Dear Lizzi:
 
>Dr. Williams, it it safe to wean him from the pred with all the rest going
>one inside of him?  Will it be okay for his liver tumor to withdraw from
>the pred?  Is the pred only to regulate blood sugar in this case?
 
Pardon my forgetfulness - did we ever establish what the liver tumor was?
Lymphoma or metastatic adrenal, or something else?  Didn't the vet say it
was an "aggressive malignancy" but with no definitive etiology established?
 
Has he shown signs of insulinoma recently?
 
All of this is important.  I don't care so much that the BG is 200 - it's
high, high enough to show up in the urine, but not life-threatening.  Plus,
if that tumor is lymphoma, the pred may be the only thing holding it in
check.
 
With a prognosis of a month (although this is a notoriously imprecise
science), compounded by the fact that we are not sure of the tumor's
identity, leaving the BG at 200 is not a bad tradeoff for keeping the
tumor in check.
 
Perhaps we should consider decreasing, rather than discontinuing the
dosage.
 
With kindest regards,
Bruce Williams, dVM
[Posted in FML issue 3295]