Meningitis And Myelitis

[Batmom]

Oh my word. Hoping the change in meds will help your darling girl.

[hikinghounds]

Still sending prayers! I'm so glad they are going to switch her medication. Poor girl. When Zephyr was in the hospital and couldn't eat I fed him a mush of food with a syringe, like you are. It did seem to help him. Hang in there!

[vjui]

I just got off the phone with the neurologist. She has perked up quite a bit. They gave her Dexis, Mannitol as well as her medications. She is now eating and drinking and standing on her own. Wow. What a change from 8 hours ago!!!!! They feel that it may be a combination of the inflammatory reaction still going on in her brain on top of the sedating effect of the phenobarbital. They are planning of starting Cyclosporin (okay, in unison everyone: "I TOLD YOU SO!!"). They are concerned because of the rapid deterioration that occured. I'm actually hoping they don't discharge her too soon. It seems like she does well in the hospital and then when she comes home it all falls apart. Thank you, hikinghounds, for your blog. It not only gives me insight as to the side effects of the Cyclosporin, but encouragement as well. My plan is to get a good night's sleep tonight, knowing she is safe and in the best place for her.

[tbhounds]

What an encouraging update. So glad she has improved. Get some well earned rest tonight. ;-)

[Batmom]

Fingers crossed for continued improvement!

[hikinghounds]

I'm so glad you got some good news and that she is doing better!! Excellent that they are going to try cyclosporin. I don't think cyclosporin is as strong as a chemotherapy like Zephyr and Sara had, probably depending on the dose. So hopefully you won't see the side effects like Zephyr had. I know other dogs have taken cyclosporin for the encephalitis though and it has helped. I'm also glad that the blog helped. One of the reasons I wrote it all was that I hoped it would help others because there is not much info about the treatment of encephalitis in dogs out there. Hope you have a good night and get more good news tomorrow.

[Guest lynne893]

sending my love and concern and very best wishes for Frappy's recovery... you've been through too much!

[vjui]

She is home!!! As of right now, she looks pretty good. I found out that they gave her 5.4 mg of Dexamethasone( steroid) + mannitol to decrease the intracranial pressure. (Ps: I googled it: 5.4 mg of Dexamethasone equals 36 mg Prednisone). So she basically had a whole days dose of steroids to get the inflammation down. They discharged her on: Prednisone 15 mg twice a day. Phenobarbital32 mg in am and 48 mg in the evening, and Cyclosporine 100 mg twice a day with food. The Cyclosporine capsules smell nasty and they say you have to use gloves or wash your hands after handling!! It sounds really caustic. Hiking hounds: did Zephyr get nauseated with the Cyclosporine at all? I am pretty scared. Please tell me we are doing the right thing. I was wondering what would happen if we just kept up the higher dose of Prednisone for awhile.

[hikinghounds]

That's great that she is home! Zephyr didn't actually take Cyclosporine, I've just read about other dogs taking cyclosporine for encephalitis. I did have a cat that took cyclosporine for his allergies, and sometimes it did make his stomach upset. I know the cyclosporine says to use gloves, but I was bad and never did with my cat, but that was only 25mg. Zephyr had four treatments of Lomustine over 5 months and then 5 months on Procarbazine. I think cyclosporine is much milder than the treatment Zephyr had, not that it's a bad treatment though. If she still continues to show signs of the encephalitis then maybe you could continue to ask about the other stronger chemotherapy type treatments. Do they have any idea what has caused this in Frappy? I know occasionally it's a reaction to vaccines. I never found out for sure what caused Zephyr's encephalitis. He was on prednisone, 5mg twice a day for about a year and a half. The neurologist wanted to have him on about 20mg twice a day, but is belly couldn't handle the high dose of prednisone. But during his critical stage he did get high doses of steroids. He started out on Phenobarbital but we switched him to the generic form of Keppra about 6 months later because all of the medications were starting to have an affect on his liver. Keppra has very little or no affect on the liver. He still takes a low dose of the generic Keppra. I will say that Zephyr had diarrhea or soft stools for weeks from all the meds and stress, but he had lost 10 lbs. and was famished at that point so I let him eat just about whatever he wanted. I also added a lot of cooked fresh beef and chicken to his meals. I definitely think you are on the right track and doing the right things. Feel free to private message me too if you'd like. I bet she is so happy to be home and feeling better. I am sure that Frappy also knows how much you are doing for her and how much you love her, and that it's helping her. It's amazing how strong they can be. Hugs to you both!

Edited September 18, 2014 by hikinghounds

[vjui]

Sorry, I just re-read the blog and realized Zephyr had Lomustine, not Cyclosporine!

[hikinghounds]

How is Frappy doing? I hope things are going well and she is continuing to feel better!

[tbhounds]

A little tip--if you keep the cyclosporine tablets in the freezer (atopica) it will reduce the nausea. Also, did they mention Denamarin?? The Denamarin will help maintain a healthier liver (the pred, pheno and the cyclosporine are tough on the liver).

[Neighsayer]

Hoping for a good update...

[vjui]

Update on our little Miss Frappy: Overall, I think she is doing better. We have her on 15 mg Prednisone & Cyclosporin twice a day. She is walking, although very slowly and her eyes look more bright and alert. She is able to hold her head up and shake. We had to board her at the vet's office this weekend, due to an out of town wedding we had to attend. (If I could cancel all of my out of town committments to stay with her, I would). Since we got her home yesterday, we've noticed two things: diarrhea and she's not eating as well. The diarrhea is pretty bad. Not even soft serve. It's pretty watery. She is also "grazing" instead of eating her whole bowl of food. She'll eat a little bit, wander around and then eat some more. It took a LOT of coaxing and some hand feeding to get her to eat most of her dinner. I'm thinking it might be the Cyclosporin. Just for full disclosure, she did have a wee bit of diarrhea last week. It was something related to the food, because our other grey, Nico, had it too. Nico's diarrhea responded well to Flagyl and we started her on it as well and it was responding just as nicely before we sent her to the vet's office. I don't know if this is food related diarrhea or medication induced diarrhea. This morning, DH noted some blood in her stool. We called the vet and she said it might be colitis from the diarrhea. Treatment? Carafate & Flagyl. So here we go again. Thank you for the tip on the freezer!!! I will definitely try that. No mention of Denamarin. I did ask about blood tests to check her liver, but they don't usually do that for several weeks out. Does anybody else have experience with the colitis/diarrhea or other side effects from Cyclosporin? Thanks everybody!

[tbhounds]

My guess is the lack of appetite is from the cyclosporine.

[vjui]

It never ends. ( ). When we picked her up at the vet's office, we noticed that her right front pinky toe was bleeding. Looks like she abraded it right above the cuticle. We hadn't even gotten to the parking lot yet. We brought her back in. The vet tech shaved the area (now it looked really big!! ) and gave us antibiotic powder to put on it. Well, when I got home this noon to walk her, the entire toe and leg (?what I would call her wrist) is swollen. She cannot put her toes together. She is not licking it, thank God. Took photos and called and emailed the office. (this is the second call from us today. I think they hate us). I'm worried it is infected and that it is spreading. Very dangerous, as she is immunocompromised. We'll see what they say.

[tbhounds]

So sorry you are having complications. I can to totally relate. Please don't apologize to the vet clinic--your girl is is very ill and they should welcome your call and concerns. Will she let you place a cold pack on her foot--bag of frozen peas??

[hikinghounds]

I'm glad to hear that Frappy seems to be doing generally better. Sorry to hear about the hurt toe and diarrhea though. Zephyr had diarrhea and really soft stools for a long time, weeks or more. He had some blood in it too, and they thought it was from the prednisone. I think stress also causes that, and Frappy's probably stressed from everything. Don't feel bad about calling the vet. One of the best things I learned from Zephyr's ordeal was to speak up and advocate for him. Plus, the vet office probably appreciates everything your doing for Frappy. You're right, she is compromised right now and she needs all that extra careful care. I hope she continues to improve. Sending good thoughts.

[vjui]

Well, the tiny abrasion to her toe has now progressed to cellulitis of her entire right front leg. Her toe, foot and arm are all swollen up to the elbow. (Don't know the dog-anatomy terms). Needless to say, I'm a wreck. The speed at which this tiny thing went so bad so fast is making my head spin. I know it is because she is immunocompromised. The vet has put her on stronger antibiotics (Clavamox) and recommended soaks. On the good news front, the diarrhea is getting better! She had a fully formed blood free stool this afternoon. Funny the things that make me happy.

[hikinghounds]

Oh gosh, I am so sorry that her toe/leg are so swollen. Hope the Clavamox will help fast. It's not fun to have other things come up when your trying to get things resolved. When ever Zephyr had a chemotherapy treatment he also had to take an antibiotic for about a week because of the lowered immune system. Congratulations on the nice stool though! :-) When Zephyr had his first formed stool I was so happy I actually took a picture of it! Hang in there!

[Batmom]

Continuing to root for your girl!

[3greys2cats]

Wow, was off GT for last couple weeks and so much happened here. I am glad that Frappy is headed in the right direction with the Encephalitis but so sorry she now has the other complication! Just wanted to add my comments on all the side effects of the drugs. Sara was in ICU for a week where they administered her chemo drug(Cytarabine) through an IV to get it in quicker, the inflammation in her brain was huge and in multiple places, her MRI showed Neurologist that and they showed me her films. She barely ate for them there but I would cook for her and bring it in and hand feed. The Cytarabine injections were given by my regular Vet, I picked up dry drug and brought it to Vets to be mixed, she got 4 injections over 48 hours every 2 weeks, so 7AM and 7 PM. The chemo drugs did not have side effects like the Prednisone, Phenobarb, she was released from ICU with Carafate and Flagyl to help stomach and diarrhea and she could walk on her own, a little wobbly @ 1st and I had to re-teach her stairs, everything had to be carpeted as she had fallen down my deck stairs at the onset of her disease and I used a harness for stablility. I want to offer you some hope that it will get better , Sara needed to be held up and hand fed at the onset and within 2 weeks, she was running in the backyard again. She got to eat in her bed because of her head tremors and that became the norm, the Vets came out to my car to give her chemo injections on her tired days. Although we kept her on the drugs a year long, she lived a normal life for 5 more years before she lost the battle to Hemangio Sarcoma in 4/12. She went to Dewey Beach for 3 years in a row, a very long ride from NH and lived life to its fullest every day. She used to steal food from Max(my big boy) when she was on Prednisone, loved eating despite all the drugs coursing through her body. Hang in there, feel free to PM me too, wished I had blogged about it but it still is fresh in my head, probably never forget that time in my life

[vjui]

Thanks everybody. The latest of Frappy is that now she is back in the ICU. The little abrasion on her toe has turned into cellulitis of her entire right front limb. They expanded the spectrum of the antibiotics and have her on Unisyn (IV form of Clavamox --what we know as Augmentin) and Baytril (I think that is a fluroquinolone--like what we know as Cipro). The swelling is actually fluctuant (feels boggy, like fluid inside) versus indurated (hard), but they are still calling it a cellulitis. The surgeon took a look at it last night and determined that there is no focal area to drain. The intensivist thought there was some component of a vasculitis. (actually, the title of the disease is SRMA: steroid responsive meningitis and arteritis(vasculitis). So they are stuck between a rock and a hard place: on one hand, we think it is an infection, and you'd want to decrease the steroids and Cyclosporine to allow her immune system to mount a defense, on the other hand, if it is a vasculitis, you'd want the steroids to mediate that inflammatory response. She has also stopped eating and drinking--a sure sign that she does not feel well. The vet called this morning. She is a little worse than when we brought her in last night. The swelling has not spread, but the color of the limb is darker. Actually she got some spontaneous drainage from the dorsum (back) of the paw last night. (remember the injury is on her TOE, not the top of the paw). Bloody purulent drainage came out. They have re-institued IV fluid and added an appetite stimulant to coax her to eat. The doctor says she doesn't think she is in danger of losing the limb....yet. I have a few photos and will see if I can figure out how to post them. Can I post to Greytalk from Dropbox? Does anyone know? Thanks.

[3greys2cats]

Oh no, poor Frappy and poor you, very hard to see them go through such difficulties, hoping they can get her leg infection under control, how scary on top of everything else! I have only posted photos from Photobucket and I am lousy @ it, maybe someone else can chime in on how to do it? I am keeping you and Frappy in my prayers :hope

[hikinghounds]

I'm so sorry that Frappy's leg has gotten worse. I really hope the antibiotics kick in and it starts to improve. I can't imagine having something like that come up along with the encephalitis. I'll be thinking of her and sending healing thoughts.