Franklin, 4½ yo maltese, trilostane (updates) [Archive] - Canine Cushing's Information and Support Forums

Franklin'sMum

10-18-2009, 08:30 AM

Hi everyone. Alison and Mia and Jenny and Buddy, thank you for a warm welcome :)
Thank you for the warning on selenium, I'll take him off the extra.
Franklin's ACTH testing history is as follows:
06 May 09.. 345 - 1031 nmol/L (the diagnosis)
15 Jul 09.. 323 - 743nmol/L (started Trilostane and was lethargic. Stand in vet said give him cortate. This test was the day after cortate and on no meds.)
05 Aug 09 ..251 -395 nmol/L
26 Aug 09.. 80 - 91 nmol/L
21 Sep 09.. 190 - 102 nmol/L (the specialist said this kind of result is quite normal. It happens when the trilo is stronger in the system at 5 hours rather than 4. Nothing to worry about, she said.)
His next test is due in about 28 days.
Initially the testing was done after Franklin became clingy, panicy, anxious and then staggered backwards and fell down. An hour and a half later we're at the vets who couldn't find anything wrong. (He was back to himself by then.)
That was February.
Fast forward to April and the same thing...clingy, anxious, staggering backwards and falling. 25 minutes after that we're at the vets, who said since that was his second episode let's do a blood test to see what's going on.
Here's the stuff that was out of the normal range:
Alk phos .. 513 u/l (<120)
Albumin..44 g/l (22-36)
Calcium.. 2.88mmol/L (2.00-2.80)
Lipase..110 u/l (1-70)
Cholesterol.. 9.3 mmol/L (3.6-8.8)

As for Franklin's pigment, he's always had pink and blue/black skin. His hair is at winter warmth length, so I don't know yet if it's changed colour since starting treatment.
We haven't done the LDDS or HDDS testing because the vet is going with the statistics of 85 % of Cushing's in small dogs is caused by the pituitary.
I hope that gives a bit more info about us, and thanks for your help
Jane and Franklin
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lulusmom

10-18-2009, 02:31 PM

ACTH is a hormone produced in the pituitary gland that stimulates the adrenal glands. ACTH (Cortrosyn) stimulation test measures the ability of the adrenal cortex to respond to ACTH by producing cortisol appropriately. An increase in cortisol after stimulation by ACTH is normal. Franklin’s ACTH results are not normal and should have been interpreted as non-stimulatory result. If as your vet said that the results were due because the drug is more effective at 5 hours than 4, then all of Franklin's test, as well as every cushdog's on Trilostane/Vetoryl would be non-stimulatory. Seriously, your vet's explanation is erroneous.

The manufacturer of Vetoryl is very clear in their packaging insert that; “In the event of non-stimulatory ACTH test during monitoring, treatment should be stopped for 7 days and then re-started at a lower dose. Repeat the ACTH stimulation test after a further 14 days. If the result is still non-stimulatory, stop treatment until clinical signs of hyperadrenocorticism recur. Repeat the ACTH stimulation test one month after re-starting treatment.”

Clinginess, panicky, anxious and falling backwards are not common symptoms associated with cushing’s. The majority definitely sound like behavioral changes that come and go. You mentioned that they appeared in February and then again April. If so, I personally don’t think most of us here would consider these as symptoms associated with cushing’s. Did Franklin have any of the following symptoms?

• Polydipsia (increased water consumption)
• Polyphagia (increased hunger)
• Polyuria (increased urination)
• Pot-bellied appearance
• Weight gain and/or weight loss
• Lethargy and reluctance to exercise
• Weakness of hind legs (Franklins falling over could be from muscle weakness but it doesn’t sound like he displays other signs of weakness like not being able to jump on furniture any longer, difficulty in getting up steps, etc.???)
• Increased susceptibility to infections
• Increased panting
• Thinning of hair
• Dull coat color
• Weakened immune system
• Slow healing of wounds

A dog’s symptoms are the number one key component in making a confirmed diagnosis. Symptoms, physical presentation at examination, medical history of the dog and the results of a series of tests, in that order, must be assessed in order to correctly diagnosis a dog with cushing’s. Because no one test can be relied upon to be 100% accurate, a series of tests are done for validation purposes. You mentioned that an LDDS nor an HDDS test had been done as the vet diagnosed pituitary. The acth stimulation test does not differentiate between pituitary and adrenal so your vet would have had to have done least an LDDS or an HDDS or an abdominal ultrasound to correctly confirm Franklin’s PDH diagnosis. I think you would remember if any of these had been done as the LDDS and HDDS tests are an all day ordeal for a dog with blood draws done a zero, 4 and 8 hours. The ultrasound would have required that Franklins tummy be shaved. Do you recall any of that?

I am sorry for asking so many questions but there are a lot of red flags that have gone up for me. My dog was only three years old when diagnosed but she is of a breed that is predisposed to hormonal imbalances. Franklin is not and he is quite young to have cushing’s and he doesn't seem to have the symptoms we normally see here. Based on your info so far, it looks like your vet confirmed a PDH diagnosed based solely on the results of one diagnostic test...an acth stimulation test and guessed that Franklin has pituitary based diseased because the law of averages says so. :confused:

If my dog were 4 years old, I would want to know for sure that he didn’t have an adrenal tumor. If he had an adrenal tumor and was a good candidate for surgery, I’d do anything to get that surgery done for him as it could be a total cure. If surgery was not an option, then I would still want to make sure that he was properly diagnosed because 1) Trilostane is not usually the treatment of choice for an adrenal tumor and 2) I would want to keep an eye on the tumor for possible growth, etc.

We always suggest that members keep copies of all medical tests and vaccine records for their babies in a folder. This comes in really handy if you ever have to take your dog to the emergency vet. I can tell you from experience that ER vets appreciate having this information at their fingertips. Plus it helps when us members keep asking you all those infernal questions. :D If you haven’t done so already, perhaps you can ask your vet to give you copies of all of the testing that was done by him to diagnose Franklin. Then can you post the results here so that we have a complete history?

I'm glad that you found us and decided to become one of the family. Franklin now has a whole bunch of aunties and uncles that will be anxiously following his progress and will always be here for his mum. Cushing's is a scarey and frustrating disease and it's a lot easier to deal with when you have shoulders to cry on, hands to hold and a bunch of people that share their knowledge and experience with you. Luckily k9cushings.com is one stop shopping for all of those things and more. :D:D:D

Glynda

P.S. I have two cushdogs, both Pomeranians. My other two kids are two beautiful, healthy Maltese boys. I have a great affinity for Maltese and think they are the best toy breed in the world.

Franklin'sMum

10-18-2009, 10:50 PM

Hi lulusmom

Franklin?s ACTH results are not normal and should have been interpreted as non-stimulatory result. If as your vet said that the results were due because the drug is more effective at 5 hours than 4, then all of Franklin's test, as well as every cushdog's on Trilostane/Vetoryl would be non-stimulatory. Seriously, your vet's explanation is erroneous.

That's what the specialist told the vet, he passed it along to me.

The manufacturer of Vetoryl is very clear in their packaging insert that; The vet found a compounding chemist to make the trilo. We have no packaging insert, it just comes in a plastic medicine bottle with the name, mg, how many, and the vet's instructions.

Clinginess, panicky, anxious and falling backwards are not common symptoms associated with cushing?s. The majority definitely sound like behavioral changes that come and go. You mentioned that they appeared in February and then again April. If so, I personally don?t think most of us here would consider these as symptoms associated with cushing?s.

That was the behaviour that led to the blood profile being done, to "evaluate non cranial causes".

Did Franklin have any of the following symptoms?
?Polydipsia - he's always been a big drinker compared with other furbabies I have lived with
?[Polyphagia - not excessively
?Polyuria - the first episode, he peed 6 or 7 times just before it happened.
?Pot-bellied appearance - from the side view, he was always straight across from chest to groin
?Weight gain and/or weight loss - no
?Lethargy and reluctance to exercise - lethargy after exercise
?Weakness of hind legs - no
?Increased susceptibility to infections - about 5 throat infections
?Increased panting - not really
?Thinning hair- no bald spots
Dull coat colour- nope. Still kinda shiny
Weak immune system- What would we be looking for?
Slow wound healing- Only 2 wounds... desexing (7 months old) and the hairdresser got a little too close to his ear about 2 years ago. That took about 2-3 weeks to heal.
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Franklin'sMum

10-18-2009, 11:18 PM

Answers..Part 2 (It wouldn't let me type more stuff. :)
Franklin has not had the LDDS or HDDS test, or MRI, catscan or ultrasound. I asked about all of these. I was told the ultrasound wouldn't pick up a small tumor if one was present, and an MRI or catscan may not pick up on a pituitary tumor if it was really small or hidden.
About the LDDS/HDDS I was told it wasn't always needed, treat for pdh (stats again) and if treatment doesn't improve symptoms or cortisol levels, then we'll look into it.
(The vet went to vet school, my research is google ) so after a couple of conversations along these lines I stopped asking. My bad. :(
Although I went to the vets today (just me) and made enquiries about the LDDS/ HDDS testing. He was in surgery, but will call me.

The specialist has told the vet that if any breed was going to develop Cushing's young, it would be a Maltese?
As for being cured, according to my research (verified by the vet)
trilo has a good chance of putting the pooch into remission after a couple of years of treatment.
(Would that be the tumor or the symptoms, anyone know?)
Absolutely, I agree about keeping an eye on the size of the tumor (assuming it is a tumor, as opposed to a enlarged or abnormally functioning gland) here's hoping.
Yes, I have copies of the results of the testing done. And so does Franklin, courtesy of a usb tag on his collar :) It also has his complete medical history.
The results are previously posted as you noted
345-1031
323-743
251-395
80-91
190-102
So glad we're part of the family :):):)
and Thank you all so much
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Franklin'sMum

10-19-2009, 08:27 AM

Hi again,
woops I forgot to include his other testing done on 21 April
veterinary profile
hb 148 g/l (115-180)
rcc 6.71 x1012/L (5.00-8.0)
hct 0.46 (0.37-0.5)
mcv 69 fl (63-74)
mch 22pg (20-25)
mchc 321 g/L (310-360)
plat 413 x109/L (200-900)
????/???? x 109/L
wbc 7.5 (6.0-14.0)
summary:
sodium 144 mmol/l (140-155)
potassium 5.0 mmol/l (3.8-5.8)
chloride 107 mmol/l (100-120)
bicarbonate 22 mmol/l (16-24)
anion gap 20mmol/l (15-25)
urea 5.6 mmol/l (2.5-9.0)
creatine 52 umol/ (40-140)
glucose 4.7mmol/l (3.5-6.7)
bilrubin <2 umol/l (<11)
alt 41u/l (<80)
alkaline phosphatase 513 u/l (<120)
protein 76 g/l (55-78)
albumin 44g/l (22-36)
globulin 32g/l (22-42)
albumin/globulin ratio 1.4 (0.5-1.8)
calcium 2.88mmol/l (2.00-2.80)
phosphate 1.3 mmol/l (0.8-2.0)
creatine kinase 187 u/l (<401)
amylase 740 u/l (<2400)
lipase 110 u/l (1-70)
cholesterol 9.3 mmol/l (3.6-8.8)
triglyceride 1.3 mmol/l (0.2-1.7)
After these test results, it was recommended that Franklin have the Acth test.
The vet got back to me, and we will be getting the LDDS testing done (although he's not booked in yet.)
Glynda, I've never heard of a non stimulatory result, I'll check with the vet about stopping his trilo til further testing. Thank you so much for that info, much appreciated.
And hello also to Roxee's Dad (John) what gorgeous furbabies babies you have :) Is Roxee on the left or right?
So glad other people also do paw painting!
Thank you all so much for your help and advice
Jane and Franklin
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lulusmom

10-20-2009, 09:35 AM

Hi Jane,

I don't have a lot of time to respond to your last post but wanted to give you the information you asked for as well as comment on a few things.

We have a lot of excellent information in our Helpful Resources section which I highly recommend that you go through in your spare time. In the meantime, however, here is a link to the Dechra's product insert and the treatment and monitoring flowchart.

http://www.dechra-us.com/File/prod_vetyrol.pdf
http://www.dechra-us.com/File/vetoryl_Treatment_and_Monitoring_Flowchart.pdf

Franklin doesn't seem to have any of the symptoms that are commonly associated with cushing's and most cushing's savvy vets would not recommend treating a dog with no symptoms. As I mentioned earlier, symptoms are a key component in making a confirmed diagnosis....so I am a bit concerned about Franklin and your vet's knowledge of cushing's. I'll be back later to give you more of my thoughts.

Glynda

Roxee's Dad

10-20-2009, 11:12 AM

And hello also to Roxee's Dad (John) what gorgeous furbabies babies you have :) Is Roxee on the left or right?
So glad other people also do paw painting!
Thank you all so much for your help and advice
Jane and Franklin

Hi Jane and thank you. :)
Roxee is on the left, Rozee is on the right.

Just a bit of my opinion on Franklin situation.

We haven't done the LDDS or HDDS testing because the vet is going with the statistics of 85 % of Cushing's in small dogs is caused by the pituitary.

I have read so many different members state that my pup hasn't read the manual on cushing's. Meaning all the stats and figures about probability didn't hold true for their pup.

After Roxee passed, I took my other pups to a vet that is much closer to home and we discussed k9cushings. He told me that his dog had cushing's and he went ahead and treated. He informed me that his dog died within 10 days. When I asked what happened, he replied that he should have researched it better. We had a long discussion and he thanked me for making him aware of the UTK. Luckily, he doesn't have any cush dog patients.

It is important that you and your vet of choice work together as a team in the best interest of Franklin. I as many others have fired a vet or two because they feel insulted when I question their decisions or choices. Roxee's vet who I liked a lot was a bit taken aback when I questioned his Rx dosage and actually stated "You know I went to school for this" I held my ground based on what I learned here. He went back to his computer, looked up the insert on the Dechra website and came back and aplogized to me. We got along great after that.:D although, we continued to have an occasional difference of opinions :)

I can go on and on.....:o You have been given alot of good information, I tend to agree with Glynda and urge you to get a confirmed diagnosis of k9cushings and the type (adrenal, pituitary and or atypical) via the UTK.

Give young Franklin a belly rub from me :)

Squirt's Mom

10-20-2009, 12:18 PM

Hi Jane,

Welcome to you and Franklin! :)

I just have to join Glynda and John in saying I have concerns about the diagnosis, starting treatment with no signs, and your vets successful experience in treating cush babies.

To put a pup on a drug as powerful as Trilo just because they fall into a certain statistical area is just dangerous, lazy and arrogant IMHO. That would be like a smoker going to the doc because they have a cough and the doc saying, "Well the odds are you have lung cancer so lets start chemo and radiation." They take an Xray but no other testing because the "odds are in favor" of lung cancer. Would you let a doc do that to you or one of your family members? In my opinion this is exactly what your vet has done to Franklin and it scares the peewaddle out me.

Franklin is only 4 1/2. Not that he is too young for Cushing's, tho it is usually found in much older dogs...this is fact presents odds that are the opposite of those your vet is operating on. No signs are another point that flys in the face of treatment based on the odds - cush pups show signs - period. The one test that Franklin has can easily show elevated cortisol that is not related to Cushing's at all, as can each of the others which is why a battery of tests is usually called for to diagnose Cushing's.

I know it sounds like we are bashing you but that is not at all our intent - we simply care about you and Franklin and do NOT want to see either of you suffer needlessly. You and Franklin are family now and we protect family here! :) We only want the best for both of you and personally, I don't feel Franklin is in the best of hands with his current vet. If it were me, I would STOP the Trilo, find another vet who can look at Franklin with fresh eyes and who will do the proper testing no matter the suspected condition...one who operates based on the pup in front of them and not statistics or odds.

Hang in there! I know this is tough at first but you are doing just fine.

Hugs,
Leslie and the girls

Franklin'sMum

10-21-2009, 07:50 AM

Hi Glynda, Thank you for those links. I hadn't come across the monitoring chart before. Very interesting.
Franklin is booked in for an ultrasound on Friday afternoon.
The vet got in touch with the specialist from the lab, and she says the LDDS test can be hard to interpret, depending on where his numbers fall. I'm still working on that. :)
Franklin's vet is wonderful, he answers all of my questions (more like friendly interrogations !:))
I'm still learning more of the right questions to ask.
I am so thankful I found this site, and so thankful to you all for your thoughts, ideas and advice for my sweet baby boy.
I know Franklin doesn't have many of the symptoms associated with Cushing's, and the vet did say we don't have to treat just yet.
But after reading the health risks of not treating, it was my decision to go ahead with the Trilostane . (The thought of Lyso scared me half to death)
The vet checked up on the lastest studies and literature, and said that there's a good chance of remission with trilo, and considering Franklin's age that could well be the way to go. Sold!
Heal my child, medicine man. :) :)
John, thank you also for your thoughts. Franklin will be getting more tests done. Absolutely.
I think we need to find a different specialist, though. The search is on.
Oh, and Franklin says thanks for his belly rub! :)
Hi also to Leslie and the girls. The vet has treated cush pups with lyso, however Franklin is his first trilo patient. (He does check dosage, adjustments, and lots of my questions with his lab specialist).
I asked the vet about him coming off the trilo til further testing has been done, but the lab specialist (who has never examined Franklin) said to leave him on it, so I'm doing that at the moment. We'll find out more at his u/s appointment.
Thank you all so much for your advice, and for taking the time to reply, we appreciate it so much.
Jane and Franklin xx
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lulusmom

10-21-2009, 08:32 PM

Hi Jane,

Please see my comments in blue below.

Hi Glynda, Thank you for those links. I hadn't come across the monitoring chart before. Very interesting.

Please do share the Dechra packaging insert as well as the monitoring chart with your vet. It seems that he is very inexperienced with the drug and he needs to follow proper treatment protocol to minimize any unnecessary adverse reactions.

Franklin is booked in for an ultrasound on Friday afternoon.

I am so happy to hear that your vet is finally going to do an ultrasound. Most vets do this routinely to confirm hyperadrenal activity which will validate the acth stim test or the LDDS. Dogs with pituitary dependent disease can have normal sized adrenals but most have bilateral enlargement. Dogs with adrenal tumors usually have one adrenal that is larger and the other is either normal, smaller or atrophied. Most dogs with cushing's also have enlarged fatty livers which can be seen on ultrasound. Other surrounding organs can also be seen and evaluated.

I thought it very odd that your vet confirmed a diagnosis of pituitary dependent cushing's based on the law of averages. Just because 85% of dogs have PDH, doesn't mean that Franklin doesn't have an adrenal tumor. As I mentioned before, at Franklin's very tender age, I personally would want to know if he had an adrenal tumor. Surgery could be a permanent cure and at his very young age, surgery would be a really good possibility.

The vet got in touch with the specialist from the lab, and she says the LDDS test can be hard to interpret, depending on where his numbers fall. I'm still working on that. :)

Occasionally, an LDDS may be so borderline so as to make it difficult to interpret and that is why other testing is a must. For the most part, a trained lab tech can easily interpret the results. You would also be surprised by how many of us here can interpret the results as well. Nevertheless, if you are going to be consulting with a specialist, I would let him or her determine the need for an LDDS.

Franklin's vet is wonderful, he answers all of my questions (more like friendly interrogations !:))
I'm still learning more of the right questions to ask.
I am so thankful I found this site, and so thankful to you all for your thoughts, ideas and advice for my sweet baby boy.
I know Franklin doesn't have many of the symptoms associated with Cushing's, and the vet did say we don't have to treat just yet.

Based on the information you gave us, Franklin has no symptoms of cushing's and that coupled with the fact that, there was insufficient testing done to confirm a diagnosis (IMO), is why I have been very concerned that Franklin is being treated.

But after reading the health risks of not treating, it was my decision to go ahead with the Trilostane . (The thought of Lyso scared me half to death)

Keep in mind that cushing's is a very slow progressing disease so you have plenty of time to make sure that the diagnosis has been confirmed according to protocol. Cushing's is the most difficult canine disease to diagnose which makes it the number misdiagnosed disease. The very fact that Lysodren is a form of DDT makes it sound evil but the fact is that it is very effective and if properly prescribed by an experience vet and administered by a vigilant pet owner, adverse effects are minimized and often eliminated completely. My 4.8 lb and 7.5 lb Pomeranians have been treating with Lysodren for the last year and doing fine. They also treated with Trilostane previously so I am very familiar with both drugs. The good news is that both are very effective.

The vet checked up on the lastest studies and literature, and said that there's a good chance of remission with trilo, and considering Franklin's age that could well be the way to go. Sold!
Heal my child, medicine man. :) :)

Throwing a dog into an Addisonian state by overdosing them may result in remission permanently or temporarily but that is absolutely not the goal of treatment. This statement is further evidence that your vet has limited experience with Trilostane. Trilostane is an enzyme blocker that interferes with the synthesis of cortisol. The goal of treatment is to find an appropriate dose that will effectively inhibit the overproduction of cortisol. Too much and cortisol will go too low, making the dog very, very sick. Symptoms are diarrhea, vomiting, extreme lethargy, not eating, inability to walk, etc. It is rare, but there have been documented cases of total adrenal necrosis and resulting deaths so intentionally shooting for remission by overdosing a dog is unconcienable. Trilostane also has an effect on aldosterone production so your vet should be checking electrolytes every time an acth stim test is done. This is not an option, it is a necessity. Has your vet been checking electrolytes? You now have the treatment monitoring chart so make sure that you and your vet follow protocol.

John, thank you also for your thoughts. Franklin will be getting more tests done. Absolutely.
I think we need to find a different specialist, though. The search is on.

I am so happy to hear that you are going to be consulting with an internal medicine specialist. There are a lot of red flags that have gone up for me so I am comforted by the fact that Franklin will be seeing a specialist that can reconfirm the diagnosis and hopefully direct treatment.

Oh, and Franklin says thanks for his belly rub! :)
Hi also to Leslie and the girls. The vet has treated cush pups with lyso, however Franklin is his first trilo patient. (He does check dosage, adjustments, and lots of my questions with his lab specialist).
I asked the vet about him coming off the trilo til further testing has been done, but the lab specialist (who has never examined Franklin) said to leave him on it, so I'm doing that at the moment.

A lab specialist is ill equipt to direct treatment and I would be very concerned if your vet is following her advice. As I recall, this is the same lab specialist that stated that if a dog is going to develop cushing's at a young age, it would be a Maltese. Unless this tech has seen hundreds of Maltese under the age of 6 or 7 with cushings, then I have no idea what she is talking about. I have spent most of my spare time for the last five years researching everything I could get my hands on regarding cushing's and there is no data to support this statement nor do the hundreds of threads we've seen over the years support this. Maltese are much more likely to start exhibiting signs of liver shunts than cushing's at a young age. Did your vet rule out a liver shunt? In any event, if it it were me, I would discontinue treatment until a diagnosis can be confirmed by an internal medicine specialist.

We'll find out more at his u/s appointment.

We'll all be anxiously awaiting the results of the u/s.

Thank you all so much for your advice, and for taking the time to reply, we appreciate it so much.

Jane, you are doing a magnificent job of answering our questions and being a great advocate for Franklin. Our goal is to make sure that you have as much information as possible so that any decision you make for Franklin is an educated one. When you and Franklin arrived here, Franklin became one of our own and be warned that some of us can become pretty protective. Those of us that have had really bad experiences with our gp vets are sometimes the first ones to pick up on the things we wish we would have picked up on when our own dogs were going through hell. Sometimes, my writing style can be interpreted as being a bit beeeeatchy so I hope you know that my motives are pure and I only want to help you and Franklin. I thought I knew a bit about the disease when I got here but boy was I woefully undeducated. These people were wonderful and I am amazed by all that I have learned since becoming part of the family here. I want to make you as smart as I think I am. :D:D:D

Jane and Franklin xx

Franklin'sMum

10-23-2009, 06:01 AM

Hi lulusmom and everybody.

Franklin had his u/s appointment this afternoon. We haven't received the full report yet, but here is what was found:
Franklin's left adrenal gland is 1.3cm and his right adrenal is 3.1cm. (and both were blurry).

There was no mention of a fatty liver, but they did say he has a distended bladder.

Franklin hasn't been checked out for liver shunts, and we have definitely not been aiming for Addison's.
He hasn't been getting his electrolytes checked, either. Now I know better :) Thank you .

Franklin is booked in for an ACTH stim test and a blood profile for Tuesday.
Lulusmom, please don't give a second thought to your writing style, you've been incredibly helpful. You all have experience and knowledge of Cushing's and I am so grateful for your advice and guidance.
Jane and Franklin xx
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Squirt's Mom

10-23-2009, 11:51 AM

Hi Jane,

SO glad you had the U/S done and am anxiously awaiting those results and interpretations on what they saw.

Hang in there!
Hugs,
Leslie and the girls

Franklin'sMum

10-24-2009, 08:24 AM

Hi everyone
I have just sent the vet an email asking approx 3 thousand questions! :D We will know more about the results and where we go from here in a couple of days.
To Leslie and the girls- We're hanging, and hope your precious babies are all doing well.
To Glynda- It's difficult when people ask "what's changed about his recent behaviour?" because he's done some things for years.
Like lethargy during and after excercise. Franklin has always rested during our walks (used to be a half hour-ish, now down to 15-20 minutes.) Even in winter, he'd lay down on the wet grass, or in a puddle for a few minutes, walk another 10 steps then rest again. It's not uncommon for me to carry him home :), where he would lay on the tiles.
As for him being a big drinker, last summer he had 5 water bowls in use. I never measured his intake til Franklin was about to start treatment, so we had a reference point.
About a month after he started the trilo, his belly began to rise at his groin. (From the side profile he'd never looked like that before. His chest to his groin had always been a straight line.) Anyway, I hope that clears up a few things,
and we hope the people and pups here are doing well.
Thanks for listening,
Jane and Franklin xx
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Franklin'sMum

10-26-2009, 07:47 AM

Hi everybody
We hope you and your furry friends are all doing well.
Just a quick update on Franklin.
He wasn't feeling so good yesterday, so app was changed to Monday. Now that's been changed to seeing the specialist on Tuesday. Fast forward a three and a half hour drive :r, and his appt is tomorrow morning.
Please cross your fingers and paws for Franklin.
All our best
Jane and Franklin xx
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Harley PoMMom

10-26-2009, 07:52 AM

Hi Jane,

Keeping all fingers, toes, tails and paws crossed that this is nothing serious, and you are doing an excellent job getting him to see a specialist. Please let us know anything as soon as you can...you know how we worry about you and Franklin.

You both will be in my thoughts and prayers.

Love and hugs.
Lori

lulusmom

10-26-2009, 10:09 AM

Fingers & paws crossed here and a lot of positive thoughts being sent your way. I am happy that Franklin will be seeing a specialist and we will all be very anxious to hear how the visit went. Hopefully, you will have the formal written findings of the ultrasound soon too.

Glynda

Squirt's Mom

10-26-2009, 06:09 PM

Hi Jane,

Can you tell us in what ways Franklin isn't feeling well? Any diarrhea? vomiting?

I hope you get some good answers for him tomorrow.

Hugs,
Leslie and the girls

Franklin'sMum

10-27-2009, 06:13 AM

Hi all and thank you so much for your positive thoughts and crossing assorted body parts.
Sunday when Franklin wasn't feeling well he vomited, was off his food and wouldn't even eat schmackos! All he wanted to do was sleep.
The vet said to give him cortate, and within 20 minutes Franklin was wrestling with me. A little while later he was eating.
I've gotta say, I love that he has an anti-dote medicine (that's what I call it).

Today at the specialists, Franklin had another abdominal ultra-sound, it showed a thickened liver.
The right adrenal gland has some nodules (she said trilo can sometimes cause those.)
Everything else looked good.

He's got a strong, steady heartbeat (woo-hoo! :) )

He also got an ACTH assay done (results could take anything up to a week ).

His electrolytes were also checked
(all good.)

The Doc didn't want to stress him further today by doing a regular ACTH stim test, so he's seeing his regular vet on Thursday (my time).

Depending on the results of the stim test and the assay, the specialist might recommend twice daily dosing, and /or lower the dose. Or possibly there could be something completely different going on.

You want to hear something? She has a cush pup herself (with diabetes also) and lots of experience with cush babies.
Ahh, the relief of finding her. She'll now be treating Franklin in conjunction with his GP vet. Yay!
No more lab specialist advising him!

Thank you all again for your kind and positive thoughts for my sweet child, for asking about how he's going, and for helping me try and keep sane :)

And an extra special shout out to Lori, HAPPY BIRTHDAY,
Glynda and Leslie and the girls.
Thank you so much.

Jane and Franklin (sleeping on the couch) xx
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John II

10-29-2009, 08:47 AM

Hi Jane and Franklin,

Just popping in to give my support as another Aussie and more importantly (:D) the one with the Maltese Cross who is also on Trilostane.

You're doing a fine job and with the Forum Elders :p giving you pointers, you and Franklin are in great hands.

I know it's an overwhelming process, but Franklin's age (youth and vigour) should be a great benefit for any treatment you pursue.

Harley PoMMom

10-29-2009, 09:04 AM

Hi Jane,

You want to hear something? She has a cush pup herself (with diabetes also) and lots of experience with cush babies.
Ahh, the relief of finding her.I am so happy you have found a specialist that has alot of experience with cush-pups, this must have been such a relief for you.

I am also very happy to hear that Franklin is feeling better, it is so heart-breaking when our furbabies are feeling yucky...but then amazingly they just bounce right back.

Thanks so much for the special birthday wishes, they were much appreciated.

You're doing a wonderful job taking care of Franklin, please let us know when the results of the stim come in and could you post them too.

Love and hugs.
Lori

Franklin'sMum

10-29-2009, 11:02 AM

Hi All,

John ll, thank you for your kind words, I still have so much to learn (what's the poop patrol ?! :o ) but I have definitely come to the right place.

Lori, hope you had a great day, and i'll be posting his results the moment they're in my hands (and hoping you all chime in with thoughts and opinions. :D)

Till next time, may you and your furbabies all be well and happy
Jane and Franklin xx
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Roxee's Dad

10-29-2009, 11:12 AM

Hi All,

John ll, thank you for your kind words, I still have so much to learn (what's the poop patrol ?! :o )

Oh no Jane, you may have opened a can of "worms" here.:p :D So many of us always keep an eye on our babies poop because it can tell us so much about how they are feeling. :):o:) So many different methods, flashlights and sticks. You may even find Jenny's "Bristol Stool Chart" :D

Franklin'sMum

10-29-2009, 11:26 AM

[Oh no Jane, you may have opened a can of "worms" here.:p :D ]So many of us always keep an eye on our babies poop because it can tell us so much about how they are feeling. :):o:) So many different methods, flashlights and sticks. You may even find Jenny's "Bristol Stool Chart" :D
Oh no!!! What have I done? :)
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Harley PoMMom

10-29-2009, 11:59 AM

And here is a link to the famous "Jenny's" Bristol Stool (poop) chart.

http://www.continence.org.au/client_images/601755.pdf

Love and hugs.
Lori

Franklin'sMum

10-31-2009, 08:40 AM

Hi extended family and Franklin's cush-cousins,
Thanks for that link, Lori, and eew! But good to know :)

Just a quick update on Franklin. He's become slow to eat , and I asked the vet if he could go back to 60mg.
He emailed me today and said yes to the 60mg, and that the test results aren't in yet :(.

We hope you all have a great weekend,
Jane and Franklin xx
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Harley PoMMom

10-31-2009, 11:27 AM

Hi Jane,

I am alittle worried about our Franklin, I am thinking that maybe the 60 mg of Trilostane is still to high for him and that the loss of appetite he is showing + the throwing up he was doing...well he might be headed for adrenal necrosis. If it were me, and since based on the information you gave us...Franklin has no symptoms of cushing's and that coupled with the fact that the his ACTH tests are not back yet, I would ask the vet/IMS if I should stop the Trilostane for now. Maybe that's just me being a worry wart...I don't know. Hopefully the others will share their opinions as well.

Hang in there Jane, I'm sorry to throw this at you, but I am worried and I just wanted to let you know because I do really care about you and Franklin.

Love and hugs.
Lori

lulusmom

10-31-2009, 11:45 AM

Hi Jane,

Sometimes it's good to go back and refresh our memories because we pick up things we may have missed the first time. For instance, I didn't recall that vet increased Franklin's Vetoryl dose from 60mg to 75mg. Firstly, Franklin is very lucky that he has done as well as he has at a starting dose of 60mg. This is twice the recommended inititing dose for his size. The recommended starting dose for dogs weighing greater that 4.5kg and less than 10kg is 30mg onec daily. Franklin's last acth stimulation test in September was perfect, meaning his cortisol levels were right where they needed to be. I am therefore confused as why your vet increased the dose by 15mg? Can you give us more information on this?

I am really happy to hear that your specialist has experience with cushing's. It's a lot tougher dealing with both cushing's and diabetes so the fact that she's been through this with her own dog is comforting. Is she an internal medicine specialist? Did she think that your vet did an adequate job of testing in order to confirm a diagnosis and did she express any concern about the dosing your vet has prescribed? I see that she mentioned that the nodules seen on the liver are caused by Vetoryl but did she mention that she saw anything on the abdominal imaging that is normally seen in a dog with cushing's?

Sorry for even more questions but I'm anal and need things spelled out for me.

Glynda

Franklin'sMum

10-31-2009, 12:05 PM

Hi Lori
He hasn't had a dose today.
I've just been reading about the symptoms of thyroid issues, and I'm thinking his initial symptoms (disorientation, seizure- ish staggering, hyperventilating and phobia [thunderstorms- only started freaking out this year]) leans towards the need for him to have his thyroid levels checked.
I don't think that's been done yet.

Plus also just read thyroid stuff can mimic Cushing's and test falsely pos, so I don't plan on giving him more trilo until his thyroid levels have been looked at.
Gotta go see the vet with a pee sample for a urine/ creatinine ratio test on Monday, so I'll find out when the thyroid level can be tested.
Franklin's lost 300 grams since 3 weeks ago, so even if he was still going to get the trilo, you're probably right about the 60mg being too high a dose for him.
Thank you for your help and ideas:)

Hopefully the results of the ACTH assay and stim and the ultra sound will be in early this week.
Then we'll probably be waiting on thyroid results.
Thank you Thank you Thank you
so much for your input and guidance for my sweet child.

I am so grateful to you all (and the boy's Nanny and Poppy are so happy to know you're here for us)

Jane and Franklin xx
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Franklin'sMum

10-31-2009, 12:48 PM

[QUOTE=lulusmom;18007]

[ I didn't recall that vet increased Franklin's Vetoryl dose from 60mg to 75mg. Firstly, Franklin is very lucky that he has done as well as he has at a starting dose of 60mg. This is twice the recommended inititing dose for his size. The recommended starting dose for dogs weighing greater that 4.5kg and less than 10kg is 30mg onec daily. Franklin's last acth stimulation test in September was perfect, meaning his cortisol levels were right where they needed to be. I am therefore confused as why your vet increased the dose by 15mg? ]

Hi Glynda
3 words "the lab specialist"wanted him to start at 60mg. I asked at the time was it too high, and was told 'that's what she starts dogs that size at'.

After the non-stimulatory result "the lab specialist" actually wanted to take him up to 90mg . The gp vet didn't want to do that, so decided to do 75mg.
(Keep in mind this was before you posted the dechra links. Thank you again.)

Franklin hasn't been all that great on the 75mg for a bit over a week (slow to eat. The weather has been warm 25-30 ? C and with the travelling he's up to about 600-700 ml water this past week. It's not even summer yet.)

[I am really happy to hear that your specialist has experience with cushing's. It's a lot tougher dealing with both cushing's and diabetes so the fact that she's been through this with her own dog is comforting. Is she an internal medicine specialist? ]

Not that I know of. Her card lists her as a BVSc (Hons). She specialises in endocrinology.

[Did she think that your vet did an adequate job of testing in order to confirm a diagnosis ]
She didn't express an opinion.
[ did she express any concern about the dosing your vet has prescribed? ]
Yes . Said that it seemed a bit on the high side.
[I see that she mentioned that the nodules seen on the liver are caused by Vetoryl ]
She said the nodules were on the adrenal gland, but both adrenals were peanut shaped. Sorry if I wrote it down wrong.
She said the liver was thickened, that it's a sign of t
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Franklin'sMum

10-31-2009, 01:02 PM

Okay, finishing the sentence now..

The thickened liver is a sign to her that the Cushing's? isn't quite under control.
The ? is because I want his thyroid checked out (after just reading some links about the similarities and false positives for Cushing's .)

Apologies about the long drawn- out post, but I'm a computer idiot and I'm doing something wrong.
It started beeping at me and wouldn't accept any more words :c

Thank you all for your help, and if you have any other ideas or advice about what we could /should be doing, please keep them coming :)
Jane and Franklin xx
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Harley PoMMom

10-31-2009, 01:34 PM

Hi Jane,

Getting his thyroid checked is a really good idea, make sure, but I am sure she knows that you want a Free T4 measured by equilibrium dialysis.

Gotta go see the vet with a pee sample for a urine/ creatinine ratio test on Monday...

Urine cortisols can be a problem. Many studies have shown that the only way to accurately gauge urine cortisol levels is to obtain the first morning voided urine sample on 3 consecutive days and then pooling the urine to run a UCCR. When done in this fashion it is likely an accurate test. Otherwise there is likely too much day to day variation to make a single random cortisol very helpful.
Dave Bruyette DVM DACVIMMaking sure that these 3 morning pooled urine samples are refrigerated and then taken to the vets office.

The ? is because I want his thyroid checked out (after just reading some links about the similarities and false positives for Cushing's .)
You are absolutely correct there, any non-adrenal illnesses can skew the ACTH and LDDS tests, and hypothyroidism and diabetes mimic the symptoms of cushings also.

Jane you are doing a wonderful job, educating youself is so very important to Franklin's well being...no apologies needed for the long post, I can read fast...I just can't type fast :eek: please feel free to ask as many questions as you want and to make as long as a post as you want.:p;):D

Love and hugs.
Lori

Roxee's Dad

10-31-2009, 11:12 PM

Hi Jane,
I just wanted to summarize Franklin's history according to your post. It will make it easier for the other members to review. Please let me know if you have any additions, I'll be glad to update. :)

Franklin 4 1/2 yo maltese
weight 7.7kg (16.9 Lbs)

Trilostane 60mg started in mid July

10/15 -increased dosage to 75mg
10/25 - Franklin wasn't feeling well he vomited, was off his food and wouldn't even eat schmackos! All he wanted to do was sleep. The vet said to give him cortate, and within 20 minutes Franklin was wrestling with me. A little while later he was eating.
10/31 - He's become slow to eat , Vet agreed to reduce Trilo to 60mg

Testing performed:
Bloodtest –Yes (see below)
ACTH –Yes (see below)
LDDS – No
HDDS – No
UTK - No
Ultrasound – Results pending (noted left adrenal gland is 1.3cm and his right adrenal is 3.1cm. (both were blurry)

21 April Bloodtest results:
(Mod Note: I only listed results out of range or close)

alkaline phosphatase 513 u/l (<120)
protein 76 g/l (55-78)
albumin 44g/l (22-36)
calcium 2.88mmol/l (2.00-2.80)
lipase 110 u/l (1-70)
cholesterol 9.3 mmol/l (3.6-8.8)

ACTH testing history:

06 May 09.. 345 - 1031 nmol/L (the diagnosis)
(12.5 – 37.36 ug/dl)

15 Jul 09.. 323 - 743nmol/L (started Trilostane and was lethargic. Stand in vet said give him cortate. This test was the day after cortate and on no meds.)
(11.7 – 26.9 ug/dl)

05 Aug 09 ..251 -395 nmol/L
(9.09 – 14.31 ug/dl)

26 Aug 09.. 80 - 91 nmol/L
(2.89 – 3.29 ug/dl)

21 Sep 09.. 190 - 102 nmol/L (Non-Stim Result)
(6.88 – 3.69 ug/dl)
(the specialist said this kind of result is quite normal. It happens when the trilo is stronger in the system at 5 hours rather than 4. Nothing to worry about, she said.)

Symptoms:
•Polydipsia - he's always been a big drinker compared with other furbabies I have lived with
•Polyphagia - not excessively
•Polyuria - the first episode, he peed 6 or 7 times just before it happened.
•Pot-bellied appearance - from the side view, he was always straight across from chest to groin
•Weight gain and/or weight loss - no
•Lethargy and reluctance to exercise - lethargy after exercise
•Weakness of hind legs - no
•Increased susceptibility to infections - about 5 throat infections
•Increased panting - not really
•Thinning hair- no bald spots
Dull coat colour- nope. Still kinda shiny
Weak immune system- What would we be looking for?

Initially the testing was done after Franklin became clingy, panicy, anxious and then staggered backwards and fell down. An hour and a half later we're at the vets who couldn't find anything wrong. (He was back to himself by then.)
That was February.
Fast forward to April and the same thing...clingy, anxious, staggering backwards and falling. 25 minutes after that we're at the vets, who said since that was his second episode let's do a blood test to see what's going on.

About a month after he started the trilo, his belly began to rise at his groin. (From the side profile he'd never looked like that before. His chest to his groin had always been a straight line.)

Franklin'sMum

11-01-2009, 01:43 AM

Hi Lori and thank you muchly.
I'm a little confused (just for a change :rolleyes: )
You posted the Dr's recommendation of 3 consecutive first pees of the am.
The specialist told me to not collect the first pee as it would be very concentrated, so collect the pee after his first, but before the trilo.
Now that we're taking a break from the trilo, I had been planning on collecting some pees through-out the day.
Which would you go with?

John, thanks for listing all the info in the one post, that makes it easier for me too!

Thank you all so much
Jane and Franklin xx
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Harley PoMMom

11-01-2009, 01:59 AM

That's a good question and I hate for you to go against your vets advice BUT Dr. David Bruyette is a nationally known veterinary endocrinologist and the medical director of VCA West Los Angeles Animal Hospital.

What you want to do is catch Franklin's pee in mid-stream, so if you don't mind getting some urine on ya :eek::) and if you do, just use a ladle because they only need a wee bit, like a tablespoon each time.

Love and hugs.
Lori

Franklin'sMum

11-01-2009, 02:28 AM

[QUOTE=Harley PoMMom;18029]

[ so if you don't mind getting some urine on ya :eek::) ]

(Chuckling to myself :) )
I've tried to collect his pee in one of those piddly :p little useless sample jars.
The vet loaned me a kidney dish :)
Ok so 3 days will make it Wednesday for the Ur:Cr test. Thank you again for your help with everything:)
Jane and Franklin xx
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Harley PoMMom

11-01-2009, 02:57 AM

If your unsure on whether to catch the morning urine or not, I would make a call to your vet and let her know that you read that you should catch the morning urine and why Dr Bruyette feels this is best...see if she knows who Dr Bruyette is, maybe she does and then maybe she'll agree. What do you think?

Love and hugs.
Lori

Franklin'sMum

11-01-2009, 04:32 AM

Hi again Lori,
Ok, here's what I'm thinking.....

Collect the morning sample and then phone the vets when they open (at least the first one will be done if they do want the three.)

Hopefully some results might be ready, also.

Will keep you all posted :)
Thanks again
Jane and Franklin xx
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Harley PoMMom

11-01-2009, 04:48 AM

Sounds like a plan! :D And definitely keep us posted. :D

Love and hugs.
Lori

AlisonandMia

11-01-2009, 04:50 AM

I am sort of wondering what a UCCR is being done for now - considering that Franklin is off the trilostane for the time being.

As far as I know the UCCR is used in two situations - one is as a screening test early in the diagnostic process and the other is see what the overnight cortisol production is in a dog being treated with trilostane, especially when once daily dosing is being done.

If Franklin is off trilo at the moment then any results from a UCCR done now won't really tell you anything particularly useful about the effectiveness of his dose in controlling the cortisol throughout the 24 hours - because he isn't getting the dose. Before the UCCR will be of any use you would want him back on his normal daily dose for at least a week (and possibly longer), I would think.:)

Alison

Harley PoMMom

11-01-2009, 05:20 AM

Hi Jane,

Thanks Alison for catching that...Alison is correct on this, unless Franklin is on the Trilostane the UC:CR is useless for trying to see what the overnight cortisol production is in a dog being treated with trilostane, especially when once daily dosing is being done.

Sorry Jane...my err there, I should of caught that in your post, that is why they want the first morning pee.

I would tell your vet tomorrow that you didn't give Franklin his Trilostane today and why you with-held it. I think all you can do is wait for your ACTH tests results to come back and then you should be able to get a pretty good picture of what is going on and Franklin's behavior should be another sign too.

Again I apologize for not catching that, and I hope I didn't cause you any undue stress or frustration, if I did, please forgive me.

Love and hugs.
Lori

Harley PoMMom

11-01-2009, 08:30 PM

Hi Jane,

How is Franklin feeling today?

Roxee's Dad

11-01-2009, 10:58 PM

Hi Jane,
I have re-read your thread a number of times and am just not comfortable with Franklin's situation.

I just want to reconfirm what Glynda has mentioned previously. Franklin has not really shown any signs of cushing's. PU, PD etc... His last ACTH test resulting in a non stim does really concern me as he is still on the Trilostane.

On Oct 25th - he was lethargic and given Cortate (Replacement therapy in adrenocortical insufficiency) and shortly thereafter continued to take Trilostane at 75 mg
On Oct 31 - He has lost his appetite and vet agreed to drop dose to 60 mg.

I have to say again, I am very concerned.

First, I'm not so sure that Franklin has cushing's. No typical symptoms only high cortisol.

Secondly the dose he has been prescribed is much higher than recommended by Dechra (the mfg of Trilostane) He is 7 kg's not 17 kg's right?

After the non-stimulatory result "the lab specialist" actually wanted to take him up to 90mg

I would ask the "Lab Specialist" if she carries mal practice insurance. :mad:

clingy, anxious, staggering backwards and falling.

These are not typical symptoms of cushing's. I'm not an expert by any means, but I would wonder if this was some kind of seizure. It happened twice that you know of?

I am glad you will be seeing a specialist. If it were me, I would stop administering the trilo. First rule of treating cushing's - Do not give trilo to a sick pup. This could be diarrhea, vomiting, loss of appetite or just being lethargic.

Another thing that concerns me is that he didn't develop a "pot belly" until after he started the trilostane. The right adrenal galnd being almost 3 X larger than the left.

His initial high cortisol may have been due to stress from an undiagnosed illness. Now that his cortisol may be so low (non stim result) he is not able to produce the cortisol his body needs to deal with the stress of an undiagnosed illness. That may be why he felt so good after his Cortate treatment and why he feels lousy now.

We are gald you found K9cushings and we only want what's best for you and Franklin. :)

Franklin'sMum

11-02-2009, 04:34 AM

Hi lovely, wise friends,
We hope and pray you and yours are all keeping well.
Sorry about the delay, hectic day.

Alison, the uccr was never done to screen for cushings. With the lack of symptoms, I just wanted all his ducks in a row :)

Lori, there was no frustration caused at all. I don't expect you to be on the ball all of the time :D
Franklin's doing well, thank you for asking. He had diced bacon for brekkie followed by 60mg trilo. (still waiting to find out if the dose should be reduced.)
I had withheld bc of his actual symptoms seeming to be more consistant with a thyroid issue. Didn't want to give trilo in case it wasn't cushings.
I checked with vet re: uccr. The hospital specialist doesn't want first voided sample, but a sample before meds that morning (to check levels when the trilo is at it's lowest)

John, thank you for checking on us, also. Yes 7.3kg now (down from 7.7kg 3 weeks ago)
Definitely not 17kg.
I have no idea if the "lab specialist" fool :mad: has malpractice insurance, she is NO LONGER involved in my baby's care. Woo Hoo!!! Happy dancing around the room :):):):):)

Franklin's ACTH assay results came in !!!!!!!!

Would you all mind helping me with this, please?

physical exam: bright and alert. mucous membranes were pink, CRT <2 seconds. On thoracic auscultation, heart rate was 120bpm.
Lung sounds normal, abdo palp unremarkable.
temp 39.4????????C. Grade 1 luxating patellae bilaterally. Unremarkable neuro exam.
TESTS: moderate hepatomegaly with hyperechoic parenchyma consistant with steroid hepatopathy. Ultrasonographic differentials include fatty infiltration, other vacuola hepatopathy; less likely neoplasia, hepatitis
Both adrenal glands on the upper side of normal-may be secondary to trilostane therapy or reflect uncontrolled hyperadrenocortism. There is no evidence of an adrenal mass.
Electrolytes were checked:
sodium -146 mmol/L (144-160)
potassium- 4.1mmol/L (3.5-5.8)
chloride- 115mmol/L (109-122)

Blood was taken for ACTH assay to confirm PDH.
27 oct 2009
>345 pg/mL
reference values (37-80pg/mL)
values below 37pg.ml consistant w ADH
values in high normal and above normal ref. range are consistant w PDH.
Assessment: Franklin definitely has PDH.
I have advised 2 further tests:
ACTH stim (results pending)
pre tab. urine sample for uc.cr ratio. - this may indicate current trilo dose not lasting 24 hours.
The changes present in Franklin's liver may suggest that control is not ideal.
depending on results of the above, I would suggest that we change to twice daily administration of a slightly lower dose.

Thank you all so much for checking on us, and for all your replies. We appreciate it more than I can put into words.
Please would you help me some more (especially the liver/ hepa..... stuff)
We hope you and your sweet babies are healthy and happy
Thank you again,
Jane and Franklin xx
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AlisonandMia

11-02-2009, 05:33 AM

Looks like you are having some sort of problem posting - it's as if you are only being allowed to post a certain number of characters or something per post. (You are using a mobile, I think??)

Maybe just try to post a couple of paragraphs at a time - we can always merge several small posts into one post once you've finished, if you want. Just put something like Pt1, Pt2, Pt3 at the top of each post and we can merge them for you.

Alison

Franklin'sMum

11-02-2009, 05:56 AM

Oh Alison, you are a gem! Thank you :) and yes I'm using a mobile :rolleyes:

Just this last bit,
John - he did have another episode (shaky, and he started circling my feet on the morning of his acth assay appointment. 27 oct)
I don't know if he was going to stagger and fall, bc I scooped him up and cuddled him. After a few minutes he started to relax, after a few more minutes I popped him down and he was fine. Told the specialist, and she checked his spine and back end, that's when she found the luxating patellas.
Thank you all for any help that you can give,
Jane and Franklin (again :o) xx
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Harley PoMMom

11-02-2009, 08:51 AM

Hi Jane,

I can't help much, just a little. :(

Would you all mind helping me with this, please?

physical exam: bright and alert. mucous membranes were pink, CRT <2 seconds.

Capillary refill time (CRT): This test is what you do when you push on your fingernail, watch it blanch and then see how long it takes for the blood to return. The same test is done on the mucous membranes(gums) of the dog. Normal CRT is 1-2 seconds.

On thoracic auscultation, heart rate was 120bpm.
Lung sounds normal, abdo palp unremarkable.
temp 39.4ÃƒÂ‚Ã‚Â°C. Grade 1 luxating patellae bilaterally. Unremarkable neuro exam.

TESTS: moderate hepatomegaly with hyperechoic parenchyma consistant with steroid hepatopathy. Ultrasonographic differentials include fatty infiltration, other vacuola hepatopathy; less likely neoplasia, hepatitis

hepatomegaly = enlarged liver
hyperechoic = more echoes
parenchyma = the internal anatomy of an organ

http://www.lbah.com/liver.htm
http://www.lbah.com/liversummary.htm

I'm thinking the vacuola was supposed to be vacuolar??

hepatocytes: cells of the main tissue of the liver
Vacuolar hepatopathy: hepatocytes becoming vacuolated or infiltrated with fat, glycogen, edema, amyloid or other metabolic wastes.

http://veterinarynews.dvm360.com/dvm/article/articleDetail.jsp?id=420799&sk=&date=&pageID=2

Both adrenal glands on the upper side of normal-may be secondary to trilostane therapy or reflect uncontrolled hyperadrenocortism. There is no evidence of an adrenal mass.
Electrolytes were checked:
sodium -146 mmol/L (144-160)
potassium- 4.1mmol/L (3.5-5.8)
chloride- 115mmol/L (109-122)

Blood was taken for ACTH assay to confirm PDH.
27 oct 2009
>345 pg/mL
reference values (37-80pg/mL)
values below 37pg.ml consistant w ADH
values in high normal and above normal ref. range are consistant w PDH.
Assessment: Franklin definitely has PDH.
I have advised 2 further tests:
ACTH stim (results pending)
pre tab. urine sample for uc.cr ratio. - this may indicate current trilo dose not lasting 24 hours.
The changes present in Franklin's liver may suggest that control is not ideal.
depending on results of the above, I would suggest that we change to twice daily administration of a slightly lower dose.

Thank you all so much for checking on us, and for all your replies. We appreciate it more than I can put into words.
Please would you help me some more (especially the liver/ hepa..... stuff)
We hope you and your sweet babies are healthy and happy
Thank you again,
Jane and Franklin xx

I hope this helps alittle, the links I pasted are articles about the liver and explains some of the terminology used.

I am glad Franklin is doing well and I am sure the "others" more knowledgeable than me will be along to help you even more with the ultrasound findings.

Love and hugs.
Lori

Franklin'sMum

11-02-2009, 08:02 PM

Lori,
Your "a little bit of help" is lots of help.
Thank you very much, and I'll take a look at those links you posted, now.
Big hugs from Jane and Franklin xx
________
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Franklin'sMum

11-02-2009, 11:57 PM

Hi Lori and forum,

Those were incredibly helpful, although my brain did shut down at the beginning of the vet news link :confused: :o
Hopefully the ole brain will start working again soon! :D
Big hugs
Jane and Franklin xx
________
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Harley PoMMom

11-03-2009, 12:53 AM

Hi Jane,

I know when Harley was first dx'd I was reading everything I could find on Cushings...but my feeble brain and eyes can only take so much reading and I have to STOP, because everything becomes a blur. :eek: I found out, at least for myself, that I have to take a break every now and then...let my brain cells rest. :p:)

Love and hugs.
Lori

John II

11-03-2009, 09:59 AM

Hi Jane,

My trick is to read the article through - and then read it again - and if necessary again until something sticks...

Franklin'sMum

11-04-2009, 11:07 PM

Hi John and Lori,
Good advice.

Franklin's stim results from 30 Oct just came in
Pre 45 nmol Post 50 nmol
(1.63-1.81 dl)
That was on 75mg. On 2 Nov dose was reduced back to 60mg.
He hasn't had a dose today, as he has only eaten about 20gm of food (Plus I'm still waiting to hear back if dose should be reduced further.)
I have some questions and I can really do with your help, please.

1) U/S showed "moderate hepatomegaly" (enlarged liver) with hyperchoic parenchyma (liver echoes?) consistant with steroid hepatopathy ???
U/Sonographic differentials include fatty infiltration, other vacuolar hepatopathy.
I'm thinking he could do with supplementation (milk thistle, SAM-e)
Is there a preference?
Do members use both on their babies?
If Trilostane treatment continues, are there any interactions with either of the above?
What would be the dosage for a pup Franklin's size?
2) We're coming up to summer here. If trilo therapy continues, and the water intake stays lowered, will he be drinking enough so that he won't become dehydrated?
3) Back to the liver. Considering Franklin has no real symptoms (aside from high cortisol and drinking lots) would I/he be better off if I concentrate on the liver issues, and leave Cushing's treatment till symptoms become more pronounced?
I don't want to stuff up his liver either way, by treating the Cushing's and damaging the liver, or by not treating the Cushing's and allowing the cortisol to do it's damage.
He is my world. What would you all do if he was your baby?
Please help me with this, as I'm kind of having a meltdown at the moment. I can really do with your help, advice and opinions.
All the best to you and yours,
Jane and Franklin xx
________
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AlisonandMia

11-05-2009, 05:13 AM

Franklin's stim results from 30 Oct just came in
Pre 45 nmol Post 50 nmol
(1.63-1.81 dl)
That was on 75mg. On 2 Nov dose was reduced back to 60mg.
He hasn't had a dose today, as he has only eaten about 20gm of food (Plus I'm still waiting to hear back if dose should be reduced further.)
I have some questions and I can really do with your help, please.

You definitely don't want to give him any more trilostane if he isn't eating well. The lack of appetite could be low cortisol or it could be something else but either way holding off on the trilostane is the right thing to do. I used to find that Mia always got a bit picky (even long before Cushing's) when the weather was hot so that could be a factor too.

1) U/S showed "moderate hepatomegaly" (enlarged liver) with hyperchoic parenchyma (liver echoes?) consistant with steroid hepatopathy ???
U/Sonographic differentials include fatty infiltration, other vacuolar hepatopathy.
I'm thinking he could do with supplementation (milk thistle, SAM-e)
Is there a preference?
Do members use both on their babies?
If Trilostane treatment continues, are there any interactions with either of the above?
What would be the dosage for a pup Franklin's size?

I used milk thistle with Mia and her liver numbers came right back within normal range once her cortisol was controlled - whether this was thanks to the milk thistle or not I don't know. I remember joking to the vet that either the milk thistle worked fantastically or that she never needed it! She weighed around 4 kg and I gave her 1/4 of a tablet (I used Natures Own which I could by at Woolies). Her liver numbers were never that high (compared to what I've seen here) but now that I look at her records I notice that her ALT had always been a little above the reference range (even long before the Cushing's) - the vet had never expressed any concern about this. After the Cushing's and the milk thistle her ALT came down within the middle of the reference range so I suspect that the milk thistle may have been to thank for that.

Here's a link to some info on milk thistle and SAM-e: http://www.k9cushings.com/forum/showthread.php?t=192

Your IMS should be able to advise on this too as, although it is "natural", it is a mainstream treatment.

I don't believe either SAM-e or milk thistle interacts with trilostane and many here use both.

2) We're coming up to summer here. If trilo therapy continues, and the water intake stays lowered, will he be drinking enough so that he won't become dehydrated?

In theory, and as far as I know, lowering high cortisol back to a more healthy level with treatment shouldn't make a dog drink less than it needs. I guess the exception could be if the dog is very nauseated because of low cortisol it may be reluctant to drink because it just doesn't want to put anything in its stomach. My dog's water consumption went way down (probably by about 300%+) with treatment but she always drank enough to keep herself well hydrated. Her water consumption simply returned to what was normal for her.

3) Back to the liver. Considering Franklin has no real symptoms (aside from high cortisol and drinking lots) would I/he be better off if I concentrate on the liver issues, and leave Cushing's treatment till symptoms become more pronounced?
I don't want to stuff up his liver either way, by treating the Cushing's and damaging the liver, or by not treating the Cushing's and allowing the cortisol to do it's damage.

If Franklin were my dog I think I would hold off on treatment for the time being. If treatment is necessary it will become clear with return of symptoms. Some dogs do seem to develop Cushing's quite slowly. It does sound like his liver function does need a thorough workup. It is possible too to have Cushing's and a primary liver problem. In your position I'd want to be absolutely sure that nothing like a liver shunt is in the picture. I gather Maltese are rather prone to liver shunts. Liver problems can cause excessive urination and drinking. And non-adrenal illness can also cause high cortisol because cortisol is a stress hormone and more is produced when an animal is ill or stressed in any way.

As a matter of interest, when Franklin had his funny turns, was that soon after a meal?

It takes years for Cushing's to actually damage the liver by which time it will have damaged other organs and systems significantly too. The liver is a marvelously resilient organ and repairs itself in most cases and certainly can recover well from Cushing's. The liver enlargement and increased liver numbers (particularly ALP/ALKP) that happens with Cushing's is largely a sign that the liver is working hard to metabolize the steroid hormones rather than a sign of damage as such. It's rather like a muscle getting big from lifting weights.

I hope this helps and hopefully you will get input from the others soon, too.

Alison

Franklin'sMum

11-05-2009, 07:54 AM

[quote]either way holding off on the trilostane is the right thing to do. I used to find that Mia always got a bit picky (even long before Cushing's) when the weather was hot so that could be a factor too.
Franklin is like that, too. He has now had 2 meals today :)

(I used Natures Own which I could buy at Woolies)
Thanks, I'll go there second thing tommorrow.

Your IMS should be able to advise on this too as although it is "natural", it is a mainstream treatment
I'll check with her first thing tomorrow.

My dog's water consumption went way down (probably by about 300%+)
Whoa! How much had she been drinking before treatment?

It is possible to have Cushing's and a primary liver problem
Wouldn't that show up on the U/S?

As a matter of interest, when Franklin had his funny turns, was that soon after a meal?
The first and third time, no. They happened within 20 minutes of getting up. The second time, I'm not sure. That one happened at 2.15pm (right as I was about to leave for work) and he may have just had lunch, but honestly I don't remember.

Hope this helps
Oh, Alison...you have been wonderfully helpful. My panic attack is over (for the time being, anyway;))
I'm sorry, where are my manners? How are you?
Thank you so much for your help,
Jane and Franklin xx
________
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Harley PoMMom

11-05-2009, 08:25 AM

Hi Jane,

1) U/S showed "moderate hepatomegaly" (enlarged liver) with hyperchoic parenchyma (liver echoes?) consistant with steroid hepatopathy ???
U/Sonographic differentials include fatty infiltration, other vacuolar hepatopathy.
I'm thinking he could do with supplementation (milk thistle, SAM-e)
Is there a preference?
Do members use both on their babies?

I use Denamarin and Marin for Harley; Denamarin has SAMe and Silybin, the most active part of an extract from milk thistle. Here is a link for the Denamarin. You can purchase the dose of Denamarin for the weight of Franklin.

http://www.1800petmeds.com/Denamarin-prod11008.html

2) We're coming up to summer here. If trilo therapy continues, and the water intake stays lowered, will he be drinking enough so that he won't become dehydrated?

I believe this is where your electrolyte testing will come into play, he'll have to be carefully monitored for electrolyte imbalances. You can also add water to his food, I do that with my boy and he never notices it. :)

3) Back to the liver. Considering Franklin has no real symptoms (aside from high cortisol and drinking lots) would I/he be better off if I concentrate on the liver issues, and leave Cushing's treatment till symptoms become more pronounced?
I don't want to stuff up his liver either way, by treating the Cushing's and damaging the liver, or by not treating the Cushing's and allowing the cortisol to do it's damage.
He is my world. What would you all do if he was your baby?

Non-adrenal illnesses can and will make the cortisol rise in a dog, even very high stress can make the cortisol rise up. If Franklin were my pup, I would stop the Trilo, step back and take a deep breath :) and assess Franklin's situation...but not alone, with our help and your IMS :).

Now I was just reading your response about Franklin acting funny sometimes after a meal, I thinking maybe he should get checked for pancreatitis, it's a test called cPLI.

Hope this helps.

Love and hugs.
Lori

Franklin'sMum

11-05-2009, 09:21 AM

Hi Lori and Harley
How are you both today?

I use Denamarin and Marin for Harley; Denamarin has SAMe and Silybin, the most active part of an extract from milk thistle. Here is a link for the Denamarin. You can purchase the dose of Denamarin for the weight of Franklin.
http://www.1800petmeds.com/Denamarin-prod11008.html
Thank you, I'll check if they export.

I believe this is where your electrolyte testing will come into play, he'll have to be carefully monitored for electrolyte imbalances. You can also add water to his food, I do that with my boy and he never notices it. :)
If the trilo is going to be stopped (for the time being, at least) would electrolytes still need checking on a regular basis?

If Franklin were my pup, I would stop the Trilo, step back and take a deep breath :) and assess Franklin's situation...but not alone, with our help and your IMS :). I'll contact her tomorrow (have just sent her an email re: SAM-e and milk thistle.)
[quote[Franklin acting funny sometimes after a meal, I thinking maybe he should get checked for pancreatitis, it's a test called cPLI. Out of his 3 episodes, 2 were on an empty stomach (he had just gotten up), and the other was mid afternoon, and I don't remember if he had had lunch. But no, he doesn't generally have problems after eating. Having said that, in warm weather when he gulps water, about 1 minute later he'll throw up spit bubbles. If Franklin gobbles down his food really quickly, he might throw up the last couple of cube bits. I have told his GP about this a couple of times, and because it's not a constant thing, he's not really concerned. Franklin doesn't seem distressed at all after eating (and also the spit bubbles and cubes don't seem to bother him.)
Lori, and everyone, I can't tell you how much I appreciate your advice and thoughts.
Thank you so much for helping me to help my boy.Big ((hugs))
Jane and Franklin xx
________
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Harley PoMMom

11-05-2009, 12:12 PM

Hi Jane,

Thank you so much for asking about Harley and I...My boy is doing great, he is loving his new diet and this cooler weather we are having...as for me, I love the cooler weather too but my arthritic bones don't. :eek:

If the trilo is going to be stopped (for the time being, at least) would electrolytes still need checking on a regular basis?

Harley's electrolytes are tested on his chemistry blood panel, which I have done every 6 months. They include: Na (Sodium), K(Potassium), Cl (Chloride), CA (Calcium), and PHOS (Phosphorus) and then there's the Na/K ratio where you want your pups to be between 27:1 and 40:1.

I have told his GP about this a couple of times, and because it's not a constant thing, he's not really concerned. Franklin doesn't seem distressed at all after eating (and also the spit bubbles and cubes don't seem to bother him.)

Harley's pancreatitis showed up on his ultrasound as saying that, and I quote " He had prior bouts with pancreatitis." Jane, I swear to you that don't remember these "bouts," if I would of he most definitely would of seen the vet about it and been tested then and there. That is why when I see someone post about their pup throwing up for no apparent reason, pancreatitis is the first thing that pops in my head.

Love and hugs.
Lori

Franklin'sMum

11-05-2009, 07:48 PM

Hi Lori

My boy is doing great, he is loving his new diet and this cooler weather we are having...as for me, I love the cooler weather too but my arthritic bones don't. :eek:
Lori, what is Harley's new diet?

Harley's electrolytes are tested on his chemistry blood panel, which I have done every 6 months.
Oh, got it. I was thinking would Franklin need testing each month (if not having the trilo ar stim tests.)

Harley's pancreatitis showed up on his ultrasound as saying that, and I quote " He had prior bouts with pancreatitis." Jane, I swear to you that don't remember these "bouts," if I would of he most definitely would of seen the vet about it and been tested then and there. That is why when I see someone post about their pup throwing up for no apparent reason, pancreatitis is the first thing that pops in my head.
Lori, thank you for this info, I just looked at the report from the specialist again, and the word "pancreas" does not appear at all, though. Also no mention of pancreatitis. Since the GP had said that it was nothing to worry about
I just kind of thought it was like a burp (with food). He doesn't do it after each meal, though.
I'll look into the testing.
Thank you Thank you Thank you
you have been so incredibly wonderful, you all have
Jane and Franklin xx
________
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Harley PoMMom

11-05-2009, 08:15 PM

Hi Jane,

I had a diet formulated for Harley by Monica Segal. Now she is not, as far as I know a certified vet. nutritionist, but I believe she is good at what she does. There are however, some very wonderful certified vet. nutritionist out there, here is a post of such one from Cushy to another member.

Karen,

Just another idea I thought you might like to know about. I don't know if you'd be interested in this, but if you are looking for help with formulating a good homemade diet for Jed, maybe you and your Vet can work with Dr. Rebecca Remillard, who works at the Angell Memorial Vet Hospital in Boston.

Here's a little blurb about her on the Angell Memorial website:
http://www.mspca.org/site/PageServer?pagename=nutrition_Team (http://www.mspca.org/site/PageServer?pagename=nutrition_Team)

She is a Board Certified Veterinary Nutritionist (DVM, Diplomate ACVN) and in addition to her job at Angell Memorial, she also has a website http://www.petdiets.com (http://www.petdiets.com/) where she does offer consultations and formulation of diets for pets with medical conditions.

I've never used her service, but I did know someone (online at another e-group) who consulted with Dr. Remillard in person at Angell Memorial in Boston, and she was very happy with the homemade diet that Dr. Remillard created for her dog.

Here's some info about Dr. Remillard's services from her website:

https://www.petdiets.com/Consult/default.asp (https://www.petdiets.com/Consult/default.asp)

Our Expertise:
We specialize in making sound dietary and nutritional recommendations for dogs and cats with medical conditions. Your pet may be sick and not eating the recommended diet well. Your pet may have more than one medical condition for which there is no single best commercial pet food. We make recommendations and formulate diets based on current principles of dietary management and the pets' food preferences. We offer choices based on the known current scientific literature and our clinical experience.

This is a Nutritional Consultation through your primary care Veterinarian:
Your primary care veterinarian as a vital partner in the care of your pet. Legally, we must work through your veterinarian because we do not have a primary doctor/patient/client relationship with you. We work as a specialty consultant to your veterinarian. Our recommendations will be sent directly to your veterinarian for review and you will be notified when the information has been sent to his or her office.

Client Education:
We also consider client education an important part of our mission and service. We provide you with the most current information specific to your pets’ medical condition(s) in an understandable prose written specifically for pet owners. Pets only need one nutritional formulation (one recipe) however, food substitutions are offered when appropriate.

Recommendations:
We fax our written recommendations to your veterinarian for review. You will be asked to provide this contact information. We will complete our recommendations generally within 10-14 business days of receiving confirming medical information from your veterinarian. Our charge for a personalized Nutritional Consultation is $250 for your first pet, but then discounted ($100) for your second pet or discounted further ($50) for the third pet in the same household IF different diet formulations are required. Most times, we can design a diet that accommodates more than one dog or cat in the household.

This fee covers product research, review of medical information and a diet formulation. It also covers all questions you may have about our diet recommendations. Food substitutions are always offered if appropriate. Please understand there is an additional charge of $100 to reformulate another homemade diet if you should later request a change in ingredients, foods or supplements that were not previously specified or if the pet should develop another medical condition.

Note that she provides different kinds of dietary advice (commercial diets, homemade diets, or a mix of the two) depending on what you ask for:

https://www.petdiets.com/popup/popup.asp?url=body.asp&sT=Types of Nutritional Recommendations (https://www.petdiets.com/popup/popup.asp?url=body.asp&sT=Types of Nutritional Recommendations)

As you can see, Dr. Remillard's service is not exactly cheap, and the client's Vet has to also agree to work with Dr. Remillard as a consulting Specialist, but if you are interested, I don't think it matters that you are in Canada and Dr. Remillard is in the States. You and your Vet can communicate with Dr. R. via e-mail and/or fax, I'm sure, or via long distance phone calls if necessary.

Let me know what you think, or if you want anymore information, please ask.

Love and hugs.
Lori

Franklin'sMum

11-06-2009, 01:25 AM

Hi Lori,

Thank you so much for that information. I think Monica Segal will be who we get in contact with.
(If Dr Rebecca Remillard only works in conjunction with GP vets, she'd be a no-go. Our GP has the opinion that "a vet recommended food and even a commercial pet food has been tested and complies with all nutritional needs for the dog" idea.)
Franklin ate 2 meals yesterday but didn't want brekkie again, today, so I went to the vet to find out some more stuff. (And pick up Franklin's claim forms)

...The pancreas can be easily seen on u/s, so because there was no notes about pancreatic issues on the u/s paperwork, leads him to strongly believe that pancreatitis isn't an issue. Coupled with the pancreatic enzymes being within the normal ranges, he has ruled it out. (For the time being at least.)
He agrees with coming off the trilo (waiting to hear back from the endo, to be sure.)

I asked about getting the full adrenal panel done if Franklin is to continue to be treated with trilo. He said "I think those hormones are mainly an issue if the dog is intact."
Franklin is de-sexed, (at 7months of age) so can anyone tell me if that last statement has any validity, as I have not come across anything like it in my research (both googling, and here:))

Thank you all so much for your continued support and encouragement,

Jane and Franklin xx
________
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lulusmom

11-06-2009, 02:51 AM

Hi Jane,

Your vet is incorrect as both intact and neutered males can have elevated sex hormones. Same with females.

Glynda

littleone1

11-06-2009, 05:27 AM

Hi Jane,

I agree with Glynda. Corky was neutered close to 11 years ago, and some of his hormones were elevated, as was evidenced by his adrenal panel. Even though this was probably due to his being on Trilo for 10 days when the adrenal panel was done, the hormone levels can still be increased.

Franklin'sMum

11-06-2009, 07:14 AM

Hi Glynda, Terri and Corky,

How are you all?

Thank you for your replies. The GP did have me wondering about it.
Next time it comes up, I'll point out to him that the adrenal glands aren't usually removed during a de-sexing op :D (I'll be nice!)

On another note, Franklin's total T4 results are in...
Total T4 = 46 (22-49)
Dr's note... T4 is within the reference interval.
(Still waiting on free T4 by ed and uc:cr)

I've been playing phone tag with the endocrinologist today.
Her advice is "to stop the trilo for a few days, and then to pull back on the dose, as we seem to have very tight control at certain times of the day and not good control at other times."

That's all the news I have at this time, we hope you and your precious ones (people and pups) are well, and have a great weekend.
Oh, and Glynda, have fun with W and W at the vet conference tomorrow :)

Love and (Hugs)
Jane and Franklin xx
________
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Harley PoMMom

11-06-2009, 07:58 AM

Hi Jane,

My boy Harley was neutered when he was 6 months, on his adrenal panel from the UTK all his sex hormones are elevated at the baseline and his estradiol is very elevated at both, he was over 12 y/o when he had the UTK full adrenal panel done.

I am very happy to hear that Franklin does not seem to be suffering from any pancreas issues.

Jane, you are doing a wonderful job, I hope you realize that.

Love and hugs.
Lori

littleone1

11-06-2009, 08:02 AM

Hi Jane,

I hope you will soon get a resolution to the issues you are having with Franklin.

We are doing good. Corky just had his 28th dose of Trilo and has really shown such a big improvement.

Have a great weekend.

Franklin'sMum

11-06-2009, 08:31 AM

Hi Lori,

Thank you for Harley's hormone info. I knew you folks would have the answers:)

The "wonderful job" I'm doing (thank you) is thanks to you all.
I would hate to think his GP would still be taking advice from his lab specialist (no offense, Debbie. You are brilliant and such a helpful person :)) and that I would still be letting things happen around me.

Hi again Terri,

I'm so glad Corky is doing fantastically :):):). That is great news. Thank you for your kind thoughts, we appreciate them so much.

Jane and Franklin xx
________
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frijole

11-06-2009, 09:27 AM

Jane,

You aren't the only one that has had a vet depending on a lab... I had the same thing happen over 3 yrs ago when first diagnosed. Thank GOD I googled cushings and found these wonderful people on the forum. My vet couldn't answer any cushings questions and said she had to call her expert at the lab for dosing amounts and protocol. Thats when I knew she was over her head... but only because people here educated me fast!

I switched vets and Haley is headed to 16 yrs in December. So give yourself a pat on the back for taking control of Franklin's care. And you are right - Deb is a fantastic help to us all.

Have a great day.
Kim

Franklin'sMum

11-07-2009, 09:59 AM

[QUOTE=frijole;18443]

[Thank GOD I googled cushings and found these wonderful people on the forum.]

I know the feeling! :)

[Haley is headed to 16 yrs in December.]

Ohhh! How wonderful :D :D Are you planning a sweet sixteenth party for your furry baby? :)

Hugs to all,
Jane and Franklin xx
________
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frijole

11-07-2009, 10:30 AM

Jane - right now I am so grateful she is still smiling and happy to be here that I celebrate each and every day. We have a month to go and if she decides to be here on that day... you betchya... she will get all kinds of special treats! Kim

Harley PoMMom

11-07-2009, 11:48 AM

I have some questions and I can really do with your help, please.

1) U/S showed "moderate hepatomegaly" (enlarged liver) with hyperchoic parenchyma (liver echoes?) consistant with steroid hepatopathy ???
U/Sonographic differentials include fatty infiltration, other vacuolar hepatopathy.I'm thinking he could do with supplementation (milk thistle, SAM-e)
All the best to you and yours,
Jane and Franklin xx

Hi Jane,

I've been doing some more research on vacuolar hepatopathy and found an article that I thought might interest you. :eek: I know just what you need...more reading huh! But here is a excerpt from it on Idiopathic vacuolar hepatopathy (Idiopathic describes a disease or disorder that has no known cause.)

Liver Diseases

PROFILING ACUTE AND CHRONIC HEPATIS: DIAGNOSIS AND MANAGEMENT
Denny Meyer, DVM, DACVIM, DACVP

IDIOPATHIC VACUOLAR HEPATOPATHY

In some dogs we were unable to identify the cause of the vacuolar changes. These idiopathic vacuolar hepatopathies are frustrating to diagnose. We observe this condition in older dogs, often that are asymptomatic, but have increases in serum alkaline phosphatase (ALP). The typical liver histology report usually reads "diffuse hepatic vacuolar change suggestive of a steroid hepatopathy-check for Cushing's disease." Evaluating the liver with special stains find that the hepatocytes contain excess glycogen. In all intense purposes this group of dogs look like typical steroid hepatopathies based on histology and abnormal serum ALP concentrations. However, further investigation finds no clinical or laboratory evidence of Cushing's disease. Often the only laboratory abnormality that initiates liver investigation is the increase in serum ALP. Most cases have no clinical signs. Conventional adrenal testing (i.e. ACTH stimulation or LDDS) is normal. If one measures the glucocorticoid isoenzyme of alkaline phosphatase (G-ALP) will find that ALP is predominately G-ALP. Ultrasound imaging of the liver shows increased echogenicity and frequently, but not always, the adrenal glands appear normal. The clinical course in these dogs is usually unremarkable however we have observed a very small number of dogs develop typical Cushing's disease at a later date.

http://www.dcavm.org/01june.htm

This is a very long article so you have to scroll to almost the bottom of the page to get to the part I quoted to you.

I do hope that I am not confusing you more, I just want to help you and Franklin because I really do care about both of you. :)

Love and hugs.
Lori

Squirt's Mom

11-07-2009, 12:38 PM

Hi Jane,

Here is another link for you to look at when you get bored! :p You'd think we were giving out homework, huh? :D

VACUOLAR HEPATOPATHY (DISORDER CHARACTERIZED BY THE PRESENCE OF CAVITIES [VACUOLES] WITHIN LIVER CELLS)
https://dog.justanswer.com/uploads/DrK/2008-06-30_222725_HEPATOPATHY-_vacuolar.doc

I hope you continue to withhold treatment until you can get some things figured out. I have been keeping up while out of pocket and, quite frankly, I have to say I have been very worried about Franklin. It was a great relief to read that you were stopping the Trilo! whew!

Hang in there, sweetie! You are doing a fine job and have already learned so much! You will be a great voice for Franklin as you learn more and more.

Hugs,
Leslie and the girls

Franklin'sMum

11-07-2009, 10:14 PM

Hi Everyone, and thank you all for checking in on us

Kim,- great to hear Haley's happy and enjoying every day :D
When Haley's birthday comes around, we'll be celebrating on this side of the world with you :):):)

Lori,- Thanks. That is a long article, indeed ;) Only made it a quarter way through so far, I'll finish reading that soon.

Leslie,- Thank you for that information (this type of "homework" is much more important than what they gave out in school, from what I can remember:p)

The endocrinologist said yesterday, "Keep off the trilo for the time being- to give his adrenals a chance to recover :eek: and when we are to start back on it 30mg twice per day."
She also said yes to milk thistle supplementation "50-250mg but that she would do the 50mg because Franklin's not a big boy"

I bought Natures Own Liver health with milk thistle.
Each tab contains...
Extracts equiv to dry milk thistle fruit (8g) 8000mg standardised to contain 96mg Silybin
Schizandra fruit 100mg
Dandelion root 500mg
Globe artichoke ext. equiv to fresh leaf 1000mg
Taurine 200mg.
Does anyone know the dosage for a pup Franklin's size (7.3kg), please?
The human dose is "1 tab twice daily with food".
But where it says "standardised to contain 96mg Silybin- would that be a half tablet for Franklin?

Thank you all so much for your thoughts, care and kind words

Hugs to all (and kisses and tummy tickles to your babies)
Jane and Franklin xx
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John II

11-07-2009, 10:36 PM

Hi Jane,

The following Milk Thistle dosages are from:
http://www.lowchensaustralia.com/health/thistle.htm

Recommended Dosage

Dog's size % of adult human dose
5 lbs 10%
5-10 lbs 15%
11-20 lbs 20%
21-40 lbs 30%
41-70 lbs 50%
71-100 lbs 75%
100 lbs 100%

Hint: Divide pounds by 2.2 for kilos and vice versa so Franklin would be 16.06 pounds and therefore 20% - (it's an Australian website why is it in pounds?:confused:)

Harley PoMMom

11-07-2009, 11:23 PM

Hi Jane,

About that article...that is one looog article isn't it, do you have any thoughts or questions on the excerpt I quoted from it?

Regarding Franklin's milk thistle, I believe John's calculation's of 20% would be 1/5 of a tablet...do you have some pill cutters?

Give Franklin some gentle hugs from Harley and me, and you and Franklin have some "mommy and Franklin time" because I know we've been keeping you busy with "homework." :eek:

Love and hugs.
Lori

Franklin'sMum

11-08-2009, 02:26 AM

Hi every one

John,
thanks for the milk thistle dosages, I need things dumbed down for me :). Cuddles to Lil Miss Cranky Pants ;):p

Lori,
About the quote you posted, I was going to ask for clarification on something, but can't form it in my head. I've re-read the quote repeatedly, and it's almost coming back to me, but not quite.
Not much help to you, I know. But it will come back to me, I'm sure (I hope :o)

Thank you all so much
Jane and Franklin xx
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Franklin'sMum

11-08-2009, 07:48 PM

Hi, how is everyone today?

Just a quick update...
We drove to the park and went for a nice stroll. Yep, you read that right, drove to the park to go for a walk :)

I spoke to the specialist this morning (Monday my time).
Franklin's last dose of trilo was Wednesday 4 Nov (once again, my time) @ 60mg.

Franklin is eating again:D Woo Hoo! He had 2 meals Thursday and has been eating well since.
She said if he's feeling fine, he can start back on the trilo. The dose has been changed to 30mg twice per day, with a stim test about 2 weeks after.
She likes her cushpups to have a pre of around 100, (so they've got a bit of reserve) and the post to rise by 10- 20 ish points. She also said Franklin should be on a low fat diet.

I was thinking we might start from tomorrow. What do you all think, please?

PS- Lori, yes we have a pill cutter.
I will get back to you about the "vacuolar" article, but right now I'm going to have a sleep.:o

PPS- John, thank you very much for the herb link, very helpful.

Lots of love,

Jane and Franklin xx
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John II

11-09-2009, 08:55 AM

Hi Jane,

We drove to the park and went for a nice stroll.
I'm sure Franklin loved the chance to go to the park again - and the driving there was a bonus! :) In fact I should try that with Angelina! Thanks for the idea.

I was kinda hoping the specialist was going to suggest restarting Franklin on one 30mg dose of trilostane per day. But that's just me. Anyway, as you've seen Trilostane wears off fairly quickly:

Franklin's last dose of trilo was Wednesday 4 Nov @ 60mg. Franklin is eating again Woo Hoo! He had 2 meals Thursday and has been eating well since. So keep an eye on him and stop the Trilostane if he stops eating again - or has any of the other symptoms (which you're probably well aware of by now) ;)

Franklin'sMum

11-09-2009, 01:17 PM

Hi forum friends :)

We hope you and your (our) babies are going along well.

I'm going to hold off the trilo at the moment, as I don't feel that Franklin drank as much Monday as what he should have, considering the heat.
I'll take him to the vets tomorrow just to get him weighed, as well.

Hi Lori,
I'll answer your "vacuolar" post when I get home from work.
Gentle hugs to the beautiful Harley from us.

Hi John,
The park has greener grass than us, and no bindi to walk through :eek:

(Twiddling thumbs icon) Still waiting on T4 by ed and uc:cr results. Aargh!

Bye for now

Jane and Franklin xx
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Franklin'sMum

11-09-2009, 07:15 PM

Hi all,

Hi Lori,
About the "idiopathic vacuolar hepatopathy" quote you kindly posted...
"hyperchoic parenchyma consistant with steroid hepatopathy"-
I'm taking that as meaning that it's from the high cortisol production from the Cushing's.

"We have observed a very small number of dogs develop typical Cushing's disease at a later date."
- Does that translate that some dogs have "dormant Cushing's" like Christine's Teddy?

Never worry about confusing me, Lori. It's very easy to do ;)

Wishing you all a wonderful day
Jane and Franklin xx
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Harley PoMMom

11-09-2009, 09:24 PM

Hi all,

Hi Lori,
About the "idiopathic vacuolar hepatopathy" quote you kindly posted...
"hyperchoic parenchyma consistant with steroid hepatopathy"-
I'm taking that as meaning that it's from the high cortisol production from the Cushing's.

The liver is compromised by excessive steroid, either through exogenous administration or secondary to hyperadrenocorticism

"We have observed a very small number of dogs develop typical Cushing's disease at a later date."
- Does that translate that some dogs have "dormant Cushing's" like Christine's Teddy?

I believe what they are trying to say here is that some dogs with this particular kind of liver disease get misdiagnosed with Cushings, but a few, at a later time do develop the disease.

Never worry about confusing me, Lori. It's very easy to do ;)

Wishing you all a wonderful day
Jane and Franklin xx

I hope this helps. :o:) and remember this is just my opinion, ok.

Hoping you and Franklin are having a wonderful day too!

Love and hugs.
Lori

Franklin'sMum

11-10-2009, 06:14 AM

Hi All,

Lori, sweet Lori,
Thank you for your translation and opinion. We appreciate it very much.

Jane and Franklin xx
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Roxee's Dad

11-13-2009, 10:21 AM

Hi Jane,
Just wondcering how Franklin is doing lately? We do get a bit concerned when we don't see an update. :o:)

Squirt's Mom

11-13-2009, 10:30 AM

Yes, Jane...time to tell what's up in your world! :D

Harley PoMMom

11-13-2009, 08:56 PM

Jane and Franklin...where are yous? :eek::(:D

Love and hugs.
Lori

Franklin'sMum

11-14-2009, 12:12 AM

Hi Everyone,

Hi John, Leslie and Lori,

Everything is good :) I didn't mean to cause any twitching :o

Franklin is eating, drinking and being merry:D!
Just got the results of free T4 by e.d. and uc:cr testing yesterday.

UC:CR-
Urine free cortisol 163 nmol/L
Urine creatinine 5.8 nmol/L
Ratio- 28.1 (<10.1)
Note: Ratio high. Uncontrolled hyperA.

Free T4 by equilibrium dialysis
32.5 pmol/L (10.0-45.0)
>20 pmol/L- hypothyroidism very unlikely. Not consistant with hypothyroidism.

As of yesterday, Franklin is still weighing 7.3 kg, but the nurse went over his records and noticed that he's heavier in the cooler months, and loses a couple hundred grams in the warm months. (How did that not cross my mind? Smacking myself in the head icon!)

We held off treatment until today
(30mg twice per day is what the specialist advised.) So he's had the am dose, and doing fine.

Thank you for checking in on us, and we hope you are all well.

Jane and Franklin xx
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AlisonandMia

11-14-2009, 12:30 AM

As of yesterday, Franklin is still weighing 7.3 kg, but the nurse went over his records and noticed that he's heavier in the cooler months, and loses a couple hundred grams in the warm months. (How did that not cross my mind? Smacking myself in the head icon!)

I do believe Mia was like this too - I never compared her weight but she looked lighter in the summer months. Actually I've noticed that Zac's (he's a much bigger dog at around 25kg) appetite is also affected by hot weather. He eats the same amount but eats slower with more looking around when its hot. When it's very cold I feed him more, of course, and he seems to take eating somewhat more seriously in winter. He never leaves anything in his bowl though not matter what the weather! Mia used to leave a bit when the weather was hot. Little dogs eat more for their size than larger dogs so that might have something to do with it.

Most humans find it easier to lose weight in the summer as well.

Glad to see that things are going well with Franklin and hope that the 30mg twice a day does the trick for him.

Alison

Franklin'sMum

11-14-2009, 02:40 AM

Hi Alison,
[Actually I've noticed that Zac's (he's a much bigger dog at around 25kg) appetite is also affected by hot weather. When it's very cold I feed him more, of course, and he seems to take eating somewhat more seriously in winter. Mia used to leave a bit when the weather was hot. Little dogs eat more for their size than larger dogs so that might have something to do with it.

He does usually eat less in summer, lays there and says, "Whaaat? It's too hot to chew." :)

Most humans find it easier to lose weight in the summer as well.

Glad to see that things are going well with Franklin and hope that the 30mg twice a day does the trick for him.

Thanks Alison,

Jane and Franklin xx
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Franklin'sMum

11-14-2009, 09:41 PM

Hi all,

Franklin didn't want his tea last night (he wanted mine, but not his).
By the time he decided to eat it was just after midnight :eek: so he didn't get the pm dose.
This morning (possibly a combination of the heat and the late feeding) he didn't want breakfast until lunch time. I gave him 15mg of the Trilostane instead of the 30mg, thinking he can have his pm dose at a more reasonable time.
Does that sound ok?

Thanks,
Jane and Franklin xx
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Roxee's Dad

11-14-2009, 10:24 PM

Hi Jane,

I gave him 15mg of the Trilostane instead of the 30mg, thinking he can have his pm dose at a more reasonable time.
Does that sound ok?

I think that is fine. It is always better to err on the side of caution. :) Just watch Franklin for any adverse sign's. Your doing great. :)

Franklin'sMum

11-15-2009, 02:33 AM

Hi John,

Thanks for your reply and kind words.
I'm watching him like a hawk!
How are your sweet babies going, John?

I cannot thank you all enough for walking me through this.
Your help and guidance is incredible. Thank you for helping me to help my sweet child.

Big (Hugs) and sloppy kisses

Jane and Franklin xx
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Franklin'sMum

11-16-2009, 09:52 PM

Hi all,

It's now been 2 and a half days on trilo 30mg twice a day.
Things are going well, Franklin is still eating well and yesterdays water intake was 350ml. (Today is only half way through, so too early to know what ml he'll drink.) He's bright, alert and playful. He has started licking his feet this morning, and at the moment he's having a snooze. :)

Will keep you all posted, and thank you all for looking in on us, and as always thank you for your help and guidance, advice and sharing your babies experiences.

Jane and Franklin xx
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Roxee's Dad

11-16-2009, 10:49 PM

Hi Jane,
Good to hear Franklin is doing well. :)

How are your sweet babies going, John?

Thanks for asking, they are doing pretty well.:) Rozee and Mickee are 14 y.o. but young LittleBit is keeping them on their toes. She has been a blessing in our home. :)

Franklin'sMum

11-17-2009, 10:35 AM

Hi John,

They truly are a joy, aren't they?:):):):):) Mickee and Rozee are very lucky to have LittleBit as their little sister. How did she get her name? Oh, and they are all so lucky to have you as their Dad as well.

Jane and Franklin xx
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Squirt's Mom

11-17-2009, 11:54 AM

He has started licking his feet this morning...

Mornin' Jane,

Glad things are going good for you and Franklin! You are doing a great job watching him...as is evidenced by the above comment. ;)

But that comment also prompted me to give you a bit of a heads up. Cortisol is a steroid and steroids are often used to treat inflammation that can cause pain, allergies and other conditions. Some cush pups are actually being "treated" by the high cortisol of Cushing's. As Franklin's cortisol "treatment" lessens on the Trilo, he may start to display some signs of arthritis, etc. The licking of the feet may, may be an indication of an allergy so I just wanted to make you aware of that so you can keep your hawk-eye on him! :D

Nothing quite like someone bumming your morning out, huh? :( Giving you something else to worry about. :( But you are such a great mom and so attentive, I didn't want you to be blindsided on down the road if the cortisol reduction reveals another condition that had been hidden by the cortisol itself.

Hugs,
Leslie and the girls

Franklin'sMum

11-18-2009, 09:33 AM

Hi All,

As Franklin's cortisol "treatment" lessens on the Trilo, he may start to display some signs of arthritis, etc. The licking of the feet may, may be an indication of an allergy so I just wanted to make you aware of that so you can keep your hawk-eye on him! :D

Nothing quite like someone bumming your morning out, huh? :( Giving you something else to worry about. :( But you are such a great mom and so attentive, I didn't want you to be blindsided on down the road if the cortisol reduction reveals another condition that had been hidden by the cortisol itself.

Thanks Leslie,

You haven't bummed me out, the more I read, the more I learn, the more I freak out and ask even more questions!:D I don't think it's arthritis as he moves quite well, so possibly a food allergy, but I am leaning more towards a grass/pollen thing at the moment. However, I could very well be wrong. Franklin hasn't been licking his feet too much today, though.

We are very happy to hear Ruby is eating again:D:D:D:D:D and her lungs are clear.

Keeping you all in my thoughts and prayers,

Jane and Franklin xx
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Franklin'sMum

11-20-2009, 11:01 AM

Hi All,

It's been 7 days now back on the trilo, and Franklin is doing well. He was a little slow to eat his breakfast this morning, I think he was holding out for something better :rolleyes: His water intake is also down to about 400ml per day now.
We've had a cool change roll in, and there is also a bit of rain about. :)
Tomorrow's temperature is only due to be 28 C with rain :) ooh, almost wintery ha ha!

We hope you and your babies are healthy and happy,

Love,
Jane and Franklin xx
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Roxee's Dad

11-20-2009, 01:09 PM

Hi Jane,
Happy to hear that Franklin is doing well. :):):)

Tomorrow's temperature is only due to be 28 C with rain ooh, almost wintery ha ha!

oooh that's about 84ish in F. Time to break out the winter coats.;):rolleyes::)

Franklin'sMum

11-24-2009, 01:17 AM

Hi all,

Franklin is booked in for a stim test on Friday. He is still eating well, and drinking has come down to an average of 400ml per day, although yesterday was up to 700ml, and it was a cooler day.

Franklin has been scratching his ears yesterday and today, so I figure we might very well be in "the zone".

The lab only runs cortisol testing twice a week :(, but I will post the results when they come in.

At the moment Franklin is beside me on the couch, sleeping peacefully, not even his feet are twitching:), and snoring quietly:D.

Love to you all, and your beautiful boys and girls,

Jane and Franklin xx
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Harley PoMMom

11-24-2009, 02:20 AM

Hi Jane,

Hi all,

Franklin is booked in for a stim test on Friday. He is still eating well, and drinking has come down to an average of 400ml per day, although yesterday was up to 700ml, and it was a cooler day.

So happy to hear that Franklin is doing so well, and that increase in water...well, our pups like to keep our "twitchers'," as Leslie says, in high alert. :eek::D

As far as the ear scratching, I believe it was mentioned before about allergies, the licking of the feet and the scratching of the ears is sometimes a sign of allergies...maybe ask your vet about it.

Best of luck with your stim on Friday and I will be looking for your post of the results. :)

You're such a wonderful person, Jane, and I'm so glad Franklin has you as his mommy.

Love and hugs.
Lori

AlisonandMia

11-24-2009, 02:27 AM

With the sudden increase in water consumption, did he have a bone or some other sort of chewy thing sometime during the day? That can increase their water consumption (but not usually their urination) quite significantly - all that drool they have to produce I guess.

Alison

Franklin'sMum

11-24-2009, 04:13 AM

Hi All,

Lori,
Will definitely be asking about a possible allergy. I have gone back to feeding him a brand that he hasn't had for about 6 months, because now they don't use artificial colours and preservatives. Although he's not getting that food every day, though.

Alison,
No bone or chewy goody yesterday, but now that you mention it, we did take a longer than usual walk yesterday. He was very perky and wanted to keep going. It was a 20-25 min walk, which we usually do in winter, but we cut it back in summer depending on the weather and how he's feeling (energy-wise.)

Thanks for checking in on us, and we hope you're all doing fine and enjoying life.

Jane and Franklin xx
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Franklin'sMum

11-26-2009, 09:02 AM

Hi all,

I've just found out from a friend that our gp vet is all in favour of yearly vaccinations, (Franklin is up to date, and has had the C5 and Proheart SR12 yearly) but I've often wondered if yearly was necessary. Having googled vaccinations, vaccinosis, and the associated health implications of yearly vaccinations, I have 95% made up my mind to reduce the schedule to 3 or 5 years minimum.

I know some of you do the reduced regimen, or have stopped vaccinating completely. Can anybody point me in the direction of a definitive study or research that states conclusively that yearly vaccs are harmful? Or not recommended for a cush pup?

I've come across papers from the AAHA and others, that state vaccine protection is lasting for a minimum of 7 years, but that they still recommend a 3 yearly protocol.

Another site (not a medical study, but a breeder) says that vaccinating after the age of 10 is completely unnecessary (in her opinion.)

I want to speak to my vet and put up a solid argument in favour of not vaccinating on a yearly basis.

Can anybody help me please?

Thank you very much,

Jane and Franklin xx
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Sabre's Mum

11-26-2009, 02:10 PM

Hi Jane

I did some research on the net last year ( and also this year with my pup) and to my recollection I did not find research papers .... this may have been that I wasn't searching with correct key words and I wasn't specifically looking for research papers.

What I did find was information from pzfier that there were still antibodies after 48 months. Also, the Australian Kennel Club is now recommending 3 yearly vaccinations and trying to get vets to understand that yearly vaccinations are unnecessary.

I initially looked at this issue when Sabre was due for his yearly vaccination last year. We were VERY wary of giving Sabre his annual vaccination as we believe his whole calcinosis cutis was triggered from his previous vaccination. There was info that an older dog, vaccinated yearly all his life should have enough antibodies so along with his history and his MAJOR reaction to his last vaccination we decided not to have another one!

I am sure this topic has come up before and someone will have some info.

Angela, Sabre and Flynn

lulusmom

11-26-2009, 03:32 PM

Hi Jane,

I don't blame you one bit for being concerned with yearly vaccinations as any pet owner should be and especially pet owners with cushingoid dogs. New three year guidelines have been adopted, I believe, by all 27 veterinary teaching hospitals in North America and most vets are seeing the light but there as some holdouts for whatever reasons....I personally think it's 1) a money maker and 2) it does get the pet owner into the office for annual check ups. To help in your discussions with your vet, I am attaching links to revised three year guidelines drafted by two organizations that your vet should be very familiar with and whose credibility should not be questioned.

I parted ways with my old gp vet because they would not adopt these new guidelines. One of my Maltese boys, Buster, was current on his vaccines in August and when he was admitted for bladder stone surgery less than a year later, they revaccinated him with everything without asking because the vial I kept to show as proof were not acceptable to them. I work in rescue so at the time, we were administering our own vaccines. I can't even tell you how mad I was and believe me, I had some heated words with both vets in that clinic!

Lulu and Jojo's IMS was very clear that because cushing's is an immunosuppressive disease, they should not get any more vaccines, period, and they provide waiver letters for purposes of licensing. All of my dogs are six years or older and as they are pretty much indoor couch potatoes, the only vaccines they will ever get again is bordatella as they do get groomed frequently. Even that is an iffy proposition and the vaccine offers protection against only a few of the many strains out there. It's kinda like our flu shots for humans. Lulu was current on her bordatella and still contracted kennel cough a few years ago. I was living with my brother at the time and his two Australian Shepherds, who were also current on bordatella, got it too. They called Lulu Typhoid Mary for a while. :D

http://www.wsava.org/PDF/Misc/VGG_09_2007.pdf
http://www.aahanet.org/PublicDocuments/VaccineGuidelines06Revised.pdf

Casey's Mom

11-26-2009, 09:05 PM

I have always been concerned with this issue. Our vets recommend every two years for rabies then on the in between year vaccinating with the combo vaccine which includes, Parvo and Distemper. I wasn't going to vaccinate Casey at all this year for the combo vaccine but we did have an outbreak of Parvo and Distemper this year and we walk in the park with a lot of other dogs every day and we have frequent visits to the vet which has a lot of sick dogs. The vets had not seen distemper for a long time and unfortunately it affected our Humane Society and all of the dogs had to be euthanized.:mad:At least the shelter only had four dogs at the time but it was very upsetting.

I had Casey vaccinated in September and the same thing happened this year as two years ago (when her cushings was undiagnosed), she became very lethargic for about two days. I believe this has something to do with her Cushings because she never had a problem before and I have always vaccinated her every two years.

Maybe there is someone else who has experienced the same problem with a cushings dog.

Franklin'sMum

11-26-2009, 09:23 PM

Hi Jane

I did find information from pzfier that there were still antibodies after 48 months. Also, the Australian Kennel Club is now recommending 3 yearly vaccinations and trying to get vets to understand that yearly vaccinations are unnecessary.

I initially looked at this issue when Sabre was due for his yearly vaccination last year. We were VERY wary of giving Sabre his annual vaccination as we believe his whole calcinosis cutis was triggered from his previous vaccination. There was info that an older dog, vaccinated yearly all his life should have enough antibodies so along with his history and his MAJOR reaction to his last vaccination we decided not to have another one!

I am sure this topic has come up before and someone will have some info.

Angela, Sabre and Flynn

Hi Angela,

I'm sorry that Sabre developed a major reaction (or any reaction, for that matter) from the vaccination. Thank you for your information about Pfizer and 48 months, (he's been getting Fort Dodge).

I will definitely bring this up, along with the Aust. Kennel Club recommendations.

Thank you again,

Jane and Franklin xx
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Franklin'sMum

11-26-2009, 09:47 PM

Hi Glynda,

Thanks for those links, much appreciated.:) I completely with your thoughts 1) money making and 2) gets pets in for an annual check up.

However, our vet realises (or should) by now that I take Franklin in whenever I am concerned about anything. (Examples are: His pads seem dry and hard, should I use a moisturiser on them? and the famous..... There's something in the corner of his eye. Yes Jane, that's his third eyelid!:o)

So he knows Franklin gets taken care of, plus now with the Cushings,
Franklin is even more closely monitored, by me and the vet.

Your old vet vaccinated Buster just for the heck of it?!? :mad: I'll bet there would have been some choice words, (justifiably so).

It's also very good for us to know what your IMS told you that because the immune system is supressed, they should not get any more vaccinations. Here's another question, if your IMS provides a waiver for the purposes of licensing, would that also qualify if one of your babies had to go to a boarding kennel? (aside from the bordetella?) Just thinking out loud here, Franklin's only been boarded 3 times, and if he ever needed to go again, I would change kennels to one that is right beside a vet hospital, where they have experience with Cushings. (If Franklin approved at the inspection!)

Hmmm. Something to check with the endocrinologist, I think. Thank you again, Glynda,

Love to all,
Jane and Franklin xx
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Harley PoMMom

11-26-2009, 09:48 PM

Hi Jane,

There is alot of information about not vaccinating your dog at the web site "Everything Vaccines."

http://vaccines.dogsadversereactions.com/

This is a small excerpt taken from a letter that Dr. Dodds wrote.

Dear Representative Rines:

I am writing in support of LD 429, An Act to Require Veterinarians to Provide Vaccine Disclosure Forms. I do so as a veterinary research/clinician scientist, who has been actively involved in vaccination issues for more than 40 years.

Background

While vaccines have significantly reduced the incidence of serious infectious diseases over the years, increasing evidence implicates vaccines in triggering immune-mediated and other chronic disorders.

http://www.dogsadversereactions.com/vDrDodds.html

This is another quote taken from a letter by Dr Dodds on that web site.

The challenge to produce effective and safe vaccines for the prevalent infectious diseases of humans and animals has become increasingly difficult. In veterinary medicine, evidence implicating vaccines in triggering immune-mediated and other chronic disorders (vaccinosis) is compelling.

http://vaccines.dogsadversereactions.com/ChangingVaccineProtocols.html

W. JEAN DODDS
RÉSUMÉ
Dr. Dodds received the D.V.M. degree with honors in 1964 from the Ontario Veterinary College, University of Toronto. In 1965 she accepted a position with the New York State Health Department in Albany and began comparative studies of animals with inherited and acquired bleeding diseases. Her position there began as a Research Scientist and culminated as Chief, Laboratory of Hematology, Wadsworth Center. In 1980 she also became Executive Director, New York State Council on Human Blood and Transfusion Services. This work continued full-time until 1986 when she moved to Southern California to establish Hemopet, the first nonprofit national blood bank program for animals.

From 1965-1986, she was a member of many national and international committees on hematology, animal models of human disease, veterinary medicine, and laboratory animal science. Dr. Dodds was a grantee of the National Heart, Lung, and Blood Institute (NIH) and has over 150 research publications. She was formerly President of the Scientist's Center for Animal Welfare; and Chairman of the Committee on Veterinary Medical Sciences and Vice-Chairman of the Institute of Laboratory Animal Resources, National Academy of Sciences. In 1974 Dr. Dodds was selected as Outstanding Woman Veterinarian of the Year, AVMA Annual Meeting, Denver, Colorado; in 1977 received the Region I Award for Outstanding Service to the Veterinary Profession from the American Animal Hospital Association, Cherry Hill, New Jersey; in 1978 and 1990 received the Gaines Fido Award as Dogdom's Woman of the Year; and the Award of Merit in 1978 in Recognition of Special Contributions to the Veterinary Profession from the American Animal Hospital Association, Salt Lake City, Utah. In 1984 she was awarded the Centennial Medal from the University of Pennsylvania School of Veterinary Medicine. In 1987 she was elected a distinguished Practitioner of the National Academy of Practice in Veterinary Medicine. In 1994 she was given the Holistic Veterinarian of the Year Award from the American Holistic Veterinary Medical Association. She is an active member of numerous professional societies.

Today, Dr. Dodds is actively expanding Hemopet's range of nonprofit services and educational activities. The animal blood bank program provides canine blood components, blood bank supplies, and related services throughout North America. Hemopet's retired Greyhound blood donors are adopted as pets through the Pet Life-Line arm of the project. On behalf of Hemopet, she consults in clinical pathology nationally and internationally, and regularly travels to teach animal health care professionals, companion animal fanciers, and pet owners on hematology and blood banking, immunology, endocrinology, nutrition and holistic medicine. She was also the Editor of Advances in Veterinary Science and Comparative Medicine for Academic Press.

http://www.dogsadversereactions.com/vDrDodds.html

Hope this helps.

Love and hugs.
Lori

lulusmom

11-26-2009, 09:55 PM

Ellen, please read the AAHA guidelines I provided Jane above. I am also attaching a link to the UC Davis vaccine guidelines that may be easier to read. I believe the AAHA chart is sideways. :D FYI, Studies have shown protection for up to 7 years against Parvo when using modified live Parvo (CPV-2) vaccine. The same applies for Distemper. Rabies is necessary every three years and tests have shown that even the vaccines labeled one year offer protection in excess of three years. Rabies is the riskiest vaccine we give our dogs and I personally will pay a fine before any of my middle aged babies get another rabies shot.

Vaccination is a medical decision and medical procedure that should be individualized based on the risk and the lifestyle of the individual animal. One of AAHA’s key recommendations is that all dogs are different — and thus vaccine decisions should be made on an individual basis for each dog. Issues to consider include the age, breed, health status, environment, lifestyle, and travel habits of the dog. Health threats vary from city to city and even in various sections of cities.

http://www.vetmed.ucdavis.edu/vmth/small_animal/internal_medicine/vaccination_protocols.cfm

Franklin'sMum

11-26-2009, 10:00 PM

Hi Ellen,

I have always been concerned with this issue. Our vets recommend every two years for rabies then on the in between year vaccinating with the combo vaccine which includes, Parvo and Distemper. I wasn't going to vaccinate Casey at all this year for the combo vaccine but we did have an outbreak of Parvo and Distemper this year and we walk in the park with a lot of other dogs every day and we have frequent visits to the vet which has a lot of sick dogs. The vets had not seen distemper for a long time and unfortunately it affected our Humane Society and all of the dogs had to be euthanized.:mad:At least the shelter only had four dogs at the time but it was very upsetting.

I had Casey vaccinated in September and the same thing happened this year as two years ago (when her cushings was undiagnosed), she became very lethargic for about two days. I believe this has something to do with her Cushings because she never had a problem before and I have always vaccinated her every two years.

Maybe there is someone else who has experienced the same problem with a cushings dog.

Franklin's last vacc. was in May this year, and he became quite lethargic for a couple of days, also.

I am so sorry to hear that all the pooches at the shelter had to be euthanised:(. It wouldn't matter if there were 4 or 14, you and the others would have been absolutely heartbroken. I'm very sorry you were put through that ordeal.

Thank you for your reply, and for sharing your experiences.

Hugs to you, Casey and Desi

Jane and Franklin xx
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Franklin'sMum

11-26-2009, 11:14 PM

Hi Lori,

You have been busy, posting all those links:). I thank you very much.

I've come across a lot of articles on numerous subjects by Dr Jean Dodds, and think she's brilliant. I had read somewhere of a study showing 10-15 year immunity of certain strains, and meanwhile am unaware of what strains we have in Australia (but looking into it), but this is hugely helpful. Thank you so much for all of your help,

Thank you, Thank you, Thank you

Very Gratefully,

Jane and Franklin xx
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Franklin'sMum

11-27-2009, 06:12 AM

Hi all
Nothing much to report. Franklin doesn't have an ear infection, just a bit of wax and a fair bit of hair. Still weighing in at 7.3 kg.

Now we're waiting on stim test results, electrolyte results, blood profile. I asked about getting his blood pressure checked, but they don't have the machine to do it.

Also spoke about a revised vacc schedule. When I dropped him in, I spoke to the nurse, she said "Dr has a strong opinion on yearly vaccs, but in Franklin's case may make an exception". Hello? May make an exception?

I spoke to the vet when I was picking up Franklin. I said that I'm really not comfortable with the thought of annual vaccs in my boy,
that yearly vaccs are lasting much longer than just 1 year, his immune system is compromised, the point of a vaccine is to provoke an immune system response, I don't feel it's in Franklin's best interests to be subjected to that.
I added that the drug companies admit that their products last much longer than the 1 year, the Australian Kennel Club recommends 3 yearly, the American Veterinary Medical Association, the WSAVA, the AAHA advise the same.

His response was, "That may be okay for a regular dog, but a Cush dog is at greater risk because of the suppressed immune system to contract an illness the vaccine protects against. He would advise staying with the yearly vaccs." :mad:

He also said that there is a way to check if he's protected (titer test) but its very expensive, and much cheaper, safer and quicker to just vaccinate. Expensive? What do I care expensive? My boy has cushings, not the cheapest illness out there.
Safer? I said what about the injection site sarcomas? He replied that happens mainly in cats. I said but it's been happening in dogs, as well. He said that is caused by the rabies shot, which we don't get here, so vaccinating is perfectly safe.!!! What?

Oh, I am so frustrated by him at the moment.:mad: Add to this, the evening news just had a report about a parvovirus outbreak in the Albury/Wodonga region. (About 40 mins away.)

The thing is, there's only 2 vets in town, the other one is never there, he always seemed to be out on a farm call, delivering a cow or something. Franklin went to puppy pre school at his dr's, and he loves going there. The next option is 25 mins away, and I don't know yet if she has cushings experience. Or 45 mins away where I know they do. Going to the vets so closely has always been a blessing, if Franklin has an emergency. Travelling almost an hour if there is an emergency, and me freaking out at 100 km an hour= not a good combination.

I'll send off an email to Franklin's endo, see what she thinks, then possibly disagree and disregard her advice.:o

Thank you all for your information, links and experiences . You have all been so helpful. Each day I thank my stars that I stumbled upon this site.

With a HUGE amount of love and gratitude,

Jane and Franklin xx
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Harley PoMMom

11-29-2009, 11:57 PM

Hi Jane,

Our vets...we have a love & not-so-love relationship with them. :)

Here is a link to a really informative article on titer tests:

http://www.canine-epilepsy-guardian-angels.com/titer_test.htm

Hope you and Franklin are doing well and I will be watching for your posting of the results of your tests.

Love and hugs,
Lori

labblab

11-30-2009, 08:20 AM

Just to throw another two cents worth into the discussion...

For what it's worth, my own specialist took kind of a middle-of-the-road position in terms of vaccinating Cushpups. He did not advise eliminating vaccinations completely, and did not feel as though it was problematic to vaccinate a dog that was being effectively treated for Cushing's (i.e., the dog appeared to be well and had been therapeutically stabilized on Lysodren or trilostane). However, he did recommend "matching" the specific vaccination program to the risk factors for each dog, so as to provide protection as it was needed without over-vaccinating.

That advice always seemed very reasonable to me, since I did want to minimize the risk that my immuno-compromised boy would contract a disease that could otherwise have been prevented, while at the same time not exposing him to unnecessary side effects. We always took daily walks in areas that were frequented by other dogs, wild animals and waterfowl, and I would have worried had I not had him immunized (or had titers checked) for certain communicable diseases. But I did not want to "over-do" it unnecessarily, either.

Marianne

Franklin'sMum

11-30-2009, 10:20 PM

Hi Lori,

Thanks for that link, very informative. I think we'll go with titer testing from now on, and then think long and hard before we vaccinate again.

Hi Marianne,

Thanks for your 2 cents! I understand what you're saying about vaccinating un-necessarily but keeping the kids safe from any communicable diseases.

The thing is, our GP conceded to doing a 3 yearly schedule on the non- core vaccines, but wants to continue doing annually the CORE vaccines (going completely against recommendations from many authorities on the subject.), I just don't understand HIS thinking.

Add to that, I was reading "The Holistic Guide for A Healthy Dog" by Wendy Volhard and Kerry Brown, DVM yesterday.
On page 101 it says "There a breeds of dogs that have a poor tolerance for vaccines--- solid -coloured dogs, those breeds with a lot of white colouration in the coat, giant breeds, rottweilers and imported dogs."
Then on pages 103-104 --- "According to Robert Kirk, writing in 'Kirk's Current Veterinary Therapy Xl -205', a textbook used in all veterinary schools, there is no immunologic reason that would necessitate annual revaccinations. He tells us that as a practice it lacks scientific validity or verification. Immunity to viruses persists for years or for the life of the dog, and revaccinating does not add to that immunity. Given the potential adverse side effects, it is best not to revaccinate"

Those are direct quotes from the book, I apologise if that infringes copyright.

About the first quote, I haven't had a chance yet to google that info further.

Speaking of apologies, I also would like to apologise about my earlier rant. I just needed to vent, and get it out of my system. :o Thanks for listening, and thanks for all of your help.

Love and Hugs to all,

Jane and Franklin xx
________
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AlisonandMia

11-30-2009, 10:30 PM

Then on pages 103-104 --- "According to Robert Kirk, writing in 'Kirk's Current Veterinary Therapy Xl -205', a textbook used in all veterinary schools, there is no immunologic reason that would necessitate annual revaccinations. He tells us that as a practice it lacks scientific validity or verification. Immunity to viruses persists for years or for the life of the dog, and revaccinating does not add to that immunity. Given the potential adverse side effects, it is best not to revaccinate"

That has always been my understanding - immunity to specific viruses is very persistent. However immunity to bacteria is another matter which is why people can get bacterial pneumonia, strep throat etc. again and again. It is also why the Kennel Cough component of the vaccination is not as effective or as long lasting - KC is caused by a bacteria. I gather that those of us immunized for whooping cough (caused by a bacteria related to KC) as children can expect to have very little if any immunity unless we've been infected or re-vaccinated in the meantime!:eek:

Apparently the protein coating of viruses makes a big impression on, and is "remembered" well by, the immune system whereas bacteria have a carbohydrate coating which doesn't excite the immune system nearly as much. If you get the same virus twice it is usually because you've caught a different strain.

Alison

Harley PoMMom

11-30-2009, 10:35 PM

Hi Lori,

Speaking of apologies, I also would like to apologise about my earlier rant. I just needed to vent, and get it out of my system. :o Thanks for listening, and thanks for all of your help.

Love and Hugs to all,

Jane and Franklin xx

My dear, sweet Jane,

Do you not know that you are part of this family and that we love you, and we are here for whatever reason you need us to be here. You listen to us rant and rave...so there is no reason for a apology, ok. So you rant and rave, and get all that out of your system all you want, we will listen, and we will still love you...always. :)

Love and hugs,
Lori

Roxee's Dad

11-30-2009, 10:47 PM

Hi Jane,

Speaking of apologies, I also would like to apologise about my earlier rant. I just needed to vent, and get it out of my system. Thanks for listening, and thanks for all of your help.

Oh, no need for apologies, it's okay to rant once in a while, especially when it comes to the health of our pups. Sometimes, we vent right along with you.:o

We do vacinate but we extend the time period and we never do any of the combination vacines. Some vet's think we are a pain in the butt sometimes:o but oh well. ;):)

Rozee and Mickee are about 14 years old now and I think we are going to titer test them and hopefully avoid and more vacines. :)

Franklin'sMum

11-30-2009, 11:17 PM

Hi All,

Alison,
Thank you for that info about the various coatings on virus/ bacteria. Now I'm wondering if diet plays any part, too.
Bear with me, I'm probably going to phrase this wrong. :o

In John and Angelina's thread, John (Roxee's Dad) and Glynda mentioned a correlation between carbs and cancer. If the pup eats lots of carbs, aside from the cancer link, does that / would that have any bearing on a lack of immunity for KC? Would a high carb diet maximise the chance of contracting a bacteria? Hmm.

Conversely, would a high protein diet keep the virus anti bodies in the 'immune memory' even longer, because they're coated in protein? Another hmmm. More research for me I think.

John and Lori,
Thank you both for your supportiveness of my rant! Oh, I needed it though. I feel much better.

Love and cuddles to you and your babies,

Jane and Franklin xx
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Casey's Mom

11-30-2009, 11:45 PM

Jane its okay to rant because we all feel that way at various times - trust me!

The breeder and previous owner of my Havanese advised me not to vaccinate her after this year, she is now 4 and had her rabies vaccine last year and combo vaccine this year.

She believes that we should do titres instead and I trust her opinion. She has been breeding and showing for a long time and has a great reputation. I wish I had done that with Casey this year but they had to order the test kit and I guess I was in a bit of a panic with having the distemper and parvo both infecting our area - Next spring I too could be fined for not getting the rabies shot as but we have never had a case of rabies in our district (a 200 km radius) for as long as I remember.

I feel for you Jane but do what your gut tells you - that and the great advice and experience you can draw on from this site.

Love and hugs to you and Franklin,

Franklin'sMum

12-01-2009, 12:11 AM

Hi Everyone,

Franklin's blood profile results just came in.
VETERINARY PROFILE
% x109/L
Hb 162 g/L (115-180) WBC 9.5 (6.0-14.0)
RCC 7.08 x1012/L (5.00-8.0
HCT 0.47 (0.37-0.5
MCV 66 fL (63-74)
MCH 23 pg (20-25)
MCHC 344 g/L (310-360)
Plat 499 x109/L (200-900)

RBC Morphology
Polychromasia+,
WBC Morphology
Show normal morphology
Platelet
Show normal morphology

Sodium 146 mmol/L (140-155)
Potassium 5.3 mmol/L (3.8-5.8)
Chloride 102 mmol/L (100-120)
Bicarbonate 23 mmol/L (16-24)
* Anion Gap 26 mmol/L (15-25)
* Urea 12.1 mmol/L (2.5-9.0)
Creatinine 43 umol/L (40-140)
Glucose 6.1 mmol/L (3.5-6.7)
Bilirubin 4 umol/L (< 11)
ALT 78 U/L (< 80)
* Alkaline Phosphatase 427 U/L (< 120)
Protein 71 g/L (55-78)
* Albumin 45 g/L (22-36)
Globulin 26 g/L (22-42)
Albumin/Globulin Ratio 1.7 (0.5-1.8)
* Calcium 2.81 mmol/L (2.00-2.80)
Phosphate 1.9 mmol/L (0.8-2.0)
Creatine Kinase 195 U/L (< 401)
Amylase 1110 U/L (< 2400)
* Lipase 581 U/L (1-70)
Cholesterol 7.8 mmol/L (3.6-8.8)
* Triglyceride 9.7 mmol/L (0.2-1.7)

Note increased lipase level - ?pancreatitis.

There was a note at the top of the email from gp to specialist says that there is usually a high reading for lipase from this lab, and that it should be taken into account.

We didn't do this as a fasting test, he had a stim so he needed to have breakfast. I don't remember what I served for breakfast, I think commercial and pretty sure it was diced lean beef as the raw.

He didn't have a pig ear or such the day before, or the morning of the test.

In a nut shell here's the differences:
21 Apr chem 27 Nov
740 Amylase 1110
41 ALT 78
9.3 Cholesterol 7.8
1.3 Phosphate 1.9
20 Anion Gap 26
5.6 Urea 12.1
513 Alk Phos 427
44 Albumin 45
2.88 Calcium 2.81
110 Lipase 581
1.3 Triglicerides 9.7

Can anyone help make sense of these results, please? As always, your input, thoughts, ideas, feed-back and 2 cents are appreciated.

Thanks in advance,
Jane and Franklin xx
________
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Franklin'sMum

12-01-2009, 06:50 AM

Hi Ellen,
Thanks for checking in on us.
My gut is telling me "NO! Don't do it!" Especially now, on the report, for red blood cells it has the comment - "polychromasia". According to an online dictionary, it's some kind of anaemia (sp?).

I googled polychromasia in dogs and I think it was vetconnect.com.au/5min something that (from what I can understand) seemed to say it was related to Auto Immune Hemolytic Anaemia :eek: and something about the liver :(.

It will be titer tests for us, from now on.

Jane and Franklin xx
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Harley PoMMom

12-01-2009, 10:32 AM

Hi Jane,

I will put my 2 cents worth in about the Lipase but the rest of the lab results I am sure Debbie will be along to give her expert opinion about. :)

Lipase is non-specific because there are digestive lipases, intestinal lipases, lipoprotein lipase and heptic lipase, hormone-sensitive lipase, and lysosomal acidic lipase.

Since Franklin did not fast the night before this blood panel, I am suspecting this is why his lipase value is higher than before. On Franklin last test, 21 Apr his lipase was 110, was this a fasting test? Now this is JMO, ok, but when any pup shows elevations in lipase and/or has symptoms of pancreatitis, that pup should have a cPLI or cPL test done. Both of these tests measure the lipase that is specific to the pancreas only.

http://www.idexx.dk/animalhealth/laboratory/speccpl/brochure.pdf
(http://www.idexx.dk/animalhealth/laboratory/speccpl/brochure.pdf)

Hope this helps alittle. :o:)

Love and hugs.
Lori

PS. Sorry this so short...I'm at work right now and they really expect me to WORK!!

Franklin'sMum

12-01-2009, 12:46 PM

Hi Lori,

I'll check out that link on my next break, thanks for the lipase info. No, the April 21 test wasn't after a fast either. It was done around 3pm, about 20-30 minutes after a staggering/ falling episode. Back before the Cushing's dx.

Your workplace expects you to work? The nerve of those people! Isn't it enough you grace them with your presence? ;)

Jane and Franklin xx
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Franklin'sMum

12-03-2009, 04:40 AM

Hi all,

The stim results from Friday's tests still aren't in. :( The lab has told the vet that they do cortisol testing on Mon and Thurs, they received the sample Fri pm. Aargh!

A couple of other things to report on, though. We have found a homeopathic vet who provides phone/e-mail consults (She's in another state), and uses nosodes in place of the traditional vaccines we had previously been getting. :)

I also rang a number of boarding kennels to double-check their vaccination policies. We found one who accepts titer tests and the use of homeopathic nosodes (with letter or phone call from vet, to clarify meanings/levels).:D Yay! I also phoned the insurance company, and they consider the use of "prophylactic nosodes against vaccine- preventable illnesses" as being protected. :):):)

Yay! No more traditional vaccinations for my boy!!!!! Daft question- how is titer pronounced? Teeter or tighter? (I told you it was daft.)

Emailed GP with questions about elevated amylase, lipase, triglycerides, and the polychromasia. Franklin is "definitely not anaemic" and as for the pancreatic stuff and if a cPCL is needed, we should wait to hear from the specialist. However, I think I know what's happening... I wouldv'e put some flax seed oil on Franklin's food that morning.

DO NOT USE flax seed oil as the lignan content is very low, and the flax oil can exacerbate pancreatitis in dogs (triglyceride levels may increase).

That is from Lori to Jeff in Mandy's thread. I had written that I didn't give fatty food or snacks the day of or the day before the test, I didn't think Flax seed oil counted, because it's the good kind of fat.:o Definitely will be keeping that in mind for future tests.

Back to the nosodes, does anyone here use/have used them? The homeopath said that when it's time for his usual vacc, to get the titer, and go from there. She usually gives a thing for detox, then the nosode/s are given twice a day for 4 days, 1 a week for 4 weeks, 1 a month for 4 months then 1 a year, yearly.
She added that if there's an outbreak, some people use it 6 monthly.
Glynda, if you don't mind me asking, you said your previous vet vaccinated your boy because they didn't accept the vial as proof of vaccination. Was the vial blood from the titer test, or a nosode?

Thanks heaps, everyone.

Hoping you and your babies are all happy and well,

Jane and Franklin xx
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Squirt's Mom

12-03-2009, 11:21 AM

Hi Jane,

Not knowing what a nosode was, I looked it up. Here is what I found for anyone else who may not know:

http://www.napoleon.org.uk/alternative.htm

What Is A Nosode?
In homeopathy, there is a special type of remedy called a nosode. A nosode (from nosos, the Greek word meaning disease) is a homeopathic preparation made from matter from a sick animal or person. Substances such as respiratory discharges or diseased tissues are used. It sounds repulsive, but the preparation, using alcohol, as well as the repeated dilution and succussion, essentially renders the substances harmless, while producing a powerful remedy. The use of nosodes in a prophylactic manner, for preventing disease, has been employed in veterinary and human homeopathy for many years. It is supported by various holistic veterinarians and authors.

Hugs,
Leslie and the girls

Harley PoMMom

12-03-2009, 10:20 PM

Hi Jane,

how is titer pronounced? Teeter or tighter?
Hey, I wasn't really sure either so I went to dictionary.com, typed in titer and let them pronounce it for me and they pronounced it like "tighter." ;):D

Thanks Leslie for that link about nosodes, I didn't know what a nosode was either. :)

Yay! No more traditional vaccinations for my boy!!!!! Great work Jane, OMGosh you have been busy.

You're such a wonderful mommy.

Give Franklin some belly rubs from Harley and me.

Love and hugs,
Lori

AlisonandMia

12-03-2009, 11:06 PM

I've always heard it pronounced "teeter" (by both docs, vets and radio and TV people) here in Australia.:) It probably wouldn't sound so good (or even intelligible) with us all saying "toiter" when trying to say "tighter".:p

Alison

StarDeb55

12-04-2009, 12:25 AM

In the US, it's "tighter". If you're not sure exactly what a titer measurement checks, it looks at the level or concentration of antibody in the blood stream against any specific organism. For instance, a titer for distemper can be checked, rather than giving the actual vaccination. The result of the titer would need to be above a certain level or concentration to insure that the pup would immune to distemper. To give you an example from the human world, most mom-to-be's have a number of different titers run such as rubella, to insure that their immune system is strong enough to protect the fetus, in case of an in utero exposure to the disease during pregnancy.

All a vaccine does is to re-expose the immune system to the specific protein that is on any organism, which will jog the "immune system" memory to recognize this protein as foreign, so an antibody response can begin. In an intact, fully developed immune system, this is really not necessary as the immune system should recognize the organism protein as foreign during any later exposures over life, after the inital round of vaccinations.

It's kind of a simplistic explanation, but I hope it helps.

Debbie

Franklin'sMum

12-04-2009, 06:37 AM

Hi Everyone, and thanks for all your inputs.

Hi Alison,
Immune memory and a high protein diet? What can I say, it was night shift.:o :) The vet says "tighter" and the homeopath says "teeter". "Toighter" ha ha!

Hi John (Roxee's Dad),
You've been doing singular vaccines? I never knew that was an option, but thinking that's a much better idea than combos. 14 years old? You and Pattee do take great care of your kids :D

Hi Leslie,
Thanks for putting an explanation and link for "nosodes" in. When I find the page again, I'll add the link and a human polio study that was done with homeopathic nosodes. Seems to be very effective.

Hi Lori,
Franklin says thank for his belly rubs! (puppy rolling on floor icon):)

Hi Debbie,
Thanks for that explanation, it absolutely helps.

In an intact, fully developed immune system, this is really not necessary as the immune system should recognize the organism protein as foreign during any later exposures over life, after the inital round of vaccinations.

I understand that a cushpup has a compromised immune system, but it would have been fully developed before the onset of Cushings, right? (Barring other illnesses.) In your experience, a pup that's had all their vaccs and at a later point develops Cushings, does that wipe out the immune system memory for vacc- preventable illnesses?

Thank you all for checking in on us, and finally Franklin's stim results are in.....
Drumroll please......
Pre -90 nmol/L
Post -94 nmol/L
The GP has asked the specialist if we should keep at 30mg am and 30mg pm, or if we should change, but hasn't heard back yet. Today was 30/15mg because he was an hour late to eat his tea (not unwell, just holding out for some raw mixed in.)

Thank you, thank you, thank you all again, :D

Lotsa love, big cuddles, ear scratches and belly rubs,

Jane and Franklin xx
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labblab

12-04-2009, 08:25 AM

Hi Jane,

I have only a moment to post right now, but I just wanted to mention one thing. For our U.S. members, Franklin's ACTH results translate into 3.26 ug/dl PRE, and 3.4 ug/dl POST. Usually, I would say that the post result sounds great. But the one issue that I see is that there is so little difference between the two results -- they might be considered "non-stimulatory" by the makers of Vetoryl? Sometimes, such a result may precede the need for a break from the medication. Here's a quote from Dechra's U.K. product insert: (http://www.dechra-eu.com/downloadfiles/Vetoryl30mgCapsulesProductDataSheet.pdf)

In the event of a non-stimulatory ACTH stimulation
test during monitoring, treatment should be stopped
for 7 days and then re-started at a lower dose. Repeat
the ACTH stimulation test after a further 14 days. If
the result is still non-stimulatory, stop treatment until
clinical signs of hyperadrenocorticism recur. Repeat
the ACTH stimulation test one month after re-starting
treatment.

Interestingly, the current U.S. Product Insert does not contain this same warning, so it may no longer even be considered an issue by Dechra. And during our time here, we have seen dogs who did not seem to have any problems at all after posting a non-stimulatory response. But we have had a few dogs who did -- they started to show symptoms consistent with a cortisol level that was too low. This may not be any issue whatsoever with Franklin (and especially because his "Post" number is not actually lower than his "Pre" number -- I've never even been positive as to exactly what is meant by "non-stimulatory results," anyway...), but I just wanted to mention it to you. This way, if the specialist also mentions it, you'll at least know what it is that is being talked about. And even though I know you are already watching him like a hawk, it might be added reason to make sure he does not start feeling "off" in the event that his dose remains unchanged.

Marianne

Franklin'sMum

12-04-2009, 03:04 PM

Hi Marianne,

Thanks for checking in on us. To be honest, I was a little curious about his result. The specialist has said to us that she likes the pre to be around 100 nmol, (so Franklin's score is great) and to rise about 20 points.
She said that they don't usually stop the trilo for several days, but just automatically lower the dose if the post isn't high enough. I'll give her a call when they open to find out what she wants us to do. (Assuming she's rostered on today.)

With love and ((hugs))

Jane and Franklin xx
________
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Franklin'sMum

12-05-2009, 06:26 AM

Hi all,

Well, the specialist doesn't work on Saturdays, she may come in to check on a patient, but today wasn't one of those Saturdays.

So still no definitive answer. I realise Jeanette's Princess in in the same (but lower scoring) boat, and has temporarily come off the trilo. Would you all recommend the same for Franklin, at least until I speak with the specialist on (hopefully) Monday?
Or to reduce the dose to something like 30/15mg? I just want to be on the safe side. Franklin is eating well, drinking, energetic and his eyes are bright and alert.
Any info and advice is as always greatly appreciated,

Jane and Franklin xx
________
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StarDeb55

12-05-2009, 06:35 AM

Jane, we are not vets, so any change in dosage for Franklin would have to be cleared by a vet. I think the best thing you can do, which I know you already are, is to which him very carefully. If you think Franklin is getting in trouble. contact your vet.

Debbie

Franklin'sMum

12-05-2009, 07:25 AM

Hi Debbie, and thanks for your reply.

I know you're not vets, but you all have so much experience and knowledge. Just wondering about a pre-emptive idea, based on your experiences, that's all.

But rest assured, still and ever-more watching like a hawk :)

Thanks,

Jane and Franklin xx
________
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labblab

12-05-2009, 08:51 AM

Hi Jane,

I just wanted to "second" what Debbie has already said. As long as Franklin is doing well, I would not stop or alter his trilostane dose until you've had the chance to speak to the specialist about his results. Since his "post" result is squarely within the desired therapeutic range, it may be the case that she will not be at all concerned about the amount of "rise" in his post-test result so long as he is doing well in terms of his appearance and behavior. So I would not worry unduly, and instead enjoy your weekend!

Marianne

Franklin'sMum

12-05-2009, 06:46 PM

Hi Marianne,

Thanks for your assurances. Will now relax, and remain alert but not alarmed ! :)

Jane and Franklin xx
________
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Harley PoMMom

12-05-2009, 07:16 PM

Hi Jane,

I agree with Debbie and Marianne, as long as Franklin is drinking, eating...doing normal Franklin stuff :) then you shouldn't be alarmed. So enjoy the rest of your weekend with Franklin and give him some belly rubs from Harley and me.

Love and hugs,
Lori

Franklin'sMum

12-05-2009, 08:52 PM

Hi Lori,

I just have time for a quick reply, thank you for checking in on us.

We will enjoy the rest of the weekend, and Franklin says thanks for his belly rubs.

Hugs to you and Harley :)

Jane and Franklin xx
________
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mypuppy

12-06-2009, 05:19 PM

He there Jane,
I just peeked in on your thread only to realize it seems you are experiencing the same issues with Franklin as I am with Princess with their levels scoring "low". I know you peeked in on my thread also not too long ago, and not sure how much updated info you read, but I will summarize for you briefly. My specialist recommended to take Princess off the trilo for 5 days and resume at a lower dose, which would have been today actually. However, after receiving some inputs on the forum, I called my IMS, and we both agreed not to restart Princesses trilo until we performed another stim and also to check her electrolytes. She is scheduled for those this coming Tuesday, and in all honesty, as your little Fraklin, Princess has been doing fine and showing no strange symptoms. The only unusual thing I noticed is her sudden not drinking any water. She drinks very very little, so not sure if that is related to her levels being low. As me, I would definitely hold off on anything until you talk to your specialist and perhaps do that stim to make sure it is ok to restart him on the lower dose. I definitely feel much better about making that decision for Princess. I will be peeking in from time to time to see how he's doing either way. I know this is definitely not fun for any of us, including the pups, but we'll get through it. Let me us know how things pan out for the both of you. Best regards, luv and xo Jeanette

Hi all,

Well, the specialist doesn't work on Saturdays, she may come in to check on a patient, but today wasn't one of those Saturdays.

So still no definitive answer. I realise Jeanette's Princess in in the same (but lower scoring) boat, and has temporarily come off the trilo. Would you all recommend the same for Franklin, at least until I speak with the specialist on (hopefully) Monday?
Or to reduce the dose to something like 30/15mg? I just want to be on the safe side. Franklin is eating well, drinking, energetic and his eyes are bright and alert.
Any info and advice is as always greatly appreciated,

Jane and Franklin xx

Franklin'sMum

12-06-2009, 09:41 PM

Hi Jeanette,

Thanks for checking in on us. Franklin didn't score "low", he just didn't stim by much. Princess scored low and didn't stim much as well.

I just got a reply from his specialist,
His results are good - I would stick to the same dose then do another stim in a month. If it is still good, we can pull it back to every 3 months.

His results from the 27 Nov were pre 90nmol/L (3.26 ug/dl) and post 94nmol/L (3.40 ug/dl), so a fair bit more cortisol reserve than your Princess. I was concerned about Princess's levels being so low, and am so glad you've spoken to your IMS:)

Franklin's specialist does not seem concerned about his not stimulating much, so I'll continue to keep a close watch on the little guy, and wait for the next stim test to be due.

When he was lower (45-50 nmol/L) or (1.63-1.81ug/dl) tested on 30 October, he was on 75mg a day. He was fine then but began to get really slow to eat his food. Spoke to the specialist and she said to lower the dose to 60mg. When the results came in almost a week later, that was when she said STOP the trilo for a few days, and wait till he's eating properly. That took a day and a half, and I continued to wait till he was drinking lots (800-900ml) of water again. Even on the trilo, he didn't drink less than 300ml.

If he ever got to the point where he wasn't drinking at all, I probably would completely freak out, while simultaneously giving cortate, phoning the specialist and driving to the vets. You handled this so great, Jeanette.:D

Oh, changing the subject, the specialist also answered my vaccination questions
Here's my questions to her:

I've been reading up on Vaccinosis, over vaccinating and the problems it causes, and come upon a number of sites that recommend a revised 3 yearly vaccination schedule. A few of these sites also state that if the dog is immuno-compromised, they would wait 5-7 years before re-vaccinating, if at all.
Do you have any thoughts on this (vaccinating yearly, tri-annually, lifetime protection, vaccinosis, immune compromised pups, homeopathic nosodes, titer tests?)
Also, do you believeor find that an immune compromised pup (who is up to date on all vaccinations) is at greater risk for contracting a disease? Or at greater risk of vaccine complications?
The websites I am referring to are WSAVA, AAHA, Pfizer, American Veterinary Medical Association, Academy of Veterinary Internal Medicine, American Association of Veterinary Immunologists, etc.

This is her reply:

A few thoughts about vaccination.
My boss' speciality is immunology and he is a supporter of vaccinations every 3 years after the initial puppy vaccinations in all dogs. There are a large number of studies from America that prove that immunity generally lasts 3 years for parvo, hepatitis and distemper, and their policy is vaccination every 3 years. However, kennel cough vaccinations only last one year, so they do need to performed annually if Franklin is going into kennels or spends a lot of time socializing.
There is actually a vaccination that is designed for three yearly use in Australia, we use them in our general practice- it is made by durramune. Rowan should be able to order it in. Tell him to let me know if he needs more details and I'll send them through.
Theoretically, if Franklin's Cushings is well controlled, he shouldn't be too immunocompromised. I would still vaccinate every 3 years.
Immunocompromised dogs are theoretically more susceptible to infections but honestly we only see secondary infections when they have no white cells at all ie after chemo in cancer patients. They tend not to be more inclined to get vaccination reactions compared with normal dogs.
Hope the little man is well.
Soph

So there's another opinion on the subject.
The homeopathinc vet I mentioned in an earlier post is Eileen McLean, and this is her website, for those who are interested.
http://www.naturalanimalcare.com

Love and Hugs to all,
Jane and Franklin xx
________
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mypuppy

12-07-2009, 03:19 PM

Jane, thanks for clearing that up. I thought they were both on the same page, but am glad you were able to get an answer from your specialist as to how to proceed. Hope that little precious face is doing better soon--he's soooo cute, I would eat him right up....haaaaaaaaa.....As for Princess, I eat her right up too...haaaaaa....she's due for her tests tomorrow, so I will keep you and everyone updated on that as soon as I get word from my IMS. In the meantime, best regards to you and Franklin and stay well. Luv, Jeanette

Hi Jeanette,

Thanks for checking in on us. Franklin didn't score "low", he just didn't stim by much. Princess scored low and didn't stim much as well.

I just got a reply from his specialist,

His results from the 27 Nov were pre 90nmol/L (3.26 ug/dl) and post 94nmol/L (3.40 ug/dl), so a fair bit more cortisol reserve than your Princess. I was concerned about Princess's levels being so low, and am so glad you've spoken to your IMS:)

Franklin's specialist does not seem concerned about his not stimulating much, so I'll continue to keep a close watch on the little guy, and wait for the next stim test to be due.

When he was lower (45-50 nmol/L) or (1.63-1.81ug/dl) tested on 30 October, he was on 75mg a day. He was fine then but began to get really slow to eat his food. Spoke to the specialist and she said to lower the dose to 60mg. When the results came in almost a week later, that was when she said STOP the trilo for a few days, and wait till he's eating properly. That took a day and a half, and I continued to wait till he was drinking lots (800-900ml) of water again. Even on the trilo, he didn't drink less than 300ml.

If he ever got to the point where he wasn't drinking at all, I probably would completely freak out, while simultaneously giving cortate, phoning the specialist and driving to the vets. You handled this so great, Jeanette.:D

Oh, changing the subject, the specialist also answered my vaccination questions
Here's my questions to her:

I've been reading up on Vaccinosis, over vaccinating and the problems it causes, and come upon a number of sites that recommend a revised 3 yearly vaccination schedule. A few of these sites also state that if the dog is immuno-compromised, they would wait 5-7 years before re-vaccinating, if at all.
Do you have any thoughts on this (vaccinating yearly, tri-annually, lifetime protection, vaccinosis, immune compromised pups, homeopathic nosodes, titer tests?)
Also, do you believeor find that an immune compromised pup (who is up to date on all vaccinations) is at greater risk for contracting a disease? Or at greater risk of vaccine complications?
The websites I am referring to are WSAVA, AAHA, Pfizer, American Veterinary Medical Association, Academy of Veterinary Internal Medicine, American Association of Veterinary Immunologists, etc.

This is her reply:

So there's another opinion on the subject.
The homeopathinc vet I mentioned in an earlier post is Eileen McLean, and this is her website, for those who are interested.
http://www.naturalanimalcare.com

Love and Hugs to all,
Jane and Franklin xx

Franklin'sMum

12-09-2009, 02:21 AM

Hi Jeanette,

We hope Princess' stim test went well, and that Princess didn't get stressed by it. Poor sweet little girl.

Will be waiting along with the others to see her results, and hope also that Princess is feeling better, and doing regular Princess things :)

Our 30 day stim is due just after Christmas, right when our GP will be closed for that week, so it'll need to be in the first week on January. He's doing very well on the 30/30 dosing, so his grandparents and myself are over-joyed :D.

Thank you for saying he is a little cutie, as are all of our sweet babies :)

Love and Belly Rubs to All,

Jane and Franklin xx
________
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mypuppy

12-09-2009, 08:48 PM

Oh Jane, he is a cutie indeed, just like my Princess. And how funny is that, Princess is due for yet another stim right after Christmas as well. UGH, UGH. I am not overly thrilled for her to be undergoing so many of these so close together, but I guess this is the process to ensure she's on the proper dose. I am trying to be patient, as I'm sure you are too with the little guy. It's really frustrating at times isn't it, but it's for their own good. Anyway, we are due to restart this coming Saturday on 60mg once a day, and I sure do hope that this dose will be right one for her for a long while at least. Keep in touch, and I will too and I did give Princess her belly rubs, and she loved them. You do the same for Franklin. Take care and Best regards, Luv, Jeanette

Hi Jeanette,

We hope Princess' stim test went well, and that Princess didn't get stressed by it. Poor sweet little girl.

Will be waiting along with the others to see her results, and hope also that Princess is feeling better, and doing regular Princess things :)

Our 30 day stim is due just after Christmas, right when our GP will be closed for that week, so it'll need to be in the first week on January. He's doing very well on the 30/30 dosing, so his grandparents and myself are over-joyed :D.

Thank you for saying he is a little cutie, as are all of our sweet babies :)

Love and Belly Rubs to All,

Jane and Franklin xx

Franklin'sMum

12-13-2009, 03:53 AM

Hi All,

Just letting you all know that things are going well. Franklin didn't have any trilo this morning, I think he was just really full from yesterday (brekkie, lunch, tea, a schmacko when I had to go out, and a bone.)

But he's had tea tonight, and his pm dose. He's now snoring softly on the floor :).

Hoping you and your babies are tail-waggingly happy (Come on Luke, you can do it!:p)

Love to all,

Jane and Franklin xx
________
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John II

12-13-2009, 05:48 AM

Hi Jane,

Good to hear that things are going well with Franklin. :)

Harley PoMMom

12-13-2009, 08:49 PM

Hi Jane,

I just had to post here about picture in your album...just love it.

Love and hugs,

And for those of you who want to take a peek:

http://www.k9cushings.com/forum/album.php?albumid=118&pictureid=1106

Franklin'sMum

12-14-2009, 07:13 AM

Hey Lori,

Glad you like the pic, I thought he was going to leap off me to get to the toy that was being waved around (hunt, kill, hump) :rolleyes:
That would've made for some interesting photos, (and possibly a lifetime ban:eek:)

Jane and Franklin xx
________
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Squirt's Mom

12-14-2009, 10:41 AM

...I thought he was going to leap off me to get to the toy that was being waved around (hunt, kill, hump)
That would've made for some interesting photos, (and possibly a lifetime ban)

Oh Jane! This is so funny....and I really needed a laugh this morning!

Thank you, thank you, thank you!
Hugs,
Leslie and the girls

Franklin'sMum

12-14-2009, 03:31 PM

Hi Leslie,

Glad to give you a giggle, :D and hope your day improves :)

Love and hugs

Jane and Franklin xx
________
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Harley PoMMom

01-05-2010, 05:03 PM

Hi Jane,

I know you have been very busy with your Mum and her pup Bailey but I was just wondering how you and Franklin were doing...we haven't had a update for a while. :( :)

Love and hugs,
Lori

Franklin'sMum

01-06-2010, 05:50 AM

Hi Lori,

Thank you for asking, Franklin is doing well, although he has missed a few doses of trilo in the past couple of weeks. (One morning, he didn't want brekkie, then in the pm he had a sloppy poop, so no trilo that day, but was eating and drinking well, and bright and perky.)

The heat, and the summer thunderstorms haven't been helping, either :(. I give him some "Homeopet-Anxiety" drops and sometimes also a "Vetalogica- Canine Tranquil Formula" chewable. But, all in all, Franklin is doing pretty good :) Very kind of you to ask, Lori, thank you.

Oh, b/c of the missed doses, I'll see if he can get a stim test next week instead of this week, as originally planned. Will keep you posted :)

With love,
Jane, Franklin and Bailey xxx
________
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Casey's Mom

01-06-2010, 10:01 AM

Hello Jane, I just wanted to let you know that I too have used Homeopet Anxiety for my Casey and it works wonderfully. She hasn't had any anxiety issues for months now but its nice to have on hand just in case we get a winter thunderstorm (it has happened in January!)

Glad to know Franklin is doing well.

mypuppy

01-06-2010, 03:28 PM

Hi Jane,
As Lori, I too was curious how the little guy was doing these days, but I just read the latest on his trilo missed doses. The anticipation of waiting for that stim is just overbearing isn't it? I just restarted Princess and will be stimmed in 13 days now. I'm hoping for some, not just good, but GREAT numbers...That's right, I am reaching for the stars at this point. Who wants to settle for anything less when it comes to these precious 4 legged babies of ours. I'm praying and hoping the same for your little Franklin--with that precious face of his. Eat him all up is what I'd like to do...haaaaa.....Hang in there and keep us afloat, ya hear? Tight xo, Luv, Jeanette

Harley PoMMom

01-06-2010, 07:29 PM

Hi Jane,

I see you have been the ever so wonderful and watchful Mum! Franklin is so very lucky to have you taking care of him. I am so happy that Franklin is doing so well...besides the thunderstorms...poor fellow. :( Harley used to be scared of thunderstorms also, but since he's been on the melatonin they don't bother him anymore.

Will be checking back for the results for that stim when you have it done! :)

Love and hugs,
Lori

Franklin'sMum

01-07-2010, 08:08 AM

Hi Friends,

Hoping this finds you and your babies well.
Hi Ellen, so glad that the Homeopet works well for Casey,:) and that Casey doesn't fret nearly so much during thunderstorms. I think it's a great product, but also feel that Franklin may need something faster acting, depending on the severity of the storm, tho.

Hi Jeanette, Franklin says "woof" to your eating him all up!:) He does like me to blow raspberries on his belly. :D:o The lab the vet uses only runs the cortisol tests twice a week :(so for me, it's the waiting for the results that is more worrying :(. As many have said, their baby seemed fine, eating, drinking and were acting like themselves, and it was only after the results came in that they knew they were on the brink of a problem. :( So I find that thought terrifying.:eek:

Hi Lori, thank you for your kind words, but truthfully I wouldn't be half as effective as his mum if it wasn't for all of you here sharing your knowledge. My eternal gratitude to you all Months ago I read on a k9epilepsy site about the melatonin being great for thunderstorm/fireworks phobias, and spoke to the vet about it. He said it's illegal or unavailable in Australia without a script, and if I bought it online, customs would probably seize it. I did find some homeopathic melatonin in the chemist (Bioglan-melatonin 6x) but haven't given him any. I emailed the company asking about dosage, and how much of a tablet would be equal to 2 or 3mg, but she said there is no comparison, homeopathic stuff has no mg measurement equivalent.

On another note, Franklin only had chicken for tea last night, he didn't want his food,he also didn't want his brekkie this morning (ate some of mine, but not his) and then ate his "mummy has to go to work now" treats. When I got home tonight, he greeted me with a smile,and then spit bubble vomit. Waited a little bit, and gave him a couple of munchies. They came up in spit bubble vomit a few minutes later. So a little later I offered some chicken slices (only a little bit at a time) and he has kept that down. He has eaten a couple more munchies (sorry Louise :p), I've put a little "pedialyte" in his water bowls just to be on the safe side. I'm planning on giving him up to an hour before I give him a cortate 5mg. So he might very well be going to the vet tomorrow, instead of next week. The vet has said in the past that its only a short acting drug, and it only needs 12 hours before a stim can be done.

On another note again, Bailey is still eating and drinking. :D Yay!!

Thank you all for checking in on us, and I'll keep you posted.

Jane, Franklin and Bailey xxx
________
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littleone1

01-07-2010, 08:25 AM

Hi Jane,

I hope Franklin feels better soon. It's sometimes so hard to know what to do when they aren't feeling well. Please let us know how everything is going.

I'm glad to hear that Bailey is still eating and drinking.:) That's a big plus.

Franklin'sMum

01-07-2010, 08:38 AM

Hi Terri,

We hope you and Corky are doing great. :). Ok, here's the latest, I couldn't wait an hour :o so I gave him a half-ish tablet. So probably 2mg, wrapped in a little peice of ham. He gobbled it down, looked at me like "Where's more? Keep 'em coming." Then went straight over and started eating his food. :D. The sweet little muppet does like to keep me on my toes :rolleyes: The Franklinstein. :) :p

So I'm feeling much better, and will see if the vet can fit him in tomorrow for an electrolyte check and base cortisol. Do you think there would be much point in a stim test tomorrow?

Thanks,

Jane, Franklin and Bailey xxx
________
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littleone1

01-07-2010, 08:53 AM

Hi Jane,

I'm so glad to hear that Franklin is eating. I love his nickname.:)

You might still want to have the stim test done, especially for you own peace of mind. You might want to give your vet a call to see what your vet thinks would be the best thing to do.

Franklin'sMum

01-07-2010, 09:26 AM

Hi Terri,

Will definitely call the vet to see what he thinks. My thought was there was no tablet at all today, and only the morning dose yesterday. So kinda unsure if getting him stimmed would serve any purpose, but concerned about his base level.

Big hugs, and will let you know what happens,

Jane and the gang xxx
________
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Harley PoMMom

01-07-2010, 11:58 AM

Hi Friends,

The vet has said in the past that its only a short acting drug, and it only needs 12 hours before a stim can be done.

Hi Jane, I am probably confused here, but what else is new! Your vet does realize that a stim test has to be done 4-6 hours after a Trilostane dose...right?

On another note again, Bailey is still eating and drinking. :D Yay!!

So happy Bailey is eating and drinking...YAAAAA!!!!

Thank you all for checking in on us, and I'll keep you posted.

Jane, Franklin and Bailey xxx

I was thinking too that Franklin could benefit from Pepcid AC 20 minutes before his Trilostane, maybe ask your vet about it...Just a thought.

Love and hugs,
Lori

Franklin'sMum

01-07-2010, 08:42 PM

Hi Lori,

Sorry to cause confusion, but I can't say for sure that I'll stop writing in such a jumbled up manner. :o:rolleyes: Thanks for catching that :). At the start of Franklin's treatment the vet said if I feel that he needs a cortate, that it is short acting and clears the system quickly. So Franklin could be stimmed (if needed) 12 hours after the cortate dose.

Yes, the vet is fully aware that a stim is done 4-6 hours after a trilo dose. ;) It was me who wasn't switched on :rolleyes:. Had also said I'd ask if the vet could just check his electrolytes and a base level cortisol with no stim test happening, and Terri suggested that the vet may want to do the actual stim. Here's more I didn't explain so well...Wednesday-no tea/no trilo. Thursday- no brekkie/ no trilo. Thurs pm vomiting spitbubbles. Then spitbubbles with a bit of a snack I had just given him. Hadn't drank much. Thurs night getting worried. Put some pedialyte in his water. Then gave almost a half cortate. Right away (withing 2 minutes) he starts eating. So yeah, he probably didn't need the cortate in hindsight, but I felt better after he'd had it tho.

At the moment I'm waiting on a call back from the vet (Franklin's regular vet is still on holiday, so they have a stand-in, very nice, Franklin has seen her before, and before Christmas the doc said he'd brought her up to speed about Franklin.)

Will keep you up-dated,

Jane and the gang xxx
________
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littleone1

01-07-2010, 08:58 PM

Hi Jane,

I'm glad to hear that Franklin did eat. Sometimes it is so hard to know what to do. I've given Corky Pedialyte before when his electrolytes were really out of whack, and it really helped him.

My thoughts and prayers are with you, hoping that everything goes well.

Franklin'sMum

01-07-2010, 10:00 PM

Thank you so much, Terri,

Franklin will be going to the doc at 3pm. Vet will be checking with specialist to see if there is any point performing a stim while not on meds, but he will be getting a check up to see if there is anything else going on that may be causing him to be really not interested in food (well, his food anyway).

Will let you know, and thanks again,

Jane and the gang xxx
________
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littleone1

01-07-2010, 10:27 PM

Hi Jane,

I'm glad that you also have a vet and specialist that communicate well with each other.

I know that once Corky's cortisol levels were under control, he wanted to eat what he wanted to eat. He got very finicky about his eating. Once he got what he wanted to eat, I didn't have any more problems with him eating.

I hope all goes well with Franklin's visit to the vet.

Franklin'sMum

01-08-2010, 05:34 AM

Hi Again,

The vet re-scheduled the app time to 4.30 to be sure she had plenty of time to catch up with the specialist. This afternoon before the app, I offered him some corned beef/silverside which he happliy ate and kept down, but he started to have a slight on and off trembling in his arms and chest as he was eating. I could feel him (he was draped across my lap) but the tremble wasn't visible. I felt his back end, no tremble, felt the back of his neck below his collar, no tremble.
Then I went outside, and Franklin pottered around then sat in the sun (35C) then he laid down :eek: I ran over and scooped him up and put him in the shade.

At the vets, Franklin wouldn't let her get a good feel of his abdomen, so the doc checked his anal glands (only a little bit of goo, she doesn't think was enough to cause inappetance) Temp was 39.1 (normal) specialist thinks maybe not enough cortisol reserve to help him get through the heat. Franklin is off trilo, and on cortate @ 1/2 mg per kg (so 3.5mg) daily until Tuesday, with a stim test on Wednesday. He hasn't been panting today until we went to get in the car. Doc couldnt hear his heart rate properly due to the panting, so she asked me to blow gently on his nose. WOW! He stopped panting, and she could hear! Talk about learn something new every day :)

She asked about pee and poop, last pee I got a good look at as we were about to leave was was clear, no yellow, I mentioned loose stool on last Friday. After we left the office and were in the carpark near shrubs, Franklin, being a very helpful little fellow ;) proceeded to poop the ickiest and brightest "chernobyl yellow" slimey poop I have ever seen :eek::eek:
And the most rancid smelling :eek: So, freshly bagged, we go back into the office....."You were asking about poop. I brought you a sample." :o:p. "It's foul smelling and yellow and slimey" so she takes the poop bag (bonus points- no hesitation) and has a good (and I mean good look. "Ooh, there's some mucous (sp?), kinda like a jelly. But it's still poop shaped, so not diarrhea. What's he been eating?" Chicken, and a bowl of dog food last night, and some snacks, nothing out of the ordinary. Doc said it could be colitis (she explained that as shedding of the lining of the colon) and to keep an eye on his poopage habits. ;) Thanks to you all, that already happens.:) Gave him 1/2 cortate (2.5mg) earlier, but hasn't wanted to eat his food.

Love to you all, and thank you for checking on us,

Jane and the gang xxx
________
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littleone1

01-08-2010, 05:52 AM

Hi Jane,

I hope Franklin starts eating better.

He was being very helpful so that the vet could see his poop. Is she doing a fecal stain on it and sending it to the lab?

Take care. I hope everything goes well.

AlisonandMia

01-08-2010, 06:21 AM

About the poop - this probably doesn't have any bearing on Franklin's problems - but for quite a while Zac has had soft, sometimes odd mucusy poops at times and it was getting more frequent and was happening just about daily. After a bit of trial and error I'm convinced it is an intolerance to chicken or, I suspect, chicken fat, even the tiniest amount. He tolerates normal amounts of other fats but the teeniest amount of chicken fat in any form (raw or cooked) and it is likely to upset him. Since removing chicken from his diet everything has been wonderful in the poop department and I think he feels better too.

I'm yet to try him on completely fat-free chicken like chicken breast but will sooner or later just so I know because it is so often what is recommended for GI upsets and it is possible that it might actually cause GI upset in Zac which wouldn't be what we'd want if he was already sick in some way. I do think I'll be using ultra-lean beef or kangaroo as the meat if he ever needs a temporary "GI-friendly" diet for any reason.

Alison

PS: He managed to eat all the marrow (very fatty and rich) out of a big beef thigh bone the other day - and it would have been none too fresh by the time he got into it either:eek::eek: - with absolutely no ill effects in fact until I saw the bone I had no idea that that he'd managed to gnaw his way that far through it! So it's not as if he's "delicate" as such - it just seems to be something about chicken that upsets him.

Franklin'sMum

01-08-2010, 06:32 AM

Hi Terri,

I hope Franklin starts eating better.

He was being very helpful so that the vet could see his poop. Is she doing a fecal stain on it and sending it to the lab?
Thank you so much Terri, that is so sweet of you. I think he's feeling a bit better. He was just tapping and poking at me to take him for a walk. So it was a very short walk, but he got the chance to check his pee-mail :p;).
She didn't mention doing a fecal stain or sending it to the lab. I didn't ask (don't know what a fecal stain is/does/will tell us.) Google, here I come :)
Thank you again, dear Terri, and please give Corky some extra big hugs and ear scratchies, and tell him all his aunties and uncles are so happy he's ok! :):)
Jane and the gang xxx
________
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Franklin'sMum

01-08-2010, 06:58 AM

Hi Alison,
That's very interesting about Zac's occasional GI upsets and chicken. Had you been feeding him chicken every day? Or was there kind of a lay-over effect?
Sometimes we just get a roast chicken from the supermarket and he really enjoys his bowl of shredded chicken. :) I haven't noticed soft poop as the aftermath of it tho, but what he's been eating over the last couple of days was chicken loaf, (the kind from the deli section, not pet food) which he usually doesn't have, so I won't be getting that for a while, just in case.
From the sound of it, it's very lucky that Zac doesn't have a sensitive stomach, :eek:, a big beefy bone that's seen better days :eek:. They do surprise us, don't they?
Thank you for your chicken theory, I'll keep it in mind. :)
Jane and the gang xxx
________
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AlisonandMia

01-08-2010, 07:09 AM

Yes, he was getting some every day. The effect seemed to build up and up.

I don't tolerate oats very well with the problem becoming more and more pronounced with every consecutive day that I eat them. Interestingly, when I was a baby, oats very definitely gave me classic atopic eczema. I've grown out of the eczema but these days they seem to trigger horrible gut-rot! I don't know if my past eczema and present GI upset re oats is related but I'm sure I could find a respected professional to say that it was - and another one to say it wasn't.:D:p I can tolerate the odd thing with oats in it but not day in day out as a staple food. I have a feeling that Zac is probably similar with chicken.

Alison

We used to live on a farm and I've witnessed dogs eating much, much worse things than that old beef bone - and surviving totally unscathed too.

Harley PoMMom

01-08-2010, 10:19 AM

Hi Jane,

Hi Lori,

Sorry to cause confusion, but I can't say for sure that I'll stop writing in such a jumbled up manner. :o:rolleyes: Thanks for catching that :). At the start of Franklin's treatment the vet said if I feel that he needs a cortate, that it is short acting and clears the system quickly. So Franklin could be stimmed (if needed) 12 hours after the cortate dose.

Thanks for clarifying that for me, Jane, it takes so little to confuse me sometimes. :eek::)

Will keep you up-dated,

Most definitely keep us updated. ;):)

Jane and the gang xxx

Hi Again,

Doc couldnt hear his heart rate properly due to the panting, so she asked me to blow gently on his nose. WOW! He stopped panting, and she could hear! Talk about learn something new every day :)

I didn't know about that trick either, thank you so much. Harley pants alot when they are trying to check his BP and I will have to try this trick next time.

She asked about pee and poop, last pee I got a good look at as we were about to leave was was clear, no yellow, I mentioned loose stool on last Friday.

Your doing a very good job on the "poop and pee patrol." :D

"You were asking about poop. I brought you a sample." :o:p. "It's foul smelling and yellow and slimey" so she takes the poop bag (bonus points- no hesitation) and has a good (and I mean good look. "Ooh, there's some mucous (sp?), kinda like a jelly. But it's still poop shaped, so not diarrhea. What's he been eating?" Chicken, and a bowl of dog food last night, and some snacks, nothing out of the ordinary. Doc said it could be colitis (she explained that as shedding of the lining of the colon) and to keep an eye on his poopage habits. ;)

She sounds like a winner, Jane, a Doc not afraid to handle poop and that is willing to explain things to you!

Love to you all, and thank you for checking on us,

Jane and the gang xxx

I am hoping soon Franklin will be feeling better and eating for you, FWIW...when I was thinking of having Harley's formulated diet revised and emailed Monica about it, Monica suggested that we could change the chicken to tilapia (white fish), tilapia is really liver friendly.

Keeping you and Franklin in my thoughts and prayers.

Love and hugs,
Lori

Franklin'sMum

01-08-2010, 10:56 AM

Hi Lori,
Thank you so much for your sweet words, and your thoughts and prayers. He did have tea eventually. Midnight. I need to get this kid a clock! :):rolleyes:
Yes, the doc today is really good. They all are, really. It's a one vet practice, but when the doc isn't available, he brings in others (Except at Christmas. not sure about public holidays, tho.) Cool trick, the blowing gently on the nose, hey?
What's happening with Harley and his chicken? Is he having a reaction like Alison's Zac? (If you don't mind me asking.)

I am hoping soon Franklin will be feeling better and eating for you, FWIW...when I was thinking of having Harley's formulated diet revised and emailed Monica about it, Monica suggested that we could change the chicken to tilapia (white fish), tilapia is really liver friendly.

Keeping you and Franklin in my thoughts and prayers.

Love and hugs,
Lori
Have you changed to the tilapia yet? How's Harley enjoying it?
One more question:o...Tilapia is really liver friendly, does that mean chicken isn't? Hoping you and Harley are figuring out the Lyso bribe (still potato bread?)
Big hugs
Jane and the gang xxx
________
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Harley PoMMom

01-08-2010, 11:12 AM

Hi Jane,

I noticed about a month ago that Harley wasn't eating his formulated diet :eek: I thought he was growing tired of the chicken, so I emailed Monica and she sent me another diet, but in the mean-time I looked in my journal to see what and if anything had changed and there it was...We had upped his BP meds from 1.25mg BID to 2.5mg BID...I called his vet and she confirmed that this can happen so we have now since dropped his BP meds to 2.5mg once a day and he is eating the chicken again (his original formulated diet.)

Monica said that the chicken is liver friendly but the tilapia is much, much more liver friendly. I did feed Harley the tilapia a couple of times and he loved it, so every now and then he gets a switch from the chicken to the tilapia.

We are still doing the potato bread Lyso bribe!!!

Love and hugs,
Lori

Franklin'sMum

01-10-2010, 03:08 AM

Hi Lori,

I'm glad Harley is back to eating well now that his bp dosage has been changed. :) The little muppets do like to keep us guessing (and pulling our hair out! :rolleyes:)
Yesterday Franklin ate (1.5 bowls of food, 2 lamb riblets, and a little bit of cooked lamb) so much so, that today he said "Food? Pass. But thanks anyway" so instead I gave him a half a haircut (he got restless and fidgety) and then a T-Bone. :o Not all of the meat tho, that will be ours for tea tonight after I cook it...in a heatwave.:(
So he's sleeping on his chiller mat in front of the air con with a chilli bandana thing around his neck ;).

After seeing Ellen's pics of Casey and Desi playing in the snow, I'm thinking we might make a day trip to the snow fields next winter :). Just need to make sure he's wearing a bright top so I can find him in case Franklin starts digging in the snow :eek:

Thinking of all of you, and sending healing thoughts and prayers for all of the people, pups and kitties,
Jane and the gang xxx
________
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mypuppy

01-12-2010, 09:31 PM

Hi there Jane, just peeking in to find out how little Franklin is doing lately. Glad he is eating his hearty meals...lol...I love to watch them eat their special meals because they do deserve every delicious bite. haaaaaa. BTW, you made me laugh so hard when you said you'd have to dig for him in the snow.....ROFL.....too cute. Not sure which season you are at in Australia, WOW! are you really in Australia? My oldest daughter is constantly speaking with an Australian accent after she made a project on Australia at school...too funny. Anyway, so happy to hear little sweet face is doing alright. Thanks for the good laugh, and keep in touch....Luv ya lots, tight ones, Jeanette
ps: Princess is still off trilo in the event you were wondering...xo

Franklin'sMum

01-13-2010, 11:22 AM

Hi Jeanette,

Franklin's doing well, thank you for asking. He went for a stim this morning, which the stand in vet kind of goofed. She took the blood in the wrong tube. Apparently it's supposed to have some kind of gel in the tube. :( So I figured while he's fasted, may as well get the blood profile run, still the electrolytes, and (I think) something else. Memory fails me now. :o Just to check mainly on his amylase, lipase and triglycerides (they were raised last time) so wanting to know if it was because he wasn't fasted, or if it was due to the flax seed oil I had been giving him. So they want to do another stim next week, and his regular vet will be back then.
Glad he is eating his hearty meals...lol...I love to watch them eat their special meals because they do deserve every delicious bite. Absolutely!!:):) And the specials... It's like "hey sweetie, you want a bone?" and he circle dances to his little mat.
BTW , you made me laugh so hard when you said you'd have to dig for him in the snow.....ROFL.....too cute. Can you imagine if he closed his eyes? I'd only have a nose to look for! :) White pooch, white snow...:)
Not sure which season you are at in Australia, WOW! are you really in Australia? We're undergoing summer at the moment. I read some other members writing about wintery 40F weather...We're suffering through 40C days :eek:
My oldest daughter is constantly speaking with an Australian accent after she made a project on Australia at school...too funny. That's so funny, Jeanette! :D:D Is it the Paul Hogan "throw another shrimp on the barbie mate" accent? Oh, that would be hilarious to hear her do! :D:D:D
ps: Princess is still off trilo in the event you were wondering...xo
Thank you :) Of course I wonder! I still read all the posts, even if I don't post a response :)

Thank you again, Jeanette, Big hugs and lots of love to you and Princess,

Jane and Franklin xx
________
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Harley PoMMom

01-13-2010, 10:22 PM

Hi Jane,

No stim...huh? Darn it...Oh well, it is very good that you are having his full labs (CBC/Chemistry) run again, tho. :)

Will be checking back for the results of the labs.

Give Franklin some belly rubs from Harley and me.

By the way, how is Bailey doing?

Love and hugs,
Lori

Franklin'sMum

01-13-2010, 10:51 PM

Hi Lori,

Thanks for checking on us :). I don't have all of Franklin's results as yet, will get on Monday. Stand in vet just rang with my main concerns, though.
Electrolytes - normal
cholesterol - high (compared to ref range)
liver enzymes -high (compared to ref range)
lipase - 72 (1-70)
amylase 545 (<2000)

She said that next time he has a period of inappetance, would be a good idea to bring him in and have his electrolytes checked, to see if they're out of whack, or maybe if it's heat related. She also said they had many pups brought in over the last week for inappetance, (when the weather was DAYS of 40C - 43C. (104-109 F):eek: At least a cool change has come, and it's soooooo much nicer at the moment. I suppose I can't complain too much as yet, last summer we had 2 straight weeks of daytime temps over 40C. Got to the point where the following week, there was a 38 C day, we're joking and saying "ooh, it's so cold. Time for the winter jumper...Brrr!"

Thank you Lori for asking about Bailey, also. He's doing well. Mum took him to the doc yesterday for a blood test and an x-ray, and they're sending off the x to Melb Uni. I'll go over to Bailey's thread and update there, too.

So glad that Harley's doing well :) Thank you again,

Jane and the gang xxx
________
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mypuppy

01-14-2010, 05:06 PM

Oh poor little guy, having to get stimmed so frequently...That really stinks! You are sooo funny! You crack me up about Franklin. Again, I can visualize a black little button nose right smack in the middle of the snow.....ROFL....hysterical.....and does he really circle dance around his mat when he knows a special treat is coming? even funnier.....Summer! how awesome. I miss Summer right now with the 10F temps....sooo cold even Princess doesn't want to be out there. Today we are actually having a heatwave, 30F, woooohooooo....haaaaa....and the Australian talk from my oldest girl is actually from my little one watching all those Wiggles cd's. Wags is there doggie, "oh me oh my he barks all day and night"....lol. You gotta love the Wiggles around here...haaaaaa.....Listen, hope little Franklin starts feeling better soon after I read his results were a little off, and give him a great big lick from yeah me, what the heck. Normally I'd say from Princess, but she doesn't know what's going on, and I do, so licks from auntie Jeanette....lol....Luv ya Jane, you're a doll...Regards to the Outback...xo Jeanette

Franklin's doing well, thank you for asking. He went for a stim this morning, which the stand in vet kind of goofed. She took the blood in the wrong tube. Apparently it's supposed to have some kind of gel in the tube. :( So I figured while he's fasted, may as well get the blood profile run, still the electrolytes, and (I think) something else. Memory fails me now. :o Just to check mainly on his amylase, lipase and triglycerides (they were raised last time) so wanting to know if it was because he wasn't fasted, or if it was due to the flax seed oil I had been giving him. So they want to do another stim next week, and his regular vet will be back then. Absolutely!!:):) And the specials... It's like "hey sweetie, you want a bone?" and he circle dances to his little mat. Can you imagine if he closed his eyes? I'd only have a nose to look for! :) White pooch, white snow...:) We're undergoing summer at the moment. I read some other members writing about wintery 40F weather...We're suffering through 40C days :eek: That's so funny, Jeanette! :D:D Is it the Paul Hogan "throw another shrimp on the barbie mate" accent? Oh, that would be hilarious to hear her do! :D:D:D
Thank you :) Of course I wonder! I still read all the posts, even if I don't post a response :)

Thank you again, Jeanette, Big hugs and lots of love to you and Princess,

Jane and Franklin xx[/QUOTE]

Franklin'sMum

01-15-2010, 07:52 AM

Hi Jeanette,

So happy Princess is doing really well :D. That's wonderful news, Jeanette. And yes, Franklin does a little circle dance to his mat for special treats like bones :). He sees me get it from the fridge and I ask him if he wants a bone, then he jumps up on the couch and I tell him he's not eating it there, on your mat, and off he circles :). What can I say, he's a gorgeous little goof :p.

The wiggles, huh? My oldest nephews and nieces missed that craze, and the youngest nieces and nephew I try and avoid :eek: !

Ok, I have just given Franklin a lick from you, his Aunty Jeanette, and I am sooo grateful that he doesn't shed ;) ha ha. Seriously.

Love to all,
Jane and the gang xxx
________
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Franklin'sMum

01-21-2010, 03:02 AM

Hi All,

Franklin's stim results are in from the 18 Jan...keep in mid he hasn't had a dose of trilo since 6 Jan
pre: 263 nmol/L (9.53 ug/dl)
post: 562 nmol (20.36 ug/dl)
But he's hot showing excessive drinking, eating, peeing, and he's not even panting as he should, (considering the heat here) so we're not starting back up just yet.

From his profile on the 13 Jan, these are the results out of range..
Anion gap 30 mmol (15-25)
ALT 85 U/L (<80)
Alk Phos 531 U/L (<120)
Albumin 45g/L (22-36)
Alb/Glob ratio 2.0 (0.5-1.8)
Lipase 72 U/L (1-70)
cholesterol 11.0 mmol (3.6-8.8)
Triglyceride 2.6 mmol/L (0.2-1.7)

Electrolytes ok. Cholestasis and hyperlipidaemia consistant with Cushings.......Pathologist.

Franklin is happy and perky and enjoying his walks when they are happening (most days). Still seeking cool surfaces to lay on. Just hasn't upped his water intake. Considering he went up to be checked out bc he was laying in the sun on a 35C day (90 ish F) and the doc he saw thought his cortisol might be too low to cope with the heat, I'll check with the specialist and vet about changing the dose to maybe something like 30/15 per day instead of 30/30. But we're not going to do anything until symptoms start again.

Big hugs and love to all,
Jane and the gang xxx
________
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BestBuddy

01-21-2010, 05:19 AM

Hi Jane,

Great news that Franklin is feeling so good. That cortisol number is climbing so it may not be long before you have to start again.

Forgive me but I can't remember Franklin's weight. You had such a dramatic drop in cortisol on 30/30 (and 30/15) that it may be worth considering even 15/15.

The idea is to lower the cortisol slowly and keep it at a good range for each dog which varies quite a bit.

Now, that's enough of the negative, it is possible you may have a much longer break. It's just going to be a matter ow watch and see.

Jenny

littleone1

01-21-2010, 06:00 AM

Hi Jane,

I'm glad to hear that Franklin is doing good. Enjoy the break from the Trilo treatment.

mypuppy

01-21-2010, 12:10 PM

Hi there Jane,
Wow! I'm no expert in interpreting these tests results, but if I remember any post cortisol over 9.1 is considered high. It is so interesting though again, because the little guy is not demonstrating any of the symptoms associated with the high levels, which is probably where I am with Princess right now. Still no symptoms whatsoever, and in fact, is so energetic lately. She has been playing outdoors soo much, and we are simply enjoying every second of it. Just love to watch her acting soo happy. Of course, we know all good things must come to and end, so as you, I am not restarting those dreaded meds until I see symptoms. It is a very nice break, so let's both enjoy it. Best regards, luv, licks to you and that little ham.....xo Jeanette

Harley PoMMom

01-21-2010, 10:03 PM

Hi Jane,

Here are Franklin's lab results from April and November, and now we have the current ones from January also to compare.

All in all, I believe everything looks pretty darn good, but I will let Debbie make that final call. I do see that the Lipase has come down substantially from 581 to 72!! YAAA!! Even the Triglyceride levels are down!! YAAA!!

Jane, you're such a wonderful mom and you're doing a excellent job taking care of Franklin.

Love and hugs,
Lori

Hi Everyone,

In a nut shell here's the differences:
21 Apr chem 27 Nov
740 Amylase 1110
41 ALT 78
9.3 Cholesterol 7.8
1.3 Phosphate 1.9
20 Anion Gap 26
5.6 Urea 12.1
513 Alk Phos 427
44 Albumin 45
2.88 Calcium 2.81
110 Lipase 581
1.3 Triglicerides 9.7

Jane and Franklin xx

Franklin'sMum

01-21-2010, 10:14 PM

Hi All :)

Hi Jenny,
Franklin normally weighs 7.7kg, but went down to 7.3 late last year. This past Wednesday he was back up to 7.7kg :). (He's not fat. Even the vet says he's a brick with legs :D). Spoke to the vet this morning, and he said that with those numbers we can start back on the trilo. I said we'd wait for symptoms re-appear. He said that Franklin didn't really have strong symptoms to begin with. I'm remembering last summer when Franklin had 5 water bowls, I'd change the water at the beginning of the day, and then refill them later in the day. (Didn't measure intake back then :o) but if the bowls are less than half full, it ain't all evaporation :rolleyes:
(We're now using 2 HUGE bowls, 1 regular bowl and a doggy drinking fountain---probably not all necessary, but I'm paranoid :o) At this stage, he's pretty much only panting on walks and for a few minutes after, and when I get home from work. Plus after we've played footsies. (Me grabbing at his feet, and tickling his back, and him pouncing around and gobbling my hands while happy growling :). Very rarely leaves a tooth dent :p). Anyways, sorry, easily distracted :o. At the moment he's averaging about 350-450 ml per day :eek: not much at all!!
On Monday, he was very gobbly with MY food. Getting his nose very close to my plate, and trying to gobble MY food as I was putting it into my mouth :eek::rolleyes: Hasn't done it since though.

Vet said we could go back to 30/30mg. I said, about that..... Can we go a little lower? 30/15mg or even real low and slow...say 15/15? (Thanks for that Jenny :)) and he said ok. YAY!!! Explained that I would totally not be able to function with the thought of his going out side to pee, and Franklin not realising it's hot, and to come back in to the A/C. :(

Hi Terri,
Happy thoughts :D. Will definitely enjoy the break. (Though he's not getting a break from tablets in general. Milk thistle, and today the worming tablet in a little raw mince. I don't think he even chewed. :p:D

Hi Jeanette,
Yep, no symptoms :). Am so happy to hear Princess is playing and so energetic lately. :D Enjoy every moment of it (as I know you are). Oh, you guys are so lucky to be in the winter season at the moment (aside from black outs, icy roads, slushy puddles, the wind chill factor and falling on your tushies :p).

Oh, poop report-- First poop this morning, very firm, poop shaped and a little blood in it :eek: and constipated . Second poop (about 3 mins after the first) teeny little ball, much straining, a little blood and a teensy bit of white/pale green mucous :eek::eek:. Figured out the blood, I gave Franklin a bone yesterday for lunch :o His crap scared the crap outta me to begin with :(:o. Gave him some Metamucil with his brekkie, vet said yep, that'll work.

Thank you all for checking on us, and for your ideas and kind thoughts,
Love, hugs and belly rubs to all,
Jane and Franklin xx
________
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Franklin'sMum

01-21-2010, 10:31 PM

All in all, I believe everything looks pretty darn good, but I will let Debbie make that final call. I do see that the Lipase has come down substantially from 581 to 72!! YAAA!! Even the Triglyceride levels are down!! YAAA!!

Jane, you're such a wonderful mom and you're doing a excellent job taking care of Franklin.

Love and hugs,
Lori

Hi Lori,
Thanks for putting the previous results on this page to compare the latest results to, much appreciated :). Franklin's numbers do look pretty darn good to me too:). I think that the lowered lipase and triglycerides are due to this test being a fasting test. YAY!! And also no more "Flax seed oil" :o. Will go back to using omega 3-6-9- capsules instead of the flax seed oil liquid.
Thank you Lori for your kind words, I hope you know how big a role you have played in educating me in order for me to take such good care of Franklin. You and everybody else on this forum have my love and eternal gratitude. (HUGE heart icon)

Hugs to you and yours, Love ya,
Jane and Franklin xx
________
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littleone1

01-22-2010, 12:22 AM

It's me again:)

I'm so glad that Franklin's numbers have improved.

I wish you and Franklin the very, very best.

Franklin'sMum

01-22-2010, 01:44 AM

Hi again, Terri,

Thank you so much for your very kind wishes. We wouldn't be where we are without you all :D.

Big Hugs,

Jane and Franklin xx
________
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mypuppy

01-27-2010, 11:11 AM

Hi Jane,
Think of you and the little guy often and was wondering how he is doing these days. BTW, I'll trade the cold weather right now for some nice 60 - 70 temps....We have had some very cold days, and have been getting a little break in between in the 30's, 40's, and I think one day it even hit 50, but its going to be dropping very low in the next few days I hear.....Yikes.....Take care and sending you our love. xo Jeanette

Franklin'sMum

01-28-2010, 05:47 AM

Hi Jeanette,

That's so sweet that you were thinking of us. Franklin is doing well, and yesterday he drank more than he has for the last few weeks. :D (But still not what I would consider adequate, considering the heat.)
I'll quite happily swap the 50 degree days, but you can keep the 20's, 30's and 40's :).

Here's a question for you all...
I've been thinking that bc Franklin has been having difficulty with the trilo (goes really well for a while, and then something comes along and needs/gets a break) could his intermediate hormones be playing a role in any of this? Phoned around, and have found that we can get all 5 hormones tested (between 2 or 3 separate labs). :rolleyes: So, assuming that if/when we get them tested, if the results come back elevated, would there be any use in continuing the trilo?
As in, would using melatonin and lignans be a losing battle against the trilo, if trilo remains his treatment drug?
If so, would melatonin and lignans and if we changed to lyso lower the hormones too much to the point of another problem?
Oh, hang on. because lyso lowers most of the hormones, you wouldn't/don't use the lignans and melatonin, huh? :o

Franklin's doc has agreed to lower the dose to 15/15 per day, but we haven't started back on it yet. Figured while he's on a break, we'll find out about these hormones. It has now been 22 days since last trilo dose.

Any help or ideas you can provide will as always be greatly appreciated.

Jane and Franklin xx
________
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Franklin'sMum

01-28-2010, 05:52 AM

If so, would melatonin and lignans and if we changed to lyso lower the hormones too much to the point of another problem?
Oh, hang on. because lyso lowers most of the hormones, you wouldn't/don't use the lignans and melatonin, huh? :o
Jane and Franklin xx

Lori, hi.
Knew I forgot something. Harley's on both Melatonin & lignans and a maintenance dose of Lyso. How does that work? Is there any chance that his intermediates will get too low?

Thanks heaps for any info you can provide,
Jane and Franklin xx
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Harley PoMMom

01-28-2010, 08:49 AM

Hi Jane,

Lysodren is very effective in lowering cortisol, progesterone, androstenedione and 17-hydroxyprogesterone levels but not estradiol. That is where the melatonin and lignans come into play...they help help lower that estradiol.

The dosage of melatonin and lignans given to your pup is based on your pups weight and this type of treatment (just the melatonin & lignans) usually takes months to show improvement but it does work. Harley was on this type of treatment plan for 7 months and his estradiol came down alot...from 132.2 to 96.3. Harley still takes the melatonin and lignans.

Harley's first UTK panel done in April, showed only his estradiol was very elevated, so his treatment plan was melatonin and lignans only.

When his last UTK panel, done in Dec. showed his cortisol and ALL his other intermediate/sex hormones were elevated that was when we decided that Lysodren was needed in his treatment plan too. Now, concerning his very elevated Aldosterone, Dr Oliver told Harley's GP that as long as Harley's electrolyte level numbers on his chemistry panel come back fine then not to worry.

One needs to monitor their pup, especially if their pup is only Atypical and is on Lysodren. I believe Dr Oliver suggests for our Conventional Cushings pups with elevations in one or more of the intermediates that you have the UTK panel done every 6 months.

Hope this helps and if not, please ask more questions, ok. :)

Love and hugs,
Lori

labblab

01-28-2010, 09:15 AM

Here's a question for you all...
I've been thinking that bc Franklin has been having difficulty with the trilo (goes really well for a while, and then something comes along and needs/gets a break) could his intermediate hormones be playing a role in any of this?

Franklin's doc has agreed to lower the dose to 15/15 per day, but we haven't started back on it yet. Figured while he's on a break, we'll find out about these hormones. It has now been 22 days since last trilo dose.

Any help or ideas you can provide will as always be greatly appreciated.

Jane and Franklin xx
Hi Jane,

Whenever things are not going "right," I think that MORE information is always better than LESS. So if the intermediate hormonal testing can be performed and you are interested in the results, it seems as though this would be a great time to see what Franklin's naturally-occuring profile looks like -- after a trilostane break.

However, having said that, I'd be more inclined to blame elevated intermediates if you were experiencing the reverse problem -- if Franklin's symptoms were rebounding or increasing even while actively taking trilostane (and while his cortisol level was in an appropriate therapeutic range). Instead, it sounds as if you are experiencing problems with him periodically acting as though he is over-medicated with the trilostane. To me, that does not sound so much like an intermediate hormonal issue.

I can't remember whether or not you have always been dosing him twice daily with the trilostane, and whether there is a particular reason for doing so? I am thinking that if and when you resume the trilostane, one option might be to try him on a once-daily schedule. Dr. Bruyette has warned us that dogs on twice-daily regimens seem to be at greater risk for oversuppression of adrenal function. So I am just wondering whether Franklin might actually feel better with only a single dose a day and a bit more cortisol rise within each 24-hour time period. Just an idle thought...:rolleyes:

Marianne

Oh dear! I've now had time to review your thread and am reminded that you DID start out with once-daily dosing and still ran into problems -- hence the switch...:o So you can just disregard that whole part of my reply!

Franklin'sMum

01-28-2010, 10:45 AM

Hi Marianne,

Instead, it sounds as if you are experiencing problems with him periodically acting as though he is over-medicated with the trilostane. To me, that does not sound so much like an intermediate hormonal issue.

So I am just wondering whether Franklin might actually feel better with only a single dose a day and a bit more cortisol rise within each 24-hour time period. Just an idle thought...:rolleyes:

Marianne

Oh dear! I've now had time to review your thread and am reminded that you DID start out with once-daily dosing and still ran into problems -- hence the switch...:o So you can just disregard that whole part of my reply!

Thank you so much for sharing your thoughts on this Marianne. I understand what you're saying about the intermediates probably not being at play here, but at this stage I'm pretty much grasping at straws to try and figure out what's going on with the boy. :p :(

The results of the UC:CR were :
urine free cortisol 163 nmol
urine creatinine 5.8 nmol
ur/creat ratio 28.1 (<10.1 ref) so yes, his cortisol was rebounding too much for his specialist's liking.

Marianne, I disregard nothing :D! I listen to any and all idle thoughts, and think them through. And then ask more questions :o.
Thank you again,
Jane and Franklin xx
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Franklin'sMum

01-28-2010, 10:55 AM

Hi Lori,
Thank you so much for this information.
That is where the melatonin and lignans come into play...they help help lower that estradiol.

The dosage of melatonin and lignans given to your pup is based on your pups weight and this type of treatment (just the melatonin & lignans) usually takes months to show improvement but it does work. Harley was on this type of treatment plan for 7 months and his estradiol came down alot...from 132.2 to 96.3. Harley still takes the melatonin and lignans.
Ok, so if Franklin remains on trilo, and that elevates his estradiol, would the melatonin and lignans have any impact on reducing the estradiol? Or would it be a constant battle for which would over power the other- trilo or the lignans and melatonin?

Harley's first UTK panel done in April, showed only his estradiol was very elevated, so his treatment plan was melatonin and lignans only.

When his last UTK panel, done in Dec. showed his cortisol and ALL his other intermediate/sex hormones were elevated that was when we decided that Lysodren was needed in his treatment plan too. Now, concerning his very elevated Aldosterone, Dr Oliver told Harley's GP that as long as Harley's electrolyte level numbers on his chemistry panel come back fine then not to worry.

One needs to monitor their pup, especially if their pup is only Atypical and is on Lysodren. I believe Dr Oliver suggests for our Conventional Cushings pups with elevations in one or more of the intermediates that you have the UTK panel done every 6 months.

Hope this helps and if not, please ask more questions, ok. :)

Love and hugs,
Lori

It helps hugely, Lori, and we thank you from the bottoms of our hearts. :D Love and hugs to you and Harley, and hope that sweet child is doing great :)

Jane and Franklin xx
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Franklin'sMum

02-23-2010, 10:47 AM

Hi everyone,

Hope you and the furkids are all doing well. Just an update on Franklin, went and had the adrenal panel and stim done on Monday, and we don't have the results back as yet. That morning I noticed a small lump on his belly at the side, and also felt 2 round vertebre where all the rest I could feel were flat and square feeling. So after circling these with texta, off we go to the vet.

The round bits of spine were where the thoracic spine meets the something spine (didn't quite catch the word.) amd was told to keep an eye on the belly lump (smaller than a smartie/m&m).
Later that night I had another check and it was gone. So I'm thinking it may have been an ant bite or something.

Will ask a urination question on my next break,

Big hugs to you all,
Jane and Franklin xx
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Franklin'sMum

02-23-2010, 12:31 PM

Hi again,

Yesterday morning when we were out for a walk Franklin peed (as he often does) and started walking again, but he dripped pee for the next 8-10 steps. From the look of the droplets on the footpath I thought it had started to rain, or someone had a garden sprinkler on. Then at the next shrub, same thing again, lift leg, pee, finish, walk on, more drips. I moved off to the side to get a better look, and it was definitely dripping from his... shall we say boy bit?!

This was probably 10 minutes into our walk. Rang the vet when he opened, asked if it could be a bladder infection, or Cushing's related. The vet said if it was an infection, he'd probably be uncomfortable urinating (didn't appear uncomfortable at all) and trying to pee more frequently (nope).
He also said he really couldn't say if it was bladder muscle loss due to the cushings. Franklin's not incontinent as such, this was the first time he's dripped urine since he was desexed at 7 months of age, and that only happened twice during his sleep.

Any and all thoughts and ideas are as always appreciated,
Jane and Franklin xx
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mypuppy

02-23-2010, 01:37 PM

Hi there Jane,
Sorry to hear about little Franklin's recent problem. I wish I knew what to make of it. All I have ever heard based on that particular symptom is that it could either be a UTI or incontinence due to age, however, I don't think with Franklin's age the latter would pertain to him. And honest to goodness I have also not learned that something like that could be associated with Cushings. Obviously, I know the more Cushings knowledgable people here on the forum will soon peek in to shed some light on this. I hope whatever it was, perhaps it was an isolated incident and just a fluke thing non related to Cushings or any other condition. For now I am sending you all my good thoughts so that history does not repeat itself for my little precious Franklin, and I'm sending you both my best regards and hugs. Luv, Jeanette

Squirt's Mom

02-23-2010, 01:43 PM

Hi Jane,

Did you happen to squat and sniff the pee? :eek::p Seriously, if an infection is brewing, the pee may well smell stronger and have a darker color. So squat-n-sniff, luv!

Hugs,
Leslie and the girls - always

Harley PoMMom

02-23-2010, 06:27 PM

Hi Jane,

When Franklin peed did you notice if his pee stream was, shall I say, as flowing as it usually is?

My other Pom. Bear had kidney stones one time, and his pee stream was like, well, he would pee alittle, then he would dribble, pee some more, then dribble.

I am hoping and praying that your vet figures out what is going on with our Franklin.

Please let us know as soon as you can.

Love and hugs,
Lori

Franklin'sMum

02-23-2010, 09:44 PM

Hi Jeanette,
Thank you so much for your good thoughts and hugs from across the pond. :D They worked for this mornings walk. We went the same way to end up at these 2 shrubs, and all the way there and the way back no dripping after a piddle (well, sometimes 1 drip when he put his leg down) but that's quite normal for him especially if Franklin needs a haircut. I'm still on pee guard and will let you know any further updates. Our best to you and Princess, and lots of love and hugs.

Hi Leslie,
Thank you for that very handy hint, I didn't squat and sniff yesterday, but I did today :eek: the puddle just smelled like urine, not really strong smelling and on the blade of grass before the pee rolled down it looked bright yellow, almost flourescent, but not dark, not orange and definitely not reddish. Today wasn't the first time I've studied and sniffed his pee :o and poop :eek: in the past.

I don't know if I've mentioned this previously, but Franklin hasn't completely outgrown the "puppy" excitement pee when certain people come around, (his nanny and poppy especially, keep in mind they also make squealy- high pitched noises to him, and one time when they greeted him normally and he didn't pee, Mum was a little disappointed and thought Franklin wasn't happy to see her.)
But when he dripped yesterday there was only him and me, and nothing really exciting was happening. Thank you so much for your info and hints, Leslie, and thank you for checking in on us.

Hi Lori,
Franklin's stream was pretty steady for the pees that I watched, don't get me wrong, he'll run out of pee for a tree, and 2 trees later has made some more and can pee again, and then towards the end of the walk is empty again and will lift his leg and pee 2 drops.

With Bear and his kidney stones, was the pee-dribble-pee-dribble happening during the one pee? Or did he pee and then dribble as he was wandering along?
Franklin's GP isn't all that familiar with the daily ins and outs of Cushing's like you all are (and like I'm trying to be) and I just remembere

remembered that he has a specialist. Duh! :o I'll get in touch and ask her if she has some ideas not already mentioned as to what this could be about. :o

Thank you for checking on my sweet child, and the kidney stone thought. How did Bear's stones get resolved, Lori? I so hope the beautiful babies are doing well my dear friend,
Big hugs,
Jane and Franklin xx
________
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littleone1

02-23-2010, 10:48 PM

Hi Jane,

I'm sorry that Franklin is having some issues with his peeing. Shortly before Corky was diagnosed with Cushings, he had been doing the same thing. It was shortly thereafter that Corky started having accidents in the house. Corky actually had 2 UTIs which were causing some of the problems he was having. They were the reason why he was dribbling after he peed.

I hope you will be able to get this issue resolved in the very near future.

Harley PoMMom

02-23-2010, 11:04 PM

Hi Jane,

Hi Lori,
With Bear and his kidney stones, was the pee-dribble-pee-dribble happening during the one pee?

Most definitely pee-dribble-pee-dribble happening during the one pee, I could tell something was wrong...took him to the vet right away...Bear had to have his stones surgically removed.

Jane, as you know there are the 5 adrenal hormones: Androstenedione is one of them and it is further converted to either testosterone or estrogen. Now with a pup being treated with Lysodren I could see that an incontinence problem, maybe, happening, because Lysodren has an lowering effect on the Androstenedione hormone. But with Trilostane, I don't know, it does effect the 5 adrenal hormones but according to Dr Oliver, Trilostane raises Androstenedione levels. Maybe ask your specialists about this??? This is probably a very long shot, but I thought I would throw it out there.

Love and hugs,
Lori

lulusmom

02-24-2010, 12:29 AM

Hi Jane,

Dogs with cushing's, especially those with uncontrolled cushing's are predisposed to oxalate bladder stones. Cortisol increases calcium excretion in urine and the extra calcium promotes formation of stones. Dogs with elevated blood calcium due to any other reason can lead to excess calcium in the urine as well.

My healthy Maltese, Buster, had oxalate stones two or three years ago which required surgery as diet cannot dissolve this type of stone. I remember that he used to dribble a bit and then dribble some more. He was also peeing blood by the time I figured out there was a problem. Almost 3/4 of dogs with oxalate stones are males and stones can get lodged in the urethra and block the flow of urine, which can be dangerous.

Lulu also had two oxalate stone surgeries within 11 months of each other just prior to being diagnosed with cushing's. Both her and Buster's urine was extremely acidic (highly concentrated) and the vet put them on Potassium Citrate as well as canned food because dogs rarely drink enough water after eating kibble to make up for the water they get in canned foods. We've not had a problem since they went off of kibble.

I hope that Franklin's weird peeing pattern is just a passing thing...so to speak but I wanted to share my experience so that you have information on various possibilities.

Glynda

Franklin'sMum

02-24-2010, 06:58 AM

Hi Terri, Lori, and Glynda,

Thank you all for your information and sharing your experiences. I think I'll start by finding out what Franklin's urine PH is.
Very good to know that excess calcium can cause oxalate bladder stones, because when I give him raw, I add a little calcium so as to keep the phosphorus/calcium ratio.
Franklin mainly eats canned, with a small amount of kibble. I also add some water to the canned if it is a warm day, or if I don't feel he's drinking enough.

At the moment, he is not on treatment (since 6 Jan) when he didn't want brekkie that morning, then the next day he decided a 36C schorcher was the perfect time to lay in the sun :eek:.

I will be getting a nutritionist on board as soon as possible, as I obviously need all the advice I can get :o
I emailed the specialist before going to bed, and haven't heard back yet, but will let you know what she says as soon as I find out.

Thank you again, and hugs to all,
Jane and Franklin xx
________
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Franklin'sMum

03-04-2010, 08:44 AM

Hi Everyone,

Franklin's specialist doubts that the dripping has anything to do with the supplements that he is on. She also said that while he is not on treatment for cushings, she can't rule it out as a cause, that incontinence can come in many forms.
She suggested a urinalysis, because cush pups sometimes do not show classic signs of bladder inflammation even if they have cystitis. If it continues after he re-starts treatment, then maybe he does have another problem, like weakness of his urethral sphincter, but she would say that this is much less likely.

I have the results of the stim done on Feb 22.
Pre 249 nmol /9.02 ugdl
Post 529 nmol/ 19.17 ugdl
These are slightly lower than the stim results from 18 Jan, which were pre 263 nmol/9.53 ugdl post 562nmol/ 20.36ugdl.
Both of these stims were when Franklin was taking a break from the trilo.
I asked if it would be safe to start the trilo again, considering the cortisol is coming down mysteriously, and he said that Franklin is still so far above normal ranges, that we should restart. Our GP vet doesn't think the slight lowering means much, and has advised us to restart treatment again, which we did, on Mon 1 Mar at 15mg x twice a day.
Franklin dripped pee on the Sun 28 Feb, and I took a urine sample to the doc on the Monday.
Here are the results of the 'Urine microscopy chemistry'
ph--6.5
Leucocytes--100 x 106/L (<10)
protein-- +++
Erythrocytes--30 x 106/L (<10)
Glucose--Neg
Epithelial cells-- +
Blood--Trace
Ketones-- Neg
Specific gravity-- 1.030
Bacteria--None seen
Casts--none seen
Crystals--no crystals seen

I asked GP how serious the blood and protein in the urine is, and if we should be doing something about them. (adding extra protein in the diet, or something.)
His response was that there can quite often be a little bit of blood and protein in the urine which is not necessarily a problem. What he wants to check with the specialist about is the increased numbers of white cells but no bacteria seen. He said that this would seem to indicate some inflammation but not an infection, and that sometimes dietary modification can fix this, but that extra protein would not be the answer.

We are still waiting (impatiently) for the hormone panel results. Aargh!!!

Does anyone have any thoughts on things so far?

Oh, before I forget, Franklin has been taking Vetalogica canine tranquil formula (helps maintain emotional balance in dogs) x2 per day (3 if thunderstorms are predicted).
(Contains: wheat, poultry meal, tryptophan, chicken flavour, Omega fatty acids, vit e, calcium, b5, b2, b3, b1, b6, vit k, folic acid, b12, biotin, vit a, vit d, taurine, zinc, iron, manganese, copper, iodine, selenium, antioxidants.) He's currently not taking any other selenium supplements.
The enquiry hotline person said it has no known interactions with traditional veterinary meds, and that the tryptophan helps the body regulate the vitamin b's, which in turn help the emotional balance. Usually by the time you finish the bottle (120 tabs) that the pup is calmer during the things that freak them out (fireworks, thunderstorms, strangers, separation anxiety), but occasionally a second bottle is needed. Is it possible that this is the cause of the cortisol coming down a little bit?
http://www.vetalogica.com.au

Thank you all in advance for any ideas concerning any of the above.

Big hugs,
Jane, Franklin and Bailey xxx
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Harley PoMMom

03-04-2010, 07:03 PM

Hi Jane,

This maybe a long shot :rolleyes: but lets talk about the tryptophan in the Vetalogica canine tranquil formula.

The precursor to melatonin is serotonin, a neurotransmitter that itself is derived from the amino acid tryptophan.
http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/otherendo/pineal.html

Now, we give our cush-pups Melatonin, and Melatonin can lower cortisol.

Melatonin. Results of in vitro cell culture (human H295R adrenocortical carcinoma cells) studies in our lab55 revealed that both 21-hydroxylase and aromatase enzymes were inhibited by melatonin. Also, in dogs with adrenal disease that are treated with melatonin, and repeat adrenal steroid panels are done, cortisol levels are consistently reduced, and estradiol levels are variably reduced.

http://74.125.93.132/search?q=cache:LPNTckWI-QMJ:www.vet.utk.edu/diagnostic/endocrinology/pdf/Steroids%2520Profiles%2520in%2520the%2520Diagnosis %2520of%2520.doc+can+melatonin+lower+cortisol+in+a +dog&cd=3&hl=en&ct=clnk&gl=us

So, my thinking is if Franklin is on the Vetalogica canine tranquil formula long enough, then yes, his cortisol will be lowered alittle.

Re; the protein loss, Harley's protein loss is due to his high blood pressure. When his blood pressure is under control he has the minimal loss 0.6 (</=0.5).

Hope this helps and waiting with you for the hormone panel results!

Love and big hugs,
Lori

littleone1

03-05-2010, 02:44 AM

Hi Jane,

I really hope you are able to find a solution to Franklin's problem. Corky and I are here with you.

mypuppy

03-05-2010, 01:07 PM

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

Franklin'sMum

03-06-2010, 10:04 AM

Hi Lori,
Thank you, thank you, thank you!!! You are truly a voice of reason, (and clarity...and sanity), and you dumb things down so nicely for me. Tryptophan> seratonin> melatonin= lowered cortisol. (See, I'm getting there. Slowly but surely).

As for the blood pressure issue, our doc doesn't have a bp monitor, neither does the other vet in town, and I've phoned a number of vets within an hour radius drive, and the best they have got is something that sounds like oxometer. Marcela (Truffa's Mom) said that she uses a human bp wrist monitor to check Truffa's bp, so I found one on ebay, but even at 11cm diameter, it seems to be a little too big for the little guy.

Do you know if there is some kind of blood test that would give some kind of indication of bp being a problem? Also, Franklin's protein loss was listed at +++,
so I don't know how or if that translates to a number.

Thank you again, dear friend
Eternally grateful
Jane, Franklin and Bailey xxx
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Franklin'sMum

03-06-2010, 10:25 AM

Hi Terri,
Thank you very much for you and Corky being here with us, much appreciated. Franklin is his normal happy self, and when he has dripped urine, he isn't bothered by it, and doesn't even seem to notice it. Hopefully we'll find out what's happening very soon.
Hugs to you and the Corkster

Hi Jeanette,
You're welcome for us asking about you, I'm so happy that you're both doing really well. Princess still enjoying the snow? Or is 3 feet beyond a joke?
Aside from the occasional pee dripping, Franklin is doing pretty well. Didn't want his food for most of today, but was happy to get a bone to chew on, and some treats. Followed by some lamb rib meat, so then he had his tea. Franklin started back on the trilo on 1 March, at 15mg twice a day, because our specialist says that incontinence can come in many forms, and that it may be cush related.
On the up-side, Franklin doesn't have urine crystals, casts or bacteria, so that's definitely a plus. Franklin said thank you very much for his belly rubs.
Big hugs to you
Jane, Franklin and Bailey xxx
________
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Harley PoMMom

03-07-2010, 10:45 AM

Hi Lori,
Do you know if there is some kind of blood test that would give some kind of indication of bp being a problem? Also, Franklin's protein loss was listed at +++,
so I don't know how or if that translates to a number.

Thank you again, dear friend
Eternally grateful
Jane, Franklin and Bailey xxx

Hi Jane,

I really don't know of any other way to diagnose high blood pressure in a pup other than using the most common way...“Doppler probe”. But there are signs to look for; One of the first signs of canine hypertension can be blood leaking into the eyes. As the pressure in blood vessels increase, one of the first places it usually escapes in is the ocular region. Other symptoms include lack of energy, difficulty breathing and lack of coordination. Now with Harley, his nose becomes very dry and crusty when his blood pressure is high.

Here is a link to an article about Hypertension from our Resource Thread:

High Blood Pressure (systemic hypertension) in our pets
http://www.k9cushings.com/forum/showthread.php?t=200&highlight=hypertension

Hope this helps.

Love and hugs,
Lori

Franklin'sMum

03-08-2010, 03:32 AM

Hi Lori,

Thanks for that link, the "marvistavet" site said that high blood pressure can well, not quite show up on, but be hinted at with kidney value results, and that kidney disease progresses far more rapidly in the presence of high bp. Speaking of high blood pressure, how's sweet little Harley doing? Bp under control, maintainance still no probs (with peptic ac)? I really hope that he's well (and you too, of course).

So, I'll phone every vet in the phone book looking for one that can check bp, just to be on the safe side.

With love and many thanks,

Jane, Franklin and Bailey xxx
________
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Franklin'sMum

03-10-2010, 08:31 AM

Hi All,

A couple of things to tell... Franklin had another "dizzy spell" episode last night (circling, semi sitting, circling again, walking backwards and waving his head from side to side.) Can't say that he's done the head side to side thing before. I rang the emergency vet, and she said it sounds kind of like a seizure, but not in the usual sense. We spoke about doing an MRI or CT scan to find out if there is anything else going on, and she recommended seeing GP vet today.
So Franklin weighed in at 7.7kg, vet listened to his heart (all good :)), checked his leg joints and movement, looked in his eyes, and also checked out his teeth (1/2-1 out of 10 for plaque/tartar- I've started brushing Franklin's teeth ;)). I haven't been giving him trilo for a few days now, as he decided he didn't want his food, but mine was ok, and so were treats and meaty bones :rolleyes:.

So GP will be speaking with specialist to ask about CT scan or MRI imaging. He also said that "they" (the they that no-one ever knows who they are) have come to the conclusion that epilepsy will usually appear before the pup is around 2 years old. GP said today that the specialist isn't worried about the urine dripping at the moment, and to see how he goes while on treatment.

Franklin is his usual happy, perky self, and is eating well. :)

Also, I FINALLY have the results for the hormone testing. For some reason, the lab only did the pre measurements :mad:, but they willl be doing a post on the 17 OH progesterone. Why they can't do the others, I have no idea :(. I wasn't given normal ranges, so please bear with me.
PRE
Vet aldosterone--59 pmol/L
androstenedione--<1.1 nmol/L
17 OH progesterone--2.3 nmol/L
serum progesterone--3.0 nmol/L
sensitive estradiol--<20.0 pmol/L

I came across a conversion website http://wwww.unitconversion.org and it said to divide the picomols by 1000 to get the nanomols, eg. 59 pmol / 1000 = 0.059 nmol, but when I try to convert nmol to ugdl by diving nmol by 27.59 (0.059 / 27.59 ) I get 0.002138455962 as the ugdl measurement, and it just looks very odd to me. (But we've found math isn't my strong point :o:rolleyes::o). I plan on emailing Dr Oliver, but can anyone help me in the meantime, please?

Thank you all so much, lots of love and puppy kisses,
Jane and Franklin xx
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Harley PoMMom

03-10-2010, 07:18 PM

Hi Jane,

I sure hope Franklin doesn't have anymore of those "dizzy" spells. :eek::( Poor fella, give him some extra loving from his Auntie Lori and Harley, ok.

With your conversions, you see, all hormones and drugs have their own "conversion factor" number that has to be used. Each hormone has its own number that is needed to convert...:eek: What I have done, I hope ;):eek: is convert your numbers so we can compare them to the UTK adrenal panels PRE numbers...like I said I hope.

Vet aldosterone--59 pmol/L = 2.124 pg/ml (11-139.9)
androstenedione--<1.1 nmol/L = 31.518 ng/ml (.05-.36)
17 OH progesterone--2.3 nmol/L = .759 ng/ml (.08-.22)
serum progesterone--3.0 nmol/L = .943 ng/ml (.03-.17)
sensitive estradiol--<20.0 pmol/L = 5.44 pg/ml (23.1-65.1)

Here is where I got my conversions:

http://www.sydpath.stvincents.com.au/other/Conversions/ConversionMasterF3.htm
http://www.globalrph.com/conv_si.htm

The 17 OH progesterone was a bugger to find, and I am not confident about that one, I found that one in a google search.

http://www.google.com/search?q=what+is+the+conversion+for+17+OH+progeste rone+nmol%2FL+to+ng%2Fml&rlz=1I7GGLL_en&ie=UTF-8&oe=UTF-8&sourceid=ie7

17OH progesterone: nmol/l x 0.3300 = ng/ml;

If my numbers are correct, and that could be a big if :eek: I have never seen a pup being treated with Trilo and having an estradiol level so low.

I hope this helps.

Love and hugs,
Lori

AlisonandMia

03-10-2010, 07:18 PM

I think a CT or an MRI is a very good idea. The episode you describe could be almost anything - if only they could talk! It almost sounds like he might even have had a buzzing in his ears or head or something. A CT or MRI will show everything in his head (including ears) and maybe the scan should take in the neck area as well?

I'll have a go at those numbers if I get the chance later today (have to go out this morning) - unless someone beats me to it. Which they are more than welcome to do as numbers are not my thing!;):p

Alison

PS: Can you distract him or gets his attention during these episodes? And what is he like immediately after?

AlisonandMia

03-10-2010, 07:21 PM

I see Lori has beaten me to it!

Maybe "sensitive estradiol" means something different - ie measured differently from how UTK does it. Are you sure about the conversion, Lori?

Alison

AlisonandMia

03-10-2010, 07:24 PM

This conversion business looks like it can be really, really complicated: http://forum.onlineconversion.com/showthread.php?t=10832
:eek::eek::eek:

Maybe that forum above could help.....

Alison

Harley PoMMom

03-10-2010, 07:38 PM

Maybe human estradiol is measured and converted differently, I checked Franklins estradiol calculation 4 times with 2 other web sites and came up with the same answer. :eek: Like I said, I could be wrong. Did you check out the web sites I posted?

AlisonandMia

03-10-2010, 07:45 PM

Yes - but they confused me!:o:o:o

I only looked very briefly though - hopefully I can have a better look later. I might not be the best person to do this though - I am really horrible with numbers. I might see if my daughter will help me out...although she's very busy at the moment with school work. She runs rings round me on quite a few subjects!

Alison

Franklin'sMum

03-11-2010, 10:02 PM

Poor fella, give him some extra loving from his Auntie Lori and Harley, ok.

Each hormone has its own number that is needed to convert... What I have done, I hope ;):eek: is convert your numbers so we can compare them to the UTK adrenal panels PRE numbers..

I have never seen a pup being treated with Trilo and having an estradiol level so low.
Lori
Hi Lori,

Thank you so much for your conversions, and typing your fingers to the bone for us. I didn't know about the different conversions for different hormones, so thank you again :).
With the estradiol level so low, the testing was done after more than a month off trilo. On someone elses thread (Bubbagump's, I think) there was also mention of aldosterone being checked with electrolytes at stim tests. By your conversion, Franklin's aldosterone is quite low also.

Franklin thanks you and Harley for his extra lovin', also. Will write more when I get home. Thank you so much Lori,

With Love,
Jane and Franklin xx
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Franklin'sMum

03-11-2010, 10:24 PM

I think a CT or an MRI is a very good idea. The episode you describe could be almost anything - It almost sounds like he might even have had a buzzing in his ears or head or something. A CT or MRI will show everything in his head (including ears) and maybe the scan should take in the neck area as well?

PS: Can you distract him or gets his attention during these episodes? And what is he like immediately after?
Hi Alison,
In your experience, would there be a preference of CT/MRI? Is one more accurate or detailed than the other?

Also, he looks at me during the episodes (not every second of them, but he knows I'm there and can see me I think clearly). He turns to me when I speak to him, but doesn't stop the circling etc.
Immediately after, he pants for a while (around 10 minutes , then falls asleep.) I've never thought to check the colour of his gums before, I'll write some sticky notes and hopefully see one if it happens again.

Thank you again,
Jane and Franklin xx
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AlisonandMia

03-12-2010, 01:38 AM

I think the CT -v- MRI thing is as follows:

CT is usually cheaper (often $600-ish -v- a couple of thousand) although that could be "subject to change" as they say, as MRI's are possibly getting cheaper as the initial costs of the machines is being recovered. I was told that the cost of a CT can vary depending on how many "plates" they need to take before they find something - don't know if this applies to MRI too (possibly not).

CT is often more available - Mia had a CT at a university vet clinic and I don't think they had an MRI machine - it certainly wasn't mentioned. I'm sure we could have accessed an MRI somewhere in a 50-mile radius if necessary but MRI's don't seem to be quite as available for animals in Australia as are CT's.

MRI does show more subtle things apparently and is probably best especially if you don't really know what you are looking for or where in the brain/head it is likely to be. It seems that that would be the case with Franklin's symptoms. Mia's neurological symptoms more or less told them where in her head they were looking and that they were looking for something that would likely be big and obvious.

I believe (and I could be wrong here) that MRI's take longer and that there can be problems with monitoring of anesthesia in a MRI machine that there isn't with a CT. Don't take my word on this though - your vet (probably after consulting with veterinary radiologists) would be able to tell you more about this issue.

In your situation I'd probably go for the MRI if I had the choice and if I could afford it.

Alison

Franklin'sMum

03-14-2010, 07:52 AM

Hi Lori and Alison,

Lori, there was nothing wrong with your estradiol conversion, Dr Oliver also says it's very low. I'm confused by the aldosterone measure you got versus what Dr Oliver got, Here is my email to him and his responses start with >>>
Hi Jane,

May I ask for your help in interpreting my little boy's adrenal hormone results, please?
Background info: Franklin is a 5 year old Maltese, castrated at 7 months of age. In Febuary 09 he had an episode of loss of co-ordination and staggering. His vet did a physical exam, and could find no reason for his behaviour.
Another episode occured in April 09, and a chemistry panel and blood profile were performed.
It showed high alk phos and cholesterol. From there it was recommended we do an ACTH stim test, and the result was positive enough for the lab technician to definitively diagnose Cushing's. We started treatment in July 09 (60mg Trilostane) based on that one stim test.
We have since had 2 abdominal ultrasounds (bilaterally enlarged adrenal glands, distended bladder, vacuolar hepatopathy, hepatomegaly,) and an ACTH assay (positive for PDH.)

Any time Franklin doesn't seem "right" I take him off of the Trilostane. The adrenal hormones were done along with an ACTH stim test in Febuary 10, as he had been off of treatment since 6 January (he was laying in the sun on a 36C day, and didn't seem to realise it was hot.)
I don't have the results of the stim in front of me, but it was something like pre 240 nmol/L post 540 nmol/L. For some reason the lab only measured hormones of the pre sample, and not the post. I am told that they will test the 17 OH progesterone post stim sample, but I haven't received results as yet.

I know you're an extremely busy Dr, but if you have a few minutes, would you take a look at Franklin's results and let me know what you think, please?

Vet Aldosterone- 59pmol
Androstenedione- <1.1 nmol
17 Hydroxy prog- 2.3 nmol
Serum Progesterone- 3.0 nmol
sensitive estradiol- <20.0 pmol

>>>These values don't seem elevated. Aldosterone and androstenedione would be normal; the progesterone and 17-OHP could be slightly elevated, but the estradiol is low. Estradiol is an assay that will vary between laboratories. We never see an estradiol level this low, so I'm not sure about the assay.

I am unsure of the conversion to US measurements, and no normal reference ranges were given. The lab who performed the testing is Vetnostics.
>>>If you divide the above values by 3, you will get a close approximation of values in pg/ml (aldosterone and estradiol), and ng/ml (for the others). It does help to have the post-ACTH stim values, as these are the most meaningful.

Franklin also had an episode in October 09 and one again this week. Please let me know if you need further information on my sweet child, as I can provide his entire medical history.
>>>No. You need to continue working with your veterinarian on this. If he wants to send us samples for assay, he cn do so. We receive samples from around the world (including places like Hong Kong and South Korea). Our testing information is available at www.vet.utk.edu/diagnostic/endocrinology.
>>>I hope this is useful. Regards, Jack.

Good Golly! I see why you are all adoring fans of the man ;) add me to his fan club :)

Alison, Franklin had another dizzy spell this afternoon (he didn't want his food or mine, so hadn't eaten since last night) so out of his now 5 episodes, at least 4 of them were when he hadn't eaten for a while (10+ hours) so I'm thinking maybe hypoglycemia could account for these. http://petdoc.com/story/hypoglycemia-dogs The article says In adult dogs , hypoglycemia may occur from hormone imbalances, as a result of severe addison's disease, liver disease, pancreatic tumors, sepsis, or a pregnancy complication and that symptoms include but are not limited to lethargy, weakness, head tilting, restlessness, trembling, disorientation, slow breathing, convulsions or seizures.
A blood test to check blood sugar levels can be done, so I'll see if the vet can do it tomorrow.
I still plan on getting an MRI if possible, or CT scan, just to make sure we're not missing anything. I've emailed Dr Charles Kuntz of Southpaws http://www.southpaws.com.au for more info, but haven't heard back yet.
Love and belly rubs to all,
Jane and Franklin xx
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Harley PoMMom

03-14-2010, 11:42 AM

Franklin'sMum

03-14-2010, 01:04 PM

Hi Lori,

Oh, Dr O is incredible. I sent another email to him a little while ago asking if he would recommend melatonin and lignans, or do another hormone panel (this time with the lab doing pre AND post stim measures, or I will officially throw a fit) :mad:

Sweetie, don't be sorry about confusing me, its not like I give you much of a challenge with that ;) :p;)

When Franklin first started with the episodes, I researched maltese stuff on the net, and most things said that they grow out of the risk of hypoglycemia as they get older, so it only just became a thought again, what with the liver issue being a factor.
Hmmm, 5 1/2 hours til the vet opens.....
Lots of love, and thank you for your thoughts and prayers,
Jane and Franklin (and Bailey) xxx
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Harley PoMMom

03-14-2010, 02:16 PM

Hi Lori and Alison,

Lori, there was nothing wrong with your estradiol conversion, Dr Oliver also says it's very low. I'm confused by the aldosterone measure you got versus what Dr Oliver got..
Jane and Franklin xx

It really bothered me that I had given you the wrong numbers, so I went back and rechecked my calculations. :eek: And low and behold, thankfully my calculations were right BUT my decimal points were not in their right place on the aldosterone and androstenedione. :eek: :o So I fixed them. :)

Vet aldosterone--59 pmol/L = 21.24 pg/ml (11-139.9)
androstenedione--<1.1 nmol/L = .31518 ng/ml (.05-.36)
17 OH progesterone--2.3 nmol/L = .759 ng/ml (.08-.22)
serum progesterone--3.0 nmol/L = .943 ng/ml (.03-.17)
sensitive estradiol--<20.0 pmol/L = 5.44 pg/ml (23.1-65.1)

But like I said before, take Dr. Oliver's word on the hormones...he is a genius in my book!

Love and hugs,
Lori

Franklin'sMum

03-20-2010, 01:53 PM

Hi Everyone,

Where to begin? It has been a very informative week, and a very scary week. Dr O replied to the melatonin and lignans question by saying that he can't really comment on a treatment plan when the testing has been done in another lab, but that we could send any further samples to UTK. Dry ice, international flight, wouldn't have thought so, but ok. He said that they get samples from Hong Kong and also Korea, so it can be done.

Dr Kuntz wrote back, (right after the news report on the radio said CTs emit heaps more radiation than x--rays) and Dr K said that it was a study on humans, our own gp said that the study was regarding victims of atomic blasts getting x-rays and CT scans, so I'm not quite quaking in my boots about the prospect (anymore :o).
They can apparently do 1 "shot" of a CT, and the computer can rotate the image. He said that a CT can pick up more than 90/100 tumors, and can pick up even more than 90/100 macrotumors.
I'll be ringing them first thing Monday morning.

Franklin had another episode on the 14th. The vet said he highly doubts that it's caused by hypoglycemia, as if it was, it would have shown up on previous blood tests. (Glucose has always been in the normal range.) A vet practice 45 mins away has finally bought a bp machine :):):), so Thursday 18th we went...
This was Franklin's average--132/61 (normal systolic (the first number) should be between 110-160) and the diastolic (last number)should be 60-90 so yay! He doesn't have high b.p (at the moment), and his pulse rate was 152, which is normal for a little pup.

So considering we had a 45 min drive home, driving into the sun, and the temp was 30C/86F I gave him water with a bit of gatorade mixed in. (I read somewhere gatorade is ok to give pups.) The instant that we get home and I pop him in the yard as I move the car, he has ANOTHER episode :eek::eek: that's 3 in the space of 9days :eek::eek: It lasted for 3 mins, he circled, sat, circled, semi-sat, bobbed his head from side to side, walked backwards and stumbled.
I managed to get this one on camera, just like the dr wanted.
I was about to go in the gate, and he circled twice, so I ran back to the car to get the phone. I think the file is way too big to post here, so if you would like to see it, please be patient while I try and figure out Photobucket or something similar.

So on Friday, our gp gave us a referral to Southpaws Speciality Surgery for Animals http://www.southpaws.com.au so hopefully they will find out what's going on with my baby. And even BIGGER hopefully it will either be nothing serious, or easily fixed.

Lori,
a misplaced decimal point? There is nothing wrong with your math, if that's all there was to it. Much better then my attempts :o:p

Hope you and your babies are all well, and love to all,
Jane, Franklin and Bailey xxx
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littleone1

03-20-2010, 02:31 PM

Hi Jane,

I'm so sorry to hear that Franklin is having more episodes. I'm sorry , but I haven't read back through your thread to see if Franklin was tested for hypothyroidism. This can sometimes cause seizures. My mind doesn't function very well at times.:D

Corky started having similar seizures about 4 years ago. They never did find out what was causing them. My vet had me keep a journal on the dates they happened and how long they lasted. As time went by, the seizures were less frequent, and they were for a much shorter period of time. Someone told me that it could have been the trauma of Corky losing Jay and being home alone when I went back to work. Nobody really figured out what caused them. So far, he hasn't had that kind of seizure for well over a year.

My thoughts and prayers are with you that they will be able to determine the cause and be able to treat it.

Belly rubs to Franklin and Baily.

Squirt's Mom

03-20-2010, 02:59 PM

Dear Jane,

Poor Franklin. :( and poor Mom. :( I am so sorry you are seeing an increase in these episodes. Hopefully, the testing will reveal the cause, it can be taken care of, and he will on firm footing once again.

Please keep in touch and let us know what's going on, what you learn, etc.

Hugs,
Leslie and the girls - always

Harley PoMMom

03-20-2010, 05:10 PM

Dear Jane,

I am so sorry that Franklin is continuing to have these seizures, and I am so sorry that I have no words of wisdom or advice to help. :( But please know, my dear friend, that you and your precious boy are in my thoughts and prayers.

With much love and big hugs,
Lori

mypuppy

03-21-2010, 12:14 AM

Dearest Jane,
I just learned of the little sweet faced Franklin's new health concerns. This must be so scary for you. I truly pray they find the problem very soon so he can get back to good health. Don't worry, my prayers will be answered, and you must believe that. Please know I am sending you my very best wishes for his quick recovery, and that I hold you both in my thoughts and heart. Luv you both bunches. I will be keeping track of his status. Hang in there, never lose any hope and remember God loves you, and so do I....xo Jeanette and licks to cousin Franklin from the Princess

Franklin'sMum

03-21-2010, 01:41 AM

Hi Terri, Leslie, Lori and Jeanette,

Thank you all for checking in on us, it means a lot. Franklin had been depressed since Friday morning but when he got up today, he was back to perky Franklin :) (maybe the McDonaldsburgers he had for tea last night helped :o no onions or anything, just the meat.)

Hi Terri
He has been checked for hypothyroidism, total t4 and free t4 by e.d- both results were in the normal range. I'm so glad that Corky has been seizure free for more than a year :D, I know how scared you must have been each time one happened. Thank you very much for your thoughts and prayers, and belly rubs my friend.

Dearest Leslie,
Thank you so much for your hopes that Franklin gets back onto firm footing again, and that whatever is causing this can be found and fixed. On the up-side, I'm told Dr K is the go-to guy, and his credentials are very impressive. Absolutely I will keep you updated for whatever I find out, thank you.

Lori, my dear friend, thank you so much for keeping Franklin in your thoughts and prayers. I've emailed Dr K again, asking for info on what types of radiation they can do, and the success rates, survival times, and median ages of pups at hte beginning of treatment, and pros and cons of each type of radiation, but it's now Sunday afternoon here, and I haven't heard back yet.

I do realise Franklin hasn't been examined as yet, and that all this may be the result of a slipped disc, pinched nerve or something like that, but if its not, I'm going to have to learn real quick, so am getting as much info as I can at this time, just to try and prepare for a semi-intelligent sounding conversation with Dr K and/or his team, and if I need to make decisions quickly re: treatment it may not be quite so overwhelming (in theory)

Oh, the estradiol that the lab measured? Part of a ferret hormone assay, they measured sensitive estradiol (17 beta estradiol) and apparently that's different to serum estradiol. Could explain why such a low reading, also the pee dripping he did (read somewhere, sorry don't remember where) that low estradiol/estragen can cause leakage (but generally in spayed females). I haven't seen him drip for a few weeks, so maybe that's not related at all. Who knows?

Hi Jeanette,
Thank you sweetie, that is so kind of you to keep Franklin in your heart and in your thoughts :) And thank you too for your prayers for a quick recovery. I would be lost without you all.

There are no words to truly express how grateful I am to you all for your advice, thoughts support and love, but please know I love you all and am so thankful I found you.

HUGE teary hugs, and much love to you all,
Jane, Franklin and Bailey xxx
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