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I have had 2 recent cases, both had very acute severe clinical signs and very low platelet counts. Both were deteriorating very quickly. Neither responded quickly enough to steroid administration and due to deterioration the owners decided on euthanasia. Would you be reaching for the vincristine almost straight away with severe cases? I feel I left treatment too long whilst waiting for lab results.
The text books always suggest using oral prednisone rather than IV. Is there a huge disadvantage to starting with IV steroid, as this is often the only way of admin if they are really unwell.