Sassy – New thread – Second Chance AIHA Dogs

Alyssa

Guest

I figured I would start a new thread for Sassy. The other one is very long!

So this past Monday, the 13th, marked 5 months. I cannot believe it has already been so long. Time seems to be flying past us. My birthday is on the 24th, and I couldn’t have asked for anything more than having her with me.

I’ve been a bit quieter about Sassy recently, I still think about everyone here but I was really losing myself!! I realized I was not enjoying my time with sassy, but just constantly worrying about what was going to happen to her. I had joined several facebook pages that offered information and support for AIHA, as well as here, and spent time googling about it each day. Really decided to stop cold turkey one night when I stayed up until 7 AM reading stories about other dogs, and just worked myself up into a mess, even though Sassy has been doing so well. I decided I needed to take a step back, and enjoy Sassy and be thankful that she has pulled through this and not keep letting myself be sure she is going to relapse. I feel I have finally reached a better state of mind after I stopped focusing so much on this.

Mind you, I am still a worry wart, and diligent about making sure she is okay, but that dark thought in the back of my mind has eased up a lot and I am thankful for that. I was feeling so suffocated. I am still so scared of losing her, but I am starting to see more sunshine.

As for Sassy – knock on wood – she is doing amazing. I daresay she is back to 100%, if not a little more than she was before getting sick – thanks to her thyroid meds. I have noticed such a jump in her energy, playfulness, and overall mood since about 2 weeks into her thyroid treatment. She wants to play all. the. time. She wants to go walking, even if it’s 107 psh who cares. She stretches like a cat all day long, she whines at me, she still hasn’t LOST weight but she didn’t GAIN either and her appetite is almost back to normal. She seems so happy & so am I.

There was a worrying trend with her blood work however, with a continued drop of PLT and also a small 2% drop in PCV. My vets (both the drs. at the small clinic I switched to love Sassy and both want to consult on her now!), decided to talk to their old professor who is one of the top guys on blood and auto immune, to get his thoughts on her treatment thus far and where to go from here. What we decided to do was something I always thought we should be doing, stopping the reduction of both immune suppressants at once – I was never too fond of this and am glad we have switched. Her old dr would reduce both at the same time, and the new dr followed that trend, but now we are going to wean the pred and leave the Aza alone. Actually, we upped the Aza a little bit and will soon be off pred completely (fingers crossed!), after which we will start a very slow, maybe once a month or longer reduction of the Aza.

Now – I know this Friday it is going to be suggested to me to stop the pred completely. I wanted thoughts on this. She is only taking 5mg a day now, at 81lbs, and her drs feel that it is literally doing nothing to her now. I’m not positive but they also may only carry the 20mg tablets, which means if I were to try and split the pills any further, well, I don’t know if I can. Do you guys feel stopping 5mg a day is too much? What would a 25% reduction be – can I achieve this by going to a every other day dose? This is the part the confuses me so much. I am unsure what to insist on this Friday. Do you think Walmart, Walgreens, or Sams Club would carry smaller tablets – I have heard it mentioned that they come in 1mg forms? Is this for dogs as well? What can I do ladies! Please help me make the right decision here, I’ve been thinking about it for a week now!

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Patrice

Keymaster

Alyssa,
Good to hear that you are finding a quiet place in your soul where you can be at peace. That is hard to achieve and it sounds like you have done well with this.

Of course we all worry about our dogs once they seem well recovered. I would be lying if I didn’t say that I was very concerned about Chance the rest of his life. But I let him guide me on that. His behavior and activity level indicated to me that he was quite comfortable with himself and I didn’t let the blood tests concern me too much. He settled into a slightly lower overall PCV / HCT of around 35-37, not abnormal for a dog who no longer has a spleen. And the HCT always came in at least 3-4 points lower than the PCV. So each CBC we did, the vet agreed it was wise to do a PCV as well.

Lowering the dose of prednisone during treatment is all about reducing the amount of immunosuppression. An easy way to think of this is to say that the amount of artificial cortisone you are giving your dog is GREATER than the normal amounts the adrenal glands would provide on a daily basis for proper handling of stress and general body functions.

Once you reach a sweet spot in reductions, where you are close to the levels the adrenal glands should be providing, you are now attempting to supplement and coax those glands to wake up again and do their own job. Training wheels. If you decrease too quickly, there can be serious side effects of extreme fatigue and even the possibility of collapse, if there isn’t enough cortisol coming from “somewhere.”

So these low doses of prednisone really don’t provide immunosuppression as much as they provide an anti-inflammatory effect. Dr. Dodds would also say that some dogs tend to need this small dose for the rest of their lives if their condition was especially difficult to treat. I would add to that if a dog has some condition that responds to prednisone such as arthritis or serious allergies that might be a reason to continue the really low dose.

Why the every other day dosing? Again this is like training wheels for the adrenal glands and is commonly done not only in dogs but in humans as well. Take the training wheels off for a day and see if the adrenals can respond properly.

Chance had terrible allergies and once he recovered he was not able to continue taking allergies shots anymore. So I fell back on something I used to give him a long time before he became ill. It is called Temaril-P “anti-puritic, anti-intussive, anti-inflammatory product. Combing the effects of both trimeprazine and prednisone, this product is used for itch relief and cough. trimeprazine, 5 mg, and prednisolone, 2 mg ”

So you can see it contains a little bit of prednisolone (useful because it is used during periods of liver impairment) and this was just enough not only to decrease his pred dose but also to help him with his spring allergies.

No, I never decreased both his Atopica and his pred at the same time. I always alternated and it took many months. Maybe as long as 6 months? It’s been a long time since I did this. But I used this formula. Always proceed each reduction with a full CBC. Reduce only one drug at a time and at no more than 25-33% at a time, no sooner than every two weeks. I put a preference on decreasing the prednisone due to the more serious side effects.

If I were you I would try the every other day reduction, watching him carefully for signs of fatigue and difficulty dealing with stressful situations. You can always go back to an every day dose if you need to. There are no guarantees because each dog is different. Let his behavior guide you as to how to proceed. Sounds like he thinks he is all better……
my best
patrice

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