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Jingles for my Ollie (avatar dog); Questions on prednisone at the bottom-you can skip the story!
Topic Started: Sep 13 2011, 01:45 PM (611 Views)
gracetw22
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I know I have been gone for a good long while, since I have not had a computer and still don't. I was luckily allowed to borrow an iPad for a couple days to catch up on everything so I thoug I would ask for some jingles for my heart dog Oliver. I came back from Culpeper and found him completely different than when I left. He seemed, to my college girl's best description, very drunk and very high, so I immediatey scoured the house to see if he got I to any of my medications or other toxic substances. Nothingness found - and I thought that was lucky. I took him to the emergency vet who let me know that things were a lot worse than I had expected. He was completely blind, severely brain damaged, and seizing regularly. He did not recognize me at all. She immediately consulted a neurologist and they concluded that he was coming down off a very major seizure and was continuing to have more minor ones. He needed a workup at the neurologist clinic several hours away as soon as possible. He stayed at the emergency vet overnight to be stabilized enough to travel, with a heavy dr of IV valium for seizures medication and an intense workup to rule out all infectious causes or anything visible by xray. By the middle of thte night he was seizing through the Valium and pacing the cage to press his head on the walls which is a common symptom of severe neurological defect in dogs. They started a drip of heavier seizure meds and some ace.

I came back at 5 am so that he could be the first appointment at the neurologist. The exam showed that several parts of his brain were severely compromised, which suggested somethig other than a stroke. They presented me with the estimate for their full workup: 6000 dollars. (three times their estimate when the e-vet called the night before) I'm a college student, and while my family is very fortunate, that amount of money for a dog who looks like he should have been euthanized the night before was just not in the cards. The best but most expensive diagnostic test was the MRI, and everyone agreed that for a dog this sick, it was highly likely that it would show the cause of the problem. Therefore I declined the collection of brain fluid and the extensive culturing of it, and chose for him to be hospitalized at home at the e-vet. That office also has a specialty practice in the day so he would have an internist all day and really fantastic vets all night. The neurology clinic made me feel like a total POS for this decision, but I was still leaving with a 2700 dollar bill ( again, far over the phone estimate for exactly what I ended up doing) The MRI ended up being completely normal, much to everyone's complete shock. He had not woken up from the anesthesia well and was very hypothermic, so I decided that rather than take him home and do a fluid collection there, I wouldn't risk him not waking up at all, and instead just treated for the conditions we hadn't ruled out, knowing that we couldn't get the fluid after treatment was started

Thus far, the diagnosis is an autoimmune disorder that attacks the brain. (the other option is. Lymphoma of the brain, which is similarly bad and has the same treatment) There are two forms, Granulomatous meningoencephalitis (GME) and Necrotizing meningoencephalitis (NME) the first form generally shows on an MRI since there are granular lesions, whereas I think the necrotic brain is slower to see on the MRI. The second form is more rare except in certain breeds (pugs, Maltese, and yorkies). Maltese (which is what Oliver is) are the most common breed to develop this form of the disease, and the proganosis is significantly worse than the granular form, which some vets are recently putting into full remission through chemotherapy. I am at this point not sure whether I would pursue chemotherapy with him, even though dogs tolerate it much better than humans.

I contacted the neurologist who is foremost in the country for these conditions. He told me that basted on his experience he suspects NME, but reiterated that I should have done the brain fluid analysis and refused to treat Oliver because I had not done it, even though I was ready to fly to Boston the next day and pay him whatever he wanted. He also refused to even give me a second opinion on the MRI. I am pushing that issue. I am very happy with the care his internist has provided, however. His treatment seems to be following the new, more aggressive protocols (very very high dose prednisone at the beginning) and while he isn't his old self anymore by a long shot, some of his vision has come back and his personality is close to what it was. His current cocktail of medications are too strong to be used for a long term basis, but at this point we are just looking to keep him comfortable for his time that he has left. We go back to the internist tomorrow, and I think both of us are going to be very happy with how well controlled his inflammation is, and then we will have to start stepping him down slowly to see what holds him.

Now the question on prednisone for anyone who doesn't have time for that novel- I would love any input from anyone with experience whether taking it personally or having a pet taking it. He is on 1 mg/lb twice a day. He drinks something like five times the amount of water that he did prior to this medication. Therefore, there is a staggering amount of pee, and he has completely un house broken himself. I would much rather have a live Oliver who pees all over the place than none at all, but if there are any thoughts on how to contain him to one spot, I would appreciate it. Also, he is STARVING, all the time. Yesterday he had his normal breakfast, I left home, and came back and he had eaten half a bag of dried pasta, and gnawed on a potato. Is there anything I can do about that?
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jillincolorado
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Oh Grace. :( Poor you and poor Oliver. I think you have done a thorough job in trying to get him diagnosed and I am miffed FOR you that the doctors and the neurology office were so blatently rude about refusing further treatment. That annoys the hell out of me!

Anyway, I have been on predinose many many MANY times in my life for asthma and allergies and I can tell you that it makes you VERY hungry and VERY thirsty (ROIDS!!). I'm not sure if you can do anything about the constant hunger except for possibly smaller, more frequent meals? Perhaps someone more in the animal medication know will post some suggestions for you.

***JINGLES*** for Oliver and HUGS to you!!!!
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RNB
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Grace.......how old is Ollie?

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gracetw22
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RNB
Sep 13 2011, 03:13 PM
Grace.......how old is Ollie?

Oliver is 11, which seems elderly to me, but is apparently just upper middle age for such a small dog. Before this he did not show any signs of slowing down. So sudden. :(
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CBoylen
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From your description that's pretty much the same thing that Rachel's dog that I told you about at the beginning has. It's been pretty normal for weeks since the Prednisone. When I last saw it you wouldn't know anything was wrong with it if you weren't told.
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gracetw22
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CBoylen
Sep 13 2011, 03:34 PM
From your description that's pretty much the same thing that Rachel's dog that I told you about at the beginning has. It's been pretty normal for weeks since the Prednisone. When I last saw it you wouldn't know anything was wrong with it if you weren't told.
Do you think you could PM me her email or phone number? I'd love to talk about it to someone who has come out on the other side.
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CBoylen
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We're on a bridge, Chaaaaaaaaarlie!
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Facebook message her, probably the easiest.
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gracetw22
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Done! Thanks for the idea.
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Indy
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:jingles: :jingles: :jingles: for Oliver & :hug: :hug: :hug: for you!

Prednisone definitely will make him ravenous. I was on it a year or so ago for my back and would have eaten off my own arm.
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incentive
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So very sorry that you and Oliver are going through this terrible time. I have no experience to offer with the pred except for short-term use, but am sending multitudinous :jingles: :jingles: :jingles: :jingles: :jingles: :jingles: :jingles: :jingles: :jingles: :jingles: and :hug: :hug: :hug: :hug: :hug: :hug: :hug: :hug: :hug: :hug: your way.
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Delia
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Grace -- so sorry about Oliver. And a I place an exploding diarrhea curse on the neurologists who guilted you. Shame on them. :pissed: The other retiree at my barn has heaves, and in the heat of summer he is on a high dose of pred. The main side effect for him is that he drinks a ton more water + pees an ocean. He always acts like he's starving, so difficult to say whether he is more or less so on the pred. For Oliver, maybe try those doggy diapers on him to control the mess?
Edited by Delia, Sep 14 2011, 09:12 AM.
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Won for Me
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:jingles: :jingles: :jingles: :jingles: :jingles: :jingles: :jingles: :jingles: :jingles:

I do know that Prednisone makes them drink and eat like they never have before. When I took a small dose for a pinched nerve, I didn't notice a change, but it was a small dose.

To care for an unwell, elderly dog, changes your life completely. Many hugs and jingles coming your way.
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kady05
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Everyone's given good advice re: the pred.

Poor guy, sorry to hear he's not doing well :(
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stephjm
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It'll be an adventure! We're going on an adventure!
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Aw, poor Oliver and poor you!!! Darn those doctors - I second the exploding diarrhea curse. I have been on prednisone, as well as my MIL's dog, and yes it does make you thirsty and hungry. Also makes it harder to sleep. I got a lot of housework done while I was on prednison. :teehee:

Anyway, bit :jingles: :jingles: :jingles: for Oliver!! Duffy sends some doggy love too. :hug:
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gracetw22
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So he did great at his checkup today! He was switched to another anti seizure med which isn't as toxic to the liver so it can be used with prednisone, and is starting a daily chemotherapy medication. Yes, I know I said I wasn't going to go there, but it's just a pill once a day rather than injections every three weeks, and it is supposedly really well tolerated. There is also recent literature on this specific drug, so I agreed to give it a go. Hopes we could get his pred lowered enough that he wouldn't be feeling the side effects so much.
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