Muscle Wastage With Predisolone

[Bokezu]

I would have thought no platelets warranted a transfusion ASAP.

ETA: I have never nursed an IMT dog though.

yes, don't know why, I will ask the vet when I speak with her again

wondering if the onset was gradual over three days, and then by Wed it had hit rock bottom

[Rappie]

I would have thought no platelets warranted a transfusion.

ETA: I have never nursed an IMT dog though.

Spontaneous bleeding can occur with a platelet count of <50 000, however we usually see it with <20 000.

Whether or not to give a transfusion depends on whether they are clinical for anything other than a low platelet count. It's hard to replace enough platelets to make a difference, but certainly if the dog is anaemic as a result of bleeding (because their blood can't clot) then they should have a transfusion.

ETA: External bleeding means there can also be internal bleeding, these guys need to be handled VERY gently and kept quiet. It's also not that uncommon to get an IMHA along with IMT.

Edited November 19, 2009 by Rappie

[Bokezu]

I would have thought no platelets warranted a transfusion.

ETA: I have never nursed an IMT dog though.

Spontaneous bleeding can occur with a platelet count of <50 000, however we usually see it with <20 000.

Whether or not to give a transfusion depends on whether they are clinical for anything other than a low platelet count. It's hard to replace enough platelets to make a difference, but certainly if the dog is anaemic as a result of bleeding (because their blood can't clot) then they should have a transfusion.

ETA: External bleeding means there can also be internal bleeding, these guys need to be handled VERY gently and kept quiet. It's also not that uncommon to get an IMHA along with IMT.

thanks for your input Rappie, will be gentle and quiet and hoping there is no IMHA present

Edited November 19, 2009 by Bokezu

[Danois]

This was Angs after about 8 months of cortisone and 2 weeks before I lost him. He has noticeable muscle wastage in his head.

poor baby so sorry Danois did Angs have IMT?

No - he had Immune Mediated Poly Arthritis (IMPA). He developed pancreatitis and when we had to take him off the pred, IMHA showed up.

[Starkehre]

Bokezu, thanks for letting us know how it is all going.

Yes, IMT is said to be possibly brought on by stress, but unless it was ridiculously huge amounts of stress, I doubt it. If the body is under sudden stress from over loads of exercise it can occur also.

It is one of those, you may never know what brought it on, which is scary as you cannot avoid it again. Hopefully it was the stress, but if it was so recent, I doubt it. They don't usually go down that fast.

Has he been swimming in any dams. These may have polutants, chemicals, blue/green algae in it. Toxins that come up from the ground, sprays. Walking through orchards that have had sprays spread around. I would be racking my brain over things like that. Laying on sleepers, these give off toxins. It is more likely to be chemical or similarly caused, and over the last 2-3 months, closer to 2 months.

And usually the downhill loss of platelets is gradual, and can be showing no clinical signs for a couple of months until they reach rock bottom, then you see everything.

Those outward clinical signs were probably owing to anaemia and temperature loss.

I remember now Dyzney's platelet count was 4 when she was first rushed in.

My girlfriend's dog recently passed from IMHA, but did not have IMT.

These immune mediated diseases are really horrible.

Hope Jordy has improved over night, and hopefully more improvement today. It becomes a waiting for the drugs to kick in game, hoping that in the mean time the dog does not crash and bleed out.

I too am surprised about him not having transfusions. sure they are not always enough to do much, but they kept Dyz alive whilst we waited for the drugs to kick in. She was bleeding into her intestines and gut.

Good info Rappie. I forget much of the technical stuff.

And you are right Bokezu, it is very confusing.

It might also pay to have a chat with your vet about just how much experience he/she has had with the disease. Their knowledge varies tremendously. Over the duration I have spoken with more than 10 specialist vets, and although much of their knowledge marries up, they also disagree on a lot of stuff, so that can be hard also.

Get well Jordy

Edited November 25, 2009 by dyzney

[Starkehre]

Diesel is kicking at his elbows today. Boy he looked crap after I spent a week at mums for work

this evening he got stuck lying down and cried and cried trying to get up

I dont know. I know what you all are going through .. will they be better or worst today, tomorrow ...

I am so sorry Nek. It is very sad for poor Diesel. I don't know how you manage to look at him each day, it must be so hard for you.

Give him a hug for me please.

[Starkehre]

Hey Bokezu, just though you might like to have a look at this. This is a link to the write up the AEC did about Dyzney. Of course they changed her name and the arthritis thing was not correct, it was a lameness which at the time we suspected sesamoid, but as it turned out later it wasn't. But anyway, you may find it informative and helpful.

http://www.aecvets.com.au/cases/cases.html

[Bokezu]

thanks so much dyzney will have a look, thanks for being so helpful everyone, waiting on the vet to call

[Bokezu]

Jordy's vet is not there today and we have another one who will be looking after him, I'm sure she is nice but Pru was fabulous. They are waiting for all the blood test results from the mainland.......don't know where they went or why? He will have his blood tested later today to see how he is doing, he def won't be coming home today.......vet will ring as soon as blood tests come back............fingers crossed nothing nasty shows up

[Starkehre]

Good luck, and keep us posted if you don't mind.

[Bokezu]

Just a quick update on my Jordy. Unfortunately his red cell count has gone very low and as well still no platelets visible, he is having a blood transfusion now, hopefully that will give him a boost, fingers crossed for my boy

[fiery_di]

My Ruby had ITP too!! Was diagnosed with it back when I first joined DOL back in 03?? I think??

Anyway, she was on the pred & also imuran for a good 3-4 years full time until I weaned her off it completely in mid 06 and the ITP didnt return (prior to this any weaning her off it over the years she was on it and she would decline & her platelet levels would drop).

The biggest concern at the time that my vet gave me was more so the pancreatitis side of things. Never mentioned muscle wastage. Ruby ended up passing away from cancer back in April 08 (totally unrelated) at the age of 7yrs & 7mths. Her muscle tone never seemed to be an issue, and the vet never made mention of noticing any muscle wastage.

Dont lose hope. The outcome can be good. Even tho I had Ruby on the meds for 3-4yrs I was eventually able to wean her off them, so the case with your dog may also be the same, on meds for a few yrs and potentially wean off again with no ITP ever presenting itself again.

I understand how difficult this must be feeling right now. So if you want anymore information re the ITP, side affects, etc. please feel free to pm me..

[Starkehre]

Thanks for the update Bokezu.

I am sorry to hear Jordy has not picked up as yet, but usually it does take a couple of days for the meds to kick in. Hopefully this transfusion will be enough to help him along while his body is absorbing the cortisone.

Will there be a vet nursing and monitoring him tonight or is he at a regular vet?

I am sending Jordy all the healing messages that I can muster.

[Starkehre]

fiery_di, do you mind me asking what breed of dog your ruby was please?

I am very sorry to hear you had one with an ITP also, but glad you managed it when meds.

Dyzney was on Imuran also plus a couple of others that I can't remember the name of. but we managed to have her weaned within 4-5 months, so we were extremely lucky.

[fiery_di]

Hey Dyzney!!

Ruby was the gorgeous dog you see in my sig & avatar. She was a mini foxie!! And a divine one to boot!! My heart dog through & through!!

In regards to Jordy!! I agree with Dyzney.. You will need to give the meds a few days to catch up, but you will then be noticing that he gets back to his old self in no time at all. Oh and a word of warning?? The appetite!! You really have to keep a watch on this!! when Ruby was on 1 Pred tab a day she would SALIVATE profusely at anything that resembled food!! Absolutely inhaled her food and then would go looking for more!! She went from a healthy 4.7kg to a whopping 5.6kg!! Quite a weighty jump for a dog her size/breed!!

Another thing too is they do tend to become excessively thirsty and you will notice your Jordy panting quite a bit. You will esp notice it with this heatwave weather occurring!!

Ruby was on the verge of requiring a transfusion as her platelets had dropped to below 7000 and the vet proclaimed that Ruby shouldnt have even been standing, let alone wanting to play with her ball!! Cant keep an MF away from those bloody things!!

As I said before, any other info you require pls dont hesitate to pm me!!

Edited November 20, 2009 by fiery_di

[Bokezu]

Thanks FD I was feeling so down, you have perked me up a bit, hopefully the transfusion will be the start of recovery

[Starkehre]

Hey Dyzney!!

Ruby was the gorgeous dog you see in my sig & avatar. She was a mini foxie!! And a divine one to boot!! My heart dog through & through!!

In regards to Jordy!! I agree with Dyzney.. You will need to give the meds a few days to catch up, but you will then be noticing that he gets back to his old self in no time at all. Oh and a word of warning?? The appetite!! You really have to keep a watch on this!! when Ruby was on 1 Pred tab a day she would SALIVATE profusely at anything that resembled food!! Absolutely inhaled her food and then would go looking for more!! She went from a healthy 4.7kg to a whopping 5.6kg!! Quite a weighty jump for a dog her size/breed!!

Another thing too is they do tend to become excessively thirsty and you will notice your Jordy panting quite a bit. You will esp notice it with this heatwave weather occurring!!

Ruby was on the verge of requiring a transfusion as her platelets had dropped to below 7000 and the vet proclaimed that Ruby shouldnt have even been standing, let alone wanting to play with her ball!! Cant keep an MF away from those bloody things!!

As I said before, any other info you require pls dont hesitate to pm me!!

Thanks fd. What a little sweety she was too. I wondered if that was Ruby.

Regarding the muscle atrophy, you will not have had hardly any as it seems to be more predominant in large breeds.

You were really lucky with your fast and great results with treatment. That is excellent.

I hope it will be as good for Jordy.

Yes cortisone increases appetite and thirst. However with dyz because she was so sick, she didn't eat hardly anything for 5 weeks, nausea and stomach ulcers. Seriously day 35 was her first day after day one that she ate and did not bring it up again. Each previous day she either would not eat or the small amount she would eat came up. We felt happy when she managed to keep one cm square of boiled chicken down for 2 hrs. that is how bad it got.

With the thirst it is tricky also, as they require the extra water that they are craving, so you cannot withold it, but when they are that unwell, if they have too much at once they will bring it all up again. that was a real juggle for us. I remember counting and only letting dyz have 15 laps every 2 hrs. if she had anymore she would vomit. It was terribe.

But all cases are different. My Ruby was not as bad as dyzney. ruby responded to the drugs quicker and better, probably more like fd's ruby. but because of the atrophy and her being barely able to walk and breathe, after 2 months (even though we felt she was on track) we PTS anyway, cause her quality of life was so poor. Plus the vets said there was probably roughly 50% chance of it recurring. I think now that maybe that was not accurate, but it is over now anyway, so no point dwelling. Back then I had to leave home for work and everything was different. But when Dyz got sick, we fought longer and harder. I was not going to let this disease get another dog of mine.

[Bokezu]

Thanks for the update Bokezu.

I am sorry to hear Jordy has not picked up as yet, but usually it does take a couple of days for the meds to kick in. Hopefully this transfusion will be enough to help him along while his body is absorbing the cortisone.

Will there be a vet nursing and monitoring him tonight or is he at a regular vet?

I am sending Jordy all the healing messages that I can muster.

vet has also started him on another med but didn't tell me the name, as she said she can always stop it but atm Jordy needs all the help he can get. No all our vets here go home for the night unfortunately. She started the transfusion and the on duty vet will go and check and finish it and then he is on his own all night. Because his red levels were dropping so low he couldn't have been left all night without a transfusion. Lets hope he starts to improve tomorrow after the transfusion and extra meds. I will know more when I ring in the morning..... hoping its good news

[fiery_di]

Thanks FD I was feeling so down, you have perked me up a bit, hopefully the transfusion will be the start of recovery

I think you will notice a difference with the transfusion. The energy levels will pick up!! It will also buy some time for the meds to kick in. All in all the vet advised that you notice a difference, even if it is ever so slightly with the first 24hrs, then things improve over and over from there.

Best way to check if your Jordy's pred levels are not too low is to check the gums.. Any sign of white/greyish gums, give a pred straight away!! That is what our vet advised us! A healthy pink is a Any sign of the pink fading, just pop either half a pred or full pred down the hatchet!! Initially I would contact the vet in a panic, and he would always just to advise to give another pred. I can tell you after being on the meds for a good few years I knew the drill, wouldnt bother the vet and just administer accordingly. You should notice the pink returning within.. say.. 6 to 8hrs if not sooner??

HTH!! FD

[fiery_di]

Thanks for the update Bokezu.

I am sorry to hear Jordy has not picked up as yet, but usually it does take a couple of days for the meds to kick in. Hopefully this transfusion will be enough to help him along while his body is absorbing the cortisone.

Will there be a vet nursing and monitoring him tonight or is he at a regular vet?

I am sending Jordy all the healing messages that I can muster.

vet has also started him on another med but didn't tell me the name, as she said she can always stop it but atm Jordy needs all the help he can get. No all our vets here go home for the night unfortunately. She started the transfusion and the on duty vet will go and check and finish it and then he is on his own all night. Because his red levels were dropping so low he couldn't have been left all night without a transfusion. Lets hope he starts to improve tomorrow after the transfusion and extra meds. I will know more when I ring in the morning..... hoping its good news

I'd say quite possibly it would be Imuran?? This is what my Ruby was on, both the pred & imuran together, the imuran being the lesser of the two..