Monday, May 9, 2011

Payton’s battle with PDE…treatment

If you missed the previous post in this series, please check it out.

Hi! It’s Christy. Payton has been gracious enough to have me back to continue her story. So let’s talk treatment and medication. First, I’ll explain our interpretation of the treatment philosophy. This is the key to keeping a realistic expectation. I remember asking Dr. Podell over and over how long she would live. The problem is that despite the hope we have, there are still so many unknowns. As destructive as the disease is, the medication that helps can have some bad side effects. So many drugs, at such high levels, can take its toll on the rest of her body. The key is to finding the lowest levels of drugs to minimize the impact on her body’s other organs (specifically the liver) yet keep away the disease in her brain. If the disease doesn’t progress beyond treatment, then eventually the medications (or at least some of them) will cause organ failure. So the sad news is that Payton is not likely to live the “normal” 12 to 15 years for small dogs. We are still shooting for that though and so far our prayers have been answered!

When developing Payton’s treatment, the very first thing Dr. Podell did was take her off of the potassium bromide given at U of I. He said that it was more harmful than good and no dog really should take it when there are so many other options available. Aside from that fact, I don’t think I can remember how exactly Dr. Podell’s prescribed medication list has evolved from day one, but I can say that we have only added meds and/or changed dosages over the last 5 years. Everything she was on from the beginning is still part of her routine. As such, I’m just going to list all of her current drugs by category or purpose. They are all human grade and it was surprising to find out that my grandfather takes (or has taken) many for his epilepsy.

Payton’s drugs (aka “legal dog pharmaceuticals”...you crack me up Puglet):

Anti-seizure
Levetiracetam (generic for Keppra)
Phenobarbital
Zonisamide
Gabapentin
Diazapam (aka valium, for emergencies only)

Anti-inflammatory/pain
Prednisone
Gabapentin

Immunosuppressive
Cyclosporine

Liver supplement
Ursodial
Denamarin
Vitamin E

Upset tummy
Famotidine (generic for Pepcid AC)

***updated January 22, 2012***
Muscle supplement
Coenzyme Q-10
Quinicarn (L-Carnitine, which according to a few websites is also helpful to combat liver disease)
***updated January 22, 2012***


As you can see from the picture, this is a lot of drugs! She has to take them throughout the day (and even at night). My husband and I don’t know what we’d do without the alarm clocks and pill tray! Luckily, Payton looks forward to taking them and gets excited if she hears the alarm. She thinks they are treats.  (ssshh! This has to be our secret!) We just wrap them in bread and put a dab of peanut butter on it if she get’s a whiff of one of the pills.

One minor side effect of certain drugs is an increased hunger. Pugs are already food obsessed dogs, so it may be hard to imagine a medically-induced food-coma pug! To help her cope, with the advice of Dr. Podell, we changed her food to the Science Diet prescription weight loss formula (WD) so she can eat more of it and more frequently. The last thing worth noting is that because of Payton’s compromised and suppressed immune system, she can’t take any of the normal vaccines, but she is still on a once a month topical flea/tick/heartworm treatment.

Like always, if you have any questions, please feel free to ask them in the comments sections, or contact us privately via email. And my disclaimer…I am not a vet so please make sure to consult your own vet before giving your dog any of the medications listed above if you have fears that you or some dog you may know is ill.

I really hope this information is useful. I’ll be back later this week to talk about Payton’s life since the diagnosis.

Love,
Christy (and Payton)

14 comments:

Minnie Moo said...

Oh Christy,

Happy Belated Mother's Day. You are an excellent mama to a four legged baby. She's so lucky to have you.

Muah,

Minnie Moo

Noodles said...

Wow - Payton is really lucky to have such special Pawrents who really go to the ends of the earth for her.
Love Noodles
PS I think my Mommys would too, tho.

Rambo and Miss Ellie said...

Christy and Payton,
I agree with Noodles you are one lucky pug, but hey we pugs are so loveable.

Happy belated Mother's Day
Love, Rambo and Miss Ellie

Anakin Man said...

It's good to be informed on this-
Very sorry all the meds little Payton is on-
Very happy and thankful for people like you who are so devoted to caring for animals with difficult illnesses~

Looks like Payton has Many Many years ahead of her!!!!! :)

love to all of you~
Anakin Man, IzZY, Josie and TriXie

Tiffy said...

Hi Payton! My foster mom had a puggie that had PDE. The puggie is at the bridge now because her little body couldn't fight anymore.

You look very strong and healthy. Your mom sure takes good care of you. You are so lucky to have her.

The pug that used to live here was on Prednisone and Gabapentin. Momma said she can send you the Prednisone if you want it (it's only from December), but the Gabapentin is liquid and she doesn't think it will travel well. Send me an email if you want me to ship the Prednisone to you. Hopefully, it will make it to your house unlike the package Puglet sent!

Tiffy

pugtails.net said...

Wow that is a mountain of drugs for one little puggy. You must have the best parents in the whole world for taking care of you like they do.
So sorry (and angry) to hear your package from Puglet was tampered with.
Licks, Sabrina

Meredith & Scarlet said...

You are one lucky puggy Payton, your parents are taking such good care of you. likewise I know you take good care of them too with love and licks.

My angel Nicki had diabetes which required daily injections; sometimes it was hard but everyday I felt so honored to take care of her.

We're lucky humans to have doggies like you.

Be well Payton!
♥♥♥
Meredith & Scarlet

THE PUGLET said...

Payton -

You are so lucky to have such awesome people looking after you & I'm glad you're giving PDE a major butt-kicking.

Sorry some postal jerk stole the Gabapentin we sent... but if Dutch rejects any other legal pharmaceuticals on your list, I'll let you know.

Go Payton!

Massimo said...

You may not know me, Payton. I'm Massimo the sock eater from Puglet's Daily blog. Anyway, you are too adorable! You are lucky to have such great humans that adore you! Stay well! :)

Massimo, the sock eater

Anonymous said...

Hello my Ava has this sickness, I just found out yesterday :-( .. Would like to find out more about what can be done to help her please email me if you could I would so appreciate it Aaronbanner1@live.ca

Kristin Dittrich said...

Hi there!

I know this is a while after you posted but I wanted to ask a question. My 10 month old pug has been having seizures for a month now. We just started on zonisamide but unfortunately without an MRI/spinal tap (cost is feasible) we don't know if it's general epilepsy or PDE.

Why are you guys on 5 different anti convulsants? Do you find they work well together?

Thanks!

Payton's mom said...

Hi Kristin,
Payton didn't start off on all 4 of the seizure medication (the Diazapam wasn't given routinely - only emergencies). When she was first diagnosed, her neurologist prescribed phenobarbital and keppra. Then throughout the years as she had some relapses and the disease progressed the zonisamide and gabapenton were added. We were told multiple drugs are better since they work on the brain differently. However if your pug's seizures are being controlled on just one drug, then I don't know that I'd want to add another. Hope this helped. Please email me at boostrom1 "at" charter.net if you have other questions or would like to discuss more - I think that'll be a more reliable communication mechanism. I'll be keeping your pug in my prayers.
Love,
Christy

Lucy's Grammy said...

My daughter's 2 year old pug Lucy just got diagnosed yesterday. We are devastated. She is now on Keppra, Zonisamide and Phenobarb. She just started prednisone and Cyclosporine. Did you ever get the IV treatment Cytosar? It was recommended by our neurologist but we would have to travel to Cornell NY to get it for her and keep her there 48 hrs. every 3 weeks. Thought we should at least try the current regimen to see if we can slow the progression.
Thank you for sharing your story. You had one amazing pug!!!!

Natalie said...

Thank you so much for sharing Peyton's story. The information is invaluable. I hope it might help some dogs (and their people) if I also share my experiences of having a pug with PDE.

My pug Jagger was diagnosed with PDE in May 2015 at the age of 4. Initially his seizures were controlled with a mixture of anti-convulsion medications. A month later Jagger began to seize and could not stop. We rushed him into the Veterinary Hospital in Zurich (UZH). When I handed Jagger over, close to death and unconscious, I never expected that I would see my sweet boy again. Luckily for us UZH were doing a study on Encephalitis of Unknown Origin in Dogs. They gave Jagger 10 doses of low level radiation over the course of 14 days and 1 year and 3 months later he is still with us and is a happy little pug. He takes a combination of Phenoleptil and Levetiracetam four times daily and has a check up every 3 months.

As is the case we PDE we know it will return at some point. We know that Jagger will not enjoy a full life, but he is very happy for now. He goes on walks, plays with his doggy brother (Magnum PI) and REALLY enjoys his food.

When he was diagnosed with PDE I read what I could about the illness and believed Jagger would be gone within a few months possibly even weeks. Our vet like many other vets advised us that we would probably need to put Jagger down within a short time of his diagnosis. Luckily for us we lived near a hospital that had specialist knowledge and they gave us our pug back. If your Pug is diagnosed with PDE make sure you get a referral to a neurologist with experience of NME. If we had not, Jagger would not be here now.