Mastecatory Muscle Myositis chronic phase

[Jen]

Desperately sad about my beautiful little Whippet hound. She has her 4th birthday in  just over two weeks time and is crippled with the side effects of drugs for her condition. Because she wasn't diagnosed till her MMM was chronic there seemed no choice but to get her into Prednisalone ASAP. She did well at first as most dogs seem to do then the inevitable slide into the side effects of long term usage kick in. She is an incredibly slight built Whippet now just below 7 kg.. an image of a skeleton wrapped in skin. Muscle mass negligible, eating difficult due to the limited 1.5 cm max gap from canine tip to canine tip. If she wasn't so spirited a little soul I would be treating her paliatively. But her eyes still sparkle under the weight of her disease and drug side effects so I hold out for hope of some sort of recovery.
I have researched extensively and have three vets, a local conventional medical vet overseeing her whole treatment plan, herbal vet , and homeopathic vet.... She currently has nutritional supplements.. greyhound recovery vitamins and electrolytes to support what muscle mass she has, Chinese herbs, sterols and sterolins for immune health, milk thistle to support her liver, medical grade CBD oils, healing treatments, laser acupuncture... and many more variants before this . conventionally we are trying to lower her Prednisalone dosage by the introduction of Azathioprine but reduction showing MMM symptoms flare up ... Her MMM symptoms started following her booster vaccinations in January 2018.. two of my vets strongly suggest Lepto 4 as a trigger for her condition.. local vet who administered Lepto 4 of course remains very quiet on this subject, in fact refuses to speak about it. She was fully diagnosed March / April time and the details above are since then.  Palliative care or still a chance of a recovery My local vet avoids this subject too.... I ask because as a health practitioner myself I know the treatment plan for the two scenarios would be very different if I was administering the health care. Thoughts and experiences most welcome. All advice greatly received...

[Catherine]

 What dosage of Preds is she having?

[Jo CIMDA]

Hi and welcome

I am so sorry your whippet is not doing well.

As Catherine has asked, what pred protocol has she been on since the beginning of her treatment? 

Has she been on a gastroprotectant? 

What clinical signs are you most concerned about? 

Sometimes even if the AI disease is still active a dog has to be weaned off the pred and a different immunosuppressive drug has to be given, especially when treating a muscle AI disease.  Long term pred use can cause muscle weakness and often when treating MMM it is better to use a different immunosuppressive drug.   Have your vets considered drugs such as mycophenolate or leflunomide?

Are you in the UK.  Can you take her to a veterinary college or referral practice?

I apologise for all the questions.

Jo