New Furmom to forum-Katie Chow Collie Mix 9yrs

[sdoran2]

Katie our chow mix rescue was just diagnosed with pituitary chushings and started Vetoryl 60 mg 2x daily. She is 30k/65 lbs and started limping badly in September. We first thought she had pulled her back muscles and know is fairly lame in her left foreleg and we now call her "Peggy". She has always panted heavily, drinks lots of water but never had an accident, loves her food and has a beautiful coat.

Since she was abused in her 1st home, neglected in her 2nd home, we adopted her at age 6, we chalked up her panting to her heavy coat and get her groomed very 2 months and the fact she was abused and many had been smacked in the face repeatedly along with being kicked based on her physical avoidance of contact sometimes, contributes to her wolfing down her food and heavy breathing. She loves laying on cold hard surfaces which does not help the limp.

She had been on Robaxin off & on since June 09 as when we got back from our mountain cabin which she loves to run & chase ground squirrels and her limping would appear and then get better. In Sept 09, the limp started appearing more regularly and so did the use of Robaxin.

We just started in Jan 10 to get acupuncture, massage, laser therapy, and Gabapentin 100mg 2x daily to try to loosen the shoulder/back muscles and xrays revealed bone spurs & fairly severe arthritis in both shoulders & elbows and blood workups have confirmed cushings and we are starting on Rimadyl.

I am also giving Katie Omega 3&6 supplements, Glucosamin, Condroitin, Magnese, Vit E, Devils Claw, Tumeric supplements in addition to her low fat, moderate protein, high fiber diet. She goes in on 2/15 for a full neuro workup at CSU vet school and any necessary MRI/ultrasounds to locate the tumor and she goes for hydro treadmill eval this week since she can't walk far and we want to her her in shape somehow but does not like water...

I do not have copies of all the results but will get copies and have a good relationship with our vet and her vet school CSU.

I want to find out after searching are there others who have larger older dogs on Rimadyl or can offer some advice.

Thanks, Sandra

[labblab]

Dear Sandra,

I literally only have a moment to post right now, but I want to welcome you to our family here at k9cushings.com! I know that others will soon be by to welcome you as well. And I'll try to get back later on to write a more complete repy. But we are very glad that you've found us, and we all look forward to learning much more about your Katie. :)

Marianne

[Squirt's Mom]

Hi Sandra and welcome to you and Katie! :)

It sounds like you are off to a good start but it will be very nice to see the Cushing's tests results. ;)

Since it is apparent Katie has some arthritic issues, you should know that as the cortisol is lowered, you may see more problems in this area. Cortisol kinda "treats" the inflammation of arthritis and other inflammatory conditions so as it is lowered, these conditions may come to the forefront.

The supplements and herbs you are using are good for inflammation. Some other options you might consider are MSM, Bromlain, Boswellia, Vit C, Yucca, alfalfa, Evening Primrose, Borage oil, super oxide dismutase, SAMe, cetyl myristoleate, and proteolytic enzymes like Wobenzyme. You, of course, want to research these to be sure they will work with Katie and any of the meds she is already taking. I would also add these one at a time so you can see how each one effects Katie and make sure there are no upsets.

Massage and TTouch would also be good for her...and you as it helps bond us even more deeply with our babies.

Rimadyl is a NSAID and NSAIDs are not recommended for cush pups plus it has a fairly negative reputation in the dog world. Below are some links on this med that you might find interesting:

Rimadyl:
http://www.srdogs.com/Pages/rimadylfr.html
http://www.srdogs.com/Pages/rimadyl.html
http://www.doglogic.com/rimadyl.htm
http://en.wikipedia.org/wiki/Carprofen
http://www.articlealley.com/article_24455_54.html
http://www.healthyhappydogs.com/MoreOnRimadyl

The real problem is that if Katie is one of the pups that Rimadyl effects negatively, then once the damage has been done, it is usually irreversible. So there is the possibility of adding ulcers and other digestive problems to her list of health issues.

One of my pups, non-cush, has some ortho problems and she has been prescribed Previcox and Meloxicam. The Previcox didn't work well and the Meloxicam made her start throwing up after 6 doses. So we have stopped all NSAIDs with her and are concentrating on non-pharmaceutical methods. A good friend of mine uses the philosophy of "first, do no harm" and to me, there is a higher chance of causing her harm with the NSAIDs than there is with the herbs, supplements, and dietary support. But that's just me. ;) I wish we had hydrotherapy in this area but I haven't been able to find any. :(

I am really glad you found us and look forward to learning more about you and Katie in the future! Ya'll aren't alone in this journey any longer. We will be here to help anyway we can. Please ask any questions you have and we will do our best to help you understand. If we don't' know, we will help you research.

Hugs,
Leslie and the girls - always

[gpgscott]

Welcome to Sandra and Katie,

It sounds like you have been very thourough.

As Leslie has pointed out there is mixed review among pet owners concerning the nsaids. I would however state that there are examples of most all medications and unintended results and that it is clear that these meds properly administered help most of the pets who receive them. In a case of elevated cortisol however and inflamatory joint issues, I really don't see that you have a choice. The natural stuff will only go so far and you are already giving recognized supplements and carfully monitoring diet. You could resort to pain meds but those also are not without risk and of course do nothing to help aleviate the underlying causes of the pain.

My pup is neary 16, she exhibited severe hip dysplaysia very young and has had hip surgery (tpo). She has been on Rimadyl off and on for over ten years and on a daily dose now for over three. I will say that it has been our experience that the recommended doses are high and even though she gets twice daily dosing it is at only 1/2 the recomended rate. Up until a year ago she was doing fine on 1/4 rate.

We also use an injectable product called Adaquan first developed for use in horses. It gives her much relief, she gets a shot once monthly. You might want to ask your Dr. about it.

You may also find that you can strike a balance between cortisol levels and joint pain managment. I don't think it is absolutely essential particulary when administering Trilo to maintain a level of 5 or less ug/dl cortisol. This is also a good discussion for your Dr. cortisol levels vs. pain managment.

Thanks again for joining, and looking forward to hearing more.

Scott

[sdoran2]

Thanks for the quick feedback: My priorities are 1) Identify the type of pituitary tumor (macro or micro) benign or malignant 2)get the joint & muscle swelling under control as quick as possible so she can walk somewhat normally as the peg leg walk is very painful even with the risks of NSAIDS on her system 4) find out how severe her joints are. The CSU vet did discuss Aquadan and I have no problem doing shots monthly.

does anyone know of a single supplement that combines fish, flax, omega, gluco, condro, MSM, A,D,E that I can give rather than uspet her stomach with a bunch of separate pills?

I will post all of Katie's results as soon as I receive them from her regular vet

[littleone1]

Hi Sandra,

Corky and I would also like to welcome you and Katie.

I really don't have any advice to give you, but I did want to say hi.

Terri

[jrepac]

Regarding the arthritis, it is always tricky. Some cushpups cannot tolerate Rimadyl (mine could not)....so, I give her "joint squares" every day with MSM and glucosomine in them. If she seems very uncomfortable, I resort to "doggy aspirin" (Arthrin chewables) which she tolerates well. She also gets Sam-e, mainly for liver function, but that is supposed to be good for the joints as well.

In terms of the other supplements being found in one pill/tab, you may want to shop around and check out the various joint and skin "snacks"...a lot of them combine the various ingredients in bite size chews or jerky strips.

Jeff

[Squirt's Mom]

Hi Sandra,


does anyone know of a single supplement that combines fish, flax, omega, gluco, condro, MSM, A,D,E that I can give rather than uspet her stomach with a bunch of separate pills?

Personally, I prefer to give individual supplements. It is easier to get the right amounts, it is easier to tell if something particular is upsetting rather than looking at a whole list of ingredients and not knowing which may be the culprit, and it is easier to rotate supplements if they are individual products. Also, some manufacturers may have a better glucosamine but another manufacturer may have a better condroitin product.

It's a PIA at times ordering all the things we use at our house not to mention keeping them straight, but I feel very good about the products we use and would not want to change them for a "single dose approach" supplement. But that is me, based on my own experience and learnin' in nutrition. ;)

Hugs,
Leslie and the girls - always

[sdoran2]

Katie's test results:
Pre-Dexa 4.5 (1.0-6.0)
Post 4hr 1.0 (<1.5)
Post 8hr 8.0 (<1.5)

Pre-ACTH 9.8
Post-ACTH 34.8

[Squirt's Mom]

Hi Sandra,

Thank you for posting the results on Katie's tests.

Someone with more knowledge than I will be along to help you with them soon.

Hugs,
Leslie and the girls - always

[gpgscott]

Hi Sandra, thanks for the results.

I am puzzled why such a vast differece in the pre number in the LDDS vs. ACTH, was Katie particularly stressed that you recall on the day of the ACTH?

But that regardless, both tests clearly indicate Cushing's, and the good thing is that although not entirely conclusive the suppression to 1.0 at the 4 hour interval is indicative of pituitary (PDH) as opposed to adrenal (ADH).

Has there been an ACTH since beginning the Trilo treatment?

Scott

[sdoran2]

Katie was a little stressed being a rescue and I wasn't there but is generally a happy girl and knows the vets office as the place she gets treats when she is done.

we will retest in 3 weeks

Katie just started Vetoryl Sat 2/6

[lulusmom]

Hi Sandra,

As Scott already mentioned, the ACTH stim and the LDDS are consistent with cushing's and I'm happy to see that your vet did both tests before starting threatment. Established protocol dictates that the first stim after starting treatment should be done no later than 10 to 14 days. This is important because Vetoryl can rapidly drop cortisol levels in the first week or two and has been known to continue to do so for 30 days and in rare cases, beyond.

With doing the acth stim test before treatment, your vet has a baseline stimulated post number to use for assessing the effectiveness of the current dose of Vetoryl. If the post stimulation number after two weeks is less than 5 or 6, I would be very concerned that perhaps 60mg BID may be a bit too much for Katie. While your vet is following dosing recommendations set by Dechra, UC Davis has established their own treatment protocol which calls for a much more conservative dose at 1 mg/kg once daily. That dose is continued for about one week until a veterinary re-check can be completed. I agree with their way of thinking that it is much better to start low and work your way up to an effective dose.

Please keep a very close eye on Katie for signs of cortisol dropping too low. Any dose, but especially larger doses, can drop cortisol so rapidly as to cause cortisol withdrawal in which case you would see clinical signs much like those you would see when cortisol is too low...such as vomiting, inappettance, extreme lethargy, etc. You know your baby best so if you should see any signs, stop dosing and contact your vet. The good news is that Vetoryl has a very short half life and a dog usually rebounds rather quickly by merely withholding treatment.

In case you haven't accessed our Resources section for detailed information on Vetoryl, I am providing links below.

http://www.k9cushings.com/forum/forumdisplay.php?f=10

As Leslie mentioned in a previous post, it is not recommended to give Rimadyl concurrently with steroids such as cortisone or prednisone. These steroids are synthetic forms of the body's natural steroid, cortisol. Since Katie is producing way too much cortisol, it is ill advised to give her Rimadyl until such time as her serum cortisol levels have been normalized with treatment. I have two cushdogs, one of which has arthritis. His gp vet prescribed NSAID, Metacam, but only after we got his cushing's under control. Even then, I did not feel comfortable administering it daily so I limited it to those days where his discomfort was evident. Since that time, we've been lucky to have been able to manage his arthritis with Cosequin (which has glucosamine HCI and chondroitin for joint & hip support) and fish oils (which contain essential fatty acids that aid in reducing damage to the joint cartilidge). Improvements were not instantaneous in Jojo's case and it took two to three months for those supplements to kick in. You can buy these products from Petco, Petsmart or any number of online pet supply companies.

Keeping fingers and paws crossed that treatment goes well and will be looking forward to your updates.

Glynda