Microsoft word - imp information sheet _my edit_.doc

IMP Information Sheet
Put simply, it is inflammation within multiple joints caused by an invasion of white cells from the immune system flooding the joints. This process causes pain and sometimes fever • Your Cavalier may be reluctant to stand and may cry when getting up, or walking. They will usually not stretch upon waking and may not bark as normal • Your Cavalier may walk very gently as if walking on egg shells • Your Cavalier may show signs of pain when touched around the back, neck or joint • Your Cavalier may have a fever or have lost their appetite If your vet thinks that your Cavalier has IMP, then the likelihood will be that you will be referred to a specialist for treatment. Once referred, if your consultant suspects IMP, then This involves a small syringe being inserted into multiple joints and fluid being withdrawn from the joints for analysis within a laboratory. This process can take a few days to produce There are two causes of IMP. Firstly, there is an underlying infection or disease that has caused your Cavaliers immune system to go into overdrive. Instead of the immune system fighting the initial infection, it also starts attacking your Cavaliers own tissues. To find out if your Cavalier has a secondary disease, further tests may be needed which can range from blood and urine tests through to X-rays and ultrasound. If an underlying infection is found then the IMP is classified as Secondary/systemic IMP The second cause of IMP is that there is no secondary infection present in your Cavalier and for some unknown reason; your Cavaliers immune system is attacking the joints with no If this is the case, then this type of IMP is classified as Primary/Idiopathic IMP. Cavalier Matters – Treatment will depend upon what type of IMP your Cavalier has been diagnosed with. If an underlying cause has been identified and is then treated, this treatment may rectify the secondary IMP infection, however, this is not always the case and the IMP will need to be Treatment for IMP tends to commence with a fairly high dose of Prednisone which is a steroid acting to supress the immune system and your Cavalier will normally respond well showing improvement within a few days of starting treatment. As Prednisone is a steroid, it cannot be simply stopped and will be reduced over time and potentially mixed with other drugs during a fairly lengthy course of treatment over several months. Many dogs will react to steroids and some of the side effects include: • Increased thirst and subsequent urine output • Increased appetite which can seem ravenous at times • Sometime there can be issues with liver function Other drugs that can be used to compliment the prednisone are: • Cyclosporine – This is another immune supressing drug • Sucralfate /Asceptin – This is a stomach protector as steroids may cause some • Ranatadine – This is another stomach protecting drug, again designed to prevent At this point, I cannot answer this. Every case is different and as our Cavalier is still undergoing treatment, we simply don’t know the answer to this. Our Cavalier is currently on a combination of the above drugs and continues to improve. His latest examination was all good news as there was no evidence of swelling or inflammation in his joints and his range of movement is excellent. He will hopefully make a full recovery, but as no underlying condition has been identified, we are aware that IMP could re-occur in the future. The only definitive test to determine if the joints are clear is a further joint tap, however, our consultant advises that it may not be absolutely necessary if there is continued improvement on a similar scale and clinical tests show no issues. Cavalier Matters – • If you own a cavalier, then you know that insurance is a must. IMP is an expensive disease to treat and can quickly eat into £4,000 of cover each year. • IMP is an awful condition as it can take some time to diagnose. Be prepared for • Even whilst recovering, your Cavalier may show an objection to walking up stairs, jumping up onto the sofa or bed (yes, Ours sleeps upstairs). Jumping • Cavaliers can have sensitive tummy’s so be prepared for runny tum with the cocktail of drugs. This can normally be stopped by giving a pro-biotic. • If IMP has been diagnosed, it’s a long road to recovery, but most dogs according Cavalier Matters –


Commonly used opioid equianalgesic doses

Pain and Symptom Control Card Commonly Used Opioid Equianalgesic Doses Tylenol #1= 8mg Codeine + 300mg Acetaminophen Medication Oral Dose Tylenol #2= 15mg Codeine + 300mg Acetaminophen Tylenol #3= 30mg Codeine + 300mg Acetaminophen Tylenol #4= 60mg Codeine + 300mg Acetaminophen Percocet = 5mg Oxycodone + 325mg Acetaminophen NB: A Tylenol#3 is equivalent to ~3mg of oral mor


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