Using Cytosar (Chemo Treatment) For Meningoencephalitis?

[arandomchic]

Does anyone have experience with using Cyotsar (aka Cytarabine or cytosine arabinoside) in treating meningoencephalitis in their hound? It’s going to be administered by IV over 48 hours, which apparently is the most effective method currently (versus the injections previously used). I’d love to get some real life input on what to expect during and after her treatment.

 

 

Background:

In early May, Molly (7 years old) was diagnosed with Immune-mediated meningoencephalitis after she began having severe stumbling (rear legs) and other neurological symptoms. An MRI and a spinal tap confirmed diagnosis. She was started on doxycycline while we waited for the test results came back to rule out a tick-born illness, and started on a high dose of prednisone (30mg 2x daily) when the test results showed it was likely autoimmune. We saw great results within days of starting the steroids, she was able to walk better, regain overall motor coordination, squat to pee/poo, and in general was more mobile. Mentally she began to normalize as well. She continued to improve for about two weeks, then the last few days before our next vet check-up we notice the progress had stalled and she was starting to show negative symptoms of the steroids. In addition to the normal hunger and frequent urination, she was starting to lose muscle mass and become more lethargic. She had dropped nearly 10 pounds since we had weighed her a month previously during a regular vet visit.

 

At the check up, our neurologist was happy with much of her progress. Her neck pain had subsided and her mental capacity was back to normal (minus the prednisone zombie look). The rear limb ataxia was much improved though not completely gone. She still stumbled a little and her gait was very unsteady. However, she was very concerned with the muscle atrophy. We started to discuss other immunosuppressant drugs to add that would allow us to more quickly reduce the prednisone based on the side effects it was causing. Unfortunately, blood tests showed elevated liver enzymes which would prevent us from adding a second immunosuppressant right away.

 

So after continuing with prednisone another couple of weeks and adding in a liver supplement (denamarin) to address the liver issues, we’ve seen some small but good progress overall. Her ataxia has continued to improve bit by bit and she seems more alert. She’s got a little bounce in her step when she’s heading to her dinner. The muscle atrophy has only mildly gotten worse, so she’s weaker from that…but more stable from the prednisone.

 

Based on Molly’s current status the vet wants to add in the second immunosuppressant, Cytosar (aka Cytarabine or cytosine arabinoside). It’s a chemo drug that should suppress the immune system and allow us to more quickly reduce the prednisone to a level that Molly can better tolerate much more quickly than most of the other options. The vet is hopeful based on Molly's progress so far that only one treatment may be needed, which would be great for all of us. Based on everything I’ve read, it’s also safer than many of the other chemo drugs used to help treat her disease (especially for liver toxicity). We know she cannot stay on steroids at this level much longer, so we’re willing to try the next option to get her autoimmune disease under control so we can begin long term treatment options.

Edited June 6, 2013 by arandomchic

[Houndtime]

I can't give you an opinion or advice, just wish you and your girl a lot of luck with the treatment. G-d bless.

[KF_in_Georgia]

Take a look at blog posts here. The sick dog was Zephyr. These posts start in March 2011, and I'll spoil the ending by telling you Zephyr's still around (suffering from hives in mid-May after something or other bit him on the head--but otherwise fine). I haven't looked at these posts in a while, but I think I remember there's info on who treated Zephyr and what treatment was given.

 

You can skip to the latest posts and make a comment for Zephyr's mom to see and perhaps she'll get in touch with you. I think she also is here on Greytalk, but I'm not sure how active she is.

 

ETA: She was on Greytalk earlier today, so perhaps you can PM her. http://forum.greytalk.com/index.php/user/20737-hikinghounds/

Edited June 4, 2013 by KF_in_Georgia

[arandomchic]

@Houndtime - thanks for the well wishes. It's been scary and stressful.

 

@KF_in_Georgia - thanks! I read through the blog, and while it's a different diagnosis, it did help. I'll reach out to her.

[Guest larock]

I do. Our Wardy was on it for 18 months to control his GME,. It was admisintered in 4 shots, one every 12 hours. All I can tell you is that other than the logistics of getting him there and back every 12 hours, it did nothing to him other than make him feel better. So as far as my experience goes, it was all good.

[Guest oakley]

So sorry to hear of your lovely lady's situation. My kind boy is going through a disc extrusion operation this Friday and just wanted to share some hope and friendship at this time. hope all improves and thoughts are with you x

[hikinghounds]

I'm so sorry Molly is going through this. I just replied to your message. We are sending lots of positive healing thoughts for Molly.