Welcome, Guest. Please login or register.
Did you miss your activation email?

Username: Password:
Pages: [1] 2 3 ... 10
 1 
 on: Yesterday at 11:09:15 PM 
Started by Alison68 - Last post by Alison68
Hi jo, i haven't posted in a while, things have been really good with Bella, her liver enzymes are back to normal and have been for quite some time. Bella turned 7 in November, her weight has increased over the past 6 months or so and she's been holding her weight. Bella hasn't had any antibiotics for more than 6 months. She's been doing fine with out them. Bella's a picture of health when she had her check up this week the vet said she has a liver problem but considering that bella's doing fine and looks really good.

 2 
 on: January 15, 2019, 07:09:03 PM 
Started by annandhenri - Last post by Jo CIMDA
Hi Ann

I looked up the side effects of metoclopramide in Plumb's Veterinary Drug Handbook, 8th Edition, and  it states that in dogs it can cause 'changes in mentation and behaviour', so I wonder if this is the problem with Henri.  See this link: 

https://canna-pet.com/side-effects-metoclopramide-dogs/

Perhaps your vet can find an alternative drug.

I hope you can sort it out soon.

Jo



 3 
 on: January 15, 2019, 06:43:37 PM 
Started by annandhenri - Last post by annandhenri
Hi everyone

I'm just wondering if anyone has experience with a hiatus hernia, or acid reflux?  My dogs on medication for this and seems to be going a bit hyper at times and then a bit out of it. I'm not sure if it's a reaction to one of the medications, or a bit old age too. He's on pred for the addisons, omeprazole, antepsin and metroclopremide for the hernia. Thanks so much, Ann and Henri

 4 
 on: January 14, 2019, 07:41:32 PM 
Started by FinntheVizsla - Last post by Jo CIMDA
Hi and welcome

I am sorry Finn has this skin problem.  My first thoughts, going by your description, were that he possibly has sterile nodular panniculitis or pemphigus foliaceous  however, Hungarian Vizslas can be genetically predisposed to Sebaceous Adenitis and therefore it is more likely to be SA  than the other two suggestions.

Below are a couple of links that might be of interest to you.  Also, if you view images of these diseases you may find an image that is very similar to Finn's and this may help obtain a  diagnosis.


https://dermvettacoma.com/panniculitis/

http://www.vizslahealth.net/sebacious-adenitis/

Some immune mediated skin diseases can be brought into remission without the use of steroids by using a combination of Doxycycline and niacinamide alongside many supplements such as essential fatty acids (EFA's), Omega 6 and 3 and Natural Vitamin E etc.... 

As Finn has already started on steroids, and if it is appropriate,  it might be worth having a chat with your vet about starting Finn on  Doxycycline and Niacinamide treatment and then you can start to wean down the steroids and continue with this treatment.

 Doxy' and niacinamide is not a fast acting treatment but it is very effective and it allows the disease to reach remission without the use of steroids.    Steroids are incredible and they certainly act fast and they are very effective but if a dog has an immune mediated skin disease that responds well to other non-steroidal treatments then it is worth trying. 

Also, with some immune mediated skin disease a topical steroid such as Tacrolimus (Protopic) might be effective.

The Hungarian Vizsla club is very proactive when it comes to health and if you contact them they may be able to help further.

So it is likely not to be an allergic reaction to food but an immune mediated skin disease and with the correct treatment it should be able to be brought into remission. 

As Finn is on steroids it might be prudent for him to have a gastroprotectant such as Ranitidine or  Omeprazole.

If you need any further help with dosages of EFA's etc, or Doxycycline or steroids please ask. 

All the best

Jo



 5 
 on: January 13, 2019, 08:03:37 PM 
Started by FinntheVizsla - Last post by FinntheVizsla
Hello everyone!

I’m not sure if this is the correct spot to be placing this post so I will go ahead and apologize in advance if not. I have a 3 year old Hungarian Vizsla named Finn. He is “as advertised” with all of the typical Vizsla traits good what some would consider as bad. He is literally the BEST family dog anyone could ask for! He loves our 2 1/2 year old daughter with all of his heart & they are two peas in a pod. With all of this being said you can imagine how concerned we are for him when he started showing these “symptoms”.  It all started two months ago when we noticed lots of tiny bumps all along his back. They seemed to come out of nowhere since he’s had the same diet. We took him to the vet right away because we were worried he was having a severe allergic reaction. They did skin scrapings and the tests came back negative for mites and the vet ruled out mange as well. She ended up prescribing him 20 mg Prednisone. After the first couple of doses of steroids the bumps went away. Then that’s where the mystery comes in. He has started losing his hair all along his back where the tiny bumps were. It looks almost as if he’s been eaten up by a bunch of moths. They aren’t big bald spots, but tiny spont. He has been licking himself much more and has terrible dandruff. It’s been extremely cold and dry this winter so I’m not sure if that has anything to do with it. We have been giving him omega 3 orally twice a day. We have also been giving him oatmeal dips once a week to help with the itching. After numerous trips to a few different Vets none of them have been able to give us a diagnosis other than allergies? He is on a grain free gluten free diet now and still the hair loss continues. Any and all help will be well received and greatly appreciated here!

 6 
 on: January 06, 2019, 12:33:59 PM 
Started by Jo CIMDA - Last post by Jo CIMDA
WHAT TO EXPECT ONCE IMMUNOSUPPRESSIVE TREATMENT HAS STARTED

If a dog has a serious autoimmune disease, then the sooner treatment commences the better chance the dog has of survival.  The main delay to starting treatment is obtaining a diagnosis or at least your vet being sure that he hasn’t missed anything that could be made worse by giving high doses of steroids.  Achieving a diagnosis can be a fight against time. 

If your vet has decided that in all probabilities your dog has an autoimmune disease, then to a certain extent, which autoimmune disease your dog has, as far as treatment is concerned, is irrelevant because with the exception of a few diseases, they are all treated the same, that is, with immunosuppressive drugs.  The main objective is to ‘knock out’ the immune system and virtually stop it from working (or near enough) so the destruction will cease and give the body a chance to recover.  As previously stated, this treatment regime works in most cases, that is, if it has been given early enough and the dosage is correct.  All dogs are different and some can tolerate the drugs better than others. In proportion to their size, small dogs seem more able to tolerate higher doses of steroids than large ones. Some diseases are more serious than others and carry a poorer prognosis. So the initial crisis is a crucial time, however anecdotal evidence shows that many more dogs survive than die if correct treatment is administered in good time.
It is hoped that a positive response can be seen within 4-6 hours of starting treatment (depending on the disease), but in a serious, life threatening situation, the first 2-7-14 days can be a very worrying time.  Assuming the dog has stabilised he will quickly feel much better, and if he is in hospital may be allowed home within a week.

When he comes home he will probably have a ‘goody bag’ full of drugs.  He will be on a high dose of steroid, usually prednisolone, and he may also be on another immunosuppressive drug, such as Azathioprine.  Your dog will be weaned off in a controlled manner according to his wellness and clinical observations. 

Note: High doses of steroids must not be stopped abruptly.  Your dog could go into an adrenal crisis if the medication is withdrawn too quickly.
 
In addition to immunosuppressive drugs he should have something to protect his stomach from excess acid.  The last thing your dog needs when he is feeling poorly is a bleeding stomach ulcer caused by the drugs.  Sometimes, Antepsin is given to coat and protect the stomach (but this must not be given within two hours of other medication otherwise it will stop the drugs from being absorbed).  Zantac (Ranitidine) may also be prescribed to take away the excess acid. Another gastroprotectant used is Omeprazole. To minimise irritation to the stomach it is usual for the daily dose of steroid to be split into two doses and given with food, one dose in the morning with breakfast and the other dose with his evening meal. I have known several dogs, who did not receive a gastroprotectant as a part of their treatment regime, and went on to develop anaemia. This is not autoimmune haemolytic anaemia but iron deficiency anaemia caused by bleeding stomach ulcers. Using a gastroprotectant is a good preventative measure. When the steroids have been significantly reduced to a low dose, a gastroprotectant may not be necessary.

Excess acid, produced because of the drugs, may make a dog prone to developing pancreatitis. A dog with pancreatitis will appear in pain and his back may be arched as if he can’t straighten up.  He may be lethargic, seem bloated and have a tender abdomen. Dogs usually go off food and water, may vomit and look depressed.  If you suspect that your dog has pancreatitis, don’t try to feed him because it will make the condition worse. Take him to the vet as soon as possible as he may require treatment or need to go on an intravenous drip to stop him dehydrating.  Again, the risk of pancreatitis should be minimal once the dog is on a lower dose of steroids.   A low fat diet is best when your dog is on high dose steroids or prone to pancreatitis. 
As your dog‘s immune system is being significantly suppressed, he will be more likely to pick up infections, and will not have the ability to fight against them.  As a precaution a broad spectrum antibiotic is often prescribed. Also it is sensible not to exercise him in areas where he is more likely to encounter infections, for example, a park or a popular dog walking area. 

Whilst your dog is on high dose steroids he will want to eat and drink excessively. However, this also means that he will want to urinate more and this can sometimes cause temporary incontinence.  You may have to get up to let him out during the night and if you leave the garden door open during the day, it may save some mopping up!  He cannot help it and won’t like it either, so don’t be too hard on him, it’s only temporary. You will notice as he is weaned off the drugs the unwanted side effects will subside and he should return to normal habits and behaviour.  Urinary tract infections and/or bacterial skin pustules are not uncommon when a dog’s immune system is suppressed, and this is often the reason for a dog to be off colour during this time.  Note: Always consider a urine infection if your dog seems under par.  A course of antibiotics will usually sort this out quickly.

Depending on what autoimmune disease your dog has, he will probably need to have regular blood tests.  Biochemical blood tests will also keep an eye on other body functions, such as those of the liver and kidneys, which is important at this stage.
Assuming good progress is being made, the clinical signs of his illness are diminishing and positive signs of improvement are apparent, your vet will want to start weaning him down from the high doses of steroid.  This process can take 3-6 months or more, and usually begins any time after 10 - 28 days from the start of treatment, depending on the results of his blood tests and his clinical signs.
 
Relapses are not uncommon, especially in diseases that are difficult to control, for example SLE.  A relapse may mean that initially, your dog needed to be on a higher dose of immunosuppressive drugs for a longer period of time, or your dog may have been weaned off a little too quickly and then the dose withdrawn too soon.
If a relapse occurs he will probably show similar clinical signs to his initial crisis.  He will have to go back on an immunosuppressive dose of prednisolone, but it may not have to be quite as high as before. A combination drug may need to be added at this stage. The weaning process will then have to start all over again. Returning to an immunosuppressive dose will mean that he has to go back on a gastroprotectant.

Side Effects of the Drugs – Iatrogenic Cushing’s Syndrome
Iatrogenic Cushing’s syndrome is a side effect of high dose steroids and is caused by too much corticosteroid in the body. To a lesser extent, the immediate side effects observed when the dog initially goes on steroids eg., drinking, eating and urinating excessively is a mild example of Cushing’s syndrome.  Personally I like to see dogs responding to high doses of prednisolone in this way, as it means that they are responding to the drugs as they should.

Usually, Cushing’s syndrome only becomes a real problem when exceptionally high doses, or prolonged high doses of steroids are administered, maybe due to a relapse, or in some cases where the vet is inexperienced in reducing steroid doses and keeps the dog on a high dose for longer than necessary; or when the dog is not responding to treatment and higher doses are necessary to control the disease.  This is where the cytotoxic drug Azathioprine is very useful. 

All drugs carry side effects and Azathioprine is no exception, but it does not carry the same side effects as prednisolone, therefore by using this drug in combination with prednisolone it reduces the risk of iatrogenic Cushing’s syndrome.  As Azathioprine takes at least 10 days to take effect, starting the ‘combination’ therapy at the beginning of treatment may enable the prednisolone to be lowered within the 10-28 day band and still maintain a good level of immunosuppression. If your dog is not responding to treatment then your vet may consider changing his treatment to other immunosuppressive drugs.

How Can I Tell if My Dog Develops Iatrogenic Cushing’s Syndrome?
Iatrogenic means ‘drug induced’.  Clinical signs of Iatrogenic Cushing’s syndrome are the same as primary Cushing’s syndrome but can present with acute clinical signs. It reflects the level of corticosteroid in the body.

The most notable side effects are, heavy panting, some hair loss, and an increase in drinking and urinating, excessive pigmentation.  This is something everyone seems to be aware of and accepts as normal when a dog is on high dose steroids. Very often the dog will be weaned down to a low dose before any major problems arise. 

Acute Cushing’s syndrome due to overdosing of cortiocoid steroids can be very serious.  Blood results will reflect this, especially the liver enzymes which may be extremely high. Red blood cells and blood platelets may also be high and blood clotting may be a risk.
So when should you alert your vet to suspected, unacceptable level of corticosteroid?  The owner should take note when other clinical signs occur, such as: Depression, anorexia, muscle wasting and extreme weakness, continuous panting, lethargy - unwillingness to exercise, skin lesions and thinning of the skin, excessive hair loss, pot-bellied appearance and sagging back, behavioural changes (aggression).

If your dog is showing these signs it will probably mean that the dose of steroids needs to be lowered. It is important that it is not confused with a relapse of the dog’s condition or an infection. The dilemma is that steroids must not be withdrawn too quickly otherwise the dog may go into an adrenal insufficiency crisis.  If the clinical signs of iatrogenic Cushing’s syndrome is intolerable, it is hoped that the high dose of steroids that he has been on will have already done their job and that his autoimmune disease will be stable. As long as the steroids are lowered in a controlled manner and in time, all the symptoms of Cushing’s will subside and your dog will return to normal, but extreme signs must not be ignored.

How Do I Know if My Dog Will Relapse?
Until you have attempted to wean your dog off of the tablets for the first time you will not know if he is likely to relapse or not.  Sometimes during the weaning off process, before you even get down to an every other day dose, he may relapse.  If this happens then the drug dosage has to be raised, probably up to the last dose before the relapse (maybe a little higher, depending on the severity of the relapse) and then start the weaning process again.  If this happens again, then you and your vet may have to settle for keeping him on a low maintenance dose to achieve a good quality of life. A low, every other day maintenance dose of prednisolone is preferred to enable the dog’s liver to rest in between doses. There are many autoimmune diseases that carry a good, drug free prognosis.  The more common, serious autoimmune diseases that may not need long term steroid therapy are: primary immune-mediated polyarthritis, autoimmune haemolytic anaemia and thrombocytopenia. However, as previously stated, all dogs are different and it very much depends on the individual dog, the severity of the disease, the experience of the vet and the vigilance and compliance of its owner.

If a relapse occurs whilst the dog is still being treated then true remission has not been achieved.  If the dog has achieved remission and has enjoyed a period without drugs or is on EOD maintenance drugs, when a relapse occurs or he develops another autoimmune disease, he has encountered a ‘trigger factor’ which has induced this change.

 7 
 on: January 06, 2019, 12:11:51 PM 
Started by Voxxy - Last post by Catherine
Your dog needs to be on at least 35mg of Preds TWICE a day (total 70mg daily) to start with so 30mg daily is not enough for a dog weighing 35kg and without the correct dose her PCV will continue to lower.

I had a dog with AIHA and it was a rollercoaster and it is tiring, physically and emotionally, looking after a very ill dog especially when you do not know too much about the disease. If your vet has not had much experience of AIHA then a specialist might be better. I do think you need to sort out the correct dosage as soon as possible.

My dog had AIHA many years ago so it was very difficult to get a diagnosis and the correct treatment but it was worth all the worry as she got better and went on to live a long and healthy life. I hope your dog can too.

 8 
 on: January 06, 2019, 10:01:28 AM 
Started by Voxxy - Last post by Jo CIMDA
Hi and welcome

This scenario is not unusual when a dog has AIHA but urinating and vomiting blood makes me wonder if she also has low platelets, if so the two AI disease together is called Evan's syndrome.

An immunosuppressive dose of prednisolone should be 1mg/kg/12hours, so if she weighs 35kg then from your account she is not on enough prednisolone.    I will copy the best immunosuppressive drug protocol I have come across and it can be confidently used as a guide.   It is by Prof Michael J Day a world leading immunologist.

If the dose of pred is correct then you could see an increase in the PCV within 5-7 days and the reticulocytes hopefully will be high.  Some dogs take longer than others to start to regenerate and you may have to give it more time before you see an increase in PCV.  If the PCV gets below 12% then a blood transfusion will buy time.  This is a common procedure.

I do hope you have better news on Monday.

Jo
 

Reducing the Tablets
When significant improvement in the dog’s condition is seen, usually between 10-28 days, the initial steroid dose is usually reduced by 25%. The dose is generally given for another 10 - 28 days and depending on the dog’s progress and clinical signs the dose is significantly reduced once more for a further 10-28 days; and again in another 10-28 days. Anecdotal evidence has shown that if at this stage the dose is lowered more slowly, or reduced to an every other day dose over a period of months rather than weeks, relapse are less likely to occur.  It is always tempting to get your dog off steroids as soon as possible, but when treating autoimmune disease, as long as the dog is on a low, every other day dose then taking the last stage slowly seems to work best, depending, of course, on the severity of the disease and allowing for the difference in individual response - no two dogs reactions are exactly the same.  With some autoimmune diseases such as SLE, the dog is likely to be on steroids for the rest of his life. Usually an every other day dose can be achieved, but you risk a relapse if you take the dose too low. Below is the best example of a reducing immunosuppressive protocol I have come across. It is an excellent guide and can be adjusted to the individual.

Example: Reduction Protocol for prednisolone:
Clinical Immunology of the Dog & Cat , 2nd Edition,  by Michael J Day
Professor Michael DayBSc, BVMS(Hons), PhD, DSc, DiplECVP, FASM, FRCPath, FRCVS 

Professor of Veterinary Pathology, University of Bristol, UK and WSAVA - Chairman of Scientific Advisory Committee.

This example is based on a dog receiving an induction dose of 1.0mg/kg/q 12hrs (q = every)
Dose                           Duration (based on clinical effect)
1.0mg/kg/q 12h                          10-28 days
0.75mg/kg/q 12h                       10-28 days
0.5mg/kg/q 12h                         10-28 days
0.25mg/kg/q 12h                        10-28 days
0.25mg/kg/q 24h                        10-28 days
0.25-0.5mg/kg EOD                    at least 21 days
0.25-0.5 mg/kg every third day      at least 21 days

Every reduction is made after consideration to improvement of clinical signs, blood results and side effects of the drugs.

Prednisolone:  "Doses above 2.2mg/kg/day do not give more immunosuppression but do cause more side effects. Many internists believe that prednisolone doses should not exceed 80mg per day, regardless of the dog's weight."  Plumb's Veterinary Drug Handbook Eight Edition.

 9 
 on: January 05, 2019, 09:46:00 PM 
Started by Voxxy - Last post by Voxxy
Hi everyone,

I have been pointed towards this forum by one of my Facebook friends and I am so grateful to have found it because I feel like I am going through hell.

I have an 11 year old Large Munsterlander who quite suddenly on New Years Day went very wobbly (I describe as drunk!), seemed to be very unsteady on her legs. She collapsed to the floor and prior to this had urinated some blood/haemoglobin. I scooped all 35kg of her up and put her and my other Munster in the car and rushed her to the vets who automatically began testing for IMHA (I had never heard of it). Her PCV was 19 and she was admitted and given immunosuppresives (azathioprine and pred), plus omeperazole. Anyone that knows the breed will be aware how anxious and sensitive they can be away from their normal environment. The next day, the vets said we could bring her home as she was quite nervous in the kennels.

She was put on 30mg (2mgs/kg) pred, omeperazole and azathioprine. She ate, drank, passed urine and faeces normally, although was panting very heavily. On the second day, Isla vomited quite severely - large amount of blood and clots which was just horrific. The vets suspected something had upset the stomach lining -
 ethey took her off azathioprine, gave her a stomach liner of sucralfate and injected with zantac + antibiotic. Day three she was much better - but still low in demeanour and panting heavily. She was eating, drinking, urinating etc. PCV count after blood vomit was 18, but yesterday it was up one to 19 (I am holding on to every shred of positivity).

Today is day four and we awoke to the tiniest bit of vomit - not bloody as before but a light brown. Vets not too worried about it but she went off her food and wouldnt eat any of the Royal Canin tins. Munsters can be selective anyway, and she was very selective with what she ate and dubious about any meds in there. We got to a point where she wouldn't eat at all. Eventually we have managed to get food down her (boiled chicken) and I am elated that she is eating.

We are having the blood smear on Monday. I feel like I am on an emotional rollercoaster - I am crying and then elated. Can someone tell me that they have experienced the same? Is this "normal"? Would you expect to see reticulocytes on Monday,  5/6 days after the initial pred dose and consistent drug regime? Has anyone experienced this increased panting?

I'm sure many of you have been clutching at straws and I just would love to hear from people to know that we are not alone it what appears to be a lonely and desperate place. My girl is my life and I know in my heart that she has years ahead of her.
Thank you.

Victoria

 10 
 on: January 03, 2019, 11:05:54 AM 
Started by Jo CIMDA - Last post by Jo CIMDA
Wishing you and your dogs a very happy and healthy New year.

All the best

Jo

Pages: [1] 2 3 ... 10