IMHA berner with uti

[Vally]

Amy, Atopica should NOT be given with food or meds. In fact ideally 2 hours away from food and other meds. Some dogs don’t tolerate it though and can have it with a small amount of food, but still it should be given away from the other drugs.

I have no doubts the antibiotics are a factor, but at the same time, they’re a necessary. What antibiotic is being used?

I may be off the air over the weekend, but I’ll check as often as I can. Most likely late evenings, my time (Sydney Australia).

Vally

[Amy]

He’s off the antibiotics now, has been for 10 days. I’m worried now. Why must atopica be given away from other meds and food? It doesn’t absorb? Or?

[Vally]

That’s what the manufacturer recommends. I can’t get into the resources right now as my internet is lousy, but if you go into it, I’m sure it has the manufacturers leaflet that you can open.

Can you try and change the way you’re dosing ?

[Patrice]

Amy,
Yes it has to do with proper absorption. Cyclosporin is a derivative of a fungus. To manufacture it properly it has to be carefully stabilized and purified then enhanced with “helpers” to ensure it is completely absorbed. Food and other medications can disrupt the biochemical reaction.

Cyclosporin (brand Atopica) went through stringent testing on dogs to determine the best effective doses, the action and the results. Then they evaluated the drug for negative side effects, including extreme doses.

The results showed that dogs tolerate this drug very well. It is very effective in targeting the t-cell lymphocytes that are the main activator of the immune system against red blood cells while leaving other elements of the immune system unaffected. This is unlike prednisone which overwhelmingly affects the entire immune system.

In terms of side effects they are limited at normal doses and are usually only gastrointestinal: diarrhea, stomach upset and vomiting. After a few days dogs generally adjust and have no problems. Lowering the dose or giving it with food in the early days helps to improve adjustment.

If side effects are more serious the drug can be stopped and side effects will go away quickly.

I contacted the manufacturer about the common practice of freezing the capsules to make it less bothersome to dogs. In fact it destroys the drug inside the carefully manufactured capsules. No wonder it doesn’t cause side effects, the capsules are ruined and the drug has lost its potency. Each capsule can be $2-3 so I am not sure why vets recommend this practice.

I prefer to see a dog take it with a little snack or at a reduced dose for a few days so they can adjust. This drug is extremely effective in treating dogs with autoimmune conditions, and is also used inhuman medicine.

In fact it was originally developed many years ago for use in patients with heart transplants. It was extremely successful and now is a standard drug.

I’m sorry about the upset gi tract. It can be the cyclo but the cellcept is a much worse bad actor when it comes to GI tract side effects.

So try a little snack about 2 hours before meals, no calcium or fats. A soft dog cookie might be enough.

At high doses some dogs (and humans) can have a side effect of feeling “spacey” but it doesn’t seem to be harmful. Chance would lie very still and stare off in the distance. After an hour or so he would be ok.
My best Patrice

[Amy]

Thank you Patrice! Could this be why he’s had a history of longer than “normal” reaction tile to the drug? Initially in the icu the internal medicine specialist said if he didn’t respond in 7 days he wouldn’t at all and it was likely not IMHA but histiocystic disease all though the testing came back negative. He was on high doses of antibiotics at the time as well. The specialist sent us home and said he had a few days. After that he began to recover and the specialist thought it may just be a weird slow reaction to the drugs. Could this be the case? Or due to dosing everything at once?

I will start tomorrow and move the atopica so it’s separate from the other drugs.

[Patrice]

Amy
I read the study results and I don’t believe I ever saw any mention of study participants that had no response to the drug. They would have had to report that as a finding in the study.

You know how some things you get, whether food or medications, have storage instructions on the label? Well on the cyclosporin package the instructions are to store it in carefully controlled temperature, neither hot or cold and to avoid freezing.

I also checked with Dr.Dodds who has dosed this to dogs for at least 20years or more. She is a clinical vet so she has plenty of experience treating dogs. She said to follow the storage instructions, don’t freeze.

I think the drug was not being absorbed properly and thus was not effective. If I had one choice for another immunosuppressive to pair with prednisone, cyclo is my favorite because it has been tested on dogs and is known to be effective, has few serious side effects which will decrease within 48 hours after discontinuing. I also like that it has exact veterinary dosed capsules by dog weight.

Give it another go.

Yes,unfortunately when mixing many drugs it can be complicated figuring out which one causes a certain side effect. Timing may help pinpoint what happens after receiving one drug. Giving 3 at once hinders your investigation.

But it is clear that anything that causes destabilizing a dog is not good for the treatment plan.
My best Patrice

[Amy]

Thank you! I’m so excited to hear this and hoping for some improvements! I have a virtual appointment with dr Dodd’s so I’m very excited to here you mention her. How long would it take to see an effect of the cyclosporine without food? Immediately or will it take a few days?

Also how would I know if he has an ulcer? Or should I just request the meds that cost the stomach and intestinal tract regardless? He is favouring cold water and only wants to drink from the bowl outside which makes me think it feels soothing in some way..

[Amy]

Also I read this article.. is there any truth to cyclosporine not being the best option?

https://www.vin.com/apputil/content/defaultadv1.aspx?id=3865580&pid=11262&print=1