Further Update on Harley

[DW]

I Hope this reaches the correct part of the Group..........

I posted a message a while ago, the first update after harley was diagnosed with IMT.
Towards the end of October, apart from the Antepsin (which was now being given 2 hours befor and not the 1 hour that I had been told to do previously...and as a result, maybe coincidentally, his platelet count started to rise after this!!!) - Harley was taking  half a Pred
(12.5mg) twice daily.  This was being given 12.5mg a.m. and the same p.m.  (25 mg daily).
He was also taking 50mg Aza. daily - along with the Zytec.
harley had suffered an upset tummy, which I am sure were caused by the meds and Promax over three days resolved this.

From the 4th November  - his platelet count had risen to around 430  and his Preds were dropped to 25mg / 12.5mg on alternate days, i.e. approx 3/4 tablet daily.  The Aza's were left to 50mg on alternate days.

From the 14th November the Platelets had dropped very very slightly (around 415) - the Preds were dropped to 12.5mg daily and again, keeping the Aza's as they were (every alt.day).

Today, we were due to have his bloods taken again p.m.     However,  about to take him out for a walk and I noticed that his eyes, particularly one eye, was droopy.  The lower lid was quite low and his eye-ball barely visibly.     I was thinking 'Horners' !!   However, he didn't have any of the other symptoms that you would expect to see with Horners.     I took him straight to the Vet but typically, by the time we got there, his eye was back to normal.
We were lucky to see our normal Vet and her suspicions were that it was likely to be down to the muscle wastage that Harley has suffered noticeably in the head region (above the eye sockets).    She felt that this wastage was a little more noticeable than before
but not to a worrying degree, as she said some dogs do get this quite severely and some that are on lower doses than Harley.
She took him off to check eyes (I was scared that maybe this might after all be turning into a 2ndry IMT and that something might be going on with his brain........we had lost a dog once to a brain tumor and she knew my thinking without my having to say anything).
The eye looked healthy and nothing to give her cause for any worry.   She checked for infection.....nothing.   Blood levels were excellent and the Platelets ?    They had risen to almost 600 !!!
I mentioned about possible clotting risks but she said at this stage, she wasn't concerned and though that the reason the count had risen over two weeks (the time he has been on Aza's) is due to the fact that the Aza's hadn't completely kicked-in at the last count.

We have reduced the steroids by a small amount again......He is now on 2 x 5mg tablets daily and a re-cheque in a week.

No one said that this was going to be a walk in the park and compared to so many of you, we should be so grateful but one thing for certain, after all this is over - I shall be doing everything in my power  to support research and offer help in anyway I can, to try and find more about A.I.D's....

I will keep the Group updated but my huge huge thanks (I am indebted) to Jo and the team for your help, advice and important support that I just cannot imagine how I would have coped without.

Thank you everyone.

Gwyneth and Harley (Who is turning out to be a very special, gutsy little chappie...a fighter)

[Jo CIMDA]

Hi Gwyneth

I hope Harley's eye improves very soon.  How is he in himself?  Do you know the vet's platelet reference range?  As the platelets have increased considerably I am surprised the vet only reduced the steroids by 2.5mg.

It is never a walk in the park Gwyneth, not even for those dogs who recover in text book fashion but it does get better and things settle down thank goodness.

Jo

[DW]

Hello Jo

I think part of that decision might have been due to my influence.   I think that the Vet was talking about reducing to 1/2  a  25mg tablet one day and a quarter the next.   I was worried about dropping it - in view of the fact that he had dropped his count once before BUT admittedly, this was when it was on a more radical drop at a time when his platelets weren't that high.

I wonder if it would hurt if I did drop them as suggested....i.e. give half a tablet one day (12.5mg) and  then give a 5mg tablet the next - this would mean he would be averaging 17.5 mg over two days ( a drop to the current rate of 7.5mg instead of 5mg over the same two day period?

I am almost tempted just to start doing that today?

Yesterday he had the first of the 2 x 5mg tablets (10mg in total yesterday)....so would I give him 12.5mg today and give him the 5mg tomorrow ?



Gwyneth

[Jo CIMDA]

Hello Gwyneth

So many different aspects have to be looked at when a dog is on preds, and none should be over looked or even dismissed.  As much as you don't want another relapse of the disease you also don't want the platelets to go very high and both are important and should be reflected in the treatment plan.  You can certainly do as you are suggesting or even lower.

Jo

[Catherine]

I must admit I found the dosing rather confusing. I prefer to work with 5mg Preds  Also, IF a dog is coping well with the medication then I think it is better to go slightly slower and for longer with the medication reduction. With our AIHA Beardie she was only on 25mg Azas plus Preds and we kept the Aza on every day at first so I am not sure how the increased Aza and every other day works out.

Have you had Harley's kidneys, liver checked to see how he is coping with the meds.? I do not have all the facts and can not see how Harley is but I think i would stick to the Preds being 2 x 5mg daily and then when he is tested next week if all okay then possibly reduce to 1x 5mg daily.

How is Harley's eye? Does he have any other symptoms?

[DW]

Hello Again

I must apologise - I am so thick and worry about myself some times!   I wonder if steroids will help my intelligence!!!
I misled you////his platelet count was actually 500 not 600.     I spoke to the Vet today and she wants to keep on the
2 x 5mg daily for a week and see how he is then before reducing further.

She said his blood count was excellent, so at least that's something less to worry about !

Harley's eye seemed to be o.k. after that one episode and it is o.k. again today.   He seems o.k. in himself - no changes, derogatory ones....in fact we have actually started to see a very little glimmer of his impish old ways.  He has instigated play fights with his mate - something that hasn't happened for, what seems like, an eternity and it makes m so happy to see......so happy.

Isn't it funny, he hasn't ever been an easy dog - he was very hyper as a puppy, very naughty and used to run off when off the lead and on one occasion, ran through three fields before I got him back.  Naughty wasn't in it - he was a little 'bugger' but do you know, I sit here each day wishing upon wish that I had all that back and vowed never ever to moan about his little ways again.   Like all of you, I adore my dogs and I get terribly emotional when they are not well and are so vulnerable.    I am just so glad that I was destined to take care of him and that he didn't go to someone that maybe, would not have given him the same attention.

Someone mentioned about Liver and Kidney function?   Is this something that the blood tests would bick up on?  She tested for infection and that was o.k.   Are you saying that the eye droop might have indicated a problem in those areas?

Many thanks
Gwyneth

[Catherine]

I asked about Harley's kidneys and liver and about his eye but not linking the two. It is usually a good idea to have biochemistry (general health profile ones) blood tests regularly when a dog is on steroids to keep an eye on the rest of the dog - the kidneys, liver, electrolytes etc. The haematology blood test is just for HCT (PCV), white blood cells, platelets etc. Your vet will be able to tell you what Harley has been tested for.

Good that he wants to play and he is making you smile.

[DW]

Thankyou for the advice.

I will ask the Vet to check these out on next visit - just to be sure.

Thankyou.

Gwyneth

[Penel CIMDA moderator]

Hi Gwyneth,
Thanks for keeping the group updated, it's great to hear that Harley is doing so well.  I hope the eye thing was just a weird one off thing.

[shawkyelisabeth]

Hi gwyneth, i am following your update on harley and with all the good advise you got from jo and others of cimda it remains that i wish you from my heart that your boy will be well again and back to his own self after slow tapering, dont give up hope and be patient..its a long way , but i am sure he will make it....fingers crossed...elisabeth

[DW]

Thank you Elisabeth and I apologise so much for not saying so sooner but I was having awful problems trying to access the site again.
I am hopeless on technical matters (goodness how I ever managed to hold down a job which involved using Computers - must be my age)...

Anyway, thankyou for your well wishes.

We have had another blood test done - all was fine  - however, despite dropping the Preds to two 5mg tablets daily (and retaining the Aza dose to 50mg on alternate days) the platelets went up again.    I suppose it sounds as tough there is no pleasing me but because of the mention of clots - I was concerned.
the week before last it was 525, then we dropped to the dose above and on Tuesday the count was 600.
I mentioned my concerns to the Vet and she said that she wasn't overly worried at this point and would be much more concerned at prescribing Asprin - given the problems with his tummy and the bleed he had.    She said she will see what it comes in at next week, after reducing the steroids again.
We are now on 10mg every other day + the Aza and from there, wants to drop very very slowly then.

She must have been concerned that I was worried and I was very impressed to have got a phone call at about 8.00 p.m. that night from her, to say that she has also spoken to the AHT in view of my concerns and they have said the same.   They feel that there is no need to worry at this point and they too would not prescribe Asprin

Could I ask, what some might think is a silly question.......as Harley is very bony, no muscle (no bone covering) - as the weather is getting colder now, although he isn't showing signs of being cold, should I put a coat on him?   Sorry if this sounds daft but I am just concerned that he may not cope as well with the cold whilst he is like this.

I have to say that he has a good coat and always walks quickly and as I say, has never shown signs of being cold - quite the opposite, he prefers to sleep on the quarry tiles in the kitchen even now, rather than his thick duvet !!!!

One nice thing as well.......Harley isn't weeing for such a prolonged time now and I think we may manage to go a full night (6.00 a.m.) before having to wake up and put him out.   This is such a treat for us...though i would never ever moan at having to do it.


gwyneth

[Penel CIMDA moderator]

Yes I would put a coat on him.  My lurcher who has IBD (I need to start a thread about him) has a thick coat too but since he's lost so much weight and is on immune suppressants - I'm putting a coat / jumper on him on colder days.

[Catherine]

It is not a silly question  I think an ill dog or one that is recovering or even an elderly dog needs a coat on when going out in the cold or rain. Their systems are not working so good so they do not want to have the added problem of keeping warm and dry. We put a warm coat on our AIHA Beardie as she had lost a lot of fur due to the disease and steroids and her backside was bare in places! I would also try to encourage Harley to his duvet at night or when it is very cold 

[DW]

Thank you for the responses.   I have a lovely dog coat that I had for my older boy when he was with us and it's a nice warm fleece inside and waterproof quilted on the outside, so it should keep him nice and cosy.

I may not have to do any encouraging as far as getting him on his warm bed at night, as we have noticed this last few days that he has been curled up on his duvet when we've gone to bed and when/if we have got up in the night....so let's hope he doe stay on it.
It's a warmer thicker duvet than even we have on our bed !!!!!  (My husband wished that he was a dog in this house sometimes).

Thank you  - yet again

Gwyneth