Reducing pred in IMHA?

Yeah, I have no idea for sure with the cyclo--I actually have most of a box of 10 mg ones, so maybe they'll do that for a bit?  Don't know for sure, but this one is definitely taking it more slowly (keeping her on the reduced cyclo for a month instead of 2 weeks before changing things again).  It does seem that she's doing very well--and I agree, I'd like her to get completely off of one thing instead of ping-ponging back and forth in reductions on both.  What all the vets seem to agree on so far is that there is no one "right" way to take them off of the two meds; each one will say, "Well, I like to do this" and her regular vet tells me what the pros and cons of that solution are.  If the doc gets a different e-vet again this time, I think I'm going to suggest that she and I just work together; the most recent couple of people with whom she's spoken have never even seem Emma before (I know they have the file, but to her she's just a case, not a real dog, I'd guess).  So anyway.

Thanks again! :)
 

This week's blood test showed Emmy's PCV holding steady at 55.  She's on 25 mg of cyclo and 2.5 of pred every other day; I'm planning on telling the doctors that I'd like to drop her to 10 before getting off the cyclo entirely (I have most of a box left, anyway).  Does that sound good?

I'm REALLY looking forward to her being off the pred, though; she was over 21 pounds this time! 
 

It sounds more sensible to me -- I wouldn't drop from 25 to zero.  but then that's me.

I talked to the regular vet today, and she agrees with me (thankfully) that the 25--> is a big drop.  She's gone ahead and reduced Emma's cyclo from 25 mg every other day (which she's been on for three weeks) to 10 mg every other day.  The other vet wanted her to be on the 25 mg for another week and them dump it entirely.

I think she's going to have her at 10 mg for about a month (I don't have a whole box of the pills, so it might just be 'til she runs out).

Emma looks wonderful, despite being pudgy.  The one thing I've noticed recently is that she seems to be drinking a lot of water.  She also pants sometimes, when she's really excited.  The vet said just to watch it and that if this continues they'll do an exam when she goes in for her next blood test.  She (Emma, not the vet!) is not having any problems urinating, and she's not drinking all the time--it's just that when she DOES drink, she seems to drink for longer, if that makes sense?
 

VERY likely a UTI.  And cyclosporine *causes* them in a big way.

Some dogs stop drinking and get really dark urine when they get an infection.  SOME dogs drink more ... because inately they realize that the more dilute the urine is the less it burns.

Does she drink when she comes in from potty?  I'd have them do take a sample -- even if it's dilute it can have infection in it.

No, I haven't really noticed her heading for her water bowl when I bring her back in.

Well, crud!  Do I need to take her in on Monday?  She just got off--whatever the antibiotic was that they put her on because of that sty.  She doesn't seem to be in pain or anything--this could explain her desperation at times to go out, though (she won't pee in her kennel, but she WILL pee on the carpet occasionally--this is only since she has been on the meds).

So, any suggestions?
 

A UTI really needs an antibiotic and you don't want an infection not getting "gone" and heading back into the body deeper.  So yeah, I'd have the vet look at her.  And you might want to put her on d-mannose or cranberry as preventive regularly til you get her off the meds and it out of her system.

Took her in today.  They did a quick "dip" test and it showed that the urine was normal, so they're doing a complete blood workup.  :(  I'm worried that she might have something more serious--the doc mentioned Cushing's and diabetes as things they'd test for.  I read some about Cushing's online, though, and it seems it usually strikes older dogs, plus she doesn't seem to have many of the symptoms (excessive thirst and urination, plus her hair looks like it's thinning on top of her head and on her ears).  The symptoms she does have can be explained by other things, including the meds she's on (I thought I read that pred can cause the hair issue, though I may be wrong about that).

Anyway, I guess we'll know soon.

I'm not a good wait-er, though.... :(

Prayers would be good.
 

HOWEVER -- the whole time they are on cyclosporine it 'mimics' Cushings in the body.  So they can have cushing-like symptoms.

this is where I wish so much you had a TCVM vet on board too -- doing things to prevent the bad side effects are so important. 

How much does she drink?  If the urine is dilute because she's drinking tons can mean there IS an infection that just doesn't show up. 

She'll drink a whole bowl, or nearly, at times.  (I just checked, and her bowl holds 2 cups.)

She isn't scarfing her food like she was, which is one good thing--I mean, she has a good appetite, but she can walk away and leave some and come back later for it instead of wolfing it all down like she was starving.

The urinalysis is the only thing that's come back so far, and it shows a trace of blood, though not much (+1, whatever that means--I spoke with a nurse, as her vet was gone by the time those results came in).  I did point out that she's been drinking a lot.  Her white blood cells and other numbers aren't "crazy," though, as they said (then again--if white blood cells indicate an immune-system response, and we're suppressing her immune system, might that not throw things out of whack?).

Was I imagining the pred (or cyclo?) and hair loss thing?

She does seem a bit better today, to me--though still thirsty, fluids don't seem as quick to go in or quick to come out as before.  I'm hoping that we can get answers fairly quickly so that, if it is an infection, I can start her on antibiotics and cranberry.

I don't want it to be "something else"--but if it is, I want all the lead time I can get to deal with that, as well.  I'm really concerned--mostly for her, but for myself, as well.  I'm really stretched, both financially and time-wise, just now.  

I committed to earn my National Board Teacher Certification this year.  Whee!   No stress at all! :P 

A side effect of cyclosporine IS big time UTIs -- they should address that FIRST.  Just **try** a frigging antibiotic folks ... or do a culture and sensitivity ... billy drank a ton too (it's a side effect of all the immune-suppressors).  Tell them to read the Atopica website -- if the globulins are at all high it's because the body is responding to infection.

Heard back from the lab, FINALLY.  Her PCV is 51.7 (I'm hoping perhaps it will drop a bit and stabilize so it's not so "thick" as it was) and her glucose levels are normal (so no diabetes, apparently), as are her liver levels (which surprised the doc--and apparently liver levels can point to Cushing's, too) and so forth.  Her kidney levels were slightly elevated, as were her triglycerides and magnesium, but the latter two levels are probably due to her being "chunky," according to the doc (she said Emma's blood sample was "fatty";).  The steroid test should be back tomorrow.  There was that trace of blood in the urine, and she's going to give me an antibiotic for her.

Oh, and the lab is refunding at least part of the fees, which is good (considering we waited four days for the results).

Guess the vitamin E and milk thistle are doing their job!  (I confess--I sometimes forget the milk thistle....Bad mommy!)
 

I use one of those 7-day plastic pill caddys (nope, I use TWO) and I portion out his meds for the week in them -- then I know I won't forget stuff.  With so much all the time your brain just whirls.  In fact I tend to keep all his meds in a gift bag  (the ones he's taking NOW) simply so I'm sure I give all of them.

THEN also if I'm running out it gives me a week's heads-up to get more!  I'm just in that senior "CRS" mode (can't remember s***) cos otherwise I'd forget half of it all the time.  *sigh*

The numbers are good --but it's funny -- Billy's magnesium was LOW all the time.  Hmmmm ..

 Finally got the thyroid results back as well.  She's a little bit low, but the doc wants to do some research because she says greyhounds naturally run a little low and isn't sure whether IGs are the same or not--plus dogs that have been ill can have low levels as well.  Either way, she agreed it's best to wait until the drugs have cleared her system before running more tests and/or starting any treatment.

The antibiotic is Cephalaxin 250 mg twice a day for two weeks.  Ick.

At least the tests seem to have negated the concerns re: diabetes, Cushings, etc....

EDIT: Oh, and when I got home today, she still had half a bowl of water left.  I noticed that she's been drinking LESS--oddly enough, this has developed over the past week, since she was in for tests.  Weird, huh?  Anyway, she still asks to go out a lot, but isn't so desperate as she was, nor is she drinking as much.  I don't know whether that means anything at all or not (I don't want her to drink too little; too much is definitely preferable, IMO!).

Thanks again for the words o' wisdom. :)