September 23rd, 2008

Hombre

Drugged Out Devon

Poor Devon. He's now on prednisone, azothiaprine (Immuran), cyclosporine and cephalxin.

I took him to see a vet at the Veterinary Specialty Hospital of the Carolinas (www.vshcarolinas.com) yesterday for a second opinion. I was much happier with this consult because I got to speak directly with the internist/oncologist and because this guy has a ton of experience. He had already looked at all the information from the vet school and from my regular vet and was familiar with Devon's case.

His recommendation was to start Devon on cyclosporine and wean him off the prednisone and Immuran. He said that the cyclosporine (brandname Atopica) works on a different part of the immune system (the T cells)so he felt it was definitely worth trying. When I asked him what we'd do if the Atopica didn't work he said something to the effect of "Devon may just have to live with low platelets."

He did seem to think that it would be worth doing a bone marrow aspiration just for the information it would provide even if it didn't change anything we eventually chose to do. At least we would know that if Devon's bone marrow isn't making any platelets then there's no point giving him any of these drugs.

Anyway, I'm supposed to give him the Atopica on top of his other drugs for a week and then start weaning him off the pred. He'll need to have a CBC in a week which is when we'll be at the beach but I'm supposed to have it drawn down there and not wait until we get back to town.

Possibly the most interesting part of the consult was what he said about the "riskiness" of Devon living with low platelets. He didn't seem to think it was so terribly risky or life threatening. He didn't forecast gloom and doom the way the vet school and even my regular vet did. In fact he was pretty casual about it and told me that it really doesn't matter if Devon gets bumped, etc, because it doesn't happen that way. It would be more likely to manifest itself by nosebleeds, blood in the stool or bleeding gums. And he seemed to think it wasn't usually the life threatening event I'd been led to believe it was even when it did happen. Certainly not the crisis situation I'd been led to believe it would be. That was a relief to hear.

But mainly I'm just really eager to get him off the prednisone and let him get back to normal (well, as normal as he ever is :-). I find myself really looking forward to seeing his old personality emerge again. Another interesting thing the vet said was that some dogs actually feel better on prednisone. Something about how it helps their arthritis. And I didn't ask him if it was possible that Devon could ever do agility again but it sounds like he might be able to at least do jumpers courses once he's weaned off it.

Oh, and the Cephalexin he's on is for the horrible nasty pustules all over his stomach because I let him play in the creek. I'd forgotten that now he's on prednisone he's going to be far more vulnerable to skin infections.

But the Cephalexin is only for 10 days and by then he'll be coming off the pred and the Immuran and maybe getting back to being a somewhat normal dog for the first time in 3 months. I can't wait :-)