CIMDA

It's been such a long time since I contributed to this forum and I hesitate in posting about my current 'problem' as though it's not necessarily an A.I. problem, it is relating to a dog that has been prone to Colitis episodes and I know this topic has been covered in the past (sometimes due to side effects?)
Briefly, Jazz is 13.  Has undergone two cruciate ops in the past 12 months and has been doing incredibly well but ever increasing effects of arthritis are causing a concern.    We used Metacam post op and then stopped it but a hiccup about two months ago meant we needed pain relief and he was put on a maintenance dose again.   He had remained on it, as both Vet and I felt some pain relief was needed - as he was getting a little stiff.  A few weeks ago, I noticed that his stools were getting a little darker and rightly or wrongly I decided to stop the Metacam - still giving half a Tramadol at bedtime.
A chat with the Vet last week, had led to us trying pardale V - giving lower than the prescribed dose (two a.m.  and two p.m.) whilst continuing with half a Tramadol at bedtime.   He has been fine on the Tramadol BTW>
He has been on the Pardale for 5 days now but the past two days it has been hard work getting him to eat his full amount of food.  He eats but leaves about a third and he is what I'd describe as a 'reluctant' eater - taking a long time.  He is currenty being fed his staple Royal Canin Sensitivity but I have been successful in mixing in a small amount of a new food I use called Greendog - which he loves.   Thought about changing him over completely to this but when we get to the 75% sub stage, it seems to trigger a tummy upset.   The same applies to Lily's tinned food (Fish) - he will pick this out of his food when I add it but again, he can't be fed this entirely for the same reason.
I am happy to provide completely home cooked but worry about nutrients.
Any advice on (a) Pain remedies for arthritic dogs  and (b) food would be gratefully received.
Also, has anyone heard of Galiprant being used on dogs?
He also has homeopathic tabet Arnica/Rhus etc.    He has two types of Joint Aid (Ymove/Synoquin and sometimes Joint Aid).
Many thanks

Hi
It has been a long time since I have commented on this Group but I have constantly maintained an interest in the messages.
Jo will know why this one interests me particularly and I would like to add a little from my own experience with Harley, who, sadly passed about 12 months ago, after a 6 year struggle with IMT, due to a malignancy on his liver.

Melatonin has been mentioned and whilst I appreciate that the RVC state nothing has been proven (and in a way they are right) I suppose you have to say that many of these drugs may work for one and not another......I have known steroids not to work as well for some !!!
In our case, we had tried steroids with Azathioprine, we tried Cyclosporin (after considerable resistance) but nothing seemed to work.
Whilst he was steroid-responsive and we would frequently stabilise his platelets - remissions were short-lived and we went through
several relapses.
Melatonin was suggested as, I suppose, a last-ditch attempt to regulate.  I'm afraid I was at the stage at the time, that I would try anything at all.   I learned that in the US Melatonin was often used at the start of IMT being diagnosed (with or without steroids) and the responses seemed positive.....so we tried.      We used 6mg dose and chose to buy Circadin, which was a more expensive way of buying them and I had to have a prescription for them.     The evidence has been anecdotal mostly and could well have been successful in part to additional and lengthened term on immuno-supp. drugs but in our case, we started on this dose of 6mg and it took a couple of weeks or so before we started to notice 'slight' increases in his platelets.    We were on, at the time, 30mg prednisolone and we continued to use the Preds, reducing them strictly in accordance with Prof. Day's protocol but we kept to the same dose of Melatonin throughout.   The platelets reached a really good level and maintained this count and we were able to eventually get the preds down to 5mg daily and then, taking things even more slowly, down to 1mg - eventually taking him off the preds completely and just using the Melatonin.   The platelets maintained at around 300 and did so for a few months but sadly, he relapsed - platelets went down to 20 and it was then we discovered the problem with his liver.
I don't know if the Liver problem was always there  or if, the years of being on steroids took their toll or that the Melatonin actually weren't able to work on their own but I am sure that the Melatonin did have a positive effect and had it not been for his Liver issue, I 'feel' that in Harley's case, the Melatonin may have been able to control his IMT.....we will never know.
I suppose what I am saying is.....read up about Melatonin.  It is a drug that has a hormonal effect and whilst normally used to aid sleep, has been found to increase platelet levels and there are plenty of articles written if you look, that confirm it's usage for IMT - though there are no guarantees...but isn't that the same with any drug?
Our recommendation came from a Vet at a referral centre and someone I had an awful lot of faith and confidence in.  We spoke about 'anecdotal evidence' but both still though it was worth trying.
Hope this helps a little in some way.
Gwyneth

HiMarie
Not sure what type of allergy test your Vet is suggesting but years ago, we had a Golden that was perpetually itching. He would scratch so badly, sores would occur.
We went the suggested route of food allergy testing, using selective single protein sources/elimination process that took a long time and didn't work at all. 
We saw a skin specialist who suggest allergy testing which entailed him being shaved (lower belly on one side) and they then tested him for various allergens.    The result was that he had a Dustmite Allergy and another mite that he would not likely come into contact with unless he was in a farm-type environment.
As a result a bespoke immunotherpay course was started.  It was expensive, made at that time overseas (Holland I think) and he had to have vaccines every week to start with, these were gradually spaced out over a period to fortnightly, then monthly etc....
It was expensive but it worked and eventually he was weaned off the immunotherapy.    It seemed to be seasonal, as it did return in a mild form once and we embarked on a short course again to clear.
I have to say that he did seem to 'grow out of it'  -  when he got to around 5, it just didn't come back !!
We did remove all the carpets in the house when he was diagnosed and replaced with solid wood flooring - so an expensive game all round.

Purely to offer a wee bit of reassurance on the symptoms side only if I can.

I have written a lengthy saga about my dog, just posted under IMTP relating to the frustrations of the meds (steroids).
They are a necessity but it doesn't stop me hating giving them.  I have had 4 relapses (a different A.I. to what you are dealing with) and each time we have been able to reduce the dose of the Preds etc., the muscle wastage, the thirst, skin irritations and yes, the changes in personality....have started to reverse and in fact, after the first remission, even his head shape started to come back, as the muscle wastage had affected those in his head and cheeks as well.

In fairness, I have to say that now,because unfortunately in Harley's case, we have been on steroids at varying doses now for so long, I am not sure what we can expect from recovery as far as muscle wastage goes but I remain optimistic.    So, in answer to that part of your worries, I would have to answer yes, you should get your dear friend back again and get that waggy tail and greeting.   You will undoubtedly see an improvement in water and food consumption as well, as the dose is reduced.   We noticed a vast improvement when we came down to around 25mg daily but this will vary from dog to dog I assume.   To help the hunger and avoid excessive weight gain, I have split Harley's meals now, to 4 meals a day and find this helps.     He actually lost weight  at the start and I needed to increase his rations, hence another reason I split meals to 4 a day, so as to avoid him having too much in one go.

I hope this helps some of your concerns.

Hi, yes we seem to have taken an eternity at times.

Harley was diagnosed when he was around two years of age, which is young as IMTP commonly occurs at middle age I'm told but certainly not commonly so young.   
When diagnosed, he wasn't presenting any of the more common symptoms and it was only thanks to an observant Vet that picked up on tiny tiny pin prick hemorrhages  in the inside of his ear flap and investigated further.  Platelets at that stage were 30.   Before even sending the bloods off to be analysed and rule out Tick disease Von WB  etc., she had started him on full I>S. dose of Preds and when we re-checked just a couple of days later his platelets had increased and then,  four days or so after that they had increased further.   It seemed, that first time, he had shot up to 600 score in a very short time and we then embarked on a reduction programme, which was decided on by the Vet.   There was no formula as such, his bloods were tested and if the platelets were good, we reduced.    Things seemed to be going o.k. until we reached around the 10mg daily dose, when the platelets started to drop again.   We would back track to the previous dose for a while and then resume the reduction - checking bloods every two/three weeks.  At around this time, the blood machine at the Vet wasn't consistent and so the results each time they dropped were sent off to the Lab.   When we reached around 12.5mg and they started to drop again, (about 152) it was suggested that I see a referral Vet and so I went to Cambridge.    Initially, it was thought that the Antepsin and Zitec (not Zantac) he was on to protect his tummy, could possibly be interfering with the absorption of Preds, even though I was ensuring the Antepsin was given two hours before the meds.    So, the first Vet we saw at Cambridge told us to stop the protection (first the Antepsin went and a week later the Zitec was stopped) and at the same time the Preds were reduced to 5mg !!!
I was really concerned, as here we were with a reducing platelet count and yet they reduced the Preds !!!   However, two weeks later we returned for a blood test and surprisingly his platelets had increased a little (I think it was around 170'ish).    We returned to have the bloods done at Cambridge two weeks later again but the platelets fell again and were back down to double figures.
The suggestion was made that we try Cyclosporin, something that had been suggested to me by my Vet but I was really against using this drug and we tried instead to go back to adding Azathioprine at 50mg daily, along with an increase to the I.S. dose of Preds again.
Harley suffered quite bad side effects...muscle wastage was significant particularly in his head shape where his occiput bone became very prominent.
We managed to get the platelets back to a more significant score but again, as soon as we dropped the dose, after a while his platelets would drop as well.  We were still being reactive rather than proactive though (great hind sight isn't it !).....
We were asked to consider Cyclosporin again and out of desperateness I agreed but despite being on this for 6/8 weeks, it did nothing for his platelets and though we also kept the Preds going, they were only given as 5mg daily with the cyclosporin.    His platelets hit an all-time low of 25 after being on this drug and so,  as it was doing nothing for him, we once again put Harley on to the I.S.dose of steroids.
A couple of weeks later, I got a phone call from my Vet at Cambridge to ask if I would consider using a drug that he hadn't tried before but was used widely in the States and he had been talking to his colleagues over there about it.   This was Melatonin and so, in March '14 we started  using it.
Though slow,  we did start to see the Platelets increase and they continued to do so.    Part of the reason for the slower increase was due to the fact that my Vet, because of the side-effects Harley was suffering, didn't want him to go back on to the full IS dose of 60mg daily - we gave 30mg daily alongside the Melatonin and of course, because Harley had suffered a gastric bleed initially (he wasn't prescribed any tummy meds when he was first diagnosed and he had a bleed a few weeks later), he was given just Rinitidine (at that time we were unable to get hold of any Antepsin).
Things seemed to be going well.   We had a slight worry with his bloods (RBC's) at one stage, as they dropped a little low and I was terrified that we may be looking at Evans, however it was confirmed that he hadn't and that it was drug-related.   His RBC's did improve but they have been a bit erratic since.

We followed the protocol of Prof Day rigidly, on my insistence this time round but when we got down to  7.5m daily, I insisted taking things even more slowly.   We went down .5mg when we reached 6.00mg Preds and kept to that all the way down, maintaining the Azathioprine, which had gone to an EOD dose at this stage.   
Eventually, months later....I think it took to September '16 (almost two years) taking things slowly, tweeking it when we thought it may be needing it, until we eventually came off the Preds all together and then the Aza's, which went from every day to every other day and then every third day before finishing those too.   We had actually stopped the melatonin as well at that stage, as he was doing so well.  His platelets were constantly around the 300+ mark.
Then, in December last year, we took him for his monthly blood test - just to make sure he was ok. over Xmas period ........his platelets were 25 !!!!
So, for the 4th attempt, we put him straight back on to the iS dose, + Azathioprine.
On the 19th January this year, 43 days later, we had a platelet score of 420.    A week later, it was 398 - insignificant maybe but now I am doing things differently.   Vet said to reduce, understandably, as the score was good and so we lowered by just 5mg to 20mg daily, even though he had only been on 25mg for a week.
Two weeks later, they had dropped to 290 and again, we were told to lower the Preds to 15mg (In fairness to the Vet,she was concerned about the side effects and the results from the blood tests ete etc).
Ten days later, we checked his bloods again and his platelets had dropped further to 192, so we stayed on 15mg an checked again a few days later, only to find he had dropped again to 159.
We then increased the Preds to 25mg daily but I then decided to put him back on to Melatonin and since then they have started to rise again.
They are currently at 434 and this time, I have ensured we stay on the doses for a full month and only, only if we stay the same on the count or increase, do we drop the preds and I want to go back to my previous rule of reducing very slowly.  We have this week reduced by 2.5mg after being on the previous dose for 4  weeks.  He is also now taking Omeprazole 20mg each day.
I know this isn't doing Harley any good, these high doses but by prematurely dropping the doses, we only cause more problems because we are constantly having to return to much higher doses.
I have also decided that if, this time round, we are lucky enough to get to 5mg daily with the Melatonin and the Aza's (EOD), then that is where we are going to stay.....  He is six years of age and his life has been one of vets visists, medications and generally losing all his youth to this horrid, horrid disease.   

I can give you a much longer version, giving all the platelet counts week by month but not sure this will be of use.   If you think it would help at all,  I am happy to format it for others to see.

One thing that I am always learning about and also getting so frustrated about is the way in which these drugs are no difference to the 'fine-tuning' of a car (a horrible analogy I know).     

Frustrated, because when you reduce the meds (even gradually it seems) and are doing well at a particular level - then, you drop the dose and you have a relapse.     These A.I. diseases are really THE most difficult things to get on top with - you just don't know all the time, what you are dealing with and as it is the most intricate parts of the dogs body that come into play - things that are not obvious, you are really using trial and error means.

Over the past few days I have been going through the reams of records I have kept since Harley was diagnosed six years ago - hoping that I could find a common factor.   Perhaps, I thought, it is a seasonal 'thing'  as I have to admit a few of the relapses have occured during the latter part of the year/very early spring  but not always.    Could it be the inter-action of drugs at various doses - it certainly seems that when we take Aza's away, we do see a change in his platelets and certainly, on a couple of occasions when relapses have occured, it has been when we have stopped the Aza's.
Perhaps he has an absolute minimum dose of Preds he needs to keep him stable -  records have shown that problems seem to occur when we reduce beyond 15mg but then, he was on 10mg EOD at one stage and seemed to be stable for a while.
After this last relapse, which followed a very brief period (6 weeks) when we were off  steroids and Aza's but kept the Melatonin going, we thought we had cracked it.....the Melatonin had worked and though expensive, had far less side-effects than the other drugs.      No, that wasn't to be and the relapse was very sudden -  from mid-300's to  25 !!!!

So, we are back again, very gradually reducing the Preds.    Even now though, we had a slight hic-cup when his platelets started to drop a bit and the Preds had to go back up.  I have chosen to re-introduce the Melatonin, as it seems (only guesswork at this stage) that the combination of Melatonin with the other drugs, help.    Every reduction we make now, makes me much more nervous than ever before and I am now almost thinking, that if we reach a stage when Harley seems to be better and the side-effects are at a minimum, then that is the dose we will remain on until blood tests tell us otherwise.

I wondered if there would be any merit, in inventing a questionnaire-type form, asking a few questions, that those of us who have dogs with Immune issues, can complete and maybe, just maybe, we may pick up one or two commonalities that could give us some food for thought?
A  simple questionnaire, asking about Age, Historical info on breeding lines, Food, Water, Environment, Exercise, Vaccinations, Wormers, Drugs etc.
I'd be happy to draw up a format but have no idea at all how I would transfer to this site !!!   I spoke to the AHT recently,  as I had heard they may be looking into A.I. disorders as a whole but unfortunately that isn't the case, they are looking at one particular disease (I think it may be SRM) but I suppose the cost of research has to come into play as well.

Just a thought

One thing that I am always learning about and also getting so frustrated about is the way in which these drugs are no difference to the 'fine-tuning' of a car (a horrible analogy I know).     

Frustrated, because when you reduce the meds (even gradually it seems) and are doing well at a particular level - then, you drop the dose and you have a relapse.     These A.I. diseases are really THE most difficult things to get on top with - you just don't know all the time, what you are dealing with and as it is the most intricate parts of the dogs body that come into play - things that are not obvious, you are really using trial and error means.

Over the past few days I have been going through the reams of records I have kept since Harley was diagnosed six years ago - hoping that I could find a common factor.   Perhaps, I thought, it is a seasonal 'thing'  as I have to admit a few of the relapses have occured during the latter part of the year/very early spring  but not always.    Could it be the inter-action of drugs at various doses - it certainly seems that when we take Aza's away, we do see a change in his platelets and certainly, on a couple of occasions when relapses have occured, it has been when we have stopped the Aza's.
Perhaps he has an absolute minimum dose of Preds he needs to keep him stable -  records have shown that problems seem to occur when we reduce beyond 15mg but then, he was on 10mg EOD at one stage and seemed to be stable for a while.
After this last relapse, which followed a very brief period (6 weeks) when we were off  steroids and Aza's but kept the Melatonin going, we thought we had cracked it.....the Melatonin had worked and though expensive, had far less side-effects than the other drugs.      No, that wasn't to be and the relapse was very sudden -  from mid-300's to  25 !!!!

So, we are back again, very gradually reducing the Preds.    Even now though, we had a slight hic-cup when his platelets started to drop a bit and the Preds had to go back up.  I have chosen to re-introduce the Melatonin, as it seems (only guesswork at this stage) that the combination of Melatonin with the other drugs, help.    Every reduction we make now, makes me much more nervous than ever before and I am now almost thinking, that if we reach a stage when Harley seems to be better and the side-effects are at a minimum, then that is the dose we will remain on until blood tests tell us otherwise.

I wondered if there would be any merit, in inventing a questionnaire-type form, asking a few questions, that those of us who have dogs with Immune issues, can complete and maybe, just maybe, we may pick up one or two commonalities that could give us some food for thought?
A  simple questionnaire, asking about Age, Historical info on breeding lines, Food, Water, Environment, Exercise, Vaccinations, Wormers, Drugs etc.
I'd be happy to draw up a format but have no idea at all how I would transfer to this site !!!   I spoke to the AHT recently,  as I had heard they may be looking into A.I. disorders as a whole but unfortunately that isn't the case, they are looking at one particular disease (I think it may be SRM) but I suppose the cost of research has to come into play as well.

Just a thought

Hi Catherine (and Jo of course....I will transfer to the appropriate pages as suggested)

I did note Catherine, your regime with the Aza's and I think that may well be one of the things I need to look at keeping Harley on long term.

The Vet didn't actually have anything against the Aza's and in fact, in September '16, prior to the latest relapse, we had completely stopped the Preds but were still hanging on to the Aza's, going lower dose and every day to EOD and every 3rd day etc, eventually stopping them too.
Looking back and pure guess work again, maybe if I had kept him on the Aza's and the Melatonin, that would have worked.   If we are fortunate t get through this one safely, that is something I will give though to definitely.

Gwyneth

Hi, yes we seem to have taken an eternity at times.

Harley was diagnosed when he was around two years of age, which is young as IMTP commonly occurs at middle age I'm told but certainly not commonly so young.   
When diagnosed, he wasn't presenting any of the more common symptoms and it was only thanks to an observant Vet that picked up on tiny tiny pin prick hemorrhages  in the inside of his ear flap and investigated further.  Platelets at that stage were 30.   Before even sending the bloods off to be analysed and rule out Tick disease Von WB  etc., she had started him on full I>S. dose of Preds and when we re-checked just a couple of days later his platelets had increased and then,  four days or so after that they had increased further.   It seemed, that first time, he had shot up to 600 score in a very short time and we then embarked on a reduction programme, which was decided on by the Vet.   There was no formula as such, his bloods were tested and if the platelets were good, we reduced.    Things seemed to be going o.k. until we reached around the 10mg daily dose, when the platelets started to drop again.   We would back track to the previous dose for a while and then resume the reduction - checking bloods every two/three weeks.  At around this time, the blood machine at the Vet wasn't consistent and so the results each time they dropped were sent off to the Lab.   When we reached around 12.5mg and they started to drop again, (about 152) it was suggested that I see a referral Vet and so I went to Cambridge.    Initially, it was thought that the Antepsin and Zitec (not Zantac) he was on to protect his tummy, could possibly be interfering with the absorption of Preds, even though I was ensuring the Antepsin was given two hours before the meds.    So, the first Vet we saw at Cambridge told us to stop the protection (first the Antepsin went and a week later the Zitec was stopped) and at the same time the Preds were reduced to 5mg !!!
I was really concerned, as here we were with a reducing platelet count and yet they reduced the Preds !!!   However, two weeks later we returned for a blood test and surprisingly his platelets had increased a little (I think it was around 170'ish).    We returned to have the bloods done at Cambridge two weeks later again but the platelets fell again and were back down to double figures.
The suggestion was made that we try Cyclosporin, something that had been suggested to me by my Vet but I was really against using this drug and we tried instead to go back to adding Azathioprine at 50mg daily, along with an increase to the I.S. dose of Preds again.
Harley suffered quite bad side effects...muscle wastage was significant particularly in his head shape where his occiput bone became very prominent.
We managed to get the platelets back to a more significant score but again, as soon as we dropped the dose, after a while his platelets would drop as well.  We were still being reactive rather than proactive though (great hind sight isn't it !).....
We were asked to consider Cyclosporin again and out of desperateness I agreed but despite being on this for 6/8 weeks, it did nothing for his platelets and though we also kept the Preds going, they were only given as 5mg daily with the cyclosporin.    His platelets hit an all-time low of 25 after being on this drug and so,  as it was doing nothing for him, we once again put Harley on to the I.S.dose of steroids.
A couple of weeks later, I got a phone call from my Vet at Cambridge to ask if I would consider using a drug that he hadn't tried before but was used widely in the States and he had been talking to his colleagues over there about it.   This was Melatonin and so, in March '14 we started  using it.
Though slow,  we did start to see the Platelets increase and they continued to do so.    Part of the reason for the slower increase was due to the fact that my Vet, because of the side-effects Harley was suffering, didn't want him to go back on to the full IS dose of 60mg daily - we gave 30mg daily alongside the Melatonin and of course, because Harley had suffered a gastric bleed initially (he wasn't prescribed any tummy meds when he was first diagnosed and he had a bleed a few weeks later), he was given just Rinitidine (at that time we were unable to get hold of any Antepsin).
Things seemed to be going well.   We had a slight worry with his bloods (RBC's) at one stage, as they dropped a little low and I was terrified that we may be looking at Evans, however it was confirmed that he hadn't and that it was drug-related.   His RBC's did improve but they have been a bit erratic since.

We followed the protocol of Prof Day rigidly, on my insistence this time round but when we got down to  7.5m daily, I insisted taking things even more slowly.   We went down .5mg when we reached 6.00mg Preds and kept to that all the way down, maintaining the Azathioprine, which had gone to an EOD dose at this stage.   
Eventually, months later....I think it took to September '16 (almost two years) taking things slowly, tweeking it when we thought it may be needing it, until we eventually came off the Preds all together and then the Aza's, which went from every day to every other day and then every third day before finishing those too.   We had actually stopped the melatonin as well at that stage, as he was doing so well.  His platelets were constantly around the 300+ mark.
Then, in December last year, we took him for his monthly blood test - just to make sure he was ok. over Xmas period ........his platelets were 25 !!!!
So, for the 4th attempt, we put him straight back on to the iS dose, + Azathioprine.
On the 19th January this year, 43 days later, we had a platelet score of 420.    A week later, it was 398 - insignificant maybe but now I am doing things differently.   Vet said to reduce, understandably, as the score was good and so we lowered by just 5mg to 20mg daily, even though he had only been on 25mg for a week.
Two weeks later, they had dropped to 290 and again, we were told to lower the Preds to 15mg (In fairness to the Vet,she was concerned about the side effects and the results from the blood tests ete etc).
Ten days later, we checked his bloods again and his platelets had dropped further to 192, so we stayed on 15mg an checked again a few days later, only to find he had dropped again to 159.
We then increased the Preds to 25mg daily but I then decided to put him back on to Melatonin and since then they have started to rise again.
They are currently at 434 and this time, I have ensured we stay on the doses for a full month and only, only if we stay the same on the count or increase, do we drop the preds and I want to go back to my previous rule of reducing very slowly.  We have this week reduced by 2.5mg after being on the previous dose for 4  weeks.  He is also now taking Omeprazole 20mg each day.
I know this isn't doing Harley any good, these high doses but by prematurely dropping the doses, we only cause more problems because we are constantly having to return to much higher doses.
I have also decided that if, this time round, we are lucky enough to get to 5mg daily with the Melatonin and the Aza's (EOD), then that is where we are going to stay.....  He is six years of age and his life has been one of vets visists, medications and generally losing all his youth to this horrid, horrid disease.   

I can give you a much longer version, giving all the platelet counts week by month but not sure this will be of use.   If you think it would help at all,  I am happy to format it for others to see.

Sorry

Forgot to add answers to your questions...

Vaccination:

It has always been my policy to have them vaccinated as puppies but no boosters after that and even the puppy vacs I tend to do a little later than
usual, as feel the mum's immunity is present for longer (probably wrong on this).


Flea Treatments:

I don't use them (at least not the chemical types) never have done.
I used to use Dynamite which was effective but latterly, use only oils.


Wormers:

Very random I'm afraid.   Hardly ever would be the best answer but no more than once a year if I do.   If I saw worms I would worm them.
Harley I don't worm though.......feel it would be too dangerous. (Liver stress etc).

Hi catherine

Of course I can do that, almost from the date dot but in fairness, when he first relapsed it was before I knew of CIMDA and the importance of keeping an eye on things closely and I didn't monitor then.

I haven't always made a remark on what reductions were made against each blood test, mainly because on the 3rd relapse, I followed my own gut feeling and disregarded to some extent the Vet's advice in reducing (which I felt was too rapid).  If you don't think it will be too long a 'saga'/
Tell me how far back and how much would be useful to mention and I would be happy to do it of course.

One thing that I am always learning about and also getting so frustrated about is the way in which these drugs are no difference to the 'fine-tuning' of a car (a horrible analogy I know).     

Frustrated, because when you reduce the meds (even gradually it seems) and are doing well at a particular level - then, you drop the dose and you have a relapse.     These A.I. diseases are really THE most difficult things to get on top with - you just don't know all the time, what you are dealing with and as it is the most intricate parts of the dogs body that come into play - things that are not obvious, you are really using trial and error means.

Over the past few days I have been going through the reams of records I have kept since Harley was diagnosed six years ago - hoping that I could find a common factor.   Perhaps, I thought, it is a seasonal 'thing'  as I have to admit a few of the relapses have occured during the latter part of the year/very early spring  but not always.    Could it be the inter-action of drugs at various doses - it certainly seems that when we take Aza's away, we do see a change in his platelets and certainly, on a couple of occasions when relapses have occured, it has been when we have stopped the Aza's.
Perhaps he has an absolute minimum dose of Preds he needs to keep him stable -  records have shown that problems seem to occur when we reduce beyond 15mg but then, he was on 10mg EOD at one stage and seemed to be stable for a while.
After this last relapse, which followed a very brief period (6 weeks) when we were off  steroids and Aza's but kept the Melatonin going, we thought we had cracked it.....the Melatonin had worked and though expensive, had far less side-effects than the other drugs.      No, that wasn't to be and the relapse was very sudden -  from mid-300's to  25 !!!!

So, we are back again, very gradually reducing the Preds.    Even now though, we had a slight hic-cup when his platelets started to drop a bit and the Preds had to go back up.  I have chosen to re-introduce the Melatonin, as it seems (only guesswork at this stage) that the combination of Melatonin with the other drugs, help.    Every reduction we make now, makes me much more nervous than ever before and I am now almost thinking, that if we reach a stage when Harley seems to be better and the side-effects are at a minimum, then that is the dose we will remain on until blood tests tell us otherwise.

I wondered if there would be any merit, in inventing a questionnaire-type form, asking a few questions, that those of us who have dogs with Immune issues, can complete and maybe, just maybe, we may pick up one or two commonalities that could give us some food for thought?
A  simple questionnaire, asking about Age, Historical info on breeding lines, Food, Water, Environment, Exercise, Vaccinations, Wormers, Drugs etc.
I'd be happy to draw up a format but have no idea at all how I would transfer to this site !!!   I spoke to the AHT recently,  as I had heard they may be looking into A.I. disorders as a whole but unfortunately that isn't the case, they are looking at one particular disease (I think it may be SRM) but I suppose the cost of research has to come into play as well.

Just a thought

Has anyone got details of a bona fide website where I can obtain, in lay man's terms, a better understanding of blood tests.

I seem to constantly be worrying myself on things showing up on the blood results and even though my Vet is good and does her best to allay my worries, I am one of these people that have to understand things as well.
This week Harley's bloods (to check his platelets) were not a worry at all but RBC's showed a slight decrease - this week they were 5.62 and last week
they were 5.91 (5.79,  5.90, 6.01, 5.97, 5.84, 6.19, 5.75) the few results before that.  The result of this recent drop means that he has fallen out of the 'normal' range (although it has been the lower end of normal a lot of the time) into the 'low' column.
My Vet has said that they have to take into consideration the HCT and HGB collectively and as these two are still well in the 'normal' range (though they have dropped as well from prev.week) they are not concerned.

I keep getting myself in a state over the possibility of H.A. or a bleed somewhere etc.

Thanks for any advice.

Hi
I wonder if I could ask a question about stools (sorry).....

I am worrying more at the moment that I am not missing any signs that can give an indication that Harley may be having problems (bleeds).
No reason at all for my anxiety, other than the fact that my Vet had put the fear of god in me by suggesting that scan several weeks ago when she thought his tummy was swollen.    His tummy doesn't feel as large but he is still on 25mg Preds daily (blood test today and I am hoping we will be able to come down to 20mg).

About 6 weeks ago, I decided to try and change Harley's dry food to Lily's Kitchen - he has been on R.C. Sensitivity for many years, not because he needs to be on it through sensitive tum problems, but because he was such a fussy eater as a youngster and wanted what Jazz had !!!!!   Jazz has this food for Colitis problems.
I have noticed on occasion his stools seems to be darker than at other times but assumed this was just down to the food he was having at the time.
Sometimes he has a bit of Spinach or Asparagus or other greens and that can make a difference, plus he is now having one third of his food replaced with Lily's.    I sometimes also use Lily's tinned food to mix, for a change.

This morning, his stools were quite a lot darker (not black) and formed totally but I am getting worried that this may mean he has a bleed somewhere?   Perhaps Liver or Spleen or from an ulcer?


Gwyneth

Hi Jo

Yes, I have tried Billy No Mates but unfortunately, with Jazz never got as far as being able to give him the full dose needed, as it seemed to upset him.  Because it was supposed to be natural, I was sure that it couldn't be that causing a problem but I left it off and tried it again...unfortunately we didn't get on well with it.  I believe that the product may contain Neem though and I have only ever used Neem Oil externally

I decided to go the oils route as they just seemed the safer bet and I decided to also add the Geranium Oi to the mix after a friend in the States recommended it - she uses it on her Gundogs in an area heavily infested with Ticks and seems to keep them clear?
Anyway, it 'seems' to have worked fine on these two.