Yeah, that's partly it. And I'm going to say right off that generally when you are an owner with one of these dogs by the time they start to reduce the drugs you feel like "Two Face" and you are more than slightly paranoid ANYWAY.
Why? Because you know the drugs are damaging the dog and you HATE the side effects and you can't wait to get them OFF the !$@#$)!@*%!#* stuff!!
HOWEVER, at the same darned time you are terrified to change a*n*y*t*h*i*n*g because the dog might crash and you're generally so terrified all the time anyway!
*yeah* been there done that lived it!!!
And ... yes, the initial reductions (and you have to remember some dogs are on ONE drug, some are on TWO drugs and some are on THREE drugs ****ALL**** with different absorption rates) may be faster, particularly if they are trying to get a dog OFF a particular drug for a medical reason
I think it's a little bit too simplistic to say that it's a difference in education -- I think medical opinion and experience has a TON to do with it, as well as the above-mentioned huge difference in the combination of drugs and amounts a dog may be on.
There is also a cost factor -- and the fact that particularly with Atopica Cyclosporine -- it only comes in specific increments -- 10, 25, 50, 100 -- so if the dog is on 200 mg a day -- if you tried to go to say 185 mg you'd have to give FOUR pills (a 100+50+25+10) which would frankly cost WAY MORE than 200 mg. And honestly 200 mg per day is more than most people's house payment A MONTH. People are already stretched with this disease ANYWAY so I'm sure that may actually have been part of the factor in how they reduce it.
We don't want to THINK that finances should have a thing to do with this -- I mean once you've gone THIS far ....
But it DOES. Particularly in today's economic climate -- Because altho someone might have been able to squeak by in December, now it's JUNE ... maybe their hours have been cut for summer, or maybe a spouse has lost their job ... or maybe the MONTHS of this never-ending expense has now eaten up savings. So something's gotta give.
In Billy's case it was a whole different thing. He started on prednisone. Then they added the Atopica (and a whole freaking lot of it for his size 150 mg). Add to that the cost of SIX TRANSFUSIONS in a month (we're now up to about $7000 in about 6-8 weeks). But it TOOK nearly 6 weeks for his body to kick in and his kidneys were taking a BEATING.
But it was SEPTEMBER before we felt we could lower **anything**. THREE months going full tilt and his poor kidneys - I was terrifed. So when they began to reduce it was the pred and they got him TOTALLY off it within like 2 months.
I was freaking terrified. But he held. It was the first drug in ... and felt like the easiest (and cheapest) but they determined it was the hardest on the kidneys. But then they made us wait almost 2 more months before we STARTED to reduce the cyclosporine. And that went from 150 to 125. I sweat bullets then too. But then they went to 110.
The interesting thing was he had MORE reactions at 110 than at 150. His skin was worse, his utis were worse EVERYTHING was more difficult.
But dang ... then when he went to 100 his pack cell bobbled.
ACKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK
So .... *sigh* we went back up to 125 AGAIN. Back to 110 (gag -- that was SOOO awful -- his skin was SO infected, inflamed ... and what are you going to do huh?? Put him on ... STEROIDS????? That *was* the joke ... poor dog had such crappy skin - I was bathing him daily, benedryl, and everything trying to keep the allergies at bay.
But this time we got to 100 with no incident. Then we went to 95 (that's a 50, 25, and TWO 10s -- not cheap) ... then incrementally down. And further between reductions.
I think going from 2 a day to 1 a day was the scariest.
But I've also quizzed human doctors on how they reduce prednisone after long term use in humans (and even shorter term but large amount use in humans). Some simply go half, half, half, half every few days. and 3 weeks you're "off" pretty much no matter the dose. Others -- not so much. Sometimes it differs by what they're treating for, sometimes by the individual ...
One day I flatly asked a doctor "why? and how to you determine that?" and he said "the difference my dear is simple. It's this mysterious thing called 'medical opinon'. It depends on your experience, where you went to school, the individual patient and what side effects they may have, and a ton of other things. But MOSTLY it's medical opinion. They began using a protocol that seemed to work and they've gotten comfortable with it and continue it. It may be different than the next guy ... but equally as valid. Or maybe not with THIS patient. And therein lies what they call the 'medical arts'."
It's true. There is not one-size-fits-all directions for this stuff. Because each being is unique and has their own unique problems and side effects and the owners have what they can deal with and tolerate. .