I have an 8 year old neutered female Golden Retriever. About two years ago, she began displaying what appeared to be symptoms of MMM (Masticatory Muscle Myositis) - the shrunken head muscles. This actually happened almost overnight following food poisoning (a person gave her a whole apple). 

For these two years her head has appeared shrunken, but her jaw opens fine, appetite is good etc. 

About a month ago, I took her for her usual blood test to check she was getting correct levels of Thyroxin for her under active thyroid. The vet then discussed the muscle atrophy with us. She thought definitive testing wasn't essential, and suggested we try her on predisone for a month, then come back and evaluate her condition. Her thyroid levels were good by the way.

After 3 weeks of pred, Bella's condition was no better. She lost 2kgs, and atrophy now appeared to have affected her mouth (not jaw) and "shoulder" muscles. The vet was concerned and suggested we immediately begin weaning her off the pred as it wasn't helping.

Two days later, Bella woke up with a lateral nosebleed. We took her for emergency care. Tests seem to suggest:

1) Her clotting capability is fine 2) She has sufficient platelets 3) Bleeding time is normal 4) Her thyroid level was very low (but I hadn't given her meds that day 5) She showed high levels of chemicals associated with liver damage

The vet said we could (next week) do a liver investigation, and CT scan or Xray to diagnose tumours or foreign body in nose. Costly procedures, and we aren't wealthy or covered by insurance.

I have read a bit about predisone online, and have come across anecdotes of dogs not with MMM suffering MMM-like symptoms on pred, and dogs on pred getting nosebleeds.

I fear that the steroid has somehow worsened the muscle atrophy, and compomised Bella's immune system/liver.

My questions (and thank you for bearing with me thus far) are:

1) Can pred be this harmful, even in rare cases, causing atrophy/liver damage/bleeding?

2) What can we do, if anything to help her liver (supplements etc)?

3) Can acupuncture or other methods be used to halt/combat the muscle wastage, as drugs seem t

My questions (and thank you for bearing with me thus far) are:

1) Can pred be this harmful, even in rare cases, causing atrophy/liver damage/bleeding?

2) What can we do, if anything to help her liver (supplements etc)?

3) Can acupuncture or other methods be used to halt/combat the muscle wastage, as drugs seem to have failed?

Bella is otherwise a happy, active dog, with an appetite for food and fun. Her urine and stools appear fine, and two days ago the otherwise worried vet seemed to think cancer unlikely...

Thank you