It's amazing how things can change in a week. Last week we were so excited that finally we could decrease the steroid dosage for Sailor and, hopefully, have her steroid-free in a month. We started stepping down on Tuesday. Everything was going well until Wednesday night. We had been crating Sailor at night because in the past month because, as I had mentioned in my last post, she has had intestinal difficulties. Specifically, she has had diarrhea with blood in her stools three times in the last month and a half. On Wednesday night (or actually early Thursday morning) she woke up my husband whining. He took her out at 2 a.m. and she had diarrhea again (this was the 3rd time). In the morning, she had another episode. Thursday was her second day to get the half dosage of the steroid. Thursday night (or rather Friday morning) she again woke my husband and he took her outside where she once again had diarrhea. On Friday, I took her back to the vet. She put her on a different antibiotic (called Tylon - a powder administered twice a day with food) for four weeks, because she considered her to have chronic diarrhea. There was some bacteria in her stool. Although she had these intestinal problems, Sailor was still the same sweet dog she's always been. However, on Friday evening, my husband wondered where Sailor was. I went to look for her and she was in our office, just standing there, glassy-eyed, not really acknowledging my presence. I sat down and she lay down, but was not really responsive. We had to help her up to take her outside. Her gait was unstable and she didn't relieve herself. When we came back inside, she went straight to her crate and lay down. We checked on her periodically, but she was not very responsive. At 1:00 a.m. we helped her up and she was able to go outside and relieve herself, but then went right back to the crate and collapsed. Needless to say, we did not get much sleep that night, wondering if Sailor would be with us in the morning. On Saturday, I gave Sailor her steroid, but not the antibiotic and scheduled an emergency visit with the vet. By the time we got to the vet, Sailor had perked up. Diagnosis - steroid withdrawal, though I have my suspicions that the antibiotic may have had some influence. The vet put her on a different antibiotic and said to give her 1/2 the dosage of steroid on Sunday; then on Monday give her the 20 mg. He called the neurologist, and today the opinion is to give her 10 mg. steroid in the morning and 10 mg. at night, every other day. We will see how this works out, and, hopefully, we won't have another relapse. We're now dealing with two problems - the chronic diarrhea and the steroid withdrawal. Hopefully, we can cure them both - just don't know right now. I'll post again soon.

After almost a year!

Yesterday, we traveled yet again to visit with the neurologist who had saved Sailor with an over-the-phone diagnosis of SRMA. Sailor has been on the same regimen of steroids - 40 mg. every other day - for the past 6 months. She has had some physical ailments - mostly about her intestinal difficulties - which have resulted in numerous vet visits (and bills) due to her weakened immune system. But, for the most part she has been relatively healthy.
The neurologist said that Sailor had gained muscle mass and no longer suffers from Cushing's disease. She weighed in at 55 lbs. which has been pretty much what she has weighed every time she's been to our local vet.
Thankfully, we have begun to reduce the amount of steroids Sailor is taking. We are going from 40 mg. every other day to 20 mg. every other day for the next 4 weeks. Then, if all is going well, we will eliminate the steroids altogether - about 1 year after her initial diagnosis. We were surprised to learn that eliminating the steroids might eliminate her constant stumbling. We thought that would always be a part of her life and was a residual effect from the SRMA. It would be wonderful if we could get her back to her "pre-SRMA" life, but we were warned that she still might retain some of the deficits.
We feel so fortunate that Sailor is still with us - thanks to our local vet and the neurologist in an adjacent city.
By the way, the neurologist said that although highly unlikely, Sailor could be suffering from a condition known as GRE (the neurologist told us the exact name which was quickly forgotten) in which the condition requires continued steroid treatment throughout the dog's life. He felt that since Sailor had gotten ill when she was so young that this GRE was not the cause of her problems, but he felt he should at least mention it. We will know more for certain as we decrease the steroid dose.
As always, Sailor captures the hearts of all those who see her. Our local vet says that she is the sweetest dog that they treat, and every time we go in, the vets and vet techs, and receptionists all have to come give her tummy pats and love because she returns all of the attention so affectionately. The neurologist and his staff constantly tell her that they love her, and what's not to love about this beautiful, loving, long-suffering pup.

Wow! It has been a long time since I've posted anything about Sailor. She is still on the same meds although the neurologist said I could eliminate the supplements. I have cut back on the L-Carnitine only giving her 1500 mg. once per day instead of 2500 mg. twice a day. She gets the COQ10 every day, but I only give her the famotidine (like Pepcid) on the days I give her the steroids.

The best news is that finally the growth on her foot pad went away. It kept getting gradually smaller and smaller until it completely disappeared. What a huge difference that has made. Now Sailor and I have resumed our twice daily walks, which we have gradually increased in distance. Well, sometimes, for reasons only known to Sailor, she decides she has walked far enough and just refuses to budge. I can drag her along, but she is so resistant that I just give up and take her back home. Fortunately, that happens only occasionally. Today, as we were coming home from our morning walk, my husband was at the mailbox and I took off Sailor's leash and she actually ran to him for about 20 yards! We held our breath for fear of a stumble and a hard fall on the pavement, but she made it without a problem. I have noticed that she rarely stumbles when she is trotting along with her head up. The stumbles come when she has her head down and is ambling along checking out all the interesting smells. I think the joint on her left foreleg bends slightly when she puts her head down to get closer to the ground, and then it just collapses on her every once in awhile. That doesn't seem to get any better as far as occurrences, so this may be a lifelong problem for her. But, it is certainly one we can live with and doesn't seem to bother her at all.

Sailor continues to obsess about food, but the fat rolls on her body have all but disappeared. I wouldn't be surprised if she is over the Cushings disease. I took her by our local vet to get her weight and it is still 56 lbs. but I think she has lots more muscle and less fat. And muscle weighs more than fat. (I tell myself this, too, when I'm on the scale).

Sailor loves to play with all her toys now. She catches the ball in the air and actually jumps for it. She still doesn't run after one that is thrown preferring to stalk it and sneak up on it. We also play hide and seek with her stuffed toys. She waits in the kitchen while I hide the toy in the rest of the house, and then she goes to find it. This is her favorite game.

We feel so blessed to have our sweet Sailor back. Still not the same as she was before this awful disease infected her, but a long, long way from the immobile, pain-wracked puppy she was in February. Sometimes I become impatient and wish she no longer had to have these steroids that still affect her, but February 2017 will come eventually and we will begin to wean her from those.

I haven't posted anything for awhile, mainly because there haven't been any significant developments for Sailor until lately. We had taken Sailor back to our local vet about two weeks ago, because the histiocytoma on her foot pad continued to be the same size and to bleed occasionally. This time, the vet sent the scraping off for a biopsy, just to make sure it was a histiocytoma although she felt that it was. After two months with no significant change, we wanted to make sure we weren't dealing with a more serious problem. The biopsy showed that there was no malignancy and we would just have to wait it out for the growth to disappear (usually within 3 months). For over two months, every time Sailor has gone out, she has to have a protective boot on her left foot. The boot makes her stumble, which precluded any walks of any length. About a week ago, the growth began to shrink. Now, it is just a tiny spot on her foot, and for the past two mornings we have gone for longer walks - not just out to the circle in the cul de sac next to our house. This is very important because Sailor needs to exercise to get rid of the fat she's built up while on steroids. Hopefully, the next time she gets weighed, she will not be 55 lbs.!
Sailor seems to be moving better and often trots as she used to before she became ill. The faster she moves, the greater tendency she has to stumble. I am concerned that she may have some permanent nerve damage in her left foreleg, but she is so much better in the last few months.

Today, after 7 weeks, we went back to the veterinary neurologist. The good news is that Sailor is progressing. She has not lost any weight, but she has lost fat - doesn't have those rolls of fat that she had previously, but still doesn't have the muscle mass that she should. Her energy level is much better, and her neurological responses in three of her four feet are good. The problem still lies in her front left leg, which is the one that causes her to stumble. That is also the foot with the benign growth. The vet expressed some concern that after a month it has not begun to recede and also the fact that it is on the pad of her foot. Most are located on the top of the foot. He suggested we have our regular vet re-test the growth. There were a lot of technical terms, but the re-test should show whether the growth is beginning to break down or whether it is still the same. If it is still the same, then surgery is a possibility to remove it. We will make a trip to our regular vet this week to see. I don't see any surgery happening until our head vet returns from vacation in August, and the neurologist said that if our vet had some reservations about removing it (it is in a very sensitive area), we could have a vet surgeon do it.
On a happier note, the vet said we could discontinue the B-12 shots and the supplements that she now takes. I think I will continue with the supplements until they run out, which the vet said was fine. As far as the steroids are concerned, she will continue with the current dosage every other day for 6 more months. Seems like a long time to me - until February 2017 - but we will do what we have to do. My husband thought the vet said that Sailor had probably regained as much neurological strength as she was going to get, but I'm not sure that's what he said. But, if that is the case, it is still 100% better than she was 4 months ago.
Sweet Sailor is so beloved by every one she meets. The entire staff of the neurology clinic has fallen in love with her, and she returns the favor. The receptionist today said she was so sorry that it would be 6 months until she gets to see Sailor again. How fortunate we are to have Sailor, and especially fortunate when we could have lost her 5 months ago.
If any of you reading this blog are in the same situation we were in back in February, please keep the faith. There is hope if you get the right treatment.

Happy to report after one week of steroids every other day, Sailor is tolerating the new regimen well. She actually seems to have more energy and wants to play with her toys (squeaking them obsessively) and will play catch with her tennis ball. That is something that she hasn't done for a long time. She is still not up to chasing after a ball, but she does stalk it:) Her feet still get tangled up sometimes when she moves too quickly, but her gait sometimes is reminiscent of her days before she developed SRMA. Definitely an improvement. I have tried and tried to upload a video of Sailor and her ball catching and retrieving, but can't seem to make it work. Finally, I think these will work.

Sailor catching ball

Sailor fetching ball

Her appetite for anything edible (except kale or spinach) remains strong. But, she is very happy with baby carrots for lunch and green beans for dinner. We think she may have lost some weight or at least replaced some of that bad fat with muscle. She's weighs too much to hold her to be weighed, so we'll just have to wait for the vet visit to confirm that. Now that she is a year old and no longer officially a puppy, we will begin switching from puppy chow to regular dog food, a process that takes about 10 days.

Just a note about the growth on Sailor's left foot. She still has some bleeding when she has been actively playing and still has to wear the boot when she goes outside, but it looks as though it is finally beginning to wear down in some spots. Three months is a long time to wait for it to go away, but we only have two more months to go.

Happy Birthday, Sailor. You have reached a milestone in your life on your first birthday. We thought back in February that you'd never achieve this, but through prayers and wonderful veterinary care, you are here with us and you're a much more energetic pup than a month ago.
We are blessed to have you with us, even though you still suffer from the repercussions of SRMA. Yesterday you went to the groomer, which brought you back to us as a sweet smelling, freshly clipped and groomed puppy, with no problems from your foot pad growth from the grooming.
Here is a photo of Sailor on her birthday - she's looking better and maybe has even lost a few pounds.

Next we embark on the next phase of stepping down the steroids. From 4 mg. once a day, we will go to 4 mg. every other day. I am very nervous about this, but am hoping for the best. The supplements and B-12 shots will continue as usual. I'll update after she's been on this regimen for a few days.