Hi, Finn was diagnosed with MUO in Nov and has been on chem and preds since. He has responded well and is now on 5mg preds every other day and chemo for 2 days every 3 weeks. He still has a ravenous hunger which I hope will diminish as the preds reduce. In Apr he has his final chemo and the vet wants to do another spinal tap and blood tests before tapering his preds. I would prefer not to have the spinal tap and bloods but just to taper and be vigilant for a relapse. Just feel if the tap says he's not better ( which he appears to be) I still don't want him having any more chemo. Any opinions would be appreciated. The vet has been so good I am worried about telling him.
Hi
I am sorry Finn has MUO, and it is great that he has responded so well. this is really positive news.
As with all autoimmune/immune-mediated diseases it isn't until the drugs are considerably reduced or withdrawn that anyone knows if a relapse will occur. If a dog is not in true remission he may relapse when the drugs are at a low dose or within a month or so after the drugs have been withdrawn. If this happens then the drugs have to be reintroduced or the dose has to be raised, usually up to an immunosuppressive dose. If the dog doesn't relapse and time goes on and the dog is still well then he has reached remission.
To develop an AI disease a dog is born with a genetic predisposition to autoimmunity. This potential cannot be detected until something within the environment such as drugs, vaccines, preventative treatments (wormers/flea spot -ons etc) stress or hormones, triggers the immune system to wrongly attack a part of the dog's own body. So long term remission - hopefully for life - is all that can be hoped for and all the owner can do is to limit, as best as possible, the trigger factors.
When Finn finishes his treatment, it is hoped that he will be in remission - and his clinical signs and blood results will indicate this. Personally, I agree with you. You know Finn's diagnosis, and you are aware of the clinical signs. If Finn is well then I see no reason for you to consider a spinal tap, and if a spinal tap is performed whilst the dog is on preds it may not be a true analysis, because an elevated white cell count may not be seen in an immunosuppressed animal/person.
If you have a concern, because Finn is exhibiting certain clinical signs, then you can have a blood test done and nothing else is obvious (it could be something unrelated to AI) and the clinical signs are as before then you can assume a relapse and start treatment all over again.
Checking blood results every now and then might be comforting, but to put his body though the stress, and the potential trigger, of a General Anaesthetic for a spinal tap might not be a good idea, especially if he is well in himself. This is a good link:
https://www.fitzpatrickreferrals.co.uk/neurology/meningoencephalitis-of-unknown-aetiology-mua/
Jo
P.S. If you are worried about telling your vet of your decision not to have a spinal tap, just say you can't afford it. It works every time!
Thank you Jo for giving up your time to give such a helpful and comprehensive response. I touched on it with the vet today but he said because Finns case was originally so severe he thinks a spinal tap is requiered. He then explained that even if he was clear Finn would still need to be weaned off
chemo so instead of twice every 3 weeks , it might be every 6 then every 8 - I was hoping that following the tap ( if we had it) and 4 months of treatment he would just be weaned off the preds and the chemo would stop. He said it was normal to wean off - I don't think they do with humans? Just a little worried I'm being taken for a ride 🤔 His original report states -CSF RBC was 70 /ul, WBC 980/ul , total protein 148.1mg/ul
74% neutrophils,19% monocytes and 7% lymphocytes.which is marked neutrophilic predominant pleocytsis.
Hi
My worry would be if Finn achieved remission the procedure and drugs used to perform a spinal tap might just be enough to trigger another episode. I have not known another dog with MUO or SRMA etc to have a further spinal tap at that stage of treatment.
It is typical, and necessary, to wean off prednisolone because it inhibits adrenal production, but the other drugs can usually be stopped as and when. It might be that your vet thinks that weaning down will be less of a shock to the system, and often taking it slowly at the later end of the treatment can be beneficial because it maintains internal stability and homoeostasis.
If Finn is not exhibiting clinical signs of MUO then remission can be assumed - it is only ever assumed anyway. You know the typical clinical signs of a relapse and if these occur then you just start treatment all over again. This is the typical approach to a dog that has an AI disease.
Ultimately the decision is yours, and I suggest you wait until that time comes and assess the situation then. I would however, be very reluctant to do anything to Finn if he is well in himself. It might be best to leave well enough alone.
Good luck
Jo
Thank you 😀 nice to be able to consult with someone as knowledgeable as you but independent of vets. I will now wait until the time comes and then I will assess the situation again as you suggest. The threads are really interesting to read - it is such a horrible disease with such a long and worrying treatment duration- reassuring to share experiences.
Hi
Yes it is a horrible disease and MUO is variable and less predictable both in treatment and recovery, and this makes the choice of drugs and the protocol less defined.
Trust your instincts though.
Jo
My cocker spaniel has Focial GME and been in remission since May 18 and off alll his med since December 18, I ask my specialist if he should have a MRI to see if the changes have made they said no it's a waste off money which I was great for the simple answer, in your case it's a big thing and costs and everything should be considered especially if they are heading in the right direction and getting on top of MUO
I have read all the Keepers posts they have been most useful thank you
Hi all,
Thank you for your support. Yesterday Finn had bloods done ( no spinal tap ) and all was clear- I am delighted. He is on 5mg pred every third day and we are now starting the chemotherapy wean down.
He was going every three weeks for two days treatment since November - the vet now wants two lots of 4 weeks for two days treatment, two lots of 5 weeks, then 6 and 7 . I think I will try to negotiate one two day treatment at 4 weeks, one at 5 ect . There doesn't seem to be many dogs on here going through such intensive chemo for MUO. Having said that, he doesn't mind going and has very little side effects- maybe tired for a morning. It is all very expensive though and Id rather not pay for something that isn't essential- I know we will need to watch him closely. He is absolutely fine in himself at the moment. :D
Thank you so much for Finn's update. MUO is less common than other AI diseases, so your input is very valuable to others.
I am so pleased Finn is doing well, and without having invasive testing too! What a lovely character he is to not mind about having chemo treatment.
It is very expensive, but I suppose if it is working then it is difficult to know what is essential treatment and what is not. It is a tough time for you both financially and emotionally. Finn is a lucky lad to have you.
Looking forward to the next instalment!
Jo
Finn continues to make excellent progress. Chemo now every 6 weeks so heading in right direction. Still on 5 mg of predisolone every 3 days. Would like to reduce this carefully. Could we go to every 4 days for 3 weeks then 5 days ect ?
Would also appreciate your opinion on neuturing him whilst on predisolone and chemotherapy. Vet didn't seem dead against it but said it would be better not to because treatment may affect recovery even though the operation is not too invasive. He get so 'excited' at certain times around dogs and people and although really well behaved can sometimes not control his instincts. I would hope that neuturing might make him more settled- i know this may not be the case. Any advice appreciated.
I am not sure what to advise about the medication reduction, but I am all for reducing slowly if the dog is coping well with the medication.
Personally I would hold off on having Finn neutered until he is off medication and seems stable.
Hi
This is such good news about Finn.
5mg of pred every three days is a very low dose and it is now likely not to be having any great effect so you can stop it, but also you may feel better if you give 5mg of pred every four days for a week or so and then 5 days for another week before stopping it altogether. There is no hard and fast rules when the dose get very low and given every 3+ days.
Personally, I would avoid surgery whilst he is on chemo, and probably for 6 months after chemo has stopped. Chemo is a tough drug regimen and it can affect so many parts of the body. Depending on what drugs are used Chemo can cause low platelets and any surgery should be avoided because of the possibility of bleeding. Higher doses of preds can inhibit the healing process too.
Often, if a dog is on prednisolone for any period of time, or chemo drugs, the dog will become impotent anyway, so you may agree to castration when in fact the drugs have done the job for you.
Also, if Finn's MUO is immune mediated then surgery may trigger off another episode. So there is a lot to think about and I wouldn't rush into decisions at this stage of his treatment.
All the best
Jo
Thank you for such a positive reply. It is great to get second opinions and you
always Instill me with confidence moving forwards. My leg will resign itself to an
8pm daily humping - a small price to pay given what he's been through !
Really appreciate this site and the support given. I will keep you all updated with any changes -
hopefully good .
Hi KazMav,
My dog also has MUO, first initial diagnosis from our vet in March was mild stroke, put on steroids, doing great until tapered to 1mg then relapsed. That's when we had his MRI done end of May and got diagnosis, unfortunately by this time his was advanced. He started cytarabine and so far had 4 sessions every 3 weeks, next cytarabine will be every 4wks. He will then do every 6 weeks and hopefully reduce or stop. (No insurance, cost is killing us) He has been tapered from 10mg to now 5mg. On his last review 5th Aug they decided not to taper his pred, instead adding ciclosporin as they said his neurological symptoms had slightly decreased. He is very nervous when he attends and refuses to stand for full examination. I'm not convinced there was any decrease and just that he was extremely nervous but what do I know! It's a long process and slowly you see signs of their character coming back. Gigi has now started showing interest in his teddy and sleeping in his bed ;) There is a blood test you can have to check for any inflammation still present, I think it's called CRP? It's a reactive protein test. Hope our dog's continue to improve.
Lorraine
Hi
That made me laugh. while Finn still has the energy to cuddle your leg then he must be feeling good.
One of my boys had systemic SLE and he was on steroids for life. His testicles shrunk as a result of the immunosuppressive treatment, but he was still a happy boy.
The CRP test is an important marker of inflammation, but isn't reliable if a dog is on prednsiolone therapy as it can reduce the CPR marker, and therefore give false low results. It is a marker for many chronic inflammatory diseases and therefore not specific to a particular disease.
Finn has done remarkably well.
Jo
Hi all,
Just an update on Finn and a question. Finn is now med free and doing well. I would like to titre test him. He had his last chem the end of Sept 2019 and had his puppy jabs in Mar 2018. I am wondering if anyone knows whether the chem will have affected him immunity to the extent that it isn't worth titre testing. My gut feeling is to try and then if he fails the vet said she would write a note to explain that he does not have injections for medical reasons. Many thanks for the support over what seems a lot longer than a year . Fingers crossed we can start to relax a little soon and if I can get him into doggy day care I could go back to working a little.
Hi
It is so good to know that Finn is doing well.
Anyone who may have a similar problem with their dog and MUO, needs to know that MUO might be difficult to treat but it is not impossible. This is such good news for anyone whose dog has a diagnosis of MUO. The treatment, and following a good regimen is very important though - and of course vigilant owners!!!! Thank you for the update.
The subject of vaccinations and dogs who have an immune mediated disease - even if the disease is in remission - the consensus of opinion is, if your dog has had an immune mediated disease then they shouldn't be given any further vaccinations.
Some years ago I attended a seminar at the Royal Vet College to listen to Prof Brian Catchpole speak about the latest advice on immune mediated diseases. I was lucky enough to have the opportunity to ask him if a dog has had an immune mediated disease, should they ever be vaccinated again? He immediately said "NO".
Vaccinating a dog once it is known to have a genetic predisposition to immune mediated/autoimmune disease is putting the dog at risk of triggering a relapse or another immune mediated disease.
Once a dog has been vaccinated, it is likely if the dog was over 16 weeks of age, or as an adult, the dog will have protective antibodies to the 'core' diseases that we vaccinate against - eg., distemper, parvo virus, and hepatitis. Leptospirosis is not a considered to be a 'core' disease, and anyway there are only a few strains that are vaccinated against (and there are about 250 different strains), and because the vaccination is not a live, attenuated vaccine but a killed virus vaccine it needs a chemical adjuvant to open up the immune system, and this can be a greater trigger than the vaccine. Below is the link to the WSAVA website and it is a must read for all dog owners.
https://www.wsava.org/WSAVA/media/Documents/Guidelines/WSAVA-Vaccination-Guidelines-2015.pdf
The decision to vaccinate has to be based on circumstances and the medical history of the individual animal, and only the owner can make that decision. I agree with titre testing because it avoids the unnecessary overuse of vaccines, but if ultimately you do decide not to vaccinate Finn again, then I don't see the point in taking him to the vet and having blood taken.
About 20 years ago, I titre tested 4 of my dogs for a period of 4 consecutive years, and the results were remarkable, and surprised my vet too. The antibody titre, for example distemper, fluctuated from one year to the next and increased too. I was so pleased when the WSAVA stated that any antibody titre, to the core diseases, correlates to immunity. Titres will naturally be low if the dog has not encountered the 'disease' in the wild and titres will increase if they do. This is how vaccination works. Antibody titres to leptospirosis, because it is a killed virus vaccine, are usually undetectable.
I will copy an article I wrote some years ago about vaccination and the new guidelines and I hope this will wet your appetite to do more research. It might need updating but the basics is there.
I am so pleased Finn is well enough for you to be considering vaccination - now you have to decide if he has them.
Jo
Vaccination by Jo Tucker
Some of us (over a certain age) may be able to recall in the 1950's 60's and 70's, the distressing signs of a young dog or puppy with a disease called distemper, sometimes known as `hard pad'. I was about ten years old when I witnessed my friend's puppy `climbing the walls' (as I remember it) during a seizure caused by distemper. It clearly had a lasting effect on me especially as there was no hope for the poor puppy and it had to be `put to sleep'. In the late 1970's many kennels were blighted with a new `killer' disease called parvovirus and this proved to be devastating, especially to puppies. Both of these diseases are highly contagious and even today parvovirus could wipe out a whole litter and the virus remain active within the environment for a year or more. Modified live vaccines were developed in an attempt to control these and other infectious diseases, including infectious canine hepatitis (canine adenovirus), and the good news is the vaccines have been very successful. Distemper and infectious hepatitis are very rare in the UK these days, and parvovirus appears to be well under control in protected dogs. No one would want to see the return of those `dark days', nor should we overlook the amazing achievement of immunisation – but can you have too much of a good thing? Is annual vaccination a thing of the past and is it doing more harm than good? Clearly some members of the veterinary profession, anti -vaccination groups and the pet owning public think so and in 2006 the World Small Animal Veterinary Association (WSAVA ) Vaccination Guidelines Group (VGG), Chaired by Prof. Michael J Day of Bristol University and author of 'Clinical Immunology of the Dog and Cat', convened to reassess the annual "vaccinate against everything" protocol (practiced by vets for the best part of 50 years) and formulate a new and more appropriate global vaccination guideline for cats and dogs based on modern science and decades of experience provided by internationally recognised experts in immunology, microbiology and vaccinology.
So why question the vaccine protocol that has been used for decades and have successfully brought these nasty diseases under control; and in doing so have saved so many dog's lives? Vaccines were genuinely considered harmless, but over the last 20 years or so, advancement in veterinary knowledge and experience, and reports of adverse reactions, such as the link to sarcomas developing at the vaccine injection site in cats; and a vaccine-linked trigger for immune mediated diseases in dogs, gave rise to question vaccine safety in companion animals. This train of thought was further fuelled by all the adverse publicity surrounding the safety of the MMR vaccine in children. Adverse reactions were, and still are, uncommon, but they do exist and vaccination guideline groups began to wonder if something could be done to reduce the small risk of adverse reaction without compromising the beneficial effect of vaccination. The safety of vaccines was not the only reason for reassessing vaccine protocols. It was the growing awareness that the duration of immunity for some vaccines was far longer than first thought and therefore likely that annual vaccination could be unnecessary.
The first WSAVA guidelines were produced in 2007 and updated in 2010. The guidelines are not compulsory but their recommendations could "assist the vet in practice to use vaccines more efficiently" (M.J.Day), and can be obtained from the WSAVA website. In addition to the Vaccination Guidelines for vets there is an excellent, comprehensive step by step document written specifically for pet owners and breeders and this is a `must' for any pet owner. These guidelines take the reader through eleven sections giving sound, factual and scientific information, covering the major infectious diseases that we vaccinate against, through to how to report adverse reactions. There is even a glossary of terms. This document is essential reading - and it's free! You just need to print it or read it on screen.
The chapter on immune response explains about the immune system and how the body responds to infections etc. It also describes how the mother's immunity (maternally derived antibodies- MDA) is passed to the pups via the placenta and mother's milk (colostrum), and how the presence of these antibodies can negate the effect of vaccinations if they are given too early in the pup's life. The maternal antibodies, present in the pup's blood, will 'fight' and consequently cancel out the vaccine. So if your puppy has been vaccinated too early, unknown to you, it may not be protected.
It also explains how the MDA levels in individual pups can differ, and why some pups in the litter may, depending on how much or how little maternal antibodies are present, respond to a vaccination at the age of 8 weeks and why others will not respond until 12 weeks or more. The waning of mother's immunity will vary from pup to pup but it is unlikely there will be any significant antibodies present after the age of 14-16 weeks.
The document explains the principle of vaccination, and how infectious disease can be brought under control, but in order for this to be possible `herd immunity' is essential, meaning that the greater number of the population has to be immunised (>65%) for full effect. BUT THIS DOES NOT MEAN THAT AN INDIVIDUAL DOG OR CAT HAS TO BE VACCINATED EVERY YEAR!
"We should aim to vaccinate every animal with core vaccines, and to vaccinate each individual less frequently by only giving non-core vaccines that are necessary for that animal" WSAVA, Vaccination Guidelines Group.
The VGG recognises that vaccination requirements may differ greatly between developed and undeveloped countries. The global vaccination guidelines, devised by the VGG, have been welcomed by countries as a basis to further develop their existing national vaccination guidelines, and adopted by some countries where guidelines did not previously exist.
Different types of vaccines, and the duration of immunity (DOI) are discussed. The two major types of vaccines are defined as infectious (core) and non-infectious (non-core). Infectious vaccines are also known as modified live vaccines (MLV) or live attenuated vaccines, and to be effective these have to infect the animal in order to cause an immune response which consequently produces protective antibodies.
Core vaccines: `Contains antigens of infectious agents every dog and cat should be protected against as those infectious agents cause lethal disease.'
The VGG's recommended core vaccination programme for dogs in the UK is canine parvovirus (CPV-2), canine distemper (CDV) and canine adenovirus (CAV), more commonly known as infectious hepatitis. Fortunately, modern science has taken the guesswork out of knowing if your dog is protected against these diseases as the level of immunity can now be established by a simple blood test which measures antibodies to the core diseases that we vaccinate against. Antibody titre testing has shown that the duration of immunity provided by modified live vaccines is far greater than we are lead to believe by many vets in general practice and also the vaccine manufacturers. Certainly the duration of protection provided by modified live vaccines is considerably longer than the non-infectious vaccine. It is known that immunity provided by MLV's can last many years; in fact, it has been proven that only one dose of a MLV given after the maternal antibodies have left (greater than 16 weeks or as an adult) can provide a lifetime of immunity for a dog. However, if the vaccination programme is started at 16 weeks of age it is recommended that two doses are given, two weeks apart, as some pups may not respond to one dose. The manufacturer's guidelines recommending MLV revaccination, or boosters, after 3 years is attributed to the duration of the product's license and not the duration of proven immunity.
Non-core vaccines: `Are to protect against infectious agents that not every dog or cat risks being exposed to. Their use should be carefully considered and they should only be given to animals with a defined exposure risk.'
Non-infectious vaccines are referred to as `inactive'. These are used to vaccinate against diseases such as leptospirosis, bordetella, parainfluenza etc. The duration of immunity created by inactive vaccines is known to be much shorter than the immunity produced by a live vaccine. Unlike MLV's, non-infectious vaccines cannot infect the animal, so in order to be successful a substance called an adjuvant is added to enhance its effect. This allows the vaccine a clear passage to the immune system. Inactive vaccines, especially if they contain an adjuvant or whole killed bacteria, are more likely to cause adverse reactions.
The need to give non–core vaccinations should be assessed by the owner and vet based on lifestyle and the possibility of exposure to the non-core diseases. For example, it may be prudent give a dog a leptospirosis vaccination if it regularly plays in water where rats may live, whereas a dog with a different lifestyle that's unlikely to come in contact with rat infested water is at far less risk of contracting leptospirosis. The owner and vet should adopt a `risk-benefit analysis' for each individual animal and not just blindly vaccinate because `it is that time of the year again'! The VGG recommend that vets should aim to reduce the `vaccine load' on individual animals. The manufacturer's guidelines are for non-core vaccines to be given annually but it is known, for example, that immunity for leptospirosis may not last for twelve months, and can be a little as three, so you may think your dogs have immunity when for most of the time they haven't! So do your dogs really need the non-core vaccinations? Perhaps if the risk of exposure is so great they may need this vaccination more often than once a year.
Unlike infectious vaccines, non-infectious vaccines do not have the ability to produce a strong antibody presence; therefore an antibody titre test for this type of vaccine is of no value. Core vaccines are often 99% effective as opposed to only 70% or less efficacy of non-core vaccines. A simple blood test can show the immunity your dog has to these core diseases and is a far better, scientific way of knowing if your dog is protected than simply giving yet another jab.
`The presence of serum antibody, regardless of titre, in an actively immunised dog over the age of 16 weeks is correlated with protection'.
Try not to be put-off by the cost of titre testing. Your dog may only need one testing to indicate life-long protection, and at least you will know if previous vaccination has been successful or not. Titre testing performed at Glasgow Veterinary School has always been very reasonably priced, and there is now a new product available in the UK, an in-house titre test called VacciCheck. This can be done quickly and simply at your vet's surgery.
Genetics play a part in how an animal responds to vaccination. Some dogs, due to their genetic make-up, will be a `non-responder' and no matter how many times they are vaccinated they will never be able to produce protective antibodies to the core diseases. Conversely, there are a percentage of dogs who respond to vaccination by producing a very high antibody titre. Most adverse reactions are genetically driven, and some breeds or families will be more likely to develop adverse reactions than others. The sire and dam of these affected dogs should not be mated together again.
It is proven that the duration of protection given by the core vaccines may last in excess of 9 years and possibly for the life of the dog and yet many vets in general practice still insist their `clients' should be vaccinated annually, even though this could be doing the animal more harm than good. A survey showed only 53% of UK vet practices had adopted the VGG recommended vaccine protocols for dogs.
A change is also needed in local bylaws that govern kennels and catteries as, unbelievably, they still insist on annual vaccination for boarders. Annual, or repeated, modified live vaccination does not necessarily increase protective immunity, as existing antibodies can fight against the vaccine, blocking it at the injection site and rendering it useless, therefore no benefit is gained. How many times do you hear if a dog has missed the revaccination date it has to have a full course of vaccinations again? Dogs that have not been regularly vaccinated but have previously received puppy shots and a yearly booster, only require a single dose of core vaccine and not a full course of vaccinations again. The VGG state that `this practice is unjustified and simply contrary to the fundamental principle of immunological memory'.
So why has the uptake of the WSAVA vaccination guidelines been so slow in general veterinary practice in the UK? I'll leave you to think about that.
This short article is intended to be an `appetiser'. It is impossible to condense such a comprehensive document into a few paragraphs. Please don't take my word for it – go into the WSAVA website and print off the information you need. It is so refreshing to have experts in the veterinary field writing a paper, specifically for pet owners and breeders, and one that doesn't try to `pull the wool over our eyes'. It has been written for good reason, in an attempt to transform the old fashioned, traditional vaccine protocol that has been in place for almost half a century, and this can only benefit our pets. Change can be made through the power of reliably informed dog owners and breeders. Yes, it is saying that vaccinating the individual is important (it must not be forgotten that vaccination was successful in eradicating smallpox virus from the world) but it is also suggesting that the decision whether to revaccinate or not lies with the owner and should be tailored to the individual dog. Annual vaccination is outdated and a thing of the past so don't let your vet convince you that you are being irresponsible by not continuing to annually vaccinate your dog – in fact you are being responsible! Your vet should be aware of these guidelines, and if he or she chooses to ignore the VGG recommendations and continue to encourage annual vaccination then it is the vet who is being irresponsible and perhaps contravening the veterinary surgeons code:
"...........to ensure the welfare of animals committed to my care and that I will pursue the work of my profession with integrity and accept my responsibilities................."
References:
World Small Animal Veterinary Association Vaccination Guidelines (WSAVA) for the Owners and Breeders of Dogs and Cats (2011) http://www.wsava.org/VGG1.htm
WSAVA Guidelines for the Vaccination of Dogs and Cats (Revised 2010)
Veterinary Record – BSAVA Congress: Different Perspectives on Vaccination Advice (April 2011) Report by Catherine Jacob
Veterinary Record – Research: Vaccination of Dogs and Cats: No Longer so Controversial? M.J.Day (May 2011)
Draft Code of Professional Conduct for Veterinary Surgeons (2011)
Antibody titre testing can be performed at University of Glasgow, School of Veterinary Medicine and other UK laboratories.
VacciCheck is now available in the UK from: Complete Veterinary Care –http://www.cvcgroup.co.uk/, telephone 01923 470 0101. The parent company's website is www.biogal.co.il/.
Thank you Jo.
I have always been sure not to vaccinate but just wondered if his years chemotherapy might interfere with his immunity. The reason I want to titre is because so many agencies require vaccination certificates or titre certificates- a few except 'no vaccinations on medical grounds' if declared by the vet. I would occasionally like to leave him in Doggy Day Care and it is required by them unfortunately.
I will probably give it a go and will let the group know the outcome.
Many thanksonce again.