CIMDA

Thanks Jo.

Well things just got more complicated! Test results showed Villain had seriously low output from his adrenal glands so vet checked his electrolytes and has diagnosed Addisons. The vet agrees I can continue to wean him off his pred and he's currently on 2.5mg x 1 a day. He has however prescribed Florinef to stop any potential crash.
Everything about this diagnosis would make sense given his previous symptoms but we never has a clean diagnosis before. 3 days in and he's doing great however, he's also been diagnosed with demoed ex so doesn't look great at the moment. He's booked in for a shampoo on Tuesday morning.

Would be great to hear back with any general tips or advice now we have a firm diagnosis in terms of living with Addisons. Thanks

Well things just got more complicated! Test results show Villain has seriously low output from his adrenal glands so its either Addisons or has been induced by the pred usage. The vet agrees I can continue to wean him off and he's currently on 2.5mg x 1 a day. He has however prescribed Florinef to stop any potential crash.
The original skin/coat problem he now thinks could be a mite and wants him to have a skin scrape. I'm going to take him back tomorrow hopefully.
Two things really. Does anyone have any similar experience on the adrenal aspect and likewise if its a mite, what should we expect? Thanks

Thanks for tip. That's a real coincidence because a neighbour has just recommended a homeopath. I'll look into it. Thanks for advice.

Hi, he's not itching at all and vet seemed to think he would be if it were mange or allergies etc. he's been on pred for 8 months so I would have almost expected some further side effects. Vet is concerned this has always been a problem that's been kept at bay by steroids given that its accelerated since his dose reduced to lowest levels.
His energy, appetite and general behaviour hasn't been this good in months though so I almost want to say lets just wean him off the steroids now that we're so close and then let's just see what happens with his coat.  Hard to know what to do for he best.

Thanks

Thanks Jackie. Did it start when he was on low doses of steroid? I'm thinking that if its Cushings brought on by the long steroid use, I need to just keep going with weaning him off but if its not, and its primary, I don't know how the vet knows the difference! Was your vet tempted to prescribe anything or did you just get him steroid free and wait? Thanks kerry

Hi, it's almost 7 months since I posted as we've basically just been on a regime of weaning off the pred. Background was that we never got a clear diagnosis before we put him on steroids (he was so poorly, he couldn't take anymore tests) however, it looked like it was either Addisons or steroid responsive meningitis. We've had a few hiccups with his withdrawal but within the last fortnight he's been down to just .25mg per day and absolutely full of beans. Lovely to see after him being so spaced out for so long.
Unfortunately, the withdrawal seems to have exposed an underlying skin condition and poor Villain is very quickly losing his hair. His paws are virtually bald, around is eyes is now very thinned out and the hair on his ears is literally coming out in little clumps. It definitely appears to have accelerated in the last week which is why it doesn't seem to correspond with the prolonged use of steroids.
A trip back to the vets but it has them puzzled. We're currently waiting for the result of an ACTH and the vet recommended we increase Villains pred to 5mg a day in the meantime. I was interested to hear if anyone had similar experience or insight into what was most likely. You've steered me very well in the past and as always, I'm grateful for any advice.
Kerry and villain

Thanks Jo.

Thanks for the ultra quick response Jo! All makes sense and absolutely I'll take a look. He has a ravenous appetite - loves his food. When I spoke to the vet last week about the first reduction etc (he was on day 16 then day 22 now) he recommended the 28 days so that we weren't attempting to do anything unsupported over the jubilee period. I think he's definately nearing the right time to reduce but understand why the vet wants to push it out.
We're going down to 7.5mg in the morning followed by 5mg at night (so that we're not trying to cut the already incredibly small tablets into quarters!).

Thanks again.
Kerry

Hi - By way of an update. We're still within the first stage of the heightened pred levels (7.5mg twice a day) together with anti biotics and zitac and we've decided we're going to take it right up to the 28 days before attempting to reduce. He's doing ok - eating well, putting a little weight on but I had a question about his behaviour & toilet habits for anyone who may be able to help.
I'd say he was currently healthy but there isn't an ounce of playful ness in him. Sometime we'll get a waggy tail and he won't leave the female dog alone! however, he does come across as depressed. He's also struggling with his bowl movements and it takes him a few attempts to go. Are these known side effect to pred?

thanks
Kerry x

Hi, good news to report. Had a conversation with the vet this afternoon and he's on board. We're going to do 1 more day of the existing levels so that Villain has had a full week on the antibiotics (just to make sure the infection has gone) and then start the increased dose on Thursday. He also said he wouldn't have recommended a reduction like the other vet did.
We've agreed on an initial 10 days and then a catch up to discuss next steps. Quick question - how do we determine whether 10 days has been sufficient or whether to carry on?
I've also got some tablets to help his stomach.

His dry eye is diagnosed as keratoconjunctivitis sicca and we have all the meds but just haven't needed them since starting the pred (which gives further weight to the vets idea that it all stems from the same AI problem). Its just been since the infection that they took a turn for the worse. Saying that they're looking better today without having put anything in them since this morning.

Thanks for all your help - it gave me just what I need to have todays conversation and hopefully get onto a plan that's going to work once and for all. 

Kerry

Thanks Chris. I know you mentioned his name a while ago. Would you be good enough to reconfirm name and number to save me searching?

Did your vet follow a similar plan to the high dose recommended here?

Thanks
kerry

Thanks. Will do. 

Thanks again.

There's one of the vets who's really receptive so plan is to book in with him, print the data off and take it in to show him. My gut feel with everything that I've read on the forum was that it wasn't right but you doubt yourself in favour of the 'experts'. Thanks again.


Do you think his declining dry eye is one of the symptoms?

Thanks
Kerry

Thanks both for replying.

We're 5 days into the anti biotics and Vil's doing ok but certainly not great. Spoke with one of the vets who is familiar with his history yesterday and she said to expect it due to his steroids and that the shivering/trembling should be ignored unless it's really severe (it isn't but it comes and goes continuously through the day and night).

Bit of history as requested Jo.

He's 8.4kg and his original pred dose was 2 x 5mgs once a day. No firm diagnosis but thinking its Steroid responsive meningitis or Addisons. We dropped 1 full tablet a few weeks ago but he appeared to have a bad reaction so we went back to the start. Up to yesterday he carried on with the 2 per day but the vet advised to try another reduction so today he had 7.5 mg and we'll alternative between 10mg and 7.5mg every other day for a week (subject to his reaction).
That's really interesting about his temp Jo. The vet said it was incredibly high (42 which converts to 107) and he didn't know how he was up and about.
He's eating ok now , energy not great (not bed ridden though) but last couple of days it's been his eyes that he's struggling with (we sort one thing and move onto another!). We have drops for his dry eye condition but they've been doing really well without up until recently. He definately has an ulcer in his left eye but his right one is really bothering him today (I thought the vet had checked both again with the dye on Thursday but nothing came up in his right one then). I'll be calling the vet tomorrow when they open for some more drops.
Thanks
Kerry