Prednisolone

[Guest hankodie]

Hi all, wondering if anyone can help. Odie's allergies have flared up again - I suspect because of the warmer weather. Mainly, her ears are bothering her to the point where she is scratching too hard and causing them to bleed It's not the first time she's had trouble with allergies but it seems to be seasonal from what we've experienced so far.

I have posted about this on here before, but she also has a congenital liver abnormality (hepatic microvascular dysplasia/macro shunting of the liver). At the moment her liver condition is stable, I am managing through very very careful diet and meds (mainly denosyl). She's been asymptomatic for the most part. Most of her health issues have been gut/allergy related which my vet thinks are separate to the liver condition.

Anyway - I took her to the vet this morning but we weren't able to see my regular vet, who has overseen Odie's case since she was a pup. The other vet prescribed Surolan eardrops for her ears as well as Prednisolone tablets to take once a day for a week.

I am mainly concerned about the Prednisolone as I read dogs with liver conditions should not be given this medication. I did ask the vet about it and he said that it should be fine but I'm still a bit worried.

Last time she had issues with he ears the vet prescribed just the ear drops and they seemed to have cleared up the issue.

Wondering if anyone can help - also I don't mean to question the vet's integrity or diagnosis, I'm just used to my regular vet as he explains things a little bit better and has spent quite a bit of time with me researching Odie's condition. As it's quite a rare condition not all vets are familiar with it.

If anyone had any insight I'd greatly appreciate it, thank you!

[minimax]

A quick Google says prednisilone is used in people with hepatic failure.

No personal experience though, sorry. Just what my 2 second research showed, I'm sure there is more out there to confirm or deny though if you have a look :)

[Guest hankodie]

A quick Google says prednisilone is used in people with hepatic failure.

No personal experience though, sorry. Just what my 2 second research showed, I'm sure there is more out there to confirm or deny though if you have a look :)

Thanks minimax! Problem is there are so many contradicting facts on google when I search. I'm also going off advice on another forum that deals specifically with liver issues.

[minimax]

A quick Google says prednisilone is used in people with hepatic failure.

No personal experience though, sorry. Just what my 2 second research showed, I'm sure there is more out there to confirm or deny though if you have a look :)

Thanks minimax! Problem is there are so many contradicting facts on google when I search. I'm also going off advice on another forum that deals specifically with liver issues.

Prednisilone is different to predisone, which is where you may be getting confused.

One they can have, and one they can't, it seems.

[Poodle wrangler]

Quick call to vet surgery?

Easy for a medication mistake to be made & best to just confirm.

[Guest hankodie]

Thanks for your help minimax. I've read that prednisilone should be administered with caution if the patient suffers from liver failure. Wish I could talk to my regular vet but I think he's away on a conference.

I think the ear drops have given her some relief though, which is good

[Guest hankodie]

Quick call to vet surgery?

Easy for a medication mistake to be made & best to just confirm.

He did prescribe me the medication that he meant to, I'm just not sure if giving them to her would be the best thing because of the compromised state of her liver. He also gave me some conflicting advice about her diet etc all different advice to what my regular vet and I have discussed in regards to her condition

Just looking for a second opinion I guess as I don't want to give her anything that might be dangerous or cause any additional stress on her liver. Will definitely give my usual vet a call when he comes back though

[Florise]

What dose of prednisolone did he prescribe(per kg)?

[Guest hankodie]

What dose of prednisolone did he prescribe(per kg)?

one 5 mg tablet a day, she's around 10 kilos I think? And then the dose tapers off after 5 days to every other day. Hope that makes sense

[CrazyCresties]

With a dog that has IMHA and was on a very high pred dose to start with, Milk Thisle and SAMe are always recommended on the IMHA forums for protecting the liver. On my phone atm, but have a Google and I'll add more later :-)

[Guest hankodie]

With a dog that has IMHA and was on a very high pred dose to start with, Milk Thisle and SAMe are always recommended on the IMHA forums for protecting the liver. On my phone atm, but have a Google and I'll add more later :-)

Thanks CC :) :)

I give her milk thistle and SAMe (aka denosyl) daily, when she was diagnosed the vet said both supplements daily couldn't hurt so that's what we've continued to do. We have taken the "if it ain't broke don't fix it" approach with her liver disorder so whenever we have to change up the routine even in the slightest I tend to worry a bit!

[SchnauzerMax]

http://www.hillsvet....co_therapy.html

Lists the side effects and considerations for using steroids.

[CrazyCresties]

Out of interest are you giving denosyl itself or human SAMe from a health shop?

[Guest hankodie]

http://www.hillsvet....co_therapy.html

Lists the side effects and considerations for using steroids.

Thanks very much SM. Looks like the worry is only there when it is used long-term but I think I will check with my regular vet just in case.

Out of interest are you giving denosyl itself or human SAMe from a health shop?

Hi CC, I give her chewable denosyl tablets that she has every night a few hours after eating :) There is also a supplement called denemarin which I think is almost the same thing except it has milk thistle in it. I've given her both but I just find that giving her the denosyl + milk thistle is a bit easier as the denemarin tablets can sometimes be harder to source.

[Christina]

When people are on it they have regular blood tests to check the liver. I did.

Maybe ask the vet for these. I know its more expense but it may ease your mind to be sure & liver damage is a serious issue.

The dose is high in comparison to people dose in ratio to body weight.

[CrazyCresties]

Ah ok, my vet has trouble getting hold of the denosyl so suggested the SAMe. Was just going to give you a heads up that if you were using the human 'enteric coated' one that it needs to be cut up before feeding. I had read this on the IMHA fb page, but my vet was insistent that they should not be cut up as the denosyl explicitly says not to.

However Louis vomited one up once about 15hrs after he had been given the pill and it was still totally intact! The enteric coating is apparently made for the intestines of people, which is longer and where food sits a lot longer? It is designed not to be digested in the stomach.

Anyway Louis's liver values started dropping nicely once I started cutting the SAMe up, of course also assisted with a reduction in his pred dose (he was on 40mg/day to start with!). Sorry going OT but thought it worth a mention in case you have to use human SAMe at any point. I hope Odie's flare up settles down soon, it's miserable when they are suffering

[Guest hankodie]

Ah ok, my vet has trouble getting hold of the denosyl so suggested the SAMe. Was just going to give you a heads up that if you were using the human 'enteric coated' one that it needs to be cut up before feeding. I had read this on the IMHA fb page, but my vet was insistent that they should not be cut up as the denosyl explicitly says not to.

However Louis vomited one up once about 15hrs after he had been given the pill and it was still totally intact! The enteric coating is apparently made for the intestines of people, which is longer and where food sits a lot longer? It is designed not to be digested in the stomach.

Anyway Louis's liver values started dropping nicely once I started cutting the SAMe up, of course also assisted with a reduction in his pred dose (he was on 40mg/day to start with!). Sorry going OT but thought it worth a mention in case you have to use human SAMe at any point. I hope Odie's flare up settles down soon, it's miserable when they are suffering

Thanks for the info, I've come close to having to use human SAMe a couple of times so that's good to know! I hope Louis is doing better? Odie's liver ALT numbers are chronically sky high but the rest of her liver values are normal so the vet thinks despite the condition of her liver it's still functioning OK.

She's doing a little better after we gave her the ear drops - though she's also come down with a bad case of the runs, poor thing she is a trooper though!

[CrazyCresties]

Oh poor thing, hope her tummy settles down too :)

Louis is ok, just weaning off the various drugs at the moment and fingers crossed his system doesn't crash again

[Rappie]

Short term use of prednisolone shouldn't cause too much of a problem. Long term use can certainly cause changes in liver metabolism. As for the prednisone / prednisolone - they are for most purposes the same. Prednisone is metabolised to prednisolone.

As for the ALT elevation, it is to be expected with microvascular dysplasia but it is important to keep in mind that the 'numbers' reflect the increased activity of that enzyme in the liver and not the function of the liver. In some cases certainly an increase in ALT will reflect damage to the liver cells in the form of acute toxins etc but not always. Specific testing with paired bile acids would be required to assess the actual function of the liver.

Sorry this is so brief, if you have further questions just ask - I'm in the middle of a pre-exam study period :laugh:

[Guest hankodie]

Short term use of prednisolone shouldn't cause too much of a problem. Long term use can certainly cause changes in liver metabolism. As for the prednisone / prednisolone - they are for most purposes the same. Prednisone is metabolised to prednisolone.

As for the ALT elevation, it is to be expected with microvascular dysplasia but it is important to keep in mind that the 'numbers' reflect the increased activity of that enzyme in the liver and not the function of the liver. In some cases certainly an increase in ALT will reflect damage to the liver cells in the form of acute toxins etc but not always. Specific testing with paired bile acids would be required to assess the actual function of the liver.

Sorry this is so brief, if you have further questions just ask - I'm in the middle of a pre-exam study period :laugh:

Thanks a million Rappie! That is what I gathered from reading up on it, the vet did suggest she might need to go onto it long-term but her allergies are only really this bad during the warmer months. Out of curiosity is there a better alternative for her in regards to similar medication or are they all typically the same?

It's been about 9 months since we ran her bile acids, they are still abnormal but much lower since putting her on a special diet and supplements.

Thank you again :)