Alopecia in a JRT on Atopica

Re: Alopecia in a JRT on Atopica

Evelyn Barbour-Hill — Sat, 13 Dec 2014 14:43:11 GMT

[quote user="Robin Grimmer"]Steroids have mineralocorticoid and glucocorticoid effects.[/quote]

All steroids? Testosterone? Oestrogen? Nandrolone?

[quote user="Robin Grimmer"]Methylpred has a lower mineralocorticoid effect than prednisolone so causes less pupd.[/quote]

And it's always been my firm understanding that methylprednisolone can more reliably be assumed to act only for 24 hours, thus making the alternate-day-dosing method of reducing adrenal cortex suppression more reliable.

Re: Alopecia in a JRT on Atopica

Anthony Todd — Sat, 13 Dec 2014 14:35:28 GMT

[quote user="Thomas Johnson"]Some confusion perhaps between the long lasting injectable form of methylprednisolone, DepoMedrone V, and the tablets, Medrone V?[/quote]

Aren't they both methylprednisolone though? [thought they were the same chemical??]

No, one's the acetate, didn't realise that made a difference.

Re: Alopecia in a JRT on Atopica

Thomas Johnson — Sat, 13 Dec 2014 10:50:06 GMT

[quote user="Anthony Todd"]

[quote user="Thomas Johnson"]I thought methylprednisolone was slightly more potent than prednisolone, so a 4mg Medrone is equivalent to a 5mg pred, and there may be less pu/pd with methylprednisolone, but otherwise the drugs were very similar.[/quote]

Methylpred. seemed to work much better by injection than oral pred and PD /PU didn't seem to be a problem. Perhaps it's owner compliance with tablets?

[/quote]

Some confusion perhaps between the long lasting injectable form of methylprednisolone, DepoMedrone V, and the tablets, Medrone V?

Re: Alopecia in a JRT on Atopica

Robin Grimmer — Sat, 13 Dec 2014 10:11:29 GMT

Steroids have mineralocorticoid and glucocorticoid effects. Methylpred has a lower mineralocorticoid effect than prednisolone so causes less pupd.

Re: Alopecia in a JRT on Atopica

Anthony Todd — Sat, 13 Dec 2014 09:55:17 GMT

Methylpred. seemed to work much better by injection than oral pred and PD /PU didn't seem to be a problem. Perhaps it's owner compliance with tablets?

For things like lick granulomas in dogs or cats, [if there is such a name now], it worked well, provided you continued the jabs until the lesion had completely resolved and combined it with distraction tricks, which help initially.

Re: Alopecia in a JRT on Atopica

Thomas Johnson — Sat, 13 Dec 2014 08:33:00 GMT

[quote user="Evelyn Barbour-Hill"]

[quote user="shanley barber"] Interesting that Medrone is 'worse' than preds, I wasn't aware of that.[/quote]

Methylprednisolone "worse" than prednisolone in some aspect? In what way, exactly?

[/quote]

I thought methylprednisolone was slightly more potent than prednisolone, so a 4mg Medrone is equivalent to a 5mg pred, and there may be less pu/pd with methylprednisolone, but otherwise the drugs were very similar.

Re: Alopecia in a JRT on Atopica

Evelyn Barbour-Hill — Sat, 13 Dec 2014 00:42:45 GMT

[quote user="shanley barber"] Interesting that Medrone is 'worse' than preds, I wasn't aware of that.[/quote]

Methylprednisolone "worse" than prednisolone in some aspect? In what way, exactly?

Re: Alopecia in a JRT on Atopica

shanley barber — Fri, 12 Dec 2014 21:04:32 GMT

Hi Andy, thanks for your (relevant) reply; I am desperately trying to get the dog off Medrone, but the tapering of the dose advised by the referral centre is incredibly slow! I am reducing it more quickly than they advised, so hopefully we will get the hair growth sooner. Interesting that Medrone is 'worse' than preds, I wasn't aware of that. I will scrape for Demodex next time she's in, but the skin is perfect (minus hair) and previous dogs on steroids with demodicosis have had horrendous thickened skin, so I didn't think of Demodex. Thanks all, S

Re: Alopecia in a JRT on Atopica

Anthony Todd — Fri, 12 Dec 2014 15:50:14 GMT

[quote user="Robin Grimmer"]Do you not need to boil the water? ;)[/quote]

Nah, that's a separate guessing trick for a different situation, something to do with the kidneys, but that's just a wild guess.

Ask Martin if you want an accurate description and eventual, [boy it's eventual, and only if a test comes up positive] diagnosis.

Don't know what you do when they're undiagnosed.

I suppose I'd smell the breath or have another guess or just say "A touch of distemper" if all else failed.

Re: Alopecia in a JRT on Atopica

Robin Grimmer — Fri, 12 Dec 2014 15:38:13 GMT

[quote user="Anthony Todd"]

[quote user="Martin Atkinson"]I once treated a 'simple IBD' with dietary control with little success[/quote]

I'll have to take you through my process, it's easy quick and cheap.

Diet Trial in a fit healthy normal animal with recent diarrhoea or vomiting.

1 Keep in, or on lead.

2. Water only 12 hours or more, max 24.

3. Make sure nobody else is feeding it!

4. Boiled chicken or boiled fish until stool is passed, hopefully formed. NOTHING ELSE.

5. NO MILK

and

6. If still diarrhoea after a maximum 3 days from the start then, and only then, your tests but only after you quiz the owner re the above.

7. Give some placebo or palliative if you think the owner wants and can use it.

[Would be before you got your biopsy results back anyway! so you could do it at the same time, you'd be happy, I'd be happy.]

[/quote]

Do you not need to boil the water? ;)

Re: Alopecia in a JRT on Atopica

Anthony Todd — Fri, 12 Dec 2014 15:28:27 GMT

[quote user="Andrew Kent"]

Generally (or at least according to the current WSAVA guidelines) the diagnosis of IBD (a sub-type of which is lymphoplasmacytic) relies on the identification of inflammation documented in cases that have not responded to trials of diet, antibiotics and anthelmintics.

We should therefore assume, if this case has been appropriately investigated (which we have no reason to doubt at present) that if the animal has been diagnosed with IBD it failed to respond to diet.

Andy

[/quote]

Yep, I totally agree only adding that some "diet trials" aren't "conclusive" for reasons I covered in my "instructions to owners".

I think some posters think I put raging parvo dogs on a diet trial......

Re: Alopecia in a JRT on Atopica

Anthony Todd — Fri, 12 Dec 2014 12:36:42 GMT

[quote user="Martin Atkinson"]I once treated a 'simple IBD' with dietary control with little success[/quote]

I'll have to take you through my process, it's easy quick and cheap.

Diet Trial in a fit healthy normal animal with recent diarrhoea or vomiting.

1 Keep in, or on lead.

2. Water only 12 hours or more, max 24.

3. Make sure nobody else is feeding it!

4. Boiled chicken or boiled fish until stool is passed, hopefully formed. NOTHING ELSE.

5. NO MILK

and

6. If still diarrhoea after a maximum 3 days from the start then, and only then, your tests but only after you quiz the owner re the above.

7. Give some placebo or palliative if you think the owner wants and can use it.

[Would be before you got your biopsy results back anyway! so you could do it at the same time, you'd be happy, I'd be happy.]

Re: Alopecia in a JRT on Atopica

Andrew Kent — Fri, 12 Dec 2014 12:32:44 GMT

Hi Shanley,

Change of hair coat can accompany both the drugs that you are using but until you get off the steroids it will be difficult to know which, but in both cases the hair should return with cessation of the drugs.

An alternative drug to be considered would be chlorambucil if you need something to manage the IBD that may have less hair issues!

Andy

Re: Alopecia in a JRT on Atopica

Andrew Kent — Fri, 12 Dec 2014 12:28:30 GMT

We should therefore assume, if this case has been appropriately investigated (which we have no reason to doubt at present) that if the animal has been diagnosed with IBD it failed to respond to diet.

Andy

Re: Alopecia in a JRT on Atopica

Anthony Todd — Fri, 12 Dec 2014 12:23:14 GMT

[quote user="Martin Atkinson"]Your insistence that anecdotal treatment[/quote]

I dunno, but back in the day when a "treatment" was given and the animal got better and the condition never recurred I sort of ,misguidedly and totally illogically , thought what I had guessed, or just made up, as a diagnosis was somewhere near correct.

How could a qualified [if stupid] professional jump to such a conclusion?

When the cat in question had had every test under the sun, even had a stomach wall biopsy ,been going on for months , and stopped, never to return when the diet excluded dried food I, arrogantly and totally mis -guidedly, thought I might have diagnosed it correctly.

To say nothing of the countless other chronic diarrhoeas and vomiting syndromes cured, even if not diagnosed, by a diet change.

Your insistence that anecdotal successful "treatment" without a diagnosis, which is only available by some sort of "scientific" test and invalid if it just involves being sensible and using experience, eyes and ears, is pretty trying for me too.

Other dinovets all sigh and say to me "I don't know why you bother"!

Re: Alopecia in a JRT on Atopica

Martin Atkinson — Fri, 12 Dec 2014 11:50:57 GMT

[quote user="Anthony Todd"]Does a dietary sensitivity become IBD and then Lymphocytic-Plasmacytic Enteritis or are they totally unrelated conditions?[/quote]IBD is merely an acronym/euphemism for irritable bowel disease borrowed from human medicine. It equally may mean inflammatory bowel disease and it could be lymphocytic, lymphocytic/plasmocytic, eosinophilic or any combination of each even with some mast cells thrown in for good measure.

[quote user="Anthony Todd"]I've also had a case in a cat which got to a stomach biopsy when it was a simple sensitivity.....[/quote]So without the biopsy how did you know, not having a retrospectoscope, that it was 'simple sensitivity'. And how do you define that? Your simple sensitivity would have a combination of any of the above in varying degrees or there would be no symptoms and how do you know it wasn't lymphoma? You may be able to control IBD with diet and that may be enough but how do you know?

I once treated a 'simple IBD' with dietary control with little success although I had advised ideally we needed a biopsy for a diagnosis. Then just before the owner finally conceded we would have to take a biopsy it crashed and bled out. Its spleen had ruptured because it was 90% mast cells as was the walls of its gut!

Your insistence that anecdotal treatment rules and reluctance to perform 'tests' is getting rather trying me old mate.

Re: Alopecia in a JRT on Atopica

Anthony Todd — Fri, 12 Dec 2014 10:56:23 GMT

Does a dietary sensitivity become IBD and then Lymphocytic-Plasmacytic Enteritis or are they totally unrelated conditions?

Before I get flamed again, I only ask because sensitivity to "diet, mucus or bacteria" is mentioned as the possible aetiology in the "scholarly articles on the condition".

I've also had a case in a cat which got to a stomach biopsy when it was a simple sensitivity.....

Could Lymphocytic-Plasmacytic Enteritis be the final result of an uncorrected diarrhoea after an uneliminated sensitivity?

[BTW, Medrone is a pretty savage steroid, I wonder why the referral centre prescribed it and not good old pred?]

Re: Alopecia in a JRT on Atopica

Martin Atkinson — Fri, 12 Dec 2014 10:35:15 GMT

Well the data sheets state 'changes of hair coat' as a possible undesirable effect so I guess anything goes. But I would second Suzanne's query.

Re: Alopecia in a JRT on Atopica

Suzanne Kelly — Fri, 12 Dec 2014 00:01:10 GMT

Have you checked for demodex?