Is There Anything Left To Do?

[Guest LittleGreys]

As some may know, Munchie has a very long and complicated medical history. To try to sum it up briefly, she has erosive polyarthritis of Greyhounds. She has been battling this roughly 3 and 1/2 years. She has been on pred since diagnosed. She is currently on pred 25mg once a day, tramadol 50 mg three times a day, imuran 25mg every other day and she gets Adequan injections every 4 days. She has chronic urinary tract infection, and by chronic, I mean ALWAYS. She switches antibiotics every 7-10 days because the bacteria becomes resistant to the one she is on. She has been on pretty much every antibiotic out there. She has been on cipro for 10 days, and her urine today is swarming with motile bacteria and is full of pus. Lovely. We will be switching to clavamox. She is on a cranberry supplement also. I am at my wit's end. We check a urine and culture every week. She is never NOT on an antibiotic. She is painful from her EPG and she has a huge corn on her front foot. I am starting to feel like it is time to make a decision and it is a decision I cannot make. She just turned 5 years old, she is a therapy dog, she is the love of our lives. Its not fair. I guess maybe I am just venting more than anything, but if anyone has ANY ideas, I am game. I am losing her and I don't want to lose her.

Edited May 27, 2011 by LittleGreys

[greyhead]

I have no advice to offer, but I surely hope someone will. I don't want you to lose her either!!

[Batmom]

What does the culture show the bacteria to be sensitive to? If it's sensitive to more than one antibiotic, have you and vet considered giving a combo? E.g., Zeniquin and clavamox. Or IV antibiotics as LindsaySF's Chase had to have.

 

I'm sorry she's poorly. I hope very much that she can beat the UTI and the corn.

[Tallgreydogmom]

Have you consulted with Dr Couto and the Greyhound Team at OSU? Please contact Jane Varley (joejoesmom). She is the foster home coordinator for out of town greyhounds in case Munchie can go to Columbus to be looked at. Five is just too young for all her problems. Please give them a chance to look at her.

[Guest LittleGreys]

The culture results are different every time. One week it will be pseudomonas, the next proteus, the next e. coli, etc and all are getting resistant to everything.

We have been to OSU as well as an orthopedist at the referral hospital in Pittsburgh,and consulting with Dr Couto online.

[Guest BlueCrab]

I'm sorry to hear about Munchie's problems. I know it must be absolutely exasperating for you to watch this.

 

I know nothing about the disease, but just want to throw out the thought: is there any chance going completely holistic could do anything? I know people like Jen / Neyla's Mom has done a lot of research and has experience with hoslitic medicine when she was struggling with Neyla's cancer. Not the same malady of course, but thinking of the principle that sometimes going off all man-made stuff and just getting down to the basics of holistic meds have solved problems in humans that other drugs couldn't help.

 

Perhaps worth looking into? She's still so young I would think there would be some sort of options out there . Keeping you and Munchie in my thoughts.

[4My2Greys]

This may be reaching far but have you ever considered Celiac Disease (gluten intolerance) as the cause of all his problems. Because it affects the immune system Celiac Disease can be the underlying problem of so many health issues, one of these being arthritis. Also found that it is linked to a high number of incidences of urinary tract infections because of weakened immune system.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1511510/pdf/archdisch00616-0084.pdf

 

The chances that this is his problem might be slim but wouldn't it be nice if all his problems could be resolved with a change in diet.

[tbhounds]

Having them on pred and imurane will predispose them to infections-- whether it's skin or bladder related. One thing to keep in mind is that you need to be careful which antibotic you choose when you are trying to supress the immune system. Some antibotics will "jump start" the immune system and thereby causing a flair. Have you used Baytril before?

[Guest MonsterMomma]

Prednisone is a powerful immune suppressant, and is likely the cause of the UTI, especially since it's not always the same pathogen. Can you control her polyarthritis symptoms without prednisone, by increasing the imuran and/or adequan?

Edited May 27, 2011 by MonsterMomma

[Guest LittleGreys]

Prednisone is a powerful immune suppressant, and is likely the cause of the UTI, especially since it's not always the same pathogen. Can you control her polyarthritis symptoms without prednisone, by increasing the imuran and/or adequan?

 

Yeh, I know that is what is causing it. That is the problem, she cannot go on any lower dose. Actually, the vet saw her today and her hips are so painful (which just started yesterday that I noticed), the vet increased her pred to 50mg. We can't increase the imuran because last time it bottomed out her white cell count. She has been off the imuran for awhile, so I just started her back on at a lower dose since she is getting so bad. Her hair is all falling out and she has open sores on her skin from the pred, so I am going to try the imuran again to see if it will do anything. Praying it works.

[tbhounds]

Do you have your hound on gabapentin? The dosage can be increased to a crazy high amount extremely safely-- can be given safely with just about any other drug. You might notice a little sedation when first starting the drug but, that resolves rather quickly. Gabapentin is also rather inexpensive.

[tbhounds]

Just had another thought-- maybe you ask about starting your hound on amantadine too. If you can get her pain under control than maybe you can reduce her pred.

[Guest sweetpea]

When I was researching greyhounds, I came across an article similar to this one about chronic UTI's.

 

I don't know if it even correlates to your situation, but I thought I'd pass it on.

 

good luck,

Buzzy

[ShantisMom]

I am so sorry. Shanti had so many problems on prednisone and imuran. Munchie is so young. Not fair! I wish I knew of something you could do. Lord knows you are trying everything!

[DaisyDoodle]

Have the vets talked about the problems from using pred every day? It can cause drug-induced Cushings by suppressing the activity of the adrenal system. I don't know if it's possible to go to every other day, but it might help balance her system a bit.

 

Also, I'd try any & every probiotic I could get my hands on. Good quality plain yogurt with multiple active cultures, Kefir (a yogurt-like drink with different cultures), supplements from a health food store etc.

 

I'm so sorry you can't find a satisfactory treatment for your poor baby.

[Guest eaglflyt]

I do understand about UTIs and necessary immune system suppression. If bacteria can find its way up the urethra to the bladder, it will happen.

 

I'm just going to offer what helped our girl with her repeated UTI's. She had an episoplasty done March 2010 and we haven't had a UTI since. Our girl wasn't immunosuppressed, so that is a consideration when having surgery, but it did rid her of the bacterial reservoir of having a recessed vulva and large skin flap over her vulva.

 

Every time we would get one UTI cleared, another was on it's heels in a matter of a week, or two, at most. We had numerous cultures and sensetivities done on her urine and every time we got her clear, another hit within days. She was on numerous courses of various antibiotics.

 

Possibly if your girl has a recessed vulva (and personally, I've never seen a female greyhound that didn't!), the episioplasty could help remove a significant source of bacterial reservoir and contamination. I know she is much more prone to UTIs since her suppressed immune system doesn't try to fight the bacteria much at all, but removing a source of the bacterial contamination might certainly help.

 

Here's a LINK for further info. I also have several other links if your are interested.

Edited May 29, 2011 by eaglflyt

[NHNora]

I am not an herbalist myself, but my pet rabbit kept getting UTIs and the handbook that I have has an herbal section at the back. There are a number of things besides cranberry that can help, so maybe check with a professional in your area about some other supplements? I now have uva ursi for my rabbit, but haven't had a chance to try it yet (luckily!!).

[Guest LittleGreys]

Eaglflyt, thank you for the info. I do think my girl's vulvular folds definitely contribute to the problem. I try to keep "that area" scrubbed with surgical scrub, but she is constantly licking. I have thought about the surgery before, but am not sure about healing on high dose pred. I am for sure going to discuss this with her vet on Tuesday. We hope to be able to decrease her pred dose soon. She is now on 60mg once a day. I also started her on Clavamox three times a day and she has improved greatly in the last 2 days. She is up playing with her toys again. I think she was getting really sick with the UTI and I didn't realize it in time because she was on the cipro and wasn't peeing the bed, which she will usually do when the bacteria return. I will just have to be more vigilant.

[Guest eaglflyt]

I really understand the difficulty of trying to make the right decision for your hound and not wanting to put her at risk with any decision. It's a very difficult situation. I'll be keeping both of you in my prayers and wishing the very best for your girl.

 

Here's some more additional info. regarding the success of the procedure that I found helpful:

 

Study link

Edited May 30, 2011 by eaglflyt

[Guest FullMetalFrank]

As a person with rheuamatoid arthritis, I feel your pain. Pred and immunosuppressant drugs mess us up; but without them, joint pain makes life miserable! I am glad she is feeling better, even if it's temporary I pray you can find a combo of meds that will make her life easier. I also suggest trying the gabapentin; I take it and because of it I think I am able to take a little less pred.

[Guest BiancasMom]

Poor Munchie! I see you said you took her to an orthopedist. Have you tried and internist? They should be able to help regulate her arthritis and help with the UTI. Maybe there are other immunosuppressants she can try so she can be on a lower pred dose? I see someone suggested amantidine. Maybe cyclosporine? I know it can work for other immune related diseases. So sorry she is going through this. She is way too young.

[Tallgreydogmom]

Our greyhound Candy had the recessed vulva. She had the surgery and she was very happy with it. So were we. I would not hesitate to have another one have that surgery. I realize you are dealing with other problems also. Hope this helps.

 

Hugs to Munchie.

[Guest LittleGreys]

So I just checked a urine, and it is full of bacteria. Not good. Only 3 and 1/2 days on the clavamox. And she is weak/unsteady on her hind legs today. This is so frustrating. I talked to the vet about the surgery and she basically said she would not be a candidate due to the immunosuppression.

[tbhounds]

Yikes-- I do agree with your vet-- she would never heal being that surpressed. Have you tried a heavy hitter antibotic like baytril or Orbax? Baytril will also not "jump start" her immune system like some other abs do. Is she on any sort of pain meds besides tramadol?

[Guest LittleGreys]

Yikes-- I do agree with your vet-- she would never heal being that surpressed. Have you tried a heavy hitter antibotic like baytril or Orbax? Baytril will also not "jump start" her immune system like some other abs do. Is she on any sort of pain meds besides tramadol?

She has been on Baytril in the past, not recently, we did cipro instead. She is only on tramadol for pain. I am going to ask about some other meds tomorrow. I don't think the tramadol does much anyway. I think I may skip tonight's dose. She is acting weird today, wobbly or weak. She has been on this dose of tramadol for awhile, so I don't think that's it, but may try it and see what happens.