Repeat CSF, risk v benefit?

Started by Lynneth, October 22, 2018, 02:14:30 PM

Previous topic - Next topic

Lynneth

Hi
So Boson was diagnosed with SRMA in August. He's doing really well now, personality and weight back to normal, and hes down to 5mg prednisolone every other day.
As part of the protocol given to us, our neurologist wants to repeat the lumbar puncture. 
I am not convinced it the necessity of this, plus , I believe there's a risk of relapse with an anaesthetic?
Please help, I need to be convincing when I ring the vet!

Jo CIMDA

Hi

I totally agree with you.  Resolution of the clinical signs indicate that the steroids have done their job and his SRMA is in remission - but this is never taken for granted until a couple of months after being weaned off prednisolone.

Relapses are reasonably common and certainly the stress of going to the vet and having a general anaesthetic could be the trigger that provokes a relapse.  I have never known a dog that has been treated for SRMA to undergo a spinal tap to see if remission is achieved - unless of course clinical signs dictate but even then, if clinical signs appear one can assume it is a relapse and immunosuppressive therapy is started once again.   Ideally, he would have to be off prednisolone for at least one month before a spinal tap is performed because prednisolone will mask results.  It makes no sense to me.

Jo

Lynneth

Thank you Jo. This is what I thought. If he didn't have the shaved lumber fur, you wouldn't know anything had been wrong with him. So there are no indications for the tap. I would be happy to run bloods, after he's completely off the prednisolone.
So do I actively contact them to refuse now (they want to do it in november), or wait to see if they contact me, then give them my thoughts?
They have been great but I just don't get the reasons for this unnecessary procedure!
Thanks again

Lynn x

Jo CIMDA

Hi Lynn

I would wait until they contact you and then say that you have thought about it and either you would rather not do anything like that now remission has been achieved, or you can always say you can't afford it - you may be surprised how many times this reason stops unnecessary procedures. 

Jo

Lynneth

Brilliant, thanks for all your help and reassurance. I will sit tight, and await contact!
Lynn x