Sadie – Weaning…..

[Linda]

Hi all.  Sorry I have been away – we have had much company – feel like a hotel here.  But it’s all family and all good.

I have a question about Atopica.  I am now down to 10mg every three (3) days with Sadie, for one month.  She continues on the 7.5mg of Prednisone daily.  I really want to get to OFF the Atopica completely.  She has been on it for a year (tomorrow).

My question is: From the 10mg (daily, in the AM, every three (3) day), which is the lowest dose, do I now need to go to every four (4) days (for a month?) , and then every five (5) days (for a month?) OR can I stop it completely at this point?  Sheena, Worzel was on Atopica right?  What did you do?

I will then, start to lower the Prednisone again.  It’s just been too long on all this stuff.  Her PCV has maintained between 46-48 over the last two months.  We go for a CBC in the morning – checking all.

Thanks – any input would be great.   Love and hugs to you all.  Linda & Sadie

[admin]

Hi Linda & my dear girl Sadie

Sorry – Worzel was not on Atopica, he was (& still is once a week) on azathioprine, so I’m not an expert on this from a personal experience point of view. Also we got him completely off the pred before starting the aza reduction, & I know you don’t want to do that with Sadie because of the relapse last time (even though we know it was because the drop was much too fast). We then reduced the aza to every other day for 2 months, every 3 days for 2 months & so on until we reached once a week. That took a year. As you know I am paranoid about a relapse & that is the only reason Phil & I decided not to risk stopping the aza altogether. My PERSONAL opinion is to lower the prednisone first (because of the long term side effects) if you can, or get it as low as possible to maintain Sadie at a good PCV & then start to drop the atopica, but I would really prefer Vally & Patrice to give you advice as they have had the experience of using cyclosporin (atopica) & the weaning too – they are the experts on this subject. When I wrote the cyclosporine glossary term, I read many articles that said that most dogs can eventually come off it altogether, so that would be wonderful for Sadie. I know it has long terms side effects so I understand why you want to reduce/stop it.   I know Bingo had a few relapses, so Vally will understand exactly how you are feeling & will be able to advise you better than I can. It is SO difficult to know what to do at this stage – I can remember worrying myself stupid at every single drop in medication. My specialist also said he wished he had a crystal ball & he was very cautious with the aza reduction, so even the vet experts don’t have an exact solution.

I am thrilled to see Sadie’s PCV is great – clever girl, she is.

Loads of love to you & Sadie from Sheena & Sadie’s fellas!

 

[Linda]

Thanks Sheena.  I guess it was  Bingo and Chance – I was thinking it was Worzel.  Da.

I am unsure if I should start again to lower the prednisone while maintaining the 10mg of Atopica every three days or what to do at this point.   My vet is great but she is a bit up in the air too and after all before (relapse), they KNOW I come here to get advice and to go forward.  And, they realize you all know what you’re talking about.  It’s nice that she listens to me and is open to suggestion.  She too, is less concerned about the Atopica, but does realize that Sadie has been on it for an entire year with not reduction until in the last two months.  The prednisone, we have been reducing for quite a while.   Her mood, her BM’s, her palsey – all have been better since reducing the Atopica.  I think it is the lesser of the ‘evils’ – and I know the prednisone needs to be omitted ASAP.  I will now go back to weaning the prednisone again.  But that is depending on what you say, Patrice and Vally (and anyone else that has dealt with this).

Sheena – how is Worzel?  I need to e-mail you (on a personal note…) about our trip coming up – game change.  You’re just going to have to come to the USA!!!!  Darn ocean….

xoxoxoxo to you all and sloppy kisses from Sadie ;)

 

[Vally]

Linda,

Bingo still takes 25mg Neoral (cyclosporine) every second day (he weighs in at a lean 7.6kg – 16.7 lbs).  His vet preferred to drop the prednisone over dropping the cyclosporine as he said the pred has more long term effects than the cyclosporine.  Last time there he mentioned we may look to drop the cyclosporine down next.  As Bingo has never really had too many side effects of the cyclosporine, we’ve worked more on the pred reductions.

I’m with Sheena too Linda, I think the dose Sadie is on now of the Atopica is quite low.  I like averages – a mere 3.3mg a day.  I too think it would be good to bring Sadie’s pred down a little in preference to the Atopica – 20% drop better, 25% drop fine though.  I understand you are worried about the Atopica though.

Love Vally & Bingo.

[Linda]

Thanks Vally. I think the pred needs to be dropped too. is the 3.3 a day the Atopica you’re referring to?   The problem is that the lowest dose is 10mg and it’s a foil wrapped gel cap – it can not be divided.  hence, the every (now) third day.

The pred is easier.  She now gets 5mg in the am and 2.5mg in the pm – 7.5 daily.  I am thinking 33% to 2.5mg in am and 2.5mg in pm?

She he is starting the lip smacking thing again, so I know we need to go in the pred reduction direction. Poor thing – she’s a happy little gal though snd otherwise doing well.

How is Mr. Antic?  Behaving and earing well? i know you’re worried about him.  So sorry you’re going through this.

Love and huge hugs, Linda and Sadie

[Vally]

Linda, yep sorry, the 3.3, I mean that by taking 10mg of Atopica every third day is equal to 3.3mg of Atopica every day.

Bingo went from 7.5 pred daily, being 5 in the am and 2.5 in the pm down to just 5mg in the am and nothing at night.

I’ve also read that if pred is prescribed once a day, give it in the morning to dogs and in the evening to cats. This more closely mimics their natural hormone cycle.

Bingo been really good lately.  Chased a cat this morning round and round and round a car, with me running after him trying to stop him waking the neighbours with his barking.

Love and some sloppy kisses for Sadie (from Bingo, not me – my kisses aren’t sloppy :)

[admin]

Hi Linda

Yes – I agree with Vally – please stick to a 20 or 25% reduction in the pred, slowly, slowly, and morning dosing is the right way to do it (as with humans actually). She is doing so well Linda – it cheers me up so much to read how good she’s feeling. OK, she may not be able to drop the pred altogether & might end up on a low maintenance dose, but it doesn’t matter as long as she’s fine. She has been through a lot with the Bell’s palsy as well as a relapse, so I think she has made a tremendous recovery, thanks to her loving Mum being such a determined lady.

Vally – glad to hear Mr Mischief is back on form!

Love to all, Sheena, Worzel & Ollie too

[Linda]

Okay – First of all – Vally, I am rolling over laughing.  Sadie is looking at me like: “W-H-A-TTTTTT?!?” – I told her about Bingo and she laughed too.  ;)  He’s back!!  Thanks Bingo!

And I’m so glad your kisses are NOT sloppy.  We’ll leave that for the pups, indeed.

We are just home from the vet.  Her PCV is again 48.  Yeah!!!  We also ran a CBC, but it won’t be back for a few days.

We decided to keep the Atopica every third day (10mg) and start (tomorrow) another reduction on the pred.  We will do as you both, Vally and Sheena, are saying, from 7.5mg daily, to 5.0mg daily.  Except, I’m wondering – you both are saying 5mg in the am?  I could give her 2.5mg in the am and then 2.5mg in the pm?  Or should I do it just the one time in the am, 5mg?  I am scared to death to do this anyway, but she’s good and I’m a hawk about continually watching her gums/mouth/demeanor.  Obsessed, yep.

About the lip smacking.  I think it may have been the Honest Kitchen’s Perfect Form.  Obviously, it dries them out a bit and that may have been it.  I don’t give it daily – just when her you-know-what’s are soft.  Every now and then I give a bit too much (which is about 1/3 what they say to give, geeze, her tummy is sensitive!!) and she will do the lip smacking.  I stop giving it and it quits.  Go figure.

Oh, and I DID start her on Tri-Heart, Plus.  I am thinking every 45 days (as Dr. Dodds recommends), but today my vet said she is a bit worried, being Florida and the nasty mosquito environment here.  She’s opting for every 30 days (as directed, but….).  Any advice?

Joe – I think of you and Nauset always – hope she’s doing well.  Nauset is why I have Sadie back on heart worm meds.

So, all is pretty darn good here with little ol’ Sadie girl, for today.  So, we’re going for a short walk before the rain starts (again).

Sadie and I are ever so thankful for you all.  xo