Split: Split: Nula (5yr old English Cocker Spaniel)

[Vally]

Ruth, Bingo also lost 2 of his 8kg in a matter of weeks in the early days, most likely because of the prednisone and the loss of muscle which that caused. Lots of little meals will help.

Love Vally & Bingo.

[Linda]

Hi Ruth. Sadie and I are off on the road today, but wanted to let you know we’re thinking of you and Nula. And just know – when we say, ‘roller coaster’ – we are al so in tune to all you’re going through. It truly is ups and downs. But Nula is doing great. Keep that positive attitude and let us know. I figure she has over 150 or more fingers and toes crossed for her!!!

[Linda]

For some reason, my ending was deleted. Maybe because I’m on my iPhone and embedded a smily face? Anyway, was supposed to say:

Love and hugs to you and Nula,

Linda and Sadie

[admin]

Hi Ruth
Great to hear Nula is coping so well – good luck with the blood test results. As Vally says, unfortunately weight loss is “usual” during treatment – Worzel was 23kg roughly & went down to 18kg. He was eating 3 or 4 times more than he normally did at one point, so we gave him lots of small meals too – he was ravenous! Lots of protein content is good because it is muscle mass they are losing. Vally is spot on – prednisolone is catabolic, which basically means it makes the body “eat” or use up it’s own muscle. This is reversible & she will slowly get back to normal when you are able to start reducing the dosage, but you have to be sure she is absolutely stable before doing that. Worzel now looks the same as he did before diagnosis, despite looking like a walking skeleton during the treatment – he’s no spring chicken either. Nula is pretty young & can get through this, but it’s not nice to see them getting thinner – it really, really worried me actually as Worzel was slim to start with. He even lost jaw muscle & started to get hollows above his eyes. It’s not a pleasant experience for any of us, but rest assured we have all seen this happen & are here to help you through this.
Right Nula! Let’s have a good PCV for your lovely Mum please!
Love Sheena, Worzel & Ollie xxxx

[Patrice]

Hi Ruth,
It does sound like Nula is more stable! That is such good news!

I wish that when we treated our dogs for this disease that they did not also have to go through all the side effects of the drugs. Sometimes they can seem worse than the disease itself.

After months of prednisone, Chance looked awful. But even worse were the unseen side effects on the “workings” of the body. One of prednisone’s more difficult side effects is muscle wasting. The medical term is catabolism.

This muscle wasting is not something that can be treated with more protein in the diet or more exercise. Reducing the prednisone will eventually stop this process.

Chance’s back right leg trembled quite a bit and even after he recovered, that leg always was a bit weaker and had the tendency to tremble.

Before all of our dogs were diagnosed with this condition they had been healthy active dogs. When we come out of the treatment process successfully our dogs may be a little different than before. But life is still good! These are bonus days!

After recovery Chance’s back leg was weaker and eventually his cruciate ligament became progressively damaged as a consequence of the long term prednisone he had been on. Two years later we had surgery done on the knee so he could continue to walk. It helped a great deal, but yet his leg did tremble at times.

Nula is playing with her toys and that is the best sign that she still has a strong will to live. She is doing her part very well. And so are you Mommy! This is hard work. Be patient with yourself. Make sure to carve out some “me” time every day.
my best, patrice

[Ruth]

Amazing news with Nula’s PCV results! Somehow she is up to 39!!!!!!!! It’s 11 days since she came home with a PCV of 26. I’m amazed!!!! The only thing they can think that’s bumped it up so much is that she’s eating so much, and I’m giving her iron rich foods as well. But I’m so pleased! The only thing is that she’s still quite tired, so they think the prednisolone might be sedating her a bit. They want to take her prednisolone down from 15mg twice a day to 10mg twice a day, and keep the Atopica the same. Her platelets are good too so finish the Aspirin then stop that. Her next PCV test and check up is 9th June. Bit worried about cutting down the prednisolone. What do you guys think? She wasn’t doing so well just on prednisolone at the start, it was the Atopica that really got her through. So not sure. Really, really pleased!!! But nervous too! Xxxxxxx

[admin]

Oh Ruth! This is wonderful!!! The food might help Nula getting better, but a jump like that does not happen with food, not even the best food. It is Nula’s body that is healing, making the change to get better! Of course it is also the drugs and it is good that they are being reduced. The suggested reduction is certainly within the recommended percentage of 25-33. I am convinced that with this reduction you will see Nula perk up and feel better. I might be wrong, but I don’t think that her adrenal glands will quite start to work on their own at this dose, they might slowly wake up with the next reduction. (Patrice might correct me on this:)) If you are worried about a relapse, you can always go in and get a simple PCV done at the vets before June 9. this would give you peace of mind.
Keep doing what you are doing and tell Nula she is a Superstar!
Best wishes from Brigitte & the poodle boys that are all doing the happy dance

[Patrice]

Ruth,
This is excellent news! A PCV (hematocrit) of 39 is well within what is considered a normal range for this value!

How did this happen? First the immunosuppression by prednisone (to start) and then the addition of Atopica, have been successful. This means that the white blood cells of the immune system that were responsible for the destruction of the red blood cells have been suppressed. Their numbers have been significantly reduced and they can’t do much damage in those numbers.

Second, the bone marrow now has the opportunity to actually make good reticulocytes (baby blood cells) and those turn into mature red blood cells within about a week. It can take some time for the body to replace the significant number of lost red blood cells. You are right that good nutrition is important in this production. The bone marrow has been trying all along but could not keep up with the number of RBC lost.

Why did this take some time? You started with prednisone, which can be a wonder drug in stopping the rogue white blood cells immediately. But as you already know the side effects began to become apparent. Adding Atopica, a drug that specifically targets those rogue white blood cells shifts the treatment protocol. That is why your vet feels comfortable reducing the prednisone a little. the Atopica is doing the heavy lifting right now.

Do I feel comfortable if you began to completely reduce the prednisone? Not really. Dr. Dodds admits there is a subgroup of dogs that can never completely stop the prednisone. She says it is kind of like a message to the immune system to “stay under control.”

Is Nula one of these dogs? Well, there is no “test” to determine that. But she is one of the breeds that is known to be genetically prone to this disease. Recovery can happen, but sometimes these dogs may relapse and it can happen abruptly. This breed is also known to develop systemic lupus erythematosus (SLE), another autoimmune condition.

So have a talk with your vet about this and express your desire to be cautious during her recovery.

I still urge you to be confident as she recovers that this will be the last time she goes through this! Your job in the future is to protect her. She will always need the best diet, protection from stresses to the body such as vaccinations, tick diseases, heartworm, viruses and bacterial infections.

If she has not been spayed, this may be something you want to consider doing when she is completely recovered. Hormones play a significant role in stress to the immune system.

I would never board her again, if this were me. I would avoid exposing her to sick dogs or places where many dogs gather like training classes, doggie parks etc. Also, if this were me I would never travel with her and that includes stressful travel like flying.

You also have a difficult decision about future vaccinations for rabies. This is a legal matter more than anything else. It is required by law and avoiding it is not a benign decision. Some areas allow vets to request a waiver and I suggest you work with your vet on this. You will have a significant responsibility to not allow her to ever bite a human or come in contact with a wild animal. But she will be safer, as Dr. Dodds generally recommends, from a relapse.

Again, congratulations! This is significant progress!
my best, patrice