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Author Topic: IMPA Well into treatment  (Read 175 times)

Mouse

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IMPA Well into treatment
« on: July 11, 2019, 04:44:21 PM »

Hello. I thought I should share my experience so far. Mouse was diagnosed with IMPA at the end of February, she has followed the recommended drug protocol on this site as prescribed by out referral vet. Her recovery has been text book to the point of reducing her pred to every other day. We noticed she was getting periods of stiffness and some pain in her joints again. This would happen every few days and last for about 2 days. Our vet recommended we step back to the daily dose of 7.5mg once a day for another 4 weeks. This seems to suit her and she was fine for more than two weeks then had another couple of days stiffness. She is eating and drinking normally, regaining some of her cheeky personality but still a bit slow on walks and hasnt had a proper run since January. We are expecting to try the drop to every other day again next week. Im really hoping we are not seeing relapse. Could the stiffness and slight lethargy be symptoms of steroid use rather than return of the IMPA? Im really hoping so as shes doing so well, from a very poorly indeed little lurcher in February to about 90% her old self now in July. Before becoming ill she was 17kg, she dropped as low as 12kg prediagnosis and is now 18.5kg. Id like to get her back to full fitness, shes just 5 years old and was a very fast girl who lived to run.
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Jo CIMDA

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Re: IMPA Well into treatment
« Reply #1 on: July 12, 2019, 04:12:43 PM »

Hello.  Thank you for the update on Mouse. 

It is difficult to know if the limping and stiffness is due to a relapse of the disease or due to the long term use of preds.   If a dog relapses then it is very likely they will have swelling around the joints and a high temperature.

Long term use of preds, especially in a lurcher dog, will take its toll and weight loss can be expected.  Other breeds are more inclined to put on weight but sighthounds are different because they have a faster metabolism. Also, muscle loss is inevitable and this will result in a stilted gait and tiring easily with fatigue.  These symptoms can be confused with a relapse of the disease.

This time around, as long as the adverse effects of the preds allow, try to take the reduction slower and nip down each reduction eg., 1mg at a time,  as opposed to reducing the dose by 25%, and get the dose as low as you can before going to every other day dosing.   You can take it as slow as you like as long as the Cushing's symptoms are not a serious problem.

I do hope the reduction works this time around, and Mouse is tearing about as she should be very soon.

Jo
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Mouse

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Re: IMPA Well into treatment
« Reply #2 on: July 19, 2019, 04:26:03 PM »

Thanks for the reply Jo,
We reduced Mouses Preds to just 1 (5mg) tablet a day around a week ago. All signs are good, shes had some good, longish walks since and is enjoying herself in the garden. She had a little run a couple of days ago. Shes interacting with us more and spending less time just laying around. Remembering that as a lurcher her normal state is upside down on the sofa! I think that after nearly six months of struggling with this horrible disease we are finally getting somewhere. Fingers crossed.
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Jo CIMDA

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Re: IMPA Well into treatment
« Reply #3 on: July 20, 2019, 07:39:27 PM »

Brilliant news.  I am so pleased, and I can feel your relief!
Jo
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Mouse

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Re: IMPA Well into treatment
« Reply #4 on: October 12, 2019, 10:10:53 PM »

Quick update on Mouse. We managed to reduce her preds to 3 mg a day. Weve now encountered a relapse. Shes been stiff and limpy for a couple of weeks now, weve upped the preds first to 4 now 5 mgs. We havent seen as much improvement as we hoped. Shes OK in herself, eating and drinking normally and seems to walk off the stiffness. The rain isnt helping as shes a lurcher and lurchers dont do rain! Speaking to the vet on Monday to see where to go from here. Hopefully shell pick up again soon and we can carry on with her taper. She was doing so well. She has now been on steroid treatment for 8 months and on the positive side is so much better than when we started.
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Jo CIMDA

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Re: IMPA Well into treatment
« Reply #5 on: October 14, 2019, 12:30:21 PM »

Hi
I am sorry Mouse has relapsed.  Unfortunately, with inflammatory IMPA  it is not uncommon but that doesn't mean that she will not achieve long term remission.

When a dog relapses, usually the dose of pred has to be increased to immunosuppressive doses again and not just a minor increase in dose.  You do need to knock out the immune system again, and wean down as before,  in order to achieve long term remission.  You will only get temporary relief if the dose of pred is marginally increased and as you reduce the dose there is a real risk of further relapses. . 

I know this is disappointing but I do hope your vet will see the necessity of resuming immunosuppressive treatment.
All the best
Jo
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Mouse

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Re: IMPA Well into treatment
« Reply #6 on: October 14, 2019, 07:25:33 PM »

Thank you Jo,
Weve spoken to our vet today and she is going to contact the referral vet. This seems to be the way things are going. Mouse has been brilliant today however, hoping she can keep it up :)
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Jo CIMDA

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Re: IMPA Well into treatment
« Reply #7 on: October 15, 2019, 12:25:00 PM »

That is good, and I hope the referral vet will give you guidance.

Fingers crossed!

IMPA does carry a good diagnosis, so I am very hopeful that Mouse can reach long term remission and ge5 back to her usual active, happy self.

Jo
 
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Mouse

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Re: IMPA Well into treatment
« Reply #8 on: Yesterday at 10:47:35 AM »

So we are back on high power preds again. Starting from the beginning but actually in a much better start place with a dog who nowhere near as poorly as she was when first diagnosed. Hopefully we are doing the right thing by her. The referral vet suggests we may be able to reduce the dose a little quicker this time around but well take is a step at a time. The prognosis is still good long term so fingers xed.
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Jo CIMDA

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Re: IMPA Well into treatment
« Reply #9 on: Yesterday at 11:21:43 AM »

Hi

I am so please the consultant has acted quickly, and like you say you may be able to reduce quicker this time around. 

This is a common scenario.  Of course that doesn't lessen your stress but knowing that is is not unusual and long term remission can be achieved I hope will give you the belief that this time around it might be achievable.

Mouse should be on a  gastroprotectant such as Omeprazole.  In light of the recent withdrawal of Ranitidine from the shelves, if she is on Ranitidine (Zantac) then I would ask the vet to change to Omeprazole.

All the best

Jo
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Mouse

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Re: IMPA Well into treatment
« Reply #10 on: Yesterday at 04:47:23 PM »

Thanks Jo, I have a supply of Omeprazole left over from her last steroid high and have started that again as well. Hoping for an improvement over the next few days.
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