https://www.vetsurgeon.org/f/clinical-questions/27090/imtp-weaning-off-azathioprine-due-to-hepatopathy Hello hive mind. Help with this case would be much appreciated :) I have a 10 yo Lab with IMTP who has responded nicely to treatment thus far. He was diagnosed about 4 weeks ago and was started on azathioprine and pred at immunosuppressive doses (azten-USTelligent Community 10https://www.vetsurgeon.org/thread/198672?ContentTypeID=1Wed, 13 Jun 2018 22:21:19 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:dc02e409-12e9-443d-8ddc-b58a2d76b286Rosie_Skinner<p>Thank&#39;s Andrew, that&#39;s very helpful.</p><div style="clear:both;"></div>https://www.vetsurgeon.org/thread/198476?ContentTypeID=1Sun, 10 Jun 2018 16:11:21 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:b2cd7e45-9757-4679-93d1-ef634f689fb9Emily Rainbow<p>What doses is he on? Would it not make sense to try reducing doses first? Eg reduce pred and go EOD with the azathioprine and see If he&rsquo;s responding well otherwise?</p><div style="clear:both;"></div>https://www.vetsurgeon.org/thread/198452?ContentTypeID=1Sat, 09 Jun 2018 15:00:56 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:7cdcd335-e5bc-4a9f-82e2-409ab69b7049Andrew Kent<p>Hi Rosie,</p> <p>We typically see raised ALT (&gt;5-600) with aza hepatotoxicity so this may just be a steroid hepatopathy. If you genuinely suspect it is toxicity then stop cold turkey and consider an alternative immunosuppressant.</p> <p>Andy</p><div style="clear:both;"></div>