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post #26 of 54 (permalink) Old 05-01-2020, 06:56 PM
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Originally Posted by t_ranle View Post
Update: I spoke to the vet regarding Primor. He skipped all his food yesterday and would throw up whatever little food I was able to get him to eat. I rushed him to the vet and they did a full CBC blood test and everything came back normal. Vet said it might be a reaction to Primor, so now heís on clindamycin. They also performed a full panel thyroid test on him and the results should come back tomorrow. Itís very odd, because he didnít have a reaction to it until the last day of his medication.
Also, do you guys know how long a full panel thyroid takes for results to come back?
I'm glad I sent that post--I don't know why it took several days for it to affect him (and realistically it might have not been the Primor 1200 that caused it) I can tell you that with stuff that causes allergic reactions sometimes the first exposure has not particular noticeable effect. My family knew I was allergic to sulfonamides by the time I was 2 years old. I'm so old that there were not many antibiotics when I was two. So sulfonamides were some of the first and I was a kid who caught colds, developed bronchitis which often resulted in pneumonia--and by the time I was four or five I was having immediate and BAD reactions to sulfonamids. The last time I went through one of the cycles of cold/bronchitis/pneumonia--they begged the US Army facility south of Seattle for some pennecillin--it was around but at that time was restricted to military use. My doctor thought I was going to die and he couldn't give me a sulfonamid again because it almost killed me that last time they tried it.

So my guess is that he was reacting to the Primor but it was slow because he hadn't encountered it before. Just to be on the safe side though I think I'd make sure that this vet and any other new vets who might see him in the future have a great big notation in his chart that he is believed to be reactive to sulfonamides. Anyway I'm glad he's on clyndamycin now.

Full panel thyroid reports (if they sent it directly to MSU) take about 4 working days to come back.) If they sent it to a local lab--and not many of them do the TgAA--that lab will send it to MSU or Texas A & M Vet and you can add on another 4 to 5 days.

Good luck--geeze, sometimes any kind of medical treatments can scare the bejeepers out of you. Keep us posted, please...

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post #27 of 54 (permalink) Old 05-02-2020, 03:19 PM Thread Starter
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I'm glad I sent that post--I don't know why it took several days for it to affect him (and realistically it might have not been the Primor 1200 that caused it) I can tell you that with stuff that causes allergic reactions sometimes the first exposure has not particular noticeable effect. My family knew I was allergic to sulfonamides by the time I was 2 years old. I'm so old that there were not many antibiotics when I was two. So sulfonamides were some of the first and I was a kid who caught colds, developed bronchitis which often resulted in pneumonia--and by the time I was four or five I was having immediate and BAD reactions to sulfonamids. The last time I went through one of the cycles of cold/bronchitis/pneumonia--they begged the US Army facility south of Seattle for some pennecillin--it was around but at that time was restricted to military use. My doctor thought I was going to die and he couldn't give me a sulfonamid again because it almost killed me that last time they tried it.

So my guess is that he was reacting to the Primor but it was slow because he hadn't encountered it before. Just to be on the safe side though I think I'd make sure that this vet and any other new vets who might see him in the future have a great big notation in his chart that he is believed to be reactive to sulfonamides. Anyway I'm glad he's on clyndamycin now.

Full panel thyroid reports (if they sent it directly to MSU) take about 4 working days to come back.) If they sent it to a local lab--and not many of them do the TgAA--that lab will send it to MSU or Texas A & M Vet and you can add on another 4 to 5 days.

Good luck--geeze, sometimes any kind of medical treatments can scare the bejeepers out of you. Keep us posted, please...

dobebug
I know, thank you so much for pointing out the Primor! Titan is now back to his normal, hyper self. I add some chicken broth to his food for a couple days to calm his stomach down before introducing him back to just full kibble. The vet said that heíd have to be on the antibiotics until the lesions disappear. The fungal culture came back negative for any type of fungi, so thatís a bit of a relief. Now I just wait for the thyroid results. Thank you guys so much for all the help, I truly appreciate it! Here is Titan sleeping very soundly after play time. Sending you guys all of Titanís hugs and kisses
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post #28 of 54 (permalink) Old 05-02-2020, 03:47 PM
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I know, thank you so much for pointing out the Primor! Titan is now back to his normal, hyper self. I add some chicken broth to his food for a couple days to calm his stomach down before introducing him back to just full kibble. The vet said that heíd have to be on the antibiotics until the lesions disappear. The fungal culture came back negative for any type of fungi, so thatís a bit of a relief. Now I just wait for the thyroid results. Thank you guys so much for all the help, I truly appreciate it! Here is Titan sleeping very soundly after play time. Sending you guys all of Titanís hugs and kisses
Ah, I love seeing Doberman's bending their ears while napping.

I'm glad the fungal culture came back negative--sometimes it's harder to get rid of fungal infections than anything that is bacterial.

Normal and hyper definitely beats feeling sick and puking--at least the good eaters will tell you immediately how bad they feel by not eating.

You can give him some rubbies and pets from me.

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post #29 of 54 (permalink) Old 05-05-2020, 02:25 PM Thread Starter
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Update: the thyroid test came back as normal. The vet recommends for Titan to be on clindamycin until the lesions are al gone. So far lesions have flattened, theyíre no longer protruding and I do see a bit of fur growing back although thereís a bit of hyperpigmentation in the middle of the lesion where all the fur is growing. The vet did mention that it might take a whole year for the fur to completely go back to normal. Heís due back to the vet in a month For a follow up. Will keep you guys updated!!
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post #30 of 54 (permalink) Old 05-05-2020, 02:34 PM
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Did your vet give you a copy of the thyroid test results. I'd love to know the results of the test for the six parts: T4, T4 by ED, T3, T3 by ED TSH and TgAA. unfortunately there are vets who get not a complete but a partial Thyroid test run and because T4 and T4 by ED and maybe TSH look OK that what they got was all they needed to know.

Good to hear the lesions are diminishing. I'm not surprised that your vet says it may take as long as a year for the skin/coat issue to fully repair itself. Often it takes both the spring and fall shed shedules to complete the process of repair.

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post #31 of 54 (permalink) Old 06-08-2020, 02:12 PM Thread Starter
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Hello guys, just a quick update on Titanís condition. So far, the lesions are still there and a couple more smaller ones have surfaced. Doesnít seem like the clindamycin has done anything. The vet performed a skin biopsy last week and we got the results back in today. The vet gave me A LOT of information, and from what Iím able to retain, the pathologist who examined the skin biopsy said that itís Titanís immune system that was overreacting to these inflammation and are causing the lesions. The following is part of what the vet forwarded me from the pathologist:

MICROSCOPIC FINDINGS:
Skin, site or sites not specified: Marked plasmacytic, histiocytic and mild lymphocytic dermatitis with color dilution and focal furunculosis; see comments.


He is prescribing Titan with prednisone....if I heard him correctly. I will be picking up the meds this afternoon. If anyone wants to see the full diagnosis from the pathologist, Iíll be more than happy to post it here. Please let me know! Thank you guys!
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post #32 of 54 (permalink) Old 06-09-2020, 11:27 AM
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Hello guys, just a quick update on Titanís condition. So far, the lesions are still there and a couple more smaller ones have surfaced. Doesnít seem like the clindamycin has done anything. The vet performed a skin biopsy last week and we got the results back in today. The vet gave me A LOT of information, and from what Iím able to retain, the pathologist who examined the skin biopsy said that itís Titanís immune system that was overreacting to these inflammation and are causing the lesions. The following is part of what the vet forwarded me from the pathologist:

MICROSCOPIC FINDINGS:
Skin, site or sites not specified: Marked plasmacytic, histiocytic and mild lymphocytic dermatitis with color dilution and focal furunculosis; see comments.


He is prescribing Titan with prednisone....if I heard him correctly. I will be picking up the meds this afternoon. If anyone wants to see the full diagnosis from the pathologist, Iíll be more than happy to post it here. Please let me know! Thank you guys!
Wow! I'd love to see the whole report if you don't mind posting it here.

With the prednisone, be forewarned if you didn't already know--dogs on pred drink a lot of water and pee alot more. It's just a part of using pred which is a very potent anti-inflamatory.

Good luck and keep us posted.

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post #33 of 54 (permalink) Old 06-09-2020, 08:19 PM Thread Starter
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Wow! I'd love to see the whole report if you don't mind posting it here.

With the prednisone, be forewarned if you didn't already know--dogs on pred drink a lot of water and pee alot more. It's just a part of using pred which is a very potent anti-inflamatory.

Good luck and keep us posted.

dobebug
Yes, I did read that thirst and frequent urination are part of the short-term side effects. I did not anticipate that the side effects will show up THIS quick. I started the dosage last night, and another one during breakfast. By midafternoon, he had 2 accidents inside the house. Poor kid he was so distressed and must be blaming himself. Will this frequent urination cause any issue in the future? Iím just more concerned about the long term side effects since it did state that it may also cause UTI.
That said, I do see very significant improvement on the lesions. They have definitely flattened out and no longer protruding like before.

Iíve attached the report as a picture file, and also posting it here on the comment box. please let me know what you think of the report and if you have any further insights. Thank you so much.

MICROSCOPIC DESCRIPTION:
The biopsies are bisected and two step sections are examined. The biopsies have an intense interstitial inflammatory infiltrate in the
dermis comprised predominantly of plasma cells and histiocytes with fewer small lymphocytes. The inflammation extends around hair follicles and focally around one apocrine glands. No abnormalities
are seen in the sebaceous glands. There is melanin clumping in and around hair follicles and within hair shafts. Melanophages are
admixed with the other mononuclear cells around the hair follicles. A focal nodular aggregate of histiocytes, melanophages, plasma cells and lymphocytes surrounds keratinaceous debris. Patchy mild orthokeratotic hyperkeratosis is noted on the epidermal surface. No microorganisms are identified.
MICROSCOPIC FINDINGS:
Skin, site or sites not specified: Marked plasmacytic, histiocytic and mild lymphocytic dermatitis with color dilution and focal furunculosis; see comments.
COMMENTS:
It is not entirely clear from the history if this dog has multiple
lesions of this type or a single lesion. If this is a solitary
lesion, the possibility of a non regressing histiocytoma would have to be considered with the marked histiocytic and plasmacytic infiltrates without a corresponding increase in small lymphocytes. There is a population of persistent or recurrent histiocytomas. If there are multiple lesions of this type, the cause is uncertain. The dog has features of color dilution in the pigment clumping in the hair shafts,
hair bulbs and around the hair bulbs. Is there symmetrical alopecia? The biopsies have been reviewed with Dr. Locke, who concurs with the diagnosis and comments.
PATHOLOGIST:
Anne Kincaid, DVM, Diplomate ACVP Anatomic Pathologist, Antech Diagnostics [email protected]
Direct: 630-686-9598 extension 959598
I am available during regular business hours (Central Time Zone), Wednesday-Saturday. If I am unavailable, and you need immediate assistance, please call Customer Service at 1-800-872-1001.
To view an interactive version of this report, please go to Antech
Online where you can find high quality histopathology images from this case embedded in the report. These images can be viewed in our Antech Online Viewer, saved, or downloaded with a pdf version of the report
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post #34 of 54 (permalink) Old 06-09-2020, 11:14 PM
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Hi t_!

So Predisone side effects....

We have a 10 1/2 yo male who was born with a congenital CV deformity. As a pup, he presented with symptoms mirroring those of Wobblers. Extraordinary measures, which I won't go into, saved his life.

He has lived a pretty normal life over the subsequent 9 1/2 years. The one holdover has been the fact that he has been on Pred or a derivative steroid his entire life. Every attempt to wean him completely off has resulted in a partial return of his symptoms. Some weakness and paralysis are the most obvious. Over the years, his dosage has been titrated and adjusted to a minimum level while still holding his symptoms at bay.

Initially, increased thirst and urination were the most obvious side effect. As he inured to he Pred, these problems went away. He also had a rapid weight gain at one point, which can also be a side effect of Prednisone. A careful diet took care of that. He is a very fine boy and best at about 65-70 lb. In his middle years, his coat started thin dramatically. A full thyroid panel showed no issues, so the assumption was that it was being caused by the long term reliance on steroids. At first, as it was strictly a cosmetic issue (he had zero skin issues), we let it go.
As more Pred substitutes became available, we tried one and his hair grew back.

Today, at 10 1/2 he is getting old and is a bit frail. However, he has never been sick. He has tremendous stamina and energy. His heart is strong. And, he has a full coat of hair with very little grey.

You were concerned about UTI's. Our boy never developed UTIs which can be a side effect of long term steroid usage.

Initially, this little guy wasn't given an ice cube's chance in hell to live. The general consensus was to euthanize him. But my son refused as the pup was neither incontinent nor in pain. Hence the "Extraordinary" (and expensive) measures.

So... Our experience was that long term use of Prednisone helped "The Sheriff" to lead a happy and healthy life, all with acceptable and controllable side effects.

John Lichtwardt
Portland OR
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post #35 of 54 (permalink) Old 06-10-2020, 02:09 AM Thread Starter
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Hi t_!

So Predisone side effects....

We have a 10 1/2 yo male who was born with a congenital CV deformity. As a pup, he presented with symptoms mirroring those of Wobblers. Extraordinary measures, which I won't go into, saved his life.

He has lived a pretty normal life over the subsequent 9 1/2 years. The one holdover has been the fact that he has been on Pred or a derivative steroid his entire life. Every attempt to wean him completely off has resulted in a partial return of his symptoms. Some weakness and paralysis are the most obvious. Over the years, his dosage has been titrated and adjusted to a minimum level while still holding his symptoms at bay.

Initially, increased thirst and urination were the most obvious side effect. As he inured to he Pred, these problems went away. He also had a rapid weight gain at one point, which can also be a side effect of Prednisone. A careful diet took care of that. He is a very fine boy and best at about 65-70 lb. In his middle years, his coat started thin dramatically. A full thyroid panel showed no issues, so the assumption was that it was being caused by the long term reliance on steroids. At first, as it was strictly a cosmetic issue (he had zero skin issues), we let it go.
As more Pred substitutes became available, we tried one and his hair grew back.

Today, at 10 1/2 he is getting old and is a bit frail. However, he has never been sick. He has tremendous stamina and energy. His heart is strong. And, he has a full coat of hair with very little grey.

You were concerned about UTI's. Our boy never developed UTIs which can be a side effect of long term steroid usage.

Initially, this little guy wasn't given an ice cube's chance in hell to live. The general consensus was to euthanize him. But my son refused as the pup was neither incontinent nor in pain. Hence the "Extraordinary" (and expensive) measures.

So... Our experience was that long term use of Prednisone helped "The Sheriff" to lead a happy and healthy life, all with acceptable and controllable side effects.

John Lichtwardt
Portland OR
Gosh, he is a fighter. I would love to see a picture of him. Please give him lots of belly rubs from me. Heís wonderful.

As far as prednisone alternatives, did you find that they worked just as fine as prednisone? If so, could you give me the names of these alternatives? I would like to run them through my vet to see if heís okay with switching it. As of right now, the frequent urination is the only side effect I am seeing. Itís as if heís not able to control his bladder at all, he would normally ring the potty bells I have by the door if he needs to go, but on all 3 accidents since taking prednisone, heís not even able to make it to the door, heís pottied 3 times in a row, all 15 mins apart. The kid looks really exhausted from urinating so much, but he also cannot stop drinking water and I donít have the heart to stop him. Should I regulate his water intake?
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post #36 of 54 (permalink) Old 06-10-2020, 11:52 AM
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Hi again t_.

Water restriction: I would not do it.

Pred can cause sodium retention... Hence the excessive drinking. Hence the excessive urination. If you limit water intake, it could cause problems.

Sheriff is on a form of prednisolone. Prednisolone does the same thing, but from what I understand, it bypasses the liver. I think that the brand name (he gets generic) is Medrol.

Honestly... The go-to in these situations is Prednisone and if it were me, I would stick with it unless something changes.

He will get used to needing to go out more frequently. If you boy is serious marker like mine, you could take him out for long walks so he will have an opportunity to completely evacuate his bladder.

Pleas remember... Although I am familiar with Pred, I am not a vet. Any real concerns should be directly addressed to Titian's DVM.

Best to you and your boy.

John Lichtwardt
Portland OR
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post #37 of 54 (permalink) Old 06-10-2020, 01:48 PM
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Hi,

I'm with John on not restricting water for a dog on prednisone. And generally if a dog is on it long term they usually adapt to it and although they still drink a lot of water they evidently figure out how to tailor trips out to pee to accommodate the additional water.

I've only had one dobe who was on pred long term (or even close to long term)--and he never had UTI's while on it (or not on it for that matter).

Prednisolone is generally used on cats because a fairly large number of cats are genetically unable to utilize prednisone. The prednisolone takes one step out of the breakdown to make it usable for kitties whose bodies can't do it for themselves.

You'd have to ask your vet about actually using it instead of prenisone.

I see that the pathologist asked about Titan's color--that's because the findings just before that question (about finding pigment clumping in hair shafts and hair bulbs is indicative of CDA (not normally found except in dilute dogs--fawn or blue).

I just realized seeing the report that I know of one other blue Dobes I've known who had similar lesions--but hers did not appear until much later in life. She had a few spots when young (that were assumed to simply be related to staph infections which are dead common in Dobes of any color when puppies before their immune system was mature.

I believe she was over three before she started having the kind of raised lesions that Titan demonstrates.

The question about whether the lesions are symmetrical is no doubt trying to figure out if it's an adjunct to CDA--which generally appears in bilateral patching.

Well, I've run out of any bona fide knowledge here--in spite of the fact that I've had quite a lot of experience with CDA on dilute Dobes.

So I wish you the best of luck--hopefully it can be controlled--but keep up posted on how the treatment goes.

dobebug

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post #38 of 54 (permalink) Old 06-29-2020, 08:03 PM Thread Starter
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Hi guys. I am crying as I type this.

Titan has been in ER since last night. 5 days ago, 06/25/2020, he started having black tarry stool and I immediately rushed him to the vet. The vet did all the necessary bloodwork and radiographs and ultrasounds and concluded that he has stomach ulcers that lead to anemia, all of which were reactions to prednisone. They did an RBC count and he was at 19%. He was kept overnight for monitoring. The following day his RBC dropped to 17%, but physically, he was showing some slight improvement, enough for the vet to allow me to take him back home with me. We were ordered to stop prednisone and were started on famotidine, half tablet per day, 2 hours before taking sucralfate, which was to be given 3xday with food-plain white rice and chicken. He was still eating and drinking at the time. He was having horrible diarrhea, which I was told was a side effect of the famotidine, hence the bland diet. By 06/27/2020, I was ordered to bring him back for another RBC test and reticulocyte test. His RBC count remained at 17%, but the vet said that heís showing some improvement and asked me to bring him back again on 06/29/2020 for another RBC count. his diarrhea subsided to just loose stool, and no longer black-tarry, although there were still some tiny specks of black in some area of his stool. By 06/28/2020, Sunday, his body completely gave out. He was too weak to even stand up. I rushed him to the ER and they immediately did plasma transfusion for him. Overnight they were able to bring his RBC up to 27% but by Monday noon, it dropped back down to 17%. He was then seen by an internal specialist and concluded that surgery at this point would have very poor prognosis because the prednisone had decreased his immune system tremendously that theyíre unsure if he will recover after the surgery. They did another blood transfusion today and administered barium.

Please keep Titan in your prayers. I am in utter disbelief and cannot put in words the heartache Iím feeling. I have so much guilt. Knowing that heís all alone in the ER without the family and in so much pain breaks my heart in ways I never thought could be possible.
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post #39 of 54 (permalink) Old 06-29-2020, 08:10 PM
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Titan is in my prayers. I'm so sorry you are both going through this.


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post #40 of 54 (permalink) Old 06-29-2020, 08:18 PM
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I know your feelings are probably inevitable, but there is no reason you should beat yourself up with guilt. Right now things are rough, and the outcome is unknown--but I do know that during the time you have had Titan, you have given him a good life and he has felt your love over and over. Your care and concern for him has shone through in all of your posts here.

You are a caring owner who has done all you could do with the information you were able to get. That is the absolute best you can do.

My heart goes out to you. I'll keep you all in my thoughts and prayers tonight.
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post #41 of 54 (permalink) Old 06-29-2020, 08:58 PM
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We will. for sure, be keeping you and Titan in our thoughts and close to our hearts.

John Lichtwardt
Portland OR
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post #42 of 54 (permalink) Old 06-30-2020, 11:06 AM
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Yes, we will keep your boy in our thoughts and hopes.

As others have said--please, don't beat yourself up--it's easy to feel guilt about medical issues like this but you had some really bad luck here with your dilute boy.

In spite of all your effort to find a treatment that worked and sometimes that just happens.

I finally had to let a very nice Dobe go early because of a kidney problem that the vets and I couldn't find an appropriate treatment for. But sometimes it is the very kindest thig you can do for a beloved pet.

And I'm sorrier than I can say that you can't even visit him because of COVID-19.

Keep us posted here and I'll be hoping for the best.

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post #43 of 54 (permalink) Old 06-30-2020, 07:34 PM Thread Starter
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Thank you so much for the support guys. My mother was allowed to see Titan today, only 1 person was allowed visitation bc of covid. Heís able to walk now, and thereís a tail wag, so I am incredibly hopeful. He is currently in stable condition. He was administered barium 3 times total since last night. His RBC count dropped only by 1%. That means the barium is working. They want to keep him for another 24 hours to administer another round of barium tonight and monitor vitals and RBC count to make sure there wonít be any significant drop. Hopefully, Iíll be able to make a full recovery from here onwards.

This aside, I want to ask you guysí opinion regarding prednisone. Titan was on 80mg per day for the first 7 days, and 40mg per day for the second 7 days and 40mg every other day for the third week. Initially, I trusted the vet and administered the meds as instructed, but upon hearing the ER vetís assessment, I am wondering whether Titan couldíve reacted bc of prednisone overdose?
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post #44 of 54 (permalink) Old 07-01-2020, 01:14 AM
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Hi t-

I'm so glad to hear about Titan's improvemnt.

So... The only warning that I remember hearing about, with regard to Pred and stomach irritation, was to avoid using certain NSAIDs. Apparently the combo can possibly have a side effect, exacerbating the NSAIDs potential to cause gastric problems. But that was in conjunction with long term usage. And even then, it was something that we never ran into. But we are talking about long term relatively low doses in our situation, so I cannot comment on the short term high dosage that Titan was receiving.

Best to you and your boy

John Lichtwardt
Portland OR

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post #45 of 54 (permalink) Old 07-01-2020, 05:57 AM
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https://www.whole-dog-journal.com/he...ogs-pros-cons/

Here is an article that provides some details that might be helpful.

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post #46 of 54 (permalink) Old 07-01-2020, 08:00 AM
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A couple of things to keep in mind - every medication, all of them, have the potential for side effects. That's the same as in human medicine. Humans can have a bad reaction to a drug, even at the correct dosage used correctly. We don't always know how a human or animal will respond to a drug before it is used. Unfortunately, sometimes there are unknown allergens, or unknown sensitivities. And sometimes there are just small percentages of people or animals that simply have bad reactions or are extremely sensitive to drugs. Medicine isn't a perfect science. While there are some less skilled vets out there, the vast, vast majority of vets are doing a great job caring for our animals.

Additionally, I just want to point out the Whole Dog Journal has a bit of an anti-conventional medicine slant. They tend towards the promotion of natural medicine, so I'd keep that in mind when reading that link. They do often have some good info, but always bear in mind the source bias.

I hope your boy is improving today. I'm praying for him.
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post #47 of 54 (permalink) Old 07-01-2020, 09:17 AM
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IMO there is "the good and the bad" in everything and our pups depend on us for the final decisions regarding their clinical treatments.
My personal practice is to look up numerous articles and look for consistancy when using the internet for research.
So I am in hopes this article might be helpful but there are many more on the same subject.
In turn this ....shall we say "research" allows you to present questions to your chosen professionals.
Really glad to hear your pup is feeling better.
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post #48 of 54 (permalink) Old 07-01-2020, 09:25 AM
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I also wasn't clear from your post if your regular vet was one you've had for a while?

I'm a firm believer in trying to find a great vet and establishing a good relationship with them. Like Di said, it's good to bring your questions to your vet, and then discuss. I've had the same vet for about a decade, and we have the type of relationship where I can ask her opinion about things, she will tell me what she would do for her own dogs, and she loves my dogs probably as much as I do. I absolutely respect and trust her education and experience. She knows far more about her field than I do. If I have a question about something that I've heard, she's more than willing to research it for me.

Everyone deserves that kind of relationship, but you also have to put in a little bit of work to get it. (Prefacing this as a general statement - not saying you haven't done this!) You have to treat your vet with respect, value them, have a good back and forth, etc. Find the vet that you can have this kind of relationship with. There's a lot of anti-vet sentiment online, so I get a bit twitchy about that. Off my soap-box now. Again, NOT directed at the OP, just in general.

OP, please, please continue to update us on your boy.


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post #49 of 54 (permalink) Old 07-01-2020, 09:57 AM
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Me : Trust but verify
I work in clinical setting for humans but I believe vet clinics are very similar.
You know a waiting room full of people ......rush rush rush to stay on schedule.
So over the years here is what I have learned about clinic settings, doctors will provide recommendations and also answer any questions that you KNOW to ask.
Docs can tell when you have done your homework by the questions that you ask. That gets a doctors attention in a positive way.
Several years ago I took Hoss to a neurologist as he was experiencing neck pain after lots of lab work and imaging studies the diagnosis was an inflamed nerve.
The neurologist wanted to place Hoss on steroids for the neck pain.
Although after researching the recommended steroid I was very concerned about the side effects.
Fortunately I was lucky enough to have a strong relationship along with a very very conservative vet.
We ( the vet and I ) called the neurologist and asked if it would be beneficial to do some additional anti-inflam. and save the steroids as a last resort.
The specialist agreed that would be an alternative .........after 3 or 4 months the neck pain went away for my Hoss. Never had to use the steroids.
It just seems meds can fix some problems yet cause others so trust your vet ...but always verify and present your questions.
Even now as your pup is recovering continue to do your homework and never hesitate to question any clinical treatments.
Hoping your petting your dog as I write this ......peace be with you.

Hoss
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post #50 of 54 (permalink) Old 07-03-2020, 11:34 AM Thread Starter
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Hello everyone. Thank you so much for all the prayers. Titan is finally out of the woods and home with me now. Initially they thought this was nonregenarative anemia bc his reticulocyte came back as very low. I had 2 vets telling me 2 different things. His private practice vet said that based on Titanís blood test, his marrow doesnít seem like theyíre making any new RBC. The ER vet on the contrary said that Titanís body is probably just taking some time to make new RBC bc it was in so much shock and had lost so much blood in such a short amount of time.

The ER vets kept him under observation for 3 days and administered 3 rounds of barium. Today, his stool is finally light brown, and no specks of black at all. Heís going to be on a lot of stomach medications for at least a month for his stomach/intestines to recover.
The first night I brought him home he was still very visibly tired. But heís been slowly getting better and livelier eversince. Eating and drinking normal.
He was seen by his normal vet this morning for a hematocrit and his RBC went from 22% to 32%, higher than when he was released from the ER.
Today, he actually started playing with his toys. Iím having a very hard time keeping him in 1 place bc he likes to follow us around the house all the time.

I am incredibly hopeful that He will make a full recovery.

As for his vet, heís actually not TitanĎs regular vet. The one whoís been seeing him since he was a puppy closed down, and this vet was a recommendation from my colleague. Heís only been seeing Titan for his skin condition. I trusted all his diagnosis and his professional opinion. Thatís not to say that I no longer do, I still do, but I have my reservations.

Also, do you guys have any suggestions on how to keep hiM put in 1 place? I donít want him to over exert himself too much, but itís
Difficult to make him listen bc he always wants to
Be part of whatever weíre doing. I have attached photos of him while in the ER and of him this morning. He still has a long road to recovery, but I am hopeful. I am so greatful to everyone here and their support and so greatful that he is still with me.
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