Killian's vet visit :(

Today was Killian's check up day. He was a good boy and even let Dr. Ball look in his mouth (a little). However, he does not like to give up any blood for testing. :rolleyes: That's always a chore.

Now, the dear sweet loveable big (still 106 lbs.) boy has drug induced Cushing's Disease (by clinical symptoms) to go along with liver disease and immune system problems (pemphigus et al). He has no undercoat anymore, has a pot belly and has muscle weakness in his rear legs. The worse news is that we cannot take him off the pred that is causing the disease. We are between a "rock and a hard place". Pred is the drug that has the least side effects for his liver, so that is what we are stuck with to keep the autoimmune disease at bay. We will TRY to cut him back by 1/4 a dosage, but it may send his system into another all out attack on his immune system. What to do!!! I watch him like a hawk, so I will try to cut back, but at the sign of the disease getting worse, I will be forced to up the dosage. I will have to look into the prognosis for Cushings to see what is in store for him. Can it get any worse?
Yes, he also has conjunctivitis. The good news is that he can use some of Shiloh's eye med to help clear it up.

Other than that, with all those diseases, he is doing well considering. He is his happy friendly wonderful self. I was truly blessed to have been able to rescue him from death row 7 1/2 years ago. I do not regret one minute. Killi, hang in there, Boy.

Shiloh will go to the vet next week. I can't take all this stress in one vet visit! :eek:

MIxed blessing glad but sorry on your news. As long as he has a good quilty of life its good news I guess. Keep up the fight Killi.

Oh Killian, Killian, Killian:( Sue, as you said, the good news is he's doing so well on all other counts. Wow, maintianging his weight! That's such great news! But oh dear, drug induced Cushings? :confused: Seems I've run into a lot of dog moms lately that have pups suffering with Cushing's. And on the radio the other day, a vet was talking about Cushings and the drugs that are used to treat it, but I can't remember the names. He did say though that most dogs lead full lives with the disease, but of course, they are not having to also deal with all that Killian has been dealt:( Did Dr. Ball mention just cutting back the Pred or cutting back and adding another med for the Cushings? Sue, your head must be spinning right now. And through it all, you and Killian both manage to hang in there and keep fighting the good fight. You are one amazing team, you and Killian. Please keep us updated Sue. We're sending you our love and support and of course, lots of slurpy licks and tail wags. Hang in there dear, brave Killian! Sandra, Cody and Star:)

Hi God ~

We're not sure Who'z in charge of passin out da *challengez* fur
us guyz livin down here onna Big Durt Ball...

But kuld You check on whut's bein handed out
fur Killian an hiz Mom?

He'z been given a LOT of *challengez* -
an he an Mom are handlin em purdy well...

Kuld You ask em to *ease off* a bit?
Mebee jest let poor Killian *enjoy* hiz Senior Years?

'Preciate any Help You can give to this matter, God.

THANKS, God!

/s/ the Prayer Pups

We are just going to try to cut back on the pred. That drug is used for his pemphigus (autoimmune disease). Right now he is at the dosage where if we cut back, it might make his pemphigus worse ( crusty, stuffed nose, outbreak of crust on ears, mouth, body, oozing sores, etc. ), but I am going to at least give it a try. The meds for Cushings might affect his liver disease. He is in such a delicate balance right now, we are afraid to do anything. His pemphigus is slightly acting up still (nose sores and crusty spots). Since his Cushings is drug induced and pred is the offending drug, we are sort of in a little trouble here. Any pred replacement will also affect his liver so we are stuck with it. Everything affects his liver!

The good news is that he still has quality of life, that's for sure!!!

You PM'd me, my inbox is full. I PM you to tell you I emptied mine, and your's is full. lol! Seems were two pretty popular ladies!:D

Hehehe, tag....you're it!! My box is emptied now! LOL

Thank you Cinder and Smoke!!

Sometimes I wonder what else can go wrong..........then it does!

Pretty soon I should know all about so many diseases that I could open my own vet practice!!

Sudilar I've been between that rock and a hard place with my Mandy in making decisions about her health, it's no fun. I'm sure you're doing the best you can. And I'm sure Killian knows how hard you try. My thoughts and prayers will be with both of you.

with the Pemphigus, but have you tried other immuno-suppressants in the past?

One of the preferred treatments is with Azathioprine, although that one can be hard on the liver. Cytoxin and Leukeran are also drugs that are used routinely.

A possible thing try that you should discuss with your Vet is to start tappering the Prednisone while starting on Leukeran at a low dose. As you continue to decrease the Prednisone, increase the Leukeran. Over a period of weeks if not months you might be able to reduce the Prednisone down to a very low level, while depending on Leukeran to keep the Pemphigus under control. The main side affect of the Leukeran will be myelosuppression or bone marrow suppression. Don't believe it will cause the liver any problems, but of course you would have to monitor for it. Else it's the rock and the hard place.

Oh Sue ............... I saw your thread heading, and the tears started ...........

BUT, lets hope that the "medication dance" works for you ....... come on Killi, you are one big, brave, strong boy ...... we know you will cope.

Sue, HUGS to you and Shiloh ........

Thank you everyone for all your support. It means so much to me!

Killian is still acting happy and eating, so I am grateful for that. We can see that his body is wearing down, but quality of life is still there.

Dragondawg, thanks for the suggestions. Is Leukeran a chemo drug? You think that it might do some good for the pemphigus vulgaris? He is susceptible to infection very quickly, so it may be counterindicated in his case being that a side effect of Leukeran can be the inability to fight off infection. He has a variety of autoimmune problems and liver disease. He has had (rare in dogs) ulcerative granulating and fibrosing eosiniphilic gingivitis, pemphigus vulgaris, lip fold pyoderma, a small liver, multiple acquired shunts and microvascular dysplasia causing high blood pressure in the liver. At the moment, the pemphigus is not completely gone but is present slightly. The minute we raise the pred dose by a little, Killi has stomach reactions and blood in the stool. If we lower the dose, pemphigus takes over. The other drug choices have even more side effects that would cause more harm to his liver. So we are very slightly reducing the pred to see what happens next.
He is on prednisone (20mg every other day), milk thistle, salmon oil, vitamin E, Sam-e, lactulose and a pace dose of amoxicillin, plus a home cooked diet.

Oh, Sue ... lost for words here. Killi has all this stuff going on but he is so lucky to have you help him through. Hugs and much love to you and the dear, sweet boy, and Shiloh too.

You are all ever in my prayers.

Chris

Sue, I read this yesterday and hardly knew what to say. I hate for you and Killian to be struck another blow to deal with. Somehow, I know you will deal with it, though. Please give that sweet boy a hug from me and don't forget Shiloh too. Hope she's doing ok. Please keep us posted and we will certainly be keeping Killian and you in our prayers.

Love,
Logan and the gang

Oh, Sue, I am so sorry to hear that there is yet another challenge for Killian and you. I don't know of anyone who could have cared for all his problems with any more of a concerted effort. It seems you have one determined veterinarian as well. In the process, you have become quite an expert, and honestly, I think you have worked a miracle in managing to keep Killian alive and functioning and enjoying life despite having almost everything in the book having been thrown at him. Keep up the good fight.