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Author Topic: stella pred reduction  (Read 58777 times)

Jo CIMDA

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Re: stella pred reduction
« Reply #120 on: September 10, 2012, 10:07:02 AM »

Day2 of our second attempt of pred treatment at 25 mg twice daily:
Stella is okay, lively, eating better, but panting heavily, that worries me a little.
In comparison to the first time this time it is much hotter that might contribute to it.
She drinks a lot and I try to keep her in cool places. She has one more day to take her antibiotics
And then hopefully the stress of medication will not be too heavy on her.

Hi Elisabeth

It is good news that she is lively and eating better.  The heat can be a problem but you will do what is best for Stella. I'm sure you have ways of cooling her down.

At this stage you can't ask for more.  It means she is responding to the preds. 

jo


 
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shawkyelisabeth

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Re: stella pred reduction
« Reply #121 on: September 14, 2012, 05:46:50 AM »

Day6: stella is ok, a bit lazy , not eating as much  as I would have expected at this high dose of preds, she is lively, but lies down quickly after short efforts, I keep watching this...gums were a bit pale at start, now  more rosy, we are due for bloods in a few days. Her hind legs were very weak yesterday after we had seen some improvement for a couple of days. I relate it to her hd now so maybe it is also the extra weight she has put on that is a strain on her legs. But I encourage her when she gets too desperate with her legs slipping apart and then she happily starts running again after her cloth ball. Hoping we can avoid side effects this time again.
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Angela

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Re: stella pred reduction
« Reply #122 on: September 14, 2012, 07:41:16 AM »

Hi Elisabeth,

I would put the cloth ball away just for now as she will need all her energy to fight this.  There is the risk of high dose and/or long term pred causing weakening of muscles and ligaments so be careful with her, the last thing you need is a torn cruciate (sp?); not saying this will happen, just that it is a another risk and best avoided if possible.

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

Shannon

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Re: stella pred reduction
« Reply #123 on: September 14, 2012, 08:25:33 AM »

Hi Stella,

That's really kind of you to let your mum rest while you have a nap. I never let my mum get away with that, she must get up when I say so. I've been a busy boy this morning, my mum and I have been to feed the horse, I've eaten my breakfast and had some apple because those little white tablets I get make me very hungry. I hope you're feeling better and that you are getting stronger. I feel quite a lot better and my mom said my eyes are sparkling again. I hope today is a good day for you and that you continue to get stronger... Your friend Cooper :)
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shawkyelisabeth

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Re: stella pred reduction
« Reply #124 on: October 01, 2012, 08:34:34 PM »

sthg must have been wrong with the cimda site lately, i tried many times to access it, but always had an insert saying bandwidth exceeded, error report to administrator or site owner. when i tried to post i was able to write but  the post icon would not  work..i hope it will now..
i really want to report about stellas latest dvelopments..she had bloods done last thursday with the following results after 18 days of preds:
WCB 27.93
LYM 0.40
MD 1.35
GRH 26.8
LY 1.4
MI %4.8
GR % 93.7
RBC 4.676 up from 3.86
HGB 11.3
HCT 34.00 up from 25.78
MCV 73
MCH 24.1
MCHC 33.2
RDW22.6
PLT319
PCT 0.29
MPV 9.1
PDW 37.4
stellas vet suggested to keep her on 25mg twice daily for another week so she would have it for 28 days following MJ Days protocol.
stella is doing fine but maybe not as well as the first time on high preds, she is not putting on so much weight, drinks excessvely, heavy panting..she has good reactions  and is lively in good spirits, but lazy and not as active as i expect her to be.
she has a diaerrhoea since this morning that i treated with a medication she accepts well.
I will get her back to the vet earlier on thursday and suggest to start reducing preds a bit earlier, as i think her blood picture is okay. her higher wbcs have no obvious infectious cause due the vet and he did not want to give her antibiotics but wait a few more days to spare her too much medication.
i do hope we can reduce quickly as i am worried that she is showing side effects. we still have a very long way to go..
greetings to all and i hope the site is accessible now without interuption.
best regards from elisabeth and stella
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Angela

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Re: stella pred reduction
« Reply #125 on: October 02, 2012, 01:33:57 AM »

Hi Elisabeth,

Stella has responded really well again, thank goodness.  JMHO but I think you could begin reducing now with these results as Stella's hct is so close to within nromal range (36-55%) and I would not delay in adding the antibiotics as controlling any infection will help with her well being and her recovery.

Big sigh of relief in Oz

Hugs to you, your family & Stella
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Angela (AIHA & Addison's)
NSW Australia

shawkyelisabeth

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Re: stella pred reduction
« Reply #126 on: October 02, 2012, 06:19:20 AM »

Hi angela, i knew you would be the first one to reply...thanks to the oceans between us..i keep a close eye on your protocol...i will get to the vet on thursday and try to reach him by phone today, ithink its time to reduce..stellas hindlegs are very weak and this i feel is not only due to the hip problems she has, i think its also a muscle weakness..we still have a long time ahead of us on high preds...i dont think we could taper by 50percent , but by 25 which means she should get 18.75mg twice daily now which is also not a small dose..keeping fingers crossed...her muscle weakness worries me...
Hugs to you and your fur kids...elisabeth and tella
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Angela

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Re: stella pred reduction
« Reply #127 on: October 02, 2012, 08:05:54 AM »

Hi Elisabeth,

You could try adding extra calcium and possibly vitamin D to Stella's diet to try to halt the effects of decreased bone density and weakened ligaments due to pred.

"Corticosteroids, such as cortisone and Prednisone, have an adverse effect on bone and soft tissue healing. Corticosteroids inactivate vitamin D, limiting calcium absorption by the gastrointestinal tract, and increasing the urinary excretion of calcium. Bone also shows a decrease in calcium uptake with cortisone use, ultimately leading to weakness at the fibro-osseous junction. Corticosteroids also inhibit the release of Growth Hormone, which further decreases soft tissue and bone repair. Ultimately, corticosteroids lead to a decrease in bone, ligament, and tendon strength.."

Surface Hippy 2005, Surface Hippy - Guide to Hip Resurfacing, Cortisone Decreases Bone, Ligament and Tendon Strength by Ross Hauser, MD, "http://www.surfacehippy.info/cortisonedangers.php", viewed 2nd October 2010

Hugs
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Angela (AIHA & Addison's)
NSW Australia

shawkyelisabeth

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Re: stella pred reduction
« Reply #128 on: October 02, 2012, 06:46:25 PM »

I already did, angela, she gets long acting vitamin D injections once a week plus calcium with her food.hugs
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Jo CIMDA

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Re: stella pred reduction
« Reply #129 on: October 03, 2012, 01:10:33 PM »

Hi Elisabeth

It was only yesterday that I thought I would post a message asking about your Stella.  As angela wrote, she has again done well and responded as you would hope, but I do agree with you lowering the steroids now and not leave it another week.  Her PCV is good and you should reduce the clinical signs that you are seeing. I presume you are giving a gastroprotectant and you could also add an antithrombotic dose of Asprin 0.5mg/kg/twice a day (Plumb's Veterinary Drug Handbook) if you thought it necessary.

I am so pleased she is doing so well and these side affects will start to subside as you know.  It is a waiting game, isn't it? Sooo frustrating!  I'm also very glad you have this new vet who Stella seems to like a lot.

Jo

p.s. Sorry you have had problems with the site. 
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shawkyelisabeth

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Re: stella pred reduction
« Reply #130 on: October 03, 2012, 03:33:03 PM »

Thank you jo for thinking about us. We are going to see the vet tomorrow and have preds reduced...and  keep on crossing thumbs and paws.. Elisabeth
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shawkyelisabeth

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Re: stella pred reduction
« Reply #131 on: October 06, 2012, 09:29:56 PM »

Unfortunately today's news from our visit to the vet are not so good. Stellas blood test revealed:
Wbc 39.87 up from 27.83  nine days ago
Lym o.40
Md 0.72
Gra 38.76
Ly 1.0
Mi 1.8
Rbc 4.055 down from 4.676
Hgb 10.1 down from 11.3
Hct 30.62 down from 34
Mcv 76
Mch25
Mchc 33.1
Rdwc 22.6
Plt 330
Pct 0.31
Mpv 9.4
Pdwc 37.2
Her vet prescribed 1 tablet of imuran 40 mg for one week and half a tablet for one week, he will see stella again after a week to assess her anew..he says he did not want to give an antibiotic because the raised level of wbcs are not necessarily related to an infection, her clinical picture does not show any indication of a n infection. He thinks that she is not responding well enough to the preds and needs azathioprine treatment to support the cortisone .
Stella did very well initially until 25 days into treatment with preds 25mg twice daily, then we tapered preds to 18.75 mg twice daily and will continue with this dose for at least a month besides the imuran.
I would much appreciate your comments on this treatment.
Stella is okay but not as good as she was the first time..She is less active and has her head hanging down a bit..her hind legs are weak and slip away often, but she can climb stairs and goes for walks in the garden.i let her out more than the first time because it raises her spirits when she is withnthe other dogs.
So deep sigh and trying not to startworryimg too much again..will it turn out well this time?
Hugs to everyone elisabeth and stella
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shawkyelisabeth

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Re: stella pred reduction
« Reply #132 on: October 07, 2012, 07:28:12 AM »

We could not find the imuran, so stella is on 50mg azathioprine once daily for a week and then 25mg for three weeks. I know that azathioprine shows effect only after 10 days so i will discuss the issue of reducing after one week again with our vet.  We will have bloods done again after a week..she will continue with 18,75mg twice daily for a total of 28 days. Your input is much appreciated.
Elisabeth and stella
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Shannon

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Re: stella pred reduction
« Reply #133 on: October 07, 2012, 02:15:53 PM »

So sorry Stella is having another hiccup. It truly is a rollercoaster ride with these special babies of ours. Will be keeping fingers crossed that the next bloods show an improvement.

Coop apologises for not replying to Stella earlier but he hasn't had a chance. He says to tell her to keep fighting this, that she'll win this battle and that she's very lucky to have a mum that loves her so very much.
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shawkyelisabeth

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Re: stella pred reduction
« Reply #134 on: October 07, 2012, 09:22:25 PM »

Hi coopi, i got your message..i am not so well these days..i feel weak with all these tablets..and it annoys me that my legs are failing me especially when i want to play with my dog friends justin and ike...i let my head hang low and i feel depressed that my mom is in trouble again with me, but i try to please her by staying always by her side..i do my best to get better and i take all my medication without complaining..hugs
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