What kind of improvement with Melatonin & Lignans?

[stoneattic]

Hi,

There is a really long story here, but I'll try to condense as best I can.

The short version is our 13 1/2 year lab, Bear, went from a strong 100 pound guy, doing 3+ mile hikes in the woods to barely being able to get around even with assistance in a matter of a couple of weeks. This started at the end of April.

We know he had problems such as Laryngeal Paralysis and allergies but other than a poor tolerance for heat he was doing well until this dramatic turn. As soon as the weakness and wobbliness occurred we took him to the vet and they did a battery of tests. Besides a urinary tract infection and Diabetes, they could find nothing else that would be causing this. So they started him on 9 units of Humulin N twice a day with meals as well as an antibiotic for the infection. We struggled controlling his glucose so we ended up at an internist who tested for everything imaginable and the only thing that showed up was an elevated Estradiol. She suggested putting him on Melatonin & Lignans. We were able to get the Melatonin locally and started him on those last week and just received the Lignans and started him on them last night.

As he is right now he can't get up without assistance by lifting his rear. He can only walk very short distances, about 5 yards, and is very wobbly doing that and frequently stumbles. Because of the layout of our house I have to carry him out to the lawn and back. Once out there I set him on his feet and he can get around as described.

He went from a voracious eater to being very picky, with little appetite.

We have tried everything, testing, meds, etc, and this is essentially our last hope. Has anyone had significant improvement in quality of life after putting their dogs on Melatonin & Lignans?

Right now he can essentially only lay around. We play with him all the time and try to keep him involved, but this is no life for him. We want to be sure we give him every opportunity to improve and help we can give him, but we don't want to keep him around like this, for us, if there's no hope of improvement.

Any thoughts or suggestions are welcome.

Thanks

http://labglenn.home.comcast.net/~labglenn/pics/beachbuddha1.jpg

[zoesmom]

Welcome to you and Bear -

He's one handsome boy, that Bear. We like to play 20 questions around here. Sounds like maybe your internist did the U. of TN panel for regular and atypical cushings and that's where she came up with the diagnosis of atypical? Is that right? It's the only place in the country where that test can be done (unless your IMS was just guessing.) If so, they'd have kept Bear for an 8 hour blood test and then sent the sample off to TN, where it would have taken a couple weeks to get results back. If that's the case, did you get a copy of those test results so you could post them here. Usually, Dr. Oliver there - the leading expert on atypical - sends his tx suggestions along to the local vets. Anything he noted would be helpful to know. The melatonin and lignans are the standard treatment for atypical. What doses is Bear taking. Any other test results, done prior, such as general labwork would be helpful as well. If you haven't gotten copies of all his test results, we recommend you get copies and keep in a file at home.

I don't have personal experience with atypical altho' many here do. But I know that improvement on melatonin and lignans can sometimes take 2 or 3 months. Has the internist mentioned possible arthritis tx's, given his size and age? Many here have had good luck with adequan injections. I'm sure others will be along shortly with more questions and suggestions. Glad you found us. I do think it's kinda odd that the weakness started so suddenly and wonder if perhaps there's an injury involved, too. Once the dogs get older and weaker, they can injure themselves doing the most ordinary things. Our lab mix Zoe weighed over 80 lbs and she was a pro at hurting herself. Had the same kind of house set-up and finally had to ban her altogether from going down the stairs to the yard.

Is his diabetes now under good control? And on the poor appetite - did that start at the same time as the weak legs? And as suddenly? Sue

[Franklin'sMum]

Hi and welcome from me too :)

My little boy Franklin has only just begun the melatonin and lignans, so I'll sit out this round of questioning with what to expect ;). It does sound like things happened very quickly with Bear, and I'm thinking along the lines of Sue, that maybe Bear has suffered an injury of sorts, or maybe arthritis might be an issue.
If it is cush related hind end weakness, a number of people use L-Glutamine for their pups. It's found in health food stores, and the sales lady told me that a number of human people use it, it helps with muscle wastage. People with muscular dystrophy use it for that reason, might be an idea to run it by your internist and see if she would recommend it for your boy.
How are you doing with the diabetes? We have cross-over members on another site, http://www.k9diabetes.com/forum and they have heaps of info re: diabetes there.
Did your internist find any sore spots on Bear during her exam of him? Just wondering if you have a canine chiropractor or physiotherapist near you.
Please keep us updated, and hope Bear feels better soon,
Jane, Franklin and Bailey xxx

[k9diabetes]

Did the internist do a solid neurological exam to see if there may be some condition that is pinching the spinal cord?

As Sue mentioned, the melatonin and lignans take quite a while... has his blood sugar crept up due to the higher hormone levels. I think last time I saw a curve it was down in the 200s to 300s.

Adequan has given my cat, who has hip dysplasia, a big improvement in mobility.

But it would depend on what's behind Bear's particular problem. So it would be good to know what all of the tests were that were done, such as ultrasound, x-rays, neurological exam.

Don't feel like you have to summarize only - details are very useful.

Natalie

[jrepac]

melatonin and lignans can take awhile to kick in, so to speak
a few months perhaps

L-glutamine is a good daily supplement for the muscle wasting problem, but that is indicative of Cushings (which your Bear tested negative for?)

Glucosamine is another good one for joints, arthritis,etc.

R U giving him Rimadyl? that can have adverse effects much like you described...

[spiritdog6]

I did have a dog with Addisons. Absolutely no energy, and stumbled a lot. I am not a vet, just an owner who had a dog with Addisons. Not trying to throw you a curve ball, or make it harder for you either. My old country vet did not do any testing, he knew by seeing her that it was Addisons. He got us some pills, I can't tell the details here, but she did improve a lot, more energy and no more stumbling.

Folks may come along who know more than I. I just know what my dog was like, and Bear sounds a bit like her.

There is an Addison forum somewhere on the net. I know someone posted it here.

I know your heart is just breaking, after all those tests and no improvement.

[stoneattic]

Wow, thanks for all the responses! I'll try to answer all the questions, etc.

Yes, we did the U. of TN panel but I think they only kept him for 1 hour. Does that make sense? He's had a bunch of other Cushing's test so maybe it wasn't a complete panel, only looking for the atypical? That's where the elevated estradiol values came from. I don't have the numbers however. The internist called with the results so I haven't seen them first hand. He is on 6mg, twice a day of the melatonin and 40mg of the lignans, once a day.

He has been on Tramadol and Previcox for arthritis for a few years, but we stopped giving him the Previcox a couple of months ago (after the weakness started) because of concerns about his liver. An ultrasound showed his liver having early cirrhosis. We did restart the Previcox recently to see if it would help, now that we are grasping at straws, but it doesn't appear to be helping. We are probably going to stop again since he doesn't appear to be in any pain with or with out it and it's definitely not good for his liver.

His diabetes is not really under control. We thought we were making progress since he was in the 400s initially and we got him into the low 200, with a few 100s, but after starting the melatonin and lignans (as well as the Previcox) his numbers went back into the 300s for the last few days. This morning he was 279 so maybe he is getting used to the change in meds/supplements.

The picky eating/loss of appetite started not long after the weakness. The weakness was not completely sudden. For a few months he needed a little bit of assistance getting up, particularly on slippery floors. If you stood with your feet on either side of his rear feet so he had something to push against he could get up. But it took a pretty dramatic downturn after a few months. He is almost 14 so we expected to have him slow down. Also, we expected some muscle wasting to go along with the laryngeal paralysis. Which you can see in his head in the pic I linked in my first post. But the muscle wasting is pretty system wide. Except his tail. :)

We read up on the L-Glutamine after your suggestion, but since he is currently eating predominately beef and other meats (he won't eat dog food anymore) we think he is probably getting a good amount already.

The internist did a very thorough exam and he shows no sore spots or pain.

We took him to a neurologist after a physical therapist though he might have Myasthenia Gravis. The neurologist (as well as our regular vet and the internist) said he doesn't, but we tested for it anyway and he was negative. The neurologist said it might be something in his neck and suggested an MRI and/or exploratory surgery. But the regular vet and internist disagreed. We were not happy with the way the neurologist examined him. He barely looked at him and what he said he saw no one else sees. He also said that he would go in and if there was significant damage he would probably not wake him. :( Either way we would not put him through that surgery at his age. It was months of recovery and as weak as he is, he would have a really though time coming back from the surgery alone.

He has been on Glucosamine since his arthritis diagnosis.

It's unfortunate that the melatonin and lignans can take months to kick in. We're not sure we (or he) wants him to live like this for 2-3-4 months. He is having no fun. :(

From our understanding of Addison's, his test results show the opposite.

Whew, I hope hit everything.

I think the bottom line right now is, short of a miracle, we are expecting him to only decline further.

He is almost 14, which is very old for a lab, particularly for a very large one. He's had a long and great (spoiled) life and he has always been very loved.

[zoesmom]

Hi again -

If Bear only had the atypical panel thru UTK (to check the intermediate hormones like estradiol, etc. which it sounds like he did), then I'd be interested to know what his results were on any earlier cushings tests. Perhaps one of your vet did the ACTH (a 1 or 2 hour test) and/or the LDDS (an 8 hour test). If so, could you get those #'s and post?

Or maybe they did a urine cortisol:creatinine ratio test which, if negative, rules out regular cushings. If positive, further cush testing is indicated. General muscle wasting can be a symptom of cushings and was one that my Zoe had - it was obvious in her head, which began to look very skeletal, although at the time, I didn't realize that was a sign of cushings. Just thought it was due to aging. Legs, of course, can become very weak from muscle wasting. The lack of appetite, however, is not usually a cush symptom and might suggest something else going on.

It's true that 14 is a long life for a large lab like Bear. And you and you alone will be the only one able to assess his current situation. My lab mix Zo, not quite as large, lived until this past March to the age of 13. Another member, gpgscott, recently said goodbye to his Moria - also a large chocolate lab. She was 15 or 16, I think. Both of our girls had mobility issues, but both were content and still enjoying life for the most part - up until the end. So it's always a judgment call on their quality of life. Somebody has posted a link in the past to a questionnaire on assessing the quality of life for our canines, to help us know if it is time to let go. I'm not sure where it is but maybe someone will know and can post that link for you. Whatever you do, we will be here to help you through it. It's never easy. If only they could talk..... :( Sue

[stoneattic]

He had the 8 hour LDDS test prior and although I don't have the numbers, they vet said he "wasn't even close" to Cushing's values.

The internist thinks there may be a degenerative neurological issue going on as well as the diabetes neuropothy and elevated estridiol, but we have not been able to find it. We even wonder if he has cancer that we can not find.

He just seems to be having things pile up on him. Besides the above he has a growth on him lower eyelid, which he's had before and is a duct issue and usually a simple operation, but in his condition and age an operation is risky. He has a skin tag on his elbow callous that recently has grown very large and has become inflamed and raw. Again, surgery is a risk for something relatively minor.

I think the lack of appetite is a combination of difficulty chewing because his teeth are worn and the loss of muscle as well as depression. He has his good and bad days and on the good days where he seems like he feels a little better he seems to eat more. Of course it could be he feels better because he ate more...

We don't have a problem with limited mobility itself, as long as he's happy. We lost Bear's "big brother", Dodge (Bear has a "little brother" now, Charger) four year ago to cancer, but for a few years prior he had a cart because of his degenerative myelopathy:

http://www.stoneattic.com/letterboxing/dodge.pdf

(If you read the above, written by my wife, you'll see a bit of a young Bear in there as well :) )

We've tried to get Bear to use Dodge's cart but he is very resistant. Bear has always been a bit of a "sissy" :) He doesn't handle adversity well, where as Dodge was always driven. The second we put Dodge int eh cart he was flying around. Bear just lays in the cart no matter what we've tried. Initially when we discovered the diabetes we thought if we could get his sugars under control and got him exercising he would improve, but it's so difficult to exercise him with the weakness/wobbliness and his refusal to use the cart.

BTW, what kind of improvement can result from the melatonin and lignans can we hope for? Everywhere I read it says that's the treatment for the elevated estradiol, but I haven't found a real "improvement" answer or story.

Thanks

[Franklin'sMum]

BTW, what kind of improvement can result from the melatonin and lignans can we hope for? Everywhere I read it says that's the treatment for the elevated estradiol, but I haven't found a real "improvement" answer or story.Thanks
Hi,
Sorry, but I'm no help at all with this question, but am keeping everything crossed that Bear feels better soon. Also that you can find out what's happening with him, and that it can be easily resolved.
BTW, love the pics of Bear and Dodge :)
Jane, Franklin and Bailey xxx

[Franklin'sMum]

BTW, what kind of improvement can result from the melatonin and lignans can we hope for? Everywhere I read it says that's the treatment for the elevated estradiol, but I haven't found a real "improvement" answer or story.

OK, back again, Bear with me ;) (pun intended :)) just found this-
One study found that melatonin releases vasotocin, which lowers corticoid levels;[13] that wouldn't be to the extent that trilo or lyso can lower cortisol, though. Here's another bit-
On the other hand, in a model of adjuvant-induced arthritis, both prophylactic and therapeutic melatonin administrations inhibited the inflammatory response.[36]. Now, if I understand this correctly :o, it seems melatonin may be helpful for arthritis (not that that info helps). That line is immediately preceeded by something about tumor necrosis (wayover my head). The bottom of the page says
Melatonin should be used cautiously, if at all, in patients with autoimmune conditions and in those with known or suspected adrenocortical insufficiency. The effects of melatonin on the immune system are complex, occasionally contradictory, and depend on several factors, including the dose of melatonin, the immune status of the animal (as well as its age, sex, and species), the season during which the immune system is studied, circadian rhythm of immunity, pineal gland status, and presence of a stressful condition.[39]
Last quote, I promise :)
Melatonin levels are low in patients with Cushing's disease,[26] a pathologic variety of hyperadrenocorticism. I included that just in case others weren't aware (like me). All this was from http://http://www.medscape.com/viewarticle/472385_3.
Hope that helps a little :)
Jane, Franklin and Bailey xxx

[Franklin'sMum]

One more
Diabetic dogs may need less insulin on melatonin. If your dog has diabetes, begin melatonin only with your vet’s close supervision and instruction, otherwise skip melatonin. If your dog is an epileptic, I would avoid melatonin as well.
That's from http://www.dogcancerblog.com/more-melatonin-and-dog-cancer/
I haven't checked into this Dr, and have no idea if this is legit. Just thought I'd throw it into the mix as Bear is diabetic.
I have however read on a epileptic dog forum that a number of people do give melatonin to their epileptic pups, and that it can help with seizures in some circumstances.

[jrepac]

as an aside, body builders are very concerned w/cortisol levels...high levels of cortisol interfere w/muscle building

so, they often take melatonin and phosphatidylserine supplements to combat cortisol...

go figure...:)

[MyRudy]

Hi,

Right now he can essentially only lay around. We play with him all the time and try to keep him involved, but this is no life for him. We want to be sure we give him every opportunity to improve and help we can give him, but we don't want to keep him around like this, for us, if there's no hope of improvement.

http://labglenn.home.comcast.net/~labglenn/pics/beachbuddha1.jpg

My husky/chow mix is 12 1/2 and is essentially at the same stage you describe with Bear. I just chimed in to say I know how you feel and let you know you are not alone! It is agonizing trying to decide what to do so that our beloved pups have the best quality of life in their declining years.

[zoesmom]

I haven't checked into this Dr, and have no idea if this is legit. Just thought I'd throw it into the mix as Bear is diabetic.
I have however read on a epileptic dog forum that a number of people do give melatonin to their epileptic pups, and that it can help with seizures in some circumstances.


Interesting, about the melatonin being low in cush dogs in general (meaning, I presume, not just those with atypical). Zoe had seizures and on the Guardian Angels website (for epileptic dogs), there are numerous comments about giving melatonin for seizures - although I think the idea is to give it in conjunction WITH the dog's regular AED drug. I have serious doubts that it would work on its own. Zo was put on sodium bromide for her seizures and that's when I added the melatonin to her regime - not because of the cushings, but because of the seizures and those comments.

Due to the fact that she also took trilostane, I figured the melatonin couldn't hurt since it's known that trilostane can mess with a dog's secondary hormones and since melatonin is usually prescribed for dogs with atypical. Sue