< Continued from page 2
The Derm Diary series of articles was authored by Lianne McLeod DVM, who was the About.com Guide to Exotic Pets for 11 years.
Dermatology Diary Table of contents
Dermatology Photo Gallery
Derm Diary "chapters"
Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7 | Part 8 |
Week 44 and More -- Progress Report
Week 44 brought disappointing news: the dogs were not producing enough IgE antibodies to proceed with the testing.
This was most likely because our reduction in prednisone had not been enough. However, even with the prednisone reduction that we did manage, the dogs flared up so badly that reducing the prednisone further wasn’t something we could readily do. This news was just demoralizing. It seemed our options were diminishing rapidly as was hope we could ever make the dogs feel better. The only remaining options seemed to be fiddling with medication forever, or trying a "general" course of desensitization (a generic set of allergy shots). A desensitizing serum could be made up, which based on their history would cover dust mites, fungi/molds , and a pollen profile based on our geographic location. The success rate of this option is pretty variable (definitely not as positive as a customized desensitization based on skin or even blood testing, which already had only a moderate projected success rate), and we’d face the added barrier of needing to minimize prednisone dosing so that the desensitization could have a chance at working.
The chances of success seemed dismal, but so did the option of trying to maintain them on medications forever, especially since prednisone seemed to the only effective option but also the one with the most undesirable side effects.
Talk about feeling caught between a rock and a hard place. We discussed options and Dr. G. consulted with a couple of dermatologists. The consensus: the generalized desensitization was not an ideal choice, but really at this point was the only feasible chance at avoiding a lifetime of undesirable medication. Feeling very discouraged, I thought about this all for a while; in the end I decided that I owed the dogs a chance, however small, at being allergy-free.
The catch: starting this program wasn’t recommended until fall – October to be exact. This meant waiting 3 months. The reasons for this is that atopic dogs tend to be worse over the summer months due to the increased number of allergens in the air, and trying to get the allergic response under control enough to allow desensitization to be effective may have proved to be impossible. So we were put "on hold" for now, and will likely just try to keep symptoms under control with prednisone and other medications until fall. While I was still trying to minimize prednisone, the dogs continued to get increasingly red and itchy, so I had to gradually increase prednisone to get them feeling better again. With the increased prednisone came a marked increase in energy, so I realized the combination of antihistamines and feeling bad had been making the dogs feel quite lethargic.
So, nearly a year later we have not made much progress except ruling out food allergies and finding out that testing isn’t going to be an option. This has been an extremely frustrating (and very expensive) journey, but at least being a veterinarian has helped me understand the nature of the process and how elusive answers can be. Since progress for my dogs seems to be on hold for a while, it is at this point that I have also decided to put the Dermatology Diary on hold until progress is possible again.
January 2010 - Part 8 update:Derm Diary - 2 years later
The Derm Diary series of articles was authored by Lianne McLeod DVM, who was the About.com Guide to Exotic Pets for 11 years.
Dermatology Diary Table of contents
Dermatology Photo Gallery
Derm Diary "chapters"
Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7 | Part 8 |
Week 44 and More -- Progress Report
Week 44 brought disappointing news: the dogs were not producing enough IgE antibodies to proceed with the testing.
This was most likely because our reduction in prednisone had not been enough. However, even with the prednisone reduction that we did manage, the dogs flared up so badly that reducing the prednisone further wasn’t something we could readily do. This news was just demoralizing. It seemed our options were diminishing rapidly as was hope we could ever make the dogs feel better. The only remaining options seemed to be fiddling with medication forever, or trying a "general" course of desensitization (a generic set of allergy shots). A desensitizing serum could be made up, which based on their history would cover dust mites, fungi/molds , and a pollen profile based on our geographic location. The success rate of this option is pretty variable (definitely not as positive as a customized desensitization based on skin or even blood testing, which already had only a moderate projected success rate), and we’d face the added barrier of needing to minimize prednisone dosing so that the desensitization could have a chance at working.
The chances of success seemed dismal, but so did the option of trying to maintain them on medications forever, especially since prednisone seemed to the only effective option but also the one with the most undesirable side effects.
Talk about feeling caught between a rock and a hard place. We discussed options and Dr. G. consulted with a couple of dermatologists. The consensus: the generalized desensitization was not an ideal choice, but really at this point was the only feasible chance at avoiding a lifetime of undesirable medication. Feeling very discouraged, I thought about this all for a while; in the end I decided that I owed the dogs a chance, however small, at being allergy-free.
The catch: starting this program wasn’t recommended until fall – October to be exact. This meant waiting 3 months. The reasons for this is that atopic dogs tend to be worse over the summer months due to the increased number of allergens in the air, and trying to get the allergic response under control enough to allow desensitization to be effective may have proved to be impossible. So we were put "on hold" for now, and will likely just try to keep symptoms under control with prednisone and other medications until fall. While I was still trying to minimize prednisone, the dogs continued to get increasingly red and itchy, so I had to gradually increase prednisone to get them feeling better again. With the increased prednisone came a marked increase in energy, so I realized the combination of antihistamines and feeling bad had been making the dogs feel quite lethargic.
So, nearly a year later we have not made much progress except ruling out food allergies and finding out that testing isn’t going to be an option. This has been an extremely frustrating (and very expensive) journey, but at least being a veterinarian has helped me understand the nature of the process and how elusive answers can be. Since progress for my dogs seems to be on hold for a while, it is at this point that I have also decided to put the Dermatology Diary on hold until progress is possible again.
January 2010 - Part 8 update:Derm Diary - 2 years later