Opinions on treatment and weaning off too fast

[Brigitte]

My take on things is that that reduction was too much too quick. Ivan was doing reasonably well on prednisone and that quick reduction could very likely have triggered allergic reactions. You did 2/3 reduction over less than one week, that could be too much for him. I don’t think the stomach issues are caused by the high dose of milk thistle but by the fast reduction of prednisone. At this stage, Ivan still needs to be on a very good stomach protectant. Are you giving that? We highly recommend sucralfate or carafate. This is a fairly cheap drug but can prevent painful ulcers like nothing else.
Best wishes,
Brigitte

[IvansMommy]

I see. I’ve never heard of sucralfate before. Do you know if it can be taken with pepcid ac at all? He’s been on 5mg 2x a day pepcid for chronic gastritis and reflux for years now. All these drugs and supplements, it’s difficult to know what goes with what or when it’s too much at once, you know? I’ll do some research into it and ask my vet as well. Maybe it can replace the pepcid altogether. I hate that he’s having to take it all the time.

[admin]

Hi Ivan’s Mum & Mum to many more lovely animals!

I agree with Brigitte – sucralfate is very good stuff.
You can read more about sucralfate in our site here:
https://www.secondchanceaihadogs.com/AIHA_Terms/sucralfate/

As you can see in that article, there is a possibility of interaction between pepcid (famotidine), so I would stop the pepcid. In my opinion, the sucralfate works better anyway – it did for Worzel. You must NOT give any tummy protector like sucralfate within 2 hours of the other medications or food – this is very important as it will stop absorption of the meds & food. A dose of sucralfate last thing at night at bedtime is very effective – it helped Worzel who had very bad tummy ache – poor boy was huffing & puffing & very uncomfortable until I started the sucralfate.

You cannot give sucralfate long-term though – you should stop it when the drug treatment is stopped or Ivan reaches his lowest possible dose. It contains aluminium which can build up in the body, but this really is a long-term, not a short-term, problem. Hope this helps!

As Brigitte says, a fast pred drop will trigger all sorts of allergies again too. Slowly, slowly for Ivan.

Sheena, Worzel & Ollie xxxxx

[Vally]

Ivan’s mum, was the reduction in prednisone actually 30mg down to 5mg in one go? or was that a typo. That is a huge reduction and very unusual.

Sheena types faster than me. Ditto everything she said about sucralfate.

Milk thistle is always a bit confusing, I think. It depends on the quality of the milk thistle and for a 20lb dog, Dr Jean Dodds recommends 20% of a human dose. There’s a product called Marin which has been mentioned before, made specifically for dogs so the dosing is simpler.

You’ll have to get yourself some dove-proof glasses. Her aim will probably improve.

Vally & Bingo
xxx

[admin]

Hi Ivansmommy.

Just a quick note to welcome you aboard and to say wow! All those animals! That’s amazing! I completely agree with what others have said about slow reductions. I also hear what you are saying with the all the different drugs and supplements. I am sure that will get easier. I hope Ivan is feeling well today :)

Mary and Mable x

[IvansMommy]

Nope. No typo. After double checking the dosage he was on, I had to call back just to be sure I had heard her correctly. I think it was because his platelets were getting way too high, so quickly, and also the damage to his liver. I went a bit slower than she’d recommended, but it was still a quick reduction. After reading up on reactive thrombocytosis, I was afraid of blood clots in Ivan’s brain. I had to weigh dropping too quickly versus not quickly enough. He does appear to be handling it fine though. He’s even getting a bit of muscle tone back. New numbers will be in probably Thurs. afternoon.
I’ve read through all your stories now and joined another AIHA group on facebook. I think I’ve narrowed the cause of his onset to long term irritation from a bladder stone and lawn pesticides pushing it over the edge. (The tick bite most likely occurred afterwards, at his first vet appointment, when he stopped to pee in the tall grass outside.) Unfortunately, there isn’t much that can be done about the stone. I do intend on spreading the word about the serious side effects of having a perfect green lawn though. People really should know the harm they’re causing.
This whole thing is crazy since he hasn’t had a vaccination, heartworm, or flea med since he was little. (He’d had a bad reaction to puppy vaccinations and two vets warned me about the over-vaccination of small dogs. His last titer tests came up in good range.) No dog food or treats from China. Homemade diet and bottled spring water only for most of his life. My childhood dog used to eat greasy dog chow, steal bags of bubble gum, and eat cat poo in the woods and never got sick at all. He was 120 lbs and lived to nearly 13. Ivan has practically had to live in a bubble. It just doesn’t make sense. :/

[IvansMommy]

Okay, so we’re back from our appointment (just a quick blood draw) and I got the print out of Ivan’s last blood work. Honestly, I’m not sure what to think now. He seems to be doing so much better, nearly normal, but these numbers are high. This would have been from before the decrease in medications (new results hopefully in tomorrow afternoon). Below are the abnormal values from original CBC at diagnosis to most recent available. Can anyone tell me what’s going on with him? Is this the reason why he had to decrease meds so suddenly? I’m looking it all up, but some things say it’s a result of steroids, some things could be caused by his bladder stone, others may mean liver or kidneys are failing.

WBC went from 6.6 to 40
RBC from 6.3 to 4.3
Hemoglobin 15.3 to 11.5
Hematocrit 46 to 35
MCV 73 to 81
Platelet count 12 to 575
Neutrophils 5214 to 34000
Bands 0 to 3600
Monocytes 396 to 1200
ALT 84 to 226
Alk Phosphatase 143 to 1576
Urea Nitrogen 36 to 44
BUN/creatinine ratio 26 to 37

[Patrice]

There is an increase in white blood cells and I believe this might be an infection. Looking at the kidney values, I would suggest that you test for a urinary tract infection.

There is a decrease in the hematocrit (and hemoglobin) that I don’t particularly like. But I am not sure that a urinary tract infection would be the single reason for this. Do you have a copy of the test you could upload for me on the Urgent Advice page on this website? I would like to see more of the other values.

I also want to know more about the tick bite, how the vet tested for any tick disease and if there was any treatment. Also, if there was treatment was there any testing after to ensure the treatment was successful? I know a lot about tick diseases. They can lead to many different physiological changes such as anemia, kidney damage, neurological issues and musculotendinous problems such as lameness. Each tick disease has their own signature of impact and a tick can carry more than one disease. Let’s face it, I HATE ticks and the diseases they carry. Treatments are not always 100% successful. This can lead to the disease(s) smoldering just under the radar.

Please upload this test so I can see it. Thank you
my best
patrice