CIMDA

Hi,
My Dobbie mutt is currently on Leflunomide (Arava) for 10 days and will be on it for 6 weeks. Prior he was on Prednisolone and had VERY adverse effects (extreme muscle wasting; no eating; severe drinking; liver enzymes up -- all within 7 days on 30/20/10megs.

Does anyone have any experience with it? It's a new drug regimen here in the US and there's only one RCT on it.  Simon seems to do fine; except the Lefl. does not seem to work so well with his raw diet--add to that the damaged liver still....

I also would LOVE to know what y'all are doing for supplements and diet. I am completely LOST now that his raw diet does not work Simon anymore--too much fat and protein.

Susanne

Hi Everyone,
I'm so glad I found the site! IMPA has been knocking me (and my 7-year-old Dobbie mutt, Simon) to my knees. It seems to just present ever so differently...I guess that's the nature of auto-immune diseases.

In Simon's case, the IMPA ball got rolling with a pneumonia. He became more and more lethargic until Sept. 28, 2014, when I finally took him to ER because he was just so weak. He has spondylosis (since 2; it's asymptomatic, really) and so I thought, he is just in pain..for some reason. Well, turns out, it was pneumonia.

Three days later, in the morning, I wake up and his frontleg is sticking out straight and he is just whincing in pain! I freaked. Took him in right away. Rads showed mild mineralization and the vet suggested, it might be osteosarcoma, I was crushed! That cancer is badnewsbears!

Well, I did not take that and called the Vet Center here at the University of Minnesota. They are top-of-the-line and Simon had an orthopedic surgeon there, who checked him out, and just pointed to his joints. I cannot believe I missed it: they were ballons--the synovial fluid was all over and joint tabs confirmed IMPA.

Prednisolone was our treatment..you all have been through it. But here's what happened to Simon. He was on 30 megs of Pred for 4 days only and that night at 4am, he woke up shaking, heart racing, panting, super nauseous (lip licking). We were back in ER at 4:30am. Finally, 4pm, 12 hours later...ultrasounds, aspirates, blood/urincultures, rads--later. The shock: Simon's reaction to Pred was just vile, and every one at the was just shocked at the tremendous muscle wasting. He went from 74 to 66! Yes; the fluid subsided. BUT Simon completely stopped eating and drank like a sailor (easily a GALLON a day! Filtered water, folks). He';s normally on a raw diet--which ended. No salmon, steak, or goat cheese in the world could coax him to eat.

We tapered him off Pred (added Omaprezole) and integrated Leflunomide (which was the plan all along). Leflunomide works differently than Pred.; it "harnesses" the white blood cells, so to speak. It's not a steroid, and thus does not have the liver side effects. Simon's been on it now for 10 days and the plan is to leave him on it for 6 weeks

But Leflunomide can cause GI issues, stomach upset, and nausea. Indeed, as I resumed his raw diet two days ago, Simon became nauseous. My hunch is that the raw diet (I resumed solid vegs and ground bone-in-duck to get his calories up), I did not realize that it's WAY TOO HIGH in fat and protein. Plus his ALT and ALK phos levels are still high from the Pred. suggesting liver damage, still. So, his liver cannot handle super high fat and protein. So last night, he pooped mucus and clear blood--ulcers.

We will see the surgeon again tomorrow and an alternative vet then.

So long story short...the challenge I find with IMPA for Simon is a mixture of handling his nutrition while sustaining his internal and hoping the Leflunomide works.

I'd love to know from others here who also had their companion on Leflunomide..what are y'alls experiences? Plus what kind of diet/supplements are y'all adding (beyond Thistle, Turmeric, and Vit C/B/E)? Just today I added Slippery Elm to his diet...I feel so darn helpless!

Susanne