Cassie - my Whippet

[Rodgerr]

Cassie is almost back to being herself. Enjoying life to the full in her walks and then sleeping most of the day. We do worry about her relapsing as the chronic rhinitis she has mean her immune system is always being challenged. I was looking for some advice around her preds. She is about to go down to 5mg per day and thereafter 2.5mg and so on. As advised on your wonderful website we intend to take this very slowly. However on some of the posts I have read that some dogs need a maintenance dose throughout their lives. The question I have is how do we know if that is the case with Cassie?

[Jo CIMDA]

Hi

I am so pleased Cassie is back to her old self and enjoying life again. Great stuff!

"However on some of the posts I have read that some dogs need a maintenance dose throughout their lives. The question I have is how do we know if that is the case with Cassie?"

Well that is the million dollar question!  There is no way of knowing if a dog needs a maintenance dose of preds for the rest of their life. You have seen a good response to the treatment and if you take this last stage very, very slowly for a period of time, then you may feel you want to chance stopping the steroids altogether and see what happens, and this is quite usual, so why not?

Many dogs never relapse again, but some dogs do and then you have to start treatment over again and then second time around you may feel that you don't want to risk stopping the preds totally.  Much depends on what AI disease the dog has. It is likely a dog with something like SLE - a Multisystemic AI disease - will not be able to come off steroids altogether but they can have a good quality of life on a low maintenance dose of preds.  AI diseases such as polyarthritis or meningitis and even the blood disorders stand more chance of the dog coming off the steroids and staying in remission.  Having said that, long term remission is the best one can hope for because if the dog encounters another trigger, that produces autoantibodies, then they will relapse or get another AI disease.

I have known lots and lots of dogs to achieve long term remission, but relapses are not uncommon.  The good news is, the dog will usually respond to immunosuppressive treatment and hopefully achieve remission again. 

So there is no easy answer.  Think about giving supplements like fish oil, which has good anti-inflammatory properties and if Cassie were mine I would take it very slowly and even perhaps reducing by 1mg at a time for at least one month, and even then you can go from daily dosing to every other day and then every third day etc........  This obviously isn't a therapeutic dose but it might just maintain homoeostasis and keep her in remission.

A thought about rhinitis:  One of the antibiotics for mycoplasma infectious rhinitis is doxycycline.  Interestingly,  doxy' is used for the treatment of some AI diseases, not for it's antibacterial properties, but because it is a very effective immunomodulatory and anti-inflammatory drug, and I wonder if Cassie still has rhinitis if it might be worth having a discussion with your vet to see if doxycycline would be appropriate to give to Cassie and it might just do two jobs.  I know things aren't as simple as that but it is worth keeping Doxy in mind.

Fingers crossed. 

Jo

[Rodgerr]

Many thanks for the advice - we will take it very slowly. Her rhinitis is idiopathic and with her 24/7. She has good days and bad days regarding the symptoms which include reverse sneezing, a constant runny snotty nose and nasal discharge. Nevertheless I will ask the vet about doxycycline. Again many thanks you have been a brick and a brilliant source of advice during this difficult time.

[Jo CIMDA]

Thank you, you are very welcome.

I have had a dog with rhinitis and it eventually went away after giving 1000mg a day of evening primrose oil. It took about 2 months before seeing a difference.  It might have been a fluke, but it worked non the less. 

Jo

[Rodgerr]

Slight hiccup and I was just enquiring if this was par for the course. We reduced Cassie's Preds from 5mg to 2.5mg. 4 days later her respiration increased and she seemed to have hoarse breathing. As a precaution we took her to the vet who recommended wewent back to 5mg per day for another two weeks.This seems to have worked but concerned to try and wean her off steroids if possible. Even with such a low dose she is still showing signs of an overactive appetite.

[Jo CIMDA]

Hi

If I remember correctly, Cassie is not a straight forward case and therefore you may have to accept that keeping her on a daily or every other day dose of preds might be the only way to keep her problem under control. She has done remarkably well to have got down to 5mg a day.

Has the increase back up to 5mg a day pred had the desired effect?  If it has then that is a really good sign and if you can get away with just putting her back on to 5mg a day for a while then that is a good result. When the time comes to reduce her preds again, you can try reducing it by 1mg at a time and very, very slowly - perhaps reducing it by 1mg every month. 

As for the side effects of prednisolone, such as eating too much, this might reduce if you go to every other day dosing but to be honest it is more important to control her AI problem and if she has to stay on 5mg a day, but she is well, then that might be the best you can achieve.

Jo

[Rodgerr]

Once again many thanks. She does have numerous problems but touch wood all of them seem under control. Increasing to 5mg has had the desired affect. I will take your advice and from now will reduce very very slowly. The 5mg tablets she has are very small I'm not sure therefore how we can reduce by 1 mg any suggestions?

[Jo CIMDA]

HI

You can get 1mg prednisolone tablets from your vet or failing that you can cut the tablets into four. A 1.25mg reduction is as near as you will get, and that's not bad.

Good luck.

Jo

[polly]

Hi , 
I haven't been on this site all year  because my whippet  who had IMHA is now doing very well.
I was intrigued to read that  Cassie's problems began  with chronic rhinitis.   
I suffered with that condition for most of my life.   To cut a long story short, I was also diagnosed with chronic Fatigue Syndrome (ME). I was  so unwell with so many different infections etc over several years that I had to stop work.

Eventually, when the nasal discharge was particularly  bad,  a new GP suggested that I have my nose X-rayed.  The X-rays revealed that I had a congenitally  malformed sinus .  This meant that bacteria within the sinus cavity were trapped - nasal sprays and other medications could not reach them. I was referred to an ENT specialist who operated. Since then my health has become normal.
I  am not sure whether Whippets have sinus cavities - but it would be worth asking your vet if this is a possibility in regard to Cassie.
Just a thought.

[Jo CIMDA]

That's very interesting Polly.  My sister had a similar problem too, and perhaps this is also possible in other species - I don't see why not.

Thanks for sharing this, and I am so pleased all is well in your home.

Jo

[Rodgerr]

Thanks for this Polly. Cassie's problem began with her reverse sneezing followed by a continuous nasal discharge. At that time she was xrayed, scanned and had swabs taken. Unfotunately no obvious condition was found and therefore the vet made a diagnosis of idiopathic chronic rhinitis. Six months later she suffered her first bout of Pyrexia eventually leading to a diagnosis of idiopathic IMD.

[Rodgerr]

Hi I have not posted for some time as touch wood Cassie has remained well. As she had previously relapsed we decided to keep her on a maintenance dose of 2.5mg every three days. She has been on this dose for about two months. In the last fortnight she has began to suffer from
Intermittent diarrhoea. At first we thought it was due to eating berries then a slight change in her diet. We have ruled these out. First thing in a morning her first stool is firm however her second is like paste before finally being very runny. I was wondering if this could be owing to the continued use of steroids? She is fine in herself and still full of life. Like most Whippets she does sleep a lot lol. Any advice would be appreciated. The vet who knows her history is on holiday and we have made an appointment for when she returns. Thank you
Rob

[Jo CIMDA]

Hi Rob

I really doubt it is due to the steroids as the low dose she is on wouldn't be having any real affect, but if it maintains stability then keep her on it. 

You could have a stool sample done to see if she has a bacteria or get some Prokolin from the vet or internet.  It has a probiotic and the kaolin firms up the stools.  It is pretty good stuff. 

Another natural remedy for diarrhoea is slippery elm: 1 teaspoon of powder two or three times a day for each 25pound bodyweight.  Mix win warm water or chicken broth.  Give at time of feeding ref: Roger DeHaan DVM, The Veterinarian's Guide to Natural Remedies by Martin Zucker.

My vet told me to get some yogurt that has pre/probiotics included and give that at mealtimes - that is if she can tolerate dairy.

I am so pleased to know that Cassie is doing well.

Jo

[Rodgerr]

Many thanks for your advice I will certainly give it a try. I do intend to keep her on the low dose of steroids and with a little luck hope she doesn't have a relapse. Kind regards Rob

[Rodgerr]

I'm hoping it's nothing related to her immune condition but Cassie has just started limping on her front leg. We went for a walk as normal where she was kept on her lead. Back home she slept in her basket again all normal behaviour. We went out for an hour and when we returned she didn't come to greet us. When she got out of her basket she was limping and looking sorry for herself. She is eating and drinking as normal. I'm sure I'm just being paronoid but would welcome any advice. Thanks Rob