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Steroid Use In Treating Ehrlichiosis


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What are the reasons for not wanting to use steroids when treating ehrlichiosis? Jax was put on them (20mg once a day) to increase his platelet and red cell counts.His last bloodwork showed RBC 4.56,Hemoglobin 10.0, Hematocrit 33.3, and platelet 296. These are all significantly improved over his prior lows. All other levels are within normal range. He is much better but is still losing about 2lbs a week. He has little appetite and eats about 1/2 his normal intake. He eats dog chow little bites and chicken breasts the best. Should I push to take him off the pred at this point? He can't afford to lose anymore weight. His normal weight was around 75lbs and now he's down to around 63 to 65 lbs.The internist that put him on the steroids is closed until Monday but I am seeing my local vet for his weekly blood draw Thursday night. The draw will include a full panel to see how his kidney and liver funcion is.His ultrasound 2 weeks ago showed enlargement of kidneys liver and spleen.I'm surprised that Jax is even still here,he was really bad 2 wks ago.The internist said the ehrlichia dx could be incidental and he may have a cancer which is causing his weight loss. He recommended BX's of the organs and marrow but I declined because if it is cancer,I would not treat it. Been there before, and it's never a good ending and the vet even said his prognosis would be very poor.So he suggested to just treat him as if it is CE and hope for the best. Even his CE dx was given a guarded to poor prognosis due to the extent that he has been affected.I got off topic question a bit, my main question is could he possibly do better being off the pred. now that his platelets are normal?

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Pred is a double edge sword-darn of you do and really darned if you don't. Personally, I would continue the course of meds as prescribed. In all

likelihood of you stop the pred he will relapse.

I'm assuming they mentioned immune mediated disease as a possibility?

The main reason clinicians are reluctant to start your dog on pred if there is a suspected tbd is the pred will reduce the immune system and therefore giving the tbd full range to flourish.

I feel your pain about the weight loss--I've been there-pred just melts muscle mass off of our hounds-hang in there-I wouldn't change a thing until you speak to the internist.

Is your hound on tummy protectants lime carafate and prilosec????

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Internists are not Gods, especially when they're going to be out of town for that long! If you're not comfortable with the situation -- and I understand completely why you might not be -- perhaps you can have the vet who's doing the bloodwork contact the internist before Monday and relay your concerns. (I'm assuming CE is chronic ehrlichia? It sounds like they say they're treating for ehrlichia but are really covering their bases by treating for other things that could possibly be in play.) Hopefully, your regular vet understands what is being done and why and could also discuss it with you in more detail if you schedule the time.

 

All I can say is that we've dealt with pred, weight loss, misdiagnoses, equivocal diagnoses, and internists at our house and have found our own instincts and observations to be very important in getting our guys through serious illnesses (but not cancer). From what I've seen on GT also, most owners have a very good sense of whether their dogs are doing better or worse. So my best advice would be to take your own concerns seriously, follow up on them sooner rather than later, and try to achieve treatment that you understand and are comfortable with.

Mary with Jumper Jack (2/17/11) and angels Shane (PA's Busta Rime, 12/10/02 - 10/14/16) and Spencer (Dutch Laser, 11/25/00 - 3/29/13).

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Is he on doxy? If he has been on pred over 10 days, you have to go down slowly and not stop quickly from what I understand.

 

To many greys, pred is very bad. I've been lucky with the guys I've had.

 

Will he eat cooked red meat? That is what I give to dogs that need their hemocrit upped.

Diane & The Senior Gang

Burpdog Biscuits

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YES, HE HAS BEEN ON DOXY SINCE 6/13 AND PRED SINCE 6/23.I'LL BE TAKING JAX IN TONIGHT FOR FULL BLOODWORK AND I'LL TALK TO MY VET TO SEE HOW HE FEELS ABOUT THE PRED AND THE INTERNIST ON MONDAY.IF HIS BLOODWORK SHOWS THAT HE IS IN KIDNEY OR LIVER FAILURE I DON'T SEE THAT THERE IS ANY CHANCE FOR RECOVERY.

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Very best wishes for your Jax. Let us know what your vet says. :clover:goodluck:hope

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Deirdre with Conor (Daring Pocobueno), Keeva (Kiowa Mimi Mona), & kittehs Gemma & robthomas.

Our beloved angels Faolin & Liath, & kittehs Mona & Caesar. Remembering Bobby, Doc McCoy, & Chip McGrath.

"He feeds you, pets you, adores you, collects your poop in a bag. There's only one explanation: you are a hairy little god." Nick Galifinakis

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