Max is Back to Chemo for His GME

Max is Back to Chemo for His GME. Max's GME Update. This is an update of the chemotherapy protocol of our dog, Max who is battling Granulomatous meningoencephalomyelitis (GME). This is a canine disease where the white blood cells attack the central nervous system.


This is an update of the chemotherapy protocol of our dog, Max, who is battling Granulomatous meningoencephalomyelitis (GME). This is a canine disease where the white blood cells attack the central nervous system

Max is Back to Chemo for His GME

In July of 2014 Max, our (now) nine year old Coton de Tulear was diagnosed with GME. I’ve written about his progress extensively, here and here and here and here and here. This is the original post where I detailed the trail to diagnoses and remission.

I have not had a blog post update on Max’s GME since October, 2016. As they say, “no news is good news” and he had been doing quite well until October, 2017. If you subscribe to the Ann’s Entitled Life newsletter, you have read a few updates about little Max.

In October 2017 he again suffered what was thought to be a GME relapse. We made a trip to Cornell, his Prednisone was increased, his CycloSporine was raised a touch, and we hoped all would be well.

A few days into January 2018 we began to notice increased circling from Max. He would still stop if I commanded him to, but the circling did not abate. We took him to Cornell on January 11, 2018, and his resident neurologist – Dr. Sarah Stephan – as well as her neurology supervisor (a chief of neurology), indicated a relapse.

Max was sent home with a huge increase in Pred (10mg), Pregabalin (for the pain), and instructions for us to watch him, and lower his Prednisone dose to 7.5mg in 5 days. The hope was we would reduce that 7.5mg dose to 5mg, and we would reduce the Pregabalin to one per day when he dropped to the 7.5mg, and less than that at 5mg.

Well, the best-laid plans…

The positive to the Prednisone – which is a synthetic corticosteroid drug – is that it is particularly effective as an immunosuppressant drug. And Max’s immune system needs to be suppressed at all times. He does not get any shots, and he does not receive kennel cough. Nothing to ramp up his system in any way.

Since Prednisone is a steroid it can have longterm side effects including bacterial infections (he had a nasty skin infection last year which he needed to have a pet dermatologist treat), and weight gain. As anyone who has ever taken a steroid knows, you want to eat and eat and eat and eat. Max is here.

Now along with a voracious appetite, Max also gains weight while on the Pred. It takes a while to get that excess weight off him once the Pred decreases, and he is an unhappy doggie at 17 pounds or more. This time, with the pred increase we had him weighed at physical therapy (where he is weighed weekly) as well as his regular vet (where he went for a blood test). They both showed him losing weight with the steroid increase.

On the higher doses of Pred Max was not responding as he has in the past. The circling increased and got tighter. There were neck stretches (a sign that he was trying to relieve the pain), and when we tried to reduce the Pregabalin there were obvious (and loud) signs of pain from him when we tried to give him oral medication (he flails his head to get away from me every time (3.5+ years now)) and was now causing himself pain in doing so.

Max is Back to Chemo for His GME. Max's GME Update. This is an update of the chemotherapy protocol of our dog, Max who is battling Granulomatous meningoencephalomyelitis (GME). This is a canine disease where the white blood cells attack the central nervous system.


Mr. Max surveying his domain before we left Sunday morning.


We called Dr. Stephan and last Friday she suggested that we come in and start Max up on chemo again. We drove down to Cornell, and he received a treatment on Monday through to Tuesday. Cornell administers the Cytosar as a drip which is less “harsh” to his system. (Max had injection chemo in Jacksonville a few years ago… let’s just say that was a crappy experience.)

Some of the protocols have changed. In the past, we would have a blood test for Max one week after chemo treatment to check his white blood cells. That is no longer necessary. He goes back for another chemo treatment in a month, and they suggested we do the full panel ahead of time again so he can get right to the treatment. (We did it prior to this treatment not knowing he was going to have chemo… the tests were to check the immune system with the pred ramp-up.)

As to the non-weight-gain with the Pred? We were told it wasn’t as unusual as we assumed.

I am keeping Max home from physical therapy this month. We had planned a long road trip for the end of January and February, so I had nothing scheduled for him anyway. (That trip was canceled when the chemo became necessary.) His next PT isn’t until March, and by then he will have several chemo treatments behind him and should be feeling more like himself (I hope).

One of the things I keep telling Hubby – and that was reinforced (kindly) by the two neurologists we saw at Cornell this month – is that Max is well past historic longterm prognosis for this terrible disease. When he was diagnosed it was “not leaving the hospital” – to – “up to three years”. Max is now at 3.5 years. Both neurologists also made mention of how remarkable this is.

Max is Back to Chemo for His GME. Max's GME Update. This is an update of the chemotherapy protocol of our dog, Max who is battling Granulomatous meningoencephalomyelitis (GME). This is a canine disease where the white blood cells attack the central nervous system.


Mr. Max resting comfortably inches away from one of his (many) beds, Wednesday morning.


I have no idea how much longer we will have the little guy with us. To date, he has been extremely tough in battling this truly terrible disease. He’s set for several more chemo treatments, and we are hopeful this will zap that crushing inflammation and Max will truly be a medical marvel. We do know that, since Cornell is a teaching veterinary hospital, his treatment therapy could be of help to future dogs that come down with Granulomatous meningoencephalomyelitis (GME).

We are just thankful for every day we have with him.


Previous Max posts (read in order from the bottom up to follow his whole story):

Max Had a Relapse
Mr. Max April 2016 Update
Max March 2016 Update
Mr. Max Post Cornell Visit Information
Max’s Latest GME Update
Max’s GME Update, One Year Later
Max’s GME Update, Month 11
Max’s GME Update
An Update on Mr Max, March 2015
Updating Max’s GME
An Update On Mr. Max
Last 2014 Trip To Cornell For Max
Back To Cornell
Max’s First Cornell Follow-up Visit
Max Exercises More Than I Do!
Updating the Mr. Max Situation
A Mr. Max Update
Mr. Max, Mr. Max, Mr. Max
It’s A Mr. Max Post!


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Comments

  1. What a tough little guy! I hope that the chemo will work wonders and you’ll get much more time with him. So thankful he has parents that are able to be so thoughtful with his care and observant to his needs. Keep up the good work!

    • Thank you, Stephanie. We shall see. The one thing we don’t want him to be is in pain. I will say even just a few days later the circling has decreased (his biggest “tell”). **fingers crossed**

      Ann

  2. Chizuko Dutta says:

    Dear Ann and Max,
    I am very happy to know Max is doing well.
    I have a 10 years old beagle in the same situation
    As Max was.
    Do you use any homiothetic medicine in addition to cytosar treatment? If so, please let me know?
    Thank you.

    • Nope. You have to kill the inflammation, and I am not sure anything but chemo can zap his flare-up. However, I am not a pet neurologist. You should consult one for your beagle. And best wishes for your pet making remission (there is, sadly, no recovery).

      Ann

      • Chizuko Dutta says:

        DearAnn,
        ThanK you for your prompt reply. I immediately
        Started writing my reply By e-mail, but I got
        Interrupted. Now two dogs, one epileptic and the
        Other with heart murmur, are asleep, and I have
        Some uninterrupted time.
        Hana is in care of the doctors in Gulf Coast
        Veterinary Neurology Hospital. After four days of stay, she is back home. Since then, she has not had any convulsion, and she is receiving Cystosar treatment now. I trust modern medical approaches.
        But I was wondering that there might be some
        Complementary homiothetic treatment.
        Best wishes,
        Chizuko

  3. My little Pomeranian was diagnosed with GME January of 2016. He is still doing well two years later but the Chemo has caused him to loose most of his fur. He is on a small dose of pred in morning and evening. He is on Phenobarbitol to stop the seizures. I give him a powerful immune liquid vitamin which I believe has helped him feel and playful and living. I also give him fish oil in liquid form from the vets office. This is also good for brain health and skin. The liquid vitamin is expensive but for a small dog, it lasts six months. It passes the blood brain barrier and has all the vitamins in it that promotes brain health. I have attached the website for you or anyone who is interested. It’s called Poly MVA for pets. https://www.globalhealingcenter.com/pets.html

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