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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Extreme muscle loss...help!
| Sunny has gone thru extreme muscle loss this past week. He can barely stand and walk with much coaxing. Will his muscles come back? Should I try to make him walk? I was moving my kid to college the past two days, and when I got home he had a dramatic turn for the worse. He is still eating and drinking if I bring the food to him. I don't want to take him to the emergency vet if I can prevent it. His regular vet will be open tomorrow. Any suggestions on muscle loss? He has been taking 60 mg prednisone daily and today I am cutting back to 40mg. His PCV has been holding in the mid 30's for 6 weeks. I know it is probably too soon to be cutting back, but I think the meds are killing him now. ????? |
| Leslie Oceanside |
| Leslie, I'm sorry I can't offer any advice but mostly worry with you about Sunny and our standard poodle, Harry. I wasn't able to retrieve your first posts about Sunny, so I don't know what kind of dog you have and all the meds that Sunny might be taking. However, your dog and ours are the only two that I've seen on this board who have maintained a reasonable PCV level for the first six weeks after they were diagnosed. Most dogs identified with AIHA seem to have their PCVs dropped into the teens or lower before undergoing transfusions. Harry's PCV has ranged from 27-32 and never dropped lower, as far as we know. He was diagnosed July 15th, went on Pred and Imuran immediately and cytotec to counteract stomach issues from the other meds. We added Atopica (Cyclosporine)ten days ago. We just reduced his Prednisone level a couple days ago. It appears that the meds (likely pred) but possibly something else has reduced his weight from 85# to 71# and his muscle mass has been reduced dramatically. he's still able to get to his feet if he has carpet under him, but not without help if he's laying on a hard surface - which, of course, he seeks out if he can find a spot. Our vet has sought advice from others with more experience, but he's stumped about why there has been no improvement. He's doing all the things that are recommended by other vets as the treatment regimen. But, I'm feeling like you that the meds are not helping and could be hurting - but, what do we really know? I'm looking at the post regarding the holistic approach using Bio-Preparation - maybe we'll try that! Here's hoping for better days ahead for Sunny and Harry! |
| Paul Spieker Colorado |
| Leslie, I've heard from a few vets, and we also have experienced this, that Pred tends to affect the bigger dogs much worse in terms of the muscle wasting- I can't remember how big Sunny is (?). Tiggs' (65 lb pit mix) back legs are so weak, that he falls over very easily if bumped. We are told that this will improve as the Pred is decreased. Also, his head (mind you he normally has a blocky, square pit bull head) is now very skeletal. You can see the bone on top of his head- it is almost the size of a walnut. His cheek bones also portrude greatly, and his once thick strong neck has skin hanging off of it. His spine is very visible as well. All this being said, his weight hasn't changed much- it's more the redistribution of the muscle. I do walk him now fairly vigorously for about 20-25 minutes a day to try to keep him moving and his joints working. I just let him tell me if and when he's worn out. Every protocol I have read indicates that Pred should be reduced NO MORE than 25-35% every two weeks ONLY if the disease is stable, and remission (normal PCV) has been attained. I would be very careful cutting Sunny's meds without consulting your hopefully very experienced vet. I know the side effects SUCK- can you say 'doggie pull up diapers??' (Tiggs seems to leak like a sieve)but be careful on reducing his meds without your vet. It seems like a few other folks' dogs here have also suffered greatly on Pred, hopefully a few more will weigh in as well. Keep us posted on how Sunny is doing- I hope you guys are well otherwise- it sounds like his PCV's are looking pretty good. |
| melissa slc |
| My dog experienced severe muscle wasting as well on pred (myself, & I think Josh (Sway), also posted about this on Paul's Harry thread). She had the skeleton head within a very short time of starting on pred. Besides the change in muscle, the weight loss was dramatic even as she was eating 8 cups of premium food a day, plus in between snacks/treats! She went from approx 77 lbs, when I adopted her ... to 64 lbs on the day of her transfusion a few weeks later. She now weighs 100 lbs, but should weigh 90 lbs. Because my dog's bloodwork was getting worse on the pred and her severe side effects, she was placed on cyclosporine and quickly taken off pred (2 weeks weaned off - dose was 160/mg a day) at the time she received a transfusion. Once she stabilized on the cyclosporine, her body composition began to improve dramatically. She was no longer on pred and that seemed work for her. There are always going to be exceptions to the rules as to what works. A few dogs, like Sierra and a couple of others, have severe problems with pred for whatever reason. Will keep Sunny (and all the dogs here) in my prayers. |
| Ronda So Cal |
| Sunny is a 50 lb. (previously 56 lb) border collie and american eskimo mix. His onset of IMHA was nine weeks ago. The first three weeks his pcv was in the teens and low 20's. He has had one transfusion. His treatment has been: carafate twice daily 30 mg prednisone twice daily pepcid once daily 50 mg azathioprine every other day. For about six weeks his pcv has been in the mid 30's. On July 19 his pred was lowered to 20 mg twice daily. By July 30th his pcv had gone down to 34 (from previous 37) and he wasn't feeling well so the vet said to go back up to 30 mg. pred. Monday night he vomitted so I took him to the vet Tuesday morning. His pcv was 35, yet he had a fever and seemed weak. He was panting and coughing mildly. He could not stand up for very long. His weight is down to 50 lbs from 56 at onset. The vet did a cbc and 3 films to see if he had pneumonia. His lungs were clear and his blood work showed some liver numbers were elevated. She said that was expected with the high doses of prednisone. She added these drugs: doxycycline twice per day SAM e 2 pills per day And she told me to change his diet to chicken and rice, 1 cup, three times per day. He stopped having bowel movements. Yesterday I gave him 1 T pumpkin with each meal. Throughout the week his muscle tone got worse and his hind legs aren't working well. He cannot get up without help and walking is difficult. Last night he was so weak that I almost took him to the ER. This morning he had a small BM. He is still eating and drinking, although he will no longer eat the pumpkin. Can you think of something else that I could add to the chicken and rice to help with the constipation? He is panting, but not coughing. This morning I decided to stop all the medicines except the prednisone, which I reduced to 30mg twice per day, the pepcid and the azathiaprine. I'm trying to figure out what is making him so ill when his pcv is in the thirties. Could it be the doxy or the SAM e? His muscles are just wasting away. Leslie and Sunny |
| Leslie Oceanside |
| Leslie, My Border Collie Jewel also had severe muscle wasting from day one of the blood loss, which was a I noticed on a Friday 7/25 and they kept her over night with IV's and then gave her 40mg of prednisone. I took her home sat. but she still had blood loss in her urine and diarrhea and on Monday she was so week she would just fall over and her gums were pale....she had a transfusion and stayed over night and was also put on Imuran 50mg...they let me take her home the next day...she was more enegetic but her hind legs were still week...as I wrote in her story in a previous posting I researched much about tick borne diseases and since she had her first 2 early this summer I felt this onset was due to a tick borne disease and requested she be put on doxycycline...Now through the resesrch I have found the doxycycline is compromised by prednisone and Imuran, so it can take longer for it to work...she improved as far as strength and alertness in the very first 5 days but I decided to take her down to 1 tablet of Imuran and 30mg pred. the first week and then to 20mg the second week. All the time she has been sick I have fed her fresh meat..liver, chicken, and beef (sometimes fish) and I blend 2 together, 2 weeks ago when I started making the changes in meds I added fresh veggies carrots for sure in every meal mixed with broccli, cauliflower, brussel sprouts, zuchinni....sometimes 2 or 3 mixed together. For sure I try to keep broccli in every time too. Because these veggies are the best in antioxidents. I also mix with oatmeal instead of rice because oatmeal is more easily digestable and more vitamin based. She has built up so much strength that she wants to run and jump but it is too early I feel and am still working with slower paced walks with her and she is taking them longer at her own pace. But muscle is building back on her hind legs which seemed to be boney and severely weak before. Good Luck and I pray for the power of Healing from the Infinite One for Sunny! Pam, Milwaukee, WI |
| Pam Milwaukee |
| Thanks for all of your posts. Sunny is feeling a bit better this evening. He still has trouble getting up but he is walking better. He pooped. Yay! Sounds so silly, but my entire family rejoiced because the dog pooped! Tomorrow I will take him back to the vet and talk to her about the muscle loss and the meds. Thanks again everyone. Leslie and Sunny |
| Leslie Oceanside |
| leslie, i just wanted to mention that my dog went through the same exact thing that you are experiencing now... after a month or 2 on very aggressive doses of meds it literally wasted her body down from 40 lbs to 22 lbs, she couldnt stand for 2 weeks, and it absolutely almost killed her. i was adament about this belief instead of believing that it was just the 'disease' taking its toll... after a weekend of 72 hour care in a hospital we pulled the meds all the way back...reducing them like 80% overall and 12 months later she is still around and holding strong. she is also on an anabolic steroid that i feel needs mentioning, but that is my 2 cents. i hope sunny begins to feel better |
| josh california |
This thread was discussed between 24/08/2008 and 25/08/2008
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