He was in amazingly good health just one short month ago with an HCT of 44% and now HCT is down to 27% and falling
(HCT = red blood cell count.) The only thing that changed in this time period was a neuter surgery (he's been sick since kittenhood and I finally got him fixed after the last remarkably good CBC). He *was* excessively hormonal when the hct was so high (marking everywhere and sexually aggressive), so now I'm wondering if the sudden loss of testosterone is what did him in. Does that make sense to anyone?
His internist wants to double his cyclosporine, which would increase the dosage to 50 mg./day. I'm not convinced this will help because he barely made any progress on a cyclo/prednisone combo and only began to show marked improvement when switched from prednisone to prednisolone. I'm of the opinion that, if anything, he may have developed a tolerance to the prednisolone- unless the sudden hormonal change had an adverse effect on his immune system- and the next logical step is trying a different steroid, like depo-medrol.
I may be slightly biased against cyclosporine because the side-effects have a been a nightmare to manage. It seemingly wiped out all beneficial flora in his intestinal tract and a potent probiotic cocktail just recently got things back on track. The thought of dealing with the IBS-D all over again gives me the sweats!
His regular vet has left the decision in my hands: double the cyclosporine or try depo-medrol (in place of prednisolone). What would you do?
His internist wants to double his cyclosporine, which would increase the dosage to 50 mg./day. I'm not convinced this will help because he barely made any progress on a cyclo/prednisone combo and only began to show marked improvement when switched from prednisone to prednisolone. I'm of the opinion that, if anything, he may have developed a tolerance to the prednisolone- unless the sudden hormonal change had an adverse effect on his immune system- and the next logical step is trying a different steroid, like depo-medrol.
I may be slightly biased against cyclosporine because the side-effects have a been a nightmare to manage. It seemingly wiped out all beneficial flora in his intestinal tract and a potent probiotic cocktail just recently got things back on track. The thought of dealing with the IBS-D all over again gives me the sweats!
His regular vet has left the decision in my hands: double the cyclosporine or try depo-medrol (in place of prednisolone). What would you do?