Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - Question about Med reduction

Dear All, I'm hoping for some help please! Our Maltese X was Millie was diagnosed with IMHA on the 22nd January this year. So far, we have done two reductions. She was on 10mg Prenisone daily (along with Imuran, which we are not reducing at this stage). This was dosed as a 5mg tablet in the morning, and a 5mg tablet at night. First reduction was to 2.5mg (half a tablet) in the morning and 5mg at night. Second reduction was to 5mg at night. My husband took Millie in this morning to the vet. Her PCV was 40 (down from 42 3 weeks ago). The vet has suggested a reduction to half a prednisone at night - 2.5mg. This is a 50% reduction. I only want to do 25% - which would be three quarters of a tablet at night. In everyone's experience, is this OK? Or would it make more sense to do one 5mg prednisone one night, then the second night do 2.5mg? ie. alternating by day. Because Millie is so small, it's going to mean a lot of pill cutting, so that's why the vet said to just cut a prednisone in half rather than fussing with quarters. I'll do whatever to make sure Millie is OK - I'm not fussed about cutting the pills into quarters! I really would appreciate your feedback. Many thanks, Samantha & Millie.

Samantha Geelong

Hello Samantha, since I have a big dog, (60 lbs) I am not much help. My advice is, do what makes you comfortable! I think somewhere in the archives of this board I read that smaller dogs can be off the prednisone quicker, but I could not find it anymore. I also recall that when going to one dose per day to give it in the morning. Again, don't ask me where I got it. I hope someone with more experiance can help you more. Best wishes to you and Millie! Brigitte and Kahlu

Brigitte BC Canada

Hi Sam, As Madison is only a bit bigger than Millie (7Kgs) so will you know her reductions. She started on 15mg pred twice a day plus half Imuran tablet at night. After 4 weeks they reduced the pred to 15mg once a day (so half). The next reduction was Imuran only every secord day. The next reduction was 10mg Pred everyday & imuran every 2nd day. Now she is on 10mg pred every 2nd day and the alternative day 1/2 tablet of Imuran. She is due for her monthly check next week so hopefully we can reduce again to 5mg pred every 2nd day and Imuran the alternative day... Sam 7 Madison

Samantha Perth Australia

Dear Brigitte & Samantha, Thanks for your advice. Brigitte - I'm going to do what I feel comfortable with, which is the 3/4 tablet each day. I also recall that Prednisone should be given in the morning - I'm wondering why my vet has Millie on it at night? Samantha - Millie was only 4.3kg when she got sick (now she's 5.7!!!), so we always knew we'd be cutting pills.... Thanks for your advice, it seems dosing every other day, then third day etc is the way people go. She's staying on the Imuran (1/4 tablet at night) indefinitely at this stage - as per the vet we see. This I agree with. Thanks again, Samantha & Millie.

Samantha Geelong

Sam, good to hear that Millie's pcv is as high as it is. I wouldn't be too concerned with a couple of points in drop. Now if it continued to drop...then I might be concerned. You are right to only want to do a 25% reduction. I think the only way I'ld be comfortable with larger reductions is if there were some sort of underlying factors like adverse effects on the liver or body. Maybe her doctor could get specially compounded meds for Millie. They are usually a bit more expensive but worth it in the long run. I'm not sure if it's possible with pred or not though. If Millie is handling the drugs alright I would definetly err on the side of caution & recommend a smaller reduction. What did that silly little tortoise say that time....Slow and steady wins the race! Hope all gets better with Millie. Hugs from Tessy & I

Johnny

Hi Sam, Madsion was 5.8 kgs when she got sick now she is just over 7kgs - i call her the little fattie now!!!!! She is nearly as wide as she is long :o) Sam

Samantha Perth Australia

Thanks Johnny. We are thrilled with Millie's PCV being 40, and I'm not concerned about the drop, as it's probably just the normal fluctuatons (Still a great number anyway!). I've done 25% starting last night, so she's now on 3.75mg Pred once daily. I'll certainly ask about specially compounded doses. The cost becomes less of an issue when you've already spent so much - keep putting it on the credit card! The good news is Millie is fine on the drugs - we are very lucky with that. Only diarrhea every now and then, which we can handle with the right food and supplements. I just read Tessy's update - good news about the HCT for sure. You must be very happy. Sam - it's going to be fun getting the weight off them! When I feed Millie her pills I wrap them in ham, and she nearly bites my fingers off to get to the ham! The joys of having a Pred Doggie! She never used to be greed, and was really lean and fit (especially for an old dog!). Now she's a guts with a huge pot belly!

Samantha Geelong

Maggie is being weaned by halves and quarters. In the beginning it was reduced by half. Now she is on a quarter of a 5mg per day, after this the vet said she will take a quarter every second day and from then she will be off totally if everything goes well. She started out on 25 mg of prednisone so she's come a long way to be at just over 1 mg at present. Prednisone may appear like a tiny pill but it is a very potent one, so the half or quarter does make a difference. You don't want to cut down too quickly or she may relapse. I speak from experience because I need to take this drug as well for a chronic health condition so I know how it works, a little up or down does make a difference.

Dorri

Hi Sam, Madison never use to worry much about food - she just liked a good treat. Sometimes didnt even bother eating her dinner... now she is like a dog on a food mission, always checking the kitchen floor for anything - trying to eat my other dogs food.. Even with all the reductions she is still always hungry - hopefully she will loose a bit of weight soon. She is now back to her active self anf i take her out on big walks every night... She does look pretty cute though with her big fat tummy... Sam in Perth

Samantha Perth Australia

My Maltese died from Autoimmune Hemolytic Anemia. He came down sick abruptly in mid-April and died May 6. He was in ICU 6 days. Had 3 transfusions. He put him down as he could not fight it.

Wendy USA

This thread was discussed between 05/05/2009 and 17/05/2009

Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) forum index

This thread is from the Vetnet archive. The live Vetnet forum is active now.