Please Help My Baby Boy, Honey Bunny, 9 y/o Maltese

[rbeasl]

I prayed to God for Guidance and I shortly found this site. Thank God for this site and the people on it. Hello my name is Rhondalyn and my baby boy is Honey Bunny. Honey is a 9year old maltese, recently diagnois with pituary cushing. He has every last symptom of cushings. I have been trying to get this confirm for almost a year now. The problem is 2 vets said no cushing and the last vet that retested says for sure yes. The last vet seem to be the most knowledgeable. I was not shocked when she told me because Im past the panic stage. I just want something to help my boy get better. She told me she owns two dashounds that have cushings and she treats with lysodren. I asked if I could start Honey on trilostane because it seem not to be as harsh to me and she said not a problem because they are both good for cushings. This was this past Friday and I decided not to start him on the medication until Monday in case he had a bad reaction. Over the week-end Im looking over his lab results and it looks like it is another language the only thing I understand is alot of results show normal. I dont get it my boy is not normal. This is when I prayed to God for guidance and I found this site. I have learned so much in two days. The people here are very nice and supportive. I learned that there is another type of cushings called Atypical. OK the vet did not tell about this and now Im worried. He has taken his second dose of trilostane and someone said that this can be fatal with Atypical cushings. I want to call her and ask if she has ruled out Atypical. I need to know are there other questions I should ask her base on his lab results. He is 26 lbs and she has him on 30mg of vetoryl.

cortisol,serum result 2.30 normal range 05.00-4.000
cortisol,baseline 2.80 normal 1.000-6.000
cortisol 4hr post
hi dexm 0.700 normal 0.100-0.900
cortisol 8hr post
hi dexm 0.700 below 1.499-1.500
T-4 RIA 2.000 normal 1.000-4.000
T-4 eq dialysis 23.300 normal 8.000-40.000
TSH 0.120 normal 0.030-0.600
ACTH-pre cortisol 2.200 normal 1.000-4.500
ACTH post 19.40 normal 5.500-20.000
WBC 13.80 normal 6.00-17.000
RBC 7.82 normal 5.50-8.50
HGB 19.000 above 12.000-18.000
HCT 55.000 normal 37.000-55.000
PLT 396.000 normal 200.000-500.00
neutrophil 0.00 below 60.000-77.000
lymphocyte
eosinophil below
ALB 2.70 normal 2.20-3.900
ALKP 538.000 above 23.000-212.000
SGPT/ALT 367.000 above 10.000-100.000
AMYL 352.00 below 500.00-1500.00
CHOL 371.000 above 110.000-320.000
GLU 115.00 normal 70.000-143.000

so much more but my eyes are starting to cross please let me know if you need other results. Any help will be greatly appreciated

Thanks
Rhondalyn

[gpgscott]

Welcome Rhonalyn and little Honey,

First, atypical Cushing's just means that hormones other than cortisol are elevated, including cortisol there are a total of 6 adrenal hormones all of which capable of causing Cushing's syndrome in dogs. Treating an atypical pup with Trilostane (Vetoryl) is not fatal, it is just not optimal in all cases.

I am having trouble understanding the results you have posted. I see what appears to be an LDDS with a pre of 2.8 and four and eight hour post numbers of .7. If I am reading this correctly it does not support a diagnosis of Cushing's involving elevation of cortisol.

Likewise the ACTH for a non cushpup looks normal to me.

Honey does have elevated alkp which is common in cushpups.

Would you please detail all of the symtoms you are observing and confirm the results of both the LDDS and ACTH.

Looking forward to hearing more.

Best wishes. Scott

[frijole]

Glad you found us. The acth doesn't look like the cortisol is very high but I wanted to ask... did you do all the testing at one time or were they separate tests?

The very first one where there are 3 readings (baseline, 4 hr and 8 hrs) ... can you look on the paperwork and tell us the name of the test? Normally it is a low dose dex suppression test but it looks like your vet might have done the High dose test.

Tell us more about your dogs specific symptoms and when it all started etc. The more info the better. Thanks. Kim

[lulusmom]

Hi and welcome to the forum.

I only have a minute but wanted to welcome you and also to say that the results of the acth stimulation test is not consistent with cushing's. You mentioned you had more information to post and I look forward to it but in the meantime, can you tell us if what you have posted thus far are tests that were done by your most recent vet?

Glynda

[rbeasl]

Hello Scott, Kim and Glyna Thank You for your response. Let me see if I can give you a little more info. Honey symptoms are
excessive thirst and urination and hunger
bad skin w scabs that will not heal
2 big patches of hair that has come out
very large potbelly
thinning muscle w rear legs that are weak

Test 1 w 1st vet completed 1/19/2010
Post ACTH 1hr cortrosyn
cortisol baseline result 3.25 range 0.1-6
cortisol 1hr post result 16.2 range <20

Test 2 w 2nd vet completed 4/29/2010
T-4 by Equilibrim result 22.900 normal 8.000-40.000
low dose dex 0.00 abnormal
this is the only info given on print out on the low dex. I may have to call office and get numbers. When I ask vet in April about the low dex results he said it was normal but I dont understand print out.

Test 3 w 3rd vet completed in Sept 2010 and the results post in first post is from the 3rd vet

9/7/2010 ACTH-Post cortisol result 19.40 range 5.500-20.000
9/7/2010 ACTH-Pre cortisol result 2.200 range 1.00-4.50
9/8/2010 TSH result 0.120 range 0.030-0.600
9/8/2010 T-4 by Eq dialysis result 23.300 8.000-40.000
9/8/2010 T-4 RIA result 2.00 1.000-4.000

9/18/2010 cortisol serum result 2.300 0.500-4.000
9/16/2010 cortisol baseline result 2.80 1.000-6.000
9/16/2010 Hi Dex 4hr post result 0.700 0.100-0.900
9/16/2010 Hi Dex 8hr post result 0.700 1.499-1.500

I want so much to trust my vet, but I just dont understand so many normal results when my boy has all symptoms of cushings.
Im so scared that maybe I rush the medication and he could have something else. Im not for sure if I should discontinue his medication or not. Vets are people and they make mistakes but Im his mom I cant make a mistake. Thanks for your help

Rhondalyn

[Squirt's Mom]

Hi and welcome to you and Honey! :)

I agree with the others - the results posted do not support a diagnosis of Cushing's. According to these results, Honey's cortisol is normal, and it wouldn't be if she had Cushing's.

If you haven't already - STOP the Trilo. Trilostane can and does cause the same problems as Lysodren when too much is given or when given to a pup who doesn't need it.

Please let us hear from you soon!
Hugs,
Leslie and the girls :D - always

[gpgscott]

Hi Rhondalyn,

So the numbers posted are for an HDDS I am not able to comment on them.

The other symptoms you describe can be caused by Cushing's.

It is hard to comment further. It is clear that if the treating Dr. has a clear diagnosis that they have not shared the basis of that diagnosis with you.

We really need more information, as Leslie has said if Honey does not have elevated cortisol Trilostane can make him very sick in a very short period of time.

Scott

[rbeasl]

Thanks Guys so Much for your help. I think you just saved my baby boy's life. I will discontinue trilostane and call the vet. I need a referral to an IMS ASAP. I will keep you updated.

Kiss your babies for me
Rhondalyn

[labblab]

excessive thirst and urination and hunger
bad skin w scabs that will not heal
2 big patches of hair that has come out
very large potbelly
thinning muscle w rear legs that are weak

Welcome from me to you and Honey, too!

I do think it's a great idea for you to call and reconfirm the results of the diagnostic testing with your new vet. It will not surprise me at all if it turns out that Honey DOES have Cushing's, given his classic symptom profile (including elevations in his lab results for cholesterol, and also for ALKP and ALT which can signal liver inflammation from Cushing's). But as the others have pointed out, his diagnostic ACTH test results are still within normal limits -- although BARELY within ("post" result of 19.4 with the normal range ending at 20).

Although I think the HDDS (high dex) results would be consistent with the pituitary form of Cushing's, the trick is that the HDDS can only be interpreted accurately if you have already established that a dog truly does have Cushing's in the first place. Like the ACTH, the LDDS is also a diagnostic test that is used to establish the preliminary Cushing's diagnosis. So since Honey's ACTH test results were within the normal range, it seems as though a repeat LDDS would have been the better "next step" rather than moving right on to an HDDS. It is interesting, though, that the April LDDS results were noted as being "abnormal." It sure would be nice to know what the actual results were at that time. Maybe your new vet does know what they were. And although still technically within the normal range, I do see that Honey's ACTH results are a bit higher now than they were in January (16.2). So perhaps this upward trend is influencing your vet's perspective, as well, in conjunction with the classic symptoms.

By any chance, do you know whether an abdominal ultrasound has been performed on Honey? Depending upon how well the adrenal glands can be seen, the ultrasound images can offer a good diagnostic indicator of Cushing's. The images also can be very valuable as far as giving feedback regarding the health of the other abdominal organs. So if an ultrasound has not yet been performed, it's something you might want to discuss further with your vet. In order to be valuable, though, it would likely need to be done at the office of a specialty vet.

No matter what, it will be good to talk with your current vet to get a better understanding of his interpretation of the various tests performed thus far. And we'll be really anxious to hear what he says!

Marianne

[rbeasl]

Marianne Thank You for the valuable info. This really gives me a better understanding of what questions that I need to go in with. When you dont know much about this disease it is very hard to know what questions to ask. I have an appointment with the vet this Friday. I will keep you updated.

[labblab]

Rhondalyn, that sounds like a really good plan. Just to help you prepare a bit more for your vet visit tomorrow, here's a link to a Cushing's diagnostic flowchart that has been prepared by the manufacturers of Vetoryl:

http://www.dechra-us.com/files//dechraUSA/downloads/Client%20Literature/47901_VETORYL_10mg_Diag_Testing_brochure_4pg_3_1_p s.pdf

As you'll see, they describe both the ACTH and LDDS as being initial "confirmatory" tests, whereas the HDDS is listed as a secondary "discriminatory" test which can help determine the type of Cushing's (pituitary vs. adrenal) after the initial diagnosis has been confirmed. Both the ACTH and LDDS have strengths and weaknesses. And as you'll see, one of the weaknesses of the ACTH is that it can more frequently "miss" diagnosing Cushing's in a dog who really does have the disease. So the fact that Honey's ACTH result fell within the normal range does not necessarily mean that he doesn't have Cushing's -- but it does mean that a repeat LDDS would probably be a good idea. Here's what that flowchart has to say:


If the [ACTH] result is negative but clinical signs and routine tests continue to suggest HAC [Cushing's] then further testing should be considered.
Given Honey's classic symptom profile and lab results, I think there is a very good chance that a LDDS would come back "positive." But if it didn't, then you'd be on much firmer ground to rule out Cushing's and consider alternative explanations for Honey's problems.

In addition to the diagnostic flowchart, you'll see that the link also includes the U.S. Product Insert for Vetoryl. It contains a lot of info about trilostane treatment and monitoring that should be helpful to you. And if it does turn out that Cushing's is confirmed for Honey, I am pleased to see that your vet has suggested that he begin at the low end of Dechra's recommended dosing range: at 1 mg. per pound. It has been our experience that dogs seem to adjust to the medication more safely and easily when they are started at a lower dose and work their way upwards if a higher dosage ends up being needed.

Good luck with your vet visit, and be sure and ask us any questions that will help you prepare for your discussion.

Marianne

[apollo6]

Dear Rhondalyn,
First off welcome, I am Apollo's mom.
Were to begin. First off in you profile about me , let us know where you are located. I can give you web site that can locate a internal specialist in your area if you are in United States.
http://www.acvim.org/websites/acvim/index.php?p=3

this web site is a run down on cushing's with actual pictures
http://www.acvim.org/websites/acvim/index.php?p=3

Apollo is on Trilostane, but this decision took me from Sept 2009 through June 2010 until I started him on it.
First you need to know what kind of cushing it is , if it is. There are three kinds as you will read. Apollo has the Ph(pituitary kind) only could determine through an ultrasound showing both adrenal glands are enlarged similarly. If one gland is enlarged more then the other it is more than likely the adrenal kind. Third kind is Atypical.
Not until you are sure if and what kind it is do you start treatment.
Apollo's signs, loss of hair on both sides, loss of hair on tail, loss of hair on ears, skin liaisons on his belly, and coat, ingrown hairs, hind leg weakness, pot belly, dark skin on his belly, excess thirst.
IN my case, I have an holistic vet who said Apollo should be tested, a regular vet who said it wasn't cushing, went to two specialists to confirm diagnose, didn't like the first decided on the second. I did not rush into it. I can't give much input on lab results .
Hugs Sonja and Apollo;)

[rbeasl]

Thank You to all my Cushing Coaches I went into my vet appointment today knowing alot more than I knew last week.

Marianne the information you gave really helped me out with what questions to ask. Thanks

Sonja Thanks for your post. Ive read your personal journey about your baby Apollo and how much you have gone through and now you sound like a medical doctor. I cant wait to get where you are.

I found out today that my vet does not know very much about cushings. Im very upset because Im putting the life of my baby boy, my best friend, my companion that puts a smile on my face every single day into your hands and the best has not been given to him. Is it really only about money at this point.

Number one concern that I had for my vet.
In April the same facility a different vet gave the low dose dex test but on my print out it says abnormal and the vet told me normal.
The printout has 0.00 value .. My question was how is this possible to have a 0.00 value? I need to know the result and the range on the result. My vet looks in the computer about 2 minutes and she is looking confuse. She goes out of the room to get something and she is still looking confuse. She looks in the computer again and says the vet only put in his notes low dose dex test is normal. She says this is strange we cant have a 0.00 value. DUH I even know that. Now Im silently thinking in my head did they even give my boy the test. Did they just leave him in the crate for 8hrs and then collected my money. I explained to her that I paid for this test and I should have accurate results for the safety of my boy. I need either the results or I need a new test to be given without a charge. She tells me she has to call the lab and she will call me.

Next question why was a high dose dex test given without results from low dose dex. She tells me she was not concern with low dose dex test because it can come back inaccurate. I then tell her but dont you need the ACTH test and the low dose dex test to be positive in order to confirm cushings and the high dose just tell me what type of cushings we are dealing with. She says that is correct she is determing diagnois from ACTH test and cortisol serum and baseline test. At this point I want to cry and run as fast as I can out of this office and never return. She does not know I have coaches at k9cushings.com

Ok next question ACTH is normal and cortisol serum and basline test is normal how is this confirming cushing. She then tells me that on the lab results you dont look at the lab range or the evaluation you have to look at a percentage on the test being given. WHAT this is really a bad nightmare. Im thinking then why is this on the print out. This is how she explained it, Honeys ACTH Pre-cortisol level was 2.200 his ACTH post corisol level was 19.40, if the post cortisol level is 6x more than the pre cortisol level then this confirms cushing. Honeys hi dose dex 4hr post was 0.700 and the 8hr post hi dose dex was 0.700 she explained that the post hi dose dex 8hr has to increase 50 percent in order to rule out cushings she said this result need to be 1.4 or 2.8.
I have not read this info yet on this site. Has anyone heard of this.

Conclusion is I told her that he needs another low dose test done and I need a referral to an IMS. She will give me a referral to Gulfcoast Vet Specialists in Houston TX. If anyone knows about this facility can you please let me know.

Thanks to All for your help and Support
Rhondalyn

[StarDeb55]

Rhondalyn, not to be blunt, but you need to get out of that clinic, & the sooner the better. They are dead wrong about how to read those test results, IMHO. The only thing I can tell you about Gulf Coast is Lone Star Shih Tzu/Lhasa rescue, where I adopted my other boy Chewy, uses Gulf Coast. I figure if they use the clinic they must be pretty good, & I know they apparently are very caring as they do all the care for the breed rescue at a discount.

Debbie

[labblab]

Ok next question ACTH is normal and cortisol serum and basline test is normal how is this confirming cushing. She then tells me that on the lab results you dont look at the lab range or the evaluation you have to look at a percentage on the test being given. WHAT this is really a bad nightmare. Im thinking then why is this on the print out. This is how she explained it, Honeys ACTH Pre-cortisol level was 2.200 his ACTH post corisol level was 19.40, if the post cortisol level is 6x more than the pre cortisol level then this confirms cushing.

WOW!!! Super good job, Rhondalyn, on advocating for your baby!!!!!!

There is lots that I could say about this vet visit, but here's the most important part. I have never heard of a diagnostic ACTH stim test being interpreted on the basis of any "percentage." A dog's "pre" result can be highly variable, based upon how stressed the dog is at the time that the test is given, etc. My understanding has always been that it is really only the "post" value that is the diagnostic indicator of Cushing's -- whether or not it falls within the "normal" range listed by the laboratory that has performed the analysis. And Honey's result was within the normal range. At the high upper end, but still within the normal range for that lab.

I do agree with your vet's statement that she could have reasonably proceeded to the HDDS if Honey had been "positive" on EITHER the ACTH or LDDS. In other words, once the initial diagnosis has been established by EITHER test, it makes sense to move forward in determining the type of Cushing's. But as far as I can see, the ACTH did not establish the initial diagnosis, since Honey's "post" result was within the normal range.

This is my thought... I believe you are absolutely correct that this vet practice owes you a free repeat LDDS if the results of the original test are not retrievable. But once you have those results in hand -- I'd make a beeline for the referral specialists. No matter how the results turn out, I think you'll be very well advised to get alternative guidance re: Honey's diagnosis and treatment.

Marianne

[acushdogsmom]

and I need a referral to an IMS. She will give me a referral to Gulfcoast Vet Specialists in Houston TX. If anyone knows about this facility can you please let me know.

Thanks to All for your help and Support
Rhondalyn

I am in Canada, so I've never used them myself, but I have heard that the Specialists at Gulf Coast Hospital in Houston are supposed to be really, really good!

http://www.gcvs.com/

[rbeasl]

I can honestly say that this site saved Honey's life and I can not Thank You enough.

Received lab results from my vet showing the low dose test to be normal. She fax all the lab results to the IMS and I was able to see him the next day. He was very easy to understand. He said you can make a sick dog well but you dont want to make a well dog sick. He told me that this is a very powerful drug and you have to be absolutely sure that cushings is confirmed and he told me he was not able to confirm cushings at this time with the lab results I had. He did suggest that we do an adrenal panel at a later date. He told me the lab results are sent to University of TN and I felt good about that because I hear you guys talk about that place. For now he wanted me to have the dermatologist to look at Honeys hair loss and skin. I was able to see her the same day and she found out that Honey has a bacterial skin infection and gave me 2 different antibodies. She wants to have it recheck in 3 weeks. I think at that time I will also do the adrenal panel.

Because of this site, I learned so much about cushings. I never looked at lab results before. I just hate the thought of what could have happen if i kept giving Honey the medication when he did not need it. Thank You So Much for sharing your knowledge and experience in order for me to help my baby boy.

I will keep you updated on the upcoming results from the adrenal panel..

Thanks Again
Rhondalyn and Honey Bunny

[Franklin'sMum]

Hi Rhondalyn and Honey Bunny :)

I'm so happy for you both that you are now under the care of an IMS :D. I'm also hoping that Honey Bunny's skin infection begins to heal up quickly with the help of the anti biotics that he gave you.

Jane, Franklin and Bailey xxx

[Roxee's Dad]

I can honestly say that this site saved Honey's life and I can not Thank You enough.

Received lab results from my vet showing the low dose test to be normal. She fax all the lab results to the IMS and I was able to see him the next day. He was very easy to understand. He said you can make a sick dog well but you dont want to make a well dog sick. He told me that this is a very powerful drug and you have to be absolutely sure that cushings is confirmed and he told me he was not able to confirm cushings at this time with the lab results I had. He did suggest that we do an adrenal panel at a later date. He told me the lab results are sent to University of TN and I felt good about that because I hear you guys talk about that place. For now he wanted me to have the dermatologist to look at Honeys hair loss and skin. I was able to see her the same day and she found out that Honey has a bacterial skin infection and gave me 2 different antibodies. She wants to have it recheck in 3 weeks. I think at that time I will also do the adrenal panel.

Because of this site, I learned so much about cushings. I never looked at lab results before. I just hate the thought of what could have happen if i kept giving Honey the medication when he did not need it. Thank You So Much for sharing your knowledge and experience in order for me to help my baby boy.

I will keep you updated on the upcoming results from the adrenal panel..

Thanks Again
Rhondalyn and Honey Bunny



Hi Rhondalyn,
When I see a post like this, it gives me chills and goosebumps :D The good kind. It's so good to know that you and Honey are now on the right track. This is why the members here ask so many questions of our new members:o;):) You did good, no, you did very good. Keep up the good work and continue to be Honey's advocate.

Great job! :D Belly rubs to your Honey Bunny.

[labblab]

Rhondalyn, thank you so much for giving us this update!!!! I am so relieved to hear that Honey is now under the care of this IMS :).

Just to clarify, did your old vet run a repeat LDDS on Honey now, or was it the April test results that were normal? If she's not been retested with an LDDS since April, once Honey's skin infection clears up, I'm wondering whether the IMS may want to go ahead and run another LDDS in addition to the full adrenal panel. Actually, the University of Tennesse laboratory will perform analysis of a combined ACTH/LDDS/full adrenal panel test all at one time. So maybe that is something your new IMS might want to consider -- or not ;). I'm sure you'll be receiving good guidance from him as far as what testing he thinks will be most appropriate or helpful for Honey.

In the meantime, don't be a stranger and please keep us updated on how Honey is doing.

Marianne

[apollo6]

Dear Rhondalyn
Glad you are speaking up. Was an ultrasound even down of Honey's abdominal. This would show if one or both adrenal glands are enlarged and if the liver, kidney, and pancreas is abnormal.


below is a site that you can look up specialist . put you state in. then when it goes to the pages of listings, click on any of the vets and read info on them.
http://www.acvim.org/websites/acvim/index.php?p=3

I already gave you this sorry for repeat.
Apollo is on Trilostane. But like everyone says. You need to have a strong diagnosis as to which cushing it is-note three kinds. And only then look at what treatments are available and remember you are Honey's advocate, the vets are working for you not the other way around. Never feel afraid to ask a question. When I started out , I asked questions about all the tests, what the readings meant, etc. Keep copies of all the tests for future reference.
Hugs Sonja and Apollo

[Casey's Mom]

Way to go Rhondalyn - you have done a great job for Honey Bunny and have been a true advocate for your pup.:):):)

[rbeasl]

You guys make me feel so good. Thank You So much.

Marianne that is an excellent idea to give to my new IMS. A new LDDS test was not run. I just went with the old one taken in April. Can both test be run in one day. If not what test do you think is the most important one to have done first. Last question how long is the adrenal panel test. Is it also 8 hrs long. I hope not because the last vet visit Honey hid under the chair and when I say medicine he breaks out running. My poor guy is tramatized

Sonja I will also ask about the abdominal ultrasound. That has never been done. Sonja I just wanted to tell you that your post was the very first one that I read and at Day 1 you were so very scared and did not know what to do and everyone here was so compassionate and caring and helped you get through everything. Then months later reading your post, you were so knowledgeable and research everything. I said that I wanted to be the type of mother you are to Apollo. YOU ARE MY FREAKIN HERO GIRL... THANKS

To everybody, I will continue to keep reading. learning and praying for your babies.
I will keep you updated on the upcoming tests.

God Bless
Rhondalyn and Honey

[Franklin'sMum]

Hi Rhondalyn,

The adrenal panel/ACTH stim only takes a bit over an hour, two hours max. Dpeends on what stim agent the IMS uses. First they take a pre sample, then inject the stim agent, wait 1 or 2 hours, then take the post sample. The LDDS is the 8 hour test, and if you request it, they may let you take Honey in between blood draws. We didn't have the LDDS, but for the adrenal panel I told mine that Franklin hates being in a cage, and I wanted accurate results, not added stress by him throwing a hissy fit in the cage, so we hung out in the carpark and went for little walks down the street :)

Jane, Franklin and Bailey xxx

[Casey's Mom]

Rhondalyn to add to what Jane mentioned you can also take him somewhere in between blood draws for the ACTH test - even if it is only for an hour. I plan to do this with Casey on her next ACTH because she gets so stressed when I leave her there.

Hope this helps,

[labblab]

Rhondalyn, everybody has already given you great info about the adrenal testing. I do think the combined ACTH/LDDS/full adrenal panel can be a bit tricky to be timed correctly (and yes, unfortunately, it would involve the multiple blood draws over the 8-hour time period). So your IMS would probably want to talk with Dr. Oliver at the University of Tennessee laboratory in advance in order to coordinate everything and to consult as to whether it would even be a good idea in Honey's case.

My own thought is just that if you end up going to the effort of sending blood to Tennessee for analysis, it would be really nice to have the whole array of test results in front of your IMS for decision-making. Honey's symptom profile and lab results are just so classic for Cushing's. It still makes me wonder whether or not he'll end up with a "positive" ACTH or LDDS further down the road. But once again, it sounds as though your IMS is being very properly cautious as far as first addressing the skin infection and then re-evaluating Honey's overall situation a little later on.

Marianne

[Squirt's Mom]

Hi Rhondalyn,

Darlin', you are amazing! You have done a superb job on Honey's behalf! :D I am so very proud of you and I know Honey is grateful beyond expressing that you fought for him. He has the best mom on his side he could ask for! :):cool:

Keep up the good work and do keep in touch often! Ya'll are family!!

Hugs,
Leslie and the girls :D - always

[apollo6]

Dear
Rhondalyn and Honey
Hang in there ask us questions . No question is silly. There is a lot to learn about this disease. It can get overwhelming. You are on the right track. We'll be here to love and support you.
Hugs Sonja and Apollo

[rbeasl]

Hello Cushing Coaches,
Hope all is well with your families and little furbabies. Your guys helped me out tremenously last time I was here. I need your help and advice once again. The last time I posted I was telling you guys that I took Honey to a specialist and he told me base on his test results to stop the trilostane and he referred me to a dermatologist for his skin problems. Well Honey stayed on antibotics for almost 2 months. The skin problem cleared up. I then asked the internal medicine specialist about other tests to be done for cushings. He felt further testing was not necessary. Long story short he did not take my concerns serious and I felt this specialist was not special to me at all. Several months later, I go vet hopping and a regular vet referred me to Texas A & M Vet college. I finally feel like I am at the right place, they are really good. After extensive testing, my poor Honey has several areas of concern. The ultrasound does not show any tumors, but there other problems that I had no idea was going on. Enlarged liver with high liver enzymes, high cholesterol, Enlarged gallbladder w stones forming. May need surgery later. High blood sugar of 189. The vet prescribed Denamarin 225mg 1 tab per day and Ursodiol 250mg 1/4 tab per day for his liver problems. He also suspect cushing and wants a LDDS test done. I do this w the regular vet when I returned home and the results are

Cortisol Sample 1 Result 3.2 ug/dL Range 1.000mg-5.000 ug/dL

Cortisol Sample 2 Result 1.0ug/dL Range 0.000-1.400 ug/dL

The regular vet tells me this is normal, but she talked to the vet in College Station and he wants to start Honey on 10mg of Trilostane instead of the 30mg. He feels that even though Honey is 26 lbs that the 30mg was probably too high and should start with the dose his intended weight should be. I remember how weak Honey looked after giving him the 30mg that I just so scared this will happen again.

After 2 weeks of a special diet of Science Diet R/D and his meds Honey is not drinking or urinating near the amount as before and he has more energy and he looks happy again.

I see the vet in College Station in 1 month. Do you guys think I should start the 10mg of trilostane with a normal LDDS test?
Should I have a adrenal panel done next ?
What should I be asking the vet when I go back?

I will appreciate any advice and sorry so long

Rhondalyn

[labblab]

Hi again, Rhondalyn!

Before commenting further on Honey's situation, I'm hoping you can clarify his Cushing's testing results. When you were last here in October, you were planning to have a full adrenal panel analyzed at the University of Tennessee at Knoxville. Was that testing ever performed? If so, can you tell us the results?

Also, the LDDS test usually involves three different blood draws: an initial draw, then one done after four hours, and a final draw after eight hours. You are only listing two results for this most recent LDDS. Can you double-check and see whether there is also a third result listed? If not, how much time was there between the first and second draw?

Thanks in advance for this additional information. It will really help us as far as our feedback about Honey.

Marianne

[rbeasl]

Hi Marianne,

Thanks for your rely. The last LDDS test was performed on 2/24/11. The paper work only shows 2 results. I will need to call the regular vet to see if she has the 3rd result. Now I am so worried that once again this test was not done correctly. I am really frustrated with wrong information from vets. I just cant have him go through another 8 hours, so Im really hoping she can give me the 3rd result.

Yes, the last specialist first mention the adrenal panel to UT and then changed his mind because of Honeys previous lab results from first vet. I later call to request all reports from this facility and found personal conversation about me in Honeys lab reports between this specialist and his assistant. It implied that I was overreacting and in his words, he would do further testing if it would make me feel better but he does not feel it was necessary. So I did not feel the love for my pet or me so I left and this is where I am now.

The new specialist at Texas A & M wants to start Honey on 10mg of Trilostane because Honey has the symptoms of cushings. The potbelly and the lost of hair. The excessive eating, thirst and urination is so much better since starting the new medication.

So Marianne, It sounds like I need to do the adrenal panel with this new vet and get the 3rd result from the regular vet.

Thanks for your help
Rhondalyn

[labblab]

Rhondalyn, I'm not sure that you are needing to have the full adrenal panel done now -- I was just wondering what the results were in the event that it had been performed back last fall. So right at the moment, I'd just concentrate on clarifying what the LDDS results were.

Marianne

[rbeasl]

Hello Everyone,

It's been quite a while since I've posted, but this is where I continue to come when I feel alone, angry, afraid, confused and frustrated. I can not Thank the person that started this site and all that have posted their stories enough. I have learned so much about this depressing disease. You have made it possible for me to be a voice for Honey, and that feels really good to know just a little something about it.

Well after about a year and a half Honey has been confirmed with having regular and Atypical cushings. I think I finally have all necessary testing completed and it is time to start treament. My vet has giving me options and I really need your help and advice on what option to take.

Several tests have been taken over the last year. I will give you the very latest and please let me know if you need other results.

5/19/2011 Full adrenal panel from Univ of Ten

Cortisol result 66.5 normal 2.0-56.5
post acth 240.74 normal 70.6-151.2
Androstenedione 1.32 normal 0.05-0.36
post acth >10.0 normal 0.24-2.90
Estradiol 77.8 normal 23.1-65.1
post acth 71.1 normal 23.3-69.4 progesterone 0.32 nomal 0.03-0.17
post acth 2.38 normal 0.22-1.45
17 OH Progesterone 0.33 normal 0.08-0.22
post acth 3.68 normal 0.25-2.63
Aldosterone <11.0 normal 11-139.9
post acth 28.3 normal 72.9-398.5
2/17/2011
Ultrasound completed
No adrenal tumor found
Diagnosis
Polyphagia-possible hyperadrenocorticism
Hepatomegaly likely vacuolar hepatopathy
Early Gallbladde mucocele
Cystic calculi
Hyperglycemia- pre diabetes
Splenic nodule
Cutaneous Nodule Left axilla

Honey was prescribed Denamarin and Ursodiol for the high liver enzymes and gall bladder stones

4/28/2011
Follow up ultrasound shows no tumor
Honey has many small urinary stones in his bladder and both kidneys Ultrasound shows some of the stones have moved into his urethra.

I Know about the melatonin and flax hulls w lignans, but I need your help if I should start Honey with the loading dose of lysodren or start with the maintenance dose. Im really scared and I want to start slow with the maintenance but I dont know if this is the right decision to make. I spoke to only my regular vet and she wants me to call the specialist, but I need your opinion first.

Thank You Very Much
Rhondalyn and Honey

[labblab]

Welcome back, Rhondalyn!

Were you ever able to get the full test results for the LDDS that was performed back at the end of February? Those results might very well influence the recommendation between starting with a loading dose vs. a maintenance dose of Lysodren, so it would be very helpful to see them.

Marianne

[rbeasl]

Hello Marianne,

Thanks for the speedy response and for being Honey's Guardian Angel. So sorry for the delay of LDDS test . I hope this can help you help me and Honey.

February 23, 2011 the LDDS test was done incorrectly.
The repeat LDDS test was completed 3/2/2011

Cortisol Sample 1.... 3.4 range 1.0-5.0 units ug/dL
2.... <0.7 range 0.0-1.4
3.... <0.7 range 0.0-1.4

Previous LDDS test on 4/29/2010

Cortisol Sample 1....3.2 range 1.0-5.0
2...<0.7 range 0.0-1.4
3 ...<0.7 range 0.0-1.4

Marianne, I dont get how do you get normal results from the LDDS tests when the test that was done at Univ of Ten the cortisol level was so high. I feel like I wasted so much time on getting Honey treated and now his liver and gall bladder is out of whack w beginning stages of diabetes. I'm feeling pretty bad right now.

Thanks for your Help
Rhondalyn and Honey

[Squirt's Mom]

Bumping up......

[labblab]

Leslie, thanks for "bumping up" Rhondalyn's thread! I've got to head out shortly on some errands, but will plan to add a reply of my own later today in addition to any thoughts that others may add in the meantime.

Marianne

[labblab]

February 23, 2011 the LDDS test was done incorrectly.
The repeat LDDS test was completed 3/2/2011

Cortisol Sample 1.... 3.4 range 1.0-5.0 units ug/dL
2.... <0.7 range 0.0-1.4
3.... <0.7 range 0.0-1.4

Previous LDDS test on 4/29/2010

Cortisol Sample 1....3.2 range 1.0-5.0
2...<0.7 range 0.0-1.4
3 ...<0.7 range 0.0-1.4

Hi again, Rhondalyn.

I'm sorry that it has taken me so long to get a reply written! I'm also so sorry that you and Honey have had so many months of worry over his condition. You have really been through a lot as far as diagnostics and different information from different vets. :o

Are you still consulting with a specialist at Texas A & M? And how is Honey doing in terms of his behavioral Cushing's symptoms (like eating, drinking, and peeing?).

I must admit that I am still a bit confused about those LDDS numbers. You've surely had a tough time getting all the relevant results from your respective vets! But I still want to double-check one thing. The results that you gave above (where all the results for the 2nd and 3rd draws were <0.7) are different from the partial results that you reported in your reply posted here back in March:


Cortisol Sample 1 Result 3.2 ug/dL Range 1.000mg-5.000 ug/dL

Cortisol Sample 2 Result 1.0ug/dL Range 0.000-1.400 ug/dL
Do you know what the third sample result was for this test, and what date the test was performed? All those <0.7 results just seem odd to me, and still make me wonder whether there is some confusion about the reported numbers which is making the test interpretation difficult for us. It is true that questions could be raised about the accuracy of a Cushing's diagnosis in the presence of repeatedly "negative" LDDS test. But I'm still not sure as to the accuracy of the testing (or your vet's reported results) of Honey's LDDS procedures.

However, moving on from the LDDS, we do see a progressive increase in Honey's ACTH results, from 16.2 (1/10) to 19.4 (9/10) to 24.1 (5/11). Also, virtually all of his intermediate hormones are also elevated with the exception of his aldosterone actually being low. Low aldosterone on the UTK panel can sometimes indicate the presence of a primary adrenal tumor, so I think it is a good thing that a repeat ultrasound was performed in order to rule that out.

Having said all of this -- and if you are still consulting with Texas A & M -- I really would defer to their judgement as to the significance of his test results and the manner in which to proceed with Lysodren dosing. An ACTH of 24.1 is not hugely elevated, but it has been steadily increasing for Honey and as you say, he is developing other health issues that are worrisome. Hopefully, they have all his complete test results in front of them. And they also have the opportunity to directly consult with UTK about the results of this full adrenal panel. So if it were me, if Honey is still exhibiting so many traditional Cushing's symptoms, I believe I would choose to proceed as they recommend. Do keep us updated as to what they say, though!

Marianne

[rbeasl]

Hi Marianne

It's so weird. I dont know you and I have really come to trust everything you tell me and depend on you. I knew you would get back with me as soon as you were available so dont apologize. I really appreciate your information. Thank You so Much.

Yes, Honey and I really have been going through alot with different vets and yes we still travel an hour and half to Texas A & M. They only did the last 2 blood panels and the last 2 ultrasounds. The regular vet did the last LDDS test. Like you I am wondering how accurate the results are. I'm just so confused. I feel like my dog is the only dog in Houston that has cushings and no one knows how to help him. Even
the first vet at TX & M wanted to put Honey back on trilostane. He wanted to put him on a lower dose because he had the bad reaction the first time. Only because what I learned from this site, I told him that was not a good idea and we needed to test for Atypical first and trilostane can increase other hormones. Thanks K9 cushings

I just spoke to another vet at TX A & M today and she wants to start Honey on a loading dose of lysodren. I told her that I was really scared because his cortisol level is high but not extremely dangerously high and if we could start on maintance dose first just to see how he reacts to it. She agreed and said it will take longer but we can try with higher dose later if this does not work. I also asked for prednisone in case of emergency. Thanks again K9.

As far as Honey. He is urinating normal and drinking alot less since he started the denamarin and ursidol. There is no more panting. The hair loss is still extreme. He is bald on the sides of his body and he has the very large potbelly. My once very proud little boy use to walk on side of me and now I noticed he walks behind me. I was wondering if he was feeling naked so I bought him some tee shirts and I really thinks he feels better when we go out.

The IMS will be mailing me the medicine and giving dosing information to my regular vet. I will keep you updated

Thanks Again and have a Great Week-End
Rhondalyn and Honey

[rbeasl]

Marianne,

I just received the lysodern in the mail and I just don't have the courage to start Honey on this medicine right now. When I opened the package there is this big bright orange sticker that says CHEMOTHERAPY DRUG... VERY TOXIC handler must wear gloves. YIKES... Yes, I read that lysodern was a very powerful drug and a form of chemo, but seeing it like this, really is scary.

IMS is starting on the maintenance dose of 125mg 4xwk for 3 wks.

Marianne, do you know when is the critical time when a owner should start lysodern. Right now Honey no longer has the extreme thirst,urination, hunger or panting. I'm not for sure if the denamarin and ursodiol had anything to do with this. The main symptons are the hair loss and potbelly and sleeping on cold floors. I am concern about the enlarged liver w high enzymes, gall bladder and kidney stones and beginning stages of diabetes.

My regular vet is excellent w regular routine care, but there is no experience with lysodern and atypical cushing. The Texas A & M vets are good but they are so far away and I'm so scared of something going wrong and not having a specialist close by that will know how to help in case of an emergency.

Please tell me if you think I'm wrong. What I want to do now is start honey on the melatonin and flax hulls w lignans for 3-4 months and in the mean time try to find a local specialist that works with Dr. Oliver and then have Honey retested to make sure we are starting off with accurate lab results before starting the lysodern.
I'm just dont know if this is the risky approach since so much is going on in the inside. Right now Honey looks happy on the outside. I'm just so scared of making him sick before making him better.

Thanks Again,
Rhondalyn and Honey

[lulusmom]

Bumping up.

[Squirt's Mom]

Hi Rhondalyn,


5/19/2011 Full adrenal panel from Univ of Ten

Cortisol result 66.5 normal 2.0-56.5
post acth 240.74 normal 70.6-151.2

Androstenedione 1.32 normal 0.05-0.36
post acth >10.0 normal 0.24-2.90

Estradiol 77.8 normal 23.1-65.1
post acth 71.1 normal 23.3-69.4

progesterone 0.32 nomal 0.03-0.17
post acth 2.38 normal 0.22-1.45

17 OH Progesterone 0.33 normal 0.08-0.22
post acth 3.68 normal 0.25-2.63

Aldosterone <11.0 normal 11-139.9
post acth 28.3 normal 72.9-398.5

Since these are the most recent results, these are the ones to work with...tho I am still curious about the odd LDDS results. ;)

HoneyBear's cortisol is elevated so that means he is considered to have true, or conventional, Cushing's and NOT Atypical. An Atypical pup will have normal cortisol with elevations in the intermediates only. A pup with elevated cortisol AND intermediates is considered to have true Cushing's.

As such, he needs more than the melatonin and lignans. The Lyso will bring all his levels back down, with the possible exception of the estradiol. This is because estradiol can be produced in areas outside of the adrenal glands - and Lyso works only on the adrenals. His estadiol is not elevated a great deal so that wouldn't concern me as much as the cortisol does.

I know the Lyso is scary but it is also a life-saver. My Squirt is taking 125mg 2x/week and she weighs 14lbs. I was scared of it, too, when I first heard about the treatments for Cushing's but now that I see what a world of difference it has made in her, I wish I had started her on it much sooner than I did.

The usual dose of Lyso is 50mg/kg/week. So at 26lbs. HoneyBear would need 590.91mg/week. (26lb / 2.2 = 11.82kg x 50mg = 590.91mg) At 125mg 4x/week, HoneyBear will be getting 500mg/week - which is a bit below the usual amount. I hope that makes you feel a bit better to know that you are starting with a lower dose.

If it weren't for the cortisol level, I would agree with trying the melatonin and lignans for a few months first but with his cortisol elevated, I think your best bet would be to start the Lyso. In about 6 months, you can have another UTK panel run to see how the intermediates are doing if you wish but the odds are the Lyso will bring them all down with the cortisol. I guess your vet is wanting to check the cortisol in 3 weeks?

The warnings on the Lyso are not to be ignored but don't let them panic you, either. The drug companies HAVE to use warnings like that to protect consumers and themselves. ;) I don't wear gloves when I use it but I have no plans on getting pregnant...if I DID no one here would ever have to worry about paying a vet bill again, trust me on that! :p I have a pill cutter that I use solely for her Lyso - nothing else is cut in that cutter. I store her cut portions in their own bottle. When she gets her dose, I cut it into as many small pieces as I can and put them in her food straight from the cutter - I don't touch the chopped pieces. She also gets 1/2 of cimetidine (Tagamet) at the same time. Pepcid AC is also used by many members here.

Your concerns about the diabetes, high liver enzymes and such are valid but you should know that by treating the cortisol, you will be helping these things, too. It is when the cortisol is not controlled that we start to see problems with other organs and systems so the sooner the cortisol is brought under control, the better all the way around.

I am sure others will be along with their take on things, too. Just don't be afraid. We will be here with you all the way. You're doing a good job, Mom, hang in there!

Hugs,
Leslie and the gang

[rbeasl]

Leslie,

I really needed your response. Thank You So Very much.. I have been a nervous wreck. This is the the push that I needed to get Honey started. You are so right in everything you have said. I talk to the vet and she said Honey is in the critical stage where he should be medicated because so much is going on in the inside and she is taking a very conservative approach to see how he will reacts. She wants to start treatment before diabetes develops. I will be starting Honey on the medication this Monday 6/6/2011.

Leslie you have made me feel so much better.... I know now this is what my baby boy needs to truly make him feel better.. Thank you so much.

Just a few questions..... Let me see if I understand. Because Honey cortisol is elevated with the intermediate hormones this makes him have just regular cushings and not Atypical.

Do you know the best diet food for dogs on cushings. He is on Science Diet RD but the weight is not coming off. Ive been reading bad things about commercial dog food. He is crazy about chicken breast and I was wondering if I should have him eat that while on lysodern, because if he stops eating that I will definitely know something is wrong.

Leslie I can finally get some sleep because of you. Please continue to help me and Honey on this very long but positive journey.

Thanks Again
Rhondalyn and Honey

[Squirt's Mom]

Hi Rhondalyn,

I so well understand where you are coming from and just wanted you to know that you are on the right path. ;)

For right now, I wouldn't change his diet. I don't care for Science Diet anything but you want to be able to tell if something changes once he starts the Lyso so to eliminate possible confusion, leave him on it for now. Once those 3 weeks are passed and you see how he is handling the Lyso, then we can talk about changing his diet.

If he is like Squirt, he will lose some of his weight once the treatment starts. She has lost nearly 2 lbs - which gave me reason to panic a couple of weeks ago because I felt her mammary glands for the first time in years and just KNEW she had cancer. :o:rolleyes::p Her vet got a kick out of it, tho! :D

Since he is on a weight loss product, on the days he has his Lyso dose you will want to give him a little oil or fat with the meal. This will help the Lyso be better absorbed in his body, effecting a better treatment. You can add a tsp of olive oil or canola oil. Some members dissolve the Lyso in warm oil and give it that way. Pill Pockets, cream cheese, Am. cheese, butter and peanut butter will also work if you don't want to put it in his feed. Squirt eats a home cooked menu with salmon and Vit E oil added daily so she gets the oil that way. Prior to home cooking, I used cream cheese often to get pills down her. ;)

Mon. sounds like a game plan to me! You and Honey have the weekend to enjoy and relax a bit. Just remember we are here any time.

Hugs,
Leslie and the gang

[Rene]

Hi Rhondalyn,

You are getting excellent advise from the group. I have to especially agree with what Leslie told you about the Lysodren. My girl Snoopie is being treated with 500mg weekly of Lysodren for pitituary cushings and it has changed her life! She was also about 26 lbs when we started loading.

Snoopie has no spleen or gall bladder and suffered from cronic pancreatitus and renal issues. So, I was very leary of Lysodren as well. I tried the HMR lignans and melatonin but her cortisol and intermediates (sex hormones) too high for them to be effective. Because the intermediates were already elevated trilostane was not an option. She was in danger of loosing her liver and other organs next so we had to treat with Lysodren. She immediately started feeling better while loading on Lysodren. As Leslie pointed, out since being on Lyso she has had no incidents of pancreatitus or renal issues. We have had incidents where she got into something that should have put her into the hospital with pancreatitus and nothing happened! So, I think it is safe to assume that by the Lysodren controlling her cortisol and intermediates it has put her pancreatitus and renal issues to bed, for now.

A few mistakes were made getting her loaded and getting the maintenance dose down. If I had posted the plan with the group the mistakes would have been caught and we would not have had to pay for repeat ACTH tests. Not to minimize any of these wonderful vet's expertise but there is a far more collective level of actual real time experience here.

Here is what I learned (I will use our dose for example):

Loading 500mg:
Use pill cutter to cut in half. Give one half in AM food one half in PM food. Pill pockets or cheese...something with fat helps with absorbiton into the adrenals. Half and half is better on them. I was not told about the Pepid and did not give it to her...thankfully, the lyso never bothered her even with her issues! Give the lyso near the beginning of meal that way you can be sure they went all the way down.

Don't stop loading until you see signs of loading. I guess my vet was being consertative and wanted to stop after 10 days and do a ATCH because of all her problems. Mistake. She didn't get loaded.

When she did get loaded the signs were clear. As soon as we started loading she started feeling better as the cortisol came down...I bet they do feel better wouldn't you? Then she was down right euphoric...I was afraid she was gonna hurt herself on walks! Many folks here report playing with toys they haven't picked up in years. Then as she got closer to being loaded these signs tapered off. Thats when we saw the classic ones...food, water...ect. That means the cortisol is becoming too low...time to stop. It's not so scary looking back now. It all makes sence.

Maintenance dose 500mg a week:

Cut pill into quarters and put into a separate bottle. Give 4 times a week. I was told once a week. Mistake. I guess they can regenerate too much adrenal tissue in the meantime...we had to reload! I tried twice a week...did not work...might work for you...Snoop just has super adrenals! Obviously trying to cut a pill into thirds is out of the question so I cut it into quarters. I just put it into a separate bottle. I know she gets one on Sunday and if the bottle is empty by Saturday we are happy. It does not have to be an exact science! So far this is working!

The food is a whole other issue that needs to be addressed. But, after you have the cortisol under control. The cortisol is the most urgent...I wish I had addressed it sooner for Snoop. One change at a time.

Of course this is just one success story...there are risks with any drug. But if you choose to go foward with the Lysodren post every thing you are going to do before you do it! The kind folks here will check you dosage, frequency and catch and red flags.

This is just my lay experience and all I have to say. I will leave you in the hands of the kind and knowledgable folks here.

Good Luck,
Rene & Snoopie

[rbeasl]

Leslie,

Thank You for the valuable information. I think I can make it through this with your help... Squirt has the sweetest face... She is a cutie pie
I think it was your post where I read about the mammary glands and what they really were. I laughed so hard because this is something that I would do. I remember taking Honey into the vet because I was so worried that the area around his private area looked extra swollen and the vet said so simple It just FAT....40.00 bucks for you to tell me my baby is FAT.. Thanks Alot... Lesson Learned ... DONT take him in for everything...

Rene,

I've been reading your post, because I see you also use lysodern. I'm praying that I will have the success that you have had with Snoop. I have been learning and laughing about you and Snoop. She is hilarious. I really needed the squirrel trap story. Thanks for the laugh. My poor little guy runs and hides when he sees the smallest bug. Its all my fault because he sees me running and hiding when there is any type of bug.

You really have been doing a good job with Snoop. She is lucky to have you for her Mom. This Cushing thing is really confusing and I'm so gratefull for the people here to help me. I'm just wondering if I made a mistake by asking my vet if we can start Honey on the maintenance phase and not loading. I just hope it will be enough to show some type of improvement.

Just one question. I've been given prednisone also. I know to give this to him if he is vomiting or has loose bowels. Do you also give it when he stops eating or drinking or is this the time that I call the vet to have him tested. Can he get loaded on the maintenance phase...

Thanks for Your Help
Rhondalyn and Honey,

[Harley PoMMom]

Just one question. I've been given prednisone also. I know to give this to him if he is vomiting or has loose bowels. Do you also give it when he stops eating or drinking or is this the time that I call the vet to have him tested. Can he get loaded on the maintenance phase...

Rhondalyn and Honey,

Hi Rhondalyn,

If Honey snubs her nose at food then I would definitely take her to the vets and if the vet is close then I would hold off giving the prednisone. Prednisone will interfere with results of an ACTH stim test.

All dogs are different and react differently but I think it is very unlikely that she will be loaded on the maintenance dosage. Are you planning to schedule an ACTH stim test in 4-6 weeks to see how well Honey is responding to the Lysodren?

Especially ones that are being treated with Lysodren, I believe it is important to give dogs pepcid ac (famotidine) 20-30 minutes before giving the Cushing medicine.

Please know that you have so many here supporting and rooting for you and Honey.

Wishing you both the best.

Love and hugs,
Lori

[rbeasl]

Lori,

Thanks for the encouragement... I'm so glad I asked this question because I would be popping him prenidsone for everything.
The vet wants Honey to be tested after 3 weeks. If I am correct from reading other posts, I wait 48 hours from the last dose for him to be tested. I will definitely take the drive to Texas A & M for this test, to make sure results are accurate. Will this be the ACTH or LDDS. I think it should be ACTH. Its been awhile since he has had this test. Do you know long this test will be?

Thanks Again Lori,
Rhondalyn and Honey

[rbeasl]

Sorry Lori

I should read before posting... DUH .. I see you already told me ACTH test.... Guess Im nervous and not thinking right.... Ok how long will the ACTH test be...

Thanks Again
Rhondalyn and Honey

[Harley PoMMom]

Your vet will probably be using the stimulating agent, Cortrosyn (Cosyntropin), at least I hope so. With the Cortrosyn, the vet takes a pre or baseline draw and then a hour later will take a post draw.

If a vet is using the gel, Acthar, as the stimulating agent then a pre draw is done and 2 hours later a post draw is performed. Studies have been done that show that Acthar is not as accurate as the Cortrosyn.

Love and hugs,
Lori

[labblab]

Hi Rhondalyn,

I'm sorry I am so tardy in getting a reply posted to you. But I see that you've been getting great advice and information re: the questions you've asked. I treated my boy with trilostane rather than Lysodren, so I'm especially glad to see that you are getting feedback from others who have personal experience with Lysodren.

Even though I have nothing more to add right now, I definitely want you to know that I am rooting for you and Honey!!!

Sending big hugs,
Marianne

[rbeasl]

Marianne,

Thanks for checking in with me. Yes, I was freaking out there for awhile, but my cushing coaches have been giving me great information and calming me down..

Honey will start this Monday and I have scheduled an appointment for June 27 for for his ACTH stim test.

I will keep you updated... Thanks SO MUCH!!!!

Lori,

Great advice, I will be asking if they will be using cortrosyn for the test. Boy my vet is going to think I know what I'm talking about and I dont have a clue... (smile)

Have a Great Week-End
and Thanks Again

Rhondalyn and Honey

[LabDad]

Rhondalyn, Lulu and I wish you and Honey the best with the ACTH test.

:)

[rbeasl]

Labdad,

I must remember this quote when I start his first dose tomorrow. THANK YOU....

The vet divided the doses into capsules and I've always given Honey
pill tablets. I did a test run today with melatonin in a capsule covered in food and he chewed it and powder went everywhere. I was busted trying to hide another pill. I'm wondering if it is ok to open up the lysodern capsule and sprinkle it over food or does it have to be given in one full capsule in order for it to be effective.

Thanks Again,
Rhondalyn and Honey

[StarDeb55]

Sorry, Rhondalyn, it's not advisable to open those capsules. Lysodren is considered to be a chemo agent & you don't want it getting on your skin. I always washed my hands thoroughly after fixing Harley's "lyso/peanut butter" ball. You also need to make sure that Honey gets the full dose. Have you tried something like peanut butter or cream cheese? I always hid Harley's lyso capsule in a blob of peanut butter, worked great. It's stick enough that the capsule can't be spit out nor break open as you have described, along with peanut butter having enough fat to aid in the absorption of the medication.

Debbie

[rbeasl]

Debbie,

Once again, I almost made a mistake. I'm so glad I asked. Thank You for your rely. I think I will try cream cheese again. He stopped cream cream awhile back when he figured out I was putting pills inside. He will not eat peanut butter or pill pockets. He likes the little debbie cream oatmeal cakes, but with all the pills now I have to find something less fattening and the boy loves everything fattening.

Thanks for the Save Debbie
Rhondalyn and Honey

[frijole]

:) PUtting it in something with some fat is a good thing they say. I used both cream cheese and peanutbutter. Give it AFTER the meal to make sure he ate his whole meal first and that he ate normally.

Also - don't give any new foods or snacks while loading because you will be wondering if it was the food or the pill that caused vomit. Learned that one the hard way. :p

You will be fine and we will be here cheering you on. Kim

[rbeasl]

DAY 1... and I gave Honey his first dose of lysodern. I cannot Thank you guys enough for giving me the strenth and the support that I needed to get him started. Instead of waiting 3 months to get him started, I now can see if the bloodwork is better, if he has more energy, if the potbelly is smaller, and if the hair is growing back in 3 months... THANK YOU ALL VERY MUCH....

Can someone help me with a question I have. I was reading another thread. LisaNriley... and I learned something very important . Honey has an appointment on June 27 to have his ACTH stim test. Honey has a slight elevation in his cortisol and elevation with intermediate hormones. My vet has only mentioned to me that we will check cortisol level. Should we be checking the other hormones
also and have the test sent to Univ of Tenn. or are we just concerned right now for the cortisol.. This will be the first ACTH after 3 weeks on lysodern.

Thanks Again for your help
Rhondalyn and Honey

[frijole]

I'd just do the acth test because lysodren will help reduce the other hormones. Dogs that have high cortisol usually have other hormones that are elevated and the lysodren helps with those as well. Some dogs just have elevated sex hormones and not cortisol. That is where the U TN tests come in handy.

Congrats on getting the first dose out of the way and one step closer to HB feeling better. :D Kim

[StarDeb55]

My Harley had a UTK panel done for diagnosis. He had a pretty severe elevation in cortisol, along with all the other hormones. He was treated with lysodren & we never did another UTK panel, for the exact reason that Kim has just mentioned. Lysodren will control all adrenal produced hormones. The only exception to this is estrogen as it can be made in tissue outside of the adrenals such as fatty tissue, & several other areas. He only had ACTHs done to monitor his cortisol level, so we could make sure he was on the proper dose of lysodren.

Debbie

[rbeasl]

Thanks Kim and Debbie,

This is really good news because the test will not cost as much.
I have to find this boy a part-time job..:)

Rhondalyn and Honey

[Rene]

Hi Rhondalyn,

Has anyone mentioned Dr. Peterson's article of splitting the Cortrosyn to save you money. Here is the link to his article:

http://endocrinevet.blogspot.com/2011/03/how-to-extend-your-supply-of-cortrosyn.html

I was being charged "$140.00 for Cosyntropnin Injection" at one vet then it went to"$37.00 Cortrosyn" at the other who was using this method. Snoop is about the same weight as Honey so the savings should equate.

The other thing was can you get the tablet form of the Lysodren instead. Sure would make it easer to dose if you could use a pill cutter. We had to do a lot of adjusting from half, third to quarter doses. Sure made life easier.

Rene & Snoopie

[rbeasl]

Rene,

Thanks so much!!!!! I will definitely look up that information. I need all the help I can get. Yes, I hate the capsule because it is HUGE.. When Honey swallows a pill I feel like I made a touch down in the Super Bowl.. The next round of pills I will ask for the tablet.

I'm glad you are back.. I missed your posts. Hung in there and STAY SRONG

Thanks Again for the info
Rhondalyn and Honey

[Rene]

Thanks...its gets easier every hour. Telling stories helps too!

Also check out this link. I use it at Cosco with my AAA membership card and get almost 20% off Snoops lysodren. You can also use it at CVS and some other places. They gave me a hard time at first because they said it was not for pet RX's. I made them read the fine print on the card itself which states it is good for pet RX's as well. They said they would have to call. They called the number on the card and I haven't had a problem since!

http://www2.caremark.com/aaa/rxdirect_aaa.pdf

Rene & Snoop

[rbeasl]

YEAH BABY!!!!!

I have a AAA card. You are giving me all kind of great information that will save me some money. Thank You So Much...

I just printing out the information you gave me about the cortrosyn. It makes sense to me since I will have to have mutiple ACTH tests. I just wonder if my vet will have a problem with this. It sounds like I buy the first full vial and the vet is only using what I purchased myself. Right..

Thanks Again
Rhondalyn

[Rene]

The way they split it for a dog of about Honeys/Snoopies size they can get three stim tests from one vial! The remaining agent is then split in tuberculine syringes and can be labeled with Honey's name and stored in a refrigerator for a month or a frost free freezer for up to 6 months.

Snoops vet is at a speciality practice and probably goes through cortrosyn rapidly. So, I am not sure if he actually holds aside the remaining agent for Snoopie. We were not charged the vial price up front. He has always just charged the $37.00 for the cortrosyn.

Someone should start a "Good to Know" or "Tips" thread in the resource section and post these links and others which have been a lifesaver.

I wish I could remember who to credit with both the AAA card and the splitting Cortrosyn information.

Thank you!

[lulusmom]

Hi Rhondalyn,

The only problem your vet might have is knowing how to reconstitute the remaining cortrosyn in the syringes for your future use. I believe Dr. Peterson provides instructions in his blog but if not, here is information provided by Dr. Wendy Blount.


Split any left over reconstituted Cortrosyn into aliquots using plastic syringes. For a vial of 250 micrograms Cortrosyn, split it into 5 aliquots of 50 micrograms each or 10 aliquots of 25 micrograms each, or any combination thereof. For about a 10 kg dog or so (probably average size of dog that we do many acth stims on), one of the 50 microgram syringes would work. For a 5 kg dog, a syringe of 25 micrograms would work. You can store the aliquots in a frost-free freezer for up to six months with no loss of activity oas long as it is not thawed and re-frozen. Since no one knows the effect of thawing and refreezing, we don't advise using ACTH that has been thawed and refrozen.

If Honey weighs 11 pounds or less, you could get 10 stim tests out of one vial of cortrosyn. Us cushparents with little dogs can save a lot of money by asking our vets to do this for us. I have two cushdogs so at the very least I should get a twofer. :D

[Rene]

Thats right it was Glenda who told me about splitting the cortrosyn...THANKS GLENDA! Tons of money.

I found the other post by Jess...she deserves all the credit on the AAA card discount!


I'm not sure if this has come up before, but I wanted to share that I recently learned that most major pharmacies will give a AAA discount on prescriptions that are not covered by insurance. You just have to fill out a "card" that you print & fill out from the AAA website (look for "prescriptions" under "discounts"). I believe the discount is ~15% for brand names and more like ~20% for generics. When I used it, I saved $25 at CVS on 15 pills of Lysodren!

Jess did say in a later post that AAA stated on their website that there is a bigger savings when using the card and ordering online but she had not checked into that.

Here is the link again for the AAA discount card for those who missed it!

http://www2.caremark.com/aaa/rxdirect_aaa.pdf

[rbeasl]

Hi Guys,

I just wanted to give you a update on Honey's recheck visit on Jun 27. It has been 3 weeks from giving him his first dose of lysodern and I took him to TX A&M to get his ACTH test. I did not get the good news I was so looking forward to getting. I am so frustrated and disappointed at myself. I took a gamble on Honey's health and I lost because I was so scared of this drug lysodren. I started Honey on the maintainance dose instead of loading and this did absolutely nothing to lower his cortisol level. Im really feeling like I failed him. I never cry and this was the first time in a long time that I have cried. It has been almost 2 years and I am so ready for the time and money that I have put into this to start paying off and show me some improvement.

OK enough whining for now... whew... I needed that.

Here are the results

June 27,2011
ACTH pre 3.6 ref 1-6 ug/dl
post 26.6 ref 6-16.9 ug/dl

Glucose 135 ref 60-135
Cholesterol 450 ref 120-247
alkaline phosphastase 1582 ref 24-147

May 19. 2011 test from Univ of Tenn
Cortisol result 66.5 range 2.0-56.5
post 240.7 range 70.6-151.2

April 28.2011
Glucose 150
alkaline phos 1073

Feb 16, 2011
glucose 189
alk phos 547

Honey was started on the maintaince dose of 125 mg every other day {total weekly dose of 40mg/kg) now the vet wants him to be on 1/2 tablet 2x daily and to have him recheck in 10days or earlier if needed. I feel like Im back to day 1 again. I HATE CUSHINGS

Good news is the vet was surprised that Honeys Blood sugar was lower so I was happy about that. I am worried about the liver enzymes. Can anyone tell how much milk thistle I can give to Honey, he now weighs 25 lbs and do you think this will bring his liver count down. Im also concern with the cholestrol, is there anything I can give to lower this. Any advice you can give me on anything I would really appreciate it.

Thanks Again
Rhondalyn and Honey

[Squirt's Mom]

Hi Rhondalyn,

Seems like you have missed some important info that will come in handy from now on........ I am the Queen of Guilt and I guard my crown zealously! :p So, no more feeling like you failed your sweet boy! You did what you believed was the best thing for him and you - and that is all any of us can ever ask of ourselves. ;)

So, now it's time to re-vamp and get him loaded - then I'm sure you will start to see those improvements you are looking for quite soon. I know how scary a load can be when you are looking at it from the beginning, but you aren't alone and you already are a bit familiar with the Lyso now...and so is Honey. Your vet has a good plan for the load. I'm not sure if we have given you the tips for Lyso but here is the link just in case -

Lysodren Loading and Tips
http://www.k9cushings.com/forum/showthread.php?t=181

As for the liver enzymes and cholesterol, you should see those go down once the cortisol is under control. Elevations in these values are typical with an untreated cush pup so I wouldn't worry overly much about them right now. It is good news that the BG has already dropped some! :)

We have a thread in the Everything Else section on milk thistle. The dose Honey will need will depend on the type you use - liquid, capsule, etc. There are several links in the following thread where you can find info on different products.

http://www.k9cushings.com/forum/showthread.php?t=2948

You are doing a good job, mom, don't forget that. Honey is a lucky boy to have you on his side in this battle. He knows, as do we, that you will never let him down.

Hugs,
Leslie and the gang

[StarDeb55]

There is nothing to be afraid of using lysodren as long as you know what to watch for to determine if Honey is loaded. I hope the A&M vets carefully explained all of this to you. The link Leslie gave you about "Lysodren loading tips" has great information on it. Did the vet provide you prednisone in case of emergency? You will probably not need it, but it is essential when loading a pup. I have successfully treated 2 pups with lysodren. My first boy, Barkley, was treated for nearly 8 years with an excellent quality of life. Just remember that Honey may load faster than the 10 days. Most vets will give you a timeframe because if you see no signs of loading in that time, you need a stim done to see exactly where Honey is.

Debbie

[rbeasl]

Leslie and Debbie,

Thank You for the valuable information and making me feel better about the decision I made about the dose. I had a weak moment and now it is time to woMAN up and fight this with all I have.

I dont know what I would do if I did not have the help and support from you guys and this site. I have learned so much and I now know what questions to ask the vet and what to look out for. I now have 2 excellent vets helping me now at TX A&M, Dr Audrey Cook and Katherine Scott. I think I saw someone mention Dr. Cook on their thread and article she wrote on cushings. So finally, I have experienced vets helping me.

Debbie you give me hope to know that your Barkley was on lysodern for 8 years. I get really depressed when I read articles about pets with cushings not having a very long life span even when treated. SO Mr. Barkley prove them very wrong.

I do have prednisone, I just hope I dont go into panic mode to early and give it to him.

Thanks Again
Rhondalyn and Honey

[addy]

Hi,

I have read articles by Audrey Cook so you are in good hands;);)

We are all here for you. You can do it.

Hugs,
Addy

[frijole]

Hi! My gal Haley was diagnosed at 12 and I treated her for 4 1/2 yrs. She passed a year ago but not from cushings. Your HB can have a long and wonderful life so don't pay attention to what you read. :D The key is a vet with experience and paying attention. You are your dog's voice and they can't talk so you need to know enough to voice their feelings/symptoms to the vet. After the loading it was a breeze. Kim

[Rene]

Hi Rhondalyn,

Leslie is right. We all have to find our own pace. HB did not get into this shape overnight so a little hick-up on mom's part getting comfortable understanding this horrible disease i'm sure she
understands :o

Snoops liver enzymes were off the charts. I really like this supplement because it is one tablet instead of giving several supplements. It has both Milk Thistle and L-Methionine (Sam-E) (Which is what Snoops vet prescribed) along with other herbs great for supporting liver health. It also has a couple digestive enzymes. The tablets are the perfect dose for our pups. I get it at Henry's Market but many sites have it online.

http://www.countrylifevitamins.com/moreinfo.cfm?Category=19&Product_ID=312&CFID=78117&CFTOKEN=39537018

As we say...Cowgirl UP!
Rene & Snoop

[rbeasl]

Hello To All,

I really need help. Honey is on Day 6 of loading on lysodern. This morning he did not eat so I did not give him his dose. Tonight I thought I would give him a special treat and give him chicken. He turns flips for chicken, he loves it but he turned it down. I did not give him his dose tonight. I know something is very wrong when he turns down chicken. He did jump up when I said GREENIE and he ate that. He is alert but he is nervous for some reason.

I called the ER to ask a couple of questions, but the receptionist will not ask the vet anything. She said I need to bring him in and that is 150.00 just to see him. I need that money for the IMS.

1. I'm not for sure at what point to give him the prednisone

2. I have an appointment with the IMS Wednesday at Texas A & M which is 120 miles away. The earliest I could go there would be Tuesday.

3. His regular vet told me last week he could be retested with her in an emergency situation but she refers I take him to TX A &M to have the same lab do the test, which I totally agreed.

4. Is Tuesday too long to wait without giving him anymore medicine to have his ACTH test. The IMS told me Not to give medicine on day of test. So He would be without his medicine on today and Monday.

I had a funny feeling this would happen to me on a Sunday evening. WHY ME!!!!

Thanks
Rhondalyn and Honey

[frijole]

:D At least it isn't Friday night!

You did the right thing! Don't give any more lysodren. The lack of hunger is a good sign - that HB is loaded. You do not give any until after you have done the acth test to check the cortisol levels.

Usually once the test is done, and assuming you are loaded you will wait one week from the last dosage and commence maintenance dosing which your vet will explain to you.

So don't worry - don't give any more... this is a good thing. When is your test ? Tuesday? That is perfect. Lysodren continues to work for up to 48 hrs so Tuesday will give you a TRUE reading of where the cortisol is.

Meanwhile - you don't give prednisone unless it is an emergency. That means the dog looks like its near death - no energy, can't sit up, can't walk, can't hold head up. You will know. If you were to find yourself in that situation then you would simply give the amount on the bottle prescribed by the vet and normally within a few hours the dog would be fine.

Again - it sounds like HB is just acting like a normal loaded dog and being a picky eater... this is a good thing. Keep us posted on any other symptoms you see and we will walk you thru whether or not you need to call the vet, give the prednisone etc.

But for now... I say great job! Oh - I see you are scheduled for a WED acth test. That would be fine if you can't switch it to Tuesday. Just don't go any longer.

Congrats! Kim

[frijole]

PS IS HB drinking water? You might cook some white rice to see if he'd eat that. Did he eat anything at all today? How much water today? Thanks! Kim

[rbeasl]

Kim,

Thank You so much... You just saved me 150.00 dollars because I was going into a panic mode.

The only thing Honey had today was 1 greenie and half of his water bowl is down. So not very much water. I would normally be at 2 bowls right now.

I will try to get him into the IMS on Tuesday and I will post the results when I get them

Now I can relax on this beautiful Sunday evening:)

Thanks Kim

[frijole]

:p My pleasure. He'll be OK so long as he drinks water and doesn't get sick (diarrhea or vomit)... if that happens pop the prednisone. Don't give any new foods or treats that way you know nothing is upsetting the tummy.

Hopefully tomorrow he'll eat some food.

If anything changes do let us know. OK?

[rbeasl]

Hi Guys,

Me and Honey made it through a scary night. Things were fine after Kim gave me great advice and I just felt more at ease until 2a this morning. Honey just could not be still. He twist and turned all night and could not be still. He did not eat the whole day and still refused to eat. Later around 5a while picking up his pee pads I found a small amount of vomit mainly white foam. Ok so now I'm thinking it is time for the prednisone, but he is not eating how do I get a pill down him. This is my first dog and I dont know how to force a pill down him. OK next thought, if he can just hold on for 2 hours I can get him to his regular vet and she can do the ACTH test and then show me how to force the pill down.

We get to the vet and Honey is smiling and kissing the vet like he was never sick. When she left the room I asked for a kiss and he gave me this look and turned his head. It was like he knew I was the one that made him sick. GO FIGURE. So now the vets comes back and she wants to give him the prednisone before the test and Im like WAIT I thought that would interfer with the test results. Dont we need to see where the cortisol is at first. She said with his symptons he needs the prednisone and it is such a small amount it will not interfer with the results. I thinking OH GOD please let her be right. We have come so far.

I go back to pick up Honey and he comes running out with this big smile and more energy. So I did see the prednisone do its magic, but I just wanted to ask someone will the test be accurate. The vet wants me to give another prednisone tonight and one in the morning, but Honey seems fine and is eating again.

Does anyone know why I give more prednisone if he seems ok now.

Also by me waiting to give the prednisone, could I have made Honey go into Addison disease.

Sleepless in Houston
Rhondalyn and Honey

[frijole]

If HB was really low you would most likely know it and you would have forced that dang pill down the throat without hesitating... trust me on that one. I'm not sure why the vet gave the prednisone first because yes, it will effect the results. The test takes an hour so it could have waited based on what you described as symptoms... I hope that they did the test immediately after giving the prednisone so the results were 'less skewed'.

If a dog has gone too low it can be permanent or temporary addisons. Addisonian is when the adrenals are eroded to the point where they don't grow back and therefore can't produce necessary cortisol. Temporary is if the acth test (2nd number) comes back at less than 1.0. but as you wait (cease giving treatment) the adrenals grow and start to produce cortisol... How long you give prednisone will depend on how long HB went. Prednisone is remarkable how it works (it mimics cortisol) but it is a steroid and the longer you give it the more likely you will have to slowly wean HB off of it... so I never push it unless the dog really needs it. You will know shortly when you get the test results.

The reason she wants you to give it tonight and in the am is because it is not a long term drug... it only provides relief for a while so she wants to make sure HB is ok. Of course after taking the pill the dog is acting normal... that is because the pill provided the missing cortisol.... you might be able to see when it wears off. Sorry for rambling... I'm just glad you got the test done. Do try to find out from the test results (the time will be written on the tests) when they gave the prednisone vs when they did the test... it will make a difference.

By the sounds of HB 's behavior you did just fine. Kim

[rbeasl]

Kim

Thanks Again.... Like you said I just did not feel Honey was bad enough to give the prednisone. I just did not see the logic in giving him the prednisone right before the test. I waited all that time to give the prednisone WHY give it right before a test that measures cortisol. WHY WHY WHY did that vet do this. I knew this and Im mad at myself for not insisting more that she do the test first. You go to a vet for help and you dont want to difficult. This was just simple logic. Now I wait to get the results, but now I have a feeling my effort to get him loaded is now down the drain.

I will keep you updated and Thank You so Much

Pissed Off in Houston
Rhondalyn and Honey

[frijole]

Kim

Now I wait to get the results, but now I have a feeling my effort to get him loaded is now down the drain.



:D No need to get too pissed off... the tests might be off a bit but your efforts to load are NOT dodwn the drain. It just means that if the test results come back with a 2nd number of 2.0 (your goal is between a 1 and a 5) that it might really have been more like a 1.0 and so you will wait a week or two to commence giving weekly lysodren. If it comes back a 4 then you figure maybe it was a 3 and you wait a week to commence lysodren.

Regardless... the progress of reducing cortisol is still done! The hard part is OVER. Easy street - maintenance is on the horizon. Happy dance time! So dont' sweat it. OK? Kim :D

[rbeasl]

Kim,

I cannot Thank You enough. I was getting ready to cry before getting your last post. Once again you put my mind at ease. I feel so out of control and confused with this cushing nightmare. I have never been so confused in my life, but you are getting me through it.

Hope you are available tomorrow when I post the results.

Feeling Better in Houston
Rhondalyn and Honey

[frijole]

:) No problem. We've all been there and remember so we understand. The folks here saved my sanity which is why I stayed around all these years... pay it forward. My dog took over 3 months to load so I understand stress. :eek: It was all worth it though. She lived another 4 1/2 yrs due to lysodren and passed of old age... 16 1/2..... so you have lots of wonderful years ahead of you. Sleep tight and we'll be checking in tomorrow. Kim

[Rene]

Rhondalyn,

Just wanted you to know we have been following along and everything seems to be right on schedule for you and HB. As usual, Kim has guided you along beautifully!.

It seems HB as been showing you clear signs which is good, especially when you go into weekly maintaince. That will be helpful when or if you are going to have to adjust her weekly dose to get it just right.

Keep listening to "your gut" and stick to your guns!

Cowgirl Up!
Rene & Snoop

[addy]

You are doing a great job. Trust your gut.

hugs,
Addy

[jrepac]

Hi Rhondalynn,

Just getting caught up on your thread here; try to stay calm. It actually sounds like you and Honey are doing OK. That first set of test numbers is not all that bad, frankly. And, a pet can do quite well even when the numbers are not "spot on perfect". Sometimes, it takes a bit of juggling to get the levels just right when you are using lyso. I too, would question giving pred before an ACTH test, but perhaps the amount was too small too make much of a difference.

As others have noted, administer the pred if Honey seems very lethargic, is vomiting, or staggering, listless, etc. This typically happens when the cortisol is too LOW and the pred essentially "replaces" the cortisol for the short term.

Jeff & Angel Mandy

[rbeasl]

Hi Guys,

Hope all is well with your families and furbabies...

Rene, Addy and Jeff Thank You for your words of encourgement, they really mean alot.

Rene, This Cowgirl fell off her horse, but I'm back on. I will listen to my gut feeling next time. When you are scared and desperate you just dont think right. I'm just so glad Honey is acting normal now.

Kim, the results are still not ready. The wait is killing me. Please look out for me tomorrow. The results should be ready.

Thanks Again Everyone

Nervous in Houston
Rhondalyn and Honey

[frijole]

:D I was wondering :D Hang in there... I take it she is acting normally and you are not giving prednisone? Kim

[rbeasl]

Hey Kim,

Yes Honey is acting normal again. I gave 1-5mg prednisone tablet last night and 1 this morning and thats it. Will call the vet around noon tomorrow to see if results are in.

Thanks for looking out

Rhondalyn and Honey

[Rene]

Hi Guys,

Rene, This Cowgirl fell off her horse, but I'm back on. I will listen to my gut feeling next time. When you are scared and desperate you just dont think right. I'm just so glad Honey is acting normal now.

Thanks Again Everyone

Nervous in Houston
Rhondalyn and Honey

Well alrightie then! Hoping your numbers will be just great!

Love,
Rene & Snoopie

[addy]

Checking in on you and Honey. Hope things are calm. If you get nervous, just post.

Hugs,
Addy

[rbeasl]

WE DID IT GUYS !!!!! WE DID IT !!!!

I just got Honey's results..... After almost 2 years I finally get some good news. YAHOOOOOOO. My Baby Boy is finally on his way to getting better.

Sample 1 <0.7 range 1.0-5.0
Sample 2 2.6 YEAH BABY

You guys held my hand the hold way through this nightmare. I cannot Thank YOU guys enough... THANK YOU THANK YOU
I have never been through so many emotions in the last 4 days, and you guys calmed me down.

I have an appointment next week. The IMS will let the regular vet know what dose should be the maintenance dose.

Kim I just want you to know that you came through at my most desperate hour to guide me and I am so very grateful. THANK YOU:)

I am worry about that sample 1<0.7 should I be concern.....
Ok LET ME STOP NOW... just trying to find something.

HAPPY IN HOUSTON
Rhondalyn and Honey

[frijole]

Hurray! Made my day. And its a perfect number.. right in the middle... keep in mind it probably would have been lower because of the prednisone... I am wondering if they might not want to lower slightly the maintenance dose. Be sure the IMS knows that you were on prednisone so that is included in the dosage decision. Also make sure you do another acth test in 30 days after you start maintenance... this is how you make sure that the dosage is maintaining (not going higher or lower).

Not sure what the first number means when it is low... I know when it is high it means the dog is stressed.

Put the feet up and relax tonight.... and I'm just glad I could help. The easy part starts now. Yeah. Kim

[rbeasl]

Kim,

That is a very good point to bring up to the IMS. I will make sure I tell her and make an appointment with IMS in 30 days.

Thanks Again
Doing the HAPPY DANCE

Rhondalyn and Honey

[addy]

Doing the Happy Dance with you


Dance, Dance, Dance:D:D:D:D:D:D:D:D

Love,
Addy

[Rene]

Congradulations!!!! Kim is just the best!!!

Thirty days on the dot!!! Very important!

Enjoy Honey Bunny your Boy!!!

Love,
Rene & Snoop

[rbeasl]

Rene and Addy Thank YOU SO MUCH

Funny Story.... I was explaining to my friend about Honeys results and he wanted to know more about cushings. I told him that Honeys cortisol and sex hormones was out of whack... I think all he heard was sex hormones. He then asked how did the sex hormones get out of whack. I told him I dont know. He then tells me poor Honey did not have a chance. You take his manhood, his name is Honey Bunny and he wears bows.... OMG MEN:eek:

So glad I got you ladies to understand....

Kiss Snoopy and Zoe for me
Rhondalyn and Honey

[Squirt's Mom]

Mornin' Rhondalyn,

What great news! :D:D:D Way to go Mom and Honey Bunny! :D:D:D Bows and all! :p In fact, ya'll need a tiara and a crown to wear together next time you go out and about! :p (The tiara is your, btw. :D )

Kim makes a very good point about the pred. I'm glad you will mention it to the IMS. How are Bunny's signs? Is he acting more like his old self?

Keep up the good work, Mom!

Hugs,
Leslie and the gang

[rbeasl]

Thanks Leslie,

So glad the hard part is over.... I need advice once again.
The regular vet called me today and said she spoke to the IMS.
IMS told her because Honey was at 2.6 and not 2.0 or less that I
should start him on the maintenance dose of 1/4 lysodern 4x per wk.
I told the regular vet that Im very concerned about the prednisone that was given to Honey right before the test. She said she did mention this to the IMS and was told because the test was given right after the prednisone and was a small amount that it did not make a difference. She wants Honey to start today, but I need your opinions.

I dont understand. If the prednisone was given as soon as we got to the office and then the first sample was taken right after that, and then the second sample was taken 1 hour later. One hour should be enough to raise the cortisol. Right?

His regular IMS Dr. Cook will not be in until Monday. If I wait until Monday and talk to Dr. Cook does this give the cortisol time to jump back up? Or do I give the lysodern today..

I dont know if I should pick Door #1 or Door #2. I've been picking the wrong door here lately and I need advice. :confused:

Thanks Again
Rhondalyn and Honey

[rbeasl]

Sorry forgot to mention that Honey is acting normal. He is eating, drinking and peeing like a normal dog right now.

Thanks Again

[frijole]

When was the last time you gave lysodren? what day and what dose? Then we can better answer the question. Thanks!

[rbeasl]

Hi Kim,

The last dose was this past Saturday. He took morning dose 1/2 tablet and evening dose 1/2 tablet. Sunday is when he crashed and did not eat all day. Took him to vet Monday..

Thanks
Rhondalyn and Honey

[frijole]

Most vets will wait one full week after loading before commencing the dosing and since you probably were lower than the results showed... if HB was my dog I would wait and start on Saturday. Pick 4 days that are easy for you to remember... Sat, Mon, Wed, Fr? or S, S, T, Th and start the maintenance.

I split my weekly dosing into 3 and did 1/4, 1/4 and 1/2... I gave the 1/2 on the day with the longer duration between doses. But that was just me.

Also I assume you still have some prednisone left over just to be safe.

Kim

[rbeasl]

KIM YOU"RE BEST,

That was the exact door I was picking. I just did not know how fast cortisol can start raising up again, and yes I still have prednisone.

Have you seen anyone needing prednisone on the maintenance dose?

Thanks
Rhondalyn

[frijole]

KIM YOU"RE BEST,


Have you seen anyone needing prednisone on the maintenance dose?

Thanks
Rhondalyn

Yes but it is rare. If the original dose was a bit high you could go lower but being over a 2 I do feel better about it. Just keep the eyes peeled and you know the drill. Plus you are giving smaller doses at a time. Same rules apply with maintenance... if the dog is sick you withold the lysodren. I had to a few times over the 4+ years with my Haley but she maintained her load just fine. Again, great job.

[rbeasl]

Thanks Kim,

I could not have done it without your help. I will be starting on Saturday and I will keep you updated.

Take Care
Rhondalyn and Honey

[Squirt's Mom]

Hi Rhondalyn,

You are doing a great job as Honey Bunny's advocate! You have worked so hard to understand and make this as easy and effective as possible. I'm proud of you and I know HB is so very proud of his mom, too!

Hugs,
Leslie and the gang

[rbeasl]

Leslie,

That really means alot!!! Thank You So Much... The people here on this site have saved Honey's life a couple of times and I am so very grateful. I have read so many stories here and learned so much. At the beginning members here are scared newbies and at the end members sound like experienced vets. I cannot wait until I'm at that point to be able to give back and help a scared newbie out.

Have a Great Week-End
Rhondalyn and Honey

[rbeasl]

Hi Guys,

I just wanted to give an update on Honey's 30 day recheck ACTH test. I'm not for sure if it is good or bad. First, I would just like to Thank All who gave me the push to start Honey on Lysodern. I was so scared that I would have never started him on it by myself. I have my baby boy back. Before the lysodern I was begging him to play with me and now after 30 days of the lysodern I'm begging him to stop playing so much. He wakes me up with the rubber chicken toy in his mouth, ready for playtime. He has more energy, drinks less, eats less and urinates less. So I am so happy he is feeling better.

ACTH Results August 18

Pre-2.3
Post- 1.9

The maintenance dose was 1/4 tablet 4x a week and now the IMS wants to reduce to 1/4 tablet 3x per week. because of the post being on the low end. She wants me to come back in 3weeks to have another ACTH test.

This number seems to be so low. I was wondering if anyone could tell me why Honey seems to be feeling fine on the maintenance dose and eating ok with the post being 1.9. When he was on the loading dose he was showing signs of being loaded on a result that was 2.6. I was wondering if I should wait a couple of days to start him on his new 3x a wk schedule. I just dont want the 1.9 to drop further down.

Thanks Again
Rhondalyn and Honey

[frijole]

1.9 is actually ideal. You want to be between a 1 and a 5. This is why your dog is so happy now - the cortisol has been brought to a 'normal' level for a cush dog.

Normally after loading vets have you wait a full week before starting the maintenance schedule. Not sure when your last pill was but you could start then and schedule the 30 day checkup for 30 days from that date. They want to do that to make sure that the reduced amount is maintaining your number. If it isn't enough you lose the load and you don't want that because then you have to do a miniload.

Kim

[rbeasl]

Hi Kim,

You have been one of my best Cush Coach and I have learned so much from you. I really appreciate your info. This was actually Honey's 30 day check up.

7/4/2011 Loading dose started on Lysodern
7/9/2011 Last day of loading dose
7/10/2011 Honey shows signs of being loaded
7/11/2011 ACTH test results 2.6
7/16/2011 1st day on maintenance dose of 1/4 tablet 4x a wk
8/18/2011 30 day check up results 1.9

I was wondering do you think I should back off the lysodern a couple of days with the results being 1.9. His new maintenance dose will be 1/4 tablet 3x per wk.

Thanks Again
Rhondalyn and Honey

[frijole]

Thanks for correcting me. :o:) I easily get confused.. anyway... Now I can really see why they reduced the amount. Yeah, wait a week and definitely have HB checked in 4 weeks or sooner if you think she is getting lethargic/low cortisol. Kim

[Rene]

Hi Rhondalyn,

Sorry I have not checked in for a while but I am so happy I did. What great news! It is so wonderful when you get "your dog back"!!!

I know folks are so worried they won't see the "signs" and give too much lyso when loading but when they have been feeling so bad for so long it is really hard to miss the "I got my dog back" phase. When that slacks off then you know you’re loaded....GREAT JOB!!!!

I know you were asking Kim about backing off the weekly dose. One thing I will tell you is stick to the plan. It is very easy to lose the load you have and it is perfect for a dog on Lyso...read the footnote on the bottom of the labs.

The lyso only erodes the outer cortex of the adrenals preventing them from releasing the cortisol, but they still are healthy and regenerating that outer cortex. That is why the good folks here recommend splitting up your weekly dose to keep up with the regeneration so they do not start releasing cortisol and messing up your load.

If you see any signs of loosing that perfect load, check with your vet before the 30 days. At 30 days re-test to see if the weekly dosage was right and your numbers held. If they did...smooth sailing for Honey Bunny!

This is just my simple way of understanding things. Hopefully someone will correct me on the things I may be off base on but I hope it helps.

Congratulations!
Rene & Snoopie

Ok...now Im confused...I saw your 1st post and not the update.

Sorry...you already did the 30 day and Honey did hold!!!
Well double Congratulations.
I can't be happier for you guys.
Hopefully the lower weekly dose will hold too.

So what is the plan now for the Gall Bladder?

[rbeasl]

Rene,

You are so sweet to be checking in on me and Honey and helping out when you have so much going on with Snoopy... You are one of a kind... Thanks for your kindness..

Well Rene, it has been a rollercoster ride with Honey. I feel like someone pushed me off my cloud 9... After the 30 day recheck the ACTH test came back with a 1.9 I thought this seemed on the low side to me. So I listened to the little voice in my head and stopped the lysodern from August 17-29. During this time Honey had alot of energy and very playful. I gave the lysodern on Monday Aug 29 and later that night I noticed Honey fell twice, he is not eating and then he threw up and so I'm like OH NOOOOO:eek: the cortisol has dropped, but how did this happen because he has been off the lysodern. I gave him the prednisone and 1 hour later he was ok and ate the greenie that he turned down earlier that evening. The next morning, I called his regular vet and asked for another ACTH to see what was going on. She also did other blood work and saw that his ALT was 800, at the IMS on August 18 his ALT was 57.... OH NOOOOO:eek: how in the heck did this happen. She calls IMS later that evening. Honey still has the same symptoms of low cortisol so I asked if I should give another prednisone and she says no because gall bladder problems will make him feel bad also and because there is such a big difference in the ALT from Aug 17 until August 30 it has to be the gall bladder. I take Honey to the IMS next day and they do an ultrasound and found out the gall bladder is filled with bile. The look on the IMS is not looking good. She gives me 2 options... option 1 Have a very high risk surgery that is 4000.00. Option 2 would be to put him on antibotics and give Ursodial 3x a day instead of 1x daily... I go with option 2 but I really wish I had the money to do the surgery. The IMS now tells me to hold off on the lysodern for now.

I finally get the results today from the ACTH test taken on Monday and the post is .7 OH NOOOOOO:eek: OMG my poor little guy I dropped the phone and run for the prednisone because he has been looking really bad and I'm thinking it all had to do with gall bladder which is really bad but it was also the drop in cortisol.. From this past Monday until Thursday he needed prednisone and I did not give it to him because the vet said no and the voice in my head said he needed more prednisone. I dont know WHY I keep second guessing myself. I am so mad... Now I am wondering if he now has Addison ... After the prednisone he is looking better but still seems a little weak and not eating much.

Can someone tell me which one is worst Cushings or Addison??

How can this happen I had Honey off of the Lysodern for so long..How did his level drop like this after starting him back on the lysodern after 12 days...

Rene you mentioned on your post about treating the gall bladder holistic.. What can I get for him...

Any advice would be greatly appreciated

Thanks
Rhondalyn and Honey

[BestBuddy]

Hi,

With both Cushings and Addisons it is a matter of drugs and monitoring so I don't know if I would choose one over the other.

If Honey is getting relief from the pred then it may just be that he will need to be on it for a little while. Remember you don't just stop it as if must be tapered down. If it is truly Addisons then there is treatment and it can be managed but it is also drugs and monitoring to get the right mix.

Fingers crossed that it is just a temporary situation.

Jenny

[rbeasl]

Jenny,

Thank You so much for your reply... This gives me alot of relief. I could really handle and accept this if this were me going through everything Honey is going through. It kills me to see him looking at me so sad and wanting me to do something that will help him. This is just another mountain we will need to climb.

Thanks Again Jenny

Rhondalyn and Honey

[addy]

Rhondayn, I am so sorry for the roller coaster ride you are on and poor Honey. What did your IMS say about the ACTH test? Was any vet input given on the new circumstances?

I am hoping one of the administrators will stop by and weigh in about all of Honey's issues at the moment.

You are a good mom to Honey and you have worked very hard to help him.

I am hoping his issues can be resolved and the roller coaster ride ends soon. Hang in there.

Love,
Addy

[rbeasl]

Addy,

Thank you so much for the love and the support. Right now I think we are off the rollercoaster and on the merry-go-round...:) I gave another prednisone this morning and Honey is playing, eating and acting normal again. He seem so happy that he made it through this storm. He even came running out when I pulled out the car keys, so of course I had to delay my trip in order to take him for a ride. Right now it is whatever you what, you got it buddy.

I learned something about myself from this episode. When I panic I competely stop thinking. I make really good decisions when my mind is clear and I have some time to think. So for now on I will work on trying to remain calm and think everything through.

IMS could not explain the drop in the cortisol or this rise of the ALT. I'm wondering if a dog has a really low cortisol level like .7 if this has a role in other numbers like the ALT to rise. For now the IMS wants Honey to stay on the prednisone Sat. Sun and Mon and call her on Tuesday to see how he is doing.

My lil guy dodge another bullet.....THANK GOD:)

Rhondalyn and Honey

[addy]

Thank goodness for this news:D:D:D:D

I think it is always easier when we have time to think it through. I do very well under pressure and thinking quickly on my feet but with Zoe those skills go right out the window:rolleyes::rolleyes::rolleyes:

Enjoy your Merry Go Round. Carousels are a lovely ride;) Here is a toast to a happy Labor Day holiday weekend:D:D

Love,
Addy

[apollo6]

Rhondalyn and Honey
Just some words of hope and support.
HUgs Sonja and Apollo
Cushing is a roller coaster ride. We try to enjoy the moments.

[rbeasl]

Sonja,

Thank You So Much for the support... It helps so much to know that Im not alone in this.

Take Care,
Rhondalyn and Honey

[Rene]

Rhondalyn just checking back in.

Sorry I missed the ride over the hump! :eek: I hope your little Honey Bunny is dong well now. No new is good news. Was it a gall bladder obstruction and now his gall bladder is fine or is it sluggish? What have they told you?

Love,
Rene & Snoop

[rbeasl]

Hey Rene,

Please do not apologize with all that you have been going through with Snoopy. I know you must be extremely exhausted.

The IMS said that the gall bladder has alot of bile inside. She could do surgery, but she does not recommend it due to everything that is going on with Honey. Right now she has put him on 28 days of an antibotic called clavamox and ursodial 2x a day. The ultrasound only showed a slight difference from 7 months ago.

While waiting for the ACTH results to come back I also found out that his post cortisol level was .7...... so I really question myself if this was a gall bladder issue or a low cortisol issue or both...His ALT did increase from 57 to 800. Right now I am really confused and frustrated because now it looks like Honey may be dependent on prednisone and with his over weight issue this is not good.

I wondering when Honey got his 1.9 ACTH result on August 18 if the vet should have taken him off the lysodern for a while. I took him off myself for 2 weeks and as soon as he started back this is when this low cortisol thing happen.....

He has an appointment this morning again for another ACTH test.
SO much money and time... I just cannot wait for this to be under control....

Take Care
Rhondalyn and Honey

[Rene]

Hi Rhondalyn,

Just checking on Honey. What did the ATCH test come back at and how is Honey Bunny doing?

Rene & Snoopie

[rbeasl]

Hi Guys,

I just wanted to give an update on Honey. It has been about a month since I last posted. I've really been having a very hard time trying to get Honey under control with his cushings. I feel that I have done everything I could possibly do to try to get him better. I have drove all over the place trying to find the right vet, I have spent so much money on different tests and medicine and done everything I've been told to do in order to get him better. I read in an article, If an owner and a vet does everything right with monitoring, dosing and testing while getting a pet started on cushing medication a pet is not suppose to get sick. Something went very wrong and right now I feel as though my vets have failed me. I am so frustrated and dissapointed.

In July 2011 Honey was Loading on Lysodren
Loading acth results were 2.6

August 18 2011 was the 30 day recheck test for acth
acth results 1.9

The specialist reduce his lysodren from 4x a wk to 3x a week.

When I got home, I thought to my self why would you give more lysodren with a result of 1.9 so I discontinued lysodren from August 19-28. During this time he is playful has energy and no signs of cushing.

August 29 I restarted his dose of lysodern. 2 days later he is sick and threw up and is not eating. So now my vet wants Honey to be on prednisone for a week. I called the specialist after a week to see what should I do next, and was told she is off clinical duty for 3 weeks ....:eek: WHAT..... REALLY I call my regular vet and she has transferred to another location.:eek: WHAT...REALLY... I did not get a call from either vet...So now Im thinking I do not have a vet. How do you find a new vet for a dog with a history and has so much going on. Two weeks past and now Honey is not eating, even with the prednisone. He is shaking and is very weak.

I called a new vet and brought in a large folder of Honeys labs and reports. She gives him an exam and told me she will look over the folder and call the lab she uses and will talk to the internal specialist at the lab to see what test we need to do. She calls me the next morning to bring Honey in to do a Total Body Function and blood pressure check. I picked Honey up around noon. Later that evening around 6pm It is storming outside. It has not rain in Houston in 99 years and all of a sudden on this day there is a bad storm. This vet calls me and tells me the lab has called her about his numbers. I must hurry back and bring Honey in, He is going through an Addisonian crisis his numbers were out of whack and his sodium was extremely low. I put a raincoat over my pajama pants and I wrap Honey in a blanket and I put him in his crate. I thought he was going to freak out because of the thunder and lightning but he is just laying in his crate sleeping and shaking. I kept screaming his name to make sure he was still alive. This clinic was closed but she waited for me... She put Honey on an IV and gave him a perconten injection. She told me the injection will take about 30 minutes to work and will last from 25 to 30 days. She left him on the IV for an hour and told me I would need to bring him in the next day to complete the IV... She let me hold Honey while the IV was dripping and she stayed on the floor with me explaining everything that was going on.

This one vet did more for Honey in 2 days than all his vets have done in 10 years. Honey had a guardian angel and I am so very grateful she saved his life. This new vet wants Honey back between 25 to 30days depending on how he is doing to have another injection. Right now she does not feel it necessary to do another acth test because the numbers will be low. I must keep him on prednisone and try to ween him off it.

I have learned so much about cushings from you guys and now I have to find a support group for Addison disease. The only thing I know about Addison is that it is the completed opposite of Cushings and his adrenal glands are not functioning. Now I feel as though I have failed Honey and after all this time he is not better he is worst.

Just a few questions... When do you give a dog an acth test when they need to be on prednisone...

Are there any other dogs here that the Cushings has turned into Addison

Do you think the specialist should have stopped the lysodren completely after having an acth result of 1.9

Thanks for reading and sorry so long but this is a month worth

Rhondalyn and Honey

[rbeasl]

Oh, I forgot to mention that Honey is doing really good right now. As soon as I brought him home he started eating and the next day he was running and playful again...

My little guy dodged another bullet

Thanks Again
Rhondalyn and Honey

[StarDeb55]

Rhondalyn, I'm so sorry to hear that Honey has had all of these problems. You did nothing wrong, it was your vet care. Obviously for 2 vets to leave without notifying you, or referring you to someone else is just bad practice, when they know how difficult it can be to successfully manage Cushing's.

I will tell you up front that depending upon how serious the Addison's is, Honey many never become Cushing's, & his treatment for Addison's will have to be a lifelong thing. In Europe, they will frequently, intentionally, destroy the adrenals in a cushpup as the clinical approach seems to be that managing Addison's is easier than Cushing's. Now, the only way you are going to know whether or not Honey's adrenals are recovering is by monitoring his symptoms, & ACTH testing. Frankly, I would not even consider re-starting any meds for Cushing's until you see a recurrence of symptoms & you get an ACTH to confirm the cortisol is, now, high. To answer some of your questions:

1. A pup should be off pred about 36-48 hours prior to having an ACTH as pred will mimic cortisol on the test.

2. We have had several instances of Addisonian crisis that have become permanent, but right now, I can't remember who the members are.

3. Probably not. The range that you want with treatment with either medication is 1-5. Granted 1.9 is on the lower end, but I doubt most vets would have stopped the lysodren. When you say that you actually stopped the lyso for about 10 days, rather than reduce the dose, what dose were you giving when Honey got sick 2 days later? Did any vet instruct you to have an ACTH done prior to re-starting the lysodren? If not, that is another error. You can never assume that the adrenals will regenerate in a certain amount of time as each pup is different. Some pups can simply miss one dose of lysodren, & their cortisol starts climbing. Other pups may miss several doses before you start seeing a return of symptoms. Again, the only way to make sure that it is safe to re-start the meds are an ACTH.

The most important test that needs to be done right now are regular monitoring of Honey's electrolytes. When a dog has a severe Addison's crisis, the aldosterone which is made in the adrenals & controls the electrolytes in the blood, can drop seriously low, throwing the electrolyte way out of balance. The electrolyte imbalance is what can make a dog critically ill.

When the vet said to try to wean Honey of the pred, she should have given you some type of schedule about dosing & how to go about this. If you didn't get instructions, you need to call & request them. I have experience doing this for myself after a severe attack of asthmatic bronchitis, so a weaning schedule would be something like this:

40 mg for 4 days,
30 mg for 4 day,
20 mgs for 4 days

You continue in this manner until you get down to 0. Once you start the weaning process, you will have to monitor Honey for signs of nausea, vomiting, diarrhea, lethargy, which could be an indication that the Addison's is coming back. Please get clear instructions from the new vet about how to wean, what specific symptoms to look for during weaning, if Honey is getting in trouble, & ask how frequently she wants the electrolytes monitored. For your piece of mind, & Honey's safety, I would not allow any meds to be re-started without a return of symptoms, & a confirmatory ACTH.

Debbie

[StarDeb55]

Rhondalynn, I see that after re-reading several posts, I see that Honey had a post of 0.7 when he became ill. I am somewhat confused about the timing of this result. Was this the stim that was done when Honey became ill after you re-started the lyso for only 2 days? As I said earlier, did you have actual instructions from the vet to stop the lyso for a specified period of time, then recheck a stim before starting? I'm getting the impression that you made a couple of these decisions about stopping & starting treatment on your own without consulting one of your vets. Please correct me if I'm wrong.

I will tell you from my experience after using lyso to treat 2 dogs, I thought I could make judgement calls about when Harley needed a dose adjustment, then notify the vet after the fact. My GP vet was not happy with me doing this. He told me that he did feel that I had a good handle on what needed to be done, & that I was very careful monitoring Harley. He told me that under no circumstances was I to make a dose adjustment on my own without consulting him first Afte that, I would call him, let him know what I was seeing with Harley, for instance he usually would be drinking buckets, again. Remind him about the current dose, offer suggestions about what I thought a dose change should be, we would talk it over, & he would make the final decision. Most of the time, he would agree with that I suggested. My GP vet had tons of experience treating Cushing's so I had no problem with him taking care of Harley. I understand that you have had serious vet problems, & have been left in the lurch when got sick. I want to re-emphasize the point that for Honey's treatment to be successful, you & the vet have to work as a team. If I were in your position, I would be sitting down with this new vet & expressing all of this to he/she, & state that both of you need to work together.

I hope I'm not preaching too much. Pleas keep us posted on how Honey is doing.

Debbie

[Cyn719]

Rhondalyn, My dog Penny went into Addisonian Crisis .8 -- At her last ACTH her numbers were normal being on 10 mg of trilo - her eletrolytes has been fine -- Dr Allen from Dechra said he does not think she has any permanent damage to the glands from the crisis - hoping he is correct - I hope Honey Bunny will be fine - glad you said he was doing better:):)

[rbeasl]

Debbbie and Cyn Thank You your response

Debbie you are so right and please preach to me because I just dont know what to do and I need all the advice and preaching I can get.
Yes I made the decision on my own to stop the lysodren and did not tell the vets. I am really having a hard time trusting my past vets because nothing is working and I really need to trust this new vet and communicate better... This is what happen..

Monday August 29 I started back on the lysodren... Monday night he gets sick and threw up..

Tues I take him to his regular vet for an acth test

Wednesday I go to the IMS and she does another ultrasound and tells me it is his gall bladder and she does tell me no more lysodern until we get results from acth test

Thursday I get the results back from acth test and it is .07... The regular vet communicates this to the IMS....

Now that I am going over this Im realizing that poor baby was probably having an Addison crisis then and not one vet mention Addison are treatment for a crisis... The IMS just told me to stop the lysodern and keep giving the prednisone... All this time has past his adrenal glands are probably just fried bacon right now....

I just dont get it .. Why would a specialist not do anything special with a cushpup with a result of .07..... OK now I feel my blood pressure going up... .07 really sounds like it is dangerously low to me....:confused:

Thanks Again
Rhondalyn and Honey

[StarDeb55]

Yes, someone screwed up big time. At .7, this is definitely Addisonian. Was Honey on pred when this test was done? If so, the result was even probably even lower. The minute that either you or the vets got this result, something should have been done. This is now water under the bridge, though. You did the best you could with the knowledge you had, & you depended on the vet/s to do their job. Hopefully, Honey will recover, but if he doesn't you just continue to treat the Addison's. I know there are a number of vets who feel that Addison's is easier to treat than Cushing's.

You still didn't answer my questions concerning a schedule to wean Honey off the pred, & regular monitoring of the electrolytes. Both of these items are very important.

Debbie

[rbeasl]

Hey Debbie,

Sorry I missed that question..Yes she did give me a schedule. Im at work right now and dont have it with me. Right now his tablets are 5mg and the first week it is 3/4 of a tablet and the next week it goes down. I would really need to have that paper to be precise.... I just really hope there is not too much damage... The vet wants me to make an appointment in 25-30 days... She wants me to pay close attention on how he is doing around this time... She will do an acth test and check electrolytes to see if the perconten injection is needed...

Thanks for your help Deb

Rhondalyn and Honey

[rbeasl]

Darn Deb

Another question missed... I had to give Honey 1 tablet the night before this test was taken because he threw up..

ok i think that is it...

[addy]

Rhondalyn, I am so sorry you have had such a time with Honey. It is sad we rely on the "experts" and then they let us down. Last week an "expert" tried to give my 87 year old mother another patients drugs, about 7-8 pills, lord only knows what they all were and I thank God hubby and I were there to help stop the incident.

You are doing a really good job with Honey. Keep a watchful eye and don't feel bad about questioning anyone ten times if you have to.

I hope Honey continues to feel better and I hope someone who went through permanent Addison's crisis will stop by or one of our members will remember.

Hang in there and I am saying many prayers for you and Honey.

Love,
Addy

[Squirt's Mom]

Hi Rhondalyn,

Here are some links on Addison's and support groups for Addison's -


Addison’s*

http://canineaddisonsinfo.com/
http://k9addisons.com/faqs/
http://pet-diseases.suite101.com/article.cfm/addisons_disease_in_dog
http://www.inmetrodetroit.com/pets/dachshund/frederick/addisons.htm
http://www.vetinfo.com/dencyclopedia/deaddisons.html
http://pets.groups.yahoo.com/group/AddisonDogs_/
http://canineaddisonsinfo.com/Support.html

Hang in there, sweetie...and do not blame yourself! Your vets failed you - they didn't educate you, they didn't do what needed to be done for Honey, they abandoned both of you - THEY were negligent. Thank goodness for the vet who got him the care he needs! This has been a rough learning experience for you but, if you're like me, these are the lessons that stick forever. ;) It sounds like you are on the right track based on Honey's behavior. And I know you will be watching him like a hawk, til your eyes ache. :D

Please take heed of Debbie's advice about restarting Cushing's treatment. Honey must be off the pred and Percorten, allowing plenty of time to pass to make sure they are out of his system; he must be showing strong Cushing's signs; he must have an ACTH that shows his cortisol is above normal. Then, and only then, can you safely consider restarting treatment.

We are here anytime you wish to talk.
Hugs,
Leslie and the gang

[Cyn719]

Rhondalyn - Please take Debbie and Leslies advice - My vet totally failed me - she knew nothing on treating my dog with trilo and she put my dog into Addisonian Crisis - I was so upset but with the guidenance of Debbie - Leslie - Kim and ALL the Cush Angels on this forum we got Penny out of Addisonian -- I was so upset at myself for letting my vet handle Pennys Cushings but I had to get past that and go forward for Pennys sake -- please know we are praying for you and Honey Bunny -- how is he today??

[rbeasl]

Addy,

Do you believe Im on that darn rollercoaster again:mad: I am so hoping that Honey can reverse this. So many obvious things went unnoticed and untreated, but I have to learn to let it go... Addy I think of you and your family alot. Im glad things are starting to look a little better... Please continue to watch your Mom and the workers at the rehab facility...Ask your Mom how she is being treated at night. Ask the name of the pills before she takes them. My mom had to go to a rehab facility awhile back and I expected to see treadmills and weights and a really nice pool...When I walked in I saw 99 elderly people in wheelchairs....I had a breakdown and starting crying... THIS IS A NURSING HOME... :eek: When we got to the room, there were was not a phone in the room....You had to have a provider put one in....So I had to leave my cell phone with her.. I wanted to spend the night and they said it was not allowed....I got home and could not sleep...Next morning she said she was mistreated by one of the workers at night...I packed her things and burned rubber out of there with her in the backseat laughing and waving to the employees.... Alot of insurance companies pay for inhome rehab....So WATCH EVERYTHING

Hey Leslie

Thank You so much for the information...This is so frustrating that I have to start all over again... I feel like I am on Day 1 and have to learn about a new disease....

Leslie do you know if I have to wait until Honey has signs of Cushings before I have another acth test done... The new vet is not worried about doing the acth test right now... I know it is because of the injection and prednisone, but do you need an acth test to fully confirm Addison...

Thanks for your help:)

Cindy this gives me some hope that your Penny was able to reverse the addison... the new vet says that it is better to have cushings than addison... I was wondering if you could tell why this is so... and give me any advice on how to reverse.... Right now Honey is doing really good.... He really looked like he was not going to make it that night. My new vet says she has used the same lab for 12 years and this was the first time the tech called her to alert her about results... So he really did have guardian angels that day....:)

Thanks Guys and please continue to PRAY for my Honey

Rhondalyn and Honey Bunny

[StarDeb55]

the new vet says that it is better to have cushings than addison... I was wondering if you could tell why this is so... and give me any advice on how to reverse.... Right now Honey is doing really good.... He really looked like he was not going to make it that night.

I agree with your vet. I would not intentionally induce Addison's like they seem to prefer in Europe for no amount of money. You are destroying healthy tissue simply to make treatment easier. The adrenal tissue really is healthy, the problem is the mass in the pit gland that is causing the adrenals to pump out the excess cortisol.

You can't exactly reverse Addison's. You have to treat the symptoms which include low cortisol, & electrolyte imbalance which is what your are already doing. You have to wait & see if the adrenals will regenerate on their own, there is nothing you can do to get the adrenals to regenerate, no meds or anything else. As I mentioned last night, the adrenals may never regenerate & the Addison's may be permanent. You don't need an ACTH at the present time as the 0.7 results tells you that Honey had a serious Addisonian crisis. You need to take one day at a time. Give Honey the pred & any other medication, eventually weaning him off the pred. Once Honey is off the pred, & is having no ill effects without the pred, then you will probably need to consider an ACTH, but even then, I would wait until youi see symptoms returning. At any point in time, during the pred weaning period, should Honey start acting ill, you need to contact the new vet immediately. My guess is you will probably have to increase the pred dose, again, or the vet may simply want a stim at that point to see if the cortisol has dropped, again. Please remember that you want to try to wait about 36-48 hours after pred is given, before running a stim. You may need to stim before that time frame, & any IMS worth a "hill of beans" should take the presence of pred into account on the results. Meaning that the results may actually be lower than they are. There is an alternative to using pred. A dexamethasone injection will act just like pred in the body, replacing the cortisol, but the dex will not interfere with a stim.

Debbie

[Cyn719]

Thanks Debbie for answering Rhondalyns question on going from Addisionians back to Cushings - you are the expert here - I just listened to what you all told me to do and she got better - I am assuming Pennys glands went back to their regular function since her numbers went up - is this corret Deb?? So if Pennys numbers went back to normal does that mean there is not damage at all?? Same for Honey I assume

[lulusmom]

Hi Rhondalyn.

The first time I loaded Jojo, he either never gave me a sign that he was loaded or I totally blew it. By the time we had his first acth stim test on day 10, his post stim was .7 He was not sick, not vomiting, no diarrhea and the only reason he got a dose of prednisone is because that low number scared the heck out of me. We waited two full weeks to start maintenance and the next post stim was well above 5 ug/dl. So we upped the maintenance and we got things under control. Like Honey, Jojo's stim was done less than 24 hours after his last dose so my anxiety was even greater thinking about how low his cortisol actually was the day after the stim. I didn't want to give him prednisone if he didn't need it, so I only gave him the one dose but watched him like a hawk. Luckily for both of us, we didn't have a crisis on our hands. Just goes to show that every dog is different but not us pet owners....we are pretty darn predictable. Heart in throat? Check! Knot in stomach? Check! Mind racing and thinking the worst? Check! Feeling guilty for allowing this to happen because after all, we are or should be in total control of everything? NOT and Check!

The adrenal glands are bullet proof and if you don't completely obliterate every cell, they will regenerate. A common protocol in European countries that haven't banned Lysodren is to destroy the adrenal cortex with huge loading doses of Lysodren. It works but surprisingly, a good number of those dogs will become symptomatic again within a year because the cells have regenerated. If I were a betting woman, I'd bet my next paycheck that you will be dealing with cushing's again.

To answer your question about which is worse, cushing's or addison's, both are serious diseases but the life threatening danger of addison's is certain if treatment is not administered immediately whereas cushing's is a very graded disease, taking years to progress to a critical point. Adrenal hormones are essential for life and with addison's the dog is producing no adrenal hormones (gluccocorticoids or mineralcorticoids) so a dog must receive synthetic forms of these hormones for life to survive. The goal of treatment for cushing's is to lower the production of only one adrenal hormone, being cortisol. When cortisol is effectively controlled, symptoms resolve and the assault on the immune system is brought to a screeching halted. I'll take cushing's any day over addison's.

To say that not all vets are created equal would be an understatement around here so I won't repeat what others have already posted. Unless I missed something, which is always possible, it sounds like you have an IMS who has set you and Honey on the right path. I know it's easier said than done but try to concentrate on the here and now and take it one day at a time.

[rbeasl]

Thanks Everyone for all the good information and advice... I understand alot better what Im dealing with and It is all so very scary. I think the best advice is to just take this one day at a time because this is all so very overwhelming....Im so glad Im not the only pet owner that freaks out on every little detail... I was thinking about asking my doctor for something to calm me down, but I see that Im normal so I will not worry about it...Everyday I wake up wondering what kind of day is it going to be for Honey... will he pee will be poop will he eat will he play will he throw up will he limp did I give him his medicine did I give him the right medicine.. I wish I would have asked more questions here... I probably would not be in this predictament right now...because you guys have been where Im at and you know... ok thats another guilty feeling.. So many freakin guilty feelings go through my head....Then my vet tells me she feels the treament was a liittle to aggressive with a beginning acth result of 26.. Is she right or wrong.... :confused:Should I have waited.....Ok Im sorry another guilty feeling..... I will let it go because there is nothing I can do about it now, but it is so hard to get out of my head....

Thanks for reading and helping me out

Rhondalyn and Honey

[addy]

Oh that darn guilt, rears it's ugly head and smashes ya' in the stomach, bashes ya' in the head and just wont quit!!!!
GUILT:eek::eek::eek::eek:

Dang, I have so much guilt about everything that I am surprised I even function, maybe I'm not functioning and only think I am:p:p:p:p

We lock up Cushings in the drawer when we need a break. We need to put guilt in the big vault, lock it up and throw away the key. Easier said than done.;);) I know.

Rhondalyn, you are doing a really good job and you are doing right by Honey and it is not your fault vets let you and Honey down.

So----- my prescription for guilt today to you:

Take deep calming breaths, breathe in, breathe out. When you get home from school, take Honey outside and just sit in nature and enjoy the moment. Just be with Honey, notice the color of the sky, is there a breeze, what are the birds doing, is Honey laying with you calm? Heck, lay down with him. I do it in the middle of the driveway and we stare at the sky. Neighbors think I'm nuts, WHO CARES:D
Watch his nose, is he smelling the air? What is he smelling, you think? Get inside his head, be a dog for a minute with your dog.

You only need ten minutes to fulfill my prescription.

Love and hugs,
Addy

[Squirt's Mom]

Ok, lady....there is something you have missed about your family here - and it's a very important factor. I am the Queen of Guilt and I guard my throne with ferocity! :p:D:p:D Sweetie, I feel guilty if I plan to take my babies to the park for a bit and it rains that day. :rolleyes: I can't begin to tell all the really stupid things I have done over the last 3 years - taking Squirt's medicine, giving her mine, giving her an extra dose...on and on and on. :o And if she, or any of them are off, oh my! I get downright sick with worry - and it's usually nothing. Our vets get accustomed quickly to me running into the clinic in a total panic, tears flowing, gasping for breath, squeezing the crap out of which ever baby I am worried about. :rolleyes::o:D So, from where I stand, you are absolutely normal! :p:p

Now, here's my prescription for stress - get everything done you absolutely have to do - and no more. Then this evening tell everyone to leave you alone for a while. Now, go run you a hot bubble bath, get a good book and a glass of wine (Chocovine is perfect for this!). Shut the bathroom door and soak in those bubbles, reading to your hearts content, sipping the wine - let your mind relax and focus on something other than Honey, illnesses, and so on for just an hour or two. If you don't read, then listen to you favorite music while you soak and sip. When you get out of the tub, crawl in bed and get some rest. Let tomorrow take care of itself for just one nite.

Hang in there, Rhondalyn - you are doing a fine job!
Hugs,
Leslie and the gang

[Cyn719]

Rhondalyn - Its hard - we all feel quiltly for different things - I can sit here everyday and blame myself for not researching what my vet knew and didnt know about cushings - and if I did that she would not of ended up in addisionian crisis - but I realized it wont help to dwell on what I did wrong - I have to focus on now - so try to put that behind you and move forward -- all the Cush Angels are her to help you - they are your support and I consider the best advice givers - hang in there - I know its hard - I have been there 2 major times already so I know what you are going through - just keep asking questions and take day by day - How is Honey today?? Sending you and Honey Love Hugs Kisses and Prayers xo

[lulusmom]

The IMS said that the gall bladder has alot of bile inside. She could do surgery, but she does not recommend it due to everything that is going on with Honey. Right now she has put him on 28 days of an antibotic called clavamox and ursodial 2x a day. The ultrasound only showed a slight difference from 7 months ago.

While waiting for the ACTH results to come back I also found out that his post cortisol level was .7...... so I really question myself if this was a gall bladder issue or a low cortisol issue or both...His ALT did increase from 57 to 800. Right now I am really confused and frustrated because now it looks like Honey may be dependent on prednisone and with his over weight issue this is not good.

With ALT at 800, there is certainly a lot more going on with Honey than Cushing's. Gall bladder issues, or any nonadrenal illness for that matter, creates a good amount stress which can transiently elevate cortisol. It is therefore quite possible that the post stim number of .7 was artificially inflated, meaning if the gall bladder was not an issue, cortisol could have been even lower.


I wondering when Honey got his 1.9 ACTH result on August 18 if the vet should have taken him off the lysodern for a while. I took him off myself for 2 weeks and as soon as he started back this is when this low cortisol thing happen.....

Actually, the low cortisol started happening after starting maintenance and continued even after dropping the dose to 375mg a week. Logically, the reduction in maintenance dose, plus the two week hiatus from dosing, should have been the right combination but just like the diagnostic tests, you can't really rely on anything to be certain. That's what makes cushing's so darn frustrating. Throw another medical condition in there and that frustration is magnified tenfold. Have you ever wondered why you haven't been carted off by the little guys in white coats? :D


I am really having a hard time trusting my past vets because nothing is working and I really need to trust this new vet and communicate better

Actually the Lysodren worked. It did exactly what it was supposed to do. Safe and successful treatment is contingent on an experienced vet and an educated pet owner. It's teamwork and it takes good communication between both. If you have learned enough about the disease and the treatment, then communication should be easy to achieve. However, continue to look over your vet's shoulder and if something doesn't seem right to you, say something. You are, after all, Honey's only voice so make it heard and never place blind faith or trust in anyone to do what's right for your baby.

Our goal as cushparents should be to become the best advocates we can be for our dogs. We can't be that for them and we can't assume a proactive participation in their treatment, if we don't take the time to learn. I know it is easier said than done but try not to waste time feeling guilty about things you can't change and focus on the things you can. You've been through a lot more than most already so you're way ahead of the game. I learned alot and refreshed my memory by going back and rereading all of the posts in this thread. I think it's a good idea to do that once in a while so that we are more likely to remember. Trying to remember and keep things straight is near impossible....kind of like patting yourself on the head and rubbing your stomach at the same time. :D


Now that I am going over this Im realizing that poor baby was probably having an Addison crisis then and not one vet mention Addison are treatment for a crisis... The IMS just told me to stop the lysodern and keep giving the prednisone... All this time has past his adrenal glands are probably just fried bacon right now....

I just dont get it .. Why would a specialist not do anything special with a cushpup with a result of .07..... OK now I feel my blood pressure going up... .07 really sounds like it is dangerously low to me....:confused:

The object of Lysodren treatment is to kill off enough tissues/cells in the adrenal cortex to stim the excess flow of cortisol, so using fried bacon as an analogy may not be that far off. :D I believe the specialist followed protocol by telling to withhold Lysodren and continue dosing with prednisone. Is there something going on with Honey right now that makes you think that he needs more than prednisone?


Then my vet tells me she feels the treament was a liittle to aggressive with a beginning acth result of 26.. Is she right or wrong....

This is a very strange statement. If a confirmed diagnosis has been made and reconfirmed by Dr. Cook, who is a well published cushing's expert in her own right, then I would have to disagree with your new vet. A post stim result of 26 is not borderline. It is definitely consistent with cushing's and does not dictate conservative treatment over aggressive treatment, especially if treating with Lysodren. In order to achieve effective results with Lysodren, you have to be aggressive. That's why it's called loading...you have to pound the adrenal glands with high doses of Lysodren. You can't get much more conservative than opting for maintenance dosing in lieu of loading and unfortunately, the poor results you achieved were not a big surprise for those of us who are familiar with the drug. Did you mention to your new vet that you tried maintenance dosing first?

[rbeasl]

Ladies,

I cannot tell you all how I desperately needed your advice and responses.... I cried as I read your comments and had to print this page in case I ever felt this way again.. THE BEST PRESCRIPTIONS I WILL EVER FILL... and Leslie I will let you keep your throne:)

THANK YOU ALL for coming to my PITY PARTY but the party is now over...As Rene would say COWGIRL UP... I fell off my horse and now Im back on... Someone here on the site started something where they would name one good thing about today... I know I see Sonja and Apollo mention a good thing for the day...My good thing for today is Honey is Alive...MY BABY BOY IS ALIVE....:) He has been through so much and he is still ALIVE... This morning he brought me his rubber chicken and I knew it would be a good day...

It is so easy after the fact to say coulda, woulda, shoulda but I AM NOT GOING TO SAY THIS ANYMORE...I will continue to do my best everyday and that is all I can do.... You guys made me realize this and I cannot Thank You enough.... Thank you for holding my hand and being there for me....

Lulus Mom

You are so very right... Dr Cook is a well published cushings expert...This is why I drove 120 miles each way to see her and pay top dollar...I just dont understand when Honey got so sick in August and had an acth result of .07 we did not check the electrolyes to see if he needed the IV fluids and perconten injection.... She really thought it was the gall bladder and needed a 4000.00 dollar surgery... I just kept popping prednisone which really did not work... This is why I think after a month has passed his adrenal glands are fried bacon... Right now after the fluids and injection the prednisone seems to be working... One day later he is playing and happy again... But like I said I will move forward and try my best to get my boy better.

Thanks Again
Rhondalyn and Honey

[rbeasl]

Lulus Mom

I forgot to mention the new vet says treament was too aggresive.. I think she got that one wrong... I forgot to mention to her that we did start with the maintenance dose and it did not work, so I will mention that to her on my next visit.... Lysodern is a great drug and it was the very best drug for Honey... It did what it was suppose to do but somewhere down the road something went wrong...

Thanks
Rhondalyn

[Cyn719]

Leslie - I think I was typing while you were posting - I just read what you posted to Rhondalyn - that was a great post!!!!!!!! I love what you said about guilt and I love your prescription for stress!:D I hope we all remember this post each time we are guilty and stressed out ! - but we know we will all have our moments from time to time:o

Rhondalyn - Like Leslie said we are family and here for you! Ok my favorite moment for the day was when I was getting my pocket book to leave and Penny started talking to me with her cute voice and going in circles saying can I come can I can I?? Who could say no the that!!!! :D I havent seen her that happy in a long time!:)

BIGS HUGS COMING YOUR WAY

[rbeasl]

Cindy

I was just looking for your thread so I can find out what has been going on with you and Penny... I will find it and see what I can learn... Dont you just love when our babies get excited and want to ride with us... Sometimes I am rushing to go somewhere and Honey comes out and gives me the look... This is why Im always late... I just cant say no....

It is so good to here something good that happen ...Thanks for that and letting me know that Im not alone

Rhondalyn and Honey

[Rene]

Hi Rhondalyn,

How has Honey been doing?

Rene & Angel Snoopie

[rbeasl]

OMG ITS RENE.... :D

Hey Girlfriend I've been missing you... Hope you are doing ok... I'm hanging in there.... Thanks for asking about Honey.... Right now I'm trying to find out if Honey has Addisons or Cushings... He has an appointment on Oct. 27 to have his electrolyes check and get another ACTH and the tests will tell me if he has to have another perconten injection on Oct 29...

Rene I have never ever been so frustrated in my life... I have spent so much money and driven so many miles and seen so many vets to get absolutely no where... I am back to square one... My little guy was not suppose to get Addisons... Some where down the road me and my vets screwed something up and I'm trying so hard to fix it..

As far as Honey... he is doing ok...I've been weening him off the prednisone his last dose was on Oct. 19 so I hope this will give enough time for it to be out of his system for the acth test on Oct 27 I just have to watch closely so that he will not have the addison crisis again... He was having problems with his rear right leg and he was prescribed tramadol and it seem to make it better.... His coat is really growing for some strange reason.:confused:.. I am noticing that he is drinking alot more water and peeing more.... so maybe the cushings is back or maybe he has diabetes:eek:... OH GOD PLEASE NO... I really dont need any new diseases right now....

So Rene look out for the results... I need you to hold my hand again on this one and give me advice...

Take Care
Rhondalyn and Honey

[Rene]

Hi Girl,

Boy you guys have really been thrown a few times but glad to see you "Cowgirl Up'ed" and got your Honey Bunny back on track!

I'm really anxious to see his results especially his blood panel with all the medications he has been on. How has his appetite and energy level been otherwise.

Love,
Rene & Angel Snoop

[rbeasl]

Hey Rene,

I thought I was riding a horse, but I looked down and it is a freakin BULL.. no wonder I've been thrown around so much, but Im hanging on... :) Honey's energy has been really good and he is eating normal right now... I am just wondering with this perconten injection that he had almost a month ago will throw off the acth results...

I am so glad to hear from you again... I will post results next week

HAVE A GREAT WEEK-END

Rhondalyn and Honey

[Cyn719]

Rhondalyn - well we are both in the same situation right now - vet screwed up on Penny with the high dose of trilo and did not check her ACTH levels (this was in June) and now we are trying to figure out if she is Cushings or Addisions because of damage to her adrenal gland from to much trilo - new IMS was last week - we are weaning her off the Pred also and then her Low dex test and ultrasound - yup its so frustrating - one day good the next day terrible - two weeks bad then 2 days good - you never know - I am keeping a close eye also - dont know how shes going to handle going off the pred --- how many days after you finish the pred are you having the ACTH test??

[rbeasl]

Hey Cindy,,

Yep my friend we are both on the side ride... I am so glad you found a new IMS.... I did not like your old vet... Honey stopped the pred on Oct 19 and the test will be on Oct 27, but you know how that goes ... just my luck the day before the test I might have to run for the predo... Like you said, you just dont know from day to day...

I wish you much luck and success... Lets keep the fingers, toes and paws crossed.....:)

Take Care
Rhondalyn and Honey

[Cyn719]

Rhondalyn - I have everthing crossed that you make it for Honeys test on the 27th - penny is still weaning off the 7 to 10 day waiting period - yup thats what I am worring about too - getting thru the waiting period - How is Honey now?

[rbeasl]

Hey Guys,

Just wanted to give you an update on Honey.... I received the results from the acth and blood panel... I have GOOD news :) and bad news:mad:... First the bad news... It looks like Honeys adrenal glands are like I suspected FRIED BACON ... His acth result pre and post came back with .07 again.... I just dont get it... I will never understand cushings... Last time he had the same result and he looked so weak and sick and now he is fine with the same result... something is so wrong... So now I have to take him back today to get his perconten injection for addisons that will last for about 30days ...

Good News on the blood panel everything has drop to normal level except the alk... but it did go down quite a bit from last test... last result was in the 800 range and now it is 249.. ALT is now 38 cholesterol has drop to 211 Sodium 150 and Potassium 5.2 and Glucose is 82...albumin 3.1 Alot more results but these are the main ones that I look at.. The hair is really growing back also... and he seems to have more energy and very frisky... I dont know, maybe its the cold weather that he loves.

The new vet says that we can wait 3 to 4 months on the acth test again.... just to see what is going on with cortisol... and regular checks on the electrolytes...

So for right now he seems to be doing ok... I will enjoy every last moment of it...:D

Have a Great Week-End Everybody
Rhondalyn and Honey

[Cyn719]

Rhondalyn right behind you - penny is going tues for her ACTH too we will know cushings or addisions -- You got good and bad news but I am happy Honey is feeling good!!! I hate when they are not!!! I hope HONEYS good days continue for a very long time!!! Keep me update!!

[addy]

The good news is that Honey is doing well, so that is a keeper:):) Also the blood work is really good news.

Oh Rhondalyn, I do so wish Cushings was not so darn hard for you and all of us. Take it one day at a time.

I hope school is going well for you.

love,
addy

[Rene]

Rhondalyn,

Im am sooooo glad Honey Bunny is doing well....this IS the good news. Give her and you and gigantic squeeze and love to you as well!

Rene and Angel Snoopster

[Harley PoMMom]

With a pre and post of .07 I would think that a corticosteroid medication such as prednisone would be prescribed. If Honey's electrolytes were all in the normal ranges I am wondering why the Percorten-V is being given.

Love and hugs,
Lori

[rbeasl]

Hey Lori,

So nice to see someone is up this late with me... Honey has been through quite alot last couple of months... Last month he had an Addison crisis and almost did not make it... So the new vet that was an emergency visit had to put him on iv fluid and give him the perconten-v injection... it brought him back to life in a very short time... He has been on prednisone but we have been weening him off it... So now with having addison and not cushings he has to have this injection every 25 to 30 days....

Thanks Lori
Rhondalyn and Honey

[rbeasl]

Cindy, Addy and Rene

Thank You all for sharing my good and bad news... I am so happy that Honey finally seems to be a little more stable on how he has been feeling... This is good timing because I have to have surgery in November... So I guess it is my turn, he has to take care of me now:) I am having the female parts come out... I dont need them anymore...So tired of the monthly nightmares.. I think it will be easier to treat the addisons right now with the monthly injection instead of the daily pill.. So everything has a way of working out for the best... maybe the cushings will come back when I recover...

Cindy,, I hope everything turns out good with Pennys test... I was reading your thread that you may have to reschedule...I will be praying for good results ... keep me updated..

Addy I think you have me mistaken for someone else..I am old as dirt and been out of school for about 25years.. The only school I'm in is k9 cushings 101 and it is the hardest class I've ever taken....:confused:

Rene, The COWGIRL IS BACK YEEEE HAW:D

Take Care All
Rhondalyn and Honey

[addy]

Oh, I do have it wrong, I was thinking you were a teacher.:o:o I am so sorry, sleep deprived is my excuse:rolleyes::rolleyes:

The current issue of Whole Dog Journal has an in depth article on Cushings. They highlight a few different case studies. One of the dogs did end up with permanent Addisions but is doing just fine and his mom actually felt it was easier to handle. The pup had been on lysodren for quite awhile and doing well and then bam- went to low.

Just trying to make you feel better;);)

hugs,
addy

[Rene]

Rhondalyn,

I'm glad both you and Honey are "back"!

I have read that so many of us here are turning 50 and having issues. We are all here for you next month and please keep up posted.

Love,
Rene & Angel Snoopie