My Sidney, 13yo Bichon Frise - Lysodren

[Marilyn Brandt]

Hello Everyone--I just found this site and have gotten set up to post. I have a 13 year old Bichon Frise that just had a Dexamethasone Suppression Test done. He has all the classic symptoms of Cushings, and the vet confirmed this. His results:
Cortisol Sample 1 - 3.7
Sample 2 - Dex 1.6
Sample 3 - Dex 2.7
Our vet is suggesting Lysodern - 1- 500 mg twice a day until water consumption seems normal, and then do another Dex suppression test and if more normal, 1/2 of 500 mgs twice a week. I guess one of the questions I have is do we need to do more testing before treating? Thanks--I so appreciate finding you guys!!

Marilyn Brandt

[littleone1]

Hi Marilyn,

Corky and I want to say hi and welcome you to a very wonderful group of very caring, supportive and knowledgeable people.

I don't know how long ago you posted, but once your membership has gone through, you should be able to see your post.

Terri

[AlisonandMia]

Hi Marilyn,

It seems you posted your first post as a Visitor Message in your Membership Profile - which explains why you couldn't find your post initially.

I have now copied it here to your thread so others can reply to you.

Alison

[frijole]

Hello Everyone--I just found this site and have gotten set up to post. I have a 13 year old Bichon Frise that just had a Dexamethasone Suppression Test done. He has all the classic symptoms of Cushings, and the vet confirmed this. His results: Cortisol Sample 1 3.7
Sample 2 - Dex 1.6
Sample 3 - Dex 2.7
Our vet is suggesting Lysodern - 1- 500 mg twice a day until water consumption seems normal, and then do another Dex suppression test and if more normal, 1/2 of 500 mgs twice a week. I guess one of the questions I have is do we need to do more testing before treating? Thanks--I so appreciate finding you guys!!

Marilyn Brandt

This test can have false positives so I would at least do an acth test and possibly an ultrasound. Also - that dosage sounds WAY high for a bichon. How much does your dog weigh?

Guess we should start at the beginning... tell us about your dog, the symptoms, and how you got here. The more detail the better!! Thanks. Kim

[StarDeb55]

Welcome to both of you! I agree with Kim, the initial dose of lyso sound way too high for a Bichon. Lyso dosing is calculated at 25-50 mg/kg. body weight, to get to kg, divide the current weight by 2.2. For example, let's say your pup weighs 20 lbs., which is 9.1 kg. The ideal lyso dosage range for this weight would be 227-455 mg.

We would really appreciate it if you could give us a little more background on your baby. We are not trying to second guess your vet, but we have seen way to many instances where pups have been wrongfully diagnosed due to incomplete diagnostic testing. The low dose test is considered to be the gold standard for diagnosis of Cushing's, but it has one huge drawback, it can give a false positive in the presence on non- adrenal illness. This is why it is critical that a positive low dose be confirmed by a second test such as the ACTH or an abdominal ultrasound. Did your vet rule out thyroid & diabetes? I ask about these 2 problems as their symptoms can mimic those of Cushing's.

Looking forward to hearing more.

Also, if you would like the title of your thread changed, please feel free to PM one of the mods or admins & we will be happy to do that for you.

Debbie

PS- The following is the link to your thread. Anytime you want to post, just pull up that link & click on the "post reply" button at the bottom left of the last post in the thread.

http://www.k9cushings.com/forum/showthread.php?t=2381

[Marilyn Brandt]

Ok--our Bichon weighs 22 lbs. This weight gain has occured over the past year or so because of his increased appetite. So, I did the math from other info, and 50 mgs. per 2 lbs of weight would be 500 mgs. Please please correct me if I am wrong. He has lost so much hair, drinks more water, eats anything that is not nailed down, his paws look strange because of the where they bend, and he pants a lot. I am thinking of calling the vet tomorrow to see what they charge for an ultrasound. So, any and all advice at this time would be greatly appreciated. Marilyn and Sidney

[Marilyn Brandt]

Thanks--I am finding the site a little confusing. Marilyn

[frijole]

Marilyn, We were frightened because you said the dose was 1 500 mg tablet TWICE a day. That is 2 x the recommended amount. So it would be ONE pill per day, cut in half and given 1/2 pill with the morning meal and 1/2 pill with the evening meal.

If you pursue the ultrasound pls know the machine needs to be a high resolution one and most docs offices don't have them. Yours might - just sharing.

Was there a blood panel done that led the vet to consider cushings? I ask because this disease is OFTEN misdiagnosed. We want to make sure the dx is solid so you don't have to go thru unnecessary testing.

I would also insist on an acth test to confirm the dx. It measures the cortisol and tells you how far you have to go to reduce it to "normal cushings dog levels".

Lysodren saved my dogs life but it isn't something to mess so you really want to be sure the dog has cushings. Kim

[frijole]

Thanks--I am finding the site a little confusing. Marilyn

Marilyn, We were all new at one time so don't worry at all.... it gets alot easier! ;)

[addy]

Hi and Welcome,

I'll share what I have been through so far:

My eight year old Zoe has thinning hair, thin and pigmented skin, rat's tail, a good appetite, she is getting slower, does not want to jump in the car anymore. She does not have drinking and peeing alot or the panting all night.

So far we have done an ultra sound, acth test, UC:Cr creatinine urine test, blood chemistry panel, urinalysis, an ultra sound and complete adrenal panel at University Tenn/Knoxville. We have not yet started our lysodren and had I not done all these tests her first vet wanted to treat her with Trilostane which we now know because of the full adrenal panel, she should NOT have because all her other intermediate hormones are also elevated, especially her estradiol which Trilostane would have made worse.

Now, I am not telling you to have all these tests but we have so many dogs misdiagnosed or prescribed a drug that was not correct that we are all very cautious. We even had one member's dog diagnosed with Cushings which was caused by her hormone cream. Her dog licked her where she applied the cream. Another dog's Cushings was caused by steriods taken for other conditions.

There is alot to read in the reference section. I have found so many helpful articles. Thought I would mention it.

Again, welcome and don't mind all the questions that will be coming up, they are a good thing:)

Addy

P.S.Cushings is not something you have to treat immediately.

[StarDeb55]

Marilyn, I just want to confirm the lysodren dosage. Is it 1/2 500 mg. tablet, twice per day for a total of 500 mgs. or a whole 500 mg. tablet given twice daily for a total of 1000 mg?

Debbie

[Marilyn Brandt]

I meant to say 1-500 mg of Lysodren a day for 7-9 days. Sorry!

[acushdogsmom]

I meant to say 1-500 mg of Lysodren a day for 7-9 days. Sorry!Whew! That dose sounds right to me.

My Bichon also weighed about 22 lbs when we loaded him and that's the dose he was on for loading - one 500 mg pill per day, divided into two halves and given as 1/2 pill with breakfast and the other half of the pill with his supper meal.

Just one thing about the time it takes to be fully loaded. The average time is about 7 days, but a dog can become fully loaded in a shorter time. I know, because my Bichon boy loaded in only three days!

Before starting treatment, he'd been eating ravenously - just vacuuming up the food in his bowl. But three days after starting on the Lysodren, he stopped and looked up at me during a meal when I said his name. That was a big change from before starting treatment (he wouldn't have stopped eating for anything!). So I called the Vet and asked to have an ACTH stim test done, to see where the cortisol production was at that point. She was sure that he couldn't possibly be loaded in only three days, but agreed to do the test to humour me, I think. And guess what - he was indeed fully loaded!

Click below to see the post that we have here about Lysodren loading instructions from the Textbook of Veterinary Internal Medicine, including some tips from our members collective experience:

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

Note that:


Lysodren administration should be stopped when:

1. the dog demonstrates any reduction in appetite; this might mean just pausing slightly during meal consumption, stopping to drink some water, or stopping in response to the owner's voice.

2. the polydipsic dog consumes less than 60 ml/kg/ day of water.

3. the dog vomits.

4. the dog has diarrhea

5. the dog is unusually listless.

The first two indications for stopping the medication are strongly emphasized because they are common and they precede worrisome overdosages.

The occurrence of any of these signs strongly indicates that the end point in induction (loading) therapy has been achieved.


1- 500 mg [per day] ... until water consumption seems normal, and then do another Dex suppression test and if more normal, 1/2 of 500 mgs twice a week.

He may be fully loaded before his water consumption is reduced. Reduction in appetite is also a hallmark sign to watch for, and appetite reduction often happens before water consumption becomes normal. My dog's water consumption only normalised a few weeks after he was confirmed to be fully loaded.

You'll be doing ACTH stimulation tests to monitor the cortisol levels during treatment (not dexamethasone suppression tests). The ACTH stim test is the only test that you can have done to properly monitor treatment - which is a good thing, because Dex suppression tests take 8 hours to do and ACTH stim tests only take an hour or two to do. :)

The weekly maintenance dose is usually the same amount as the daily dose was during the loading, so you may start weekly maintenance at 500 mg per week, but you may find that your dog needs a smaller weekly dose if he loses weight, like mine did.