’t like it. He runs off as soon as he hears me with the bag of cotton pads so I always have to bribe him to agree to it but he’ll put up with it in exchange for something tasty! He is very good natured.

Thanks again Dr Tillman,

Keely.

Murry has completed a further 3 weeks of the Silicea treatment twice daily in water via pipet.

Unfortunately it doesn’t appear to have helped.
Murrys lip fold infection has worsened again since stopping the zinc topical cream 3 weeks ago. His prepuce infection appears unchanged.

I have included a link below to a short video clip I filmed 2 weeks ago of Murrys infection in the hope that it might be helpful.

I hope this helps, thanks again Dr Tillman.

Keely.

February 26, 2015

Hi Keely,
You wrote,
Murry has completed 3 weeks of the Silicea 6C… it doesn’t appear to have helped.
Murrys lip fold infection has worsened…
His prepuce infection appears unchanged.

I suspect the 6C may be too low a potency. Would you be able to find 30C? Make it up the same way as the 6C, one pellet in a 2 oz glass dropper bottle filled with Spring Water or filtered water whichever is easier.

Give Murry 1/2 dropperful by mouth ONE time daily for 3 days, then one time per week for 3 weeks.

You wrote,
I have included a link below to a short video… of Murrys infection…

Apparently the link expired and it says ‘you tube clip unavailable’. Could you make another one of Murry?

Send me an update at the end of 3 weeks after the Silicea 30C.

Please keep us posted by coming back to this page and clicking the ‘click here to add your own comments’ link below.

Take care,
Dr. Carol Jean Tillman

DISCLAIMER: The above should never replace the advice of your local veterinarian, as they have the ability to evaluate your dog in person.

Hi Dr Tillman,

I will get hold of some Silicea 30C and do as you suggest.

One 6C pellet in the spring water dropper bottle would last Murry for about 2 weeks a time until I used it all up and needed to make up some more so I assume that was a very low dose?

I’m sorry about the youtube link.. I have added a new link below please let me know if it does not work again.

I will also video Murrys infection again after the silica 30C treatment in about 3 weeks time.

Thanks again Dr Tillman,

Keely

February 27, 2015

Hi Keely,
Thank you for re-doing the you tube link. It worked!! I got a great look at Murry! He seems like a very calm dog, and did not object to the handling of his lip at all. I am concerned about his prepuce, and how red and ‘raw’ appearing it looked in your video.

Silicea may not be the correct remedy, but it is a very good remedy for ‘moist’ lesions that appear to be infected or abscessed. Hopefully, with a higher potency he will have more of a response.

Please keep us posted by coming back to this page and clicking the ‘click here to add your own comments’ link below.

Take care,
Dr. Carol Jean Tillman

DISCLAIMER: The above should never replace the advice of your local veterinarian, as they have the ability to evaluate your dog in person.

Hi Dr Tillman,

I just wanted to give you an update on the progress of Murrys infection..

It has been 6 days since Murry completed the Silicea 30C treatment.
Unfortunately his condition does not appear to have improved and in fact it seems to have got a bit worse.

The infection has now just started to spread to just below the outer edge of just below his anus which is something I always feared as I always felt the infection is connected to the mucous membranes.
I noticed this had occurred because very recently he has started licking his bottom which is something he would rarely do normally. When I checked it I could see a very small patch of infection trying to take hold just below the outer edge of his anus.

I have made a before and after video regarding the silica treatment so that you can see how his lip and prepuce appears now. If you would like me to include any more video footage or if it is unclear please let me know. The link to the video is below..

I look forward to hearing from you Dr Tillman
Thanks again,
Keely.

Hi Dr Tillman,

I think my last message may have been missed.?

Thanks again,

Keely.

April 8, 2015

March 27, 2015–Silicea 30C given

Hi Keely,

Thank you for your patience, and I apologize for my delayed response. I had to update some computer apps to access the video.

You wrote,
“It has been 6 days since Murry completed the Silicea 30C treatment.”

From what I could see of Murray’s lip area, with the scab that forms, it seems about the same. The prepuce area actually looks a little better to me. Unless there has been more change in the time since you posted it.

And now that he has some inflammation/crusting around his anus, I am not that alarmed.

The explanation is this: according to Hering’s Law of Cure, the direction of Healing is from front to back, top to bottom and inside out. So, if Murray’s mouth is the same, and prepuce is improving, but now there is an area of inflammation around the rectum, I would expect to see the mouth and prepuce improve as the anus worsens, and then the final stage would be improvement of the anus.

Do not give another dose of Silicea 30C yet.

Continue to clean with the saline solution.

Please keep us posted by coming back to this page and clicking the ‘click here to add your own comments’ link below.

Take care,
Dr. Carol Jean Tillman

DISCLAIMER: The above should never replace the advice of your local veterinarian, as they have the ability to evaluate your dog in person.

Hi Dr Tillman,

Thanks so much for your reply..I will do as you say and report back when there is some change.

Thanks again,

Keely.

Hi Dr Tilllman,

I am just posting an update of Murrys progress.

I think that there might be a little bit of improvement on Murrys lip. Also he has not been rubbing his lip as much and he hasn’t been licking his bottom or prepuce as much recently which he was doing both much more frequently during the Silicea 30C treatment.

I have included a link to the video footage that I have just shot below..

Please let me know what you think.

Many thanks,
Keely.

Hi Dr Tillman,

I don’t know if you got my last message or not..?
The patch of infection on Murry’s bottom has now got quite a lot bigger and I can’t generally see any real improvement overall in his symptoms. The infection now appears to be worse than ever.

I am now even more convinced that Murry has the condition Mucocutaneous pyoderma (page 7 of below study)

http://www.research.ed.ac.uk/portal/files/11436709/Suggested_guidelines_for_using_systemic_antimicrobials_in_bacterial_skin_infections_part_1.pdf

Apart from Murrys condition looking just like the images I have seen of this condition, page 7 of the above study says this :

‘Mucocutaneous pyoderma (Fig 3b)
Mucocutaneous pyoderma is characterised by crusts and erosions localised to one or more mucocutaneous junctions including the lips, eyelids, vulva, prepuce and anus. German shepherd dogs seem to be predisposed to this. This form of pyoderma can be clinically and histo- pathologically mistaken for immune-mediated or neoplastic diseases, but can be differentiated by complete resolution following an appro- priate antibiotic course.’

Murrys infection responded extremely well and nearly completely resolved with medical grade stabilised Allicin which is another reason that i think this condition might be the cause. I think the reason the Allicin didn’t clear it up completely was either because Murry has an underlying condition (of which I am not aware) or the pathogen responsible for the infection is protected by biofilm and hence the Allicin was not strong enough to penetrate it without the aid of biofilm disruptors.

However I am not a vet and I would be extremely grateful for your opinion on what to do about Murrys condition and whether you feel that Murry may benefit from further homeopathic treatments.

Many thanks Dr Tillman,
Keely.

PS. Another thing I wanted to mention is that since from a young age, Murry has often had a dirty and smelly ear but only in his right ear, (coincidentally the same side of his body that seems to be most affected by this infection). It often has dirty black deposits building up in it and gets smelly. I have always just cleaned it with some diluted apple cider vinegar. I wanted to mention this since I don’t know if the ear thing could somehow be related to his chronic infection..

May 11, 2015

Hi Keely,
Yes, I did get the last message. I feel that I am unable to properly prescribe a homeopathic remedy for Murry without actually seeing him. He may have some obstacle to cure, that hinders his ability to properly respond to a homeopathic remedy, or he may have a weak Vital Force, or some other reason.

At this time, it may be best to give him some conventional treatment, and provide some relief for him so he is not so uncomfortable.

You wrote,
“…since from a young age, Murry has often had a dirty and smelly ear but only in his right ear, (coincidentally the same side of his body that seems to be most affected by this infection). It often has dirty black deposits building up in it and gets smelly…. I wanted to mention this since I don’t know if the ear thing could somehow be related to his chronic infection….”

I am sure that it does. But as I am unable to take his case in *entirety* without seeing him in person, I will not be able to prescribe a proper remedy.

Also, I am relinquishing my position on the Organic-Pet-Digest to devote more time to patients that I can see in person.

Another resource for vets knowledgeable in homeopathy is AVH.org.

Please keep us posted by coming back to this page and clicking the ‘click here to add your own comments’ link below.

Take care,
Dr. Carol Jean Tillman

DISCLAIMER: The above should never replace the advice of your local veterinarian, as they have the ability to evaluate your dog in person.

This thread reads like it is a joke or satire of homeopathic treatments. None of the treatments suggested helped the dog and yet the owner completely abandons things that are working or the idea of finding someone in person to help their dog. Yet, you just keep trucking along and blaming vaccinations and other non homeopathic treatments from years ago! For goodness sake, and the sake of the dog find an actual professional to help with treatment or at least trust in the things that were working like the penaten cream (proven safe and a viable option for lip dermatitis). Who keeps believing some person on the Internet that has not seen the dog but keeps pushing a treatment that has proven ineffective. Just as you decided to stop trusting typical vets, I’d take a hard look at your current care and Think about why your placing so much faith in this silica treatment which as far as I can tell has done nothing!
I came to this board to see if I could find homeopathic treatments for my dogs lip dermatitus but after reading it will be calling my vet and following their prescribed care.

Hi there,

Thank you for your comment..I am currently booked in to see one of the best holistic veterinarians in the UK.

I used to do everything by the book as far as my dog was concerned, i.e.: wormed regularly, front lined flea treatments regularly, booster vaccinations, the recommended dry dog food on display at the vets surgery etc.. I am afraid I don’t believe any longer that these are all good things.. they didn’t do much to help my dog.. I have done ALOT of research over the past couple of years or so and am also a biology student studying gut bacteria, immune system etc and environmental interactions.. From what I have discovered a natural diet and a very careful and only sparing vaccination protocol should be used, not this willy nilly annual booster crap with is scientifically proven to be unnecessary (why do you think humans aren’t told to get boosters every year?) and overstimulates the immune system which is a very dangerous thing (just ask anyone with an autoimmune disease). My dogs problem has occurred probably because I used to follow the current recommended conventions, I now follow a more natural route in order to get him better and hopefully ensure a long and healthy life thereafter.. I am not against conventional medicine but I am looking for the root cause and I am afraid that dogs with the problem my dog has often go on antibiotics regularly for the rest of their lives because the underlying cause is not found and addressed..it is believed to be secondary to another underlying condition, possibly some kind of allergy..
I hope your dog gets sorted out and that they don’t have to go on multiple rounds of antibiotics eventually followed by a suggestion of surgery to remove the outer lip fold all because the underlying cause is not addressed and the problem keeps returning.. Just do the research and check out the forums with people who’s dogs have lip fold dermatitis and you’ll see what I mean.. Just remember at least 70% of the bodies immune system resides in the gut and the microbes that live there..therefore lots of antibiotics destroys the bodies defence mechanism opening it up to pathogenic overgrowth, other diseases or even cancer.. The info is all out there, just search Pubmed..

June 6, 2015

Hi Keely,
Great response, and glad to hear that you are able to locate a holistic veterinarian to sort things out for Murray!

Please keep us posted by coming back to this page and clicking the ‘click here to add your own comments’ link below.

Take care,
Dr. Carol Jean Tillman

DISCLAIMER: The above should never replace the advice of your local veterinarian, as they have the ability to evaluate your dog in person.