🙏🏻

It is accompanied by a loss of blood supply to the affected tissue, thus the term "ischemic."

Treatment exists beyond steroids (glucocorticoids) which have been the mainstay (humans get something somewhat similar). It is an exclusion diagnosis, though, meaning that even with a biopsy there have to be a lot of other conditions excluded before they can definitively conclude.

The studies on this are not great and there is a belief that case series of vaccine associations are greatly overstating an association as the few larger better conducted studies show at least half if not more cases have nothing to do with rabies vaccine. Similar to autoimmune conditions in humans where recent vaccination CAN be associated but rarely. There are as yet unidentified "triggers" including possible recent infection with many organisms including vector-borne disease.

Therapeutic options include pentoxifylline, glucocorticoids, oclacitinib, and/or other immunosuppressive agents (eg, mycophenolate, modified cyclosporine, sulfones, sulfasalazine).

Good luck!

There's some good info posted here.


I have a whole list of questions for the vet when we go back.

Except good thoughts for your big puppers.

Please keep us posted.