Update: Poor Biscuit is back in ER

[SammieMom]

God bless Biscuit. So glad he made it home to mom and dad.

[Furbabies mom]

So glad that Biscuit is home with you. He'll be continually in my prayers, and pray that he continues to improve.

[Piccolina]

Vinh and I have been communicating in private since this thread first showed up.

I have been giving him all the information of my experience at the visit in the Animal Hospital in Boston with Dr. Sisson so that they are well equipped and know what to expect.

I am very glad that they decided to go to Boston and be seen by the best: Dr. Sisson.

[vinhle68]

Originally Posted by Piccolina

Vinh and I have been communicating in private since this thread first showed up.

I have been giving him all the information of my experience at the visit in the Animal Hospital in Boston with Dr. Sisson so that they are well equipped and know what to expect.

I am very glad that they decided to go to Boston and be seen by the best: Dr. Sisson.

Picoolina have been a huge blessing just like everyone here who have shared concerns and optimistic to help get Biscuit better! Ann and I are both lucky to have found SM otherwise we would probably still be lost right now.

[vinhle68]

Originally Posted by pammy4501

This is all very very familiar to me. My dog Lola ended up having NME which was confirned on necropsy. We used Potassium Bromide (KBro) for seizures. Please watch the liver enzymes with the pred and phenobarb. It can shoot them up and off the charts. My only observation of this regieme is that the pred dose seems on the low side to me. And I am not seeing the continuation of the Lufonimide or Cytosar. It is the only thing that will keep his immune system in check. The goal witht he pred is to get the inflamation under control and then to wean off of it all together. Are you still planning on seeing Dr. Sisson? He will bump that pred dramatically. You are on the right track. Keep up the good work.

Thank you Pammy! for this great tip and suggestion. What is the process to check the liver enzymes? Is this something the Vet would look for from standard bloodwork and test results?

[Snowbody]

Praying for Biscuit and happy he's home.

[vinhle68]

Happy Sunday Everyone,

We need some advice on an important issue. We have been getting a lot of tips and suggestions on increasing Biscuit’s Prednisone (steroid) doses to a higher dose to help fight the potential inflammatory progression in his brain.

In fact in Dr. Sisson published medical newsletter, he has specifically noted that his method for treating this would be a more aggressive dose of steroids to combat the inflammation.

We also know that generally traditional Veterinarian tends to take the more conservative approach by prescribing lower dose of steroid, which seem to indicate marginal benefit and possibly the lower doses only true effectiveness is to contain the seizure. Of course Ann and I am no expert when it comes to this matter and we’re definitely not doctors. Having said that what we do know is right before for Biscuit 2nd relapse of more severe seizures, the Prednisone doses were decreased.

Also we spoke with another Maltese owner in the GME forum who had a dog that went through almost the same symptoms and illness Biscuit is facing and she spoke to Ann for a long conversation today sharing historical information and such. She said that at her dog was 3.5yrs but was close to the same weight as Biscuit and at the time of treatment, Dr. Sisson prescribe at least 20mg per day (10mg twice a day).

Biscuit is currently only on a 5mg per day (2.5mg twice per day). We are seriously debating if we should just make the call and increase his Prednisone (steroid) to 10mg per day (5mg twice per day) but we're afraid if we do it without a direction from Dr. Sisson or Vet, we could be causing more harm than good.

On one side we are seriously worries that the longer Biscuit goes on with the wrong amount of medication he could be heading for more severe brain damage. Even Dr. Sisson has pointed this out.

However, without an official consent from a Vet or Dr. Sisson to increase the dosage, we fear that making the call ourselves could even worsen Biscuit already unstable and critical condition! Gosh...this is stressing both Ann and I out and we can’t wait to be able to see Dr. Sisson.

To make it worse Dr. Sisson earliest available appointment is this Wednesday in which we will be contacting his secretary first thing tomorrow to secure the appointment. The harder part is finding flights FROM/TO Boston and back home. Ann has been searching and she said getting to Boston might be possible, but getting home would be tough. Gosh...things never seem to fall your way when you need them most!

One good thing out of all this is that our new lady friend from the GME forum has provided us with the contact to her Vet, the one that has worked with Dr. Sisson in the past, and we have booked an appointment for a consultation with her tomorrow.

A little update on Biscuit. He's still tend to tilting his head to the right and circle tightly to the right as well clockwise. However when he roam around the house he can actually walk unsteadily and wobily but pretty straight at time at very slow motion. We also started to pay more attention when he is in a deep sleep. His breathing tends to shorten but at a more rapid rates, which usually end up with him waking up sharply and extending his tonge and pants heavily. When this usually happen either he has to poops, or thristy, or simply just panting which is an expected side effect from the meds. Every now and then he'll wake up and start opening and close his mouth like he has something stuck in it that is bothering him, but we can't tell if this is actually a lite or mild seizure happening. But we noted the incident down with date/time so we can provide the info to the Vet and Dr. Sisson.

We have created a confined comfortable spot next to where Ann sleeps on the floor with him but he hates being inside. The only thing he does inside the confined space is pees! lol some time poops. I got some pics so show how he tried to climb out of his confined space today.

[pammy4501]

I would not alter the meds without consulting the vets. There needs to be close attention paid to lab values (as I was mentioning earlier). How soon are you planning on seeing Dr. Sisson? Are you aware that he takes long distance consultations? Perhaps you and your current vet could arrainge this? There isn't one clear answer on this disease. Dr. Sisson is one approach. There are others. I saw Stacy Sullivan at Animal Specialty Group in Los Angeles. She was wonderful, and very well versed in Dr. Sissons work. She is alot closer and very good for us. She did right by my dog. Here is her contact info:

Stacey Sullivan, DVM :: Veterinary Neurology + Neurosurgery

And here is a short article she wrote about GME.

Immune-Mediated Encephalitis :: The Case of the Loopy Shepherd