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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - For Patrice/Carafate Question
| Patrice, After starting a new thread "No Good News," I read your response about the Carafate and the Soloxine. Now I see that I made a big mistake this morning when I gave Darcy the Carafate right after she ate breakfast. I'm pulling out my hair, trying to figure out how to adjust the medication schedule. It seems the only thing I can do is to give Darcy the Carafate at 4:00 a.m.; feed her at 5:00 a.m.; give the Soloxine at 7:00 a.m.; the Cyclosporine at 8:00 a.m.; repeat all this in the p.m., plus the Prednisone at 9:00 p.m. This is so difficult, because Darcy is a little food hound and usually starts barking for her evening meal at 4:30. Also, because of my work schedule, I don't have the luxury of giving her meds between 8:30 a.m. and 4:00 p.m. I have a limited timeframe. Last night when I emailed Dr. Dodds, I mentioned that I had learned about giving the Carafate 1-2 hours before the meds. I also asked about the Soloxine and Cyclosporine dosing. She answered back "I'd separate the Soloxine and cyclosporine by at least 30 mins and give the Soloxine at least an hour before any food or other drug." I'm still confused. Karen |
| Karen NC |
| Karen, Take a deep breath and relax some. Let's look this over and see how we can change it a little to fix the problem. First, let's make a list of all the drugs and put the most important ones on the top of the list in priority. You can finish up from where I have started. We are treating, first and foremost, the hyperactivity of the immune system. We are trying to suppress the action of the t-lymphocytes so they won't be in enough numbers to destroy red blood cells. So the meds we use for this should be at the top of the list. Since you are using cyclosporine, this is your most important drug right now. The next drug of importance is the prednisone because it is assisting in this job. Make these your highest priority. Give them at a time and in a way that you know they are absolutely being absorbed. Now the next thing to look at are other drugs that may be contributing to the making of blood. Soloxine is high on the list, if there has been a documented case of hypothyroidism. So add that to your list next. I would put stomach protection from the prednisone next, this would be pepcid. Preventing any damage from the prednisone is very important. I would consider making sure that any vitamins and supplements are being properly digested along with food because they contribute to the making of blood, so this is very high on the list. Go back and read about the sucralfate again, it doesn't prevent stomach ulcers, it only helps heal ones that are there. So in almost all of our cases, we don't know if there actually is an ulcer! We just know that the chance exists that there could be one. I would consider it high on the list only if there is a KNOWN ulcer. If it doesn't fit into your schedule, see if you can drop it right now. It's more important to have the cyclosporine and soloxine being absorbed properly. If you continue to use the pepcid properly, you are acting responsibly to protect the stomach. I can really feel for your dilemma. There were two of doing the meds around the clock, I work nights and my husband works days, so we were able to get it all done. If you don't have help like this you need to find someone who can help you for a little while. If you don't have neighbor or family member, do you have a friend who can help? If this were me I would go to my local church and ask if they have any animal lovers who could help me give meds to my sick dog during the day. If you can afford a pet sitter, they are usually qualified to give meds. You can do this, we all have confidence in your ability to get the job done. It's not forever, just for a while, and when you are done, you will get the rest you so need right now. Congratulate yourself for how well you have done so far and how much you have learned. We all make mistakes and that is why we are here on this list, to learn how to do it all better. my best patrice |
| Patrice NYS |
| Patrice, You are so calm cool and collected. Your advice will not only help Karen but will definitely help me to see things a little clearer. I am the medicine giver, vet appt taker, and the get up at night person at my house (recently it has been three times a night causing alot of tired work days). Thank you so much for reminding all of us that it is only for a little while and that there is help out there in areas I would have never thought of, if we so need it. Chris |
| Chris |
| Patrice, Thank you so much. The responsibility of taking care of Darcy is on me. My husband is of no help and my poor mother, well, I just can't burden her. I've just been having a bad day and when I got the PCV results it made me take a downward spiral. I'll be okay. I'm thinking seriously about switching from Carafate to Pepcid, but I will discuss this with the specialist when I speak with her tomorrow. Pepcid is what I always gave Darcy in the past whenever she had to take medication. The vet prescribed the Carafate whenever I insisted that they send blood to Dr. Dodds for testing and Dr. Dodds recommended the Soloxine for an eight week period. Darcy's thyroid levels weren't that low, but I believe Dr. Dodds reasoning is that it should be given to help the bone marrow produce red blood cells and it should be given even if there's no indication of thyroid problems. Dr. Dodds also recommended a stomach protectant, so I guess that's why my vet prescribed the Carafate. I space 30 minutes between the Soloxine and the Cyclosporine. In the PM she gets the Prednisone one hour after taking the Cyclosporine. I'll see what the specialist has to say about my dosing routine. If you have any other advice, I'd certainly welcome it. Thank you for all your help and concern. Karen |
| Karen NC |
| Karen, My prayers are with you tonight. It is a tough disease to fight and can be overwhelming at times. Hang in there! We are all rooting for you and Darcy. Hope tomorrow is a better day for you. Leslie |
| Leslie Oceanside |
| Karen - It's so clear that you are doing your best. Darcy is so lucky to have you on her side to love her and give her a fighting chance against this disease. Patrice -- thanks for being here for those on the forum who are fighting for their dogs. I wish I'd found this forum before I lost my dear Wiley, because there is so much help here -- moral support, informed experience, and medical experience. I was pretty much on my own, and while I sometimes wonder if things could have been different, I prefer to think about how wonderful it is that there are so many great helpful people here such as you, Joanne, Penny, and so on. Thanks for your thoughtfulness in sharing your knowledge and experience with others. |
| Brenda VA |
| Hi Karen Not sure this will help you but here is what I did for Ginger, not sure if it is the right way but it was our way and worked well for us. Set alarm for 4:15 am gave keep Cyclosporine in bedroom and gave that then. Back up at 6:15 for work gave her the Soloxine at that time. Gave her the sulcrafate at 7:00 breakfast at 8:00 am with predisone, pet-tinic, milk thistle and azathioprine right in food bowl pepicd as I was heading out the door around 8:30 then I just reversed the process in the afternoon, it was tough as it made for a late dinner for Ginger but she got used to it after awhile. I think it is a great sign that Darcy is eating and acting fine and I would be pleased with that and not so concerned with the numbers. Ginger stayed in the 20's for a few months and seemed just fine too. Sending hugs and tail wags your way. Cheryl & Ginger |
| Cheryl & Ginger Pineville PA |
| Thanks to all you guys. I told my mother last night that I just don't know what I'd do without the wonderful people on this forum. There's so much support, information, encouragement, and love here. I am truly thankful that I found this site. While my friends have shown concern, they ultimately just forget what we're going through, but I can always count on those of you who have gone through or are going through the same thing with your dogs. Darcy seems fine today. I spoke with the specialist and she didn't have the CBC results because bad weather had prevented transport or something to that effect. I've taken Darcy off the Carafate because the specialist said she doesn't show any signs of ulcer or stomach problems and there was the absorption issue. I can give the Pepcid if I choose to do so, but she didn't encourage doing that. So now I'm just giving three medications plus the supplements. I pray every day for all of you and your little ones. Karen |
| Karen NC |
This thread was discussed between 28/10/2008 and 29/10/2008
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