Maggie May

[Jen]

Hi everyone, this isn’t an AIHA question but just asking for any advice/ suggestions. Maggie hasn’t been feeling well lately so I had her checked at vet & her liver is enlarged. I’m awaiting results of CBC with organ functions to compare to her last one taken in the fall. She has had protein in her urine since last Sept when she was diagnosed w Lyme disease. She is still on 200mg milk thistle ED, omega 3 ED, Sam e ED, 2.5mg prednisone every 3rd day, blood pressure meds, & just started Apoquel for allergies 2 wks ago. She was given stool softener bc she’s bound up in her colon and topical creams for ear infection & skin infection. I was thinking of starting Dr Dodds liver cleansing diet or should I do the kidney cleansing diet? Or both?

 

*****(Jen I’ve added your second post here to keep it together – Vally)

Also, could her liver be enlarged just because she’s been on pred for almost 2 years & cyclosporine for 5-6 yrs?

[Vally]

Hi Jen, sorry to hear Maggie May isn’t feeling well.

Once you have the results of the CBC, send them through on the Urgent Advice for someone to have a look at.

Did they do an ultrasound at all?

How was she treated for the Lyme disease? Doses and how long on antibiotics.

Jen, I would definitely go with the liver cleansing diet for now.

Vally & Bingo
xxx

[Sheena]

Hi Jen

That is a low pred dose, so I doubt if it’s to blame completely, but may be partly. I presume this is as low as you “dare” go on the pred? Linda’s Sadie has been in the same boat & she has started Dr Dodds liver/kidney diet, plus a very, very slow minute pred dose reduction – things are starting to look better on the liver & kidney front for Sadie – Linda has of course been consulting Dr Dodds closely with this as Sadie has relapsed in the past. Obviously, you need to be very careful reducing further if Maggie has had problems with reductions along the way.

I assume she’s not on cyclosporine or anything any more?

Like Vally said, could you tell us more about the Lyme Disease & the treatment – has it gone completely? That nasty thing can certainly damage organs. So, yes, liver & kidney diet from Dr Dodds would be a good option for now. There is also something called Ursodiol which many dogs are given to help their liver – great to see the milk thistle there, Jen, but worth asking your vet about adding Ursodiol.

I am concerned about the Apoquel – sending you a link below in a separate message in case it messes the text up here. Studies show it has an adverse effect on the liver, plus other things – I have read the study – my personal advice is to drop that drug. I would – I don’t like what I read. Are you in contact with Dr Dodds still? I would like you to ask her opinion on this obviously as I’m not a vet, but it looks risky to me. Sorry to be “scary”, but it could be this drug that is giving Maggie more problems. I would not give this drug to Worzel unless Dr Dodds gave me the all clear to use it.

Much love & hugs to you both
Sheena, Worzel & Ollie xxxxx

[Sheena]

Apoquel

http://www.2ndchance.info/Apoquel.htm

Quote “Zoetis does not recommend using Apoquel at the same time that corticosteroids or Atopica/cyclosporin are being given to your dog. They say they have not accumulated negative data regarding the use of these treatments combined with Apoquel; but that the possible effects have “not been investigated in any meaningful way so far”.

FDA info/study
http://www.2ndchance.info/Apoquel-FDAfreedomOI2013.pdf

[Sheena]

Sorry Jen – me again

She is still on cyclosporine, isn’t she? I think long-term use of this also affects liver/kidney.

Bearing in ming she’s on pred & cyclo, the apoquel is not a good option in my opinion.

Love Sheena xxxxx

[Jen]

Thanks Vally & Sheena. She just started Apoquel 2 wks and 3 days ago bc her allergies are insane. At that time I dropped the cyclo. She’s been on cyclo forever for both allergies & AIHA. The pred is a low dose now but we stuck at high doses for probably the first 8-12 months. I’ve never really tried to get off pred completely for fear of relapse. I hate to say but I keep thinking cushings disease- I called my vet to test her bc she has several similar symptoms ( crazy lady). I will upload the results ASAP. She was treated with high doses of doxy 2 X day per Patrice’s suggestion for 3 months. We never tested to see the levels so I don’t know if it’s gone. Is there a test to give her that will be accurate to see if Lyme is gone or will it come back positive bc she was exposed to it already?

[Jen]

So the vet called and her white cell counts are up slightly & one of the liver enzymes are elevated. He wants to do ultrasound tmrw so we are scheduled for one. I brought up cushings and he said the ultrasound should help determine that but agreed that cushings would enlarge liver, explain protein in urine, & would explain the liver enzyme that’s elevated. I’m a little frustrated bc in the back of my mind I’ve been thinking and asking this since the fall but the vets
Haven’t connected the dots or really thought it would explain her issues.
I’ve researched cushings but there is a mix of info some say treatable but some say most dogs die a few years after diagnosis. Also, which type of cushings is it. Is it from long term steroid use which should reverse itself when pred stopped. I’m down to 2.5 mg every 3rd day which I would think would’ve low enough to reverse some of the damage…. Sorry, I’m just very worried & sad.

[Sheena]

Hey Jen

Don’t be sad – all these things can be overcome with diet & drug tweaking.

I feel very strongly about the Apoquel – I am not happy about it at all – sorry to be blunt.

I hope they will be looking at those adrenal glands – let’s see what comes up with the ultrasound etc – please do send the bloods etc when you get a chance.

Getting Dr Dodds involved again would be your best option when you know what you are dealing with – she has helped us all with tweaks & alterations to get our babies back on track.

Need to dash off for a while – will be back shortly!

Sheena x