Very long story short, our 6 year old pup was diagnosed with MMM about a year. Our first vet dropped the ball and misdiagnosed her for a solid 6 mos, which I think affected her chance at remission. She has relapsed 3 times this year, with each episode requiring significant steroid usage. She recently suffered pancreatitis and gastroenteritis as a result of the meds, and her liver enzymes are off the charts.
We are concerned that the dosage she is on is way too high. She weighs 32 lbs. Each episode our vet has her taking 60mg of Prednisone a day for 3 weeks, tapering to 40 for 2, 30 for 2, and then down to 20 for a week. Like I said, she has done this 3 times this year. Does this seem excessive? He also just gives us the steroids and tells us we know her best and that she doesn't need to come into the clinic. He has not taken any blood work on her whilst on treatment, we only had this done at the ER visit when she suffered from pancreatitis.
We have asked for alternatives or additions to her steroid usage. When we went to the ER vet they prescribed probiotics, an antacid, and a stomach coating to ease some of the gastro distress. They were shocked at the steroid dosage she was on.
Do we need to find a new vet to offer different treatment? Any advice is appreciated.
Greetings, all!
This is a sub for professional veterinary advice, and as such we follow strict rules for participating.
OP, your post has NOT been removed. Please also check the FAQ to see whether your question is answered there.
This is an automated general reminder to please follow The Sub Rules when discussing this question:
Your comment will be removed, and you may be banned.
Thank you for your cooperation!
I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.
I would seek a second opinion, potentially from a specialist to better manage this condition and the steroid affects.
Ok, thank you. Does this seem like a super high dose for her weight?
Yes it’s definitely high but at the same time Immunosuppresion is required for treatment but the key is the length of time. High dose for a few days then taper down a little and stay on for 1-3 months, and continue over like a year. These guys shouldn’t stop and start steroids repeatedly, it’ll make relapse worse. A good portion of pups do have to live on a low dose long term.
My last MMM dog we slowly tapered over about 12 months and at the end we realized he had some mild symptom reoccurrence so he stays on the lowest effective dose. I saw him monthly to check his jaw tone and muscle wasting. Every 1-2 months or so depending on how he was doing we would drop the dose just a little.
I’d seek a second opinion from someone more up to date with masticatory myositis, ideally a specialist like an internal medicine specialist