Pred/Atopica not working anymore

[Mike Chen]

PCV check shows that Lola is holding steady for now (and all the steak/carrots/rice ballooned her weight from 29.5 to 31.2 lbs). Awaiting results of TSH test, but for now we are keeping things as is. My vet explained that there could be three possible reasons why the bone marrow isn’t regenerating well enough: 1) azathioprine/atopica were suppressing it 2) it was “tired out” and needed iron to fuel it 3) the AIHA has decided to attack the source.

We are addressing #1 and #2 (and she said that often with #3, there’s very little you can do about it so let’s hope it’s not that). We are also adding on weekly B12 injections.

She said holding steady is a good sign, though obviously we would have hoped for an increase. It at least means that the cold-turkey atopica stop and every-other-day azathioprine wean hasn’t caused Lola’s system to crash.

Question for you guys — is there a usual timetable for Pet-Tinic/iron supplementation to begin to help the bone marrow? I know it will vary from dog to dog but I wasn’t sure if it takes weeks to start working or just days?

[admin]

Mike,
you should be very happy that Lola is holding! I am not sure how long it takes until the petinic shows any results. Is Lola on Thyroxine now? I think you could see a result from that at the next blood test. For now, just take it one day at a time.

Best wishes,
Brigitte

[Vally]

Yes, if thyroxine hasn’t been started, ask about starting it. Just makes sure it’s also given away from food. Ideally 1 hour before or 3 hours after food.

Vally

[admin]

Hi Mike

Number 3 is what Worzel had, so yes, you can do something. If the azathioprine hadn’t worked, we would have stopped it & tried cyclosporine. If that didn’t work, we would have kept on trying other drugs. My specialist said we would try anything & everything & we would not give up – small transfusions to keep him going until we found the answer. It’s much more rare to have a bone marrow problem, obviously, so hopefully it is number 1 or 2 & you won’t need to think about number 3!

Really good to hear Lola is holding steady & adding B12 injections has got to help – that will go straight into her system, but I don’t know how quickly it will take effect – sorry. Worzel had a different supplement from PetTinic – being in France means we get different medicines from you guys – he only took it for a month & his hemoglobin came up really well (6th Dec hgb was 7.7, 12th Dec hgb was only 6.9, rose to 16.9 on 8th January – wow!) – hope the same will happen to your lovely Lola. Our specialist also suspected he was short of red cell building materials because he had been ill for so long. He also agreed with Dr Dodds suggestion to add thyroxine if Worzel didn’t improve & was very open to all her advice, thank goodness.

If you you would like me to I can send you a spread sheet of Worzel’s progress – PCV, hemoglobin & reticulocytes, plus medications – it shows that the aza (& iron supplement) made him regenerative at the beginning, BUT reducing it made his PCV rise & rise after he became stable. He also had the tick borne disease which had to be eliminated & this was a vital part of the initial treatment too. Ehrlichia is a nasty but clever disease which can hide itself away in the bone marrow for a long, long time before any symptoms appear. I know we were lucky in that we eventually found the cause though – that doesn’t always happen. I wish our local vets had done more to find out what was wrong with him in the first place, before he was knocking on death’s door. That is why I’m such an old nag about encouraging everyone to get every possible test done.

Anyway, I hope you get a nice surprise – an increase in retics, PCV & hgb would be good, but it’s early days. Let us know how she’s doing.

Sending all our best wishes
Sheena, Worzel & Ollie x

[Tamara]

Great news that Lola is holding steady. Ashki, like Worzie, has the form of disease where it attacks the red blood cell precursors in the bone marrow, and it is treatable. Dr. Dodds has a lot of experience with that so it’s wonderful she’s on your team now in case that seems to be a piece of the puzzle for Lola. But since she is low iron, I’ll bet the additional iron will do the trick.

She recommended folate rich foods to us, too, so I have been making a “folate soup” for Ashki. I cook his regular vegies, green beans or zucchini, and also add the high folate foods: kale or spinach, cooked lentils (with the cooking liquid), and shredded carrots. Cook it until it is all mushy (I just use the crock pot) and then cool it off in the frig and then run it through the food processor so it’s like baby food. Because these drugs compromise the GI tract so much I do everything I can to make Ashki’s food as digestible as possible.

Are you doing the thyroid test through Dr. Dodds’ lab? Her testing is the best, and they are able to interpret the results in light of the medications and IMHA which is important. Most of us do her thyroid 5 panel. Ashki was quite hypothyroid so he is on thyroid hormone replacement too.

all the best,
tamara and ashki

[Mike Chen]

Just a quick note from this morning’s checkup: PCV is holding steady at 15. She’s been off atopica since Tuesday and has been EOD on azo since then, so the change hasn’t made her system crash. My vet said that barring a miraculous immediate upward swing, this is good news.

We didn’t do a CBC yet, so we don’t know how well the Pet-Tinic and additional support is helping the bone marrow yet. Next PCV check is Tuesday (which will also be the last day of azo), so the next two weeks will probably give use a good indication of where to go.

In the meantime, Lola is asking for more steak but we are resisting. She’s getting plenty of raw carrots though since she loves those (and I love hearing the crunch-crunch-crunch sound she makes while eating them).

[admin]

Hi Mike. I have been MIA over weekend – sorry. But wanted to pipe in quickly about the PetTinic.

From my understanding, it is already helping. Sadie was on this from day one (thank you Dr. Hamilton and Dr. Dodds!), since onset in March 2009. The only time she has been off it was last September 2014, when we THOUGHT we could wean to to a very low 2.5MG prednisone (only) daily. I stopped the PetTinic too. She relapsed in October. We immediately started her back on 20MG prednisone (only, no other immune supressant), tummy protection, liver protection and anti-clotting AND PetTinic. Her PCV rebounded in one week to 30% (from relapse of 20% – she has never gone real low, but collapses, never the less). I swear by PetTinic – Sadie will most likely be on a maintenance dose if prednisone and PetTinic for life.

So glad to hear Lola is maintaining! Way to go!! Will check in later – on phone – please excuse typos.

Love and hugs,

Linda and Sadie

[Linda]

Hi Mike. Just checking in on Lola. I think Lola was tested Tuesday? If so, how’d it go?

I’m sure you face Lola a nice steak for Valentines Day?! Hope so. I just love her pic – precious face.

Let us know how things are going, when possible.

Love, Linda and Sadie