Zoe By My Side- Our Journey with Cushings

[addy]

Hi, my name is Addy and I have two dogs Zoe and Koko. Zoe may have Cushings and I need advice. Here is the long history. I am at work so won't be able to post again for 5 hours. Thank you.

Rescued Zoe, a Lhasa Apso, on 4/17/07 from animal control. She weighed 19 pounds and was 11” high at the shoulder. Probable age 5 years but not sure. Put her on Canidae all stages dog food. Had a bit of a touchy stomach. New food gave her soft stools. Only other problems were reverse sneezing and paw chewing.

August 08 brought home nine month old male dog from animal control. Zoe hurt her paw and had trouble walking, took her to emergency before picking up new dog. Thought it was just strained, rest and pain killers. Saw regular vet, gave her Rimadyl. Had bad reaction to drug. Could hardly stand up. Lots of stress in house with new dog who is sick with kennel cough. Then Zoe ate something in the park, her Canidae formula changed unbeknown to me. Got diarrhea. Vet put her on flaygl and canned Hill’s ID. Told me to pick out new food and transition. Should not be a problem. Was a problem, could never get her off the canned ID. Sometimes even one piece of kibble would cause water stool. Had to supplement canned ID with rice and pumpkin. All blood work normal back then.

April 09 both dogs had vomiting and diarrhea. Put Zoe back on Flaygl but stools never got to be 100%. Went to new vet, blood work again normal. Gave me more Flaygl and Panacur. Two months later went to holistic vet also trained in western medicine and asked for help. She thought Zoe had stress colitis. She did thyroid panel sent to Michigan State. Said Zoe was in the low range, treatment not recommended. However, she wanted to try a glandular thyroid drug called Armour. She put Zoe on a raw commercial diet, Shen Calmer and Armour along with Culturelle probiotic. Zoe went on new diet cold turkey. She said I went too slow trying to transition, and had me journal. We went up and down with water stool but most days she only had one small stool a day. Energy level went up, she lost weight, sore paw was better. She ran into trouble a few months later, put her on Flaygl. Tapered her off it according to new vet, added some Honest Kitchen to her diet and a miracle happened. Zoe was normal again and stayed that way all last winter until we took her to groomers in February. Noticed her coat was very thin after the groom, like she lost her undercoat.

March 10 went back to holistic vet, asked to take Zoe off Armour, I had read drug had been reformulated in Spring of 09 and humans were complaining of hair loss as a new side effect. Thought it was affecting her coat. Thought she may also may a urinary infection as has been licking her potty since last August. She said do urine test for Cushings. Also did panel for thyroid but only checked Free T4 and T3, not full panel. Test came back that Armour really wasn’t affecting her levels, said ok to stop it but that Urine Creatinine test came back positive with very high numbers and she said dogs with that high of numbers always have Cushings, wants to do low dose dex test. She is already picking out what drug to use. I told her I did not even collect urine specimen correctly, no one told me it had to be first urine of the day. Zoe had eaten breakfast, drank water, went for a walk, urinated a few times and then I took the specimen around 10:30am. She is very reactive on walks. She said that did not matter and Zoe had to have Cushings drugs or her hair would all fall out in 2 months. Told vet she would be too stressed all day to stay in c:confused:age at vets and worried it would not be accurate test. Vet said stress would not affect the test.

Everything I read tells me the opposite of what this vet says. HELP! She has no other symptoms except a poor coat. She hasn’t even had a physical exam. If I post her test numbers could anyone give opinion? I feel like I need to start all over with blood work, exam, chemistry panel, etc before testing again for Cushings.

[zoesmom]

said ok to stop it but that Urine Creatinine test came back positive with very high numbers and she said dogs with that high of numbers always have Cushings, wants to do low dose dex test. She is already picking out what drug to use. I told her I did not even collect urine specimen correctly, no one told me it had to be first urine of the day. Zoe had eaten breakfast, drank water, went for a walk, urinated a few times and then I took the specimen around 10:30am. She is very reactive on walks. She said that did not matter and Zoe had to have Cushings drugs or her hair would all fall out in 2 months. Told vet she would be too stressed all day to stay in c:confused:age at vets and worried it would not be accurate test. Vet said stress would not affect the test.

Everything I read tells me the opposite of what this vet says. HELP! She has no other symptoms except a poor coat. She hasn’t even had a physical exam. If I post her test numbers could anyone give opinion? I feel like I need to start all over with blood work, exam, chemistry panel, etc before testing again for Cushings.

Hi and welcome -

Well, here come the questions - pretty standard for new members so bear with us. Can you post the results of the urine cortisol:creatinine ratio test. That test will rule out cushings if it is negative. However, a positive result just means that you need to do more testing to confirm cushings and your vet is suggesting the LDDS (low dose dex test) next, it sounds like. (That might be premature . . . has general bloodwork been done yet?) I suspect you are still a long way from a firm cushings dx. And you are also right . . . more definitive testing is probably in Zoe's future.

Cush dogs will usually have certain elevated enzymes. If bloodwork has been done, then also please post anything that was high or low - out of normal range. (If you didn't have copies of all her test results, start asking for them and keeping a file.) You are also right that stress can skew a dog's cortisol levels on testing. With Zoe having few symptoms, there are other possibilities besides cushings. Hypothyroidism can cause coat issues as can atypical cushings. It could be any number of things. But do give us whatever details you can. Zoe's weight, age, other meds, recent test results, other suspect symptoms - if there are any. Cush pups usually have a voracious appetite and thirst (causing excessive urination), those elev. liver enzymes, are prone to infecctions, weakness in legs, poor coat, muscle wasting, some have skin issues. Not all cush dogs have all the symptoms, and some will only present with a few - but they can mimic the symptoms of several other conditions, which is why it's not always easy to diagnose. Do check out our resource section and start reading as much as you can. You'll get lots of pointers here on what to ask your vet but we do need more info from you. ;);) Sue

[StarDeb55]

I am so sorry that Zoe has been having so many issues, but welcome both of you to our group. I will warn you that we tend to ask a lot of questions of new members but that simply helps us to give you the best advice possible from the group's collective experience. From your post, it's not clear as to which vet is in the rush to test/treat for Cushing's, is it the holistic vet or regular vet? You are correct about the way you collected the urine not being ideal. Was the urine test a urine cortisol:creatinine ratio? If it was simply a urine creatinine, that will tell you nothing about Cushing's. High levels of stress with a vet visit can certainly affect a low dose dex test. A lot of members who have dogs who stress at the vets will take the dog with them during the 4 hours between blood draws, go to the park, go home, whatever you want to do as this will lower the stress levels.

Is the hair loss, poor coat condition the only symptom that Zoe has? Some of the other symptoms can include excess drinking & urination, pot belly, muscle wasting especially in the rear end, & an absolutely voracious appetite. We can most definitely help you understand the labwork that Zoe has had done already. In fact, I'm a medical lab tech with 30+ years experience. If Zoe has had something like a senior wellness panel or super chemistry panel, could you please post only the abnormal results, along with the normal ranges, & reporting units.

When it comes to the low dose dex test (LDDS), this test is considered to be the gold standard to diagnose Cushing's, but it has one big drawback as it can give a false positive result in the presence of non-adrenal illness such as diabetes or thyroid. This is why it's very important to get these other 2 medical issues ruled out. It is also crucial to get a positive LDDS results confirmed by a 2nd test, usually an abdominal ultrasound.

Looking forward to hearing more.

Debbie

PS-I see Sue was posting at the same time, so sorry for any duplication.

[Roxee's Dad]

Hi Addy,
Just wanted to chime in and welcome you and Zoe. You have been well advised and we are looking forward to the details of testing. Don't let any vet push you into treatment until there has been a proper and thorough diagnosis. Also find out if your vet has had experience treating a cush pup. Sometimes we find that you can get to the bottom of some of these mysteries by consulting with an Internal Medicine Specialist.

[Dutchboy]

i am very new at this, in fact, just found out that my dog probably threw a false positive. he saw an internal med specialist yesterday that said absolutely, stress can make a difference in the test results. my dog had a low dose dex test and was extremely agitated at the vet's that day. he pooped his run; ran around in it and painted the walls. i cried and worried for 5 days that he had an adrenal tumor.
maybe your vet could refer you to a specialist, as well. they could look at the bloodwork, etc. you have already had done and give an informed opinion.

[addy]

Thanks to all of you for responding. Latest test
Michigan State-4/13/10
Urine Cortisol 422
Urine Creatinine 4.0
Urine Cortsol/Creatinine Ratio 106 H ref range 8-24
Total Thyroxine TT4 27 ref range 15-67
Total Triiodothyronine TT3 1.1 ref range 1.0-2.5
Free Thyroxine Ft4 9 ref range 8-26
Free Triiodothyorine FT3 2.5 L ref range 4.5 -12
Thyroid Stimulating Hormone 7 ref range 0-37

she was taking Armour Thyroid (glandular) 30 mgs 2 times a day for 7 months.

Original thyroid panel 8/21/09

Total Thyroxine TT4 17 ref range 15-67
Total Triiodothyronine TT3 .9 L ref range 1.0-2.5
Free Thyroxine Ft4 13 ref range 8-26
Free Triiodothyorine FT3 1.2 L ref range 4.5 -12
Thyroid Stimulating Hormone 12 ref range 0-37

Zoe is possibly 8 years old, could be older. She currently weighs 18.5 pounds. I measured her water intake, does not even drink average amount, she finishes her food in the same amount of time as my other dog, she begs for food the same as my other dog, they are clicker trained with food, her stomach seems different than younger dog but I don't think it looks like the pictures. She jumps on the bed just fine. I see no other symptoms. She has gained one pound since I weaned her off the Armour. I started that process one month ago and she has been 100% off for 2.5 weeks. I was worried the drug was making her hyperthyroid or causing the hair loss.

here is the thing, she got into a plastic bag with turkey in it and ate some of the plastic and had a bout of diarreha 2 weeks before the test. I gave her Flaygl to stop the inflammation caused by the plastic. That plus not collecting the urine correctly makes me doubt the validity of the urine test and since I feel we have not been taking a detailed approach, I don't trust the validity of the low dose dex test when I know how badly stressed Zoe will be. When she went for her dental they had to put a towel over her head to even get her in the crate.

I have been misdiagnosed by the human medical community, over dosed on drugs I should never have been given. I am cautious of any doctor or vet.

We have only one internist in town that I can find. I don't know how good she is.

I feel I need to start with a chemistry panel, complete blood count, urinalysis and a physical exam. I don't care if I have to pay all over again. I just need to know I am doing right by my Zoe. I do NOT want the holistic vet to do these tests as she already has made up her mind on the diagnosis.

Am I just putting my head in the sand? Am I just afraid to see what is in front of me? My gut is telling me to start over. I do not feel good about this test the holistic vet wants to do. I want to start at the beginning which is what I keep reading to do.

Thank you. Some times my brain is going faster than I can type

[StarDeb55]

First of all, please don't let any vet rush you into treatment. Cushing's is a slowly progressing disease, literally taking years to do its damage to a pup's internal organs. You need to take the time to learn & educate yourself about the disease, including such issues a diagnostic testing medication, & monitoring tests for either medication that is used to treat, trilostane or lysodren. You also need a vet that is willing to work with you as a team for Zoe's best interests. A vet who is willing to listen to your concerns, & answer any & all questions.

Now, the Urine creatinine cortisol ratio (UCCR) does, indeed, point the finger towards Cushing's. I must stress that a positive UCCR test simply indicates that Cushing's is a possibility, but further testing is required. If I were in your shoes, I would be really concerned about letting this vet rush me into treatment. I think it would be in Zoe's best interest to ask for a referral to an internal medicine specialist as a large number of general practice vets, simply do not have the in depth knowledge required to accurately diagnose & treat Cushing's. If you have copies of the general labwork that has already been done on Zoe, as I said earlier, if you will post the abnormal results, I can take a look at them, & see if there is anything else that might point toward Cushing's. Most cushpups have abnormal liver function test results, so I would be especially interested in seeing those results. I don't think it would be necessary to repeat the general labwork. Get that referral to a specialist, & you can take all of Zoe's records with you for their review, letting them decide on how to proceed.

One last thing, a Cushing's savy vet usually will not treat a pup who doesn't have strong symptoms. Monitoring a change in symptoms is one of the primary ways of determining how a pup is responding to the medication.

Debbie

[addy]

Thank you Debbie. The problem is the blood work is one to two years old and I am afraid may be irrelevant. I could get the 2 year old blood work but last year's test was done by a very stange vet. He was so odd, I really don't want to call there. He claimed to know Zoe and said he treated her as a puppy. I found the whole visit extremely uncomfortable. That is why I moved on to the holistic vet. She was recommended by a friend.

Do I have to have a referral to an internist? One cannot just make an appointment?

Also, is it better to just present Zoe with her hair loss and let the internist start from scratch or tell her about the Cushings link? I have found with human doctors, they seem to dwell on the previous diagnosis and let it influence them.

I am trying to read all I can. I am not retaining alot at the moment, I am too upset, I think. I am afraid of the drugs but I know that seems to be a common reaction. I certainly won't give them to Zoe if I could not even tell if they were working that was one of my concerns. How would I know? I was looking at the melitonan and flax hull treatments, wondering about that.

Could the hair problem be from her diet? Will her hair really fall out in 2 months? Why would the vet want to scare me like that? Are her numbers that bad?

I am like everyone else. Zoe is my life. All I have done for 3 years is try to help this little dog. I leave and breath Zoe 24 hours a day, seven days a week.

Thanks again.
Addy, Zoe and Koko's Mom

[addy]

Hi All,

I have been in the process of waiting six weeks after the withdrawal of the USP thyroid medication-brand named Armour-natural glandular product. We see the internist tomorrow. Zoe's hair is starting to grow back-so much for her vet saying it would all fall out in 2 months because of her possible Cushings diagnosis. One thing I was not expecting was to see a flare up of her colitis. Has anyone experienced loose stools after withdrawing thyroid meds? Perhaps it is unrelated but I sure had hoped I would not have to focus on her colitis tomorrow with the internist. Zoe was being treated for hypothyroidism because her numbers were on the low side, although Michigan State did not recommend treatment. Her hair started thinning and her tail started looking bad after a groom in February. She then had urine cortisol - ceatinine ratio that showed 104. I did not collect urine correctly and suspected a false positive. She had a colitis flare up going on then as well. I don't think it ever resolved. With so much going on I am worried which way the internist will approach and I want to be thorough. Any suggestions?

Thanks for your help. Hopefully I explained everything. Wasn't sure if you needed by previous post so started a new one. let me know the proper way to do it.

Thanks,
Addy
---------------------------------------

Moderator note: Addy, we have merged this post (originally posted in the "How to and Comments" Forum) with your original thread here in the Questions and Discussions Forum. We like to keep all posts about each specific dog in one single topic, so that we can easily look back through the topic to see what was posted about them previously. It's just easier for everyone that way! :)

[addy]

Hi Addy here,

I first posted probably 3 months ago but had to wait for testing further. I have also cried for 3 months while waiting and today I am falling apart after speaking to internist last night. I need to get it together but it is so hard. What does it mean when they have not just high cortisol but four other hormones high?

Finally have results back so started new post. Original Urine creatine test was 106. History is on first post but thought I should start new one now with all the test results. New tests done through internist.

Does she fit diagnosis? Do I treat the symptoms or the diagnosis? UTK says lysoderm so does internist. I don't know what to do. Lhasa apso maybe 8 yrs old but unknown, has been with us for 3 years, came from Animal Control. on raw commerical diet for 1 year
Blood work does not seem what it should be for Cushing dog, why is Platlet so high?

symptoms: thinning skin on belly, thinning hair, rats tail, exercise intolerance, back legs getting stiff, water intake below normal, food intake- eats as fast as other dog, begs the same, wants to lick EVERYTHING and chew alot on her Kong, does seem hungrier since starting raw diet, not as active, does not do well in heat, only pants when colitis is bothering here and has bad poops, on Shen calmer, was taking armour thyroid natural glandular product and was taken off drug when I noted thinning hair. thyroid tests from Michigan test did not indicate thyroid treatment but she was on the low side so vet tried it. Needs Flagyl frequently for chronic diahrrea and vet wants her on it to maintain stools so has been taking 125mgs 1 time, every other day for 3 weeks. Helps her.

ultra sound- adrena glands larger than normal with one being slightly larger- nothing of signifigance with other organs

cbc, gastro panel from texas state, urinalysis, serum chenistry, full adrenal panel utk, acth test to UTK

SubTest Name Normal Values Results
SP-TY Collection Method Cysto
Hyl None Seen None Seen NORM
Fine None Seen See Notes ABNORM
Coarse None Seen None Seen NORM
Renal Epi Casts None Seen None Seen NORM
WBC None Seen
RBC None Seen
Squam None Seen See Notes ABNORM
Mucus None Seen None Seen NORM
Bacti None Seen None Seen NORM
Urinalysis-Microscopic Thu, 5 /27/2010 11:23 AM
Results/Comments
Fine: Rare/LPF
WBC: Rare/HPF
RBC: Rare/HPF
Squam: Rare/HPF
Vol: <5
Amorphous: None seen
SubTest Name Normal Values Results
Glucose 74 - 145 mg/dL 88 NORM
AST(GOT) 13 - 81 U/L 18 NORM
ALT(GPT) 14 - 151 IU 46 NORM
Alk.P.Tase 13 - 289 IU 325 HIGH
Total Bilirubin .1 - .5 mg/dL 0.1 NORM
Cholesterol 98 - 300 mg/dL 503 HIGH
Total Protein 5 - 8.3 g/dL 6.2 NORM
Albumin 2.6 - 4 g/dl 3.5 NORM
Globulin 2.7 - 4.4 2.7 NORM
Urea N 8 - 30 mg/dL 15 NORM
Creatinine .5 - 2 mg/dL 0.6 NORM
Phosphorous 2.5 - 7.9 mg/dL 3.4 NORM
Calcium 8.7 - 12 mg/dl 9.7 NORM
Sodium 141 - 159 mmol/L 149 NORM
Potassium 3.4 - 5.6 mmol/L 4.4 NORM
Chloride 100 - 118 mmol/L 107 NORM
Bicarbonate 16 - 31 mmol/L 23 NORM
Anion Gap 15 - 25 mmol/L 23 NORM
GGT 3 - 19 U/L 9 NORM
A/G Ratio 1.3
Animal Profile 1 Thu, 5 /27/2010 11:24 AM
Results/Comments
No significant hemolysis or lipemia present.

SubTest Name Normal Values Results
Red Blood Cell Count 4.48 - 8.53 M/ul 7.50 NORM
Hemoglobin 10.5 - 20.1 g/dl 18.0 NORM
Hematocrit 33 - 58.7 40 53.5 NORM
Mean Corpuscular Volume 63 - 78.3 fL 71.3 NORM
Mean Corpuscular Hemoglobin 21 - 27 pg 23.9 NORM
Mean Corpuscular Hgb Conc. 30.8 - 35.9 g/dL 33.6 NORM
Red Cell Distribution Width 11.9 - 18.1 % 15.7 NORM
Platelet Count 140 - 540 K/ul 589 HIGH
White Blood Cell Count 4 - 18.2 x 10^3/ul 5.4 NORM
Seg. Neutrophil Absolute # 2.5 - 15.7 x 10^3/ul 4.05 NORM
Band Neutrophil Absolute # 0 - .2 x 10^3/ul 0.11 NORM
Lymphocyte Absolute # .3 - 3.9 x 10^3/ul 1.08 NORM
Act Lymphocyte Absolute # 0 - .9 x 10^3/ul
Monocyte Absolute # 0 - 1.4 x 10^3/ul 0.16 NORM
Eosinophil Absolute # 0 - 1.3 x 10^3/ul
Basophil Absolute # 0 - .1 x 10^3/ul
Other Absolute # 0 - 0 x 10^3/ul
Blast Absolute # 0 - 0 x 10^3/ul
Promyelocyte Absolute # 0 - 0 x 10^3/ul
Myelocyte Absolute # 0 - 0 x 10^3/ul
Metamyelocyte Absolute # 0 - 0 x 10^3/ul
Hemogram Thu, 5 /27/2010 11:24 AM
SubTest Name Normal Values Results
Segmented Neutrophils % 75
Band Neutrophils % 2
Lymphocytes % 20
Activated Lymphocytes %
Monocytes % 3
Eosinophils %
Basophils %

SubTest Name Normal Values Results
Folate 11.3
Serum Cobalamin (Vit B12) 962
TX AM B12/Folate Thu, 5 /27/2010 11:26 AM
Results/Comments
Normal Ranges:
Folate Fasting: 7.7-24.4 ug/L
Serum Cobalamin: 251-908 ng/L
Printed on: 6/17/10 at 9:09 PM *VL1 3
UT Adrenal Panel Thu, 5 /27/2010 11:27 AM
Results/Comments
Endocrinology Lab Case# EN 10-4088
Test: Result: Normal Range** Result Normal Range**
(post ACTH)
Cortisol ng/ml 47.7 2.1-58.8 304.4* 65.0-174.6
Androstenedione ng/ml 1.05* 0.05-0.57 7.69* 0.27-3.97
Estradiol pg/ml 114.8* 30.8-69.9 102.2* 27.9-69.2
Progesterone ng/ml 0.99 0.3-0.49 5.91* 0.10-1.50
17 OH Progesterone ng/ml 1.18* 0.08-0.77 20.33* 0.40-1.62
Aldosterone pg/ml *** 33.9 11-139.9 357.1 72.9-398.5
* Above or below reference range
** Mean normal range values for spayed female dogs (N=36). QNS = Insufficient sample.
*** Normal range values for male and female dogs (N=72 baseline, N=23 post-ACTH.
These results indicate presence of increased adrenal activity. (SIGNIFICANT)
Comments: Values are increased as indicated.

I have had no sleep so I hope I did this all correctly. Is it too much info?

Thank you all so much.

Moderator's Note: Addy, I have merged your new thread with Zoe's test results into Zoe's original thread. We prefer to keep all posts on a pup in a single thread as it makes it much easier for other members to refer back to the pup's history, if needed.

Debbie

[apollo6]

Dear Addy, I am new to this also. My vet /acupuncture/holistic referred me to a specialist in endocrinology. Told me to get these tests.
ACTH Stim Test
Blood pressure
Urinalysis-Antec
Urine Culture MIC
full blood panel.
The senior members can best help you. Also read up on the caine Cushing the resources . Don't just jump into the treatment. Hang in there. Ask questions and get info.
Sonja and my little Apollo.

[apollo6]

this is a link to looking up a specialist in your area
http://www.acvim.org/websites/acvim/index.php?p=3

[frijole]

Addy, Usually Dr. Oliver from the Univ of TN writes a report with the dx and the recommendations at the bottom of the report. Can you type that if you have it?

I can answer some of your questions. It is common to have multiple hormones elevated in cush dogs and the lysodren should help that. That is why lysodren is being recommended for treatment. I used it on my dog Haley. She was 12 1/2 when diagnosed and she just passed on 5/22 at the age of 16 1/2 so you can see the drug does work!

Not all dogs have all symptoms. The ones you describe,except the diarrhea, are all signs of cushings.

My concern would be the diarrhea. I would email Dr Oliver (nice guy, he'll read it and respond!) since he is THE GUY regarding this test. Tell him about the diarrhea issues. I wouldn't treat the cushings until I figured out what is causing the diarrhea and try to get her stools normal. (I know you have done alot already)

I also noticed the cholesterol was high. Did he mention this in his report?

Cushings is NOT a death sentence. And it does NOT need to be treated right away. I would continue to focus on the diarrhea. Has anyone ever mentioned Tylan to you? It is a powder antibiotic used to treat poultry I believe. It is not approved by the FDA for use by dogs however many vets recommend it. Just google it and read what many others are saying. You'll see that it is just a powder that you mix with food in very small quantities. I couldn't believe what I read about it. Very positive reviews.

Glad you found us. Keep us posted. Kim

[BeachgirlK]

Hi Addy,

I am not an expert, but I just wanted to wish you and Zoe well on this journey. I have just started lysodrene therapy (yesterday) with my Great Pyrenees Sonoma, and I know what it's like -- all the ups and downs and frustrations. I have spent several thousand dollars on tests and medicine and special food, but more importantly, known the fear and frustration, along with subjecting my poor pooch to all these tests, all before a diagnosis was even given.

This therapy procedure is terrifying to me, the icing on top of a very stressful time in my life apart from my pet's issues.

I'll be sure to add anything if I discover any helpful tips during this next week. The posters here are amazing, much better than the myriad of vets I have consulted.

Take care and try to get some rest! Things are always worse on no sleep.

Karin

[addy]

Right now the chronic loose stools bother Zoe and me more than ehr Cushing symptoms but we have tried to fix this for 2 years. We get better and then in Spring it all gets worse. She always tests out normal for her stool problem. Internist thinks the lysoderm may fix the problem. I read it can make it worse or better depending. Seems like stress colitis, she is afraid of thunder storms and has dietary indiscretion, she eats something in the grass and I can never see what it is, I know she likes crabapples and bunny poop. She was doing better for 3 weeks on the Flagyl and now since I am trying to get her off the Shen Calmer and she ate something in the grass again, she is worse. I hate to up the flyagl again to 2 x a day. Vet suggest Hill's W/D at first but no way do I want to feed that to a Cush dog. Am I being too stubborn? Now vet says don't change food if we are going to treat Cushings as too many changes muddy the waters.

Has anyone had loose stools that got better with lysoderm?

I am at my wits end. I will try to get Dr. Oliver's last page, not sure why vet did not include it but she was working late and nice to call me after hours and talk for an hour.

Also, she said she won't give me prednisone to have on hand. She said she would start on a low dose and it there was a bad reaction, she needs to come in and be seen because if it is that she can't tolerate the drug verses in crisis they need to know as I should not give prednisone if it is drug intolerance it would make it worse. They are emergency center 10 minutes away, open 24/7. Does this sound right?

[frijole]

Addy, Yes, do get the recommendations from Dr Oliver. I repeat, I would email him directly to ask some questions - Assuming that Dr Oliver recommended lysodren therapy I would make sure he is aware of the chronic loose stool symptom. The reason is because diarrhea and vomiting are signs that a dog has too much lysodren. So if you go into this with diarrhea you will not necessarily know if it is from too much lysodren or not.

That is why I suggested focusing on that first. I would be interested in Dr Oliver's take on this.

Regarding the prednisone, alot of vets are not aware that a dog can go seriously low (cortisol) using trilostane. Read Lulusdad's thread (went too low late on a Saturday night and had to go to the ER) and Apollo's thread where we are having the same discussion here:

http://www.k9cushings.com/forum/showthread.php?t=2220&page=11-

It is easy to say, drive on in but it is much easier to have it on hand. And it can save you an ER bill. Better safe than sorry.

Don't know if you saw my mention re Tylan - I have never used it but I read such incredible testimonies from people who had been struggling with digestive issues for a long period of time and had tried many many kinds of antibiotics, etc. It is worth a few minutes of google research.

Hang in there! Kim

[zoesmom]

Addy - hi again.

Based on Zoe's test results, it does appear that lysodren would be the best drug. For both the excess cortisol and all of those other hormone(with the possible exception of estradiol) that were out of range on the UTK panel. (Trilostane, on the other hand, can cause some of those secondary hormones to rise over time, and most of Zoe's are already out of range.)

I agree with Kim on the diarrhea and not starting the lysodren until that is sorted out. It is NOT a cushings symptom and will make it harder to tell when Zoe is loaded (as soft stools/diarrhea are some of the signs of too much lysodren.)

However, I did notice that your Zoe's folate/B12 test showed that the latter was elevated. The folate/B12 test is used to diagnose small intestinal bacterial overrgrowth (or SIBO). My Zoe also had that test and her B12 was ok but her folate was out of normal range. And that was what led us to try tylan on her (the drug Kim mentioned.) Not sure but I think usually, both are out of range in SIBO, but I was so desperate to 'fix' the problem that our IMS thought it was worth a try. I had just always figured Zo's intestinal issues were IBD - as an u/s showed that evidence. However, with her there was apparently more going on, higher up in the intestinal tract (the small intestine.) And the tylan did do the trick.

So as Kim said, if you google tylan (or tylosin), you will find that it is used with good success in treating dogs with diarrhea and similar intestinal problems. Zoe's symptoms were soft stools, sometimes diarrhea, and really horrific gas. The drug is a fairly safe and inexpensive antibiotic, especially if you order the powder online and fill empty gel capsules (available at any health food store.) You wouldn't need an rx by doing it that way (as its sold to farmers for use in chicken and bee populations) but you would need your vet to figure out the right dose for Zoe. That just might do the trick for the diarrhea. I'd say it's well worth discussing with your vet before you start the cushings treatment. If your vet is unfamiliar with it, print out the info and take it with you to discuss. I may have saved some of my bookmarked links about tylan so will check and let you know.

The only other thing is the prednisone. I think, especially with lyosdren, having some on hand is important. Dogs can drop too low at all hours of the day, night, week, weekend. I guess having an emergency clinic close by is a plus, but again, taking them there after hours can get real pricey. Sue

[addy]

Thank you all. I did google tylon and internist mentioned that was an option but since Zoe had been responding to Flaygl and I was used to it she said let's continue with it and it was fine until Friday night. But Friday I tried to again cut back on Shen Calmer and we had thunderstorms and company so maybe she got at something and the 2 combos sent her over the edge. Yesterday she was at the groomers so who knows what happened there and today soft mush stools continue even with Flaygy once a day. So maybe we need to switch and try Tylan. I will call her. I emailed a request to her for Dr. Oliver's last page and will follow up with a phone call tomorrow. Once I have that I will email Dr. Oliver.

Internist said since Zoe responds to antibiotic treatment she felt it was bacterial overgrowth but she thought it might go away once we start treatment. I did read somewhere that it does sometimes happen but I also know lysoderm causes loose stools so I am worried about starting it.

I guess at this point the prednisone is not an issue because I really need stool problem fixed first. I was just trying to get a feel for your thought on how accurate she is. Trying to assess her experience I guess.

I really think some of Zoe's loose stools are from stress as well, but I wanted her off the Shen Calmer in case we tried melitonin and because noone can tell me how Shen Calmer works and the ingredients are in Chinese and holistic vet says, oh no problem but she is not always thorough and I am super parinoid now.

Thanks for letting me ramble and vent. My Zoe is my heart and soul and I feel like I am loosing both. Too much stress, maybe I should use her Shen Calmer. (My attempt at humor while I cry)

Should we change my thread title? We know now it is real diagnosis.

[apollo6]

Andy and Zoe , what a sweetheart your little one is. This is tough. Glad to be of support. The senior members can be very helpful. Most importantly you should not be afraid to speak up for Zoe, if you have questions are not sure of what ever do not hesitate to ask your vet.

this website shows the ingredients on the bottom but think in Chinese,
maybe this might help

http://www.euroherbsshop.nl/shen-calmer-900g-powder-p-1888.html?osCsid=8108b4c045a57ad1d6301300520b5ae6

The input on this site is supportive. There is a lot of knowledge and experience here. I am just starting.

[addy]

Today I found the courage to email Dr. Oliver and I received an auto reply he is out of the office until July 6th.

Current thinking:

If Zoe needs Shen Calmer for her anxiety could I not replace it with melatonin? I read there is some thought it helps fear of thunderstorms. Would that not also possibly help her coat? If the flax hull lignans are a laxative could they work like pumpkin and pysillium and possible be a fiber that could absorb water in Zoe and possibly help her stools if we find the right doseage?

If the tylon is an antibiotic with anti inflammatory properties and leaves the body through the kidneys, I would not need to worry about Zoe's liver as with the metronidazole which leaves the body through the liver.

Diet- Cushing dogs need high quality protein with low fat and low fiber and should not eat raw? Zoe is on commerical raw turkey with minimum 16% fat and her tablespoon on Embark has flax in it. Will that be too much flax? She only gets 1/8 cup of the Embark per dayand flax is the second ingredient.

Also, if Zoe has "kind of sort of Sibo" is thay why she has such a sensitive stomach and has so much trouble eating new things?

How come all her blood work and urine tests look so normal except for the colestoral which is the same as it was 2 years ago. I mean her alk phos is above normal but with her on going colitis issues, could that not be from her gastro stuff? Am I not reading her tests correctly?

Just throwing all of this out there in case someone may have answers.

Feeling much calmer since I know I have this group to turn to. Thanks guys!!!!!!!

Addy

[frijole]

Addy,

Ironically I mentioned the tylan and within days I had to buy it for my gal Annie who was just diagnosed with bacterial overgrowth. :eek: She doesn't have diarrhea - she won't eat. I've been giving her anti nausea pills and that got her eating. Now I'm giving tylan to give her relief. She must have cramping and internal gas because other than a bit of growling in her tummy for a few days I didn't notice anything.

Anyway - I cannot treat the cushings until this is done either. So I understand your situation. Hang in there - we can lick this thing. :) Kim

[Harley PoMMom]

Hi Addy,

My boy Harley was scared of thunderstorms until he started taking the melatonin, now he's no longer bothered by them :) According to the Treatment Option Considerations Sheet:
Typically, a dose of 3 mg is given q12hrs (BID) for dogs <30 lbs;
http://www.vet.utk.edu/diagnostic/endocrinology/pdf/TreatmentInfoAtypicalCushings201005.pdf

Harley gets 3mg twice a day (BID). When buying melatonin, you want just the regular melatonin...not the rapid-releasing or fast-acting kind.

Harley takes the flax hulls with lignans also. The lignans that Harley takes are high in fiber and since he has such an elevation in the estradiol hormone I was giving him a little more than what the UTK Treatment Option Sheet recommended. With Zoe having some issues with new food tho, I think I would slowly introduce the flax hull lignans over time.

Her elevated ALP could possibly be from the gastro stuff or it could be from the elevated estradiol and cortisol or the combination of all of them. This only means that her liver is having to work harder, there's no real harm done, ok? Many of us do give our pups some kind of liver supplement like milk thistle or denamarin...ask your IMS about this.

Hope this helps.

Love and hugs,
Lori

[addy]

Thanks for the input. It seems like July 6th is so far away!!!

I am continuing the metronidazile until I get Zoe off the Shen Calmer so I am able to see what is happening without starting something new. I am keeping her on 125mgs 1 x per day. The weaning off Shen Calmer is taking longer than I expected, we are having storms almost everyday and it seemed like whenever I try to ielliminate the pm dose of Shen Calmer, her poops get bad. So internist said give metronidazole every day or 2 times a day if storms are bad.

Any thoughts about weaning her off Shen Calmer? I tend to be too conservative which will make me go slow but she has been on it since last August at different doseages. I have her down to 1/8 teaspoon 2 x per day and 2 days ago again tried to cut pm dose to 1/16 teaspoons hopefully for 3 days and then get rid of it.

I bought 1 milligram melitonin (regular) yesterday. Maybe I should just make the switch? He current vet IMS doesn't know anything about Shen Calmer. Should I start at 1mg or do the 3mgs right away?

Appreciate any input. Like I said, I start things small and go very slowly, sometimes too conservative.

Lori-where do you purchase your lignans, what brand are they?

Can she be on the melitonan and lignans prior to loading in August? maybe I should wait on the lignans.

I worry all of this will take so long that I won't know if her poops are really better by mid August.

Thanks for letting me ramble again.

Addy

[apollo6]

You might try to call a licenced Holistic vet. in your area about withdrawing from Shen Calm and explain what other medications Zoe is on, symptoms, condition. Maybe suggest an alternative which won't interfere with the other medications. Again make sure your IMO knows before making any changes.
Below is a link to find one in your area.
Herbs can be tricky, even in humans.

http://www.ahvma.org/

[Harley PoMMom]

I bought 1 milligram melitonin (regular) yesterday. Maybe I should just make the switch? He current vet IMS doesn't know anything about Shen Calmer. Should I start at 1mg or do the 3mgs right away?

Appreciate any input. Like I said, I start things small and go very slowly, sometimes too conservative.

Some pups can get sleepy or a little lethargic on the melatonin so buying the 1mg and trying that first and watching her reaction, I think, is a very good idea. You can always increase her melatonin by 1mg increments, and of course watch for any change in her behavior/poops.

Lori-where do you purchase your lignans, what brand are they?

I buy Harley's flax hulls here: http://www.flaxhulls.com/order.html

Can she be on the melitonan and lignans prior to loading in August? maybe I should wait on the lignans.

Yes she can but like I mentioned before, if it were me, I would add the lignans slowly to her diet.

I worry all of this will take so long that I won't know if her poops are really better by mid August.

Thanks for letting me ramble again.

Addy

We are here for you Addy, hang in there, ok?

Love and hugs,
Lori

[addy]

Lori- thanks you so much for the info. I will wait on the flax hulls. I also emailed Honest Kitchen to ask how much flax is in their Embark. I don't want to over due it.

I will try the melatonin 1mg at a time. I think the storms have stopped for the new week.

Sonja-

Thank you for the link. I do have a holstic vet but her advice sometimes concerns me-she will say "just stop doing it" I usually have to rethink whatever she tells me. I will call again tomorrow but so far not liking info I get on the phone from her tech and never can talk to her directly unless I schedule appoitnment.

Her poops were better today on the 1/16 even though we had another storm. Maybe need to go slower. Yikes! Pretty soon I won't have to worry about her poops and loading because it will be winter and she is always better then :)

Thank you all so very, very much.

Addy

[apollo6]

Dear Andy
Sounds like you need another vet. on the site I gave you maybe look up another vet and just call see if they will give you an answer about the Shen Calm. If you are not happy with the vet , listen to your gut feeling.

[apollo6]

I tend to be slow at doing things also. You are doing the right thing.
Trust your gut feeling. Never be afraid to ask questions.

[addy]

I called another vet today after dear Sonja prodded me (I need prodding so thank you)

She said I could continue using the Shen Calmer with the melatonin but if I wanted to stop it I don't have to wean her off. Last night I stopped the pm dose. I did have some panting from Zoe last night. This morning I gave her 1/8 teapsoon and again no dose tonite. No panting tonight.

Thursday am will be her last morning dose. I am home for 5 days so I can watch her.

Hope to start her melatonin July 5th, Dr.Oliver gets back July 6th, sounds like a plan to me :)

Oh, Honest Kitchen emailed back right away (they are so nice) Zoe eats 1/8 cup of EMBARK with her raw. They told me that had 14.5 grams of organic flaxseedin it.

How do I figure that into the flax hull equation?

Thanks!
Addy

[apollo6]

Glad to hear. you are in my prayers also.
Keep fighting like the rest of us.

[apollo6]

Trust your self, listen to your gut feelings. Don't jump into anything without getting the information you need. You have gone through a lot. Don't forget to take care of your self also, to be there for Zoe and your other little fur ball.
Sonja and Apollo.
We'll be praying for you.

[SavingSimon]

I called another vet today after dear Sonja prodded me (I need prodding so thank you)

She said I could continue using the Shen Calmer with the melatonin but if I wanted to stop it I don't have to wean her off. Last night I stopped the pm dose. I did have some panting from Zoe last night. This morning I gave her 1/8 teapsoon and again no dose tonite. No panting tonight.

Thursday am will be her last morning dose. I am home for 5 days so I can watch her.

Hope to start her melatonin July 5th, Dr.Oliver gets back July 6th, sounds like a plan to me :)

Oh, Honest Kitchen emailed back right away (they are so nice) Zoe eats 1/8 cup of EMBARK with her raw. They told me that had 14.5 grams of organic flaxseedin it.

How do I figure that into the flax hull equation?

Thanks!
Addy

Hi Addy,
I just read your thread from start to finish, and wonder if the runny poops issue ever resolved itself? My guess is that it wasn't the plastic, it was the raw diet that caused the problem. Dogs can get salmonella, and all of the other diseases and parasites that humans can from uncooked meats, particularly any kind of fowl or pork. I'm thinking of the "Bones And Raw Food" diet ... not sure if that is what you mean by "RAW" though. the "BARF" diet was a pretty big fad about seven to ten years ago and all research shows that it is not the best choice in diets for dogs. I am sure there are people that will want to fight that statement, and I'm not trying to start any kind of arguments, just hope that you are cooking any meats that you feed your baby. In the wild dogs are lucky if they live to be two years old, and in the wild dogs don't eat turkey, chicken, beef, pork, etc. has always been a point ignored by those who want to stand by feeding their dogs raw meats. Plus in the wild, dogs are catching wild rabbits, rats, etc, and introducing diseases into the domestic dog community like rabies, parvo, distemper., etc.. I think it's great if you want to cook for your dog and their are healthy ways to feed them that way, and raw vegetables and lignans figure into that, but never raw meat. It will make your dog sick if it isn't already, and for a Cushing's dog, it will make being able to tell what is dietary and what is medication complications a nightmare. All of this is just my opiinion, and so feel free to ignore it and proceed as you are, I am not making any judgements, I KNOW you love your dog from your thread, and I know you love her dearly, so I'm sorry if that seemed kind of didactic and definitely don't intend it judgemental - just recommendations that you can take or leave.
I wanted to answer the other dietary issue that you brought up about how to figure in the "organic flaxseed". My guess is that organic flaxseed is not the same as the lignan (which is the hull) of the flax seed, so I don't think it probably adds up to much at all - but I'm totally guessing on that one. The best way to find out would be to ask Dr. Oliver or your Vet, who could calculate it in to what is recommended for your dog if it is indeed the lignan and not just the entire flaxseed which is what it sounds like it is from the way you described it, but on the other hand, doesn't sound like it is from the way it is measured. You might want to call the food company and ask them if it is a the lignan, or if it is the whole flaxseed like it sounds like it is before you ask the vet or Dr. Oliver, that is what I would do.
Welcome to here, from me and Simon, even though here is a place I'm sure none of us wish we had to be, I know that the support and advice that we have received so far has been crucial to getting through all of the confusion and fears and frustrations that come along with a Cushing's diagnosis. If there is any thing that I can do to help, please let me know. Simon's diet needs to be adjusted and is far from ideal too in my opinion, it's just there are so many things to do when you have to manage this disease and your life and your other dogs, and your Cushings dog - I know it is overwhelming, frustrating, scary, and infuriating sometimes. If you ever need someone who can relate to all of that stuff - we are here for you, and you and your sweet Zoe (who has beautiful eyes by the way) are in our prayers.
Love,
Dena, Simon, & pack

[addy]

Hi Dena,

I agree completely with you on the raw diet and I know she can no longer be on raw with Cushings but the IMS said not to change her food now or we will have too many new things going on and will not know what is causing what. Zoe is on a commerically prepared raw diet called Nature's Menu, we tried it as a last resort. She cannot tolerate kibble and I spent a year trying to get her off the Hills canned prescription food that she was not doing well on. I could never transition to another food without getting watery squirty poops by the 3 day no matter how slowly I went. The raw was the only food we transitioned to without watery squirty poops and we did it cold turkey. She was fine with it all winter until I stopped the thyroid meds, she ate plastic, etc and we have had a major flare up since. Ims originally wanted to put her on Hills W/D and I know in my gut she cannot eat that food.
Since we now have the Cushings diagnosis she said "do not change the food yet, we will look at that down the road" and the IMS is no fan of raw." I have no strong opinions one way or another except I will not feel W/D to Zoe.

The metronidazol is helping her but I don't get consistant firm poops. Since she loves to eat bunny poops, I don't know that I ever will unless I muzzle her ever time she goes outside. I don't have the heart to do it.

Compared to where we were when I first posted, poops are much better. Am still waiting to hear back from Dr. Oliver, I resent email yestderday and did not get a auto reply :)

Thank you for your input. It helps to hear from others. I hate having to go so slow but other than her coat her symptoms are not horrible yet. I worry her numbers were sky high but I really believe that because of the significant colitis flare up and the severe stress, she skewed her numbers. They had to muzzle her at the vets, it was all too much for her.

I did notice she has been anxious again when she is taken from me or if I leave her all alone, like if I take Koko for his walk, she gets very upset. That might be having no Shen Calmer. SHe was like that when I first rescued her.

So many problems in the equation:)

Addy

[Squirt's Mom]

Hi Addy,

I am not a raw feeding fan by any means but that does not mean it is wrong, even for a cush baby. The only time a raw diet is NOT recommended is when a pup is fighting certain types of cancer. If Zoe does better on the raw diet she has been on, then I wouldn't change it right now. When/if you do decide to change, the best thing is to contact someone who specializes in canine nutrition and have them design a diet specifically for her. They will take into consideration all of her health issues including blood/lab work, environment, lifestyle, activity level, climate, ect. in designing her menu. But for now, I wouldn't change anything. :)

What works for our Atypical babies in the lignans is SDG - which stands for a word a mile long! :p The hulls apparently have a higher concentration of SDG than the seed or oil from flax. The SDG content is usually listed on the bottle and that is what you want to look at. My Squirt weighs about 13 lbs and she takes 3, 40mg capsules of a standardized lignan. The bottle reads, "...flaxseed extract standardized at 20% SDG..." That means that 20% of the 40mg is SDG so she needs 3 caps to meet the amount of SDG Dr. O recommends.

Somewhere on here is a discussion about this topic and I will try to find it for you...my files are on my other computer and my memory is scary :eek: to say the least! :p

I also want to tell you that you are a very special person. We all question "Why?!" when our babies get sick with this condition and seek to find a reason...perhaps even something we have done in our pasts that our babies are asked to pay for. But that's not it. We are given this challenge because we can handle it, because no one else could love and care for them as we will, because the Powers that surround us know they are in the very best of hands. We seek to learn, we blanket them with our love and devotion, giving our all, we hold them up in gratitude for the love they have brought to our lives and show the world what true companionship is meant to be. You are so very special because, you see, you are the only one who can do these things for your precious Zoe. Our babies were sent to us from the beginning because we are the ones they would need at this point in their lives...and you are most worthy of that gift.

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

[addy]

aww, squirt's mom

what a meaningful post, thank you so much.
your kind words and support mean alot.

Addy

[addy]

thought I should clarify something:

On the package of Zoe's raw food from Nature's Menu it states

"if your dog has an auto immune disease, cook this diet"

which is why I agreed with Dena about not wanting to keep her on it long term. I really don't want to cook it. Also, it has 30% organ meat and I am worried about that fat.

although some people continue to feed raw to Cushing pups, I am not comfortable doing it with Zoe and especially this particular diet.

I sure don't relish the thought of switching foods again when we get to that point :(

Have a Happy Fourth of July everyone!!!!

Addy

[Harley PoMMom]

As far as I know, Cushing's is not an autoimmune disease. An autoimmune disease is when the body actually attacks its own cells. The immune system mistakes some part of the body as a pathogen and attacks it.

http://www.nlm.nih.gov/medlineplus/ency/article/000816.htm

[apollo6]

Dear Andy,
I know what you mean, last time I had a blood panel on Apollo, he let out such a shrill scream when they took him in the back. I almost started crying my self. A day after the test he had a bruise almost all the way down his neck. I guess this is another part of cushing(easy bruising). The little guy now has sores and small cuts on his paws(skin thin). I don't like giving medications, because he has such a sensitive stomach. So , yes I am apprehensive about him being on this. For me so far the bops are not bad(can you picture all of us looking down to inspect their bops-what a site that would be) need some humor in all of this. Like I said before I got Apollo off Dog food and have him on a low fat diet now with supplements. Hope you and Zoe are doing okay.
Hugs and licks Sonja and Apollo.

[addy]

oops, read it wrong it says "cook the diet if your dog has a immune compromised condition:" I then asked her IMS and she said yes, Cushings was just that.

gee, and here i just posted how smart the IMS was since she knew about the hormone cream :(

i still am going to take her off the diet at some point. It was sold recently and I just know the formula will change. They always do after a sale. I was even suspicious tonite, the patties look pinker.

Do I sound parinoid? Yikes!!!

Addy

[Harley PoMMom]

oops, read it wrong it says "cook the diet if your dog has a immune compromised condition:" I then asked her IMS and she said yes, Cushings was just that.

gee, and here i just posted how smart the IMS was since she knew about the hormone cream :(

Addy

"immune compromised condition," yes, our pups immune system can be compromised by the excessive cortisol. So your IMS is right! ;):D

[StarDeb55]

Addy, all of this means is that our pups will frequently suffer from repeated infections that may be hard to get them to heal up. For instance, about the 6 months prior to my Harley's diagnosis, we had been fighting a recurring corneal ulcer. When we were at the IMS for his consult at diagnosis. darn, if his eye didn't look all gross, again. I asked the IMS if this repeated problem was probably due to the immune system being compromised from the Cushing's, she said yes.

When it comes to a raw diet, I fed both my boys Primal raw for over a year & they did fine. I pretty sure that Glynda (Lulu's Mom) feeds all of her pack Primal, including both of her Cushpups, & she swears by the food.

Debbie

[addy]

okay, i am calming down now. I freaked when I read her food. the thing is, I believe I am doubting everything I did last year, the raw diet, the Armor supplement, the shen, because now she is sick with Cushings. Did I do this to her? I can't get that out of my mind. There, i finally said it out loud. Did I make my dog sick? She wasn't sick before this. I am now having a major meltdown. I only fed her turkey, i did not rotate protein, the holistic vet said keep her on turkey. i didn't even do it right.

I am so sorry, I can't type any more.
Addy

[apollo6]

Addy, You didn't cause it.
You are not to blame, I blamed myself also. In 2003 Apollo had some kind of allergic reaction or was stung by a bee, wasn't home when it happened. That night his face starting swelling up, then he got hives all over his body, had to go to the emergency at 1a.m. -Superbowl weekend will never forget, he couldn't breath. He was put on so many medications over a few days-lots with steroids in it. He also has back problems was on prednisone on and off, allergy tablets.Then he started having hives, lumps on his little belly, ingrown hairs I had to squeeze out, it was bad. His belly turned grey, liver spots. I question myself if all this caused it. But the positive is he is still here. This disease sucks. Apollo had stomach problems for years, was always throwing up intermediately, he ate the back of my husband's dress shoe, socks, had a yellow string come out the other end once when he popped. I had to put him on a low fat diet because of the pancreatitis( the ultrasound showed scaring chronic pancreatitis), I also do holistic, with supplements and it did help Apollo for a while, the throwing up stopped his coat did get better for awhile. You do the best you can. They know it with the love they give you back. You need to ease up on yourself. Sending you hugs Sonja

[SavingSimon]

okay, i am calming down now. I freaked when I read her food. the thing is, I believe I am doubting everything I did last year, the raw diet, the Armor supplement, the shen, because now she is sick with Cushings. Did I do this to her? I can't get that out of my mind. There, i finally said it out loud. Did I make my dog sick? She wasn't sick before this. I am now having a major meltdown. I only fed her turkey, i did not rotate protein, the holistic vet said keep her on turkey. i didn't even do it right.

I am so sorry, I can't type any more.
Addy

NO! YOU did NOT do this to her. Have you tried "probiotics"? Don't get them from Iams - they are crazy expensive, but read Iams ad about them if you can find it. I think it may be a good idea for ALL dogs with tummy problems (and maybe those without). I just gave "Frijole" (Kim) the contact info on how to hopefully get the same less expensive probiotics I have been giving Simon.
My friend, I wonder if I "did this" to Simon sometimes too - was it drinking the pool water? Did I not see it for too long? But then I stop myself. Have you noticed how many purebred dogs are amongst us? In fact, I have yet to see anyone with a "mutt" ... personally, I think it is a genetic predispostion, and from the breeding and breeders I have seen throughout the U.S. - even the ones I thought were HIGHLY ethical, I kind of think this looks like something that may just be a genetic predispostition. I think that we do go through everything for a reason, and that reason will work out to be good if you can hand it over to God. This is all again, just my opinion. I am sorry if I am the one who caused you to start going down the road of self-blame. Trust me, you didn't do it. It just happened, and now you are doing everything in your power to make it better for your baby. So don't freak yourself out (take it from the one who tends to do that dailly.)
I just re-read what you wrote and see I misunderstood. You are wondering if you made your dog sick with the food. I stand corrected, however, the answer is still NO. Even if the food is what made your baby sick, you did NOT "DO IT" to her, the food might have, so now you just get her well, focus on that. Blaming yourself (like all parents do) isn't going to help either one of you. When you feel bad, she worries - so you gotta KNOW you didn't do this. Even if you messed everything up (which I have no idea, not up to date on your thread). What you ARE going to do is make her get better. So hang in there for her, and believe me, if it was the food, you can blame the food company - just don't blame yourself, okay? I would tell you if I thought it was your fault. And I am telling you that it is not. It's just your job to get her better and so focus, listen to Harley's poor Mama, who always says "take a deep breath" - take ten, and then start making plans on how you will get her feeling better. You are her Mom - you can ONLY make her feel better - and if you asked her, that is what she would tell you.
Praying for you both.
Love,
Dena and Simon

[SavingSimon]

Addy, also I know a lot of people are going to not like this one, and I did just catch up on your thread ... but I just read an article recently by a veterinary endocrinologist that says Hills ID is the best choice for dogs with Cushings. I don't have the link, but you can google it. I have to get to work - but wanted to tell you you might want to look into that - it is made for dogs with stomach and digestion problems. Also, I really am a believer in probiotics, as I said in my last post, and most of a dogs immune system is in their gut so I really believe probiotics will help. Food is so hard of a thing to figure out what is right, but if you left it up to your baby, just think of what she would have been eating on her own. You will resolve this. Lastly, are you feeding the flax seed hulls? A little too much of that can give a dog (or a human) the runs, and so be sure your vet has looked up the exact right dose for your baby's weiight, and remember it is once a day - not twice.
Hope I am helpful (if not please just ignore). I am very relieved that you agree about "raw raw" - raw meat is the last thing a Cushing's dog's tummy can tolerate ... but my understanding is that is NOT what you were doing, so I'm wondering if it could have been too much flax., or maybe it is just getting the plastic out of her system. It WILL resolve ... just keep trying to do what is right, that's the best you can do. For me it's really hard with 7 dogs to get Simon not to eat all of their food. And last night Coulter (my Anatolian "JUNKY" shepherd ate a half a bottle of Simon's Sam-E and she's fine. She grabs a bottle of vitamins or any RX she can get her big mouth around any time I leave a door where she can get to it. I think she is trying to kill off the JRTs, but my point is that healthy dogs can get away with a lot more than Cushing's dogs, and that doesn't mean that YOU did anything wrong, okay? I just hope I can help by suggesting stuff that might work. Probiotics, and as much as we all hate Hills, ID is a very good intestinal diet and has recent research to show it is helpful in Cushings. It is not very good looking food, though and I'm not totally convinced - but when I have put dogs with stomach problems on it, it has helped. And so does reglan - were you the one that had that but was afraid? Take one yourself first if you don't believe me - it sounds like your stomach might be upset, it works in thirty minutes and is a total relief - I will tell you a funny story about it later but gotta get to work now. Praying for you and your girl.
Love,
Dena and Simon

[Squirt's Mom]

ok...here is the link to the thread where we discussed the dosages and SDG I told you about. The discussion starts a page or 2 before this link but the main ideas start here:

http://www.k9cushings.com/forum/showthread.php?t=368&highlight=flax+hulls&page=11

About guilt....obviously no has told you but I am the Queen of Guilt here and have no intention of giving up my crown any time soon! :p I haven't quite figured it out yet, but I am sure I had something to do with the Gulf tragedy! :D So you just put that crap in the trash.

Unless there have been some new studies, no one really knows what causes Cushing's to develop (other than the Iatrogenic form). It can be found in families but not always; there are sometimes commonalities in the history of the pups but not always; some breeds are more prone to the condition but not all of them will succumb. Truthfully, I think Cushing's is much more common that is currently believed but it goes undiagnosed or is mis-diagnosed more times than not. That is one reason what we do here is so very important. By our love, determination and self-education each one of us has taught and is teaching our vets the truth of this condition; it CAN be treated, the pups CAN live a normal, healthy life-span, and there are parents who DO care and will do ANYTHING to help their babies. It may not be in our lifetimes, but the day will come when Cushing's is no longer a feared, mis-understood condition and that will be in large part due to parents like you, sweetie, who are fighting so hard today.

So when that nasty guilt pokes its head up, remind it who is the Queen ;) and that what you and Zoe are facing has an important purpose for all babies.

Hugs,
Leslie and the girls - always

[apollo6]

Dear Andy I will post what I feed Apollo:
A.M-low fat cottage cheese, Greek nonfat yogurt, egg white
, low sodium turkey slice, supplements

NOON- long WHEAT grain rice, cooked chicken, teaspoon canola oil,
Lite salt-potassium chloride
ADDED PURRED,CARROT

AFTER 4P.M-cooked potatoes with skin, chicken
Nutria Deni mini chew or Greene
Halo-Live N Little skin & Coat treat with Salmon
Have alternated with organic baby food-summer veg with pumpkin, turkey with veg, spinach.
Slice apple, sometimes blue berries, honey melon
I have given Apollo -Solid Gold-made in San Diego, Halo, and NUtrilite. You are getting to much overload on information, check with your vet and holistic vet to work together on Zoe's diet. That is what I am doing. Maybe Dena is right about pure breeds, my little guy has a super sensitive stomach. Although he will eat anything he can get his teeth into. Just take it slow. I am here if you need to talk or should I say post. You are on the east coast and I am on the west Coast-Original from Toronto, Ontario , Canada-know more then I want about the cold.

[addy]

Thanks to all of you for your much needed support. I think I just needed to put Cushings away for a day. I feel much better.

Zoe was on the Hills' Icanned ID for nine months and still had colitis flare ups frequently, I had to supplement it everyday with pumpkin. She chewed her paws terribly and gained alot of weight from the food. Her stool always had mucus in it. I tried Animal Esstenials Enyzmes and probiotics, it was hit or miss, not consistant. Tried Forti Flora too. She has been on Culturelle 1 time per day, half capsule now for almost a year.

Last night I gave Zoe her first 1mg of melatonin. I wanted to start that for a week without the lignans. I always have to do things one new thing at a time. Well, it didn't really knock her out, she was waking me up at the crack of dawn as usual. Tommorow I will try 2 times a day.

It probably was just a fluke and nothing to do with the melatonin, but this morning she had the most perfect beautiful poops I have seen since March. Now, you know I love my dog because I have become an expert poop examiner!!! And yesterday was not even a metronidazole day. I have again cut her back to every other day as she seemed a little sick to her tummy on the every day Metronidazole dose.

At any rate, last night I thought I should look at things differently and maybe because of what I did do last year she does not YET have all the normal symptoms of Cushings except for the coat and skin. Tried to put a positive spin on it :)

Anyway, I will allow Squirt's Mom to remain the "queen of guilt". Thanks for all the kind words, it really helps when I have a melt down.

Addy

[Harley PoMMom]

It probably was just a fluke and nothing to do with the melatonin, but this morning she had the most perfect beautiful poops I have seen since March. Now, you know I love my dog because I have become an expert poop examiner!!!

I shall say that around here we do get quite excited about perfect poops!!!! :D
Poop patrol rocks! :D:eek::)



At any rate, last night I thought I should look at things differently and maybe because of what I did do last year she does not YET have all the normal symptoms of Cushings except for the coat and skin. Tried to put a positive spin on it :)
Good for you! A positive attitude is essential when dealing with this disease, so if that negative energy comes calling again, well as you say...put it in a drawer and never open it! And you know that you can come here to talk about the fear and anxiety that this disease can create in us.

Love and hugs,
Lori

[Squirt's Mom]

You go, girl! :D:D:D

Ain't poop patrol fun?!?! A few years ago, a neighbor asked me if I had lost a diamond! :p After a while, they quit asking and just decided this old broad was simply nutso!

Hugs,
Leslie and the girls - always

[frijole]

Addy, Just wanted you to know that we know this can be very stressful. Even those of us that have been around this for years need to take a day or a week off. Just went thru it myself. You are doing a great job. Remember to take care of yourself too in all of this. Kim :p;)

[apollo6]

Dear Andy,
Hang in there. I noticed Apollo's pop was a little watery today, yesterday he had some good ones. Pretty sad when you get excited over dog pop. Just some humor.

[addy]

OMG, you won't even believe this. Yesterday, my husband came back from the grocery store and I carefully put all the food away safely. I had 2 bags of hamburger buns that I figured I would stash on top of the refrigerator out of reach, where I usally do, I had not other place to put them, I once tried the oven and we forgot the rolls were in there and turned it on to preheat:eek: Is that called a senior moment?

Now I try to be so careful with Zoe, when the kids come over we nag them to death about don't eat anywhere but seated at the table, don't spill the grapes, becareful of the chocolate and on and on and on. They think I am loony tunes the way I fuss. Well, somehow one of the bags containing EIGHT hamburger buns fell from the refrigerator top. The dogs must have thought it was raining bread! I had already ran out to pick up my elderly mom and of course you know the rest of the story. From the looks of her stomach, guess who ate most of them?

I can't even believe this happened. And she just had perfect poops. Her stomach looks like she is expecting a litter of puppies, she is pooping orange gluey mushy stuff and she can't stop panting and it has been 24 hours. I took her to emergency and told them she was The IMS's patient. Dr. told me to not feed her for the rest of the day except a small amount of food tonite, give her metronidazole tonite and that it should be out of her system in another 24 hours.

I keep hitting myself in the head, but I have stashed rolls on top of the frig for ten years, they never fell down. Why would they fall down now?Koko of course is perfectly fine but Zoe is "sick as a dog!"

I don't believe this. I really don't. I was so upset yesterday I told my husband he can't go grocery shopping anymore, we have to eat out from now on.

OMG!:eek::eek::eek:

Addy

[apollo6]

Dear Andy, I have had the same thing happen, in a way you just have to laugh. Apollo in August of last year, I was having a senior moment, left Apollo at home, in the kitchen where there is a doggie door to go outside as usual. Forgot I left a plastic bag full of dog food samples from a fair I had gone to, on the kitchen table. I come home, Apollo is bloated out like a balloon, see what is left of some of the bags of dog food, ate the plastic also. Went to vet tried to give him some laxative and x ray to see what was in his stomach. He was a very happy fat dog. I did not feed him for a day. But didn't know he had cushing so it took forever for his stomach to go down. Not the first time, he got into blue berry scone, once he ate 1 and 1/2 wheat bagels, etc. Be grateful it was only food. The little guys keep us on our toes always.

[addy]

I know, you almost do have to laugh.

I told my neighbor I was going to be a cat lady in my next life!!!!

Yesterday afternoon I called the ER and they told me to feed her small frequent meals because that was alot of food and I needed to make sure it moved through her system. I think that advice made her sicker. She will not let me pick her up at all this afternoon. Though she sure did not turn down her breakfast portion. I knew I should have not fed her:(

I f I offered her a steak right now, she would eat it;) I still can't believe they ate eight hamburger buns. And you know Zoe had at least five of them if not more. I don't remember my Golden retriever doing this stuff, but she was not part of a tag team :)

Did you post Apollos's picture from the Fourth? How is his bump?

Addy

[Roxee's Dad]

Dear Andy,
Hang in there. I noticed Apollo's pop was a little watery today, yesterday he had some good ones. Pretty sad when you get excited over dog pop. Just some humor.


Well I think it's time for Jenny to once again present or reintroduce her special "Stool Chart" :) When I was first introduced to it, I would refer to the poop type with a number as per the chart. I still always watch my precious pups poops :p

[apollo6]

Dear Andy will post picture, not great because pretty overcast. Did one today. Apollo was not interested in possing, but you can see the lump on his tail. Will be going for ACHT STIM test tomorrow and will bring up his tail. Need to further investigate and hopefully remove.

[addy]

okay, we seem to be almost over the bun incident, tummy is still sore but Zoe did manage to jump on the bed today, could not do it for a few days. IMS said watch her for signs of pancreatitis when I called in to renew her script for metronidazole today.

Hopefully, we can get back to our melatonin and lignans now. I swear, is a higher being trying to keep me from loading with lysodren? It's enough to make a girl wonder:confused:

I am thinking maybe I should do one more acth test or stim test in August. Thoughts anyone? Here are mine:

1- will be off her glandular thyroid meds for 3 months, will be off the Shen calmer for a month and hopefully colitis flare up will be over.

It is not than I don't think she has Cushings but I worry that all that stress and inflamation made her numbers higher than they would have been. I mean it said "SIGNIFICANT"

Also, feeling really bad that Dr. Oliver has answered others but still has not answered me. Should I rewrite the email? Maybe I didn't ask the question correctly.

Input, please:confused:

Thanks,
Addy

[apollo6]

Dear Andy,
Like you , I want to believe Apollo doesn't have cushing. When I emailed this is the answer I got back.
If your veterinarian wanted input on what we do at Tennessee, I’d be more than happy to discuss things with him (865-974-5729). Jack
You might ask Dena-Simon's mother, she has dealt with Dr. Oliver.
In my thread, I posted about Apollo's test and the doctor wants to follow up in 4-6weeks for another test and blood panel to see how his organs are. I just hate putting the little guy through all this. When the tech took him in for his test , he let out a shrill cry and looked at me with fear. Ask your Vet want they think, be persistent with them, Zoe is your baby.
Apollo has had episodes of pancreatitis in the past, was usually put on bland diet. His stomach is still gurgling. My vet says improvement can take up to months. I don't blame you about the Lysodren. But a lot on the forum have used it, so I really can not give any input. You have enough going on with Zoe's other issues.
Love Sonja and Apollo

[Harley PoMMom]

okay, we seem to be almost over the bun incident, tummy is still sore but Zoe did manage to jump on the bed today, could not do it for a few days. IMS said watch her for signs of pancreatitis when I called in to renew her script for metronidazole today.

If this were me, instead of watching for signs of pancreatitis I would ask your IMS to test Zoe for pancreatitis, the test is called a spec PL test.

Hopefully, we can get back to our melatonin and lignans now. I swear, is a higher being trying to keep me from loading with lysodren? It's enough to make a girl wonder:confused:

I am thinking maybe I should do one more acth test or stim test in August. Thoughts anyone? Here are mine:

Another acth stim test, IMO, would hinge on the results of the spec PL test. If Zoe's spec PL results are high for pancreatitis then this needs to be addressed first even before the cushings...JMO.

1- will be off her glandular thyroid meds for 3 months, will be off the Shen calmer for a month and hopefully colitis flare up will be over.

It is not than I don't think she has Cushings but I worry that all that stress and inflamation made her numbers higher than they would have been. I mean it said "SIGNIFICANT"

Also, feeling really bad that Dr. Oliver has answered others but still has not answered me. Should I rewrite the email? Maybe I didn't ask the question correctly.

Most definitely email him again. Dr. Oliver always responds back. Something must of happened to your first email...lost in cyber-space, maybe??

Input, please:confused:

Thanks,
Addy

Hope this helps.

Love and hugs,
Lori

[addy]

She had the test for pancreatitis at the end of May. Everything was normal, no evidence, she had the tests thru Univ. Texas and her ultrasound. You think I should retest her because of the eating six hamburger buns?

I think she has Cushings but what I question is how high her numbers were and perhaps if she was retested (ACTH) once her colitis is stable for a month (if we can ever get that) and everything else is stable, could it be the numbers would not be so high? Does it matter for loading her? This is what I question, I guess.

Since she ate the buns, she won't jump on the bed. She had jumped on the bed the night of the incident and jumped off, landing hard and turned and looked at her back leg. I can't find any evidence of injury, perhaps she pulled a muscle. If it does not improve we will have to get that checked too. She is not walking funny or favoring the leg, does not yelp if I gently stretch it out. She runs around the house and will jump on the sofa, just not the bed. She was flying on and off the bed with no problem until this happened on Sunday.

I sent by email twice to Dr. Oliver.

Addy

[marie adams]

Hi Addy,
Welcome to the Best Cushing Site you will find. I was new in February--been there and done it all!!!:D Worry, Quilt, Watching POOP, and even got excited when the pee was yellow and not clear.

Maddie is finally on her first true maintenance with Lysodren and we do the 30 day test tomorrow. Today on our morning walk she was out front and walked further than she has in months. I think things have finally turned around for her, but I still WORRY!!!:( My husband says no matter how long she has, she has had the best life we could possible give her--freedom and love! Remember the good stuff and just make it as good as we can for the future time we have together.

You are doing all the right stuff for Zoe and like everyone has said take care of yourself because you have to be there for our pups.:):) It is all a journey.

I also want to add: I started feeding raw when this started because I read to take a cushings dog off of grains; we have friends who have horses who have gotten cushings--they have to have a special diet also. I just cut back the raw and started a dry that is also grain free--not sure if this is why she has more energy, but she seems to not feel like she hasn't had enough to eat. I also give milk thistle, l-glutamine, fish oil, vit c, c & c to help her. The raw is Northwest Natures and the new dry is from Nutra--California Naturals, has an Aussie on the front--gee wonder why I bought that--haha!! (Maddie is an Aussie). She has not problems with eating all of this--still has good poop. We all can tell you what works for our dogs and give opinions to help, but in the end it is what works best for you and Zoe!!

Welcome again and keep up the good work!!!:);):D

[Harley PoMMom]

She had the test for pancreatitis at the end of May. Everything was normal, no evidence, she had the tests thru Univ. Texas and her ultrasound. You think I should retest her because of the eating six hamburger buns?

If her tests for pancreatitis came back normal then I would not have her retested because of her eating 6 hamburger buns although bloat would concern me...maybe members with more experience/knowledge with this will share their opinions.


I think she has Cushings but what I question is how high her numbers were and perhaps if she was retested (ACTH) once her colitis is stable for a month (if we can ever get that) and everything else is stable, could it be the numbers would not be so high? Does it matter for loading her? This is what I question, I guess.

IMO it is always good to get a "starting point" when one begins to load their pup on Lysodren, a very recent ACTH stim test, I believe, is important.

Since she ate the buns, she won't jump on the bed. She had jumped on the bed the night of the incident and jumped off, landing hard and turned and looked at her back leg. I can't find any evidence of injury, perhaps she pulled a muscle. If it does not improve we will have to get that checked too. She is not walking funny or favoring the leg, does not yelp if I gently stretch it out. She runs around the house and will jump on the sofa, just not the bed. She was flying on and off the bed with no problem until this happened on Sunday.

I sent by email twice to Dr. Oliver.

Addy

Keeping you and sweet Zoe in my thoughts and prayers.

Love and hugs,
Lori

[apollo6]

Dear Andy,
Slow down, take a deep breath. Maybe it will take a day or so for Zoe to recover from the hamburger buns. It is just bread. Apollo ate the back of my husband's leather dress shoes once, last summer he ate part of a brand new pair of shoes I bought. What I am trying to say Apollo is still here despite the cushing. Apollo sometimes can hardly get up the stairs I have for him on the bed and couch, sometimes he can hardly step over a brick, then all of a sudden he look like his old self. This disease is so nasty. As far as loading, I'd have to go back on your thread to read what is going on.
Some of the medications Zoe is getting may have steroids in them, if so they can cause cushing systems (Apollo was on Prednisone, dexam, rima,(not sure of all the spelling) Secondly before you jump at anything , check with your vet, about all the other issues Zoe has.
These are the tests I had for Apollo;
Sept 16, 2009-blood panel
January 2010-ultrasound-adominal (disc)
May 25, 2010-blood panel
May 28, 2010- ACTH Stim Test
Blood pressure
Urinalysis-Antech
Urine Culture MIC
Ultra sound, Focal Abdomen (only gall balder- sludge )
Was an ultrasound done? It can show if both adrenal glands are swollen or if one is larger then the other. I was lucky, Apollo's urine was normal, but cushing pups can have urinary infections. Have you distinguished as to what kind Zoe has? Atypical, Phd, or Adrendal ? What I am saying in Sept of last year is when things started not looking right, the hair loss on the tail was over 1-2 years. It wasn't until July of this year that I started treatment.

[addy]

just heard back from Dr. Oliver. he says lysodren even with Zoe's chronic diahrrea.

stool is normal today, even alittle constipated. No metronidazole today, I will cut back to every other day again. Seems like she is burping alot and tummy rumbles. i have not been giving her full rations yet. Her tummy does that when she does not get full rations of her raw food. Wonder if I should try Pepcid? If I over ate the human equivilant of what she ate for her tummy size, my tummy would not feel too good for a week or two!

I worried about bloat but I don't think that is it. She has not vomited and wants to eat and drink. OMG, I have always said if my Zoe stops eating, I have to be seriously worried.:( she seldom throws up and always wants to eat. Must be the Cushings though I did read Lhasa's are Hoovers.

I am going to do a consultation with IMS and go over options. I think I want to do one more ACTH test before loading starts next month.

I think I have had too much time to think so then I start doubting things. It has all taken too long. Maybe it is a blessing in disguise.

Thanks for input all:D

Addy

[addy]

I also want to add: I started feeding raw when this started because I read to take a cushings dog off of grains; we have friends who have horses who have gotten cushings--they have to have a special diet also. I just cut back the raw and started a dry that is also grain free--not sure if this is why she has more energy, but she seems to not feel like she hasn't had enough to eat. I also give milk thistle, l-glutamine, fish oil, vit c, c & c to help her. The raw is Northwest Natures and the new dry is from Nutra--California Naturals, has an Aussie on the front--gee wonder why I bought that--haha!! (Maddie is an Aussie). She has not problems with eating all of this--still has good poop. We all can tell you what works for our dogs and give opinions to help, but in the end it is what works best for you and Zoe!!

Maddie's Mom- thanks for the welcome! I find this info interesting because Zoe seemd hungrier on the raw from the very first day but she can't eat kibble, or at least she couldn't last year. I tried to switch her to California natural lamb and rice could only get to 1/4 cup. Did you switch foods after she had been on lysodren for awhile? I worried about the raw becasue of what it said on her food package and because others told me they took there Cush pups off raw once diagnosed. I read also try to stay away from grain but there is so much food info out there ! Hard to tell what will work or not so I know what you mean.

I will read Maddie's thread. Thanks again.

Addy

[apollo6]

Dear Andy,
I give pepcid when Apollo has an upset tummy, I use less then a quarter of a tablet, thrown in with his food. He has always had a big appetite. Again check with your vet first.

[addy]

Really?

what is pedica and where do I buy it? How do I know how much to give?

The only test Zoe did not have is LDDS and that was because I can't leave her that long at the vets, too much stress. All tests point to Cushings, IMS said no tumor so not adrenal.

I know Sonja, I am going too fast again. My mind is racing. I need to slow down and give Zoe some time and me some time. Just felt a little pressure yesterday when I called in for her meds refill. Thanks for giving me your time line, that little bit of info just helped me so very much! See, I need to know tidbits like that;) I'm serious, I really do. It helps put things in perspective.

She can't jump on the bed so I start to freak that the hamburger buns made her Cushings worse:eek:

Addy

[zoesmom]

Addy - in Apolla/Sonja's thread, you asked about the 'unexpected' side effects that my Zoe got from the tylan. I don't know if any of these would be relevant to your Zoe, but this is what happened.

I started Zoe on tylan for SIBO on a Friday (in summer 2008). On Saturday, her drinking dropped by half or more. She'd had polydipsia (and polyuria) her whole life and even after going on trilostane - at age 9 - those things did not totally resolve. One good formula for figuring normal water consumption is 1 c. of water per each 10 lbs of body wt. Zoe (who usually weighed around 80 lbs) drank upwards of 15 c. of water/day - pre-cush diagnosis. Even after starting on trilo, she still drank 12 or more cups of water/day. And those amounts would always go up when she'd get a urinary infection. So virtually overnight, her drinking/peeing dropped to a normal range and stayed down. Her average after that was 4 - 8 c./day. That was great, to my mind......but then over the coming weeks and months, I began to notice other positives as well.

First off, her lifelong battle with uti's came to a screeching halt. I think she only had two more after that and one was very minor (bacteria count not all that high). This was a dog who sometimes got uti's every 6 - 8 weeks. Not a year went by that she didn't have several bouts.

Zoe went to the bridge this last March. But in her last year and a half (on the tylan), her thyroid levels and her cortisol levels finally stabilized. She'd previously taken thyroxine in doses ranging from .2 to .8 mg. She'd also taken ever-increasing doses of trilo, and yet sometimes her cortisol would rise to around 9 or 10 - once to 13+. I don't think we ever got an ACTH reading below 5, except once (much to my and our vet's amazement, she dropped to a pre of .7 pre and a post of 1-something. Don't remember when that happened but I think it was during the same summer we put her on tylan.) Would have to look.

So those were the 'unexpected' benefits that I saw. I think it probably had to do with how well she was absorbing her medicines - before and after the tylan. The reason we tested for SIBO was house-clearing gas (she also had the intestinal rumblings called borygmus-sp.??) and more often than not had soft, mushy poop - :eek: not quite diarrhea but she had bouts of that more than I care to recall, too.:rolleyes: So as hoped, with the tylan, her poop firmed up and the bad gas improved. As far as her appetite, she was always the opposite of the typical cush pup. Pre-diagnosis and when her cortisol #'s would creep up, she wasn't much of an eater. The lower her cortisol, the better her appetite. She was definitely not a dog who'd 'read the book!' Sue

[addy]

zoe's mom

Thank you for sharing Zoe's story and I hope it was not too painful for you. Tylan has antiinflamatory properties as does metronidazole. I wonder if once we get all that inflammation down, some cortisol drops, meds get absorbed better, etc. their bodies just respond better when they don't have to cope with their insides inflamed as well as gettting rid of that bacteria they harbor.

Do you know of any literature about inflammation and cortisol?

I just can't shake the thought that my zoe's inflamation when we did her Cushings tests contributed to her "significant numbers" and that if I retested her after a period of "non inflamation" if I could achieve it, it would possibly bring down those numbers to moderate.

I am not saying it would get rid of the Cushings diagnosis, as I believe it is real, maybe just her numbers would not be significant but maybe moderate. Not sure how that would affect loading her, if it changes the doseage or the post load ACTH comparison.

Does it seem odd that a dog with "significant" Cushings, does not have the frequent infections, blood work is not anything like alot of the other dogs, symptoms are not as strong as other dogs., etc.

I am a practical person and something does not add up for me.
Maybe I am too hung up on Dr.Oliver's wording of signifcant :)

Thank you again so very much for sharing with me.
Addy

[apollo6]

Go with your gut feeling. The pepcid(not sure of spelling), I use Bismuth, is just over the counter medication for upset stomach, I sometimes try to get the children's , another one is Pepsto for children( in pink bottle I think) any regular drug store would have - like CVS, walmart, etc. I use less then a quarter of a tablet in Apollo's food occasionally. See what other members do. I keep hoping I'll wake up and the cushing will go away.
I do see the effects of the skin lesions, and I feel the lump on Apollo's tail is from ingrown hairs, that are inflamed. I just want to cut that awful thing out.

[addy]

Hi All,


It has been a week since the "bun" incident and finally yesterday, Zoe was able to again jump on the bed and this morning, bless her heart, she jumped up on the bed and woke us up with her normal antics.

I was about to order pet stairs for her and schedule appointment with vet for next week, worrying how was I going to take off work for that, I am down to being a one girl office for a month! Big sigh of relief.

That Cushing's panic is hard to overcome, I thought we had a new symptom. I see Cushings everywhere sometimes.

So back to the melatonin and lignans!!!:D

My current problems seem so small compared to what others here are going through lately.

You all are in my thoughts and prayers and I hope things get better!

Addy

P.S. link for paper on Trilostane- Zurich Conference 2010. Thanks Harly's Mom!!!


http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2010&Category=&PID=56127&O=Generic

[apollo6]

Dear Andy,
Hope you are doing fine, I am so obsessed with Cushing, that my vet ordered me to take a brake from it. My family says I am looking for something on Apollo everyday, for another sign. Well I go in about 3 weeks for Apollo's check up, new blood panel, and new ACHT STIM
TEST. Like so many I am overwhelmed with a lot on top of this.
My husband and I are ready to close our store and sell our building. We are no spring chickens. Been in business 36 years. Problem is it is in Reno, Nev and the economy is real bad there. We are struggling week to week in our flooring business. My mother is 78 and I am doing more and more. It just never seems to end.
Thank you for the link.

[addy]

Oh Sonja,

I am so sorry to hear about your business. That is so very hard. We had to close a family business a few years ago, it really is heartbreaking to go through.

this weekend we were trying to trim branches on a tall evergreen and my husbanf got stung by hornets. His arm swelled up so badly, his doctor put him on prednisone for five days.

It is always something. My daughter thinks we are jinxed lately!!!! Oh, I was just glad I did not get stung because I had a swarm of them flying around my head. I was swatting at them. I thought they were flies because they were black and buzzing

I think we need a condo but you can't sell a house in Milwaukee right now:(

Hope Apollo is doing well and his next batch of tests are good. I need to figure out the lignans for Zoe and I don't think well with that side of my brain.

Addy

[apollo6]

I know what you mean. My husband and I feel the same way sometimes, like there is a dark cloud over us. I tried to blow it away over the weekend. We are in the same place, would like to sell our house and building in Reno, NV. But the economy is so bad and every month the values go down. It has just got to get better for all of us.
I pray every night for the the members and their cushing babies. On the brighter side, my brother, the professor, just had his third daughter , July 3rd in Columbus, Ohio. He said he plans on going for long bicycle rides when all the women are all on their period. He doesn't want to try for a boy, but you never know.

[apollo6]

Dear Andy,
So wrapped up in myself, forgot to ask how your husband is doing. Hope he is doing well. How are you and Zoe doing.

[StarDeb55]

Addy, on the general labs that were done on 6/18, Zoe has the typical elevations in cholesterol & alk phos that all of our pups seem to have. The one good thing is neither of the 3 liver specific enzymes, ALT, AST, or GGT were elevated which should mean that her liver is still in pretty good shape, & probably has not suffered a whole lot of damage from trying to process the excess adrenal steroids. I would double check with your vet about this. The one thing that I didn't see posted was the urine specific gravity on the UA results. Cushpups can't concentrate their urine so that result should be low. Since you told me in the PM that these labs were done in the middle of a colitis flare, that would probably explain the elevated platelet count. I think the general labwork is just another confirmation of the results from the UTK panel. I'm not sure exactly what you're looking for, but I hope my explanation helps.

I don't remember what treatment plan you & your vet have discussed, but from all of Zoe's results including the abdominal ultrasound, IMO, she needs to be treated.

Debbie

[addy]

Thanks Deb for checking the labs. I was just confused because I thought a dog with "Significant" hormone levels would have more things wrong on the other labs so I was worried that her flare up and stress maybe bumped her adrenal numbers from maybe moderate to significant which would perhaps change the treatment recomendation. She doe not have panting, frequent thirst, potty accidents, frequent infections, etc. We just have the thin skin and hair thinning, rat's tail and licking everything.

IMS wants to load with lysodren and I wanted to wait until I could be home for a week and not have to worry if I have to take off work, which means mid August.

Until then I wanted to try melatonin and lignans for her estorel (not sure I spelled that right) and try to get the flare up under control.

I was hoping the melatonin would help her anxiety as I took her off her Shen Calmer. We are starting with 1 mg and I have not yet figued out the lignan dose.

Everyone wanted me to check with Dr. Oliver about loading with lysodren and her chronic diahrrea. He was away and I finally heard back and he said lysodren and that he was not aware of it causing diahrrea so should not be a problem. Another vet said no problem administering metronidazole with lysodren. She also said no problem with loading.

So, just wanted to cover my bases before next month.

Thanks again,
Addy

[apollo6]

Dear Andy,
Just do what you think is right . How are you and Zoe doing, how is your husband recovering from the bee strings. Saw a wasp in our patio today, took Apollo, inside right away.

[addy]

Hi Sonja,

My husband's arm is so much better, thank you for asking. The prednisone kicked in the second day.He is almost good as new :)

I am trying to figure out these lignans for Zoe. If I undestand it (and I probably don't) if the flax is a 40 mg capsule with 20% lignans and Zoe needs 1 mg per pound that would be 18 mg's of lignans so I would need 2 capsules I guess which is 16 not 18 but I hope that is close enough.

Do I have it right? Yikes, I can't think with that side of my brain.:confused:

How is Apollo today and how are you? I hope you both had a good day. We all need them, don't we? I will go on your thread. We had horrible storms last night and our power was out at work so when it finally came on at noon I did not have much time to get my Cushing's forum fix :) I missed you all today.

Love you,
Addy

[apollo6]

Thanks for asking. Today was a hot one here on the West Coast, over 80 degrees. Apollo has been wiped from the heat. Don't know if it is the heat or the cushing, seems more tired then before. Crazy day at work, even though we want out we still have to keep things going until we look into all our options. Not a good time to be in know.

[lulusmom]

I'm a little inland on the west coast and it was a scorcher today...triple digits at my house with no end in sight for a while. It's not fit for man nor beast out there, which is why all of my beasts are lazing around indoors with a/c.

[Harley PoMMom]

I am trying to figure out these lignans for Zoe. If I undestand it (and I probably don't) if the flax is a 40 mg capsule with 20% lignans and Zoe needs 1 mg per pound that would be 18 mg's of lignans so I would need 2 capsules I guess which is 16 not 18 but I hope that is close enough.

Do I have it right?

Yes that is correct :D Each 40 mg capsule contains 8 mg lignans.
Good job Addy!

Love and hugs,
Lori

[addy]

Yes! i have the lignans figured out!!:D

Next question: I have not given Zoe her Heartguard yet and the mosquitos are getting really bad here. Her hair is so thin and her tummy is shaved from the ultra sound.

What is everyone currently doing about heartworm medicine? Since Zoe's Cushings is not yet controlled, I did not know if you could have it but yet getting heartworms can't be good either.

Should I call the IMS and ask her? A little worried about the answer as she seemed not happy I held off on the rabies shot. I mean she did not say it out right but she had "the Look"

Addy

[apollo6]

Dear Andy
after reading your post. I would check with the vet about the heart worm.. This year is a lot more humid and there are more mosquitoes. Especially with their weakened immune system, the little guys need more support. We are of the same generation: mini skirts, hip hugger, bell bottoms, platform shoes, pixie cuts, the Toni perm(God did I hate when my mother gave me one, I have wavy hair , I looked like a poodle with blonde hair) ,the Beatles, the Beach Boys, Peyton Place, etc.- If this generation only knew how much they are getting from our generation(HA!HA!):D

Deep down inside, I feel all the vaccines, heart worm and flea medications did not do the little guy well. When he started having black heads and hair loss on the bottom back part of his neck, I thought maybe the flea medication was causing it. Every time I applied the medication, first thing he would do , go outside and try and rub it off. God knows what it was doing to his skin. Not realizing it may have already been the start of cushings. I use Sentry Natural Defense Natural Flea and Tick Squeeze-On . All I know is every time Apollo got the multi vaccines(pharmaceutical companies lump more then one vaccine into one for profit margins) he would be lethargic, throw up . In my own case , I should be on 4 medications if I listen to doctors. 15 years later I never took one and I am still here. It blows my mind why so many of our little guys have cushings disease? I do feel a lot is environmental-foods, medications. Most vets are medication happy. Only in the past few years has there been controversy on all the vaccines( half of which are so unnecessary) I mean really, where was I going to go to contract half of the stuff , Apollo was being vaccinated for. I even had a vet I dropped, say , the medications were okay because , he probably would die of cancer!!! Just think 50 or more years ago , dogs on farms ate what ever their owners ate, and they didn't get vaccinations. If you knew what was in half the pet food, you'd probably be sick to your stomach. I had Apollo on Solid Gold Hundenflax-made in San Diego, Halo and Natural Choice-had to stop all that. I am really being careful in reading labels now. No by products, etc.
Love Sonja and Apollo

[addy]

I know what you mean. I have always been worried of too many vacinations, and the flea treatments and heartworm. You try to do what the vet says is right and then you end up with Cushings. After the recall in 2007 I became a food freak and read every label. Sometimes I get discouraged, I have friends and neighbors that go to the grocery store, buy whatever food, don't read the label, don't really do much of anything and their dogs are bright eyed and healthy. Here I am freaking out about food and medicines and supplements and Zoe has Cushings and I think Koko may have a partially collapsed trachia. Makes a girl wonder:confused:

I will call IMS later today and get her opinon on the heartworm. The news said with all the rain and heat, the mosquitos will be the worst we've seen in ten years! I worry about giving it to her but I am even more worried about getting heartworm. It is a hard decision.

I thought I had covered all my bases because I had a regular vet and a holistic vet but now I have those 2 vets and the IMS and I still am not happy. I must be difficult:o
Either that or I dream of the perfect vet and that does not exist.

Zoe seems zonked out from one mg of melatonin at night. Or maybe she is just bored, being inside so much with the heat all last week. We did not have many car rides. I don't know what is up but she is not right. A mom always knows.

Addy

[marie adams]

Hi There Addy,

Maddie has always been on Sentinel since she was a puppy and it works so well I stopped giving the Advantage after the first spring/summer. I asked the vet if there was any connection with the heartworm medicine and cushings--she said no. I am still giving her the monthly dose and no problems. We live near a wetlands area which Maddie has and is always out there--no fleas--nothing.

I hope this helps!!!

[labblab]

Hi Addy,

I am glad you are asking your IMS about Zoe's heartworm medication, because I think it is always good to check with your vet about questions like this. Your vet is the person who is most familiar with Zoe's specific situation. But I am not aware of any member here whose vet has counseled AGAINST giving heartworm meds, regardless of their dog's Cushing's status.

My personal thought is that the known risks of heartworm are so great that I would not want to expose my dog by withholding the medication. Without protection, I would be a nervous wreck every time I saw a mosquito landing...:o. And I am not aware of any negative interactions between heartworm meds and either Lysodren or trilostane.

Marianne

[addy]

Thank you all for the input. It is good to know. I do know my holistic vet was not keen on the heartworm meds.

I think I am too worried not to give it and just wanted to make sure it can't hurt Zoe in anyway not having her Cushings controlled yet or because I want to load her next month.

It is good to hear others are using heartworm products. I am hoping she can advise which one she usually gives. Zoe has had Heartguard Plus in the past. Last year there was one month we thought she may have had a diahrrea reaction to it but we can't be sure.

Thank you again for your input, it always helps me :)

Addy

[apollo6]

Dear Andy,
quick , Hi will post a little latter.
Hang in there.

[apollo6]

Dear Andy
Hope you all are doing okay. Having a senior moment, can't remember if I posted or not. Apollo is doing as well as can be. The weakness in the hind legs is very noticeable. I make him walk a little every day to keep up his strength. Just love the little guy so much.
When they look at you with those soulful eyes, my heart melts and I tell Apollo , we are not giving up and will keep on fighting.
Love Sonja and Apollo

[addy]

sorry, hit the button twice !!!!

see post below

addy

[addy]

yup, the eyes do it every time:)

Zoe is going for her heartworm test Saturday am, should have results Monday and start her back on Heartguard Plus at that time. That is what she had been on since I brought her home. I think the loose stool last year was unrelated, but if we see a problem we will switch. I could kick myself for letting that go, every week it is some crisis either with the dogs or someone in my family::( Now I get to worry she has heartworm:eek:

I have upped her to 2 mgs of melatonin in the evening and she is moving slowly and seems like she gets winded faster. It has been very hot and humid so the ac is constantly on so it is quite a transition going outside. This process is so painfully slow with her.

We have not had to use metronidazole for even a maintenance dose for over a week and her poops are very firm. Sometimes I wonder if she is constipated here and there. That would be a NEW problem for us, never had to worry about that one.

I even cut back her probiotic to 3 x a week, once meal per day.

She has had no Shen Calmer for a few weeks now.

What has everyone using melatonin experienced? If she is this slow now what will it be like when she has it durring the day? Do you have to give it twice a day? What if she can't handle 3mgs? Do you have to give 3 mgs? I had hoped it would help her Estradiol. Look how high it was.

Estradiol pg/ml 114.8* 30.8-69.9 102.2* 27.9-69.2

I was going to start the lignans but now have to wait a week for her heartguard dose.

Hoping anyone can shed light on the melatonin.

Thanks as always,

Addy

[Harley PoMMom]

What has everyone using melatonin experienced? If she is this slow now what will it be like when she has it durring the day? Do you have to give it twice a day? What if she can't handle 3mgs? Do you have to give 3 mgs? I had hoped it would help her Estradiol. Look how high it was.

Estradiol pg/ml 114.8* 30.8-69.9 102.2* 27.9-69.2


Hoping anyone can shed light on the melatonin.

Thanks as always,

Addy

Hi Addy,

Some pups do get lethargic on the melatonin. Some parents stop the melatonin, reduce the dosage or they opt for the implant.

The lignans, according to the UTK treatment option sheet, will help get that elevated estradiol level down:
4) Lignan. Lignan has phytoestrogenic activity, and competes with estradiol for tissue estrogen receptors, with less biological effect. Lignan also inhibits aromatase enzyme (lowers estradiol) and 3-beta HSD enzyme (lowers cortisol). http://www.vet.utk.edu/diagnostic/endocrinology/pdf/TreatmentInfoAtypicalCushings201005.pdf

So happy to hear that Zoe's poops are firmer! ;):D You're doing a great job, Addy!

Love and hugs,
Lori

[Squirt's Mom]

Hey Addy,

A while back I got concerned about the fact that Squirt was sleeping more than she used to...more than I was comfortable with. So I cut back on her melatonin and she did perk up a bit. Bear in mind, she is an old lady, melatonin or not! :p However, her next UTK panel came back with unsatisfactory numbers so she went back to the full 3 mg/2X/day recommended by Dr. Oliver. :o I had rather her sleep than let those hormones get all out of whack.

Squirt will be 13 this Feb. so maybe I expected too much of her in wanting her to be more active. :o She has her moments when she is full of piss and vinegar, wants to play a minute, and shows her delight or joy over something...and I am happy with these times!

Don't worry over much about Zoe sleeping a bit, especially right now. Her little body may just need some time to adjust. Plus, as Lori said, the lignans are needed to help control the estradiol; it and the melatonin work together to accomplish this. So, right now she isn't getting the full effect of the treatment. Once she is going on both supplements, you may see a change in her behavior and energy level.

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

[apollo6]

dear Andy,
Maybe it is the medicine that makes our little guys more tired. Apollo seems to want to sleep more then before. I am buying a stroller, since Apollo can not walk that far and I get tired carrying home.:( Never thought it would come to this. But if I mention treat, or dinner or breakfast, boy can his energy level go up. They do know how to wrap us around their paws.:D

[frijole]

Addy - I've given both my dogs melatonin for sleeping purposes and it relaxes them and yes they do sleep better with it. I've never given it long term - just when there is a storm outside or firecrackers. :p

Lysodren made my Haley tired until she adjusted to it. Then she was fine.

Hang in there - at least the poop is firm! :);) Kim

[Casey's Mom]

My Casey gets melatonin at night when she is restless to help her sleep. I zonks her out and I give her 3 mg for her 40 lb weight. However she does not need it for her cushings as she has Pituitary cushings and not Atypical.

I echo what Lori said with Atypical you need both the lignans and the melatonin to work together - that much I have learned here.

Love and hugs,

[addy]

Thanks for all the responses. Sorry I did not respond sooner. We had a horrible storm come through Milwaukee Thursday nite and we had no power until late last night. We had 7" of rain in 2 hours and you can't believe the mess:eek:

Thankfully, we fared better than alot of people, I just had to stay up all night running a generator to keep the basement dry. We had no water because of course the well need electricity. The dogs were troupers even though it was hot in the house and I was stressed.

Rabies shot opinions please:

Zoe went for her heartworm test this am. They had to muzzle her again. I wonder if they are doing that more often because she has a rabies vaccine waiver and they want to be extra careful. I don't mind but it stresses her even more. She looked terrified standing on the table with the muzzle on. A soon as she saw it she started shaking. After they took it off, I lifted her down and quickly whipped out chicken and told her what a good girl she had been. She ate it and looked at me with those big beautiful eyes and then after I stopped treating her she went into the corner behind me and hid. Maybe I should buy a muzzle and click and treat and practice with her so she gets used to it.

Could you share experiences with rabies waivers? Should I just give her the shot because she is so reactive? I am not 100% positive she will not bite. It would be more of a hard nip not a serious bite if she did but I suppose she might break alittle skin if she gets stressed enough and does not feel well. It would be a problem for her.

She does not like being picked up we had to really work on that, she's been like that since I brought her home. She was doing better with being picked up because we praticed everyday but since her visit to the IMS and the lengthy ordeal and all the tests, she is not happy about it again.

I wonder if it hurts her? Though she did not want me to touch her paws either when I first brought her home.


I did order the lignans today:D:D:D

Addy

[littleone1]

Hi Addy,

Due to Corky's age and medical conditions he will no longer be getting the Rabies shots or any other vaccines. He will be getting a waiver on the Rabies shot. Rabies shots should not be given to dogs that aren't healthy, and Cushings definitely qualifies a dog as not being healthy.

Terri

[apollo6]

Thank you for your input. I was worried about Apollo getting any more rabies shots. Now I know no way. I stopped vaccines about over 2 years ago when I read articles on how long they last and how many are not called for.
Dear Andy, it sounds like Zoe was traumatized by this experience. Apollo has never been muzzled at the vet. The only reason to do so would be if she is biting . Doesn't make sense. When ever I introduce Apollo to something new I let him smell and look at it first. I try to be in the room with Apollo and hold him and speak to him. I have put a muzzle on Apollo before to stop him from barking to let him know not to do it when people have come near me in the past in our store. Don't do it anymore , but he didn't resist at the time.

[addy]

Hi Sonja,

She was fine at the IMS until they took her from me and she must have freaked out, she kept trying to pull to us and they said her behavior was such that they had to muzzle her so she would not bite. She used to give a warning, like snap her head around like she wanted to bite or nip but then I would pet her side and tell her "up" and she would stop acting like that and allow me to pick her up. It took 3 months of practice to reasuure her about "UP." She would not let the vet or technicians touch her after her ultra sound. She was traumatized. When she got home she even threw up and she never throws up. As soon as I took her out of the vet's building and told her "UP" she let me pick her up and continues to do so at home. When we went to the vet's Saturday she did not want to be in the examining room and tried to hide under the bench and did not want me to pick her up, she just freaked. I told her "up" and picked her up and put her on the table and they said they wanted to muzzle her because she did not have a rabies shot.

She has to go to the groomers every eight weeks. I don't want to give her the shot but I also don't want her to be put in quarentine if she bites or nips someone.

I don't know what to do. I am making an appointment with IMS for next week for a follow up. I know they will muzzle her again not that she bit but because they are afraid she will.

I titer rather than give shots now with both dogs but the rabies thing with a reactive dog that has to go out to the groomers and vets, well, I don't have any experience with that. She never had to be muzzled before at either place.

Addy

[Squirt's Mom]

Hi Addy,

My Crys had to wear a muzzle and I hated it but it was necessary for her. She had to wear one starting pretty young because of Pica - she would eat non-food items. In fact, she got off and ate the first 3 muzzle types we tried! :rolleyes::p

She never did really adjust to them but she did learn to deal with them and not fear them. The one that she couldn't eat was mostly metal with leather straps and made her look like Hannibal Lector. :eek: She had to wear the muzzle at home mostly, until she nipped a kid at the vet's office one day. :eek::(

Crys was timid and the boys couldn't keep their hands off of her and they were rowdy, making her nervous and she nipped. Scared the crap out of me! After that, she was muzzled when we went into the office. She had never offered to bite them but I wasn't prepared to take a chance. On the few occasions that I forgot hers, they would let me put one of theirs on her before the exam. She accepted it better from me than from them and it was less traumatic on her.

Maybe if you asked your vet to let you muzzle Zoe, she wouldn't be so upset. Also, getting one like they use and using it from time to time at home on Zoe might help her learn it could be endured for short times and wouldn't hurt her.

It really broke my heart to have to muzzle Crys, even tho I knew it was the best thing for her at the time. The danger she was putting herself in by eating weird things all the time plus the fear of having her taken from me after she nipped that child made it easier to do, but I still hated it.

So often it seems our babies develop a fear or down-right hate of the vet office when they are diagnosed with a condition like Cushing's. All of a sudden, they are at the vets a lot, especially during the diagnostic phase, being poked, stuck, prodded, spread, and drained frequently...none of it pleasant to remember. We can't explain to them that this is all for them, all to help them feel better, all because we love them. All they know is they DO NOT want to go in there! So we battle the emotions these necessary steps bring and do what we must to make sure our babies are safe and healthy as possible.;)

Hugs,
Leslie and the girls - always

[addy]

Hi Leslie,

Thank you for answering my question. Zoe tends to be fearful anyway so a bad vet visit will do here in.

I think you have good suggestions and I will get a muzzle and work with her at home so I can put it on. I also will never let them take her from me again if I can help it, I will tell them I have to go along to wherever they are taking her.

I don't mind they muzzle her I just don't want her to be so scared about it because I worry that the stress will skew her tests.

I wonder now if all this reactivity stems from the cortisol. I read it can cause behavior problems.

Do you think if I get her use to the muzzle I won't have to give her a rabies shot? I feel like i am between a rock and a hard place I believe the saying goes:eek::eek:

By the way, did you ever cure the Pica? I have been working hard with my Koko because he tries to eat little stones, sticks, etc when he goes outside or when we walk. I read in Whole Dog Journal to try enzymes, didn't help, then tried Seacure, didn't help. He may be looking at a muzzle as well:(

Addy and the Muzzlers:)

[marie adams]

Hi Addy,

So sorry to hear about Zoe's experiences. I know the feeling about letting them take them in the BACK -- what are they doing to them:eek::eek:. I have not heard any remarks they have had problems with Maddie, but I do know she doesn't like to be picked up especially by someone other than us--of course she does weigh in the 65 lb range so not likely someone would just pick her up. I do not know if they put her up on a table to take her blood or maybe just work with her on the floor (I hope this is what they do), but she comes out not really excited to see me; so it must not be so bad. She didn't spend a lot of time at a vet's office before all this joyful :D testing started.

I hope your working with her and the muzzle helps. Dogs sense when we are tense so things happen--doesn't the Dog Whisper talk about the way we hold the leash and the tension goes right down it to the dog--haha!!! If the vet's office help are nervous then it causes Zoe to be nervous and they only know one way to defend themselves--with their mouth--poor thing:(.

Take care!! I love the Addy and the Muzzlers---cute!!!

[addy]

Hi Marie,

You are so right, if they seem tentative, Zoe senses it. She seems to respond better to the male vets and male techs rather than the female. They seem more self assured with her and then she is fine. Unfortunetly, her IMS is female and I can only find female IMS vets. We don't have many in Milwaukee.:(

I have been following your thread too, thanks for posting and for the positive vibes:)

[apollo6]

Dear Andy
So sorry to hear about poor Zoe. I think with all the needles, pocking our poor little angel are being subjected to it is no wonder they are fearful of going to the vet. The last time I was at the IMO, Apollo let out such a scream and the fear in his eyes, tore me apart.
You might try having the muzzle at home, leaving it on the floor for her to sniff, but it on top of her nose, let her smell it, then slowly but it on. If they insist on the muzzle, maybe it should be you who does it and be her own muzzle. Give her a treat before and after if need be. I am going to fight not giving Apollo the rabies shot in September and I also do the titer test. These little guy's immune system is already been compromised by the cushing, with the skin sores, etc. so how are they going to be able to tolerate more shots? Maybe this might help.
love from Sonja and Apollo
p.s I am thinking about water therapy to strengthen Apollo's weak hind leg muscles. My husband suggested just filling up the bathtub and letting Apollo swim in it with my help. Any input from the rest of you?

[labblab]

Hi Addy,

I'm so sorry that poor Zoe is having to suffer through so many vet visits and so much poking and prodding. I do want to offer a bit of a different slant on the rabies vaccination question, though. Once Zoe becomes stabilized with her Cushing's treatment, I am not as certain as some other folks that you would not want to reconsider rabies vaccination, especially since she does appear to have some issues with snapping or biting.

It has been several years now since my own Cushpup was alive and we regularly visited our IMS. But his vaccination policy at that time was "middle-of-the road" and seemed pretty reasonable to me. Vaccinations of any type were withheld for dogs who were actively or acutely ill, and all vaccination protocols were tailored to the age, vaccination history, potential for exposure, and the lifestyle of any individual dog. But since my own Cushpup was relatively young and very active outdoors in areas frequented by dogs and other wildlife, once he was stabilized on trilostane, our vet did not discourage us from vaccinating for specific illnesses for which he was most at risk.

From some experiences of my own with human organ transplant patients, I've been told that people who are chronically immunosuppressed may actually be more aggressively targeted to received certain vaccinations because they are even more at risk to develop these illnesses than the general population. Of course, there are many individual factors to consider, including timing and stability of treatment. Also, vaccines based on killed viruses may be acceptable for immunosuppressed patients whereas vaccines that use live virus may never be OK, or can only be used in certain situations.

I know that humans are not dogs, but these same principles make sense to me. And that is why I personally do not feel comfortable with extreme positions on either end: that all dogs should be given every type of vaccine available, or that no dog who has ever been diagnosed with a medical condition should ever receive a vaccine of any kind. For my own dog, I would want to weigh the relative risks and benefits of any specific vaccine or disease.

I do believe that canine rabies vaccine is readily available in the form of killed virus. And in many states, vets are now able to offer it in the form of three-year protection in order to keep from having to be given annually. So if your own vet does not think there is any reason why Zoe would not be a vaccination candidate once her Cushing's is under control -- you might want to revisit the question, both to potentially increase her own level of protection and also to minimize the concerns that others might have about handling her.

Marianne

[addy]

Thank you Marianne,

I did not know you could get rabies vacine killed virus. I thought it was always live. That is good to know. I will look into that.

I understand your explanation. I have to weigh the risks of her biting someone and being put in quarantine verses how sick will the vacine make her.

She really is so very sweet and tries so hard for me. I feel so badly she is so scared and thinks she has to use her mouth in those situations. I had worked so very hard for these 3 years I have shared my life with her to build her confidence and make her less fearful. It is hard to see her take a step backward, we have worked so hard and come so far from those first days she came to her forever home.

Aw darn, now I'm crying thinking about it. I sure wish I wasn't such a sentimental sap:mad:

Anyway, thanks for your input, it is good to hear and consider:)

Addy

[Roxee's Dad]

Hi Addy,
I once had an older Lhasa (Bailee, pics in my album) that our vet named the "piranha Lhasa" :p He was a foster that I kept because he was a fierce biter. We knew we would never be able to find him a home. :( So he spent his retirement years with us. Between the vet and I we always managed to handle him without a muzzle. The vet techs would let me hold him while the vet or vet tech's had to do their job. She was a great and compassionate vet and she trusted that I would hold him well enough to keep him from biting her.

Grooming him was my biggest challenge, and yes I did get bit a few times. I would sweat bullets when I knew I had to clean his eyes and face.:p Maybe your vet would let you hold Zoe while they do what they need to do.

[littleone1]

Hi Addy,

I'm so sorry that Zoe is so afraid of going to the vet's. Corky has gotten worse with every visit. He doesn't try to bite anyone, but he shakes and pants very badly. Our furbabies have definitely been poked and prodded so much and have had different machines used to check things. They have no idea what's going on.

I hope Addy will be able to settle down and not be so afraid.

Hugs,

Terri and Corky

[labblab]

I understand your explanation. I have to weigh the risks of her biting someone and being put in quarantine verses how sick will the vacine make her.

Hi again, Addie.

I just wanted to clarify that I don't think the only risk that you have to consider is whether or not Zoe will bite someone and thus be put into guarantine. But also Zoe's own risk of contracting rabies should she come into contact with an infected animal. Since you are guessing that she is only five years old, she may or may not have lifetime immunity from any previous rabies vaccination. Even though canine-specific rabies has recently been eradicated in the U.S., unvaccinated dogs can still contract rabies from other infected wildlife. So depending upon Zoe's lifestyle and the prevalence of rabies among animals in your area such as raccoons, foxes, and bats -- the possibility remains that she coud still be exposed. If she remains primarily a house dog with little risk of exposure, this may be a moot point. But if not, for her own safety, you may still want to consider revaccination at some point in the future.

Here's a quote from the Veterinary Merck Manual (http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/102300.htm&word=rabies)that underscores the continuing danger for dogs whose lifestyle and geographics put them at risk:


Where terrestrial wildlife or bat rabies is known to occur, any animal bitten or otherwise exposed by a wild, carnivorous mammal (or a bat) not available for testing should be regarded as having been exposed to rabies. The NASPHV [National Association of State Public Health Veterinarians] recommends that any unvaccinated dog, cat, or ferret exposed to rabies be euthanized immediately. If the owner is unwilling to do this, the animal should be placed in strict isolation (ie, no human or animal contact) for 6 mo and vaccinated against rabies 1 mo before release. If an exposed animal is currently vaccinated, it should be revaccinated immediately and closely observed for 45 days.

Marianne

[addy]

Zoe is mainly a house dog and is not allowed outside unless we are with her and then she is leashed. I suppose there is a remote possibility she could come in contact with a rabid aninmal, but not a great one at this time. We estimate Zoe to be eight years old at this time. We think her first owner had her for about four years and that she had all vacinations. We do not know what happened to that first owner but Zoe went to another home which is where she got in trouble and confiscated by animal control. That is if we can be sure of this story, who knows:(

The rabies vacaination is something I need to sort out and I am always happy to hear others opinions and suggestions, so thank you:):):)

Addy

[addy]

New problem:

Zoe is constipated. I had thought all week her poops looked smaller and dry and I thought she might have a minor impaction. They did not look right to me but then she would go and they seemed better. Last night she had a rather larger stool followed my a small one with mucus on it. I thought she may be clearing out.

Well, last night she went in the den and never woke us up this am. She did not do anything normal but begged to go outside. I would take her out and she would strain to poop to no avail. Liquid drops came out of her. After an hour of this I put her in the car and headed for the emergency room because I had no way to again take off work and did not know when I could get her in to her regular vet.

Her exam was "unremarkable" and attending vet said she thought she might be having spasms at the start of diahrrea. I kept insisting I thought she was constipated. They took an exray and sure enough, stool backed up inside. I don't remeber how far, but pretty far. I asked if there was an obstruction, she said no. I hope she is right.

I know it was those darn six hamburger buns. Everyone kept telling me no way but she is NEVER constipated. What else would it be? Unless the melatonin caused it.

So now she is home resting with a laxative medicine that will hopefully work in 24 hours they thought. Otherwise she has to go back and be put out and given an enema.:mad::o:(

Well, our crisis for the week. Any suggestions would be welcome.
Hey we had a male tech who handled her very well and she put the muzzle on just fine and they said she was a good girl :)

Addy

[littleone1]

I hope the laxative helps Addy.

Terri

[marie adams]

Hi Addy,

I loved that Maddie's thread was hijacked :D:D

Maddie hasn't been constipated before --it looks like it now, but it is just the food she is getting and it makes her really work to poop. Sometimes it is drier than other times; I think it is more than she use to have and not as regular timing as in the past. I can't believe how much we talk about poop. :D:D

I hope Zoe is feeling better and you are too!!!

[apollo6]

Andy
Sorry to hear about Zoe. Wish I had some suggestions. But maybe a laxative is the best options. Never a dull moment with these guys. I am still dealing with the lump in Apollo's tail. When does it get easier, we all could use a rest. I am also concerned about giving Apollo another rabies shot, know that he has cushings. He is an indoor dog and is with me all the time. I just don't think I want to give him one.
Hope you got to enjoy your weekend some. Will be praying for you and Zoe.

[Squirt's Mom]

Hi Addy,

How is Zoe this morning? The constipation any better? If not, you might try some plain pumpkin (if you can find any!). NOT the kind for pies with the spices and sugar in it, but just plain pumpkin.

I am not sure about the feed you are using, but sometimes those prepared raw diets don't have enough fiber which can result in constipation. Some other options to add a bit of fiber would be well-cooked brown rice, quinoa, butternut or acorn squash, cabbage, apple, green beans, lettuce, or even a little bit of Metamucil. The fruits and veggies should be fresh, not canned to avoid sugars, additives and to provide optimal benefit. Just use small amounts until you see results - don't overload her system or you may have the opposite situation! :eek::D

Hugs,
Leslie and the girls - always

[judymaggie]

If not, you might try some plain pumpkin (if you can find any!).

Hi! Here is one option for the pumpkin -- I have never used it for my pets but know others who have used it with good results. I have seen it for sale on Amazon.

http://fruitablespetfood.com/fruitables_digestive_supplement.html

[addy]

Hi Everyone,

Thanks for checking on us. I had a nice stash of cans of pumpkin in the pantry and we have been using it along with the laxative. Seems to have done the trick. Today I will cut back on the pumpkin and the laxative, weaning her off the laxative for a few days. I stopped the melatonin for a few days now.

Last night she pooped like a great dane and seemed very pleased with her self.:) What a relief. For a dog with chronic diahrrea, this was mind blowing:o She seems to feel alot better.

Her lignans came so we will restart the melatonin with the lignans as soon as we are weaned off the laxative and I guess wait to see what that brings.

I might not have to keep using the pumpkin once she has the lignans. I always kept the pumpkin around for her diahrrea. Funny to use it now for constipation!!!!!! How do you go from one extreme to the other???????????????

They sure do keep us on our toes, don't they? But it is hard on the pocket book:(

We see the IMS in a week.

One of Zoe's vets once said to me "Do you every have a dull moment in your life?" One of the dogs had been in to see him almost on a weekly basis for something.

"No, not really", was my answer:)

Addy

[judymaggie]

So glad to read that Zoe is doing better!


How do you go from one extreme to the other???????????????

Speaking from very personal experience, it is quite easy!! :(

[addy]

It is so weird, I have to always be so careful, I could not even give her a raw diet with fruit and veggies in it, she could not tolerate it, she gets diahrrea just thinking about eating something different, her system is so touchy.

She get's Nature's Menu turkey, 70% muscle meat, 30% organ meat, no bone, synthetic calcium instead of bone is in the food with viatmins and minerals. I add 1 tablespoon per meal of Honest Kitchen Embark. Up until now I could never even increase the Embark without getting mushy stools.

The only fruit I could give her is one blackberry. She can eat rice, maybe a smidgen of oatmeal, pumpkin and that is about it.

So I guess we will now learn why she is suddenly going through constipation.:(:(

Addy

[marie adams]

Addy,

So glad Zoe is doing better and you too. You are lucky to haave stocked up on the pumpkin because it doesn't exist here in the grocery stores. Quite a while back I went looking for it to make some muffins and the store manager said they always had it before, but this past year it isn't....

Talk to you later---falling asleep typing this--haha!!

[apollo6]

Hope you and Zoe are doing better. I found pumpkin in some organic baby food, but I can't find it in the grocery store again. The fruits I give Apollo are a slice of apple each day, blueberries a few times a week, melon. Apollo would eat anything. We take better care of our little fur balls and too often forget to take care of ourselves.
Apollo almost has two drawers in the refrigerator, two sliding drawers on the kitchen counter, a portable pantry in the kitchen. What does that say about me? But when he looks at me with those big brown eyes and the floppy ears, I do melt.

[addy]

Hi Sonja and Squirt's Mom,

Zoe LOVES apples! I mean she goes nuts for them. I had to stop giving them to her when she first came down with colitis.

I wonder if she could have a slice a day again like Apollo now that she is constipated?

I think I will try just a little and see how it goes.

Thanks everyone for all the good suggestions.

Oh, since the lignans are fiber and may cause loose stools, do you think that they might help with her constipation? I asked Dr. Oliver that question and he said he did not think they worked that way. I'm confused:(

Addy

[littleone1]

Hi Addy,

Some stores now have Stokley's plain pumpkin. I just got some for Corky. Some of the bigger grocery store chains are now starting to carry it.

Terri

[addy]

Thanks Terri!

I had cans of pumpkin put away but if I am supplementing her food long term, I don't have enough. Her vet won't let me change her diet till we are stable on lysodren.

We will go tonite and look at some other stores.

Thanks again for the help:)

Addy

[Squirt's Mom]

If my memory serves me, the pumpkin shortage is because of flooding the fields last season, rotting the pumpkins. Hopefully, they will have had a better growing season this year and they will be available again soon!

Hugs,
Leslie and the girls - always

[addy]

Hi Leslie,

I asked Dr.Oliver since the lignans are fiber and may cause loose stools, could they act as other fibers and bulk up the stools, absorbing more water, like the pumpkin does.

He thought they did not work that way.

I thought well, if they are fiber and I don't know if they are considered soluble or insoluble fiber, could they not be beneficial for Zoe?

What do ya think????????????????? Or is it not enough fiber to matter? If it can cause diahrrea, you think it would matter.:confused:

Please, oh wise one, your opinion on this matter:D:D

Addy

[Squirt's Mom]

Let me do a little research on nutrient content for the hulls and I'll get back to you. The "wise one" LOL :o has no idea...LOL

[Squirt's Mom]

From what I have seen, flax lignans contain both soluble and insoluble fibers. Here are some links on nutrient analysis. Both links used the same lab for the analysis but the last one also offers another analysis, tho it doesn't say who did it. I hope this helps:

Flax Hull nutrient analysis:

http://www.aidshivawareness.org/flax_why.htm

ANALYSIS OF CONCENTRATED FLAX HULL LIGNANS
Test Results Unit
------------------------------------------------------------
Moisture- Forced Draft Oven 9.30 %
Protein - Combustion 24.96 %
Ash 4.89 %
Fiber, Acid Detergent 18.1 %
Lignan 30-65 %
Fiber, Dietary, Total 51.5 %
Carbohydrates, Calculated 52.64 %
Calories 384 Calories/100 G
Tryptophan 0.24 %
Cystine 0.41 %
Methionine 0.42 %
Aspartic Acid 2.28 %
Theonine 0.93 %
Serine 1.15 %
Glutamic Acid 4.32 %
Proline 0.84 %
Glycine 1.39 %
Alanine 1.05 %
Valine 1.10 %
Isoleucine 0.90 %
Leucine 1.31 %
Tyrosine 0.47 %
Phenylalanine 1.02 %
Lysine, Total 0.88 %
Histidine 0.48 %
Lignin 7.0 %
Arginine 1.88 %
Total Fat* 8.21 %
Saturated Fatty Acid** 0.76 %
Total Monounsat. Fatty Acids Calc 1.30 %
Total Polyunsat. Fatty Acid Calc 5.79 %
Calcium 0.48 %
Phosphorus 0.58 %
Iron 0.010 %
Magnesium 0.43 %
Potassium 1.06 %
Sodium 0.042 %
Zinc 0.0055 %
Niacin 34.4 MG/LB
Vitamin B1 - Thiamine Hydrochloride 7.12 MG/LB
Vitamin B2 - Riboflavin 2.69 MG/LB

*Reported as triglycerides
**Reported as fatty acids

(Analysis done by Woodson-Tenent Laboratories: www.wtlabs.com)


Microbial Analysis for Concentrated Flax Hull Lignans
------------------------------------------------------------
Aerobic Plate Count 50 CFU/g
Yeast and Mold Count 30 CFU/g
Coliform Count None detected
E.coli Count None detected
Salmonella spp.(+/-) Negative

(Microbial Analysis done by Department of Veterinary
& Microbiological Science NDSU at Fargo, ND)


http://www.flaxhulls.com/results.html

FLAX HULL REPORT OF ANALYSIS
Test Result Units
Moisture - Forced Draft Oven 9.30 %
Protein - Combustion 24.96 %
Ash 4.89 %
Fiber, Acid Detergent 18.1 %
Lignin 7.0 %
Fiber, Dietary, Total 51.5 %
Carbohydrates, Calculated 52.64 %
Calories, Calculated 384 Calories/100 G
Tryptophan 0.24 %
Cystine 0.41 %
Methionine 0.42 %
Aspartic Acid 2.28 %
Theronine 0.93 %
Serine 1.15 %
Glutamic Acid 4.32 %
Proline 0.84 %
Glycine 1.39 %
Alanine 1.05 %
Valine 1.10 %
Isoleucine 0.90 %
Leucine 1.31 %
Tyrosine 0.47 %
Phenylalanine 1.02 %
Lysine, Total 0.88 %
Histidine 0.48 %
Arginine 1.88 %
Total Fat 8.21 * %
Saturated Fatty Acids 0.76 ** %
* Reported as triglycerides ** Reported as fatty acids
Total Monounsat. Fatty Acids Calc 1.30 %
Total Polyunsat. Fatty Acids Calc. 5.79 %
Calcium 0.48 %
Phosphorus 0.58 %
Iron 0.010 %
Magnesium 0.43 %
Potassium 1.06 %
Sodium 0.042 %
Zinc 0.0055 %
Niacin 34.4 MG/LB
Vitamin B1 - Thiamine Hydrochloride 7.12 MG/LB
Vitamin B2 - Riboflavin 2.69 MG/LB

Respectfully Submitted,
Woodson-Tenent Laboratories, Inc.
David Gross, Mgr of Support Svcs.

Microbial Analysis for Flaxhulls by NDSU
Microbial Analysis for Flaxhulls

Aerobic Plate Count 50 CFU/g
Yeast and Mold Count 30 CFU/g
Coliform Count Non detected
E.coli Count Non detected
Salmonella spp. (+/-) Negative

(Microbial analysis done by department of veterinary & microbiological science at NDSU at Fargo, ND)

Flaxhulls analysis (unknown source and date)
Moisture 8 %
Protein 35 %
Ash 4.1 %
Fiber 41 %
Carbohydrates 41 %
Lignans (SDG or SD) 3.9 %
or 39 mg per gram of product
The following are per 100grams
Calories 391
Calcium 189 mg
Phosphorus 62.6 mg
Iron 7 mg
Magnesium 374 mg
Potassium 716 mg
Sodium 37 mg
Zinc 4.22 mg
Niacin 1.5 mg
Vitamin B1 019 mg
Vitamin B2 .19 mg
Click on these links for More Reports
E and H Labs 2006
August 2005 NDSU Lignan
NDSU 2002

Hugs,
Leslie and the girls - always

[addy]

Wow Leslie, where do you find this stuff? I did not expect that much info. I thank you from the bottom of my heart and Zoe's too:):)

Addy

[apollo6]

Dear Andy glad to hear Zoe is doing better. I have never concentrated so much on Apollo's pops like now. Some times it 's watery, then like a stick, sometimes normal. I wonder with the weakness in his hind legs and muscles if it is harder for him to go. He has fallen a few times just walking. It just kills me inside , will have to mention to vet , tomorrow.
Send our love and prayers
Sonja and Apollo

[addy]

Hi Sonja,

Zoe has been stumbling a bit too. She has a weakness in her front paw. She had a soft tissue injury two years ago and it bothers her on and off. Funny thing is when she was on the thyroid supplement, it did not bother her at all. Since I took her off the tyroid Armour natural glandular product, it is bothering her again. I agree, it is sad to watch.

I have had to be a poop watcher for 2 years now. But the good thing is I always know early on when something is wrong and can be proactive about her colitis before the flare up gets really bad. I can catch it early so we never advance to bloody poops. I guess that is looking on the bright side of poop detail:confused::):o

Hang in there, girlfriend, it is almost Friday!

Addy

[apollo6]

Dear Andy,
Thanks , today was a little tough. i will post the same on my thread.
The IM0 said he felt Apollo was looking pretty good, until he noticed Apollo stiff walking. He had a neurologist check out says it it muscle atrophy, could be from the cushing. Apollo's skin is somewhat improved, still has a great appetite, hair loss has stopped , some hair has grown back-but very little, still lump in tail (told cystic inflammation and to leave alone-which I have not done)Test done"CBC and Chemistry Profile, Urinalysis, Cystocentesis( to get the urine-go figure?) ACHT Stimulation Test w/o Cort/Antech.
Vet said maybe the good effect of the Trilostane doesn't stay in his system long enough, and maybe will need to give twice a day. Sometimes muscle strength comes back, sometimes no. My husband was so sweet, said if we have to Apollo will get race wheels, we are not giving up on the little guy.
Will get results tomorrow. Nervous.
I cried going home thinking about the muscle wasting. Please tell me it will get better.

[addy]

Dearest Sonja,

I believe with all my heart Apollo will get better. You just started the medicine, give it some time. Twice a day dosing sounds like a good plan to me. Don't cry about muscle wasting, lets see what we can do to make it better. Let's focus on making it better, if we can.

I know how hard this is for you and I am so sorry about that. Dear girlfriend I have tears in my eyes knowing how upset you are.

Okay, time to rally!!!! Cushings will NOT defeat you, repeat after me, Cushings WILL NOT DEFEAT US!!!!!!!!

Let us research the muscle wasting, you will feel better thinking about how to help that symptom. It will give you a purpose and hope.

Love you,
Addy

[marie adams]

Hi Addy,

You are such a GOOD Rallier (is this a word??:D) Keep up the good vibes!!

I think the muscle wasting is part of the game we have to play with cushings. I think just as with arthritis we have to keep them moving. I know Maddie stumbles, her paws sometime bend under, but if it doesn't bother her and she keeps on going then it has to be okay with me--so we all have to be troopers for them. They can sense when we are feeling down; so that is where Addy comes in to save the day!!

Thanks for being there and have a wonderful day with Zoe!!!:):) I get to go fight with my tech department again because for almost 2 weeks my contract system will not work properly and I even got a new laptop:eek::eek:this is how I felt yesterday wanting to pull my hair out or punch something:eek::eek:, but it is Friday and this weekend I get to spend it down at the beach watching the US Open of Surfing Finals front and center (it helps to have a daughter who works the media/PR portion of the event--haha!!):D:D

[addy]

Hi Marie,

I agree, our babies sure know when we are down. I try to rally Zoe and keep her going, sometimes I worry I push her too hard.

Have a wonderful weekend. Surf's up!!!!!:D

Addy

[apollo6]

Thanks for all the input.
Like you said take a break from cushing, after I get the test results.
Praying for a good result.

[addy]

let me know as soon as you get the results too. I am saying special prayers for Apollo and you.

Sonja, it will be all right. I know it will be all right, the tests will be fine, if we keep saying and believing that, it will be so:)

I gave Zoe her lignans today, hoping she doesn't get diahrrea. Oh well, I still have lots of metronidazole if she does:(:(

Sorry you have to worry all weekend about Apollo's tests. I think a trip to the ocean in his red stroller is in order!!!!!

Love you,
Addy and Zoe

[apollo6]

Addy got the results, rushing out the door.
Will post later, good and concerns. will let you know.

[addy]

We are seeing the IMS today for a recheck and to discuss treatment options and Lysodren. Ims orignially told me she would start Zoe on a conservative dose.

My question: I have read on a link here that 50mg per kg is loading dose. I have also read the UC Davis says if dog is not polydipsia loading dose is 25mg per kg. Another paper with a vet from UC Davis just said outright 25mgs per kg, not 50. I think that paper was in our links as well, can't remember which one, I read so many.

If dog's symptoms are mild without polydipsia or excessive hunger and panting, would the 25mg per kg be the more appropriate loading dose?

I have also read members had loading that when on forever with too conservative of a dose.

Just trying to get my thoughts in order before consultation.

Thanks for your help,

Addy

[lulusmom]

Addy,

Both of my little guys loaded at 50mg/kg but they were being treated by an IMS that has been treating dogs with Lysodren for years. I have listened to audios and read every paper I could get my hands on by Dr. Edward Feldman. He's a world reknown endocrinologist from UC Davis that I have affectionately nicknamed Mr. Cushing's. He and a few others I've followed state that vets that are leary of Lysodren will load at the lower dose while experienced vets use a higher or maximum dose. Inexperienced vets will also prescribe prednisone concurrently with the Lysodren, which is a really bad idea because the pred masks signs of loading. We've seen dogs here that have gotten into trouble because their vet used this protocol. I asked our IMS that protocol and he agreed that a lot of vets that use that protocol are uncomfortable with Lysodren.

With no polyuria, polydipsia or a voracious appetite, a lot of vets would not treat with Lysodren with so few symptoms. I personally would be very hesitant to treat my dogs with Lysodren with so few symptoms. I had a foster that was diagnosed with Cushing's. Her diagnostic tests, bloodwork and ultrasound were textbook cushing's but her only symptom was severe skin and coat issues. Her dermatologist prescribed Trilostane and she did quite well on it.

[addy]

Thank you LuLu's Mom,

Zoe's other hormones are high too and she can't have Trilostane, according to the IMS because it could elevate those hormones even more. She has typical and atypical Cushings.

I am hesitant to treat now. Zoe has hair coat symptoms, licks everything and chews, does not want to jump in car anymore, she likes to eat but she doe not beg anymore than my other pup, just more voal about it. But her adrenal panel numbers were sky high. Dr. Oliver said "Significant". Her blood work is not horrible, either,
I really think her numbers were sky high because she had some active infection going on, she had colitis flare up durring all the testing and was severly stressed at the IMS. While I believe she does indeed have Cushings my dilemna is wait to treat ot treat.

After what Kim went through with Annie, I am even more concerned about Zoe and did think perhaps I should continue with the melatonin and lignans and wait for a month of good firm poops, if I can get that and then retest her.

If it was your dog?

Addy

[addy]

http://www.dvmnews.com/dvm/Small+animal+Medicine/Comparing-therapies-for-canine-hyperadrenocorticis/ArticleStandard/Article/detail/460965

this article referred back to an interview with Dr. Feldman and then went on to state 25mg/kg so not sure if that can be traced back to Dr. Feldman or not. Article is from 2008.

it is in our reference links

still looking for the polydipsia article.

Addy

[apollo6]

Dear Addy,
Sounds like you are stressed out , like me. When I started Apollo on the trilostane , I did not listen to the vet, I read on the companies web , site and called their vet specialist, because I felt 30mg was too high, I confirmed to start at 10mg, which was the right choice for Apollo. The vet said it would take longer if I started low, and I said then so be it. If they are started too high , a lot of other symptoms can make things worse. So it was me I would start at the lower dose. Most vets just go by the rules and instead of each individual circumstances. What is good for the majority is not always good for the individual. I would talk to your vet about how you are feeling. If it is a good vet , they should discuss with you.
Hopes this help. Better safe then sorry.

[lulusmom]

Hi Addy,

I have the audio of that lecture given by Dr. Feldman in Seattle and it was this lecture that he mentioned the 25mg/kg vs 50mg/kg. Every hypothetical case he used, the dog was getting 50mg/kg. I'm not quite sure why Dr. Hoskins only picked up on the 25mg/kg in the article. :confused: If you check out the Lysodren Loading Instructions in our Helpful Resources section, you will see that these instructions do indicate the loading dose to be 50mg/kg. You will also see that these instructions are from the Textbook of Veterinary Internal Medicine, which Dr. Feldman co-edited with Dr. Stephen Ettinger. These two gentlemen have written the Textbook of Internal Medicine for years and years. I actually purchased a later edition and boy are they heavy books.

I think your concerns about not having a gauge to determine if Zoe is loaded are justified. I think I mentioned before that I would be hesitant. My Lulu, was on Trilostane for two years before I switched her back to Lysodren. She has typical cushing's with elevations of all intermediate hormones. We went through more than a 30 day washout because we waited until she was symptomatic again. Despite the fact that her intermediates were sky high, she did not become symptomatic until her post cortisol was 25 ug/dl. Lulu weighs less than 5 lbs so there was no way I was going to start loading her until I had something to go on. I made sure her appetite was raging and she was drinking and peeing buckets again.

Dr. Feldman says that the appetite is very important in loading and in order to insurer that the dog has a huge appetite while loading, he recommends that pet owners decrease the dog's food by 1/3 two days before loading. If Zoe's few symptoms become problematic for you and her and you want to start loading, this is something you might want to consider.

Glynda

P.S. I meant to tell you that 25mg/kg is protocol and if you feel more comfortable loading at a low dose, then go for it but be prepared for the possibility that loading will be long and drawn out.

[acushdogsmom]

http://www.dvmnews.com/dvm/Small+animal+Medicine/Comparing-therapies-for-canine-hyperadrenocorticis/ArticleStandard/Article/detail/460965

this article referred back to an interview with Dr. Feldman and then went on to state 25mg/kg so not sure if that can be traced back to Dr. Feldman or not. Article is from 2008.

AddyThe article says:


25 mg/kg, given BIDand BID means twice a day, so the dose referred to in the article may very well mean 25 mg/kg given twice a day, which would = a total of 50 mg/kg/day, just as it says in the Textbook of Veterinary Internal Medicine.

The loading dose mentioned in the Merck Veterinary Manual does say 25 mg/kg/day, so that is indeed an acceptable protocol for loading, but I think that the Textbook of Veterinary Internal Medicine loading dose (50 mg/kg/day) is the more accepted and more commonly used loading dose protocol, especially when the Vet is an Internal Med Specialist.

[addy]

Back from the IMS, I think I am stressed from the long visit. She was very patient, answered all my questions. Her first observation was that Zoe looked "harrier" than last visit. Her hair did grow out longer faster but is still thin. She checked the hair on her tummy and said she sees some new growth there and explained the hair cycles to me.

I told her about the constipation, she thought that was odd. Told her we have not used metonidazole since 7/12 and she started lignans and her poops so far have been good.

Discussed my concerns about starting lysodren without symptoms and she said we will wait 3 months, see if she can have a normal 3 months, no more diahrrea, etc and then retest. I almost fell off my chair because that was what I really wanted to do in my heart. If new symptoms develop then we have to go back to looking at lysodren.

She has different protocols for lysodren depending on symptoms. She seems to treat the symptoms, not the numbers. Don't know if that is good or bad but I feel that way about it too right now.
I asked about how can her adrenal panel numbers be so high and her symptoms so mild and her blood work not as bad as other dogs? She said their hormones can fluctuate just like ours so some vets currently don't like the adrenal panel for that reason, you get false picture with some dogs. Zoe does not follow the norm with this. Also if she was stressed and had infection going on, we get elevated numbers. So said lets retest in 3 months and only do the one test first thing in the am so Zoe does not get so stressed.

She said wait for her to be "normal" for about 4 weeks and then give rabies shot. She said with a dog that has a tendency to be snappish, she recommends the shot. Just wants me to wait a bit longer to make sure she stays healthy.

She is so patient and answers all my questions, I really like the IMS alot. I think I could have a good relationship with her. Also she seems up to date on things, so like that even more.

Hope she knows what she is talking about but right now I trust her. Looks like we enter that "gray zone" for awhile now. I know some of you have been there too.

Zoe was unbelievable, no muzzle, greeted IMS, you would not have known it was the same dog, she was so calm and quiet. I though someone switched dogs on me. She was like she used to be so sweet.

Oh, she detected a slight heart murmur she could not hear before. She said very slight, don't worry about it right now.

That was it. Opinions?

Thanks all,
Addy

[Squirt's Mom]

Hi Addy,

IMHO, your IMS is spot on! :) Giving Zoe a chance to get healthy again and get over her recent problems, and then see if the signs stay and strengthen is the way to go. The signs are so important not only in diagnosing but in monitoring treatment. Your IMS is also right about other problems causing things to look like Cushing's when it isn't.

Treating symptoms (signs) and not the numbers is what we say here. As long as a pup is doing well, the numbers aren't that important. Some pups do better with their cortisol a bit higher, or a bit lower, than the numbers say is right. So treating the dog not the numbers is a good plan.

I am curious about her "different protocols" for using Lyso, tho. This could be an issue down the road depending on what that means if it does turn out Zoe has Cushing's.

For now, YIPEE!!! You and Zoe have a reprieve and I hope it is permanent! But, that doesn't mean you get to just disappear...oh no! You have to keep in touch and let us know how ya'll are doing, ok?

Hugs,
Leslie and the girls - always

[addy]

Hi Leslie,

Oh thank you for your input. First I was relieved after the appointment and then at 2:00 this morning I got scared, worrying the IMS might not know what she is talking about:confused:

I think Zoe has Cushings, I really do. I think we go to watch and wait for 3 months.

IMS did not go into detail about her protocol, just that if she has a dog presenting strong symptoms she will want to go after the adrenal gland and "hit the Cushings on the head and burn some adrenal gland off" i think was the phrase she used and she would load with lysodren. Some strong symptoms IMS mentioned: extreme weight problem so she doesn't have to worry about diabetes, excessive panting all night, excessive drinking, accidents in the house, all the symptoms Glynda mentioned to me, or IMS said milder symptoms, which she did not explain, she would put on maintenance dose "to coax it along" and not load. We never got to discuss the actual dosage.

IMS wants to see what Zoe's coat does when fall comes. She said we might see stimulation of new hair folicles at that time.

I gave Zoe 3mgs of melatonin last night, she is zonked this morning. I will wait a week and try to start giving some durring the day. I sure hope I can keep her healthy.


Why would she behave so differently? She has been terrible at the vets the last 3 times. I sat in the back seat of the car with her and held her and massaged her for the hour drive and when we got in the examining room I had brought chicken and asked her to do some free shaping and she gave me some cute behavior and I rewarded it and then she calmed down and just lay on the floor, did not care I picked her up to put her on examining table, let IMS touch her, OMG, maybe she finally just feels better and nothing hurts?:eek::):D

And don't worry, I am not going anywhere, you won't give rid of me that easily!!!!:D:D:D

Thanks so very much,

Addy

[marie adams]

Yeah Addy!!!! and Zoe too!!!!

Good news!!:D Maddie had too many of the symptoms so it was not an issue to treat or not and the numbers were there also.

I am soooo happy for you, but you have to stick around you have such a good way with words to cheer everyone on.....:D:D

So does this mean Zoe doesn't have ATypical also???

[addy]

Hi Marie,

Atypical? Who knows?:confused:

I forgot to ask. :o

She has Cushings, IMS just wants to wait for more symptoms to develop. Wants her to get healthy before treating with anything other than the melatonin and lignans.

Feels her symptoms only warrant that at the moment. I do not know how long we will wallow along in that area everyone calls the gray zone.

I took vacation time next week thinking I would be loading Zoe. Guess we will try to have some happy time now instead.

I just worry about keeping her healthy.

Thanks for being there for us Marie,

Addy

[MyRudy]

Just wanted to say Zoey is absolutely adorable!!!! My best to you both trying to get this darned disease figured out.

Donna

[lulusmom]

Hi Addy,

For what it's worth, I really like what your IMS had to say. It all makes perfect sense to me. I also understand her different approach to treatment depending on the symptoms. I think I mentioned to you earlier that a cushing's savvy vet will not recommend treatment if a dog is asymptomatic or if symptoms are extremely mild.

I love the way your IMS explained how she would go after the adrenal glands. :D Her description of burning some adrenal gland off could put off a pet owner but I personally think it's great because if the vet is doing her/his job, the pet owner needs to know that Lysodren is one serious drug. I think she made her point with that statement.

I've heard that phrase "we're treating the symptoms, not the numbers" from members who treat with Trilostane. It is exceptable for post cortisol to be as high as 9 ug/dl as long as symptoms have resolved. Some members have found that their dogs do better by letting the cortisol run a little high. I don't believe this is what your IMS was referring to. I believe her rationale is that if a dog has overt symptoms like voracious appetite, panting constantly, peeing and drinking buckets, then she is going to recommend that full on lysodren loading be started. Once you start loading your vet will have shifted gears from symptoms, which are apparent, to the numbers and will be aiming to get Zoe's post stim number in the tried and true therapeutic range of 1 - 5 ug/dl.

If symptoms are mild but troublesome to you, her or both of you, she's not going to be comfortable with loading with such mild symptoms so her plan of attack is a maintenance dose of lysodren to try to reduce the cortisol a bit. This will also reduce some, if not all, the intermediates so that's not such a bad approach.

I don't know about the rest of you but I could be wanting to rip somebody's head off but if you massage me for an hour and then feed me something that activates my salivary glands to the point of making me drool, you will succeed in taking the wind out of my sails and greatly adjusting my attitude. Why wouldn't Zoe feel the same way?

Glynda

[apollo6]

Good for you Addy,
It sounds like your IMO is good. Good luck to Zoe, sounds like she knew when she went in things were going to be okay, and trusts the IMO. All I know is when I go to see my IMO, Apollo seems excited to go in? Maybe he know he is going to be taken care of ?

[addy]

Glynda, Donna, Sonja,

I always take chicken with me to the vet, it just was different this time, can't explain it. Maybe asking her to give me tricks short circuited her brain out of fear, all I know I had my Zoe back for that visit and it felt so good.

Thank you Donna, you baby is pretty darn good looking too!!!!

Glynda- I understood everything you told me I was just so terrified of what would happen to Zoe if I did not treat but IMS says 3 months is no problem for Zoe. I think you hit it right on the head about what IMS was telling me.

The IMS seemed very suprised Zoe had not been on a maintenance dose of metronidazole since July 12th. She did say that if the diahrrea starts up again and Zoe has frequent bouts, we have to revisit the lysodren.

NO PRESSURE THERE!!!!!!!:eek::eek::eek:

If you think I was obsessed with poops before, LOOK OUT!!!!!:D:D:D

Honestly, I feel exhausted right now.

Sonja- I have to check your thread to see what happened today. Need to walk the pups first.

I'll be back!
Addy

Addy

[Roxee's Dad]

Hi Addy,

Haven't posted much but have been following along.


I don't know about the rest of you but I could be wanting to rip somebody's head off but if you massage me for an hour and then feed me something that activates my salivary glands to the point of making me drool, you will succeed in taking the wind out of my sails and greatly adjusting my attitude. Why wouldn't Zoe feel the same way?
Glynda

Made me laugh but but true ;) also the thought that dogs have a keen sense about them and just maybe Zoe felt or sensed the kindness and confidence that your IMS has.

Wishing you continued good luck and like Leslie said, you better not disappear:eek: Need to keep hearing from you and Zoe. :)

[littleone1]

Hi Addy,

I'm glad you found a good IMS. She definitely seems to know what she is doing. My IMS is the same way. When Corky's symptoms disappeared, she definitely told me not to treat Corky until there were clinical signs, which was actually 7 months later.

I hope things go well for you and Zoe. Relax and take some deep breaths.

Terri

[addy]

Oh thank you guys, so good to hear from you.

I don't feel like I have a reprive, I will just be watching everyday for new symptoms:eek:

The thought of trying to keep her poops firm is freaking me out!!!!! This morning I thought I lost a baggy with chicken in it and Koko and I ran for 4 blocks to get home to check to see if Zoe had it. I kept thinking, oh come on, it has only been 2 days!!!!

Now, I have asthma, so that was no small feat, let me tell you!!!!:D:D

Maybe I have revisit to Addy and the muzzlers!!!!

Addy

[littleone1]

I understand how you feel, Addy. I know I was watching Corky very closely, but you will definitely know if the clinical signs are returning. The main things I use to watch were his appetite and water intake. I use to measure the amount of water he drank and the food he ate, so I knew I was giving him the same amounts. If he ate the food I gave him, and then started sitting in front of me looking for more food, I knew something was going on.

Corky hasn't had a normal poop for over 2 years. He had a bad bacteria that actually made them watery. With antibiotics, they finally got form to them, but have never gotten back to normal, and they never will. Don't let it drive you crazy.

Terri

[addy]

So many feel so alone.

I want to share something will all of you, especially our new members and those of you who might feel so alone right now. I came across something I wrote down one month after hearing Zoe may have Cushings. I thought I was crazy with grief and no one would understand.


Anticipatory grief. I did not know it had a name. I am not crazy, just grieving over a beloved family member, my Zoe . I fear the future and what it will bring. Guilt over the past, is it my fault she has this disease? Live in the now? How? I was supposed to write a book. I only finished chapter one. It was to be about a woman and her love for a little dog from Animal Control, written in a warm, witty style. Will it now be of our journey together and how it relates to her disease? Zoe my Zoe, oh, how I love my Zoe. How do I write your story now?

Because of all of you, I can read those words and funny thing, I don't feel that way anymore. I know that no matter where this journey with Zoe takes me, I will never feel that alone again.

Thank you all from the bottom of my heart. And thanks for letting me be a sentimental drip tonight:):) Maybe soon I will be able to work on my book again.

Addy and Zoe

[apollo6]

I pray and hope you do write that book, it would be so wonderful.
I felt exactly the same way.
Will post on my thread what my other vet said.
I am very tired tonight.

[addy]

I am rereading the medical notes from Ims visit last Monday.

Heart ausculation, maybe Grade 1-II/VI systolic murmur, normal lung sounds.


Questionable new finding of a mild heat murmur. Heartrate is reasonably slow and no arrhythmias are detected. Full cardiac assessment not indicated at this time. Will listen at each follow up visit. Continue to monitor for any signs of heart disease such as cough, collapse, shortness of breath or exercise intolerance.


Please talk to me about this.

My Koko came back from groomers and she said he had alot of mosquito bites. We are having the worst mosquito season on record. I had Zoe tested early July and we started heartworm medicine then but I read she should be retested in six months since I started her later in the season. Could heartworm cause heart ausculation?

Could those of you using melatonin and lignans share experiences? Zoe has been on for 3 weeks now. I did read Squirt's thread about how it affected the nails - growing faster. Is it about 3 months before her hair may start filling in? Zoe feels like she put on a little weight, I cut back on her food, could it be the lignans? It has been very hot so not walking much, maybe it is lack of excersise.


I'm sick, so hope this post makes sense!!!!:o

Addy

[lulusmom]

Hi Addy,

Some dogs are born with heart murmurs and like humans, can develop a heart murmur with age due to valve disease. Parasites that cause anemia can also cause a heart murmur but unlike the first two causes, the heart murmur can go away once the parasites are gone and the anemia has been corrected. My Jojo has a slight heart murmur and his IMS monitors it every time he goes in for a stim test. He's been our boy for over three years and there has been no change. Working in rescue, with emphasis on seniors, we see a lot of dogs with different levels of heart murmurs. Some of our most serious cases are still doing well with medication.

I don't think the lignans are causing Zoe's weight problem. Lulu was on lignans and melatonin for quite a while and she didn't gain weight. As a matter of fact, she lost weight. There is no guarantee that these supplements are going to be effective or completely effective. I believe I've read that these supplements have only a 40% to 50% effective rate. It is also a long term proposition and it's not uncommon to see no improvement for a few months. UTK usually recommends that you wait three to four months and if no change is noted then they usually recommend adding a maintenance dose of Lysodren to the treatment regimen.

I hope you feel better.

Glynda

[addy]

Thanks Glynda,

Since she has had normal poops again, it seems like she has beening gaining weight. I usually like her about 18 pounds, but she was 18.5 at the vets and she feels like when she weighs 19-20.

Will continue to cut back on food and up the exercise if the weather breaks. I think hubby has been sneaking her extra turkey!!!!!!! He overfeeds all of us:):)

I guess I was just worried could she have heartworm and was that causing the sound the IMS heard? We only have one cadiologist in this city. Not alot of choices if I need one!!!!!!!!:confused::):(

Thanks Again,
Addy

[lulusmom]

Addy, I think if your IMS had any inkling at all that Zoe could possibly have heartworms, he would have recommended a heartworm test. If you are concerned about it, be sure to talk to your IMS about it.

[Marlene]

Addy,
I read your post citing your initial "aniticipatory grief". It really hit the nail on the head for me. I keep thinking I have GOT to stop this. I am very weepy. I went out for the day today with my daughter and grandchildren although I had to make myself leave Lacey. I know I am being crazy, so I'm trying to make myself stop. I need to stop dwelling on what can happen every minute of the day. She is actually doing very well right now. I want to enjoy that as I always have in the past.

I, too, am so very appreciative of this "home" to go to where I can post my fears, post my questions, chat with people who are experiencing what I am and who are completely dedicated to their doggies.

I feel like my head is going to explode sometimes. I have read everything I possible have time to read. I am actually getting pains between my shoulder blades from sitting here at this computer searching and reading. After reading your posts, I am wondering if Lacy should start treatment yet. Of course, she hasn't finished her testing yet, but everything seems so nebulous. Nothing seems to be black and white. I am like you in that I watch her constantly to see what symptoms she might have today. In addition to her possible Cushing's, she has heart failure. So I listen to her lungs. I see if she looks exhausted. She seems to be doing fine in those areas. But then, I try to determine how she is doing with Cushing's symptoms--how many, how severe. Her hair is no different. She has lots of energy and is still chasing and playing with our cat. She jumps up on a fairly high chair to look our the window. I monitor her going up stairs to see if I see any weakness developing. I haven't seen any. She does drink quite often, but she is on Lasix. She doesn't seem to pee a lot more than usual. She has had some accidents in her sleep. Maybe two in the last month. She whines for the cat food she can't have but doesn't seem to be ravenous about other food. She pants. She has developed a pot belly. She does feel warm to the touch. And, like I have seen others remark about here, she no longer wants to sleep on our bed, but prefers the cool floor. I, too, watch to make sure her poops are ok. I see that you are giving Zoe melatonin and lignans. I wonder, "Should I be doing that for Lacey?" I don't even know what lignans are!:o So, I will start on another search to see what they are and whether I should know about these things and be using them. This post is getting waaaaay too long. I will stop there, but obviously, while you are freaking out I am over here driving myself UP A WALL!!!:D:D I completely understand where you are. Thank goodness, the vet at CSU is very willing to answer questions because I have a list for tomorrow!!:)

I just wanted to tell you I saw your picture of Zoe on the couch, and she is so cute. I hope she remains symptom-free for a long while!
Marlene

[Casey's Mom]

Its okay Marlene - take a deep breath and relax. Lacey sounds like she is in pretty good shape and cushings is a very slow progressing disease so you don't have to rush into any treatment without having all test results and information in hand.

Relax and give Lacey some belly rubs from us:)

Love and hugs,

[addy]

Sweetie Marlene,

Remember to breathe!!!! Do you know that when Zoe has her flare ups and one day would have bad poops and the next day good poops, I did not realize it but I was holding my breath every time I took her out. This made her worry about her poops!!! I had to remind myself to BREATHE Addy!!! and smile at her no matter how bad her poops were.:)

You are not crazy. it is anticipatory grief truly. I have a saying, when I would get so overwhelmed I would tell Cushings out loud to get in the drawer, I would even open a drawer and say out loud "get in the drawer NOW!!! and don't come out!!" and I would physically close the drawer. If I was in the car, I would open the glove box and do the same thing. Try it, it helps!!!!

Heart problems can have some of the same symptoms as Cushings from what I read recently, I will go on your thread

Addy

[Squirt's Mom]

Ok, girls...what ya'll have going on is called "twitching"...something some of us are really good at, myself included! :p When we find ourselves looking at every little thing and going, "gasp! what is that?", "what does that mean?"....then you know the twitcher has been engaged. :D

Twitching is a fairly common phenomenon among parents in the canine Cushing's world and we are all subject to it's power at one time or the other tho some of us are more prone to twitching than others. :o:p It isn't a fatal condition tho at times it feels like it just might be and, while not actually contagious, it can spread.

At it's most extreme, victims will look like they have just seen a ghost...pale, hair sticking out on ends, eyes bulging and darting around, drool or actual slobber around the mouth, extremities trembling, and a distinct inability to concentrate. In it's milder form, victims can look and act absolutely normal but you can hear the tremble in their voices that indicates a full blown episode is just below the surface.

Twitching is usually not a long term condition but comes and goes in those of us afflicted. Once victims learn what is happening to them and that they are not going crazy and not having a heart attack or stroke, the episodes are not as scary...to the individual afflicted anyway. :p

I hope this helps! :p

Hugs,
Leslie and the girls - always

[Roxee's Dad]

Hi, my name is John.....I am a twitcher. :o

I haven't had a twitch for about 20 days, I am tempted to twitch when one of my pups misses her poop times or leaves food in the bowl. When I get the urge to twitch, I get on line and talk to my fellow twitchers....:o:o;):D

I am and will always be a twitcher. :p

[addy]

lol,

confessions of a twitcher!!!!!!!

is there a club called twitcher's anonymous? I think I need to join. Now I may be sick, but I am laughing so hard I think I split my side.

actually, Zoe came back from the groomer and I was just thinking how good she looks and she didn't even bite anyone!!!!:D:D:D


Thank you!!!!

Addy

[Loladog]

It's nice to know that I now have a name. "Twitcher" instead of just a neurotic, anxious mess!:D I've been so anxious lately about Lola that I feel like I need to go on some permanent medication. Lola probably thinks that I'm the one that needs medical attention, not her.:D Yes, I also look at all of her poops daily to see how things are going.:o My life lately revolves around Lola and her symptoms or lack of but that comes with the territory when you love someone dearly. It's nice to know that there are so many others here that are going through the same thing.:)

[apollo6]

I must be a twitcher also. :D But I think I am a poop inspector also.
It is pretty bad when my husband calls me from across the lawn and says you better check before I pick up.:p I think I am watching Apollo like a hawk. Is heat intolerance a cushing thing? It is not that hot here and Apollo is not doing well in the heat. His body seems warm a lot?
On the lighter side Apollo and our Karma were moaning and shrieking the other day, so my husband and I joined in , they looked at us like we were crazy.:eek:

[MyRudy]

Haha, I can just see the 4 of you moaning together!:)

I don't think heat intolerance is a cushings thing because Rudy still goes outside to lay in the sun every day and it is right around 100 degrees here.

[addy]

sometimes when Zoe and Koko are barking at something outside, my husband and I will start barking too. It drives the dogs nuts. We probably should not tease them but we can't help it:D:D:D

I'm afraid to say anything about Zoe in fear she will contradict me.

She looked so pretty when she came back from the groomers, though her tail looked bad and you could see how thin her hair was along her spine. But boy, did she strut her stuff, so she obivously felt pretty good getting all cleaned up.

My week of being a stay at home mom is over and it sure was nice to be home with my babies and walk whenever we wanted, play whenever we wanted. If I did not have two dogs at work to hang out with, life at work would not be good. My boss has a pug, a rottie/lab mix and a South African mastiff, the last two were adopted from a rescue group and they stay at work, while the pug goes home with him. The mastiff sleeps in my office under my desk most of the day, what a gentle giant!!!!! The lab/rottie is smart as a whip and so easy to train, I love teaching her things.:D

Everyone at work thinks I am dog nuts so I have to be careful how much I talk about them:mad:

I am trying very hard not to twitch!!!!;)

Love you all,

Addy

[frijole]

Haha, I can just see the 4 of you moaning together!:)

I don't think heat intolerance is a cushings thing because Rudy still goes outside to lay in the sun every day and it is right around 100 degrees here.

Wow... that is strange because cush dogs LOVE to lay on cool tile. They really don't like the heat... Rudy must be 'special'. ;):p

[apollo6]

Good to be a little light hearted.
Our other dachie, Karma is the store mascot, she owns the place. When we pay for their in cabin air fares, I always write head of security.

[addy]

Hi All,

Okay, so after the great discussion on Dena and Simon's thread I am reviewing everything. I don't think you can classify it as "twitching" :)

I found the below quote in our reference section.

Question one- Zoe's acth test- Cortisol ng/ml 47.7 before (normal range=2.1-58.8) after 304.4* (normal range=65.0-174.6) from UTK adrena panel

is the unit of measure ng/ml a different unit of measure from what I highlighted in the below quote which is nmol/l?

Question two- how many of our dogs were over 500 nmol/l on original acth test?

Just investgating.:cool:


Dogs with hyperadrenocorticism theoretically have an exaggerated response to ACTH. The absolute post-ACTH cortisol concentration is most frequently used to assess the response during an ACTH stimulation test. Although values above the reference range are frequently cited as abnormal, most clinicians use a value that significantly exceeds this range, often between 600 and 650 nmol/l. Approximately 80% of dogs with PDH have an exaggerated cortisol response to ACTH while only approximately 60% of dogs with AT have such results. Despite the low sensitivity of this test, an advantage is that it is highly specific (approximately 0.9) and has a relatively high positive predictive value. The likelihood of an abnormal result in a non-cushingoid dog generally increases the more severely or chronically ill the animal is. Occasionally, dogs with AT have a subnormal cortisol response to exogenous ACTH.

In conclusion, an abnormal cortisol response in a dog with suspicious clinical and clinicopathological features is supportive of hyperadrenocorticism but provides no information on the site of the lesion. Although abnormal results can occur particularly in an animal known to have concurrent non-adrenal illness (e.g., unstable diabetes mellitus), a more common diagnostic dilemma is finding a reference range (or rarely subnormal) cortisol response in a highly suspicious case. Decreasing the post ACTH cortisol cut-off point (e.g., to approximately 500 nmol/l) for hyperadrenocorticism improves the test sensitivity with minimal effect on specificity and helps improve the diagnostic performance of this test. Alternatively, a more sensitive diagnostic test should be considered in these suspicious cases.

addy

[Harley PoMMom]

is the unit of measure ng/ml a different unit of measure from what I highlighted in the below quote which is nmol/l?

Yes...ng/ml is the abbreviation for nanograms per decilitre (conventional units) ; nmol/l is the abbreviation for nanomoles per liter (SI units). What we are used to seeing are ug/dl (conventional units). To convert the nmol/l into ug/dl, divide the nmol/l results by 27.59 but this is for cortisol only...500 nmol/l = 18.12 ug/dl. For the UTK results, just move the decimal point over one place...304.4 ng/ml = 30.4 ug/dl.

Hope this helps.

Love and hugs,
Lori

[apollo6]

Dear Andy the figures don't make sense.:confused:
Apollo's first reading was as follows:
CORTISOL SAMPLE 1 6.9 (RANGE 1.0-5.0 UG/DL) HIGH
CORTISOL SAMPLE 2 37.0 (RANGE 8.0-17.0) HIGH

THIRD READING AFTER TRIOLSTANE USE
(READING DID GO UP FROM PREVIOUS)
CORTISOL SAMPLE 1 2.9 (RANGE 1.0-5.0 UG/DL)
CORTISOL SAMPLE 2 5.1 (RANGE 8.0-17.0) LOW
Hope this helps.

[Harley PoMMom]

Hi Addy,


In conclusion, an abnormal cortisol response in a dog with suspicious clinical and clinicopathological features is supportive of hyperadrenocorticism but provides no information on the site of the lesion. Although abnormal results can occur particularly in an animal known to have concurrent non-adrenal illness (e.g., unstable diabetes mellitus), a more common diagnostic dilemma is finding a reference range (or rarely subnormal) cortisol response in a highly suspicious case. Decreasing the post ACTH cortisol cut-off point (e.g., to approximately 500 nmol/l) for hyperadrenocorticism improves the test sensitivity with minimal effect on specificity and helps improve the diagnostic performance of this test. Alternatively, a more sensitive diagnostic test should be considered in these suspicious cases.

This quote speaks volumes to me but particularly the last two sentences. My boy Harley had normal cortisol levels in the beginning of his cushing's journey but he had all the prevalent cushing's symptoms. I had every test I could think of done on him...both of his endogenous tests came back high, which meant he was PDH but his ACTH stim tests kept coming back within the normal ranges. So at that time I did not pursue any type of conventional treatment, like Lysodren or Trilostane, I just kept treating him with the melatonin and lignans. Which now I know, at least for Harley, this was not the way I should have gone. Cushing's is a clinical disease and my boy did have all the commom symptoms but I was so focused on them normal stim numbers.

I should have put stock in the endogenous tests and his two ultrasounds plus his clinical signs that were telling me that Harley has PDH and needed to be treated with conventional medicine, but I waited until his ACTH stim test told me so, and it's been a rough road trying to get his cortisol under control...we're not there yet but I hope soon we will be.

Love and hugs,
Lori

[addy]

I could never figure out why Zoe's numbers were not like anyone else's. Now I see if I convert the measure by moving the decimal, Zoe was 4.7 pre and 30.4 post stim. I did not know how to convert it so THANK YOU:):)

So how high is that? Now I am worried about IMS plan although I understand it. How much of that 30.4 could be from stress and her bad flare up?

I think I will just keep the current plan of seeing if she can stay healthy, stool wise, and retest in 3 months unless new symptoms develop. She has been so happy the last few weeks, throwing toys around and just calmer. I think a big part of that is her tummy does not hurt anymore from all the gas and pains from her bad poops.

She actually acts happy after she poops now. Do you know I scared her and made her nervous because I was holding my breath waiting to see if it was going to be bad? I didn't know I did that. Now I make sure I put a smile on my face and BREATHE while I wait for her to go.:o

I hope I am not making a mistake by waiting 3 months. I really worry about that sometimes.

Oh, she is starting to get fuzz on her belly where she was shaved for her ultrasound:D

Thanks for all your help, it makes it so much easier to understand.

Addy

[apollo6]

Dear Addy
I am not a tech but the first reading is within the range . The second reading is high (Apollo was 37 when he started) Apollo first reading was also high. So don't know what to tell you.:confused:
This stuff can drive you crazy. Best to go over with the vet.

Hope this helps.

[Franklin'sMum]

Question one- Zoe's acth test- Cortisol ng/ml 47.7 before (normal range=2.1-58.8) after 304.4* (normal range=65.0-174.6) from UTK adrena panel

is the unit of measure ng/ml a different unit of measure from what I highlighted in the below quote which is nmol/l?

Question two- how many of our dogs were over 500 nmol/l on original acth test?

Just investgating.:cool:

Hi Addy,

I think UTK uses different cortisol measurements for their panels, then what regular labs use for regular cortisol testing. Franklin's cortisol results from his UTK panel in May 2010 were
pre: 46.5 ng/mL (2.0-56.5) post: 151.2 (70.6-151.2) If you look up other members' results, you'll notice sometimes there's a difference in what UTK considers 'normal' for the post measurement. Neuter/spay status comes into it, maybe also the age of the pup.

Franklin's first stim test ever (May 09) was pre 345 nmol/L, and post 1031 nmol, which converts to 12.50 ug/dl and 37.36 ug/dl.
Hugs to you and Zoe,
Jane, Franklin and Bailey xxx

[addy]

Now that I know how to convert I will go back and read other's tests. That is Zoe's original adrenal pane from the end of May.

All I know is she is right now running around the house wrestling with Koko which is something she has not done since March when her colitis first flared again and she was then sick all those months.

My mouth is dropping down to the floor:D

She has only been on the melatonin 2 times a day and lignans for a month. I started everything one at a time with her in July, slowly increasing the dosages.

I am greatful for today.:D:D:D

Addy

[apollo6]

So glad to hear.
:D

[addy]

Thanks sweet friend for sharing my joy even though you had such a bad day.

I hope I can remember Zoe's good days when the bad days come around. it is so hard to do sometimes.

I have had my Zoe such a short time and she has been sick so much of that time. Yesterday I was so very greatful to see her play again.

Love to you and Apollo,

Addy

[apollo6]

Dear Addy
Thanks for the encouragement. I was an art major way back when then switched to business administration. I feel like all I do is go to doctors with Apollo, Sept 7 another ACHT STIM test, then same day neurologist check if stiff gait is from muscle loss or hip problems arthritis.
Sept 10th acupuncture for his back(he likes that) then Sept 24th yearly check up, titer test to check if vaccines still working. Stopped 2 years ago with vaccines.
When I read how many of our cushing babies get overdosed starting too high a dosage, I just don't want to increase Apollo's if I don't need to. This is so difficult at times to take.

[addy]

Hi Sonja,

That is alot of doctor visits, once you get the hind legs figured out and his dosage right, it should calm down. I don't blame you for not wanting to increase, but if you go small amounts, than maybe it won't be scary for you, that is if you need to do it.

I know I am lucky to be in reprieve but I also know it isn't going to last!!!!! I just keep watching and waiting:(

I have a four day weekend so am home today with my pups, weather finally broke, it is cool and I hope to get some gardening done if the pesky mosquitos are gone.

You should turn to your art for stress therapy, your talent is amazing, don't let that fall by the wayside. It would be theraputic for you:)

Hugs to you and the pups!!!

Addy

[apollo6]

Enjoy some quiet time this weekend.
Hugs from Sonja and licks from Apollo.
P.s. I think Apollo has eyes for Zoe.:p:D

[littleone1]

Hi Addy,

I was glad to hear that Zoe is doing good. It's always such a good feeling when they start playing again.

[addy]

Thank you Terri:)

Zoe is finally on 3mgs melatonin twice a day. I kicked her up to the last mg for her morning dose Friday. I knew I would be home with her for 4 days to observe.

We had a loud thunderstrom this morning and she went on top of my bed rather than underneath it:) I put some classical music on for her, rubbed her ears and she seemed pretty calm.:) Curled up on my pillow, what a sight, not at all spoiled do you think?:rolleyes:

I was worried she would be total zonked out from the melatonin but she's handling it better than I thought!:) I can't believe I will soon have to order more lignans!!!

Her weight came down too. I had cut back a tad on her food and perhaps the lignans kicked in now and her weight is good, tummy does not look bloated and tight at all.

Did Corky lose weight on melatonin and lignans? I know Glynda said her pup did. I almost started twitching thinking oh no is she diabetic now? :eek: I then banished that thought from my mind although I do worry about it.:o

Happy Labor Day!!!! No laboring allowed:D:D:D

Addy

[Marlene]

Addy,
I just finished looking at your new album. Cute, cute. I have read about older, weird ladies (I fit the description so far:) )who have 20 or so dogs in their homes. I think I could easily become one of those.:eek: I love the baby pictures here. I could just reach out and hug Zoe and Koko.

I do want to start Lacey on Trilostane. Her skin problem just started this week and is concerning me.
Hugs,
Marlene and Lacey

[Squirt's Mom]

Squirt lost a little weight at first...but, like her mom, has no problem finding lost poundage! :rolleyes::p

Her weight fluctuates between 13 and 16 lbs. depending on her activity level. I try to catch her before she reaches that 16lb. mark and reduce the calories she intakes. She needs to stay 14lbs. and under. I have learned that a medium Milk Bone will last at least a week; she doesn't care how much of a taste she gets at once as long as she gets a taste! So they get broken into the tiniest little pieces and she's just as happy as if I gave her to whole thing! ;)

Hugs,
Leslie and the girls - always

[littleone1]

I'm so glad that Zoe is doing so much better, Addy.

The only time that Corky takes melatonin is when we have storms. He can have 3mg a day, so I cut the pill in half and give it to him as needed twice a day.

Before Corky started treatment for Cushings, he was almost 24 pounds, which was high for him. He always weighed between 18-20 pounds. His weight is now normal for him. He did lose the weight quickly.

I hope that Zoe continues to do well.

[apollo6]

Glad to hear Zoe is doing better. Today I go for Apollo's ACHT STIM test, and neurologist about hind leg weakness.
Hugs Sonja and Apollo.

[addy]

Thanks, Sonja, Leslie Marlene and Terri:)

Terri- Hope Corkster has a good day too on his twice daily dosing
Sonja- Good luck at the vets
Leslie- You always have such good advice!!
Marlene- Hope Lacey is feeling better

Zoe's weight was better of grain but then when she got her flare up and I took her off the thyroid supplement, armor, she started gaining weight though I did not increase her food. I have cut her food back a bit now and try to make her walk up the hill in front of our house as much as possible but it had been such a hot summer:( She took that pound off pretty fast and I did not really cut back that much on her food.

I have this bad feeling this reprieve is not going to last. Maybe because of what I have been through with her on other health things. I just can't shake this feeling things are going to go down hill. I am trying to take one day at a time and be grateful for each day but I have this gnawing in my belly that won't go away:mad:

Thanks for all your input, it helps:)

Addy

[addy]

Hi All,

I don't want to restart the rabies vaccine debate but I just wanted to share with you:

As I weigh my options and risks verses benefits for Zoe, I came across the name of the doctor at our University in Madison, Wisconsin who is researching the vaccine in hopes to change the laws to being required every five years or more. He is researching it in conjunction with Dr.Jean Dodd. So I thought, I'll go straight to the horses mouth, so to speak and I found his email address. I thought, well, I have nothing to lose maybe he will answer me.:cool:

AND HE DID within an hour!!!!! :D

I just thought that was so cool and how it just shows if you reach out people will sometimes respond.:)

We sure live for little things, don't we? Doesn't take much to make us happy. When you think about it, we are blessed in that regard because we know we have to take time to stop and smell the roses :)

So I just wanted to acknowledge Dr. Schultz's kindness to me.

Addy

[apollo6]

Dear Addy
Thanks for the concern.
Will try to post more tomorrow. I am not doing the rabies shot. My vet who does the acupuncture says with the cushing , Apollo has enough going on, so doesn't want me to do. I know of some dogs who had horrible reactions to the shot. I know a few people who should get a rabies shot.:D:eek::p

I just starting crying out of the blue about everything today, like a running faucet. Sometimes we just need to let it all out.
Take care my friend , How is Zoe doing.

[addy]

Hi Sonja,

I'm waiting a bit on the rabies shot too per my conversation with Dr. Schultz. Would like to wait a few more months, closer to the 4 year mark if possible. She is not snappy anymore when you pick her up. I keep giving her chicken before, during and after we pick her up, she is happier again about it and stopped trying to bite. Also, I think it does not hurt her now to be picked up since her tummy is better.

QUESTION:I have to be careful with the lignans with Zoe, her system is so sensitive. I have to split the dose up, she gets one capsule in the late morning in a snack and 1 capsule in the evening with a snack. This has worked well for her and her system is tolerating the lignans. I want to add another 1/2 capsule but when I added it to the evening dose, it bothered her tummy. You could tell the way she laid on the floor. Could I give the 1/2 capsule with her evening meal, 2 hours before the night time capsule? Does it matter she does not get the lignans in one dose? I did that last night and she was much better.

Also do I have the dose right? She is 18 pounds so needs 18 mgs lignan. Vitacost is 40mg capsule with 20% lignans so I figure 8 mgs of lignans per capsule. 2.5 would be 20 mgs but I would rather be over than continue under if she can tolerate it.

Suggestions? Thoughts? Thank you for your help and experience:)

She has again adjusted to the extra 1 mg of melatonin and was perky last night when I got home from work. Can't believe how slow I have to go with all of this so we don't tip the scales out of favor:eek:

ONE MORE THING- I just reread in our Resource section about the intermediate and sex hormones. I did not know that a NAI could cause elevation in those as well:eek: Does it make sense that Zoe's Estradiol was elevated before she was stimmed then went DOWN after? What is that about? She was elevated 4 out of 5 intermediates BEFORE she was stimmed. I keep trying to research that.

LAST THING- I want to thank ALL of you who have posted on my thread. I appreciate your experience, knowledge and support so very much:) I feel I learn something everyday and Leslie and Glynda and John, thank you for making me laugh when I need it so badly:D:D:D

Love to all of you,

Addy

[Harley PoMMom]

QUESTION:I have to be careful with the lignans with Zoe, her system is so sensitive. I have to split the dose up, she gets one capsule in the late morning in a snack and 1 capsule in the evening with a snack. This has worked well for her and her system is tolerating the lignans. I want to add another 1/2 capsule but when I added it to the evening dose, it bothered her tummy. You could tell the way she laid on the floor. Could I give the 1/2 capsule with her evening meal, 2 hours before the night time capsule? Does it matter she does not get the lignans in one dose? I did that last night and she was much better.


With Harley having such high elevations in his estradiol I did give him more than the required recommended dose and I did split it up...some in the morning and some in the evening.



Also do I have the dose right? She is 18 pounds so needs 18 mgs lignan. Vitacost is 40mg capsule with 20% lignans so I figure 8 mgs of lignans per capsule. 2.5 would be 20 mgs but I would rather be over than continue under if she can tolerate it.


By my calculations you are correct! ;):D



ONE MORE THING- I just reread in our Resource section about the intermediate and sex hormones. I did not know that a NAI could cause elevation in those as well:eek: Does it make sense that Zoe's Estradiol was elevated before she was stimmed then went DOWN after? What is that about? She was elevated 4 out of 5 intermediates BEFORE she was stimmed. I keep trying to research that.
Addy

I don't if this will help you or not, this is email I received from Dr Oliver about estradiol:
Estradiol is definitely not affected by ACTH or Dexamethasone, so you almost always see similar baseline and stim results in our canine adrenal panel. In fact, the baseline tends to be higher than the stim values in most cases. In Harley’s case, they are virtually identical. The estradiol can definitely be secreted by adrenal tissues and primary adrenal tumors, but also is formed in other places, like fat cells, hair follicles and the liver. If other hormones are increased on our panel, then it’s likely that the estradiol is being secreted by the adrenals.

You're doing a wonderful job, Addy!

Love and hugs,
Lori

[addy]

Thank you Lori!:)


The estradiol can definitely be secreted by adrenal tissues and primary adrenal tumors, but also is formed in other places, like fat cells, hair follicles and the liver.

If the estradiol was formed in the hair follicles could that be why her coat and tail are bad?



If other hormones are increased on our panel, then it’s likely that the estradiol is being secreted by the adrenals.

Does that point to adrenal tumor? IMS said thought Zoe had PDH though one adrenal gland was slightly
larger than the other, she did not think adrenal but I did not do low dose dex test because of Zoe's stress levels, so would that mean we don't really know for sure what kind she has?

Lori- I am thinking of adding maintenance dose of lysodren when I have to. My thoughts are: she is soooooo touchy and I never know how she is going to react and she will get diarrhea at the drop of a hat. My thought was if I did maintenance dose first, I could see how she adjusts to it. If I did maintenance dose first does that have any negative impact if I would have to change to loading? Just thinking ahead, trying to plan the end of the reprieve.

Thank you:)
Hugs,
Addy

[gpgscott]

If I did maintenance dose first does that have any negative impact if I would have to change to loading? Just thinking ahead, trying to plan the end of the reprieve.

Thank you:)
Hugs,
Addy

Hi Addy,

I don't see a bit of downside going the route of maint only Lysodren in a pup with symtoms and diagnostics supporting a Lysodren treatment. If the cortisol is near normal I really don't see another way to approach it. If a Dr. decides later that a loading is required I can imagine you would have two approaches, either suspend treatment for up to a month or resumption of significant symptoms or just be acutely aware that the Lysodren already circulating in the pup's system will likely result in a very short loading.

Scott

[apollo6]

Wish I could help.
Apollo is falling a lot, will hold off on rabies shot, may not do at all.
But can't give input on this.
You and Zoe are in my prayers.

[addy]

something is wrong. I upped the last 1mg of melatonin 2weeks ago today. She was very spacey the first day and I changed our routine that day and she had a potty accident in the house. I attributed it to being spaced out on the melatonin. She seemed to adjust to it now and was perky when I got home from work the last two nights. Tuesday night I took pups for ride in the car, she jumped from back seat to front seat and then later when koko tried to join her on the car seat she held up back foot. Last night and this morning she could not jump on the bed but walks fine. Back leg seems stiff and would not let me stretch it out. We did not walk this morning, give leg a rest, now since she is up and moving I can stretch it out. But she came to me while I was getting ready and I did not think much of it, she had been out to do her business an hour before. She came to me again so I stopped and took her outside and she peed. But then in the house I found a pee accident. I don't think it was Koko, judging from her behavior it was Zoe. Also last night she wanted to sleep with me. She only does that when she does not feel good or a bad storm is coming. We had no storm.

1-Cushings getting worse
2-UTI
3-Diabetes
4-some kind of stone

She has been licking her potty off and on for the last year but we never find a UTI, she stopped for awhile the last 2 months and only did it occasionally, she is licking it more now.

This has just been since we upped the melatonin to 3mgs 2 times a day. Both accidents were in the AM not long after I gave her the melatonin.

Not sure what to make of this. Thoughts?

Addy

[Squirt's Mom]

Hi Addy,

When Crys developed struvite crystals, she would lick her privates a LOT! She never developed stones and we treated her with anti-biotics and diet. The vet explained that the crystals irritate the urethra as they pass plus some will stay in the tubes, etc. causing more irritation, so they lick to sooth the area and try to remove the "pricklies".

I don't recall reading anything about melatonin having any affect on the crystals, but I was only concentrating on struvite and there are other kinds, each caused by different things.

When a pup is constantly licking, that usually indicates some problem somewhere and I would think your vet would have looked for crystals in the tests for UTIs, but one never knows.

Just my 2 cents worth as usual! :)

Hugs,
Leslie and the girls :D - always

[Roxee's Dad]

Hi Addy,
Good input from Leslie, I just wanted to add that Roxee was checked numerous times for a UTI but came up negative. I was sure that something was wrong and insisted on a culture. Culture came up positive and she was put on antibiotics and cured.

I insisted because she was licking and because of the discoloration and some clumping of stuff around her private parts. We called it her twinkie :p Most dogs I have groomed that have a brownish discoloration seem to have some kind of infection and many times it is a yeast type infection.

[addy]

Oh John and Leslie, thank you for the good input.:) Leslie, your 2 cents=1,000,000 cents:) Then I can call IMS and ask to bring her in for a culture?

I think I forgot to breathe this morning when I posted. I have been so scared she will develop diabetes and then with the leg thing AND the accident today I panicked:eek:

How do they find stones and crystals, through a culture too? I kept telling the vets she never used to lick herself before but they poopooed me:mad: They said well, maybe that is just the way she is. IMS did urine test and said it was clear and did not think much of the twinkie (thanks John, I like that)licking either.:confused:

I think I should insist now. For awhile I thought it was the wet grass in the morning bothering her twinkie but with 2 accidents in 2 weeks, something is wrong.

Thank you so very much for your input!!!!

Addy

[Roxee's Dad]

I kept telling the vets she never used to lick herself before but they poopooed me

When the 1st vet said no UTI for the 3rd time, I asked about the gunk around Roxee's twinkie? The vet took her in the back room and shaved it and brought her back to me. :eek::mad: Well heck I could have done that but it didn't cure the cause. Last time I saw that vet!

Not saying you should give up on your vet. This all happened in my early days with this forum and one of the family team here recommended I get a urine culture about the time I was looking for a vet with some experience in cushing's. Finally found one that was a little over an hours drive each way.

Just another note...Their can be numerous reasons for the licking, pain, irritation, with my Rozee, she will start licking herself when she needs to go out and pee. Since her leg problems, she is totally dependent on us to help her relieve herself. So if she is licking, I feel like a bad daddy cuz I waited too long to take her out.:(

[addy]

she licks herself after peeing, it is the only time she licks herself. sometimes she will squat once and urinate, sometimes twice, she was licking after every pee but then she stopped and only did it infrequently. Could have been around the time she was on metronidazole. She had the staining on her twinkee, paws and face but after i stopped the armor thyroid medicine and she went on metronidazole for a month, it all went away.She has just started licking herself again after her morning pee when the grass is really wet. Now 2 accidents.

Sometimes I think if i present too many problems at once to the vets, they can't focus.

Can raw diet cause crystals?

I will explore this with the IMS, I feel best with her.:)

Thanks John,
Addy

[Harley PoMMom]

Hi Addy,

My Bear has had calcium oxalate stones removed, twice now. Each time they have showed up on his urinalyses and confirmed with x-rays and ultrasounds.

I have attached a word doc. that decribes how to avoid the risk factors of calcium oxalate stones which was sent back with Bears stone analysis. Don't know how much help this will be now and hopefully you will never need it but maybe good to have on hand?

Love and hugs,
Lori

[addy]

just got back home, Zoe was left for 4.5 hrs, no accidents, went out to urinate, squatted once, came in and did not lick her twinkie. Grass is dry. She is running around the house as happy as can be:confused: and also jumped on the bed:confused::confused::confused:

Mary Strauss did a series of articles on stones for Whole Dog Journal, guess I better reread them all.

Thanks Lori for the link. I'll have to reread about the diet too.

Do any of you ever feel that people think you are like the Mom or Dad who keeps going to the doctor with her/his child for the attention? Sometimes I think my friends think I am nutzo because Zoe is forever going to the vet and their dogs never go.:eek: A couple of them have made references, I don't say anything anymore:o

Addy the Confused

[Squirt's Mom]

Do any of you ever feel that people think you are like the Mom or Dad who keeps going to the doctor with her/his child for the attention?

Addy, this is so funny! :D

Squirt's new doc and staff keep referring to her "novel", meaning her file! :eek:;) I sometimes wonder if there really is such a thing as canine Munchhausen's by Proxy! :p:o:p If so, several of us here can expect to be hauled in wearing straight jackets just any day now! :p

Hugs,
Leslie and the girls :D - always

[apollo6]

First off I am so glad to hear Zoe is having a good day.
No I don't think that. It is their problem not yours. :mad::eek:We know our dogs best and with cushing and all the other alignments we need to be vigil.:D I have seen people come the er after being ignorant about a problem their pet has when it might be to late to save them:(So just ignore them. Like my husband says, Apollo is lucky to have a mom like me, and my holistic vet says you are doing all the right things, just think how bad Apollo would be if you weren't so concerned.

[addy]

Well, we have put the hind leg problem behind us, five days of really short walks and we are back to jumping on the bed and I can't see any problem with Zoe's back leg:) Sigh of relief:D

The sometimes licking her twinkie is still going on as it has been on and off though when I looked this morning, she gave her twinkie a lick and then was licking her inner thigh.

I have not been able to schedule appointment with IMS for a urine culture because I have to figure out when I can take off work to take Zoe. I've had a headache for 4 days now and am on antibiotics, they think sinus infection, arggg, I can't think when my head hurts.

This licking started when I switched her to raw and added supplements. We have gotten rid of all the supplements though I still use Culturelle probiotic, and still eat the same raw food. The 2 accidents are new, she had not done that before except on a very rare occasion (company and I did not pay attention). I am thinking out loud again, Nope, she needs the culture, hope I can get her in next week.

Leslie, what you mentioned makes alot of sense. If she had crystals would it show up in a culture?

Well, at least my leap of twitch to Oh my gosh she has diabetes now has eased somewhat since her hind leg is better.:confused:

Thanks for letting me ramble in my delirium.:eek:

Addy in Misery

[Franklin'sMum]

Hi Addy,

I'm sorry about your headache :(Great news about Zoe's legs though :D. I'm curious, how short were your short walks?
Crystals and casts will show up in a freecatch urinalysis, too. Do you check Zoe's pee with dipstix/multistix or such? (They can be purchased from most pharmacies, in Australia anyways, for around $20-$50 depending on how many things it checks, for 100 stix). If so, white cells and leucocytes are the things that point to a UTI. If positive for white cells and/or leucos, a culture and sensitivity will need to be performed to find out the correct a/biotic for treating the particular bug if found. (It's a bugger, but not all strains of bug will grow in culturing mediums :(.)

One more thing- a raw diet can sometimes cause elevations in BUN (urea) and creatinine when having blood work done (Dr Jean Dodds has studied this). Just wanted to mention that in case it happens and your vet/IMS mentions the possibility of early stage kidney problems, you can read up on this and explain about the diet. And not freak out :eek::o (so much)
Hope some of this helps,
Jane, Franklin and Bailey xxx

[addy]

Thank you for the response, Jane,:)

I knew about the elevated bun so i won't "twitch" that. I will go to the pharmacy and look for the sticks, I did not realize I could do that myself so thanks for the info on that:)

By short walks, I meant instead of 2 walks a day we went for 1 walk about 1/2 block and back, slowly. We were walking 2 times a day, a.m. walk was about 4-5 blocks, evening walk was up and down the hill in front of our house and another block.

Is it possible the raw diet changed the PH in her urine and thus she licks on and off now? I can't switch her food right now, looking at that down the road. I have been trying to cut back on it in tiny increments, while increasing the Honest Kitchen Embark. Although that is also raw it is processed somewhat (it is dehydrated) and has flax, potatoes and other ingredients in it.

I upped her lignans 1/2 capsule and she is tolerating that so that is good news:D

Thanks!!!!
Addy

[littleone1]

Hi Addy,

I'm glad to hear that Zoe is improving. I hope she continues to improve.

I hope your sinus infection soon clears up. I just went through that a few weeks ago. The antibiotic really helped.

Give Zoe a big hug from me.

[apollo6]

JUst a quick
Hi. Hope you are feeling better. Nice to hear about Zoe
HUgs Sonja and Apollo

[addy]

Thanks Terri and Sonja for checking in with me. I am starting to get rid of my headache so antibiotics must finally have kicked in;)

I was feeling kinda blue so it was really nice to see you both said hi.:D Do sinus infections make you feel weepy?

Hope Apollo and Corky are well and Zoe says hi to them both. WOOF!

Hugs,
Addy

[littleone1]

Hi Addy,

I hope you continue to feel better. When I had my infection, I had a constant pain over my right eye. The infected sinus was on my right side. It affected my ear and my jaw.

I hope Zoe is doing well.

Take care.

[apollo6]

Know what you mean.
Sending warm hugs and love your way. Hope you start feeling better.
Apollo sends you his high pitched shriek.:p

[addy]

Well, I called Zoe's IMS for appointment to discuss urine culture. I was supposed to go for a recheck if anything new developed so thought, okay accidents in the house, that's new.

When I made appointment, they told me IMS is now only there 2 days a week instead of four. i can only get apointments at noon or three two days a week.

Where am I going with this? If I have to load Zoe how can I have a doctor with such limited hours? I am freaking out.

We even discussed in length at the August visit that we don't want to start any lysodren treatment with her if she is not going to be available. She said she wasn't going anywhere, NOW THIS:eek:

I have no good options to replace her. I am really worried about Zoe. I have been noticing she chews and chews on her Kong and then runs and gets a drink of water. Then chews and chews again and runs and gets a drink. If I take the Kong away, she wants to lick and then she ends up licking and chewing on her paw. Now the accidents, I mean I know one for sure was Zoe but the other 2 I am speculating. I doubt it was Koko.

Otherwise she is in such good spirits and seems so good. She lets me pick her up without a complaint, she has not been as aggressive outside, her hair is growing in on her tummy, I just don't know what to think and now I don't even have a IMS.

Okay, this seems minor compared to some of your problems and I should not be having a melt down but I am. I know something is wrong.

Addy

[littleone1]

Hi Addy,

You're definitely allowed to have a melt down. I know how frustrated you feel. Since the IMS isn't available very much, you might be able to find a good vet who is knowledgeable in treating Cushings.

You know Zoe better than anyone else, and you know when something is wrong. The accidents in the house could definitely be related to Cushings, and they might also be related to a UTI.

I hope you will be able to find someone that knows what they are doing and will be available when they are needed.

Hang in there. We're here for you and Zoe.

(((HUGS))) for you and Zoe.

[addy]

New twist to the potty accidents. I found an old stain in a place Koko had an accident a year ago. It is the kind of stain a male dog would leave so now I don't know what to think about the other 2 house accidents I attributed to Zoes.

How do you know when you have 2 dogs and you don't see them do it? What if I think this is from her Cushings and it isn't even her?

I made an appointment with a traditional vet Zoe used to see. We discussed him with IMS and she thought he would be good team member. I see him next week. Wish me luck.

The idiot yard man sprayed our lawn with pesticide even though we told him not to. He said he "forgot":eek: Zoe has soft poos now and I won't know if it is again from her heartworm medicine or the yard. We kept her away from our yard, I even carried her down the driveway for 2 days. I rinsed with water a small section of grass for her but we only use it 2 times a day otherwsie we take her off property.

How long do I have to wait for the pesticide to go away? Does anyone know?

All of this has been such a distration for me I have been trying to research the intermdiate hormones. I have some lysodren questions, but will wait to ask:)

Hope everyone has a good day

Addy

[Franklin'sMum]

Hi Addy,

Couple of things (I'm a bit behind :o). A page back you asked if raw feeding can cause ph issues, I'm not entirely sure, but it is possible to change the alkalinity/acidity by dietary changes. Before I'd even attempt doing that, I'd want to find out if the ph is actually not normal-ish for Zoe. As in, if she usually has a low ph or high ph, and it stays around the same ph level, it may just be her body level and nothing to worry about.
If however it's usually a 5 ish, and jumps up to an 8+, I'd be getting an appt to check for infections.
Changing the diet to alter the ph may cause other issues (bladder stones for one thing), and I don't know nearly enough about diet to make any food suggestions one way or the other. I know if you were interested in going down that path you would research thoroughly before hand.

Do you have your IMS's mobile/cell phone number? Just thinking that if you don't really have any other options nearby you may be able to call her if she is unavailable in the office at the time. Wishing you huge luck with Zoe's previous vet, I really do hope he is up to the challenge :D

Pesticide- if you know the brand of what your lawn man used, maybe some of the US members may be able to help with that question, or you could look up the MSDS (material safety data sheet) or poisons info on google. If it was me, I'd play it safe and not let Zoe on the grass for at least a week (unless it rains. The stuff I used to use for weeds (bought from th supermarket) said something like "do not use within 3 days of rain", so I think rain dilutes it to almost harmless, as long as she doesn't lick the wet grass, and you wipe her feet when she comes inside. But again, that would depend on what was used - supermarket stuff versus heavy duty.

Love and hugs to you and Zoe,
Jane, Franklin and Bailey xxx

[addy]

Oh Jane, thank you so very much. I went on line to look at the dip sticks you told me about but I got confused so thought I would just take her in for a culture. That was when I found out about the hours and just had a total meltdown, I felt so defeated. I did see dip sticks that test for PH but I did not realize that if the PH went higher than normal it could indicate infection so thank you for explaining that to me.

I then had a meltdown with the pesticide because it was time for Zoe's heartworm pill and I suspect that it is bothering her poops and now the pesticide muddles the waters, so to speak.

Our plan was to give Zoe her melatonin and lignans, see if she could stay healthy for 3 months and then retest her. The reason I wanted to test her again with a full adrenal panel was because she was ill when we did the first panel and I wanted to see of the numbers changed at all if she was healthier and not having colitis flare up.

What I would like to do and it was one of the treatment options Dr. Oliver had on his sheet for Zoe was to then add a maintenance dose of lysodren. I thought perhaps that way I could see how she tolerates the drug because everything gives her diarrhea. For some reason the melatonin helped her loose stools, I can't explain why. I keep trying to research the intermediate hormones and melatonin and lignans but can't find much info except for Dr. Oliver's.

I know I am all over the place and have too many thoughts to probably sound cohesive, or maybe I need to switch to decaf:D

Meanwhile, Zoe's honey colored spots are slowly turning white; all that is left are the spots on her face and ears and they are fading.

I am hoping the old vet will work with the IMS so that someone is always available and that IMS will be available by phone as well. I see IMS in 2 weeks. I need to interview old vet first.

Thank you for letting me ramble on and on. I need to formulate a step by step plan and not get sidetracked.:o

Hugs,
Addy

[gpgscott]

Addy,

I would call the lawn service. They are required to keep material safety data sheets on file and should be able to provide you with exact information concerning the material they sprayed and when it is safe for Zoe to use the lawn again.

Scott

[addy]

Thanks Scott, my husband did ask and he said it was safe for Zoe after 24 hours but the thing is Zoe is not a normal dog and if anything sticks to her paws, she licks and chews them and will ingest it and I don't know if wiping them will remove it completely. When I walk in the road (we don't have sidewalks) in front of our house I can still smell the stuff quite strongly and there is no rain in the forecast:eek:

Oh how I long for a tiny yard in the city with street lights and sidewalks and a tiny bit of grass I could mow myself after taking an Allegra:D:D:D This giant lot looked good 10 years ago, now not so much:p:rolleyes::):mad:

So I need also some comments on my "trying to formulate my lysodren plan" Of course I would need to discuss with IMS but she said originally back in June if I wanted to try that I could. Maybe her thoughts have changed though.

Thanks guys for being there and listening. It has been a few tough weeks for me in my non dog life so I have extra stress right now.

I guess I should go watch Rozee's videos, that always perks me up:D

Hugs,
Addy

[apollo6]

Dear Addy
Sounds like you have your hands full.
this site lists internal medicine vets
.http://www.acvim.org/websites/acvim/index.php?p=228
I have a regular vet, an holistic chiropractic vet and the internal medicine vet.
You need a vet you can reach when ever you have an emergency, or question. On the urinating if it is Zoe , then talk to vet about it. I can't give input on this medication.
I know what you mean when you have two dogs, when we find an accident, both dogs just look at each other, like saying "I didn't do it it was her or him ":D
I found poop by my exercise bicycle, look at the dogs and they just roll over for a belly rub.
As far as the grass, wipe Zoe's feet every time she comes in until you can make sure the pesticide is out of the grass. Like you said with Cushing's our fur balls have a weakened immune system to start out with.
Hugs Sonja and Apollo.

[littleone1]

Hang in there, Addy. You're doing a great job.

I'm glad that Zoe's fur is turning white again.

When my neighbors get their lawns sprayed, they always let me know. I keep Corky off of them for two weeks. This is my own personal way of making sure that Corky is safe.

[Franklin'sMum]

Hi Addy,


I did see dip sticks that test for PH but I did not realize that if the PH went higher than normal it could indicate infection so thank you for explaining that to me.
I think "normal" is between 6.5-7.5 (neutral is 7.0 and is the ideal acc. to most labs), but each pup has their own "normal". Some might be 5.5, and that may be their normal, so unless you know what Zoe's ph is usually at (when she's well and not suffering infection or colitis) being "higher" doesn't give any real clue as to possible infections :o

Great idea about phoning the lawn company, Scott :). (things that escape my mind part 1 ;))


I keep trying to research the intermediate hormones and melatonin and lignans but can't find much info except for Dr. Oliver's.

Have you tried http://www.flaxhulls.com ? They have a booklet that they sent with my order, fascinating reading (just on the lignan side of things), and I daresay at least some of it would be on their web page.

Don't worry about being all over the place, have you ever read one of my posts? :eek::o:p (And I don't even drink coffee :D) Hoping your old vet passes your interview. The more I read, the more I think it's essential to have a complete team of vets. And this way, if one drops the ball, :mad: or goes on holiday, you don't have to start all over again. Really would like to think that each one has their strong suits and fits in well, without egos or a clash of egos. Ramble on anytime, we're here for you, and it's amazing where side tracking can take us :D
Bigs Hugs to you and Zoe

Jane, Franklin and Bailey xxx

[addy]

Thank you again, Jane and thank you Sonja.

I finally got some sleep last night so I am feeling better today.;)

I am going to get the dip sticks now that I understand even though Zoe is going for a culture.

We will continue to only take her to the little spot I washed or take her down the road for a week and wipe her paws. We have been doing the same with my Koko too.

I am getting confused about the trilostane and lysodren and the discussions to my question for Dena on her thread. I don't want to high jack her thread so maybe we could continue here on mine.

What it will boil down to for Zoe is:

add maintenance dose of lysodren

load Zoe on lysodren

or buck Dr. Oliver and try trilostane

My gut tells me she is going to need the lysodren but she will have diarrhea from it. I know she is going to need something but what is the question?

Should I stop all of this pre planning and wait until she is retested at the end of November in case something has changed?

This is why I keep trying to research the melatonin and lignans and keep rereading the trilostane.

Has anyone added maintenance dose of lysodren without loading, to melatonin and lignans when their dog has high cortisol and intermediates, not just high intermediates?

Maybe retest without colitis flare ups will show different numbers?



Thanks,
Addy

[addy]

Okay wait, I was just reading on the flaxhull lignan site and they mentioned a few dogs had problem with increased thirst and urination so follow the dose on Dr. Oliver's page which says:

WWW.VITACOST.COM/NSIFLAXSEEDLIGNANS. Standardized, lower concentration lignan product (40 mg capsules). Give SID: 1 capsule for dogs <30 lbs; 2 capsules for dogs > 30 lbs.

I KNOW I read another of Dr. O's papers that said 1mg lignan per pound and the Vitacost is 20% lignan in 40 mg capsule so that is 8mgs of lignan per capsule so Zoe gets 2 which is lower than her 18 pounds.

Which is it and can they really have thirst problems: She does go drink water after I get it to her, I mix it in alittle water and dehydrated food until it disolves. When I tried putting it in her meal, her poops got bad. Her regular meal has flax in it.

Addled Addy:eek:

[StarDeb55]

Has anyone added maintenance dose of lysodren without loading, to melatonin and lignans when their dog has high cortisol and intermediates, not just high intermediates?


Addy, Lori would be the one you need to get in touch with. This is how her Harley was being treated.

Debbie

PS- I had not read the last couple of posts, so I want to clarify a couple of things about urine pH, cultures, infection, etc. In general, normal urine pH for dogs is 5.5-7.0, 7 being neutral. A lower pH indicates an acidic environment, higher is a basic environment. Most bacteria do not do as well in an acidic environment, so this is why an increased pH may be an indication of infection, may be is the key word. Increased pH may be also due to several other things including something as simple as a high protein diet, I believe. On a urine dipstick, the 2 squares that give a clear indication of an infection are leukocyte (WBC) esterase, & nitrite.

[labblab]

Addy, I just wanted to add a comment about diarrhea and Cushing's treatment. My Cushpup, Barkis, suffered from bouts of yucky diarrhea throughout his life. I had learned early on that steroids are often used to treat recurrent inflammatory bowel issues. So when Barkis was finally diagnosed with Cushing's at age 8, I asked my IMS, "How come his elevated cortisol hasn't at least helped to control his diarrhea?" To which he answered that, paradoxically, the longterm, constantly high circulating cortisol of Cushing's can sometimes increase GI issues for dogs. I'm not sure why, but that's what he told me. So he also said that Barkis' diarrhea might never improve until we finally got his cortisol under control. Now, I'd love to tell you that his diarrhea DID improve with treatment. Actually, it didn't. He still had bouts from time to time. But it also didn't get any worse. It just stayed about the same. The only reason why I mention this is because you may reach a point where your vet advises you that it may be best to go ahead and get more aggressive about Cushing's treatment with Zoe, regardless of her bouts of colitis.

Secondly, can you remind us what her most recent ACTH results were and how long ago she was tested? I apologize for being too lazy to look back in your thread :o. Or if you already posted the results, just tell me when it was and I'll go back and look at them myself to save you from typing them all over again. The reason why I ask about this is because I think your decision about maintenance vs. loading doses of Lysodren really will depend upon what her cortisol level is doing. Either way, if your IMS has experience with Lysodren and is comfortable with Zoe being treated, then I don't see any reason not to stick with the Lysodren as oppposed to going the trilostane route. I don't know that either drug will necessarily be easier or harder on her GI system. It may just be a matter of giving one a try and seeing how she does. And since you do have question marks about her intermediate hormones, why not just go ahead with the Lysodren -- since you KNOW that it won't elevate them additionally. I can't think of any real reason why trilostane would be a better choice for you unless it turns out that Zoe really cannot tolerate Lysodren well.

Marianne

[Harley PoMMom]

Okay wait, I was just reading on the flaxhull lignan site and they mentioned a few dogs had problem with increased thirst and urination so follow the dose on Dr. Oliver's page which says:
WWW.VITACOST.COM/NSIFLAXSEEDLIGNANS. Standardized, lower concentration lignan product (40 mg capsules). Give SID: 1 capsule for dogs <30 lbs; 2 capsules for dogs > 30 lbs.


I KNOW I read another of Dr. O's papers that said 1mg lignan per pound and the Vitacost is 20% lignan in 40 mg capsule so that is 8mgs of lignan per capsule so Zoe gets 2 which is lower than her 18 pounds.

Which is it and can they really have thirst problems: She does go drink water after I get it to her, I mix it in alittle water and dehydrated food until it disolves. When I tried putting it in her meal, her poops got bad. Her regular meal has flax in it.

Addled Addy:eek:

The Treatment Considerations Option Sheet that Flaxhulls is showing is from 01-23-2009. Since then Dr. Oliver has revised it to say:


4) Lignan. Lignan has phytoestrogenic activity, and competes with estradiol for tissue estrogen receptors, with less biological effect. Lignan also inhibits aromatase enzyme (lowers estradiol) and 3-beta HSD enzyme (lowers cortisol). Use either FLAX HULL (SDG) lignan, or HMR lignan. See LIGNAN at our website under TREATMENT for details. DO NOT USE flax seed oil as the lignan content is very low, and the flax oil can increase triglycerides. SOURCES OF APPROPRIATE PRODUCTS are listed at the website. Lignans are safe, so doses don’t have to be exact. Suggested doses: SDG lignan; one milligram/lb B. Wt./day. HMR lignan; 10-40 mg/day for small to large dogs.This was revised May 1, 2010.

http://www.vet.utk.edu/diagnostic/endocrinology/pdf/TreatmentInfoAtypicalCushings201005.pdf

For Vitacost, on Dr Oliver's list:


1. Vitacost (www.vitacost.com/NSIflaxseedlignans).
Low SDG flax hull lignan product.
Each capsule contains 8 mg of SDG lignan.
A LinumLife™ product.
http://www.vet.utk.edu/diagnostic/endocrinology/pdf/20100810-LIGNAN-Write-Up-Revision03.pdf

Addy, I did try a maintenance dose of lysodren with Harley when his cortisol level reached 26.2 ug/dl. I couldn't get his cortisol under control with the maintenance dosing and finally tried loading him. As you know all pups are different so hopefully it will work for you if you do decide to go this route with Zoe. Whatever you do decide, we'll be here for you and Zoe.

Love and hugs,
Lori

[addy]

Zoe's test, sky high numbers, she was severly stressed and had colitis flare up going on for over a month, her symptoms are still mild,mostly coat and tail as they were then:

UTK Adrenal Panel Thu, 5 /27/2010 11:27 AM
Results/Comments
Endocrinology Lab Case# EN 10-4088
Test: Result: Normal Range** Result Normal Range**
(post ACTH)
Cortisol ng/ml 47.7 2.1-58.8 304.4* 65.0-174.6
Androstenedione ng/ml 1.05* 0.05-0.57 7.69* 0.27-3.97
Estradiol pg/ml 114.8* 30.8-69.9 102.2* 27.9-69.2
Progesterone ng/ml 0.99 0.3-0.49 5.91* 0.10-1.50
17 OH Progesterone ng/ml 1.18* 0.08-0.77 20.33* 0.40-1.62
Aldosterone pg/ml *** 33.9 11-139.9 357.1 72.9-398.5
* Above or below reference range
** Mean normal range values for spayed female dogs (N=36). QNS = Insufficient sample.
*** Normal range values for male and female dogs (N=72 baseline, N=23 post-ACTH.
These results indicate presence of increased adrenal activity. (SIGNIFICANT)
Comments: Values are increased as indicated.

IMS thought her stool would improve once Cushings was controlled, too but then was suprised when it improved so much on the melatonin.

I am so worried, how would I know if she is too low or she can't tolerate the drug when she gets diarrhea from the lysodren,note I said when not if, that is how sure my gut is about it.

Lori, was it bad to go from maintenance dose to loading?

Maybe by November she will be peeing buckets and drinking like a fish and this will be more clearcut for me.:eek:

Thank you all for your help, our grandchild was here tonight and I am really tired now to post well:o

Addy

[apollo6]

Dear Addy
Sorry you are going through so much. Can't give you input on Lysodren. All I know is Apollo has improved a lot with the Trilostane, but then I have been very conservative on dosage and any increase.
Which kind does Zoe have? Apollo has the pituitary cushing.
Wait till you get the results. I don't understand the labs that great, only if they improve. Waiting for Apollo's next results by Monday.
Hope you and Zoe are doing better.
What a roller coaster ride this cushing is.:eek::mad::confused:
Put the cushing in the drawer for a while. Enjoy your grandchild.
Hugs Sonja and Apollo

[marie adams]

Hi Addy,

Never a dull moment. Maddie is on Lysodren but has never had a problem with it such as diarrhea. I know the feeling of not much symtoms to judge a loading dose by. This has been the problem trying to load when the numbers are just slightly too high. I have not seen anything that I would consider side effects so far. Her coat is starting to make her a lot warmer if you will consider this a side effect. Her panting seems like more but I am thinking it is from being too hot now. And to think I wished for her coat to come back--haha!! She looks great and you really cannot tell she is sick other than being slow and a little stiff in the hind legs, but then when you are approaching 12 years old and then make that dog years I think I would be a little like that too. She keeps on going though the trooper she is...

I haven't read back on your thread, so I am hoping things are not too bad. I am lucky not much bothers Maddie. Sometimes I get a little nervous her raw diet might cause some indigestion if I let it sit a little too long before I mix up her dinner or breakfast. I have it pretty easy. Good luck with your plan you will be great at it.:)

[addy]

Hi Sonja and Marie,

Thanks for checking in. Today was actually a good day. We took Zoe and Koko for a ride and stopped in a nearby town with sidewalks, took a walk and Zoe was the old Zoe, happy as can be, walking really fast, not panting, peeing on very tree just like her brother (never knew girl dogs did that too until I got Zoe) and then saw a Halloween skeleton in some one's yard and proceeded to tell it off:D

It is sooo up and down:eek: She wont jump up on the bed any more in the dark, she sits and cries for me to pick her up. I worry about SARDS and everything else that might be happening inside her.

I was reading through the question and answers with Dr. Bruyette and came across this


This is what I recommend and there are geographical/personal issues with regards to what drugs to use in dogs with PDH.

1) For dogs with mild symptoms or for owners where cost is an issue we start with Anipryl for 2 months. If that fails to resolve the symptoms we move on to another drug.
2) For dogs that failed Anipryl initially or that have moderate to severe symptoms and we don't want to wait 2 months to see improvement we use trilostane.
3) We only use op-DDD when everything else fails. We and others have approached the FDA in the past about getting op-DDD approved in the dog and there is about zero chance of that happening. Too many side-effects and manufacturing issues and the drug will probably come off market soon in the US since very few people take the drug.
4) Any adrenolytic agent or enzyme blocker can raise steroid intermediates to some degree. Whether this is an issue clinically depends on the given dog, the dose of medication used, the duration of treatment and concurrent diseases and/or medications.

Dave Bruyette DVM DACVIM

I think I have read it 20 times. Zoe has mild symptoms but high numbers, we also just found a heart murmur. She also has colitis.

I am just getting even more confused. I guess I wait for the test in November. Who knows what things will be by then and I am just driving myself crazy.

Marie- Zoe is still on her raw diet too, does Maddie's tummy ever make growling or rumbling sounds? Zoe's started doing that when I put her on the raw diet, it does not do it all the time, once in awhile, yet her gastro panel from Univ. Texas showed no pancreatitis, we did the PL1 and some other tests, nothing showed up. I wonder if that is why she licks and chews so much.

I think if Maddie is doing well, don't change her diet.:)

Hope you are all having a good weekend, Zoe is happily snoring at my feet so it is a good night:D

Love ya all,
Addy

[littleone1]

Hi Addy,

I'm glad Zoe had a good day today.

Don't beat yourself up. Sometimes, the more we learn, the more confused we get. Take a day off from Cushings and do something you enjoy. Put it on the back burner for a day.

(((HUGS)))

[Harley PoMMom]

This is what Dr Feldman says about dogs with PDH:
Trilostane is my first choice in dogs with an adrenal tumor. My first choice for dogs with pituitary-dependent hyperadrenocorticism is mitotane.
http://veterinarynews.dvm360.com/dvm/Internal+medicine/Cushings-disease-and-other-adrenal-gland-disorders/ArticleStandard/Article/detail/672663?contextCategoryId=40534

Addy, I truly believe that the cushing medicine that you decide to treat Zoe with, whether it be Trilostane or Lysodren, will be the best one for her.




Lori, was it bad to go from maintenance dose to loading?
AddyNot quite sure what you're asking me here. :o:eek: I am sooo feeble minded sometimes! :eek: Let me know exactly what you what to know and I will be more than happy to help. ;):)

Love and big hugs to you and Zoe,
Lori and Harley

[addy]

Not quite sure what you're asking me here. I am sooo feeble minded sometimes! Let me know exactly what you what to know and I will be more than happy to help.

Not you Lori, it is me, I think faster than I type;)

What I meant was how hard was it to go from a maintenance dose to loading? How do you know what the maintenance dose is? Do you have to do things differently regarding the load? Do you have to be even more cautious about the dog going too low? What are the ramifications of going from a maintenance dose to a load? What would I have to be worried about?

I just thought it could give me a chance to see how she handled the lysodren.

Hugs and hope Harley is doing okay. I was so sorry to hear about the kidney issue. Thank you for trying to help me when you must have alot on your mind.
Addy

[Harley PoMMom]

Not you Lori, it is me, I think faster than I type;)

What I meant was how hard was it to go from a maintenance dose to loading?

This was not difficult at all. We were already at a maintenance dose of 125mg 4 times a week and this was not controlling his cortisol so I knew that a loading was the next option.


How do you know what the maintenance dose is?

According to Dr Oliver in an email to me: Veterinarians often begin maintenance Lysodren at 25 mg/kg, given once per week. It can be given 2 to 3 times a week if the initial response is less than desirable.

Do you have to do things differently regarding the load?

Usually the 25 mg/kg maintenance dosing is not enough to erode the adrenals but all dogs are different and Lysodren lasts up to 48 hours in a pups body so one should take this in consideration when loading.

Do you have to be even more cautious about the dog going too low?

When I tried to load Harley, his pancreas couldn't tolerate the Lysodren, his lowest post cortisol on Lysodren was 18 ug/dl, not even close to being loaded.


What are the ramifications of going from a maintenance dose to a load?

Except with Harley's case, I don't know of any ramifications of going from a maintenance dose to a loaing phase. You see, with Harley I should of just loaded him from the beginning. I don't want to sway your thinking here, ok, this is my opinion about Harley only.

What would I have to be worried about?

Harley did well with the maintenance dosing but it just didn't control his cortisol and when I tried to load him then his pancreas acted up and I had to stop the Lysodren...then the Vetoryl journey...kidney disease...and now that's ended.

I just thought it could give me a chance to see how she handled the lysodren.

This is the same thought I had with Harley, see how his pancreas would handle the Lysodren so I went with a maintenance dose. Looking back now I wish I would have just loaded him but one can not go back, only can go forward. I know you will make the best decision for Zoe and we will be here for both of you.

Hugs and hope Harley is doing okay. I was so sorry to hear about the kidney issue. Thank you for trying to help me when you must have alot on your mind.
Addy

Hope this helps, any more questions, just ask!

Love and hugs,
Lori

[gpgscott]

Zoe is still on her raw diet tooAddy

Addy,

Just noticed this, I know a raw diet can raise issues for a person with colitus/crohn's, I wonder about pups.

Scott

[addy]

Just noticed this, I know a raw diet can raise issues for a person with colitus/crohn's, I wonder about pups.

Hi Scott,

IMS says no change in food now or it will affect her poops and we won't know where we are. Trying to change Zoe's food is a diarrhea nightmare. Actually the raw was the only food she transitioned to with minimum problems which is how I ended up with it, every other food, canned or kibble, I could not tranisstion off the prescription canned ID and that gave her mucus poops.

But food change for us is down the road. IMS wants 3 months of solid poops so that means no food change now.

Lori-if the lysodren bothered Harley's pancreas on maintenance dose, would it not have bothered it loading? I hear what you are saying and I guess that is what I am trying to determine, just forget the maintenance and go with the load is the question. I think I already ruled out the Trilostane last night.

Marianne- I have questions for you too but need to go back to your answer on my thread the other day.

My biggest sticking point is if Zoe has a touchy system and gets loose stools easily, how will I know if she develops loose stools if it is from the lysodren or going to low? Would I just have to stop the drug and do a stim?

Thanks for all your help,
Addy

[lulusmom]

Hi Addy,

Whether you are treating with Trilostane or Lysodren, the primary concern is that cortisol can drop too low so no matter what phase you are in (loading, maintenance, back to loading) you always want to closely monitor Zoe.

When and how much maintenance dose is a subjective call by the vet. They look at the loading dose, how many days did it took to load and if a baseline acth stim was done, how far did cortisol drop during loading. As examples, if a dog loads in less than 5 days on 50mg/kg and the post stim is higher than 2 and less than 5 ug/dl, a vet might prescribe a maintenance dose of 25mg/kg to be started a week to 10 days after the last loading dose. A dog loading in the average time of 5 to 7 days and the post stim is in the aforementioned range, a vet would probably prescribe a maintenance dose equal to the loading dose (50mg/kg) to be started a week after the last loading dose. If a dog loads in 5 to 7 days but the post stim is less than 1.5 ug/dl, the maintenance dose would probably be reduced to 25mg/kg and started 10 days to 2 weeks after the last loading dose.

When going from maintenance to a load or reload, a vet would normally look at the post stim prior to loading and decide if a dog needs a full blown loading and test again at 7 or 8 days unless signs of loading are observed sooner. If the post stim is less than 10 to 12 ug/dl, a vet might do a short three day load. Our IMS had me do a mini load of 25mg/kg for three days and then resume regular maintenance for 30 days and then stim. Like I said, it's all subjective based on a number of factors.

With reference to Dr. Feldman's preference for Trilostane for adrenal tumors, based on the entire content of this interview as well as an audio of one of his lectures where he states that Lysodren is his choice for adrenal tumors that are not to be surgically removed, I believe Dr. Feldman prefers Trilostane as presurgical treatment of adrenal tumors. UC Davis used to use ketoconazole to rapidly reduce cortisol in preparation for surgery; however they have since changed to Trilostane due to Keto's adverse impact on the liver. If you read the paragraph before the sentence where he states that Trilostane is his treatment of choice for adrenal tumors, you'll see that the treatment is limited to one to two months of treatment.


Dogs with a cortisol-secreting adrenal tumor should be treated for eight to 16 weeks with trilostane. The initial dose should be about 0.5 mg/kg twice a day. Then, assuming that good control has been achieved for about eight weeks, surgical removal of the adrenal tumor should be performed. Remember that a large percentage of adrenal masses extend into the vena cava or other major blood vessels, so it is important that the surgeon be experienced in removing such masses.