IMPA in dogs-Information for those seeking it

Taken in 2019-Healthy and back to running

I have honestly pondered several times starting a FB group for those of us who have had dogs battle IMPA.  I searched out others who had battled this disease when Stella was diagnosed and now that we are through and on the other side, I have become a resource for others who are now battling this horrible disease with their beloved pets.  I wanted to put together a blog post that covers the basics of how to navigate this disease.  I will try and reference papers so if you are like me, you can search, but most of this is coming from those of us who have battled this horrible illness.

1.  This disease never goes away.  Your pet can be in remission but the disease is still lurking inside of them waiting for the next time to hit them hard.  We are currently in remission but believe me, every time she limps, every time she takes a while to get up from laying down, any time she acts funny, I am bracing myself for it's return.

She lost quite a bit of weight and had shaved legs for a while

2.  Proper diagnosis.  Joint taps are almost necessary for clear diagnosis.  Rule out all other diagnosable diseases that have proper tests first, but if IMPA is in question, do the joint tap under sedation for a clear answer.  It is worth the money and time to know, and it does not cause your dog anymore pain than any other diagnostic test.  The dog is under light sedation, so they feel nothing.

We sat in many waiting rooms and became pros at waiting

3.  This disease is a marathon, not a sprint (quote credit give to my good friend Shanda). While I am sure there are those dogs out there that quickly get better, most take months if not years to get over this disease.  As we found out with Stella, backing the prednisone off too quickly = relapse.  Manage your expectations by understanding that this disease takes MANY medications and many step downs and can take lots and lots of time.  For Stella that took almost a year of weekly and then monthly vet visits including routine blood draws, adjustments of medications, checking of urine and blood pressure, and time off from work for me.  My final bill was over 6 thousand dollars, but I would do it again in a heartbeat to save my baby.

Pre IMPA

4.  The drugs that it takes to beat this disease can have very horrible side effects, but it takes strong medication to completely put your dog's immune system under submission.  Due to the prednisone (Pred), Stella basically peed so badly all over our house that what little carpet we had left had to be ripped up and trashed.  We also will have to rip up and replace a section of hardwood that she frequented.  She was also very very hungry and testy, and we had to manage her very carefully, especially with a kiddo in the house.  She would snatch food out of your hand and not care if she was suppose to be getting said food or if she got fingers or hands in the process.  Her hunger ruled her world. 

Swelling in her hind legs

5.  Combo of drugs may have to be explored.  Usually your vet will try the cheaper more generic drugs first (or at least we did) and then move to the more expensive combos.  Pred will more than likely be the main drug of choice but there are lots of combos that vet's can try.  What worked for Stella was a combo of Pred and Azathioprine.  There are lots and lots of combos out there that can work so do your research.  Ask lots of questions.  This isn't a common disease in dogs, so most vets don't have a ton of experience with this disease.  We were VERY lucky in that we had KSU 20 minutes away to get the diagnostic tests we needed and the pharmacy to provide the meds.  My local pharmacy also helped me source the cyclosporine as it was very expensive (and eventually deemed ineffective, thank goodness).

First official marathon 2018

6.  Every journey is different, but ask lots of questions of those who have been through it.  A lot of my questions and concerns were answered via FB because I had put out a plea to have anyone and everyone who had heard of this disease or experience with it to contact me.  I had several people that I did not even know contact me through PM and help me through. I even had a few phone calls when we thought it was Rocky Mountain Spotted Fever that I basically had crying break downs during, but they were necessary to get information.  The treatment plan that eventually worked for Stella was one that a new FB friend had used for her dog.  She even sent me the complete medical history of her dog so that my vets could take a look and see if anything they used could be of use for Stella.  You just never know what gem from other people will help you with your expectations.  Take lots of notes when you take your dog to the vet and or take someone with you.  I did this several times by taking my undergrad students with me.  Having another set of ears helps you because you are trying to digest everything and make sense of everything and you may miss something.

Here are some links to articles I found helpful:

https://www.vetspecialty.com/new-treatment-option-immune-mediated-polyarthritis/

http://veterinarymedicine.dvm360.com/recognizing-and-treating-immune-mediated-polyarthritis-dogs
https://vetspecialists.com/immune-mediated-polyarthritis-impa/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2583415/


As always listen to your vet and do your research!  My vets at KSU and my primary care vet were both very receptive to me bringing in any research I could find and asking lots and lots and lots of questions.  I always tried to be respectful with my questioning and I even got a few immunologists involved to help me decipher the science behind this all.  Feel free to contact me to talk as well!  My email is redaussie3@gmail.com.  I also am on FB at Running with Reds as well as instagram Redaussie3.  I wish you much luck if you are going through this with your pet.