paltinas
Can someone give me an idea of the appropriate weaning process for pred? Duration and dosage?
Pred has always seemed to bring her out of her episodes rather quickly. My vet has recommended leaving her on it long term, but I HATE the side effects. Even low doses (<10mg) lead to increased appetitie, thirst, urination, body temp (heat), and personality change. I have always wanted to get Bella off pred sooner than later, as from a quality of life standpoint, I do not care of it. However some of the herbal treatments (i.e. Cool the Blood) has helped.
I think this may be where you're having the problem. The protocol for weaninng off ANY of the steroids (pred) or super-steroids (Atopica, Azathiaprine, etc.) is DIFFERENT for these diseases.
Normally when you wean off pred you do something like 1st week full dose, 2d week half, 3rd week half again, 4th week maybe off.
NOT WITH THESE
Literally you have to 're-train' the body. It's not about just bringing them "out of [their] episodes" -- weaning off that fast WILL encourage relapse.
Billy was on I can't remember -- 150 - 200 mg of Atopica for maybe 8 weeks but I know by the time he came home from Gainesville he was on 150 mg. (with 40-50 mg pred -- and he was 30 pounds). And the 4-5 weeks he was mostly up in Gainesville he was not responding. He began having really heinous problems with the UTIs and his kidneys and they decided right after he was stabilized that we HAD to get him off the pred right away.
I was terrified -- they did the test to see what the cyclo level was and then began the pred wean-off. They actually got him OFF the pred completely in like 5 more weeks. I think they lowered the pred 10 mg a day once a week got down TO ten and then halved it to 5 and then off.
BECAUSE they felt like they had the cyclo bearing the lion's share of the suppressing.
We started reducing the cyclo in November (they left him a month with no reduction) and that reduction was MAJORLY slow.
Shannon, I am probably one of the most holistic people on here -- my dogs go to a 'regular' vet but they have monthly visits with a vet who does homeopathy and one who does TCVM (acupuncture -- Traditional Chinese Veterinary Medicine). We did the TCVM wtih Billy all the time he had IMHA. I HATE PREDNISONE more than I can even tell you.
In fact, I am a life-long asthma sufferer -- and frankly I can't take pred AT ALL myself. My body literally reacts to it as tho it were 'poison'.
You can't imagine how eager I was to get Billy off these drugs. MANY times I asked my holistic vet "Are we going to be able to DO this?? CAN we get him weaned off these horrible drugs before the drugs kill the dog before the iMHA does??"
But the drugs saved his life.
The side effects?? Shannon and Karla -- they are HORRIFIC. Billy had end to end urinary tract infections -- I had ALL I could do to keep them treated so he wasn't in pain - but even more, so that the body wasn't so inflamed all the time. It took all the Chinese medicine, and the cranberry and d-mannose I could give him to keep them even marginally under control because you can't let them BE inflamed.
For some dogs it's nausea, for some it's diarrhea, for some it's urinary tract infections, and the list goes on and on. You DO have to simply treat the side effects because if you pull them off the drugs too fast they WILL relapse.
It's not just that they will relapse tomorrow. It's that you have to get the body convinced that it's not an option TO relapse. For Billy? it took 18 months to get him off the drugs. BUT EVEN THEN he was a mess. That's where Dr. Demers and the homotoxicology/homeopathy came in -- it allowed me to get Billy detoxed **safely** and to get his immune system back functioning somewhat normally.
Side effects? How do you cope?
MILK THISTLE!!!!!!! It is your friend.
Frankly, I darned near drowned Billy in it. People think I'm joking. I'm NOT. At that time I didn't know how to get the powder in bulk. And I knew the tincture was stronger than the powder so that's what we used. Billy was SUCH a good sport about it. Milk thistle tincture is VERY alcoholy tasting. But I stirred it in his food with the d-mannose (which is magnesium as a form of sugar -- it's sweet like confectioners sugar) and he ate it for me.
But I *started* giving him 2 droppers FULL of milk thistle tincture TWICE a day. That's double the human dose. Then -- and I swear I did this -- every single time I got scared I'd give him a little more. 2 1/2 droppers became 3 .... that became 3 1/2 ... which then became 4 ... by the time the 18 months was up he was getting FIVE droppers FULL of milk thistle tincture **TWICE** a day.
Why? Because I know that milk thistle protects the liver. But in QUANTITY it protects the kidneys as well. And his kidneys took a horrific beating.
But 4+ years alter?? HE HAS A LIVER THAT WORKS!!! RAH!
He also has kidneys that work.
**BOTH** are damaged. But functioning very well.
You can use whichever works -- or you can use some of both. But milk thistle is a facilitator -- because it helps the liver and supports it -- it actually helps the liver process the drugs more easily so the work better.
paltinas
Bella is ~53lbs and I had her on 200mg a day for 12 days, and now she is on 100mg a day for at least another 2 weeks then we will re-evaluate the path forward. She is a MUCH happier dog on the 100mg vs the 200mg. Her playful self is coming back :-)
Shannon -- it's weirder than that to be honest -- there are certain doses which just somehow seem toxic. Billy functioned BETTER on 150 mg a day than he did on 110. Because of the weird dose sizes when you wean down you get really creative in order to wean down in small increments.
We went from 150 to 135 (2 50's + 25 + 10). They NEVER dropped him a whole 100 mg not EVER. That's a massive drop. But that's part of what I"m saying. they do NOT wean these drugs like they typically wean pred.
He went from 150 to 135 to 125 to 110 .... then he bobbled and we went back up to 125. Back to 110 and then 100. Then 85, to 80, to 70, to 60, to 50, 45 to 35, 25 (a scarey drop), then 20 to 10 ... and then we pulsed it to 10 every other day, every 3rd day, every 4th day, and a couple of weeks of once a week.
But literally you are trying to train the body to respond without turning on itself as an option.
There must be SOMETHING that is triggering Bella. It's so like clockwork -- it may be weather or moon-related. But you'll have to break the cycle -- I'm honestly amazed you've pulled this off. Typically a relapse is so often fatal with IMHA -- not so much with IMT
I'm going to copy this post over to the other thread too.
I'm not trying to be ratty about keeping them together. it's just that it's difficult to keep track of the posts. I completely MISSED that you guys were posting here and I check the "posts you've not seen" forty times a day and it never showed up. I'm sorry -- I didn't mean to just ditch you over here..