Prednisone

[Stacy]

So, I'm hoping to pick the brains of everyone who struggles with allergies in their dogs. I know I should just go to the dermatologist for skin testing and allergy shots, but honestly I'm not ready to put her through that yet. 

I've tried several antihistimines and the duoxo shampoo with limited success, and I know we need to go further. So I talked to my vet and he said we can do prednisone or apoquel. I said I was concerned with the long term side effects of both. And he felt that she did well on low dose prednisone the long term side effects would be minimal. He suggested 10-20mg prednisone every 2-3 days. 

She got a steroid shot on the 9th and then I gave her 10mg of prednisone on the 12th. Then I gave her another 10mg today - she really started getting itchy again last night and this morning. But I felt that she was much less itchy before that. 

Anecdotally, she is very well potty trained, but after the steroid injection she peed in the house once on the 10th and the 11th. She hasn't done it again since. I want to attribute that to the steroid. And I really don't want that to become a thing. I'm not sure if it would have a higher incidence with the injectable steroid than with oral steroids, or... I don't even know. Maybe it was coincidence. 

I really want to do the right thing for her, I just don't know what it is. I would love opinions on this. 

Thank you! Stacy

[Karen, Jasper and Jackdoodle]

Well, you know I'm going to tell you that the best thing to do is to see a dermatology specialist. Just for a consultation; you don't have to do the testing right now, the dermatologist may not even want to do that right now. He/she may have other ways to manage her symptoms right now that your GP vet doesn't know about. Your vet, no matter how good he might be, simply cannot be an expert on every disease or every treatment for every disease, let alone newer ways to treat them.

To give you an idea of what constitutes a "low dose" of prednisone, JD is on a maintenance dose of 5 mg every other day, and he weighs 75-80 lbs. IMO, the dosage your vet prescribed is not a "low dose." 

I can also tell you that one of JD's liver enzymes quadrupled in just a couple of months after he was put on prednisone for his IBD. And that was on a lower dose than Ava's on. It has continued to go up steadily ever since. That's why you really don;t ever want to keep a dog on prednisone long term if you have other options. It will have serious side effects. 

Steroid injections can be anywhere from 4 to 20 times stronger than the usual oral dosage. JD's dermatologist told me a long time ago that I really shouldn't ever let anyone give him a steroid injection if there was any other alternative, i.e. it should be used for emergency situations only. 

I do know people who have had success with Apoquel. There are risks with that, too, including an increased risk of cancer with long term use. That's why the safest treatment is still immunotherapy for any dog who needs medications for allergies more than 4 months of the year. 

You asked, so here it is: My opinion is that the best thing to do for Ava really is to make an appt with a veterinary dermatology specialist. :)

[Stacy]

You're right Karen - and you always have the answers I'm looking for. I don't know dog medication dosing. I wasn't sure if 10 - 20 mg was a low dose for a 60 - 65 pound dog or not. And I don't want to kill her or destroy her liver or give her addison's disease. And I'm just not getting the answers I need from my vet. He's good for very general things, but I want him to sit down for an hour and talk about our options and create a plan and he's never going to do that.

I think part of my hesitation is that I'm not really sure if her issues are "bad enough" to see the dermatologist. I hear of dogs that are so much worse off. Are her allergies really bad, or do I just have a low tolerance for feet chewing? I play the "are you sick enough to go to the doctor" with myself too. I am a million times more likely to take the girls in than I am myself. 

But I am not one of those people who asks for answers and then ignores them. So we have an appointment with the veterinary dermatologist for next Tuesday at 10:30. I just hope that he doesn't laugh at me and tell me that it's all in my head! 

Thank you again! Your information really helps me.

[Karen, Jasper and Jackdoodle]

I can absolutely promise you that the dermatologist will not laugh at you or tell you this is all in your head. And I'm very glad you're seeing a specialist. I think you'll be glad, too. :) 

[Stacy]

I'm already glad to have made the appointment. My DIY allergy treatment is a total failure. But I gave it a real attempt. My biggest concern is that the treatment is not more harmful than the disease. I want them to fix her without shortening her life! I'm excited they were able to get us in so soon! I'm secretly not excited about the cost - I'm not sure what it will be, but I bet it's not insignificant. Still, Ava is worth it. 

My other worry is that over the last few months I feel like Katie is starting to show some of the same symptoms. She'll be laying really quietly on the floor and I look down and she's licking her front feet. And I think she's about the right age for that - she's almost 2 1/2. But if that's the case Ava's treatment will pave the way to figure out what to do for Katie. 

You know I wouldn't trade my girls for anything, but I wish I had done more due dilligence when I was picking a breeder. I know hindsight and all, and I love them to pieces. But I was suckered by a really pretty website and puppy pictures. And it will be different next time.

[Karen, Jasper and Jackdoodle]

I truly hope that "next time" is a long way off. :)

Tomorrow is the 11th anniversary of the day I walked into that shelter and met JD. I ask myself, if I had it to do over again, knowing what I know now, would I still make that 90 minute drive? Then I look at him, and of course I would. He is so worth it.  

I look forward to hearing what the dermatologist has to say about Ava. 

[Stacy]

I hope next time is a long way off too! I just had 3 friends get puppies this week and it's hard not to get puppy fever - but for me 2 is enough. You've heard my no room in the bed woes. Where would I even sleep with a third! And I plan for these girls to be with me for a long time!

Happy Gotcha Day Jack! He always sounds like such a wonderful boy! I know you wouldn't trade him. And through him you have become an ambassador to all doodles everywhere! I have had dogs for a long time, but I think I am a better owner than I've ever been. Definitely more informed. I also have the least healthy dogs I've ever had, but that's a different story!

[Karen, Jasper and Jackdoodle]

Jack is by far the least healthy dog I've ever had, too. Just about the least healthy dog I've ever known. 

Isn't it ironic that one of the marketing tools they use to sell these mixed breed dogs is that they have "hybrid vigor" and "they're healthier than purebreds". 

[Stacy]

Seriously, right? We either just got lucky and hit the genetic jackpot or someone needs to rethink hybrid vigor! Actually, I do think there could be something beneficial in hybrid vigor if really stringent selective breeding is also a factor. I know you have been in the purebred world too. You could talk to the papillon breeders for days about why they selected two dogs to breed. A better angle on a hock or more fringe on an ear or something about the topline. And some of those people bred their dogs to a stud clear around the world for a specific trait. And they would cut them from a breeding program for an almost imperceptible fault. And I mean no disrespect to the doodle breeders, but because we don't have a breed standard, even if you do all the health testing there doesn't seem to be breeding for a specific quality. I think a long time in the future I might go with a standard poodle or a portugese water dog. I haven't done much research on them, but I like the way they look. I probably spend too much time thinking about my dogs ;)

[Karen, Jasper and Jackdoodle]

Amen, and thank you for pointing out how dog breeding should be done. And of course, those great breeders also do not breed for the sole purpose of selling puppies. 

[Lynda Kamrath]

One of my dogs gets poison oak and prednisone is the only thing that works for him.  It does seem to have that other side effect however - peeing, even though trained - so weigh it for yourself.  I use it for me and my dog when it seems to be called for.  I prefer oral steroids as it seems easier to control, but you will have to see what works for you.

[Stacy]

Don't get me wrong, I think that prednisone has it's place in medicine. There are a lot of people and dogs, I'm sure, that would be worse off without it. And for events like poison oak (or asthma or croup, or a lot of things) I wouldn't think twice about giving a steroid. My concern is the side effects of long term steroid use. And these allergies don't even seem to be seasonal. It's been four months that she's been here, and first I was waiting for it to freeze and the ragweed to die. Then I was hoping maybe an OTC antihistimine would help. But even though the steroids do seem to help, I am worried about the consequences of giving them forever. Especially if there is a less toxic alternative.

I love western medicine. I think we have a much better quality of life with our medical care. But the reality is that nothing is without a side effect. Allegra works really well on my (cat) allergies. And it seems like a no brainer to just take it, but I hate taking it because it gives me the worst dry mouth. Sometimes I'm not sure if I hate the itchy eyes or the dry mouth worse. Actually some of the allergy eye drops work really well and that seems to have less side effects. I can deal with all the other allergy symptoms okay as long as my eyeballs don't fall out. 

[Karen, Jasper and Jackdoodle]

It is the long term use of prednisone that's problematic. In the short term, it can be a life saver. 

One of the nice things about the immunotherapy shots is that when it's successful, there are virtually no side effects at all. And while there are no "cures" for allergies, the immunotherapy does more than just mask the symptoms by suppressing the immune system, which is what prednisone, apoquel, atopica, etc do; the immunotherapy treatment actually increases the immune system's tolerance for the allergens.