Internal bleeding from prednisone

[maneumann]

So poor little Jack is now suffering from internal bleeding as a side effect of the prednisone. They can give us medicine which will help heal his intestine, however, clearly he needs his medication changed or reduced. Waiting for his neurologist to make a recommendation.

Currently Jack is taking 2.50 mg every other day. Before this he was on 1.25 mg daily, but in attempts to reduce the side effects his vet wanted him to start pulsing (effectively doubling up one day and not taking nay the next).

We tried pulsing initially, but it caused Jack to have some very bad days, so we went back to daily dosage. This second effort has been OK, and he is mostly having good days. However, now internal bleeding. Jack also takes 75 mg Gabapentin twice daily and has weekly acupuncture (which seems to really be helping with energy levels and mood!).

What have others done with medication? And what dosages of Prednisone and frequency are most dogs on?

Thanks,
MA

[Nancy]

what medicine are they giving him? I know sucralfate before meals is supposed to coat the stomach to avoid ulcers. I had a dog who also took tagamet or pepsid when taking steroids.

[Cathy Moon]

I hope Jack feels better soon.

Charlie is taking:
80 mg Gabapentin 3 times a day
40 mg Amantadine once per day
10 mg Prilosec once per day

On his bad days we can also give him 25 mg Tramadol up to 2-3 times a day, if needed.

Charlie was on Prednisone for 2.5 weeks following decompression surgery, and he had diarrhea with a small amount of blood. It turned out that he had an overgrowth of Clostridium. He took liquid Flagyl and Benebac to heal from that. He's on his second 'syringe' of Benebac now and finally back to normal.

[maneumann]

The vet gave us sucralfate and pepcid AC, because they don't want to reduce his Pred. So the same stuff.

Good to get some reference on the medication, so Charile does not take any pred?? Are the Prilosec and Amantadine easier on the body?

Kindest regards,
MA

[Friday's Mommy]

Friday was on prednisone early on before and right after her surgery. I disliked it because she was so hungry all the time. She used to be a very picky eater and since then it changed her view on food.

Friday is on 100mg gabapentin 3x/day
25mg furosimide once a day (morning)
tramadol as needed (usually 1 or 2 per week)

Tried the prilosec and didn't see any difference.
Amantadine I've never heard of and I'll ask my doc about that. Cathy, is it a new drug to treat SM? It looks as if you and Cathy are having good results with acupucture and I may check more into that too. How often do you do it?

[Cathy Moon]

The vet gave us sucralfate and pepcid AC, because they don't want to reduce his Pred. So the same stuff.

Good to get some reference on the medication, so Charile does not take any pred?? Are the Prilosec and Amantadine easier on the body?

Kindest regards,
MA

No, Charlie doesn't take Prednisone; only for that short while when he scratched his incision from the decompression surgery.

Prilosec is an over the counter acid-reducer drug which happens to have a side effect of reducing the amount of cerebral-spinal fluid the body produces.

Amantadine is an antiviral drug that has neurological side effects which are currently used to treat Parkinson's disease in humans.

I think the drugs that Friday is taking are the ones that are most often recommended by Clare Rusbridge.

I'm not sure why Charlie isn't taking those, except for the fact that he had severe neurological symptoms such as proprioceptive ataxia (dizziness, coordination problems), tetraparesis (weakness in all 4 legs), and a hypermetric gait (stepping high with front legs). The ataxia is gone - Dr. A. feels it was the high doses of Gabapentin which caused that, but Charlie has permanent neurological damage remaining.

We have to go to a compounding pharmacist to get the Amantadine and Gabapentin 80mg prescriptions, and it is costly! I don't know if these drugs are easier on the body. But they're working for Charlie, so we're staying with them.

[Cathy Moon]

Amantadine I've never heard of and I'll ask my doc about that. Cathy, is it a new drug to treat SM? It looks as if you and Cathy are having good results with acupucture and I may check more into that too. How often do you do it?

I don't know if Amantadine is new.

We're going once a week for acupuncture. I'm not sure how many appointments will be needed as we've only gone one time so far.

[Barbara Nixon]

Perhaps your vet will prescribe a different steroid. When Teddy had them, for his skin, the vets swapped between Prednisolone and Medrone, saying they had slightly different effects.

[maneumann]

We're going for a second opnion in two weeks, so I'll be sure to bring up some of these other medications.

Regarding the accupuncture, Jack has been going for 4 weeks. I think his holositc vet, whom I like very well, would like to keep seeing him weekly indefinitely. But it is $90 a session, so my plan is is go for 3 months (which I've read is the time needed to "rebalance" weekly and then every 10-14 days for maintaince.

[Karlin]

Hmmm -- I'd really rethink this with the vets as they are starting the usual treatment protocol in reverse. Have they considered pulling him off steroids entirely and just putting him on a higher dose of gabapentin? What he's on now is extremely low as a dose -- the very minimum Dr Rusbridge recommends for example. My Leo, who only weighs 15 lbs, takes 100mg twice daily and he only has moderate scratching symptoms and no clear pain. Clare Rusbridge only puts them on preds when *nothing else works* or to bring immediate relief for a seriously affected cavalier. You'll note her treatment protocol says to begin with a low gabapentin dose but to increase if there's no relief. Steroids are her last recommendations before moving to surgery or for seriously affected dogs for whom surgery isn't a consideration.

Also, gabepentin clears the system after 8 hours for many dogs and he is probably being left with no relief at all from it for two four-hour periods daily. I'd talk to a neurologist about changing this regime as a matter of urgency if he is having internal bleeding, and/or maybe go through the Rusbridge recommendations with your vet?