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Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Pulse Dosing Cyclosporine?
| Hello again everyone....Tessy has an appointment tomorrow morning so that's why I've been asking so many questions lately. Trying to cover all the basis. I was just wondering about pulse dosing cyclosporine. I've heard Patrice (I think it was) talking about it but don't really know too much about it. I was wondering if it is a good thing to do? Should Tessy stop taking it on the weekends? Will the drug start to have no effect on her if taken without breaks? etc. etc. I thought I remember someone saying that Dr. Dodds suggested doing this. I wrote to her and asked her her thoughts on this and her response was this ... "Haven't tried pulse dosing with cyclosporine, but I know that some advocate it." Maybe she just didn't want to say "Do It." I'm kinda in limbo now on what I should ask my vet. Are there lots of cases out there where people do this? Is this common? Thanks for all the input, Johnny and Tessy |
| Jonathan |
| Jonathon, Jean has probably "misplaced" the memory of using this with Chance, but that was, after all, 3 years and many thousands of dogs later! If you write her again, mention that she did recommend this with Chance: "Our cyclosporine protocol is taken from human medicine for treating refractory IMHA or ITP. We've used it since 1988 without problems with the once a day, 5 days on 2 days off protocol." "Once you add the cyclosporine [not more than 5 mg per kg daily, 5 days on (Mon-Fri), 2 days off each week (Weekend), you can reduce the steroids more quickly. It takes about 48 hours for the cyclsporine T-lymphocyte immunosuppressive effect to kick in." I believed every word she said, did it this way and never looked back. I had forgotten that she referenced human use of cyclosporine this way but there must be some human medicine literature *somewhere* that advocates this pulse dosing. I am time pinched this week, but maybe I can look into it in the future. Look, this is your decision, after reviewing it with your vet. They may or may not have any knowledge of pulse dosing with humans and may be concerned about a two day lapse in treatment. Since I didn't know any better back then, I had no concerns about it. I think that perhaps this kind of pulse dosing may be more beneficial to "refractory" cases, as Jean says. Cases like Chance's which were non-regenerative, with damage occurring at the bone marrow precursor cells rather than the mature RBC in the blood stream. I wish I could help you more. my best patrice |
| Patrice NYS |
| Thanks Patrice. That makes sense to me. Tessy takes it twice a day. I think I might just keep her on it until she is at least down to once a day. Are you feeling better nowadays? How is Chance? Give him a hug from Tessy and I. Thanks again for the words of wisdom....you're one smart lady. Johnny & Tessy |
| Johnny |
| Thanks Jonathon, I *finally* had an MRI of my shoulder, now nearly 4 months after falling into a manhole. The PT kept insisting that I was showing positive signs of rotator cuff injury. Her notes to the orthopedic doctor were going unread. Trying to get an appt to see him required lying and cheating on my part. <VBG> He agreed that there is some kind of deficit, got me the MRI and mentioned surgery is most likely. I will know more this coming thursday. Chance's checkup showed improvement in his knee after surgery (nearly 2 months ago) and his heart checkup was ok as well. He is on some serious heart meds and we wanted to make sure that the dosages are correct. My biggest concern now is trying to get some weight on him. He's lost about 6 lbs since his surgery and heart diagnosis. He's eating really well, but this is a common side effect of having a heart condition, in dogs as well as humans. I'm trying some supplements that I learned about when I attended a day long seminar on Canine Nutrition for Medical Conditions (presented by the vet in charge of Cornell's veterinary nutrition program.) I think that the dosing of cyclosporine is just fine, many dogs respond very well to it. It just acts very differently than prednisone does in the body. my best patrice |
| Patrice NYS |
| Sounds like quite the battle you were/are having. Good to hear that at least you are making progress. Just the sound of surgery makes me quiver. Hopefully the news you get on Thursday will be good. You deserve it! I'll pray for good results for you. Good to hear that chance is improving. I'm sure that because you are his mommy he'll get the best possible care and therapy he needs. You're both very lucky to have each other. Give him an Easter hug from Tessy and I. I'll keep the both of you in my thoughts and prayers. Hope for positive things in the future. Johnny & Tessy |
| Jonathan |
This thread was discussed on 13/04/2009
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