stella pred reduction

[shawkyelisabeth]

Dear all, so sorry for not having posted for quite some time, I was away to Europe for a couple of days and had no access to my laptop i AM TRYING TO GET A KONG FROM ABROAD, I AM SURE THAT WILL KEEP STELLA OCCUPIED. sHE HAS IMPROVED IMMENSELY SINCE MY LAST POSTING, RUNNING , VERY LIVELY, EATING WELL BUT NOT SO MUCH ANY MORE, LITTLE YOGHURT WITH FRUITS DURING THE DAY AND ONE BIG MEAL IN THE EVENING, WITH LOTS OF VEGGIES chicken, meat noodles etc. I give her some supplementary herbs, kelp, folic acid, she is still on 10mg preds for another  3 days which will make a total of 2 weeks on this dose. Then I intend to reduce to 5mg once daily for 2 weeks and   , then 21 days 5mg eod and then 5mg every third day sticking to MJDay protocol. and for another 21 days[/i]. For the time being I do not want to do any bloods, it is very hot, we have a long way to go to the vet, there the situation is very stressful for stella, they have to tie her down to get a blood sample and I really dont want her to go through this any more. She did not want anyone to touch her legs and biting immediately when we just got close to her legs, and now she has improved and forgotten about all the torture she has been through with all the infusions and blood sample taking and injections, I dont want her to loose trust in people around her any more, she has dropped most of her aggressive behaviour, but is very alert and protective  now and really improving day by day, so I take the responsibility for not doing blods and still reducing preds, her clinical signs are very good with very rosy gums, strong muscles and good appetite inspite of the heat we have here in egypt. maybe we will do bloods before switching to 5mg eod, my only question is, can we then drop preds completely after three weeks eod and three weeks every third day? or should we keep up 5mg every third day for the rest of her life? when should you give very low doses of pred for a lifetime? I hope Jo agrees to my decision to not do bloods, I trust my stomach feeling, with reduction of preds she is getting better now every day.
Many greeetings to all of you from elisabeth and stella

[gschellinger]

You will probably get a different answer from some, but I like to follow my gut instinct too. With her extreme dislike of having her blood drawn it puts extra stress on her, lots of it by the sounds of how you describe her. I also would be going by the signs of her health. Just my opinion, since I also have a reactive dog. Not at the vet but with people who come here. We have had to manage Lola for many years. She is agitated,not aggressive, but it is too much stress. I hope Stella continues on her road to health. I can't answer your questions about reduction but I'm sure Penel or Jo will.
Hugs to you and Stella...
gail and Lola

[shawkyelisabeth]

thank you gail, so good to hear from you! my thoughts are with lola often though I dont post much! Hugs to you Elisabeth and Stella

[Penel CIMDA moderator]

Hi Elisabeth,
if you want me to buy a Kong and post it to you let me know, it's no problem.
I agree with you about not doing bloods at every reduction - but I would also say that in the meantime, you ought to try and get Stella used to having her legs touched.  So you can just stroke her legs at first whilst letting her lick something yummy - I have a wooden spoon that I smear with cream cheese if I really need to do something to one of the dogs (for example removing a tick) - I just let them lick it while I do what I need to do.
Then when she is used to you stroking her legs whilst licking yummy stuff, you can begin to hold her leg for just a second or two to start with.  You must build it up very slowly.

(as an aside have any of you seen the footage of zoo animals who are clicker trained to press their necks up to the bars in order to have bloods taken - it's amazing).

Regarding the pred reduction, you are doing it all right.  With regards to the final pred reduction / dropping the Pred - it depends on how she reacts to all the other reductions.  You can never tell what is going to happen unfortunately - so you just have to "suck it and see".  Some dogs come off preds completely and never relapse - some come off and relapse a week later, some 3 months later.  It's not really something we can advise on, because all dogs are different.

I would probably spread her one big meal, into two smaller meals - just so that her blood sugar is kept more even throughout the day.

[shawkyelisabeth]

we ve been through so much that i really hope we dont see a relapse , I will do bloods before definitely dropping the preds but we still have some time to go and in the meantime building up all the strength she needs. thank you for your advise and psychological treatment, it seems that german shepherds are especially sensitive and stella knows how to play her role well! she is very intelligent and knows how to take advantage of any given situation. I will get back to you if anything unforseen happens.Thank you penel! I have already got a kong , not the original one but something similar, and the original will be sent to me from the U.S.

[Angela]

It sounds like Stella is where she should be    My girl took many months to get her self confidence, we are still working on it even on.  I think that she still has some issues caused by the low dose of pred but because of her history I am very hesitant to stop it altogether.


Hugs

[shawkyelisabeth]

Hi Angela, thank you for always rsponding so quickly! I will reduce to 5mg from tomorrow , should I give this in one dose or divide it into 2 and a half mg twice daily. I understand you suggest I should keep giving Stella  5mg maybe every third day for a lifetime? we still have a little time to decide on this, but I am trying to gather experience to take the right decision. Our vet wants to reduce as quickly as possible but I am afraid of a relapse.
Many hugs to you and your girl! Elisabeth and Stella

[Penel CIMDA moderator]

I'd give it once a day in the morning.

[Angela]

I'm with Penel,
Giving her 5mg only once a day will also help her bladder 

Hugs

[shawkyelisabeth]

well I am giving it once a day in the evening with her main meal, ok i will switch it to the morning thanks and hugs to you and your fur kids!

[Jo CIMDA]

Hi Elisabeth

I've been away on holiday and it is really good to read your posting about Stella's improvement.  She is doing so well and you have had excellent advice about reducing her preds. Stella has been a pleasure to get to know and her wellness is down to you and your gut instinct, your bravery and management.

I hope Eygpt settles down now the elections are over.

Jo

[shawkyelisabeth]

Hi Jo, I had just wondered where you were and intended to send a message when found your - as always encouraging- posting.  Welcome back and I hope you had a good holiday, I really missed you and it is always comforting to know that you are around.Thanks for your encouragement it is only to you and  everybody else s insistence on putting stella on high doses of preds  (that I followed blindly against my vet) that saved Stella, can only repeat it again and again.
With  the reduction of preds stella eats much less now, that sometimes worries me a bit but I think that should be expected, isnt it, I also relate it to the heat here in egypt.
Stella is now on 5mg daily for another couple of days to make it two weeks and then I want to go 5mg eod. Can I still not do bloods since I find her very well, red gums, lively etc. We are having very hot weather now and the trip to the vet is really stressful (for both of us).  What I am still not sure about is : what are the reasons to look for to keep a dog on very low preds for the rest of his life and when can you stop preds altogether. I intend to give her 5mg eod for 21 days and 5mg every third day for 21 days. Can I then drop it definitely if stella continues to show good clinical signs or should I do bloods and decide from there? What should the bloods be to encourage dropping of preds definitely? As always too many questions thank you for your patience with me.
Hugs to everyone Elisabeth and Stella

[Angela]

Hi Elizabeth,

Well done both of you!

You can afford to extend the time between reductions now she is down to 5mg once a day to ease her gently down.  Do you think Stella could manage taking this dose for a month or is she still showing side effects?  You could then drop her to EOD (every other day) for a month.  Just a suggestion 

Hugs

[Jo CIMDA]

Aw thank you Elisabeth, it's nice to be missed.  I've also had computer problems and that is very annoying!

  Don't underestimate YOUR courage in treating Stella.  Many wouldn't have taken the chance - but oh boy, I'm so glad you did!

You ask the 6 milliion dollar question!  There are no guarantees - as you know but Stella has done so well and you have reduced the steroids so slowly and steadily that I am really hopeful that you will be able to finish the course as you describe and then leave the steroids off altogether.  Some owners feel happier to leave the dose on EOD for even longer and then go to every third day -  and there is no right way - having said that there is a wrong way but that doesn't apply to you and Stella's drug regime.

As for blood tests, if Stella is well and you have no reason to suspect that she isn't,  then carry on with your plans and dont' worry about taking her for a blood test.  Stella doesn't need the stress, nor the heat in the car.  You are so in-tune with her I'm sure your sixth sense will kick in if anything is wrong.  By the time Stella is off the preds her bloods should be back to normal.   They are probably normal now because she is in remission but they must stay that way and that is why the last stages of treatment is taken slowly - you know, no shocks to the system!

Jo

[shawkyelisabeth]

I think I will stick to both of your advise, Angela and Jo,and I will give Stella 5mg per day for three weeks and then go 5mg eod for a month. She has no side effects other then she does not eat so much any more, but nothing else obviously. I feel that she is much more herself now and not under influence of medication, she is developing her own character now, she was only 8 months when she fell so sick and she was not at all the personality that she is now.
So I think I can take it even slowlier hoping not to see a relapse when dropping preds altogether. She is of course still on a gastroprotectant and I think I dont have to worry about ulcers or tummy upset in that case.
hugs and greetings from Egypt (things look a little safer now politically but we still have a long way to go for democracy-keep us in your thoughts, it will help!)