Steroid Responsive Meningitis ?

[Elaineb1624]

Hi,
Firstly i'll start with my apologies, i'm new to this and may not be posting the right thing in the right place, but here goes.....

Our little Whippet, of 18 months, fell ill a few days ago, so we did the right thing and took here to the vets, but after x-rays, ultrasound, in house & external blood tests, antibiotics, she is no better and we have no real diagnosis. Tomorrow we have another appt. with the vet, and we have a choice of continuing with the treatment she is currently on, antibiotics etc or going down the steroid treatment route.

However a lot of her symptoms would appear to fit with SRMA, lethargy, crying, shaking, fluctuating temperature, loss of appetite, but how do i go about presenting this to the vet, without them thinking another diagnosis from the internet, and perhaps more importantly finding the right vet (referral ?), in the south of England, to rule or out or rule in SRMA ?

Any advice will be greatly appreciated

Many thanks.

[Clover]

You should see an internal medicine specialist, and can ask your vet for a referral if one is needed.

[Jo CIMDA]

Hi and Welcome

I'm sorry you little girl is having this problem.  I think the best way to tackle your vet is to say that it is known, and well documented, that Whippets can have a genetic predisposition to autoimmune disease, and as they are unsure how to proceed could they please refer you to an internal medicine specialist. 

If you are in the south of England you have a lot of good options. The Royal Veterinary College is at North Mimms,  and that is a  great location for anywhere near the M25.  Anderson Moores is near Winchester.  Wey Referrals is in Woking.  VRCC is in Laindon in Essex. All of these have a very good reputation but there are a couple of referral centers, I won't mention,  that I wouldn't recommend.

The problem with your vet giving steroids is this masks other tests and you wouldn't be able to have, for example, a spinal tap to confirm SRMA if she is on steroids.

I do hope you can get help very soon. 

Jo

PS. you can tell your vet that the Whippet club has had seminars about autoimmune disease.

[Elaineb1624]

Hi Jo,

Thanks for your response, unfortunately because of the atrocious weather we missed the last seminar you spoke at hosted by South West Whippet, but have the notes from that that talk and have passed these onto our vet, plus other notes we got directly from you from a 2001 seminar.

Our vet was going to refer us to Anderson Moores but with money being an issue we've chosen to treat it symptomatically, however our vet has said she will speak to Anderson Moores regarding the condition.

So far our little girl seems to be responding well to treatment.


Elaine.

[Penel CIMDA moderator]

Hi Elaine,
That's good to hear your whippet is responding to treatment.  Be aware that whippets (and other sighthounds) find prednisolone hard to tolerate - don't forget the gastroprotectant in particular.
Fingers crossed.

[Jo CIMDA]

Hi Elaine

It's great to hear that she is responding to the treatment.  You just have to make sure the reducing protocol is correct and the example in the notes by Michael J Day, is the best one I have come across.

Jo

[Elaineb1624]

Hi Jo,

Many thanks for your further observations, where could i obtain a copy of the notes you refer too ?

Thanks

Elaine

[Elaineb1624]

Hi,

Another question if i may ......

Now our girl is on steroids we've been told she will eat & drink like a horse, when ? Accepting the steroid course started in earnest yesterday she is still be very picky about eating and drinking and we're perhaps concerned she isn't eating or drinking enough.

Thanks again.

E.

[Jo CIMDA]

Hi Elaine

This protocol is in the seminar notes.

Example: Reduction Protocol for prednisolone:

Clinical Immunology of the Dog & Cat , 2nd Edition,  by Michael J Day

This example is base on a dog receiving an induction dose of 1.0mg/kg/q 12hrs (q = every)

Dose                           Duration (based on clinical effect)
1.0mg/kg/q 12h                          10-28 days
0.75mg/kg/q 12h                       10-28 days
0.5mg/kg/q 12h                         10-28 days
0.25mg/kg/q 12h                        10-28 days
0.25mg/kg/q 24h                        10-28 days
0.25-0.5mg/kg EOD                    at least 21 days
0.25-0.5 mg/kg every third day      at least 21 days
Every reduction is made after consideration to improvement of clinical signs, blood results and side effects of the drugs..
The dose of azathioprine 2mg/kg/24 or 48 hrs, can be reduced initially by giving a lower dose tablet per day, or gradually reducing from daily dosing to every 2nd day, every 3rd day, every 4th day etc.....  Remember, azathioprine tablets should not be broken or handled without gloves.


What dose of steroids is she on?  I presume she is on prednisolone.

Jo

[Elaineb1624]

Hi Jo,

Thanks once more your response, yes we have those notes from the SWWC seminar.

She is on Prednicare, 40mg per day, 20mg x a.m. & 20mg x p.m.

However the latest development is that she had to be admitted to an emergency vet this morning to be rehydrated, and we are waiting on a call around luchtime to update us with her status.

Elaine.

[Penel CIMDA moderator]

Hopefully by now you've had some good news Elaine.

[Elaineb1624]

Hi,

After a days rehydration (yesterday) she has come home a lot brighter, and more like herself. She is sleeping well, temperature still seems good, so fingers crossed the rcovery can start properly now.

Elaine.

[Jo CIMDA]

Hi Elaine

Why had she dehydrated?  Do be mindful that Whippets get Addison's disease.  I am not saying for one moment that she has this but when things don't go according to plan then you have to think outside the box.  Do you have any blood test results?  Is she on a gastroprotectant?

Jo

[Elaineb1624]

Hi Jo,

Sorry for the delay in responding.

Think the dehydration was really our fault, we weren't keeping a close enough eye and what she was or wasn't eating/drinking. Since her last rehydration she seems much better, both her appetite for food & drink seem to be returning, and whilst it is early days on a long road she seems to be becoming better & brighter with each passing day.

Fingers crossed, many thanks for your advice and support, will post an update after her next veets appt, next Tuesday.

Elaine.

[polly]

As |I am a whippet owner I am so sorry to read about your whippet's distress. Hope a firm diagnosis is made soon and she recovers.