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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Vet
Satisfied Customers: 31069
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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My six year old Australian labradoodle was diagnosed with primary

Customer Question

My six year old Australian labradoodle was diagnosed with primary Addison's disease in April 2015. She is 10kg and is on 4 X 0.1mg florinef and 1 X 0.5mg prednisolone per day. She has started to become weak again and has bad leg tremors. The vet says she is on a high dose already but is there an upper limit for florinef?
Submitted: 1 year ago.
Category: Vet
Expert:  Dr. Michael Salkin replied 1 year ago.
To answer your question directly, no. Once stable, however most 10 kg dogs will eventually require 0.2 - 0.3 mg of Florinef daily and so if 0.4 mg or higher is necessary a close look at Lulu's serum electrolyte concentrations is necessary at this time because dosing is adjusted in 0.05 - 0.1 mg increments based on those concentrations. In addition, although 50% of dogs being administered Florinef will not requre supplemental prednisone, Lulu may and so if electrolytes concentrations are acceptable at this time, her prednisolone dose might be increased to as much as 5 mg daily particularly if Lulu is experiencing more stress than usual. Finally, when high does of Florinef are required for normal sodium concentrations, salt supplementation should be considered and dosed to effect. Please respond with further questions or concerns if you wish.
Customer: replied 1 year ago.
She had a blood test about 10 days ago and her levels were still a little low. My vet suggests giving her an extra half tablet of florinef (0.45mg) tomorrow and 1mg Prednisolone. We do sprinkle salt on her food.
Expert:  Dr. Michael Salkin replied 1 year ago.
Those recommendations are very reasonable. Be sure to recheck her electrolytes in 7-10 days unless she worsens further before that time. Please continue our conversation if you wish.
Dr. Michael Salkin and other Vet Specialists are ready to help you
Expert:  Dr. Michael Salkin replied 1 year ago.
Thank you for your kind accept. I appreciate it.
I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience.
Customer: replied 1 year ago.
Many thanks. Will get her blood tested again in a weeks time. She has never had a blood test where her levels were normal so far but she has been quite well for the last couple of months until this week. I believe some dogs have problems with absorption of florinef!
Expert:  Dr. Michael Salkin replied 1 year ago.
Sounds good. I don't have the pharmacokinetics of this drug in dogs but in humans it's well absorbed from the GI tract with peak levels occurring in approximately 1.7 hours; plasma half-life is about 3.5 hours but biologic activity persists for 18-36 hours. If Lulu continued to be difficult to regulate, injectable DOCP should be considered but unless things have changed it would need to be ordered from outside the UK.