Vets say my dog has Vasculitis!!!

[Shazanne]

Hi. I'm looking for advice and guidance. My 12+ years old terrier mix, Millie, has been diagnosed with vasculitis. Even though the biopsies taken of the lumps on the end of her pinnae (ear flaps) were benign for this illness, he is adamant that she has this condition. He wants to start her on a drug called Pentoxifyline, which is difficult to take and almost certain to cause nausea and Millie is a very bad eater as it is.
Millie has a number of flat lumps and one round hard lump on the edges of both her ears. The hair on both her ears is almost gone and there are identical (almost mirror images) bald patches on each ear. She doesn't have any problems on her paw pads, which is where this disease also strikes. Her tail was docked before I rescued her so I can't speak for this other likely area where vasculitis typically strikes.
I wish to point out that my vet is very good and I would not normally question his judgement. But I am concerned in this case that Millie will start a medication that will adversely impact on her without a definitive diagnosis.
I am wondering if anyone else has seen similar symptoms in their dogs and what the diagnosis was? Could it be allergies or a reaction to anything?
I will be very grateful for any information I can get.

[hazelrunpack]

For sure, if there is no clinical confirmation of vasculitis, I'd be a little skeptical. as well.

It would be pricey, but if there is a veterinary college near enough for a day trip? I think, given that Millie isn't a good eater and this might well put her off food even more, I'd see about getting a referral for a second opinion at the nearest veterinary college teaching clinic. They see a lot of odd cases and have much more experience with the less common ailments than a regular vet might have.

[MaxaLisa]

I would be curious if any bloodwork has been done, and if you asked for a copy. On my radar would be tick disease. This could be a dormant tick diseases that has become active as your dog has aged. Bartonella causes blood vessel damage, and is notoriously difficult to test for. I once knew a dog that would lose fur on his paws when his anaplasmosis flaired.

It could also be a collagen disorder, again, getting worse as your dog is aging. There are few drugs for this. Odly, the antibiotic doxycycline helps for this because it inhibits the enzyme that breaks down collagen. I saw one website for bald guys where they commented that they had hair growth on doxycycline, which I thought was odd. My dog has a collagen disorder and before I started treating her, she had bald ear tips.

That said, one of the obvious things to eliminate is some kind of bacteria or fungus. We also found my dog had too much staph, and it was showing on her ears only, and sparse hair on her belly.

I would recommend a second opinion by a canine dermatologist.

It is possible that that the drugs might be tolerated.

[Shazanne]

Thank you for taking the time to reply. Yes, Millie has had blood work done and everything was normal. She does not have hair loss on any other part of her body, but does lick aggressively at her groin on occasions but there is no pattern to this licking.
She has lumps on the edges of her ears - some flat (almost like warts) and one hard lump like a little ball.
I am strongly considering a dermatology consult for her and am also having her allergy tested.
If the biopsies she had on her ears had identified vasculitis I would be happy to get her any treatment she requires, including the pentoxifyline if that were the best available. But the biopsies did not give a diagnosis, which is why I am reluctant to give her a medication that may cause her unpleasant side effects if her condition could be something else.

[Shazanne]

I just want to thank the two members who responded to my post and also give an update.
I had the larger of the lumps on Millie's ear removed and again I sent it for analysis. Still no diagnosis of vasculitis. So I am going to just monitor her closely for a while and see what happens. At the present time she has just one flat type growth on one ear and nothing on the other ear. Ear margins are looking good and nothing has deteriorated to the point that I am worried. I am giving her Omegas to help her overall skin condition but will not give her the medication originally suggested by my vet as I do not think she needs it. The vet is now in agreement with me on this.
Thank you both for your replies and advice - it is greatly appreciated by both me and Millie!!!

[hazelrunpack]

I'm glad the vet came around and Millie's spared the unpleasant side effects of the vasculitis meds! Did the path reports come back with any new information?

I just revisited that pic of Fonzie and Millie that you posted in your other thread! They sure look like sweeties! Give them both a hug from me, please!