CIMDA

Dear all, after 16 days of stella being on 10mg pred twice daily she will have her blood test today. She is doing well eating a lot and gaining weight. Clinically everything is fine, the only thing I noticed lately is that she is a bit weak on her hind legs, walking and then somehow not finding her balance and kind of lowering her hind legs until she stabilzes again. Could it be that she has put on too much weight due to preds and her legs havent kept pace with the increase in weight? or could it be a kind of muscle weakness due to preds? I will wait for the blood result and hopefully be able to reduce preds to 5mg twice daily. I am still very anxious about reduction and relapses and will get the results to you hoping for your comments. If bloods are fine and hematocrit increased again is it ok to keep the reduced dose for only two weeks and then go to to the same dose eod for 3 weeks ? She is still quite agressive with everybody but the closest family, I am not in a hurry but I would like to see her to be her own self again without medication and start all over with training and education, she is very receptive but I am still worried about exhausting her too much. Thanks for your input and I will keep you updated. Elisabeth

Hi Stella,

I hope all the unrest has eased and you can travel safely again and very to glad to hear from you.

Pred does cause muscle and ligament weakness so this is likely what is happening with Stella's back legs.  With reductions  you initially get the dose down as quickly as possible but the length of time between reductions actually increases from where you are.  I think Stella has been on 10mg am & pm for 3 weeks?  The next reduction will depend on the blood tests; perhaps then you could work on dropping the evening dose or reducing that first.  Once you can get her down to one dose a day you should see real improvements in her temperament (the ravenous behaviour, extra drinking & peeing will get much better to :)  but she will need to stay on the lower doses for 4 weeks or so between reductions.

Hugs

I hope all the unrest has eased and you can travel safely again and very to glad to hear from you.

****Hi Elisabeth, I too hppe that things are easier in Egypt.  I know you have elections today.  Stay safe!


Pred does cause muscle and ligament weakness so this is likely what is happening with Stella's back legs.

****I agree with Angela.  It is the preds that are causing Stella's muscle weakness and this is to be expected given the length of time she has been on the preds. Sometimes the side effects dictate when to reduce the preds.

perhaps then you could work on dropping the evening dose or reducing that first.

****If you reduce her preds to 5mg x 2 a day then you can, as Angela says, give her 10mg in the morning. As before, monitor the side effects and review again in a couple of weeks.

She has done so well Elisabeth!
Jo

Hi Angela and Jo, thanks for always keeping up with me, you give me so much confidence with the pred reduction.
We did a blood sample for stella threedays ago but unfortunately until we got it to the lab (we have to bring them there by ourselves) it was spoiled and we have to do it again next Sunday. My vet told me to reduce the pred  starting from tomorrow to 7 and  a half mg twice daily, for a period of at least two weeks and then we will see where we will go from there.This means that she will have got 4 weeks of 40mg , 4 weeks of 30mg and now 3 weeks of 20mg and starting from tomorrow 15 mg per day. He is very happy with her and I also see an improvement in her behaviour, a little less agressive, less peeing .Her panting also is obviously less then before and does not cause any concern any more She is also back to very regular eating and toilet times. He prescribed vitamins B for her leg problem, that has also started to be less obvious. I will get back to him with your suggestions and I think we are on the same way with stellas treatment.

Yes we are going through troubled times in Egypt. The dictatorship and supression and disrespect for the people seem not to go away any time soon, even with the election of a president, still the military will have a say and since we have no constitution and very week state institutions  the country is in a big mess.  If Egypt received as many good thoughts as we give to our dogs we would live in paradise!But we are relatively safe and try to stay out of trouble.

Thank you for all your help. I have not been able to post so much at the webforum as I could with the emails on my blackberry, but you have done a wonderful job with the new cimda site and whenever I open my laptop its always the first place to go. You are really amazing people, God bless you! Elisabeth

Hi elisabeth

Ifr at anytime you think Stella is struggling eg., to get up on her back legs due to muscle weakness, then you should consider lowering the dose.  It is all about achieving a blanace of drugs and disease.

I am so sorry you are having to live under such a regime.  I pray you will be safe and the situation will improve before too long.

Jo

Thanks God ,Jo, Stellas weakness in her backlegs has not reached the point of actually collapsing, it is just an occasional kind of slipping away especially when she runs down the stairs or is in a hurry to get somewhere or after a longer nap. I think it has already improved with the last reduction .I give her more time out in the garden playing with the other dogs, she seems also not to get exhausted so quickly any more. Have a lovely day! Elisabeth

How lovely to switch on & read your news of Stella's vast improvement when one rememebrs what a sick dog she was .I am so glad that you feel that you have  receieved such positive & practical support for Stella & that eventually once  the preds are  really wound down  she will be  full of mischief again. We have many success stories  within CIMDA & it is such a conmfort to those  whose dogs   become so ill.
It must be so worrying for you with the  current  unrest in the country & I pray you all keep safe & better times come for Egypt.
Best wishes Sylvia.

Sending good vibes & prayers for Stella & you Elizabeth, AND Egypt!

Hugs

 Sorry that I could not go to my laptop for a couple of days and only now see the lovely messages you sent me> Really I am so moved and have tears in my eyes actually for your compassion and care. AGAIN AND AGAIN  I say that you from CIMDA saved Stella and she would not have the great time she is already having now though still on preds. Unfortunately it has already become quite hot
in Egypt so most of the day she is sleepy and inside the house but in the evening she gets quite active and naughty and we are back to training and education and actually I would need some advice and a help group on German shepherd training now!  (My experience is only with Beagles who are easy to care for)I hope so much that with further reduction she will stay as stable as she is now< I will be very careful about relapses and not expose her to any risks as far as I can. She is very intelligent and knows that she is being spoiled and takes advantage of it but I always have to cuddle her from time to time to make her feel how happy we are to have her with us.
We dumped the last bloods because it is too stressy for her and her clinical signs are so good that we continue with 7 and a half mg twice daily for another week then do the bloods and then hopefully reduce to 10mg once a day. I think we will keep this dose then for at least three to four weeks, lets wait and see.
Egypt is in a mess.....positive thinking is all that we can do now!
Thank you for your good thoughts.
Elisabeth and Stella

Good to hear Stella is still improving. I hope things also improve in Egypt!
gail

Quote from: shawkyelisabeth on May 31, 2012, 11:53:25 AM
most of the day she is sleepy and inside the house but in the evening she gets quite active and naughty and we are back to training and education and actually I would need some advice and a help group on German shepherd training now! 

--------
****That's lovely to read Elisabeth

-----------
We dumped the last bloods because it is too stressy for her and her clinical signs are so good that we continue with 7 and a half mg twice daily for another week then do the bloods and then hopefully reduce to 10mg once a day.

****In a situation like yours, and now you have a feel for what to expect when a dog is on preds, you can 'play it by ear' to a certain extent.  You will, I'm sure, now appreciate how  in tune you get when dealing with a dog on steroids.  I'm sure you will detect any change and act on it, so if  a blood test is not convenient or possible and you feel a reduction is in order then you probably won't be wrong.  I always say to trust your instinct.

Good news Elisabeth.  I just hope your political situation calms down soon.

Jo

Egypt is in a mess.....positive thinking is all that we can do now!
Thank you for your good thoughts.
Elisabeth and Stella

Elisabeth,
just a suggestion - can you feed Stella her meals from a Kong or such similar type activity toys? this is quite a calm way of giving a dog a lot of mental stimulation and one we use regularly in behaviour modification.

penel, what is a kong?

ahha, this is a Kong
http://www.kongcompany.com/products/for-dogs/rubber-toys/classic-rubber-toys/classic-2/
A GSD would probably need a large or XL/ giant kong.  You stuff their food into it, and it takes them ages to eat.  You can even put treats in kongs, like tuna / yoghurt, and freeze them - esp great for dogs in hot countries.

Lola's favorite time of day is Kong Time  ;)

Dear all, so sorry for not having posted for quite some time, I was away to Europe for a couple of days and had no access to my laptop i AM TRYING TO GET A KONG FROM ABROAD, I AM SURE THAT WILL KEEP STELLA OCCUPIED. sHE HAS IMPROVED IMMENSELY SINCE MY LAST POSTING, RUNNING , VERY LIVELY, EATING WELL BUT NOT SO MUCH ANY MORE, LITTLE YOGHURT WITH FRUITS DURING THE DAY AND ONE BIG MEAL IN THE EVENING, WITH LOTS OF VEGGIES chicken, meat noodles etc. I give her some supplementary herbs, kelp, folic acid, she is still on 10mg preds for another  3 days which will make a total of 2 weeks on this dose. Then I intend to reduce to 5mg once daily for 2 weeks and   , then 21 days 5mg eod and then 5mg every third day sticking to MJDay protocol. and for another 21 days[/i]. For the time being I do not want to do any bloods, it is very hot, we have a long way to go to the vet, there the situation is very stressful for stella, they have to tie her down to get a blood sample and I really dont want her to go through this any more. She did not want anyone to touch her legs and biting immediately when we just got close to her legs, and now she has improved and forgotten about all the torture she has been through with all the infusions and blood sample taking and injections, I dont want her to loose trust in people around her any more, she has dropped most of her aggressive behaviour, but is very alert and protective  now and really improving day by day, so I take the responsibility for not doing blods and still reducing preds, her clinical signs are very good with very rosy gums, strong muscles and good appetite inspite of the heat we have here in egypt. maybe we will do bloods before switching to 5mg eod, my only question is, can we then drop preds completely after three weeks eod and three weeks every third day? or should we keep up 5mg every third day for the rest of her life? when should you give very low doses of pred for a lifetime? I hope Jo agrees to my decision to not do bloods, I trust my stomach feeling, with reduction of preds she is getting better now every day.
Many greeetings to all of you from elisabeth and stella

You will probably get a different answer from some, but I like to follow my gut instinct too. With her extreme dislike of having her blood drawn it puts extra stress on her, lots of it by the sounds of how you describe her. I also would be going by the signs of her health. Just my opinion, since I also have a reactive dog. Not at the vet but with people who come here. We have had to manage Lola for many years. She is agitated,not aggressive, but it is too much stress. I hope Stella continues on her road to health. I can't answer your questions about reduction but I'm sure Penel or Jo will.
Hugs to you and Stella...
gail and Lola

thank you gail, so good to hear from you! my thoughts are with lola often though I dont post much! Hugs to you Elisabeth and Stella

Hi Elisabeth,
if you want me to buy a Kong and post it to you let me know, it's no problem.
I agree with you about not doing bloods at every reduction - but I would also say that in the meantime, you ought to try and get Stella used to having her legs touched.  So you can just stroke her legs at first whilst letting her lick something yummy - I have a wooden spoon that I smear with cream cheese if I really need to do something to one of the dogs (for example removing a tick) - I just let them lick it while I do what I need to do.
Then when she is used to you stroking her legs whilst licking yummy stuff, you can begin to hold her leg for just a second or two to start with.  You must build it up very slowly.

(as an aside have any of you seen the footage of zoo animals who are clicker trained to press their necks up to the bars in order to have bloods taken - it's amazing).

Regarding the pred reduction, you are doing it all right.  With regards to the final pred reduction / dropping the Pred - it depends on how she reacts to all the other reductions.  You can never tell what is going to happen unfortunately - so you just have to "suck it and see".  Some dogs come off preds completely and never relapse - some come off and relapse a week later, some 3 months later.  It's not really something we can advise on, because all dogs are different.

I would probably spread her one big meal, into two smaller meals - just so that her blood sugar is kept more even throughout the day.

we ve been through so much that i really hope we dont see a relapse , I will do bloods before definitely dropping the preds but we still have some time to go and in the meantime building up all the strength she needs. thank you for your advise and psychological treatment, it seems that german shepherds are especially sensitive and stella knows how to play her role well! she is very intelligent and knows how to take advantage of any given situation. I will get back to you if anything unforseen happens.Thank you penel! I have already got a kong , not the original one but something similar, and the original will be sent to me from the U.S.

It sounds like Stella is where she should be  :D  My girl took many months to get her self confidence, we are still working on it even on.  I think that she still has some issues caused by the low dose of pred but because of her history I am very hesitant to stop it altogether.


Hugs

Hi Angela, thank you for always rsponding so quickly! I will reduce to 5mg from tomorrow , should I give this in one dose or divide it into 2 and a half mg twice daily. I understand you suggest I should keep giving Stella  5mg maybe every third day for a lifetime? we still have a little time to decide on this, but I am trying to gather experience to take the right decision. Our vet wants to reduce as quickly as possible but I am afraid of a relapse.
Many hugs to you and your girl! Elisabeth and Stella

I'd give it once a day in the morning.

I'm with Penel,
Giving her 5mg only once a day will also help her bladder  :D

Hugs

well I am giving it once a day in the evening with her main meal, ok i will switch it to the morning thanks and hugs to you and your fur kids!

Hi Elisabeth

I've been away on holiday and it is really good to read your posting about Stella's improvement.  She is doing so well and you have had excellent advice about reducing her preds. Stella has been a pleasure to get to know and her wellness is down to you and your gut instinct, your bravery and management.

I hope Eygpt settles down now the elections are over.

Jo

Hi Jo, I had just wondered where you were and intended to send a message when found your - as always encouraging- posting.  Welcome back and I hope you had a good holiday, I really missed you and it is always comforting to know that you are around.Thanks for your encouragement it is only to you and  everybody else s insistence on putting stella on high doses of preds  (that I followed blindly against my vet) that saved Stella, can only repeat it again and again.
With  the reduction of preds stella eats much less now, that sometimes worries me a bit but I think that should be expected, isnt it, I also relate it to the heat here in egypt.
Stella is now on 5mg daily for another couple of days to make it two weeks and then I want to go 5mg eod. Can I still not do bloods since I find her very well, red gums, lively etc. We are having very hot weather now and the trip to the vet is really stressful (for both of us).  What I am still not sure about is : what are the reasons to look for to keep a dog on very low preds for the rest of his life and when can you stop preds altogether. I intend to give her 5mg eod for 21 days and 5mg every third day for 21 days. Can I then drop it definitely if stella continues to show good clinical signs or should I do bloods and decide from there? What should the bloods be to encourage dropping of preds definitely? As always too many questions thank you for your patience with me.
Hugs to everyone Elisabeth and Stella

Hi Elizabeth,

Well done both of you!

You can afford to extend the time between reductions now she is down to 5mg once a day to ease her gently down.  Do you think Stella could manage taking this dose for a month or is she still showing side effects?  You could then drop her to EOD (every other day) for a month.  Just a suggestion  :)

Hugs

Aw thank you Elisabeth, it's nice to be missed.  I've also had computer problems and that is very annoying!

  Don't underestimate YOUR courage in treating Stella.  Many wouldn't have taken the chance - but oh boy, I'm so glad you did!

You ask the 6 milliion dollar question!  There are no guarantees - as you know but Stella has done so well and you have reduced the steroids so slowly and steadily that I am really hopeful that you will be able to finish the course as you describe and then leave the steroids off altogether.  Some owners feel happier to leave the dose on EOD for even longer and then go to every third day -  and there is no right way - having said that there is a wrong way but that doesn't apply to you and Stella's drug regime.

As for blood tests, if Stella is well and you have no reason to suspect that she isn't,  then carry on with your plans and dont' worry about taking her for a blood test.  Stella doesn't need the stress, nor the heat in the car.  You are so in-tune with her I'm sure your sixth sense will kick in if anything is wrong.  By the time Stella is off the preds her bloods should be back to normal.   They are probably normal now because she is in remission but they must stay that way and that is why the last stages of treatment is taken slowly - you know, no shocks to the system!

Jo

I think I will stick to both of your advise, Angela and Jo,and I will give Stella 5mg per day for three weeks and then go 5mg eod for a month. She has no side effects other then she does not eat so much any more, but nothing else obviously. I feel that she is much more herself now and not under influence of medication, she is developing her own character now, she was only 8 months when she fell so sick and she was not at all the personality that she is now.
So I think I can take it even slowlier hoping not to see a relapse when dropping preds altogether. She is of course still on a gastroprotectant and I think I dont have to worry about ulcers or tummy upset in that case.
hugs and greetings from Egypt (things look a little safer now politically but we still have a long way to go for democracy-keep us in your thoughts, it will help!)

Sorry I wasnt around for some time with problems of internet access in our home! Stella is doing well < I discovered some  fur loss on her forlegs with some white dandruff like stuff that I interpret as a kind of fungus> I do relate it to the preds and I decided to reduce her dose now to 5mg eod after 18 days of 5mg once daily. I do not get back to my vet because he does oppose such a long pred treatment anyway and would prefer to reduce much quicker.
Yesterday she did not eat  but drank a lot which I referred to the high heat here in Egypt, in the cooler breeze in the evening she ran a little bit but not quite as lively as I am used to. This morning she woke me up very early to tell me she had to go out to the garden when I found she had diarrhea, I gave her a medication for it  and now I hope it does not develop into something bigger because I really dont want to get her on antibiotics or any other stuff! I hope I can get her to eat today, her normal menu is joghurt with honey in the morning or at midday and meat or chicken with noodles and some vegs in the evening, its a routine and there was no change in her food. Did I do something wrong with the reduction ?
Hugs and greetings to everybody Elisabeth

No Elisabeth, you haven't done anything wrong with the reduction of meds. 

One has to be very brave at every reduction, but it has to be done.  I would guess that the diarrhoea is unrelated, and like all dogs an upset tummy will happen from time to time.  It's good you have 'stuff' to give to her.  I hope it works soon.

You are so sensitive to what is going on with Stella and it is natural that the thought of a relapse is always lurking somewhere in the back of your mind.  We have all been in that situation and although that doesn't make it any easier for you, as time passes you will become more confident that a relapse is unlikely. There are no guarantees  but eventually we have to believe it because if we don't we are driven crazy and become seriously paranoid.  It's strange because you never forget these memories and the feelings of insecurity that goes with them.

Just something to watch out for if the dog is anaemic is orange coloured stools, and the dog starts to eat dirt or stone. Not all dogs show these signs but many do.  The fur loss would be due to the preds.

I look forward to reading that her stools are normal again and she is fine.

Jo

Hoping for the best with Stella and her poorly poops. Keep up the good reports!
gail

Thnk you both for always giving me confidence stela has eaten yesterday and her stools are normal today , she is very lazy and i stil atribute this in large part to the heat herebut the way she is walking reminds me a bit of the bad days we have hd with her head down and not proudly raised as what i have seen in her lately. Yes joe you are right maybe i am alredy getting a bit paranoid but that is due to the really very hard times we have gone . I hve a bit of a doubt that she is feverish so i gave her a tablet just to see if it improves her condition nd then i will have to consider taking her to the vet. I think it might just be due to the high heat e have here and i keep her in cool places most of the time . Hugs elisabeth

A good tip that might help - you can freeze small bottles of water, and place them around the areas she likes to lay down, it sort of acts like air con (as long as she doesn't chew them!).

Hi Elisabeth

If Stella is hanging her head, I wonder if she has an infection that may need antibiotics. You are so in tune with her, go with your instinct.

Jo

Yes jo i suspect some kind of infection as well.
Maybe sore throat, since she refuses to eat anything, she sniffs t the food nd then leaves it, i got some joghurt with honey into her tody only. Few spoons thats it. I contacted my vet and he advised to give her an antipyhretic and see her tomorrow so i will do bloods as well. I will keep you updated hugs elisabeth

Hi Elisabeth

Stella is clearly not right.  If it carries on then you may need to take her to the vet -  but can your husband get antibiotics for her?  Perhaps he could take blood and send it to the hospital for tests.

Hope she picks up soon.

Jo

HeRt  jo i am just on my way back from the vet, he thinks that i reduced 5mg eod too early and wants stella back on 5mg daily, he says she got a respiratorry tract infection due to the reduction, she obviously has a weakness in her back legs that he thinks is not related to the cortisone, he prescribed vitaminee injections for that and an antibiotic for the infection. Do you think it is right to go back to 5mg daily after one week of 5mg eod, can this really have such an effect or could it be just an infection  that could have occured anyway?he wants to continue her on 5mg daily for another 21 days which will make a total of 439 days then and he. Says she moght have to stay on that dose for the rest of her life?i would like to know your opinion. The blod test result will be out this evening, i will keep you updated, hugs elisabeth i have to add thtat she had no fever this morning and was much livelier but still refused to eat, even her favourite cheese.my husband suggested to go eod in his opinion the reduction could not have caused the infection. Pls comment

Hi Elisabeth

High doses or prolonged doses of preds are more likely to cause infection, and I haven't known a reduction to do so.  If anything, a reduction will improve the immune system and lessen the chances of an infection. Also putting her back to 5mg a day certainly won't do anything to help an infection but the antibiotics will. If it is a relapse of AI, increasing the dose back to 5mg every day will not address the problem, so I don't really know where your vet is coming from.  If she is feeling brighter today then my hunch is Stella has an infection.  UTI's are very common, and debilitating, and it might be worth testing her urine.  Can you buy Multistick testing strips for humans in Eygpt? These can be used to test dog urine too. They are very useful to have in stock.

I don't understand why he doesn't think that her back end weakness isn't due to the preds.  Given the treatment she has been on it would be expected.   

5mg every day for a while longer probably won't make much difference to her if you want to keep her on this dose for another 21 days.  All it does is delay the next stage of going EOD.  Some dogs have to stay on daily steroids for life, but it is more common, if a dog can't be taken off steroids, for the dose to be given every other day even if the dose is doubled.  In Stella's case the EOD dose would be 10mg and this would be more beneficial to her than 5mg a day.  I still have a feeling that you will be able to get Stella off the steroids.

These blips do happen and I am hoping that Stella will continue to pick up and will be back to her old self very soon. I'm so please you have some AB's for her and it will be interesting to see what her bloods are doing now.

Jo

Poor Stella. I will keep her in my thoughts. Such a long time on pred. I would agree that the pred reduction didn't cause her illness, but rather the other way around? Being on pred takes it's toll on the immune system.
Just my gut feeling.
gail.

Hi Elizabeth,

Did you mean your vet is recommending 49 days at 5mg every day?

My only suggestion is that you wait until you have the blood test results back before making any decisions.  Stella has obviously been off colour & it may be a UTI in combination with the extreme heat you are having or have had which has caused the upset.

Breathe deeply, you know her best & your gut instinct has done very well so far.

Hugs from Oz

Hi everybody, my vet meant 39 days, i made a mistake.
Now stellas blood results after 28 days 20mg twice daily, 21 days 15 mg twice daily, 2o days 10mg twice daily, 12 days 7'5mg twice daily, 14 days  5 mg twice daily, 18 days of 5 mg once daily, and  8 days 5mg eod :
Haemoglobin   12.9
Rbcs.               4,95
Haematocrtit.   41,0
M.c.v.               82,7
M.c.h.               27,0
Mchc.                31,5
Platelets.          220
Wbcs.                 8,25
The laboratories comment: normoblasts 6/100wbcs are seen
                                        Normocytic normochromic anaemia
                                        Neutrophils show shift to left
I have to mention Haemoglobin up from 3,4 , rbcs up from 2.0 and haematocrit up from 11.4.!!!
She is a bit better today eating litle and on Antibiotics since 36 hours. I do want to keep herr on 5mg eod, i think her muscle weakness is related to the preds and i hope will improve with the reduction.i am very confident in what jo is telling me and my gut instinct tels me that she wil do fine with maybe a month on 5mg eod and then reduced to evy third day. I think it is only some kind of infection that always comes along at any time , she is livelier now and yes angelA the heat might certainly play a great factor. I very much appreciate your comments on her bloods and on the labortories comment about that anaemia.
She has not had her heat yet but i found few blod drops arounsd her, could it be tht she has got her first het and that is a reason for her being not so well?
Hugs to evyone and thanks so much for your constant suport,
! I se the vet only for taking bloods oyherwise i am not in sync eith him any more and itake my own risk in stellas treatment elisabeth

                                         
                                         

That is certainly good news concerning her blood count. I am not certain what all the numbers mean but the hematocrit must be good!
About her heat...always the hormones can play a part in the wellness of the dog, esp. if there are other things going on. But you want to be sure not to blame something on one thing "just because" it happens at the same time. But perhaps you are right about the timing of the events with her heat cycle. At least things are looking up for Stella!
Best wishes for Stella, as always, and you too, Elisabeth.

gail.

Big hug from stella to lola and have a good day together! Elisabeth

Hi Elizabeth,

The drops of blood could be her season or she may have a bad UTI, the neutrophils indicate an infection. Stella's hct looks good at 41% but I can't shed any light on what is meant by normocytic normochromic anaemia.

Hugs

Hi Elisabeth

The reference ranges are not there, but on the face of it the platelets look ok and although her HCT is on the low side I would be pretty happy about the results.  If Stella is having a season or bleeding due to a UTI then that may be the reason for the comment normocytic normochromic anaemia.  41% is ok and she should improve on this number as she gets over this infection.  UTI (if that is the problem) often need several courses of antibiotics before the infection has totally gone.  Leaving Stella on EOD preds (as opposed to daily preds) will assist her recovery. Trust your instinct Elisabeth.  I'm sure you husband will give you a lot of medical support.

Quote:
Normocytic-Normochromic anemia: Megalocytic-Normochromic is a blood disorder characterized by normal amounts of haemoglobin within normal-sized red blood cells. However, the number of red blood cells is low.

Jo

This morning I found Stella with a lot of fresh blood drops around her that could not possibly have come from a season so I got her up on her feet to find that blood was coming from her nose, it dripped down quite a lot with a big blood clot. Then she put her nose into cold water and the blooding stopped somewhat with only an occasional drop coming out of her nose. At first I thought that she might have hurt herself with some sharp object but I could not find anything that could have caused such an injury. So I packed her into the car off to the vet, he found she had a fever of 40.5 C and related the bleeding to the strong heat mainly and in part also to the longterm pred treatment. He gave her an injection to stop the bleeding and another to control the fever and prescribed two tablets daily for the same purpose. She got a vitamin injection which I am supposed to give her at home for a couple of days,, but I cannot do because she gets very agressive at anybody -even me- when it comes to injections. So i give her multivitamins and vit b tablets, iron and liver protectant, antibiotics and a gastroprotctant as well as 5mg pred eod. It seams we are heading back to that intense medication that i am not really happy about but we have to deal with.
Do you have any clue about what the cause of the nose bleeding could be, is it the extreme heat we have? I am trying to not dramatize events. Stella was comparatively well in the morning barking, running around , bringing her favourite toys for me to throw to her,  but not eating. She ate a little bit of meat yesterday leaving the noodles behind.
hugs elisabeth

I think there are various reasons for nose bleeds. I have looked into all sorts of reasons why Lola is so congested in her sinus. One reason is nasal cancer. A symptom of nasal cancer is nose bleeds. Don't mean to alarm you but it is ONE reason. Lola has not had a nose bleed so we are not thinking cancer anymore. I believe ususally there is also nasal congestion in addition to nose bleeds with cancer. So don't worry. Just be aware, I guess.
Poor Stella has sure had her share. Hang in there...

gail.

Yes I have already looked into the causes for nose bleeds clinging to the extreme heat here in Egypt as the most comforting explanation. I keep her in cool rooms hoping that it is the heat and she will improve. Overall she is ok but does not eat! Elisabeth

Hi there. Poor Stella.  Her fever was pretty high,is her nose bleed not connected with the cause of the fever? Did the vet do a blood smear to see if there were any parasites in her blood cells? I'm sure the heat is a possibility though. Hope she's on the mend soon.

Hi Elisabeth
I'm so sorry you are having these problems with Stella.  Do you know the reference range for the blood results, especially the platelets?  I don't think it could be a platelet destruction because her platelet number seems fine and a spontaneous bleed wouldn't occur until the platelets were down to 40. It may be the heat but would that send her core temperature up? You would know that more than me. She may have a bacteria or a fungus.  Was the nose bleed from both nostrils or just the one? Does she have any mucus coming down her nose? Could she have knocked it and it bled due to trauma? Should you check for babesia?

Jo

Maybe not eating because of the heat? It does affect some people like that too.  Have you tried some yummy sorts of foods she doesn't usually get to have?  I hope she is better soon.
gail.

The platelet reference range is 150 - 450.Could it be  a secondary disease ITP, IMT, Evans syndrome? Thats what I quickly found connected with nose bleeding and IMHA, but have no idea what it could mean. Still clinging to the heat and infection with fever explanation. The thought of renewed babesia is frightening but a possibility that I cannnot investigate. I cannot get Stella through this blood test again, heat, traffic chaos in Cairo, she refusing  and very agressive at anybody touching her legs for bloods....lets still think positive and assume that it is nothing serious that cannot be dealt with within reasonable limits. I will keep my eyes on her fever that should disappear with effective antibiotic treatment. Other then that back to nursing with ice packs on her nose for vasoconstriction! I hope she will eat a little in the morning, at least her favourite joghurts. your input is very much appreciated...hugs to everyone Elisabeth and Stella

I think the bleeeding is from one nostril and there was very little  mucuous as far as I have seen but I will have a closer eye on that. During the night there were also some blood drops on the bathroom floor with some clots.

I dont think it could be bleeding due to trauma.
The ref range for 12.9 haemoglobin  is 13-17
4,95 rbcs    ref range 4,50 - 5,50
41.0 haematocrit ref range 38.0-50.0
82,7 MCV ref range 80.0 - 101.0
27.0 MCH ref range 27.0-32.0
31.5 MCHC ref range 31.0 - 35.0
220 platelets ref range 150-450
8,25 WBCs ref range 4.00 - 11.00
would you also need the Differential leucocytic count?
These are human reference ranges since we do the test in a human lab, no vet lab in Egypt!

Hi Elizabeth,

Stella's platelets are within range so it is unlikely to be Evans Syndrome; other than that, the nose bleeds are quite odd but I have no experience with them in dogs.

Fingers crossed here that the antibiotics fix whatever it is & soon

Hugs

Hi Elisabeth,

I hope Stella is feeling much better today. The WBC differential may be helpful as it can give an indication of what kind of challenge the body is dealing with. What antibiotics is she on? Really hope she's on the mend.

Differential leucocytic count
Basophils 0% relative                        0.00% absolute                  up to 0.10 ref range
Eosinophils 0%                                  0.00                                    0.02-0.50
Neutrophils 68%                               5.62                                     2.00 - 3.00
           Staff  14%                               1.16
           Seg    54%                               4.46
Lymphocytes 26%                                2.15                                  1.00 - 4.00
Monocytes       6%                                0.50                                 0.20 - 1.00

Hi there,

So its just the neuts that are high... High neuts generally indicate a bacterial infection. Hope the antibiotics are kicking in and she's feeling better and eating now?

Quote from: shawkyelisabeth on July 18, 2012, 03:33:23 AM
I think the bleeeding is from one nostril and there was very little  mucuous as far as I have seen but I will have a closer eye on that. During the night there were also some blood drops on the bathroom floor with some clots.

****She may have a polyps or ulceration, or a foreign body up her nose. I think she is too young to think of anything sinister. It is possible she has aspergillosis but there would be other purulent discharge. Are her eyes watery?  I presume she has no other skin lesions. 

As Angela says, her platelets are within range so the bleed wouldn't be due to an immune mediated disease.  I don't live in a hot country so I have no idea what the extreme heat can do.  You are more informed and if you say this can happen to dogs in hot countries then unless other clinical signs become apparent you can only put it down to that and hope with the antibiotic treatment she is having it will all subside in time.  Such a worry, but blips happen and you have to believe that it is just that - a blip.

Fingers crossed.

Jo

 

Yes Jo hopefully it is a blip, some foreign body maybe, no other ulcerations, My vet tells me it can happen with the heat, she gets a tablet for homostasis twice daily for 4 days and a cold wrap around her nose every now and then which she obviously enjoys! She is still on antibiotics, eating but very little ,  that doesnt worry me much any more, stools ok and lively in the evening when we have a bit of a cool breeze, I give her an antiphyretic with the antibiotics although I am not able to take her temperature. I judge it by her behaviour, head down feeling her gums,, not eating etc.. I am optimistic and do not relate it to preds tapering (any more).
Thank you all, big hugs and I want to send some degrees of our around 45 Celsius of heat we expect  today to good cold old England! Elisabeth

No news is good news! Want to keep you updated! Thanks GOd Stella has gotten over the blip as Jo calls it (I like this word!) She is off antibiotics now and I have thrown all her other medications away except for her 5mg pred eod, a gastroprotectant, vitamins twice daily. She is back to normal, sleeping most of the day because of the heat but very lively and playful at night in the cooler breeze, her leg weakness also has disappeared , I keep her away from the air condition because I am afraid she might catch some respiratory tract infection. I hope so much she will stay stable now especially that I will be away for two weeks to Austria leaving her with my daughter and with some relatives alone for a few days and since she is ver y much attached to me we are already training h to get used to her dog sitters so not to feel lonely when I leave, I hope she will be alright, I have become so much attached to her that I am really worried about how she will cope. Oh how much easier it is with my Beagles, who just run about wagging their tails at anybody!
HUgs and thanks to all of you for your support in this minor crisis, you've helped me al lot like always, especially with the nose bleeding that was a frightening issue for me but thanks god seemed to have been nothing serious.
Greetings from Egypt Stella and elisabeth

That is very good to hear Elizabeth, I'm sure you will have issued very careful instructions to Stella's sitters.  Enjoy yourself in Austria!

Hugs

A big hug across (how many) ponds to Australia, thank you Angela! Elisabeth

That is so lovely to read Elisabeth.  I'm so pleased Stella is back to normal.  Try to put the nightmare behind you otherwise your stress levels will soar (even more).  5mg EOD is perfect and she can stay on this dose for a very long time, with no detriment!  You have managed her in such a sensible, logical way - which is great.

I hope you have a good trip to Austria.  I'm sure you will welcome a cooler climate.

Jo

This all sounds like good news, I hope Stella is ok while you're away and that you have a great trip Elisabeth.

We love good news. Have a great trip Elisabeth. Try not to worry about Stella while you are away. So happy to hear about Stella  :)
gail

Just one rather large pond Elisabeth, the Indian Ocean :)  Even then I am on the east coast of Australia so there is a large desert (the red heart) in between also :)

Dear all :) this is Elisabeths daughter Lisa, who is currently taking care of Stella. I just wanted to give you a quick update on how she has been. Unfortunately she was a bit weak yeaterday and today morning and had a loss of appetite so my mom told me to give her antibiotics every 8 hours. They worked like a miracle. After the first dose she was already more alive and alert and she ate. Does this mean that she might have some infection due to the reduction of her preds? She is still on 5mg every other day. Should i keep on giving her the antibiotics?
Thank u so much :) lots of love all the way from egypt

Hi Lisa,

Yes, we suspect Stella has an infection so she needs to finish the course of antibiotics to help clear whatever she has.

Good luck with Stella sitting  :)

Hugs

Hi Lisa,
you're doing a great job looking after Stella.  As Angela said, you should keep giving the antibiotics until the course is finished.  Hopefully the rest of your dogsitting will be ok.

Hi Lisa

How is Stella now?  I hope she is continuing to so better.
Jo

Hi, Jo I am on my way from Salzburg to Vienna on the train and on the net for the first time in days and checking on cimda, thanks for your concern. I am told Stella is fine I am worried though, I am back on Friday and hope to find her well, especially her bloods, will keep you informed, many greetings from cool and beautiful Austria!

Hi Elisabeth

It sounds as if you are having a lovely time on your holiday.  I'm sure you will be relieved to see Stella again though.

Best wishes
Jo

Hi jo, back to hot and dusty egypt i found stella very well thanks to lisa and my nice dogsitters whobspoil her a lot. I am not able to do bloods to check on her anemia but clinically she has rosy gums which gives me confidence that she has not dteriorated. She is not stable though what concerncs her physical strength, tht is especially her back legs that collapse from time to time. Some days she is goood and some days she does not want to move much. She is on 5mg eod and I keep her on that for the forseeable future. I give her vitamins, dandelion, kelp, milk thistle, a gstroprotectant, shwagandha, seaweed calcium, do you see anything wrong in that? The natural remedies i give based on jane dodds advice, maybe someone someone could advise me with the doses.  She does not eat well but still i think it is the hot weather and our very healthy fury friends also dont eat much, but she drinks and eats her joghurt with honey and some treats from time to time and then again a lot when she gets too hungry! We will take her to the sea for a week next friday and the weather there should improve her apetite and her overall condition and make her a bit more energetic.
I am not really fully back yet , so i had not yet had the time to check on all the posts at cimda but send a big hug to evyone hoping al of you and your fur kids are well and will check on the progress of everyone as soon as i can
Love from elisabeth and stella out of egypt

Hi Elisabeth,
glad to hear you're home safely and that Stella is doing ok.  The back leg weakness is probably from a prolonged use of steroids, it does take a while for the strength to come back.  I'm not familiar with all of those supplements so perhaps others can give their opinions on them.
I bet the trip to the seaside will be great!

Hi Elizabeth,
I hope you had a great trip away; Stella will be pleased you are back though, I'm sure  ;D 
Most of your supplements look fine to me, JD will have given you great advice and she knows her stuff. I don't know what shwagandha is.  Dandelion leaf is high in potassium - I used it for my boy that had heart issues, dandelion root has other properties which I'd have to look up.  Ironically I had an Addison's boy at the same time, one boy needed potassium & no salt (heart), the other needed salt & no potassium (Addison's) >:(

Hi elisabeth

I'm glad to hear that you are back safe and sound and with Stella again.  I bet she made a big fuss of you.

I can't advise on all the supplements you are giving Stella because I haven't used all of them and maybe others will have more personal experience, but sometimes when the dog is stable and on low doses of prednisolone all the issues that are seen when a dog is on high doses don't apply anymore and one need to re-think the supplements based on the current siituation rather than what has been.  For example Stella's liver enzymes should be much lower now, if not back to normal, so does she need the same amount of milk thistle etc? I can quote the doses from the references that I have. Milk thistle 250 - 500 mg twice a day for dogs depending on size and the severity of the condition (The Veterinarians Guide to Natural Remedies for Dogs by Martin Zucker)  Kelp: small dogs: 1/8th - 1/4 teaspoon daily;  Medium dogs: 1/4 - 1/2 teaspoon daily;  Large dogs: 1/2 - 1 teaspoon daily.  Note: Caution;  the iodine content in kelp is very inconsistent and excessive supplementation is likely to lead to iodine toxicity (salivation, watery eyes and nose, irritation of the stomach and suppression of the thyroid gland leading to lethargy; Kronfeld 1983) Therefore it should be given in measured quantities rather than added freely. Note; Kelp may not be beneficial in thyroid disease of dogs or cats.  (The Pet Lovers Guide to Natural Healing for Cats and Dogs by Barbara Fougere BVSc) From the same book Dandelion dosing 0.25ml of tincture per 5kg bodyweight up to three times a day. It says it is very safe and can be used for long periods. I couldn't fine a reference to seaweed calcium but apparently the rule of thumb for adding calcium is to 'supplement if you are feeding homemade meals and not to add calcium if you are using strictly a commercial food'. Sorry but I don't have a reference for  shwagandha.  If you are in doubt you migh drop Jean Dodds a short email asking her for the doses etc.

I do love the confidence you have now when managing Stella.

Jo

Let me give you a big hug jo for all the time you are giving me in looking up all the references for the doses of supplements, i have also done my reading homeworks as far as i could and am dropping some of the supplements, like ashwaganda , i will reduce the milk thistle and the kelp, thanks for your description of its side effects,i will reduce it or drop it all over, maybe it is a reason for  some of stellas lethargy. I try to exclude all of the reasons that could be due to the medications that she is still taking by slowly dropping or reducing the supplements, but since she is a bad eater i have to get some vitamins into her, so i will stick to a multivitamin syrup with iron that is commonly given to children and that she likes.
After 40 days of 5 mg pred eod i have decided to go for every third day. Stella is quite weak on her back legs and i think this is due to long term pred treatment and  i hope it will gradually strengthen her muscles with the reduction. I hope you can support me with this decision. Her gums are rosy and she is in a good condition overall, picky when it comes to eating but eating when she gets really hungry. I feel she is good and her lazyness is due to either pred side effects or to the heat.
One more big hug to you and i have to comment on your being blunt (as on one of your other posts):thank you again and again for having been blunt with me and stella !!Your bluntness saved her life twice when we did the blood transfusionn for her and when we gave her the high dose of steroids which my vet refused. THANK YOU!!!!! Elisabeth

Being online i have to send some hugs and greetings from egypt and the mediterranean over the big pond and red desert to australia, the us and uk . We are having a holiday after the fasting month of ramadan and take the chance of breathing some fresh sea air hoping this will also do some good to our fur kid.hope you are fine angela, penel and gail.
Also hugs to everybody who asked about stella while i was away, it is so comforting to know that stella actually has dogsitters all over the world !

Thank you Elisabeth - blunt isn't my usual approach.  You sound so confident now in the way you are managing Stella and it is lovely the way you have a feel for her condition.  It is something that so many of us can identify with.

Have a happy festive time.

Jo

Help!!! Stellas hind leg problem have deteriorated within the last two days. After being only weak she has shown signs of not being able to get up on her legs in the morning needing help 2 days ago improving in the evening yeaterday we had to carry her down the stairs to the garden. She had mo problem moving on the grass but difficulty walking on marble floor. This morning she was not able to walk at all. She tries to get up on her back legs but they kind of slip apart so she lands on her tummy with both her back legs widely spread unable to get up again. We started to give her vitamin B injections and i consider getting her to another vet today. Do u think anything related with autoimmune disease still lingering around or God beware is it a hip displacia common in GSD's? When are we going to see a little bit of a real healthy dog...?

Hi Elisabeth,

I don't have any experience with GSD's or HD & I'm very sorry to read Stella is having some sort of muscular or joint problem; I hope Jo is around, she may have some ideas. 

Hugs

Hi Elisabeth

I'm sorry to read this.  Stella needs a full biochemical blood test and possibly a scan to see if there is anything else going on, spleen etc.,  Does she have a distended belly?  Is she pale -  in pain - is she eating - has she had diarrhoea, is she dehydrated, does she have a high temperature? Is her heart beat normal and regular? Are her reflexes working ok? GSD get degenerative myleopathy but I would have thought she is a bit young for that. Is there a problem with her spine? Could it be the return of babesia or anothe tick borne disease? Sorry for all the questions. 

Check for Addison's disease - see below or the article in the files.

Thinking of you Elisabeth.  good luck
Jo
PRIMARY ADDISON'S DISEASE (HYPOADRENOCORTICISM)
The diagnosis of primary Addison's disease is not complicated but some vets seem to have a reluctance even considering it in their differential diagnoses. It is often misdiagnosed as  CRF (chronic kidney failure), heart failure, gastrointestinal disease and even AIHA.  Many vets say "It won't be Addison's as we never see it". Unless your vet is looking for Addison's disease then it will not be diagnosed.  Addison's disease is known as 'The Great Pretender'. Many dogs are presented to their vet at least three times in the six months prior to diagnosis, and many are in an Addisonian crisis before it is identified.  Note: Dogs have died waiting for the results of an ACTH test. 
The biggest hurdle is to convince your vet to consider that it's possible that your dog may have Addison's disease and not to dismiss the notion without proving it by carrying out a thorough investigation and possibly an ACTH test. 
It is important not to become obsessive and suspect that your beardie has Addison's just because of a bout of diarrhoea or an episode of being a little off colour, but it is equally important to be aware of the telltale signs which could aid a diagnosis and maybe save your beardie's life.
Points to consider when identifying primary Addison's disease:
Is your dog young / middle aged?
Over a period of time, has your dog experienced several of the typical symptoms and has he/she responded well to fluid therapy?
Has your young to middle aged dog been diagnosed with kidney disease?  Is he/she improving on the special treatment/diet provided by your vet? If the answer is no, then consider Addison's disease.
Do you have a dog whose breed is known to be genetically predisposed to Addison's disease?
Do you know of any relatives of your dog who may have been diagnosed with Addison's disease or kidney failure at a young age, or other autoimmune disease? Speak to your dog's breeder; he/she may be able to give you valuable information.
If you suspect Addison's disease
Have a Full Serum Biochemistry panel and a Complete Blood Count test done and ask your vet for a copy of the results for your own records.  Study the results yourself and check for abnormalities. Addison's disease is characterised more by the absence of abnormalities rather than their presence, eg., reverse stress leucogram.  If symptoms persist, have a further blood test done to see if there are any changes, but don't leave it too long in between (a week or less) as deterioration seems to quicken in the last stages.  Keep each laboratory report for comparison. Blood testing is never a waste of money (in the long term it can save you money), and it provides a 'bench mark' on which to base further tests).  Addison's disease is progressive so a blood test is only valid for the time it was taken.  As the disease process progresses the values will change.
The telltale signs when looking at blood test results
Routine Laboratory Abnormalities  -  Haematology & Biochemistry
Sodium/Potassium Ratio
Greater than 90% of Primary Addisonian cases will have high potassium and low sodium values, with a ratio of less than 27. 
Prior to diagnosis, Addisonian dogs often show a ratio of less than 23. The low ratio alone is very suggestive, but not diagnostic, of Addison's disease. Individual electrolyte concentrations can be more reliable.
As the disease progresses, the ratio will drop even further and the dog may collapse and become critically ill especially if stressed or excited.  Stress or excitement, to a dog with reduce adrenal function (even in one who has not exhibited typical, clinical signs of Addison's disease), can cause the dog to collapse or even die suddenly.
When examining laboratory results, look for:
INCREASED: 
High Potassium (K)
High Creatinine,
High Urea, (BUN – blood urea nitrogen; or SUN - serum urea nitrogen)
High Urea/creatinine ratio (Azotaemia)
Increased Eosinophils
Increased Lymphocytes
High Bilirubin -  in some cases
High Calcium (mild to moderate) – in some cases
ALT- ALP - AST (Mild to moderate increase of liver enzymes) – in some cases
DECREASED:
Low Sodium  (Na)
Low Sodium/potassium ratio (K:Na ratio -  less than 27) Addisonian dogs often have a ratio of <23.
Low Chloride  (80% of Addisonian dogs will have low chloride values)
Low Glucose – in some patients
Low Albumin (moderate to severe) – in some cases
Total white blood cell count (WBC) – in some cases
Red blood cell count (RBC or HCT)
Another possible difference between kidney disease and Addison's may be seen in the white blood cells (eg., neutrophils, eosinophils, lymphocytes). When a dog is poorly he becomes stressed and this is reflected in the white cells. The neutrophil numbers would be expected to be high/normal or increased, and the eosinophils and lymphocytes would be decreased or low/normal numbers. This is called 'stress leucogram' and is seen in both chronic and acute renal failure, but not in Addison's disease. A dog with Addison's disease may show a much lower white cell reading than would be expected in such a poorly dog.  In fact there may even be reverse of what would normally be
Reverse Stress Leucogram – may be seen in Addisonian dogs
Low/normal values of neutrophils
Higher value of lymphocytes and eosinophills
Electrocardiogram
•   Electrocardiogram  (ECG) is a very useful tool to detect various abnormalities of the heart resulting from high potassium levels in the blood.
Another very awkward differential is autoimmune haemolytic anaemia (AIHA).  I have known a few beardies to be diagnosed with AIHA prior to being diagnosed with Addison's disease. The usual treatment for AIHA had been implemented but the dog's clinical signs did not improve, as expected, and clinical signs of typical Addison's disease, remained. 
If this happens the previous blood test results should be carefully examined to see if there are any undetected telltale results such as high potassium, low sodium.   These cases are further complicated because of the steroid treatment the dog will now be receiving for AIHA. An ACTH test cannot be performed whilst a dog is on prednisolone, as it will interfere with the test results, so the dog's medication would have to be changed to dexamethasone for at least 2-3 days before an ACTH test is performed.
Prompt diagnosis and treatment, or supportive treatment, is crucial to the outcome of an Addisonian crisis and must be treated as a true emergency if the dog is to survive.
Life saving support
From BSAVA Manual of Small Animal Endocrinology, Chapter 19 – Endocrine Emergencies
"Whenever a diagnosis of Addisonian crisis is likely, treatment should be initiated without delay." 
"A tentative diagnosis of acute adrenocortical insufficiency can be made on the basis of the history and results of physical examination."
"Since death from acute adrenocortical insufficiency is usually attributed to vascular collapse and shock, rapid correction of hypovolaemia is the first priority in treating this condition."
1.   Restoring blood volume (dehydration) and
2.   Correcting imbalance of sodium and potassium levels and
3.   Treatment of life threatening cardiac arrhythmias
Within 1-2 hours, a saline only intravenous drip can restore correct hydration status, increase sodium levels and lower potassium levels which may be causing hyperkalaemic myocardial toxicity. In addition, other protocols may be used if myocardial toxicity is life threatening.

Elisabeth,

Poor Stella. I wonder if she is having a pinched nerve or spinal problem. Lola has trouble with bare floors too so we have carpet runners all over the place. Our house is totally set up for her disabilities.  I hope you find out soon what this problem is. Seems like DM is slow in showing up, so at least maybe it isn't that.

Sorry to hear she is having more issues. Try to have faith it will be resolved.
gail.

Hi Elisabeth,

I'm so sorry Stella is having more problems. A little bell is ringing in my head that this may be discospondylitis (an infection in one of the vertebral bodies). I may be totally wrong but it might be worth considering... Discospondylitis can be a sequel to a UTI and might present with the clinical signs you're seeing. If it is this, she should have a high temperature. They can diagnose it with radiographs and it is treated with a long course of antibiotics.

I had a GSD that had this and she started off struggling to rise and the vet thought she had injured her hip so put her on anti inflammatories. She seemed to respond for a few days but overnight she became completely paralysed in her hind quarters and the vet put two and two together when he found she had a raging temperature as well as cystitis. It took 6 weeks for her to get back on her feet and a lot of nursing and antibiotics but she recovered.

I hope she is doing better today and that you get some answers soon.

Thank you for all your input i am a bit shockedca bout all the bad outlook of diagnoses still hoping it is only a side effect of preds. To answer jos questions: no she has no distended bellyher gums are rosy, she is not in pain, she has had a diarrhoea, but not a very heavy one on and off with some medication for the last week with orange coloured stools, i was not able to take her temperature but would say  no, her reflexes are okay, she eats little but eats when handfed, her heartbeat seems normal to me, she is panting but i attribute thils to the heat we still have here in egypt. She was fine at the sea, although already showing  weakness in her legs. It is more in the morning after a long sleep and improves in the course of the day.
I will see a vet on saturday or sunday at the earliest for blood tests, in the meanwhile i will read about addisons as jo suggested, but really i hope it is not this, i feel i dont have the strength any more to go through another lifethreatening disease with stella again.....could it not be a relapse?

I ve done all my reading about addisons and about shannons post( thank you shannon)  and i feel i am back to square one with stella like in the beginning of her misery when we did not know what she had.i will try to do bloods for her as quickly as possible and hopefully with mu husbands help in diffential diagnosis and the protocols at cimda establish what is wrong with her. I might see another vet but i have little confidence in egyptian vet medicine...is addisons a disease that has to be expectesd after a long term pred use? I still hope it is not all that and only a blip (maybe this time a bigger one) but i admit i am desperate!we had been doing so well! It would help me if someone could descridbe me the typical clinical signs of a relapse of ai disease or the muscle weakness that is a side effect of preds. Thank you.

I ve done all my reading about addisons and about shannons post( thank you shannon)  and i feel i am back to square one with stella like in the beginning of her misery when we did not know what she had.i will try to do bloods for her as quickly as possible and hopefully with mu husbands help in diffential diagnosis and the protocols at cimda establish what is wrong with her. I might see another vet but i have little confidence in egyptian vet medicine...is addisons a disease that has to be expectesd after a long term pred use? I still hope it is not all that and only a blip (maybe this time a bigger one) but i admit i am desperate!we had been doing so well! It would help me if someone could descridbe me the typical clinical signs of a relapse of ai disease or the muscle weakness that is a side effect of preds. Thank you.

Hi Elisabeth

I'm so sorry you are having to deal with Stella being unwell again.  If you say it is just like the first time then this is probably on the top of your list of differentials and I hope a blood test will confirm this.  I know very little about Babesiosis, I'm sure you and your husband know much more, but I did look up some details in a veterinary book (if it helps) and it states that 'Microscopy and PCR may be better for post-treatment follow-up, as IFA titres may persist for years; Dogs with B. gibsoni remain persistently infected and can act as carrier animals even after treatment; Dogs infected with B. canis may be cured after treatment; co-infection with other vector-transmitted pathogens (eg., Erhlichia, Haemobartonella, Leishmania) should be considered, especially in animals that fail to respond to treatment'.

I dont think it is at all likely that her muscle weakness is due to the preds as she has been on such a low dose for a while now her muscle strength should be good enough not to cause these symptoms.

Addison's is not expected in dogs that have been on long term pred use.  Addison's is an immune destruction of the adrenal glands. The only reason I mentioned it is because it should be considered in any dog who becomes exercise intolerant or who collapses, because it can so easily be overlooked.  Addison's disease occurs in dogs with a genetic predisposition but when a dog has one AI disease there is always a possibility of them getting another - it doesn't always happen but it does sometimes and we have no way of knowing what AI disease/s our dogs are predisposed to.

In a way Elisabeth if Stella is positive to Babesiosis then you know the course of treatment and it has worked very well before, and also you will be a step ahead of the game this time.

Hurry up with those blood tests!

Thinking of you.

Jo

Blood results will only be out by tomorrow, a first update of our visit to the vet  revealed that stella has hip dysplasia not related to the autoimune condition but definitely genetically inherited and most probably evident quiker than in oher dogs due to her long history of sickness at a young age.her back also shows. Deformity which is uncommon at this young age, her reflexes are compromised, due to a nerve condition. X rays revealed this and i have to accept this as a fact i have to deal and live with. As long as stella can walk acceptably and without pain we can deal with it, when we have to start carrying her around...i dont know how i will manage. I will wait for the blood results tomorrow and take it in little steps from there.....

Hi Elisabeth

I'm so sorry you have further problems with Stella.  You must be exhausted.  I hope there is something that can be done to make her more mobile. Are you using a sling to help her at the moment? This might be just an acute stage and even a towel under her middle, so you can assist her along, may be useful and I am hoping that this acute phase might pass.  What about anti inflammatory drugs or pain relief for her hip dysplasia. I wonder if she was in pain when she went through her grumpy phase a couple of months ago.

Take a few deep breaths Elisabeth.

Jo

Really jo i am in tears now reading your post for all your compassion, i dont know what i would do without you and all the other cimda friends...stellas blood results turned out badly...her hematocrit is down to 26.8from 41 last time six weeks ago her haemoglobin is 8.3 from 12.9last time, her rbcs are 4 from 4.95 last time, her wbcs are high at 33.8, she has an infection, but the new vet who was very understanding with her ai history was not able to establish a reason yet. I will still discuss the bloods with him today and see what kind of action concerning the inflammation he suggests. I
I syart to reproach myself that i might have reduced the preds too quickly at the stage of 5mg once daily to eod and maybe should have kept her on the daily 5mg much longer, but i considered three weeks long enaugh with all her clinical signs being really good, now i have to look ahead and think: is this a relapse? If yes, at what dose am i supposed to restart, is it worth it, should i start with the antibiotics treatment first andvsee how it works out, then i am afraid rbcs will be destroyed again and anoher blood transfusion is out of question. And then i have to deal with the diagnosis of hipdysplasia which has definitely no cure for stella. She is well today on her legs but always hesitating to go upstaiirs. She has always been weak in her legs but this extreme weakness turned out all of a sudden.
Addisons was definitely excluded by the vet as well as my husband, but thank you jo for always giving a hint of what could be.
Pls help me with establishing if this is a relapse! Thank you because if it is i have to take actin quickly.
Hugs elisabeth

I have to add that stella is walking fine in the evening but has problems getting up in the morning, her walking condition is on and off, better and worse, maybe the last days was an acute phase, i will still have to look for something to relieve her if she really gets into pain, most probably will have to join a forum for gsd congenital hip dysplasia victims!
And i have to add the new vet doubts very much that it could be a relapse of babesia , i hope he is right.

I have just been on the phone with stellas new vet: he suspects a relapse, not a real infection that couls be related to anything physical but kind of the immune system thinking it has to fight something that is why her liver enzymes are high and wbcs are high. Sorry i cannot explain it better scientifically, but it sounded logic to me. He wants to give her a medecation called depometrol ampula 80mg per week to be given subcutaneously that is slowly released as a supportive treatment for the infection, the liver and the anaemia, then levanox and liver albumin and cephalaxine antibiotics. Pls comment, he seems reluctant to go back to the very high doses of preds but i have not yet discussed it with him, i think he wants to try out this supportivetreatment for one week and see how she responds.

Prayers & fingers crossed here for you Stella

Hugs from Oz

Quote from: shawkyelisabeth on September 01, 2012, 12:06:26 PM
I have just been on the phone with stellas new vet: he suspects a relapse, not a real infection that couls be related to anything physical but kind of the immune system thinking it has to fight something that is why her liver enzymes are high and wbcs are high. Sorry i cannot explain it better scientifically, but it sounded logic to me. He wants to give her a medecation called depometrol ampula 80mg per week to be given subcutaneously that is slowly released as a supportive treatment for the infection, the liver and the anaemia, then levanox and liver albumin and cephalaxine antibiotics. Pls comment, he seems reluctant to go back to the very high doses of preds but i have not yet discussed it with him, i think he wants to try out this supportivetreatment for one week and see how she responds.

Hi Elisabeth

Firstly you didn't do anything wrong in lowering the preds.  Stella was in remission otherwise she wouldn't have had an HCT of 41%.  Her weakness certainly could be due to 26% HCT and the high white cell count of course can be due to an infection but I feel it is likely due to a relapse of AIHA. Does your vet know if the anaemia is regenerative or non regenerative?  For a dog to relapse a trigger has to occur and this can be any stressful situation whether it be the body trying to cope with drugs or any emotional/hormonal situation. 

Depometrol ampula, I presume is methylprednisolone?  If it is, then the drug more potent than prednisolone.  It is an immunosuppressant and therefore I can only think your vet is giving  it to Stella for the AI disease and not for an infection, but perhaps I haven't understood your message properly. I cannot comment on the dose as your vet is giving as it is in a form that I am not familiar with. Perhaps you can check with the vet (or your husband) if this is an immunosuppressive dose, which is essential.  If it is then it will hopefully stop the immune destruction of the red blood cells but you will have to continue with oral steroids and wean down as usual.  There is no other way when a relapse happens. 

Personally, I think  a week is too long to go between blood tests because if her anaemia is non-regenerative and the supportive treatment Stella is having does not work then she could be losing red blood cells at a rate of 4% a day and if it is regenerative then it can happen a lot quicker.  You need to avoid her going so low that she may need a transfusion again. 

Just because this has happened now doesn't mean to say that you can't reach long term remission in the future and Stella will be OK again. Don't even think about her hips at the moment because when she is back to normal again her hips may not be a problem to her. Everything might settle down. This whole episode might be caused by the immune problem she is having at the moment.  You know Stella responds to the steroids and this is a good sign because she can do it again.

Your new vet sounds a good guy with a better understanding of AI disease than your previous one.  I know you don't want to go down this route again but when she is in remission you will be glad you did!

Thinking of you

Jo
 

Yes jo it is methylprednisolone acetate , given intramascular 80mg , once a week meant as a supportive treatment. I will try to get him on the phone to make sure he is aware stella might need an immunosuppressive dose again. In the meanwhile iwill continue with preds every third day as i did. She is doing better today more lively but i am aware that this might be due to the extra shot of cortison and i am not sure if this wil stop her decrease in rbcs. Okay back to the vet. I am glad anyway that he uis understanding. Hugs

My husband who had been on the phone with the vet on saturday tells me it is an immunosuppressive dose that is given intramuscular and is slowly released and does not need weaning or tapering. I personally am not sure how this goes with e,g. Michael j days protocol how it fits in , but i am waiting for the vets answer to this question. The vet told my husband to stop the oral preds . Stellas 5 mg  every third day are due this evening so i still have time to get a definitive answer from my vet concerning the immunosuppressive dose.keep fingers crossed this crisis will pass! I just need to get myself on the way again with the treatment for stella and be sure that i do the right thing. Would the normal thing be to go back to 20 mg twice daily?

Quote from: shawkyelisabeth on September 03, 2012, 01:21:59 PM
My husband who had been on the phone with the vet on saturday tells me it is an immunosuppressive dose that is given intramuscular and is slowly released and does not need weaning or tapering. I personally am not sure how this goes with e,g. Michael j days protocol how it fits in , but i am waiting for the vets answer to this question. The vet told my husband to stop the oral preds . Stellas 5 mg  every third day are due this evening so i still have time to get a definitive answer from my vet concerning the immunosuppressive dose.keep fingers crossed this crisis will pass! I just need to get myself on the way again with the treatment for stella and be sure that i do the right thing. Would the normal thing be to go back to 20 mg twice daily?

Hi Elisabeth

The only long acting steroid I am familiar with is dexamethasone but the duration is only 72 hrs and it does have a half serum life so oral immunosuppressive treatment is needed after 48 hrs, so I can't comment on Stella's currrent treatment. 5mg of pred every third day will not have any effect so there is no point in giving it at the moment.

If a dog relapses then the treatment regime has to start again and that is with 1mg/kg/12 hrs.  I would expect Stella (being a GSD) to be heavier than 20kg and if this is so then she will need a higher starting dose then 20mg/12hrs.

You will get yourself back on the road again and although it is a disappointment you at least know what to do and what to expect.

Fingers crossed

Jo

Hi Elisabeth,

I think we are definitely in the same boat at the moment and you are right, all we can do is start again and pray that the treatment is successful and both our precious babies get back to normal soon. It is such a scary place to be and one feels so powerless! I think we are probably just as afraid as each other at this point in time. The support and advice that Jo,Penel as well as all the other CIMDA people so freely give makes such an immense difference and I'm so grateful for it. Good luck with Stella, she and Coop just have to get through this because we love them so much. They will be the two African success stories!

Hi, shannon and jo, yes we are in this together, i have been through this all alone against ther will of the first vet and now am not going to wait and take any more risks we have had too many hard times before, i hope i am not too late, this relapse came totally unexpected, stella was so well and showed only minor signs of blibses and i had no possibility of doing bloods more often , that i reproach to myself now, but anyway i look ahead of the road, deep breath, still i try to get on the phone tonight with my new vet who seems to understand ai diseases but reluctant to put her back on high doses quickly enough.
Shannon were are you from? I hope we can make it for our fur kids, i get attached to stella more and more and she is grateful for every moment that she feels better and it breaks my heart to see her coming to me with her cloth ball in her mouth waning me to throw it to her which i do and then she cannot run after it because she is too weak.
I should have started to worry when she showed an orange coloured poo about two weeks ago that was when she started slowly to be poorly .
Big hug to you jo and head up high shannon maybe we can make it!
Elisabeth

Have just been on the phone with my new vet, he is well aware of the dngers of a relapse and assures me that the 80 mg  depo medrol intramuscular are immunosuppressive with A half life of at least one week to three weeks, he told me not to worry and that he preferred this to giving her oral preds. He will,see stella and do new bloods on thursday that means only three more days and he is sure that there will be no xdeterioration on her hematocrit until then. So i should have confidence, shouldn t i and i cannot now on my own increase her oral dose of preds because that would definitely mean an overdose for the time being. Stella is better and lets hope for the best, itis a rollercoaster! Elisabeth

Elisabeth is there a particular reason you can not get Stella to the vet sooner for blood tests? (Sorry if you have mentioned it before, I am still finding my way around the new site). Having seen that her PCV had gone down quite a bit, I am afraid I would be having her tested every three or four days just to make sure it was not sinking even lower.

Has Stella had a full biochemistry blood test done recently to check her liver, kidneys etc.?

Sorry I can not be more positive, but I am a great believer in regular blood tests to keep an eye on things and especially when things are not going so well. I did this with my AIHA Beardie and we also reduced the medication gradually - it took a year!

Yes i am considering it not to wait until thursday and do it earlier, her kidney values are good, her liver enzymes high, she gets liver madication. The reason for not having her blod tested in lose intervals was the horrible traffic situation in cairo postrevolution, very hot congested and  ewe had to get the blood to the lab by ourselves, now i found a new vet. Who does the test at the clinic an d is dealing well with stella trying to keep her as stressfree as possible. Thank you for your concern, i stiked to the m j day protocol when reducing preds and everything went perfectly well and i have no idea what could have triggered the relapse

Quote from: shawkyelisabeth on September 03, 2012, 06:04:03 PM
Have just been on the phone with my new vet, he is well aware of the dngers of a relapse and assures me that the 80 mg  depo medrol intramuscular are immunosuppressive with A half life of at least one week to three weeks, he told me not to worry and that he preferred this to giving her oral preds. He will,see stella and do new bloods on thursday that means only three more days and he is sure that there will be no xdeterioration on her hematocrit until then. So i should have confidence, shouldn t i and i cannot now on my own increase her oral dose of preds because that would definitely mean an overdose for the time being. Stella is better and lets hope for the best, itis a rollercoaster! Elisabeth

Hi Elisabeth

No point in giving oral preds now.  You must give this vet a chance.  He does seem to have a better understanding than your other one.

We will all be routing for Stella and you.  It is amazing just how close we 'moms' get to our poorly dogs and how they become to rely on us and look at us with total adoration.  There is something very special about this relationship.

Thanks for the hug!

Jo

Hi Elisabeth,

I'm from Zimbabwe but am currently studying in South Africa so we're at opposite ends of the continent.

I hope Stella is feeling better this morning. We just have to take one day at a time I think (easier said than done!), do the very best we can for our babies and like you say, just breathe. We will get through this with them!

Yes shannon we will have to get through this somehow, but at the same time as jo said once try to keep our sanity and not worry too much which I start doing again right now, I have had dogs for the last 25 years but Stella has been really special because of the hard times we had together, i had a beagle girl that died of a heart condition at 13 who could literally read my thoughts, and Stella  at one and a half years is even more attached to me, inspite of her inherited disabilities she is a beauty, extremely intelligent and iI will do everything to save her. So I will try to give this vet a chance hoping that his supportive treatment does not harm to her hematorcrit and check her bloods even earlier then Thursday and then get back to the M J Day protocol starting all over again.
Thank you JO and one more big hug for telling me to give this vet a chance, and I will give him the M J Day protocol.which I think he knows. Elisabeth

Hi Elisabeth,

What Jo says about staying sane when all this is going on is so true, yet it seems to be so difficult. The worry seems to consume one when these things happen to those we love.

I understand what you mean about how close you have become to Stella, we become inextricably linked with them and when they've been as sick as our lot have been it seems to reach another level. I really hope Stella is feeling better today. Coop seems to be brighter so I am hopeful that we are on the right track again.

After seeing our new vet yesterday i can report that we agreed on getting stella back on the initial high dose of preds, he asked to wait until saturday so not to overdose her after this initial suportive shot of cortisone that he gave her. We did bloods that turned out with highly improved wbcs indicating that the ab treatment with the cortison shows effect, but lightly decreased hematorcrit and rbcs that we hopefully will fight against starting from tomorrow. We keep all our fingers and paws crossed , maybe it works this time! Stella is still on antibiotics to fight any possible infection she might have (she had diarrhea and eats little) and on a bunch of supplements for liver and joint support. She walks better although she is still weak but in good spirits. Thanks for your support, will keep you updated and i am full of hope again that we can make it this time. Hugs to everybody and good thoughts from elisabeth and stella

Hi Elisabeth

There is nothing in your posting that I can't agree with.  I like the sound of this new vet.  He seems to assess the situation and is not frightened to treat appropriately.  His job is made easier because of you and your husband's understanding of what is going on with Stella.

Don't forget the gastroprotectant. 

If her platelets get a bit high you can always include asprin to thin her blood a little:

To decrease platelet aggregation/antithrombic: 0.5mg/kg/12-25 hrs (Plumb's Veterinary Drug Handbook)

Stella responded so well last time, she will do so again.

Jo

It's not the outcome I would have wished for you & Stella but you do know what you are dealing with now & that's a head start.  When my girl went through this the second time she needed to be on the initial high dose for a month before reductions began as her bone marrow was very sluggish, and later in the treatment developed pancreatitis after I unwittingly made changes to her diet - so remember to keep the fat content in her food down to no more than 10% if you can (some manufactured dog foods are around 30% fat).
Prayers & hugs for you both (& Egypt) from Oz

Big hug to you jo and angela, i reread your report about the second reduction angela and it will certainly help. No we will not forget the gastroprotectant and i am aware that i should keep her food  lowfat. She eats very little now but that is possibly going to change with the high dose of preds and i will go for chicken and rice and liver and some vegs, she refuses dryfood.
The new vet is well read in autoimmune diseases and even knows the m j day protocol, but his approach for a relapse is different with prescription of high dose longacting depo medrol injections.nevertheless i was able to convince him that we should restart with immunosuppressive doses of oral preds and he had no objection seeing it only as a different approach but still convinced that his approach would have the same outcome. Still i am relieved that we restart the oral preds because i am confident that this is the right thing to do with stella, hopefully she will respond well without side effects. We will now see him on a regular basis. He has a very good way with stella and is able to take a blood sample without tying her down and she accepts it without biting or any stress which is a miracle!
Seeing the protocol and dates that i tapered stellas preds he assured me that the was nothing wrong and as jo and other cimda people said  a relapse can happen at any time and is unpredictable, so i try to take it lightly now, i know i have a sick dog that i have to care for for a long time, we will try to get as much quality of life for both of us and we are into this together. With the new vet i will have someone hopefully who will be of help when any crisis occurs or in case of side effects this makes me A little calmer but he will never replace the good advice and reassurance of you  jo and all our other friends.
Big hugs and i will keep you updated.
I just saw that this post got 800 views, are so many people interested in our story?
big hugs over the ocean to oz, angela, for your positive thoughts.

Hi Elisabeth

It is so comforting to have a vet you can work with. We all need that.  I'm sure I am a real pain to mine but we work and learn together.

800 hits, that is amazing, and you don't know how many unknown dogs Stella's story will help.

This may be her one and only relpapse - who knows?

Jo

A big good morning hug to you JO! Stella and ELisabeth

hullo Elisabeth. Iam one of Stella's 800 followers.I do not post too much these days but follow all my "old friends" trials with their AI problems. I am so pleased that you have a vet with whom you can work this is always to everyones advantage has Jo has said..We are ALL on a continuous learning curve.
Sending big hugs to you & your girlie through cyberspace.

Much love Sylvia & the Afghan Hounds UK.

Thank you sylvia you have helped me so much with stella when we still were dealing with her babesia....hope you are doing well, many greetings from egypt elisabeth and stella

Day2 of our second attempt of pred treatment at 25 mg twice daily:
Stella is okay, lively, eating better, but panting heavily, that worries me a little.
In comparison to the first time this time it is much hotter that might contribute to it.
She drinks a lot and I try to keep her in cool places. She has one more day to take her antibiotics
And then hopefully the stress of medication will not be too heavy on her.

Good luck Elisabeth! I hope the sailing is smooth for Stella.
gail

Quote from: shawkyelisabeth on September 09, 2012, 02:22:26 PM
Day2 of our second attempt of pred treatment at 25 mg twice daily:
Stella is okay, lively, eating better, but panting heavily, that worries me a little.
In comparison to the first time this time it is much hotter that might contribute to it.
She drinks a lot and I try to keep her in cool places. She has one more day to take her antibiotics
And then hopefully the stress of medication will not be too heavy on her.

Hi Elisabeth

It is good news that she is lively and eating better.  The heat can be a problem but you will do what is best for Stella. I'm sure you have ways of cooling her down.

At this stage you can't ask for more.  It means she is responding to the preds. 

jo

Day6: stella is ok, a bit lazy , not eating as much  as I would have expected at this high dose of preds, she is lively, but lies down quickly after short efforts, I keep watching this...gums were a bit pale at start, now  more rosy, we are due for bloods in a few days. Her hind legs were very weak yesterday after we had seen some improvement for a couple of days. I relate it to her hd now so maybe it is also the extra weight she has put on that is a strain on her legs. But I encourage her when she gets too desperate with her legs slipping apart and then she happily starts running again after her cloth ball. Hoping we can avoid side effects this time again.

Hi Elisabeth,

I would put the cloth ball away just for now as she will need all her energy to fight this.  There is the risk of high dose and/or long term pred causing weakening of muscles and ligaments so be careful with her, the last thing you need is a torn cruciate (sp?); not saying this will happen, just that it is a another risk and best avoided if possible.

Hugs from Oz

Hi Stella,

That's really kind of you to let your mum rest while you have a nap. I never let my mum get away with that, she must get up when I say so. I've been a busy boy this morning, my mum and I have been to feed the horse, I've eaten my breakfast and had some apple because those little white tablets I get make me very hungry. I hope you're feeling better and that you are getting stronger. I feel quite a lot better and my mom said my eyes are sparkling again. I hope today is a good day for you and that you continue to get stronger... Your friend Cooper :)

sthg must have been wrong with the cimda site lately, i tried many times to access it, but always had an insert saying bandwidth exceeded, error report to administrator or site owner. when i tried to post i was able to write but  the post icon would not  work..i hope it will now..
i really want to report about stellas latest dvelopments..she had bloods done last thursday with the following results after 18 days of preds:
WCB 27.93
LYM 0.40
MD 1.35
GRH 26.8
LY 1.4
MI %4.8
GR % 93.7
RBC 4.676 up from 3.86
HGB 11.3
HCT 34.00 up from 25.78
MCV 73
MCH 24.1
MCHC 33.2
RDW22.6
PLT319
PCT 0.29
MPV 9.1
PDW 37.4
stellas vet suggested to keep her on 25mg twice daily for another week so she would have it for 28 days following MJ Days protocol.
stella is doing fine but maybe not as well as the first time on high preds, she is not putting on so much weight, drinks excessvely, heavy panting..she has good reactions  and is lively in good spirits, but lazy and not as active as i expect her to be.
she has a diaerrhoea since this morning that i treated with a medication she accepts well.
I will get her back to the vet earlier on thursday and suggest to start reducing preds a bit earlier, as i think her blood picture is okay. her higher wbcs have no obvious infectious cause due the vet and he did not want to give her antibiotics but wait a few more days to spare her too much medication.
i do hope we can reduce quickly as i am worried that she is showing side effects. we still have a very long way to go..
greetings to all and i hope the site is accessible now without interuption.
best regards from elisabeth and stella

Hi Elisabeth,

Stella has responded really well again, thank goodness.  JMHO but I think you could begin reducing now with these results as Stella's hct is so close to within nromal range (36-55%) and I would not delay in adding the antibiotics as controlling any infection will help with her well being and her recovery.

Big sigh of relief in Oz

Hugs to you, your family & Stella

Hi angela, i knew you would be the first one to reply...thanks to the oceans between us..i keep a close eye on your protocol...i will get to the vet on thursday and try to reach him by phone today, ithink its time to reduce..stellas hindlegs are very weak and this i feel is not only due to the hip problems she has, i think its also a muscle weakness..we still have a long time ahead of us on high preds...i dont think we could taper by 50percent , but by 25 which means she should get 18.75mg twice daily now which is also not a small dose..keeping fingers crossed...her muscle weakness worries me...
Hugs to you and your fur kids...elisabeth and tella

Hi Elisabeth,

You could try adding extra calcium and possibly vitamin D to Stella's diet to try to halt the effects of decreased bone density and weakened ligaments due to pred.

"Corticosteroids, such as cortisone and Prednisone, have an adverse effect on bone and soft tissue healing. Corticosteroids inactivate vitamin D, limiting calcium absorption by the gastrointestinal tract, and increasing the urinary excretion of calcium. Bone also shows a decrease in calcium uptake with cortisone use, ultimately leading to weakness at the fibro-osseous junction. Corticosteroids also inhibit the release of Growth Hormone, which further decreases soft tissue and bone repair. Ultimately, corticosteroids lead to a decrease in bone, ligament, and tendon strength.."

Surface Hippy 2005, Surface Hippy - Guide to Hip Resurfacing, Cortisone Decreases Bone, Ligament and Tendon Strength by Ross Hauser, MD, "http://www.surfacehippy.info/cortisonedangers.php", viewed 2nd October 2010

Hugs

I already did, angela, she gets long acting vitamin D injections once a week plus calcium with her food.hugs

Hi Elisabeth

It was only yesterday that I thought I would post a message asking about your Stella.  As angela wrote, she has again done well and responded as you would hope, but I do agree with you lowering the steroids now and not leave it another week.  Her PCV is good and you should reduce the clinical signs that you are seeing. I presume you are giving a gastroprotectant and you could also add an antithrombotic dose of Asprin 0.5mg/kg/twice a day (Plumb's Veterinary Drug Handbook) if you thought it necessary.

I am so pleased she is doing so well and these side affects will start to subside as you know.  It is a waiting game, isn't it? Sooo frustrating!  I'm also very glad you have this new vet who Stella seems to like a lot.

Jo

p.s. Sorry you have had problems with the site. 

Thank you jo for thinking about us. We are going to see the vet tomorrow and have preds reduced...and  keep on crossing thumbs and paws.. Elisabeth

Unfortunately today's news from our visit to the vet are not so good. Stellas blood test revealed:
Wbc 39.87 up from 27.83  nine days ago
Lym o.40
Md 0.72
Gra 38.76
Ly 1.0
Mi 1.8
Rbc 4.055 down from 4.676
Hgb 10.1 down from 11.3
Hct 30.62 down from 34
Mcv 76
Mch25
Mchc 33.1
Rdwc 22.6
Plt 330
Pct 0.31
Mpv 9.4
Pdwc 37.2
Her vet prescribed 1 tablet of imuran 40 mg for one week and half a tablet for one week, he will see stella again after a week to assess her anew..he says he did not want to give an antibiotic because the raised level of wbcs are not necessarily related to an infection, her clinical picture does not show any indication of a n infection. He thinks that she is not responding well enough to the preds and needs azathioprine treatment to support the cortisone .
Stella did very well initially until 25 days into treatment with preds 25mg twice daily, then we tapered preds to 18.75 mg twice daily and will continue with this dose for at least a month besides the imuran.
I would much appreciate your comments on this treatment.
Stella is okay but not as good as she was the first time..She is less active and has her head hanging down a bit..her hind legs are weak and slip away often, but she can climb stairs and goes for walks in the garden.i let her out more than the first time because it raises her spirits when she is withnthe other dogs.
So deep sigh and trying not to startworryimg too much again..will it turn out well this time?
Hugs to everyone elisabeth and stella

We could not find the imuran, so stella is on 50mg azathioprine once daily for a week and then 25mg for three weeks. I know that azathioprine shows effect only after 10 days so i will discuss the issue of reducing after one week again with our vet.  We will have bloods done again after a week..she will continue with 18,75mg twice daily for a total of 28 days. Your input is much appreciated.
Elisabeth and stella

So sorry Stella is having another hiccup. It truly is a rollercoaster ride with these special babies of ours. Will be keeping fingers crossed that the next bloods show an improvement.

Coop apologises for not replying to Stella earlier but he hasn't had a chance. He says to tell her to keep fighting this, that she'll win this battle and that she's very lucky to have a mum that loves her so very much.

Hi coopi, i got your message..i am not so well these days..i feel weak with all these tablets..and it annoys me that my legs are failing me especially when i want to play with my dog friends justin and ike...i let my head hang low and i feel depressed that my mom is in trouble again with me, but i try to please her by staying always by her side..i do my best to get better and i take all my medication without complaining..hugs

Hi Elisabeth,

Had you started Stella on he AB's?  I know when my girl had issues affecting her health other than the AIHA (eg pancreatitis & at other times what appeared to be infection from her blood work) her hct decreased by 4-6%, once on AB's her hct rose again. 

It is also possible she is having an adverse reaction to being on pred at a high dose for an extended time, in this case decreasing the pred actually causes the hct to rise.  How long has she been on this high dose for?

Hugs & prayers from Oz

No her vet has not given her ABs saying that he doubted she had an infection and that her high WBs were more probably related to the long term preds. She was on 25 mg twice daily for 25 days and is now on 18.75mg twice daily (for three and a half days now).he wants her on this dose for a month.
Hugs to OZ ELisabeth

Quote from: shawkyelisabeth on October 07, 2012, 07:28:12 AM
We could not find the imuran, so stella is on 50mg azathioprine once daily for a week and then 25mg for three weeks. I know that azathioprine shows effect only after 10 days so i will discuss the issue of reducing after one week again with our vet.  We will have bloods done again after a week..she will continue with 18,75mg twice daily for a total of 28 days. Your input is much appreciated.
Elisabeth and stella

Hi Elisabeth

Can you or your husband get hold of Multistick to test Stella's urine? A urine infection should be considered, and ruled out, because a UTI is so common when a dog is on preds and you won't necessarily know she has one. It is reasonably common practice to keep a dog on AB's whilst they are on high doses of preds, and I don't think it is a bad thing.  I don't see a good reason for not using a broad spectrum AB at this stage of her treatment.

Also, do you have the facility to look at a blood smear to check for spherocytes (infiltrating immune cells) and agglutination?  This can confirm, or otherwise, that the drop in PVC is due to AIHA as opposed to some other reason for the current anaemia. 

I don't see the point in reducing the Aza after one week, but you have thought of that already.

I know it is disappointing but pick yourself up and be positive.  You know these blips happen.  Also, was the blood sample a good one or did it have some clumping?  If it had some clumping then the actual reading would be higher.

Hugs to Stella

Jo

I tried to do my homework of reading about azathioprine but i havent found enough information.how long should the dog stay on 2mg per kg bodyweight? Penel wrote it takes up to six weeks for the drug to show effect...in combination with the preds? I need advice with the dose and tapering regime so i can discuss it with the vet..i will try to get a smear test today and get stella on antibiotics..with her head down looking at me she tells me something is wrong...

Please jo give me an idea about how the smear test for agglutination and spherocytes should be read...i am at the vet to take a sample..what values would you want to see to exclude failure of pred treatment and what would mean that she has an infection...thank you...i mean what indicates that the anemia is due to ai disease?

I have checked the files but i have not found anything on how to read the smear test....

Hi Elisabeth,

Sorry you're having a hiccup with Stella. I'm sure Jo will be able to answer this much better than I can.

When looking at the blood smear and evaluating whether the anaemia is due to IMHA, one would expect to see a high proportion of spherocytes (which are basically red blood cells that have had a piece of their membrane lost and instead of being a biconcave disc are now  spherical ball) and agglutination may also be present. This will look like bunches of grapes as the red blood cells are clumping together. They can then do something called an in saline agglutination test to see if it is true agglutination as well as a Coombe's test.

For infection they will assess the number of neutrophils and other white blood cells present on the smear. The presence of mature neutrophils as well as immature neutrophils and their proportions relative to each other, will give a good indication of the presence of infection.

Hope this helps. Hugs to you and Stella and I hope she's on the mend again soon.

Thank you shannon, i will discuss it with the vet. He called me today to tell me that the retycolicytes are high ( which i think is good) but that her liver enzymes are extremely high..i havent got the numbers in writing ,i will meetvwith him tomorrow and get the lab report written...he wrote another liver protecting drug for her...stella eats well,drinks a lot but does not want to move much, getting exhausted quickly with heavy panting, she is not the same like at the first round of her pred treatment, my vet suggests its the liver hat has been affected by the long term pred..he will see her tomorrow and we will discuss how to proceed. Should we already reduce the pred and keep the aza? Suggestions needed... Thank you all. Elisabeth

Hi Elisabeth,

I'm so sorry Stella is having a hard time. I'm no expert but reticulocytes are a good thing, it means the anaemia is regenerating. Maybe her liver enzymes will drop once the pred is lowered. Will be keeping fingers, paws and hooves crossed here that Stella is on the mend soon. Coop sends her a hug from this side of Africa.

What was the liver protection - was it SAMe - I think that is often used.  The Aza should start to work after 10 - 14 days.  Let us know what the vet says tomorrow, good luck, thinking of you x

Hi Elisabeth,

High reticulocyte (new rbc's) numbers is brilliant news;I think she had/has non-regenerative AIHA & if she has it is indicative of reducing the pred & this will considerably help her liver in addition to the SaMe/Ranitidine/other that the vet has prescribed.   Do you have her Jean Dodd's liver cleansing diet?  It's basically white potato, sweet potato & fish but I've had good results with chicken instead of the fish.

I'm not sure if Jeanna is around at the moment but I know at one stage when her girl was extremely ill the pred was reduced every few days to a week or so to get it down quicker. 

You really only need to extend the dose time at the beginning if they are slow to respond & towards the end when the pred is reduced considerably to wean them off more gently.

Fingers crossed here

Thanks angela i just dont know how long to stay on the aza and when to start to reduce it.can you start to reduce the pred even when you have not been on the aza for ten days yet?

I can't really help with Aza as I have no experience with it but I believe that once it kicks in the pred can be reduced quite quickly & the Aza is reduced later.
I hope Jo has her computer going again soon.

Hugs

Good angela that you also dont know..i thought i had overlooked something in the files..thanks for always being so quick in answering and encouraging me..

The situation with stella is the following after our last visit to the vet:
Liver function test:
Total bilurubin 0.83
Direct bilirubin 0.20
Indirect bilirubin 0.63
SGOT (AST) 380
SGPT (ALT) 205
Alk phosphatase 1159 !!!
¥ GT 114
Total protein 6.3
Albumin 3.6
Globulin 2.7
A/G ratio1.3

CK-total (CPK) 200

Kidney function test
Serum urea 40
Serum creatinine 0.44

Haematology
Red cell count 3.3
haemoglobin 9.8
Hb. %  61.3
Haematocrit (PCV) 29
MCV 87.9
MCH 29.7
MCHC 33.8
Reticulocytic count 2

So we have extremely high liver enzymes, her vet prescribed her another liver supporting drug named ursofalk and fat free diet.
Her blood results are slightly lower that could maybe be related to the lab that is different from the blood tests taken at the vet clinic, in egypt you can rely on results and compare them only when you have the tests made at the same lab, so i am not too worried about the light decrease in blood values.
My vet wants to keep her on the same dose of pred that is 18.75 mg twice daily for another week, then do a test and decide about the reduction of dose. Her liver enzymes should improve with the tapering, but still i dont know when we can taper the preds and when the aza? she has been on 50 mg of aza daily for 9 days now, shall we continue with it and reduce the pred by 25%?
The ¥GT value indicates a bilary duct infection, due to the vet ,she has been on Ceporex antibiotic for 6 days now.
Stella eats well, drinks excessively, she does not move much, gets exhausted quickly, she has her head down most of the time, she reacts very well to any stranger or people she doesnt like barking heavily and is very inventive and communicative when she wants to tell me something, so she is in comparatively good mood and fighting but she cannot overcome her weakness of course.Stools are good, gums rosy, not pale, her fur is shiny and looks healthy, her legs are weak, but she copes with it and listens when i tell her not to rush and take it slowly....i am waiting for some advise on the pred reduction...with all my hope that this will improve her condition...hugs to everybody

Hi Elisabeth,

I do feel that the pred at very least does need to be reduced immediately & this may be enough to get things going in the right direction again.  As I said earlier, I don't know much about Aza or how to tweak it effectively so I am hoping Jo is at hand.

Hugs

Hi Elisabeth,

Again I'm no expert but if it is the ALP that is worrying you a lot, that liver enzyme can be directly related to the pred. ALP is an enzyme that has different forms called isoenzymes. It can come from bone, liver, muscle and a few other organs, but most importantly it can also be caused by high levels of endogenous or exogenous cortisol. As the pred dosage tapers the ALP should drop with it. GGT is an enzyme associated with the bile ducts of the liver so that, like your vet says, can indicate a cholangitis. I'm glad she's on liver supporting meds, they can only help her. Stella will fight her way through this and get well again. Hugs to you both.

Jo is doing her best to get back online, and said to tell you reducing the pred may well help.

Pls look at my post on JOs COMPUTER IS OUT OF WORK.. I have to add the stella is also on antibiotics for another week , three kinds og food supplements to support her liver, glucosamine for her joint problems, another drug for her liver plus regular vitamin d injections.. Plus aza plus preds...its a handful of tablets..sometimes i think she is just getting too much of it and i better throw away everything and let her heal all by herself, but this is wishful thinking of course..and i try to be patient and give her all the time it takes, i hope i am doing the right thing..

Have copied and pasted your post Elisabeth.  I will phone Jo today and read it to her.

h, thats why no answer from jo to my posts...i started to become desperate..i needed some reassurance from her about the aza..how long shall we give it to stella  until we can start to reduce the preds. I did it on my own today reducing the preds to 12.5 mg twice daily after  14 days at a dose of 18.75 mg 2 x daily and 11 days of aza at a dose of 50mg once daily.. My vet is very understanding but he is inexperienced with the combination treatment aza/preds and wanted to stay on the 18.75 mg dose for anoth week , but stella is very week due to her liver problems, she has difficulty walking and has ulcers on her inner gums that increase in size..so being sure that this all is pred related i take the risk and reduce the preds, with her hematocrit around 30 i think that is not a completely wrong decision and now i keep all fingers crossed that her anemia doesnt get worse again. I am away for a few days to europe leaving her in the good care of my mother, i hope she will not miss me too much and get depressed.. Do you think that we can reduce the preds again after a fortnight or so and hen stay on a lower dose for a longer period?

Thank you penel!

Quote from: Penel CIMDA moderator on October 18, 2012, 11:48:06 AM
Have copied and pasted your post Elisabeth.  I will phone Jo today and read it to her.

h, thats why no answer from jo to my posts...i started to become desperate..i needed some reassurance from her about the aza..how long shall we give it to stella  until we can start to reduce the preds. I did it on my own today reducing the preds to 12.5 mg twice daily after  14 days at a dose of 18.75 mg 2 x daily and 11 days of aza at a dose of 50mg once daily.. My vet is very understanding but he is inexperienced with the combination treatment aza/preds and wanted to stay on the 18.75 mg dose for anoth week , but stella is very week due to her liver problems, she has difficulty walking and has ulcers on her inner gums that increase in size..so being sure that this all is pred related i take the risk and reduce the preds, with her hematocrit around 30 i think that is not a completely wrong decision and now i keep all fingers crossed that her anemia doesnt get worse again. I am away for a few days to europe leaving her in the good care of my mother, i hope she will not miss me too much and get depressed.. Do you think that we can reduce the preds again after a fortnight or so and hen stay on a lower dose for a longer period?

First of all I must apologise for not being online.  As Penel kindly posted, my computer was not working but we have managed to link it up to another monitor so for now I am back on the forum. Thank you to all those who keeps this forum going - I'm not sure I'm needed here anyway, as the advice from members has been so good.

Hi Elisabeth

I'm sorry you have been worried and unfortunately I've not been here for you, but to be honest what you have done is exactly how I would have managed the situation.  It does sound like Stella's main problem is the side affect of the preds and now she has been on Aza for 9 days you can reduce the preds and 12.5mg twice a day seems just about right.  I hope now that the preds are reduced her PCV will increase and you should see a gradual drop in her liver enzymes.  I would plan to reduce the preds again in two weeks.  If the side affects do not improve but her PCV is stable you could reduce again after 10 days, but the situation has to be assessed at that time. Certainly if her reticulocytes are high then her bone marrow is working well so I am hoping that you will soon see an improvement in her anaemia.

Usually you work the preds and Aza alongside each other.  The object is to lower the preds and keep the Aza dose the same until you get the preds down to a low dose eg., 5-10mg a day or even wait until the pred dose is EOD.  Then you can start to lower the Aza, and the most logical option is to reduce the Aza to 25mg a day (it comes in 25 & 50mg tablets and they should not be broken).  If you only have 50mg tablets then you start the reduction by giving 50mg Aza EOD and at the next reduction, every third day etc.....

That's probably enough info' for now.  I'm sorry I've not been able to help but thanks again to all those who have given support and advice.

Jo

Thank you jo, thats exactly the reassurance i waited for, it is when to start reducing the aza..so i have something to get to my vet with and he will accept this . Penel, Shannon, Angela have all given good advice and i knew i had to reduce but did not know how to handle the aza and Everyone said...we hope jo will be around soon ! So you are needed along with everyone! Welcome back! Sorry for one more question: do you give aza and preds together or should you leave an interval between them and when you come to eod 5 mg preds do you then continue with the low maintenance dose of preds and stop the aza altogether?
So that was actually two questions!! Hugs Elisabeth

Thank you Elisabeth. Yes you can give both tablets together.  You do know not to handle the Aza, don't you?  you can tip it into food or use gloves when handling it.

The answer to your second question is not necessarily. And nearer the time we can discuss how to reduce the two drugs.

Have a good time in Europe.

Thanks for the hugs.

Jo

So good to have you back again, Jo!

I am in prague and i have bad news from home: stella is very weak and apathic, lethargic, refuses to eat and take her medication, she drinks a little, but does not eat at all. She slept in the gaden at night refusing to get into the house most probably because she felt too weak to move. Het hind legs collapse constantly, she did her toilet inside the house today after she was carried inside. Since she did not take her medication the vet told us to give her dexa injection, the long acting cortison that lasts for a few days since she does not take her preds. Neither my husband nor my mother wereable to get her to take her meds...her stools are very dark. They will try to get her to the vet today...i think i dont need advice any more but only only your good thoughts,,...i have done everything i possibly could..my mother told me on the phone it looksbad..and i cannot be back home before wednesday...if it has to be...maybe then it isbetter for her,,she willbeatpeace..she has gone through too much in her short life..it just hurts that i cannot be with her right now but maybe this had to be..i hope she still fights until i get back home...

Stella is gone.......
I ve just got the news....
I thank you all my friends for helping me with her..you ve taught me so much ...she was the best dog i ve ever had..although she was given to me only for a short time....
Oi am Grateful for the good and bad times we had togeth...

I dont want to ask myself whether it was wrong to have gizven h the aza..she started to collapse exactly ten days after the beginning of the treatment, but if i had not given it to her then i might have regretted as well..so,...i need some time to recover and ...life goes on...THank you and god bless you.. Without stella i would not have known you..wonderful compassionate peope...thank you....

Oh Elisabeth,

I am so very sorry to hear of Stella's passing,my heart breaks for you. She could not have had a more loving mum and no one could have cared for her better or done more for her, she was as blessed to have been your dog as you were to have her in your life. I'm sure your heart is broken but she will be with you always. Big hugs winging their way to you from Coop and I.

Oh Elisabeth, I'm so so sorry to read this, Stella was part of the CIMDA family and we will miss her so much  :'(   I am so sorry for you being away from her when she passed away.
You have been a fabulous Mum to Stella and have devoted yourself to her care, you couldn't have done more for her.
Sending you all our love and thinking of you at this sad time.

Oh Elisabeth, I too am so upset to here this very sad news.  Stella touched all of us and she will be remembered with such affection. I felt I knew her personally.  You are right to be grateful for the short time you had with her but I know the pain is deep and it will take a while to heal before you can smile again.  Stella was such a lucky girl to have you.  She could have had no one better.

Please know Elisabeth that you are in our thoughts. 
Sending you love.

Jo
x

Hi Elizabeth,

Just read of your sad loss. I can only imagine how you must feel, but from reading above I know you truly cared for Stella.

Take care

Steve

Oh Elisabeth,
I'm devastated, it breaks my heart to read you have lost your brave, courageous Stella.  What I do know is they never truly leave us, she will always have a place in your heart & in mine.  RIP dear one.

"Those we love don't go away,
They walk beside us every day,
Unseen, unheard, but always near,
Still loved, still missed and very dear."
Anon

Dear shannon, penel, steve, jo, angela...
I am sitting in my hotel room trying to cope with what happened...i knew it would happen, i was at a loss and saw no hope for her recovery few days ago when stella really showed weakness and i feel now that at that point she felt with me  and gave up fighting..the morning i left i gave her her gastroprotectant early so my husband could give her her other meds later and she took it without objection.when i said goodbye to her at the door i just hugged her telling her " be a good girl". Now i remember that i always used to tell her "come, be a good girl, sit down and wait for me" that was my routine words and that heard she would stay laying at the door until i came back. This time my husband tells me she left the door and hid somewhere in the house and when it came to take her meds she refused to open her mouth and by no means would take her medication. She slept in the garden that night and xwhen they carried her inside the house she hid in a place that she had never used before. She passed away in her sleep, my mother was beside her, when she Felt her breathing had become very calm and stopped at some point. Stella was asleep in her typical elegant way, very proud, ...she was a beauty ...physically and mentally..
I do have to tell you this because i feel there is a supernatural connection between us and our furbabies , they feel the way we do.. The minutes she passed away i felt very sad and worried about her and it was as if she was sending me a message.. " i am leaving now.."  i felt it although l was thousands of miles away........

If her story is kept in the files then maybe it can help others..so after her short life stella leaves a legacy.
...It was a life worth living... THANK YOU.....i love you all..

Oh Elisabeth, thank you for writing again and letting us know more about Stella and her last days. I know what you mean about a spiritual bond between us and our dogs - especially, it seems, the poorly ones that we become so close to.  The relationship becomes so very close that there seems to be an unspoken understanding between us that doesn't need to be explained.  It just is.  When the physical bond is broken the spiritual or heart bond remains and will stay forever.  Eventually the pain of loss subsides, but thankfully the feelings of that unique relationship survives and helps us to remember how lucky we were to have those precious memories that belong to only us.

I put the pain in a 'compartment' and that allows me to enjoy, for most of the time, the pleasurable memories that I don't want to forget.  I wish that for you Elisabeth.

Love, and a long, gentle hug to you.

Jo


 

i am back home, jo, and the house is empty...although stella seems to be everywhere...i am not able yet to put the pain in a compartment...everyrhing came so quickly...when i feel a bit better i want to post some thoughts about her treatment so i can come to terms with what happened. I do need a bit more time though...
i big gentle hug to you too, jo,i dont want to miss your compassion..
love e lisabeth

Of course you need much more time Elisabeth.  We all understand and feel for you.  It is a lot for you to deal with at this time.

Know that we are here.

Jo
x

Oh Elisabeth I have  only just got back on line & just read  abt your dear girl.I am so sorry. You did so much for her, such a precious  life & when the intense pain of her loss  eases you will remember her  with so much joy. These special ones who creep into our hearts.YOU take care.

sincerely Sylvia

thank you sylvia.you helped me so much with stella when she  was very sick with suspected babesia at the beginning of her long ordeal...she was a very special fur baby..i miss her terribly...

i'm sure you do, they leave such a gaping hole in our lives don't they.  :'( thinking of you Elisabeth.

Coop and I send hugs to you, Elizabeth.

I'm so sorry Elisabeth. You and Stella tried very hard to stay together. And like some others have said, as well as yourself, it is a bond which can't be broken. We are always connected to the lives of those we love.

Take care dear one.
Thinking of you. And remembering how brave you and Stella, The Stellar One, are.
gail and Lola.
******************
I'm sorry I didn't see your post until today. My computer was not letting me get into my account so I had been using my husbands account w/o the CIMDA link, for some time.

Thank you all for thinking about me and stella..thank you gail..you have been a constant source of inspiration for me over the past months..i remembervthat i once posted to you telling you to let lola decide for herself and she would tell you...now, stella has let me know quite some time ago ..at the beginning of her secound course of preds when she had her relapse..i saw her weakness but i choose to ignore it but tried to do everything possible with our limited means of diagnostic s here in egypt..i now remember that following jos advise , i contacted jean dodds   At the very beginning of her sickness and with the clinical signs and stellas story in full she gave me little hope then, referring me to statistics that give such dogs only a 20percent chance of survival within one year of diagnosis.i choose to fight and we did! We lived the best months i have had with a dog and i am sure stella too had the best of time of her short handicapped life! But the disease was stronger!
When i first met with ber new vet about two months ago, he explained her xrays to me, showing me that she had the backbone of an old dog and that her hip dysplasia was extreme  with a bilateral hipreplacement the only cure, of course out of question for stella!
He told my daughter in a very cautious and compassionate way that he would follow her progress closely for two months and then reassess the situation and that maybe he might have to suggest a solution that would be painful to us but a relieve for her..my daughter did not tell me that only after stella had passed away, it would not have been an option or even a thought of it! Butbthere was also the thought that stella might not have had babesia in the first place but an autoimmune condition from early on and been misdiagnosed since babesia is extremely rare and that the ai disease together with her hip and back bone condition was congenital and the result of bad breeding.this we knew from early on but got confirmed professionally by this vet.
Stella would have been the perfect case study for a dog psychologist, the case of a dog that is extremely impaired physically and extremely bright, lively and intelligent intellectually. It was heart breaking to see her cope with her impairments, especially her weakness when she wanted to do things every healthy dog does, let alone an extremely intelligent and intellectually demanding dog, and could not because her legs or her breathing or just being unwell overall would not allow her to do so. I think that s why we talked a lot to each other! I would explain to her like to a human being that she could not run or jump and she should take it easy and she would listen, walking a few steps and then look at me as if to ask: see i am ok, is it alright if i walk like that? We would do a lot of things that did not involve physical
stress and until her last days she would challenge me with new behaviour or tricks that she invented for herself to keep herself occupied. Besides that she would never be moody or grumpy , but extremely proud and elegant in her movement and in her ways with our other dogs, she was always the number one althoughnshe was the youngest!
I had the best time of my life with her i had ever had with any dog and she taught my husband, who had never been too fond of dogs (egyptians in general dont love dogs much) how much affection a dog can give. Stella was extremely protective and responsible, knowing very well the place she wanted to defend..that was within her character, she had never been taught that. She was very attached to HER people and would not let any stranger to her get close to us.at the weakest of times she would bark terribly , get her backhair up and ready to jump , although physically she could not. She would wait for my husband to get home every evening refusing to get to my daughters room, that was the place where she would sleep, unless he opened the door, let her out into the garden, waited for her to get in again and then would without objection get into her room with her nose on the open balcony for her nights sleep.
You, my friends, have helped me in giving her the best possible quality of life that she could possibly get under her circumstances, i am immensely grateful to all of you for all your good thoughts , hugs and good vibes over the continents...please keep in touch, i dont want to miss your company...it soothes my pain to get on the cimda page site as often as i can .  Elisabeth

I would like to post some of stellas last pictures , i have them on my iphone. Could anybody tell me how i get them on the cimda page or on this thread specifically? I am not good at these technicalities....

Elisabeth...Your description of Stella was so much like my Lola! They must be kindred souls. Lola is also a very highly intelligent dog. She knows the limitations she is living with to some degree. But she keeps herself busy in her dwindling world. No longer able to even walk through the yard off leash, she still will sit and stay while I do something I need to do in the yard. She really can't do anything by herself. I hand feed her and hold her head whild she drinks because she has intention tremors when she concentrates. But she can still move herself from room to room when she has to. I know that I am more tired and stressed from having to help her with everything. But she is still wanting to go on, so who am I to say when it's time to go?  This is the most strange of experiences I have had in my entire life. Only other dog people would give it any notice though. Others think I must have lost my mind. We don't even have people who Lola isn't comfortable with come into our house anymore. Lola's condition makes her very sensitive to them. She wants to be social and she doesn't know how now, so she just barks and barks. Being a pit bull, she then scares them into thinking she would bite them. She wouldn't. She only want's love but knows not how to express herself.

Thank you so much for telling us all about Stella. Surely you will never forget her, nor will she forget you.
gail.

Dear Elisabeth,  Thank you for your post telling us about Stella and your very special relationship with her. I know how hard it is to write like that.  I love the way this forum brings like minded people together. It is some comfort knowing that we can share the inner-most, personal emotions about our dogs.  I'm glad you are staying.

Jo

Hi Gail

Lola has got you where she wants you.   It is so lovely to read about how she copes, or should I say how you cope with her disabilities.  I know her problems are severe but I can't help smiling when I read about the relationship you two have. 

Long may she call the shots and you keep your sanity.

Jo

Jo,
Yes, she rules the roost, still!  We used to describe her as a dog and a half. She has graduated, she is approximatly three dogs now. So now I have four dogs although in visual reality I have only two.
g.

hi angela, i just remembered the little poem you sent me..i miss your good vibes from oz over the net..i am doing a   bit beter..hugs over the oceans
.elisabeth

hi gail.how is lola today.since i do not have to take care of a sick dog anymore i feel kind of not challenged enough..so let me share with lola..i wish you and her a good day...eli sabeth

It is 8 AM here and Lola is still in bed. Sometimes it's just hard for her to get up and get going.  She has been pretty good the last few days. Congestion has moved from terrible in her sinus, to her throat again. It cycles like that. She still has sinus congestion but the mucus gets to be much less and then she coughs a lot more and hacks up stuff. I can't figure it out. But the cycling of this is becoming more frequent. She may have 2 weeks of lots of mucus and then about a week of lots of coughing. Then the mucus gets worse again and the coughing goes away.

I tried contacting the University vet school where I took her a few times but since she hasn't been there for a while they won't talk to me unless I bring her back. It's too much for her now. Ataxia makes it hard to really do anything anyway.

I know when Lola is no longer with me I will be just like you, sort of lost without her.
Thanks for your help!
gail

Hi Gail

That update is not too bad for Lola given that you know  the best you can hope for is a management of her problems.  I understand why you don't take her back to the University. The effort can be too much for them.

Jo

Jo,
Yes. She is happy and she is eating, and still active. Once I gave up thinking it was a decision I needed to make for her, life is better here. She is what she is. She is so darn cute yet too, which helps  ;) I know there is no fix, so we don't go to the vet looking for one anymore. Still I wish I knew why the congestion cycles from her nose to her throat. Today she hacked up a huge gob of gunk and it hit the wall. We find it in strange places, often on our pantlegs, from sneezing and coughing, since we have her on leash so much, even in the house.
g.

Hi gail, give lola a big hug from me...have a good day...elisabeth

Dear cimda friends, missing stella and tried to put sadness in a compartment as jo said....
My daughter found me a new german shepherd puppy from a known austrian breeder, it was coincidental that i travelled to austria at the time when she was exactly 8 weeks and could be separated from her mother and siblings. She is a sweet little lady, healthy, full of energy and i brought her to egypt two days ago. Stella helped me understand dogs better and i will bring cecil (thats her name) up in stellas spirit and i will see her always as what stella could have been if she had had the chance to live a healthy life. Stella will not be replaced, she is in our hearts and she has taught us everything about dogs. Now life will go on with little cecil...hopefully she will not fall sick but still i will keep you updated on her news on the general doggy chat page...where anything goes, isnt it. Pls keep in touch, i do not only miss stella i miss all of you cimda people. Hugs to everybody and good vibes to all our hairy friends...elisabeth and cecil

Oh Elisabeth, that is such lovely news and Cecil will bring you much joy and this will help you to remember all the fond memories of Stella.

Please keep us informed of her progress.  She's a lucky girl.

Love and best wishes

Jo

Elisabeth I am so pleased to read that you have  taken a new friend into your life.
NOTHING can ever replace our lost furry friends but i do believe they guide us and there is always another furry friend awaiting out there, the RIGHT dog comes along at the RIGHT time. This certainly proved so for me  after i lost my Tessa(lymphoma) in 2009 , although we were far more fortunate than many in so much that  we had  good long years together.Each dog teaches us so much.
My thoughts are with you at this special time.
Sylvia & the Affis UK.

Thank you for your good wishes,...i do have to say that i was hesitating getting a puppy aand considering seriously getting a rescue dog..unfortunately this is not possible in egypt, since there are no rescues here and i went as far as spain but it wOuld not have been possible to ship the dog to egypt. So i decided to start all over again with little cecil.. I would have loved to help  a dog, even a sick one, with the experience i have now.
Greetings from elisabeth and cecil

Hi all of you, I keep reading your posts ! Jo and Penel..Angela , sending you good vibes to Oz, havent heard from you in a long time, ...Gail, how is lola doing, hope she is coping well ..shannon, how is cooper.no news is always good news..sylvia...and eveybody out there...cecil is doing fine brightening our days at 11 weeks of age...going to have her second shot of vaccination..again with the turmoil here in Egypt, the trip to the vet will be difficult and i have to find a time loop hole when there are no demonstrations and traffic jams, shei is not too fond of travelling in a car yet but getting used to it. I am getting back tonthe files on vacination and will discuss the necessity to vaccinate every year with the vet after the basic shots.
Hugs to everybody
Elisabeth with Cecil and her late soulmate Stella

Thank you Elisabeth.  Yes I would like to know how the others are getting on.  I have been aware of the unrest in Egypt.  It is reported on our news programes.  Thinking of you and hoping it will all settle down very soon.  It must be very worrying for you all. 

It is lovely to have reports of how your little Cecil is getting on.  It will be a good job when all her vaccinations are over and you can enjoy going out with her more - political situation permitting.

Jo

Hi Elisabeth, thanks for thinking of us. sorry I've been so quiet, Have been having a bit of a rough time as my clinic rotations have started. 

Coop is doing well thanks, had a couple of little hiccups but I wonder if they're not related to the heat. I'm so glad you have your little Cecil, I'm sure she brings you much joy and laughter.

Been thinking of you with the rumblings in Egypt. Please keep safe. Coop sends wags to Cecil :)

Hello Elisabeth, and congratulations on your new baby Cecil! The world is a strange place. So different here where we put so many dogs to sleep because there are not enough people to adopt them from shelters. So sad. You will have a long happy life with your new puppy!

On Christmas day Lola took a bad turn for the worse. She would not get up. I had to carry her out of her bed. She didn't want to do anything and kept to her bed all day. Walking was almost impossible as her ataxia was suddenly much worse, affecting her right foreleg the most. She was not interested in her ball or in drinking water.I watched her closely and came to terms with taking her to the vet the next day. But the next day she decided she was better. She played three rounds of ball again and although her right foreleg is still more affected, she seems to be coping and compensating quite well again.

My husband has been in the hospital since Dec. 5th with spinal cord injury from a tumor, which wasn't discovered until a week later. So I am just now catching up on CIMDA. He can't walk. So things here are pretty hard right now. We don't know yet how much mobility he will get back. I'm glad I didn't have to say good-bye to Lola just yet. It would really be almost too much right now.

Praying for peace in Egypt and the rest of the world.
gail

a happy new year to evryone at cimda!
good to hear from you again shannon..hugs to cooper..and a healthy year to him and a lot of fun with the horses and apples for breakfast..cecil gives us a lot of joy and reminds me of stella inmany ways..it is obvious that stella had a health issue fromthe very beginning and she was nevwr able to run about as much as cecil does.she is a bundle of energy..always up to something but already obeying very well ..she is also very protective already staying at doorsteps to check who would be allowed in..
dear gail, my thoughts are with you at this tough time wishing you andyour dear ones all the strength it takes..lola wants tobto be there for you, too, to help you cope in her special way and she feels that you need her. give hera big hug fromme and a tender bite in her ear from little cecil, i really love this dog of yours fromall her long history and your incredible devotion to her...you are as always a great inspiration..love
elisabeth

Hi Elisabeth

It is lovely to read that your little Cecil has already established her position in your household.  She sounds very confident and happy.  she's a lucky girl.

Happy New Year to you all.

Jo

hi jo.just wanted to send you some greetings after i had not been able to access the cimda site for some time
most probably it is the egyptian internet to blame.
things are going wel, cecil is growing by the day helping us cope with  the loss of stella who is still greatly missed. she has made at least one egyptian vet look deeper into  immune diseases and that will hopefully raise awareness and better diagnosis in the future.
elisabeth

hi gail.havent heard from you in some time.how is lola.i hope things arr going smoothly .thinking of you..elisabeth
i also want to send some greetings to angela in oz and shannon.havent heard from you in a while.i hope everything is good with you
love elisabeth

Hi Elisabeth,

Cecil sounds like an absolute joy and although she will never replace precious Stella, she will fill your heart and soul with memories of her own. Coop and I are plodding on, my routine has changed a lot now that I am on clinic rotations so I cherish the time I have with him and his mischievous antics very much.

Towards the end of last year I was working terribly long hours so my mum came to stay so the hairy monsters wouldn't be alone and he cooked up some new tricks. He worked out if my mum couldn't touch the house keys in the morning she couldn't let me out the gate, so every morning he could be found guarding the keys and I'd have to take them away from him so she could push the button on the remote! She's very tolerant of his rude ways, luckily, and loves him just as much as I do. He's a naughty, little monster but I do just love him soooooo much. He sends both you and Cecil many naughty wags :)

Hi Elisabeth...how is the new puppy doing? They sure have a way of keeping a person on their toes. As well as the entertainment factor :)

It is hard to look beyond the day we are in right now. Lola is OK. Her problems continue. I considered letting her go, since life has changed so much here and I am fairly exhausted from all of it. But I resisted and I'm so glad I did. I can still care for her while I care for my now dis-abled husband. He is still in rehab. Scheduled to come home yesterday, but he fell, so now scheduled for next Tuesday.

Life was (I now realize) pretty easy, in the past.

Thanks for thinking of us.
gail and Lola (The Lovely One)

I have to get back to Stellas site and posts from time to time so as not to want to let go of this..I use it to send greetings and good vibes to everyone at CIMDA, hope everyone is doing pretty well. Things in Egypt are not too good we ve actually lost hope for a democratic development of the country any time soon, too many young people fighting for their and all our freedom are being killed or arrested and tortured every day and the world does not even look on because they are not informed enough...
Elisabeth

Cecil is doing very well becoming very naughty at age  4 and a half months , most probably becoming a teenager and forgetting what she has already learned.. She is a bundle of energy, eager to learn new  things at any  time and I wonder if I can keep up pace with her when she will be a fully grown GSD, so I do my best to teach her discipline and she understands, but decides to test me out and challenge me from time to time, she is wonderful! She is filling our lives with joy and sends happy naughty wags to everyone at CIMDA!

It is so lovely to hear from you Elisabeth and the antics of young Cecil.  Thank you for the encouragement you give to others.  Every time there is news of the unrest in Eygpt I think of you and worry for you all.  It is a very difficult situation, so please do keep in touch and let us know how you and Cecil are doing.

Love

Jo
x

Yes Jo, I will..CIMDA has really become part of my daily routine, if it just wasn' t for internet connection problems that appear every now and then.
Hugs Elisabeth

Cecil sounds like she is keeping you well occupied. I love that age. They are learning so much, are so awkward, yet beginning to show what the adult dog will be like.
Thanks for keeping us updated on her. Puppies are so much fun and so much work ;)

xoxoooxoooo
gail

Unfortunately I ve had some episode with Cecil..Three days in  a row I found her regurgitating her dry food..a quick trip tothe vet and an xray with contrast revealed she has a mild form of megaoesophagus..the vet says it could easily disappear, it occurs often in very young dogs and prescribed Zantac and something to increase movement of the oesophagus ( i will get the name).i changed the dry food and she is very well again, eating normally, no regurgitation. Of course again I did my reading getting over frightening things again related to autoimmune diseases..has anybody of you heard that this could really get away completely? Elisabeth

Hi Elisabeth.

I trust your vet is using megaoesophagus as a term rather than a diagnosis. Cecil may just have gastric reflux rather than MegaO. Meanwhile you might be better to soak her kibble to make it soft and if you think she is having difficulty in swallowing it then you can feed her with her front paws on a step to straighten her oesophagus.  I wonder if the other drug is omeprazole?

I'm so pleased you have seen improvement already.

Jo

Hi Elisabeth,

Hopefully, as Jo said, your vet has used the term MegaO incorrectly but here is some information anyway.  I know how CIMDA members love a light read  ;)  I do hope Cecil is doing well now

http://petprojectblog.com/archives/dogs/megaesophagus-and-the-bailey-chair/

Hugs from Oz

Sending my thoughts your way that Cecil is only having a growing up bleep in her development.
Hugs to you both.
gail.

The other medicament is  motinorm..domperidone.
Cecil is now eating well with her kibble soaked and I introduced home cooked food to her diet.she loves it and eats very well.she  is also very lively again and her own self.bit still tthevet said it was a very mild form of megaoesophagus that g could grow out  as he said when getting older.
Thanks for the as always good read Angela
Elisabeth and cecil

Sorry you're having a blip with Cecil. I really hope she grows out of it. Glad that she has improved on the soft food though. Coop sends wags to her :)

I'm so pleased you can see improvement Elisabeth.

Jo

A short update on Cecil..everything is back to normal again..she eats very well and is lively and energetic as ever..but I do keep an eye on her behaviour after meals..owners of MegaO dogs have said that the oesophagos can deteriorate and it seems to be rare that they outgrow it..so I still hope it was a wrong diagnosis and misnaming although the x ray shows a little pouch.
We enjoy our life together and not worry anymore...too much worries in the past.
Best wishes to everyone at CIMDA
Elisabeth

That's brilliant Elisabeth, and just the attitude to have too.  Enjoy your little Cecil.

Jo

I have a general question: When a dog is very restless after meals, with his head down, sniffing around incessantly , and some sticky  , a little foamy saliva in his mouth, what could this indicate? Could it be hyperacidity? He is eating well and it is not that he wants to do his business.
Elisabeth

Is this happening now Elisabeth or has it been happening over several days? If it is now it could be bloat and you need to rule this out IMMEDIATELY if it is.

Sorry to scare you, but a few of the symptoms could be pointing to it.

I don't know Elisabeth.  Has the dog vomited? Are the stools normal?  Does the dog looked bloated or is he in pain?

Jo

This has been going on with Cecil for several days now. She eats well and a lot, is very lively, runs a lot and seems very normal to me  except for this restlessness after meals. Thanks for the quick reply.
Elisabeth

She has not vomited and stools are normal.

If she were mine Elisabeth I would feed her moist food (not dried) even if it is your own and try to keep it low fat.  Also try giving her smaller meals and more often.

Can you get some ranitidine?  The dose is 2mg/kg/3 times a day.  It won't do her any harm and it might just settle her down.  It is a very good drug and it has a wide safety margin.

I hope she improves very soon.

Jo

Thank you Jo, I will do that, maybe the reason is that I changed her puppy kibble Purina Proplan salmon to Kibble for high energy large breed puppies that may have more fats and being soaked with water maybe develops more gases and she might as well have had too large meals being constantly hungry.
She sends you a big wag .
Elisabeth

Hi Elisabeth

You could always put her back on her puppy kibble.  Maybe she isn't ready for the big girl stuff yet.

Jo

We are doing fine, having a vet appointment tomorrow for a routine checkup to see if the vet's suspicion of mega O can definitely be outruled, cecil eats well, runs a lot...everything is well.
I am getting her used to my mother who will be in charge of her as well as my daughter  as I will have to undergo hip replacementsurgery beginning of May..I hope that wont mean a setback in her development and she will have to cope a bit without me.
Greetings to everyone at CIMDA and I will try to check in as much as possible.
Elisabeth

Hi Elisabeth

Good luck at the vet's today. 

I'm sorry to hear you are going to have an operation.  Please keep in touch and inform us of your progress.

Wishing you a speedy recovery, and you know where we are if your mother or daughter needs help with Cecil.

Love and best wishes

Jo

Thank you so much, Jo!
Cecil is fine, vet is happy with her, hervoesophagus   shows only  a weekness in the wall at the beginnimg and one in the end, but with the wet puppy kibble in small doses she is doing very well  and has never  regurgitated since that one episode.  And it is also hoped that this will not deteriorate. She is 28 Kilos already and a bundle of energy and joy and sharing her due place now beside Stella in all our hearts.
Hugs
Elisabeth

Quote from: shawkyelisabeth on April 11, 2013, 07:02:38 PM
Thank you so much, Jo!
Cecil is fine, vet is happy with her, hervoesophagus   shows only  a weekness in the wall at the beginnimg and one in the end, but with the wet puppy kibble in small doses she is doing very well  and has never  regurgitated since that one episode.  And it is also hoped that this will not deteriorate. She is 28 Kilos already and a bundle of energy and joy and sharing her due place now beside Stella in all our hearts.
Hugs
Elisabeth

28kg already!!!!

I do hope this will all settle down - if it hasn't done so already.  She sounds such a lovely girl.

Jo

Back home from surgery.everything went well and now I just have to pass the post op period of six  weeks not yet fully functioning.. Cecil is with my daughter and very well, she is having her first heat right now and growing to be a young lady, I am so much looking forward to be running again with herin the garden and taking her to the beach....heat is already setting in in Egypt so we try to keep her cool ....many regards to everybody at CIMDA
Elisabeth

That's great news Elisabeth , now all you have to to is be a good patient and get well again. At least you won't be tempted to chase after Cecil.  She will be a changed, grown-up girl by the time you get her back.

Take care and get well soon.

Jo
x

Hi Elisabeth,

Hope you're all healed up really soon. Cecil will be so glad to be back home with you I'm sure! Coop sends licks and wags to the both of you :)

Big hug to Coopi..I am getting better every day and Cecil, with a lot of respect of my walker ,does not leave my side whenever I can sit beside her..
All the best to you
Elisabeth

Unfortunately Cecil is goving us some head ache these last few days. I had to have my kitchen sprayed against rodents and had her and the pack locked in our big crate in the garden (that has  plenty of space for the four of them) overnight until cleanup to make sure none of them would be harmed. She ate the dry kibble of her companions leaving her soaked kibble.As always she gulped it down with plenty of water afterwards and I was too late to prevent her from doing so. In the evening she vomited a little bit of saliva but was very lively and normal. The next morning she vomited all her food , first grass thatbshe had eaten in the garden and then the kibble. She drooled excessively and licked her mouth in an unusual way with the tongue in and out very quickly. I send her to the vet and she vomited saliva twice on the way.
Her vet did an xray with barium contrast medium and it revealed that her mild oesophagus issue, though still diagnosed as mild, had adcvanced a bit, now showing three weak spots in the oesophageal wall, after initially showing only one at the first incidence.
Her vet prescribed her Nexium and Motilium, he excluded poisoning  and said she had hyperacidity.
She didvery well the next day, lively, eating her own moist kibble plus frozen joghurt in Kong, stools ok.
When she started to vomit saliva again mynvet advised to put her on fluids for two days. So yesterday she got Joghurt with apple sauce which she loves, she was lively . At midday she started to vomit saliva , then ran in the garden, eating a lot of grass that the vomited again afterwards. When there was nothing left in her stomach any more she vomited green bile with a lot of liquid..the water that she drinks excessively.
She ate a good portion of mashed potatoes in the evening with good appetite, she seems to be very hungry.
My vet phoned me in the evening to see owshe was doing and advised to give her a Zantac injection to help stop the vomiting  which I did, and suggested we bring her to the clinic today for IV infusion. I suppose he is worried about possible dehydration.
She is still sleeping now and I will get up to check on her hopefully finding that she has not vomited the potatoes from yesterday.
Since my vet is off today and one of his colleagues will see her at the clinic I willwait until the afternoon to  see how she is doing and then decide if we will go to the clinic to get her IV infusion? I will mostbprobably send her, even if she is better, I think an infusion cannot be harmful and only help her overall condion.
her vet will only be there tomorrow.
Please give me your opinion, I am as always too much worried, that comes with having gone through too much mAybe.
Thank you and hugs to everyone
Elisabeth

Hi Elisabeth,
I would be worried just like you. Having gone through what you did with one dog makes one very vigilent with another. A bit like post traumatic stress, I think. It's how I am with Bizzy. Afraid of a rabies vax even though she has never shown any sort of immune disorder.

I would take the side of caution and have her looked at, if she were my dog. I have a hard time getting over all the lessons Lola taught me.
g.

Oh Elisabeth, it is such a worry for you, on top you your own issues.

Does your vet think Cecil's problem is regurgitation/reflux due to her megaO or does he think she has some form of gastrointestinal disease? Is she having problems taking in food and water, or is the stomach simply rejecting it?  I presume they have considered a blockage. Are her stools soft? How about doing a full biochem blood test?  Sorry for all the questions.  The drugs she is on seem appropriate and hopefully this will all settle down as it did before. It might be just one thing she ate that has set off this reaction. I do hope so.  Keeping her rehydrated is a good thing.

Let us know how she is later.

Jo

Sorry Jo of not getting back to you quicker,  but I had a very stressful time these last two days.
After finding Celia again having vomited all her food in the morning I sentnher to the vets where she was given an IV infusion. They said she had a severe irritation of the stomach most probably due to something she had eaten or maybe to have ingested some of the chemicals (i would exclude that since the other dogs showed no sign of it and she was away from it all the time, but one never knows)
Coming home from the vets she was better and in the evening gulped down all her wet kibble plus rice with chicken. No regurgitation or vomiting!! Thanks God!!
This episode was  not related to her mild MegaO.
The stomach was simply rejecting any kind of food or water, no problem with the intake.
Her stools were soft but no diarhea.
She is good now, has lost some weight, but the vets said she should not gain too much weight quickly, since she has a predisposition to Dysplasia and she should not climb stairs.
There is nothing difficult about thatto deal with, but I ask myself, is it the breed that is so prone to all kinds of diseases and issues? Are there no healthy GSDs out there? She is a puppy from a well known reliable Austrian breeder or is it that there is just no way to get a 100 percent healthy dog.
I have a 14 year old beagle, MR. Justin, who has never had a single health issue all his life , running aboutbfreely in the garden, watching over my sheep and cattle, eating cheap Egyptian dry kibble all his life and althoughngetting a bit slower these days has never given us a moment of concern.
The same with his 9 year old daughter that I kept from a litter of six and our 11 year old mix Swiss shepherd and beagle. They are all the least cared for and the healthiest!
Thanks Jo  and Gail for sharing these issues  although they are not AI related.
Hugs Elisabeth

I'm sorry you have had a couple of stressful days Elisabeth.  I hope things have calmed down now.  Unfortunately, GSD's do have a number of health issues but I hope they would have the HD problem in hand.  I know there are no guarantees even if the parents are hip scored but, the breeders should do their best and only breed from low scoring parents.  GSD are prone to digestive problems too but I am hoping Cecil will grow out of the previous problems she had and as you say this last episode isnt connected.  It could be that a dog like Cecil would be more senstitive to any potential trigger for gastrointestinal problems and, whereas something won't affect your others, it may affect her.  On a personal note I have had gastric problem in the past and there is a homoeopathic remedy that I found very good and that is nux vom.  I don't know if homoeopathic remedies are available in Eygpt but it might be worth looking into.  Also, I always keep activated charcoal in stock just in case something nasty is eaten.  It can push the toxins through the body (liver) much quicker and hopefully minimise the damage.

Aren't you lucky to have Mr Justin and his daughter?  What a pleasure!

Jo

Thank you Jo, Cecil is back to her normal food, but with the heat getting quite high these days eating less. can you give ice cubes to a dog? She does love her deep frozen Kong with Joghurt.
She sends you wags under the watchful eyes of Mr Justin who has taught her manners ( although he is only half her size) and whom she respects a lot and has learned to treat tenderly feeling that he is not able to run about and play with her  as much as she would like to. Its a joy to watch how much dogs can give to each other not only to their humans.
Elisabeth

Lola loved ice cubes. I gave her the kind which are softened up by floating them in water for a while. One day I gave too many and she shivered for a while. So they do cool the dog down. Wtih Cecil's sensitive tummy you would not want to give too many until you found out how she was with them. I think right from the freezer they are too hard and could cause tooth damage. Does Cecil like to swim? maybe a baby pool in your garden would help her cool down.
gail

Running out of Cecil s Purina Pro Plan salmon and rice kibble I brought from Austria I now have to look for what is available in Egypt. I wanted to switch to Taste of the Wild but unfortunately it seems not to be imported any more. So I can get Royal Canin Rice and chicken specially for GSDs . can anybody advise me if this is good? I remember to have once heard it could cause allergies?
I used to feed her raw meat once a week, but switching to raw completely does not seem easy.Any ideas?!
Thank you.
Elisabeth

I am careful with ice cubes and let them melt like you did Gail.
cecil will get swimming lessons by a friend in the pool, she loves to splash in the water, but does not getit how to swim and I am still not fit enough yet to teach her..but we have a lot of fun!