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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Prednisone use: some comments
| I have been reading alot about the Prednisone and have a couple of comments. It is hard on the dogs, but once it is stopped after a LONG weaning period or lowered, most if not all the side effects go away. My Sofie was on Pred for 4 months, and started off at 100mg per day. She was 5 1/2 months old when this started. I hated her on the Pred for that long, but as we slowly, slowly weaned her down off the Pred, she had no setbacks at all, her counts stayed high and her poochy belly and her horrible thirst and peeing went away. My vet did not allow me to wean her lower on the Pred until she stayed at 40%-45% PCV for 2 week, and only then did we start weaning her down. Maybe some would say he waited along time, and I admit more than once I wanted to start dropping her sooner, but I am glad I waited because once we started dropping it by 25% each time, Sofie stayed up on her counts and never dropped them. It has been 10 months, she is totally med free for over 5 months and I have been showing her at dog shows. One other comment, something I have not seen anyone mention, and maybe it means nothing, but then again, maybe it means something. Once Sofie started on the high doses of Prednisone, I never ever took her anywhere except the vet clinic and only then when I was sure nobody had been sick. I did not taking her out walking on the streets or the park, no dog shows, and if I helped treat a sick dog at the clinic before I came home, I stripped down and showered before I ever saw her.Even if I came in contact with stray dogs, I showered. Why you might ask was I so careful? I never gave it any thought until my vet reminded me that since Sofie was on Prednisone she had no immune system and therefore could not fight off any diseases. It struck me like a blow to the head, if she had no immune system because of the high does of Prednisone, then no way was I going to subject her to getting ill and having to fight anything else besides the AIHA. So, keep this in mind if you haven't thought of it already, even if your dog feels good, don't take them out where they can be exposed to other diseases. Prednisone and I am sure any of the Chemo type drugs lowers the immune system and makes your dog unable to fight off a germ that a healthy dog might. |
| Joanne Wyoming |
| Joanne, Very good reasoning on your part! Yes, this is somewhat true. One sign of a very low tolerance by the immune system would be opportunistic infections. When we talk about AIDs patients, we usually mention these as the thing that makes their lives so hard. They get all kinds of skin diseases etc. These diseases are usually caused by "stuff" that is normally on or in our body that we are not bothered by at all. A good example is e-coli. This bacteria exists in everyone's digestive tract, and for the most part it doesn't bother us one bit. But in someone whose immune system is compromised, it can be deadly. (There are deadly strains as well that we don't have normally in our body) Think of those rare cases of meningitis in college students that kills them. We all carry the bacteria or virus of meningitis, but we don't express this as disease because our immune system "throws off" the disease without our ever knowing it. One sign that Chance showed when his immune system was highly compromised was that he began to get staph infections on his skin. They were oozing red spots that became hairless. We all have staph bacteria on our skin, but we don't normally have infections from it. The danger with staph infections are that there are certain strains that are resistant to treatments called MRSA and if a dog being treated for AIHA is exposed to this variant, it can be very hard to treat. Another caution I got from the specialist was to stop giving Chance his raw diet. I immediately began cooking everything I had normally given him raw. I realized the danger of exposing him to e-coli and salmonella and took no chances. I was very careful about keeping his eating area as clean as possible and kept him from drinking bad water. Normal dogs can throw off e-coli and salmonella easily. But in an immunocompromised dog, they can easily take over. Suppression of the immune system by prednisone is comprehensive. And that is why it is so important if there is long term treatment needed to get off that drug and onto something that is less suppressive of the whole immune system. Cyclosporine was developed for humans who had organ transplants. They didn't want them to reject the organ, so they had to suppress the immune system, but they didn't want them to be so sick that they couldn't recover from the surgery! It selectively suppresses just the T-cells of the lymphocyte line. They call these killer T-cells and they are the ones that usually become overzealous in their jobs. In our case destroying healthy red blood cells and causing AIHA. Of course, we all know this drug now on this list also as Atopica, which was marketed for dogs who have atopic dermatitis or allergies. There are other drugs that are used like azathaprine. There are other conditions that occur because of this immune suppression and vets are well trained and prepared to recognize these and treat them. patrice |
| Patrice NYS |
This thread was discussed between 12/10/2008 and 13/10/2008
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