My Hazel Jane & Lysodren Treatment

[HazelJane]

Hello, first off let me say how glad I am to have found this site. My dog Hazel was diagnosed with Cushings in September of 2009. She was approximately 10 years old at the time. I adopted her when she was 8 and the adoption agency said she could be between 8 and 11 so I just went with the 8...she could be older :)

She is a chinese crested powderpuff dog...she was kept in a basement for about 5 years...never to see sunlight along with 7 or so other little dogs. She was rescued and has been with me ever since.

Once she was diagnosed with cushings, I did the Lysodren loading dose, then her bi-weekly loading dose. her symptoms got better and all was well. then i noticed her acting "cushinoid" again...went back to vet, her cortisol levels were high again. Did the loading dose again, then back to maintenance. Just recently she relapsed again. Went back to vet...her cortisol levels were high again. I asked the vet if this happens often....where the loading dose doesn't get the job done the first time. she said no. I think it may have something to do with the fact that she told me to stop the loading dose as soon as i saw a slight change in Hazels drinking/eating. this time around, she said wait until its a significant change?

Anyways....so i started the loading dose last week. on the 7th day i noticed zero changes in her. I called the vet. she said i can go up to 10 days. so i gave her her dose that night. Next thing i knew...Hazel was guzzling water faster than I could fill her bowl. Her bowel movements increased. I took her to vet and they tested her and her cortisol levels were "right where they wanted them". but they had no idea why she was drinking excessively.

So here I am...my poor Hazel cant stop drinking and peeing. She doesnt seem well to me, and the vet has never seen this before. Does anyone have any kind of insight what could have happened to make her drink MORE than before I began the loading dose?

I can't afford a kidney specialist at the moment, but I have already started saving for her to have a kidney ultrasound.

Thank you in advance for any information/advice you have

Lee and Hazel Jane

[frijole]

During all of these loads and in between, are you having acth stim tests done to measure cortisol? Do you have copies of them? If not, please get them and post us the results.

Also - did you ever increase the dosage amount? Normally if a dog doesn't stay loaded its because the dose isn't high enough and it is gradually increased by loading and testing to see if it is maintained until such time as it is maintained.

Please also post your dog's weight and the current dosage amount.

Thanks! This info will help us help you better. Glad you found us. Kim

[AlisonandMia]

With regards the recent drinking and peeing - has diabetes been ruled out? She has probably been tested for this in the past (it is a part of most standard blood panels) but diabetes can come on "overnight" so if she hasn't been tested for diabetes since the excessive drinking and peeing started this time then that is something that needs to be ruled out ASAP.

It sounds like you have been getting her loaded ok but that the maintenance dose she has been on has not been adequate to keep her loaded. As Kim said can give us details regarding ACTH stim test results (the actual numbers) and let us know how much she weighs and what loading and maintenance doses she has been on?

It is very, very common for a dog to "unload" at least once during treatment, usually in the first few months as it can take a while find the correct maintenance dose for a particular dog. (It happened with my dog.)

Alison

[HazelJane]

Hi Kim, yes for every loading dose I've done, I've had the Stim test done. I will post the numbers when I get them from the Vet this weekend (for each stim test done over the past year)

I have never increased the loading dose (1/2 tab in am, 1/4 at night...500 mg tab)

However, the vet recommended I increase her maintenance dose this time around...so she is getting 1/4 tab 3 times a week. (167 mg every 56 hours). I have just given her second dose this week of her maintenance dose.

She is 17 lbs

[HazelJane]

Alison, diabetes has been ruled out. They tested her blood this past saturday when her excess drinking presented. It wasn't a fasting blood test though...just a random one, she had breakfast about 5 hours before the test was done. Her blood sugars have always come back normal.

[frijole]

Glad Alison asked about the diabetes dx and you had that checked. That dosage is within range for a dog your size. I'll be interested in seeing the test results.

FWIW my dog Haley weighed the same amount and we started her off at 1/2 a pill then loaded at 3/4 a pill.... she was one of the rare dogs that required alot higher dose to load. She ended up at 1 1/2 pills a week.

Glad you are getting the info this weekend as we can only speculate without them. In the meantime - I love the photo of Hazel Jane... such a cutie. Kim

[HazelJane]

I also forgot to mention that Hazel has always had issues with urinating. She never holds her pee for long. She goes on a pee pad in the house. For awhile in the beginning I managed to get her trained where she held it for about 4 hours. That didnt last long, and we've used the pee pads ever since. She also doesn't empty her bladder with one shot...it takes her 2-3 times to empty it. I always attributed the issues to the fact that she was kept indoors for so long...but now I am wondering if it is that coupled with an underlying kidney issue that she could have had all along. I will post again when I have the actual numbers. thanks again

[AlisonandMia]

Here's a link to a very good article on the possible causes of polyuria/polydipsia:

http://web.archive.org/web/20060904045120/http:/courses.vetmed.wsu.edu/vm552/urogenital/pupd.htm

Has Hazel Jane ever been checked out for bladder stones (which can result in a very small bladder capacity and difficulty emptying the bladder.) And recently, was the possibility of a urinary tract infection ruled out?

Alison

[HazelJane]

Ill try the article again, but its having trouble loading for some reason. Thank you

No she has never been checked for bladder stones. I will definitely ask her doctor about that this weekend.

They tested her urine a week ago and there was no sign of infection.

Her urine was very dilute do the excess water intake...so Saturday am I am going to try and keep her from peeing for about 4 hours (I dont know how I will do that) and they are going to retest her again to see what...if anything is in her urine

[frijole]

Good luck with that! ha. Every urine test I have had done they requested the urine be drawn from the first one in the morning as it is the most concentrated. fwiw... Kim

[HazelJane]

ok so her most recent cortisol levels (after her loading dose) was 2.4-3.8

She just went for a abdominal ultrasound yesterday, and the Dr. believes that the excessive drinking is related to something other than the cushings. He mentioned a possible renal medullary flush....or a low grade kidney or UTI infection. He rececommende putting her on amoxycillin just in case. He also mentioned she could be in the beginning stages of CRF...in which case she may just not be able to concentrate her urine anymore, but she can drink enough to ensure proper kidney function.