utk results 8/23 for Sidekick

[spiritdog6]

Just got a call from my vet. The results are in from UTK. Side has high sex hormones, I'll post the results on a new thread when I get them, via email by my vet.

But the high try, didn't seem to make a difference for Dr. O.

My vet agreed, he is too scared to try the Ly or Tryi, on top of the melatonins, and lignans, he wants me to go elsewhere, he said his ego is not in this.


But just to post, the high tri's, don't seem to make a difference to the acth test at utk. They got a result.......J

Administrative Note: This reply was copied from another thread in order to provide an introduction for Sidekick's UTK results given below.

[spiritdog6]

baseline normal range result post stim normal range post stim

Cortisol 39 38 2-56 293 71-151
Androstendione .36 .05-.36 4.6 .24-2.9
Progesterone .15 .03-.17 3.33 .22-1.45
Estradiol 98.4 23.1-65.1 484.8 23.3-69.4
17 OH Progesterone .18 .08-.22 5.27 .25-2.63
Aldosterone 86.1 11-139 212 72-398

[labblab]

Hi Jean,

Thanks for posting Sidekick's test results. In addition to the elevations in sex hormones, it turns out that Sidekick's cortisol is also elevated. From your earlier reply on Marlene's thread, I wasn't sure if you meant that you are planning to switch to a different vet in order to gain control of the elevated cortisol? That's why I went ahead and copied your reply here as well -- so that you could discuss the situation further and get some additonal feedback...

Marianne

[spiritdog6]

Thanks Marianne. Looks like I may have to redo it, as I copied/pasted what the vet sent me and all the columns are no longer columns. Not sure you all can read these?

[spiritdog6]

Cortisol 39 baseline 38 normal range 2-56 result post stim 293 normal range post stim 71-151

Androstendione baseline .36 normal range .5-.36 result post stim 4.6 normal range post stim .24-2.9

Progesterone baseline .15 normal range .03-.17 result post stim 3.33 normal range post stim .22-1.45

Estradiol baseline 98.4 normal range 23.1-65.1 result post stim 484.8 normal range post stim 23.3-69.4

17 OH Progesterone baseline .18 normal range .08-.22 result post stim 5.27 normal range post stim .25-2.63

Aldosterone baseline 86.1 normal range 11-139 result post stim 212 normal range post stim 72-398

I hope it is easier? to read this way? Couldn't make columns. I am just so excited to have some answers finally I don't even know what all my vet said. Shame on me, I'll be better when I have the papers in my hand, and off to my new IMS.

[Franklin'sMum]

Thanks Jean,
That definitely made it easier for me to read! Good luck with your IMS appt.
Jane, Franklin and Bailey xxx

[frijole]

As Marianne said, it shows sex hormones and cortisol are elevated. Usually Dr Oliver puts his comments and recommendations clearly at the bottom of the report. I assume you have this on hand. Can you please share what he wrote for recommended treatment?

Sorry but am having a hard time remembering your dog's history. You are planning to switch vets? Be sure you have copies of all these tests to take with you... will save you time and money.

[spiritdog6]

I didn't have the papers in hand yesterday, that is all the vet emailed me.

He did say he talked to Dr. O, and about using melatonins, lignans, and Lysodren.

Dr. O's comments were : Hormones are considerably elevated as indicated; especially the estradiol level at stim. Consider items 1-5, or item 8, on the treatment option sheet attached. Item 6 would also be a consideration. Because estradiol and progestins are increased, consider also item 10 on the TO sheet.

That only leaves out item 7, 9, 11, 12. Jeesh.

It is a "treatment option considerations Steroid profiles in the diganosis of Atypical Cushings Disease" sheet.

#1 is Ultrasound and or Endogenous ACTH
#2 Melatonin.
#3 Melatonin implants
#4 Lignan
#5 Maintenance dose of Lysodren
#6 Lysodren traditional treatment for cushings disease
#8 Ketoconazole Cushings disease treatment
#10 Hormone cream exposure. (if this is asking if Side ever had any of this, no he didn't.)

I am going to try an IMS, this vet is nice but in over his head and he agreed.

[StarDeb55]

#10 Hormone cream exposure. (if this is asking if Side ever had any of this, no he didn't.)

Jean, this isn't asking about Side. It's asking about you. We have already had one new member join who was using some type of hormone cream on her arms, & I don't know where else. Her pup was licking her arms & therefore ingesting the hormone cream which was causing the symptoms. There are now documented cases in the literature for just exactly this situation where a pup is being exposed to a human drug containing estrogen & other hormones. The pup is licking the cream of the person's skin, & develops all sorts of "Cushing's like" symptoms". When Dr. O sees a case with an extremely elevated estradiol, he is now including the above in the treatment recommendations.

Debbie

Jean, would you mind giving us a brief refresher on Side's history, including symptoms, & testing that has been done? We would also like to review any other results you have available. It's extremely difficult to give any meaningful feedback without being able to refer to the pup's history.

[spiritdog6]

No I have never had any hormone cream. I thought it was asking if he ingested any. Side is a licky dog. He licks the water off my legs after a shower, he loves toes, etc. But I do not use any hormone cream.

I may use regular lotion here and there, and I won't let him lick me then.

[spiritdog6]

Symptoms, PU/PD, voracious appetite but gains no weight, fur will not grow, what is left has become brittle and dry, less energy, pants all day and night, heat intolerance, now exercise intolerant. The only 2 things he doesn't have is back leg muscle weakness (cept he won't jump in the car), but is a bouncy welcome home dog, and bouncy front paws in the air jumping on hind legs"give me food" dog., runs up and down the stairs, and he has no pot belly.

Bloodwork highs.

Platelet count 469 reference range 170-400
Total Protein 7.7 range 5.0-7.4
Alkaline Phosphatase 534 range 12-118
GGT 141 range 1-12
BUN/creatine ratio 32 range 4-27
Cholesterol 471 range 92-324
AND THE BIGGIE
Triglycerides 4346 range 29-291 (fasted!)

T4 LOW 0.2 range 1.0-4.0 He was put on thyroid .2 for a month then had another T4 done results:T4 Post pill .8 range 3.0-5.0. The vet then upped him to .3, there has not been another T4 done and it has been over a month. No symptom changes/relieved either.

Highs in urine

Urine Ph 8.5 range 5.5-7.0
Urine Protein 1+ range negative
Urine microalbuminurai 12.1 reference range 2.5

He had later a false positive urine test (free sample) for staph. Retested from bladder no staph.

He had an LDDS test

Cortisol sample 1 results 2.3 range 1.0-5.0
Cortisol sample 2 Dex results 1.5 (high) range 0.0-1.4
Cortisol sample 3 Dex results 1.9 (high) range 0.0-1.4

[spiritdog6]

hello? I thought I posted all that was wanted?

[frijole]

You sure did type it all out and that was a lot to type. It looks to me like your dog has quite a few symptoms of cushing's, the ldds looked like cushing's, the cortisol is elevated indicating cushing's.

Alot of dogs have both traditional cushing's (elevated cortisol) and elevated sex hormones (atypical cushing's). Due to the sex hormones being elevated if it were my dog I would NOT use trilostane but instead would use lysodren.

I'm sorry but I know lysodren can reduce most but not all sex hormones so I'm not sure if the melatonin and lignons are needed. Hopefully an atypical expert will chime in.

I think you mentioned going to an IMS. I would take all this information to him/her and be prepared to be told your dog has cushings and they will probably go with lysodren and perhaps the melatonin/lignons.

Did I miss any questions? Good luck! Kim

[Franklin'sMum]

Due to the sex hormones being elevated if it were my dog I would NOT use trilostane but instead would use lysodren. I'm sorry but I know lysodren can reduce most but not all sex hormones so I'm not sure if the melatonin and lignons are needed.

Hi there! :)

If you do go the Lysodren route, and Sidekick has issues similar to Lori's Harley, then please just keep an open mind about Trilostane. I think if using trilo and dealing with elevated hormones, melatonin and lignans can still be used (to try and prevent the hormones from a continued elevation).
Estradiol is the pesky hormone that is produced both in and out side of the adrenals, and Lyso usually helps with lowering the estradiol, but not always.
Jane, Franklin and Bailey xxx

[spiritdog6]

Thank you frijole and franklinsmum.

I see the IMS next Tues. I don't know how much or little she knows about Cushings. It was one my vet picked. When I looked her up on the clinics web page, she seems to specialize in things in cats, which bothers me a bit.

I worry she will want to do an ultrasound, something I don't believe I can afford. That is my reality.

From what I have read and such, I believe Side is Adrenal, and yes both Cushings and atypical cushings too.

Ok, this may sound really dumb, but I have to put it out there just in case it isn't dumb.

I keep thinking about his high estradiol. I know it is a hormone. He loves our cat. She is an old cat, and they have always liked one another. She "asks" him all the time to groom her, on her back. Could licking the cat fur and dander somehow transfer the hormone estradiol? Yes I am grasping at straws here trying to find answers. And yes I will ask this new IMS too, since she seems to specialize in cats.

I am up in the middle of the night for the 2nd night in a row, because I wake up to Sidekick barking downstairs. I have no idea why. He is not barking "at something outside", it is not a hyper bark, it is a repetitive bark. It is not because he is starving, it is not for lack of water, it is not a need to go pee or poo, and it is not because he can't go up the stairs (I just tested him and he can, so it's not back leg weakness). I don't know why he is doing this.

[Harley PoMMom]

Depending on how high the estradiol is, if it were me, I would still continue giving the melatonin and lignans to my pup with the Lysodren. 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 the UTK panel, then it’s likely that the estradiol is being secreted by the adrenals.

I am no expert but I hope this helps.

Love and hugs,
Lori

[addy]

Hi,

I will just chime in, my Zoe has very high estradiol, was really evevated pre stim and post stim was even higher:eek: All other hormones were high except for aldosterone. She was diagnosed with typical and atypical. She is on melatonin and lignans and we may have to add lysodren. IMS said no triolstane. We are waiting for more symptoms to develop as hair loss is main symptom.

Take your time to figure things out.

And I forgot to say welcome!!!

Addy

[spiritdog6]

I moved his ACTH test over to this page so it would all be on one page, not 2.

Cortisol 39 baseline 38 normal range 2-56
result post stim 293 normal range post stim 71-151

Androstendione baseline .36 normal range .5-.36
result post stim 4.6 normal range post stim .24-2.9

Progesterone baseline .15 normal range .03-.17
result post stim 3.33 normal range post stim .22-1.45

Estradiol baseline 98.4 normal range 23.1-65.1
result post stim 484.8 normal range post stim 23.3-69.4

17 OH Progesterone baseline .18 normal range .08-.22
result post stim 5.27 normal range post stim .25-2.63

Aldosterone baseline 86.1 normal range 11-139
result post stim 212 normal range post stim 72-398

[spiritdog6]

Thank you HarleyPommom and Addy.

Addy it sounds like our ACTH tests are the same. But Side has a lot more clinical signs than your Zoe.

HarleyPommom, you mentioned hair follicles. Once again my dumb question. Could Side have high estradiol because he ingests my female cats fur/dander? She is 15, and her fur just pours off of her (due to old age). She likes Side to lick along her back. I mention this only because DebStarr mentioned that dog that licked hormone cream off the owner.

My old vet did speak with Dr. O the day he got the results, and yes, melatonin, lignans and Lyso were all mentioned as the treatment. It sounded like to me, that all 3 should be given.

[StarDeb55]

Jean, I seriously doubt that licking the cat has anything to do with the elevated estradiol.

My Harley has true Cushing's with multiple elevations in the other adrenal hormones, including a very elevated estradiol. Yes, all 3 need to be given. The melatonin + lignans are used to try to control the non-adrenal sources of estradiol. Any of the hormones produced in the adrenals will be covered by the lysodren. Since there are non-adrenal sources for the estradiol, such as fatty tissue, liver, & gonadal tissue, this is where the other 2 meds come into play. By the way, is Side neutered? I ask because an intact male will produce small amounts of estradiol in their testicles.

Debbie

[spiritdog6]

Thank you StarrDeb. I had to ask, dumb as it may have read/sounded.

Yes Side is neutered. I don't remember any problems with the neutering, as far as one not dropping and such. But it was 11 years, so my memory is vague if there was anything abnormal about his neuter. So I am believing that there wasn't.

[spiritdog6]

The day started off rough, overslept, Hunter didn't get his diabetes shot at the right time, Sidekick crashed into Hunter to get to his swim pool this AM, making Hunter yelp, etc...

The IMS seems practical to me (which I really like, but time will tell if that is true or not). She acted and sounded like she has seen Cushings a lot for the past 20 years. She did not come across arrogant, but we will see.

The only testing we did was Side's BP, which was perfectly normal at 120. So that meant to her that his kidneys are not involved.
She didn't feel the need for an ultrasound, because, as I have been told that 85% of dogs are pituitary. Because he is a small dog
and I forget her other reason, she felt safe believing it is Pituitary. I had already had a urine test, and the first ACTH, so she had no other tests she wanted done.
She said it was good he didn't have a pot belly, or leg weakness that we have it at the early stage.

She didn't seem impressed with the UTK, I got the impression she didn't feel it was necessary to go that far. But maybe it did give her a few clues anyways.

Side will start Lyso on Thurs. , she said she didn't expect any type of reaction until day 5 which is Monday. He is to get 1/2 tab in the AM, and !/4 in the PM. But I do have the Pred also.

I can take my bottle of cortryson from this vet down to her and use it there. I can pack it in a chest with ice packs for the 45 minute drive.

At the very latest his next ACTH test will be next Thurs. if other signs show up he may have it earlier.

She did say he was cushings and atypical. Oddly or not she never mentioned milatonins or lignans, and I forgot to ask. And seeing as it only worked in 40% of the cases, I am not too worried. I will ask her about them later.

She said to continue with the thyroxine for now, but yes; that may all be due to cushings (or not), as she believes his lypemia is due to cushings as well.

I really wanted to just get the drugs and get started, so I am relieved. I have been looking at a dog that screams Cushings for months now, so this is wonderful news to me.

And everybody fell in love with Side. It's his forever puppy face. From the receptionists, to the techs, to the vet, even in his bedraggled state, they all loved his face. The tech came back from the BP test and had to tell me what a great patient he was, he did not struggle at all, but was stoic and laid on his side quietly (she seemed impressed by that), and how all the other techs just had to pet him. He is loved there already.

Both dogs acted differently there too. I will have to think about that, to be able to say why. It was a very upscale, clean, and PROFESSIONAL feeling, is what I got. Not like the 3 ring circus I have endured since May.

....J

PS. When I questioned her about herself, that the website said she was into cat things, she told me "I didn't like that I was being deemed the "cat vet" as I like dogs too, and now I couldn't do a spay, its been 20 years, I tell people I know a lot about a few things", and it sounded like she meant Cushings as one of them. I sure hope so.

PPS. The paper instructions mention using rubber gloves to handle the Lyso, is that true, and is that normal? And what do you all use?

[Harley PoMMom]

PPS. The paper instructions mention using rubber gloves to handle the Lyso, is that true, and is that normal? And what do you all use?

I am so happy that you have found an IMS that you like and are comfortable with and I wish you and your furbabies the best of luck.

Re; the gloves: When I was splitting the Lysodren pills for Harley I didn't wear gloves but I did dedicate a pill cutter just for the Lysodren. Altho if one does have a cut on one's hand/fingers, I think it would be wise to wear gloves in that situation. After I would get done handling the Lysodren I would throughly wash my hands.

Hope this helps.

Love and hugs,
Lori

[spiritdog6]

Thank you Lori, that makes sense.

I just realized this AM, that Monday is a holiday, so I can't start the Lyso on Thurs., as it will be the 5th day, her techs were suppose to call me that day.

I also realized that even though she said she would be happy to use my bottle of Cotryson, she said they charge by the shot. I would think I would be charged less because I am providing the drug right? Otherwise I am paying double for the bottle.

Sigh. Will have to call there today and get it all straightened out.

[spiritdog6]

I wanted to mention that Sidekick got his first dose of Lyso this AM. So we have started. Keeping fingers crossed that the sign of loading screams at me when it comes.

[addy]

Hi,

I wanted to let you know that you have an amazing group to hold your hand while loading, so it will be okay.

Remember it could be just a slight sign, not always screaming. Some print out loading instruction to help remind them what to look for. Also it has been suggested feed part of the meal first and then give the pill so that if the pup does not want to eat you would not give the pill.

We are here for you and hoping you have a easy load with Sidekick.

Addy

[spiritdog6]

Thank you for your support Addy. I watched him eat this AM, and was not happy to see him look up from his food, with no Lyso in him, so it may be tough to see the sign.

He got his pill after he ate, wrapped in cream cheese.

Once again thanks for acknowledging this new road for Side and me.

[Harley PoMMom]

Hi Jean,

We are definitely here for you and Sidekick, ok? Like Addy mentioned any slight hesitation with food or with leaving some in the bowl could be a sign of being loaded. Also another thing you can watch is Sidekick's bowel movements...POOP PATROL!!!! If Sidekick starts to have runny or loose stool this could be a sign of low cortisol or loading.

Do you have prednisone on hand?

Please remember we are here for you so don't hestitate to ask questions, ok?

Here is a link with info about Lysodren and loading: http://www.k9cushings.com/forum/showthread.php?t=181

Love and hugs,
Lori

[littleone1]

Hi Jean,

Corky and I are keeping everything crossed that Sidekick's loading goes well.

Terri

[spiritdog6]

Thank you Harley Pommom. I already have printed that out, read it a couple of times and it is on my fridge now too. Yes I have the Pred.

The poop might also be tough. One of the things that changed in Side before we ever went to a vet was a change in his poo. He and Hunter used to poo exactly the same. During winter this year, they both changed. Hunters got very dry and hard (diabetes sucking the moisture out) and Sides got wetter, still form, but looser. If it looses any type of shape during this, then I will know. But just loose, is something we already have.

The IMS tech gave me her personal cell # for the up coming weekend in case of an emergency. I am glad to have it.

I have attempted to put all my "ducks in a row", I am having the acth test done up here since they made me buy the entire bottle of cortisol, and it is only 5 minutes away, I have informed this vet that I will need the test done as soon as I see the "sign" that I can not make an appt. for this if it comes to that. I have already set up a test time at 7 days if Side has not shown any signs. I have gotten a firm quote of costs from them as well. I am doing everything I can not to have another 3 ring circus from this clinic.

The IMS will charge me $35 to read the results of the test and decide our next step. I find that a bit greedy, but that is how she works. If I had the test done down there I would not be charged this. But it is an hour drive down and back, plus the one hour wait in between, and the wear and tear on my very old car. Plus having to transport a frozen bottle of cortysol to them.

If there is a 3 ring circus this time, I will do it down there next time.

I really hope he shows a sign before 7 days, it will be hard to swallow the costs of a second stim test days after the 7 day test if that happens.

Thank you again Harley.

Thank you also Corkie for the paw crosses, it is appreciated.

[Squirt's Mom]

Hi Jean,

You will do just fine with the loading! Anything you notice that seems odd, just come and ask asap before the next dose so we can get back to you.

We know what a good mom you are and have full faith in you! Keep in close touch over the next few days and let us know how he is doing.

Hugs,
Leslie and the girls :D - always

[spiritdog6]

Thank you Squirt!

Already something changed today, which seems impossible that 250 mg of the drug did this.

But I did notice Side didn't want to go up the stairs this afternoon, and after our walk, and his run to his pool here to cool down on my back patio, he refused/couldn't jump back up the 6" from the patio to the apartment.

Coincidence or ? Could the drug already affected him?

[frijole]

Hi! I would bet that anything you saw was either result of cushing's (the steps) or being tired from the lysodren. It is a chemo drug so like any drug the dog has to adjust to it. I remember Haley being real tired at first. I used to watch to see if she was still breathing. :p But she was and the lysodren was doing its thing which was all good.

You can still go for the walks - just might have to shorten them a bit. Keep reporting in. You'll be fine! Kim

[spiritdog6]

Thanks Kim, really. I did call the IMS tech down there, she (personally, talked nonsense, torn ligaments etc). She did not believe it was the Lyso at all. I insisted (2x times) it was noted in his chart though. I don't like the fact that she is not open or concerned, ie I didn't feel "heard" of my concerns.

The walk was a different area today, they were bored in the house, and we are all tired of the same walk. It was only a few minutes longer than any of our walks, and he trucked along in front of me, and seemed fine. His refusal to go up the stairs was BEFORE the walk. The refusal to jump the 6" back into our apartment after the walk was a shock. He did this jump this AM, and even jumped into the car this AM, so....this is a huge change.

I won't change the walks again. But we all needed a new perspective this afternoon.

He has been "presenting" his backside to me for petting lately, that may have been a sign the past week or so...it may be the Cushings moving on.

Thanks again Kim.

[frijole]

You are welcome. It is normal to fear lysodren at first but trust me... it saved Haley's life. She lived to be 16 1/2! Four years on lysodren. Keep watching over Sidekick - look for changes in water consumption (I measured it daily) and food intake - subtle changes in appetite, the way he eats etc.

Anything - hold off on lysodren and report in here and we'll give you our 2 cents! :D

[spiritdog6]

I welcomed Lyso honest.
But now....sigh, the dog that pawed in the air for food, did not do it tonight. He ate, but did not paw in the air....yelp in hunger etc


This is not a normal response.....it hasn't even been 24 hours and he has changed.........HELP.

[frijole]

Please describe in a little more detail what is normal and what SKick did tonight. What dosage lysodren are you on and how often? What is Sk's weight? Just checking the dosage amt. Thks, Kim

[spiritdog6]

Kim, he was put on 1/2 tab in the am, 1/4 at night. He just started this AM. He weighs to them 16 lb. I have weighed him at 17.

Side always paw paws for food , stands on hind legs, yelps, starving, none of that occurred tonight.

I gave him his 1/4 tonight. But ............if it gets worse......no more..

[frijole]

Thanks. That dose is in line with a 17 lb dog.

Maybe it was just bad luck that he did that tonight. Awfully soon but if you are worried, report it to the IMS tomorrow.

Not sure anyone told you but do NOT give any food or treats that are not normal in the diet. I gave Haley some popcorn when loading and it caused her to vomit a wee bit. Scared me thinking she had overdosed... but it was just not smart of me to do that. So... stick to the dog food and normal treats. Nothing new or from your plate while loading... it makes things easier.

Watch the poops as you know.

Hang in there!!! Kim

[spiritdog6]

Thanks for the heads up about "new treats", I appreciate that. Well it's midnight, and he peed downstairs and he made it back up stairs sometime in the night. I let them outside to pee again just now, and he hesitated jumping up the 4" into the doorway. I woke up to him just sitting in front of his fans, wide awake.

After this initial testing it looks like I'll be looking for a new IMS. I am not pleased with the one in Springfield, looks like Portland for me. A much longer drive, but I have to feel my concerns are "heard and recognized".

At 3AM we went back to bed. He refused to go up the stairs, I had to carry him. Since we have lived here he was the dog that was first up the stairs, beating Hunter and I.
Yes I think it is very bad luck this happened on his first day of Lyso.......

[frijole]

Sitting in front of a fan, getting up in the middle of the night to pee and then not sleeping, not going up steps are all signs of a dog whose cortisol is high so these are all normal even if it hasn't happened to SK before.

Before I even knew what cushings was I remember Haley would be up all night and sometimes she'd go outside via the doggie door. I'd look out and she'd be sitting there like a wolf with her nose up in the air and howling. I about died. At the time I was more concerned about the neighbors complaining and had no idea it was cortisol causing all this.

Same thing with stairs. No idea why sometimes she'd do it and other times she'd just sit and wait for me to carry her up and down. This was at least a year before we accidentally discovered cushings.

Hoping you have a good day today. Your call on the vet. I've been down that path. ;) Go with your gut.

[addy]

Hi Jean,

Sounds like you had a rough night. I hope today is going better.:)

Addy

[spiritdog6]

And a rough morning when the diabetic poodle didn't want to eat. Dog vs human mind for 15 minutes.

Does anyone know if leg weakness can come on this suddenly? He is not his bouncy little self, can't bounce now.

[lulusmom]

Jean,

Yes, leg weakness can come on suddenly with Lysodren and Trilostane. While more common with Trilostane, Lysodren at higher doses can also cause a rapid drop in cortisol which will make a dog depressed, lethargic, weak and generally feeling pretty pukey for a few days. Side is taking a healthy daily dose, plus you are wrapping it up on cream cheese, which enhanced absorbtion, so this could be what is happening. Dogs on Lysodren can also experience some degree of neurotoxicity in the initial stages of dosing but they improve in a day or two. There is also the possibility that Side simply can't tolerate the drug.

If Side is not interested in food and continues to exhibit debilitating weakness, quit giving him the lysodren. The recommended loading dose is anywhere between 25mg/kg to 50mg/kg. Side is getting the equivalent of 50.5mg/kg and it may be too much for him. You have some leeway so if Side doesn't appear to be adjusting to the dose, you can always talk to your IMS about reducing the dose to 1/4 tablet twice a day. This would be equal to 34.5mg/kg, which is in the middle of the recommended dosing range and might be easier for him to handle.

[spiritdog6]

Hi Glynda,

He isn't depressed or lethargic, his appetite is good.

It was a shock that in 8 hours after having the drug, he could no longer jump the 6" from the patio to inside. He didn't jump up and down when I came home today, he was happy to see me but he didn't jump/bounce.

He even hesitates going up the 4" front stoop.

He did the stairs once today, after that I held his harness and he went up the stairs with me holding on. He is an independent little guy and didn't want to be carried.

Hard to wrap my head around this. Isn't leg weakness also just a sign of Cushings? But would it come on this fast?

I have yet been able to talk to the IMS since I saw her 10 days ago, I can only get as far as the techs. I have now put in a call again to them, asking if they told the IMS about Side's leg weakness. I didn't want to keep letting this go for the entire weekend without some message from the IMS. I want to be sure the IMS was told. I did insist yesterday that it be put in his chart, but I don't know if they told her. Sigh

[lulusmom]

Leg weakness is common in cushing's due the muscle wasting; however, I don't recall you mentioning that Side had a problem with this. Keep in mind that cortisol is the body's natural anti-inflammatory so if a cushdogs has arthritis, he's self medicating himself with an abundance of cortisol. A lot of times when treatment lowers the cortisol, arthritis is unmasked and the dog is noticably uncomfortable. Side's weakness came on rather rapidly so I'm not convinced that this is what is happening but I suppose it's still possible. I'm just glad to hear that he is otherwise alert, happy and eating. Hopefully, this weakness will get better in a day or two.

[spiritdog6]

Glynda,

The only noticeable difference these past few months was his inability to jump into the car. I have a Subaru wagon and the back part of the car is laid flat for them, so it is a high jump. He would jump in occasionally, as he just did on Thurs. morning. But he has done the stairs, and been bouncy dog all these months until Thurs. afternoon. I heard nor saw a trauma to him, no yelp, nada, just all of a sudden refusal to jump. He walks fine.

The IMS was off on Fri. so was my vet. I will have to take Side in on Monday to one of them and have him checked out, and see if it is leg weakness, or some other problem. Spine, hips,?? Something. He is still unable to get back in off the patio as of this very early Sat. morning. This will be day 3 of drugs.

Hunter the diabetic is giving me troubles too. He is food shy, so feeding time is difficult, watch Side eat and watch the other not eat but has to eat for insulin.

Once again, my Yin/Yang opposite dogs.

[spiritdog6]

Almost dinner time on day 3.

I am even more puzzled by his lack of jumping and the why. It seems he can do it, but it seems "selective" , sometimes he jumps the 6" from patio to inside, and last night I know he came down and peed, but he was upstairs this AM, so that means he did the stairs too. If it was true cushing leg weakness would he be able to be selective about it???

He didn't bounce when I came home today.

And he is not begging for an insane amount of dog cookies, I don't know if that means he is "loaded" or what. He changes so much every day that it is hard to tell. He is still devouring his meals.

All opinions/ideas welcomed.

[frijole]

I think the stairs and bounciness changes are lethargy/adjusting to the drug. If he went down stairs to go out to potty that means he can do it when he needs to... probably just doesn't feel "up to it" other times.??

Treats - not sure.

So long as the appetite and the manner of eating food is the same (speed) I would say he isn't loaded yet but really you know best. Way to be sure is via monitoring of water intake (any change there?) and the poop. I used a stick to poke it and look for signs of it softening. I stopped before it got to the point of runny and bingo Haley was loaded.

When in doubt - cease the drug. This truly is the tough part. Once you make it thru this it is sooooo much easier so hang in there!!! Kim

[spiritdog6]

Thanks for commenting Kim. I appreciate it.

Tonight I woke up to Side barking downstairs, this time he couldn't come back up the stairs and was doing his singular bark as in "Mom" "Mom" "Mom" come get me. So now I am up again at midnight. The dark circles under my eyes are not pretty...

I don't think he is loaded either, even if he isn't driving me nuts for cookies.

The water intake had gone down the past few weeks so that really won't help me now.

His poo has been "wetter" for a lack of a better term for months and months, so unless it becomes runny, it will be difficult also.

I know the critical days are still ahead of me. Days 4 and up will really have to show me something. I hear it can take up to 10 days, with a stim test at the 8th day. I sure hope I don't have to get 2 stim tests in one week, financially that's an OUCH.

[gpgscott]

Loading is such a different thing pup to pup and I appreciate very much your concern for your little one and every little change in behavior.

I think like the others that the bounce issue is probably more one of reduced cortisol leading to some pain which was previously masked rather than weakness due to wasting. The wasting should be visually apparent and takes a while to come on.

Your doing a great job watching appetiete, water uptake and stool.

Hoping you catch the load just right.

Scott

[spiritdog6]

Thank you Scott for your support.

If you mean visually ie can see the muscle disappearing, I could not as he is a furry little guy. I have to feel his hind legs to feel any difference. I can't see his rear legs because of fur, unlike short haired dogs.

Do I feel less muscle back there? Actually I do now. Or is it my imagination? I lack from a good sleep, so I don't know.

Back to bed now, have to get up in 2 hours to give Side his thyroxine 1 hour before food at 6, which is my diabetics dog time to eat and get a shot, then I'll probably go back to bed again.

[addy]

Here is to hoping you are catching up on some much needed sleep.

You are doing a really good job of watching Sidekick.:)

Hang in there, I can only imagine how stressed you probably are.

Hugs and smiles,
Addy

[spiritdog6]

Thanks Addy. Yes I do feel as if a truck keeps driving over me.

Well he ate voraciously this AM of day 4. I had 5 minutes of my old Sidekick back, when he went up the stairs after breakfast on his own, and wanted back in bed with me! It is a rare occurrence for him to do that since Cushings started going berserk in him. But it is not a sign, as he has done this before the drugs too. It was super nice that he wanted to be with me more than be in front of the fans. Course his panting on the bed made it tough to go back to sleep, the bed bounces with the pants.

Thank you everybody for your support, its not as lonely or puzzling with you here.

[spiritdog6]

We are 1/2 way through day 5. Nothing different in his eating. There might be a change in urination. He didn't pee at all last night, no mistakes found in the AM. He did want on the bed again last night for awhile too.
We just woke up from a nap (bad neck/headache here) where he once again wanted back up on the bed (which is very surprising 3x in row now). I watched his breathing and compared it to Hunters, and it was EQUAL, I haven't seen that in months. Of course later it went back to the fast pace, but still it was different! And he didn't ask to get off the bed to pee or drink.

We have been up an hour or so and he has not asked to even go outside and pee.

His leg weakness seems to come and go, sometimes he can, other time he wants assistance.

The IMS tech did her one dutiful call to me today.

Now he is to have a stim test on Thurs. if nothing else changes in the next 2 days. Thurs. will be day 8, and I am not to give him any more Lyso on that day or until the results are back in.

The problem I see is that the test will not be "read" until Monday, the IMS is off on Fridays, and then there is the weekend. So that will be at least 5 days off Lyso. Does that mean if the test shows he is not "loaded" that we will have to start at day 1 again and aim for a 10 day stim test????

And I wonder if the above small signs are pointing to an almost loaded dog? Guess it's just more waiting to actually know huh...

[addy]

The Waiting Game, sigh, no fun:(

Let's try to think positive and that Sidekick will be loaded.

I hope your headache is better.

I think you do start over but I'll check on it.

You are doing an awesome job!!!!! I would have a major migraine, I don't even want to think about loading Zoe:(

Crossing fingers, toes, paws and eyes:D:p

Addy

[frijole]

I'd guess the signs you are seeing is improvement - a relief due to the lowering of cortisol. This is great. You are probably close so keep up the great work and take deep breaths. ;):D Kim

[Casey's Mom]

I have used Lysodren with my dog for over a year and a half and it sounds to me like Sidekick may be loaded or very close. I have also learned here and since have had it confirmed by my vet that the dog needs to be off Lysodren for 48 hours before the ACTH test - did your vet mention that to you? Lysodren continues to erode the adrenals for I believe up to 36 hours after a dose is given.

The best way to tell if they are loaded is the decrease in water consumption - when your dog is drinking normally I would stop giving the drug and wait for the results of your test. Following results of the test if your dog's cortisol is in range you usually wait about 10 days to two weeks to begin maintenance dosage of Lysodren.

Hope this helps,

Love and hugs,

[spiritdog6]

Hi Ellen thank you for your information.

My IMS had Side start on a Thurs. I am to have his test this Thursday. He will be on the meds thru Wed. which is not the time limit you and your vet have described at all. It will be 15 hours after his last dose that the test will be performed. I seem to remember the IMS tech also telling me that the test MUST be performed within 24-48 hours.

The instructions papers I got from my IMS say start on Thurs. test the following Thurs.

I can not go by water intake. #1 his consumption has varied (by sight) the past few weeks. #2 I have another dog in the house. A diabetic one. Now I could test the consumption for maybe a day, but I can't do it continuously as Side must always have access to water and I can't risk forgetting, or being out of the house and him not having access to water. Nor can I separate the dogs, we are a constant "pack". #3 Because Side runs "hot" he goes in his pool every morning after our walk, and yes he drinks there too.

He did ask to come on the bed tonight for the 4th x, and stayed there until I woke up with this splitting headache. So it could be a sign, just a different one, and not a strong enough one to stop the Lyso.

You and I seem to have conflicting vet reports huh?

I am glad your dog is doing well on the Lyso, I have high hopes for Sidekick.

[Casey's Mom]

Yes Casey is doing very well on the Lyso but in the beginning and until I found this forum it was not that easy! At 14 1/2 she continues to amaze me.

Did you read this from our site?

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

Your vet did say between 24 and 48 hours so you should be okay for the ACTH test althought I was told 48 hours.

Good luck and don't hesitate to ask questions okay?

Love and hugs,

[spiritdog6]

That's great about Casey, I hope I have that many years with Side.

I called the IMS tech again this AM, the way they do it is different than what you folks say. She said to give him his full dose Wed. morning 1/2, and evening 1/4 and just not to give him any more on Thurs. morning. I made sure she knew he was having the test at 9AM Thurs.

I have to go by their protocol, she may read the test differently than others. I don't know. But it will be 15 hours after his last dose.

[Squirt's Mom]

...the way they do it is different

This statement is bothersome to me. There are long established protocols for testing when a pup is treated with Lyso and varying those established protocols can lead to problems. The ones who made this drug are the ones who know best how it works and they are the ones who set the protocol. By testing sooner than the time established will not give a true reading as the drug is going to continue to work for a day or so after they test their way.

Side is your dog, you are paying for his treatment, and you have the right to say that he will be tested according to the established protocol set forth by the manufacturer. And that is exactly what I would do in your shoes. ;)

Hugs,
Leslie and the girls :D - always

PS. The "reading" of the results does not vary other than units/norms from lab to lab so your vets "reading" of the results has no bearing on the manner of this test either.

[spiritdog6]

Please give me the link from the manufacturer that says what the protocol is.

I can't argue with the IMS tech blindly.

[spiritdog6]

She didn't say they do it different. She said there are varying protocols vets follow, this is their way. I said they do it differently.

[lulusmom]

Lysodren (Mitotane), manufactured by Bristol-Myers Squibb, is a human prescription medication and is used off label for veterinary use. Packaging inserts for dosing is irrelevant for veterinary use. I suspect that veterinary treatment protocol was set based on results of testing on dogs when the drug was originally discovered as well as hands on experience by the many vets that have used the drug in the last 40 years.

Not all vets use the exact loading protocol. For instance, there was a survey conducted a few years back that showed that most gp vets are more likely to prescribe a loading dose of 25mg/kg whereas specialists, because of their extensive experience and educational background, prescribe at 50mg/kg. General practitioners are also more likely to prescribe concurrent prednisone due to their fear of side effects. In our experience, this protocol is more likely to result in adverse side effects as the prednisone masks signs of loading.

The average loading time for a dog is 5 to 7 days. Based on the law of averages, plus a vet's experience, some prescribe 7 days of loading and if no signs of loading are observed before that time, the dog goes in for a stim test on day 8. This is what Side's IMS has prescribed and it is also the protocol followed by Lulu's IMS. Jojo's gp vet, who treats a lot of cushdogs, instructed me to load for up to 10 days and if no signs of loading are observed, a stim is done on day 11. Jojo showed no signs of loading; however, his post cortisol on day 11 was .8, which was scarey low. Luckily, he never got sick.

If an IMS has lots of experience with cushing's and has used Lysodren extensively, s/he knows how to assess the results of a stim test based on many factors. Deciding whether to continue the same loading protocol or maybe a mini load for a few days or go straight to an appropriate maintenance dose is anything but cut and dry....I know this personally because we've done it all.

[spiritdog6]

THANK YOU GLYNDA.

I also called my gp here, he looked it up on the private vet (IMS) site. There is no time limit protocol on testing a dog who is taking Lyso, it went on to explain why. It did say that it does make a difference with Trilostane though.

I may not have gotten my gp's vets words correctly in the above, but the synopsis is that Side is just fine at 15 hours for an accurate test.

[Squirt's Mom]

I second the thanks! I have been looking and looking for info to support this and could not find it!! Now I know why! :o

My apologies if I upset you....that was never my intent. I am such a worry wart about everything, especially when it comes to our babies here. If it bothers me, I have to say something. :rolleyes::o

And, yes, I am accustomed to a snack of words! ;):)

Thanks again, Glynda!

[acushdogsmom]

I have also learned here and since have had it confirmed by my vet that the dog needs to be off Lysodren for 48 hours before the ACTH test - did your vet mention that to you? Lysodren continues to erode the adrenals for I believe up to 36 hours after a dose is given.


Lysodren (Mitotane), manufactured by Bristol-Myers Squibb, is a human prescription medication and is used off label for veterinary use. Packaging inserts for dosing is irrelevant for veterinary use. I suspect that veterinary treatment protocol was set based on results of testing on dogs when the drug was originally discovered as well as hands on experience by the many vets that have used the drug in the last 40 years.

Not all vets use the exact loading protocol. For instance, there was a survey conducted a few years back that showed that most gp vets are more likely to prescribe a loading dose of 25mg/kg whereas specialists, because of their extensive experience and educational background, prescribe at 50mg/kg. General practitioners are also more likely to prescribe concurrent prednisone due to their fear of side effects. In our experience, this protocol is more likely to result in adverse side effects as the prednisone masks signs of loading.

The average loading time for a dog is 5 to 7 days. Based on the law of averages, plus a vet's experience, some prescribe 7 days of loading and if no signs of loading are observed before that time, the dog goes in for a stim test on day 8. This is what Side's IMS has prescribed and it is also the protocol followed by Lulu's IMS. Jojo's gp vet, who treats a lot of cushdogs, instructed me to load for up to 10 days and if no signs of loading are observed, a stim is done on day 11. Jojo showed no signs of loading; however, his post cortisol on day 11 was .8, which was scarey low. Luckily, he never got sick.

If an IMS has lots of experience with cushing's and has used Lysodren extensively, s/he knows how to assess the results of a stim test based on many factors. Deciding whether to continue the same loading protocol or maybe a mini load for a few days or go straight to an appropriate maintenance dose is anything but cut and dry....I know this personally because we've done it all.


THANK YOU GLYNDA.

I also called my gp here, he looked it up on the private vet (IMS) site. There is no time limit protocol on testing a dog who is taking Lyso, it went on to explain why. It did say that it does make a difference with Trilostane though.

I may not have gotten my gp's vets words correctly in the above, but the synopsis is that Side is just fine at 15 hours for an accurate test.Firstly, I want to say that I agree 100% with everything that Glynda just posted.

I also agree with the fact that there is no time limit protocol for doing the ACTH testing when a dog is on Lysodren in the way that there is when a dog is on Vetoryl/trilostane. (when on trilostane, there is a "window" of time - just a certain number of hours - right after the dose is given during which the ACTH stim test needs to be completed)

But that said, I think that Casey's Vet may be referring to the way I learned it from my dog's Internal Med Specialist, which is that all of the daily loading doses of Lysodren given one day after the other actually have a cumulative effect and so the Lysodren can go on working (eroding away some of the adrenal cortex and lowering cortisol production) for several days or more after you stop giving the daily Lysodren loading doses.

If you test immediately after stopping the loading, the results of the ACTH stim test will be correct for the actual time that the blood was drawn for the test, but it's possible that the cortisol production can continue to go even lower until the full effect of all the daily loading doses is achieved. And that's why some Vets prefer, when possible, to wait a couple of days after stopping the Lysodren loading to do the ACTH stim test - so that the result will more accurately reflect the full and complete loading dose effect than if you test immediately after stopping the loading.

Of course, as Glynda pointed out, an experienced IMS should/would be taking all of that into account when interpreting the test results.

[spiritdog6]

Of course, as Glynda pointed out, an experienced IMS should/would be taking all of that into account when interpreting the test results.

Exactly! That is what I was trying to say, my IMS does it "differently".
She seems confident on how she treats Cushings. She may do it differently than your IMS, or your gp.

But I was upset with some of the posts, as it made me scramble this AM to make sure Side was being well cared for!

So just one way is not set in stone, and that is the way some of the posts are coming across to me. Of course I want the best for Side, but because it is not done at the optimum 48 hours does not mean he is not getting the best.

My gp read to me that "the test can be given anytime within a 48 hour time period" from the IMS vet site.

I know all too well there are bad vets out there, and I do everything I can to protect my dogs.

[SavingSimon]

We are 1/2 way through day 5. Nothing different in his eating. There might be a change in urination. He didn't pee at all last night, no mistakes found in the AM. He did want on the bed again last night for awhile too.
We just woke up from a nap (bad neck/headache here) where he once again wanted back up on the bed (which is very surprising 3x in row now). I watched his breathing and compared it to Hunters, and it was EQUAL, I haven't seen that in months. Of course later it went back to the fast pace, but still it was different! And he didn't ask to get off the bed to pee or drink.

We have been up an hour or so and he has not asked to even go outside and pee.


His leg weakness seems to come and go, sometimes he can, other time he wants assistance.

The IMS tech did her one dutiful call to me today.

Now he is to have a stim test on Thurs. if nothing else changes in the next 2 days. Thurs. will be day 8, and I am not to give him any more Lyso on that day or until the results are back in.

The problem I see is that the test will not be "read" until Monday, the IMS is off on Fridays, and then there is the weekend. So that will be at least 5 days off Lyso. Does that mean if the test shows he is not "loaded" that we will have to start at day 1 again and aim for a 10 day stim test????

And I wonder if the above small signs are pointing to an almost loaded dog? Guess it's just more waiting to actually know huh...

Did you ever get answers to your questions? I certainly can't answer them, and at the same time would be asking the same things. It is CLEAR that you love your Sidekick so much, and are doing your best to have him at his best. To me, it truly sounds like he is on the road to recovery. I know coming back to sleeping in the bed is HUGE as far as an important improvement!!! That is awesome, and I am starting to think that I have Simon on the wrong drug, which is scaring me, but it is good to know. I might cut short the time until he is tested again, because I guess you have to wait a while to switch from Trilostane to Lysodren, and I am not seeing anywhere near the results you are in at least four times as long of waiting! Thank you for sharing your journey through this awful process with us! You are both doing great, in all sincerity!
Love,
Dena and Simon and the rest of the pack. :):)

[lulusmom]

The best way to tell if they are loaded is the decrease in water consumption - when your dog is drinking normally I would stop giving the drug and wait for the results of your test.

If only we pet owners could actually hang our hat on everything our vet tells us. :( Unfortunately, and as many of us know, nothing about this disease is predictable. My vet(s) told me one thing and my dogs told me something else. Who are ya gonna believe? It's enough to drive you crazy and I gotta tell ya, I've ended up eating my hat a lot more often than I've ever been able to hang it on it anything. If I ruled the world, I'd make it a kinder, gentler world by passing a law mandating vets to hand over a prescription for stress meds to the pet owner, for the pet owner, before telling them that their dog has cushing's. Just think about all that hair we'd still have and what's left wouldn't be so gray. :p

According to a lecture given by Dr. Edward Feldman, he said every veterinary textbook since the beginning of time says to monitor the dog for change in water consumption to determine when to stop loading, but that changes in eating behavior is actually the more reliable symptom. I think Drs. Feldman and Ettinger touch on the reason why in the Lysodren Loading Instructions, which was an excerpt taken from the Text of Veterinary Internal Medicine.


Usually the initial loading dose phase is complete when a reduction of appetite is noted or after water intake approaches or falls below 60 ml/kg/day.

The water intake in polydipsic dogs may decrease to the normal range in as few as 2 days or take as long as 35 days (average is 5 to 9 days) Owners must continue to monitor the water intake daily until it falls to or below 60 ml/kg/day. Usually the water intake diminishes within days of beginning treatment, but it does not usually become normal until after some reduction in appetite is observed.

My Jojo is a perfect example of a dog that would have undoubtedly had an addisonian crisis had I used change in water consumption to gauge his loading. As it was, I was watching for changes in his eating habits and we almost had an addisonian crisis. The little turd never showed me anything but the back of his head buried in his food dish. He's been well controlled for at least two years and he still eats like a pig and drinks and pees buckets. He was eventually diagnosed with an incurable, untreatable form of diabetes insipidus and we've learned to live with it. DI is a rare condition that most people will never have to deal with but there are a lot of dogs who simply have had pu/pd for so long that the time needed for their kidneys to regain their ability to concentrate urine again can take a lot longer than it takes to achieve loading.

Nobody knows our dogs like we do and we can only do our best and hope that they cooperate and give us the courtesy of showing us a sign, whether it be water or food. Ha! Unfortunately, not all cooperate and follow the dang directions. Just like every other thing about cushing's, you can only go with the law averages and hope your dog is in the majority. Both of mine are in the minority which is why I am a wrinkled up old prune with ulcers and sparse gray hair. :p:p:p

[addy]

You gotta love our Glynda!!! Hopefully, she eased your headache a bit. I'm sorry, I checked in to wish you luck and read her post and I am still laughing:D I really hope she lightened your day.;)

Good luck today!!!!! Fingers and paws crossed:)

Addy

[spiritdog6]

According to a lecture given by Dr. Edward Feldman, he said every veterinary textbook since the beginning of time says to monitor the dog for change in water consumption to determine when to stop loading, but that changes in eating behavior is actually the more reliable symptom.




Just in case anyone missed the actual point of Glynda's post, I have bolded it.

[StarDeb55]

Jean, you have to keep in mind that statistically, the appetite being the best gauge of loading is correct for the majority of dogs. There will be dogs who "don't read the book" as we like to say around here. As Glynda mentioned her Jojo was one of them. My 1st cushpup, Barkley, never read the book either. We were at day 8 on loading with absolutely no change in his huge appetite & no apparent change in his water consumption. He had a stim on this day, the vet calls me the next day, asked if I had checked water consumption, yet. I said, no. She said she would wait. Low & behold, his water consumption all of a sudden dropped by 60%. I got back on the phone, the vet's response was that his stim numbers reflected that. In fact, his stim numbers were so low, Barkley was put on prednisone immediately, & we did not start maintenance for another week. Through all of this his appetite never changed, he would have eaten until he literally popped, if I had let him. His Cushing's was well controlled with lysodren for nearly 8 years, but he never, ever lost the voracious appetite. You really need to look at all aspects of a dog's behavior during loading to look for any change, even some change that is very small, could very well be a sign that the pup is loaded.

Debbie

[SavingSimon]

Okay, poor Jean and Sidekick!
This is all I know for a fact is that water intake or output cannot be used as a gauge for anything Cushings because of my own experience. That is the one and only symptom my dog has never had, probably will never have, and if I wouldn't have wasted so much time waiting for him to have it, he would have been treated sooner. Now his syptoms are worse, I don't know if I ams just upset because Trilostane isn't working the miracles it is advertised to, I am too impatient, or my dog is on the wrong drug. Talk about scary and frustrating!!!

If he is on the wrong drug, and I switch to Lysodren, your thread is helpful in knowing what to expect each day, but I certainlly cannot gauge anything by water with Simon because it is the only Cushing's symptom he DOES NOT HAVE.

As much as all dogs are different, all owners and vets are different, all of these tumors are different too. In my opinion the ONLY "gauge" are the numbers you get from the Vet and the changes in behavior or physical appearance that you see.

The problem is it is ALL "atypical" - no two threads are the same. So I really can't say "you can't gauge anything by water" maybe you can but I can't. What if I switch Simon to Lysodren? Water will tell us nothing. It NEVER has and I am really upset he did not get treated so long because for over a year - closer to two, I guess vets were waiting for that and meanwhile he went from "atypical" to "full blown Cushings" (and atypical according to some). No one symptom can gauge anything is my two cents worth that might be worth less than that, but the water thihg just really gets me upset -- sorry if this is out of line, or whatever, but people need to know that - I wish I didn't keep gettting "watch the water intake" preached to me while I was watching EVERY other symptom get slightly worse, and waiting for something that in Simon's case probably willl never happen. Who knows why? They are just all differemt, and what "lab-lab" says on my thread is what a lot of people need to understand.
Hugs to you and Sidekick from me and sorry I am frustrated and HATE this disease!!!!!!!
Love,
Dena & dogs

[gpgscott]

You gotta love our Glynda!!!
Addy

For real! cause if you don't she is subject to beating you about the head and shoulders:eek:

Scott

[Casey's Mom]

I think we all need to remember every dog is different - what I said and was told about water consumption worked with my dog. Her water consumption decreased dramatically on about day 5 if I remember correctly. Her ravenous appetite also decreased about a day later and her panting stopped around the same time.

Good luck with Sidekick - you are doing a great job.

[addy]

Hi Jean,

How are things going with Sidekick? Do you get your test results today?

Hope things are good,

Addy