Luca 13 Month Lagotto Romagnolo

Started by Joanne Denton, June 20, 2018, 08:58:27 AM

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Joanne Denton

Hi Joe

Just an update on Luca :  He has now been on a full dose of 75mg of Atopica twice daily for a complete month, he is still taking 2 x 5mg preds a day too.   He has been briliant up to yesterday,  running playing etc.   Had checks on his bloods and all shows fine.  They want to start reducing the steroids in the next week or so.     BUT  Yesterday afternoon at approx 3pm and again at 2am this morning he was sick, throwing up undigested food.  The symptoms are exactly the same as when he was put on the Atopica in the first place at the high dose of 75mg twice daily.    We have been to our vets and she is not sure if it is the Atopica that is causing this,  she has suggested that we reduce to 50mg twice daily and see how we go.   She also gave him an injection of antisickness medicine. 
Question :   In your opinion do you think that it could be the Atopica as he has been on the high dose of 75mg twice daily for a month,  I wonder if it is or not ?    It seems odd that he should all of a sudden have a reaction to it.   Or is it because he has been on such a high dose for such a long time ?     I worry about this drug.   
Please can you tell me what you think,  I really value your expertise.   
Thank you
Best REgards
Joanne

Jo CIMDA

Hi Joanne

It is impossible to know exactly what is causing this gastro upset so I will just put a few theories to you.

Sickness, reduced appetite and diarrhoea,  as a reaction to Atopica is very common in the early days of treatment and often if the dose is reduced and then increased gradually the dog can usually tolerate Atopica  (as you know).   There are some dogs that can't tolerate it at all and the drug has to be withdrawn but clearly, after a shaky start,  Luca  has tolerated it reasonably well.  Do you give the tablets on an empty stomach or with food?  The tablets should ideally be given at least one hour before food or two hours after, but if the vomiting is due to the Atopica then it can be given with a little food.  If it is the drug, I would expect the vomiting to occur soon after giving the tablets.  To reduce side effects (and costs) some dogs are put on a combination of (Cyclosporine) Atopica and ketoconazole or grapefruit powder to enhance the effect of cyclosporine which then allows the dose of cyclosporine to be reduced. 

It might be as the immunosuppressive effect has built up over the last couple of months his immune system is not able to control the common bacterium that most dogs carry and is controlled by their immune system. A bacterial infection of the gastrointestinal tract can cause sudden vomiting. Does Luca have diarrhoea? He may need a course of antibiotics.   

Could he have eaten something that may not have agreed with him?

Another possibility is long term pred use can cause pancreatitis and the clinical signs for this is sickness and inappetance, and also some abdominal  pain.   Is Luca showing signs of being unwell or is he just bring up his food?

Luca has been on the initial dose of Atopica for a month now so perhaps it is time to reduce it and see if the vomiting stops.

My gut feeling it he has a bacterial infection caused by either eating something he shouldn't have or because his immune system is suppressed which makes him vulnerable to infections, but there are other causes of acute vomiting such as blockage etc....... 

I don't know what you feed Luca on but for a while you could give him home prepared bland food such as rice with fish or chicken. 

I do hope this acute vomiting stops abruptly.

Jo