http://www.medicanimal.com/setSessio...Z&locale=en_GB
it is much cheaper with a prescription from your vet.
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http://www.medicanimal.com/setSessio...Z&locale=en_GB
it is much cheaper with a prescription from your vet.
Thanks for that - I got his first lot from the vet (nearly fainted at the price) but I started getting prescriptions and get them from either Medicine4Pets or Animed. Animed are slightly cheaper but the service at Medicine4Pets is excellent.
It's almost half the price of getting it from the vet - it's actually shocking how much more expensive it is from the vet.
Just know it is not your fault about Cairo, I know you love and care for him. Dechra certainly is hurting a lot of dogs by not changing their instructions and updating things the way an responsible company should. The vet, now there I have a problem. They should be keeping abreast of the changes as we are if they are treating dogs using this drug, there is no excuse for their ignorance. As far as the vet not being swayed, she does not have a life outside her office with this dog. So if things go wrong, it will be you that is impacted not her, so if it were my dog I would not allow her to do this. She has already made many wrong decisions that could have been fatal. I would tell her if she cannot compromise after all the errors she has made I would go to someone with a knowledge of this disease and that is willing to work with you. This is your dog, not hers so you will have to put your foot down, as far as her making final decisions. There are many vets that know very little about this disease and it's treatment, I have one of them. My dog would be dead if I let him make the decisions. Instead we go over what is going on, and after I consult with everyone on this panel, I then make the final decisions. He knows it must be that way, and believe me anyone on here can tell you how many times I have gotten into it with him over my Tipper. I know when he is wrong and I must face the facts and confront him with the issues. It is not fun let me tell you, but I do what I have to do. You are the only advocate for Cairo so please consider what I have said. I only say it out of my deep love for all animals, and don't want you to lose your dog, not to blame you. Blessings
Patti
buying vetoryl from the vet is indeed very expensive. lots of bonus for the vet selling it at those high prices. half of it is profit.
glad you found a cheaper way to buy vetoryl.
I've had a good talk with my mum and said to her that when he goes back on Friday, if the vet won't listen to us, we need to try and find a vet that will. We're a bit restricted here as there are only two other vets local to us and I've not heard great things about them. There is another vet miles away but he might be worth speaking to.
I just want to check though - the vet has increased his prednisolone to 10mg twice a day - for a 60lb dog, is that OK?
His stools are a bit loose - not diarrhoea - just a bit squishy and he is absolutely stinking - could it be the pred causing that?
He's still not managing much of a walk and we're not letting him go far - just enough to toilet then home again.
I will have to let someone with prednisone experience answer your question. I believe you are doing the best thing for Cairo searching out a new vet. I am so sorry he is not feeling well, but he has been through a lot, and to his credit survived all this. Hopefully he will be on the mend soon and you will be able to get him straightened out. He is a beautiful dog and looks like he kept most of
his muscle. I am sure everything will work out once he gets to feeling better and
gets on the correct dose. Blessings
Patti
"I dose prednisone or prednisolone at 0.1-0.2 mg/kg/day. If the dog develops polyuria and polydipsia (PU/PD) or any other signs of iatrogenic Cushing's syndrome, I would lower the dose as needed. I rarely, if ever, give a higher dose than 5-mg per day to ANY dog. The 5-mg dose is the average human maintenance dose, and we see very few dogs that weigh over 70 kg."
I found this on one of Dr. M. Peterson's blogs as a response to a question on Addison's topic. I know Cairo is not yet proven permanently Addison's but he's having an Addisonian crisis, right?
20mg daily seems a lot. Is this 10mg BID for a short term use? How many days are you supposed to give it to him?
Yes, he had a crisis - his cortisol levels weren't even registering when they were checked on Friday last.
He got a steroid injection on Friday night and then he was started on 5mg once a day on Saturday but he wasn't picking up so we took him back to the vet on Monday and he had his electrolytes checked and the vet gave him another steroid injection and said to increase the pred to 10mg morning and night until he goes back on Friday - they don't want to have him on that any longer - so it'll be 3 days on 20mg and then on Friday, he'll get the 10mg in the morning and then he's at the vet.
He's certainly peeing for Scotland at the moment but we knew that he would with the steroids.
I'm now just questioning everything after what's happened to him. I didn't know how quick he would pick up after starting the steroids but I don't want him to be getting too much either.
If he's on a high dose of steroids, even for 3 days, would he need weaned down off it?
We're a bit dubious about giving him 10mg in the morning and at night. He's had 10mg this morning but we're thinking of not giving him the night time dose and changing it tomorrow to 5mg in the morning and 5mg at night.
I don't know what to do.
We're even wondering if once he's off the steroids if we should get a different vet to retest him for Cushings.
I think I would get another vet to test him. This vet seems to have really messed all this up and I would not be trusting her. Remember to feed him and Vetoryl given, then the test within 4-6 hours. I take my Tipper at the same time of day every time she is tested. I don't have experience with prednisone, so I cannot speak to that question. I would start off new with someone else willing to listen to your concerns and willing to work with you. I am so sorry you and Cairo are having a bad time. My Tipper has some issues this morning too, so I am watching her for signs she is too low. Blessings
Patti
I feel absolutely sick with worry (and all this worry isnt' doing my Addison's any good). I've got to pop out this afternoon so I'm wondering if I should go into the other vet and ask them about their experience with cushy pups.
I would, and ask if they are willing to work with a knowledgeable owner?? I just looked on Dr. Mark Petersons blog. This is what he says:
Stopping the prednisone abruptly can cause destabilization of the metabolism. So that is your answer, he must be gradually taken off. The recommended rescue dose is 0.1- 0.2 mg. Any polydipsia or polyuria going on you must reduce the dose. You will need to get Cairo's file, so the new vet can look it over. Just be
honest and tell them your concerns about Cairo's safety. Wishing you luck, and hoping this new vet will be a better choice for you and Cairo, as you don't want the same situation you just had. Blessings
Patti
We're arguing with ourselves about the 2 x 10mg pred doses a day. He had 10mg this morning and certainly seems more like himself but we're not sure about the 10mg at night. My mum's wondering if we should give him just 5mg instead of the 10mg and instead of not giving him any. The peeing seems to have calmed down as well. Yesterday he seemed to be desperate for a pee all the time but today it's a lot more normal.
I will certainly be querying about weaning him down. My mum says to wait till we take him back to our vet on Friday and see what she says and if we're not happy, then we'll hot foot it to the other vet. I know what she means but I'm still worrying
I would think you could tell if he needs the pred tonite or not. If he seems to be backsliding, I would give what the vet recommended. ;)
In another one of his responses I read that some vets prescribe higher doses to help with inflammation , etc. for a short term use only for a few days and then gradually reduce the amount down (usually by half each decrease) to the ideal maintenance dosage. So I hope that's what your vet is doing to jump start his system tho 20mg seems quite high.
I wouldn't know how but if you do, maybe you can try to get on Dr. Peterson's blog and ask him and see what he says? Google - Q&A: what's the ideal prednisone dose for dogs with Addison's diease? - and go from there and I hope you will be successful talking to him. You will see many links to him.
In regards getting a new vet, how about try to find a good IMS (you may have to travel a long distance) and get a consultation? If your vet is otherwise nice and willing to work with you, follow the new IMS's direction on how to treat Cairo from now on but get all testings done by your regular vet as that will save you a lot of money. Be upfront about it with your vet and all three of you are going to work as a team to treat precious Cairo. You may need a referral from your vet but you're not obligated to see who she normally refers her patients to. You can research and find the one you like and it could end up who she recommends.
That's what I ended up doing with my dog and the costs are less than half with our regular vet. She just performs tests for us and I must say she is not thrilled about it as far as I can tell. When I think about my Ginger's well being and I'm her ONLY voice, magically it takes all the fears away that I had toward any professional and I become brave:eek: to my surprise. You just have to make her understand that you, the owner makes the final decision for YOUR dog and not her.
I hope Cairo gets better really soon but be patient as it takes time, weeks or months to find out what's really going on inside their body and how to stabilize their whacked hormonal balance back to ideal level. I'm so sorry you have go through all this but things will get better. I will pray for you and Cairo.
Thanks all. I'm just away to take him for his evening outing so I'll see how he is. If he has less energy than this morning, we'll maybe give him 5mg instead of 10mg of pred. I don't want him pinging off the ceiling by giving him too much.
I did think of contacting Dr Peterson - I have before when we had no synacthen here for his advice and he was lovely and replied quickly.
What's an IMS? I'm not sure if we have specialist vets here. We do have the veterinary college about 100 miles away but you need a referral there and it's whether my vet would do it or not - but if you don't ask, you don't get.
This will teach me for feeling smugly satisfied that Cairo was doing so well. It's brought us down to earth with a crash though I was worried if I'd recognise the signs that all was not well but I guess at least it's shown me that I did recognise the signs but I most certainly wouldn't have wanted this to happen just to show me :(
Hi Alison
I've been reading your thread I'm from Scotland too and used a fab IMS internal Medicine Specialist if you demand your vet refers you then they have an obligation to do so. Let me know where you are and I will see if I can help with the IMS. I used a fab one.
IMS = Internal Medicine Specialist
Good and good. I'm sure Dr. Peterson will reply quickly as he sure will recognize the urgency in Cairo's situation. Please, let us know what he says.
That's wonderful that Tracy can help you with finding an IMS in your area, a good one. There are good ones and not so good ones from my experience.
Just request for a referral to see a specialist which I think is within your rights as a patient and probably she will refer you to whom she usually works with who you're not obligated to go to. If there's a better one around, go see that IMS. I hope Cairo keeps improving.
We're just back in from a short walk - he wanted to go further but we're not risking it. He was skipping along, although he was panting - but so was I because it's quite warm here today. He is having rather long pees. The higher dose of pred this morning seems to have worked a bit better though we're still wondering if we should be giving him another dose tonight :confused:
Am I better contacting Dr Peterson through his website or posting a comment on his blog? Anyone know?
What about the one you were successful contacting him the last time and got a quick reply? Or why not all?;):eek:
Hahahahaha. It was his blog I posted on last time.
You'd better get on it then. It's 2:10 EST here yet. Good luck.:)
I would try the blog, and if nothing go to other means of contacting him. I would be cautious like you in this warm weather about him walking. Tipper can't go when it is hot or humid because of her heart, or when its real cold. I know how you are feeling, and worrying that cannot be good for you. I know when they used to make me take prednisone it was a gradual reduction to get off it. I also read something very interesting about prednisone, that the liver makes it into prednisolone. If your dog has any hepatic issues you should use prednisolone instead of prednisone. All this stuff you have to learn we should all be licensed vets by now!! Hope you get an answer quickly. Blessings
Patti
I think asking Dr Peterson's on his blog is a good idea. I just looked at his blog concerning addison's and many people have asked questions to which he has answered. Here's a link for anyone interested in that article: Q & A: What's the Ideal Prednisone Dose for Dogs with Addison's Disease?
Hugs, Lori
I've emailed Dr Peterson (since it was fairly long winded) but I'll post to his blog as well - belt and braces approach!!
My mum phoned our vet to say that he was as bright as a button so should we hold off giving him the other 10mg pred tonight as we didn't want to overdose him and we certainly don't need him up all night either. The receptionist said that if the vet said twice a day we should give it twice a day but she'd get her to call back - we're still waiting and they closed an hour ago.
He was absolutely starving so he's had his dinner - minus the 10mg pred - I hope we've made the right call but he's so bright and chirpy, he doesn't look like he needs it.
I knew about the synthesis (or whatever you call it) re prednisone but it is prednisolone he has.
Honestly, in days gone by, you trusted your doctor or vet to know exactly what to do but nowadays you've got to become your own research expert to make sure that things are getting done properly.
What worries me is that since Cairo is on such a high dose of pred that a tapering might be needed. If Cairo seems to be "off" than an additional dose of pred may need to be given.
Hugs, Lori
That's what's worrying me as well. There's no way that I'm going to just stop it. If we're told just to stop it, then that's going to be the final nail in the coffin with the vet.
We didn't give him the dose tonight, so he's had 10mg today instead of the 20mg they said but we'll keep a close eye on him. As I said, he seems very bright so far which is part of the reason we didn't want to give him even more steroid.
Now a days you have to be up on everything it seems. What is great is that we have more access to information too, which in the old days we wouldn't have had.
No they haven't put out anything different to the vets here I don't think, however, on various phone calls with members, they have suggested starting at low end range.
Sharlene and molly muffin
You are doing the right thing. Dr. Peterson says to taper it off, so that is the correct procedure. I cannot believe that your vet never even addressed this situation with you and just gave you the prednisolone but failed to give instructions on weaning him off to prevent further problems. She is very careless in my opinion. Yes gone are the days of letting your vet handle things. It puts a lot of pressure on the owner to check everything the vet is doing to make sure it is right. My vet has made so many errors that would have been fatal that it is pathetic. I only use him as there are no other vets where I live, and I need him for prescriptions etc.I basically tell him what needs done when something comes up and he does it. That is our relationship as I do not trust him. Thank God for this forum, my girl probably would not be here without it. Blessings
Patti
Well, he's a lot better this morning. He had a nice walk - not too far - but no puffing and panting and stressing.
I confess we didn't give him the extra 10mg last night - he was totally hyper off the morning dose. We tried to speak to the vet last night but nobody phoned us back.
My mum spoke to a vet this morning who said that the prednisolone wouldn't be making him hyper - he was just feeling better - and to keep giving him 20mg a day - he said that was quite a low dose for him.
I beg to differ on all that. I know what high dose steroids do and 20mg prednisolone is equivalent to 80mg hydrocortisone and that's a massive dose.
I've not heard back from Dr Peterson yet but I realise there is a time difference so I'll keep an eye out for a reply.
??? 20mg prednisone is quite a low dose for him? Wow!
I don't know what to say to that. If Cairo is feeling better now does he still need 20mg? Why not start to wean him off like 5mg in AM & 5mg in PM so on and so for until he gets down to his maintenance dose?
I wish I knew more about this.:(
Too bad you haven't heard from Dr. P yet. Hope he replies today.
Hang in there, Allison. You are a wonderful mom to Cairo.:)
Pred doesn't make you feel hyper?! Oh, I beg to differ! Pred will make you feel all kinds of weird and do strange things - I just finished a short round myself not long ago and could tell some tales! That vet does NOT understand drugs in the least it seems. :rolleyes: I think I would suggest they take an equivalent dose for humans for the same amount of time then tell you it didn't make them hyper! :D
Oh I know. I have Addison's and when I had to get a tooth out, I needed extra steroid cover but they gave me double what I really needed. I was bouncing all over the place and really agitated and starving hungry, so telling me that it's not the pred just doesn't cut it.
I think Leslie was trying to do hand stands and jumping jacks at the same time when she was on the pred. :eek: :D:D
That is a vet who has never had to take a steroid themselves eh. ;)
You on the other hand on doing just great with Cairo and know a thing or two about the pred stuff.
hugs
sharlene and molly muffin
Hi Alison how is Cairo tonight still good I hope
He seems to be well tonight. Still peeing for Scotland but I'm knackered. What was meant to be a gentle stroll turned into our usual "staffy pace" walk - it's like a bloomin route march. He was racing up the road though he did slow off a bit on the way back - in total, it's probably less than half a mile he's doing but it's all he's getting to do just now.
He's just had his dinner which he scoffed down like he hadn't been fed in a week. It's nice to see him eating properly. He's content after his dinner so I'm not too worried - he's not trying to scrounge more food (unless somebody has fruit on the go - he loves an apple)
Hahahaha, I can imagine. I was meant to rest after having an extraction and I was cleaning and looking for food, lay down, jumped up, looked for more food, had chicken noodle soup and got a noodle stuck down the socket so went back to the dentist, got home did more cleaning, ate some more - you get the picture! LOL
Quote:
Originally Posted by molly muffin
It would seem everything this Dr. says is wrong!!! Good thing you know about the pred. I am glad he is feeling well. Hope he continues to improve, and now you can take a deep breath and relax as your baby will be OK. Blessings
Patti