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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Pred reduction question
| Hi, As I stated in my earlier post, Wileys Pred is being reduced. (yaay!) Its going from 20mg to 10mg today. Do you think this is enough to see a change in his eating and drinking habits? Right now he is a eating fiend and pretty much has to go outside every 4-5 hours. Hoping that he will at least me able to make it through the night now. |
| Lisa Ct |
| I think you will notice a change but not a huge one. Ginger is on 5mg EOD and she is 75lbs and I can really tell the difference on the days she has those 5mgs of Pred as she drinks and pees more. I think if you put Wiley out around 11 or so he maybe able to make it until at least 5 or 6 and who knows maybe even longer once he is on the 10mg for a few days. When Ginger was on 10mg she did not have to go out during the night but as the say every dog is different. Keep us posted on how he does with the pred reduction. Cheryl & Ginger |
| Cheryl & Ginger Pineville PA |
| Dear Lisa, I do think a reduction of 50% will bring a change in eating/drinking habits. Millie had her Pred reduced more slowly, but by the time she was on half of what she started on, things began to settle down in terms of eating and drinking. It is nice to get to sleep through the night, so hopefully Wiley will be the same! Sam & Millie. |
| Samantha Geelong Australia |
| Lisa, reductions of pred should be no more than 20%. You can cause other problems reducing too much. One of them is Latronic Cushing. Why does your vet want to recduce the pred so much? Laurie |
| Laurie CA |
| Laurie, I am not sure. When we left the vet's office, I just assumed that this was standard procedure, then the next day when I was going through the archives on this board and some other boards I realized that was quite a big drop. Its been 4 days, he seems to be doing fine. I have been checking him constantly. Now I am not sure what to do? I do trust our vet, she has treated many cases and I hope she knows what she is doing.... Should I just leave it the way it is and keep a close watch on him? Thanks, Lias |
| Lisa CT |
| Laurie, You might want to call your vet and tell her that you are feeling uncomfortable about this large of a reduction in the prednisone (if indeed you are) and that you would prefer to drop it to 15 mg rather then 10 mg and get her feelings in regard to that. I do have some information that might be helpful to you in regard to the prednisone reduction. This information is from a Magazine called “Veterinary Medicine” subtitled clinical solutions for practicing veterinarians. This is the June 1999 issue. In the article called “Managing immune-mediated hemolytic anemia in dogs” by Stephanie J, Lifton, DVM, Dipl. ACVIM which was peer reviewed before publication we find the following information and I am quoting here: “The level of medication should be kept constant until the PCV is normal for at least three to four weeks. If the dog is having severe side effects from the prednisone (e.g. polyuria or polydipsia, panting, exercise intolerance) the dose can be lowered slightly after two weeks or another medication such as Azathioprine can be added to the treatment regimen. Remember this medication needs to be given two to three weeks to take effect before the dose of prednisone can be decreased. “Once the disease is in remission, the dose of prednisone can be lowered by 25% to 35% every three to four weeks until the lowest dose that keeps the disease under control is reached. This can be accomplished by either decreasing the dose or the frequency of administration (e.g. twice a day to once a day then every other day then every three days and so on.) If the dog is receiving more then one immunosuppressive drug, change the dosage or frequency of only one drug at a time.” End of quote. Even though this is a from a source that is several years old, this is the prednisone reduction schedule that many of the veterinary teaching hospitals follow in regard to AIHA/IMHA. If your vet does not want you to raise the pred back to 15 mg you might want to do frequent blood work, to make sure that Wiley's PCV is not dropping. |
| Joanne MN |
| Mention was made on this thread to latrogenic cushing. Here is an excellent site on Canine Cushings disease: http://www.kateconnick.com/library/cushingsdisease.html |
| Joanne MN |
| Lisa, I am also an adovcate for slow medication reductions. Millie had her Pred and Azathioprine reduced slowly and carefully, and she is happy and healty a year and a half after diagnosis. This certainly reduces the risk of relapse. I have heard of many dogs having reductions of 50% and being OK, however personally I follow the recommended 25%-35% per reduction every 4 weeks and no more. There were even times when Millie's PCV dropped below 40, and our vet decided to wait another 4 weeks just in case before we did the reductions. Sam & Millie. |
| Samantha Geelong |
This thread was discussed between 16/07/2010 and 20/07/2010
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