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Dr. Altman
Dr. Altman, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 11114
Experience:  Practicing small animal veterinarian for 17 years.
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I am a neurophysiologist. I have a 12 year old F beagle with

Customer Question

I am a neurophysiologist. I have a 12 year old F beagle with steroid responsive meningitis who has had 4 episodes over the last 6 years.
She generally responds to 20mg prednisione PO within 1h which I taper 25% over 4w.
She had another attack today about noon and was administered 15 mg over 1h and had significant remission, but has been sleeping and awakes every few hours with mild respiratory distress and howls with some pain. She was given another 10mg prednisone PO aboit 1h ago and appears to be resting somewhat restlessly.
As she has had 25mg prednisone over the last 6h I am reluctant to administer a lot more, I have read some papers where dosages up to 40mg/24h would be appropriate for her weight (10kg).
Should I consider administering another 15 mg or more, and if so how much more, over the next 12h?
What symptoms should I watch for?
At what point should I consider he steroid responsive meningitis refractory and consider euthanasia as this condition can cause intractible pain
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. Altman replied 1 year ago.

Welcome to Justanswer! I am Dr. Altman and happy to assist you both today!

I am so sorry your dog has had so many relapses! I have had 2-3 cases over the years and have not had to experience what you have over a six year period...

Ideal is to keep her at a 2 mg/ kg dose but if she is not getting comfortable with the 2.5 mg/kg dose I would consider bumping up to 3 mg/kg (another 5 mg) tonight if needed.

In addition, do you have access to gabapentin (neurontin) or tramadol (ultram) to hopefully help her rest tonight?

Expert:  Dr. Altman replied 1 year ago.

I hate that you have not gotten past her threshold yet. The hope is that we can get her over that pain threshold and comfortable tonight and then be able to taper to a more manageable level the next 3-5 days...

The question is the restlessness and respiratory changes related to the steroid dose or pain, I understand she is crying out related to pain but not sure if the other symptoms are steroid related in origin or pain or a combination of the two...

Expert:  Dr. Altman replied 1 year ago.

Please let me know if this information makes sense and any additional questions I can assist with or clarify. If you need assistance with dosages of other medications for example...

I am online another 15 minutes tonight to assist you

Intractable if you are forced to go up to the 40 mg dose tonight to keep her comfortable

Here are two great handouts related to pain and quality of life in dogs that I use regularly for patients as your Beagle:

Quality of life assessment handout: http://www.peacefulpetdepartures.com/quality-of-life-assessment/

Pain assessment handout: http://www.csuanimalcancercenter.org/assets/files/csu_acute_pain_scale_canine.pdf

If you have more questions or if I can help in any other way, please do not hesitate to ask! If you would like to accept my answer, please press RATE OUR CONVERSATION (I am not compensated in any other way). Bonuses are always welcome. Thank you and best wishes to you both tonight, truly

Expert:  Dr. Altman replied 1 year ago.

Good morning, how is your Beagle doing today? Were you able to get her comfortable? I would love an update when you are able. Please let me know any additional questions I can assist with or clarify today.

If you are satisfied with my responses please rate at the top of the screen with the stars. Thank you and Happy Thanksgiving!

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