Monty’s March 4th checkup with the neurologist went OK, so we decided to drop the Cyclosporine to every other day offset with the Prednisone every other day. Today he had another checkup and we opted for the full blood panel to see if there has been any improvement with his white cell count. Unfortunately this number ticked down another whole value in the last 2 months so we’re dropping the Leflunomide to 20mb/day to try to get that value rebounded. The other off thing in the last month or so is we’ve seen a little bit of a decrease in activity and spunk. Being overly sensitive to any perceived changes in behavior I brought it up with the neurologist and just to make sure there’s nothing lurking we decided on a course of a general antibiotic for 7 days. I was hesitant to use Clavamox again since his last bad reaction, but the doc felt it was the best general use one given the lack of anything specific to go on. Guess we’ll see how this goes.
It’s been a while since Monty reminded me to post anything about him…
The checkup in early December went well so he got his Cytosar injection and the Prednisone dose was reduced to 2.5mg/day. Then I went out of town for a few days in mid-December and he very suddenly out of the blue developed a corneal ulcer in his right eye, which of course is the only eye he has vision out of. Panic! So C took him to the family vet and managed treatment and by the time I was back everything was fine. Around Christmas time I tried again unsuccessfully to drop the antibiotic (Cefpodoxime) from his daily med dose, and while we lasted over a week this time his immune response ultimately wasn’t up to the task just yet. His next checkup just before the new year again went well, so he got another Cytosar injection and a further reduction of Prednisone to 2.5mg every other day.
Fast forward to today’s exam, and while his neurological responses were great his white count came back low so the decision was made to keep treatment as is and to not have a Cytosar injection. Hopefully it’s nothing, so we’ll wait and monitor until early March.
The good news is that the little dude has his energy and spunk back. All indications point to him feeling much better these days with the low Prednisone dose, and continues to surprise no one with his grit and determination through thick and thin.
Monty has been much more active & cognizant since the last step down of Prednisone, so overall October has been a good month. Today’s checkup included another Cytosar injection and a full blood work up in addition to the standard CBC, as well as a further reduction in Prednisone to 5mg/day. The test results showed improvement in liver health with the “slightly elevated” ALT/AST numbers coming down again over the last two months, so the supplement seems to be helping. He’s been eating a lot more lately which means several walks a day around town, and we’re now at the Prednisone dose threshold where we should start to see the negative side effects fade away for good.
Monty is extremely sensitive to the side effects of Prednisone (see Cushing’s syndrome), but it is also the only drug proven to keep GME at bay. It’s a delicate balance of disease treatment and symptom management we’ve been through before and will get through again.
Today’s neurologist checkup went well with the CBC panel coming back normal, so he had another Cytosar treatment. We’ve started a new daily supplement called Denamarin to help support his liver functionality and health with all of the medications he receives daily, and have introduced Leflunomide in the hopes of supplementing and eventually replacing the Prednisone that gives him such a hard time. While Leflunomide has not yet gained widespread acceptance as a GME treatment, Dr Allen Sisson (one of the leading doctors in the research and treatment of GME) has seen remission rates of up to 90% at 1.5 years when including the drug in long term treatment protocols. Additionally we decided to see if we can drop the daily antibiotic without any new UTI or hot spot issues in an effort to reduce the daily med load.
Today was the three week checkup and unfortunately not everything went according to plan… Monty had his Cytosar treatment, got the hot spots scrubbed up good with a hospital grade topical, and even got his nails trimmed. I started discussing how things were going with the neurologist and I mentioned that we’ve seen a few cases of him “spacing out” the last week or so. I had always thought this was due to the heavy medication, but she considered it suspect. Since he’s so sensitive to the Prednisone it was decided to up the Cyclosporine to twice a day for the next two weeks to see if there is any difference. Next checkup is four weeks so hopefully he continues to improve.
Things have been moving pretty quickly around here the past few weeks so I haven’t have a lot of time to reflect on the fact that it has been 10 months since Monty’s diagnosis with GME, 3 months since his last Cytosar chemo treatment, 2 months since his last dose of Prednisone, and 1 month since his last dose of any medication of any kind. As of today he will see the neurologist bi-monthly with the goal of phasing them out long term, and the rest of the lifestyle restrictions have been lifted.
It has been an exceedingly difficult road to get where we are today, but it has also been exceedingly rewarding.
Monty’s monthly neuro checkup was today, and while his white count was still on the low end it has come up a little since last month. Everything considered he is doing remarkably well and as of today he has taken his last dose of medication. I was warned this is a very dangerous time for the possibility of a relapse, so we’re continuing to keep a really close eye on him but remain optimistic considering everything we’ve been through.
Today was the February checkup with the neurologist and it was for the most part OK, however here was some concern about his CBC results in that the white count was below normal for the first time ever. The doc made a comment that his white count has always been on the lowish side of normal, but never below normal like today, so it was decided not to make any changes to the current treatment regimen and skip chemo just to be on the safe side. I still haven’t seen any physical or behavioral changes that have raised any relapse flags and this is only precautionary to protect his immune system from becoming too weak. Overall he continues to respond and improve but has started to shed an insane amount which is probably due to the combined long term prednisone/chemo. We’re trying to address this by adding an Omega-3/fish oil supplement daily to his meals, so if you enjoyed his bulldog gaseousness before I invite you to stop by again soon… =)
We’re very excited to say Monty is doing very well and continues to improve with every day that goes by. The latest CBC and additional Superchem tests came back great so he had what may be his last Cytosar chemo treatment for a while today, and we’re now down to alternating Prednisone/Cyclosporine doses every other day.
Thanks to everyone for your continued support and inquiries – we’re hoping to spend a lot of quality time in 2013 with the little dude and hope you can too!
More good news today for Monty, and don’t let the sad face fool you (he still loves car rides, the photo was just post Chemo/Cytosar).
The neurologist has again lowered the Prednisone dose, this time to 5mg (1/2 tab) every other day and hopes to be able to begin lowering the Cyclosporine does to every other day beginning late next month. She made a comment on how quickly he has returned to his old self both physically and mentally, however remained cautious indicating this might be the most dangerous period remission-wise in that there is a 10% chance the GME could come back today, tomorrow, next week, whatever. I’m not sure about the percentage but keenly recognize the possibility and have been keeping a close eye on him for anything out of the ordinary.
In other news my car now officially says Monty has officially gained all of his pre-GME weight back since he finally sets off the seat belt warning sensor in the seat again, and after losing strength enough to jump up on the couch or bed he can now hop his front legs up on both so it’s only a matter of time before we see the frog work his magic again. Also of note it has been 3 weeks since we discontinued all antibiotics and have not seen any recurrence of UTI symptoms, and he can now run, lift his leg for pees, and do the poop-scoot-grass-shuffle almost as well as he used to. Not that I’m watching…