Cyclosporine

[JMM]

Of course I'll discuss everything with my vet and the internist, but you guys always have such down-to-earth advise.

Mikey should start cyclosporine next week for his IBD. I'm fairly careful with him already. We walk only where we know the other dogs in our neighborhood; he goes to work with me (vet clinic), but we don't see parvo or distemper, only kennel cough which is kept isolated; but he does go to agility every 1-2 weeks. I do privates with him so he is only around my instructor's dogs that we know well. He's not current on any vaccines but RV, though his titers are still adequate for parvo and distemper (he hasn't had an actual vaccine since 4 months of age for those). How much do I need to worry about him being on immunosuppressive therapy and continuing to do his normal things?

[Traci]

I'm sorry, JMM, can you remind us how old Mikey is? You said his last DHP-PV were at 4 months of age, but were those the full puppy series? Is your vet that confident in the use of titers? (sorry, I wouldn't be).

Do you know the vaccination history of the instructor's dogs that Mikey is exposed to? Are the premises kept clean and sanitized at all costs?

Immunosuppressed dogs are at a much higher risk for opportunistic infections and for viral infections, but it sounds like this is something you need to discuss with your vet and discuss all the potential risks for Mikey in particular.

[JMM]

Traci, that's definately the plan.

He finished he series of 4 DHPP vaccines at 4 months of age (he was a little off for his 3rd, so we did 4). His titers are still "more than adequate" at age 4 now.

The instructor's dogs are all current on a 3 yr DHPP. There are only 2 of her dogs that he interacts with, one of which is completely retired and just comes for me to run. It is an indoor place and they do clean up, but with the flooring, they certainly can't bleach the whole place down.

[JMM]

We're just waiting for the drugs to come in now.

Both vets said without hesitation to let him continue with his private lessons and that the one other trial we wanted to do this fall would be fine as long as I take the same precautions as always (keep him in the car or x-pen with mat and carry him to the ring). They said he's been immunosupressed with pred before and this is a last resort...let him enjoy. I thought that made a lot of sense to focus on his quality of life.

[JMM]

I thought I'd post a little up date. Mikey has been on cyclosporine for almost 2 weeks now. We're having some issues with the initial level we were suppose to do. We're waiting to hear back from Auburn about it.

Overall, Mikey has done pretty well as far as vomiting and diarrhea goes. His nausea is moderate. The end of last week and this week he has been quite lethargic, but we suspect it is just one of his episodes. He hasn't had any side effects from the cyclosporine which is fantastic. We'll give it 2 full months and re-evaluate then. Hopefully, it will just take a little more time for him to totally improve.

[JMM]

Just a little update in case anyone is curious about M's cyclosporine trial. He was on 5 mg BID for a few weeks and then was back to doing his normal vomiting, diarrhea, and skipping meals. We checked a level and pow-wowed with the IMED vet. His level was low so we put him on 10 mg BID and just drew his next level today. We sent it to Cornell this time so that it will come back faster. His appetite is really down and he's slowly dropping weight. Hopefully it will be low and we can increase his dose. He also developed a skin infection so he's on a short course of Baytril. Otherwise he has perked up a bit since his symptoms have returned. He's even run in the yard a few times and played with another dog.

[Traci]

JMM, Don't take this the wrong way please, I know you have a lot of faith in your vet, but....do you think it might be time to seek a second opinion for all of Mikey's health problems?

[JMM]

He has 2 regular vets, we have consulted with a liver specialist, he has seen a double-boarded onco/IMED person, and another IMED person. Do you have a suggestion of somebody else we should see? Both of the IMED people were very honest with me and told me that his prognosis was poor since he never responded to steroids or dietary trials. They also each approached his case very differently as well, so I feel like we've seen a few different perspectives. We also see a holistic vet on the premise that it probably won't hurt and I want to try every option. If you know of another avenue we could pursue, I'd be more than willing to try it.

[Traci]

A suggestion, maybe ask your vet(s) to contact the Comparative Gastroenterology Society, it is a research group with various special interests in gastroenterology/liver disease and nutritional management.

[JMM]

Thank you, Traci. I'll ask Mikey's internist about it when she calls me with his test results.