Vero mentioned that Toby vomitted last night. After that he hasn't wanted to eat. This all comes as a result of the move back to oral meds. Toby's second disease, IMHA, is an auto-immune condition and treating it means getting his immune system suppressed. Science has found drugs that can do this but none of them come without consequences. The big three are prednisone, cyclosporine and azathioprine. Prednisone cause the major havoc with his insulin and throws the diabetes off but it is effective. We're on 5mg per day now, if we can get the IMHA moving further into remission the we eventually drop off the pred. Cyclosporine is an immune suppressant, Meg is actually on it for itchy skin. Oral cyclosporine can cause vomitting, which the doctors believe is the cause of Toby's vomitting and loss of appetite so we have to stop it. We can put him back on the IV cyclosporine but it is a long infusion with some risks so while it works within the hospital, it doesn't help with the goal of getting Toby regulated at home. That leaves us with Azathioprine as the alternative to Pred, problem with this one is the loading does can take 7 days and Toby has only been on it for the last 4. We're trying to take this one in stride but we're holding our breath a bit. His PCV came up a point to 23% and we'll get another look later today.
His attitude is fairly positive, he really really really wants to be held. We spent a half hour, just hanging out and watching the goings on in the treatment room. He's always been a cuddler, usually he wants to flop down next to you but given the lack of seating in the hospital he was very content to lay in my arms.
We'll update more later today when we get an updated PCV.
Thanks, John, Vero, Toby, Meg and Pepper