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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Prednisone & Dental Disease
| Hi All - my 5 yr old Miniature Schnauzer was diagnosed with IMHA last May and just went off Pred about Thanksgiving time. Last year when he was diagnosed, he was due for a dental cleaning but of course, that didn't happen. He did have the dental today but had to have 19 extractions!!! and more teeth will probably be lost next time. Has anyone had the same problem after long-term Pred use? He was also on Cyclosporine. It just seems that that is remarkably rapid deterioration of his teeth, especially at such a young age. He had a dental ablut this same time in 06 and had no extractions. With all the other nasty things that come with Pred, I'm just curious if these could be related or if any of you have similar experiences. By the way, his PCV has remained consistently in the 44-45 range and as far as IMHA goes, is doing fabulous. The vet has released him until August unless I notice symptoms. Thanks for any input, Barbara |
| Barbara Portland |
| Barbara, I cannot comment on the dental problems and prednisone, but how wonderful to be in remission and off of the drugs! I look forward to the day when Holly will be med free. She has been on since last March 2007. Congratulations! Linda |
| Linda Sapphire |
| Thanks Linda! This was the most awful experience of my life! I can't believe we survived! Looking back and having done a lot of reading here and elsewhere, I realize that although we just about lost Cecil, once he turned the corner, he's really been on the fast track to recovery / remission. I feel so much for those not so fortunate but because of the heartbreaking stories I've read, I'm that much more grateful for my boy! |
| Barbara Portland |
| Barbara, It is my GUESS and only my guess that your dog's dental problems may have resulted from the Changes in calcium utilization caused by the prednionse useage. This Web page http://www.peteducation.com/article.cfm?articleid=1422 Says and I quote "Changes in calcium utilization: The glucocorticoids also affect calcium utilization in the body. Not only do they cause less calcium to be absorbed through the intestinal wall, but they also cause the kidneys to excrete excessive calcium through the urine. Combined, they cause the body to steal from its own major storage site of calcium, the bones. As it selectively removes calcium from the bones for use in other areas, the bones become weaker and could be more prone to fracture. Although the biochemical pathways in which this can occur are easy to understand, bone problems associated with steroid usage in pets are very, very rare." End of quote While this quote talks about bones, we all know calcium is needed for healthy teeth as well. What did your vet say when you asked him what may have caused this dental problem? |
| Joanne MN |
| Barbara, Oh dear, that is dreadful news to hear. I am so sorry to hear. I have two Giant Schnauzers and have a particular fondness for all Schnauzers in all sizes. There is a very common link in humans to bacteria in the mouth and dental problems. Gingivitis is the disease that leads to loss of teeth. In some cases, a human who will be undergoing dental surgery that might release this bacteria into the body, is asked to undergo prophylactic antibiotic treatment before the surgery. More common instances of this are people with some kind of heart disease or someone who has a pacemaker for instance. High doses of prednisone and cyclosporine are meant to suppress the immune system. This can impact the body's ability to protect itself against bacterial infections. That is why so many owners have been prescribed antibiotics to give to their dogs continuously while under immune suppression. My guess is that this suppression of the immune system allowed bacterial growth in the gums around the teeth. This may have set up a kind of doggie gingivitis that lead to the vet needing to remove so many teeth. We worried very much about Chance's teeth while he was on high immune suppression doses. I could no longer give him raw bones to chew on to clean his teeth and gums. So we started brushing his teeth with a doggie toothpaste that is supposed to help cut the bacteria. I know this is after the fact for you. I am so sorry. You might be able to save some of the teeth left with this brushing. Check with your vet. The paste comes in a little sample kit that your vet might be able to give you to try. My best, Patrice |
| Patrice New York State |
| Hi Patrice - I do love Giants! I also do rescue work but for Miniature Schnauzers. As it happens we placed our first Giant this year, Nimbus! He is a beautiful boy! What both you and Joanne said makes a lot of sense. I can't believe that at age 5, he would go from 0 extractions at his 06 dental to 19 in less than 2 years were it not for the drugs & disease. I am considering switching him to a raw diet and / or adding more calcium & phosphorous to his diet. One of the problems too is that he does not chew his food so he does not get the good scrapping actions. I'm curious Patrice, why did you have to stop giving Chance bones when he was on the drugs? Is he off now? My vet did a fabulous job with Cecil but he was not on antibiotics during that time. She has treated several dogs with IMHA and has good success but I will print this thread so she can review to possibly add antibiotics and calcium supplements as well in future cases. Barbara |
| Barbara Portland |
| Barbara...It probably has more to due with the prednisone's suppression of the dogs ability to deal with infections. Most people, and probably dogs, have alot of naturally occuring bateria in their mouths. Normally the low grade infections are controlled by the bodies natural immune system and everything stays fairly constant. You give a person a broad spectrum antibiotic for a long period of time and they get a yeast infection in their mouth or with women a vaginal yeast infection. The antbiotic kills off all the bacteria that normally keep the yeasts in check. You kill off all the wolves, and the deer population grows. The prednisone suppresses the bodies reaction to the low grade bacterial infection and what would not usually be a problem becomes a full blown periodontal problem. I see it all the time in my dental practice.... If you have been following my saga with Daisy and her perforated ulcer, we have stopped her prednisone cold turkey so she can overcome the peritonitis she developed from her stomach contents spilling into her abdominal cavity. I just asked Jean Dodds to verify that was the correct decision. She is in Europe, but still took the time to e-mail me back and confirm that it was the correct choice. Good luck.....Ron |
| Ron B San Mateo |
| Barbara, Many Giant owners have several Giants and often own one or two mini's too. We call them "pocket Giants." Another Giant in rescue, oh dear. I am the owner and moderator of the first Giant email forum. We have been in existence since 1996. We certainly do struggle with the rescue issue. Are you affiliated with any groups? Keep my email address on your list of contacts for rescue. I have fed Chance a raw diet from the day we got him from our breeder. She advised us to feed him that way and gave us the information we needed to get started. The day we sat with the specialist last June he told us that Chance had very serious non regenerative anemia and neutropenia. He advised us of several things. One was to make sure we kept him on antibiotics the whole time we gave him prednisone and monitor his temperature every 4 hours or so and to return to our vets if it went over 103. We did keep him on one antibiotic or another the whole time until his white blood cells returned to normal and his pred dosage was dropped. The other advice he gave us was to stop feeding the raw diet due to the risk of opportunistic infections. I was smart enough, thankfully, to understand exactly what he was telling me and that was the last day Chance had his raw diet. He stood to leave the room, looked longingly at Chance, said "You have a beautiful dog." and sadly turned to walk out. I am sure he felt Chance would be dead in a month. Chance has been fed everything he always got in his raw diet since then, only I have cooked it all. I had to stop giving him raw bones and substituted either bone meal or crushed egg shells for the calcium in his diet. I asked Dr. Dodds if I would ever be able to feed him a raw diet again and she said, "possibly never." I have to admit that in the last month I have given him a raw marrow bone once a week that I rinsed in hot water. It's a risk and I'm not sure how smart I am to do it. He reached his 10th birthday last week in such incredibly great health that he deserves some reward for all the hell he has been through since last June. This kind of bone doesn't substitute for the kind of bones he was getting, they are considered recreational and help clean teeth but don't add any calcium to the diet. I am going to wait until he is completely off of prednisone for a while before I consider what to do. There is a great forum on yahoo for canine nutrition that is very helpful to owners who want to try to feed their dogs in a more nutritious way. It is very helpful to owners who own dogs who have illness. http://pets.groups.yahoo.com/group/K9Nutrition/join Patrice |
| Patrice New York State |
This thread was discussed between 02/02/2008 and 03/02/2008
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