Pit Diagnosed with AIHA

[Alyssa]

Sorry, also! Any suggestions for splitting pills easier? I notice my pred still will crumble sometimes with the pre cut line thingy. I’m worried how cutting it again will work. Is there a special type of knife or something?

[Vally]

Oh Alyssa, I’m sorry this will cause “discussions”. I guess too many of us have been there and done that, and if a relapse happens, it so very frustrating to have to push the dosage back up again.

Yes your maths is spot on. You’re using 20mg tablets, currently giving half morning and half at night. So yes, you should give the half tablet (10mg) in the morning and the quarter tablet (5mg) at night. I was always told do the bigger dose in the morning, and when you cut down to one a day, give it in the morning.

To cut into quarters, make sure the cutter is clean each time of prednisone dust when you use it. I find the crumbs/powder from cutting each time, makes the next one more likely to crumble. So I wipe the blade (CAREFULLY!!!! – many a time I’ve sliced my finger) and the flat side of the cutter. It’s not always perfect, but if the tablet is pretty good, even though it may be a smidgen out or a smidgen has crumbled off, I still use it.

I know Sheena has used or had available, soluble prednsione, so you dissolve say half a tablet in say 5 mls of water and syringe up the exactly 2.5mls of the mixture to get a quarter of the tablet dosage. I’m not sure the soluble tablets are available here (Australia), although I never actually asked.

I’d probably not bother telling anyone. When you go in for your next check, just admit to being too worried about the reduction and the possibility of a relapse that you went slower on the reduction. My specialist and I would bargain the reductions down. He’d say start skipping a day, and I’d say, maybe skip every 4th day for now. He knew I was very worried each time so it was never a problem with him.

Vally & Bingo

[admin]

Hi Alyssa

So glad you’re taking it slowly – it’s safer, it really is.

We are always given soluble prednisolone (Solupred in France), not prednisone in Europe from our doctors – it does exactly the same thing – just a slightly different form the the same drug. I bought a pill cutter from the chemist – they are not perfect by any means & I sometimes ended up with broken bits too. When we got onto lower doses, it was easier to ask the chemist for the soluble form & dissolve it in a syringe (no needle of course). But I don’t know if you can get a soluble version over there in the USA! So, the easy maths would be to dissolve 10mg of soluble pred in 100ml of water or 5mg in 50ml of water – that always gives you 1mg in 10ml – easy to work out then. You need to be patient & shake it really well, then shake it thoroughly each time you use it. Of course, your vet may have smaller dose tablets available anyway – it’s worth asking first.

Hope that helps.

Love & hugs, Sheena x

[admin]

Alyssa

Here is Dr Dodds Heartworm preventative advice which you can find through the Hemopet Resources page on this site. If it were me, I would do exactly what she recommends in this article & only use the drugs she recommends too.

https://www.secondchanceaihadogs.com/hemopetresources/
Which leads you to
http://drjeandoddspethealthresource.tumblr.com/post/46289883129/dodds-heartworm-preventives#.VU9GWPmqpBd

I feel for you all having to deal with heartworm over there – it is a horrible thing & it’s always worrying to have to decide what to do for the best with our AIHA dogs with all these preventatives. We are lucky where we live so far – heartworm is only present much further south at the moment, but with global warming, it is apparently getting nearer & nearer to us every year. Scary.

Sheena x

[Alyssa]

It seems I have reached an impasse with my vet, and I’m not sure where to go from here.

I talked with her today, and after much persuasion I did at least get her fine with doing 15mg everyday instead of 20mg every other day, for now.

However, the maintenance dose she wants sassy on for her weight is 20mg every other day, with azathaoprine at 25mg every other day.

Those seem like really high doses for lifetime maintenance to me??? She said anything less would be like giving nothing, considering her weight (70lbs at onset, currently 77). Sassy has *been* on 20mg a day and she is not the same dog. 20mg every other day, for the rest of her life, still seems really high to me. Basically, according to her, we’ve reached maintenance (after only 2 months), and further reductions other than moving aza to every other day wouldn’t be happening.

She isn’t interested in internet research I have done, really – and basically said unless a specialist wants to call and discuss Sassys case, she is not comfortable going another path with her. I am pretty much tapped for money and I believe such a call would probably cost $100, for just that one call.

I don’t know where to go from here. I think the suggestion is going to be find another vet, but I’m in a really small town with only a few vets, and I have a feeling I’m not going to have success with that.

[Alyssa]

She did say she has treated this illness before, and does consult with a specialist, and that this protocol has worked on the other dogs she has treated.

[Vally]

Alyssa, there is no reason why Sassy has to stay on prednisone. Sure some dogs do (Bingo does), but most dogs can be weaned off it totally.

Now Bingo is currently on 1.25mg a day (he weighs 7.5kg). That’s a minimum dose for him. Just now tried to bring him down lower and he’s having joint problems again, so going back to 1.25mg daily. Sassy is 5 times Bingo’s (77 pounds is about 35kg) weight so I make that about 6mg daily.

I suppose she’s saying 20mg every second day, which is equivalent to 10mg a day.

But I don’t think it actually works that way anyway. The usual process is to keep weaning down. The intention was always to get Bingo off all drugs totally but it didn’t work. Hopefully it will work for Sassy.

Love Vally & Sore Legs

[Alyssa]

Valley, this is what I feel. I am prepared to reduce as slow as I need to, but I would like to TRY to give her a drug free life. My dr is not even willing to try that. And, ontop of that, I feel the maintenance dose she wants to do is too high. It’s not just Pred 20mg every second day, but Azathioprine 25mg on the days she doesn’t take the Pred.

I feel Sassy has responded very quickly to treatment, already up to 46.97% (knock on wood). To refuse to alter the treatment plan…

But she is not budging. I do not know what to do. I have a feeling she will no longer feel comfortable seeing Sassy if I don’t follow her protocol.
She seemed pretty offended, after I mentioned talking with so many other people that have gone through this and reading days and days worth of case studies, she said “I don’t use google as an information source”.

Bringing her any advice from any of you will not be accepted. The only advice would come straight from a specialist of some sort, and even then, I have a feeling she wouldn’t agree, and it would be a waste of time and money.