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  • Thank you Heather. I will try doxycycline on him. I had not used doxy in him yet. I have not done azathioprine either, just pred, cyclosporine, mycophenolate and currently leflunomide. He unfortunately does get more lame when the swelling starts back. ...

  • Also I'd say if he's not clinical from the joint effusion (lameness etc) I might just let him live with a fat joint to spare steroid side effects Sent from my iPhone

  • Jill- I don't have any great words of wisdom other than to say I've had a rough case like this before. We don't really think about refractory IMPA- but it clearly occurs. I'm still half convinced we will discover that immune mediated disease is often ...

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