Lola, 10 yr old Boxer mix (treatment with Lysodren) UPDATE: Lola has passed [Archive] - Canine Cushing's Information and Support Forums

Loladog

02-13-2010, 05:38 PM

Hello,

My name is Aimee and we have a 10 year old Boxer mix named Lola. She was diagnosed with Cushing's in September of last year and we are treating her with Lysodren.

This all started after she had a routine dental in August. Routine pre-anesthetic lab work showed that her Lipase levels were through the roof. Further testing (Spec cPL) showed that she had Pancreatitis even though she wasn't showing any symptoms. Her Spec cPL levels were so high at that time, that the vet was concerned about her making it through the weekend. It's been a while but I believe her levels were at around 1000. We immediately switched her from a moderate fat level diet to a low-fat diet and we started looking for a cause of the Pancreatitis since she wasn't showing the typical symptoms (her appetite was very good and she had no vomiting or diarrhea). She had been eating Orijen dry with Wellness Core canned. We started to discuss symptoms of Cushing's and Lola had almost all of them. Her appetite was over the top and she was constantly begging for food and getting into the trash. Her thirst was non stop and she was also losing a lot of hair. Lola also started having skin infections which were initially misdiagnosed as ringworm..

I believe it was the dex suppression test? which officially diagnosed her with Pituitary Cushing's. Unfortunately, I don't have any of the original #'s to give to you.

We decided to treat Lola with Lysodren and during the induction period, she was done in less than a week. Unfortunately, we went a little long during the induction period and she became ill with a complete loss of appetite, extreme soreness from her arthritis, diarrhea and lethargy. We rushed her in to the vet and her Cortisol levels were down to .5 on the resting Cortisol test. They tested her electrolytes and fortunately, we didn't do any irreversible damage. After two weeks of Prednisone, we were able to bring her levels back up to .8. I think we then went about a month with nothing and then started Lysodren maintenance- one 500 mg tablet twice per week.

After her last test on the maintenance therapy on 12/23/09, her Cortisol levels were 2.2 with an ACTH Stim test. Her Spec cPl level was 375 which still indicates Pancreatitis but this was a definite improvement. After this test, her next was to be in March. Lola seemed to be doing very well with her diet which was most recently Innova Large Breed Senior dry (lower in fat but still a good amount of protein, etc.) with some Spot's Stew canned and she has had good energy.

Unfortunately, last weekend Lola started hesitating at meal times. She also started eating a lot of grass and we've noticed that she's been a lot more stiff and sore from her arthritis lately. On Monday night, she didn't finish her dinner meal and Tuesday morning, she refused her breakfast completely. She went outside and would not come in because all she wanted to do was eat grass. Poor thing was just standing out in the pouring rain!

Her last dose of Lysodren was Saturday 2/6/10 and I of course stopped once she started showing her unusual symptoms. I took her in right away to the vet who examined her and ran a bunch of blood work. Her standard panel and electrolytes came out looking good but her Cortisol was back down to .9 and her Spec cPL back up to 535. Her Alk-Phos was also 607 but the vet believes this is normal for her age and situation. In August, her Alk-Phos was apparently 673. We started her on a 2 week course of Prednisone on Thursday and then we will go a few days before rechecking her resting Cortisol.

Since she was having a great deal of digestive upset, our vet recommended a home prepared, bland diet. I've been feeding her boiled chicken and rice with a small amount of low-fat cottage cheese. Even prior to all of this, Lola has had a history of digestive issues including runny stools and very bad gas. Again, she's a Boxer and it has been very hard to find foods that agree with her. Now with all of her issues, it's even harder. Our vet highly recommended we start feeding her a home-prepared diet permanently and I agree that I think this would be best for her. I'm just nervous because I'm a vegetarian and I don't even cook for myself or my husband! However, I will do anything for Lola if it helps. I'm currently researching how to prepare a good, low-fat, home cooked diet that is balanced but I would also love to hear what you all feed your Cushing's dogs. Do many of you feed home prepared or do most of you use commercially prepared?

On a last note, Lola's skin infections stopped right away once we started her on Lysodren. Her hair started growing back in and now it's a completely different texture and length. Instead of the short, shiny Boxer coat, she now has long, curly, fuzzy hair and she seems to be very warm now. She often seems to get too hot in the house and she pants a lot more.

Lola also has severe arthritis in her hips and lumbar spine so when we took away the excess Cortisol, she really starting feeling the effects from this. When we saw the vet the other day, she started Lola on Tramadol for the pain. For years now I've been giving her Cosamin DS as a Glucosamine/Chondroitin supplement. I'm also giving her Denamarin to support her liver but I'm looking into a less expensive option for the Milk Thistle and Sam-e (the Denamarin is costing us $83/month).

Even though I've written a book here, I feel like I'm forgetting a lot. Hopefully I've given you a good introduction. I'm so happy to have found your group!

Sincerely,

Aimee and Lola

gpgscott

02-13-2010, 06:04 PM

Welcome to you both.

It is clear that Lola is very sensitive to Lysodren and so her dosing needs to be adjusted to take that into account.

On the joint issues, please ask about Adaquan.

You are very attentive and have already been through at least one crisis all by yourself and did well.

Very glad you are here, there are many here with a lot of first hand experience who will be able to help you understand and tailor Lola's treatment.

Scott

eta, many members administer pepcid, (famantodine) before the Lysodren as Lysodren does cause gastic upset with some. Ask your Dr. about a dose.

Harley PoMMom

02-13-2010, 06:39 PM

Hi Aimee,

Welcome to you and Lola from me and my boy Harley. My boy Harley has PDH Cushings and he has pancreatitis. He also shows no symptoms of pancreatitis except for the results of his cPLI tests. His pancreatitis was found on his first ultrasound, talk about a shocker for his mom!

With my boy having Cushings, pancreatitis, high blood pressure and just recently starting Lysodren, I have since enlisted the help of Monica Segal to formulate a diet for him. Here is alittle about Monica:

"Every dog is an individual," says Segal, who has a certificate in animal health care from University of Guelph and who has published two books about feeding your pet according to the problems and illnesses they are genetically inclined to develop – or have. "It's no different than you and I."

http://www.thestar.com/living/pets/article/739261--feeding-the-need-for-love-and-nutrition

You can read more about Monica here at her website:
http://www.monicasegal.com/aboutus/index.php

You mentioned an induction phase, was this a "loading dose phase?" and how much was the loading dose? On her last test on the maintenance therapy on 12/23/09, you wrote that her ACTH Cortisol levels were 2.2, was this her post? What was her pre?

With Harley's pancreatitis issues and giving him Lysodren, and knowing that this could cause an upset, I give him Pepcid AC 20-30 minutes before his Lysodren meal. This has been approved by his vet.

Here are some other informative reading tips from our Resource Thread.

Lysodren loading Instructions and related tips
http://www.k9cushings.com/forum/showthread.php?t=181

Remember your not alone on this journey, we are here to help you and Lola in anyway we can, so ask all the questions you want and we will answer them the best we can.

Love and hugs,
Lori

Nathalie

02-13-2010, 07:22 PM

Hello Aimee,

Welcome from me as well. :)
I think a good homemade diet, whether it be raw or cooked is an excellent idea. I feed raw to all my dogs (vegetable & meat) including my cush dog Phillip who has also pancreatitis. He does extremely well on this diet and you have complete control over the fat content and anything else that goes in it. Here is a good link http://dogaware.com/wdjpancreatitis.html with sample diets etc.
Personally, I prefer to feed raw whenever possible to cooked as their main feed because I don’t want to have to start supplementing what gets lost in the cooking process and I need the extra counter space for Phillip’s supplements specific to his condition. ;)
After his second and last pancreatitis attack I fed him rice cooked to a mush slowly adding more cooked meat over 5 days and by the beginning of week 2 I started mixing the mushy rice with his regular raw until at the end of week 2 his was back on his regular raw diet but with less Sunflower and Herring Oil – I also had to cut out the peanut butter that I used to give him with his ‘lyso meal’ to help with absorption.
I also give 3000 mg of L-Glutamine predominantly in hopes of helping him rebuild muscle mass but it also is good for intestinal health.
We started of with 10 mg of Pepcid AC prior to the Lyso but his stomach still got upset and giving him 20 mg 30 min before has helped a lot. Mind you my Phillip is on the opposite side of the spceturm when it comes to Lysodren sensitivity – his maintenance dose is currently at 3500 mg per week and he weighs 63 lbs. I also divide his maintenance dose into 5 doses.
Since Lola is so sensitive to the Lyso and is currently on 1000 mg per week I would split it up into 250mg 4x per week.
Regarding the arthritis – there seems to be some good evidence that high doses of Esther-C can greatly improve arthritic/skeletal conditions. If you are interested in the whole article and want to discuss it with your vet just send me a PM – it is way to long to post here.

As for liver support all I am giving currently is Milk Thistle tincture from ‘Vogel’ 12 drops, 2x daily and I am convinced it is responsible to bringing his ALT down to around 35 from over 130. The cost is about $12 per month.

Nathalie

frijole

02-13-2010, 07:53 PM

You have already received from great feedback but I will add my 2 cents to the mix. First off, welcome! I agree with Scott that Lola is sensitive to the lysodren and needs the dosage (once you resume it) reduced. You just want a level that maintains a reasonable amount of cortisol in the system.

The hair regrowth is normal. We have seen dogs have hair come in a totally different color. :D Arthritis is normal given reduced cortisol. I also agree with Scott that you might want to check into Adequan. I started off with fish oil, glucosamine with SAME for the joints and this has really helped my girl... but she just turned 16 in December and 6 mos ago I started her on the Adequan injections and it has been wonderful.

I didn't add the tramadol until a few weeks ago... and I had to go with 1/2 of the recommended dose as she was loopy - it is an opiate. So watch when you first give it and if she acts strange it is probably the drug.

I also use milk thistle for the liver. I don't know if there are any scientific findings that it helps but my girl had cushings for 2 yrs before I tried it. Her values were still high. After using it they finally went down. Maybe I lucked out but I'm sticking with it.

Thank God I don't have to home cook so I'll let those that do offer you advice. Meanwhile, glad you found us. Kim

ChristyA

02-14-2010, 11:34 AM

Hi Aimee and Lola,
WOW, you have really done well on your own with all this. My Boxer male was a cush dog. He seemed to be pretty sensitive to the lyso also. I did have to cook for him he would eat 99% fat free ground turkey breast white meat only, and boiled skinless potatoes cut real small in his food. He did really well on that for a long time. He had intestinal issues as did my female Boxer.

My female (not cushing's) had arthritis she took Previcox and it worked wonders for her. I fed her the Innova Senior Plus. She had terrible GI issues, jelly poop and all, from the beginning.

Glad you're here, ask away the folks here are the best!
Christy

Loladog

02-14-2010, 02:34 PM

Thank you all for your support and suggestions!

In response to Lori's questions, Lola's loading dose of Lysodren was 2 3/4 tablets daily (500 mg tablets).

With her last maintenance blood work on 12/23/09, the ACTH stim test was 2.2 pre and 3.6 post.

Also, it's great that you mentioned Monica Segal as a resource for home cooking. I have both of her books and I was planning on booking a consultation today!!!

Christy, Thank you too for the welcome. It was through your suggestion on Boxerworld.com that I found this great site!

I really appreciate all of the suggestions for arthritis meds and supplements. I will ask our vet about the Adaquan and look into Ester-C as well. I forgot to mention in my 1st post that I'm already supplementing w/ fish oil that also contains Vitamin E.

I'm going to ask our vet about giving Pepcid AC prior to the Lysodren when we start up again. We already give Pepcid on occasion when Lola has an "upset tummy" but it's great to know that it can be given a 1/2 hour prior to the Lysodren. I will continue with the Milk Thistle and Sam-E whether it be with the Denamarin or "human" form.

Thanks again everyone and I will keep you posted on how things go!

frijole

02-14-2010, 03:56 PM

First off... that is the cutest photo of Lola! Adorable.

Meanwhile..I want to double check the lysodren dosing just to be sure I know where we are...

You originally loaded at 2 3/4 tablets daily. She loaded in a week but was too low.

For this reason when you started on maintenance you reduced the dosage to TWO 500 mg pills weekly. Is this right?

I couldn't see where you posted Lolas' weight. Recommended dosing is between 25 and 50 mgs per kg of weight. Take Lolas weight and divide it by 2.2 to get kgs. Take that amount x 25 and then x 50 to get recommended range.

Where does your current dose fall? Thanks!!!! Kim

Loladog

02-14-2010, 07:32 PM

Hi Kim,

Yes, Lola's maintenance dose was two 500 mg pills per week. Her weight is 63 lbs. We will have to go lower on the dose once we're ready to start back up again since this caused her levels to be too low. When the time comes, our vet will consult with an Internal Medicine Specialist to see what dose she recommends trying next.

Thank you for the compliment on Lola's photo! :)

Right now, we're doing 5 mg of Prednisone twice daily for a week and then we will go down to once daily for a week. We will then wait a few days and re-check her resting Cortisol before starting the Lysodren again.

All day today she's been acting like she's starving! I don't know if it's because maybe I'm not feeding enough of the home prepared food or if it's because of the Prednisone? :confused:

frijole

02-14-2010, 07:45 PM

It is the prednisone I would bet. I would phone the vet because you might have to reduce it. Caution you could see a return of urination issues and water intake as well. Prednisone mimics the cortisol that dog is missing.

If I re-read your notes right the first time you were low at .5 and the last time it was .9? Since a 1.0 is an acceptable reading I would be concerned with using prednisone dosage for 2 weeks.

No biggie - just call your vet and tell him/her about the increase in appetite. They might want to reduce the amount and length. Seems Lola is equally sensitive to prednisone. ;)

Kim

Sabre's Mum

02-14-2010, 09:34 PM

Hi Aimee

Welcome to this forum.

I have found with our Hungarian Vizsla, Sabre, he has also been sensitive to Lysodren. Sabre has been treated with Lysodren for nearly two years and we have gone all over the range with maintenance and we have only just recently got him stabilised. He is now on 1/2 tablet two times a week (500mg per week - approx 20mg/kg). He now weighs just under 25kg (55lb) - he was 34kg at the time of diagnosis!

There may be scientific evidence out there somewhere, (I am think Alison may have more info on this?) but my gut feeling and what I have seen here ... larger dogs seem to be more sensitive to some drugs. We did start out at the high end and were ok for a month ... but three months later he had gone low. With regards to the pred ... I have also been told (from a non-vet source) that large dogs have lower tolerances to prednisone. This was told to me recently ... as we are treating our other 7 month old vizsla with high doses of prednisone.

I am pleased to see that you will be retesting before you restart Lysodren. In our treating of Sabre I felt this was the most important thing to me so we were able to really see what was happening with dose changes and more importantly making sure that he was "in range" before restarting maintenance.

All the best
Angela, Sabre and Flynn

Squirt's Mom

02-15-2010, 03:28 PM

Hi Aimee,

Just dropping in to welcome you and Lola! It is good to have you both join our little family here. :)

You have been given some great info and I don't have anything to add at the moment but will be keeping up with ya'll. With my big mouth, it is likely I will have something to say before long! :p

Hugs,
Leslie and the girls - always

Loladog

02-22-2010, 11:34 PM

Hello all,

I need some advice on some developments with Lola. In the beginning of my post, I explained about Lola's low Cortisol level (.9) and high Spec cPL (535). This came out of a vet visit on Wednesday 2/10. The plan was to give her 5 mg of Prednisone twice daily for a week and then once daily for a week. Well, after only a couple of days on the twice daily dose of the Prednisone, she became very ravenous and seemed to be feeling a little too good. She was trying to get into the trash and was constantly begging for food. She was only on this dose for 3 full days and then I cut her back to once daily on Sunday 2/14. I gave her the once daily dose through Thursday 2/18 and then stopped. This turned out to be one full week on the Prednisone. Since she was doing so well, I decided that would be enough and I confirmed with my vet that it was ok to stop. I have an appt. scheduled for this Wednesday the 24th to re-check her lab work.

Unfortunately, starting this morning she is hesitating at meal time again and she didn't finish her breakfast or dinner. She's eating some grass again and she vomited a small amount of grass and undigested breakfast (plus a Denamarin) while I was at the gym. I fed her dinner when I got home before I noticed the vomit. She seems just "off" to me again so I'm worried that I stopped the Prednisone too soon. Should I start it back up again?

Also, I've been feeding her a bland diet of boiled chicken, rice and some low-fat cottage cheese ever since the vet visit almost two weeks ago. I requested a consultation with Monica Segal to try and get a balanced, home-prepared diet that agrees with her tummy. It concerns me that she's not really digesting this now.

Sorry for the long post again and thank you all for listening!

AlisonandMia

02-22-2010, 11:40 PM

Hi,

I think if this was brought on by stopping the prednisone you would have seen problems (loss of appetite etc.) around 24 hours after the last tablet of pred you gave.

If I'm reading it right and she'd been off the pred for a couple of days I'd suspect that it is something other than low cortisol making her feel unwell. Quite probably pancreatitis considering the results of the specific cPL. It sounds like you need to contact the vet ASAP and probably hold off feeding her until you can get her checked out.

She hasn't had any Lysodren since starting the pred has she?

Alison

Loladog

02-22-2010, 11:59 PM

Pancreatitis is what I was worried about. She hasn't had a dose of Lysodren since Saturday 2/6. Alison, that makes sense that if it was from stopping the Prednisone, her symptoms would have started sooner. She seemed perfectly fine yesterday and she was begging for food all weekend. Yesterday, we might have given her too many treats because I have to treat her when trimming her nails. The treats I use are "Pecks" by the Honest Kitchen. The fat listed on the box is 4% minimum but I don't know what the max is.

Another thing really concerning me is that I haven't actually seen her poop in days. I walked her yard this afternoon and I only found one small, semi-fresh stool. It rained the entire day yesterday so I don't know what might have been there before. I'm very worried that she might be constipated from her bland diet of Chicken and Rice.

Update: Lola just pooped in her yard but it was very small. At least she's not having diarrhea. On the downside, she's eating A LOT of grass which might lead to more vomiting.

marie adams

02-23-2010, 02:18 PM

Hi Aimee,

I am new also and was reading thru all the posts for Lola. My Maddie just started Lysodren this past week so I am keeping an eye on her.

I started Maddie on a raw diet of chicken from Northwest Naturals a while back and she loves it--right now she can't get enough of anything to eat--haha!! I talk to my client who sells it at his pet shop and they said it is better than cooking your own because they include ingredients like fruits, vegetables, etc.; they even completely grind up the bones for the calcium/protein aspect. It is a complete meal. I also read that a Cushing's dog should not have grains/rice or even beef, so I decided to pull all of that from her diet. My client and one of his clients who doesn't even sell this food--he sells the Stella brand they have seen dogs with liver problems get back the energy they had when they were younger.

So far so good and even the vet said she has been hearing good things about the dogs eating raw. It comes frozen. If you think about it, wouldn't a wild dog eat raw and the vegetables & fruits of their kill would be ground up in the kill's stomach--this is how they explained it to me---If you are going to give raw fruit and vegies they should be finely ground up.

I hope this helps. Good luck!!! I am so impressed with the information I have received so far!!!!!

Harley PoMMom

02-23-2010, 06:09 PM

Hi Aimee,

I am sorry Lola is having issues, and it does sound like it is pancreatitis. The one thing I do recommend, if you can, is to stop her from eating the grass. I mean any animal could of used where she's eating that grass as their bathroom area! :eek: Please ask your vet about giving her Pepcid AC.

Yesterday, we might have given her too many treats because I have to treat her when trimming her nails.

If Lola's glucose is normal try giving her carrots as treats, my boy Harley loves these, I get the baby carrots and cut them up like coins, maybe 1/4 inch thick.

Please let us know how you both are doing.

Love and hugs,
Lori

Loladog

02-23-2010, 09:50 PM

Today Lola is doing a little better. At breakfast time, I offered her chicken, rice and low-fat cottage cheese again because that's all I currently have on hand. She ate everything but the rice which she let fall out of her mouth all over the house.:) After I left for work, my husband said that she kept begging for chicken which is in the fridge. This evening, she ate a little grass when I first got home for work. I then offered her only chicken and cottage cheese for dinner. She ate this happily and licked her bowl clean.

Poor thing is very constipated though. She went out in her yard and strained a bunch but only passed a very small amount of stool. She then started scooting in the wet grass.:(

Tomorrow, I take her in for a re-check with the vet and they will order a resting Cortisol and Spec cPL.

I know that boiled Chicken and cottage cheese is not a balanced diet so yesterday I ordered a bag of California Natural low-fat Rice and Chicken which she did well on at the very beginning of all of this last year. Unfortunately, I live in a very rural area and can't buy the food I want in a store! My plan is to add this back into her diet until I have more time to research on home-prepared and/or the consultation w/ Monica Segal starts.

I do usually give Lola a Pepcid AC when she's having stomach trouble. Unfortunately, I think she may have vomited up her dose last night. It definitely does seem to help her at times though.

Harley PoMMom

02-23-2010, 10:15 PM

Hi Aimee,

Harley's diet is formulated by Monica Segal also, and when he started not wanting to eat the rice she reformulated his diet to include white potatoes. Now, I have to peel the potatoes and boil them too, but Harley seems to like this better than just having the rice alone as his carb. His diet consist of skinless/boneless chicken breast, chicken gizzards, rice, potatoes, carrots, squash and various minerals and vitamins.

Although I am no vet, I believe switching her food around is hard on her already troubled digestive tract, and keeping her on the bland diet will help her and her tummy/pancreas heal. Please talk this over with your vet before making any decisions.

Also I wanted to mention that with Harley's cPLI that it is a 12 hour fasting test.

Hoping Lola feels better soon and keep us updated...please...Best of luck to you both.

Love and hugs,
Lori

AlisonandMia

02-23-2010, 10:46 PM

Re the constipation, it may help to add a fiber supplement such as Benefiber could be very helpful. White rice and dairy products are two things quite notorious for their binding effects - sometimes that's exactly what you want but it can cause problems too.

You'd probably want to introduce it gradually, make sure she's drinking enough and, very importantly, get the ok from the vet first.

Good luck and keep us posted.

Alison

PS: Glad to see she's feeling better today.

Loladog

02-23-2010, 11:34 PM

Lori and Alison,

Thank you so much for your recent replies. Your support makes me feel so much better! I definitely need to be careful not to switch Lola's diet around too much because I don't want to cause her any more digestive upset. I just want to find a balance that she will eat to tide us over until Monica Segal has time for our consultation. I filled out the questionnaire last week so I'm not sure how long it takes from there. I really appreciate hearing about the diet formulated for Harley. This is all so new for me because I don't even cook for myself or my poor husband!:o

As for treats, Lola unfortunately will not eat baby carrots. I've tried and tried but she is anti vegetable unless it's totally disguised. I'll have to figure something else out in that department.

I will let you all know how things go at the vet tomorrow. Thanks again to everyone for your ideas and support.

Squirt's Mom

02-24-2010, 11:55 AM

Hi Aimee,

My Squirt is also on a diet designed for her by another consultant and she is doing absolutely wonderful! The wait and the work is well worth it for our babies!

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

Loladog

02-25-2010, 11:18 PM

Well, I took Lola to the vet yesterday and we got her lab results back today. She hasn't been feeling well because her Cortisol level is down even more for some reason. The results came back at .6 and she was at .9 two weeks ago. She hasn't had a Lysodren since Saturday 2/6 and she was on Prednisone for a week.:confused:

Her Spec cPL came back at 450 and two weeks ago it was 535.

The plan now is to start her back up on Prednisone (her last dose was Thursday 2/18). We're going to do one 5 mg tablet per day for two weeks then one every other day for a week. We'll then wait a week and re-test her resting Cortisol in a month.

At least I know she'll start feeling much better soon while on the Prednisone. Poor thing. I can't imagine how it must feel to have your Cortisone levels all over the place.:(

AlisonandMia

02-26-2010, 01:00 AM

Did the vet do an ACTH stim test or just a resting, baseline cortisol test? The resting/baseline cortisol level can vary considerably depending on things like time of day, stress levels etc. A baseline/resting cortisol of 0.9 or 0.6 could be considered to be within normal range - however a post result like that on an ACTH stim test would most certainly not be. It is a definite possibly that her cortisol is indeed low (or even if it isn't absolutely too low, it may be too low for her - many dogs don't like being at the lower end of the desired level on the post of 1 - 5) but without an ACTH stim you cannot really know. It could be quite possible for a normal, healthy dog to have a resting level of 0.5 and a post ACTH level of 10 or 15 or even higher.

You really need an ACTH stim on which to base treatment decisions - the resting/baseline measurement is just too unreliable and really gives very little idea of what the true cortisol-producing capacity of the adrenals might be. The cortisol-producing capacity is what the ACTH stim test measures.

I suspect the change from 0.9 to 0.6 (if those are resting cortisol measurements) actually reflects a fluctuation in baseline/resting cortisol levels rather than indicating that her cortisol-producing capacity has actually dropped between the two tests.

Alison

Loladog

02-26-2010, 10:42 PM

Yes, the 0.9 and 0.6 results were just from resting Cortisol tests. The plan now is to just re-test the resting Cortisol in a month (after 3 weeks of Prednisone, and one week with nothing). Should I request an ACTH Stimulation test in a month instead then?

After just one day back on Prednisone, it's clear that her levels had been low enough to make her feel bad. The difference between yesterday and today is like night and day. Today her appetite is back to "normal", her eyes are bright and overall, she seems to feel much better.

ChristyA

02-27-2010, 09:01 PM

It is amazing how much difference on little pred dose can make. I hope Lola's cortisol gets in control and stays there. You are doing a fabulous job with her, she's a lucky girl.
Christy

AlisonandMia

02-27-2010, 09:47 PM

Yes, the 0.9 and 0.6 results were just from resting Cortisol tests. The plan now is to just re-test the resting Cortisol in a month (after 3 weeks of Prednisone, and one week with nothing). Should I request an ACTH Stimulation test in a month instead then?

Yes, I think that you do need to request an ACTH stim test rather than just the resting cortisol. And you may end up wanting to test before the month is up. How long it takes the adrenals to regenerate is incredibly variable - some dogs can go too low then have regenerated enough to be showing Cushing's symptoms again within a week whereas some never really regenerate and may stay on a low dose of pred forever or may not need either pred or Lysodren ever again or at least for many months. Most are in between those extremes but you never know how a particular dog's adrenals will behave. If she is still needing some pred in a month's time (and that is possible but unlikely) then there would probably not be a lot of value in testing then. The best time to test (do the ACTH stim) would be when she is doing well with no pred, whenever that is.

Good luck and keep us posted.

Alison

PS: Pred is a real miracle when it's necessary isn't it? Just like watering a wilting plant!

Loladog

03-12-2010, 11:01 PM

Hello all,

I just wanted to give an update on Lola. Some of this is a repeat from my replies in Brenna's post regarding Brandy. Lola was on 5 mg of Prednisone daily up until yesterday and now we will be giving her the 5 mg every other day for one week. Up until Monday, I was feeding her a combination of California low-fat chicken and rice along w/ some fresh boiled chicken. She was doing very well until Monday when she had a diarrhea accident in the house while we were at work.:( She had diarrhea and loose stools off and on through Thursday when she had another accident in the house. We called the vet and took her in right away along w/ a stool sample. The vet said that a trace amount of blood in the stool along w/ mucous indicated Colitis and this was probably diet related since she wasn't having any other symptoms. Our vet sent the stool sample out for testing and it came back clear of any bacteria or Giardia. However, there was the presence of a lot of yeast. Lola looked very good upon examination but they did note that she's lost 4 lbs. in the past two weeks which we will have to keep an eye on.

The vet recommended no more commercial food ever and she said to put her back on a bland diet of boiled chicken and rice until her stomach settles. She also recommended she go on probiotics indefinitely and she prescribed a 7 day course of Flagyl. The vets office gave us a month worth of Forti-Flora samples but I hate the fact that it contains Animal Digest for taste. Any recommendations for Probiotic supplements would be appreciated. I've heard that Jarrow makes a "Pet-Dophilus" which I might look into as they are a reputable company. Now I'm just waiting for my home-prepared diet consultation to start with Monica Segal.

On another note, we will be re-testing her Cortisone levels in two weeks at which time she will have been off the Pred for one week. The vet mentioned today that we might want to consider looking into Trilostane instead of Lysodren when the time comes to start treatment again. Our vet has always used Lysodren so that's what she's comfortable with but she's concerned with how sensitive Lola is to it. Also, she's been hearing more and more about vets in our area using Trilostane instead of Lysodren. Has anyone ever switched treatment methods like this? Also, are there any opinions regarding one drug compared to the other? Although Lola is extremely sensitive to Lysodren, I feel that I at least know now what symptoms to look for when she's being treated with it.

I guess we 1st need to just wait and see where here Cortisone levels are at in two weeks and go from there. Maybe she will not even need to be treated again for a while. I just want to learn as much as possible about the two drugs so that I'm prepared when the time comes. I'm sure there's a lot of good info on this website about the different medications so I will start searching. :)

StarDeb55

03-12-2010, 11:11 PM

Aimee, I will tell you up front I'm not a trilo parent, but I've been on the forum long enough to tell you that to make the switch to trilo, Lola will have to have a 30 day washout period from the lysodren, & I believe some return of symptoms. Trilostane is really no safer than lysodren. Where problems occur is when a vet is inexperienced using either med, does not follow standard dosage/monitoring protocols, & the pup pays the price. My concern is since your vet has experience with lysodren, what is the experience level with trilostane. We have also had more than one instance in the past year or so with new members who started their pup on trilostane at diagnosis, perhaps the dose may have been just a tad high, I don't recall exactly, but the cortisol levels on the pup dropped low enough to be considered Addisonian. Trilostane was stopped completely, & the pup has been on a med holiday waiting for a return of symptoms, & for the cortisol to be high enough to treat. The last pup that this happened to is Jeanette's Princess, & I believe Princess has now been on a trilo holiday for something like 5 months.

Debbie

Loladog

03-12-2010, 11:17 PM

AlisonandMia

03-12-2010, 11:20 PM

Sensitivity to Lysodren shouldn't really be a problem - it just means that you will have to think in terms of using smaller doses than many dogs need. We have several dogs here that seem to be very sensitive to Lysodren (ie don't need very much). These sensitive dogs sometimes end up needing to have "Lysodren holidays" every now and again as well. The same thing can happen with Trilostane too - although being sensitive to one drug doesn't necessarily mean a dog will be sensitive to the other. Not needing so much can actually be a good thing as it means you don't have to spend so much on the medication!

I think it is usually best (and cheapest) to give whatever med you started with a really good go and see if you can work out any little kinks before taking the plunge and switching. Switching (whichever way) almost always ends up meaning you need to run several ACTH stims (usually 3 at a minimun) in the month you start the new treatment - and sometimes it can end up being a lot more than that too. When switching from Lysodren to trilostane (or the other way) it is also generally regarded as being necessary to leave at least a month between the last dose of one and the first dose of the other - unless the dog becomes really strongly symptomatic in the meantime. Giving the two meds too close together can result in damage to the adrenals.

One thing to remember with Lysodren is that the amount of fat/oil in the food with which it is given can have a really big effect on how much the dog actually absorbs (more fat/oil = more Lysodren absorbed) so giving the Lysodren in with a small meal that contains a fixed amount of fat can help get things stable as it means that the dog is truly receiving a certain dose each time rather than possibly having the dose vary quite considerably which can give some very unpredictable results.

Alison

Loladog

03-21-2010, 07:45 PM

I have sort of a silly question that's not related to Lola's progress. For those of you who treat with Lysodren, do you handle the pills without gloves? I hadn't really thought about this until I was reviewing literature about the medication and it's relationship to DDT.:eek:

In regards to Lola, she's been off of the Prednisone since Wednesday of last week and I take her in for a re-check this Wednesday. I'll keep you posted on how things go.

Harley PoMMom

03-21-2010, 08:24 PM

There is no such thing as a silly question, ok. I have started giving Harley 125mg of Lysodren which I have to cut a 500mg pill into quarters. I do not use gloves, but the cutter it designated for Lysodren only and I wash my hands throughly afterwards. If gloves make you feel more comfortable using it, then by all means use them.

One warning tho, if one is pregnant...DO NOT handle the Lysodren at any time.

Hope this helps.

Love and hugs,
Lori

lulusmom

03-21-2010, 08:24 PM

My dogs are treating with a compounded capsule version of Lysodren as the 500mg tablets cannot be split into small enough doses for them. I therefore don't have to cut pills and get Lysodren dust all over my hands. Those pet owners that have to cut pills should take greater precautions. I must admit that I don't wear gloves when handling the Lysodren capsules but I do wash my hands well after dosing my two cushdogs. If you are pregnant, you most definitely want to wear gloves.

Nathalie

03-21-2010, 08:29 PM

No, no gloves. When I have to cut pills in half I put one on a paper towel, hold it on the side and cut it with a utility knife. While I cut it the papertowel just folds over it so nothing 'jumps' off the counter.

Probably shouldn't but I do touch them but wash my hands after.
Nathalie

frijole

03-21-2010, 08:41 PM

:o I used to use gloves. But I'm almost at this for four years and I now just wash afterwards. If I have a cut on my hand I wear gloves though.

Loladog

03-21-2010, 11:01 PM

It makes me feel better to know that I'm not the only one who doesn't use gloves.:D Although, the designated pill cutter for Lysodren only is a great idea. Thanks everyone!

Loladog

03-22-2010, 12:30 PM

Well, today has started off to be a rough one for Lola.:( Her last dose of Prednisone was last Wednesday (3/17) and the plan was to re-check her this coming Wednesday. At 2:00 this morning, she wanted to go outside and my husband said that she had diarrhea and then she just wanted to lay on "her mat" outside. She didn't want to come back in but he was finally able to coax her inside. This morning when I woke up to feed her, she seemed extremely spacey and she's extra stiff and sore again from her arthritis. Surprisingly, she ate her breakfast well but then again, she just wanted to lay outside in her yard (in the cold). I got her to come back in and then went to get ready for work. My husband said that she immediately started whining to go outside and then she vomited up her entire breakfast. Overall, she now seems to be lethargic and "out of it". I called the vet's office immediately and I will be taking her in at 9:50.

My concern is that every time we stop the Prednisone, this seems to happen a few days later. She hasn't had a Lysodren since 2/6 so I can't understand why she will start having symptoms of low cortisone levels when the Pred is stopped.:confused: I'm very worried.

frijole

03-22-2010, 03:06 PM

Please check back in when you get home. I too am concerned because if her levels are still low after two weeks she could be Addisonian and require the prednisone. Have you had her electrolytes checked? Sorry I can't go back and read... peeking in from work. Will look forward to your update. Kim

brandysmom

03-22-2010, 05:38 PM

Aimee,

I just read about Lola. I'm so sorry she is having such a difficult time too. Hopefully it can be controlled with the prednisone again. Please give us an update on her vet visit as soon as you can. I hope she is feeling better than she did this morning. My thoughts and prayers are with you. Take care and I look forward to hearing your from you.

StarDeb55

03-22-2010, 07:03 PM

Aimee, based on your description of what is going on with Lola it is CRITICAL that her electrolytes be checked ASAP. Screwed up electrolyte levels due to an Addisonian crisis, if severe enough, can be life-threatening due to a severe lowering of the aldosterone produced by the adrenal glands. There are 2 drugs that can be used to replace the aldosterone, if the dog is permanently Addisonian, florinef or percoten. You may want to ask the vet about this, since Lola is becoming ill every time you stop her pred for any length of time.

Debbie

Loladog

03-22-2010, 10:54 PM

When I took Lola in to the vet this morning, they kept her to run an ACTH Stim test as well as a Spec cPL. I picked her up this evening. They didn't check her electrolytes and now I'm even more worried based on everyone's responses. I gave her a Prednisone as soon as I got her home and the vet is supposed to call me tomorrow w/ her lab results. The vet today didn't think we needed to check her electrolytes because they've been normal the past two times we've checked them since we stopped the Lysodren on 2/6.

The vet said that she fed her a small meal there and she happily ate it and kept it down. I offered her Chicken and Rice tonight and she gave me a look like I was crazy. I'm about to roast up a tasty batch for tomorrows breakfast so I hope she eats it.

Addison's is what I started to worry about this morning since this has been happening like clock work a few days after stopping the Pred. How will I know if this has turned to Addison's? I'm so scared that we caused some permanent damage here.:(

frijole

03-22-2010, 11:13 PM

The acth should tell you if she is producing cortisol. What was the last reading? If she is addisonian she could no longer produce it and as Deb said you would give prednisone and florincef (or similar) for life. At this point I would continue with the prednisone and wait for the results. I am concerned about the electrolytes. If Lola doesn't eat I would consider giving her some Pedialyte or similar to supplement. You can buy Pedialyte at a pharmacy in the area where baby formula is. I mixed it with water to get my dog to drink it when she had a severe bout with the flu.

Sending warm thoughts - keep us posted. Hugs, Kim

AlisonandMia

03-22-2010, 11:22 PM

I am with your vet on the electroyte test - if it was ok in the past and she hasn't had any Lysodren since then its most unlikely that there would be any problem now.

It sounds like her adrenals have not regenerated and are not producing enough cortisol. It is possible that they may never regenerate (sometimes they don't) or that it may take many months for them to do so. There is not really a problem with this as long as she can continue on an appropriate dose of prednisone every day.

There are sort of two levels of Addison's: the more severe form where the adrenals cannot produce cortisol or aldosterone (the hormone that balances the electrolytes) When this happens a med like Florinef or Percorten needs to be given replace aldosterone and so help balance the electrolytes. When Percorten is given the dog will almost always need some pred to replace cortisol too. (Florinef often both balances electrolytes and provides cortisol replacement.) The other type of Addison's is what is called Atypical Addison's - and it looks like this is most likely Lola's situation at the moment. In this type of Addison's the adrenals are still producing aldosterone, and so the electrolytes are ok, but is unable to produce sufficient cortisol for the body's needs. This is treated with prednisone (or sometimes some other cortisol-replacing artificial steroid) and meds like Percorten or Florinef aren't needed.

This second or Atypical kind is by far the best kind to have and it is cheap and easy to treat. There are only really two "problems" with this - one is that the adrenals can eventually regenerate and the Cushing's return, and the other (and this applies with the first type of Addison's too) is that if dog is unable to keep oral medication down for some reason then some form of injectable steroid will need to be given until the dog is able to keep pills down.

Both types of Addison's can occur naturally or be caused inadvertently by treatment of Cushing's.

Good on you for giving Lola her pred as soon as you could - did she respond well?

Alison

Loladog

03-22-2010, 11:25 PM

The last acth stim test Lola had was on 12/23/09 and it looked good so we continued w/ the Lysodren. At that time, the pre was 2.2 and the post was 3.6. She started having symptoms the 1st part of February (we stopped the Lysodren on 2/6) and since then, she's had two Resting Cortisol tests. The first showed her level at .9 and the next was .6. Since her last resting Cortisol test, we did two weeks of one 5 mg table of Pred daily and then one week of one 5 mg tablet every other day. Her last dose was Wednesday 3/17 and here we are today very symptomatic of low cortisone levels again.:confused: I'm very eager to find out what the acth stim test results show tomorrow.

Loladog

03-22-2010, 11:30 PM

Loladog

03-24-2010, 12:14 AM

We got Lola's lab results back today and the vet said that she's definitely Addisonian. Her results are as follows:

ACTH Stim test:

Pre- 1.0
Post- 1.2

Spec cPL- 232

Our vet said that the Addison's is most likely Cortisone dependent only since her electrolytes looked really good the two times we checked since the Lysodren was stopped on 2/6.

There isn't much of a plan now other than to give her 5 mg of Prednisone daily for approx. 2 weeks and then try every other day. She said that we will most likely need to play around with the Pred dose to see what she maintains on. We're supposed to minimize Lola's stress as much as possible and make sure she's had her Pred if she's going to be in a stressful situation (for ex, going to the vet).

The vet said that there is still the possibility that her adrenals will regenerate but who knows. She recommended re-checking her ACTH Stim test in about 6 months. She said that if there isn't much improvement in 6 months, most likely she will be this way for life. Our regular vet was out of the office during all of this so I'll be interested in hearing what her opinion is too.

I feel so bad for putting Lola in this situation. I'm just thankful that it didn't go so far as to effect her electrolyte levels. Also, I'm not sure what's worse, a daily dose of Prednisone for life or Lysodren treatment for life?

All I can say is what a difference a day and two doses of Prednisone makes. Lola is rolling around on the floor with a squeaky toy right now, looking and acting perfectly healthy.:D

brandysmom

03-24-2010, 04:50 PM

Aimee,

I am so glad to hear Lola is feeling more like herself with the Prednisone :D

Loladog

03-26-2010, 10:40 PM

Hello all,

Our regular vet called me on Thursday to go over what she discussed with an Internal Medicine Specialist. According to the IM Specialist, the ACTH stim test results showing 1.0 pre and 1.2 post are good and this is right where you would normally want a dog being treated w/ Lysodren to be.:confused: This is after we were told that these results indicate Addison's. However, the fact that Lola keeps getting sick when we discontinue the Prednisone shows that she's ultra sensitive and we need to bring the #'s up slightly higher.

The plan discussed between our regular vet and the IMS is to keep Lola on Prednisone for the next six weeks while gradually decreasing the dose every couple of weeks (for ex, do 2 weeks at a full 5 mg tablet daily then go down to 3/4, 1/2, 1/4). At 6 weeks, they want me to take her off the Pred completely for 48 hours and then re-check the ACTH stim test. The IMS said that we need to be careful not to take her back to where she's having all of the Cushing's symptoms because we don't want to put her through a "loading phase" of Lysodren again.

Do you all think this is a good plan?

StarDeb55

03-26-2010, 10:48 PM

Loladog

03-26-2010, 11:00 PM

Aimee, this sounds like a reasonable plan. IMO, these numbers are really not where you want them to be, as this is what is termed a "non-stimulatory" result, meaning the pre & post values are basically identical. This means that the adrenals are not able to respond to stress they way they should & increase their production of cortisol as they have no cortisol in reserve to release into the body.

You can never stop pred "cold turkey". It must be a gradual weaning process over a pretty good period of time depending on what the initial dosage has been. It sounds like this IMS is pretty "on the ball", except for saying that the stim numbers are where they need to be.

Debbie

This is why I was so confused because the vet who saw Lola on Monday said that the post # should be about double the pre #. This is why she immediately said Addison's when she got the results back. Debbie, you explain everything so much better than our vets!:D

I will make sure to wean her off the Pred slowly before she has to go off for 48 hours pre ACTH Stim test in 6 weeks. Lets keep our fingers crossed that her symptoms don't return as I reduce the Prednisone.

Harley PoMMom

03-27-2010, 08:52 PM

Hi Brenna,

I got the diet plan from Monica Segal a couple of days ago. It calls for starting off w/ just Ground Turkey and Rice and then gradually adding in some boiled Zucchini, carrots and vitamin and mineral supplements. If Lola tolerates everything ok, she might replace some of the supplements w/ food that contains the necessary vitamins (for ex, Beef Liver). So far, Lola will eat the Turkey and Rice but only if it's warm. I don't know what she's going to do once we add the vegetables because she will usually do whatever she can to pick around veggies. I have to say that the diet plan first looked VERY overwhelming to me. Some of the food needs to be measured in ounces so we had to purchase a kitchen scale. I really hope that I can get a good routine going.

Take care and I hope you don't have to work all weekend again!:(

Hi Aimee,

I was overwhelmed too at first when I got Harley's diet from Monica! I did buy a kitchen scale...digital one with big numbers!

As far as the veggies go, I asked Monica if I could substitute the carrots and squash in Harley's diet with strained pureed baby carrots and squash, the ones you buy in the grocery store for babies...she approved.

Best of luck with Lola's diet. Keeping you both in my thoughts and prayers.

Love and hugs,
Lori

Loladog

04-03-2010, 10:29 PM

Up until today, I've been cooking Lola's new diet as needed every couple of days. Today was my first day cooking a weeks worth of food in one large batch. I have to say that I'm now exhausted!:( I feel like such a wimp but that was a lot of food to put together! On the plus side, the diet seems to be agreeing with her (knock on wood).

I'm still giving Lola one 5 mg tablet of Prednisone daily and she seems to be feeling good.:) I'll reduce the dosage slightly next week and we'll see how things go from there.

Harley PoMMom

04-03-2010, 10:37 PM

Hi Aimee,

It is alot of work cooking for our furbabies, so you are no wimp!

I am so happy that the diet is agreeing with Lola...knocking on wood too!

Love and hugs,
Lori

MiniSchnauzerMom

04-03-2010, 10:55 PM

Hi Aimee,

Don't think I've posted to your thread before but when I saw your post I said to myself "ah-ha....this is a topic I'm all too familiar with".

Believe me, a wimp you are not! I have been home cooking Munchie's diet (from UC Davis vet nutritionist) since 2008. It definitely can be exhausting. Currently I cook only 4 days worth at a time as cooking enough for 10 days at a time did me in. I've purchased assorted goodies to make the prep "less painful" - rice cooker, I was required to buy a gram scale and my latest acquisition was an automatic potato peeler as I have ended up with "potato elbow" (as opposed to tennis elbow which probably would have been more fun. :D )

I do not have the problem of selective eating with Munchie but it was suggested to me that everything be lightly processed together in a food processor or blender to prevent this. I also add some water to his food (recommended for stone prevention) so it's a bit like soup. He slurps it right up. Don't know if any of this would work for Lola but thought I would pass the info along just in case.

Glad Lola's new diet is agreeing with her.....and hang in there!

Louise

Loladog

04-03-2010, 11:21 PM

Louise and Lori, I really appreciate your support. It helps to know that I'm not the only one who finds this difficult. People who have been home cooking for their dogs for a while make it sound so easy sometimes.:)

The hardest part for me today was cooking the 7 days worth of rice and trying to cook it long enough to make it "mushy". I had to add water over and over and continue stirring for an hour. In the past, I always just used a rice cooker which is so much easier but the diet consultation I received led me to believe this is not the way to go.:confused: I'm not really sure why and I'd really like to go back to my lovely rice cooker!

In terms of Lola being picky, that totally disappeared when we purchased a microwave. She gobbles her turkey and rice right up and then licks the bowl as long as it's been re-heated in the microwave. Problem solved.:D

AlisonandMia

04-04-2010, 04:26 AM

Maybe you could try doing the first part of the cooking in the rice steamer and then put the rice in a saucepan for the cooking-it-to-a-mush part of the process. A slow cooker could be good too, I'd think, especially if you steamed the rice first and then slow cooked it with plenty of water until it was totally gluggy.

More washing up that way though....

Alison

PS: Have they stipulated what sort of rice you should use? I believe short-grain and medium-grain rices are easier to get to go gluggy than long grain.

MiniSchnauzerMom

04-04-2010, 04:30 AM

Aimee,

I'd sure double check about using the rice cooker. There was no problem with using one with Munchie's veterinary nutritionist (who is also a DVM). I have some less than fond memories of charring more than one pan of rice prior to the rice cooker. :eek:

Glad Lola is lovin' her food and licking that bowl clean!
Louise

Sabre's Mum

04-04-2010, 08:23 PM

Loladog

04-06-2010, 01:30 AM

Hi Aimee,

I have been keeping up with your thread but haven't had time to post. Debbie has given you some great info re Lola's stim results. I do think the plan of weaning the pred slowly over several weeks is a good plan, particularly if Lola appears to need the pred. In Sabre's case he took 3 months to go from pre 1.34 post 1.48 (non-stimulatory) to pre 2.35 post 3.73 with NO lysodren. Sabre was only on pred for a few days. What I have observed over the last couple of years is that the larger dogs who go low or have non-stimulatory ACTH stim tests seem to take longer for their adrenals to regenerate.

All the best
Angela and Flynn ... and our dearly departed Sabre

Thank you Angela for this information on how sensitive Sabre was. Even though I haven't been a member of this group for long, I always think of Sabre when I'm wondering about Lola's sensitivity.

I need to lower Lola's Prednisone dose slightly this week and this is making me nervous. I'm just going to go down from one 5 mg tablet to 3/4 of a 5 mg tablet for a couple of weeks and then down to 1/2 and then a 1/4. We'll see how she does as I start lowering the dose.

Loladog

04-18-2010, 02:22 PM

Well, so far so good with Lola's home-prepared diet. I think I'm actually starting to get comfortable with the cooking part too!:) I'm using a rice cooker which helps. Also, Lola surprised me by eating her zucchini and baby carrots mixed in with the ground Turkey and Rice. She doesn't seem to even notice that she's eating vegetables.:D

I've got her down to 3/4 of a 5 mg Pred tablet daily right now. Next week I will be reducing the dose to 1/2 of a 5 mg tablet. She'll be due for a re-check ACTH stim test around May 6th so I have to wean her off of the Pred by then. I'd also like to have them run a Spec cPL at that time to see how her new diet is helping with the Pancreatitis.

I have a question for you all about L-Glutamine. Lola has had a lot of muscle wasting in her hind in from the Cushing's and her arthritis. I'm wondering how many of you use this supplement for this and does it help? If you have any brand or dosage suggestions for a 60 lb dog, I would greatly appreciate it.

Thanks everyone!

Nathalie

04-18-2010, 06:24 PM

Hi Aimee,

Phillip is 64 lbs and gets 1000 mg daily.
He has lost a lot of muscle in his hind legs and I have not noticed any gain in muscel mass but I also don't see any further loss.
Another reason why I am using L-Glutamin is to help with any GI issues. My first considderation when buying vitamins/supplements is a brand I trust and then cost and then easy availability.
I like Natural Factors, Sisu
I stay away from anything generic.

Nathalie

brandysmom

04-18-2010, 07:37 PM

Hi Aimee,

I'm so glad Lola is doing great on her new diet:D

I have been giving Brandy L-Glutamine for the past few months for her GI issues as well. I havn't noticed a difference in her muscle mass - she too has lost a lot of it over the past year or more. I have been giving her 500 mg 2x/day and she weighs in at 63 lbs. I purchase through the Monica Segal website. Best of luck and take care.

Harley PoMMom

04-18-2010, 08:23 PM

I also use the L-Glutamine for Harley. I started him on it within a few months of his cushing dx and he doesn't have that much muscle wasting. He also doesn't seem to be losing anymore either. I orginally started him on the L-Glutamine to help his GI tract but since reading of it's benefit to help the muscle wasting, I just love this product and Harley's vet thinks it's a good thing too.

I buy his from Monica Segal's web site, only because she formulated his diet and she stands by all of her products.

I am so happy to read that Lola is doing so well on her new diet, it is alot of work but so worth it when it makes them feel so much better, ain't?

Love and hugs,
Lori

Boxer_lover

04-19-2010, 09:29 AM

I don't have any thing to add about treatment with Lysodren as my Boxer (Ben) is on Trilostane. I just wanted to say hi to a fellow boxer owner (aren't they great?) and say I love that picture of Lola. So sweet!! :D:D:D:D:D

Loladog

05-02-2010, 07:01 PM

Hi all!

I've had a little set back with Lola's home prepared diet over the past two weeks. She was doing great until I started adding in the vitamin/mineral supplements. I only add one at a time and then wait a couple of days in between each one. I added Di-Calcium Phosphate, Calcium Carbonate and then Magnesium and Lola started having very loose stools. I thought it was the Magnesium since it can cause this so I discontinued all supplements until her stools returned to normal. I then started the process of adding in the supplements one at a time again and found that she started having problems after I added the Di-Calcium Phosphate. She had diarrhea this morning so I'm going to have to cut out the supplements again until everything goes back to normal. I e-mailed Monica Segal to see how I should proceed from here. Lola does great with the base diet but I don't know how long we can go without the vitamin/mineral supplements.

I've also weaned Lola down to just 1/4 of a 5 mg Prednisone tablet daily. Tomorrow is the last day at this dose and then I have to cut it out completely because she's due for an ACTH Stim test on Thursday (5/6). I'll let you all know how that turns out. The thought crossed my mind that it's the reduced Prednisone causing her loose stools/diarrhea but she's not showing any other symptoms of low Cortisone levels. Usually when her levels get too low, she loses her appetite and gets lethargic along w/ diarrhea. Her appetite and energy levels are so far so good.:) We'll see how things go this week.:confused:

Harley PoMMom

05-02-2010, 07:35 PM

Hi Aimee,

So sorry to hear Lola's having issues with the Di-Calcium Phosphate. Great job on your part for introducing the vit/min supplements slowly so that you could tell exactly which one was the culprit. I am sure Monica will be able to figure out what to do to help you and Lola.

I will be looking for your update for the next stim and about the supplement issue.

You are doing a wonderful job! :)

Love and hugs,
Lori

brandysmom

05-04-2010, 04:47 PM

Aimee,

I'm glad Lola is doing well with the home cooking and so sorry the supplements aren't agreeing with her. You did the right thing by narrowing it down to which one. Any response from Monica?

And good luck with her ACTH stim test. Keep us posted! :)

Loladog

05-06-2010, 11:05 PM

Monica Segal told me to discontinue all supplements for a full week and if her stools have resumed to normal, I should add the Di-Calcium Phosphate only back in to make sure that's really the supplement causing her problems. Her stools are finally back to normal today after 3 full days without supplements.

I took Lola in for her ACTH Stim test today as well as a Spec cPL. When I scheduled the appt, they told me to not feed her breakfast because she needed to be fasting for the first blood draw.:confused: I was very confused because they've never told me this before. They told me to bring her breakfast with when I dropped her off and they would feed her after the 1st draw. I got the saddest looks from Lola when I fed the kitties and not her this morning. It really broke my heart.:( To make matters worse, she was absolutely trembling when we arrived at the vets office and then she didn't want to be taken to the back. When my husband went to pick Lola up around noon, they handed him the food that I left for her breakfast and they said they didn't "need to feed her as part of the test after all". When he told me this, I was furious.:mad: Even if they didn't "need" to feed her, they should have simply because she was probably starving and you shouldn't do that to a sensitive old lady!

Anyway, I'm sorry for the venting.:o I will post her lab results tomorrow once I have them. Can I verify with someone here whether or not the ACTH Stim test needs to be fasting?

ChristyA

05-07-2010, 01:43 AM

I would have been upset too about them not feeding her. I can't remember if they need to be fasting for the STIM, someone else will let us know I'm sure. I hope all is good on her results.
Christy

brandysmom

05-07-2010, 07:07 AM

I would be mad too. :mad: Brandy has had 4 ACTH stim tests since December and she never had to fast for any of them. Hope the results are perfect! :D:D

Harley PoMMom

05-07-2010, 05:24 PM

Hi Aimee,

For cPl test a pup definitely needs to be fasted. Now, for the ACTH stim test many labs do prefer that a pup be fasted because the excessive lipids in the blood may affect cortisol assay results, but if your pup is on a very low-fat diet, as my boy Harley is because of his pancreatitis, and/or the pup has had no problems before with their lab work, then fasting isn't always required. Harley isn't fasted for his ACTH stim tests.

I can not believe that they didn't feed Lola her breakfast. :( Give sweet Lola some extra hugs and kisses from Harley and me.

Love and hugs,
Lori

Loladog

05-08-2010, 12:08 AM

Our vet called with Lola's lab results this evening and they are as follows:

ACTH Stim test:

Pre- 1.6
Post- 2.8

Spec cPL- 642 :confused:

The vet was very concerned about her lab results showing that she has Pancreatitis and we are extremely confused because she's been on a a very low-fat, home prepared diet. Her lab results from 3/22/10 were:

ACTH Stim test:

Pre- 1.0
Post- 1.2

Spec cPL- 232

As I've mentioned in my recent posts, Lola has been having loose stools and some diarrhea over the past two weeks. We were thinking it was related to the addition of vitamin/mineral supplements to her diet but it's continuing even after discontinuing all of the supplements. Maybe it's related to the Pancreatitis?:( It's very strange because she will be fine one day and off the next. For example, she had a perfectly normal bowel movement yesterday and then a loose, yellow colored bowel movement this morning. We can't get much lower in fat than her current diet and she's showing no other symptoms

In terms of the ACTH Stim test, the vet said that she definitely doesn't need any Lysodren. The plan is to give her 1/4 of a 5 mg Prednisone every other day for two weeks and then stop. She's been off of the Pred since Tuesday 5/4 so I started her back with a 1/4 today. The vet said to re-check her ACTH stim test 4 to 6 weeks after I stop the Pred unless she starts showing symptoms that warrant testing sooner.

Poor Lola......she's on such a roller coaster.:(

I asked the vet this evening about the fasting and she said that it's not necessary. She apologized that the staff told me that and said to ignore them in the future. I still don't know why they couldn't feed her breakfast.

Harley PoMMom

05-08-2010, 01:01 AM

Hi Aimee,

Lola's stim numbers look great ;):) That pancreas is such a fickle organ! Anything can set it off and make those cPL numbers elevated...so it really doesn't surprise me that Lola's are high because she was having some issues with her supplements before she had the cPL test done, right?

I think I mentioned it...but I'm not sure :confused::) my boy Harley's pancreatitis was found on his first ultrasound :eek: Yep, the ultrasound showed that he had PRIOR BOUTS of pancreatitis, and I never knew it. Holy crap that scared the you know what out of me and I went on a mission to find out about pancreatitis and how in the heck I missed it in my boy. Harley's first cPLI results were 528 and he showed no symptoms of pancreatitis.

Since then I have done everything I can to bring those numbers down, and they are slowly coming down. Lola's will get down too, it just takes time. ;):)

Love and hugs,
Lori

Loladog

05-08-2010, 03:59 PM

With Lola's Stim test results being at 1.6 pre and 2.8 post, does the plan the vet gave me sound good to you guys? The plan is to give 1/4 of a 5 mg Pred every other day for two weeks and then stop. Re-check the Stim test 4 to 6 weeks after stopping the Pred or sooner if she becomes symptomatic. No Lysodren..............

The Spec cPL results of 642 is higher than Lola's been in months. It's the highest # I have in my journal for her.:( I will be e-mailing Monica Segal to see what she suggests but I don't see how her diet could go any lower in fat. I wonder if she got into something that we don't know about?

Lori, Lola has never been symptomatic with her bouts of Pancreatitis either except for the loose stools that we're now putting together with the high Spec cPL levels.:o Her Pancreatitis wasn't discovered until she had pre-anesthetic lab work for a routine dental. Her Lipase levels were over 1000 if I remember correctly and the vet at the time gave us his home # because he was worried she'd die over the weekend.:eek: The Pancreatitis without symptoms is what led the vets to look for Cushing's. If it wasn't for the pre-anesthetic blood work, we never would have known. It's all so crazy.:confused:

Casey's Mom

05-09-2010, 10:52 PM

Her stim results to me look like her cortisol is a little low. I am also treating with Lysodren and for the vet to prescribe the small amount of pred looks good to me - that seems to be a very conservative amount. Your vet is trying to get her cortisol up a little bit and then recheck.

I know with my dog Casey she feels best when her post is a little over 5 but also all dogs are different.

Love and hugs,

Sabre's Mum

05-10-2010, 12:45 AM

Hi Aimee

Lola's stim results are actually bang on where you want them. When treating with Lysodren you want the post result to be between 1 and 5. Another thing you want when your dog has gone "low" as in Lola's case is as least a 25% increase between pre and post and you have a 75% increase between pre and post which is great. Personally, I would have wanted to restart Lysodren (at a lower dose though) if it were me but we were never dealing with Pancreatitis as well. Although given that it has been about three months (if I have read it right) that Lola went low she might be still in range in 4-6 weeks.

Does Lola need the pred at the moment? How was she on the days which she didn't have pred? I am not familar with pancreatitis issues but when dealing with cortisol levels we have only given pred if Sabre's levels were low ... but never at a level of post 2.6 ... this is just a normal post level for a dog treated with Lysodren ... in fact this level is what I would call perfect ... bang in the middle. The level of pred dose is so tiny I am not sure whether it would be having any effect???? Don't quote me on this though. For a 25kg dog this equates to 0.05mg per kg. The rescue dose for low cortisol is 0.25mg per kg and we have never weaned at this level ... just stopped after three days of pred.

Obviously, in Lola's case she is also dealing with pancreatitis and someone else may want to comment on this.

Angela and Flynn and our dearly departed Sabre

Loladog

05-12-2010, 01:39 AM

After I gradually weaned Lola off of 6 weeks worth of Pred she went 3 full days without it so that she could have her Stim test on Thursday 5/6. Per the vet's recommendation, I started her up on the above mentioned 1/4 of a 5 mg tablet every other day on Friday 5/7. To me, she's been a little "off" for the past couple of days. Although it's very subtle, there have been things that have caused me to be concerned. For example, she's been a little lethargic and "spacey". This morning, she wanted to just sit out in her yard instead of coming back in as she usually does. It actually snowed here last night so she was just sitting out in the cold "zoning out". However, her appetite is still good which is great but she's definitely not as lively as when she was on a higher dose of Pred. Also, we think that she vomited earlier this evening. Unfortunately, it was right as I was arriving home. My husband said that she had been running around excited that I was home and then he heard her licking up something in one of the bedrooms. When he investigated, there were bits of undigested rice spread all over the carpet where she was licking. She must have vomited but we don't know exactly how much. Also, was it from the excitement and running around, or is it related to the Pancreatitis?:confused: When her Cortisone levels have gone low in the past, these subtle signs were present but then she also had loss of appetite and diarrhea/vomiting. I left a message today for the vet to call me and we'll just have to see how she does over the next few days. Even though what I've been noticing is subtle, I feel like we pretty much know when she's "off" now.

Angela, it makes me feel better that your think her levels are right on. I really appreciate everyone's feed back because I wasn't sure if her Stim test results were good or bad. It's unfortunate that we're dealing w/ Pancreatitis too because we're never really sure what's causing her symptoms.

Loladog

05-13-2010, 01:59 AM

I spoke w/ our vet today regarding Lola's subtle symptoms since stopping and then re-starting the Pred at a 1/4 of a 5 mg tablet every other day. She said that despite the fact that Lola's Stim test results indicate we should start her back on Lysodren, we want her to feel well more than anything. Obviously, Lola is very sensitive and things definitely haven't been going the way the vet expected.

The vet recommended I put her back on 1/2 of a 5 mg tablet of Pred daily now for a week to see if she starts feeling better. They will call me next week to see how things are going and then we'll decide what to do next at that point.

This is such a roller coaster ride that I feel like I need to go on anti-anxiety meds.:o I'm so glad that I have this forum for support.:D

Loladog

05-19-2010, 12:21 AM

Hello everyone,

For those of you who supplement w/ Milk Thistle and/or Sam-E for liver support, can I ask what you use and at what dose? I've been supplementing w/ the veterinary formula Denamarin which is a combo of both Milk Thistle and SAM-e. However, this runs around $85.00 per month and I'm a bit overwhelmed with veterinary expenses right now as I'm sure you can all understand. I'd like to find human formulas that might save me a little money but then I'm not sure of what dose I would give (Lola weighs 60 lbs.). Any advice would be greatly appreciated.

Here's a quick update on how Lola is doing. She's been on 2.5 mg of Pred daily since last Wednesday 5/12. I'm supposed to check in w/ the vet later this week to see where we should go from here. Lola seems to be feeling good but she's still having loose stools everyday. I've been corresponding w/ Monica Segal regarding her diet and she suggested I cut out her fish oil and Glucosamine for a few days since these are both fish products and they might be the culprit. Unfortunately, it's been close to 3 days now and Lola is still having loose stools.:(

This evening, I noticed that some of Lola's hair was standing up near her tail. I went to smooth it down and found that it was falling out. I of course had to pull and lots of chunks started to come out. Her coat is very dry and fuzzy right now too. It's only been a week and a half since her ACTH stim test #'s were good but I now feel like we need to be careful that we don't put her back into active Cushing's. She grew in a very different long/fuzzy coat after we started her on Lysodren but the dryness now is odd. Either this is Cushing's related or maybe she's lacking in nutrients because of her limited diet.:confused:

BestBuddy

05-19-2010, 01:01 AM

Hi Aimee,

I never used the sam e for my Buddy but I did use human milk thistle. This is the site I used for my guide.

http://www.lowchensaustralia.com/health/thistle.htm

Jenny

mypuppy

05-19-2010, 07:33 AM

Hi Jenny,
I find myself reading a lot here on the forum on the wonders of milk thistle, however was curious if this supplement should ONLY be used on a pup who has liver issues or can it be used on a cushdog as a preventive supplement? Thank you for any info. you can provide. Best regards, xo Jeanette

Nathalie

05-19-2010, 08:09 AM

Hi Aimee,

I use Milk Thistle tincture from A. Vogel (http://www.avogel.ca/en/shop/natural_remedies/milkthistle.php)- Phillip is 64 lbs so he gets 12 drops 2x per day with his food.
The bottle costs about $16 and last approx. 2 months.

I am not sure if it could be used as a preventative and if what the regiment should be - in general I supplement on a need basis only. 2 of my dogs are on Milk Thistle due to elevated liver enzymes, Matthew is not.

OmegaAlpha makes a Liver Flush (http://www.omegaalpha.ca/en/product/102/LiverTone_trade/)that can be done once per year to promote liver health.

Nathalie

BestBuddy

05-19-2010, 08:12 AM

There is probably plenty of documentation about when and why to give milk thistle but I started using it on Buddy as a preventative.

The way I saw it was that the liver is the body's filter for toxins and most medications can have this effect on the liver so treating a cush dog would be a good reason to help the liver any way possible.

Buddy was also on constant antibiotics for UTI so that doubled the reason I wanted to be pro active. I never actually had any testing done on Buddy so I really don't know whether he needed it or even if it did any good.

I do believe that both sam e and milk thistle does work because I tested it on myself.;) I take medication for RA that isn't very liver friendly and at the start of treatment I had normal liver values and every month (before the same e and milk thistle) the numbers started to climb to a point the specialist wanted to cut down the dosage but after a month of same e and milk thistle the numbers started dropping and after several months the liver values are back to normal.

Jenny

brandysmom

05-19-2010, 05:38 PM

Loladog

05-19-2010, 11:38 PM

Thanks everyone for your input on the Milk Thistle and Sam-E. The Denamarin is very easy because it contains both and is only one pill per day but as Brenna said, it's very expensive.

Lola's loose stools continue.:confused: I spoke w/ our vet today regarding reducing her Pred dose (I'm going back down from 2.5 mg to 1.25 mg daily) and we discussed her digestive issues. The vet is very worried because there are too many variables right now. We don't know if it's the Cushing's, the Pancreatitis, her diet or a possible undiagnosed GI disease. Even though she's the one who recommended the home prepared diet, she's now recommending a Prescription diet to see if things improve. She said that it doesn't have to be permanent, but she's worried about not knowing the cause of the loose stools. She said once we can get the Cushing's and Pancreatitis under control (when/if), maybe we can explore other food options. I absolutely cringe at the thought of the ingredients in the prescription diet:eek: but I also agree that there are too many variables right now. I told the vet that I will run all of this by Monica Segal (who I just e-mailed) and then think about it for a couple of days. I would feel like a failure going from a nice home prepared diet to a nasty prescription but I'm feeling very overwhelmed right now.

brandysmom

05-20-2010, 11:20 AM

Aimee,

Do you still give Lola Tramadol? Look what info I found below. It said this was a "moderate" side effect. I never knew this. I have only given Brandy Tramadol a couple of times. None of her "shivering" moments were during those times. Just wanted to send this your way as an FYI.

Tramadol (Ultram) can affect a chemical in the brain called serotonin. SAMe can also affect serotonin. Taking SAMe along with tramadol (Ultram) might cause too much serotonin in the brain and side effects including confusion, shivering, stiff muscles, and other side effects.

frijole

05-20-2010, 02:41 PM

Not sure how tramadol got into this conversation but just in case it is important I wanted to share a recent experience. My dog is over 16 and I finally decided to give her tramadol for those aching joints. The original vets dosage was in line with the recommended amount for her weight.

I gave it to her and it was a complete nightmare the first night! She was totally loopy, walked into walls literally, then stood staring at the wall. She got multiple bouts of diarrhea throughout the night and it was just awful.

I found out that several other members here - in fact all I believe - that have used it had to go with about 1/2 of the recommended dosing amount. She is now doing just fine on it.

Kim

jrepac

05-20-2010, 02:56 PM

Aimee,

I have been giving Brandy 175 mg of Milk Thistle 2x/day, 200 mg of Sam E 2x/day with 400 mg of Vitamin E 1x/day, per the advice of my regular vet. She wanted me to purchase the Denamarin, but it was too expensive so she gave me this alternative. Brandy weighs a little more than Lola at 66 lbs.

The typical milk thistle caps you'll find in the store start at 175mg.; you may be able to find higher levels if needed. From what I've read, 200-300mg is fine for a dog that requires/would benefit from liver support, which includes a cushpup. The SAM-E is usually in 200mg tabs as well, tho' you may see double strength tabs out there. 200mg is a fine starting dosage. Buying these 2 separately, "over the counter" at Walgreens or similar is much cheaper than buying Marin, Denosyl or Denamarin, tho' those brands would claim that they effectively deliver more of the "active ingredients" to the dog. I am not sure if that is proven or just hype.

brandysmom

05-20-2010, 05:19 PM

Sorry about throwing the tramadol in there. Aimee and I discussed it in my thread for Brandy. Kim, you are right. I can see Brandy a little loopy on only ½ the dose, but not too bad. I think it helped the 2 times I gave it to her because she jumped on the couch :)

Loladog

05-20-2010, 10:26 PM

Wow! That's very interesting about the Tramadol and Sam-E. It's definitely something to think about. It's been a while since I've given Lola her Tramadol because she's been on Pred and therefore she hasn't been stiff and sore. I was giving her the Tramadol when she was on Lysodren because as expected, she felt her arthritis once the excess Cortisone was taken away. I was giving it to her on a daily basis and I never noticed it making her overly spacey or loopy. I didn't really notice much of a difference with her pain either. Unfortunately, there was a lot going on w/ the Cushing's and her Lysodren treatment at the time so I couldn't get a good reading on the Tramadol. I will not hesitate to try it again though when she starts showing signs of arthritis pain again. However, it sounds like I better make sure to not give it at the same time as the Sam-E.

Monica Segal responded to my e-mail last night and even she supports our vet's recommendation to put Lola on a RX diet. So it looks like that's the direction we'll be going. Does anyone else here use an RX diet for Pancreatitis and which formula do you use? The vet recommended Iams Low-Residue but I found that Royal Canin Digestive LF has slightly less nasty ingredients.

Loladog

05-27-2010, 11:05 PM

I caved in and switched Lola from a home-prepared diet to an RX diet last week.:( On the plus side, her diarrhea stopped the very next day and she's had perfect poops ever since.:D She also seems to be feeling a lot better. Our vet said that once we have her Cushing's under control, I can feed her whatever I want. We just don't want the question of "is it her diet?" as a variable when we're trying to figure out where she needs to be in terms of the Cushing's and Lysodren treatment.

I've weaned Lola down on the Pred to 1.25 mg every other day now. The plan is to give her this dose for two weeks and then stop completely. Our vet spoke w/ an IMS today and she said that ideally, we should do her next ACTH Stim test 4 to 6 weeks after stopping the Pred in order to get the best idea of where she's at. Of course we will re-test right away if she starts having symptoms again after stopping the Pred. The IMS also said that most likely she will not stay Addisonian permanently because her electrolytes were never affected when we over did it on the Lysodren. Plus, her post level was higher than the pre on her last ACTH test.

I'm very happy that she's feeling good right now. She's been doing a lot of zoomies around her yard in the evenings which always makes me smile.:D

Loladog

05-31-2010, 07:51 PM

I took Lola's Pred dose down to 1.25 mg every other day on Wednesday 5/26. This past weekend, I started to notice very subtle side effects again. She's not all that interested in food although she will finish her meals. Also, she's sleeping a lot more and is stiff and sore again from her arthritis. I gave her a Tramadol this morning for the first time in a while. So far, she hasn't had any vomiting or diarrhea but just like the last time I tried to wean her off the Pred, she is showing subtle signs of being "off" to me.

I'm supposed to give her the 1.25 mg every other day for two weeks and then take her completely off of the Pred. The vet would like for us to ideally wait 4 to 6 weeks before she has her next ACTH Stim test. I'm just worried because I want her to feel good. Do I just need to get used to how she feels without the excess Cortisone or are these symptoms still a result of us putting her into Addisons?:confused: It's now been since the first part of February since she had her last dose of Lysodren. We've been on a roller coaster ride ever since with the Pred.:(

labblab

06-01-2010, 09:20 PM

Aimee, I wish I had some concrete advice to offer you, but it sounds as if you're having to suffer through some "trial-and-error" in terms of finding the best way to keep Lola comfortable...:o

Even though I have no advice, I CAN still offer you two my best wishes. And I'm hoping that some other folks with more specific suggestions will also be stopping by, as well.

Please give Lola a big hug for me, OK?

Marianne

Sabre's Mum

06-02-2010, 01:20 AM

Hi Aimee
I can only write from our experiences with Sabre. He went low and was off Lysodren for four and a half months but only ever had pred for three days at the start.

Even throughout treatment ... low or in range Sabre was always tired and slept lots... it was something we just had to accept and lived with. He was happy but appeared to be tired a lot. But ... he would have times of absolute energy and exuberance that was a joy to see. It may be just in some dogs the low levels of cortisol (than that of a "normal" dog) just affect them in this way.

My concern with food would be if Lola wasn't eating her food ... then it is likely that perhaps her pred dose needs to be higher. Cush dogs will eat anything in sight ... and when their cortisol levels get within the 1-5 range some become quite fussy eaters and something they ate in the past is on the "I don't want" list! We fed Sabre a raw diet and once treated with Lysodren he would always leave some of his minced veges!

As Marianne said it is trial and error. There seems to be some written rules but not all of our dogs appear to have read them! I don't want to alarm you but we took 17 months to get Sabre's maintenance dose sorted out. He was great for the first few months ... then somehow he started metabolising the Lysodren differently and the dose became too high. He ended up with a dose which was 20mg/kg! Obviously Sabre refused to read the manual!

The only way you are truly going to see exactly where
Lola is .. is with an ACTH stim. I would say with how she is feeling .. my gut feeling is that it is unlikely that her cortisol levels are above range.

All the best
Angela and Flynn and our dearly departed Sabre

Harley PoMMom

06-03-2010, 09:14 AM

Hi Aimee,

Although I don't have any sound advice to offer either, I do wish you and Lola the best of luck. We all are here for you and Lola, always.

Love and (((hugs)))
Lori

brandysmom

06-03-2010, 09:46 AM

Aimee,

I wish I had some advice to offer too, except maybe another ACTH stim test now? I'm sorry Lola isn't feeling herself. It's funny how our babies can seem totally normal to everyone else, but we can always notice when they are a little off and not quite right. I completely understand. She is very lucky to have such a caring and attentive mom. I truely hope she is feeling better. Give her a boxer kiss for me. :) Take care.

marie adams

06-03-2010, 01:23 PM

Hi Aimee,

Boy this is not an easy task we have signed on for--I guess we can look at it as a learning experience so we can share with others in the future--pay forward. I am now in the reloading stage with Maddie. We loaded again last week; I thought she was there, but the test showed she was still high; so we are back at it this week. :confused: I changed vets because the first one was too conservative--I think they really didn't know enough. Part of me wants results right away, but all the wonderful people here tell us to be patient; so I figure they have been there and done this multiple times and know best. :)

Hang in there you are doing the best you can and I can tell you not to worry, but we all know that is the hardest task of all!!! :D

Loladog

06-03-2010, 11:28 PM

Thank you all for your caring thoughts.:) I've decided that even though Lola seems to be sleeping a lot more, I'm going to try not to worry as long as she's finishing her meals and having normal poops.:D In the past when her Cortisol levels were too low, she had diarrhea, some vomiting and she lost her appetite completely.

A lot of what Angela said regarding her experience with Sabre is ringing very true for us. Lola is definitely not going by the book either. I'm thinking that I just got so used to how she was with the out of control Cortisol (appetite for anything and everything and constant "nervous" energy). Now maybe she is more "normal" and just showing her age. She's finishing her meals but she will not eat things that she used to enjoy such as some banana when I make my smoothie in the morning or string cheese with her pills. She won't touch either of these now.:(

Angela, Lola was doing very well on her maintenance Lysodren dose in the beginning too (the dose was one 500 mg tablet twice weekly). On 12/31/09, her Stim test was Pre- 2.2 and Post 3.6. We thought everything was going well until she became very ill in February. Resting Cortisol tests showed .9 on 2/10/10 and .6 on 2/24/10. I wish I'd insisted on an ACTH Stim test back then but the vet wanted to do something fast when she was symptomatic. She didn't have another ACTH Stim test until 3/22/10 and it showed Pre- 1.0 and Post- 1.2. Her most recent Stim test was on 5/06/10 and the results were Pre- 1.6 and Post- 2.8. She's been off of the Lysodren completely since 2/06/10 and she's had to be on Pred in varying doses ever since. It doesn't surprise me that it took 17 months for you to get Sabre on a good maintenance dose. We're definitely headed in that direction!:eek:

On Monday, I tried the Tramadol again since Lola gets more stiff and sore as the Pred dose is brought down. The Tramadol made her even more tired. I even checked a couple of times to make sure she was still alive because she was sleeping so soundly.:o It didn't seem to help with her pain either so I haven't given her any since. Brenna, do you think the Tramadol is helping Brandy at all?

Next week I will be taking Lola off of the Pred completely so I'll keep you posted on what happens in our saga.:rolleyes:

Sabre's Mum

06-04-2010, 01:48 AM

Hi Aimee

Yes, your experiences sound oh too familiar. You appear to be on the right track with your thoughts and plans.

All the best, take care and keep us updated

Angela and Flynn

Harley PoMMom

06-04-2010, 07:38 AM

Some use adequan for their pups arthritis, maybe ask your vet about this.

Love and hugs,
Lori

brandysmom

06-07-2010, 08:17 AM

Aimee,

I've only been giving Brandy 1 tramadol at night with her 3rd meal. I can't tell if it helps because all she does is sleep anyway. I'm afraid to give it to her during the day because of the Sam E interaction. I really need to look into something that helps her, but is also safe with all her ailments and in combination with all her meds/supplements. I don't know if there is such a thing :confused:
I hope Lola is feeling better.

Loladog

06-12-2010, 04:47 PM

Lola had her last dose of Pred on Tuesday 6/8 and that was supposed to be it unless she started showing symptoms again. The plan was to try and go 4 to 6 weeks and then re-test her ACTH stim.

On Thursday, I started to notice she was becoming extremely lethargic although I tried not to worry because she was still eating and having normal stools. Yesterday, her lethargy was extremely obvious so there was no doubt that it coincided with stopping the Pred on Tuesday. She was still eating but she was not enthusiastic about her meals at all. She was eating her meals very slow and she kept stopping to look up at me. I spoke w/ our vet yesterday evening and she told me to start the Pred again and keep her on it for at least 4 weeks. The dose she manages on is 1.25 mg daily (extremely low). We'll check in with the vet in a month and then decide what to do from there.

Sabre's Mum

06-13-2010, 03:54 PM

Aimee

You are doing such a great job being observant of Lola's pred requirements. I believe you and your vet are on track ... you only need to be off pred for 24 hours to get a valid ACTH stim so if Lola needs the pred ... so be it.

Take care
Angela and Flynn

Harley PoMMom

06-13-2010, 04:32 PM

Hi Aimee,

You are doing a wonderful job taking care of Lola. I have a thought that you may want to ask your vet about. If your vet is trying to stop the prednisone to just get an ACTH stim test then why not give Lola dexamethasone instead. Dexamethasone is more potent than prednisone but it does not interfere with an ACTH stim test.

Love and hugs,
Lori

Loladog

07-05-2010, 02:15 PM

Hello everyone,

I just wanted to give an update on Lola since it's been a while. On 6/25, I called the vet because she'd been acting very lethargic again and she wasn't showing much interest in food. We decided to try and increase her Prednisone up to 2.5 mg daily and this seemed to help her perk up a bit. Even though she seems to feel better, she's still not very interested in her food and I'm thinking that she doesn't find her Rx diet to be very tasty. Also, I used to be able to hide her pills in her food and/or small pieces of string cheese but she will not allow either of these options anymore. I'm now having to shove all of her medications and supplements down her throat. Does anyone have any suggestions for pilling a picky dog on a restricted diet? She will not even accept her fish oil sprinkled over her dry food which she used to have no problem with. I'm thinking of purchasing some of the canned food version of her Rx diet to hide pills in but the ingredients are so nasty I'm having a hard time with it. She's currently eating the Royal Canin Digestive LF dry only.

One other thing is that she's shedding like crazy!:eek: It appears as though she's blowing the long coat that grew in with her Lysodren treatment and it just won't stop. With the amount of hair that she's losing, you'd think she'd be bald by now but it seems like there's no end to it. We can't keep up with vacuuming clumps of hair up in the house. Has anyone else experienced this? Her coat is completely different from the short, Boxer coat that she used to have.

sunimist

07-05-2010, 03:10 PM

Hi Aimee,

One thing you might try that I found very effective with the prescription dog food...Get the canned version, slice it into thin slices and bake until it browns. Seems to make it more appetizing to them. Doesn't smell too great cooking, but it might work for Lola. You can put portions in baggies and freeze until needed. Pop it in the microwave for a few seconds and it's good to go. Might give it a try..won't hurt.

Good luck,

Shelba and Suni~~

Sabre's Mum

07-05-2010, 03:33 PM

Hi Aimee

Yes... our pups do seem to be more picky with their low cortisol. With regards to the blowing of the coat. I found that when Sabre was having a Lysodren "holiday" his coat would moult. He would grow hair back after Lysodren was restarted. What does regrow back with Lysodren treatment is very different to the normal hair. We had the hairest Vizsla in the world ... more like a labrador's coat than the fine short hair of a Vizsla.

Take care
Angela and Flynn

addy

07-05-2010, 03:44 PM

Hi,

I did read that often a dog's coat will grow back in differently, color could change,texture, curly verses straight. I don't believe anyone stated why, just alot of people reported that happened to their dog's coat once they started treament. I will look to see if I can find the article for you.

Zoe had a honey colored spot on her back end and it is gone now, hair is white and the new hair growing from the base of her tail is curlier than it was and she has not yet started treatment. The IMS said the honey colored spot might come back, she wasn't sure.

Addy

apollo6

07-05-2010, 04:44 PM

It does seem Cushing does change the coat, before treatment Apollo's hair behind his ears grow back a golden color, his normal coat is dark red and some black, a little grew back on his hind legs, golden also. But that was the end of the hair growing back. His beautiful ears have just a few patches of hair now.

Loladog

07-10-2010, 02:57 PM

This morning, we found two lesions on Lola's back that are oozing puss. You can tell that there will probably be hair loss coming soon once the lesions dry out. This is exactly what we saw about a year ago and it was one of the symptoms that led us to her Cushing's diagnosis. Once we started treating her with Lysodren, the skin infections stopped and this is the 1st we've seen of them since. I don't know why this is happening again though because she's not showing any other signs of active, untreated Cushing's.:confused: Her appetite has been practically non-existent lately and it's been hit and miss as to whether or not she will finish her meals.:( Unfortunately, our vet will not be in the office again until Wednesday 7/14 so I'll have to wait until then to take her in. I'm going to give her a bath today to see if I can get a better look at the skin lesions.

marie adams

07-10-2010, 04:11 PM

Hi There,

Maddie's fur doesn't seem to be growing back and she has been on Lyso since February. Last week combed thru her coat and got tons out. She still has lots of fur, but the even bald spots on belly, back hind legs, under front legs, and no underfur. Her fur is normally black, but turned a reddish color. She seems to have lost a lot of the black on her face and the tan has taken over. Maybe there has been regrowth just not where I wanted it to come back---weird.

Maddie still has her appetite--has never lost that, but she isn't ravenous any longer. She doesn't get any grain in her diet. I googled "a diet for a cushings dog" and they said don't feed grains. I think this is what horses have to do also--no grains when they get cushings. She eats raw chicken and a new dry called California Naturals from Nutra--comes in different versions--I am using Venison. She will eat pills in her food; so I am fortunate--sometimes the fish oil pill slips out of the bowl, but she will chew on it and finally get it down.

I hope Lola starts feeling better soon!!!:):)

Sabre's Mum

07-10-2010, 04:26 PM

Hi Aimee

When Sabre had his Lysodren holiday his calcinosis cutis would erupt more. Even though his cortisol levels were below where they should be ... the Lysodren appeared to keep his skin conditions at bay.

This may be the case with Lola as well. When skin infections were a problem we used an oatmeal shampoo (one that you leave on for five minutes after lathering up - I think it is called Aloveene). We also gave him antibiotics for periods of up to 5 weeks to try and abate the infections and also betadine or diluted iodine applied to the spots.

All the best and take care
Angela and Flynn

Loladog

07-10-2010, 09:56 PM

Angela,

That is very interesting that Sabre's skin infections would act up even though his Cortisol levels were below where they should be. This definitely seems to be what is happening with Lola. I will talk to the vet next week to see about a round of antibiotics and I'll also look for a good Oatmeal shampoo. Prior to the Lysodren treatment, the vet prescribed some medicated skin washes but they didn't seem to help. Oral antibiotics were the only thing that seemed to do the trick and then of course, the Lysodren. I"m so glad that you're still following my posts because Sabre's case seems to be very similar to Lola's.

Marie,

I would love to be able to feed Lola a grain free diet but she needs to be on something very low fat due to chronic Pancreatitis. She's on a Rx diet right now that's only 5% fat (Royal Canin Digestive LF). I really hate having her on this diet but this is the 1st food that has agreed with her in a long time that's also low fat. Prior to this, I tried many different low fat, high quality dry and canned foods plus a home prepared diet but diarrhea and high Spec cPL levels persisted. I actually recently looked up the new California Natural grain-free diets but they are too high in fat for Lola's situation.:( The vet told me that I will not have to keep her on an Rx diet forever but she wants her to be on it until we get her in a more stable place. If she has diarrhea, we need to know that it's not her diet causing it.

It's so crazy what happens to their coats with Lysodren treatment. As Angela described Sabre, Lola's coat definitely looks more like a Labrador than a Boxer.:) There's also a lot of black mixed in that was never there before.

I'm just wondering if it might be time to re-test Lola? Her last ACTH Stim test was on 5/06/10. If we re-test, we will need to wean her off of the Pred first.

Harley PoMMom

07-10-2010, 10:22 PM

I am so sorry that Lola is having these issues and I am hoping that the lesions clear up soon.

I'm just wondering if it might be time to re-test Lola? Her last ACTH Stim test was on 5/06/10. If we re-test, we will need to wean her off of the Pred first.Maybe ask your vet about using dexamethasone instead?

Love and hugs,
Lori

brandysmom

07-14-2010, 08:55 PM

Aimee,

I'm sorry to read you are having issues with Lola. I can honestly say I never had anything like the skin infections with Brandy. Her fur was thin and she shed a lot, but I have never seen the different fur from Lysodren, but then she has been on a low dose.

Lola is still not too interested in food? What supplements is she on now? Brandy has been doing excellent on the Artemis food. I haven't had her numbers tested, but her pancreatitis has been almost non existing. If you get a chance, Google their website. Look at the Weight Management formula. The ingredients are really good and there's no corn, wheat or soy. The fat is the lowest I could find while still maintaining a 5 star food.

I hope you were able to speak to the vet and got her the antibiotics she needs. I saw your post on Boxerworld regarding Brandy's arthritis. I think I'm going to give the Adequan injections a try. I'm just trying to shop around for prices and the vet will give me a prescription. Take care.

AlisonandMia

07-14-2010, 10:09 PM

I don't think it is the Lysodren as such that causes the weird coats that we see with our treated Cushing's dogs. It seems to be more the big changes in their bodies caused by the initial high cortisol and then having it reduced back to a more healthy level again with treatment. Trilostane-treated dogs get exactly the same thing, too.

I also wonder (this is just me wondering so don't take this as any sort of "fact"!) if the pituitary tumor couldn't have some effect on the coat too. In horses with Cushing's (quite common in elderly horses, unfortunately) one of the main symptoms is a long, shaggy coat that never sheds but just gets thicker and thicker - and with horses the pituitary tumor itself (not the cortisol) is what is blamed for this.

Alison

Loladog

07-15-2010, 12:55 AM

I took Lola to the vet for an exam this evening. She gave us an Rx of Cephalexin for her skin infection and she ordered a complete blood panel with a Cortisol add-on. I also purchased a few cans of Rx canned food to top her dry and she licked her bowl clean tonight. I told the vet today that I would like to get her off of the prescription food and she said that's fine, but maybe I should wait until she's done with the course of antibiotics as that might upset her stomach (her Rx is for two weeks). I also feel like maybe I should wait until after our road trip in August before I try to transition her because I would hate for her to have a Pancreatitis episode while we're traveling.:eek:

Brenna, I'm going to look into the Artemis Weight Management and I was wondering where you order it online? I'm also considering Canidae Platinum or Eagle Pack Holistic Select Senior Care. I've tried
the Eagle Pack Holistic Select in the past and she did well on it but
the fat content might be a little high for her Pancreatitis.

We also discussed Adequan injections today and the vet said that it's definitely worth a try. She said for some dogs, it works great and it's like liquid gold. Other dogs show no improvement. The vet said today that Lola looks a lot different to her since she was last there in May. She said that her hips are a lot thinner and looking more like a dog with hip dysplasia.:( Overall, she felt that she looks a lot more frail even though her weight hasn't changed. Once the vet studies up on the Adequan protocol, I will most likely start the process. I just hate that Lola will have to go in weekly for an IM injection. She's not going to be happy about that. I really worry about causing her more stress.

frijole

07-15-2010, 01:13 AM

I don't know if this would help or not with the skin issues but I happen to have some of this and was reading up on it to see if it could help Annie and noticed all of the reviews regarding how it helped with skin and bad coat issues. It is Seameal from Solid Gold.

http://www.petco.com/product/15044/Solid-Gold-Seameal-Mineral-and-Vitamin-Supplement-for-Horses,-Dogs,-and-Cats.aspx

brandysmom

07-15-2010, 07:53 AM

Aimee,

On the Artemis website there is a link for where to purchase locally. I had a few choices, but they did not regularly carry the weight management formula. I do have a pet store that orders it for me when she places her regular order for Artemis. In a pinch, I was able to purchase through Petfooddirect.com, but then there's shipping. :mad:

Again, it's funny you mentioned about Lola's hips. I was just thinking the same thing about Brandy. There is nothing there anymore! She is all bone in her hip area. Her muscle is gone, but she also weighs the same. :confused:

I don't know how you would feel about this, but my vet is willing to give me a prescription (or pay double through them) of the Adequan and give Brandy the shots myself. The normal protocol is 2x/week for 4 weeks then 1x week for 4 weeks. There is no way I could take Brandy in that often. Just a thought...

Loladog

07-15-2010, 11:06 PM

I just spoke w/ our vet regarding Lola's lab test results. Her blood panel looked good except for the Alkaline Phos (sp?) which was elevated to 1000. She said with Lola's previous blood panels, this ran around 500-600. She said the 1000 could be something to worry about but it could also be normal since she's being treated with Prednisone.:confused:

The Cortisol was at 2.4 which is higher than she has been but again, she's currently on Prednisone. The vet is very confused and I'm even more confused.:confused: She said that we do have to consider that Lola might be in active Cushing's again and she would like for me to start weaning her off of the Pred to see how she reacts. The vet is going to call her IM Specialist contact tomorrow and present all of Lola's information. She'll call me again tomorrow after speaking w/ the Specialist. As for now, I'll go down from 2.5 to 1.25 mg of Pred starting tomorrow morning and gradually reduce from there. We will re-test her ACTH Stim test if she doesn't get ill again from stopping the Pred.

Lola has been eating better with the canned food added but she's still not very enthusiastic about food. She seems very "spacey" to me too although it has been extremely hot here. I'm not feeling very good because of the heat so I can only imagine how she must feel.:(

Brenna, I asked the vet about administering the Adequan myself at home and she said that she would like to check on whether the injections are Sub Q or IM (she couldn't remember). She said that she doesn't really feel comfortable with having owners give IM injections but she knows it would be better for Lola to stay home. She'll let me know what she thinks tomorrow. Thank you very much for mentioning that to me.:) I still plan on looking into the Artemis food but it looks like I will not be able to switch for a little while. If I'm going to be reducing Lola's Pred, I don't want to make any more changes because I will need to know the cause of diarrhea if she starts having it.:( I live in a very rural area so most likely I will have to order the food online. I can't even buy Innova where I live.:mad: The only good foods available to me in stores here are Wellness and Canidae.

lulusmom

07-15-2010, 11:25 PM

Hi Aimee,

I am also confused so it's a party!!! :D My confusion comes from your vet's thinking that Lola is cushingoid again. If the 2.4 you posted is the post acth stim number and Lola is on prednisone and still not eating good, I personally doubt that Lola is ready to be weaned off of the prednisone. Hopefully, the internal medicine specialist your vet is consulting with will be able to unconfuse all of us.

Glynda

Loladog

07-16-2010, 01:03 AM

Hi Glynda,

Lola didn't have an ACTH Stim test yesterday, the vet just requested a resting Cortisol test with her blood panel when I took her in to have her skin lesions looked at. The resting Cortisol came back at 2.4 and the vet said the normal range is 2 to 6. I'm also very confused as to why she thinks she might be Cushinoid again.:confused: The only symptom that might point to this is the skin infection but everything else (lack of appetite, low energy) point more towards low Cortisol levels. I really can't wait to hear what the IM Specialist has to say.

The vet keeps telling me that testing her while she's on Prednisone is not going to be reliable because the results will include the Pred. Plus, if she's been on the Pred, her Adrenals aren't having to produce as much because it's already in her system.:confused: Due to this, we're not getting a good idea of what they would produce on their own without the Pred. However, whenever we try to take her off the Pred for a decent length of time for an ACTH Stim test, she becomes ill and her levels go too low. Lori has mentioned a couple of times that we could give her Dexamethasone and test so that we don't have to wean her off of the Pred. Do I have this right and can someone please explain to me how this works exactly? I'm feeling very dense right now and my head is spinning!:eek:

Thank you!

Harley PoMMom

07-16-2010, 02:24 PM

Lori has mentioned a couple of times that we could give her Dexamethasone and test so that we don't have to wean her off of the Pred. Do I have this right and can someone please explain to me how this works exactly?
Thank you!

Dexamethasone is a synthetic corticosteroid that is approximately 10 times stronger than prednisone.

Dexamethasone is also used in some diagnostic tests, including the Low-Dose Dexamethasone Suppression test (LDDS).

When Harley was loading with the Lysodren he was not the typical cushings pup, no ravenous appetite and no excessive drinking. So I didn't have the usual symptoms to see wane if he were loaded. In preparation of an emergency for my boy I asked Harley's vet for Dexamethasone shots. Harley's Dexamethasone shots were to be given subcutaneous (under the skin) and his vet even had me practice giving shots to him with just fluid in them. Dexamethasone can be rough on their stomach and intestines but I think this is with long term use. I still would recommend giving Dexamethasone by subcutaneous instead orally because it will not have to pass through the stomach and it will take effect sooner.

Dexamethasone is a potent corticosteroid that does not interfere with assays for plasma cortisol.http://www.newmanveterinary.com/CushingDiag.html#Provocative

This is an Answers and Discussion from Colorado State University emergency medical case of the week:

Select the corticosteroid you would use in the emergency treatment of Grisby.
Dexamethosone sodium phosphate is the corticosteroid of choice for the animal in an Addisonian crisis. The reasons for this choice are related to the following question.

Select the test you would use for confirmation of a diagnosis of hypoadrenocorticism (Addison's disease).
An ACTH stimulation test is used to confirm hypoadrenocorticism. Because you are not frequently prepared to run the ACTH test, dexamethasone sodium phosphate is often used to provide glucocorticoids while not interfering with the ACTH stimulation test.
http://www.cvmbs.colostate.edu/clinsci/wing/emcases/answer7.htm

Hope this helps.

Love and hugs,
Lori

Loladog

07-17-2010, 06:24 PM

Our regular vet spoke w/ an Internal Medicine Specialist yesterday and they both think that I need to try and get Lola off of the Pred.:confused: The plan is two wean her off over the next month and then run an ACTH Stim test and a Spec cPL at least 72 hours after she's completely off of the Pred. They also want me to keep her on the Royal Canin Digestive LF Rx diet so that if she develops diarrhea while I'm weaning her off of the Pred, I'll know that it's from stopping the Pred, not diet related. I really want to get her on a better diet but I agree that we shouldn't change anything else while stopping the Pred.:(

If everything goes as planned, she will be off the Pred completely while we are on our road trip. This worries me but I will obviously make sure to bring the Pred along just in case. As we've experienced up until now, things usually don't go as planned anyway.:D

I will be taking Lola to a radiology specialist on 8/5 for an ultrasound to get another look at everything. She had an ultrasound in 10/09 but the vets are worried about her elevated Alk Phos (liver enzymes?). The results were 1000 this week and they've never been above 600 since she was diagnosed with Cushing's.:confused:

Lastly, I'm trying to decide whether or not Adequan injections will be worth it for Lola. The vet said that she's willing to train me to do IM injections at home but she'd prefer they do them since there's a chance of hitting her sciatic nerve plus other things. She said that the injections can be administered SQ but they are meant to be IM. She feels they should be administered as directed for the best possible outcome. If we decide to do this, they recommend injections twice weekly for 4 weeks then once weekly for 4 weeks then once every two weeks. She said that you'll usually know after the initial 4 weeks whether or not they're helping. I'm trying to decide if putting Lola through all of the painful IM injections will ultimately be worth it for her.:confused: For those of you who used Adequan for your pups, do you remember how it was administered and do you feel it helped?

Roxee's Dad

07-17-2010, 06:34 PM

Hi Aimee,

For those of you who used Adequan for your pups, do you remember how it was administered and do you feel it helped?

Seems to be a number of protocols on this.:confused:

Our Mickee is on adequan. Started with once a week shots for 4 weeks then on to once a month. He is doing much better. Sometimes if he starts limping because he trips or something, we do use metacam but only as needed for any inflammation. Mickee is our 15 year old, 30 lb. Wheaton mix, arthritic shoulder and elbow, deaf and almost completely blind. Still loves life. :)

BTW, he hardly ever noticed he was getting the shot in his hiney.:)

judymaggie

07-17-2010, 06:41 PM

Aimee: My Maggie had a series of Adequan shots for severe arthritis in one of her rear knees. I took her into the vet once a week for four weeks. I was in the back room with her and the vet as he administered the shots and Maggie didn't even flinch. I was advised that some dogs need the initial series and then follow-up shots periodically. Maggie never needed another one -- they helped immensely with her stiffness and pain.

I wouldn't hesitate to use Adequan again if necessary with another pup.

Casey's Mom

07-18-2010, 01:02 AM

Aimee I have used Adequan on Casey for almost a year now and the shots have really helped her arthritis. She got the initial dose 2x a week for 4 weeks then monthly ever since. The vet tech gives it to her in her back leg muscle. Casey doesn't even feel it because as they explained to me the needle is very fine so she can't even tell its going in.

Sometimes she does Casey outside or in the parking lot. Its a very quick visit - probably because I see the tech and not the vet. They charge me $15 for each injection and I purchase the Adequan through the vet separately.

Hope this helps,

Loladog

07-18-2010, 02:40 PM

Thank you all for sharing your experiences with Adequan injections. From what it sounds like, it has really helped ease the pain in a lot of dogs. Our vet said that she was going to talk to their office manager to see if they could meet us somewhere to administer the IM injections. They definitely don't want Lola to have to come into the office. If nothing else, they said they could go out into the parking lot (as has been the case with Casey).:D

I was reading up on supplements to use for arthritis too and I'm thinking of trying Dasuquin w/ MSM. Has anyone here had any luck with this? I've been giving Lola Cosamin DS and fish oil for years but I think I need to increase the fish oil amount. I've also been using a liquid fish oil which Lola doesn't find appealing anymore. I may need to switch to capsules now since she doesn't care for the liquid on her food.

Lola is still pretty lethargic and she's not finishing her meals completely. She will eat all of the canned food that I add in to make it tastier but she leaves some kibble behind.

I wish I didn't have to wait until 8/5 for her to have her ultrasound with the radiology specialist. I'm really eager to find out what's going on in there especially with her Liver. I know that elevated Liver enzymes are normal with Cushing's and steroid treatment but what are your thoughts on a level of 1000? Is this something I should be worried about?

Thank you all for your input!

brandysmom

07-20-2010, 08:25 AM

Aimee,

If you decide to go through with the Adequan, we'll have to keep eachother posted. I am just waiting to receive the rx and then schedule an appt with the vet tech to show me how to give the shots to Brandy. Also, just an fyi - my vet wanted to charge me $109 for a 5ml vial. Instead, they gave me an rx to purchase elsewhere. I found it for $48.99 at Drs Foster and Smith and the shipping is free!

I'm waiting to see if you get any responses regarding the Dasuquin w/ MSM. I was also looking into that. I have been giving her a liquid glucosamine (Flexicose), but haven't seen much improvement as of yet. I know it's supposed to take time :( Also, did you happen to ask your vet if you can supplement with glucosamine while taking Adequan? I'm curious, but haven't asked yet. How much fish oil do you give her?

Good luck with weaning her off the prednisone. I hope all goes well for her.

Roxee's Dad

07-20-2010, 12:37 PM

Hi Aimee,

I know that elevated Liver enzymes are normal with Cushing's and steroid treatment but what are your thoughts on a level of 1000? Is this something I should be worried about?

I don't remember if you are giving Lola and supplements but many of us give our pups Milk Thistle. There is an excellent article and information in our resources section, here's a link : http://www.k9cushings.com/forum/showthread.php?t=192

My Roxee's high numbers came back within the normal range. Not sure if it was the Trilostane or the Marin (milk thistle) or a combination of both.

As with any medication or supplements, always check with your vet.

Loladog

07-21-2010, 12:28 AM

I'm currently giving Lola 150 mg of Milk Thistle twice daily. I previously had her on Denamarin (Sam-e and Milk Thistle) but I went to a human form of Milk Thistle instead to save some money. The Denamarin was about $90.00 per month.:eek:

I started Lola on fish oil about 5 years ago when she was diagnosed with a toenail condition that causes her nails to separate from the quick. They crack and break very easily and the vet said that she needs at least 1200 mg daily of Omega 3 EPA. I've been giving her a liquid fish oil called Sea Pet with Natural Vitamin E. I give her two tsp daily which provides 1550 EPA and 400 IU's of Vitamin E. Unfortunately, I have no idea how many mg's of the fish oil this equals. Now that I'm looking at fish oil to help with arthritis, does anyone know what the recommended daily dose is? She no longer likes the fish oil on her food so I'm going to have to buy capsules next.

As of right now, I'm having to shove all of her medications down her throat because she's become so picky.:( She's currently getting her antibiotic twice daily, Pred once daily, Milk Thistle, Cosamin DS and she'll need capsules of Fish oil and Vitamin E.:eek: She's not going to like having all of this shoved down her throat.

Brenna, I can't believe the pricing difference on the Adequan between your vet and mail order! I really look forward to hearing how it works for Brandy. I still haven't decided yet what I'm going to do but I wish they would just give me the medication to administer myself. Please let me know if your vet trains you to give the injections IM or Sub Q. Next time I speak with our vet, I plan to ask her about the Dasuquin w/ MSM and whether or not Glucosamine can be given at the same time as the Adequan.

Lola seems to have perked up slightly since I reduced her Pred dose last week.:confused: Even though her appetite is still down, she seems a bit more lively.

In terms of diet, I went against the vets recommendation and purchased Lola some Eagle Pack Holistic Select Vitalize Senior food. Even though this is higher in fat than the Artemis Weight Management and the Canidae Platinum, she's done well on it in the past and so I'm going to give it another try. The thing I like about it is that the protein is a little higher (26%) which I feel is important for dogs that are losing muscle mass. I just hope that I don't put her into a Pancreatitis episode with the switch.:o I personally feel that the extremely low fat content of the Royal Canin Digestive LF Rx food was having a negative effect on her coat and toe nails. I could be totally wrong but she looks worse than ever since she's been on the Rx food. The only positive is that her stools have been firm. We'll just have to see how it goes as I start to switch her over to the new food. If she can't tolerate the fat content of the Holistic Select, I will try the Artemis or Canidae before going back to an Rx food.

Loladog

07-30-2010, 10:40 PM

Hello everyone,

I'm looking for advice on diet fat content and Chronic Pancreatitis. As I mentioned in my last post, I transitioned Lola from an Rx diet to the Eagle Pack Holistic Select Senior Formula. The bag lists the fat content as 10% and then I e-mailed the company for the "as fed" content. The response I received is 11.98%. In the past, our vet has said that dogs with Pancreatitis should be on diets well below 10%. The two Rx diets we tried her on were Iams Low-Residue (fat 9% min) and Royal Canin Digestive LF (fat 5% min). I have no idea what the "as fed" fat content of these diets are. Do you think I'm feeding her a diet that's too high in fat now with the Holistic Select?

In terms of how Lola has been doing, things have been pretty up and down. Up until today, she's had a fair amount of energy. Her appetite has been ok but not great. She usually hesitates at the start of her meal and then she won't finish it. However, she often comes back to finish the meal later. She's had no vomiting or diarrhea and her stools have been firm. No gas either which is unusual for her.:D

Unfortunately, she has me worried today. She didn't eat any breakfast and she didn't want to come in from outside. I was actually late for work from trying to get her back into the house. When I came home to check on her at lunch, she immediately rushed outside and started eating grass. She was acting uncomfortable and her stomach was gurgling. I offered her a meal again but she wasn't interested. I offered her biscuits and she didn't want anything to do with food period. I gave her a pecid and then offered her some Chicken baby food which she gulped down after some initial hesitation. After she ate the baby food, she ate a few kibbles from her bowl. I called and left a message for our vet and was going to take her in but they didn't have any appointments. She still seemed a bit stressed but I had to go back to work.:(

This evening when I returned home, she seemed a bit perkier. I offered her dinner and she ate about 3/4 of the meal. The vet just returned my call and I explained everything to her. She's at a loss as to why Lola hasn't had an appetite except she thinks there's a possibility that her Pancreatitis is acting up again (or never went away). I can also tell the vet doesn't support me taking her off of the Rx food but she's been so picky that it's hard to even get her to eat that food. I take Lola for an abdominal Ultrasound on Thursday 8/5 and the vet is very glad that we're doing this. I wish I could get her in sooner. I'll know on Friday what the results are. The problem is that in the past, Lola didn't have any typical symptoms when her Pancreatic enzymes were through the roof. No vomiting or diarrhea doesn't necessarily mean that she's not having a Pancreatitis episode.:confused:

In terms of the Pred, we're now down to 1.25 mg every other day effective today. This dose is miniscule and she'll be weaned off completely in two weeks. We leave for a road trip (with Lola of course) on Tuesday 8/10 and I'm worried about how she's going to feel on the trip.

brandysmom

07-31-2010, 10:05 PM

Aimee,

I'm sorry you are having such a hard time with Lola :( Everything you just described is exactly how Brandy acts when she has a pancreatitis attack. She will not eat, except for maybe grass and her tummy makes terrible noises. After several hours she will snap out of it and be somewhat normal. Brandy also doesn't drink when she has an episode.

The fat content should definitely be lower than 10%. I have a link on my computer at work that gives a lot of information about that. When I am there Monday I will send you the link. That's how I learned about the Artemis food Brandy has been eating and so far I am very pleased. I'm hoping it's the food, but she has also been taking the L Glutamine and the Seacure since then. Her stool has been mushy, but I can live with that as long as her tummy has been feeling better.

I wish you the best with Lola's ultrasound and I am eager to hear her results. Brandy's paws are crossed for good news :)

Loladog

08-01-2010, 07:37 PM

Hi Brenna,

If you could send me the link regarding Pancreatitis and fat % on Monday, I would greatly appreciate it.:) I'm also wondering if you can tell me what the top ingredient is on the Artemis Weight Management? Their website shows Rice 1st and then Chicken Meal 2nd but on dogfoodanalysis.com and other places it shows the opposite.:confused: So far, I've been referencing an article written by Mary Straus (sp?) for the Whole Dog Journal regarding healthy low-fat diets for dogs with Pancreatitis. She lists the Eagle Pack Holistic Select Senior Formula but as I found out, the fat is 11.98%. I'm very confused.:confused:

Lola has been a little better since our hard day on Friday. She's been finishing her meals and her stomach doesn't seem to be gurgling. She is a little gassy now though. She's sleeping in my office with me as we speak and it's getting a little toxic.:eek: Oh well, as long as she's content, right?

I forgot about the Seacure and the L-Glutamine......I really need to purhase those supplements once I have her on a food that works.

By the way, I found out yesterday that the Iams Low-Residue dry that I was feeding her has been recalled for possible Salmonella contamination. In all of my years of feeding healthy foods, I never purchased anything that was later recalled. This just reaffirms that what the vet sells isn't always the best option.:(

brandysmom

08-02-2010, 04:15 PM

Aimee,

Here's the link but I'm pretty sure it's what you have already been reading up on. I found it very informative at the end where they show you how to calculate for the actual % fat based upon the kcals. And you have to look at the protien too. A lot of low fat foods tend to have low protien as well.

http://www.dogaware.com/articles/wdjlowfatdiets.html

I am picking up a new bag of food tonight. I will read the ingredients and let you know what it says. I don't recall rice being the first.

Everytime Brandy has had a pancreatitis episode, she has the most toxic gas for the next few days :eek: I think it has something to do with all that gurgling in the tummy. I hope Lola's feeling better. I can always deal with the gas as long as she feels better :)

Loladog

08-02-2010, 11:46 PM

Hi Brenna,

That article is exactly what I've been studying!:D I've been calculating the "GFK" for all of the foods I research. Her list is where I actually found the Eagle Pack Holistic Select Senior Care and I was drawn to it by the higher protein of 26% and the low fiber %. Despite this, I'm worried because the actual fat content is 12% and I know I should stick to below 10%.

Today, I went out and purchased a small bag of Canidae Platinum because it's available at a local store. The fat % of this food is 8%. With the Artemis, I would have to order it online which normally isn't a problem but I'm running out of time with our road trip coming up next week.

I had every intention of transitioning her over to the Canidae Platinum but today she seems to be feeling great and I'm scared to change anything. She's been eating her meals consistently since Saturday, and her stools are normal. The question is now, do I stick with what MIGHT be working or switch to lower fat?:confused: I swear, I'm going to make myself sick stressing over all of this. :( My husband thinks I should stick with what's agreeing with her especially since she likes it.:)

Lola is acting like a puppy today!:D She gobbled down all three of her meals and she's running around with some squeaky toys that I bought her. I wish everyday could be like this.

Thank you for concern about Lola and for sending me the link to that article. I really appreciate it!:)

brandysmom

08-03-2010, 09:38 AM

Aimee,

You're right about the Artemis. It lists brown rice as the first ingredient on the bag. I don't think it was like that before. I am going to email the company to find out if maybe they changed something.

I'm glad Lola is feeling better. I just love it when they play with their toys at this age :D Brandy has been a little off the past couple of days, although a little better last night. The stress is enough to make us sick :( I hope Lola continues with those "puppy" moments and eats well with no tummy issues.

marie adams

08-03-2010, 11:48 AM

Hi Aimee,

So good to hear Lola is feeling better:D--I love those moments also when they go get a toy and want to play--such good memories.:) Of course they are so cute when they do this. I also love it when they meet up with a dog they want to play with, which in Maddie's case--she is queen around these parts and usually ignores most dogs, but it is so cute to see them nudge and get down on their front legs with their bottom in the air waging their tail (of course Maddie's is only inches long--haha!!! I guess Lola's is too!:D). We cherish these moments the most because we are not stressing out.

Take care of your self and enjoy your vacation!!!:)

addy

08-03-2010, 02:37 PM

Hi

Glad to hear Lola is feeling better.

I just wanted to add:

The Dog Aware web sight is very helpful and you can also email Mary Strauss with questions and she answers back right away!!! She is very knowledgable and has been writing articles for the Whole Dog Journal. She knows her food.

We emailed back and forth when Zoe first had her UC:CR test and Zoe's vet was so wacked out. Mary really is wonderful, in my opinion.

Good luck, I know how hard it is to find the right food for our babies and then when you think you have, RECALL!:mad:

Addy

Loladog

08-04-2010, 11:10 PM

Hi Addy,

I've found a lot of the Mary Strauss articles very useful and I always enjoy reading them in the Whole Dog Journal. I agree that the website is a great reference too! That's nice to hear that she accepts e-mails. I will definitely keep that in mind. Thank you!:)

Lola has her Ultrasound tomorrow. I will keep you all posted on the results.

addy

08-06-2010, 10:31 AM

Hi Aimee,

Just thinking of you and Lola's ultrasound. Sending positive thoughts your way.

Addy

Loladog

08-20-2010, 05:18 PM

Hello everyone,

We just returned from our 9 day road trip last night. I"m so sad to be back to the hot, dry weather.:(

Prior to the road trip, Lola's appetite was really starting to decrease and it went even more down hill during the trip. While on vacation, we had to purchase some Chicken and Turkey baby food as well as some canned white meat chicken to try and entice her to eat. We even purchased a different kibble (Canidae Platinum) to see if something new would make it all more interesting for her. Unfortunately, she will rarely finish a meal even with the tasty additions and she now hasn't finished a complete meal in days. She ate part of her breakfast yesterday but didn't eat any dinner last night. She's also refusing to eat today. I called the vet this morning and I will be taking her in at 2:00 for a resting Cortisol test as well as a Spec cPL. They are also going to check her weight because I believe she's lost a lot.

The ultrasound results from right before our vacation came back looking pretty good. Her Pancreas looked good and there was nothing remarkable or scary looking. The radiology specialist did see some small nodules on her Spleen which were also there at the time of her last Ultrasound but he was not concerned about this.

She's also been sleeping A LOT. On the road trip she was often tired but then she would perk up considerably for hikes and walks on the beach. We were on the Oregon Coast as well as the Washington Olympic Peninsula so there were never ending beautiful places to walk. I think the cooler weather up there helped although we did experience a couple of hot days during an unusual heat wave in Washington.:( She generally seemed to have some fun and her stools have remained normal so those are both good signs.

When talking to the vet today, she suggested I think about taking her to an Internal Medicine Specialist to look a the whole picture. My regular vet feels that appetite is everything for dogs so if she's not wanting to eat, something is definitely wrong. The IM specialist she recommends is at least a 3 hour drive from where I live but I guess you all can understand traveling far to see a good vet.:D

It might just be that she needs more Prednisone again. This past Wednesday (8/18) was her last dose of 1.25 mg every other day. I'll let you all know what I find out about the lab work she's getting today after I get the results back.

Loladog

08-21-2010, 05:29 PM

The vet called me this morning with Lola's lab test results and it's no wonder she hasn't been feeling well.:( Her Cortisol is low again. She is 1.4 on the Resting Cortisol test and normal range is 2-6. Her Spec cPL is also now over 1000 again.:confused: A new development is that her Thyroid is a little low at .8. The vet is requesting an add on T4 to try and confirm whether or not she's Hypothyroid. This might help explain why she's so tired all of the time. On the plus side, her Liver enzymes are down from 1000 to the 300 range. Electrolytes and everything else on the blood panel looked good.

So, it's back on the Pred. We started her back up on 5 mg daily today. I'm not sure why we even keep trying to wean her off except for the fear of her going back into active Cushing's. We were worried this might be happening last month because she developed another skin infection and her water intake was up. Since we now know she needs the Pred, it looks like she'll be on it for a while which is fine with me. I just want her to feel better.:(

She also needs to go back on the low-fat Rx diet which I'm willing to accept at this point. I need to stop worrying about what I think is healthiest for her and just go with what agrees with her. Her comfort is the most important factor at this point especially with her age. It makes me sick to think that I might be causing her Pancreatitis flare ups with diet experimentation or stress.:( I'm feeling very guilty for taking her on a road trip in this state. I should have known what was going on and upped her Pred dosage.

I'll know the results of her T4 next week. The vet also suggested a chest x-ray to make sure there's not something else going on. Her weight has gone down from 63 to 56 lbs since this all started.:(

ChristyA

08-23-2010, 09:54 PM

Hi Aimee,
Glad to hear they are getting Lola back on pred. so she will be feeling better soon. Don't feel guilty about taking her on a trip, she wouldn't have wanted to be anywhere but with you.
Christy

Loladog

08-23-2010, 11:23 PM

I started Lola back on the Pred Saturday morning and she gobbled down her dinner completely Saturday evening.:D The difference the Pred makes is like night and day. Since Saturday, she's finished every meal. Her eyes are brighter and she has much more energy. I feel so bad for not recognizing the signs of low Cortisol levels. I should have increased her Pred dose sooner.:( Live and learn I guess, right?:o

ChristyA

08-24-2010, 10:27 AM

Aimee,
Don't be hard on yourself. It could have been one of many things making her not feel well. Now she is feeling better and it is amazing how fast that cortisol works. So glad she is eating and bright eyes.
Christy

brandysmom

08-25-2010, 09:54 PM

Hi Aimee,

I agree with Christy. Please don't beat yourself up with guilt about Lola. I know it's easier said than done because I would be feeling the same if it were Brandy. You are doing everything right and she is very lucky to have a mom that is so in tune with her every need. I am so glad the prednisone is doing the trick. It sounds like she needs it all the time to feel like herself. And please don't worry about the low thyroid. Brandy has been doing fine since on the Soloxine. Is your vet doing the free T4 also? Why is she suggesting a chest xray? Does she suspect anything? Please keep us posted.

I have a question for the experts here... Why does it seem that so many of these cush pups develop into hypothyroid also?

Loladog

08-25-2010, 11:35 PM

Hi Brenna,

The vet called today with Lola's Free T4 results and she said she was in the "perfectly normal range". She gave me the #'s but unfortunately, I was overwhelmed at work and I didn't write them down. The vet was confused as to why her Thyroid was low on the health check panel but the free T4 was normal. She said that maybe it had to do with her low Cortisol levels or the Pancreatitis.:confused: For now there doesn't appear to be the need for medication. Lola's energy levels went way up with the Prednisone so that made the vet think that she's probably not hypothyroid. However, I'm sure we will revisit the issue again in the future to make sure.

She wanted to do a chest x-ray because of Lola's weight loss, lethargy and lack of appetite but we now know that it all seems to simply have to due with low Cortisol levels. At the time of the recommendation, she wanted to rule out Cancer but she doesn't feel the need to do the x-rays now.

I also would be very curious to hear from the experts as to why so many of these dogs end up with hyperthyroidism.

One of these days I need to update Lola's Avatar picture. She looks so different now! What a difference a few years and Cushing's makes.

ChristyA

08-26-2010, 01:37 AM

So glad she is doing better. I would love to see a new picture of her. Dexter turned completely white in the face w/cushings.
Christy

Franklin'sMum

08-26-2010, 10:08 AM

Hi
Meanwhile, I'm not one of the experts, but found this (in relation to people) http://kidshealth.org/parent/general/body_basics/endocrine.html

Although it is no bigger than a pea, the pituitary gland, located at the base of the brain just beneath the hypothalamus, is considered the most important part of the endocrine system. It's often called the "master gland" because it makes hormones that control several other endocrine glands. that was from page 2,
The Pituitary Gland
The tiny pituitary gland is divided into two parts: the anterior lobe and the posterior lobe. The anterior lobe regulates the activity of the thyroid, adrenals, and reproductive glands. Among the hormones it produces are:
•growth hormone, which stimulates the growth of bone and other body tissues and plays a role in the body's handling of nutrients and minerals
•prolactin, which activates milk production in women who are breastfeeding
•thyrotropin, which stimulates the thyroid gland to produce thyroid hormones
•corticotropin, which stimulates the adrenal gland to produce certain hormones
The pituitary also secretes endorphins, chemicals that act on the nervous system to reduce sensitivity to pain. In addition, the pituitary secretes hormones that signal the ovaries and testes to make sex hormones. The pituitary gland also controls ovulation and the menstrual cycle in women was from page 3. Broken down even further is this
Thyroid hormones also play a key role in bone growth and the development of the brain and nervous system in children. The production and release of thyroid hormones is controlled by thyrotropin, which is secreted by the pituitary gland
Jane, Franklin and Bailey xxx

Loladog

08-26-2010, 11:23 PM

Thank you for the good info Jane. It's amazing how everything is so connected. Our bodies are some pretty complicated, sensitive systems.:)

Thank you also Christy and Brenna for your kind words and reminding me not to be so hard on myself. I have to remember that my only goal in life these days is to do what's best for Lola!:D

Loladog

09-04-2010, 04:11 PM

Lola has been doing pretty good lately on 5 mg of Pred, her supplements and Rx diet (cringe). The only thing that has been worrying me is that she's panting A LOT. It's been hot here on and off but she pants a lot even when it cools down in the morning and at night. Sometimes she pants so fast and shallow that I can't understand how she doesn't hyperventilate. Do you all know if this is normal for a dog in her situation? I know that excessive panting can be a sign of Cushing's but what about a dog who needs to be on Pred because her Cortisol levels are too low without it?:confused:

I'm starting to think that a chest x-ray maybe isn't such a bad idea.

spiritdog6

09-04-2010, 04:58 PM

Hi,
I don't know if it is part of Lola's illness, but I wanted you to know I do empathize A LOT with you regarding the panting. My little Pom Sidekick has been panting all day, all night, for months now. I watch the breathing get shallow, almost double puffs of breath. I could swear he is wearing himself out from all the panting.
He is a Cushing dog, but we haven't started treatment just yet.

I wanted to let you know that I too stress out over the insane panting.

About the only time he stops is when he lays in his little pool of water. He loves water, and although the panting is not from heat, the pool sure seems to help him. Unknown why though.

Loladog

09-04-2010, 09:46 PM

Franklin'sMum

09-05-2010, 02:51 AM

I know that excessive panting can be a sign of Cushing's but what about a dog who needs to be on Pred because her Cortisol levels are too low without it?:confused:
I'm starting to think that a chest x-ray maybe isn't such a bad idea.

Hi Aimee,

Glad to hear Lola is doing well. :) Panting can be a sign of cushings, yes, and pred mimics the effects of cushings, so that could explain the panting.
Also keep in mind that if Lola's liver is enlarged that can compress the lungs and cause panting, too. Hope that helps,

Jane, Franklin and Bailey xxx

Loladog

09-05-2010, 04:27 PM

Hi Aimee,

Glad to hear Lola is doing well. :) Panting can be a sign of cushings, yes, and pred mimics the effects of cushings, so that could explain the panting.
Also keep in mind that if Lola's liver is enlarged that can compress the lungs and cause panting, too. Hope that helps,

Jane, Franklin and Bailey xxx

Thank you Jane. I start to think with my emotions sometimes instead of my brain.:o What you said makes perfect sense.:)

Loladog

10-10-2010, 04:00 PM

Hello everyone,

I just wanted to give an update on Lola since I haven't written in a while. On 9/30, I took her in for a chest x-ray and another Cortisol test since her panting has been excessive and her appetite very sporadic. She wasn't always interested in her meals and when she would eat, she usually wouldn't finish the meal. Her last resting Cortisol test was on 8/20 and it came back at 1.4 (normal 2-6). We've had her on 5 mg of Pred daily since. Well, on 9/30, her Cortisol levels still came back low at 1.8 and a Spec cPL test came back at over 1000 again. This is after she'd been eating an Rx food for dogs with Pancreatitis (Royal Canin Digestive LF).:confused: On the plus side, her chest x-rays came out normal except for showing some arthritis in her spine.

We increased her Pred dose to 10 mg daily and I'm now giving her 50mg of of Tramadol twice daily for arthritis and/or possible Pancreatitis pain. It took a couple of days but she now seems to be feeling much better. Her appetite is very good and she's eating her meals completely when offered. She seems to have more energy and she actually got into the trash while I was at work on Friday. She hasn't done this since before the Lysodren treatment so it looks like I'm going to have to make sure to put the trash out whenever we leave again now. She's still panting excessively but it must just be from the Pred since the chest x-rays didn't show any reason for it.

Since she continues to need the Pred, it's looking more and more like she might be permanently Addisonian. As a reminder, her last dose of Lysodren was in February and she's been on Pred ever since (in varying doses). I have no idea why the Chronic Pancreatitis continues even while she's on a very low-fat diet. I'm currently transitioning her from the Rx food to a new food by The Honest Kitchen called "Zeal". It's a low-fat, fish based diet that's designed for "sensitive" dogs. So far with the transition, her stools are firm but she is passing some undigested fruits and veggies from the new food. I don't know whether or not this is something to worry about. I'm still doing the transition so I don't know whether or not this food will work out. Also, I just read Melanie's post about Mila and now I'm concerned that the new food is too high in protein for a dog with Chronic Pancreatitis. The Honest Kitchen "Zeal" is 35% protein and 8.5% fat. Does anyone have any opinions on protein content and Pancreatitis? The Royal Canin Digestive LF Rx food is 20% protein and 5% fat.

For now, I'm happy that she seems to be feeling better.:)

Harley PoMMom

10-10-2010, 06:12 PM

Hi Aimee,

Prednisone can elevate serum lipase levels: Prednisone Treatment Alters the Serum Amylase and Lipase Activities in Normal Dogs without Causing Pancreatitis, found here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1236025/pdf/compmed00006-0014.pdf

I've read some articles saying that there may be a relationship between the use of glucocorticoids and the development of pancreatitis, although it has not been proven. However in Lola's situation the need for the prednisone is a necessity for her health and well-being.

Love and hugs,
Lori

Loladog

10-30-2010, 03:07 PM

Hello everyone,

This past week on Wednesday I noticed that Lola has another skin infection on both of her hind leg inner thighs.:( There are darkened spots, the skin is peeling like crazy and the hair is about to fall out. It looks exactly like when she was misdiagnosed with ringworm prior to the Cushing's diagnosis. I called our vet who prescribed a 3 week course of Cephalexin which I started giving her on Thursday evening. Right about the same time on Thursday, my husband noticed that the lymph nodes in her neck are extremely enlarged. It feels like she has golf ball sized lumps.:( When you look at her, you can clearly see the lumps as well. I tried to get her into the vet Friday morning but they can't see her until Monday. They could take her as a "drop off" but that's no longer an option as Lola gets extremely stressed at the vet now. I don't know if the lymph node swelling is related to her skin infection or something else.:confused: She's never had the lymph node swelling with any of her previous skin infections (that I've noticed). Since I started her on the antibiotics Thursday, it seems like the swelling has gone down slightly but not much. My mind of course is racing to the worst case scenario. Have any of you noticed signs of infection like this in your Cush pups? Any advice would be greatly appreciated.

addy

11-01-2010, 09:42 AM

Hi Aimee,

I can't comment on the current post but I did want to let you know that the Dogaware website feels it is best to calculate how much fat per calorie in a food. Mary has a whole formula to figure it out and she gives examples. She did not calculate out Honest Kitchen's Embark or Zeal but she did do some of their other foods as well as some of the popular and prescription foods. I have been using Honest Kitchen and I really like it alot. So do my dogs.

How much fat?
As a general rule, veterinarians consider diets with less than 10 percent fat on a dry matter basis (less than 17 percent of calories from fat) to be low fat, while diets with 10 to 15 percent fat (17-23 percent of calories) are considered moderate fat. Foods with more than 20 percent fat are considered high-fat. A few dogs may need a very low-fat diet, especially if they have hyperlipidemia, or if they react to foods with higher levels of fat.
When comparing the percentage of fat in different foods, you must consider the food’s moisture content. The percentage of fat in wet food (canned or fresh) must be converted to dry matter (DM) for comparison purposes, or to use the guidelines above. To do the conversion, first determine the amount of dry matter by subtracting the percentage of moisture from 100, then divide the percentage of fat by the result. For example, if a food is 75 percent moisture and 5 percent fat, divide 5 by 25 (100 – 75) to get 20 percent fat DM.

Percentages give you only a rough estimate of the actual amount of fat your dog will consume. For a more exact figure, calculate the grams of fat per 1,000 kcal (kilocalories, the standard caloric measurement). For simplicity’s sake, I will call this GFK, though that is not a standard abbreviation. Veterinary nutritionists consider diets to be low-fat if they have less than 25 GFK (22.5 percent of calories from fat). This measurement can be used for any type of food: dry, canned or fresh.

The ratio of fat to calories is more accurate than the percentage of fat in the diet, since the amount of food your dog needs to consume is determined by calories, not by weight or volume. For example, a diet that is 10% fat with 4,000 kcal/kg provides 25 GFK, while a diet that is 8% fat with 2,700 kcal/kg provides 30 GFK. Your dog would actually consume more fat when fed the same number of calories of the food with the lower percentage of fat.

In other words, for every 1,000 kcal your dog consumes, he would get 30 grams of fat from the food with 8% fat, but only 25 grams of fat from the food with 10% fat. part of a quote from her page on low fat diets.

hugs,
Addy

Loladog

11-07-2010, 03:10 PM

Well, my worst fears were confirmed when I took Lola in last week to have her swollen lymph nodes checked. We found out that she has Lymphoma.:( She's gone from Cushing's to Addison's, she has Chronic Pancreatitis and now Cancer.:( Despite all of her health issues and her age (she's 10 1/2), we've decided to treat her with Chemo which will start tomorrow. From what I've learned in a very short amount of time, there is a very good chance of putting Lymphoma into remission with treatment. If left untreated, she might have 4 to 6 weeks left. Of course, there are also risks with Chemo treatment but the most important thing is that she has a good quality of life. Apparently, the Chemo treatment for Lymphoma is generally very well tolerated so I hope that's the case with Lola. I definitely don't want to make her sick just to have a chance at having her around a little longer.

She seemed to be feeling fine until this weekend and that's why we decided to pursue treatment. She's been eating well, enjoying daily walks and she still likes to run around her yard. Unfortunately, over the past two days her lymph nodes seem to be getting larger and her appetite isn't quite as good. Yesterday she wasn't finishing her meals all at once. She'd eat a little and then come back later.

Part of the treatment process includes Pred. She's already been on Pred in varying doses since February since we accidentally put her into Addison's with the Lysodren treatment. Over the past few months, she's really been losing a lot of weight and the vet kept thinking that something else was wrong. Despite this, abdominal ultrasounds and a set of chest x-rays didn't show anything alarming. Her last abdominal ultrasound was in August and the chest x-rays were last month. Since Pred is used to slow down Lymphoma progression and to make the dog more comfortable, our vet thinks that Lola's was kept subdued for a while due to her Pred treatment. As I said, her first Chemo injection will be tomorrow morning. Part of the first week of Chemo includes giving them high doses of Pred so we just increased her dose from 10 mg daily to 40 mg daily. Everything is happening so fast but it has to due to the fast progression of this type of Cancer.

I just don't think she's feeling this well over the past couple of days and I'm scared to death about whether or not we're making the right decision to treat her. If Chemo treatment works for an individual dog, the Lymph nodes are supposed to start shrinking right away and remission starts. If it's going to work, you don't have to wait the full 25 week treatment for improvements to start showing. I feel like we have to try.

Lola has been on Pinnacle Trout and Sweet Potato food over the past month. I switched to this since the fat content is relatively low for her Pancreatitis (10%) and it has really been agreeing with her sensitive stomach. Her poops have been perfect and she hasn't had any gas. I wanted her off of the low-fat Rx diet and this is what I chose. However, now everything I read about canine cancer says that they need to be put on a high protein, low carb diet since cancer feeds off of Carbs. The chance of remission is much higher if a dog is put on a cancer diet. How do I do this if Lola also has the chronic pancreatitis???:confused: I'm tempted to just feed her a Cancer diet and not worry about the Pancreatitis but but that's all she needs is for me to put her into a flare up. Any advice on this issue?

Anyway, I just wanted to give you all an update. I know that she doesn't technically have Cushing's any more but you all have been so supportive and helpful. I will keep you posted on how things progress.

Harley PoMMom

11-07-2010, 04:29 PM

Hi Aimee,

I am so sorry to hear this news. Please know you and Lola are in my thoughts and prayers.

Here is a link to a good article: "Nutrition and Cancer: Frontiers for Cure!" by Gregory K. Ogilvie, DVM, Diplomate ACVIM (Specialties of Internal Medicine and Oncology), Professor of Oncology and Internal Medicine, Animal Cancer Center: http://web.archive.org/web/20010213234901/http://www.cvmbs.colostate.edu/cancercure/nutrition.htm

I have read that simple carbohydrates are generally not good but complex carbohydrates are less of a concern.

With much love and (((hugs)))
Lori

lulusmom

11-07-2010, 05:00 PM

Hi Aimee,

I'm so sorry to hear that Lola has Lymphoma. My brother's Aussie, Major, was diagnosed three weeks ago with Lymphoma and he's had two chemo sessions already. He just finished his last dose of Pred a few days ago. Apparently some dog cannot tolerate a few of the drugs that are normally included in the treatment regiment. They did bloodwork on Major and unfortunately, the gene responsible for the intolerance to these drugs was found. The specialist said that he had a double whammy as he got that gene from both mom and dad. :(

Major never acted sick and still doesn't. My sister in law felt the swollen lymph nodes and took him in right away. All of his lymph nodes were involved and the imaging, biopsy and needle aspirate confirmed the diagnosis. After two chemo treatments, he's still acting like his old self. He's a big galoot who loves everybody and to look at him, you'd never know he has cancer.

Please keep us posted on Lola's progress. I'll keep you both in my prayers.

Glynda

P.S. Here's a picture of my sis in law and the Aussies. Major is the big beautiful boy on the right.
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Squirt's Mom

11-07-2010, 05:10 PM

Hi Aimee,

I am so sorry to read of Lola's diagnosis but I know she is in the best of hands. I hope the treatment has an immediate and long-lasting effect for Lola.

Hugs,
Leslie and the girls - always

Sabre's Mum

11-07-2010, 05:42 PM

Hi Aimee

I am so sorry to hear of the latest from you and Lola. It appears that you have everything in hand.

Take care and all the best
Angela and Flynn

Loladog

11-07-2010, 07:50 PM

Thanks everyone for your kind words and support. It really means a lot to me. The thing is, I know what you're supposed to feed when a dog has Cancer but that equals high fat, high protein and low carbs. This is exactly the opposite of what you're supposed to feed when a dog has Pancreatitis. She's been on a low-fat, high carb diet for about a year now due to the Chronic Pancreatitis and I'm sure this didn't help much with the development of Lymphoma. I'm wondering if I should ignore the Pancreatitis since she's never really been symptomatic anyway in order to have her on the proper diet for Cancer? I've read over and over this weekend that for the best chance of remission, a dog needs to be on the proper Cancer diet. I've also read that a dog will do much better with Chemo when they haven't already had any weight loss which unfortunately, Lola already has. She's down from 63 lbs. at the beginning of the year to 51 lbs. now.:(

AlisonandMia

11-07-2010, 08:24 PM

Hi Aimee,

My two cents:

In your position my inclination would be to stick with the pancreatitis diet - maybe increase the protein and so decrease the carbs if possible - but not increase the fat. From what I've read, fat is the main problem with pancreatitis so adding some more lean protein shouldn't cause a problem (as far as I know.)

My reasoning on this is that pancreatitis could make her miserable and sick (or even kill her) far faster than the lymphoma will. With chemo she could well go on for a year or two and even live out her normal life span with a good quality of life. Also if you change her diet at the same time as starting chemo you will have a hard time knowing whether any problems, especially of the GI sort, are caused by her not tolerating the chemo or the change of diet. (Most dogs tolerate chemo really well though - but I'd imagine that there would always be that nagging doubt.)

I think you should be guided on this first and foremost by the treating doctors (you have an IMS?) and not make any dietary changes without their approval.

Good luck - we've seen quite a few dogs with lymphoma do really, really well on chemo for extended periods of time.

Alison

PS: To Glynda: Is Major's genetic problem with one of the chemo agents related to some collie-type dogs not being able to handle big doses of ivermectin and related drugs? Is it the same genetic defect affecting the metabolism of another drug - this time a chemo med?

lulusmom

11-07-2010, 09:38 PM

Alison, Major has the MDR1 gene so yes, Ivermectin could kill him. What I didn't know is that there are other drugs that are also extremely toxic for dogs that carry this mutated gene. I asked my sister in law the name of the drugs but she couldn't remember.

Spiceysmum

11-08-2010, 04:33 AM

So sorry to hear about Lola. I am sure she is in the best hands and will be thinking of you both.

Linda

Loladog

02-06-2011, 08:27 PM

Hi everyone,

I just wanted to share the sad news that we lost Lola back on 1/12/11. I'm sorry that it has taken so long for me to write. We tried treating her Lymphoma with Chemo but she didn't respond. They think we were dealing with "multi drug resistance" since Lola had been on Prednisone for so long. She took a turn for the worst and we knew exactly when it was time to let her go. Fortunately, our vet came to our home and she was able to go in peace on our bed.

I have to say that she was just never the same after we accidentally over treated with Lysodren and she became Addisonian. Things were just never right again after that and then the Lymphoma showed up. It's very difficult but I'm trying not to feel guilty for the treatment choices we chose. Her best interests were always most important to us. She would have been 11 in February.:(

Anyway, thank you all for your help when we were dealing with Cushing's. Your input was invaluable and it made me feel as though I wasn't alone. I will check back in periodically as even though the time here was short, I really feel like I got to know a lot of you and your pups. We have adopted a new pup who has brought a great deal of joy back into our lives but there will never be another Lola.