4mo pup IMHA – Page 13 – Second Chance AIHA Dogs

Keymaster

Amy,
When you get down to the lower doses of prednisone they are not necessarily immunosuppressive anymore but rather the reduction is done to help wake up the adrenal glands. These lower doses are considered anti-inflammatory and are used for conditions like skin allergies or arthritis.

So the objective is to help the glands wake up properly. The task is to provide the body, as best as you can, the amount of cortisol the adrenal glands would produce each day if they were healthy and working properly. Since each dog is different, the dose can be different from one dog to the next to help wean the dog from prednisone.

Stress is the trigger for the body to release more cortisol. For humans that might be seeing another car coming straight at you. But for a dog stress can be as simple as you get up from the chair to answer the door bell, your dog will react quickly and with extreme vigor. The cortisol stimulates the heart and lungs to ready it for fight or flight. I am sure you have felt this on a few occasions as you react to stress.

So what if the adrenal glands are not working very well yet and the door bell rings? If your dog doesn’t have enough cortisol at this point, they could jump up and feel very weak. They could be a little dizzy or the worst is they could collapse.

Please read my guidelines for prednisone reduction:
https://www.secondchanceaihadogs.com/AIHA_Terms/prednisone-dose-reduction/

You can be the judge of how your dog is reacting to the doses of prednisone you give them. When you get to lower doses like this, try to simulate as best as possible the normal doggie day by giving the dose in the morning. So 5mg in the morning would be fine to try. If you see what you think is listlessness, give 7.5mg. That would be an additional half tab.

Eventually your vet will want you to attempt to go to an every other day dose. To do the math properly, average out the daily dose by adding up the doses over 10 days (to make the math easier) . So 10 days x 5 = 50 mg. Now take either 25 or 33% of that.

So lets try 50mg x .66 = 33mg. (33mg / 10 = 3.3mg per day.)

50mg x .75 = 37.5mg (37.5mg / 10 = 3.75mg per day.)

Pick something close you can dose with. If this were me I’d go with buying 2mg pills and give 4mg every other day either all in the morning or giving 2 mg twice a day.

So if there are issues with weakness, collapse etc, you could add another 2mg pill to get 6mg every other day (so maybe 4mg in the morning and 2mg at night). The objective is to not to half the total weekly dose suddenly but make an average decrease over the week by 25%.

Once you have read the page I linked to carefully you will know what side effects to look for. You can do this, it’s not hard. Watch your dog’s behavior closely.

I should also note here for anyone else reading this. When you decrease prednisone you may see other conditions suddenly become worse. That can be confusing and make you think that this is a bad reaction to the lowered dose.

Conditions like arthritis for instance respond well to prednisone and removing the drug makes the arthritis return.

Skin allergies can also be suppressed during high dose use and suddenly become very bad when the dose is lowered.

There are many conditions like this that are treated with prednisone that can return when the dose is removed. Try to anticipate this will happen and work out another way to treat these other conditions.

For instance allergies respond very well to Atopica and that would be a valid use of this drug. It doesn’t interact at all with the prednisone, but rather would take the place of the prednisone’s anti-inflammatory behavior.
my best
patrice

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