Update on Nora (IMTP)

[Boxacrazy]

Today we had back the results of Nora's first blood test since being off steroids completely (3 weeks),
Sadly it's shown her platelets are dropping from 158 (and all those zero's) to 98 (and all those zero's).

Gutted as in herself she'd been doing so well, she'd put back her weight (she'd dropped to 24kgs whilst on steroids and is now up to 28kgs) and we were slowly trying to get back her body condition that she'd lost over the 6months that we have been battling with her IMTP.

I had her titre tested so could prove that she didn't need her booster and both the vet and I were pleased with
those results and opted not to challenge her immune system with a vaccination as the titre tests showed she had immunity.

So Nora is back on steroids at 4 x 5mg preds and have a blood test booked .in 2 1/2 weeks time to see if the steroid dosage
will help increase the platelets.

Is relapse common amongst older IMTP sufferers? (Nora will be 7 y.o. this August & Boxers average age is 10 y.o.)

The only other odd thing that is happening is that she's losing the hair off her ear edges, but the skin isn't inflamed or scaly.
Nor is there anything wrong with the hair shaft. Not sure what this could be indicating?

[DW]

Hi

I am so sorry to hear about Nora's relapse.    I was unable to find your previous posts so I have no idea how long Nora has been on steroids before stopping them or what dose she was finally brought down to.
Since being involved with this problem IMTP, I have learned, both within this Group and those outside, that whilst it is common to achieve remission, it is also common to have relapses as well - though sadly, in your case, for only a very short while.

We have tried on two occasions to achieve remission  but each time we get down to around the 12.5mg stage, his Platelets start to drop. I understand that this is more unusual and that we do have an unusual case on our hands.
We were referred to Cambridge last August and at one stage were maintaining a 'reasonable' count at 10mg - 5mg daily but it was short-lived and despite trying an alternative drug, Atopica (one that I resisted giving at the start and now feel I was right to do so) his Platelets dropped to 20.

We are now back on a 30mg dose daily.    On the past two occasions when he has dropped to the low 100's, he has been put back on to 60mg daily but because of the time he has been on steroids and the side-effects, we have tried this time, to achieve a reasonable count using just 30mg.   Not sure where this will take us as we are due for a blood test this Tuesday.  We have also embarked on a new drug regime but haven't been given any assurances at this stage - just that there are little or no side-effects.

Harley, just as Nora,started to come back beautifully.   his weight gain, muscle improvement and coat condition  -  then we had to increase the Preds, so the effects are noticeable once more.   he did lose hair and was thinner in some areas.   Part of Harley's probs was that he had to be shaved for an ultrasound in August and his coat has only just come back but not fully - it is still thin in that area.

One thing I have done is change his diet, thinking that a higher protein one may improve muscle.   We have been feeding Eden for a couple of months now and I have to say the results are good.   His coat is much denser now and very shiny.  Also, he was suffering from terrible dandruff (big large white flakes - though his skin wasn't inflamed at all, it was  normal colour) and this seems to have improved since he has been on this food.

[Jo CIMDA]

Hi

I'm sorry Nora 's platelets are dropping.  What sort of drug protocol has she been on - eg. dose and duration, and what is her weight?

It is not unusual to relapse but it is hoped in time to reach long term remission.

Baldness on the ears isn't a normal hair loss pattern that is caused by steroids.  I presume your vet has checked for mites etc.  If there is nothing obvious then you could try massaging the ears with Aloe Vera Gel up to 6 times a day.  I know a Yorkshire terrier that had hair loss on his ears and the Aloe did the trick.  Apparently Yorkies are prone to this problem.

Jo

[Boxacrazy]

Nora is currently back on a 20mg dose of prednislone once daily (4 tablets) and is due to be blood tested again on Wednesday.
Her initial dose was 6 tablets twice a day and then slowly tapered down to when she was just on one tablet every other day.
She was first diagnosed in October 2013, so just over 6 months since first diagnosis.

When she was weighed at her last blood test she was 28kgs.

Nora's ears are improving so it seems to have been just a temporary blip.
I have also given her Evening Primrose Oil 10ml a day.

She is fed protein at 31% - Millies Wolfheart Countryside.

Plus I am giving her Milk Thistle from Dorwest Herbs whilst she's on the prednislone.

Just have everything crossed that she can achieve long term remission as she really took a hammering with the steroids when she was on the 60mg a day dose.

[Jo CIMDA]

I do hope this dose of steroids will do the trick but she may need to go back on prednisolone 1mg/kg/12hrs.

Fingers crossed.

Jo

[Boxacrazy]

Really pleased - Nora's blood results are really good (vet called today) her platelet count has risen to over 300.
Vet is also very happy to see her respond so quickly to steroid treatment.

[Penel CIMDA moderator]

That's great news, woohooo! Happy Easter!

[Jo CIMDA]

Great news for Nora and you.

Jo