Awaiting diagnose of auto immune disease and bone marrow

Started by Suzy2509, September 05, 2017, 10:56:51 AM

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Suzy2509

After vets discussion with someone they suggested adding another medication but the less aggressive on Cyclosporine. One a day 1.1ml oral.
He's back tomorrow to check pcv again!
They said however this medication can take a few weeks to start showing results
I'm now worries the medications won't have time to start taking effect that another transfusion will be needed and then if we do that we still don't know if the medication is going to work!
One of the reasons the vet wanted to take some advice was that he was concerned we could be stopping production all together, I think that's why they chose the less aggressive one.
I obviously want to do anything we can but also don't want to put him through all this to get no where. Also I have pet insurance and I'm covered for up to 8k per condition and we are already over 4k and concerned this treatment is going to be such a long procedure that I'm going to run out of cover and I would struggle with vet costs such as these!
Pip has actually been quite perky this last week even when his result was 15.
He is getting terrible with licking everything and has a cough to. He also pooped in the house today which is very unusual for him and he's having very large amounts of poo and very soft!

Suzy2509

One more thing!!!!

I'm concerned also as his results throughout have shown kidney damage/disease and all this medication could effect his kidneys

gmhampton

Hi, I am just going through this with my Golden, she has just come out of critical care.  No platelets, red blood count so low she had to have two transfusions.  Immune-mediated thrompocytopenia diagnosed.  Very high dose of steroids given (60g per day for a 30kg dog), which she did NOT initially respond to, so added mycophenolate (an immune-suppressant), one dose of vinicristine (which is an anti-cancer drug but does have the effect of stimulating platelet production from the marrow), omeprazole to protect the stomach, anti-metic against the vinicristine and doxycycline against any potential tick borne diseases.  She was in intensive care for a week.  Now back home.  Her red blood count stabilised after the second transfusion, still low but stable.  Her platelets have shot up.  So the specialist has reduced the steroids after a week and a bit, but she is still on mycophenolate.  I have permission from the specialist to give her Milk Thistle for her liver.  After a very worrying week, she is turning around, and the specialist said the outlook with the correct treatment is usually good.  So take heart!!  If you have a competent specialist they will tailor the treatment to what your dog needs at the time.

Suzy2509

Glad to hear she's doing well
Unfortunately my pip isn't responding too good and has been being sick alot and overall gastro side effects but already on 2 forms of stomach protections. He's back today to check if these side effects have improved.
But I discussed the future with the vet yesterday and he doesn't seem to be responding how we want to the steriods and cyclosporine as his pcv isn't going up to the levels we need. So I'm preparing myself for the huge decision to let him go if we see no improvement by next week. As he hasn't got a great quality of life at the minute with all this medication and because he's not increasing like we want, there is no way we can reduce is doeses yet!
He was 7.5 when he was taken in and the highest we got to was 21 then it dropped to 15. It has gone back up to 18 but still not to the levels we need
It's the hardest thing I'll have to do but I don't want to keep him going to go round in circles and get nowhere.

gmhampton

#19
I`m so sorry, it`s very hard when things don`t go to plan, Roxy didn`t respond initially so they added Vinicristine to stimulate the bone marrow into producing platelets, it takes a few days to work so you won`t see an initial response.  Is it platelets or red blood cells that are low in Pip?  We had to have two transfusions because red blood cells were low, and Vinicristine because her platelets didn`t register (they were 0).

Jo CIMDA

Quote from: Suzy2509 on September 19, 2017, 08:24:46 AM

Unfortunately my pip isn't responding too good and has been being sick alot and overall gastro side effects but already on 2 forms of stomach protections. He's back today to check if these side effects have improved.
But I discussed the future with the vet yesterday and he doesn't seem to be responding how we want to the steriods and cyclosporine as his pcv isn't going up to the levels we need. So I'm preparing myself for the huge decision to let him go if we see no improvement by next week. As he hasn't got a great quality of life at the minute with all this medication and because he's not increasing like we want, there is no way we can reduce is doeses yet!
He was 7.5 when he was taken in and the highest we got to was 21 then it dropped to 15. It has gone back up to 18 but still not to the levels we need
It's the hardest thing I'll have to do but I don't want to keep him going to go round in circles and get nowhere.

Hi

Some dogs really don't cope with the side effects of the Cyclosporin and it might be worth having a chat with your vet about withdrawing this drug and replacing it with another.  Mycophenolate is a drug that is being used more and more these days and it has a quicker onset of action than Azathioprine, so perhaps this is an option for Pip.

Removing a drug that is producing intolerable side effects from the regimen can make such as difference to how the dog is feeling.  You have nothing to lose.

I hope you see some improvement very soon.
Jo