Less Prednisone

For a couple of days, we've had Jack on a 1/4 tab of prednisone (1.25mg) twice a day.  I've been noticing some thin spots in his coat, and I'm sure that's from the pred.  So far, so good on that dosage.
We did a full pack walk up the hill this morning in preparation for a couple of little backpacking trips I'm planning.  He did just great.  He started out a little 'skitty', but his confidence returned as we climbed.  Of course, my mind was thinking there might be some correlation between 'skitty' and the pred. dosage.  We'll see.

Stable..but expensive.

Jack's electrolytes are really stable on this 28 day program.  I had the 'lytes tested at day 25 again, and find:
Sodium: 148, +1.5 from midpoint, Potassium: 4.3, -.25 from midpoint, Ratio: 34, +1.5 from midpoint.
I suspect we can ease his dosage down, as DOCP is supposed to be given when K is up above midpoint, and Sodium slightly below.  But his 'lytes results have never looked like that, they've always looked pretty close to healthy.
Clinically, he's healthy, a touch overweight (52.6lbs) active, still a little 'skitty', especially this morning, just before his DOCP injection.
We had his vaccines updated Friday, when they did his 'lytes, so the bill today was a steamin' $427.
If I can do the DOCP myself, I can save $40/bottle (2 injections) on that, $35/injection, and $61 on the electrolytes test.

Jack's Electrolytes		Sodium	Rel to Midpt	Potassium	Rel To Midpt	Ratio	Rel to midpt
Date		midpoint=	146.5	midpoint=	4.55	midpoint=	32.5
4/13/12- midterm		149	2.5	4.3	-0.25	35	2.5
4/24/12-25days		149	2.5	4.3	-0.25	35	2.5
5/8/12- midterm		152	5.5	4.6	0.05	32.5	0
5/21/12-25 day		148	1.5	4.8	0.25	31	-1.5
6/16/12- 25 day		151	4.5	5	0.45	30	-2.5
7/13/12- 25 day		148	1.5	4.3	-0.25	34	1.5

Since my last post, Jack has been getting better all the time.  At least, everything is stable.

We got out of town for a few days at Inn at Schoolhouse Creek near Mendocino.  A very nice road trip that allowed SA to get a long and well deserved massage, and Jack and I to go walk on Big River Beach.  It's now all 'on leash' unfortunately, and the town of Mendocino isn't near as dog-friendly as it used to be.  Probably due to a large influx of drifters, homeless, crazies and their dogs.
Jack got pretty comfy with the idea of just hanging out on the beach... after a while...

I say, if you're going to be a California Dog, you'd better get comfy with hanging out on a beach!

For the 4th of July, we went to Half Moon Bay, where they have a "Dog Parade" within their old fashioned all-community parade.  Jack did really well with this, marching along, distracted by everything from 300 or so dogs to horses, ponies, pigs, chickens, treats, kids throwing candy, food dropped on the ground... Shoo! If that didn't stress him to the breaking point, nothing will.  He's having a pretty good time here:

Sue Ann puttin' on the dog.... 

We met a number of nice poodles, including Ella posing here with Cleo on the lawn before the parade.

I suspect that 28 days is the right amount of time on Jack's DOCP.  I also suspect we can start reducing the dosage, but I need to talk to Dr. Doe about that, and do another electrolytes test.

A great walk up The Hill this morning.  Jack's enthusiasm was almost back to...if not pre-crash levels, at least early post-crash levels.  He dragged going up the hill a bit, but once we got to the second landing, he had some water, and seemed much more comfortable in his skin than he has lately.  He was still a little 'skiddy' about the people we encountered, but we went off leash on the last pitch, and he chased off looking for rabbits for the first time in a long while.  Better still, he returned when I asked him to!
We'll keep watching to see how he does, but I feel pretty good about his medication level and timing.

Day 28 DOCP

It seems the lower amount of prednisone (5mg/ day) is the right amount at this point.  It doesn't make Jack any less crazy, or less 'skiddy', but it keeps him together without the prednisone side effects.  Might be able to go lower still.
Throughout the pred increase, and subsequent decrease, his behavior didn't really change.  That is, his reticence to going up the hill, or anxiety about reaching a certain point and wanting to turn back.  He still does it.
Our hike this weekend was very like the rest.  He got up the trail a few hundred yards, and I had to put him on leash to make him continue.  Once he got into it 3 miles, or so, he was fine.

I decided to wait to his day 25 to get his electrolytes this time.  Very glad I did.  It came back:
NA151 (4.5 above range midpoint)
K 5.0   (.45 above range midpoint)
Ratio: 30 (2.5 below range midpoint).
DOCP dosage is constant at 2ml/50mg Percortin-V on day 28 this time.

Trending this data, it looks like both the Na and K numbers are increasing over the three months.  Sodium is consistently above the range midpoint, and K moving from below to above the range midpoint.
Na/K ratio is consistently declining.
Um... does this mean he's getting too much of a good thing, or that we're doing it right, and can just go to 28 days between injections?  I'm inclined to think we can back his dosage down 10%, and give them on day 28.
It seems a part of my brain is now permanently committed to assessing Jacks biochemical situation relative to behavior and what little analysis we have.

Well, it doesn't seem like MORE prednisone is the answer.  After a conversation with the vet, we took his pred back up to 5mg in the AM, and 2.5 in the PM.  Not good.  WAY too much water/pee/food/runny poop.  In addition, he was panting in his crate.  Back down to 2.5mg AM 2.5PM.
After a couple of days at that level, we'll try The Hill again tomorrow early.

A tiny 'ah-ha!'

Jack has been on 3/4 of a prednisone tab in the morning, and 1/2 in the afternoon since just before his last DOCP.  It occurred to me on a walk up by Lake Chabot this weekend, that this dosing might be the reason for his anxiety at the onset of our walks.
Once again, Jack was anxious going up the hill from Chabot Park, and almost had to be dragged.  We got just about to Bass Cove, and I gave him another quarter tablet (1.25mg) of prednisone.  Within 10 minutes, he was trotting down the trail, just like he and I used to do.
Understanding prednisone dosing is tricky.  It doesn't last all day in the system, like I've been expecting.  I'm thinking now that smaller 'regular' doses, say with breakfast and lunch, accompanied by micro doses, when going out for adventures might be the better way to give it.

We saw a Bald Eagle circling the lake, too!  Great day for wildlife.  Huge roaring bullfrogs, a bird I've never seen before (perhaps a Green Heron?  Wild looking, with a cry to match).  Turkeys up by the campground.