Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Need help with meds????

Is there any difference between Atopica from the vet and cyclosprine from a drug store? I realize they are technically the same drug but is one more effective than the other? Also, Jack is being very picky eating even being on the Prednisone (has been on for 3 mons), what type of human food is good for him and what should I stay away from...Please any help I would really appreciate!!!!! I believe Patrice mentioned eggs has anyone had luck with eggs!!!

Robin NYS

From what my vet said there could very well be a difference. Others with more experience with this can help you. Good luck.

Mardi Northern Cali

Hi Robin, Yes, there can be. There are two basic forms of cyclosporine, the older Sandimmune and the newer Neoral. These are human meds. As time went by Novartis, the drug company, was able to perfect the manufacture of cyclosporine and Neoral was introduced. It is considered more bioavailable. This just means that the body uses the meds and absorbs more. Atopica is simply the same thing as Neoral, but packaged in capsules that are weight dosed for dogs (and cats). It's a convenient and easy way to dose your dog. Jack should be getting this dosage to start: 126 lbs X 0.45359237 = 57 kg 57 kg X 10mg/kg = 570mg Split this into two daily doses (285). (I would round this to an even number according to the sizes the vet has available. ATOPICA contains 10 mg, 25 mg, 50 mg or 100 mg Cyclosporine A per capsule. So I would use two 100 (200) plus a 50, plus a 25 plus a 10. This would equal 285.) http://www.ah.novartis.com/products/en/atopica_dog.shtml (If you are able to get a generic of Neoral at a drug store then you can go that route) Administer this according to Dr. Dodds instructions below. 1. 570 mg for 5 days, rest for 2 days Now half that dose 570/2 = 285mg 2. 285 mg for 5 days, rest for 2 days 3. Now repeat that dose in a 5 days on 2 days off cycle as long as is needed (usually 2-3 courses of 5 days) When you buy this keep in mind that you will be buying certain doses in capsules and cannot break them up. If you buy too many in a large size, you may end up not being able to use them all. In this case, buy smaller dose capsules so you can maximize their use. From Dr. Dodds' protocol: 3) For severe cases, other immunosuppressive therapy is given. We prefer cyclosporine (Atopica, or Neoral, or Sandimmune, 100 mg/ml oral syrup) instead of cyclophosphamide (Cytoxan) and give it at 10 mg/kg for 5 days rest 2 days, then at 5mg/kg for another 5 days. The lower dose is repeated after a 2 day rest on a 5 days on, 2 days off cycle as long as is needed (usually 2-3 courses of 5 days). This drug induces rapid T-cell suppression within about 48 hours and has been safe, effective, and well-tolerated at these doses. In cases where sustained more potent immunosuppression is required for clinical stabilization, azathioprine (Imuran) should be instituted along with cyclosporine. Dose is 1 mg/lb/day for 7-10 days initially followed by a downward tapering over several weeks. Azathioprine may be needed every other day or less often, on a longterm basis. As azathioprine takes about 10 days to effectively suppress T-cells, clinical responsiveness will not occur immediately. Cyclosporine is therefore given concurrently in the early stages of the disease to provide rapid immunosuppression until the azathioprine takes hold. The goal of this immunosuppressive therapy is to stabilize the ongoing immune destructive process. The dosage guideline we use is adjusted to maintain the absolute lymphocyte count as about 1/3 of the normal range (750-1500/ul). my best patrice

Patrice NYS

Robin, You might want to check out this Web page http://www.marvistavet.com/html/cyclosporine.html for additional cyclosporine info

Joanne MN

Robin I can't help on the drug front, but in relation to natural food for dogs I can share with you the diet my two dogs are currently enjoying - though, obviously I don't know about Jack's nutritional needs - all I know is that natural food is far better than commercial dog food. I moved over to natural food about 3 years ago when I realised that it was commercial dog food that was making one of my dogs quite ill. These are most of the ingredients I use - white rice brown rice rolled oats pasta cous cous weetabix brewers yeast free range chicken free range eggs turkey (can't find, let alone afford free range) organic cheese pro-biotic yoghurt (small amount) mackerel sardines coley (white fish) salmon tiny bit of chicken's liver potatoes sweet potatoes broccoli carrots spinach parsnip garden peas red apple banana seaweed (when I can get hold of it) Yarrah bio-organic vegetarian duo snacks (these are brilliant biscuits that my dogs go crazy for. They are free from chemicals, aromatic substances, colourings and flavourings) The information below is cut and paste from a website here in the UK - www. petskitchen. co.uk The author (a vet) writes - "Before you launch into cooking for your dog, it’s worth looking at the theory and also some of the do’s and don'ts of canine cuisine! Firstly, and most importantly, you have to always remember that you are cooking for a dog and not for a person. Dogs and people have different nutritional needs and some foods which are fine for people can be dangerous to dogs – and vice versa. And don’t forget that some flavours which you might find horrible will be the ones that your dog absolutely loves, so be prepared to hold your nose and work through the smell barrier for your dog! Secondly, some of the recipes use an ingredient called Brewer’s yeast which you might not be aware of. It’s basically the pasteurised residue of commercial brewed beer and it’s packed full of all sorts of nutrients including protein and vitamins. You can buy it in powder or tablet form from your local health store, and it’s well worth getting a jar if you’re keen on following a few of these recipes. And finally, a few tips on what you can and can’t use in recipes for dogs. The most important foods to avoid are: * Tomatoes – a small amount of ripe tomato is unlikely to cause any problems, but green tomatoes can cause serious stomach upsets and even heart problems, so it’s best to avoid them. * Onions (and garlic) – can cause blood problems including anaemia. Again small amounts are very unlikely to cause any problems, but to be on the safe side I only use small amounts of garlic and very little onion in my recipes. * Grapes and raisins – both can cause very serious illness including kidney problems, and large amounts have been known to be fatal to dogs, so avoid wherever possible. * Chocolate – one of the ingredients of chocolate, theobromine, is related to caffeine, and some dogs react very badly to it, showing signs such as hyper-excitability, increased heart rate and muscle tremors. Dark chocolates contain the most theobromine, but I’d advise keeping all chocolate away from dogs. * Mushrooms – best avoided as some dogs will not tolerate mushrooms well and they can cause serious toxicity. On the other side of the equation, there are a few rather surprising ingredients which are really healthy for your dog, such as: * Fruit – in the wild, dogs would have scavenged windfall fruit as well as digesting the remains of fruit eaten by other animals when they pick over the carcass, so giving your dog fruit is not as strange as it might sound. Fresh fruit is packed full of anti-oxidants, vitamins and all sorts of other healthy nutrients, so it’s great for keeping your dog in top condition. The only tricky part is persuading him that he really does want to eat fruit – which is where some of my more ingenious recipes involving fruit and liver come in! * Yoghurt – this is a great source of protein, calcium and vitamins, and is particularly good for dogs with diarrhoea thanks to the probiotics it contains. * Cottage cheese – another surprisingly healthy dairy food which is great for growing puppies and lactating bitches." Robin, I hope his helps. Best wishes, Claire

Claire Cumbria

Claire- Thank you so much for the recipes and info. Jack will be thanking you too. I really appreicate it. You are in my thoughts and prayers - Robin and Jack

Robin NYS

Claire - I can't order the recipe book, it is not available in the states. Any ideas???? Robin

Robin NYS

Robin: Are you just trying to supplement Jack's regular kibble or replace it? We feed Sheba (GSD/Cocker Spaniel mix) regular dog food but usually throw a little "people food" in to the mix to liven things up and have found the following to be things she enjoys: chicken, tuna, salmon, steak (in very limited quantities), hamburger, turkey, most fruits (peaches, pears, green apples, bananas, plums, cantaloupe, watermelon, musk melon, honey dew melon), most vegetables (the exceptions being raw carrots, lettuce and celery), brown rice. And of course junk food but we try to avoid that! I hope you have some luck finding something that will tempt him but in the meantime please know that we are thinking about you and Jack. Rita, Mike and Sheba

Rita IA

Patrice, can you also share Dr Dodd's recommendation for weaning off of the Cyclosporin... Thanks Wendi and Calypso

Wendi Ohio

Wendi, This schedule was specifically designed for Chance by Dr. Dodds, he had non-regenerative anemia and neutropenia, so this isn't a recommendation for use in any other dog's case. He was around 95 lbs, give or take, throughout this period. How a dog reacts to these meds is an individual case. When we added the Atopica at his full dose, we spent 10 weeks simultaneously decreasing the prednisone slowly from 80 mg to 5 mg. So keep one med at full dose while decreasing the other one. The Atopica dosage was: 9 weeks 225mg Mon-Fri, sat & sun off. Week 10: approx. 1/3 decrease to 150mg Mon-Fri, Sat & Sun off Week 11: approx 1/3 decrease to 100mg Mon-Fri, Sat & Sun off Week 12: 1/4 decrease to 75mg Mon-Fri, Sat & Sun off Weeks 13-16: approx 1/3 decrease to 50mg Mon-Fri, Sat & Sun off. Sometimes the dosages for Atopica have to be adjusted a little to accommodate the packaging sizes. So instead of a 1/3 change, there might only be a 1/4 change. my best patrice

Patrice NYS

We have a German shepard dog that the vet wants to put on cyclosporine for anal fissures (?sp) and the cost would be $200.00 for two weeks. We want to know if the human brand Neoral would be the same medication and would this work for our dog?

Lisa Kusick Escondido

This thread was discussed between 27/08/2009 and 18/09/2009

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