Katie-9 yr. old Beagle (Lysodren) updates

[katiesmom]

Hi! My name is Cathy, I'm from Nova Scotia and the proud pet mom of Katie, my 9 year old beagle. I'm new here and this is my first time posting. Katie has just been diagnosed with cushings and from there on I felt like my life had been lifted away from me, like someone pulling a rug from underneath my feet. I've been doing nothing but googling this drug....and googling that drug etc...and I'm on information overload to say the least. I feel totally powerless and scared to death. This prompted me to set out and find support groups and info boards where I could at least chat with other people who share the same fears. I'm torn between..treating her with Lysodren or Anipryl...sorry about the spelling.....or should i try cushex drops(alternative therapy)....i was wondering if anyone on here as tried Cushex drops? and if they have...did it help relieve some of the symptoms
Thx

[katiesmom]

Hi again...I forgot to mention that Katie has the pituitary kind of cushings and I am suppose to start her on Lysodren today. I'm scared to death....after reading all the side effects and it's such a powerful drug. I'll be keeping a careful eye on her.

Is it normal for cushdogs to tremble while they are laying down? I've noticed for weeks now, that when she is laying on the floor, her back legs shake a little, sort of like quivering or shivering. She has to pee about 4 times a day, but has stopped needing to pee in the middle of the night...is that normal too? She still has an appetite, but her breathing seems worse...sort of laboured, almost like she is snoring. I hope by starting Lysodren today, that I am not going to make her symptoms worse. I've been having horrible nightmares that she has liver-thyroid or diabeties and gets treated for the wrong disease, cushings instead. Katie has had an abdominal unltrasound and it showed an enlarged liver along with sludge in her gallbladder and two enlarged adrenal glands that the vet said are probably caused from stressed adrenals, her blood work came back from the low dose dex test and her baseline count was 243 and the vet said a normal dog would be around 180. I've been crying off and on, uncontrollably. I've always thought of myself as a strong person, but these past 2 weeks, I've been having major meltdowns. I don't have any children, these are my pet kids(Ihave 4 dogs) and because Katie is 9, I feel cheated...by at least 3 years, thought for sure she would be around till she was 12, now I don't know what to expect. I switched from commercial dog food to the raw food diet, and have been giving her milk thistle for her enlarged liver. Breaks my heart, to see her with no pep and bounce....I'd give anything to see her tail held high again like a white tipped flag blowing in the wind. I'm so incredably sad at this very moment. Am I doing the right thing by giving her such a powerful drug? or will I make her worse. My b/f feels that I am making a mistake and that by giving her this drug, she will be going through hell,he told me to prepare for putting her to sleep........... after he said that, I broke down and cried my eyes out. I'm off to the vets to pick up the precrisption to take to the pharmacy......wish me luck! I wish all of you on this board could hold my hand and come with me...I'm ashamed to say...I'm a big chicken s***t.:o

[frijole]

Don't worry, just pay attention to all signs and follow these instructions. report in and ask questions.. you will feel like we are there! Been there 4 yrs ago and I have another dog with it and about to do it again. It isn't fun but it is totally doable. You just need to pay attention.

Here are instructions for lysodren in case you haven't seen them. Print them out and follow them religiously. Good luck!!! Kim
http://www.k9cushings.com/forum/showthread.php?t=181

[Nathalie]

Hi Cathy,:)

Just wanted to welcome you and let you know I totally can understand how you feel right now. I too had quite a few meltdowns in the process.

I have to keep this short because I have to get ready for work (always gets in the way) but could you please post Katie’s weight and how much Lysodren your vet said to give during loading?
In order for people to give you better feedback, could you please also post any of the cushing tests results as well as any other test results that where not within normal range including the reference ranges? Did you do a Thyroid panel?

9 years is still young for a Beagle and there is no reason why Katie should not be able to live for many more years with very good quality of life once the cushings is under control.
My Phillip, who is a Collie/Beagle started treatment at 11.5 years of age – he is now 12.5 and still going strong. If I would not have started treatment he would be dead by now.

Like Kim said – this is totally doable as long protocol is followed, you have good communication with a knowledgeable vet and you educate yourself and be your dogs advocate.

Cheers,
Nathalie

[Rebelsmom]

Hi Cathy, welcome to the board. I'm new here also and the people on here have been saviors of my emotions and fears. I don't know much about Lysodren except I had the same reaction you did when I read the side effects. My vet put Rebel on Trilostan? Is that not an option in Canada? I know there are many people here using Lysodren and can help you get through this. Many hugs and love for you and Katie.

Melissa

[Casey's Mom]

Hi Cathy - welcome to you and Katie.

My dog Casey is 14 and has been on Lysodren for a little over a year. She is doing wonderfully on Lysodren as have many other dogs on this board. You have a young dog and you can expect her to live out her normal lifespan with treatment.

Did your dog has an ACTH stim test? If so can you post the results?

Do read up on the link given to you in an earlier post. You will be on a loading dose at first and you need to know what to look for so that you know when to stop the loading dose. Also make sure that the vet gives you prednisone to use if necessary.

Ask lots of questions, many people here have been right where you are now, myself included, scared to death. We are all here to help and hold your hand on this journey.

By the way Cush X drops are a total waste of time and money.

Love and hugs,

[mypuppy]

Hi there Cathy,
Welcome from me and my 7 year old chocolate lab, Princess. Goodness, after reading your post, it just brought it all back for me when my pup was initially diagnosed with cushings. I felt the very same way and thought this was the end for her. I finally snapped out of it, tried to control my emotions and decided instead to try to help my baby rather than fall apart. That's when I decided to try to educate myself about all this "dreaded" cushings stuff, and found this great forum with such wonderful individuals who have done nothing but held my hand from beginning up to this very day. I am sorry for your precious Katie, but as others will soon post, it is not the end. Obviously this is not a fun ride any of us willingly wanted to take with our pups, but as some have already mentioned, with proper treatment, a VERY communicative IMS, your Katie can successfully be treated, and at some point get her back to being your old dog again. I do not know much about Lysodern because I treat Princess with trilostane, but I know there are many here on the forum who use the lyso, so I am hoping you will be hearing from them soon with their experiences. I know they will be asking for test result numbers, so it may be a great idea if you start posting those soonest you have them in order for them to give you some input. Cathy, I do so wish I can hug you and make it go away, but please be patient, stay on board here and ask a lot of questions because I can assure you we are all here for you every step of the way from this day forward, and we have your pup's best interest at heart. I promise you that. Hang in there and chin up, and perhaps your b/f and you can both get educated together....I will be looking forward to some positive updates on Katie. Keeping her in my prayers....tight hugs and belly rubs, xo Jeanette

[SasAndYunah]

Hi Cathy,

welcome from me as well :)

Eventhough my experience with Cushing's is limited, one thing I still remember clearly. I was as insecure and feeling inadequate as you. And I am still glad I held off treatment untill I felt absolutely convinced and knowledgeable about the diagnosis and the treatment needed. It won't hurt Katie to wait a few more days or a week before starting treatment.

It sounds like not a lot of tests were done and other people here on this board can guide you much better then I ever could. Perhaps you could wait for their input and questions they will need to ask you about tests performed and results. That will help you feel more comfortable and will give you some more time to read about Cushing's, the diagnosing process, the treatments available...in short to become more educated. And then when you start treament, you will be much more calm. And your calmth will be a great help to Katie as well...

Just a thought :)

Best of luck,

Saskia and Yunah :)

[lulusmom]

Hi Cathy and welcome to you and Katie.

I have two cushdogs, both toys weighing in at 4.5lbs and 6.5lbs and both have been treated with lysodren for a very long time. Lysodren is a serious drug but if you have a vet that is extremely knowledgable of the disease and the drug, and you do your part by monitoring Katie closely for signs of any adverse reactions, you can ace the loading phase with no problems. If your vet didn't hammer into you how important it is to monitor Katie and what to watch for then s/he wasn't doing his/her job. Make sure you read and print out a copy of the Lysodren Loading Instructions and Related Tips and keep it handy on the kitchen counter. My two have been through a loading phase no less than three times and my copy of this paper is dogeared and splattered with food. :D Neither of my dogs have had any adverse reactions during the loading phase.

I have included the rest of my comments and questions in blue text within the body of your last post below:



Hi again...I forgot to mention that Katie has the pituitary kind of cushings and I am suppose to start her on Lysodren today. I'm scared to death....after reading all the side effects and it's such a powerful drug. I'll be keeping a careful eye on her.

I know you'll be like a mother hen during this time and again, make sure you read and reread the Lysodren Loading Instructions. Most cush dogs have a voracious appetite and I am hoping that Katie does too because it is the appetite that is the easiest to use for signs of loading. A cushdog, including both of mine, usually plows into the food bowl and never lifts the head up. When they pause, even for a few seconds or look up at you and then starts eating again, this can be a sign that loading has been achieved. You know Katie's habits well so you'll be able to tell if anything is different.

Is it normal for cushdogs to tremble while they are laying down? I've noticed for weeks now, that when she is laying on the floor, her back legs shake a little, sort of like quivering or shivering.

My second cushdog came from the shelter and his back legs trembled constantly. This is due to the muscle wasting caused by the excess cortisol and it will resolve once you get the cortisol down.

She has to pee about 4 times a day, but has stopped needing to pee in the middle of the night...is that normal too?

Peeing four times a day is not excessive and I would consider that normal. A cushdog that was once housebroken will drink voluminous amounts and will have accidents. It is not normal for a dog with cushing's to start concentrating their urine without treatment so that's a red flag for me as to a correct diagnosis. Did your vet do a urinalysis? 85% or more dogs with cushing's do not concentrate their urine so the urine specific gravity (USG) is low and their pee is dilute (clear like water). A good number of dogs will also have a bit of protein in the urine. A urinalysis is pretty standard in diagnosing cushing's so I hope your vet was thorough.

She still has an appetite, but her breathing seems worse...sort of laboured, almost like she is snoring. I hope by starting Lysodren today, that I am not going to make her symptoms worse.

Is Katie's appetite normal or is she like most cushdogs and always hungry and searching for food? if Katie's appetite is less than usual, do not start treatment with Lysodren under any circumstances. A cushdog that is not eating or picking at their food is considered to be a sick dog and you never give Lysodren to a sick dog.

I've been having horrible nightmares that she has liver-thyroid or diabeties and gets treated for the wrong disease, cushings instead.

Cushing's is a very difficult disease to diagnose because all of the tests pretty much have issues with false negatives and positives which is why more than a few tests have to be done for validation and differentiation purposes. Because it's one of the most difficult to diagnose, it is also one of the most misdiagnosed. I feel more comfortable with your vet's diagnosis because the abdominal ultrasound showed organ abnormalities that are common in cushing's.

We can help you understand the tests that should have been done and while we're not vets, we know how to interpret these tests. Can you please get your hands on copies of every test your vet did to diagnose Katie and post the results here? If you don't have them, your vet should be very happy to give them to you.

Katie has had an abdominal unltrasound and it showed an enlarged liver along with sludge in her gallbladder and two enlarged adrenal glands that the vet said are probably caused from stressed adrenals, her blood work came back from the low dose dex test and her baseline count was 243 and the vet said a normal dog would be around 180.

It is not the baseline draw that is used to determine if a dog has cushing's, it is the 4 and 8 hour draws that your vet should be looking at. Dogs that are stressed out or have a nonadrenal illness can have high baseline cortisol so I'm not understanding why your vet thinks the baseline count is significant. Once you get your hands on the tests, you'll want to post the baseline, the 4 hour and the 8 hour draws, including the reference values. From the baseline numbers you posted, it would assume that the lab may be reporting in nmol.

I've been crying off and on, uncontrollably. I've always thought of myself as a strong person, but these past 2 weeks, I've been having major meltdowns. I don't have any children, these are my pet kids(Ihave 4 dogs) and because Katie is 9, I feel cheated...by at least 3 years, thought for sure she would be around till she was 12, now I don't know what to expect.

Cathy, you are feeling exactly like most of us when we got our own pups' diagnoses. It's a scarey disease and the drugs are scarey too, especially when you don't understand most of what your vet is telling you. I don't have two legged children so like you, I consider my four dogs and four cats to be my children and I worry no less for them than a parent of a human child. I remember all the hand wringing and tears when my Lulu was first diagnosed almost five years ago. She was only 3 years old when diagnosed and at 8 y.o. she's doing fabulously and so is mom.

Try to remember that Katie is not really in any pain. She's listless because excess steroids make you tired. I can guarantee you that at this moment if Katie could talk, she'd tell you to chill out because she's perfectly fine and she wants you to remain calm and focus your energy on learning about the disease and lysodren so you can be an excellent advocate for her. When it comes to cushing's, knowledge is the most effective tranquilizer for us pet owners. The more you learn, the more peaceful you become.

I switched from commercial dog food to the raw food diet, and have been giving her milk thistle for her enlarged liver.

This is all good. Because cortisol is a catabolic steroid, it chews through protein like nobody's business. This is why a good quality high protein diet is best for our cushdogs, unless of course, the dog is in chronic renal failure, in which case lower protein diets may be indicated. My dogs are on a commercially prepared raw food diet and they love it and have thrived on it.

Breaks my heart, to see her with no pep and bounce....I'd give anything to see her tail held high again like a white tipped flag blowing in the wind. I'm so incredably sad at this very moment. Am I doing the right thing by giving her such a powerful drug? or will I make her worse.

Don't be sad, be happy that Katie has been diagnosed and you can get her back on track to a better quality of life. I still remember how elated I was with both of my dogs when I saw them returning to their former selves. It's an amazing thing and you'll see the wonder of it all for yourself in Katie.

My b/f feels that I am making a mistake and that by giving her this drug, she will be going through hell,he told me to prepare for putting her to sleep........... after he said that, I broke down and cried my eyes out.

With all due respect, your boyfriend obviously knows little about the disease or the drug so please don't believe a word he said. It's simply not true! Perhaps you might suggest he read a few threads here so that he gains a better understanding that cushing's is absolutely not a death sentence and that Katie can live out her normal life expectancy with a very good quality of life.

I'm off to the vets to pick up the precrisption to take to the pharmacy......wish me luck! I wish all of you on this board could hold my hand and come with me...I'm ashamed to say...I'm a big chicken s***t.:o

We're all chicken when it comes to loading so don't be ashamed. It's all part of being a good mom. Before you start treatment, you must have prednisone on hand in the event Katie's cortisol should go too low. Prednisone is not an option, it is a necessity so do not start treatment without it. Again, make sure you have the Lysodren loading instructions handy.

Cathy, we're all great handholders and even though we aren't there physically holding your hand, we're there in spirit. Please ask any questions you might have because somebody is going to be here to respond. It sucks that you had to find us in the first place but I'm sure glad you made your way here. You're not alone any longer and I hope that brings you some comfort so dry your eyes, take a deep breath and let's all work on getting Katie on the right track.

[sunimist]

Hi Cathy, and welcome to you and Katie from me too. :)

Glynda pretty well covered everything you need to process right now, but as Saskia pointed out, we really could use all the test results you have had done on Katie to help you understand what is going on.
If you have copies of those, would you please post them. If not, ask your vet for photocopies of all tests done and future test results also.
That's just something we pretty well demand from our vets and are certainly entitled to. :)

If the diagnosis is correct and it is definitely cushings, you will do just fine with Katie. We will be right here to assist and support you all day, every day. And FWIW, my girl had cushings disease for 6 years and managed well with Lysodren, so see, it is not as bad as you are thinking right now and I was a basket case in the beginning also. ;)

Hang on, cause I know you are determined to make your Katie well.

Shelba and Suni

[lulusmom]

Cathy, I forgot to ask how much Katie weighs and what dose of Lysodren has your vet prescribed. You should be giving her twice daily doses.

Glynda

[mypuppy]

Hi Cathy,
I just want to say to please read Glynda's (lulusmom) last post several times, and all her advice will start making some sense for you. Someone posted on my thread a while back and informed me "she's a geek", and I can assure you I know why--LOL. BTW, she's a very sweet, loving, caring, knowledgable, tells it like it is, wonderful kind of geek...LOL. So take heart ya' here and all will be well. Tight hugs, xo Jeanette

PS to Glynda: "Glynda, You Rock! xo J.

[lulusmom]

Thank you Jeanette. I love you too!

[katiesmom]

WOWWWWWWWWWW!I feel sooooo much better! THANK YOUto each and everyone of you that replied. I feel each and every one of your spirits with me, I"m no longer frightened like I was previously, and I'm ready to dry my eyes and snap out of it!:) Katie needs a strong mom, as do my other 3 dogs. I'm so ready to do this now. I appreciate all of your support, it's been more helpful than you'll ever know.

I asked my vet to forward all the tests results to my email, so that I can post them on here. It's all greek to me.

I tried to pick up the Lysodren today...and not one, but two pharmacies didn't carry it and said they would have to order it in. It will be ready for pickup tomorrow around noon. Tomorrow is the big day! I will print off the instructions and post them to my fridge. My vet did give me 15 tablets of prednisone for emergencies. My vet wants to start her on 500mg but to divide the dose into 2-250mg for half a tablet with first meal then the other half a tablet for the second meal(Evening). Katie weighs 39.4 lbs.

Here is the test results....thanks again....I truly feel so much better! I'm looking forward to reading lots of posts and getting to know you all better. HUGS&KISSES from Cathy and my sweet katie...also know as katiebear...lol.

Ultrasound results:


Pertinent Hx and Clinical Signs:

Skin infections, polyuria and polydipsia, elevated ALP, pot-bellied appearance, hepatomegaly on palpation.

Ultrasonographic Findings:

The liver was severely enlarged with rounded margins. The hepatic parenchyma was diffusely and severely hyperechoic and hyper attenuating. The gallbladder was moderately distended and contained amorphous echogenic debris. The left adrenal gland was symmetrically thickened, measuring 10mm thick at the caudal pole. The right adrenal gland was also symetrically thickened, measuring 10mm thick at the caudal pole. The remaining abdominal structures were sonographically normal.

Conclusions/Diagnostic recommendations:

Bilateral moderate symmetrical adrenomegaly. Severe hepatomegaly with diffuse hyperechoic, hyperattenuating liver parenchyma. The adrenal and hepatic changes are most consistant with pituitary dependent hyperadrenocorticism (Cushing's disease).


Cortisol Results:


Samples Received Tests Requested Completed Reported

DEX-PRE x 1 CORTISOL 20-APR-10 20-APR-10

DEX- 4 x 1 MULTIPLE CORT 20-APR-10 20-APR-10

DEX- 8 x 1 MULTIPLE CORT 20-APR-10 20-APR-10

Results:

Cortisol Baseline DEX-PRE 243- nmol/L Reference range 14 - 180

Post Dexa DEX- 4 257- nmol/L

Post Dexa DEX- 8 440- nmol/L

Reference: Post Dexamethasone: <30-40 NMOL/L at 8 Hrs for LOW DOSE;

Below 50% of baseline at 8 Hrs for HIGH DOSE =s adequate suppression

This dog has shown inadequate suppression of the cortisol concentration 8 hours following a low dose of dexamethasone, which supports a diagnosis of hyperadrenocorticism- Be aware, however, that these results can also be seen due to stress associated with other conditions- Therefore, please interpret in view of the history, clinical signs and diagnostic findings- If you feel hyperadrenocorticism can be supported, the lack of decrease in cortisol concentration to below 50 % of baseline at 3—4 hours does not allow differentiation between pituitary—dependent hyperadrenocorticism and adrenal neoplasia A high dose (01 mg/kg) dexamethasone suppression test and/or ultrasonography may assist in this differentiation- You may wish to also perform an ACTH stimulation test, particularly if you are contemplating medical therapy, as it serves as baseline information- Please call if you have any questions about this report

Noel Clancey BSc, DVM, MVSc

Clinical Pathologist, Diagnostic Services

Atlantic Veterinary College

[lulusmom]

Hi Again.

Thanks for posting additional information...it helps a lot. Firstly, I'd like to convert the LDDS results to ug/dl which is what we are used to seeing here:

Baseline draw: 8.8 ug/dl
4 hour draw: 9.3 ug/dl
8 hour draw: 15.95 ug/dl

As the ultrasound interpretation already mentions, those numbers are consistent with hyperadrenocorticism but it doesn't tell you which form is involved. Luckily, the ultrasound was able to confirm PDH. I will say that if I didn't have the benefit of an abdominal ultrasound, I would have bet money on an adrenal tumor as Katie did not supress at all. About 10% of dogs with PDH don't suppress on the LDDS and Katie must be in this minority.

Your vet is going conservative with Katie's Lysodren dose of about 27mg per kg. A lot of us, including my two tinies, loaded at 50mg/kg. I think there is a huge difference between an internal medicine specialist who is comfortable with prescribing 50mg per kg because they know the drug so well, and a general practitioner that is wary of side effects. There's nothing wrong with doing it this way but in my experience, Beagles sometimes take longer to load so with such a conservative dose, just know that you may have a protracted loading on your hands. In any event, your vet should have instructed you to take Katie in for an acth stim test on day 8, 9 or 10 unless she shows signs of being loaded before then.

Give Katiebear a big hug for all of her aunties and uncles here at k9c.

Glynda

[maggiebeagle]

Welcome to a fellow beagle lover!
My Maggie was diagnosed at about 12 years of age. We lost her in December at age 15, a normal lifespan for a beagle. We couldn't have made it without our friends here. We were all where you are now, confused and scared. Things will get better. :D
Wishing you an easy "load".

[lulusmom]

Just two more things. If you can't get the Lysodren until tomorrow at noon, then don't start dosing until Saturday morning. It's optimum to start loading on a weekend anyway. On average, most dogs load in 5 to 8 days so starting on a Saturday increases the odds of your vet being open in case you need to get Katie in quickly. Also, I don't think you ever answered my question about Katie's appetite? Is she hungry all the time?

[katiesmom]

Hi Glynda,
Katie is scheduled for a stim test on April 29th (next thursday) and starts her first dose tomorrow. Will that be enough time before her next stim test? My vet leaves next week (friday) for her vacation. She'll be gone for a week and decided to schedule Katies test for thursday.

Since the prescription won't be ready for pickup until noonish tomorrow, she will be getting her first dose then, so how much time should be giving in between doses before katie gets her second dose? Ideally, I had wanted to start her at breakfast time.
This saturday I will attending a wedding for approx. 5 hours....saturday will be Katies second day of Lysodren therapy, will she be okay for those 5 hours, or should I skip the wedding and stay home to monitor her. I'll be gone from 5:00p.m until 10:00p.m. I'm a nervous wreck about it, I asked my vet and she said, no katie will be fine and not to worry. Would love your advice about this?....am I being a worrywart?

[lulusmom]

It is not right to start a dog on treatment and go on vacation before the dog is our of the woods so to speak. Does your vet plan to associate in an on call vet in her absence? If not, I would delay starting treatment until the vet is back in town. I think our last posts crossed so you didn't see that I suggested that you not start treating until Saturday morning. Since that will be the first day of dosing, I think you should be okay with going to the wedding. Lysodren has a cumulative effect so I'd be more concerned about keeping an eye on her after the first couple of days. I hope this helps.

P.S. It's okay to be a worrywart because we are all going to be worrywarts right along side of you through this. For this reason, we expect to get frequent reports from you.

[sunimist]

I agree with Glynda about starting Saturday morning. Better to get off to a good start rather than starting in mid stream. :) Ask your vet if you are uncomfortable with this protocol, but I think anyone who has gone through loading would agree. However, there are no professionals here, just moms and dads who have gone through the cushings diagnostics, treatments and management of the disease (some with more than one cushpup at a time). Waiting 12 hours is nothing considering cushings is slow to manifest itself to a point that requires testing and 12 hours is certainly no big deal when starting treatment. :) I am in no way advocating that you go against your vet's recommendation, just speaking from experiences here on the forum the past 8-9 years. :)

Also, I do hope your vet has an associate vet who can oversee Katie's progress satisfactorily, and has experience with cushings dogs, when your vet leaves. I would make sure of that before starting treatment.

Good for you to print out specific instructions and have them at your fingertips. Katie is a lucky girl to have such a conscientious and loving mom!

You will do fine!

(((HUGS)))

Shelba and Suni

Just thought of something else. If you do start at noon, be sure you give the lysodren with food to avoid stomach upset.
Another reason to wait until Saturday morning (IMO), especially if Katie is not used to eating a noon meal.

[frijole]

Just checking in and I see you got all our messages. You are doing a great job of getting up to speed! I agree with Glynda - if the vet isn't around you need to know who you can count on to help if you needed it. The best vets at treating cushings are ones who have had dogs that had it because they "get it". :)

There is no rush to treat in most cases. So don't worry about it if you have to delay it. At first giving the drug is scary but once Katie starts feeling better you will relax. Kim

[lulusmom]

Hi again,

I've been kicking your thread around with Shelba (sunimist) and we both think that if you will have a vet available to you in your vets absence, you should probably put off starting the loading period until Sunday. You need to give the two doses approximately 12 hours apart and if you have to be at a wedding at 5:00 pm on Saturday, you'll have to get up pretty early Saturday morning to give Katie her first dose. There's absolutely no rush to start treatment so please consider starting the dosing at an optimum time. If there is no vet filling in during your vet's vacation, do not start the treatment until she is back in the office.

Glynda

[katiesmom]

Thanks for the advice....I will call my vet this morning and express my concerns about when the best day is to start loading. It never dawned on me that if the doses should be approx. 12 hours apart, then if I would have started her around noon, then I would have to give her next dose at midnight right? Katie usually eats between 5-6a.m (We're early risers in our household) then again between 4-5p.m for her supper. Sometimes even at noon(I work from home) she sucks me in with those big soft brown eyes...lol..
Glynda-sorry I didn't see your previous posts until now...and yes katie has a wonderful appetite. I am a bit nervous to say the least about my vet going on vacation, and I will ask if someone will be in her place while she is away for a week. I just started taking Katie to her recently. She is a holistic vet and just down the street from me. I suppose her stim test could be done at another vets place that has lots of experience with cushdogs. She expressed her concerns about wanting to start katie on her Lysodren treatments right away.
So far katie has a great appetite, when she drinks her water, it's usually a large amount at one time, then she is good for several hours before wanting to drink again. She has a terrible skin infection, the vet injected her with an antibiotic(She has a sensitive tummy and couldn't tolerate Novalexin) All of her back from her neck down to her tail has circles of bald patches and red scaly skin, some sores have a sticky substance oozing out from them. I bathe her 2 a week in a medicated shampoo, but the next day she looks horrible again.
I forgot to ask you guys on here.....before her symptoms were noticable to me, she use to lick the sofa(it's microfiber) for example the seat cushions, or the arm rest for a good 5 minutes on a daily basis, and take kleenex out of the garbage and chew that.....anyone else on here experience that?

[Rebelsmom]

Thanks for the advice....I will call my vet this morning and express my concerns about when the best day is to start loading. It never dawned on me that if the doses should be approx. 12 hours apart, then if I would have started her around noon, then I would have to give her next dose at midnight right? Katie usually eats between 5-6a.m (We're early risers in our household) then again between 4-5p.m for her supper. Sometimes even at noon(I work from home) she sucks me in with those big soft brown eyes...lol..
Glynda-sorry I didn't see your previous posts until now...and yes katie has a wonderful appetite. I am a bit nervous to say the least about my vet going on vacation, and I will ask if someone will be in her place while she is away for a week. I just started taking Katie to her recently. She is a holistic vet and just down the street from me. I suppose her stim test could be done at another vets place that has lots of experience with cushdogs. She expressed her concerns about wanting to start katie on her Lysodren treatments right away.
So far katie has a great appetite, when she drinks her water, it's usually a large amount at one time, then she is good for several hours before wanting to drink again. She has a terrible skin infection, the vet injected her with an antibiotic(She has a sensitive tummy and couldn't tolerate Novalexin) All of her back from her neck down to her tail has circles of bald patches and red scaly skin, some sores have a sticky substance oozing out from them. I bathe her 2 a week in a medicated shampoo, but the next day she looks horrible again.
I forgot to ask you guys on here.....before her symptoms were noticable to me, she use to lick the sofa(it's microfiber) for example the seat cushions, or the arm rest for a good 5 minutes on a daily basis, and take kleenex out of the garbage and chew that.....anyone else on here experience that?

Man I thought it was just my dog that had a licking problem!! He would just sit and lick the carpet over and over until I would catch him. He also started pulling tissue out of the bathroom garbage. I thought he was just living up to his name again (rebel). Driving me nuts..

Melissa

[mypuppy]

Hi Glynda,
I understand you feed the babies a commercially prepared raw diet. I have contemplate switching Princess to one, however, I have received numerous opinions, both good and bad so I still have her on the Merrick dry and wet brand. I need to pick your brain (again) regarding diet with cush dogs. . I would be most interested in your opinion considering it seems to be working well for babies. BTW, does a cushdog need to be on a certain type of diet, per say, low fat, high/low protein. I just want to make sure I cover all bases with my Princess and switch her need be. In addition, should I be giving her the milk thistle for liver support as well, even though she has never (knock on wood) experienced any problem in that area? Life with you on the forum is always a learning experience....Take care...xo Jeanette

[lulusmom]

Hi Cathy,

I see that you already heard from Melissa on the licking behavior. I believe we've had other members that have reported this weird behavior as well. The trash digging is certainly not uncommon because dogs with cushing's are usually hungry all the time so they go scavenging. Bigger dogs will turn into counter surfers so nothing is safe at counter level. My brothers dog is perfectly healthy but has always had a huge appetite so they have to keep everything tucked away or on top of the refrigerator.

With respect to Katie's skin problems, has your vet diagnosed the condition? I ask because there is a condition known as calcinosis cutis that some cushdogs get and it's a bear to gain the upper hand on. Basically, cutaneous calcium deposits form under the skin. Sometimes they remain just bumps but sometimes they can erupt into an oozing bacterial infection. Make sure that your vet has done the proper testing to determine what is going on with Katie. If it is calcinosis cutis, it should get better with treatment; however, sometimes it can take months so hang in there.

Here are links to some pictures of Augie, an English Bulldog, that has a severe case of calcinosis cutis and to pictures of Sabre, who also had a severe case. Our beloved Sabre has passed but his mom, Angela, still checks in on members so if you have any questions, she's our resident expert.

http://www.k9cushings.com/forum/album.php?albumid=189
http://www.k9cushings.com/forum/album.php?albumid=97&pictureid=783

Jeanette, I never contemplating switching my dogs to a commercial raw food until a friend of mine told me how well her dogs did on it. My Buster had horrible allergies and my vet had just told me to put Lulu and Buster on canned food because they didn't drink enough and both have a history of high PH urine and oxalate bladder stones. I was told that you don't have to transition with raw food so they all went cold turkey. Oddly enough, within a day, their poop was actually firmer and for the first time, Jojo's poop was firm. Within a month, I could tell a big difference. Buster was a pudgster from all the grains he was getting in the kibble and his vet told me he to get the weight off. Well the weight came off and it was like he came out of coma and started playing like a puppy again. All four started acting years younger and Buster's staining on his face improved. Because their bodies utilize everything they are eating, they poop a whole let less. Their poops are a lot firmer which helps with keeping the anal glands expressed on their own so my groomer likes it; their poops disintegrate and blow away in a matter of days and it doesn't smell.

As long as a cushdog has not been diagnosed with chronic renal failure, they need to be on a good quality high protein diet. That doesn't mean you have to go raw or grainless, just try to find good foods with gluten free grains. If there wasn't a commercial raw food out there, I doubt that I would have gone raw because I can't imagine throwing a raw piece of chicken to my dogs in the house nor spend the time making sure they get all the other supplements they need. It's not cheap but I'm already destitute with vet bills so what the heck.

Glynda

[Nathalie]

Occasional excessive licking of floors/furniture, lip licking, air licking can indicate that the dog has an upset stomach or nausea.

" I can't imagine throwing a raw piece of chicken to my dogs in the house ...."

It's not that bad at all ;) - you pass the chicken neck to the dog and you are done - no cooking or dirty dishes. The boys get their turkey necks in the yard and little Sophie eats on a towel. :)

Nathalie

[katiesmom]

Omg girls....I just typed the longest post and hit reply and it said I'm not logged in..argggggg, even though I am logged in.
Well here we go, hope this works. I called my vets yesterday to see about changing the loading phase till the weekend. I received a reply back via email that no, Dr. Bishop would like you to start right away. Katies meds weren't ready until 2:30p.m. I knew I wasn't going to be up at 2:30a.m next morning to give her the second pill, so I waited until supper time.I was nervous, but took a deep breath. She was hungry and ate no problem...pill and all. This morning she had her second pill(250mg)and had a good appetite. I did notice she seems to be more thirsty, and a bit warmer, other than that, no vomiting or diarrhea. Right now she is sleeping soundly. When she is awake she is scratching at her sores until they bleed. It made me think of karen (Mrs J) on here with her katie.
It's nice to know other dogs have that weird licking problem too:)
The raw diet has been great on my other 3 dogs....what a difference in their coats, nice clear eyes, more playful, and breath is much nicer too. They all switched over very easily. I started them on it about 2 weeks ago. I recently bought a high quality canned food for Katie at the vets, just to hide her pills in it and to feed her as a main meal. It's a high protein food. I still give her raw chicken as well. Is anyone else using the brand Home Made 4 life? It's the raw food that you can buy from the freezer section at pet places and vetsI bought that for convenience as well. I'll keep you posted regarding katie. I also want to check out the forums too. Thanks everyone, I'll keep you posted.
Cathy xo

[Nathalie]

Hi Kathie,

A friend of mine fed Pets4Life for several years - and she was very happy with their products/quality.

Make sure that you give the Lysodren right after Katie finishes eating so you can withhold the Lyso if she shows signs of being loaded. You would want to wrap the pill in something such a piece of bread with a little cream cheese perhaps.

Regarding the scratching - my begale Matthew used to scratch himself to pieces - dug right into the bloody sores with his nails.
Since you can't prevent them from scratching, putting dog boots on the hind legs works beautiful - they still can scratch but can't do as much damage because the nails are covered.

Nathalie

[lulusmom]

Cathy, I'm sorry that your vet was in such a hurry to have you start treatment that he failed to tell you to give Katie's first dose with her evening meal. Lysodren is better absorbed with food, plus the food helps with preventing tummy upsets that happen frequently with Lysodren. I use cream cheese for pilling my two cushdogs and they gobble it right down.

Since waiting a few days to start treatment under optimum conditions is in a dog's best interest, I must assume that your vet is either concerned with an underlying condition that must be controlled quickly by lower cortisol or he is simply not that experienced with treaty a cushingoid dog. In this case, could the rush be due to Katie's skin problems?

Now for more questions. I typed them all out in a paragraph but there were so many I decided to list them. :o:o:o

1. How many doses of Lysodren did your vet give you?
2. When did your vet tell you to bring Katie in for an acth stim test?
3. Did your vet tell you that he would be in contact with you frequently during the loading phase to check on Katie?
4. Did your vet give you explicit instructions on what to do if Katie were to stop eating, start vomiting or have diarrhea?
5. Did your vet give you the name of the doctor on call in his absence and will that doctor be fully informed of Katie's status before he leaves?
6. Did your vet give you the name of the closest emergency clinic in the event Katie experiences an adverse reaction during off business hours?
7. Did your vet diagnose the skin condition and what treatment did he prescribe for it?

Sorry for all the questions but your answers really do help us understand the big picture.

Glynda

[katiesmom]

1. How many doses of Lysodren did your vet give you?
2. When did your vet tell you to bring Katie in for an acth stim test?
3. Did your vet tell you that he would be in contact with you frequently during the loading phase to check on Katie?
4. Did your vet give you explicit instructions on what to do if Katie were to stop eating, start vomiting or have diarrhea?
5. Did your vet give you the name of the doctor on call in his absence and will that doctor be fully informed of Katie's status before he leaves?
6. Did your vet give you the name of the closest emergency clinic in the event Katie experiences an adverse reaction during off business hours?
7. Did your vet diagnose the skin condition and what treatment did he prescribe for it?

Sorry for all the questions but your answers really do help us understand the big picture.
Hi Glynda....sorry for the delay in responding...had company for 2 days staying at our house. Now, I'm free and able to answer your questions.

1)30 tablets of 500mg. I'm to give Katie 250mg in the am with her meal then another 250mg with her supper. She weighs 39lbs.
2) In 6 days time from her loading phase.
3) No, she didn't. So I emailed her and told her that I had been reading the loading phase instructions on Lysodren and that the vet should be in contact from second day of loading on to check in on how everything is going. She now has been responding via email this weekend.:)
4) Yes, she told me not to hesitate to give Katie (2) 5mg tablets by mouth of the prednisone and to stop the lysodren.
5) No, not yet. She will be leaving for her vacation next friday and Katie will be having her stim test on thurs.(day before vet leaves on vacation) someone is replacing her while on vacation.
6)No, she didn't. I'd have to look it up in the phonebook.
7)Not that I recall, she did examine her skin and gave Katie an injection(antibiotic) because katie couldn't tolerate oral tablets(novalexen)

Glynda....I tried to click on those links you had posted regarding skin infections, but it says I'm not logged in. Tried a few times, I'm logged in though, not sure what I'm doing wrong. Would love to be able to see pics. Katies. skin is just horrific! If it was just patches of hair falling out, I could deal with that, but it's these aweful oozing sores, the best way I could describe it is....it smells sort of like stinky feet that have been in the same socks forever! All my vet said was it was a skin infection probably due to cushings and we need to get cushings under control and that should help out alot. Maybe that is why she was in a hurry to get katie started on Lysodren right away.
Thanks Glynda for all the questions!
Cathy

[Harley PoMMom]

Would love to be able to see pics. Cathy

Here is a link to Angela's Sabre:

http://www.k9cushings.com/forum/album.php?albumid=97&pictureid=783

Love and hugs,
Lori

[acushdogsmom]

Glynda....I tried to click on those links you had posted regarding skin infections, but it says I'm not logged in. Tried a few times, I'm logged in though, not sure what I'm doing wrong. Would love to be able to see pics. I'm not Glynda - but I think that I know why the links weren't working for you. The links that Glynda posted did not have www in them, after the http:// part. They really should work with or without the "www" in there, but for some reason, sometimes they don't work if the www isn't in there. I just fixed them (by adding back in the www parts) and they should work now, as long as you are logged in when trying to view them.

Augie:
http://www.k9cushings.com/forum/album.php?albumid=189

Sabre:
http://www.k9cushings.com/forum/album.php?albumid=97&pictureid=783

[StarDeb55]

Cushy, I just tried the link for Augie, it's still not working. The one for Sabre is ok.

Debbie

[sunimist]

You must have got them fixed. They both work for me.

[katiesmom]

Thanks.....I was able to see the pics. Sabre&Flynn are so beautiful. Thanks for sharing. The pic of Sabres' back kind of looks like what katie has, but I'm not 100% sure. Katie has so much of her skin torn and bleeding from scratching, that it is hard to tell really. If i were to take a bunch of pics of Katie....am I able to show them on here like you did. I'm a newbie at all this so you may have to walk me through it:) When you guys asked me to post katies' test results...I actually had to ask my b/f how to copy and paste..LOL..(sad but true) When it comes to computers, I've only used my laptop for emails-facebook and surfing the net...that's the extent of my computer knowledge:eek:

[katiesmom]

Oh wait a sec!...........sorry I missed Augies' pics.....yes! that looks like what Katie has......what is it?....calcium deposits???? what causes that? and how is Augie now? what did you use on him? Poor Augie....it looked so painful! Ouch!

[katiesmom]

Nathalie.....I tried your advice about the dog booties and hiding the pill in cream cheese and giving her the pill after.

Thanks.....it worked! Great idea. :)

[Sabre's Mum]

Cathy

I have been following your thread to see what you have to say about Katie's skin condition. What Augie has and Sabre had (Sabre passed away just over a month ago) is called "calcinosis cutis". I recently posted on Elly and Augie's thread some info on this for Elly. This is the link to her thread

http://www.k9cushings.com/forum/showthread.php?t=1400&highlight=Elly+Augie

In Sabre's case his scabs and surface skin issues (if this makes sense??) cleared up but he still retained the large plates of calcium deposits. His hair also grew back ... although a lot fluffier and longer than he ever was. We called him the hairest Vizsla in the world ... more of a labradors coat!!

If you have any questions .. please ask away. I am working night shift but do read from time to time.

Take care
Angela and Flynn

[katiesmom]

/B]Hi Angela,
Sorry to hear about Sabres' passing. May I ask how old he was when he passed? I loved that pic where it looks like he is posing for the camera....very regal looking!:)

After reading about Augie, and seeing his pic, I'll definately be asking my vet to have another look at katies' skin condition.

When a dog has been diagnosed as having cushings disease, is it part of the normal process to have more and more hair falling out? She is getting worse not better, around her neck she will be bald soon!

Well I'm on day 3 of Katies' loading phase(Actually vet instructed me to start friday evening-supper time) so does friday count as day 1 even though it wasn't a full day of dosing? Anyhow....lastnight was horrible. I never slept from midnight until 2:30a.m. Katie paced and paced...tried resting on a cool surface, that lasted 2 seconds, up again to try a new spot....on the couch-off the couch...sratch-sratch-scratch...I felt her belly and my gosh it was so hot! She was panting quite a bit....drank alot of water in one sitting....finally she fell asleep-poor thing. I fed her lastnight...raw chicken breast...and the pets4life or home made4 life raw food(turkey)...I mixed a bit together. She scratched for about 5-10 min. after supper then slept-snored through the night right up until midnight. After that she was hyper-hot-and extremely restless. So. approx. 6-6.5 hours after she eats she awakens and is hyper...etc...is this a normal part of the cushings process? She is loading on half the required dosage, so I imagine her loading phase will take alot longer right?

Is it possible she may have thyroid problems too? She has always been a hyper dog all her life, and I know through blood work-stim test-low dex test and ultrasound that they feel it is indeed cushings disease, I'm just wondering if she has an underlying problem along with cushings. She will be going in for her first stim test since loading on thursday coming up, do you guys think I should have a thyroid panel done too? or not bother.

Guess I just need to be patient:(

[katiesmom]

I forgot to mention in the last post...she only became lethargic a few years ago....I assumed it was because of her heart murmur. Last year she was diagnosed with idiopathic disease(facial paralysis) and half her face never did return back to normal. She has small circles over her pupils too. Neither my previous vet , nor my holistic vet(new one)seemed concerned about it, so I assumed it wasn't a big deal. When she had her blood panel work done(am I saying that right) I was told her glucose was fine. She did eat a big meal before the blood work was done, would that affect the readings at all? Is it ok if I post those readings here too. Will have to call my vet to email them to me...it's greek to me, but I am hoping you guys can explain it to me.

Sorry for the babbling, just trying to give as much info as possible.

[lulusmom]

Hi Cathy,

You can never give us enough informaton on Katie so please post whatever tests results you have. To make easier, you can just post the high or low values for any bloodwork done and remember to include the reference ranges and reporting units, i.e. nmol, ug/dl, etc. Debbie, one of our moderators, has over 30+ years as a lab tech and she has been invaluable in helping interpret labwork so I'm sure she'll be by to review anything you post. She can also explain what values you can expect to be affected if a dog has eaten a alrge meal just prior to a blood draw.

If Katie's skin condition is calcinosis cutis, be prepared for a long healing process. From everything I've read, it takes several months and sometimes up to a year to heal after you've gained control of the underlying cause. In Katie's case, it's undoubtedly the cushing's disease.

Because your vet has prescribed a very conservative loading dose, it is quite possible that you will have a long loading period. I will tell you that I was more concerned about the conservative dosing for Katie because of her breeding. I've noticed on the forum that Beagles seem to be over-represented when it comes to protracted loadings, even with the higher dosing of 50mg/kg. It will be interesting to see if Katie breaks the mold. :D

A very small percentage of dogs with cushing's will also have primary hypothyroidism; however the majority will have low T-4 which is only secondary to the cushing's. The latter is called euthyroid sick syndrome, a temporary condition which should resolve once the cushing's is well controlled. For this reason, most experienced vets will wait until a dog has been stabilitized on cushing's treatment and then retest the T4. If the T4 is still low, then primary hypothyroidism is a possibility and a free T4 by equilibrium dialysis (EQ), at the very least, should be done.

Katie's sleeping patterns should improve greatly as the cortisol is reduced. Humans with cushing's and dogs with cushing's are pretty darn different in most ways but I think both species can experience inverted sleep/wake cycles. I do remember my Lulu being pretty much in a coma during the day and up all night long. I finally had to quit letting her sleep with me because she drove me absolutely nuts.

I hope I have touched on any of your remaining questions but if not, please let us know and somebody will be glad to provide feedback.

Glynda

P.S. Dogs with cushing's are sensitive to heat and dogs with hypothyroidism are more likely to be sensitive to cold. Lulu has both conditions and with her, the hypothyroid trumps the cushing's because she has always been sensitive to cold, even when she had some hair.

[katiesmom]

Hi Glynda!
Thanks for all the info. Well...tomorrow morning will be Katies first stim test since her loading phase. Today is day 5. Something very upsetting happened tonight, I fed her supper same time as other nights...she had a hearty appetite, but half way through her meal, she flipped out on her back, started shaking, it only lasted a minute...if that...then went right back to eating like nothing ever happened!!! I was so scared! That was her first seizure ever! I called the vets and she told me that the pituitary tumour is probably larger than anticipated, and because of its' size, it is pushing on her brain, which caused her seizure, and that the prognosis may not be good. My question to you guys is...could the Lysodren have caused her seizure? I just thought it was strange that this is her first seizure ever, and she never had one before starting Lysodren.
What steps am I suppose to take if she has another one??....that really scared me tonight:confused:
Cathy

[lulusmom]

Hi Cathy,

I remember how terrified I was when my Lulu had her first seizure so I totally understand how upsetting it is. I have the worst memory but I think Lulu had her first seizure about two years ago and she's only had one since. Some dogs have one or two and never have another one in their life so I'm hoping we've seen the last of them. Lulu's IMS told me that seizures are usually a whole lot worse for the pet owner than they are for the dog. I'd have to agree with that because when Lulu came out of it like nothing happened, my heart was still pounding out of my chest and I could not catch my breath.

Beagles are a breed that seems to be overrepresented when it comes to seizures so I wouldn't jump to conclusions about an enlarging pituitary tumor. I also would not spend money on an MRI or CT to check for a macroadenoma based on one seizure. I am hoping that Sue (Zoe's mom) will post and share her knowledge of seizures with you. She's got a lot more experience than I do.

Glynda

[judymaggie]

Hi, Cathy -- I, too, can identify with that terrified feeling at the first seizure. My beagle, Maggie, had seizures in her later years and someone shared the Epi Guardian Angels website with me and it was a tremendous help so I am passing it on:

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

There are specific suggestions about how to help your pup through a seizure, what to have on hand, suggestions about diet, etc. -- really a wealth of information. I was still terrified every time a seizure started but then calmed down as I realized I knew how to prevent Maggie from being hurt among other things. The first thing to do is to sit down and write as many things as you can remember about Katie's seizure -- the time of day, what she had been doing, what she ate that day, even the weather and exactly what she did during the seizure and after. Did she lose urinary control/bowel control? Was she "woozy" afterwards? Alert? A journal will be a huge help to both you and Katie's vet.

Glynda is right -- many beagles do have seizures and I expect 99% of them do not have Cushings. Hang in there and I will be sending good thoughts your way that this was Katie's one and only seizure!

[littleone1]

Hi Cathy,

I can definitely relate to your feelings. Corky started having seizures about 5 years ago. At that time time he was not cushoid, and was not on any medications, except for his thryroid med, which he had been on for several years.

I know how you feel. It is very frightening. Corky's seizures started to occur less often and for shorter periods of time. He hasn't had one for almost 1 1/2 years. There was no explanation for them, except that he had been through a traumatic experience which could have caused them. Hopefully, Katie will also not have any more.

Terri

[katiesmom]

Thank You Glynda&Judy!
It makes me feel better to hear other peoples stories and experiences.Judy, I will go check out that link now. Thanks again.

Lori sent me a great article on seizures, and after reading it, i could see signs. Now, I know what to look for next time(but hopefully there will be no next time). I thought something was odd this afternoon, I went out to run a few errands, I was gone exactly 2 hours. Came home, and for the first time ever...no Katie at the door to greet me. I looked for her and found her hiding/sleeping on the floor in a closet, on a blanket. ( I keep tons of blankets all througout the house for my sweet katiebear to sleep on) The blanket was wet!

Katies' hind legs were soaked. I smelled the blanket, but couldn't detect any urine odour. I thought to myself....could she have sweated profusely, but that much! It had to be urine. She was sooo lethargic. Within an hour, she jumped out and started looking around the kitchen for food....I felt relieved! I was so close to giving her pred. She was trembling before she ate, then half way through supper, she has a seizure, lasted less than a minute, then goes back to eating like nothing ever happened. I just stood there dumb founded, I thought to myself....did I just see what I thought I saw. It happened so fast! I thought for a split second, that perhaps she was choking on her food. I'm wondering now...if she may have had a seizure in the short time I was gone, and wet herself, and was so lethargic. I had put her out to pee just before I went out, so I was shocked to see that if she did indeed pee, that she was just laying in it.

I wonder if she should have a full thyroid panel done as well. Suppose it wouldn't hurt would it? She has to go in for a stim test tomorrow anyway. Poor katie...a grade 4 heart murmur, a terrible skin infection(which by the way the vet doesn't feel it is calcinosis cutis) she feels strongly that it is yeast related. Cushings and now her first seizure.

I don't want to jump the gun or anything.....but if katie doesn't improve and things get worse(her breathing isn't improving) as much as it tears me to peices to even think about it....I will have to do the right thing for Katie.....not for me...but for my sweet katiebear. I don't want her to suffer. If she does require radiation treatments..I don't know if I can afford that route, if it came down to that I mean. All I know is that I don't want her to suffer, just for my own selfishness of wanting to keep her around until she is 15 at least. I wish, she could live to be 20!!! Unheard of I know, but of course that would be my wish. My b/f and I had a heart ot heart discussion tonight about Katie. He looked at me and said, Cathy....do you really see her improving, because I don't. Do you really want her to suffer? I don't see a happy dog, you need to really think about....I can't even say the unthinkable, can't even type out the word.

I really need to take a little break from the computer for an hour or so, I'm crying as I'm typing...just so scared-fear of the unknow I guess....sorry everyone!

Judy, I will read that article and thanks again....just gotta take a little breather...back later everyone
Love Cathy xo

[katiesmom]

Back now...sorry about that..just needed to take a little breather. I feel a bit better now, more calmer than previously. Terri....thank you for your post, it gives me hope. I must have been posting mine the same time as you did, sorry I didn't see it until I came back.

It's funny how sometimes you think you see an improvement, then the next day or the very same day, you don't. I've been focusing so intently on watching for signs of vomiting, diarrhea etc...and feeling relieved that Katie has shown no signs of a sensitivity to Lysodren. It doesn't seem to be consistent though.....this whole loading phase. For example....she isn't going to her water bowl frequently like she was, but instead she is still drinking copious amounts of water but doing so right after breakfast, then again right after supper. When she does drink...it's almost non stop, she leaves some water left in the bowl. I've been filling it twice a day with 6 cups each fill....but as I said...less frequent trips to the water bowl.

I noticed the last few days, that when she was awake, she appeared hyper, for example....doing a few laps around the living room-hallway back into the living room....like a big circle, then she goes back to sleep, a few nights ago she was up for hours on end scratching.

This afternoon...lethargic, personality change ,wetting her blanket and laying in it(I'm assuming that's what happened) I'm getting ready to grab a couple of 5mg of prednisones thinking she is going the other way, when within an hour she has her paws on the kitchen table looking for food......then trembling...eats...has a seizure in the middle of her supper, then back to eating.....so that's what I mean about the whole loading phase being so inconsistent. I figured I would see a slow gradual improvment, but instead, it's really weird....so, on one day...off the next.

I'm still debating on wheather to run it by my vet to test her thyroid too. Wish me luck tomorrow girls....and thanks again for your kind support and kind words....it's great that you can all share your experiences. I can't begin to tell you how happy I am that I found this site.......there is no way I could ever get through this without you all. To think support is coming from all over the place...florida, ontario, texas, nebraska etc......just amazing! I love you guys! You rock!
Cathy

[Nathalie]

Hi Cathy,
Since you are already in the loading phase I would wait with having the thyroid panel done until after Katie is loaded and she has been on an adequate maintenance dose that is controlling Katie's cortisol for a couple of weeks to get most accurate results.
A while back I had emailed Dr. Jean Dodds to find out for how long does the Cushing’s disease have to be under control until thyroid production will go back to the level it was prior to the onset of Cushing’s disease and her recommendation was to wait 2 weeks before testing Thyroid function.

Hope this helps,
Nathalie

[frijole]

Cathy, Hang in there! You are doing great. I remember like it was yesterday when Haley was loading she was 12 1/2 at the time. I prayed for more time. Well, thanks to lysodren and these people at the forum I got it. FOUR years has passed. So don't throw the towel in.. let the drug work.

Don't switch up the food or treats because you want to know for sure that any change is due to lysodren and not something new being introduced. Keep monitoring and reporting back. This is the hardest part and shouldn't be long.

When cortisol levels are high dogs pace. I remember my dog walking around and licking the carpet. A number of us has seen that... so don't get freaked out over that either. ha. Have faith..keep following the instructions. You are getting there. Kim

[katiesmom]

Thanks Kim and Nathalie....I did take your advice.:)

Well here's an update on my Katiebear:Her personality is s-l-o-w-l-y starting to come back and I can't tell you how pleased I am about that:D

I have a silly question to ask all you experts out there...because my vet was in such a hurry to start Katie on Lysodren treatment, insteading of starting on saturday morning or sunday morning, she started friday evening.....half a tablet(250mg) and from there on she got 2(250mg) tablets a day...one in a.m(breakfast) and the other half a tablet in the evening(supper)....so when did her actual loading day start?....do I count friday evening as day 1? or should I count saturday as day one(as that was the first day she got both tablets-12 hours apart)? My vet has left on vacation and left me instructions to keep giving half tablets twice a day for 8 days straight. Thursday she only had a half tablet with supper, as she was at the vets all day for her stim test, so they told me not to give her anything in the a.m. So...should tonight be her last half a tablet? or tomorrow morning?(sunday)?:confused::confused:
She is suppose to start her maintenance phase next week, I don't even know her stim test results yet....they told me it would take a week.....so, the instructions say after you finish your 8th day of lysodren, start giving Katie a full dose every 3rd day until her results come back, to which we will then adjust her doasge if needed.
I had to call my vets office to see how much...250mg? every 3 days or 500mg. every 3 days, they said give her 250.mg.
I guess I'm just surprised that she will be on a maintenance dose, when we don't even know her results yet, from my observation she hasn't loaded yet....I've been looking for the signs. Oh well....I'll do as instructed, and she is due for 2nd stim test in two weeks.(350.00) each time I go(they did a critical care test on her too)....I better get a second job....lol..how often do cushdogs go for stim tests?

I have to get back to work....I'll check on here later....thanks everyone:)
Cathy&Katie

[frijole]

Cathy, Maybe I am not understanding everything but here is what the protocol is:

You give a certain dosage every day for between 7 and 10 days all the while looking for changes. If there are any changes you STOP and do the acth test. This test is to see where you are towards the goal of a reading of between 1 and 5.

If the test comes back high you go back to daily dosing amounts. If it is between 1 and 5 you can start weekly maintenance. The weekly maintenance amount is EQUAL to what you gave daily during loading. You can split that total amount into multiple days. This is an amount designed to maintain Katie between a 1 and 5.

So if I read your post right you started loading on a Friday night and had the acth test done Friday morning and skipped Thursday? So you only went 5 1/2 days at loading dose before doing the test? And then your vet split town?

Do you have a backup vet to contact should something happen? The results from labs - assuming they sent them in on Friday - should be back in a couple of days so even though your vet is gone I would be calling in daily to get an answer.

The problem with your vet's plan is that you went 5-6 days at one amount and then he's telling you to change it to another amount so you will never know what level is the one that is working. It appears as if the plan was based around a vacation and not veterinary protocol.

Have you seen any signs whatsoever of loading? Any change for the better in symptoms? Is there a backup vet you can get in touch with? I need those questions answered before I can even think of offering advice. I can see why you are confused over this.

Hang in there. Let us know more and we'll help as best we can. I will be checking back later this evening. Take care. Kim

[Nathalie]

Hi Cathy,

In my books, this is complete unacceptable.
Your vet leaves town with some generic instructions and the lab takes 1 week – yikes. I had a stim done yesterday and had the results back this morning.:eek:

I believe your dog is on a very conservative loading dose to begin with – I was scanning your thread but could not find Katie’s weight – there is a very good chance that she is not even loaded.

I am wondering about this vets experience in treating cushings. It is ok to go on vacation but not without appointing another vet to take over the care of your dog especially during the loading phase.

If you follow your vets suggestions, which are not protocol, you may end up spending a LOT more money on testing and re-testing with no or little resolution in Katie’s symptoms.

Stim tests need to be done after loading with a follow up stim after 4 weeks on maintenance dose.
Each time you change a maintenance dose you need to follow-up with a stim test after 4 weeks to ensure that the maintenance dose is adequate.
If your dog escapes control and requires a mini-load a stim test is required with another in 4 weeks.


Here is a link to IDEXX's Lysodren Dosing and Monitoring chart (http://www.idexx.com/pubwebresources/pdf/en_us/smallanimal/snap/cortisol/cortisol-mitotane-protocol.pdf)

Protocol needs to be followed because this is what has been scientifically proven to be the safest, most effective and cost effective way of treating the disease.

When I first started treating my Phillip about 1 year ago and Phillip’s vet did not follow protocol – the result was additional tests and Phillip feeling lousy for longer then was necessary.
Then I joined this group, asked question, read and re-read and basically relied completely on the recommendations of this boards members to get us well on the way.

Looking forward to your answers to Kim’s questions.

Nathalie

[katiesmom]

Hi Kim&Nathalie!
I know....this is so messed up...now you can see why I am so confused. Katie was only on her lysodren loading phase for 5.5 days when they sceduled her for a stim test. I thought this was odd, I've been reading alot on here and through links that you guys post etc...so here is Katie getting her first stim test after only 5.5 days, then they send the results away and tell me it will be about a week to come in....and to continue with treatment for another 3 days. After that, she is to go on 250mg. every 3 days. They booked her for a second stim test in 2 weeks time.
There is someone replacing my vet while she is on vacation, but I feel like all this was done around her vacation...scheduling an early stim test the day before she leaves on vacation???? now another one in 2 weeks. Katie hasn't shown any signs of loading. She is still plowing through her meals like no ones business, drinking lots of water.....she is starting to act like her old self again. BTW.....she weighs 39 lbs.
Maybe, I'm wrong here but I feel like my vet is all about the money.
I'm the one who has been emailing every day with questions and calling etc....They do answer my emails and will return my calls...but I'm the one taking the initiative. I purposely didn't contact them on monday or tuesday....to see if they would contact me regarding katie...how she was making out with her lysodren.....and no phone calls...nada...nothing. So on wednesday I called them with lots of questions. While Katie was in for her stim test, they did an additional test, which ended up adding another 150.00 to my bill. I was not impressed. I feel like my vet doesn't care and is all about the $$$$. I took the advice from here on an earlier post about making sure they tell you where the emerg is, in case you need to take Katie...the vet tech said she wasn't sure.......can you believe that????:mad: So I told her to look it up please!!!! as i would like to know in case katie has a seizure or a reaction to the lysodren...etc...sometimes the girls that work there giggle etc....because I email them pretty much on a daily basis, except for this weekend. I don't know what I would do if i didn't find this site!!!!
This is where I am learning everything!!!!!!! I have paid this vet well over 1,300 in a 2 week period and I'm starting to get really pissed!:mad::mad::mad:

[frijole]

Cathy,

Deep breaths my friend, deep breaths. ;) I totally understand the frustration. It does appear things were rushed to meet someone's schedule but let's figure out what can be done...

If I am reading things accurately you are still on the loading amount and have not yet reduced it to once every 3 days. Right? If so AND SO LONG AS KATIE SHOWS NO SIGNS OF LOADING, DIARRHEA, VOMITING then I would keep on giving the loading dose.

The reason is because if you still aren't loaded then you are dragging this thing out needlessly. And most important, it seems that the vet is not following protocol.

Again, I repeat - this is only if nothing is out of the ordinary. It is very simple. If the dog appears to be loaded then you cease giving the drug and schedule an acth test. YES, another one. Because you want to know where your dog is now. Giving the first test after only 5 days when your dog showed no signs of being loaded in my opinion was a waste of money. Normally it would be done 7 to 10 days into loading. Since your vet was gone it was moved up is my guess... however, the replacement can surely do this test.

You are on a conservative dosing amount as has been mentioned before. So reducing the amount given before you are loaded is only going to make the cortisol levels go back up and you will lose ground.

Does this make sense? You are aiming for an acth test score of between 1 and 5. Lysodren is how you get there. You are tweaking to get the dose just right so that once you get to that level you can maintain it by making the daily dosing amount your weekly amount.

I want to make sure you understand that if you do continue giving the loading amount that you know to continue watching and stop as soon as you see any teeny sign of progress - like the dog eats slower, pauses while eating when they usually don't. Anything like that. Also watch the poop. If it gets soft - close to diarrhea it could be a sign that you are loaded.

So if you stop, even if your vet is out of town - call the replacement vet and say you need to schedule an acth test. You want to schedule it for a couple days from the last pill given as the drug keeps working for 2 days. That way you get a true score.

If any of this scares you - then go conservative and do what the vet told you to do. Clear as mud??

Hang in there!!!!
Kim

[Nathalie]

Cathy - I just send you a PM.
Nathalie

[katiesmom]

Forgive me as it's been several weeks since I've been online.

I wish I would have followed everyones advice on here, but I ended up following my vets instructions instead......here is an update on katie.

To refresh your memory.....my vet starting loading katie on 500mg of lyso a day for 8 days straight. B.T.W....Katie weighs 39lbs.

So, she was getting 250mg in the a.m.....and 250mg in the p.m. My vet was going on vacation, so she did katie's stim test 5 days into the loading phase. The results took a week to come back. I don't have them on hand at the moment, but the vet said her cortisol levels were still high. In the meantime, I was instructed to give Katie 500mg a week.....and to do it this way....give 250mg every 3 days and we will tweak the dosage if need be, once the results get back.

Katie has been on her maintenance phase for almost 4 weeks of 250mg of lyso every 3 days. So here is the kicker....on the days that i give her 250mg, she looks horrible, her eyes look really strange to me....best way to describe it is like she was drunk or something, bloodshot, sad looking like a basset hound, and almost like the 3rd eyelid is closing, like she can barely keep her eyes open. To touch her skin and belly, she is so freakin' hot! Like she is on fire. She was still eating her meals regularly, then yesterday, I gave her 250mg of lyso, today she was drooling, went to her water bowl, took a look at and walked away, her legs were a wee bit wobbly. I gave her 2 tablets of prednisone...they are 5mg each. I suck at giving pills....I have no idea if she brought them up again when she went outside. She looked as if she wanted to vomit. I'm not sure if they got into her system or not. I called my vets, and she said it won't hurt her if you give another pred. tablet of 5mg. This time, I made sure she swallowed it. In about an hours time, she came out and started to drink water.....very gingerly though. Then she saw me feeding my other 3 dogs and came over looking for food. I feed them all raw food. So, she ate her supper tonight. I just went to check on her and she is in a deep sleep, a bit of drool coming out of her mouth, her skin is hot to the touch again, and her eyes are dopey/droopy looking.....poor thing! Her stool this afternoon was normal, not runny.

So, my question is.....what the heck is going on? Is she going addison on me? Should I give her any more prednisone? or wait to see how she is in the morning?

Is anyone on here experiencing side effects of lyso? such as more panting, hot belly and skin .....lethargy on the days that you do give your dog lyso? then the next day normally she appears better, today being the exception.

I am not giving her anymore lyso until I get a post blood sample taken? or another stim test. I'm kind of freaked about this lyso drug and I can't say that I like the effect it has on her on the days that I do give it.

Anyone else on here not happy with side effects of lyso? and how often should I give her pred? Is there such thing as overdosing on pred? maybe, I should let her sleep tonight, then see how she is tomorrow morning. I know a handful of you on here have had very successful results using lyso, could it be that it just doesn't agree with my dog for some reason?

Thanks
Cathy

[frijole]

Lysodren gave my dog Haley 4 more years of life. It is more than a handful of people here. I won't mince my words...I would not take it out on the drug... but I would take a hard look at my vet.

If Katie was my dog, I would not give any more prednisone tonight. If you gave her 3 pills you probably are over the recommended emergency dosing amount. I would call my vet in the a.m. and set up a time to do another acth test. You would NOT want to do the ACTH stim test tomorrow because you should wait at least 24 hrs from the last prednisone to have the test done so it is valid.

If Katie's prednisone wears off and she goes back to wobbling and not eating you might have to give her another. The bottle should tell you how much to give her. You should have been given an emergency no. on how to contact your vet at times like this. Make sure your vet is there for you.

I will now try to answer your questions - lysodren can make dogs drowsy when they are taking it. It is a chemo drug. It is strong and that is what makes it WORK! The key is you need to know how to use it. Too much causes problems and that is what happened to you.

Drowsiness, being hot and flatulence are all normal signs when loading. Vomiting, diarrhea are signs of overdose. Not eating or drinking are warning signs that you should STOP giving it because she's about to go too low.

I know you did one test at 5 days. did you ever do the 2nd one? You went on a maintenance dosage of 250 mgs every 3 days. I would divide the 500 weekly mgs into 2 or 3 doses spread out over SEVEN days vs every three because you are slightly increasing the dosing amt by going every 3 days at 250.

Anyway... what you are describing really sounds like LOW cortisol. If she were Addisonian she would be lying on the floor, unable to get up, lift head etc. So stopping and testing is what you need to do.

You need the tests done in order to understand whether or not the weekly dosing amount is too high. If you do what your vet has told you to do you are crap shooting and it leads to trouble.

I am going to give you a link on lysodren to read. It explains alot of this. Print it. Live by it. Ask us questions. Go in armed with knowledge when you meet with your vet. Either they need to start following protocol or you need to find a vet who will.

I will defend this drug because not only did it save Haley's life but my dog Annie was just diagnosed and is loading now. But it is real important that you become as knowledgable as you can so you can be your dog's voice in this. We are here to help. I had to fire my first vet too. And I still argue with my current one. :p But the knowledge I get here is what gives me the ability to do that.

Glad you found us. I too wish you would have followed our advice the first time but hopefully now you know we are experienced. We aren't vets but we know what your vet should be doing. Your vet isn't following the rules for this drug. So please know that this drug can save Katie. Just understand how it works, read, ask questions. My guess is that if you hold off on the lysodren for 24 hrs, do the acth test (and still hold off until you get results) the cortisol levels will creep up a bit and you will be in good shape. It does sound like Katie's levels were low but not terribly so.... my guess from your description.

Sorry for rambling... its' late here! Good luck and let us know how she is doing in the a.m. ok?? Kim

http://www.k9cushings.com/forum/showthread.php?t=181

[Nathalie]

Hi Cathy,

Glad to have you back.

Kim is again right on the money.

Are you giving Pepcid 30 min before you give Katie her lyso? How is she doing this morning?

“I am not giving her anymore lyso until I get a post blood sample taken? or another stim test. I'm kind of freaked about this lyso drug and I can't say that I like the effect it has on her on the days that I do give it.”

I would call the new vet you mentioned when we spoke on the phone and book a stim for at least 24 h AFTER you gave the last pred and do a pre and post blood draw. Treating cushings with Lyso without doing stim tests at appropriate times would be like doing heart surgery with the lights off. These tests are not optional but essential in keeping your dog save and getting the cushings under control which in turn will make you feel in control.
If finances are a real issue you 'might' only do a post blood draw but if Katie is truly heading towards addisonian I would want to know where her cortisol is prior to stimulation to make sure that there is a definite increase between the pre and post number.

I will be gone all morning but will be checking for your update as soon as I get back home.

Nathalie

[katiesmom]

Well Everyone....what a day my poor Katiebear had. She has been on antibiotics administered through an I.V all day until 8p.m this evening.
She has a high fever, a bad infection, swollen lymph nodes, and was having a hard time swallowing and eating, now I know why....an x ray revealed thickened soft tissue on her throat, plus a hard white lump on the back of her tongue, and a balloon like lump underneath her tongue. I was told it could be 3 things....1) Cancer 2) calcinosis cutis deposit that maybe be blocking her salivary glands 3) maybe caused from the infection....he said let's keep our fingers crossed that it is due to the infection. He told me that katie has so many things going on within her body that he felt weren't related to cushings, he told me to take her off lyso.....the lumps at this point are so pronounced that lyso isn't going to help. I was told to see how she responds the next dew days to the antibiotics, but to perhaps discuss that putting her down might have to be an option. He said I can't tell you what to do, but you may want to think about it, if she gets worse.
That was my day. All this time i thought it was because of the lyso, but turns out that poor Katie has numerous things going on within her body at the same time.
I didn't sleep at all lastnight, I'm dead tired right now, I'm off to bed to sleep with my katiebear and my other 3 dogs(king size bed...good thing)....I will see how the next few days go...for now....I will spend as much time with my Katiebear as possible. I love her so very much, it is painful to think about the other.....but I don't want her to suffer either, so we'll see how things play out in the next few days.
I'm quite frankly exhausted and in much need of sleep.....so I'll sign off now and keep you posted.
I would like to thank everyone on here that gave me support and advice. This is a wonderful site! A special thank you to Nathalie for the long phone chat we had a few weeks ago. It's wonderful to chat with people who understand what you are going through, they get it...cuz they are going through it as well.

Cathy

[Nathalie]

Dear Cathy,
I am so, so sorry about Katie's current issues. I know how much you love her. Sometimes these things can turn around and what looked quite hopeless today starts taking a turn for the better the next.

I have no experiance with what Katie is going through but others might.

Once you got a good nights sleep and the antibiotic has had time to work you and Katie will hopefully both feel a bit better.

If you need an ear to listen you can call me anytime, you are not alone.

Keeping you and Katie in my thoughts.


Nathalie

[frijole]

Cathy, I am so sorry! Poor Katie has lots going on and you are right.. the lysodren is the last thing to worry about. Keep us posted on how you and Katie are doing and if we can help we will. Meanwhile sending warm thoughts and strength your way Kim

[Casey's Mom]

Oh Cathy, poor Katiebear. Hopefully you all had a good sleep and things will turn around for you. Sending warm healing thoughts,

Love and hugs,

[Nathalie]

Cathie, just in case you are checking in I wanted you to know that I have been thinking about you and your Katie and I am hoping the antibiotic has kicked in and Katie has started to feel better.

Big Hug,
Nathalie

[katiesmom]

It's been awhile since I posted....here is the latest. Katie's balloon size lump under her tongue disappeared, the white lump on her tongue is still there. She is on her second month of antibiotics, was taken off of lysodren, due to other problems going on. An xray of her throat was taken and it showed soft tissue that wasn't suppose to be there.

I have a feeling she may have had thyroid problems for quite some time, I'm on my second vet now and have asked if she should have a full thyroid panel test done. She has lost alot of weight in record time. Down to 33lbs. from 47lbs. I asked the vet if this is common for cushdogs and he said no it isn't, let's beef her up and up her calorie intake, so she is now on puppy food....dry kibble from Medi-cal. She still loves to eat but is losing weight so fast. She can't yawn like she use too...she can only open her mouth so far...I can tell her throat is really sore. Her bark changed 3 months ago. I'm thinking she either has thyroid cancer or has hyperthyroidrism. Anyhow...2,000 dollars later, I still have a sick beagle with no concrete answers....so depressed and I feel bad for katie being poked and proded and pilled to the nines...poor thing. Anyhow, just wanted to keep you up to date. I should go check the links on here about thyroid problems, I'm pretty sure that is what is going on with her, but no vet will really come out and say it or even suggest a thyroid panel be done.

Moderator's Note: Cathy, I have merged your update post into Katie's original thread. We normally like to keep all posts on a pup in a single thread as it makes it easier for other members to refer back to the pup's history.

Debbie

[Wendy Tillotson]

Hope she is feeling better.

If you have a local university nearby such as UPenn or Cornell - you might want to consider taking her there. Sometimes local vets just dont have the experience or equipment to properly diagnose things.