Here is part four (of five) of frequently asked questions dog lovers have asked me since Lilly’s ill-fated response to a vaccine earlier this year. This series of questions / answers covers the treatment of Lilly’s vaccine-induced meningoencephalomyelitis / meningoencephalitis (inflammation of the brain and lining of the brain and spinal cord).
Please note: These questions and answers were posted when it still looked like Lilly might survive. That was not ultimately the case. Lilly died on December 17, 2013. We lost the fight, after spending 23 months and nearly $31,000 trying to save her.
How did veterinarians treat Lilly’s adverse vaccine reaction?
The veterinary neurology team immediately put Lilly on intravenous, massive doses of steroids – along with IV fluids. Once we had a diagnosis, then Lilly did a 36-hour cycle of a chemotherapy drug (cytosine) often used for lymphoma (in people and dogs). Because nervous system inflammation is mostly processed through lymphocyte cells (white cells), this drug works well for cases like Lilly’s. It is given in very different / lower doses than if veterinarians were treating cancer.
There was a risk it would ruin her bone marrow, but complete blood count (CBC) tests done later showed that Lilly’s bone marrow and red blood cells were fine.
Lilly received this chemo drug through intravenous infusions:
- 12 hours on
- 12 hours off
- 12 hours on
Once Lilly began having seizures due to the inflammation in her brain, the veterinary neurology team added THREE different anti-convulsants – Phenobarbital, Keppra, and potassium bromide. When Lilly did have seizures (often 2 close together), the team also gave her some rectal valium.
Lilly also received and continues to take an immune-mediator drug called cyclosporine. It’s often given to people after an organ transplant to prevent “rejection.” It keeps the immune system from attacking the body.
What medications / treatment does Lilly still need for her adverse vaccine reaction?
Lilly came home with a LONG list of required medications, including some that needed to be given in the middle of the night:
- Dexamethasone (steroid)
- Cyclosporine (immune-mediator)
- Keppra (anti-seizure)
- Potassium bromide (anti-seizure)
- Pepcid (to help with digestion side-effects of steroids)
- Vitamin E (antioxidant for her brain)
When her steroid-induced diarrhea raged on, we added a couple more “tummy medicines:”
- Metronidazole
- Tylan
When Lilly’s nose bleeds also would not stop, and we realized from the ER visit that she was suffering from scary high blood pressure, the veterinary team also added a blood pressure medicine:
- Amlodipine
As Lilly’s tummy improved, we dropped the metronidazole and tylan. Once Lilly’s potassium bromide levels got up to protective levels in her blood stream (that takes several weeks), we were able to wean her off the Keppra (over two weeks).
Currently (May 2012), Lilly continues to take the following medications:
- Dexamethasone (steroid)
- Cyclosporine (immune-mediator)
- Potassium bromide (anti-seizure)
- Pepcid (to help with digestion side-effects of steroids)
- Vitamin E (antioxidant for her brain)
- Amlodipine (blood pressure med)
Does Lilly still take her fear / anxiety medications?
No. The veterinary neurologist had us stop giving Lilly her chlomipramine (twice a day) and xanax (as needed) cold turkey. He does not want anything else in her system that can suppress her brain function.
What about other medications Lilly had been taking before her adverse vaccine reaction? Does Lilly take those?
The veterinary neurologist had us stop giving Lilly monthly heartworm / tummy worm preventives.
He also had us stop giving Lilly fish oil since she is now getting the Vitamin E. He said it was OK to continue her glucosamine, but just to be safe, I dropped that as well.
To make up for the lost fish oil, I do give Lilly some organic coconut oil with her meals.
Is Lilly a wreck without her fear / anxiety medications?
Surprisingly, no. I think it’s partly that she still doesn’t feel “well,” but I also think it’s partly because her brain is so slow to process stimuli. Lilly continues to show signs of cognitive delays, and I also think her vision isn’t great anymore. Those things might slow her reaction to some stimuli.
Lilly indeed remains fearful, including reacting to other dogs, loud noises, and other daily life things, but she isn’t a total wreck. She can function in her day-to-day life OK since her world has become very small during her recovery:
- Lilly doesn’t go out in public much.
- Lilly doesn’t take any dog training classes.
- Lilly cannot think / move fast enough to take herding lessons.
- Lilly doesn’t interact with other dogs, except her brother / housemate Ginko.
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If you are new to our story, feel free to use the blog post category pull-down menu in the sidebar or this Adverse Vaccine Reaction category link to access all the posts we’ve published since Lilly got very, very sick with meningoencephalomyelitis (inflammation of the brain and lining of the brain and spinal cord) after an adverse reaction to a rabies vaccine given January 23, 2012. We’re working VERY hard to help her fully recover from both her cognitive and neurological deficits.
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If you want to access all 5 blog Adverse Vaccine Reaction FAQ blog posts, please use these links:
FAQ Part 1 – Lilly’s health status and vaccine history.
FAQ Part 3 – Symptoms, diagnosis, and Lilly’s prognosis
I pray that Lilly feels better fast. It must be so heartbreaking for you to have to see her this way.