Worried – Small Drop in PCV

[Vally]

This is so good to read.

Vally & Bingo
xxx

[Trish]

Hi everyone – we’ve been laying low for a few months…Max got pretty stable at around 44-45 PCV, and we were slowing reducing pred until last month (December 2015). At that point, our specialist decided we’d reduce his mycophenolate from 250 mg a day (125 twice a day), to 125 mg once a day. For the last two weeks, we’ve noticed a distinct/worrying change is his energy level/demeanor. While his gums were still pink, he was/is slowing down on his walks, and general energy level around the house has changed markedly. So, when my husband brought him in for monthly CBC today, it was ALMOST not a surprise to find out that his PCV came in at 39. Now, I know that technically that’s normal, and that his CBC results might be different than his manual PCV (we should get those tomorrow), but given his demeanor, I am very concerned. Should we immediately increase him back to his previous mycophenolate dosage of 250mg? I know that mycophenolate has some side effects that include bone marrow suppression and pancreatitis – what are the chances that the PCV drop is due something like that? I am so confused/rattled by this I am not sure what to think. Did we reduce too fast, i.e. going from 250 to 125? Just when you start to breathe a bit easier, with IMHA you turn around something takes the wind out of your sails. His fur is coming out IN CLUMPS and has been for awhile – he’s a chow mix, and barely looks like one any more. He’s on 7.5 mg of prednisone every other day, we have not reduced that since November. Will update when I get his CBC back, hopefully tomorrow, wish we’d get something today.

[Vally]

Hi Trish, of course you’re worrying and I swear they do it on purpose to keep our 120% attention focused on them.

What did the vet say at the result? You’re right it’s not a big drop and yes it’s in the normal range, but the demeanour worries me as that often shows a lot. I have no experience with mycophenolate, but I’ve read that it needs to be weaned carefully:

https://www.secondchanceaihadogs.com/AIHA_Terms/mycophenolate-mofetil/

So I’m suspecting that that the reduction may have been a bit too much. See what the results show tomorrow, but I’d be asking the vet about going back up a little and doing the reduction a bit slower.

Waiting to hear.

Love Vally & Bingo

[Sheena]

Oh Trish, we completely understand why you are a bit concerned. It’s lovely to hear from you, by the way, but I’m sorry to hear Max has suffered a small drop.

This might just be a drop we expect after a drug reduction, but I am also not an expert on MMF as few people have used it on here. Just see what a PCV re-check shows, to see if Max has just dipped & then come up again. My instinct is the same as Vally – that this is too big a reduction in one go, but let’s see what happens. I wonder if there are any withdrawal symptoms for MMF that are making Max feel bad. People would feel rubbishy with that kind of dose reduction, so why not dogs? Maybe ask you vet about this? MMF causes a lot of hair loss in humans – again I would imagine the same in dogs too, plus pred does this as we all know. It will grow back, so please don’t worry Trish.

Can I ask if there is any reason you haven’t continued to reduce then discontinued the pred altogether? It’s a more conventional way of doing it, but sometimes our dogs need a small dose always.

Good luck – please let us know

Love Sheena x

[hope]

hey!

I know i’m very late to the group, but from what I understand a drop of about 3-4 at any given time is not a huge deal. When my Steve was first diagnosed, he was in the hospital for over a week. They checked his PCV four times a day!! (Which I’ve also come to see is a lot even for really sick dogs) His would fluctuate about 2-3 points between every single blood draw.. I don’t think we ever had 2 back-to-back that were the same. A lot of things determine PCV, including hydration levels, quality of the blood draw, even how long it takes them to do the testing once they draw it.

Hope