Following a course of Prednisone, Caesar was doing well. He regained full mobility of the jaw, all pain seemed to go away, and in short he seemed much more his active self.

We kept him on the prednisone even though the symptoms had resolved, not wanting to discontiue the medication too prematurely. Once the prednisone side effect of general muscle wasting began to be seen around Caesars spin and hips we began to wean him off of the medication as per the vets instructions.

Caesar is still on a reduced dose and will be on progressively smaller doses for the next month plus.

Here comes the bad news. Just tonight Caesar was showing discomfort and pain just as he did when this all began. Although he had regained full jaw mobility and was once again holding the softball size tennis balls in his mouth a week ago, tonight he refused to open his mouth wide enough to take one.

What to do?

Obviously the symptoms are coming back as the medicine is decreased. Yet, he was on the prednisone to the point that I really feel that the side effects were reaching a point that Caesar could no longer tolerate the dose without an end in sight.

I'll be calling the vet tomorrow, but I really can't imagine what the best course of action is. To not re-up the prednisone the symptoms will continue to get worse. With the prednisone the side effects will eat away at the rest of him.

Once again, What to do?

No suggestions other than googling yourself away

http://vetneuromuscular.ucsd.edu/cases/1999/may99.html
http://www.marvistavet.org/html/body_masticatory_myositis.html

These look like informative articles but recommend keeping that dose high enough to eliminate symptoms. I imagine you can slwoly rebuild mucsle mass aftewards.

- it looks like they propose keeping on a level high enough to eliminate symptoms for 6 mos after symptoms are resolved. It "may" be the price you have to pay for that period of time.
-about the only other thing I can see is discussing with a homeopathic vet, but I imagine you have only so much time to work with the more conventional cure and it is a pretty high risk to take.

Sure this must be very tough to go through and see your dog go through.............

Thank you for the links Nancy.

As it is, the vet says the muscle mass lost in the head may never be regained.

It is so depressing to look at the pictures of his once broad head and then now to see the sunken eyes and boney ridge of his skull.

It hasn't even been a month since I last looked to you forum members for some direction on this. Well, I'm back hoping for some advice with helping me make the decision as to whether or not it's time to put Caesar down.

After the consultation with the vet last month, we put Caesar back on the higher dose of Prednisone. Although that seemed to help with the symptoms that had reappeared, Caesar has generally gone down hill. I believe it to be a combination of the disease process and the side effects of the medicine.

His coat looks terrible, the skin is flaking BAD, the spring in his step and energy are very short lived, he is demonstrating increased difficulty chewing his food (even when it is softened with water), he is getting fat around the flanks as Prednisone tends to cause, and his muscles are just wasting away throughout his body.

The picture I am attaching demonstrates the lack of muscle now on his head as is evidenced by my finger sinking up to the first knuckle when placed into the hollow area on the skull.

My wife worries that he is in constant pain. It is just so hard for me to think of putting down this dog that is barely 6 years old and has accomplished anything I have ever asked of him.

How do I make this decision?

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Mods,
Sorry. I linked a Photo Bucker URL. I don't know why the actual pics posted.

Eric,
I am so sorry. Having to ask yourself if it's time to let go is tough enough with an old dog at the end of a good life - it's especially heartbreaking with a dog that by rights should have had many more years. I have no specific advice to offer on the progress of the myositis, but I was at this point three years ago with a much-loved 7 year old dog whose lymphoma was no longer responding to treatment. One thing that helped me decide was asking myself whether I was keeping the dog going because he was still capable of getting pleasure out of life, or whether I was just keeping him alive for me. If you are honest with yourself you will know.
Sometimes it also helps to remind yourself that a gentle end is the last best gift we owe our dogs in return for all they have given us.

Eric, I just read this post. I can't express to you how sorry I am to hear that your dog is not responding well to the treatment.
Your heart will guide you in your decision...

Eric, I'm sorry you have to go through the horrible pain of trying to make a decision with Caesar. I'm sorry Caesar got so sick so young. His full face picture tears at my heart.

Maybe this will help you with your decision: "How Do You Decide that Today is the Day to Put Your Best Friend to Sleep?" by Ed Frawley:
http://www.leerburg.com/bridge.htm

When I put my last GSD to sleep because of advanced kidney disease, I opted to have a vet come to our home so she could pass in her own home rather than at the vet's office, a place she never liked. I was not as prepared as I thought. There were things I hadn't thought of that I'd like to share with you so you don't go through any of the extra heartache I had to go through. Talk with the vet and make sure he/she knows (whether at home or at the vet's office) that you want absolutely no interruptions when the time comes. You would think a vet would know this, but the one who came to our home had his cell phone on, and got a call in the middle of injecting the fluid, took the call and proceeded to talk on the phone while my dog was dying. You can imagine how this felt to me.

The other thing I hadn't thought of was when it became time for the vet to take her body away. That was hard for me.

Another decision to make beforehand is burial or cremation. I chose cremation.

Another point - yes my dog's heart and breathing stopped but she looked up at me even through that and our eyes and souls met. People say it's instant death when the heart and breathing stop. But they forget there's a soul in that body. Death is when the soul leaves, not before.

Oh Eric, that's horrible and I'm so sorry for what you're going through. I wish there was an easy way to deal with the decision you have to make.

I don't know much about the disease, but will say that in my experience, the Prednisone can make dogs miserable. My Corgi was on it once for about a month and he was SO depressed and sluggish and miserable, as well as unable to control his bladder. A ghost of the dog he was, and this was not a symptom of his disease, it was only the effects of the drug. I decided then if his condition ever meant long-term Prednisone, then I would choose euthanasia instead of making him live like that. Prednisone can make it difficult to determine if a dog is in pain because it sure makes them show the same signs of it, IME.

If you do decide that it's time to let your boy go, perhaps you could consider letting him go off the Prednisone for a short time before you do. I don't know if that's even feasible with his condition, but if it is, it might be a good way for you to see a bit of the dog you knew when you say good-bye.

And I agree that for the dogs that depend on us and give us heart and soul, the last good deed we can do for them is to give them an easy ending. Again, I'm sorry Eric.