Next Steps

Unfortunately after the MRI and spinal tap Georgie seemed even worse than before she had the procedures. The vet immediately upped her dosage of Prednisone and scheduled her for her first sessions of Cytosar injections (Cytarabine) on the weekend. The injections are given 12 hours apart and given over a 48 hour period, i.e. 4 injections over the weekend.

I immediately got to work trying to find out as much as I could about GME. Unfortunately a lot of the information on the internet is fairly outdated and based primarily on the use of Prednisone as treatment. Prednisone is extremely tough on the body and does a lot of damage if used for a long period of time. In many cases Prednisone alone is not sufficient to stop the disease and once the dosage is reduced the symptoms quickly return and often more aggressively than before, Fortunately I found forums and other more up to date information that gave me a bit more hope.

Georgie wasn't responding much to the increased Prednisone and Cytosar. The vet (Dr Frikkie Strydom) suggested upping the Prednisone to a higher dose and adding the drug Cyclosporine to the mix. I readily agreed, desperate to try and help my little girl. Unfortunately she vomited a few times and cried beforehand so we took her back to the vet to check it out. He booked her in for the weekend to rule out any seizures and monitor her. Fortunately they didn't pick up any seizures and it seemed like the vomiting was just an initial response to the Cyclosporine. It stopped before she was discharged. 3 weeks after the initial Cytosar sessions she was due for her next round. We continued with this method of treatment and I continued to research as much as I could and was in regular contact with my vet who I must say is absolutely incredible and puts up with me telling him everything I have researched. The hospital he is a partner in is of a very high standard and treat a lot of these cases (Fourways Vet Hospital in Johannesburg, South Africa). Regardless of their experience and my lack of experience he has always been open to whatever I have had to say.

 

After very little improvement even after the 3rd round of Cytosar I decided to send the vet a paper from Veterinary Neurologist Dr Sisson in the USA. Dr Strydom was already using 3 of the drugs in the paper and I asked him whether we could look at the others Dr Sisson uses, primarily Leflunomide which he now uses in all GME cases. Dr Strydom researched what I had sent him and immediately made arrangements to order to Leflunomide and find out about the necessary blood tests being analysed at a human lab (the veterinary labs in South Africa don't test Teriflunomide levels).