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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - protecting the stomach
| Thanks to this board I knew from the beginning, that it s important to protect the stomach of an AIHA dog taking all these heavy duty medications. Kahlu had diarrhea from the prdnisone. When we started the Azathioprene he had bloody vomit and stools. With the stomach protectants given at the right times and I guerss the body getting used to it, it all cleared up nicely and for the last 4 months he had no problem. He is now on 25mg Aza every 3 days and 2x 2.5mg pred ED. He gets 1mg sucralfate 2xper day. We stopped the misoprostol about a week ago. My vet said to stop the sucralfate as well, when i run out. I know Melissa posted at one time that she gave something as long as Tiggs was on medication. Should the sucralfate be given every day or just on the days they still take pred/aza? My gut feeling (no pun intended)is to continue to protect Kahlu's stomach. Considering he is swallowing a pill that I am not What are your thoughts on this? thanks for your thoughts, Brigitte & Kahlu |
| Brigitte BC Canada |
| Hi Brigitte, You remembered correctly, we did keep Tiggs on Pepcid even when he was on very low doses of Pred, and then again even after he was only on Aza every 3 days. It wasn't until he was totally OFF of both of those meds that we stopped Pepcid. Not sure if that's true for everyone here, just what we did. Now that he's on thyroid meds, though, we don't give Pepcid, but I don't think those are as tough on the tummy. Good luck researching, I'll be interested to hear what others have done. melissa and tiggs |
| melissa slc |
| As long as you are on Prednisone you should give something to protect the stomach every day. I would guess the same in regards to the Aza. Prednisone is really hard on the stomach. When I take it myself it kills my stomach despite me taking lots of meds to protect my stomach. For Calypso we used Pepcid 10mg twice a day (she ~35lbs). Then they said that we could add Sucralfate if the Pepcid did not fully take care of the problem. Hope that helps, Wendi and Calypso |
| Wendi Ohio |
| The interesting thing about sucrafate is that is generally used to treat "active duodenal ulcers." I used it primarily because I didn't know what was going on inside Chance and I felt that I could control any potential future problems with prophylactic use. It does *interfere with absorption of nutrients and meds* so dosing it must be done carefully. I finally picked a time early in the morning, when Mark first gets up around 5 am, to dose it. By the time Mark exercised etc and left for work at 7:30, over two hours had gone by and we could dose his next med. In afterthought, it would have been better on an overnight fast. But he didn't get his last prednisone dose until I get home from work at midnight (and often later) so I would have had to stay up past 3 am to dose the sucralfate. But most families don't have my crazy schedule so they can dose just prior to bedtime. This puts a wide margin of time between the last meds in the early evening and the first meds of the day. If you keep this stuff in mind, it's certainly not going to hurt to keep using it while you are dosing prednisone. If the cost is killing you, then stop it. You can also use slippery elm from your local health food store. Here is a recipe given to me by a cat owner. (Thus the dosing instructions for cats, not a dog!) Most health food stores have a specialist on staff to help people and this would be an excellent question for them. I believe it is pretty similar to sucralfate in its action. "Slippery elm syrup may help ease his digestive tract. Boil two tablespoons of water and add 1/4 of a teaspoon of 'bulk' powder, from a health food store or 1/2 of a teaspoon from a capsule. Mix and let cool. Not sure of the dose for a dog, but it's about 5mL for a 4-5 kg cat, so you can probably extrapolate to your dog's weight." If this were me I would continue to use the pepcid twice a day, as directed by your vet, until the pred is finally stopped. my best patrice |
| Patrice NYS |
| Thank you Melissa, Wendi and Patrice for your answers and suggestions. I will definitely discuss it with the vet next week. I just realized I made a typo, I meant "considering he is swallowing a pill that i am not supposed to touch". Meaning the Aza. Patrice, I have always tried to give Kahlu the sucralfate two hours away from his other pills, but i have now started to give it before bed and mid day and I moved the thyroid med and Same up 2 hours. It is a juggling act! but now we are off to the lake and get those muscles fired up! Best wishes to all, Brigitte & Kahlu |
| Brigitte BC Canada |
This thread was discussed between 17/08/2009 and 19/08/2009
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