Mypuppy:Princess (10 yr. old Lab on Trilostane) - has crossed the rainbow bridge

[mypuppy]

Dear All, NO TRILO for Princess today...Hooorayyyyyyy! But she still had her delicious slice of ham rolled up. She sucked it right up.....bet it tasted a lot better without that pill stuck in the middle.....LOL....Luv ya'll.
xo Jeanette

[Annie's Mom]

Hi Jeanette, Yippee! Glad to hear Princess continues to get a break from Trilo. I, too, have been confused about this disease. You're not alone on that! I've questioned the frequency of testing too, and the more I read other's experiences here, the better I understand it all. Annie is having an ACTH test tomorrow. I call it the $350-400 "peace of mind" test. I'll post more on my thread. You're such a great mom! Barb

[mypuppy]

Oh Barb, you are so kind, thanks. I think you're a pretty neat mom yourself--lucky Annie. I will try and read your posts later--here's hoping Annie gets some great results on her ACTH just to put your mind and ours at ease. Thanks again. I Luv ya. xo, Jeanette

[mypuppy]

Hey there everyone,
I have a quick question for anyone who is willing to elaborate related to this "blowing of the coat" Princess is experiencing. I understand it varies with every pup, but can anyone predict how long this process takes to subside, meaning when will she stop the excessive shedding and flaky skin? Will she lose her entire coat. I'm concerned about that. Thanks everyone. Hope everyone and their pups find themselves happy and healthy. Tight hugs, Luv, Jeanette

[haf549]

Jeanette:

The 'blowing' of the coat can take anywhere from 2 to 8 weeks. Kira, being a husky, usually blows her coat twice a year (fall and spring). With her, it usually lasts about 2 months (an eternity :eek::eek::eek:) When she first developed the cushings, she didn't blow her coat at all that fall and even in the spring. She finally had a good blow again this fall and her fur is soft as a puppy's. I never noticed a thinning of her coat. She just loses 'chunks' but I don't know where they're coming from. Well, that's not entirely true; it's coming off her 'pants'; but her pants never really seem to thin out. Now I don't know about Princesss. Is she actually thinning? I understand some cushpups can actually get bald in spots. Is that what is happening to Princess? Even after Kira's surgery, she was shaved in several spots on her legs, but it's all growing in just beautifully again. My friend has a black lab and she loses her fur about 6 weeks in the fall and spring. Hope this helps.

Heidi

[mypuppy]

Hi Heidi,
Thanks for your quick reply--it definitely helps, anything helps when it comes to this. Now for your question "is Princesses hair thinning?" Yes, indeed it is, that is why I got so frightened in the first plac. I'm not used to this new thing, who is? It's thinned out so much that she actually look as if she has lost a lot of weight. It's very disturbing. But I did notice that her shaved belly from her ultrasound several months ago is finally starting to grow back slowly. I have not seen any more clumps of hair after last week's clumps, clumps, clumps everywhere. Now all I see is fine hair, but a lot of it. We shall see how long it will take her to remove all that dead hair and skin. I hope it's not bothering her in some way. Hoping Kira is doing well these days. Is she still on treatment? For now my friend, this is it. Thanks again for your much appreciated info and for all your love....luv ya too, xo Jeanette

[lulusmom]

Hi Jeanette,

If you want to see a bad coat, or lack thereof, check out Lulu! I am not surprised that Princess' coat has thinned and I wouldn't be surprised if she blew her coat completely. The fact of the matter is that the coat is usually the last symptoms to resolve, usually within 4 to 6 months and a lot of changes can go on before the end of that time. Some dogs lose most of their coat and the new coat may look like the old coat or it may look really weird. Some dogs just thin a bit but it thickens up again and some dogs like my Jojo tend to lose all of the guard hairs and end up with what looks like a fuzzy down undercoat. Then there are those dogs, like Lulu, that never regrow a coat. Come to think of it, I believe Lulu is the only cushdog here that never regained her coat. After almost five years, I don't think it's going to happen but I don't care cuz she's still my cute pain in the butt. I believe that Princess' coat issues are strictly cosmetic at the moment and I have every reason to believe that once she's stabilized, she will regrow a coat in time that will make her mom proud.

Glynda

[labblab]

Hi Heidi,
But I did notice that her shaved belly from her ultrasound several months ago is finally starting to grow back slowly. I have not seen any more clumps of hair after last week's clumps, clumps, clumps everywhere. Now all I see is fine hair, but a lot of it.
Jeanette, if you are seeing fine hair beginning to regrow, I think that is a very good sign. Prior to lowering his cortisol level, my boy never showed any hint of hair regrowth whatsoever in his "bald" areas. But once he started treatment and lost those clumps of old hair, I was thrilled to see new "fuzz" in all those underlying patches of bare skin.

Remind us, I think you have another ACTH scheduled before long?

Marianne

[mypuppy]

Hi Glynda,
Wow! I just keep learning more and more on the forum from you and everyone else. I never knew a Cushdog can possibly blow her entire coat. BTW, as you, if Princesses coat never grew back again, I would still love her just the same, if not more, as you love your precious faced little Lulu. I wouldn't see it any other way. If I could prevent it from happening, I would in a heartbeat, but that I have no control over. Thank you for your post. Hope you and Lulu are doing well these days....tight hugs and luv, Jeanette

[mypuppy]

Hi Marianne,
Yes, I thought the same as you when I finally saw some hair growing back in her shaved belly. So we'll see. How funny would it be that she blows the rest of her coat and has a big bush on her belly....lol..Now getting to your question on when she's going back to get stimmed. Since I have not seen any of the symptoms that I am suppose to be looking for to restart her trilo (extreme thirst and appetite), I think I am going to hold her off perhaps for another month, and see where her levels are. But do have a question about that? If and when I stim her, what happens if her levels are sky high but I still don't see symptoms. Is it possible for a cushpup to have very high cortisol levels without the symptoms. This is where all the confusion kicks in for me. Hope you and the lab are doing great. Lots of tight hugs, and luv, Jeanette

[labblab]

Jeanette, I'm going to be sneaky here and ask you a couple more questions before I try to answer yours ;). Is there ANYTHING abnormal about Princess' behavior right now? Do her thirst and appetite seem totally normal to you -- not too high and not too low? How about her energy level? Any panting, seeking out cool places to lay down? Or does she seem like a healthy, happy girl to you at the moment (aside from the hair loss...).

Marianne

[mypuppy]

Marianne, not sneaky at all on your part. This is what is mind boggling to me, aside from the excessive shedding or "blowing of the coat", Princess is her happy go lucky self. Eating and drinking normal, no panting whatsoever, not looking for a cool place to lay. Ever since she started her initial treatment and stopped, she has been sleeping in our bedroom in her own bed at the foot of my bed without wanting to be let out or going into the dining room seeking the coldness of the hardwoold floors or the tiled bathrooms. It's been heaven knowing she's right there sleeping with me all through the night. She is interacting in floor play--minute we throw that ball or toy, she's right there to fetch it. Today, since we had an unusual heatwave- 30F- Wow! we played outside in the snow, she ran and fetched her ball for 30 minutes straight without even getting tired. It's just amazing to watch. Here I'm thinking "and you're suppose to be sick here, helloooooo" who'd know? So I hope this answers all your questions so you can come back with some more even sneakier ones. Lol. Who luvs ya Marianne? xo Jeanette


Jeanette, I'm going to be sneaky here and ask you a couple more questions before I try to answer yours ;). Is there ANYTHING abnormal about Princess' behavior right now? Do her thirst and appetite seem totally normal to you -- not too high and not too low? How about her energy level? Any panting, seeking out cool places to lay down? Or does she seem like a healthy, happy girl to you at the moment (aside from the hair loss...).

Marianne

[Franklin'sMum]

Hi Jeanette,

I can't help with your question, but am so happy Princess is doing great! :D Had to do a double take when you said Princess is enjoying floor play, though ;) !
Am so happy for you both that she's back to a happy little girl full of energy :):):)

Jane and the gang xxx
________
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[haf549]

Jeanette:

I was so happy to read your post about how your baby is her happy normal self. I'm really happy for you and Princess. It's wonderful to hear stories like yours.

Heidi

[lulusmom]

Jeanette,

When we switched Lulu from Trilostane to Lysodren, we went through a washout period and waited until her post cortisol was over 25 and she was symptomatic again. As I recall, her first post stim was 22 and she was not yet symptomatic. Sometime after that her symptoms started returning with a vengeance and the next post stim was 25 or 26 so we started treatment with Lysodren at that point.

All dogs are different and Princess could go for months before symptoms return, they could come back next week or they may never return. Never would be great but it's highly unlikely. My advice is to enjoy whatever time off of Trilostane you have.

[maggiebeagle]

It sounds like things are going well right now except for the hair loss. My Maggie was treated successfully with trilostane for 2 years before she went "too low". Her symptoms had just started to return after a year without treatment when other things started going wrong and we had to let her go. During treatment, she also lost her old fur and when it regrew it was a fluffy puppy coat. She also had the most awful case of "dandruff" ever.

Enjoy your trilo vacation and give Princess and extra hug for me.
Virginia and Angel Maggie

[mypuppy]

Hi again Marianne,

At Lori's suggestion, she thought it would be a good idea if I addressed you regarding Princesses water intake. Last time I spoke to her I did mention that her water consumption doesn't seem to be a lot. I would say perhaps a cup or cup and a half per day which includes her dry kibble and wet food and her water bowl intake. As I explained to Lori in my PM to her today, I feel the drastic drop in temperature and Princesses less frequent activity level may have something to do with her lack of interest for her water bowl??? In fact, as I had posted yesterday, we played and ran outside for a long while, and when we went indoors Princess ran to her water bowl and drank the entire water in her bowl. I have noticed this pattern each and everytime she gets that little extra boost in activity, so again I'm thinking this may play a factor. Would love to get your opinion on my theory (OR ANYONE ELSE'S) for that matter. I will put my theory to the test again today since we are expecting 40 degree temps today. Thank you Marianne. Look forward to hearing from you, at your leisure, of course....Luv and hugs, Jeanette


Jeanette, I'm going to be sneaky here and ask you a couple more questions before I try to answer yours ;). Is there ANYTHING abnormal about Princess' behavior right now? Do her thirst and appetite seem totally normal to you -- not too high and not too low? How about her energy level? Any panting, seeking out cool places to lay down? Or does she seem like a healthy, happy girl to you at the moment (aside from the hair loss...).

Marianne

[haf549]

Jeanette:

Do have snow where you are? I know in this weather, Kira only wants to go outside and eat snow. She'll bypass her water bowl and head straight for the 'snow cone' I've built up for her on the deck. She'll lie on that for hours and munch away on the snow at regular intervals. If Princess is eating snow, that will account for some of her water intake as well.

Heidi

[mypuppy]

Heidi, yes, we have a lot of snow on the ground still, and yes, Princess does eat it her fair share of snow once in a while--lol...I don't think it's harmful to them is it? I think she just enjoys putting it in her mouth for some reason...hey, I've seen my kids eat snow themselves, but that I stop dead on their tracks since we do have a lot of wildlife where I am, and don't know what's peed or pooed in my yard. haaaaaaa.....Thanks for your post. How is Kira with the lovely eyes? Take care. Luv ya, licks to Kira, Jeanette

[labblab]

Hi Jeanette,

Thanks so much for giving us the additional information about Princess' water consumption. I must say, I was feeling nervous when I started out by reading that she has generally only been drinking about a cup of water a day -- that seems like a very small amount for a dog of her size. I know there can be a really wide range of "normal" drinking behavior, but for a 70-pound dog, the general expectation would be that she would be drinking between 4 - 9 cups of water a day. But I was very relieved when I read that Princess IS drinking much more when she has been playing or exercising hard. If that's the case, then probably your guess is right -- that she simply isn't needing as much water in this cold weather when she's less active. And it's great that she is feeling so energetic and playful once again! Still, I think it is very good that you are continuing to carefully monitor how much she is drinking so that you will be aware of any big changes in one direction or the other.

As for your question about the possibility of really high cortisol levels and no symptoms...this is sort of a "cop-out" answer, but I just don't think that's going to happen. I think you'll see symptoms again once her cortisol reaches a certain high threshold, basically the way that Glynda described her situation with Lulu. So just like the other folks, I'm gonna tell you to make the most of this medication "vacation," and then we'll cross the next bridge if and when you see more problems reappearing. ;)

Marianne

[haf549]

Jeanette:

If Princess is eating snow, then she's getting some water there too. I think they really like the snow, because it's so fresh. I'm constantly telling Kira not to eat the yellow snow :D:D:D

Kira is doing fine. She's enjoying the snow. Every morning, after her breakfast, she goes and lies in the yard, or on the deck, on her 'snow cone'. The last couple of days the weather has been milder, but damp and I think her arthritis is acting up. But when there's something interesting to do, she's there, tail wagging.

Heidi

Heidi, yes, we have a lot of snow on the ground still, and yes, Princess does eat it her fair share of snow once in a while--lol...I don't think it's harmful to them is it? I think she just enjoys putting it in her mouth for some reason...hey, I've seen my kids eat snow themselves, but that I stop dead on their tracks since we do have a lot of wildlife where I am, and don't know what's peed or pooed in my yard. haaaaaaa.....Thanks for your post. How is Kira with the lovely eyes? Take care. Luv ya, licks to Kira, Jeanette

[mypuppy]

Heidi,
Glad to hear Kira is doing well, aside from her arthritis..that's always a pain, no punn intended. And it seems she just loves the outdoors, as Princess and the rest of these puppies. It is gorgeous here today for a change and in the high 40's, we have been outside playing and enjoying this little short break, because we know it is not going to last long--it's only January, we have a loooong way to go yet. Take care and licks to the blue eyed baby....xo luv, Jeanette

[mypuppy]

Oh Virginia, so sorry about your Maggie. That must have been so difficult, and I know you must miss her a great deal, more than words can say. Did she have other complications unrelated to her Cushings which steered you into letting her go? I'm thinking she was a bit older, and what do I know, but guess that factor works against them. It really stinks. Thank you for your post, and yes, Princess and I are trying to enjoy this trilo break indeed. Right now, we're off outdoors again to play some more--she'll be drinking those 4 -5 cups of water today for sure...lol.....Lots of luv to you and tight hugs....xo Jeanette

[mypuppy]

Hi there everyone,
Gosh it seems as if I have been gone for quite a while. Just wanted to let everyone know all is still well on this end with Princess. She just has very flaky, dandruffy skin and if anyone knows of a product that can possibly help her with this, I would appreciate it. She seems to be a bit itchy with it, and tries to scratch more than usual. I hope everyone is doing well with their pups and I do look forward to your updates on their health. Luv you all dearly.....xo Jeanette

[Franklin'sMum]

Hi Jeanette,

I'm so glad to hear Princess continues to do very well. About her flaky, itchy skin, have you tried oatmeal shampoo?

She just has very flaky, dandruffy skin and if anyone knows of a product that can possibly help her with this, I would appreciate it. She seems to be a bit itchy with it, and tries to scratch more than usual.

Hope her itch clears up soon.

Jane and Franklin xx
________
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[mypuppy]

Hi Jane,
Thank you for the oatmeal suggestion. I am actually going to ask my groomer if she carries any special shampoo for these type of irritations or an oatmeal based product. I will also call my vet to ask the same. Thanks again for your great wishes. I wish the same for you and my little sweet faced Franklin....luv you lots....xo Jeanette

[haf549]

Hi Jeanette:

Glad to hear that things are still going well for Princess (except for the skin irritation of course). Is she still off the trilostane?

Heidi

[mypuppy]

Hi there Heidi,
Nice to hear from you....in answer to your question, no, Princess has not yet restarted her trilo since she is still not showing any of her Cushings symptoms. She's doing great thus far, aside from the skin irritation, but I noticed she doesn't seem to be losing as much hair anymore since several weeks wherein I was just seeing clumps of hair. Im happy for that. How is Kira doing as well, still on her trilo? Take care of you and look forward to posting again....Luv ya, Jeanette

[Franklin'sMum]

Princess has not yet restarted her trilo since she is still not showing any of her Cushings symptoms. She's doing great thus far, aside from the skin irritation, but I noticed she doesn't seem to be losing as much hair anymore since several weeks wherein I was just seeing clumps of hair.

Yay!!:D I bet she's enjoying the break from it even more than you are ;). Poor little sweetie :( half bald and a skin irritation :(:(. Please give Princess some huge hugs and squeaky kisses from her Aunty Jane and cousin Franklin xx. Big hugs to you too, Jeanette :)
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[mypuppy]

Hey everyone,
I just noticed something unusual in Princess which prompted me to first call my vet and post on the forum. She is eating fine, drinking, exercising still, no symptoms of Cushings, etc. However, today at around 4 p.m. I noticed drops of water on my kitchen floor, so assume it was my little one who washe her hands and didn't shake them off and dry--she usually does this. I mopped it up quickly. Princess came into the kitchen immediately after because it was dinner time for her. At that moment while she was standing next to me watching me prepare her dinner, I noticed she was drooling excessively. Not something common for her to do. She does drool a little more than usual when we have food near her, but this was different today. I wiped her mouth several times, fed her, and up till just now (6 p.m.) I still notice excess drool still. Does anyone have any comment on what this may mean? Her vet told me when a dog drools it means she has nausea. I haven't noticed her throw up lately unless it's a sign that she may have an upset belly and may end up vomitting at some point. Don't know. Has anyone ever experienced this with their pup? Vet said if it doesn't stop, we should have her checked. Thanks to anyone who is willing to comment. Best regards, xo Jeanette

[StarDeb55]

Jeanette, is Princess also licking around her mouth quite a bit at the moment? That is also a sign that they are nauseated.

Debbie

[mypuppy]

Hi Debbie,
In fact, yes I have noticed her licking constantly in the last day or so. I had also noticed with that licking some watery discharge from her nose as well, but thought perhaps it was from the extremely cold weather after she had been outside exercising, or probably thought it may be a doggie cold. Do they get colds? If your/vet's theory is correct about the nausea, is there anything I can give her to alleviate that feeling? Thanks for your prompt reply. Jeanette


Jeanette, is Princess also licking around her mouth quite a bit at the moment? That is also a sign that they are nauseated.

Debbie

[haf549]

Jeanette:

You could try giving Princess Children's Gravol. A couple of times when Kira appeared nauseous I gave her that and it seemed to help. It makes them sleepy though (just like their human counterparts).

Heidi

[Harley PoMMom]

Hi Jeanette,

This could be a sign of her being nauseated and/or a tooth hurting her. Did you check inside her mouth and see if there was anything going on inside there that...well...looks odd?

When I had Harley at his GP in Dec. his GP thought he was nauseated from everything that was done to him from the tooth extractions and she had me put Harley on Pepcid AC (famotidine). Ask your vet about this.

Hoping Princess feels better soon and will be keeping you and Princess in my thoughts and prayers.

Love and hugs,
Lori

[mypuppy]

Thanks Heidi,
I've never heard of Gravol, never used it on my kids. Usually when my kids are nauseated I give them ale, saltines, tums. But I can try to look for it and wouldn't hurt to try it out. Would you happen to know what the proper dose would be for a dog against a child? Thanks again, and hope you and Kira are doing well....Luv, Jeanette

[mypuppy]

Hi Lori,
Looking inside her mouth was the first thing I tried doing. You would not believe how she would not want me to look in there. Was not budging, and I didn't persist because I didn't want to hurt her if anything was going on inside there. I am waiting for my husband to come home and he will definitely pry her mouth open, and we can look then. He shouldn't be long before he gets home. I have heard about the Pepcid. In fact I know Terri (Corky's mommy) uses it on him, so I will run it by my vet as well. Thanks for always being there for me and my precious Princess. Hope you and Harley are doing alright these days. How did all go with his maintenance dose? Have not seen any posts on him. Take care...xo Luv, Jeanette

[haf549]

Thanks Heidi,
I've never heard of Gravol, never used it on my kids. Usually when my kids are nauseated I give them ale, saltines, tums. But I can try to look for it and wouldn't hurt to try it out. Would you happen to know what the proper dose would be for a dog against a child? Thanks again, and hope you and Kira are doing well....Luv, Jeanette
Gravol is an anti-nausea, over the counter medication. For a dog Princess' size, you could give her 1 child's pill. That's what I give Kira.
It won't cause any adverse affects.

Kira is doing well. Thanks for asking. Today she's been a real hand full. She's been barking at me and making motions like she wants to play. She practically ran around block when I walked her. She even pulled a couple of toys out of her toy box. I haven't given her any metacam for a couple of days and she still appears to be doing OK, arthritis-wise.

Heidi

[MiniSchnauzerMom]

Hi Jeanette,

Lori already suggested taking a peek into Princess' mouth, which I think is a good idea. Is there a possibility that she ate something different? Anyway, I'm sure the last thing you want to do is read but I am giving you a couple of links from WebMD Pet Health about excessive drooling and lip smacking that tells you what to look for in the mouth. Just my opinion....If this is something that continues I'd suggest a vet visit to find out what is causing the excessive drooling and lip smacking in the first place.

Links from WebMD Pet Health below:

http://pets.webmd.com/dogs/dog-drooling-excessively
http://pets.webmd.com/dogs/my-dog-smacking-lips

Hope Princess feels better soon.

Louise

[AlisonandMia]

I just looked up Gravol (http://en.wikipedia.org/wiki/Dimenhydrinate) and it is a little worrying from the point of view of giving it to dogs. It contains 8-chlorotheophylline, a chlorinated derivative of theophylline. It says "Theophylline was added in order to counteract drowsiness.

The article goes on to say: "Theophylline is very closely related to caffeine and theobromine, mild central nervous system stimulants." Theobromine (and caffeine) is what makes chocolate toxic to dogs and for this reason I'd be very, very wary of giving Gravol to a dog. Some dogs appear to tolerate chocolate better than others so although it could be ok in one individual it could be dangerous for another.

Heidi, did a vet recommend Gravol?

I see in the article that it has been used in pets - but I'd still be wary of it myself....

Alison

[AlisonandMia]

A bit of further research shows that theophyline is used in dogs and cats (off label use of human med). Seems to be safe if dosed and monitored correctly etc. However stomach irritation and nausea etc are listed as possible side effects - not that uncommon with nausea meds actually.

http://www.petplace.com/drug-library/theophylline-theo-dur/page1.aspx

Alison

[Franklin'sMum]

Hi Jeanette,

Hmmm, nausea from an anti-nausea drug. Just like people medication. My family use to have a toy poodle, and if one of us went to the cupboard and got a doggie choc for him, Pokie would drool then. Also, at the bakery one day, a man was walking his pooch, (lab, I think) and the dog was drooling with anticipation waiting for him to finish his lunch to share the last bit with the pooch.

Franklin has never really drooled, but when he licks his lips a lot I've taken him to the vet, and he's been dx'd with laryngitis/pharyngitis sore throat stuff. The vet said lip licking is one sign that they have a sore throat. If you open their mouth and see bubbles way at the back, and also if the roof of the mouth near the back is red/darker than normal for the pup, that could be another indication of a sore throat.

Jeanette, I hope you figure out what's up with our girl, I'll check back later in the day.

Love Jane and Franklin xx
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[littleone1]

Hi Jeanette,

When Corky started to drool, which he had never done before, It was actually because of his teeth. He was also licking everything. Princess might have a problem with her teeth. I know Corky won't let me look in his mouth. I know that there are so many things that can cause this. I hope you are able to get this resolved.

[mypuppy]

Dear All,
First I wanted to thank everyone for all your quick replies yesterday. It helped so much. Oddly enough, I have not noticed any more drooling or lip smacking from Princess today, so perhaps the theory about her being nauseated may have been correct. Whatever it was seems to have passed. My husband and I finally did get mouth opened, and we looked deep in there and did not find anything unusual to us. Therefore, I will keep an eye on her for now, and if I shall see the drooling again, I think I will take her in for a visit. Hope everyone and their pups are doing well, and once again, thank you bunches. Love you all....xo Jeanette

[gpgscott]

Jeanette,

Pepcid (famotidine) and Zantac (ranitidine) are both safe and effective for gastric upset. Your Dr. could suggest an appropriate dose and you can buy it OTC.

Scott

[jrepac]

I have not heard of gravol for nausea; in a pinch, 1/2 tsp of Pepto Bismol Liquid is good; can give hourly until it subsides

[littleone1]

Hi Jeanette,

I also give Corky half a tablet of Pepcid AC every morning. His IMS wanted him to continue taking it, especially with all of the other meds he was on.

Talk to you soon. Big hugs and kisses for Princess. Luv ya.

[Casey's Mom]

Casey has always had bouts of nausea throughout her life, getting into something or other when we lived on the farm or the yard. Thanks to the wonderful people on this site I now give her 1/2 pepcid AC before her Lysodren dose and also any time she wants to ravenously eat grass which is how she has always told me her stomach is upset.

My vet agrees with the use of Pepcid AC and said it couldn't hurt her at all.

[mypuppy]

Hi Ellen,
Thanks so much for your input. I'm thinking the same thing with Princess...We're on the farm too with lots of wildlife and God knows what else, and she may have at some point without me looking may have ingested something very foreign. I know she sniffs the deer droppings often, ewwwww! LOL, but that's a pup for ya.....haaaa...Take care and hope you are well. Best regards, xo Jeanette



Casey has always had bouts of nausea throughout her life, getting into something or other when we lived on the farm or the yard. Thanks to the wonderful people on this site I now give her 1/2 pepcid AC before her Lysodren dose and also any time she wants to ravenously eat grass which is how she has always told me her stomach is upset.

My vet agrees with the use of Pepcid AC and said it couldn't hurt her at all.

[gpgscott]

I know she sniffs the deer droppings often, ewwwww! LOL, but that's a pup for ya.....haaaa...Take care and hope you are well. Best regards, xo Jeanette

Jeanette,

Moria is also well known for being interested in leavings;)

It is hard to convince them otherwise, but it is very bad for them, possibility of bactirial issues and parasites.

Scott

[labblab]

I think it may be a "Lab" thing...all three of mine have been especially partial to rabbit "kibble." :o :rolleyes:

Marianne

[mypuppy]

Scott and Marianne,
LOL....that was pretty hilarious! Thanks for the good laugh. I have a friend with a yellow lab also, and she's very drawn to everyone else's business but her own...Go figure....haaaaaaa.....You must be right, "it must be a lab thing" alright....haaaaa....I always stop Princess dead on her tracks, but Scott, thanks for the lesson--I never knew it could be bad for them. Best regards to both of you....Jeanette

[mypuppy]

Lori Hi,
I have read numerous times that one should have prednisone on hand for any emergencies. I distinctly recall asking my IMS, and she was reluctant to prescribing it. Although Princess is now in remission, is this something you feel I should stress for when we restart Princess's trilo again? xo Jeanette


Hi Melissa,

I agree with everything Leslie has said and I want to add one more thing...when one starts treatment, they must always have prednisone on hand. From reading your thread I see that you do not have prednisone on hand. So since you don't have the prednisone to give to Piggy if she had an emergency situation then the Lysodren should not be given.

Love and hugs,
Lori

[gpgscott]

I think it may be a "Lab" thing...all three of mine have been especially partial to rabbit "kibble." :o :rolleyes:

Marianne

I suspect because 'elephant kibble' is not readily available:D

Truly, Jeanette,

Mine will eat almost anything, and has to be watched continuously.

I suspect Princess has similar traits.

Scott

[StarDeb55]

Jeanette, it is always a good idea to have pred on hand, no matter which drug you are using to treat. It is not as crucial with trilostane because of the drug's short life in the body, about 12 hours. This is why most vets will not give a trilo parent prednisone to keep on hand. When you are treating with lysodren, having a ready supply of pred available is CRITICAL because lysodren is a long-acting drug, lasting about 48 hours in the body, after a dose is given.

Debbie

[mypuppy]

Actually Scott, I have to sincerely admit Princess is not your typical lab when it comes to that. She has never destroyed a single article in our house even while having the entire run of the house since 6 months old. In addition, she has never had the tendency of stealing anything in her parth to chew on, unless they were her own toys or unless we allowed her to do so, for instance and old sock or shirt, etc.. She really is such a good girl and has made us so proud in that respect and then some. As for the yard droppings issue, I know she sniffs it out and all, but I don't feel she would actually proceed to ingest it. I just don't even like when she sniffs it, that's all. xo Jeanette

[mypuppy]

Dearest All,
Wanted to say a quick hello to all my friends and their furbabies, and hoping everyone is doing well these days. Princess is still going strong and my groomer found a wonderful oatmeal shampoo that has helped her immensely with her dry, flaky, dandruffy skin condition. In fact, after just one treatment, her skin was looking wonderfully. We are in the middle of a huge snowstorm up here, probably over a foot or more, but Princess is enjoying the snow greatly and I'm enjoying watching her puppy uppers in the snow...It's precious and priceless to see such happiness in her. Have a great day ya'll and keep in touch. I send everyone and their pups all my luv and blessings. xo Jeanette

[lulusmom]

Hi Jeanette and thanks for checking in. Can you share the name of the shampoo that your groomer used on Princess?

[mypuppy]

Hi Glynda,
I can absolutely share the wealth...This wonderful product may be obtained online from petedge.com or petco.com -- It's called Fresh n Clean oatmeal and baking soda shampoo. She also did conditioner, and it's the same brand name as the shampoo plus aloe.
In addition to that she mentioned another product: All in one dematting undercoat remover and leave in conditioner. You can purchase that one from quadrupedpetcare.com. Is Lulu having any issues with her skin? Hope not, but honestly, I am sooo happy with the great results after just one treatment. Let me know how you make out. Hope you are well. Luv ya lots...xo Jeanette

[mypuppy]

Hey everyone,
It's been a lazy, long, snowy day here today, so Princess and the gang have been having fun in the snow. Hope you check out my new picture album and witness the fun yourself...Enjoy...xo Jeanette

[haf549]

Where are you located Jeanette? It looks like a good portion of the U.S. is in a snowstorm. You guys are getting our weather. We've barely had any snow here this winter. So little, that when that big storm was hitting you guys, we are supposed to get a tail end of it and their making a big deal out of 6 -10 cm of snow. That's usually considered 'snow flurries' here.

Heidi

[haf549]

Great pictures Jeanette!!!:):):) Give us back our snow.

Heidi

[Harley PoMMom]

Hi Jeanette,

Loved the pictures!! And I see you are getting hit with this white stuff too! Over the weekend I got 22 inches of snow and yesterday it started again...accumulation this time...close to 15 inches or more with 30-40 mph winds.

Heidi, you can have your snow back!! :p;):)

Love and hugs,
Lori

[mypuppy]

Hi there Heidi,
How funny you asked, I actually noticed a typo in my last post when I say we have been having fun in the sun....I meant to say fun in the snow...oops.! I am located in the East Coast, New York state. Up in the mountains, about an 1.5 hours from the Catskill mountains, and we've had a lot of snow this winter season, we've had close to a foot by now or 12 inches. Glad you are lucking out and not getting much on your end this season. Don't get me wrong, we all enjoy playing, but the shoveling is quite a chore and tiring. How is Kira doing lately? Please give her lots of belly rubs from me and best regards to you...xo Jeanette


Where are you located Jeanette? It looks like a good portion of the U.S. is in a snowstorm. You guys are getting our weather. We've barely had any snow here this winter. So little, that when that big storm was hitting you guys, we are supposed to get a tail end of it and their making a big deal out of 6 -10 cm of snow. That's usually considered 'snow flurries' here.

Heidi

[mypuppy]

Hi Lori,
Glad you enjoyed the pics. This snow is ridiculous isn't it? Does Harley like to play in the snow...I can just picture this little precious squirt running in the snow and getting buried in it and you digging him out. Too cute for words...How is little Harley? Hope you are both well and trying to stay warm and dry....haaaaaa....and I agree with you, Heidi can gladly have her snow back, all of it, and the shovels too....haaaaaaa....xo Jeanette

[Harley PoMMom]

Harley and Bear love the snow...but when it is ALOT taller than they are, they're not so fond of it, and neither is their mom. Shoveling is the pits!!! I shovel out a path for them to go potty and a couple hours later...5 more inches of snow. The drifting is what is getting so bad now. It's a total white-out here. I want SPRING!!!

My black pom, Bear, is funny with the snow, tho, he's got this thick black fur and the snow sticks to him like velcro. He'll come in with little snowballs hanging off of him and he will try to fling them off and they won't come off and then he'll come over to me and look at me like saying "Get these blasted things off me!" He's such a wuss, he doesn't like anything hanging off his fur. :rolleyes::p:) Our pups!! :)

Does Princess act weird like that with the snow?

Love and hugs,
Lori

[mypuppy]

Oh I agree with you 100%. The shoveling is certainly a drag when you have to keep going out there to keep the path clean for the pups. We bend over backwards for these little furry friends alright. Yes, bring on Spring so we can go on an Easter egghunt. And Bear is just too funny. Princess does not mind the snow in the least. In fact she digs her entire face in it and rolls in it as well. I feel cold just watching her do that. However, she really doesn't appreciate when my 5 year old tries to play dress up with her and runs all over the house, shaking to get the princess dress and accessories off her. We are still working on that with my little one...lol. Give Harley and Bear a nightie night kiss, and warm hugs for you...Let's pray for some dry weather or rain to wash away the white stuff....

[frijole]

Had to comment on the snow... you are wise to shovel a path for them... and keep an eye on them... they will still try to wander into the depths and it can cause injuries...I know firsthand. :( Haley has lower disc issues that I am sure happened while wondering in drifts years ago.

So keep shoveling and keep an eye out! They don't know that they can sink in the drifts, or slide on the ice etc. Hopefully you will get some sun next week and it will start melting. Kim

[mypuppy]

Hi Debbie,
Upon reading your last post to on twistmare's thread, it opened up a whole new can of worms for me regarding hypothyroidism. Let me explain why? When Princess began with her unusual symptoms and we began the testing process, by copies of her medical records which I had requested from her gp, pointed out "hypothyroid", but her gp never verbally mentioned this to me until I approached him about it. In addition, he was very evasive and did not give me any further explanation or discuss a plan of treatment, so I assumed it was nothing. About a week or two after my discussion with my gp, I spoke to my IMS regarding the same issue, and asked her opinion on Princess's T4 test, and she in turn said Princess was borderline hypothyroid. I asked if we needed to treat Princess, and she emphasized it was not necessary. To this day, I still have some very high doubts if Princess was properly diagnosed regarding this condition. Would it be possible for you to look into these test results and let me know how you would interpret them, and, if you feel Princess should be classified as "hypothyroid" and in need of further evaluation, or is considered "euthyroid sick" which you discussed on twistmare's thread, and it's just related to the cushings as you discussed? Thank you kindly. This would help hugely in order for me to determine if Princess needs to be treated. Best regards, xo Jeanette.
+++++++++++++++++++++++++++++++++++++++++
Princess's T4 of 9/24/2009:
Results: 0.6
(Reference range: 0.9-3.9 ug/dL)
Flag: L
Interpretive ranges:
<0.9 Low
0.9-3.9 Normal
>3.9 High
2.1-5.4 Therapeutic

Dogs with clinical signs of hypothyroidism and results within the normal reference range are likely euthyroid. Dogs with low T4 concentrations may be hypothyroid or "euthyroid sick". Occasionally, hypothyroid dogs can have T4 concentrations that are low normal. Dogs with clinical signs of hypothyroidism and low or low normal T4 concentrations may be evaluated further by submission of free T4 and canine TSH. A high T4 concentration in a clinically normal dog is likely variation of normal: however elevations may occur secondary to thyroid autoantibodies or rarely thyroid neoplasia. For dogs on thyroid supplement, acceptable 4-6 hour post pill total T4 concentrations generally fall within the higher end or slighly above the reference range.
++++++++++++++++++++++++++++++++++++++++++
Princess's Free T-4-ed (ng/d/L)
Results: 1.2
Reference range: 0.7-3.7 ng/dL
++++++++++++++++++++++++++++++++++++++++++
Princesse's Free T-4-ed (pmol/L)
Results: 15.4
Reference range: 9.0-47.4 pmol/L
++++++++++++++++++++++++++++++++++++++++++
Princess's cTSH:
Result: 0.45
Reference range: 0.05-0.42 ng/mL
Flag: H
Comments:
Increased canine TSH values may occur in dogs with untreated primary hypothyroidism. Sick euthyroid dogs are expected to have low normal TSH concentrations. Secondary or tertiary hypothyroidism (pituitary or hypothalamic lesions) are reported to occur in less than 5% of hypothyroid dogs.

[StarDeb55]

All of the free T4 results are within normal range, so that would indicate you probably dealing with sick euthyroid. There is a catch to this in that the TSH (thyroid stimulating hormone) is just ever so slightly elevated which, as the interpretation, states may indicate hypo. Since we are talking about .03 elevation, I'm not sure that's considered elevated enough to treat. One of your vets will have to make the final determination, but I would at least ask.

Debbie

[mypuppy]

Thank you so much Debbie,
Just one other question, which one of these tests actually determines the diagnosis for hypothyroidism?--The T4, Free T4 or the TSH? And which one shall I request next time I take Princess in? I will definitely keep a close eye on these numbers in the future, and ask her IMS to discuss if treatment is warranted. I appreciate all your help. Hugs, xo Jeanette

[StarDeb55]

All I can tell you is what I do for Harley. Harley has long term medication bloodwork done every 6 months which includes a T4. After 2 of them came back low, & the vet called to add-on a free T4, after clearing it with me, the free T4s came back normal. The vet & I now have an agreement that any future regular T4s that come back low, he will automatically call the lab & request the free T4. I do know that you need to keep on top of this as Barkley's thyroid testing was fine until the last couple of years he was with me, then he all of sudden went low & his IMS put him on thyroid replacement. I don't know if this happened because of the Cushing's or the development of the lymphoma at about the same time, but after that experience, I do watch Harley's results carefully.

Debbie

[Franklin'sMum]

Hi Jeanette,

How are things with you and Princess these days? You haven't checked in for a while...
Big hugs,
Jane, Franklin and Bailey xxx
________
MICHIGAN MEDICAL MARIJUANA DISPENSARIES (http://michigan.dispensaries.org/)

[mypuppy]

Hi there Jane,
Thanks for checking in. I spoke to Terri (Corky's mom) just today, and she mentioned you were asking about us. Thanks so very much. I know I have not been on in quite a while. We had over 3 feet of snow last week, the kids were off from school and this week I am finally trying to catch up from being snowbound. Princess is still doing wonderfully and off the trilo....I can't believe it! It's like the miracle I was faithfully praying for, but I know with this condition things can change at a moments notice, so I am just trying to take it one day at a time and trying to enjoy my Princess while she is still her normal self. I have tried signing onto the forum and notice a lot of new threads, which I would love nothing more than to just sit all day and reply to every single one, but it is close to impossible with little ones and just life in general. But enough about me, how about you? Terri mentioned my precious faced Franklin is still having problems with his pee. Did you ever find out what the problem is? I am sure it is frustrating for you, and who knows for him too. I hope he recovers from that soon and get him back to normal. Maybe it's just a little phase he's going through? Who knows? Jane, thanks again for your concern and checking in. Give that little guy lots of belly rubs from me and tight hugs for you and lots of love for both of you....xo Jeanette


Hi Jeanette,

How are things with you and Princess these days? You haven't checked in for a while...
Big hugs,
Jane, Franklin and Bailey xxx

[Franklin'sMum]

Hi Jeanette,

I'm so relieved that you're all ok. :) You're more than welcome for the concern (you know how we worry). Isn't it true that life gets in the way of living? :rolleyes: 3 feet of snow? Whoah! I remember just before the winter olympics, the news said that 49/50 states had snow, the hold out was Hawaii, but still... 3 feet. :eek: Very happy for you that you're no longer sonwbound, and that Princess continues to do really well. It's all we can ask/hope/pray for :)
Thank you so much for asking about Franklin, that's very thoughtful of you. He's doing reasonably well (didn't want his breakfast today, didn't even want any of mine :eek:) but he was quite happy to eat a bone, and snacks. Plus, I cooked up lamb riblets for my tea, and kept some of the meat aside for him, :) yum, so after putting them in his bowl that enticed him to eat some of his food. So no trilo today.
The specialist thinks the dripping may be some kind of incontinence, and the GP (after a uninalysis) is wondering about a high level of white cells, which could be a sign of inflammation, rather than infection. So everything is still kinda up in the air, but the sweet child is happy and in good spirits. Thank you again for asking about Franklin, I'll give him your belly rubs when he wakes up :)

With love to you and your's, and hopes for continuing good health,
Jane, Franklin and Bailey xxx
________
Wellbutrin withdraw (http://www.classactionsettlements.org/lawsuit/wellbutrin/)

[labblab]

Jeanette, thanks so much for your update. I am so happy for you and Princess, and I am hoping that you will continue to have many more "drug-free" days together!!

Please give her a bunch of pats from her Lab-cousins, Peg and Luna ;) :p
(And also a bunch from me, too!)
Marianne

[maggiebeagle]

Maggie's trilostane "vacation" lasted over a year before we saw a return of symptoms. It was nice to have a break from pushing pills and paying bills!

[mypuppy]

Dear friends,
Wow, it took me a while to get to my page with all the new threads lately. I never thought i'd have to search for my puppy's thread on page 4. It's all gooooooood. I wanted to wish every single one of you and your babies, wonderful Easter blessings and lots of great health to all your pups. I love you all deeply as I do my very own family. Hoppy Spring.....Tight hugs to all and big belly rubs and lots of good treats for the babies on easter. Xo Jeanette and the Princess

[Harley PoMMom]

Hi Jeanette,

Thank you so much for the Easter blessings, they are very much appreciated. You and your family are wished a very Happy Easter from Harley and me, and we love you, your family, and sweet Princess very much.

Love and hugs,
Lori and Harley

[Squirt's Mom]

Hi Jeanette!

Back attcha, darlin'!

Hugs, belly rubs and love all around!
Leslie and the girls - always

[lulusmom]

Hi Jeanette,

Thank you for the beautiful sentiments. Of course, I wish you and yours all good things!

Hugs and wet sloppy kisses from me and mine,
Glynda

[Franklin'sMum]

Hi Jeanette,
Thank you so much, and happy easter wishes to you and yours as well. Please give Princess some extra hugs from us,
Love ya,
Jane, Franklin and Bailey xxx
________
Glass pipe (http://glasspipes.net/)

[mypuppy]

Hi Everyone,
I am sorry to report that my short lived miracle has again turned into reality for my Princess. Unfortunately, she begun to show signs of her cushings a couple of days ago. It was a coincidence that with the extreme change in temperature, she began to drink excessively, and I was really hoping it was just that, the heat taking over, but it has cooled down, and Princess still seems agitated and uncomfortable and trying to keep cool, no longer sleeping in her own bed in my bedroom. Hey, it was a nice break, mostly for her, but I did have the open mind all along this may change. I have scheduled a stim for Wednesday just to make sure her levels are high enough to restart her trilo, and we will take it from there. Hope everyone and their pups are progressing with their treatments, and it looks as if we've moved back to page 1 again-lol. All our love, xo Jeanette and Princess

[haf549]

Jeanette:

Sorry to hear about the relapse, but I guess you knew it was coming eventually. Good luck with the restart of the trilo. Take it nice and slow and I'm sure Princess will be fine.

Heidi

[Harley PoMMom]

Hi Jeanette,

Sorry to read that Princess is displaying some cushings symptoms. :( Did her appetite increase also? I'm asking, just incase, that she might have a UTI...just a thought.

We will be anxiously waiting with you for the results of her stim.

Love and hugs,
Lori

[mypuppy]

Hey there Lori,
Interesting you asked about her appetite. I have been watching her appetite, and have not noticed any increase, but just the same I didn't think anything else of her symptoms since they are the same ones she started with, minus the excessive appetite. I guess I should ask why you thought UTI? Is excessive thirst a symptom of an UTI? I didn't know that. Other than that would you mind telling me any other signs of an UTI? Thanks for your post. Hope little Harley is well these days. Luv, Jeanette

[Harley PoMMom]

Increased thirst and urination are symptoms of an UTI...UTI's can be frequent in our female cush-pups. Sometimes, the pup has spots of blood in their urine or the urine might be a darker color...sometimes they show no other symptoms than the increased drinking/peeing.

Love and hugs,
Lori

[mypuppy]

Wow! Thanks Lori. I thought with an UTI they would experience the trickling and accidents in the house? Perhaps I should have her checked for an UTI first before having her stimmed? I know Princess was tested for an UTI when we were initially trying to find out what was wrong with her 6 months ago, but my memory does not serve me right now to remember which test determines a positive diagnosis for an UTI? Is it blood work, urine sample or both? xo J.

[mypuppy]

PS to Lori:
I have noticed Princess has had a runnier nose than usual and at times tends to do that lip smacking at random times during the day. I will address all these issues with her vet on Wednesday.

[Harley PoMMom]

They will need a fresh urine sample. An Urinalysis is done to determine the presence of bacteria, red blood cells, white blood cells and crystals. Excessively alkaline urine indicates the possibility of UTI.

Love and hugs,
Lori

[StarDeb55]

Jeanette, it would probably be a good idea to go ahead & request that a urine culture + sensitivity be done, along with the urinalysis. This will show what kind of bacteria are present, & what antibiotic those "buggers" are sensitive to.

Debbie

[Annie's Mom]

Hi Jeannette,
From my experience with Annie, I would definitely get the Urinalysis culture results BEFORE doing the stim test. If she has a UTI, that infection will skew the stim test results and you won't accurately know where her cortisol is at. Annie has recurring UTI's and I feel I have wasted a lot of money by doing the urine culture on the same day as the stim. Every time Annie starts drinking more water, I think it's her Cushings out of control, but it turns out to be a raging UTI. My only indication that something is "off" is the increased thirst, and a little more frequent urination. Years ago she had a UTI with blood in her urine; over the past year none of her UTI's have had blood in the urine, so they are good at hiding their symptoms! Others will chime in here, but I definitely would get urinalysis results first.

hugs from Barb and Annie

[Franklin'sMum]

Jeanette, honey,

I'm sorry Princess is displaying symptoms again :( Hopefully the others are right, and it is just a UTI and can be easily remedied. My fingers (and Franklin and Bailey's paws) are all crossed that you get good news (wouldn't have thought a UTI could be considered good news, but :o)

With love,
Jane, Franklin and Bailey xxx
________
Lovely Wendie (http://www.lovelywendie99.com/)

[mypuppy]

Thank you Jane, Barba, Lori, Debbie, everyone for all your comments. My only feeling at this point is that all her symptoms are pointing to her Cushings. She just started with the last symptom I was watching for, the excessive appetite, begging and scrounging for stuff outside in the yard. I mean does an UTI coincidentally cause all of these symptoms? I'm thinking definitely "NOT" and this is the Cushings taking over again. What to do though. Now I have a conflict as to whether to check for UTI tomorrow or have her stimmed? Decisions, decisions....Im sure I will resolve it by the end of this day. I appreciate all your advice. Hope ya'll and the pups are well. xo Jeanette

[labblab]

Hi Jeanette,

Gosh, I'm so sorry that your trilostane vacation may be coming to an end! But it was a wonderful break while it lasted, wasn't it :o... Prior to your most recent reply, I was also hoping that maybe it was only a UTI that was causing Princess to drink/pee more once again. But now -- adding in the increasing appetite in addition to her restlessness -- it does sound as though her Cushing's symptoms have kicked back in again.

If you do decide to go ahead with the ACTH tomorrow, you know we'll be very anxious to hear the results. Please remind me -- what dose of trilostane was Princess taking prior to her break?

Marianne

[clydetheboosmom]

Jeannette! Just wanted to pop on and say hi and give you and Princess big hugs.....thank you for all your support and I am now going back to read your most recent stuff....hugs to you!!!

And I love your phrase so I'm going to reuse it - "God loves you and so do I".

Lynne, Clyde & Bailey

[mypuppy]

Hi there Marianne,
So great to hear from you. As for Princess, my heart is telling me it's her cushings alright. I breathed those symptoms day and night with her at the initial stages, so I immediately picked up on them this time around. A mom knows....And yes, the break was just a dream. I was enjoying Princess to the fullest being so happy and energetic and sleeping in my room at night. She hasn't been for the last several days, and of all things with this condition, it's one of the most frustrating aspects for me. I feel complete when she's right there by my side every night, and oh yeah with my husband too ---- lol. I think everyone here knows that feeling all to well. But anyway, I think I have decided to go ahead with the stim tomorrow and see where that takes us. I will most definitely post results as soon as I have them. All the best to you and the pups. xo Jeanette

[sherrylwatts]

Good luck with your ACTH tomorrow. I'm not at the point where I get a break with any meds, but I can understand how much you must have enjoyed it. I haven't read all the posts, so I didn't know, did she have any bad reactions to the Trilostane? What dosage was she using?

Hugs to you and your Princess!

[mypuppy]

ps to Marianne: Sorry, forgot to mention Princess's initial dose of trilo. It was 2 (60mg) once a day. xo J.

[mypuppy]

Hi Sherry,
Thanks for the good wishes. And I understand it's hard to keep up at times with everyone's threads as much as we would love to do just that all day, but unfort. life does take over. But anyway, long story short to sum it up for you. Princess started on 2 (60mg) pills of trilo once a day, however at her 14 day stim we determined her cortisol was extremely low and could have possibly crashed to Addison's, so we immediately stopped the trilo, and although her IMS instructed me to restart her trilo in one week at a lower dose (1 60mg pill once a day), I called Dechra directly, and they recommended only to restart trilo if both the cortisol levels were high (9.1 or over) and also demonstrating the Cushing's symptoms. That was not the case with my Princess. Her Cushings symptoms went into remission and so I did not proceed with my IMS's instructions. Up until just recently when she began her Cushings symptoms again which lead me to scheduling her stim tomorrow just so I know for a fact where her levels are at this point. I will post those results soonest I have them. But in answer to your question, did Princess have any side effects while on trilo? No, she did not experience any unusual side effects while on the meds, aside from, again her cortisols dropping so low, but probably due to the high dose. I am hoping if and when she begins again that the 60mg will be sufficient for her to maintain control of her symptoms. Do not fear the worse with the meds the way I did. As long as you and your IMS are both monitoring all the factors associated with the protocol, then you should feel confident you are doing the right thing for your Pepper and even look forward to a break from pushing pills on Pepper one day soon. I really am wishing your Pepper all that's good in life, because oh boy, they are all so deserving of it. Luv ya bunches. xo Jeanette


Good luck with your ACTH tomorrow. I'm not at the point where I get a break with any meds, but I can understand how much you must have enjoyed it. I haven't read all the posts, so I didn't know, did she have any bad reactions to the Trilostane? What dosage was she using?

Hugs to you and your Princess!

[Spiceysmum]

Hi Jeanette,

Looks like we are starting back on the Cushings journey at the same time! How long has Princess been in remission? Spiceys lasted for 18 months and it was great but the signs have been returning slowly for a few months.

How much does Princess weigh? Spicey weighs about 18 kg and is starting back on just 30mg Trilostane as 60mg was obviously too much for her. Admittedly it did take 15 months for her to go low but we are taking it much slower this time.

Good Luck to us all!

Linda and Spicey

[clydetheboosmom]

Hi again -

I wanted to pop on and tell you that Bailey (my trilo pup) went Addisonian three times on Trilo. Each time I got a break from medicating her, although not as long as you did, and then she went on a lower dose. she started off at 120, then 90, then 60, then 40, and now she is on 30 per day, and has been holding steady with that dose for quite a while. She weighs about 76 pounds. When her symptoms returned, it was increasingly obvious...so I feel your instincts are correct. Good luck with the stim test, but you may find yourself buying less Trilo than before! :)

Let us know - and hugs to you....

Lynne, Clyde & Bailey

[mypuppy]

Hi Linda,
Princess had been in remission for exactly 5 months. She is weighing 72 lbs as of today. Just dropped her off a little while ago for her stim to check her cortisol levels. I know she definitely needs to restart because her symptoms are making her very uneasy. On another note, WOW! I can't believe your Spicey lasted 18 months off the trilo. That is just awesome to hear, but I am sorry she's starting to show signs again. UGH, UGH, UGH. I will post Princess's stim results when I have them. I hope Spicey hangs in there and doesn't need to restart any time soon. Keep us posted please. Take care. xo Luv, Jeanette ps: Belly rubs to Spicey

[mypuppy]

Hi again Lynne,
Thanks for the info. So at 76 lbs on only 30mg was sufficient to keep her levels down? That's pretty good. Gosh, I'm rethinking if I should even restart Princess at the 60mg weighing at 72 lbs??? Perhaps I will ask her IMS to restart her even lower, maybe the 40mg and work our way up, just to avoid a possible crisis. This time around though, I have asked for the prednisone just to have it ready in the event of anything unusual. I don't want to be caught off guard and not know what to do. Thanks for your post and will keep you informed. Take care of you...xo Jeanette

[mypuppy]

Dear All,
I dropped Princess off for her stim a little while ago. I also decided to get her first urine sample this a.m. and brought that in as well for an urinalysis. There was no indication of an UTI, so I feel my instincts were correct. I hope I can get some numbers when I pick her up so I can post later today. Thanks to everyone for your concern. Luv you all. xo Jeanette

[mypuppy]

Hi everyone,
As suspected, just received Princess's stim results, and they were way off the charts, UGH :( UGH :( We have faxed a copy to my IMS for further instructions, which I am assuming is starting at the 1 60mg once a day. Here are Princess's numbers for the taking:
Pre Cortisol: 16.4
Post Cortisol: >50 (OUCH)...

Hope all is well with everyone. Not looking forward to this again, but as you can tell from the numbers, we have no choice. Luv ya'll, xo Jeanette

[zoesmom]

Ouch, is right. :eek: But all will be fine as you are so good at 'reading' your Princess. Onward . . . . to getting those numbers back down. ;) Sue

[Harley PoMMom]

Oh Jeanette,

I am sorry to see that Princess has high numbers :( but you are such a wonderful mom and, now, such a cushy-savy parent that you'll be able to help her with this time with ease! And remember we are all here to help and support you and Princess if you should need us.

Love and hugs being sent your way, my dear friend.
Lori

[lulusmom]

Hi Pre Cortisol: 16.4
Post Cortisol: >50 (OUCH)...

Holy guacamole, I think it's safe to say that you can start the Trilo again. :D:D We're all here to do it again with you.

Hugs,
Glynda

P.S. Is Princess really, really nervous at the vet's? Just asking cuz the pre cortisol is very high.

[labblab]

Hi Jeanette,

Well, I am truly searching for the silver lining in the cloud -- but with a "post" result of >50, it looks as though you can have greater comfort and confidence in going ahead and starting back with the 60 mg...:o

Just like Sue and Lori and Glynda have said, we'll all be here for you and Princess. And I'm keeping my fingers crossed that this time around, the reduced dosing will suit her just fine. :)

Marianne

[sherrylwatts]

Wow! So sorry you have to start again with the Trilo, but at least you knew what signs to watch. After doing this before you'll be a pro (well, trying to find a silver lining). Hopefully once she starts again her numbers will come down quickly - glad you took her in when you did. Hugs to you & Princess!

[mypuppy]

Dearest Sue, Lori, Glynda, Marianne and Karen,
Thank you all so very much for the encouraging words. As much as I know there is no fun in all this, I can truly say I feel totally confident taking this ride again, and only because I am much more mentally prepared and more educated than I was 6 months ago, and I couldn't have done it without most of you being just right there by my side, day in and day out. Wow! I've still feeling blessed to have found every single one of you. I love you all deeply. All the best. xo, tight hugs, Jeanette and licks from my precious Princess

[mypuppy]

Hi again Glynda,
Sorry, I realized I didn't reply to your ps on your last post. Princess does seem to get a bit apprehensive even in the car as we are approaching the vet's office. I know that sounds strange, but as if she knows where the darn place is located. She does seem to shake a little bit in the car, but only when we're going to the vet's, and shakes a little more once she's in the examining room, but other than that, doesn't show any other stress. I know that stress can raise their levels a bit. Regardless, the symptoms are all there so I know it's definitely time. And my IMS better call me today to give the ok. She had her vet tech call me back after I had left her a msg. regarding Princess's levels, and I was floored by the vet's reaction to my not having treated Princess for 5 months. I will quote her "oh my, is Princess seriously ill, you may have done some damage from stopping the trilostane for that long"....WHAT? Ohhhhhhh, Can't wait to hear back from the IMS about that one. See, I'm pretty much in the same place as Karen (Katie's mom). I feel I have been. Ever since I went against Doc's orders 5 months ago, let's just say my IMS has not given me the time of day, and I do sense she is peaved with me for not going against her wishes. Oh well. I have been as diplomatic and patient, oh so patient with her, but once I hear back from her, I think will let her down, let's just say not so gently any longer. I'm paying beaucoup dollars to have her call her vet tech and insult me that way.....OHhhhhhhhhhhh.....This has been aggravating me to no end for the last couple of days, but I won't let it get the best of me. So my friend, this is where we are at this point. Hope you are well. Best regards and much love...xo Jeanette

Holy guacamole, I think it's safe to say that you can start the Trilo again. :D:D We're all here to do it again with you.

Hugs,
Glynda

P.S. Is Princess really, really nervous at the vet's? Just asking cuz the pre cortisol is very high.

[mypuppy]

Sherry,
Thanks. I can't say I'm anywhere close to being an expert with this stuff--(yet, lol), but luckily I am definitely more aware of things and know what questions to ask. Take care of you and Pepper...xo Jeanette

[EllyAugie]

Hi Jeanette, I'm hoping Princess will be feeling more comfortable very soon by starting her treatment again.
Take care.
Elly and Augie

[lulusmom]

Hi Jeanette,

I think Princess was a bit stressed at the vet so that's probably the reason for the high pre stim number; however, her post stim was pretty darn high so I wouldn't be surprised if the amount of cortisol floating around before stimulation added to it also.

I gotta tell ya that I am as surprised by your vet's ignorant comments as she was surprised that Princess has been off of Trilo for five months. Unless a dog has had the disease for a very long time or resolution of an underlying condition is dependent on controlling the cortisol quickly, a dog is not going to get deathly ill by withholding treatment "as recommended by the manufacturer" in circumstances like Princess. I have some great advice for your vet; "Educate yourself about the serious drugs you are prescribing to your patients." Good grief!

Isn't it ironic that you've been dealing with one dog with cushing's for a very short time and now know that after an addisonian episode, you wait until symptoms return and/or the post stim is high enough to warrant restarting the dose, yet your vet doesn't have a clue, even though she's had plenty of time to research how to "safely" restart treatment for a dog that has had an addisonian crisis?? You have done a terrific job of being a great advocate for your baby girl so good for you, girlfriend!!!!!

Hugs,
Glynda

[littleone1]

Hi my dear friend,

Did you ever hear from your IMS as to the dosage she wants Princess to go back on?

We're all here with you.

Give Princess big hugs from her aunt, and special ones for you. Luv ya.

[mypuppy]

Hi Terri,
It's almost 3 p.m., and I have not heard back from my IMS. And if she doesn't call back today, that means I must wait until possibly Monday or whenever she decides to call me back. I am actually going to call her again as soon as I log out of the forum, and leave another message. This is so infuriating, the fact that she hasn't acknowledged any of my emails in the last 5 months, and not calling me back on a timely fashion. UGH, UGH. Where do these individuals get their bedside manners honestly? Wish me luck. I will keep you posted. Luv ya, xo Jeanette

[mypuppy]

Glynda,
I couldn't agree with you more. In all honesty, all I have to thank my IMS for initially recognizing/diagnosing Princess's Cushings, against the gp who said "crazy behavior"...Thereafter, I do not believe she was extremely happy with my constant questions, and the fact that I second guessed her several times on treatment, etc., that moved me to the top of her *(#% list. LOL. I don't have great faith in her any longer, and basically want to speak with her one last time, get the ok to start Princess's trilo, and then schedule her 14 day with another IMS. No questions asked. Tune in for more. xo Jeanette

[mypuppy]

Thank you so much Elly. I also want my Princess to feel good again, and get her back to sleeping in her own comfy bed, next to mommy. Will let you know when that happens. Best regards and much luv to you and Augie. xo Jeanette



Hi Jeanette, I'm hoping Princess will be feeling more comfortable very soon by starting her treatment again.
Take care.
Elly and Augie

[maggiebeagle]

I've been in a similar situation with my vet but was able to work it out. It was uncomfortable for a while though. Sometimes you just can't fix the relationship and must move on with the knowledge that you are doing the best for your Princess.
Our vet did say that when Maggie was on her "trilo vacation" that she wouldn't even consider starting to medicate her again unless she started exhibiting symptoms again since you use that as part of the way to monitor treatment.
That's the point you have reached now and you shouldn't second guess not starting to treat again until now. You know your baby best!
Good luck as you start the journey once more.

[Harley PoMMom]

Hi Jeanette,

I gotta tell ya that I am as surprised by your vet's ignorant comments as she was surprised that Princess has been off of Trilo for five months. Unless a dog has had the disease for a very long time or resolution of an underlying condition is dependent on controlling the cortisol quickly, a dog is not going to get deathly ill by withholding treatment "as recommended by the manufacturer" in circumstances like Princess. I have some great advice for your vet; "Educate yourself about the serious drugs you are prescribing to your patients." Good grief!

Isn't it ironic that you've been dealing with one dog with cushing's for a very short time and now know that after an addisonian episode, you wait until symptoms return and/or the post stim is high enough to warrant restarting the dose, yet your vet doesn't have a clue, even though she's had plenty of time to research how to "safely" restart treatment for a dog that has had an addisonian crisis?? You have done a terrific job of being a great advocate for your baby girl so good for you, girlfriend!!!!!

Hugs,
Glynda

I had to quote this from Glynda because I knew there was no way that I was going to say it any better than she did!

Jeanette, please do not let Princess's IMS let you think that you are not doing a great job taking care of Princess because YOU are. You are doing a fabulous job...remember that.

Love and hugs,
Lori

[mypuppy]

Lori, thank you for always encouraging/motivating me to do my very best for my Princess. As much as I acknowledge have felt a tiny bit confused/guilty/hurt after the vet tech blatantly suggesting I may have done damage to my dog's health, I will stay the course, and refuse to be dragged down by such "ignorant" (quoted Glynda) remarks. I am staying the path, standing firm in my decisions, and keeping the faith. Love you bunches, xo Jeanette ps: belly rubs to Harley and Bear.

[mypuppy]

Hi everyone,
Finally spoke to my IMS yesterday. She barely said 2 words about Princess's results, did not ask how she was doing or comment on her 5 month remission. Helloooooooooo, anybody in there? Yikes! Basically, I did all the talking. Got the ok to restart the trilo. Princess took her first dose today rolled up in her slice of ham--sucked it right up, didn't even chew. haaaaaaaa.....Will keep you all updated on her progress and hopefully some improvements in symptoms. Luv you all deeply....xo Jeanette

[Spiceysmum]

Hi Jeanette,

What is it with vets at the minute! You have nothing to feel guilty about, you can only go on what symptoms you see and we know how are dogs are behaving better than anyone.

Good Luck with the treatment and we are looking forward to the updates.

Linda and Spicey

[Squirt's Mom]

Hey Jeanette,

How are things today? I've been kinda quiet lately but have been keeping up with you and Princess.

I know you will do just fine! You are a great mom!

Big hugs,
Leslie and the girls - always

[mypuppy]

Oh Hi Leslie,
No nice to hear from you. Quiet feels lovely at times, so don't worry. Princess had her second dose of trilo, but I haven't seen a change just yet with symptoms. She's extremely hungry all the time. It really is heartbreaking because obviously I can't feed her all day, but it does break my poor heart. I scheduled her 14 day stim for May 3rd with a new IMS. I finally fired my other one. It took a lot, but I did it. I am hoping I did the right thing, but my heart tells me I did. I hope you continue to enjoy your peace and quiet and are enjoying your little Squirt. Hope all is well too. Luv ya bunches, xo Jeanette

[Spiceysmum]

Hi Jeanette,

Glad the second dose didn't cause any bad reactions and hope her symptoms are alleviated soon. Perhaps it will take a few days before you see any great improvements.

Hope it all goes well with the new IMS. Well done!

Linda and Spicey x

[mypuppy]

Linda,
Thank you kindly. What a load off my mind, and when I meet with my new IMS, I will very nicely spell out what I need from her while she's caring for my baby--communication. Take care of you, and thanks again for your friendship....xo Jeanette

[mypuppy]

Hi everyone,
We're on day 5 and unfortunately have not seen any improvements with Princess's symptoms. Goodness that girl can eat! LOL...But I was planning on this taking a bit longer than the first time due to the lower dose. However, I need some advice from anyone, in the event her symptoms have not subsided by the time she goes for her stim. How long do we give before we decide to up the dose, and of course, I know this will also be based on her 14 day stim. And if we decide to increase, does anyone know the guidelines again for increasing from 60mg? Do we do 10mg increments? Just want to get your inputs so I can be ready with it for my NEW IMS on May 3rd. Here's hoping all your pups are doing great and happy. Luv ya'll sooo much, xo Jeanette

[Rebelsmom]

Since I have not been in your situation I wouldn't have a clue.. lol I just wanted to post and tell you we are here to support whatever you have to do. I hope your new IMS is more expierenced and supportive than the last. Take care.

Melissa

[mypuppy]

Thank you so very much Melissa. Hugs, Jeanette

[lulusmom]

Hi Jeanette,

Dose adjustments at the 10 to 14 day mark are pretty much contingent on the results of the post stim number. For instance if cortisol dropped quite a bit in the first two weeks and you're close to being within range, then you would want to wait until the 30 day stim to reassess the need for an increase. Conversely, if there is little evidence of improvement in the same time period, then an appropriate increase could be warranted, Your IMS should make the call based on Dechra's recommended dosing in accordance with improvement in symptoms and the results of the acth stim test. There's a fair amount of information on Vetoryl in our resources section. Use the link below, take a look at things and jot down or print pages that might help you when meeting with your IMS.

http://k9cushings.com/forum/showthread.php?t=185

I hope this helps.

Hugs,
Glynda

[Franklin'sMum]

Hi Jeanette,

I'm so sorry Princess's trilo vacation has come to an end, but you know in your heart, soul and mind that you did the right thing by with-holding treatment when there were no symptoms to treat.
I agree with everybody that your previous IMS was not well equipped with skills of communication, bedside manner, courtesy, LET ALONE knowledge of the medication she was treating Princess with. :eek:

Hoping Princess gets a resolution of her symptoms soon, and becomes happier in herself and back to regular Princess :)

Good luck with your new IMS, I hope this one is waayyyy better than the last.
Keeping you both in my thoughts and prayers,
Jane, Franklin and Bailey xxx
________
SCUDERIA FERRARI SPECIFICATIONS (http://www.ferrari-wiki.com/wiki/Scuderia_Ferrari)

[mypuppy]

Thanks so much Jane,
I most definitely know I did the right thing for my Princess and not following my IMS's orders. I am hoping my new IMS will be everything we need during the course of this journey. So glad to hear from you. Take care of you and regards to the OUTBACK. haaaaaaaaaaaaaaaaaaaa......Luv you lots, Jeanette and Princess

[Spiceysmum]

Hi Jeanette,

Hope you are seeing some improvements in Princess by now. It will soon be time for her first ACTH since starting the Trilo so you should have a good idea whats happening. I wouldn't be in any rush to increase the dose even if the results are higher than you would like, I would wait until the next one before deciding. Hope all is well.

Linda and Spicey x

[mypuppy]

Hi Linda,
I wish I could say I have seen some improvement in Princess's symptoms. Unfort. they have not improved. Still drinking a lot and the appetite, oh the appetite. I feel terrible for her. Her next stim is next Monday, May 3rd, so I will see where her levels are at that point and discuss any increases with her IMS at that point, but if her numbers come back high again or have not decreased by much, I think I would probably want to up her dose at that point, just to help her. She seems so uncomfortable and hungry all the time and is restless at night, and so is mommy. Tune in next week when I get the results of her stim. Thanks for checking up on us. Hope Spicey is doing well. Luv ya, xo J.

[mypuppy]

Hi Everyone,
Princess had her 14 day stim today, and needless to say, I came home extremely disappointed and frustrated with yet my new IMS. Hopefully it's not me reading too much into things and wanting to expect nothing but the best quality care when it comes to my Princess, but here's how my office visit went.

We went into the exam room and the new IMS finally came in, introduced herself and then basically had no idea of Princess's history. She was all over the place--did not know she had started treatment again and the dose amount, had no clue Princess had been off the meds and in remission for 5 months. I requested to have the electrolytes checked, and she said it was not necessary and instead did a urine culture again to r/o an UTI, which was already ruled out 2 weeks ago. I have no idea what on earth was going through this dr.'s mind at the time, but the icing on the cake for me when she referred to Princess as "this boy here" several times throughout our brief visit--hellooooo!, last time I checked Princess is a girl's name and Princess is a girl, MORON...LOL.....ugh, ugh....My feeling was that she was not prepared in the least for this visit. It was as if they had just dumped Princess's file on her 2 minutes before I walked in, and had never taken the opportunity of even glancing through it till our office visit. To add to my frustration, I asked her recommendation on how she will handle dose increases if her symptoms do not resolve, and her plan is to double Princess's dose again (120mg) which almost got her into trouble in the first place...WHAT? And then she graciously threw in a WHOMPING office visit fee of $200.00 in addition to all the other fees. She also charged me for another 30 day's supply of trilo which I specifically advised her would be purchasing directly from an online pharmacy for less. UGH, UGH, :( :(. At any rate, I do not have her stim numbers yet, but she said I should have them by tomorrow. I will post again tomorrow with those. I have decided not to double up Princess's dose until I give her at least another 2 weeks on the 60mg in the hope I will see some improvements with her symptoms. However, if at that point I do not see any improvements, do I want to go up to the 120mg anyway? What to do here anybody? I hope someone has some great advice for me, as always. Sorry for ranting everyone, but I am at my witt's end with these inept doctors lately. Looking forward to hearing from anyone. xo Jeanette

[Rebelsmom]

Hi Everyone,
Princess had her 14 day stim today, and needless to say, I came home extremely disappointed and frustrated with yet my new IMS. Hopefully it's not me reading too much into things and wanting to expect nothing but the best quality care when it comes to my Princess, but here's how my office visit went.

We went into the exam room and the new IMS finally came in, introduced herself and then basically had no idea of Princess's history. She was all over the place--did not know she had started treatment again and the dose amount, had no clue Princess had been off the meds and in remission for 5 months. I requested to have the electrolytes checked, and she said it was not necessary and instead did a urine culture again to r/o an UTI, which was already ruled out 2 weeks ago. I have no idea what on earth was going through this dr.'s mind at the time, but the icing on the cake for me when she referred to Princess as "this boy here" several times throughout our brief visit--hellooooo!, last time I checked Princess is a girl's name and Princess is a girl, MORON...LOL.....ugh, ugh....My feeling was that she was not prepared in the least for this visit. It was as if they had just dumped Princess's file on her 2 minutes before I walked in, and had never taken the opportunity of even glancing through it till our office visit. To add to my frustration, I asked her recommendation on how she will handle dose increases if her symptoms do not resolve, and her plan is to double Princess's dose again (120mg) which almost got her into trouble in the first place...WHAT? And then she graciously threw in a WHOMPING office visit fee of $200.00 in addition to all the other fees. She also charged me for another 30 day's supply of trilo which I specifically advised her would be purchasing directly from an online pharmacy for less. UGH, UGH, :( :(. At any rate, I do not have her stim numbers yet, but she said I should have them by tomorrow. I will post again tomorrow with those. I have decided not to double up Princess's dose until I give her at least another 2 weeks on the 60mg in the hope I will see some improvements with her symptoms. However, if at that point I do not see any improvements, do I want to go up to the 120mg anyway? What to do here anybody? I hope someone has some great advice for me, as always. Sorry for ranting everyone, but I am at my witt's end with these inept doctors lately. Looking forward to hearing from anyone. xo Jeanette

Wow I can't believe the IMS!! If I were you I would have refused the trilo and not paid for it. I also would have said a few words to the IMS for her lack of knowledge on Princess.. I mean could you not even read she is female!! Come on! I know I don't have much exp with this stuff yet but I'm not sure I would double it. Maybe just add another 30mg?? I'm sure others will have more input. You can always road trip and bring her to see my vet!

Melissa

[labblab]

Oh dear...:( :( Nothing about this vet visit sounds good! :eek:

Jeanette, I'm so sorry that you had such a maddening and disappointing experience. As far as a potential dosing increase, we really need to await the ACTH results. But I'd tend to agree with Melissa -- if an increase is needed down the road, 30 mg. would seem much more reasonable given Princess's previous overload on 120 mg.

But a huge question right now is, how are you going to be able to get what you need from this IMS????? Or more exactly, WILL you be able to get what you need from her? Was there something specific that led you to select her? And were there ANY positives about the experience today? So far, what we've heard sure sounds pretty bad...!

Marianne

[Harley PoMMom]

Oh Jeanette,

I am so sorry that your IMS visit did not go well. It does seem that this IMS did not review Princess's case before your scheduled visit, which IMO, is wrong. For if she would have she would know that Princess can not take 120mg of Trilostane and she would have listened to you and had Princess's electrolytes checked. I think I would run from this one too, but not before getting my money back for meds that I did not want.

If you need to increase her dosage, what about looking into buying 10mg and/or 30mg capsules...But lets see what her stim results are first, ok. Do her symptoms appear to get worse at night or are they just not getting any better?

Jeanette, we are here for you always, so you go ahead and rant/rave. I think I would of had to tell that IMS a thing or two if she would of called my boy Harley a "she" :eek: and acted the way she did...UGH!!!

Love and hugs,
Lori

[frijole]

Rant away baby - you earned the right! WOW. I am so sorry you went thru this - and paid for it to boot.

I'd also like to know how you ended up with this particular IMS. A specialist owes you an ear. They aren't all special as you just learned. :mad:

Kim

[mypuppy]

Thank you all for your replies. Marianne, I found nothing positive about my new IMS or our office visit. I also forgot to mention in my last post, she charged me for the office visit and never even examined Princess, did not check her mouth, ears, feel her adbomen, etc, so AGAIN, no, nothing positive. This one was worse than the other I think. I was told by the facility when I was looking to switch specialists that this new one was the best out of the 4 specialists in the group, so I thought, this is a good thing, and well if this is as good as it gets, I'm bailing out of the facility altogether. I'm looking into other areas today. As for the dose increase, I am waiting for her stim results, and then I will challenge her on going back to 120mg and point out had she backtracked to Princess's med. history would have learned 120mg was too high for her. Thanks again. Tune in for more. xo J.


Oh dear...:( :( Nothing about this vet visit sounds good! :eek:

Jeanette, I'm so sorry that you had such a maddening and disappointing experience. As far as a potential dosing increase, we really need to await the ACTH results. But I'd tend to agree with Melissa -- if an increase is needed down the road, 30 mg. would seem much more reasonable given Princess's previous overload on 120 mg.

But a huge question right now is, how are you going to be able to get what you need from this IMS????? Or more exactly, WILL you be able to get what you need from her? Was there something specific that led you to select her? And were there ANY positives about the experience today? So far, what we've heard sure sounds pretty bad...!

Marianne

[mypuppy]

Hi Lori,
I agree with everything you said here. I do want to run from the entire facility, but oh, I feel so let down, and feel if things continue this way, my Princess's quality of life will be shortened. I am so scared of losing her. This is so emotionally and financially draining. I feel as if I've taken a turn in the opposite direction with these doctors. I WILL NOT put Princess on the 120mg again. I would definitely try to do the 10mg, but how do I make this doctor understand this, and what if I can't find another specialist. As I mentioned this hospital is the closest to me, and that's an hour drive as it is. I feel useless right now to my Princess, but I will not give up on her. And yes, part of me wanted to speak my mind during our visit yesterday, but I tried to avoid confrontration considering my baby was in her hands. Once I get my stim results and urine culture perhaps I will let her down not to gently. UGH, UGH. Thanks for everything. I know you are all here for me just to lend an ear or in this case, eyes. haaaaaa...corny....xo Jeanette ps: I hope Bear is doing well after his surgery. I need to go on his thread to find out....xo

[mypuppy]

ps to Lori: Sorry I forgot to write about Princess's symptoms. I have seen a very tiny improvement in her water intake during the day(not much) but all the others are still the same. I have noticed her panting more at night and is still laying on the hardwood floors during the night. I miss her....

s
Oh Jeanette,

I am so sorry that your IMS visit did not go well. It does seem that this IMS did not review Princess's case before your scheduled visit, which IMO, is wrong. For if she would have she would know that Princess can not take 120mg of Trilostane and she would have listened to you and had Princess's electrolytes checked. I think I would run from this one too, but not before getting my money back for meds that I did not want.

If you need to increase her dosage, what about looking into buying 10mg and/or 30mg capsules...But lets see what her stim results are first, ok. Do her symptoms appear to get worse at night or are they just not getting any better?

Jeanette, we are here for you always, so you go ahead and rant/rave. I think I would of had to tell that IMS a thing or two if she would of called my boy Harley a "she" :eek: and acted the way she did...UGH!!!

Love and hugs,
Lori

[mypuppy]

Thank yo so much Kim,
I picked this new IMS myself based on what I was told at the facility (that she was the best out of the 4). Well you could've fooled me..lol. And yes, not all of them are as special unfortunately for our babies. I will keep the faith in the hope of finding a real qualified and good hearted one. I promise. xo Jeanette


Rant away baby - you earned the right! WOW. I am so sorry you went thru this - and paid for it to boot.

I'd also like to know how you ended up with this particular IMS. A specialist owes you an ear. They aren't all special as you just learned. :mad:

Kim

[clydetheboosmom]

Oh Jeanette! Such trials for you and your baby! I wish I could package up my IMS and send her to you, she is so wonderful.....want to come to Boston?

I will pray for a good doc to come your way....

Lynne, Clyde & Bailey

[zoesmom]

Jeanette - don't give up the faith and yes, stick to your guns. I had a flashback when I read about your latest IMS encounter. Early in Zo's treatment, we went to see an IMS who was supposed to be 'the best' and ran smack into exactly the same kind of encounter you are describing. (Could it possibly be that we saw the same vet???? Where do you live?) She didn't even GLANCE at Zoe as we talked. Very cold and unfriendly. Hadn't even taken the time to breeze thru Zo's records. After having Zo on trilo for over 3 months, she wanted me to just up and quit it and put her on lysodren. We still used our gp vet - and continued to do so until we moved - but I wanted some more expert input on some of the neuro symptoms Zoe was having. She hardly addressed that issue. So I paid the exorbitant bill, walked away as fast as I could, and found another IMS.

Well, the difference was night and day. The second IMS and all of her staff were so wonderful and caring and took lots of time with us. She answered all my questions, discussed the options in detail, and followed up with us, too. So hang in there. They aren't all cut from the same cloth!!!! Thank God!!!! As further proof, after we moved, we began seeing an IMS as Zoe's regular vet and she, too, was absolutely Maaaah-velous. Sue

[Squirt's Mom]

Hey sweetie,

What a terrible thing for you to have to endure AGAIN! Like Sue, it sounds a lot like the first IMS Squirt saw...she acted almost as if she were doing me a favor to see my dog, made no effort to connect with me or Squirt, and didn't feel it necessary to mention that tumor on her spleen which allowed it grow anther four months. :mad: If I knew where she moved, I would be warning everyone I knew in that area to STAY AWAY from Dr. X!

Also like Sue, our second IMS was wonderful. Kind, compassionate, spent time with Squirt getting to know her before he examined her, listened to me, talked with me not at me and kept me informed. So don't give up. You have come so very far in your Cushing's education since Princess was diagnosed and that knowledge will help you find the right doc for her. You're a great mom!

Hang in there,
Hugs,
Leslie and the girls - always

[mypuppy]

Hi there Lynne,
So nice of you to post. And yes, please send some good internists my way. I don't know why I keep striking out with them. Would love to visit Boston again, lovely city. Hope you are doing a little better each day that passes. I luv ya lady...tight ones. Jeanette



Oh Jeanette! Such trials for you and your baby! I wish I could package up my IMS and send her to you, she is so wonderful.....want to come to Boston?

I will pray for a good doc to come your way....

Lynne, Clyde & Bailey

[mypuppy]

Hi Sue,
Well what a coinkidink ain't it! My specialist is located in Paramus, New Jersey, but I live in New York State (an hour away from the facility). Is that where yours worked out of? LOL. Honest to goodness, I am breaking my mind trying to figure out how some of these doctors sleep at night knowing they breeze right through their day at work without making a difference. IMO, you chose one of the most rewarding careers and you don't put your whole heart into it? Just doesn't add up. I will just keep trying to find the one who will care/treat and love my baby unconditionally. Take care of you and hope you are doing well these days. Luv ya. Jeanette

[mypuppy]

Hi there my lady Leslie,
That was just as awful what you went through with Squirt's first dr., and glad you were finally able to find the compassionate provider. It does make such a difference for us. And I understand what you mean when you say these doctors act as if they are doing us a favor. You nailed it. The mentality is simply ludicrous, but for now, I have to suck it up at least for one more week this until I figure out what to do next or where to go, and dish out yet another whomping fee just for an office visit for another doctor to review her records. UGH, UGH. BTW, I won't give up on this precious baby, NEVER. She's too special for that. I am relentless when it comes to her. You know that feeling all to well. Thanks again my dear friend. Always such a pleasure to hear from you. Hope you and the little Squirt are doing great. I love you both, xo Jeanette

[mypuppy]

Hi again everyone,

Heard back from my Vet with Princess's stim results. Here they are:

Pre Cort. 5.9
Post Cort. 10.7

Wow, that's a tremendous drop from her last post. cort. stim of >50.
Her recommendation is to keep her on the 60mg for another 4 weeks and retest at that point. I am pretty content with the results even though symptoms have not resolved. I am hoping perhaps I will see some improvements within the next few weeks if not sooner. Best regards to all. xo Jeanette

[Rebelsmom]

Hi again everyone,

Heard back from my Vet with Princess's stim results. Here they are:

Pre Cort. 5.9
Post Cort. 10.7

Wow, that's a tremendous drop from her last post. cort. stim of >50.
Her recommendation is to keep her on the 60mg for another 4 weeks and retest at that point. I am pretty content with the results even though symptoms have not resolved. I am hoping perhaps I will see some improvements within the next few weeks if not sooner. Best regards to all. xo Jeanette

Jeanette, glad to see her numbers are down. Maybe she just needs a little more time for the symptoms to resolve a little. I hope things get better for you and for her. Make a trip to Daytona to see my IMS? lol She is a saint and office visit is only $55, but if Rebel is having other stuff done she doesn't even charge me the office visit.

Hugs and belly rubs,

Melissa

[Harley PoMMom]

I have to agree with you, that it is very significant drop in 14 days. Keeping her on the 60mg is a good idea and I believe that her cortisol will continue to drop on this dose. I am hoping you will see her symptoms abate, which by her numbers should be soon. ;):)

Sending good thoughts and energy your way ~ maybe the new IMS just had a bad day when you and Princess had your visit, which is no excuse. :mad:

Love and hugs,
Lori

[jrepac]

well, those are good results! hopefully, the symptoms will subside soon! So sorry to hear about your not so good experiences at Oradelle...they are unreal over there. For the money they charge, one would think they could tell a boy dog from a girl dog, huh? OYE!

that's what agitates me...when you are paying top dollar, these guys should be at the top of their game, all the time....otherwise, what kind of "specialists" are they?:mad:

I'm agitated w/my current vet, as he sent me blood test results when the blood sample was obviously of poor quality, so much so that the results were meaningless...I have to wonder, did he even read it? And, yes, some vets have a notorious habit of not always looking at patient history....I've gotten used to this over the years w/various vets. Having to remind them about recent events/conditions, allergies to meds, you name it. :confused:

We have to be the mouthpiece for our pups, since they can't speak for themselves ;)

Jeff

[littleone1]

Hi my dear friend,

I'm glad that Princess's cortisol level has dropped. I am also glad to hear that your IMS had enough sense not to increase her dosage to 120mg a day. She actually did something right.

I'll talk to you later.

Luv ya.

[sherrylwatts]

So sorry to not post before - hate that you had a bad experience with the new vet, but so glad your stem results were good! Sometimes I wonder what gets into these vets, I know, I feel like I have to fight for consideration of all the circumstances so often!

Glad your Princesses results are so good! Hugs and belly rubs to y'all!

[Spiceysmum]

Hi Jeanette,

Very pleased to see those great results, hopefully you will soon see an improvement in symptoms too. Sorry the new IMS didn't come up to scratch either, hopefully she was just having an off day!

Linda and Spicey x

[mypuppy]

Dear Lori, Terri, Jeff, Sherry, Linda, and Melissa,
Thanks so much. I am happy with the results, but certain things raise some other concerns which I will point out a bit later. For now, I appreciate everyone's encouragement. Luv ya'll, Jeanette

[mypuppy]

Hi again everyone,
I got to thinking, considering Princess's levels dropped so quickly in a matter of two weeks, would I be taking a risk in waiting 4 weeks to have her stimmed again? I'm concerned her levels dropping even more to the negative side again? I'm thinking a 2 week recheck may be more reasonable in order to make sure she is stabilized at that point. But, how do I call this IMS and inform her I am going against her wishes? UGH, UGH...and btw, I know a few pointed out here perhaps this dr. was having a bad day the day of Princess's stim, and I did opt to give her the benefit of the doubt, however, that went out the window when she called me back yesterday with stim results and made a rude comment for interrupting her. But anyway, I won't rant about that. I'll try to focus on the real issue here, Princess. Would welcome your opinions as always. Thanks all. Love ya...xo Jeanette

ps: if I decide to stim in 2 weeks against 4, do I go ahead even if her symptoms have NOT improved?

[Annie's Mom]

Hi Jeannette, Glad to hear Princess' results are heading in the right direction! Others with more experience will chime in I'm sure. Although you aren't seeing her symptoms improve, Princess must be feeling a bit better, since her numbers are coming down. Love the new pic with Princess with a snowy muzzle! Sending hugs from Annie and Barb.

[labblab]

Hi Jeanette,

I know the Dechra flowchart recommends performing the first ACTH test at 10-14 days, and the subsequent one at "greater than or equal to" Day 30. So technically, she could be due for another stim in two weeks. But this is just my opinion, but especially if her symptoms have not resolved by then, I wouldn't rush to retest her in two weeks. It's true that her cortisol has come down quite a bit, but 10.7 is still a LONG way from being too low. And on a consistent dose, I think you would expect that the greatest decline will occur within the first couple of weeks, with additional but less extreme lowering after that.

Remind me, but I think the first time around (on the 120 mg.), she had stopped drinking water right at the time that the ACTH showed that her cortisol had dipped too low? So in retrospect, that could have been a warning signal that you'd know to watch for again. Bottom line, I think you can make the decision about when to restim a little further down the road, taking into account how Princess is doing. I know that you surely don't want her to get into trouble again. But given how expensive the testing is, you do want to get as much bang for your buck as possible. And so giving her a bit longer time on the 60 mg. will allow her to really stabilize on that dose before you're confronted with question marks about another dosing change. And of course, you're not really locked into any "specific" day -- you could "split the difference" and retest her three weeks down the road, for instance. Let's see how she does over the next couple of weeks.

Marianne

[mypuppy]

Hi Marianne,
I guess I didn't see things the way you pointed out. I was just quite taken by how quickly her levels dropped and thought may drop even lower in 30 more days, but what you said makes more sense now. In answer to your question as to when Princess stopped drinking water while she was on the 120mg, well, if I recall, by day 3 she was not even going near her water bowl. I was amazed that the trilo kicked in so quickly, yet thought it was strange she was not interested in drinking whatsoever, but little did I know that was a sign of something. I just assumed the trilo was doing it's job. For now, that has not yet been the case. She is still drinking away, so as you pointed out, if and when I see her reverse then I shall act. Thanks a million for your input. You alway seem to put things in perspective. Take care of you. xo Jeanette

[AlisonandMia]

Have you noticed any variation in her drinking through the day? Is she drinking more in the late afternoon/evening than she is in the hours after taking the trilostane, for instance?

If her drinking is consistently more marked in the later part of the day it could suggest that her cortisol could be going quite a bit higher as the dose wanes. Nothing you'd want or need to do anything about at this stage, but probably worth noting if there is a pattern (or not).

Alison

[mypuppy]

Hi Alison,
Yes, her water intake does seem to increase later in the day up to the evening. I will wait these 4 weeks for some symptoms to improve, have her stimmed and take it from there. Thanks for you comments. xo Jeanette

[Franklin'sMum]

Hi Jeanette,

I'm so glad to hear Princess's cortisol is closer to the desired range than her last stim. How is she feeling in herself? As in, does she seem more comfortable as her cortisol lowers?
I know what you mean about when she sleeps on the floor, and missing her presence on the bed. When Franklin used to do that a lot, I was like, "where's my little foot warmer/pillow hog?" We're just getting the cold weather now, and he's back to snuggling. Even when he uses my knee as a pillow and I wake up not being able to move my arm (from not being able to roll over- don't want to disturb him) I much prefer that to him sleeping on the floor.

Wow! You haven't been having much luck with specialists, huh? Really now, you'd think at some point in the visit, you would have said "honey, sit. Good girl" or used her name or something that should have clued in the IMS (aside from her medical history, obviously). The woman told you off for interupting? Madness :mad: does it not cross her mind that it's almost impossible to get a whole heap of onfo and be able to remember what you needed explained, at the end of it all?
If the IMS does want to increase Princess's trilo, there have been a couple of members here whose pups were started at a high dose, developed low cortisol, and then started back with a low dose. With stims and symptoms not resolving, they gradually went back up to the initial dose (and above) that caused the problem in the first place. But the increased dose happened very slowly, over a period of months. But I agree with you, if any vet/IMS wanted to go straight to 120mg, I'd run too.

Wishing you and my Princess all the best,
Jane, Franklin and Bailey xxx
________
Avandia Lawsuit (http://classactionsettlements.org/)

[mypuppy]

Hi Jane,
So glad to hear from you always. I haven't notice major improvement with Princess's symptoms, specially the appetite. Her water intake is the only thing that has decreased, but even that, very little. I have received some great guidance from Marianne, Glynda and others and decided to wait the 4 weeks for the next stim as my new IMS suggested. We will take it from there at that point. I certainly hope within that time frame, that trilo may have kicked in and see at least some symptoms resolved. Otherwise, I am almost sure there will be a dose increase suggestion, but I still think to jump up to the 120mg so quickly would be a bit risky for my Princess. We will see what that stim shows. Tune in for more in June. Hope little Franklin is doing great lately and improving himself. Take care of you and Warmest regards....Luv lots. Jeanette and Princess


Hi Jeanette,

I'm so glad to hear Princess's cortisol is closer to the desired range than her last stim. How is she feeling in herself? As in, does she seem more comfortable as her cortisol lowers?
I know what you mean about when she sleeps on the floor, and missing her presence on the bed. When Franklin used to do that a lot, I was like, "where's my little foot warmer/pillow hog?" We're just getting the cold weather now, and he's back to snuggling. Even when he uses my knee as a pillow and I wake up not being able to move my arm (from not being able to roll over- don't want to disturb him) I much prefer that to him sleeping on the floor.

Wow! You haven't been having much luck with specialists, huh? Really now, you'd think at some point in the visit, you would have said "honey, sit. Good girl" or used her name or something that should have clued in the IMS (aside from her medical history, obviously). The woman told you off for interupting? Madness :mad: does it not cross her mind that it's almost impossible to get a whole heap of onfo and be able to remember what you needed explained, at the end of it all?
If the IMS does want to increase Princess's trilo, there have been a couple of members here whose pups were started at a high dose, developed low cortisol, and then started back with a low dose. With stims and symptoms not resolving, they gradually went back up to the initial dose (and above) that caused the problem in the first place. But the increased dose happened very slowly, over a period of months. But I agree with you, if any vet/IMS wanted to go straight to 120mg, I'd run too.

Wishing you and my Princess all the best,
Jane, Franklin and Bailey xxx

[mypuppy]

PS TO JANE,
And yeah, my new IMS royally sucks! HAAAAAAAAAAAA. We shall see how much more rudeness I can suck up. xo J.

[mypuppy]

Dear All,
Just received results on Princess's urine culture, and it was negative for any UTI's, (no growth after 24/48 hours). yehhhhhh. On another note, IMS asked me how she was doing with symptoms, I told her not much resolved and she came back with "well that's because she was off her meds for so long"....and my reply (in my head that is) was "that's because she was not symptomatic and had extreme cortisol levels Sherlock".....ughhhhhhhh....but at any rate, this is it for now. I have scheduled her next stim for June 1st in the hope her symptoms have resolved by then. Take care everyone. Luv ya'll ....xo Jeanette.

[gpgscott]

Hi Jeanette,

The avatar is too cute.

Sorry to say that I am not up to date and so will not comment on your last post, but I did want to post and wish you both well.

Scott

[mypuppy]

Oh that's ok Scott, I can't expect everyone to keep up with all the threads. I wish I could. I notice so many new members and wish I could reply to every single one of them, but I realize it is impossible. Nevertheless, thank you for being there no matter what and hoping for the best for all our babies. And yes, I thought this was a cool pic of my Princess. It was even more precious watching her roll in the snow this winter. Thanks again and warmest regards, xo Jeanette

[Dawn]

hi my boy has cushings and I also got mixed opinions on what to do we ended up on trilostane although only a few weeks been on it in general appears a litlle better but his water intake has completley depleted his fur is ok, but he is very wobbly due to his back end losing the body mass.Hope this is of some help to you everyone on this site is very helpful to help in any way they can

[mypuppy]

Hi Dawn,
Thank you for posting. My Princess is currently using trilostane as well. Although her symptoms have not yet resolved, I feel much more at peace she is on the lower dose and yet her cortisol levels have been lowered. I appreciate your input, and hope your boy's problems resolve soon. Best regards, Jeanette

[haf549]

Hi Jeanette:

Hang in there with the trilostane. It took a few weeks before all of Kira's symptoms resolved. We kept having to tweek the dosage (downward) as we started high. My advice: stay at the lower dosage if at all possible. You've seen the results of starting too high.
Give Princess a big belly rub and hug from me.

Heidi

[mypuppy]

Hi there Heidi,
Gosh, in the midst of all your heartache you still manage to provide comfort to the rest of us. I don't know what to say. Again, I was so devastated to learn precious Kira had passed, and I know you hold such beautiful memories of her to sustain you, but it still hurts, oh so much! As for Princess, I am keeping the faith that she is on her way to being symptom free and that soon I will wake up one morning and she will be sleeping at my side again. Thank you so much for your encouragement always. It means the world to me. I am praying for you to ease your pain and for your precious Kira. I luv you bunches...xo Jeanette and licks Princess

[clydetheboosmom]

Jeanette! I'm catching up with you and Princess.

Hoping all is going well?

Lynne, Clyde & Bailey

[mypuppy]

Hi Lynne,
How are your spirits these days? I think of you often and wonder how you are doing. Please let me know. So glad you are keeping up with us, but in order to avoid you so much reading, here's a brief update: Princess is on 60mg of trilo/day, cortisols have dropped from the last stim, but symtoms are still unresolved, due for another stim on June 1st to see where her levels are and then decide if we should up her dose at that point. Other than that, not much more to report, she is happy, energetic, eating well, pooping well, etc. So this is it, see aren't you glad I cut down on your reading time? haaaa. Listen, I hope you are well. Let me know what's going on with you, k. I luv ya bunches. xo Jeanette and licks from Princess

[mypuppy]

Hi All,
I do not have anything new to report on Princess for now. I just have a general question for anyone regarding prednisone dosage because I think my vet may have given me an incorrect dose for Princess from what I have read here on the forum. He advised me to give Princess 2 (20mg) pills as an initial dose at the onset of a crisis and then 1 (20mg) pill each day thereafter. Does this dose seem too much to anyone? I appreciate anyones input. Regards Jeanette

Ps: Princess is weighing 70-72 lbs these days. xo

[Franklin'sMum]

Hi Jeanette,
So glad to hear that there haven't been any problems with Princess :). Regarding your pred question, Franklin pills are cortate (cortisone acetate 5mg), and his vet said the dosage for those are .5mg per kg. So when he weighed 7.7kg, the dose was 3.5mgs. Hoping Princess continues do handle things well, and love and hugs to you Jeanette,
Jane and Franklin xx

He advised me to give Princess 2 (20mg) pills as an initial dose at the onset of a crisis and then 1 (20mg) pill each day thereafter. Does this dose seem too much to anyone? I appreciate anyones input. Regards Jeanette

Ps: Princess is weighing 70-72 lbs these days. xo
________
BODY SCIENCE (http://bodyscience.ws/)

[Rebelsmom]

Jeanette I posted this on my thread for you but not sure if u saw it. It's a link to get the veteroyl cheaper with free shipping.

http://www.valleyvet.com/ct_detail.h...e-562663425dfe

hope this helps.

Melissa

[mypuppy]

Melissa,Thanks so much. I had seen the link on your thread but I appreciate you posting it on my thread as well. I do have another online pharmacy which I can get the pills for approximate. 70.00 for 30 pills but I still have not used them since first time I treated Princess her IMS very "generously" auto shipped me the first months supply for a whopping 200.00. How very generous indeed. LOL. And at that time I was not aware of all the online pharmacies aside from Petmeds of course but they were about the same price. Since Princess had only been treated for 14 days I had a lot of med still left which I used on this second round of treAtment at the lower dose but somehow at Princess's last IMS visit she also sneaked yet another months supply at the 100 rate when I specifically told her I could get them for less. UGH. I will make sure next time this does not happen again. Thanks so much again. Tight jugs. Jeanette

[mypuppy]

Hi there everyone,
Back to page 1! Just heard back from my IMS with Princess's stim results. Needless to say, I was extremely happy with the post number and they are within normal range (5.1), however, I was not thrilled with doctor's comments thereafter. She said her symptoms may still be present due to a delay in medication and may have to give it more time, or she asked to follow up with her at the end of the month to find out how Princess is feeling, and if she is still symptomatic, she wants to have her tested for kidney disease, diabetes in the event something else is going on. No mention on a dose adjustment whatsoever, and this brings me back to many, many posts ago wherein we were discussing treating the numbers or the symptoms? So here we go again with the same question? Should we not adjust Princess's trilo considering her levels are at a normal range? I also asked about a possibility of hypothyroidism, and to my surprise, she said the excessive thirst and appetite are not symptoms of such, but I believe I have read here on the forum and have heard from a few also those could be symptoms of a hypothyroid dog as well. So, now I'm back to the "who's word do I take" status again. UGH, UGH....Someone please "chime in" here and try to sort this out for me once again. Thanks all, I luv you guys! xo Jeanette

[lulusmom]

Hi Jeanette,

I don't think you are back to page 1 just yet. I just went back a few pages in your thread and determined that Princess is on once daily dosing right? The majority of dogs do quite well on once daily dosing and have a resolution of all symptoms. However, a small percentage, probably less than 20%, will require twice daily dosing before you see complete resolution of symptoms. Which of Princess' symptoms have not resolved? With a post stim of 5.1 with unresolved symptoms, your vet should do a UC:CR. If the ratio is high, then twice daily dosing is recommended. It's a relatively inexpensive test and you will have to collect the specimen from Princess, preferrably the first pee of the day, before meds and food. Just make sure you have it to the vet within an hour or two; otherwise, refrigerate it.

If Princess' only symptoms is too much drinking and peeing, it could be because she's done this for so long that she's lost the gradients that kidneys need to concentrate the urine. This is called medullary washout and it is not uncommon. Sometimes it just takes a bit longer for the kidneys to regain their concentrating powers. Then there is a very small number of dogs, like my Jojo, that will have life long polyuria/polydipsia. UC Davis reports that this happened with a small number of dogs they treat with Trilostane. The latter is a pretty depressing prospect but I wanted to throw out all the possibilities.

I hope this helps.

Glynda

P.S. Polyuria/Polydipsia is not a common symptom of hypothyroidism. Coat and skin issues, big appetite and lethargy are usually the symptoms most pet owners see. I sure saw that when Lulu was diagnosed with hypothyroidism at one year old.

[Harley PoMMom]

Hi Jeanette,

Did the IMS run a Chemistry panel on Princess? If so could you post the values for the the following:

1) Glucose
2) Creatinine
3) Urea Nitrogen
4) Sodium
5) Potassium

Are Princess's symptoms increasing at night or is it just that they have not resolved at all?

Keeping you both in my thoughts and prayers...great stim results!

Love and hugs,
Lori

[mypuppy]

Hi Lori,
Thanks for your reply. In answer to your question, no, she did not have a chemistry panel done. Her IMS never suggested any other testing done on her yesterday at her stim visit. Perhaps I will call my local vet and have this done through him, and if you don't mind my asking, what is it that we're looking for with the chemistry panel? Thanks so again for all your continued support and friendship. It means the world to me. Luv ya, Jeanette
ps: Princess's symptoms are the thirst, excessive appetite and trying to find a cool place to lay all the time. And it's an all day thing with her at this point. xo

[lulusmom]

Hi again,

I don't see Lori logged on but I think she wants to know if diabetes mellitus and kidney disease have been ruled out.

[mypuppy]

Hey Glynda,
Thanks so much for getting back to me. Gotta ask, is the UCCR the same test as the chemistry panel Lori mentioned here? I am just baffled that my IMS did not even touch base on those or even recommend a dose adjustment instead of now wanting to dig for other diseases. I certainly don't want to start poking and probing Princess unnecessarily again and in the end find out she just needed a little boost on the trilo. Yikes! As for hypothyroidism, I must admit lately Princess hasn't been her active self, but I attribute it to the heat and her cushings, but who knows now, and she is excessively hungry, even tried going into my garbage several times over the weekend which is way out of character for my Princess, so I don't know Glynda. I guess I will try to take this one day at a time and start out with one test at a time before I drive myself insane again trying to get to the heart of the matter. Thank you, thank you as always for being so quick to reply to my concerns and at the drop of a hat. I just can't say it enough but "what would I do without you"? You are my ROCK. Luv ya Baby Doll. xo Jeanette

[mypuppy]

Glynda and Lori,
We had ruled out diabetes mellitus/insipidus back when Princess started with her initial symptoms prior to her cushings diagnosis, but I can only imagine it is something that can develop at any given time and should be tested again for it???? I will do as IMS instructed, call her at the end of month and take it from there I suppose. Have to run out with my little one for soccer, but will be back later on tonight for sure. Warmest regards, Jeanette

[lulusmom]

Jeanette, the UC:CR stands for urine cortisol creatinine ratio and it is a urine test, not blood chemistry. I don't think you need a blood chemistry panel done at this point. If Princess is still symptomatic at the end of the month, I'd definitely want to determine if she needs twice daily dosing before I set off on a mission to find another cause before ruling out the most obvious ones. If you can't handle Princess' symptoms and dread waiting til the end of the month, you can arrange to have a UC:CR done any time.

P.S. I've copied and pasted an excerpt from an October, 2007 article in DVM Magazine that discusses UC Davis' Trilostane treatment protocol. This excerpt addresses the UC:CR. The entire article can be found at http://veterinarynews.dvm360.com/dvm/article/articleDetail.jsp?id=460965&sk=&date=&pageID=3


The goal of therapy is an owner who is completely pleased with the response. As aids in achieving this goal, both urine and blood tests are indicated. The urine should be checked, at a minimum, for specific gravity, glucose and urine cortisol-to-creatinine ratio (UCCR). An ACTH stimulation test should be started at the time the dog is seen, again about two to three hours after trilostane administration.

The UCCR result should be within the reference interval and the post-ACTH serum cortisol concentration should be between 1.5 and 5.5 mcg/dl.

If the serum-cortisol concentration is within that goal and the UCCR is abnormal, the medication should be given BID. If the serum-cortisol concentration is too high, the trilostane dose should be increased. But if the serum-cortisol concentration is too low, the dose should be decreased.

This approach should be used at each re-check until the dog is doing well.

[Harley PoMMom]

Hi Jeanette,

I completely agree with Glynda, she has given you really good advice and about the UC:CR.

Love and hugs,
Lori

[labblab]

Hi Jeanette,

Gosh, I am sorry that Princess is still showing symptoms. I agree with everybody else that the post-ACTH result of 5.1 is "good," on the face of it. But as Glynda has suggested, it may turn out that Princess is one of the dogs who would do better with twice daily dosing. The fact that she doesn't seem to be controlled at any time of the day does make me scratch my head a bit, though. I would feel more optimistic about that solving the problem if Princess' symptoms did seem to be controlled during the first part of the day, with recurrence later on. But as Glynda says, the UC:CR is a simple urine test to perform (once you catch the urine sample, that is :rolleyes:). And the results may shed some light.

One cautionary note, though. During a conversation here with one of our members, Dr. David Bruyette, he made the point that a single day's urine collection may not give very accurate results. As an alternative, he suggests collecting the urine on three successive mornings and pooling it together prior to testing. If you take a look at this set of back-and-forth questions on his thread, you'll see what I'm referring to. There is a reference to actually performing an ACTH test at the 24-hour mark, right before the next day's dosing, in order to find out how high a dog's cortisol has risen over the course of a day. That would be the most accurate gauge, but not many people have that done. So the UC:CR is the simpler, less expensive alternative. Here's the conversation with Dr. Bruyette:

http://www.k9cushings.com/forum/showthread.php?t=543&post#2

Bear in mind that if you DO switch to twice daily dosing, you are not doubling her total daily dose -- you are instead splitting it in half, or increasing it just a little bit before halving it...

Marianne

[mypuppy]

Glynda,
Another quick question on the excerpt you copied for me (thanks btw), what does "give medication BID" exactly mean? Sorry, gotta catch up with my cushings terms. Thanks a bunch...xo Jeanette

[labblab]

Jeanette, it's "me" instead of Glynda, but "BID" refers to giving a medication twice a day. ;)

Marianne

[mypuppy]

Hi Marianne,
I agree, I wish it was an easier fix here with those darn symptoms, and it all sounds so complicated with the twice daily dosing approach and performing acth stims simultaneously with the UC:CR. Ugh. I mean I guess if it's an option for my Princess, so be it, will go to all extremes to get this pup well. Thank you for getting back to me with all my options possible and for defining the term BID for me, and not Glynda (haaaaaaa), I welcome valuable advice from the both of you. I learn something new every day. I emailed my IMS earlier regarding the UC:CR and twice daily dosing, so I will definitely keep everyone updated on what we decide. Take care of you. xo and luv, Jeanette

[AlisonandMia]

Glynda and Lori,
We had ruled out diabetes mellitus/insipidus back when Princess started with her initial symptoms prior to her cushings diagnosis, but I can only imagine it is something that can develop at any given time and should be tested again for it???? I will do as IMS instructed, call her at the end of month and take it from there I suppose. Have to run out with my little one for soccer, but will be back later on tonight for sure. Warmest regards, Jeanette

Definitely worth revisiting the diabetes mellitus possibility - it is something that can come on literally overnight (more like over the course of a week though). Most noticeable symptoms are increased urination and drinking and appetite. There is usually weight loss as well, despite the increase in appetite.

Testing for DM is quick, inexpensive, easy and pretty definitive too. It isn't something that you can afford to leave untreated for long so getting that checked out pretty promptly would be a good idea.

Alison

[BestBuddy]

A really quick test for Diabetes M is something you can do yourself with a diastix or even ketodiastix strip. The strips should be available at pharmacies or your vet could probably do it in a minute. You just need a urine sample.

There should be no sign of glucose in the urine.

Jenny

[mypuppy]

Thanks Alison,
The only thing I question about the DM is that Princess has actually gained a couple of pounds instead of losing, so not sure there? She had a water deprivation test back in Sept to rule out diabetes and I hope there is a different test out there to rule it out because that water dep test was definitely tortorous and don't think I can subject Princess to holding off her water for that long again. tune in for more. Warmest regards. Xo Jeanette

[mypuppy]

Hi Jenny,
Thanks for the info but couldn't I just take an urine sample to my vet and check her sugar levels to determine diabetes? Best regards, Jeanette

[Harley PoMMom]

Hi Jeanette,

You can take a urine sample into your vet and she can check it right there for you. ;):)

Love and hugs,
Lori

[labblab]

Jeanette, please remind us --

Back during Princess' first go-round with trilostane, I'm thinking that all of her symptoms DID resolve throughout the day. If anything, she was drinking too LITTLE water at that time. But is my memory correct? Aside from the fact that her ACTH results were too low at that time, was she otherwise doing well with her symptoms resolved? And how long ago was it that she was first taking the larger dose of trilostane?

I'm still scratching my head over her situation. If all her symptoms did resolve the first time around, maybe it is true that she just needs a bit of a higher dose. But given her history of going too low, I do understand why your new vet may not be rushing in to increase the dose quite yet. Oh, if only we had that magical crystal ball...!

Also, just wanted to tell you that a water deprivation test is associated with a different type of disease: diabetes insipidus. What people are talking about testing for right now (sugar in the urine or blood) is diabetes mellitus. It is confusing, since they both start out with "diabetes." But the mechanisms of the two diseases are very different.

Marianne

[Harley PoMMom]

I also wanted to add that for the DI (diabetes insipidus), a vet/IMS will not do a water deprivation test in a cush-pup or a pup that they suspect of cushing's because this could be lethal to the pup. What they usually do is try giving the meds and see if that helps.

Love and hugs,
Lori

[mypuppy]

Marianne hi,
I'll refresh your memory a bit. I started Princess on 2 (60mg) capsules once a day back in November '09. Took her for her 14 day stim with a post result of 1.1. Ims instructed me to stop trilo for 5 or 6 days but I did not restart her because all her symptoms had resolved completely (lasted 5 months without treatment)--best 5 months. I saw total resolution of symptoms within 3-5 days of starting treatment. My heart is telling me as yours that she may just need a little boost with her trilo. I mean it is half the dose she was initially on so that is a huge difference I feel. As for the diabetes issue, yes I am aware of both dm and di. My gp tested for both at the time Princess began with her excessive thirst and urination. That's when my gp performed the water deprivation test, and since My gp never suspected cushings I would not have known at the time it was a risky test for a cushpup since we hadn't diagnosed her yet. Regardless, cushings or not that test truly scared me. So there you have it. As you I don't know what to make of this right now and which way to go. BTW, I always forget something. You had asked if Princess's symptoms were resolved mostly during the day during her initial treatment (the 120mg)? They were resolved all day and night. Again it was just awesome. If you think of anything else I would certainly love to hear it. Thanks for your help always. Xo Jeanette

[mypuppy]

Lori,
As you already know I just have not had the best of luck with vets and IMS's. My first gp performed that God awful water deprivation test on Princess and he was the one that missed the cushings and said Princess was drinking excessively out of habit. That's when I knew something was not right. ugh. Luckily Princess did not suffer any consequences from this water test. please keep your prayers going everyone for some good vets for my Princess please, geez! Thanks. luv ya Lori. Jeanette. Ps. How are Harley and Bear doing? Pps: I almost forgot. The issue of switching Princess from trilo to lyso would not be an option for her because her IMS facility does not treat any patients with the Lyso therefore even if I considered switching I would be stuck as to who would treat her. UGH. Wanna come to New York and treat Princess for me? Lol. You'd probably do a greater job than I'm paying the real professionals to do . Lol. take care. Xo



I also wanted to add that for the DI (diabetes insipidus), a vet/IMS will not do a water deprivation test in a cush-pup or a pup that they suspect of cushing's because this could be lethal to the pup. What they usually do is try giving the meds and see if that helps.

Love and hugs,
Lori

[mypuppy]

Hi everyone,
Quick post tonight with an update. Heard back from Princess's IMS to discuss the uc:cr and the possibility of twice daily dosing, and her response was that twice daily dosing was not significant for her. In other words, it's not something she would recommend. She still feels we should give it until the end of June and if still symptomatic, she will perform a chemistry panel. I asked about the diabetes possibility and she mentioned appetite and weight gain are not symptoms of such. So back to the waiting game again. Any thoughts from anyone? Thanks. I am pretty drained and am exhausting my patience with all this. Good night everyone. Jeanette

[Spiceysmum]

Hi Jeanette,

Just to let you know I am thinking of you and Princess and have been following your updates. I know how you feel playing the waiting game, especially after having such good results last time round. We have just been away for the weekend and Spicey didn't want to do much at all, it was very hot though. She is now on 30mg after increasing from 10mg then 20mg but still isn't her old self. I think this might be as good as it gets as she is now 14 but as Princess is only 7 you should be hoping for things to get back to normal, whatever normal is!!

Linda and Spicey x

[Franklin'sMum]

Hi Jeanette,

No thoughts or advice to offer, just sending love and best wishes.

Jane, Franklin and Bailey xxx
________
Vermont Marijuana Dispensaries (http://vermont.dispensaries.org/)

[mypuppy]

Hi Linda,
Thanks so much for your good wishes and understanding always. I agree Princess is still so young, and to have her back to her old self, even if for a little while again would just be great. Nevertheless, although Spicey is 14, I am sure that feeling is just as strong as when she was 7. Thinking of you both and hoping your beautiful girl will also soon be feeling well again. Take care. Luv ya bunches, Jeanette

[mypuppy]

Dearest Jane,
I'll take the love and best wishes anytime. It just keeps me going throughout all this, so for that, I feel blessed for that much. Ditto for me on this end as well with your little sweet face. Hope all is well. Luv ya both, xo Jeanette


Hi Jeanette,

No thoughts or advice to offer, just sending love and best wishes.

Jane, Franklin and Bailey xxx

[Harley PoMMom]

I asked about the diabetes possibility and she mentioned appetite and weight gain are not symptoms of such. So back to the waiting game again. Any thoughts from anyone? Thanks. I am pretty drained and am exhausting my patience with all this. Good night everyone. Jeanette

Hi Jeanette,

This can get pretty frustrating, ain't? And I hope that I don't add to your frustration but diabetes mellitus may cause weight gain in a dog and an increased appetite in a dog is one of the symptoms of diabetes mellitus along with excessive urination and drinking.

I believe if I were you and since your IMS is doubting diabetes mellitus that I would take Jenny's suggestion and do the home-testing for diabetes on Princess...JMO, of course!

Keeping you both in my thoughts and prayers.

Love and hugs,
Lori

[mypuppy]

No worries Lori. I appreciate you running it by me and second guessing my IMS, considering her track record. However, I did a little googling on my own after I spoke to her because I just don't know which way to go with this anymore, and I didn't find the weight gain as a symptomfor both DM or DI. If you don't mind my asking, where did you learn that weight gain was a symptom of DM? Here's a copy of what I extracted from the internet.

Diabetes Mellitus Symptoms:
•Excessive drinking and urinating.
•Pail almost clear urine color.
•Weight loss despite increased appetite.
One of the earliest signs is that the dog will want to urinate more frequently and may even do so in the house. Owners of older dogs that develop diabetes often mistake these symptoms for incontinence when in fact it is due to the dog drinking excessively due to great thirst. In addition, diabetic animals tend to lose weight despite an increased appetite because they breakdown stores of fat and protein to make glucose and ketones in the liver. The dog may become lethargic with little interest in anything except sleeping. All of these symptoms together are definitely cause for concern and expert diagnosis should be obtained from you vet at the earliest opportunity.
-------------------------------------------------------------------------- Diabetes Insipidus Symptoms
• PU/PD (polyuria - means pees a lot / polydipsia - means drinks a lot)
No one measures urine output, but you can measure water intake
• CAT - Daily intake in excess of 100 mL/kg for a cat is abnormal. This would be about 12 oz or 1.5 cup of water for an 8 pound cat.
• DOG - Daily intake in excess of 90 mL/kg for a dog is abnormal. This is about 1.38 oz per pound … so if your dog weighs 23 pounds, consumption of more than a quart of water a day would be abnormal.
• Urine has low specific gravity (SG): usually less than 1.012 and often less than 1.008
• May lose weight
• May be a bit dehydrated with a scruffy, dry looking coat
• May be incontinent or break house or litter training
• Rarely, may have a fever of unknown origin

------------------------------------------------------------
Nevertheless, although the weight gain is not mentioned anywhere, I will still consider doing the home test. I have nothing to lose. Also, at the end of the month, I am definitely having a full chemistry panel on Princess which I feel will tell us more if anything else is going on. Thanks again for all you do and reaching out. Tight ones, xo Jeanette

[Harley PoMMom]

On the other hand, your diabetic dog might experience weight gain because he is not burning off the right amounts of sugar due to the insulin deficiency in his system.

http://www.vetinfo.com/diabetes-dogs-symptoms.html


Love and hugs,
Lori

[mypuppy]

Hi Jenny,
I purchased the Keto-Diastix Reagent strips today, and have a quick question. Should I do this test first thing in the morning, first pee of the day or can it be done at any time? Thanks a bunch...Jeanette


A really quick test for Diabetes M is something you can do yourself with a diastix or even ketodiastix strip. The strips should be available at pharmacies or your vet could probably do it in a minute. You just need a urine sample.

There should be no sign of glucose in the urine.

Jenny

[mypuppy]

just great!!!!!!!!!!!!!!!!
Ugh!!!!!!!!!!!!!!!!!
:( :( :( :( :( :( :( :( :( :(

http://www.vetinfo.com/diabetes-dogs-symptoms.html


love and hugs,
lori

[BestBuddy]

For a diagnostic test you can test at any time of the day.:D
If you were tying to monitor a diabetic you would skip the first pee in the morning because the glucose that had spilled over would accumulate all night and you would get a higher reading that it should be for that current time.

Good luck.

Jenny

[zoesmom]

Just watch out for your fingers/hand when holding that diastix!! :eek::eek::eek:

Maybe you can hold it with a pair of OLD tongs, just to make sure. I always liked the idea of using a long-handled soup ladle to catch a urine sample, too. Of course, that doesn't mean you won't get the evil eye, either way. :D;):p Sue

[Casey's Mom]

Jeannette, I have used the long handled soup ladle, works great!! My vet told me about it when Casey kept having UTI's, that's what they used to catch the urine. I then would suck the urine up into a syringe and take it in for testing. The ladle doesn't work so well on a tiny dog but worked great with Casey and should work just fine with your Princess.



Love and hugs,

[mypuppy]

Soup ladle--that's brilliant! Hopefully, my little one won't throw it back in the utensil drawer....LOL...Thanks for the good tip. xo Jeanette

[mypuppy]

Hi everyone,
Was wondering if anyone who has previously used the Keto-diastix strips can tell me if I am doing the test correctly? I did read the instructions carefully twice and I think I did do it right but just want to make sure. I dipped the strip with the two color tips into urine, removed, counted 30 seconds and there was no change in any of the colors which indicates a negative for glucose and ketone. Can someone tell me if I performed the test properly? Thanks all. Princess is hanging in there and am slowly seeing a little more improvement and has now been sleeping back in our bedroom every night----ahhhhhhhhhh! What a nice, corn chip fragrance to sniff each night again-lol. Luv you all. Xo Jeanette

[BestBuddy]

It sounds like you did the test fine. No ketones are great and the neg on the glucose just means that the BG is not over 180 (renal threshold) since the last pee. The stix are not precise enough to know how much under 180 the BG would be so unless there are any signs of low then that would be good too.

Jenny

[mypuppy]

Hi everyone,
A little concerned. 10 minutes ago Princess tried to get up from laying down and she had a very tough time getting up and once she did she was limping. Could this be related to trilo or arthritis or maybe something else going on. We were out in the yard after dinner and she did her usual ball chasing with no problem and am thinking she may be a bit sore. I hope she didn't tear anything in the process though? BTW, my friend mentioned that when a pup's cortisol is finally under control it can actually cause inflammation and that cortisol actually reduces inflammation. Is this accurate? If so, is there anything I can give/do to reduce her inflammation or any pain? I have heard it is ok to give pups baby aspirin? What dose would be ideal for her at 72 lbs.. Thanks anyone. I'm a bit worried considering we are due to travel this weekend with her and would like to address this issue before we leave. Xo Jeanette

[StarDeb55]

Cortisol is a natural anti-infammatory, so when the cortisol level is brought down, things like arthritis will frequently come to the forefront. I do not want to alarm you, Jeanette, but since this occurred after playing ball, my concern is a cruciate ligament rupture. This is exactly what happened to Barkley. I was throwing a toy back & forth through the house for him, he went running onto the linoleum in the kitchen, I heard him kind of squawk, & he comes back toward me, limping to beat the band. I would keep her as quiet as possible tonight, see how she is doing in the AM. If she is still limping, you need to call the vet. Please do not give her baby aspirin without checking with the vet first. If is some type of strain or even a cruciate rupture, most vets will put them on crate rest, & anti-inflammatories for 7-10 days. If there is no improvement after that, then you're probably talking surgery.

Debbie

[mypuppy]

Wow, sorry, I know it's too soon to tell but that just scares me. Did your Barkely end up having surgery to correct it? She is in her bed now for the night and Ill be watching her all night until the morn. Should I give her her trilo in the morning or does that not have any bearing on this? thanks Debbie. Jeanette

[Roxee's Dad]

Hi Jeanette,
Can't really comment on the trilo for tomorrow, I would think it would be okay but also missing a day is really not a big deal. Agreeing with Debbie, if Princess is still limping, you will want to get that checked out as soon as possible. My Roxee went through the same thing, ACL rupture, surgery and about 6 weeks of very, very limited activity. There is actually a picture of her with her post surgery cast in my album.

Hopefully she is just sore and will be perky tomorrow.

[frijole]

Jeanette - since you didn't see anything happen it could be anything, including a torn ACL or even arthritis that is showing up due to cortisol lowering. As Deb mentioned - just keep her relatively calm and from running around and see how she is in the a.m. Great that she is sleeping. Maybe she'll wake up and be back to normal. As she said, if it is still bad in the morning, call the vet because you don't want to wait until Tuesday for help if you need it. Fingers crossed for you. Kim

[StarDeb55]

Jeanette, Barkley had to have surgery twice. The way it was explained to me by the orthopedic surgeon, they basically use a type of suture material to replace the ruptured ligament. B had been doing fine for about 5 weeks or so post-op. I took him out of his crate for supper one evening, I kind of heard a squawk, turned around & he's limping. He was simply walking to the kitchen. Speak of the devil, the above happened over a July 4th weekend, so we couldn't get to the ortho surgeon until the following Monday. Barkley was back in surgery on Tuesday, & the surgeon said that the suture material has basically stretched way past what it was supposed, so it was basically ruptured, too. The second time around worked like a charm. Of course, the stupid ortho surgeon tells me that he actually had to take an English Bulldog to surgery 3x before it finally held up. I told him, "Gee, thanks for the real confidence builder." Abnormal pre-op labwork including a sky high alk phos is what put Barkley & me on the road to a Cushing's diagnosis.

Debbie

[mypuppy]

Thanks John, Kim and Debbie,
Will give you an update in the morning. Hopefully a good one. Good night to all of you and your babies. Jeanette

[mypuppy]

OMG Debbie! Barkley's story is just too much. How did you do it with two surgeries and recovery time? Yikes. That's just awful. Will have to hear more on that. Good nite. Xo Jeanette

[Franklin'sMum]

Hi Jeanette,
I really hope it's nothing serious with Princess, and hope she's moving normally in the morning. But if not, good luck at the vets.

Hugs and sloppy kisses
Jane, Franklin and Bailey xxx

[Harley PoMMom]

Hi Jeanette,

I too, hope it's nothing. Did you take a look at her paw to make sure that she didn't step on something??? Around here in the summer-time we have to be especially careful with bees, yellowjackets make their nests in the ground and they are a mean bee. :eek::mad:

Keeping you both in my thoughts and prayers.

Love and hugs,
Lori

[Spiceysmum]

Hi Jeanette,

I hope it's not anything too serious with Princess. I remember a couple of years ago Spicey started limping for no apparent reason and yelped every time she got up of the floor. Vet couldn't find anything wrong, gave her anti-inflammatories and a day or two later she was better! I would make Princess rest until you've seen the vet though, just in case.

Hope she is ok for your holiday.

Linda and Spicey

[labblab]

Hi Jeanette,

I'm so sorry to hear about Princess' limp! Is the problem with a front leg or hind leg? The more experienced "cruciate parents" will know better, but I THINK it's more likely to be a torn cruciate if it's a hind leg...

We're having a front leg issue with our non-Cushpup Luna right now. She's our nearly two-year old yellow lab. She's had an on-and-off front leg limp for a couple of months now. It actually seems to be more of a shoulder issue for her. The first time it happened, it was totally out of the blue -- we were just out walking, and she suddenly started to walk funny. By the time we got back to the car, she was fine. But then she did it a couple more times after that -- always clearing up within a day, though. Most recently, she landed really hard after running to catch a ball, so that was an obvious cause. Our vet didn't see anything obvious in his physical exam or an initial set of x-rays. So as Debbie said above, he put her on 10 days of an anti-inflammatory (Deramaxx) and restricted activitiy. From the first dose of the medication, she stopped limping. She's been off the med for about two weeks now, but we're still trying to be somwhat careful. If the limp recurs again, we'll undoubtedly be off to the orthopedist. :(

So I'll be crossing my fingers for BOTH Princess and Luna that the limp turns out to be nothing besides a sprain! Do keep us updated. And I agree, if she's still limping this morning, you'll want to take her in to be seen before the holiday weekend.

Marianne

[mypuppy]

Good morning everyone,
Princess slept all through the night fine. I got up this morning as usual to give her breakfast with her trilo. She was able to get up without any limping, but I feel she's not out of the woodwork somehow. I took her outside for her morning business, and she was hesistant to go into the yard and do anything and was just gazing into my eyes and giving me her paw as if saying something??? I'm thinking she may be in pain and is afraid. I stayed outside with her for 10-15 minutes until she finally managed to tinkle in our front lawn. It's an easier walk than the backyard. I made her lay down again. My vet opens at 8 a.m. and have the phone in hand to try to get her in today. We are going away for a week, and would hate for this to act up or get further aggravated while we are away. UGH, UGH. Marianne, depending on what her vet says today, I'm sure he would know to prescribe an anti flammatory to help Princess, but if he doesn't, should I insist on it? If so, do I suggest the same medication your Luna is on (Dematrix?). What about a cortizone shot? I know some vets do that for a one time fix, or should I just go with the 10 day meds to be on safe side since I'll be away? Sorr for all the questions, but want to make sure I am prepared for anything. I read labradors are very suceptible to the cruciate tears. My friend's yellow lab is in her last week of recovery, goes to ortho today to get the final ok to run wild. They do like to run so wild don't they? "It's a lab thing!" But anyway, running to call vet. I will let everyone know what her status is upon our return from the vet. Thanks all for your quick replies. xo Jeanette

[labblab]

Jeanette, since I'm so new to these orthopedic issues, I'm afraid I don't know a lot about the best treatments (for instance, oral meds vs. a shot). However, in the case of a Cushpup, I'mthinking that a nonsteroidal med would be preferred over cortisone, for instance. And I'm thinking that certain painkillers/anti-inflammatories would be preferred because of less liklihood for gastric irritation in a Cushpup.

I know that the Deramaxx that Luna was given is a non-steroidal. I don't know how often it causes gastric upset...

Bottom line, I think it'll be your vet's call based on your descriptioin of the problem and the physcial exam. Good luck and keep us posted! (AND WHY DO THESE THINGS ALWAYS HAPPEN RIGHT BEFORE A WEEKEND, A HOLIDAY, OR A TRIP????)

Marianne

[StarDeb55]

Jeanette, no steroids!!!!! Marianne brought up a good point, which one of us should have asked last night. Cruciate problems are in the rear legs. If the limp is not in the rear leg, it's something else.

Debbie

[mypuppy]

Hi Debbie,
Yes, I did learn a while ago on the forum that cushpups should not receive any steroid medication, and I will make sure of that today at Princess's office visit. Princess's limping is from her hind legs. Don't know which one or both? Hope it is not the acl issue. My friend's lab's recovery from acl surgery has been dragging, so I have an idea what it would entail. Ugh. I will post later today after Princess's appt. Thanks again. xo Jeanette

[Squirt's Mom]

Hi sweetie,

Hope it is nothing bad with Princess. Please let us know what the doc says.

There are several supplements that can help with inflammation so once you have seen her vet and have an idea of what you are dealing with, I will get a list for you...as I am holding to the thought this is a simple aggravation of some sort and will go away with a bit of TLC!

Hugs,
Leslie and the girls - always

[mypuppy]

Hi again everyone,
Boy it's been a heck of a day. By chance was it a full moon? Ugh. Just got back a little while ago from Princess's vet appointment. He examined her but was unable to pinpoint any rupture, nevertheless he didn't rule it out completely. He put Princess on anti-flammatory (Deramexx) for 14 days. Advised to keep her activity very limited, yeah, try saying that to a lab, but she has slowed down quite a bit since the cushings, although still manages to chase every ball. What can I say, she's my soccer dog. She seems to be doing fine today and have not noticed anymore limping, so I really am hoping whatever it was, is has subsided for now, but I do feel better having the anti flammatory for our trip at least. If anything else comes up with this again, I will address it upon our return. I want to thank each of you hugely for your prompt help with this little wrench yesterday. I honestly depend on all of you dearly. Thanks bunches from the bottom of my heart. I luv ya all. xo Jeanette

[mypuppy]

Hey Leslie,
So great to get a reply from you. All seems fine for now I hope. As for the TLC, that part is well taken care of. That Princess is spoiled rotten with the hugs, kisses, rubs, pats, baby talk, goodies, toys, you name it, and as it should be with all our pups. Thank you dearly for your sweet thoughts. Luv ya bunches. xo Jeanette

[labblab]

Whew! Sounds like a good plan, Jeanette. We're gonna be doing some traveling soon, too, and we're planning to do the same thing with Luna -- ask for some Deramaxx to have on hand "just in case" while we're gone. And then if the problem recurs, we'll have her checked out more thoroughly after we get back.

And I can totally sympathize as to how hard it is to keep them quiet. We've been doing our best to limit any outdoor rough-housing, but she'll just tuck her tail and take off racing around the house to try to hunt up a ball INSIDE...:eek:

Hope you ALL have a great trip!!

[apollo6]

Just my input. Apollo has had back problems for years. He was on prednisone, dexam, etc. all steroids. I knew this was not good for him. Did have x rays to confirm herniated disc. I started doing acupuncture to get away from the steroids and it has helped a lot.

[mypuppy]

Thanks Sonja, truth be told, this is the first time Princess has ever experienced difficulty getting up and limping. Although nothing is conclusive yet from today's visit since we did not xray, I have faith the anti-flammatory medication will hopefully help her and get her through our week we will be away. This is a non-steroid drug, so I am relieved it will not interact or aggravate the cushings. Hope Apollo is doing fabulous by the time I get back and check in again. Thanks again for your thoughts. Best regards, xo Jeanette

Marianne,
I am happy with the outcome so far and that Princess has not demonstrated any more problems today, and that I have the meeds. And I couldn't agree with you more, things like this always happen right before a planned event, dang it! It's funny but I can always remember my husband being away on business and having some freaky thing happen inside the house, like a flooded basement, a broken water heater, etc. ALWAYS when he was away....ughhhhhh......xo luv ya and you too have fun on your get away....

[mypuppy]

Hi dear friends and furbabies,
Wanted to wish you all a very happy 4th tomorrow and a great week. I will miss you all considering this may be the longest break I will have taken from the forum--it's killing me already --lol. I will be thinking of every single one of you and your babies and will look forward to getting back and hopefully reading some positive updates on your babies in the hope they have made some progress. Princess is still doing fine since her last limping episode, and I am so anxious to watch her enjoy life at the beach with us and just a change of scenery will do us all wonders. I'm staying my feet out of the waters though after the news alert on sharks heading toward us. Yikes! Be well everyone and we luv you bunches. Xo Jeanette and The Princess
Ps: FREEDOM!

[Franklin'sMum]

Hi Jeanette,

I'm so glad to hear that Princess isn't limping :D:D and hope that the derramax (sp) will do the trick for her. Hope you all have a great holiday. Sharks? Where are you going?

Big hugs,
Jane, Franklin and Bailey xxx

[mypuppy]

Hi everyone,
Just a quick update on my Princess. She did great on our vacation, enjoyed lots of walks on the beach and playing with some new fur friends. She is still afraid of the water though. Go figure a lab afraid of water (that's unheard of), but that's my Princess. Princess did not have anymore limping episodes since that one night prior to our vacation, so someone must be looking out for her. All in all, it was a very nice vacation, but are happy to be back in our environment. I do have one question also regarding the canned pumpkin. It seems Princess has developed a little bit of constipation within the last day or so. Is the canned pumpkin good for both diarrhea and constipation or just diarrhea? If so, what may I possibly give her to loosen her up a bit? Thanks all. Glad to be back and need to catch up on your babies. Hope they and all of you are well. Luv lots. Xo Jeanette

[mypuppy]

Hi Jane
Sorry I never got to reply to your last post before we left on vaca. Thanks for the good wishes. princess did great with no more limping episodes, thank God. We were in the Outer Banks of North Carolina. I had heard on news they sighted a shark in Massachussets, so that made me leery of going into the beach, but wouldn't you know it that fear went out the window the second I saw that beautiful ocean, and luckily I came back in one piece--LOL. hope you and little precious face Franklin are doing great these days. Luv ya, xo Jeanette


Hi Jeanette,

I'm so glad to hear that Princess isn't limping :D:D and hope that the derramax (sp) will do the trick for her. Hope you all have a great holiday. Sharks? Where are you going?

Big hugs,
Jane, Franklin and Bailey xxx

[mypuppy]

Hi family,
i just uploaded a new album of our recent vacation at the beach. I hope you enjoy them. Luv you all....jeanette and princess

[Franklin'sMum]

Hi Jeanette,

Gorgeous!! Princess looked to be having a great time on the beach (Yay for no sharks!!:)) I see you were stricken by glorious weather :p Hope Princess gave you lots of birthday kisses and that
you had a wonderful time

Jane, Franklin and Bailey xxx

[Squirt's Mom]

Hey Jeanette,

LOVED the pics! You and Princess look to be having so much fun!

PLUS you survived your first separation from the site! :p I remember when that happened to me...OMG, I was just lost. :eek: Still don't like not having contact every single day even if it's just to read. :rolleyes:;)

Hugs,
Leslie and the girls - always

[mypuppy]

Thanks Jane,
Yes Princess had a very nice time at the beach, however she is not your typical lab who enjoys swimming or the water per say. She never has in fact. Nevertheless running loose through the sands was enough to put a great big smile on mommy's face. Thanks again. Love lots xo Jeanette

[mypuppy]

Hey Leslie,
The plan was to not have internet access, and we didn't until my husband decided to set up a temp. Account. Temptation was just to much to resist and I was checking in as often as possible--lol. So much for that break--lol. We had a wonderful time away from the same old scene--there's something about the beach that just takes your breath away. Glad you liked the pics. hope Squirt is feeling well and healing fast. Luv ya dearly. Xo Jeanette