Advice needed on feeding.

[Ashley]

Hi All, I have a 9 year old Lurcher called Casper. He was taken ill on 21st Oct and immediately diagnosed with IMHA. He spent the next 9 days in hospital. His PCV had dropped from 60 down to 30 and continued down to 18 over the following week. He was on 75mg pred, 200mg cyclosporine, 1/4 pill of aspirin, omeprazole and on a drip.
Wow what a rollercoaster of a ride since then. His PCV is now back up to 39 and we quit the cyclosporine and reduced his pred down to 60mg. I was worried that was too quick so the vet suggested dropping one 5mg pill a day until we are down to 60mg, so I have done this. He gets his PCV checked in two days.
Casper has had a lot of trouble with eating. At times he is hungry but when offered food he just wont eat. I’ll find a food he’ll eat and then after a day or two he won’t touch it. Before the IMHA he was raw fed but the vet advised not to feed raw because of the immune suppressants. But sometimes it’s the only thing he will eat. He lost 7kgs in all. I’ve bought many kinds of dry food, all of which he turns his nose up at. Tinned dog food he won’t touch. Today he is asking for food but wont eat anything I offer. There is always a selection of food down for him. He is also on Pro Kolin/kaolin and this usually helps but not today. How can I get him to eat? Is raw still not ideal even though he has finished the cyclosporine?
Thanks in Advance
Ashley

[Vally]

Hi Ashley and Casper

Welcome to the forum and I’m so happy to hear that Casper has improved.

First of all, the reduction is much too quick. Is it known what caused the immune system to go crazy? Has Casper been checked for ticks? Immunised recently? Anything different?

We all recommend a much much slower reduction. In fact it is more common to reduce prednsione before the cyclosporine as prednisone is the one that has a lot of side effects. Saying that, though, some dogs don’t tolerate the cyclosporine, particularly tummy wise, so if the cyclosporine has stopped, and Casper still has problems with his tummy, I don’t think that was the case.

Prendisone should be reduced at a maximum of 25-30% reduction over a minimum of 2 to 3 weeks. I’d really really suggest slowing the reduction down or it’s possible Casper can relapse. That’s exactly what happened with my Bingo. We reduced too quickly and he relapsed.

With Casper not wanting to eat, is he on tummy protection? Prednsione is very rough on the stomach and can in fact cause ulcers. If Casper seems hungry but then won’t eat, I think the problem is his stomach is hurting. The best for stomach protection is sucralfate, but it must be given at least 2 hours away from food and meds, or it stops absorption. Pepcid also reduces stomach acid, so that’s another one. If Casper is not on anything, please ask for something. Tell the vet exactly what you’ve said here. Seems hungry but then won’t eat.

I was also told to stop feeding raw but in fact Bingo had a bad case of gastro and so I did stop. Have you tried roast chicken? The one bought from the shop. I don’t know any dog that can resist that. But I think he needs tummy protection.

Ask anything Ashley, we love to help.

Vally (angel Bingo) and the new pest, Saba.

[Ashley]

Vally – thanks for your response. This is a minefield! So much information to learn and I have read and read about this condition and learned much more since finding this site. I’ll try to answer everything in order…

The vets believe it is primary. He has had ultra sounds and a CT scan to rule out cancer. However, for about 6 weeks prior to the crisis he had been to the vets for lethargy, excessive hunger, excessive hair growth and general slowing down. His T4 levels were unreadable and his Tt4 or Ft4 (I can’t remember which) were very low. 3.3 and the range started at 6.6
We treated him with thyroxine for a month and there was no change at all in his levels. The vet doubled the thyroxine dose for 2 weeks but the crisis happened at that time so I don’t know if that made a difference. I’m not sure Ticks are an issue in UK? We have them but not sure they carry anything? I don’t believe in over vaccination so he hasn’t been vaccinated for about 4 years, I had his titres done though. We did test for leptospirosis but that was negative.
Casper has perked up in himself after quitting the atopica and got some of his sparkle back. But today he has been weak and sleepy. I just realised, I dropped his pred from 15 x 5mg tablets to 10 x 5mg tablets yesterday and today. That is what the vet wanted but I told him I didn’t feel good dropping that much. I just realised that is 50mg, a 33% drop! So I just gave him 2 more tablets which will be 60mg which is a 20% drop. Have I worked that out correctly?
Tummy protection, he is on omeprazole which is a proton pump inhibitor, reduces stomach acid and also pro kolin which is good old fashioned kaolin, that definitely seems to help. The vet felt his tummy and said he had no tummy pain. We have gone through cooked chicken, cooked liver and heart, ham, ground beef cooked, 5 types of complete dry food, fish and cheese! Have you ever heard of a dog associating the food with the hidden tablets? I have wondered if he knows I’ve hidden things in something so he refuses it. I’m only guessing. He would stand by my GSD and watch her eat her raw diet, licking his lips so out of desperation I gave him some and he scoffed it. I’m sorry this is so long! But having read all of your stories I know that you all know what I am going through and vice versa.
Kind regards
Ashley

[Vally]

Ashley, I always noticed when I reduced the prednisone, even small reductions, they would affect Bingo and he would feel it for a few days. But I would do as you’ve done and just slow it down. My vet also suggested reducing quicker, even after relapses, saying that being on such small doses (this was later when he was in remission) wouldn’t be a problem, but I always noticed. I ended up just saying, I couldn’t cope with bigger drops and he let me proceed with dosing as I felt comfortable.

I think if it were me, I would feed him the raw if that’s what he wants. Maybe do a few extra smaller meals instead of 2? main meals.

I’m not sure about ticks in UK. I’m in Australia and supposedly we don’t have Lyme Disease, but when I took Bingo in, they treated him for it in any even, as they were saying they were seeing symptoms in dogs.

Vally

[Vally]

Casper:

[Vally]

Ashley, he is gorgeous. And Casper is the perfect name for him.

Vally

[Ashley]

Oh Vally thank you! He is gorgeous and I called him Casper like Casper the friendly ghost. His PCV was 42 so that is an improvement on 39. I was so worried about reducing his meds. I’d still like to do it slower than the vet recommends. The vet thinks it will take 3 months…. at 75mg being the starting dose then I am not so sure. I will stand my ground for sure! You guys are amazing xx

[Patrice]

Ashley,
How is Casper doing? I am rereading your first post and I am concerned that the vet was not prescribing the thryoid medication properly. The dosage is very important, but it is critical to test a full thyroid panel first to determine what the dose should be. Hemopet is the lab I use (I use panel 4) because it evaluates the results by comparing with a database that includes the breed, age, sex, health, neutered/spayed or not. I test my dogs twice a year. Dr. Dodds also compares previous tests to the current test to evaluate changes in my dog. Hypothyroidism is often discovered in cases of autoimmune hemolytic anemia, thrombocytopenia and bone marrow failure.

Do you have any test results you could send us to look at? You can do this by going to the Urgent Advice page on our website and uploading the file. It will come to our emails.
My best, Patrice