# Prednisone causing muscles to atrophy in head



## Kobys_mom (Feb 19, 2018)

Hi- I wrote a week or so ago about my pup Koby, who has Protein Losing Enteropathy, caused either by Lymphoma or Inflammatory Bowel Disease. We opted not to do the surgical biopsy to figure out which is causing the low protein, since the risks of surgery were very high. Instead, we opted to treat is if it's inflammatory bowel disease. The vet put him on a very high dose of prednisone, and his protein rose only slightly in the last week and 1/2, but his poor head and back legs. His muscles seem to be gone in his head - his beautiful head - and his regular vet said it's from the very high dosage of prednisone. He also has lost so much strength in his back legs - he can't seem to jump up on the bed, or even in my back seat anymore. 
I'm planning to call back down to the internal medicine vet tomorrow to see if there's something else he should be on. Has anyone had this happen to their dog after being on prednisone? Also, I thought that they would be tapering it a bit after the first week or so, but the dosage goes as long as he has pills (for now), and that's 20 days worth. I'm really afraid what it'll do to him. 
Food-wise, they are going to put him on a hydrolized diet, and I'm afraid he won't eat at all with it. He's been on a bland diet, which he mostly likes, but I've heard it should be a high protein/low fat diet for protein losing enteropathy? I know she's treating the inflammatory bowel, so I guess that's why. 

Would love to hear from others who have been through this, and what you've done. He's still happy - just has a really weird shape now and a really skinny head 

Thanks-
Koby's mom


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## CAROLINA MOM (May 12, 2009)

I'm so sorry, I don't have any experience with this, good to hear you're contacting the Vet to see if there's another medication that can be given.


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## Our3dogs (Apr 3, 2008)

Sorry you have to go through this. When our first Golden developed lymphoma, we opted not to do chemo. We started on Pred. While the pred worked wonderful and controlling the lymphoma for almost a year, it definitely had the muscle affect you are facing right now. Wish I could give you a better answer. Hopefully your Vet can give you something different. Good luck!


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## GoldenMom999 (Apr 14, 2017)

In the beginning my dog was like that as well. She was on a high dosage of pred as well for her IBD. She was also on Azathioprine. I remember calling my vet because because her exhaustion was so alarming. He said that it was not the prednisone, she wasn't getting any nutrients. When the body has no more fat to burn, it burns muscle. If her intestines healed she would perk up and the muscle would come back. She was exhausted from no nutrients.  It was very hard. I felt like I was giving her a pill that was killing her, but it wasn't the pill. It took a month of the high dose prednisone before she started to feel better. 

At that time she was not on special food. She was on the eat anything and everything, just eat something-diet. What finally worked that she really liked was heated up cooked ground beef and rice, sometimes with raw or scrambled eggs mixed in. She wanted it, but only a little at a time. I fed her 6 times a day in the beginning because things passed through her intestines so quickly. When she woke up I was there with a warm bowl of food. If she wandered into the kitchen nose in the air while I was cooking something....within reason it was hers. I still remember my vet telling me....she has to eat, she will die if she doesn't eat. Give her whatever she wants.  And I did.

I found my notes that I brought her to the vet when she got her IBD diagnosis. After a month of treatment the symptoms were significantly better.

EXHAUSTED
Exercise intolerance
Ataxia- sleeping like a Sphinx, easier to get up?
Stumbles, very needy.
6 pound weight loss in 2 months.
Not hungry- refusing foods she normally loves.
Won’t play, not interested in toys.
Bark is not normal
Chewing on her toes badly.
Diarrhea, loose stools alternating with regular stool.
Eating weird things like a rabbit nest, grass
Sick to her stomach, but does not vomit
Pacing back and forth when she pees, this continued even after UTI treatment
Drinking and peeing a lot.


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## pandamonium (Apr 18, 2012)

I am so very sorry... It is so easy to see how much you love your Golden, and are trying your very best to help. I hope that you are able to find something that works. It is such a hard thing to experience...


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## Kobys_mom (Feb 19, 2018)

GoldenMom999 said:


> In the beginning my dog was like that as well. She was on a high dosage of pred as well for her IBD. She was also on Azathioprine. I remember calling my vet because because her exhaustion was so alarming. He said that it was not the prednisone, she wasn't getting any nutrients. When the body has no more fat to burn, it burns muscle. If her intestines healed she would perk up and the muscle would come back. She was exhausted from no nutrients.  It was very hard. I felt like I was giving her a pill that was killing her, but it wasn't the pill. It took a month of the high dose prednisone before she started to feel better.
> 
> At that time she was not on special food. She was on the eat anything and everything, just eat something-diet. What finally worked that she really liked was heated up cooked ground beef and rice, sometimes with raw or scrambled eggs mixed in. She wanted it, but only a little at a time. I fed her 6 times a day in the beginning because things passed through her intestines so quickly. When she woke up I was there with a warm bowl of food. If she wandered into the kitchen nose in the air while I was cooking something....within reason it was hers. I still remember my vet telling me....she has to eat, she will die if she doesn't eat. Give her whatever she wants.  And I did.
> 
> ...


Oh my gosh - those symptoms are so similar! It breaks my heart, seeing Koby like this. He just can hardly jump up on anything - just rests his head on the side of the bed and smiles :frown2:, and his poor skinny (now) face. And, his appetite is so weird, he will eat something one day, and minutes later, won't eat it. They have him on a "bland" diet - ground beef, chicken, sweet potatoes, eggs - and a canned "bland" food that he turned his nose up at last night. Sometimes he eats with gusto. Sometimes he spits everything out. And this is my pup that would eat anything and everything. Of course, he still wants whatever I'm eating 

They want to switch him to a hydrolized (canned food only) diet, but I'm really afraid he won't eat anything if we do that. 

What is Azathioprine? Koby is on an antibiotic - metronidazole - and now getting B12 shots every week. What is your dog eating now? And was it the prednisone that worked? Is yours still on prednisone? How soon did they taper it?

I'm so worried about him. Did yours ever get a biopsy done to rule out lymphoma? 

Thanks, and sorry about all the questions!

Theresa


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## Kobys_mom (Feb 19, 2018)

Our3dogs said:


> Sorry you have to go through this. When our first Golden developed lymphoma, we opted not to do chemo. We started on Pred. While the pred worked wonderful and controlling the lymphoma for almost a year, it definitely had the muscle affect you are facing right now. Wish I could give you a better answer. Hopefully your Vet can give you something different. Good luck!


I'm so sorry about your pup! But, wow - the prednisone worked for a year? What kind of lymphoma did yours have? And, did yours have the facial muscle atrophy and the weakness in his/her legs? It's so worrying and I'm afraid it will continue to get worse.


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## GoldenMom999 (Apr 14, 2017)

It's OK...I had a million questions too!

I wrote on your other post too... this link is really good about explaining types of IBD and treatments:

https://bluepearlvet.com/medical-art...l-disease-ibd/

I really believe that feeding her many times a day, small amounts really helped and my vet agreed. Every time she ate she would eventually have to poop....and IBD causes very bad, painful cramps. The less that she had to poop all at once the better. Because the less pain she was in...the more she would eat. So anytime she looked at me and wanted to eat because she wasn't in pain...I fed her.

Azathioprine is another immunosuppressant. They tapered her pred dosage after a couple weeks, but she took prednisone every day for over a year and B12, Metro and Azathioprine for the rest of her life. She was on a VERY high dose of pred in the beginning. I can't remember how much, but it alarmed me. This was in addition to her anti-siezure meds as she had epilepsy too.

My vet didn't recommend the diet although I did switch her to it because I thought I would give it a try...but not until after she had gained back her weight. She ate canned Royal Canine Venison Hydrol Protein and really did like it. It smelled bad. But I still gave her whatever else she wanted, just stopped the home cooking. 

Yes, she had a biopsy, but with an endoscopic. No Lymph. She passed away 2 years after her diagnosis..but from heart disease not IBD. But they were good years!


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## murphy1 (Jun 21, 2012)

I have experience with prednisone myself. Insist it is tapered! If the doctor says it's not necessary, say it'll make you feel better. The body needs time to bring itself back from the drug. My girlfriend was on 40mg a day for a month and the doctor stopped it cold turkey. She experienced high fevers for ten days and total exhaustion for weeks.
I hope your pup is ok.


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## Kobys_mom (Feb 19, 2018)

GoldenMom999 said:


> It's OK...I had a million questions too!
> 
> I wrote on your other post too... this link is really good about explaining types of IBD and treatments:
> 
> ...


Thanks for all your information! We couldn't do the endoscopic biopsy, since they said Koby is too big  Did your pup have protein losing enteropathy too? Koby started again not wanting to eat, yesterday. He'll eat a couple bites of something, and then spit the next one out. We're at a loss - I know he's hungry. He's just gotten so turned off by food  And, the internal medicine vet didn't call me back yesterday, which irritates me......

He's not in pain at all, which is good. At least, I don't think he is. I haven't seen any cramps. I'm still hoping that it's Inflammatory Bowel, and not Lymphoma  And, his weakness in his legs is even more apparent - my husband said he stumbled for the first time. This so worries me........ 

Anyway, thanks so much. I'm feeling like we do need to feed him whatever he'll eat right now! He hasn't lost weight, that we can tell - the the muscle atrophy. He had gained a bunch (10 pounds) when I first took him in, but I think it was fluid, since he was back down in a week and has been holding steady, thank goodness. When did they prescribe the immunosuppressant?


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## cwag (Apr 25, 2017)

I am sorry you are having to go through this. I would be worried too. Hopefully he will take a turn for the better very soon.


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## GoldenMom999 (Apr 14, 2017)

Kobys_mom said:


> Thanks for all your information! We couldn't do the endoscopic biopsy, since they said Koby is too big  Did your pup have protein losing enteropathy too? Koby started again not wanting to eat, yesterday. He'll eat a couple bites of something, and then spit the next one out. We're at a loss - I know he's hungry. He's just gotten so turned off by food  And, the internal medicine vet didn't call me back yesterday, which irritates me......
> 
> He's not in pain at all, which is good. At least, I don't think he is. I haven't seen any cramps. I'm still hoping that it's Inflammatory Bowel, and not Lymphoma  And, his weakness in his legs is even more apparent - my husband said he stumbled for the first time. This so worries me........
> 
> Anyway, thanks so much. I'm feeling like we do need to feed him whatever he'll eat right now! He hasn't lost weight, that we can tell - the the muscle atrophy. He had gained a bunch (10 pounds) when I first took him in, but I think it was fluid, since he was back down in a week and has been holding steady, thank goodness. When did they prescribe the immunosuppressant?


I wish I could remember exactly, but it was very soon after she was diasgnosed. I think it was a few days later when she didn't respond to the prednisone as well as the dr wanted. I remember he called in a prescription to our human pharmacy for me. It's a serious drug and so she was on it every day only for a short time, then she went to every other day, which is what she was on for the rest of her life. The way I could tell she was in pain was when she would go to the bathroom she would pace and pant. And she would hold it for as long as possible. She has some accidents in the house at night, because she just wouldn't go...it hurt so she tried to hold it too long. She also chewed her paws which can be a sign of pain.

I don't know if she had protein losing enteropathy, but she may have. Because she had the endoscope procedure they were able to diagnose the IBD and treated her for that. I also went back and looked at her records from before she went to the specialist. I had been complaining to my vet that her appetite was decreasing for a couple of months. My vet said that food hurts...so they don't want it unless it's really good and worth it. That's why he told me just to get her to eat....whatever she would eat. I still remember what I fed her...for so long. She got 1/2 cup of ground beef and 1/2 cup of cooked rice or elbows in a square tupperwear container which I held for her, 6 times a day.

In the beginning I hand-fed her until she was strong enough to eat it herself. She didn't eat from her own bowl for about 6 months. When they have no energy, because they are not getting enough nutrients, everything is just too hard. I remember her standing there and looking at her bowl and then sighing and walking away to go lie down. Standing was an effort, the act of picking up the food from the bowl was an effort. So I made eating as easy as I could. I brought the food to her, I held it the container and if she didn't want it herself, I hand fed her while she lay on the couch. I gave her other stuff too like hardboiled eggs. I just had to be careful and not give her anything that was too fatty. It's hard to digest. No store snacks...most actually have a very high fat content.


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## jennretz (Jul 24, 2013)

I am personally on prednisone and azathioprine. Prednisone has to be tapered; Koby will crash if it isn't. I can tell you that when I have tapered too quickly, it makes me very ill. The azathioprine is a disease modifying drug. It is an immuno suppressent. With IBD, they are trying to get inflammation down. I have been on both prescriptions for 20+ years. With the azathioprine, you just need to be careful if another vet prescribes something else that would suppress his immune system. You may want to double check with your vet about vaccines as well. I cannot have "live" vaccines - have a feeling that probably carries through to canines as well.

I mentioned in your other thread that Duke was recently diagnosed with IBD. He cannot handle steroids, so we are treating with diet (hydrolyzed protein and rabbit from stella and chewy's). He also gets CBD oil (.5ml two times a day) and metranidazole. Sometimes I supplement with Pepcid if he seems urpy. They had originally prescribed Prilosec, but he didn't handle it well. We do B12 monthly now.


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## Normy (9 mo ago)

Kobys_mom said:


> Hi- I wrote a week or so ago about my pup Koby, who has Protein Losing Enteropathy, caused either by Lymphoma or Inflammatory Bowel Disease. We opted not to do the surgical biopsy to figure out which is causing the low protein, since the risks of surgery were very high. Instead, we opted to treat is if it's inflammatory bowel disease. The vet put him on a very high dose of prednisone, and his protein rose only slightly in the last week and 1/2, but his poor head and back legs. His muscles seem to be gone in his head - his beautiful head - and his regular vet said it's from the very high dosage of prednisone. He also has lost so much strength in his back legs - he can't seem to jump up on the bed, or even in my back seat anymore.
> I'm planning to call back down to the internal medicine vet tomorrow to see if there's something else he should be on. Has anyone had this happen to their dog after being on prednisone? Also, I thought that they would be tapering it a bit after the first week or so, but the dosage goes as long as he has pills (for now), and that's 20 days worth. I'm really afraid what it'll do to him.
> Food-wise, they are going to put him on a hydrolized diet, and I'm afraid he won't eat at all with it. He's been on a bland diet, which he mostly likes, but I've heard it should be a high protein/low fat diet for protein losing enteropathy? I know she's treating the inflammatory bowel, so I guess that's why.
> 
> ...


Hi

I have just seen your post.
My fur baby was diagnosed with exactly the same as yours 9 weeks ago.
I have noticed the muscle wasting in his head also.
Just wondering if you successfully reduced the steroid.
Thanks


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