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stella pred reduction

Started by shawkyelisabeth, May 21, 2012, 02:01:45 AM

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shawkyelisabeth

Sorry I wasnt around for some time with problems of internet access in our home! Stella is doing well < I discovered some  fur loss on her forlegs with some white dandruff like stuff that I interpret as a kind of fungus> I do relate it to the preds and I decided to reduce her dose now to 5mg eod after 18 days of 5mg once daily. I do not get back to my vet because he does oppose such a long pred treatment anyway and would prefer to reduce much quicker.
Yesterday she did not eat  but drank a lot which I referred to the high heat here in Egypt, in the cooler breeze in the evening she ran a little bit but not quite as lively as I am used to. This morning she woke me up very early to tell me she had to go out to the garden when I found she had diarrhea, I gave her a medication for it  and now I hope it does not develop into something bigger because I really dont want to get her on antibiotics or any other stuff! I hope I can get her to eat today, her normal menu is joghurt with honey in the morning or at midday and meat or chicken with noodles and some vegs in the evening, its a routine and there was no change in her food. Did I do something wrong with the reduction ?
Hugs and greetings to everybody Elisabeth

Jo CIMDA

No Elisabeth, you haven't done anything wrong with the reduction of meds. 

One has to be very brave at every reduction, but it has to be done.  I would guess that the diarrhoea is unrelated, and like all dogs an upset tummy will happen from time to time.  It's good you have 'stuff' to give to her.  I hope it works soon.

You are so sensitive to what is going on with Stella and it is natural that the thought of a relapse is always lurking somewhere in the back of your mind.  We have all been in that situation and although that doesn't make it any easier for you, as time passes you will become more confident that a relapse is unlikely. There are no guarantees  but eventually we have to believe it because if we don't we are driven crazy and become seriously paranoid.  It's strange because you never forget these memories and the feelings of insecurity that goes with them.

Just something to watch out for if the dog is anaemic is orange coloured stools, and the dog starts to eat dirt or stone. Not all dogs show these signs but many do.  The fur loss would be due to the preds.

I look forward to reading that her stools are normal again and she is fine.

Jo

gschellinger

Hoping for the best with Stella and her poorly poops. Keep up the good reports!
gail
gail and Lola (SLE, hereditary cerebellar ataxia, chronic undiagnosed nasal congestion) usa

shawkyelisabeth

Thnk you both for always giving me confidence stela has eaten yesterday and her stools are normal today , she is very lazy and i stil atribute this in large part to the heat herebut the way she is walking reminds me a bit of the bad days we have hd with her head down and not proudly raised as what i have seen in her lately. Yes joe you are right maybe i am alredy getting a bit paranoid but that is due to the really very hard times we have gone . I hve a bit of a doubt that she is feverish so i gave her a tablet just to see if it improves her condition nd then i will have to consider taking her to the vet. I think it might just be due to the high heat e have here and i keep her in cool places most of the time . Hugs elisabeth

Penel CIMDA moderator

A good tip that might help - you can freeze small bottles of water, and place them around the areas she likes to lay down, it sort of acts like air con (as long as she doesn't chew them!).
Penel
(SLE, Surrey - UK)
Forum Owner
CIMDA

Jo CIMDA

Hi Elisabeth

If Stella is hanging her head, I wonder if she has an infection that may need antibiotics. You are so in tune with her, go with your instinct.

Jo

shawkyelisabeth

Yes jo i suspect some kind of infection as well.
Maybe sore throat, since she refuses to eat anything, she sniffs t the food nd then leaves it, i got some joghurt with honey into her tody only. Few spoons thats it. I contacted my vet and he advised to give her an antipyhretic and see her tomorrow so i will do bloods as well. I will keep you updated hugs elisabeth

Jo CIMDA

Hi Elisabeth

Stella is clearly not right.  If it carries on then you may need to take her to the vet -  but can your husband get antibiotics for her?  Perhaps he could take blood and send it to the hospital for tests.

Hope she picks up soon.

Jo

shawkyelisabeth

HeRt  jo i am just on my way back from the vet, he thinks that i reduced 5mg eod too early and wants stella back on 5mg daily, he says she got a respiratorry tract infection due to the reduction, she obviously has a weakness in her back legs that he thinks is not related to the cortisone, he prescribed vitaminee injections for that and an antibiotic for the infection. Do you think it is right to go back to 5mg daily after one week of 5mg eod, can this really have such an effect or could it be just an infection  that could have occured anyway?he wants to continue her on 5mg daily for another 21 days which will make a total of 439 days then and he. Says she moght have to stay on that dose for the rest of her life?i would like to know your opinion. The blod test result will be out this evening, i will keep you updated, hugs elisabeth i have to add thtat she had no fever this morning and was much livelier but still refused to eat, even her favourite cheese.my husband suggested to go eod in his opinion the reduction could not have caused the infection. Pls comment

Jo CIMDA

Hi Elisabeth

High doses or prolonged doses of preds are more likely to cause infection, and I haven't known a reduction to do so.  If anything, a reduction will improve the immune system and lessen the chances of an infection. Also putting her back to 5mg a day certainly won't do anything to help an infection but the antibiotics will. If it is a relapse of AI, increasing the dose back to 5mg every day will not address the problem, so I don't really know where your vet is coming from.  If she is feeling brighter today then my hunch is Stella has an infection.  UTI's are very common, and debilitating, and it might be worth testing her urine.  Can you buy Multistick testing strips for humans in Eygpt? These can be used to test dog urine too. They are very useful to have in stock.

I don't understand why he doesn't think that her back end weakness isn't due to the preds.  Given the treatment she has been on it would be expected.   

5mg every day for a while longer probably won't make much difference to her if you want to keep her on this dose for another 21 days.  All it does is delay the next stage of going EOD.  Some dogs have to stay on daily steroids for life, but it is more common, if a dog can't be taken off steroids, for the dose to be given every other day even if the dose is doubled.  In Stella's case the EOD dose would be 10mg and this would be more beneficial to her than 5mg a day.  I still have a feeling that you will be able to get Stella off the steroids.

These blips do happen and I am hoping that Stella will continue to pick up and will be back to her old self very soon. I'm so please you have some AB's for her and it will be interesting to see what her bloods are doing now.

Jo

gschellinger

Poor Stella. I will keep her in my thoughts. Such a long time on pred. I would agree that the pred reduction didn't cause her illness, but rather the other way around? Being on pred takes it's toll on the immune system.
Just my gut feeling.
gail.
gail and Lola (SLE, hereditary cerebellar ataxia, chronic undiagnosed nasal congestion) usa

Angela

Hi Elizabeth,

Did you mean your vet is recommending 49 days at 5mg every day?

My only suggestion is that you wait until you have the blood test results back before making any decisions.  Stella has obviously been off colour & it may be a UTI in combination with the extreme heat you are having or have had which has caused the upset.

Breathe deeply, you know her best & your gut instinct has done very well so far.

Hugs from Oz
Angela (AIHA & Addison's)
NSW Australia

shawkyelisabeth

Hi everybody, my vet meant 39 days, i made a mistake.
Now stellas blood results after 28 days 20mg twice daily, 21 days 15 mg twice daily, 2o days 10mg twice daily, 12 days 7'5mg twice daily, 14 days  5 mg twice daily, 18 days of 5 mg once daily, and  8 days 5mg eod :
Haemoglobin   12.9
Rbcs.               4,95
Haematocrtit.   41,0
M.c.v.               82,7
M.c.h.               27,0
Mchc.                31,5
Platelets.          220
Wbcs.                 8,25
The laboratories comment: normoblasts 6/100wbcs are seen
                                        Normocytic normochromic anaemia
                                        Neutrophils show shift to left
I have to mention Haemoglobin up from 3,4 , rbcs up from 2.0 and haematocrit up from 11.4.!!!
She is a bit better today eating litle and on Antibiotics since 36 hours. I do want to keep herr on 5mg eod, i think her muscle weakness is related to the preds and i hope will improve with the reduction.i am very confident in what jo is telling me and my gut instinct tels me that she wil do fine with maybe a month on 5mg eod and then reduced to evy third day. I think it is only some kind of infection that always comes along at any time , she is livelier now and yes angelA the heat might certainly play a great factor. I very much appreciate your comments on her bloods and on the labortories comment about that anaemia.
She has not had her heat yet but i found few blod drops arounsd her, could it be tht she has got her first het and that is a reason for her being not so well?
Hugs to evyone and thanks so much for your constant suport,
! I se the vet only for taking bloods oyherwise i am not in sync eith him any more and itake my own risk in stellas treatment elisabeth

                                         
                                         

gschellinger

That is certainly good news concerning her blood count. I am not certain what all the numbers mean but the hematocrit must be good!
About her heat...always the hormones can play a part in the wellness of the dog, esp. if there are other things going on. But you want to be sure not to blame something on one thing "just because" it happens at the same time. But perhaps you are right about the timing of the events with her heat cycle. At least things are looking up for Stella!
Best wishes for Stella, as always, and you too, Elisabeth.

gail.
gail and Lola (SLE, hereditary cerebellar ataxia, chronic undiagnosed nasal congestion) usa

shawkyelisabeth

Big hug from stella to lola and have a good day together! Elisabeth