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 1 
 on: Yesterday at 09:33:49 PM 
Started by KaajalTiwary - Last post by KaajalTiwary24
Hello Jo:

Sorry for the delayed response. We hit a curveball with Diesel.

1. The neurologist did the MRI (spine and neck) yesterday. She found a few bulging discs (minor - she doesn't think these are causing any symptoms) and some fluid in the spine.

2. The Spine CSF tap shows slightly elevated WBC. She is sending his blood for an infectious disease panel. She is wondering if his IMPA is secondary to AI Meningitis.

His PCV yesterday was 39%. It's fallen from 41% from the 5th of January.

What are we missing? Please help! They can't seem to understand what's going on with him.


 2 
 on: Yesterday at 12:06:06 AM 
Started by KlassyBandit - Last post by CDASH
Hi, sorry to revive an old post, but what you've experienced with Rosie seems very, very similar to what we're experiencing with our Charlie. He's a 3 year old Collie mix and he became ill in July with infections and neutropenia. Bone marrow biopsies showed the same as with Rosie - his neutrophils weren't being allowed to mature. Other blood cells were affected at times, too, and nothing has lined up exactly with a diagnosis so we've both heard IM neutropenia and IM pancytopenia.

He went on high doses of steroids but his neutrophils kept getting better and then bottoming out again. So he's now about a month into having a immunosuppressant added to his regimen (mycophenolate) and it seems to really be helping - his last few blood checks have been good.

Unfortunately, though, we're still dealing with some issues. He's lost weight (about 2 lbs. - he typically weighs about 42) and muscle mass, and he recently had issues with bloody diarrhea.

So we're still on this journey, trying to get him stable and hopefully to remission.

I wanted to see - is there an update on Rosie? How are you all doing? Have you been able to get any additional answers?

Thanks!

 3 
 on: January 21, 2021, 12:30:14 PM 
Started by KaajalTiwary - Last post by Jo CIMDA
Hi Kaajal

When you say bad poo, do you mean runny?  What colour is it? Is it blackish?  Is his Addison's being well controlled? 

If Diesel has diarrhoea then you must make sure that he is well hydrated. It could be, as Diesel is immunosuppressed, that he has picked up a bacteria so taking a poo sample to the vet might be a way forward, or ask your vet if he or she would treat speculatively and prescribe Metronidazole.  This is a very good antibiotic for gastric issues and it has the ability to remove water from the faeces as it passes through the gut, thereby making the stools firmer.   

Probiotics are also a good remedy for some causes of diarrhoea, and kaolin.  You can buy Prokolin from the internet without a prescription.  Meanwhile give Diesel very bland food and make sure he is drinking sufficiently, and if he isn't then syringe some water into his mouth if he has watery stools.

I hope this resolves very soon.

Jo




 4 
 on: January 19, 2021, 12:09:24 PM 
Started by KaajalTiwary - Last post by KaajalTiwary
Hello Jo:

Thank you for your timely help always. I am so sorry I have so many questions.

Diesel had bad poo 2 nights ago. He didnít poop until tonight and it was bad again. Do you have any insight on what I can do? Is it time to taper his meds a bit? He is also on stomach protectant.

 5 
 on: January 18, 2021, 07:58:26 PM 
Started by Karen Churchill - Last post by Jo CIMDA
Hi Karen

Yes they can, in fact essential fatty acids have anti-inflammatory properties and are known as 'steroid sparing'.

Jo

 6 
 on: January 17, 2021, 01:23:10 PM 
Started by Karen Churchill - Last post by Karen Churchill
Our girl has dry skin after all the steroid medication for IMT. She is off steroids now. Can dogs with immune conditions have fish oil supplements?

 7 
 on: January 17, 2021, 01:17:44 PM 
Started by KaajalTiwary - Last post by Jo CIMDA
Hello Kaajal

I have only just seen your last two postings.  Sorry.

Different laboratories have different reference ranges, so with this in mind, and assuming that the reference range that you have given is relevant to the lab that your vet uses, then the results are all within, or around about, the reference range and I would say that there is nothing for you to be concerned about especially if Diesel is not limping or appears to be in pain.   Good clinical signs suggests that the dose of Atopica is suppressing the immune system sufficiently enough to bring the IMPA under control.  This is particularly good because Diesel doesn't tolerate preds very well.  In fact the low dose of preds isn't doing anything to assist the IMPA treatment, but if Diesel is Addisonian then it is very likely that he will be needing a small replacement dose of preds for his Addison's disease. 

An article that you may find useful:

https://todaysveterinarypractice.com/oral-cyclosporine-use-in-dogs/

It seems as though everything is going according to plan and therefore I wouldn't be in a hurry to do anything drastic and the dose of Atopica can be reduced over time. 

I trust you will have a good meeting on the 19th. 

All the best

Jo


 8 
 on: January 17, 2021, 06:30:33 AM 
Started by KaajalTiwary - Last post by KaajalTiwary24
Hello everyone:

Can someone please advice? Diesel was diagnosed with IMPA on the 31st of December. He weighs 65 lbs.

His meds are:

Starting Dec 31: Atopica 100mg twice daily
Starting January 2nd: Prednisolone 10 mg once daily
Starting January 12th: We started alternating Prednisolone between 10mg and 5 mg

I've attached his bloodwork. Hopefully the excel sheet will come through to review. I am a little concerned about his WBC, RBC, HGB and Neutrophils.

                           January 5th   January 15th
WBC             4.9-17.6                9               17.8
RBC            5.39-8.70              6.29        5.9
HGB            13.4-20.7              14.6       13.9
Neutrophil    2940-12670     5.346      12638

Can someone please tell me what should I do? Thank you for any help you can offer. I don't understand why his numbers are trending like this and what I should so about it. I have a follow up with the IM Specialist on the 19th.

Waiting in anticipation,
Kaajal


 9 
 on: January 13, 2021, 01:19:41 AM 
Started by JenNara - Last post by JenNara
My 2 year old Mini Aussie was diagnosed with IMPA just when she turned 1. Her weight is around 12.5 - 13.5 lbs and we started prednisone from 10mg. After staying on it for 4 weeks, we started reducing 25% every 2 weeks as per vet's recommendations.

She relapsed when we went from 2.5mg every other day to twice weekly. We restarted at 5mg and reduced 20% every 4 weeks after I asked if we could go slower. We also switched to prednisolone/liquid form so we could be more accurate.

Fast forward 8 months since the first relapse, she recently relapsed again when we went from 0.6ml daily to every other day, after a week. This was supposed to be one of the last doses as the vet thought we could go off completely from pred, but based on how her body reacted just from going every other day, I guess not. The vet thinks she may just need pred for long term management.

So we're back at 0.6ml daily while we try to improve her gut health. I'm wondering if there's anything else we can try that may help us reduce pred even more. I'm wondering if the drop was just too much, and maybe we should even reduce in smaller increments, like going down to 0.5 everyday next time, and staying on one dose longer than 4 weeks.

Any thoughts? Would increasing the duration like 6 - 8 weeks on one dose be helpful? Or would improving her gut health (currently just started on Animal Biome) be something that could help her from relapsing in the future? A holistic vet also thought maybe laser therapy could help since it's supposed to help with healing/regenerating and reduce inflammation that's being controlled by pred.
I'm really hoping we don't have to stay at this current dose forever, although my vets seem to think this is it.

 10 
 on: January 11, 2021, 05:42:04 AM 
Started by KaajalTiwary - Last post by KaajalTiwary24
Thanks Jo. Appreciate your detailed response. Diesel was on high doses of steroids 3 years ago when he was diagnosed with AI Neutropenia. His body doesnít handle prednisolone well. Even at 5mg for Addisonís disease in 2014 - he steroid induced alopecia.

Heís been on Atopica (100 mg twice a day) since the 31st of December and Prednisolone (10 mg once a day) since the 2nd of January for IMPA. He is not limping at the moment.

1. Should I still talk to the IM Specialist about increasing his prednisolone?

2. With IMPA, at what point would you actually consider reducing the dosage gradually?

3. Stomach Protectant - Sucralfate and Prilosec?

Thank you for your help and guidance. Appreciate it so much. Hope all is well in your world.

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