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From Orka to Porka: Vitiligo
by Leska Emerald Adams
It
started with his tongue. He had thick dark black adorable markings on
his big bright red-pink tongue. At the tip was a V. In hindsight,
looking back over sequential pictures, there were other signs, but the
tongue signaled to our newbie senses that something was going haywire
with our Newf pup Orka. The V sagged and slipped and became an X. The
bright red pink tongue became pink and then white. The black markings
faded, then disappeared. Fast, in days.
I've seen so many of my hospice patients
come out of the hospital after their last surgery with thrush. I
wondered if Orka had some similar tongue obscuration? His diet
composition had not changed; his breath smelled the same; his teeth
remained strong glistening white sharp new adult teeth. No fuzz
scratched off the tongue. What snatched the spots?
He
was approaching 6 months of age and undergoing many changes. Everything
about him fascinates me; watch him day and night wondering all about
him. He started lifting his leg to pee, and I wondered if the tongue
changes were a hormonal response. But his coat was also changing. It
had always had areas of browns and reds in certain lighting, but now
those non-black highlights became more pronounced even indoors, and in
the sunshine he looked flaming brilliant auburn. Waves of white and
gray surfaced in his fur. The tips of his hairs turned white and
frizzy.
Orka
Oslo had been jet black perfect and from young puppyhood I used to
watch him on Skype and look at his pictures and feel thrills of
aesthetic pleasure in his pin-up movie star gorgeous looks. When I
finally held him I was overjoyed with his presence, playful expressive
personality and handsome striking strong Newfoundland perfection. I was
looking forward to showing Orka and winning. I'd wake up in the middle
of the night to potty train him and take him to the playground across
the street and gaze in wonder at his face in lamp and moonlight. With
me 24/7, by day I wrestled with him and work-trained him, getting him
used to basic commands. I brushed him, petted played massaged horsed
around with him and delighted in his every contour and detail. We went
to a new park trail river or lake almost every evening, and he became a
wonderful walking pal, off and on leash, ever better socialized with
humanimals and other dogs.
Orka
is my Dr-prescribed service dog. I have autism with spatial mobility
deficits, neuro-alimentary problems, and like to kayak, so a big
intelligent water rescue dog fit to a T, task specific trainable.
Decades ago I used to watch teams of Newfies and their owners do
waterwork training at George Rogers Park in the Willamette River and
since the 1st time witnessing that amazing spectacle, wanted a Newfie.
So I bring Orka with me everywhere, and he is surrounded by squeals of
"Bear!" and innumerable questions, adoration, dog-gazing and
spontaneous photo / video ops.
Orka's
beautiful eyes began changing. They became cloudy. Their shape changed,
more almond, and the lower lids sagged. The 3rd eyelids' rims,
perfectly lined with luxurious thick black natural mascara, began
spotting, turning white, then disappearing. Orka's eyes swelled, turned
red and puffy, and began oozing pus. Then the skin around his eyes
turned bright white, losing all black, and the hair fell out. Suddenly
he looked zombie ghostly and ghastly. His dark eyes turned yellow like
a cat's. Some of his eyelashes turned white.
And
his formerly jet black nose suddenly faded, and went bald, gray, pink,
white, speckled, splotched. It looked like he dipped his muzzle in
bleach and it ran in rivulets beneath his jaw and chin leaving big
streaks of bald whiteness.
His
black jowls flews lips and gums turned pink then white. The changes
were fast and every day his colors were a surprise. He began rolling
his eyes back to avoid light, so he looked like a gruesome Halloween
mask. Patches of hair around his face thinned, went bald, grew back in
different textures and colors, changing daily. One can literally see
cells dying and multiplying hourly, a continual Color War of
Chaos.
I
was typing changes in Orka's behavior looks and personality as he
approached 6 months because there were so many new differences. I
already had several questions to ask the vet, Dr Andy Nuijens at
Wilsonville, for Orka's mandatory 6-month rabies vaccination
appointment. Orka is a very healthy bouncy playful willful smart vocal
lovebug puppy so my questions were fairly routine except for the color
changes. When I took Orka to the vet on May 20, a week before his
6-month anniversary, his tongue, eyes, lips, gums, and nose had just
become visibly different enough to cause the vet to take Orka to the
tech room and examine him under bright lights and magnifiers.
The
vet said Orka's color changes were unusual. He listed several things
that can cause color changes and depigmentation. He said Orka was quite
young to have these changes. He said it could be vitiligo,
Michael Jackson's disease that turned the pop star from black to white
and caused so much controversy out of ignorance. Dr Nuijens looked at
Orka's balding blanching nose and said it might be caused by vigorous
digging in wood chips, but could have many causes and to watch it
carefully and not let Orka dig until we knew what it was. Also, the
weather around Portland was very cold, dark and wet, setting cold and
rainfall records all the way through June, called Junuary this year.
Winter lasted until July. Since some pigment changes can be seasonal
and weather related, that was mentioned as a possible contributing
factor. Dr Nuijens was excellent and went over what to look for, and
said Orka should take some supplements for skin health. These are
routinely suggested for skin issues and are in no way a criticism of
the dog's diet.
So
Orka had a good productive vet visit, got his 6 months rabies vax and
we left with skin supplements, a no-digging order, a list of possible
depigmenting conditions and the hope that we would not have to see a
vet for another year when Orka was due for the next mandatory rabies
vax. Test results on stool sample the next day showed no parasites, and
bloodworkup results showed elevated lymphocytes.
But
then, Oh no! What's this? Good Lord look at this dog! After the vet
visit Orka's black footpads began turning pink, then white. You could
watch the black speckle then recede around the edges then disappear
inward. Hair around his eyes and whole face turned milky white. His
skin turned fluorescent eerie bright white. His nose reflected light in
the dark. Walking him at night in the forest, I could tell where he was
by his white glowish blob of nose bobbing through the trees and
underbrush.
I googled the conditions Dr Nuijens mentioned, read a lot of articles. It certainly matched vitiligo but
worse, it had too many similarities to uveodermatologic syndrome aka
Vogt-Koyanangi-Harada-like Syndrome (uv-vkh). That is the #1 mortality
concern in young Akitas and causes blindness. Uv-vkh dogs almost always
have vitiligo, and vitiligo dogs get uveitis, so what is the difference? and what tips vitiligo into
uv-vkh? Both syndromes are destruction of pigment-producing melanocytes
and both affect skin and eyes. Melanocytes are pigment producing cells.
Orka displays such obvious relish of his senses and uses his vision
continually in all his off-leash trail explorations and in service to
me, so after reading the urgency that to save vision, treatment has to
start immediately, I knew I had to act proactively to get a precise
diagnosis.
Called
Dr Nuijens and left message; he called back next day and said he felt
Orka needed to see a specialist vet dermatologist, and recommended Dr
Amy Randall in Beaverton. We called her office and took the first
available appointment, 8/a on May 26.
So
on Orka's 6-month birth milestone (born Thanksgiving Day! 11/26/09) he
went to Dr Randall. His eyes were swollen, red and pussy and his nose
and skin light white pink. Dr Randall was wonderful with him, and said
something was obviously destroying his melanocytes at an alarming pace
and she could do skin biopsies that day, and that we were to be
commended for acting fast. She examined his eyes and said it did not
appear he had uveitis but that the black was disappearing from his eyes
and something was affecting them. She prescribed steroid/antibiotic
eyedrops and claritin (this being a record year for mold allergies) to
reduce the eye inflammation and said after we get the biopsy and
thyroid tests back, Orka will need to see an ophthalmologist.
Skin
punches were taken from Orka's nose, lip, and footpad, all requiring
stitches, and sent to NYC for cutting and then Canada for
histopathology. Blood was drawn for a full panel thyroid test, sent to
Michigan State University. It seemed to us a very long time before we
got the test results back: weeks. The biopsy results came back
vitiligo and the thyroid normal for a Newf Orka's age. We emailed
pdfs of the test results to Dr Jean Dodds, the premier expert, and she
was so helpful to us. She called and discussed Orka and said he is
young for hypothyroidism or uv-vkh and that we should re-test him in
November. She said vitiligo is a genetic hereditary condition that
should not be downplayed because the autoimmune system is busy
destroying the dog's melanocytes (pigment-producing cells) putting him
at risk for skin cancer and also can be an indication of other
autoimmune risks. Dr Dodds told me that vitiligo is often
precipitated by a rabies vaccination, which explains why his
depigmentation got so dramatically worse right after the vet appt --
his immune system kicked into overdrive.
After
Orka came back from the long day and surgery at Dr Randall's, he became
very suspicious and skittish, afraid of being messed with or, as the
tech said, "sliced and diced." We had to buy a muzzle and go through
trials to get the eyedrops in his eyes. Orka is very vocally expressive
and the screams, terror chattering and howls he produced at the sight
of the eyedrop bottle was astounding. We had to keep him away from
other dogs because he loves to play and we had to wait 2 weeks before
the stitches came out. The stitches on his footpad burst open but the
wound granulated from within and healed well. Because the loss of black
pigment makes people and dogs extremely susceptible to sunburn and skin
cancers, we had to buy baby sunscreen protection = > 50 for his
nose, socks and booties for his paws, and dog sun goggles, Doggles, to
protect his eyes, with instructions to avoid bright sunshine. A nurse
at work suggested getting a white glove to reference Michael Jackson so
we wouldn't get the continual barrage of questions from everybody. We
found a white toddler sock that fulfill this visual context admirably.
Orka looks quite the jazzy dude when going out and gets squealing
crowds wherever he goes. It's a circus, with Orka the outfitted Michael
Jackson service dog starring, his service harness adding pizzazz to the
ensemble.
The
steroid eyedrops and claritin reduced his eye inflammation, and the
redness, swelling and pus finally went away. On June 12th Orka saw a
vet ophthalmologist. To our absolute utter joy his eyesight was
perfect! The ophthalmologist said we will have to watch him like a
hawk, and every time he goes to a vet his eyes will have to be
examined. She advised getting fake teardrops and training him to accept
eyedrops 2/x/day in case we need to go back to steroid eyedrops and
other eye medications should uveitis present in the future. His
prognosis is uncertain because he is so young to present symptoms and
the ophthalmologist did not know how or if vitiligo turns into
uv-vkh and the dermatologist is still researching that question.
Orka
continues to exhibit color changes daily; his pigment waxes and wanes.
Black is coming back in squiggles and scribbles on his nose; parts of
his eyerims are filling back in; black hairs are growing sparsely back
in his muzzle. More hair in general all over his body is turning white
and his skin fluctuates between grey, pink, blue, white and brilliant
fluorescent white. His eyes are continually changing color, from pale
yellow to dark brown. He remains a rambunctious curious extremely
playful funny puppy, smart and full o' beans, eager to investigate
everything, wrassle and lovebug, walk and explore with us, splash in
every puddle river lake and bay, and grow, in size, maturity,
obedience, service and love. His vocal expressiveness is operatic and
Orka expands his repertoire daily. He is the delight and focus of Lynn
and my lives, and brings such joy and laughter to our home. His severe
vitiligo pummeled our wallet, between vet bills and supplies, well
over $1000, and it's been a learning arc.
The Prez of our local Newf Club asked me to write an article about Orka's vitiligo , since vitiligo
runs in Newfies, and we pray this helps increase awareness in the Newf
community and hope any new puppy owner encountering these symptoms will
not go through the worry we did, and will know that we're here to offer
support and compassion to those experiencing vitiligo.
Here is a chart that lists depigmentation conditions, symptoms and treatments:
http://www.peteducation.com/article.cfm?c=2+2111&aid=425
Causes of Pigment and Color Changes in the Skin and Coat in Dogs
Here are supplements shown to increase production of black pigment and help skin:
Vitamin E, Vitamin D3, Salmon Oil, B
Vitamins, Ester-C, Ginkgo Biloba, Piperine, and garbanzo beans (which
we sprout and give raw).
Study done at OHSU where I worked for a year and occasionally do private caregiving jobs:
http://www.sciencedaily.com/releases/2008/04/080413172937.htm
I get Orka's piperine here:
http://www.vitacost.com/Source-Naturals-Bioperine
Vitiligo depigmentation
-- de-pig-mentation -- has made Orka's nose look more like a pig snout,
so sometimes we affectionately baby nickname him Porka. But he may come
to resemble the black and white Orca or Landseer more than the all jet
black Newfoundland he was, and we now also have an auburn Newf,
complete with a custom designer nose pattern that changes daily and
elicits Rorschach responses and endless commentary.
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