Detroit transplants living in Dallas
Sometimes I wonder what’s going through his mind; if he knows what he’s been through, what WE’VE been through with him. I’ve always enjoyed these quiet moments together in the park, it’s just lately they’ve become even more important to me because I know there’s one less to be had.
A week after going off antibiotics the hot spots are back with a vengeance. At this rate there won’t be much fur left to trim.
So we got Monty a water bed. Yep, I’ll let that sink (har har) in a little…
As a result of the Prednisone side effects, we’ve been watching him splay out for weeks on the Terrazzo floor trying to stay cool. In an effort to keep him comfortable AND cool we picked up the Cool Bed III and have been happy to see him using it regularly. With the amount of body heat he is putting off it’s hard for him to stay in any one place that absorbs and retains his heat for very long, so this has been the perfect solution to help regulate his body temperature. He uses it on the floor during the day while I work, and at night we have been putting it on the end of the bed. I’ll admit I was a little skeptical, but when I pick him up in the morning to go out the temperature difference of any part of his body not on the bed is pretty amazing.
Over the last two weeks or so we’ve progressed from zero interest in walks to walking to the park and back twice a day. I’m happy to say that so far this week we have extended our walk to the park several blocks and beyond. This morning we managed just two blocks short of our pre-relapse routine, and he was still very much ready for more.
It’s a small victory, but definitely a good sign.
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.
I had good news today. Honestly I did. Unfortunately it has now been squashed over new hotspot concerns…
For the last three days Monty has been more active and actually interested in taking walks in the morning and evening. Since over the last two weeks we have more or less walked out the door with him doing his duty and turning right back around to head in, this seemed like a major breakthrough. The original hotspot had been treated and was on the mend. Things were feeling good!
Then last night we discovered two new, larger hotspots. OK, fine, been there done that, no big deal. Shave, wash, iodine, powder, bed. I called our vet today to get more of the prescription powder, and also left a message with the neurologist so she was aware of what was going on with the hopes that if there was something else we could be doing she’d let us know. In the afternoon she called back and we decided that since his next checkup isn’t until late next week just to be safe she would phone in prescription for an antibiotic (500mg Cephalexin 2/day) to get us through until she could evaluate him again. An hour later I found two more hotspots that weren’t there when I checked him over this morning. Shit.
So now he looks like how I’ve felt some weekend mornings, but he still has his spirits and is running around the house alternating between chewing on a bone and squeaking his beer bottle toy. I just wish the guy could catch a break at this point.
Today marked a year since Monty’s original GME diagnosis, and I wish I could say no news is good news. Over the last two and a half weeks while he no longer seems in any pain and we haven’t seen any overall worsening of neurological symptoms, he has descended back into the Prednisone zone/funk and has already developed a hotspot/skin infection similar to what happened last year.
After I was injured early last week the doctor prescribed me Tramadol with the same dosage that Monty was taking, and after discovering how it made a 150 pound human feel we immediately decided to taper him off. Luckily by this time the heavy Prednisone dose seemed to have started working it’s magic on the GME so didn’t seem to be in any further pain. I can only imagine how the 35 pound dog must have felt with that much Tramadol, but once he was tapered we immediately had to start back up with the 2 hour bathroom break routine so I’m pretty sure he just couldn’t feel anything. Unfortunately it’s also plain to see the Prednisone saving his life is ravaging his muscle tone and strength once again with the emergence of “pred head”, water retention, and splaying of his legs when he sits or lays down.
Yesterday I happened to find a small clump of matted fur on his back and after some investigation and clipping discovered a dime sized hotspot on his back. Given the history and our leftover supplies we were able to trim his fur, wash the wound, and start treating with Iodine & prescription topical powder (Neo-predef With Tetracaine). So far it seems to have been kept in check but will of course have to keep a close eye on it for any worsening.
Today marks the end of the two week 15mg 2/day high dose of the Prednisone, and we begin the slow tapering process again with 10mg 2/day. Our next recheck and Cytosar treatment with the neurologist is scheduled for 7/26, so we continue doing our best to keep him doing his best.
It was really no surprise that this afternoon the neurologist confirmed Monty’s GME relapse, so we’re starting over with his treatment of: 15mg Prednisone twice daily, 50mg Cyclosporine once daily, 10mg Omeprazole, and he had the first of several planned Cytosar injections today.
The good news is that he seems to be responding favorably to the heavy medication as he is more active and aware. The doctor did note a neurological deficiency with his left rear leg, which coincided with the abnormality we experienced with his front left leg. Luckily his CBC levels were back to a normal level after being low earlier this year so at least we are not starting with a treatment deficit as that would not bode well for his long term outlook. It’s going to be a rough couple of weeks to get through the worst of the side effects, but we remain hopeful we can make it through with him.
We had been excited to reach the 1 year anniversary since Monty’s diagnosis with continued good news about his status and prognosis. He’s been one of the lucky ones having fought back from the brink of death for 347 days. It’s been a daunting road, draining mentally, physically, and financially, but the rewards during that time have been enumerable and unquantifiable. Unfortunately, it’s now apparent he has suffered a relapse.
All of his current symptoms can be explained by a condition once called Beagle Pain Syndrome, but has since been renamed as Steroid-Responsive Meningitis-Arteritis and recognized as a form of GME.
Beginning Wednesday, Monty experienced acute onset neck pain, loss of appetite, stiffness, change in stance (hunched appearance), weakness, and jaw pain. Thursday we went to see the vet, and started him back on 10mg Prednisone 2x daily with 50mg Tramadol 2x daily to try to manage the pain. We’re waiting to determine the next steps with the neurologist, but the voicemail I just received indicates we will also be restarting Cyclosporine, Omeprazole, and possibly Cytosar. So far he seems to have quickly rebounded with the initial medication, though I have some fear that’s only due to the Tramadol.
We’ll know more soon and will pass it along as we can.
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.
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