Losing Weight On Prednisone-How Much Is Okay?

[Shaysmom]

My sweet boy, Seamus, 9 years old, has been taking prednisone for a little over a month for a neck problem. In that time, he has lost ten pounds, which has me very worried. His appetite is excellent (even ravenous), and he licks his bowl clean every meal. His regular vet thinks it is a concern and told me to give him more calories to see if we can get him to gain a little back. He doesn't think that prednisone should cause such a dramatic loss and wants to do more tests if he doesn't gain weight. His blood work (taken last week) looked normal.

 

The orthopedic vet, on the other hand, thinks that it could be a result of muscle wasting from the pred and lack of exercise. He is the doc who saw Seamus for the neck pain and gave him the pred. He also said to up his calories and see it that helps.

 

Seamus has suffered with back end pain and weakness for over two years--and is also taking Gabapentin. I can see how much more frail he is right now, and I worry that his back legs will just start to give out because of the muscle loss.

 

Can prednisone cause such an extreme weight loss? What are the best ways to up his calories? There really is nothing he won't eat.

 

 

[greyhead]

Yes, pred causes muscle wasting and weight loss in GH's. It must be given for something like cancer, but I can't see keeping your dog on it for neck pain. We've used Tramadol and gabapentin for lumbosacral stenosis, as well as acupuncture and chiropractic. Perhaps there's an anti-inflammatory that would help your dog too. But, yes, after losing 10 pounds and age 9, I'd stop the pred. The vet who doesn't think it's the pred causing it doesn't know greyhounds well enough, IMO.

 

ETA: When one of my greys was on it briefly, he lost 5 lbs in three days. That's when we stopped.

Edited September 17, 2013 by greyhead

[Houndtime]

Fuzzy had diarrhea and lost 6 lbs. When they put him on pred, he lost another 4. I started to wean him off and today should be his last day.

[Shaysmom]

Yes, pred causes muscle wasting and weight loss in GH's. It must be given for something like cancer, but I can't see keeping your dog on it for neck pain. We've used Tramadol and gabapentin for lumbosacral stenosis, as well as acupuncture and chiropractic. Perhaps there's an anti-inflammatory that would help your dog too. But, yes, after losing 10 pounds and age 9, I'd stop the pred. The vet who doesn't think it's the pred causing it doesn't know greyhounds well enough, IMO.

 

ETA: When one of my greys was on it briefly, he lost 5 lbs in three days. That's when we stopped.

When the neck pain started, he was on Gabapentin and Tramadol, and he was still crying out in pain. The ortho vet thought it had to be something serious for him to be crying out while on those two pain meds, and suggested a tumor or herniated disc. The xrays showed nothing so he put him in the prednisone with the thought that it would give him relief, which it did right away. An MRI is not an option for us, and the pred was the next best thing, I guess. He didn't think anti-inflamatories would help. I want to wean him off the prednisone and try something else. The vet is reluctant to do that, but will if I insist.

[greyhead]

I hope someone who has faced a similar problem with chime in with good suggestions. We did use vanilla Ensure to add more calories whenever needed, but only a half-bottle at a time. (We had GI issues, and too much Ensure at once made the poops too loose. YMMV.) But I don't recall hearing much that would make for optimism that you can really stop the weight melt while on the pred.

 

If you'll share what area of Oregon you're in, I can help find a certified acupuncture and/or chiropractor vet. (Ours is both and lives in Olympia, WA.) They can tell a lot just by using their hands when x-rays don't reveal the problem.

[Shaysmom]

I hope someone who has faced a similar problem with chime in with good suggestions. We did use vanilla Ensure to add more calories whenever needed, but only a half-bottle at a time. (We had GI issues, and too much Ensure at once made the poops too loose. YMMV.) But I don't recall hearing much that would make for optimism that you can really stop the weight melt while on the pred.

 

If you'll share what area of Oregon you're in, I can help find a certified acupuncture and/or chiropractor vet. (Ours is both and lives in Olympia, WA.) They can tell a lot just by using their hands when x-rays don't reveal the problem.

Thanks, we live in Eugene.

[greyhead]

Found Dr. Matthew Fricke at McKenzie Animal Hospital in Springfield. (See http://mahpc.com/ ) He does a range of things that could help, though I found him on the AAVA web site while looking for members. I think all the practitioners on that web site are certified, but it doesn't explicitly say so; or at least I didn't see it. I'll keep looking for other practitioners, but this could get you started.

 

ETA: The AAVA page for Oregon practitioner search:

http://www.aava.org/search/newsearch.asp?bst=&cdlGroupID=&txt_country=United+States&txt_statelist=Oregon&txt_state=Oregon&ERR_LS_20130917_153905_20679=txt_statelist%7CLocation%7C20%7C0%7C%7C0

 

Here's the certified chiropractor site: http://www.avcadoctors.com/ Follow the links, starting with Find An AVCA Doctor. I wasn't sure how close some of those docs are to you.

 

It looks to me like Fricke might be a good, nearby place to start! Maybe you won't need a chiropractor specifically. Best of luck!

Edited September 17, 2013 by greyhead

[greyhead]

Thanks, we live in Eugene.

I added more stuff to my post, so I wanted to be sure you knew that. There are more certifying bodies than the two I consulted, but these were the two I used. Not entirely up on Oregon geography, but I hope this helps.

[Shaysmom]

Thank you! I will look into that. Springfield is very close to us. Seamus saw a chiropractor a few years back, but at that time, it didn't really help (for hind end weakness, not his neck). Just this last year, he had cold laser therapy and underwater treadmill work, again with no improvement. The one thing we haven't tried is acupuncture, and I have been told it can really make a difference for some dogs.

[KF_in_Georgia]

When I needed to fatten up an older dog, all I did was give him more of what he already ate. We went from 3 cups a day to 4 cups on a smallish--65 pound--boy.

 

Please be careful about giving fattening food: that can trigger diarrhea and all kinds of trouble. I knew Sam would be okay with eggs, so I gave him an egg a day (microwaved in a custard dish, so no significant fats added). That and extra kibble, and rice on a few nights, too.

 

If four cups a day is too much at individual meals, feed him more meals. I was giving Sam three meals a day (a bedtime meal). Then, once I started working from home, we went to four meals a day because his back end was giving him trouble and it was hard for him to stay on his feet through a big meal.

[Hawthorn]

What dose of pred is he on?

 

My boy Sunny lost a huge amount of weight and muscle (he was truly skeletal - we nearly lost him) whilst on a high dose (100mg daily) for a serious autoimmune disease but started to regain it once we got down to the lower doses. He's been on a low dose of 7.5mg every other day for the last few months and has now regained all his weight (in fact we had to put him on a little diet as he got too fat!) and about 80% of his muscle mass.

 

We managed the weight loss as best we could by feeding him 5 good-sized meals a day and as many (lowish-fat) treats as he'd eat. We avoided giving him high-fat food because being on steroids makes them more prone to pancreatitis.

 

Regaining the muscles seems to be harder, for us anyway, but we are continuing to see improvements as he is able to exercise more.

[Shaysmom]

He is taking 20 mg total per day. The vet started him out at 80 mg. per day, which was a disaster. Seamus was peeing huge amounts every hour nonstop, even through the night. He was having several accidents in the house each day and not getting any sleep (us either). We kept reducing it down until we found a place where the peeing wasn't so extreme. The vet said I can reduce it again by half starting this weekend.

 

It sounds like I need to feed him more meals in a day. I didn't think about the possible problems with higher fat foods. That is good to know. I was picturing feeding him cheese and peanut butter.

 

It does seem like once they lose the muscle, it would be hard to gain it back. That worries me.

[tbhounds]

Have you tried robaxin for your boy yet???

[Shaysmom]

No, we haven't tried robaxin. I am not familiar with it--might that work instead of the prednisone? I asked the vet about alternatives to the pred when Seamus started having such extreme side effects, but he wasn't optimistic that anything else would do the trick. That was frustrating.

[Hawthorn]

I just checked back on the records I kept when Sunny was ill and the dose of pred he was on when he started to regain his weight was 12.5mg every day. With each subsequent dose reduction we saw more improvement. You may find that when you reduce the dose, and especially when you can go to an every other day dose, that the weight loss improves. We have no side effects at all now that we're on 7.5mg every other day.

 

The muscle loss is a worry, I agree, and I can't be much help there. There are some supplements that can help with muscle regeneration and maintenance (I give Sunny half a teaspoon of L-Glutamine powder a day and 90mg CoenzymeQ10) and we are definitely seeing improvements. The other thing I do is trot up hills with him as often as possible (fortunately we live in a hilly area so this is easy for us) and I think this is helping. Physiotherapy of some kind is another option we've considered but I really don't want to stress Sunny out with more vet visits (stress affects the immune system) so as we're seeing improvements with what we're doing we're just going to continue with that for the time being.

 

Hope you find something that works for Seamus. Perhaps he won't need to stay on the steroids once they've done their job, or he will be OK on a lower dose?

[tbhounds]

No, we haven't tried robaxin. I am not familiar with it--might that work instead of the prednisone? I asked the vet about alternatives to the pred when Seamus started having such extreme side effects, but he wasn't optimistic that anything else would do the trick. That was frustrating.

My girl has IVDD and I found the best combo that works for her is a NSAID (Deramaxx), Tramadol, and Robaxin (muscle relaxer). Gabapentin could be safely added if needed. Honestly, I would ask about starting robaxin while reducing the pred.

[racindog]

Yes. Aggie had to take it too and even at only 10mg/day she literally melted away in front of my eyes. Like you I am not sure the extreme muscle loss is not responsible for literally making them so weak they can't go. It is heartbreaking to watch. It was impossible to compensate for it by food intake-it literally melted her life away day by day right in front of me. I don't know what to say but you asked and I'm just being honest with my prednisone experience. I love Seamie. Please give him a gentle hug and kiss for me. Cash had extreme neck damage and extreme pain but we used tramadol etc. for her and it worked and we were spared the prednisone nightmare. Robaxin is good too. That is what Momma is on. Momma has neck issue too-robaxin is amazing stuff-really helps her- and it causes her no side effects.

Edited September 18, 2013 by racindog

[o_rooly]

Another vote for trying robaxin/methocarbamol. It has made a HUGE difference for Aston in terms of his lumbosacral stenosis.

[Shaysmom]

I will talk to the vet about other medicine options. Thank you to everyone for your suggestions and advice.

 

How do you find a vet that is knowledgeable with pain management issues and drug combinations that work? We have seen 4 different vets in the last two years, and not one has really been able to offer much beyond the basics. Should I go in with the information and just ask for what I want? I already feel like a big thorn in their side when I go.

[greyhead]

Did you adopt Seamus locally. You could ask people in the greyhound adoption group who they use. ETA: Even if you didn't adopt from them, there are one or two greyhound adoption groups in Oregon that could be helpful.

Edited September 18, 2013 by greyhead

[Shaysmom]

Yes, I actually volunteer with our local adoption group, which is a small branch of a larger group two hours away. This new vet we are trying is on recommendation of someone in our group. We are in a city of 150,000, but it seems very small when it comes to vets for some reason. Most suggestions for excellent vets involve driving to the bigger city for care. That is where we would have to go for neurology and also MRI. Seamus is an anxious car rider and anxious at the vet, so I hesitate to put him through that usually. But within our community, I am starting to feel like a serial vet-hopper.

[greyhead]

I still wonder if you'd do best to see the vet practice in Springfield. Our acupuncture/chiro vet also writes greyhound-savvy prescriptions for pain control when needed. But in any case I wish you the best in getting through this and hope you'll let us know how things evolve.

 

We went through a couple supposedly savvy vets the first year we had our first greyhound before the third finally diagnosed the problem. Even then, the treatment wasn't adequate. We moved 30 miles away and landed with a fourth vet. But we've needed specialists too, such as the acu/chiro vet who is basically a rehab vet. It happens and isn't anything to feel guilty about!

[Burpdog]

20mg per day for a neck problem for a month is huge.

 

I hope you go to the acupuncture vet

[KF_in_Georgia]

My vet doesn't know everything about greyhounds--but he realizes that. I've gone in and told him what I read here. He's willing to take that info and go Google and otherwise search the internet and ved-med sites and get recommendations. At a chiropractor's suggestion, my vet added Robaxin when Sam's arthritis put him in a lot of back pain. After Greytalk's suggestion, my vet researched gabapentin and prescribed it for Sam. (As much as 900mg a day for my boy, and my vet wrote the script for 100mg capsules so I could control the dosing better than with 300mg capsules I'd have to split--total amount and dosage as recommended here on Greytalk.) We managed to stay off prednisone completely for Sam (although we used it briefly for the girl dog who had a bad skin infection).

 

Be careful about meloxicam vs metacam. Metacam is a liquid and is more expensive--and possibly not available at a regular pharmacy. Meloxicam is a pill version that humans take, but it's appears to be much rougher on a dog's stomach and can trigger ulcers, which happened with Sam. I'm pretty sure you can't use either meloxicam or metacam while your boy is on prednisone, but your vet might want to use one as an anti-inflammatory once you've managed to phase out the pred.

[Guest blueberri]

Sparky went on Prednisone as a trial for lumbosacral stenosis, to see whether the epidural steroids were likely to alleviate his symptoms. He was on it for a week, and within days it was clear he was losing weight dramatically. Ended up increasing both the quantity and frequency of feeds to try and keep condition on him. By the end of the week he was eating 3 x his usual, but weighed 6 kilos lighter (and that was with him having recovered some of the weight already). It was a scary-fast process, and the vet was shocked... but then Sparky's had major issues with both Rimadyl and Apo-morphine.

 

I'd be concerned at staying on the steroids that long. If there is an area of inflammation, surely a depot steroid shot would be more effective, and less likely to cause systemic effects?