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I haven't written much about Diesel lately because we have had a tough month. His appetite only got worse and other things developed which I summarized below.
Diesel finished a long taper off of prednisone on the 22nd of July. Two days later I gave him one of his favorite chewy treats and it took him a few hours to find enough interest to chew it. I didn’t think much of it because there had been a few times during his treatment when he waited to chew on something. Also before his gingivectomy he showed reluctance to chew sometimes.
About 5 or 6 days later, Diesel started walking away from his bowl before he was finished. I though it was because one of his supplement capsules had burst and was bitter. He was willing to finish the parts that hadn’t touched the powder if I fed him by hand.
This went on and progressed to the point where he was eating less and less, and then wouldn’t even eat what I’d put in the bowl. I took him to the vet twice, initially she thought it was because of the heat, that he just wasn’t hungry. He had thrown up the day before, but I didn’t think much about it. But he threw up again the day after we saw her. When I emailed her that he had thrown up twice in three days, she said if it persisted we should run a blood panel. We got through the weekend, but on Tuesday he threw up again. I took him in that morning for a blood draw, and it all came back perfect.
I started just feeding him whatever he would eat—his favorite meaty treats, or roasted chicken and rice. I made him a beef stew, which he ate when it was fresh, but the next morning had no interest in it. This became the norm with everything I tried feeding him. One day he was interested, and the next he was not. After a week or two of this behavior, I noticed that he had less and less energy, and sometimes flinched when I touched him. I could see that he was feeling pretty rotten. I thought he might be in pain, maybe had a headache. His balance was also a little wobbly at times. I wrote to our friend Billy the Bloodhound’s mom to see if he had had any changes in his appetite. She said he was eating fine, but they had gone through something similar when he stopped taking prednisone for arthritis. They had a very hard time getting him to eat. So I started searching the Internet for anything about prednisone withdrawal and gastric upset, etc. I found many articles that mentioned gastric issues after stopping prednisone, including peptic ulcers. The next thing we tried was some Pepto Bismol. It helped a little and he ate a couple of meals of scrambled eggs. Then I got the ok to give him some Pepcid. It was getting harder to get him to take anything, so I wasn’t able to get the Pepcid in him very consistently. By this time he was refusing most food and treats in the morning, but eating small bits in the late afternoon. His saliva was always pretty foamy, and when he threw up it was foamy and bright yellow.
I sent all the articles I found online to Diesel’s vet.
This is the most succinct:
http://www.mayoclinic.com/health/prednisone-withdrawal/AN 01624
I spoke with our good friend who is a pharmacist and he told me that even with a long slow taper like I did with Diesel these signs of cortisol withdrawal can still show up because there is no timetable for tapering prednisone that works for everyone. It is basically a crapshoot and if symptoms come back you re-up the dose and slow down.
We decided to give him some pain meds for a couple of days to determine if he was having some pain. After the first day of Rimadyl, he was definitely happier. Marco let him out in the back and he rolled on his back and kicked in the air for the first time in over a week. I switched to Tramadol the day I took the urine sample, just in case we were going to start the pred again.
I requested a cortisol test from my vet, and by this time she had consulted with an internist in Phoenix and had learned that this condition also occurs in dogs (albeit rare; the internist said she sees one case in two years). Diesel’s vet is having all of the other vets in her clinic read up on it now.
Diesel’s urine test came back with an 8 on a scale of 1-20. Not super low, but low enough for us to decide to go ahead and try giving him some pred again to try to get him back in balance.
At this point, it has been over a month since his last dose of pred. The longer he was off of it, the more symptoms showed up. He has eaten barely a handful or so of food per day for the last 2 weeks. He has lost quite a bit of strength. He was his perfect self a month ago at 5 mgs of pred per day. Getting stronger, his silliness had returned and he was wagging his tail and rolling in the grass all the time. He was a happy guy and feeling good.
I gave him 5 mgs yesterday (August 30, 2008) and this morning around 7 a.m. Already he is moving around more than he has been wanting to. He goes from room to room to be with us whereas he would not bother before, preferring to just lie still or sleep.
I am eagerly anticipating the moment when he decides he would like to eat something.
I know this has been a long, hard road for all of you. We are sending all the bullie mojo that two bullies can send and a little bostie mojo to go along with it.
We are so sorry about poor D-Man. We wish you all the luck in the world. Try the apple and peanut butter for some reason the dogs perk up for that all the time.
Take Care.
You want Bully MOjo you got it!! we will give you all of ours!! We don't need it right now.
Shaun.. You are such a strong and amazing person. I know Diesel is so thankful that he has you as his mom. I know that this has been a big rollercoaster ride and you are ready to get off!! I will continue to add you and D man in my prayers!!
If you need anything I am just a call or email away.
We have plenty of Bully mojo on tap and sending it your way. You guys have been throug so much with D, we have our fingers and toes and paws crossed for you all.
Thanks everyone. I am pleased to report that he did just eat a little bit of scrambled egg, and three small medallions of some raw food that my neighbors gave us. He might have eaten more of it if I had more, so off to the store I go! I sure hope he doesn't reject it once I bring it home. He seemed quite interested in it.
Shane, The girls are saying their puppy prayers and sending all the Bully Mojo to Diesel.
Thank you for the box. The girls love the treats.
Keep us up to date on the D man.
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