Treating G M E With Chemo?

[macoduck]

A friend's little yorkie has been diagnosed with GME, granulomatous meningoencephalitis, after she had 5 seizures in a day.

She had an MRI.

Lab work was normal.

She is on prednisone and is to get chemo monthly.

Anyone know exactly why chemo would be used? After searching assorting google finds prednisone is always mentioned but not chemo.

Edited January 30, 2014 by macoduck

[KF_in_Georgia]

Start with this blog post: http://hikinghounds.blogspot.com/2011/03/zephyr-has-been-sick.html

 

Then this one: http://hikinghounds.blogspot.com/2011/03/not-good.html

 

Then keep going. There are explanations of what they tried and why, and I think info on the doctor involved is there, too. Zephyr survived, but it was scary.

 

Also, Zephyr's mom, Hiking Hounds, is here on Greytalk. Try PMing her through Greytalk or through her blog posts.

[greyhndz]

Ducky, check in with Roberta (3greys2cats), whose GH, Sara, lived with GME for several years. She had an amazing outcome, although Roberta lost her 2 years ago. She can describe the diagnostic and treatment plans.

 

One of the authorities on GME is Dr. Alan Sisson at Angell Memorial Hosp in Boston. I brought Lexi to see him when she was quite ill and we were concerned about the possibility of GME. He is an extremely sharp cookie, and after spending a short time with her, and hearing her symptoms, he ruled out GME as her problem, and correctly diagnosed her with immune mediated polyarthritis.

 

This is a very active yahoo group They post many articles and publications by Dr. Sisson and provide support as well as their experiences utilizing different types of immunosuppressive treatment.

 

Actually, I just came across this link to an article by Dr. Sisson. Hope this will answer your questions!

 

ETA: leflunomide is a chemotherapy Dr. Sisson often recommends. Lexi was on this for her IMPA, and really did not have any problems while taking it.

Edited January 30, 2014 by greyhndz

[hikinghounds]

Hi, just saw this. Yes, my Zephyr went through this and is doing great now. I highly recommend the chemo treatment and I think it's the preferred treatment. I think there are different types of GME, some breeds have a tendency to it, and they might be treated differently. Also, I think there's a lot they still don't know about what causes it, etc. We used Lomustine (CCNU) for four chemo treatments over about 5 months. Then he was on procarbazine for about 6 months, but we started reducing the amount at about 4 months. He was also on a low dose of prednisone, 5mg, for about 16 months, and that was reduced during the last 3 months or so. Zephyr has never had a relapse of the encephalitis. He does still take a low dose of Keppra for seizures, which are totally controlled by the Keppra. Some dogs recover and then don't have seizures, but his seizures returned when I tried to reduce and take him off the Keppra. His seizures are likely from small scar tissue that formed from the encephalitis, although it didn't show on his final MRI. I think Roberta's girl Sara didn't have to continue with seizure meds. She was super helpful when I talked to her when Zephyr was sick. It's very scary. Sara's encephalitis never came back either. I hope your friend's pup does well with the treatment and recovers!

[macoduck]

Jordan, thanks for the Dr Sisson link. The yahoo group thing I've never been able to figure out how to do. The specialty clinic told the owner to stay away from reading on the internet. I wanted to make sure that the protocol was reasonable.

 

Hikinghounds, thank you so much for sharing Zephyr's story on your blog. Your posting here makes things sound more hopeful.

[hikinghounds]

I'm so glad the blog helped! There are many posts describing his treatment and progress over the year and a half or so that it went on. I kind of have to agree with the recommendation to not read much on the internet, and that's coming from someone who normally is all over internet research. I did find all the official research or veterinarian articles that I could, but there just wasn't much out there and it was often vague. I found the forums, but in this case for me, I just couldn't spend a lot of time reading them, etc., because it was too scary and upsetting. I think it just depends on the person. I realized there were many kinds of encephalitis and treatment varied. I was already in a total panic and worried sick, and for me reading about the others made it worse and made me second guess things. Zephyr is sensitive and he could tell how upset I was, so I really felt like I needed to stay positive for him to recover. I felt like I was getting him the best treatment I could and worked with and trusted my vet, the neurologist, and the oncologist. I will say that I learned to trust my instinct, speak up, ask questions, and advocate for my dog (always politely, but very thorough) and I know that helped save him. Sorry to go on, it was quite the experience. :-) Again, best wishes to your friend and Yorkie girl.

[3greys2cats]

Just seeing this, Jordan sent to me. When Sara was diagnosed in 2007, we had an MRI and spinal which revealed multi-focal GME, meaning she had several areas of her brain and spinal column with inflammation. She had seizures, was ataxic, swaying, could not stand without falling over, a severe case. They started her on Prednisone, 2 different antibiotics(before they ruled out other infections), Pepcid, Carafate for stomach. After 3 days in ICU we took her home and she had a cluster of seizures, we took her back while in the midst of her seizures and the next day the Neurologist put her on Cytarabine which is a chemo drug used for Leukemia,she was given a 50% chance of survival, it was given by IV and the next day when the Vet was making rounds, she was standing in her cage which she had not been able to do. She was being rolled out on a table to go potty hours before, it was truly miraculous. After a week in ICU, she came home and for the next 10 months, she had Chemo(Cytarabine)every 2 weeks, then every 3 weeks, 4 injections within 48 hours each time, Prednisone, Pepcid, Carafate. Along with this was blood work every 2 weeks to check her white cell count and her kidneys and liver as these drugs can cause damage. She needed to be taught stairs again and we used a harness for the 1st 4 weeks. Sara lived another 5 years, symptom free, ran and walked and played, never had a relapse as all the articles I read said would happen, GME is not curable but can be pushed into remission like cancer. Sara died 4/13/12 of Hemangio Sarcoma, an inoperable tumor was found in her spine, she was almost 11 years old. Glad to see Zephyr is still doing great, it is really scary and very few cases are success stories, hope this information helps for your friends Yorkie. Also got to meet Dr Couto @ an event and shared my story of Sara w/him, he said that he had been using Cytarabine(drug they used on Sara) for 20 years and people thought he was crazy using a Leukemia drug on dogs but he said he had great success w/it and limited side effects.