Long term steriod use

[Cate]

Hi,

I’ll try to keep this as brie as possible. My baby girl, Leila, 10 year old Goldendoodle was diagnose with ITP, last May (2017), in reaction to an antibiotic she was given (Covenia). Luckily, when she first became sick, we caught it right away and she was able to avoid hospitalization and blood transfusion. She was immediately put on 40mg of prednisolone and doxycycline (while we awaited the tick panel). She thankfully responded to the pred right away. We followed a very slow taper throughout the summer of 2017 and she was eventually able to wean off the pred around September 2017 fully.

We enjoyed a few blissful months of health and then around December 2017, we noticed that she wasn’t interested in eating that much. She has never been a big eater and she was free-fed throughout the day/night, so it took a few weeks for my husband and I to realize she wasn’t eating much at all. End of December beginning of January we realized she had stopped eating all together and she quickly lost a lot of weight. She was thin to begin with, never weighting for than 54 pounds (for standard goldendoodle). She quickly dropped to 43 pounds.

We ran every test imaginable. EPI, Cushing, Addison’s, more blood tests, x-rays, ultra-sounds, biopsy, you name we tested for it.

Around this time, she also developed, extreme diarrhea. So, if she would eat, it would essentially come back out, in diarrhea and most of the time the food was undigested. We tried every type of diet out there, and I would say in a month’s time, we spend over $1,000 on various diets (home-cooked, raw, dehydrated).

she was tested for intestinal parasites, given a dewormer, put on probiotics. Saw a holistic vet, got acupuncture.

At this point, her regular vet, referred us to an internal medicine specialty at UC Davis Vet School He ran a bunch of tests and determined, that Leila was now also suffering from Inflammatory Bowel Disease.

Essentially, we all think, she was predisposed to immune issues (she was the runt) and once she had the reaction to the antibiotic, her was enough to tip her immune system into overdrive, so at first, it attacked her platelets and now it’s attacking her intestines.

After a month of trying to avoid steroids, she started vomiting and that was it, I couldn’t watch her suffer any longer. We decided to try the prednisone again (at 40MG initially) and after one dose, she was a different dog. Ate her food right up.

We still had to play around with her diet, but we eventually relented and put her on a prescription diet (royal canine white fish) and thankfully that plus the steroids, she bounced back. She gained back all her weight and was back up to around 53/54 pounds.

We were able to wean her down to 10mg of prednisone and she has been on that since May 2018. So, here we are. She has been doing great (fingers crossed) but she is started to show the signs of long term steroid use. Mainly, muscle wasting (she is down to around 51 pounds). On some of her pressure points, she gets scabs bc she is so bony.

So her regular vet would like to try and switch her to cyclosporine bc it doesn’t have the side effects that he prednisone does HOWEVER, the one thing, I’m terrified of is that the main side effect it does have is gastro upset. The LAST thing we want to do is to send her into an IBD flare.

We have an appointment tomorrow with her internal medicine doctor to get his opinion.

I should mention that we still regulary check her platelets and this entire time, they have been good. We do have to send her blood sample out to be hand counted bc her platelets are so sticky and at times, the machine counted way, has given us false low readings. One thing, the vet mentioned is that she is still a bit anemic. Not terribly but a tad, and he mentioned that platelet health obviously plays a role anemia.

Her thyroid is also low, so she is on a low dose of thyroid meds which thankfully regulates it to normal.

In addition to the pred and the thyroid meds, we also give her Standard Process liver support and we just started her on Standard Process Immune Support. We are hoping that will help negate some of the side effects from the prednisone.

So, my question to you all, is this, at what dose of steroids, do the side effects go away? I think I’m leaning more towards trying to reduce her prednisone dose before we try switching her to a totally different medication. We did try to reduce it to 5 back in May 2018, but she slowed down her eating, so we put it back to 10MG and have left it there.

I should also mention, she still acts like a puppy. She plays ball for 2 to 3 hours a day. Jumping in the air, running. So even with the muscle wasting, she is still able to play.

I feel so torn. If there is something that can make her feel even better, I feel guilty not trying it bc I’m scared, but at the same time, I feel like I know my dog better than even a vet, and my gut is telling me to stay on the prednisone. With her complex history, we all feel that she will need to remain on some type of immune suppressing agent the rest of her life. Also, factoring into this is her age. She was 8.5 at age of onset and she is now 10.

If you have made it this far, you are an angel. Thank you!!! I look forward to hearing people’s thoughts on what they would do. In my experience, navigating these immune diseases, the vets are great, but it’s the pets parents that really know best.

[Vally]

Hi Cate and welcome.

It’s never too long a post. There is always so much to explain, so don’t apologise.

First of all I totally totally agree with you that you know Leila best. I loved my internal specialist, he was a great guy and he helped caring for my Bingo. He was a big believer in listening to a fur parent, even if said Bingo was happy to make an idiot of me because I’m explaining to the vet, this is happening, and there are no symptoms and no blood results showing it. He always said he believed what he was told and said in his experience, the clinical symptoms showed up well after it was noticed by a pet owner.

We also decided to keep Bingo on low dose prednisone for the rest of his life, more for his arthritis than anything else. Whilst he recovered well from his AIHA, when taken off the prednisone, his PCV would drop and he would develop polyarthritis. Specialist said he thought we should keep the “old boy happy and keep him on the low dose”, so Bingo ended up on 2.5ml (he weighed 7kg), which I would lower to 1.25 every now and then but as soon as he showed any type of symptom, I’d put it back up to the 2.5 and he stayed on that.

Yes, it did leave him with very bony hips and weak legs, but he was happy, and I don’t regret it. I just put runners throughout the house.

I remember one vet, when I brought him in urgently and his regular vet wasn’t there, told me he was in terrible condition due to him being on the prednisone, and I was a mess when I walked out and burst into tears. I later discussed this with his regular vet and the internal specialist, who said she was an idiot. In fact my vet ended up sacking that particular vet, not because of her comments to me, but this was her attitude to too many people.

Yes, it does leave them with long term damage, but he was comfortable and happy.

My very best,
Vally

[Cate]

Hi everyone it is with a heavy heart that I am writing this message. On Wednesday afternoon, my beloved 10 year old goldendoodle, Leila passed over the rainbow bridge. She was a fighter to the end but her body just couldn’t fight any longer. And in one last act of love, I feel she took the decision out of my hands and passed away.

Her journey over the last two years was a rocky one but she bounced back from immune mediated thrombocytopenia only to develop IBD. She battled back with that and on a low dose of prednisone, lead a good life the last year.

Last Friday night I noticed a black large growth on her paw (that wasn’t there even a few days before). I took her to the vet first thing Saturday morning and they confirmed it didn’t look good. We scheduled surgery for her on Monday morning. We knew it was risky with her compromised immune system but we didn’t have a choice.

She made it through the surgery fine and we took x-rays of her lungs before and after intubation. Her lungs were clear. We brought her home Monday night. She awoke Tuesday with energy and went out to pee and poop and was eating and drinking. by Tuesday evening, she developed a cough and raspy breathing. We immediately contacted the vet who put her on strong antibiotics for a lung infection. She continued to go down hill and we rushed her to the emergency vet hospital on Wednesday early morning.

they told us she was critical. She had developed pneumonia and was septic. We started treatment and we knew the next 24 hours would be telling. Once she was admitted to the doggie ICU, my husband and I were able to visit with her and gave her lots of snuggles and kisses and told her what a good doggie she was. She was stable so we went home and told her we would be back in a few hours to visit again.

As soon as we got home, 5 minutes later, the ER doc called us and told us Leila had collapsed, probably suffering a stroke. We told them we were on our way. The vet asked us if Leila was suffering could they administer medication and we told her definitely, the last thing we ever wanted was our sweet girl to suffer.

We were 5 minutes away when the vet called and told us Leila was really struggling to breathe so she administered medication. Our baby girl was gone.

We are heartbroken but are trying to take comfort in the fact that she lived 10 good years. We spoiled the hell out of her and gave her so much love. We basically have given up everything and spent all our money on her over the last two years to get her healthy and I don’t regret any of it.

She saw us through so many milestones (my first apartment of my own as an adult, meeting my husband, being our flower girl at our wedding, teaching us how to be selfless, teaching me patience, and most of all acceptance.

No length of time would ever have been enough and we will NEVER forget her. I hope that she is swimming and playing ball non-stop.

Lots of love to all,

Cate, Danny and Leila

[Vally]

Cate and Danny, I am so very very sorry to hear this. Our dogs are so special, they can never leave our hearts, even though they have left our worlds.

All the fighting you did to help Leila fight, is a huge sign of your love for her.

I hope all the wonderful times you all had together shine forth and help you through this present time.

When you are ready, and it may not be just now, there is a page written by one of our ladies, after losing her own dog. It’s truly beautiful and I hope it helps you.
https://www.secondchanceaihadogs.com/the-bridge

My deepest condolences.
Vally

[Cate]

Hi,

I’ll try to keep this as brie as possible. My baby girl, Leila, 10 year old Goldendoodle was diagnose with ITP, last May (2017), in reaction to an antibiotic she was given (Covenia). Luckily, when she first became sick, we caught it right away and she was able to avoid hospitalization and blood transfusion. She was immediately put on 40mg of prednisolone and doxycycline (while we awaited the tick panel). She thankfully responded to the pred right away. We followed a very slow taper throughout the summer of 2017 and she was eventually able to wean off the pred around September 2017 fully.

We enjoyed a few blissful months of health and then around December 2017, we noticed that she wasn’t interested in eating that much. She has never been a big eater and she was free-fed throughout the day/night, so it took a few weeks for my husband and I to realize she wasn’t eating much at all. End of December beginning of January we realized she had stopped eating all together and she quickly lost a lot of weight. She was thin to begin with, never weighting for than 54 pounds (for standard goldendoodle). She quickly dropped to 43 pounds.

We ran every test imaginable. EPI, Cushing, Addison’s, more blood tests, x-rays, ultra-sounds, biopsy, you name we tested for it.

Around this time, she also developed, extreme diarrhea. So, if she would eat, it would essentially come back out, in diarrhea and most of the time the food was undigested. We tried every type of diet out there, and I would say in a month’s time, we spend over $1,000 on various diets (home-cooked, raw, dehydrated).

she was tested for intestinal parasites, given a dewormer, put on probiotics. Saw a holistic vet, got acupuncture.

At this point, her regular vet, referred us to an internal medicine specialty at UC Davis Vet School He ran a bunch of tests and determined, that Leila was now also suffering from Inflammatory Bowel Disease.

Essentially, we all think, she was predisposed to immune issues (she was the runt) and once she had the reaction to the antibiotic, her was enough to tip her immune system into overdrive, so at first, it attacked her platelets and now it’s attacking her intestines.

After a month of trying to avoid steroids, she started vomiting and that was it, I couldn’t watch her suffer any longer. We decided to try the prednisone again (at 40MG initially) and after one dose, she was a different dog. Ate her food right up.

We still had to play around with her diet, but we eventually relented and put her on a prescription diet (royal canine white fish) and thankfully that plus the steroids, she bounced back. She gained back all her weight and was back up to around 53/54 pounds.

We were able to wean her down to 10mg of prednisone and she has been on that since May 2018. So, here we are. She has been doing great (fingers crossed) but she is started to show the signs of long term steroid use. Mainly, muscle wasting (she is down to around 51 pounds). On some of her pressure points, she gets scabs bc she is so bony.

So her regular vet would like to try and switch her to cyclosporine bc it doesn’t have the side effects that he prednisone does HOWEVER, the one thing, I’m terrified of is that the main side effect it does have is gastro upset. The LAST thing we want to do is to send her into an IBD flare.

We have an appointment tomorrow with her internal medicine doctor to get his opinion.

I should mention that we still regulary check her platelets and this entire time, they have been good. We do have to send her blood sample out to be hand counted bc her platelets are so sticky and at times, the machine counted way, has given us false low readings. One thing, the vet mentioned is that she is still a bit anemic. Not terribly but a tad, and he mentioned that platelet health obviously plays a role anemia.

Her thyroid is also low, so she is on a low dose of thyroid meds which thankfully regulates it to normal.

In addition to the pred and the thyroid meds, we also give her Standard Process liver support and we just started her on Standard Process Immune Support. We are hoping that will help negate some of the side effects from the prednisone.

So, my question to you all, is this, at what dose of steroids, do the side effects go away? I think I’m leaning more towards trying to reduce her prednisone dose before we try switching her to a totally different medication. We did try to reduce it to 5 back in May 2018, but she slowed down her eating, so we put it back to 10MG and have left it there.

I should also mention, she still acts like a puppy. She plays ball for 2 to 3 hours a day. Jumping in the air, running. So even with the muscle wasting, she is still able to play.

I feel so torn. If there is something that can make her feel even better, I feel guilty not trying it bc I’m scared, but at the same time, I feel like I know my dog better than even a vet, and my gut is telling me to stay on the prednisone. With her complex history, we all feel that she will need to remain on some type of immune suppressing agent the rest of her life. Also, factoring into this is her age. She was 8.5 at age of onset and she is now 10.

If you have made it this far, you are an angel. Thank you!!! I look forward to hearing people’s thoughts on what they would do. In my experience, navigating these immune diseases, the vets are great, but it’s the pets parents that really know best.

[Vally]

Hi Cate and welcome.

It’s never too long a post. There is always so much to explain, so don’t apologise.

First of all I totally totally agree with you that you know Leila best. I loved my internal specialist, he was a great guy and he helped caring for my Bingo. He was a big believer in listening to a fur parent, even if said Bingo was happy to make an idiot of me because I’m explaining to the vet, this is happening, and there are no symptoms and no blood results showing it. He always said he believed what he was told and said in his experience, the clinical symptoms showed up well after it was noticed by a pet owner.

We also decided to keep Bingo on low dose prednisone for the rest of his life, more for his arthritis than anything else. Whilst he recovered well from his AIHA, when taken off the prednisone, his PCV would drop and he would develop polyarthritis. Specialist said he thought we should keep the “old boy happy and keep him on the low dose”, so Bingo ended up on 2.5ml (he weighed 7kg), which I would lower to 1.25 every now and then but as soon as he showed any type of symptom, I’d put it back up to the 2.5 and he stayed on that.

Yes, it did leave him with very bony hips and weak legs, but he was happy, and I don’t regret it. I just put runners throughout the house.

I remember one vet, when I brought him in urgently and his regular vet wasn’t there, told me he was in terrible condition due to him being on the prednisone, and I was a mess when I walked out and burst into tears. I later discussed this with his regular vet and the internal specialist, who said she was an idiot. In fact my vet ended up sacking that particular vet, not because of her comments to me, but this was her attitude to too many people.

Yes, it does leave them with long term damage, but he was comfortable and happy.

My very best,
Vally

[Cate]

Hi everyone it is with a heavy heart that I am writing this message. On Wednesday afternoon, my beloved 10 year old goldendoodle, Leila passed over the rainbow bridge. She was a fighter to the end but her body just couldn’t fight any longer. And in one last act of love, I feel she took the decision out of my hands and passed away.

Her journey over the last two years was a rocky one but she bounced back from immune mediated thrombocytopenia only to develop IBD. She battled back with that and on a low dose of prednisone, lead a good life the last year.

Last Friday night I noticed a black large growth on her paw (that wasn’t there even a few days before). I took her to the vet first thing Saturday morning and they confirmed it didn’t look good. We scheduled surgery for her on Monday morning. We knew it was risky with her compromised immune system but we didn’t have a choice.

She made it through the surgery fine and we took x-rays of her lungs before and after intubation. Her lungs were clear. We brought her home Monday night. She awoke Tuesday with energy and went out to pee and poop and was eating and drinking. by Tuesday evening, she developed a cough and raspy breathing. We immediately contacted the vet who put her on strong antibiotics for a lung infection. She continued to go down hill and we rushed her to the emergency vet hospital on Wednesday early morning.

they told us she was critical. She had developed pneumonia and was septic. We started treatment and we knew the next 24 hours would be telling. Once she was admitted to the doggie ICU, my husband and I were able to visit with her and gave her lots of snuggles and kisses and told her what a good doggie she was. She was stable so we went home and told her we would be back in a few hours to visit again.

As soon as we got home, 5 minutes later, the ER doc called us and told us Leila had collapsed, probably suffering a stroke. We told them we were on our way. The vet asked us if Leila was suffering could they administer medication and we told her definitely, the last thing we ever wanted was our sweet girl to suffer.

We were 5 minutes away when the vet called and told us Leila was really struggling to breathe so she administered medication. Our baby girl was gone.

We are heartbroken but are trying to take comfort in the fact that she lived 10 good years. We spoiled the hell out of her and gave her so much love. We basically have given up everything and spent all our money on her over the last two years to get her healthy and I don’t regret any of it.

She saw us through so many milestones (my first apartment of my own as an adult, meeting my husband, being our flower girl at our wedding, teaching us how to be selfless, teaching me patience, and most of all acceptance.

No length of time would ever have been enough and we will NEVER forget her. I hope that she is swimming and playing ball non-stop.

Lots of love to all,

Cate, Danny and Leila

[Vally]

Cate and Danny, I am so very very sorry to hear this. Our dogs are so special, they can never leave our hearts, even though they have left our worlds.

All the fighting you did to help Leila fight, is a huge sign of your love for her.

I hope all the wonderful times you all had together shine forth and help you through this present time.

When you are ready, and it may not be just now, there is a page written by one of our ladies, after losing her own dog. It’s truly beautiful and I hope it helps you.
https://www.secondchanceaihadogs.com/the-bridge

My deepest condolences.
Vally