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Muscle Wastage With Predisolone


Bokezu
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my young Vizsla is in the vet with a bad case of "immune mediated thrombocytopenia" after a scrape with another dog begun bleeding and wouldn't stop.

The vet has started him on predisolone this morning, and tells me it will be at least 48 hrs before he starts making some platelets, so his blood can start clotting. She told me this morning a side effect of the predisolone will be muscle wastage, and that his head will change shape permanently, but his other muscles should restore. I know this is irrelevant as he has to have it or he will die, but has any one out there had the muscle wastage with this drug and if so how severe did it get, particularly around the head? Thanks in advance

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corticosteroids - increase protein catabolism and reduce protein synthesis in long term use hence muscle wastage.

HeadMM.jpg

There are large muscle groups all around the dogs skull, muscle wastage will shrink these and alter the outward shape of the head, not the skull itself

ETA considering it's not a heavily used muscle in most domestic dogs that do not catch prey, tear animals to eat etc the muscle is not exercised and wastes more then the others

Edited by Nekhbet
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my young Vizsla is in the vet with a bad case of "immune mediated thrombocytopenia" after a scrape with another dog begun bleeding and wouldn't stop.

The vet has started him on predisolone this morning, and tells me it will be at least 48 hrs before he starts making some platelets, so his blood can start clotting. She told me this morning a side effect of the predisolone will be muscle wastage, and that his head will change shape permanently, but his other muscles should restore. I know this is irrelevant as he has to have it or he will die, but has any one out there had the muscle wastage with this drug and if so how severe did it get, particularly around the head? Thanks in advance

Long term doses of prednisolone will cause the muslces to waste, and will make the head shape different. Those of us with Cushing's dog see this. If you dog is required to be long term (i.e. months) on pred I would be asking the vet what other options may be available, or maybe seeing a specialist vet. :)

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Hi Bokezu, I feel sick to the stomach to hear your young lad has contracted IMT. I have had 2 bitches with this awful disease an so can forward you a fair bit of info on the subject.

Cortisone almost immediately causes muscle atrophy in dogs, but more so in larger dogs. Generally the larger the breed, the more severe the atrophy.

Even small doses given over a short period of time for other treatments I have found noticeable loss of head within 48 hrs. This has returned though.

You may find it less so in your Vizsla.

Muscle atrophy spread throughout the body owing to cortisone use whether it be short, mid or long term use will normally restore provided exercise etc is also restored. But other criteria come into play also such as hormones. If your male is an entire, which I assume he is, and if he remains entire then there is an excellent chance of his body muscle returning and a reasonable chance of his still developing into a full entire male head.

As Nek says, the loss of head is also an atrophy of the muscle, it is not skull related.

There are other drugs they can give the dogs that suppress the immune system like the pred does, that do not cause the muscle atrophy, however, from my experience I believe they always like to start with the cortisone, and you can change it over later.

I am assuming from your post that the vets do not seem overly concerned about your boy, perhaps his platelets have not dropped too low.

Hopefully you have caught it nice and early. I really hope he is OK.

I perfectly understand your concerns about the muscle atrophy, as it sounds as though it may be your only concern at this stage, and I truely hope it is.

Unfortunately for us, the atrophy was the least of our worries. Both cases were life and death issues, intensive care, and on going treatment for months.

To IMT I lost one of my bitches Ruby, and the other one that survived Dyzney, well put it this way, none of her specialists can believe that she pulled through from IMT. She had the worst case they had ever seen, that the dog actually survived. So we are very lucky to still have Dyzney.

I wish you all the very best of luck with your boy.

I am more than happy to chat further about the disease if you would like some more info, just PM me.

Actually here is a pic of each of my girls. The first one of Ruby a couple of days before she passed. And the other of Dyzney. You can see that both bitches lost their heads completely and had complete muscle wastage to the point where they needed asistance to walk. Ruby also struggled to breath when she lay down, she became so weak with lack of muscle.

Cortisone is a disgusting drug that does some horrible things, yet it is also a brilliantly amazing drug. If it didn't exist I would not still have my Dyzney today.

post-27202-1258608751_thumb.jpg

Edited by dyzney
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OK, this is the photo of Dyz, same shrunken head.

Their tummies became so distended just from them not having any top line to carry it anymore. I was so concerned when emptying them that their legs would break, as they would fall over so easily.

Just remembering what we went through during the time when both girls were sick is bringing it all back again. It is still so raw for me.

I really hope your boys platelets pick up quickly.

Oh, I just remembered something else, another of the drugs that can help supress the immune system can cause stomach ulcers and nausea. When Dyzney finally got to the point where her bloods were on the improve, yet she was still on so much and so many different medications, we went through a period of about a week where after all the IC and everything else, we nearly lost to emmaciation and stomach ulcers. She would not eat, owing to nausea, and when she did, she could not keep anythign down owing to stomach ulcers. they couldn't put a stomach tube in because of fear of the bleeding starting again,

I swear it was the most horrific nightmare of my life.

post-27202-1258609010_thumb.jpg

Edited by dyzney
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IMG_4349.jpg

thanks everyone for your advice and Nekhbet for your diagram, I will pm you dyzney, I think I will need lots of help over the next 6 months or so

Jordan had no platelets yesterday, he started pred today, vet rang this morning to tell me he was bleeding from everywhere and was covered in bruising. I went in to see him and he was soooo happy he was wagging the tail and ate some chicken I took, no sign of blood apart from all the dry blood stuck to every part of him, I was only there for about 15 mins but he really perked up, hope thats a good sign. Will be back in later to ask some more questions

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IMG_4349.jpg

thanks everyone for your advice and Nekhbet for your diagram, I will pm you dyzney, I think I will need lots of help over the next 6 months or so

Jordan had no platelets yesterday, he started pred today, vet rang this morning to tell me he was bleeding from everywhere and was covered in bruising. I went in to see him and he was soooo happy he was wagging the tail and ate some chicken I took, no sign of blood apart from all the dry blood stuck to every part of him, I was only there for about 15 mins but he really perked up, hope thats a good sign. Will be back in later to ask some more questions

Oh poor Jordan, then it does sound serious Bokezu. No platelets! We had extremely low levels in dyzney, but still she required 5 blood transfusions and 3 plasma transfusions within the first 5 days. she was critical. the bleeding risk is mostly internal, gut, brain etc. You will usually see small pin prick of blood on the gums and some blood in the faeces and in the urine, but not always. Severe cases can throw up blood also. Temp drop and lethargy are signs of imminent crash. With both mine, they were perfectly fine as far as I coulf see, the over night they looked like death warmed up. absolute shock. Vets initially thought poisoning, of course I knew it wasn't.

When the vet suggested IMT when I presented dyzney, I just said "no, it can't be, I have already had it before". It is a rare enough disease as it is, well not extremely rare, but rare enough to be a shock to have 2 dogs get it.

Man, I wish you luck, I really do.

I am glad Jordan was feeling bright and happy to see you.

Have you any idea what caused this. It will depend on if it is primary or secondary, but if it is primary has he had any drugs or vaccinations in the 2-3 months, as that is the time frame.

If it is secondary they may well want to run a plethera of tests for bone marrow cancer and other nasties.

Of course the primary form of IMT is idiopathic (you never really know for sure what causes it), but you can generally work it out. We suspect Stibestrol with Ruby (incontinence drug) and Rimadyl with dyzney (non-steroidal anti-inflammatory).

Yes, please feel free to contact me. I can give you my number if you want to talk.

Hopefully Jordan will respond quickly and well to the pred.

Nek, how is poor Diesel?

Edited by dyzney
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I can't believe the timing of this post, I was having this exact discussion with a neurologist today

My dog Diesel has a brain tumor, he needs the prednisone to reduce the swelling, but he has been on it for about six months now, and it is making him very weak, his head is basically just skull and skin, I don't like to touch the sides, I worry about it being too soft. His back legs are very weak and his spine shows a lot. I would love to try something else... I hate seeing him waste away

In saying that, it's only been the last three weeks he has gone down hill, the pred has been great for his quality of life

Good luck with your pooch

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I can't believe the timing of this post, I was having this exact discussion with a neurologist today

My dog Diesel has a brain tumor, he needs the prednisone to reduce the swelling, but he has been on it for about six months now, and it is making him very weak, his head is basically just skull and skin, I don't like to touch the sides, I worry about it being too soft. His back legs are very weak and his spine shows a lot. I would love to try something else... I hate seeing him waste away

In saying that, it's only been the last three weeks he has gone down hill, the pred has been great for his quality of life

Good luck with your pooch

so sorry to hear Diesel is not doing well, hope there is some improvement soon

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Bokezu, is Jordan staying in overnight? Is he is an emergency centre having 24hr supervision?

I hope you have some good news tonight about him. If they are set up to, they will probably be running in house bloods to get some idea of how his platelets are going.

I hope you get good news soon.

I have everything crossed for you.

Did you know that IMT is much rarer in males? Definitely predominantly a bitch disease.

Danois, sorry to hear about Angs. He looks gorgeous boy.

DW, I hope Diesel manages to continue coping for a while yet. Hang in there.

Edited by dyzney
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Diesel is kicking at his elbows today. Boy he looked crap after I spent a week at mums for work

this evening he got stuck lying down and cried and cried trying to get up

I dont know. I know what you all are going through .. will they be better or worst today, tomorrow ...

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this is really scary stuff, its certainly not going to be easy thats for sure

what happened with Jordy is I let all the dogs out early Sunday morning while I had a shower to get ready for work. Husband didn't hear anything. I let them all in again and Jordy was all scared and shaky, he's normally a real livewire,

I said to my husband one of the dogs has got into him he had some toothmarks on the back of his head, no blood at all, thought it was his Dad who has been a bit funny with him lately but they hadn't had a fight. Anyway I locked him in his pen as we were both working and really thought nothing more of it. Came home he was really quiet head down, but still didn't notice any blood. later I noticed small amounts and then there was quite a bit coming from his mouth, I could see he had lost two front teeth and it was just all bloody. Monday and Tuesday he was quiet sleeping a lot and still bleeding and we were concerned that it should still be bleeding so Wednesday morning when he still hadn't perked up and the bleeding was getting heavier I rang the vet. So I know I left it a long time, and I am very lucky he didn't have a huge bleed and die........I never knew anything about this disease. I think the stress of the fight with his father bought on the start of this illness. I will try and find the source but I was reading last night online and one said stress is a trigger, so will try and find it. I don't believe he had it Sunday when the fight occured and he had the teeth ripped out, because there was no blood. I really don't know enough about it so shouldn't be saying anything but it seems strange to me. There were no platelets yesterday but if there had been none on Sunday he would have been bleeding a lot, but there was no sign of blood Sunday ????? very confusing for me

Jordan is on no medication whatsoever and has not been vaccinated since 16 weeks he is now 15 months

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Bokezu, is Jordan staying in overnight? Is he is an emergency centre having 24hr supervision?

I hope you have some good news tonight about him. If they are set up to, they will probably be running in house bloods to get some idea of how his platelets are going.

I hope you get good news soon.

I have everything crossed for you.

Did you know that IMT is much rarer in males? Definitely predominantly a bitch disease.

Danois, sorry to hear about Angs. He look s aorgeous boy.

DW, I hope Diesel manages to continue coping for a while yet. Hang in there.

he will be in until they are happy with his platelet production, although she did say with him because he is pining he is better to come home sooner, because he will be happier. He had full bloods sent off to specialists on the mainland, results due tommorrow, so hopefully nothing else shows up. there is no one there overnight

my husband called in to see him and was told not to let him get excited as it puts his blood pressure up, although he had no platelets he wasn't critical as your two were dyzney, very strange, and vet never mentioned internal bleeding although his whole body is covered in bruises, maybe it effects different dogs differently, and yes all reading states more common in females, just hope he has a good recovery

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