Doberman with AIHA – Page 22 – Second Chance AIHA Dogs

Keymaster

Karlexx,
I’m sorry Louis is having a hard time with the cyclosporine. Chance also experienced this at the higher doses. It behaved like he was experiencing a psychotic episode. He would stare into space for about an hour after his initial high loading doses of 225mg (he was 90lbs) for about 3 weeks. We were using Dr. Dodds pulse dosing which is dosing M-F and not dosing on S-S. Once we began to see some positive changes in his CBC, we were able to decrease that dose. He was fine on the lower doses for a long period of time, months.

If we asked Dr. Dodds, and I have in the past, she would advise two temporary solutions. First, for a week or so, go ahead and dose with some food, this helps with the gastrointestinal side effects. Most dogs do get these side effects during the first exposure to cyclosporine, but they will diminish after a short period of time. Most dogs do adjust in about a week.

These known side effects were documented during a complete trial done on dogs by Novartis when Atopica was preparing to be marketed. Go to this page and click on the picture of the Atopica brand symbol to open the product insert where you can read the complete information about dosing dogs with cyclosporine.
https://www.secondchanceaihadogs.com/medication-resources/#mg

Secondly, first check with your vet about what I am suggesting. Try lowering the dose temporarily for about a week. That will depend on what size capsules you bought. For Chance, I had bought 100mg packages plus 25mg packages. If I had wanted to temporarily decrease his dosage I could have used one 100mg capsule plus probably 3-25mg capsules to get him down to 175mg for a short period of time. And then I would have increased in increments of 25mg to get him back up to 225mg. Does this math make sense to you?

As it was, since he was pulse dosing, taking no cyclosporine on the weekends, that was sufficient for him to adjust to the very high dosage. If your vet insists on dosing 7 days a week then these two adaptations I am suggesting will help him adjust to the cyclo.

If you see bloody diarrhea, call your vet immediately. They may decide to halt the dosing entirely.

This is really a very safe drugs for most dogs, only a few ever have any serious side effects. Novartis developed the dosing specifically for dogs with severe allergies and the use with autoimmune conditions is considered “off label.” In other words, Novartis has not done a trial on dogs that have AIHA, IMHA and therefore they do not market it for this use. That doesn’t mean that it can’t be used for this purpose, in fact plenty of veterinary clinics use it for many different autoimmune conditions, only that Novartis is not allowed to market it for those conditions until they perform a second trial. That would be expensive and far more complicated for them to administer. They are probably satisfied at this point with the profit from marketing it for canine allergies.

Interestingly, the dosing for allergies and autoimmune conditions is very similar. This drug works by reducing the number of T-cell lymphocytes. These white blood cells are responsible not only for initiating canine atophy (inhaled allergies) but they are also the cells responsible for the autoimmune attack on red blood cells in AIHA and IMHA and even bone marrow failure. So once you have achieved this reduction of cells, whether for allergies or AIHA IMHA bone marrow failure, the drug has been successful. Thus the similar dosing.
my best
patrice

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