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If you request further information on Leflumonide, please speak to a qualified veterinarian.
      This is an e-mail correspondence which was kindly forwarded to the Perianal Fistula list by Marjorie Zimmerman of the Degenerative Mylopathy List. Special thanks to Marjorie for sharing this valuable information with us.

      I emailed Dr C to see if perhaps he has treated PAF with anything else. I know he sees alot of PAF because DM and PAF show up together, many times, as you know. Dr C has been researching Leflumonide ( Arava) in relation to DM, so I asked him if he has ever used it to treat PAF. Here is his response, which I know you will want to read. It looks promising!

      Subj: Re: Arava
      Date: 03/07/2001 8:58:50 AM Eastern Standard Time
      From: (R.M. Clemmons, DVM, PhD)
      To: Marjorie Zimmerman


      I have and it worked better than cyclosporin. Our surgeons tell me that cyclosporin is the accepted therapy for perianal fistulas since the problem is an immune disease and, therefore, surgery is no longer indicated. It can take 8 weeks or longer to correct the problem with cyclosporin and it is possible the treatment would need to be continued longer. With leflunomide, the fistula I treated was gone in 4 weeks and the cost was less than the cost of cyclosporin. Our surgeons are going to try it instead, since it worked so well. I used the same dose of 10 mg a day (in a GSD). It will still cost about $125 a month if the 20 mg pills are used and cut in half. Certainly, they need the other components of used to modify the immune response including the DM protocol supplements. Without DM, they would not need the NAC or EACA, just the vitamins and herbs.

      The vitamins and herbs are as follows:

      Dietary Supplements:

      1.Tofu (4-6 ounces) daily with food
      2.Carrots (2 raw or 4 cooked) daily
      3.Sardines (2 or 1 Tbs ground Flax seeds) daily
      4.Garlic (2 raw cloves or -1 tsp powdered) daily with food
      5.Ginger (dry or fresh -1 tsp) daily with food
      6.Mustard (-1 tsp dry) daily with food
      7.GLA (500 mg borage, black current or evening primrose oil) 2 times a day
      8.CoenzymeQ (100 mg) once a day
      9.Ginkgo bilboa (1 capsule or 50 mg standardized extract) 2 times a day
      10.American ginseng or Dong quai (1 capsule) once a day
      11.Siberian ginseng (1 capsule) 2 times a day
      12.Green tea (1 capsule or 1 cup) 2 times a day
      13.Grape seed extract (1-50 mg capsule or 1 cup grape juice) once a day
      14.Bromelain (250-2000 gdu) twice a day
      15.Curcumin (500 mg) twice a day
      16.Vitamin E (2000 IU) once a day
      17.Vitamin C (build up to 1000 mg) twice a day
      18.Vitamin B complex (B100s) twice a day
      19.Selenium (200 g) once a day


      "Leflunomide - The New Drug on the Horizon"

        Leflunomide analog, MNA-715, plus cyclosporine reduces renal allograft rejection in mismatched dogs.
        Kyles AE, Gregory CR, Griffey SM, Bernsteen L, Jackson J, Morris RE
        Comparative Transplantation Laboratory (A.E.K., C.R.G., L.B., J.J.), Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, California, USA

        Combination of antilymphocyte globulin and leflunomide leads to superior grafts.
        Woo J, Zhang W, Gao L, Shen J, Chong A, Buelow R
        SangStat, The Transplant Company, 94555, Fremont, California, USA

        Immunomodulators Leflunomide (Arava--Hoechst Marion Roussel) is a promising immunomodulating agent which is being tested in the prevention of transplant rejection as well as in RA. It is a novel isoxazol derivative, with disease-modifying properties. Following oral administration, the drug is rapidly metabolized to its active form, a compound with a long elimination half-life (approximately 11 days). This metabolite is believed to interfere with T-cell proliferation, leading to an inhibition of the synthesis of pyrimidines. This reduces the number of proinflammatory cytokines, and leads to an anti-inflammatory effect.

        Imuran is used in humans as an anti rejection drug after organ transplants but has been used successfully in the treatment of AIHA in dogs because it like prednisone suppresses the immune system. Because it takes Imuran several weeks to start working it is used as an adjunctive therapy with the prednisone. Two side effects that should be noted with Imuran are bone marrow suppression and increased susceptibly to infections. Other drugs used in the treatment of AIHA are Cytoxan (cyclophosphamide) and Neoral (cyclosproine). Two anabolic steroid's, danazol and winstrol are also some times used in the treatment of AIHA. Recent clinical studies at the University of California, Davis have shown that a drug called Arava (leflumonide) also appears to be successful in treating AIHA.