Red blood cell count decreased

[Hope]

Litas Bun is high and RBC dropped from 25 to 22.. WBC also up.. doesn’t look like generic neoral is working.
Now I pray that going back to expensive atopica $170.00 and maybe more a week will work .
This has been horrible! Cytoxen and prednisone was used on my dog Shiloh 15 years ago and worked wonderfully! Why isn’t it used anymore?

[Patrice]

Hope,
I’m really sorry to read this. There is nothing more frustrating and frightening than for an owner to be put out of the loop about their dog’s health.

This ketoconazole dosing to lower the dose of cyclosporine protocol has been studied and it was the recommendation from the study to use this as a method to reduce the costs of cyclosporine. The study came to the conclusion that the blood levels of cyclo remained at therapeutic levels.
https://www.ncbi.nlm.nih.gov/pubmed/9449179
But please note they used 5 Beagles that were healthy for this study.

I would never urge an owner to try this method of treatment considering how critical the cyclosporine is to the treatment protocol. Some vets may dose this way and feel confident and I won’t criticize them. Other vets follow more closely their own clinical experiences of success and may not carefully follow recommendations from such a limited study.

But a study with 5 healthy dogs isn’t really a glowing review for me. If I was an owner with a very sick dog I would want to read a study that tested this on hundreds of dogs.

Such a study was done on Atopica when Novartis was looking to market it for treatment of canine atophy (inhaled allergies.) You can find the product insert where the results of these trials are presented in the Medication Resources page. Of course you can read all the negative side effects but for all drug trials there will always be some participants who have these. The degree of the side effects and the percentage of the whole are the critical considerations. Note that this trial was to determine if this drug reduced the allergic reactions of the dogs, it was not to test it for us in treating autoimmune blood diseases. But from this trial we know how dogs react to this medication and what possible side effects there may be, this is good general knowledge that can be applied to its off label use for many autoimmune conditions.
https://www.secondchanceaihadogs.com/medication-resources

The solution is really simple. Put her back on the Atopica brand or a suitable generic and see if this results in an improvement. If this were me I would not continue with the ketoconazole. You may want to temporarily increase the dose of prednisone as well.

Have you thought about doing a consultation with Dr. Dodds? I would highly recommend this as an excellent way to get a second opinion from another veterinarian. You can find the link to the consultation form on this page, second link on the top of the page.
https://www.secondchanceaihadogs.com/hemopetresources
Many of us have used Dr. Dodds as our guardian angel. She saved Chance’s life.

my best, patrice

[Patrice]

Please reread Dr. Dodds protocol on the Hemopet Resources page that I posted the link to above. Look for this title
Dr Dodds IMHA Disease and Bone Marrow Failure.

She specifically mentions why she does not recommend Cytoxen. Her protocol is very clear about all the drugs and dosages she recommends.
my best
patrice

[Hope]

At the doctors office and infection not cured after all by amoxicillin and other drug so another drug that’s not resistant will need to be administered by shot every 12 hours.. it’s a bad infection. Can’t remember name right of hand.
Anyway Lita going back on atopica and ketoconazole .. I pray this works! Don’t know what else to do..

[Patrice]

Hope,
Is this a skin infection or internal infection?
Did they mention MRSA, or staphylococcus? These are 2 possible skin infections that can occur during immuno-suppression treatment. Staph usually clears quickly on antibiotics. MRSA is a far more resistant skin infection that doesn’t respond to treatment with certain antibiotics. It can be severe in dogs. If you need more information let me know.

I’m not a fan of using ketoconozole for this treatment. Why is the vet so eager to do this?
Goodluck, thinking about you tonight
Patrice

[Hope]

Sorry been long day.. infection started out as uti not skin..

[Vally]

Hope, I’m so sorry to see this, you must be out of your mind right now. I would absolutely agree with Patrice about getting the opinion of Dr Dodds. With the one payment only, you can keep emailing your results through to her and she will continue to help her, so really you are getting an expert opinion at very little cost.

I asked for her help a few times with Bingo, and she responds very quickly and I absolutely trust her.

Vally

[Hope]

Please send me consultation link I don’t see it..

[Hope]

Litas Bun is high and RBC dropped from 25 to 22.. WBC also up.. doesn’t look like generic neoral is working.
Now I pray that going back to expensive atopica $170.00 and maybe more a week will work .
This has been horrible! Cytoxen and prednisone was used on my dog Shiloh 15 years ago and worked wonderfully! Why isn’t it used anymore?

[Patrice]

Hope,
I’m really sorry to read this. There is nothing more frustrating and frightening than for an owner to be put out of the loop about their dog’s health.

This ketoconazole dosing to lower the dose of cyclosporine protocol has been studied and it was the recommendation from the study to use this as a method to reduce the costs of cyclosporine. The study came to the conclusion that the blood levels of cyclo remained at therapeutic levels.
https://www.ncbi.nlm.nih.gov/pubmed/9449179
But please note they used 5 Beagles that were healthy for this study.

I would never urge an owner to try this method of treatment considering how critical the cyclosporine is to the treatment protocol. Some vets may dose this way and feel confident and I won’t criticize them. Other vets follow more closely their own clinical experiences of success and may not carefully follow recommendations from such a limited study.

But a study with 5 healthy dogs isn’t really a glowing review for me. If I was an owner with a very sick dog I would want to read a study that tested this on hundreds of dogs.

Such a study was done on Atopica when Novartis was looking to market it for treatment of canine atophy (inhaled allergies.) You can find the product insert where the results of these trials are presented in the Medication Resources page. Of course you can read all the negative side effects but for all drug trials there will always be some participants who have these. The degree of the side effects and the percentage of the whole are the critical considerations. Note that this trial was to determine if this drug reduced the allergic reactions of the dogs, it was not to test it for us in treating autoimmune blood diseases. But from this trial we know how dogs react to this medication and what possible side effects there may be, this is good general knowledge that can be applied to its off label use for many autoimmune conditions.
https://www.secondchanceaihadogs.com/medication-resources

The solution is really simple. Put her back on the Atopica brand or a suitable generic and see if this results in an improvement. If this were me I would not continue with the ketoconazole. You may want to temporarily increase the dose of prednisone as well.

Have you thought about doing a consultation with Dr. Dodds? I would highly recommend this as an excellent way to get a second opinion from another veterinarian. You can find the link to the consultation form on this page, second link on the top of the page.
https://www.secondchanceaihadogs.com/hemopetresources
Many of us have used Dr. Dodds as our guardian angel. She saved Chance’s life.

my best, patrice

[Patrice]

Please reread Dr. Dodds protocol on the Hemopet Resources page that I posted the link to above. Look for this title
Dr Dodds IMHA Disease and Bone Marrow Failure.

She specifically mentions why she does not recommend Cytoxen. Her protocol is very clear about all the drugs and dosages she recommends.
my best
patrice

[Hope]

At the doctors office and infection not cured after all by amoxicillin and other drug so another drug that’s not resistant will need to be administered by shot every 12 hours.. it’s a bad infection. Can’t remember name right of hand.
Anyway Lita going back on atopica and ketoconazole .. I pray this works! Don’t know what else to do..

[Patrice]

Hope,
Is this a skin infection or internal infection?
Did they mention MRSA, or staphylococcus? These are 2 possible skin infections that can occur during immuno-suppression treatment. Staph usually clears quickly on antibiotics. MRSA is a far more resistant skin infection that doesn’t respond to treatment with certain antibiotics. It can be severe in dogs. If you need more information let me know.

I’m not a fan of using ketoconozole for this treatment. Why is the vet so eager to do this?
Goodluck, thinking about you tonight
Patrice

[Hope]

Sorry been long day.. infection started out as uti not skin..

[Vally]

Hope, I’m so sorry to see this, you must be out of your mind right now. I would absolutely agree with Patrice about getting the opinion of Dr Dodds. With the one payment only, you can keep emailing your results through to her and she will continue to help her, so really you are getting an expert opinion at very little cost.

I asked for her help a few times with Bingo, and she responds very quickly and I absolutely trust her.

Vally

[Hope]

Please send me consultation link I don’t see it..