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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - ? about next med reduction
| hi everyone, We are at the next phase of reduction, and I'm not totally sure what to do. Tiggs is on 5 mg/Pred per day along with 30 mg Aza/day (and of course Pepcid). My vet is discussing starting the next reduction by going to every other day on the Pred and leaving the Aza for now until he is off of Pred. Some protocols (like CSU) would suggest reducing the Aza to every other day now and not touching the Pred...what do you all think? I can't seem to find Dr. Dodds protocol. Our vet would like to see him off of meds completely within the next 2 months. Any input appreciated. Tiggs has been very stable (thank God!) for a couple of months, with PCV's in the low 40's. I just want to be sure that if we are moving in the direction of no meds, that we go into the final med phase smart and conservative. Thanks all, melissa and tiggs |
| melissa slc |
| Hi Melissa, This is just from our experience and as per Dr Dodds recommends each month for our Holly. When I first contacted Dr Dodds back in November, Holly's PCV had been in the 50's for months. After we had the ultrasound done and all was good, she gave us our first reduction. At that time Holly was on 2mg prednisone daily and 1/4 tablet (whatever that is) of aziathioprine. First thing she had us do is change the aziathioprine to every other day. After 2 weeks on that regimen as long as she was okay, pink gums and acting okay, then we reduced the prednisone (still 2 mgs.) to every other day but on the off days of aziathioprine. Then 2 weeks later we ran her blood work, both full chemistry and CBC, PCV still in the 50's. So then she had us go twice a week on the aziathioprine, and still every other day on the 2mg of prednisone again on the off days of each other (I had to mark on the calendar to keep straight). We did this for 1 month, and retested and again, PCV in the 50's. So now we have started per her suggestion, 2mg of prednisone twice a week and the aziathioprine only once a week on the off days of the pred, and will retest in another month. I think it is always better to go very slow with the reductions and not chance that relapse. You can send Tiggs bloodwork like for the last 6 months to Dr Dodds and $30 consult fee and she will guide you through the reductions. That is what we did and our vet was okay with is, well let me put it another way, I did not give my vet a choice, I told him this is what we were doing. Linda |
| Linda Sapphire |
| Keiko was on Pred and AZA for 9 months with the pred weaning down until finished in March of 08. She remains on the AZA today, although we have now been slowly reducing. Jess and Keiko |
| Jess BC |
| Our reduction schedule was similar to what Linda described. Slinky's aza was only every day for a week and then eod after that. When we reduced the pred we went slowly and when it was eod it was offset from the aza, that was 3 months from the first dosage decrease. We weaned the pred down to once a day and to eod, then weaned the aza further, and to zero (6 months from first decrease), then weaned the rest of the pred. The whole weaning process took 9 months. We went VERY slowly because there were a lot of stressors in Slinky's life at this time (birth of a baby for one!). There were times when we held meds constant for 6 weeks or so between reductions. Be patient, watch your dog and hang in there! |
| Stephanie Chicago |
Kelly, you should post a new thread with your concerns and questions, there are many AIHA survivors here that had PCVs that low. And if you havent already please check out Joannes site http://www.cloudnet.com/~jdickson/ Have your vets talked about adding stronger drugs? sometimes prednizone is not enough, you can read about them on Joannes site. Laurie |
| Laurie CA |
This thread was discussed between 17/01/2009 and 02/02/2009
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