A diagnosis is normally made on the basis of first excluding other causes of spinal pain (like bone or soft tissue infections, immune-mediated joint disease, infections) by obtaining a blood sample and performing radiographs. Then, cerebro-spinal fluid (CSF) analysis is performed by obtaining a sample of CSF from the neck or lower spine (or both) in a sterile manner under general anaesthesia . Your pet will have dedicated one-to-one care during their CSF tap by one of our nurses from the prep nursing team who are trained and experienced in anaesthesia and sedation . The demonstration of inflammation and the presence of a specific type of inflammatory cell facilitate a presumptive diagnosis. Although infection is very unlikely, we will normally run a panel of various blood and urine tests to exclude this possibility.
Intravenously administered glucocorticoids , such as prednisone , are the standard of care in acute GvHD  and chronic GVHD.  The use of these glucocorticoids is designed to suppress the T-cell-mediated immune onslaught on the host tissues; however, in high doses, this immune-suppression raises the risk of infections and cancer relapse. Therefore, it is desirable to taper off the post-transplant high-level steroid doses to lower levels, at which point the appearance of mild GVHD may be welcome, especially in HLA mis-matched patients, as it is typically associated with a graft-versus-tumor effect. [ citation needed ] . Cyclosporine and tacrolimus are inhibitors of calcineurin. Both substances are structurally different but have the same mechanism of action. Cyclosporin binds to the cytosolic protein Peptidyl-prolyl cis-trans isomerase A (known as cyclophilin), while tacrolimus binds to the cytosolic protein Peptidyl-prolyl cis-trans isomerase FKBP12. These complexes inhibit calcineurin, block dephosphorylation of the transcription factor NFAT of activated T-cells and its translocation into the nucleus.  Standard prophylaxis involves the use of cyclosporine for six months with methotrexate. Cyclosporin levels should be maintained above 200 ng/ml.  Other substances that have been studied for GvHD prophylaxis include, for example: sirolimus, pentostatin and alemtuzamab. 
All bets are off the table when high-dose testosterone and its many metabolites are used illegally, such as with anabolic steroid abuse. Strokes, embolisms, and cardiovascular disease are all more likely, as is sudden death, and liver and kidney disease. 44 In women, acne, irreversible deepening of the voice, baldness, increased facial hair, enlarged sex organs, breast reduction, depression, and infertility have all been reported. In adult men that abuse anabolic steroids, acne, baldness, permanent infertility, gynecomastia, loss of libido, erectile dysfunction, testicle shrinkage, and profuse sweating are all reported side effects. Increased testicular cancer hasn't been reported, though. 45,46