Prednisone Side Effects

[Guest cypselus]

Our 10.5 year old greyhound has been on 80 mg of prednisone, along with 200 mg of doxycycline and 100 mg of cyclosporin for thrombocytopenia. His platelets had dropped to 7,000 last Thursday from 90,000 the preceding Friday when I took him in for swollen paws and bruising, so something drastic was in order. He's suffering the usual prednisone side effects. He's anxious, he's losing weight, drinking like a fish, urinating constantly, and panting all the time. He's also trembling as he lies in his dog bed. Can prednisone do this?

 

I don't know how much more of this he can take, or how much longer I can keep doing it to him. His bruising is gone, and there's no blood in his urine anymore, but he seems so weak and restless.

[KF_in_Georgia]

Prednisone can do this. And the thrombocytopenia -- along with the drug cocktail -- can make your boy miserable, aside from the Prednisone.

 

I'm afraid I don't have much counsel to give in this situation. I lost my Jacey to IMT just four weeks ago. The massive doses of Pred she got couldn't turn the IMT around, and she went from fine on Tuesday (8/16) to hospitalized three days later (8/19); three days after that (8/22), we put her to sleep when she developed other complications, at least one of which would have been fatal even without the IMT. Jacey was 8.

 

If all your boy's current discomfort is pred-related, then I think it will ease up as you're able to taper off the Pred dosage. We just never got that far on Jacey. How's your boy's platelet count now? And is he home? (Jacey was never stable enough to come home.)

[Guest cypselus]

I read about Jacey while frantically searching for information on thrombocytopenia. I'm so sorry.

 

His platelets were up to 37000 on Saturday. I will take him back for another test tomorrow. He has been home the whole time.

 

He seemed healthier at 7000

 

We don't know if it's IMT. Ultrasound showed something about 1.6 cm across on his spleen. We're not sure it's cancer, and after last year's cancer that wasn't, I'm not quite ready to assume that it is on the basis of an ultrasound, but it's not encouraging, either.

[KF_in_Georgia]

Don't let Jacey's case scare you. Your boy has already lived longer than she did after the thrombocytopenia diagnosis--and your boy's platelet count was worse than hers was. And Jacey was so desperately ill that hospitalization was necessary from the get-go. (Her vet's office took one look at her on Friday morning, said she needed to go straight to the ER, phoned ahead to the hospital, plugged in a catheter, and carried her out to my car for me. We were at the vet's office only 20 minutes before we hit the road for the ER.)

 

You know, dogs can survive without a spleen. And although it's certainly not minor surgery, I think it doesn't have a super-long recovery time. Harrison may not be healthy enough at this point for the surgery, but it's something to consider.

 

And maybe ask the vet tomorrow if there's something Harrison can take to eliminate the worst side effects of the pred.

 

I'll be thinking about you...

[Guest sweetpea]

Sweetpea had dreadful side effects from prednisone, so much so that it's a "last resort" drug on her file now.

And yes all that you listed she suffered through, including having to pee 18 times in one 24 hour period.

(In a second floor condo, we have to leash walk her.....nightmare)

 

It's awful to think that the cure is worse than the disease, in Sweetpea's case it was just supposed

to be an anti-inflammatory for a neck injury.

 

However, I had a Ridgeback who had a bout with Thrombocytopenia, he responded very well to prednisone

as the treatment and made a full recovery. But he was only on pred. I don't know if the combination

of the other two meds might magnify some of the worst of the pred, or if they have their own side effects

on top of what the pred is doing.

 

Good luck.

 

Buzzy

[tbhounds]

80mgs is a tough dose to deal with- I would have the shakes too. Hopefully, the Drs will slowly start to reduce the dosage Fingers crossed your pup continues to improve.

[KF_in_Georgia]

I seem to remember that cyclosporin can have some nasty side effects, too. I don't remember details (and I'm off to get dressed for work), but you might look up side effects of that drug and see if that's part of Harrison's problem.

 

Good luck.

[XTRAWLD]

Kasey is on a very low dose (10mg twice a week or less). I can't imagine having to give him 80. I feel for you and am so sorry. Kasey pees like a racehorse too with just 10mg, and cannot seem to gain weight, but those are the only side-effects I am aware of, esp since he's on so much of a low dose compared to yours!

[racindog]

Maybe consider some Pepcide to protect his stomach from such a high dose?

[Guest snakes]

My Allie was on pred for thrombocytopenia after a dental and she was the same way although she was so exhausted she couldn't tremble much, she was very intolerant to sunshine as well. Her platelets dropped to 1-2000 (at that point accuracy wasn't an issue). As her platelets started to come up we started lowering her pred dose slowly. She ended up being almost all the way off it before i lost her but i think that was more due to the fact we stopped the doxycycline to early and she was 11.

 

My FedX was very intolerant of cold on pred and would get the shivers very easily.

[Guest cypselus]

Harrison has been on pepcid for over a year, 20 mg 2x a day.

 

He regurgitated a couple of times last night, and this morning he didn't finish his breakfast. He hasn't failed to finish a meal since he had surgery six years ago. Even when his stomach was an inflamed mess and he was eating grass and vomiting every day he'd always clean his bowl. He was too weak to jump in the back of our car, too. He tried, but his legs just couldn't do it. Now I'm really scared.

 

We just got back from the vet. They took blood, and I'll hear results later today. I related his symptoms to the vet tech, and I should be hearing from the internist this afternoon.

 

He's only down a pound. I'm not sure if I'm reassured by that or not.

[Guest cypselus]

Platelets are up to 156,000! But, he looks really, really sick. I just gave him an ondansetron, but if his appetite isn't back tomorrow, he needs another abdominal ultrasound. The vet only wants to drop his prednisone a half-tablet a day, which would put him at 70 mg. She said it could account for most of his symptoms.

[KF_in_Georgia]

Dropping the prednisone dosage slowly is important. Harrison needs that "tapering off" period.

 

Has your vet done chest x-rays? Hate to be scary, but I'm sure you've considered the possibility that the spot on his spleen in the first ultrasound is cancerous. If there is cancer and it has metastasized, often that will show in chest x-rays. That could have a big impact on your treatment protocol for Harrison. But if there are no lung mets (fingers crossed), you can just concentrate on getting his appetite back up to normal.

 

I'm sure you've tried lots of things to tempt him to eat. If he's still willing to drink, try vanilla Ensure. Also, meat baby foods are good--go down easily--as do sweet fruit baby foods and yogurt. (My dogs have always been partial to vanilla yogurt.)

 

And the prevailing opinion seems to be that green tripe is irresistible. (*shudder*)

 

Congratulations on the improvement in his platelet numbers. Having a nice big turnaround like that is so very encouraging.

[Burpdog]

Talk to the vet about reducing to 60mg or 40mg per day. Ask for carafate prescription -- very important for a dog on that much pred & the doxy.

 

Sending prayers

[Guest cypselus]

Cancer is very much on our minds. Harrison had x-rays at his initial evaluation at our regular vet on the 9th, which didn't show any abnormalities. He didn't have a full 3 view chest X-ray, though. I know cancer can move very fast.

[tbhounds]

I would bet the medications are tearing his tummy up. I would get him on carafate asap. You can also get him started on priolec (one a day). Of course always clear all medications with your vet. I had my girl on high doses of pred and the carafate and prilose were a godsent.

Glad to se the platelets are up!!

[Guest cypselus]

Would he take carafate in addition to the pepcid he's already on?

 

He ate his dinner. I gave him canned food (Evanger's duck and sweet potato) mixed with cottage cheese and beef broth. He left specks in his bowl, but this morning he only ate half of his food, and turned up his nose at canned sardines this afternoon, so I'm relieved.

[tbhounds]

Yes, carafate can given while your using pepcid. Carafate is a tummy coater--it should be given at least 1/2 hour prior to food and other medications. I used to give it 1 hour prior which meant getting up earilier in the a.m. but, it really helped so it was worth the loss of one hour sleep.

It's usually given 3 times a day. Sucralfate is the generic name. Please ask your vet for a prescription (btw it's not expensive).

[Burpdog]

Yes, please ask for the carafate! His platelets are in good shape if they are up to 156,000

 

The most pred I've ever had a grey on was 60mg per day. Greys don't do as well with pred as other breeds. You need to talk to the vet......

[Guest cypselus]

We're back from an afternoon at the vet's. He had an ultrasound which found no changes from a week ago when he was still eating like himself (no fluid, no obstruction, pancreas, intestines, stomach all look OK), an FNA of his splenic nodule (which is still the same size), and they looked at a suspicious growth on his haunch, which appeared normal. His blood chemistry is all normal except for an elevated BUN. The vet sent us home with carafate and more ondansetron, and said to lower him to 60mg of prednisone. When we got home, he drank an entire bowl of water in about 20 minutes, laid down on his dog bed, and vomited/regurgitated it all on one of our rugs. He spit out the carafate in a piece of hot dog I offered him shortly after. I noticed too that his rear paws had swollen up a bit, too, which is what prompted us to go to the vet in the first place two weeks ago. She said he could come off the doxycycline if his appetite doesn't improve over the weekend. My poor boy looks terrible.

[KF_in_Georgia]

Perhaps ask your vet about Pentoxifylline. It didn't help Jacey, but it may be useful for your boy and the swelling in his feet.

Edited September 23, 2011 by KF_in_Georgia

[Guest cypselus]

He's hospitalized now since 4:00 AM. His platelets have dropped (maybe, they're rechecking), he hasn't held anything down since yesterday morning, and he was so weak last night he couldn't stand. His heart rate was in the 180s. He's off the doxycycline, and on IV fluids, baytril, and pentoxifylline in addition to the steroids, pepcid, and ondansetron. Candidates are (trying to remember everything) pancreatitis, liver toxicity, infection.

[Burpdog]

Sending lots of prayers.

[KF_in_Georgia]

I'm sorry to hear he's worse. I'll be thinking of you both.

[tbhounds]

Ugh--please keep is posted. I've been there- it is full time job worrying over our babies.