13 year old border collie pituitary cushing's - Max has crossed The Bridge

[mr. max]

My 13 year old border collie has just been diagnosed with pituitary Cushing's. After watching his ALP climb for a couple of years, with blood work, ultra sounds showing nothing, my vet decided to test for Cushing's even though Mr. Max was not showing clinical symptoms. We were suprised when the results were postive. The recommendation was not to start medication until he showed clinical symptoms as the meds can be harsh and Mr. Max has a history of adverse reactions to medications. At this point the only symptom we are seeing is a thinning of his coat. I have started omega three oil but wondered if there was anything else I might do about his coat.

Has anyone else had a dog with Cushing's who did not have most of the clinical symptoms?

Debbie

[labblab]

Dear Debbie,

Hello and welcome to you and Max! The short answer to your question is, yes, we have had other dogs here who have tested positive on Cushing's diagnostics but who have not suffered from obvious symptoms other than some abnormal lab values. Usually in those cases, the recommendation is exactly the same as you have been given by your vet: hold off on treatment until/unless clinical symptoms begin to manifest. I am not a vet, but I think the reasoning for this is twofold. First, no Cushing's diagnostic test is perfect. Both of the standard blood tests (the ACTH and LDDS) can be skewed by stress or other nonadrenal illness, resulting in false positives even when a dog does not have Cushing's. So in the absence of clinical symptoms that correspond with Cushing's (and in Max's case, also in the absence of any abnormalities in his ultrasound) the diagnosis always remains somewhat suspect.

Secondly, one of the key components of monitoring the effectiveness of Cushing's treatment is observation of overt symptom resolution. So for a dog who isn't exhibiting symptoms in the first place, it becomes much more difficult to judge the effectiveness or appropriateness of any given dose of Cushing's medication.

I do think your vet is advising you properly by not yet launching into treatment. But I'm really glad you've found us so that you can educate yourself more thoroughly about treatment options should the need arise. And also, I hope some other folks will also be stopping by to give you some hints for improving Max's coat.

Marianne

P.S. It would be great if you could post Max's actual test results, both for the Cushing's test and also for his most recent elevated ALP.

[mytil]

Hi and welcome from me too.

I agree with Marianne on this. This advice was given to me too with my Mytilda as she was not showing any of the clinical signs.

Please do post those numbers.

Did your vet test for other conditions too - thyroid problems or diabetes?

Keep us posted
Terry

[mr. max]

Dear Debbie,

Hello and welcome to you and Max! The short answer to your question is, yes, we have had other dogs here who have tested positive on Cushing's diagnostics but who have not suffered from obvious symptoms other than some abnormal lab values. Usually in those cases, the recommendation is exactly the same as you have been given by your vet: hold off on treatment until/unless clinical symptoms begin to manifest. I am not a vet, but I think the reasoning for this is twofold. First, no Cushing's diagnostic test is perfect. Both of the standard blood tests (the ACTH and LDDS) can be skewed by stress or other nonadrenal illness, resulting in false positives even when a dog does not have Cushing's. So in the absence of clinical symptoms that correspond with Cushing's (and in Max's case, also in the absence of any abnormalities in his ultrasound) the diagnosis always remains somewhat suspect.

Secondly, one of the key components of monitoring the effectiveness of Cushing's treatment is observation of overt symptom resolution. So for a dog who isn't exhibiting symptoms in the first place, it becomes much more difficult to judge the effectiveness or appropriateness of any given dose of Cushing's medication.

I do think your vet is advising you properly by not yet launching into treatment. But I'm really glad you've found us so that you can educate yourself more thoroughly about treatment options should the need arise. And also, I hope some other folks will also be stopping by to give you some hints for improving Max's coat.

Marianne

P.S. It would be great if you could post Max's actual test results, both for the Cushing's test and also for his most recent elevated ALP.
Dear Terry,

Thanks for the welcome and the encouraging comments. It's been difficult as we have been chasing an elevated ALP reading for a couple of years. When it first went up to 600 my vet ran bile enzyme/acid tests to make sure Mr. Max's liver was functioning properly. It was normal. As the ALP continued to increase we repeated the test a few times all with normal results. The reading was reached 1300 (very high) and he was having some intestinal upset (diarrhea) which responded to Tylan. However my vet suggested we do an ultrasound to rule out liver issues as there were still no other symptoms. The ultrasound showed a bit of thickening to his intestinal tract (normal in an older dog who has always had a touchy tummy) and a few nodules in his liver which the ultrasound doctor felt were not cancerous. Finally, when the ALP hit 1700, my vet asked if I would do a dexamethasone test, which he fully expected would be negative but it would rule out Cushings. We did this the beginning of Nov. the results were:

Cortisol (0 hr) 87
Cortisol (4 hr) 23
Cortisol (8 hr) 66

So my vet diagnosed pituitary Cushings. The dog is still otherwise asymptomatic other than a bit of thinning to his coat. I have found all this quite upsetting and it's difficult to know what is Cushing's and what is just due to the fact he's 13.

Debbie

[apollo6]

Dear Debbie
Welcome.
I am posting a simple breakdown on cushing and pictures of dog with cushing.
http://www.kateconnick.com/library/cushingsdisease.html
Maybe this will help as to signs and symptoms.

If Max had an ultrasound it would have shown both adrenal glands are enlarged similarly. That would determine if it is pituitary cushing which Apollo has. I did not see any notation about it.
My Apollo probably had cushing for over a year or more before I got tests and with a lot of research before I started medication.
You are doing the right thing for now. Better to take it slow.
Hugs Sonja and Apollo

[mr. max]

Dear Sonja,

Thanks for the link which I had bookmarked previously. Mr. Max's ultrasound was focused on his liver and intestine but I'm sure covered the area where adrenals are located as well. I will ask my vet next time I talk to him. Mr. Max suppressed cortisol levels on the HDDS led to the diagnosis of pituitary Cushings.

At this point the only real symptoms are a thinning coat---no bald patches or loss of fur in clumps but his coat is thinner. He is also more reluctant to jump but he is also 13 and has metal plates in one rear leg so jumping has always been an issue. His water consumption is 4 cups at day which for a 53 lb. dog is well within normal. He goes out at 8:30 in the morning and does not go out again until 5---there have been no accidents. He is a bit more aggressive about begging for treats but is not showing excessive interest in food. I have also noticed that his is panting more. I have also notices his tummy (the pink bit) has become a bit droopy but he is not showing signs of bloating.

We have a standing appt. with the vet every month so she can monitor changes.

Debbie

[addy]

Hi Debbie and a belated welcome from me.

We started our journey last winter with a thinning coat. We noticed it after a trip to the groomers. I thought it was my Zoe's thyroid medication she had just started. That was last February. I had to wean her off the thyroid medication and Shen Calmer, struggle with chronic diahrrrea and then tested her for Cushings the end of May based on a UC:CR test that came back elevated.

We started melatonin and lignans in July very slowly one at a time. She was doing well until the end of October. She had a colitis flare up and now we are seeing Cushing symptoms we did not see before.

That is not to say this will happen to your pup, each dog is so different. Zoe has very high intermediate hormones as well as cortisol. Dr. Oliver at Unn. of Tenn. told me the intermediates seem to do the same thing as the cortisol.

Our internist did not want to treat Zoe with lysodren or trilostane until we saw more symptoms so we had been on wait and hold.
I found wait and hold hard:o

Not sure if our experience helps or not. With Zoe each symptom started gradually and then increased. She started not wanting to jump on the bed in the dark. Little by little, she stopped jumping on the bed until now she won't at all.

Her water intake is normal but little by little I noticed her heading to the water bowl at times she did not drink before so while it is not excessive water intake it is more for her.

Now she seems to looking around for food more. It started sniffing more in the house, checking out floors, carpet. Now she is doing it outside. More so than before.

So her symptoms are creeping up more and more. We don't have the panting yet nor the sagging tummy. In fact, she is losing weight.

Be watchful would be my advice.

Happy Holidays!!!!

Addy

[Rebelsmom]

My boy Rebel had a few symptoms and was started on Veteroyl for the cushiings. For his ultrasound they shaved his belly and the hair was not growing back. So I started him on melatonin and within a few eeks his hair had grown back and was longer and thicker before. So you might ask your vet about starting melatonin just to help with the hair loss issue.

[mr. max]

Thanks for the tip on melatonin. I'll speak to the vet the next time we go, probably in January.

[mr. max]

Hi,

Update on Mr. Max. He is still not exhibiting any of the classic symptoms (urination and increased water consumption) however I've noticed that he is panting more and is less interested in exercise. I've been giving him melatonin for the fur issue as per advice here that was okayed by my vet.

I'm still not medicating him but wonder where the line is---how much panting and lethargy before I start the medication? Any feedback?

Debbie

[StarDeb55]

Debbie, a belated welcome from me, too! Regarding your question, the 2 most common symptoms that are used to monitor treatment with either medication are a voracious appetite or increased water consumption. In most circumstances, there will be a change in appetite before a decrease in water consumption occurs. If Mr. Max really isn't showing either of these 2 symptoms, it's going to be extremely difficult to monitor treatment. Coat/skin issues can take several months to clear up, once treatment has started.

Debbie

[lulusmom]

Hi Debbie,

Panting and lethargy are not the troublesome symptoms that usually dictate when you start treatment. As Debbie already mentioned, it is the voracious appetite and the excessiving drinking and peeing that are the most common symptoms. Were you able to obtain a copy of the ultrasound findings? I would be very interested to see if the usual abnormalities associated with cushing's were noted, such as an enlarged liver and bilateral enlargement of adrenal glands. If both were normal, I would question the validity of the low dose dex test. This test can yield a false positive result in the face of non adrenal illness and stress and with no real symptoms and no organ abnormalities, I'm wondering if there may be something else going on with Mr. Max.

As I recall, Mr. Max had gastrointestinal problems a few months back. Was this problem addressed and completely resolved before the LDDS test was done? Is Mr. Max showing any signs of stomach problems now such as lack of appetite, loose stool, gas?

[mr. max]

Thanks for the feedback. Mr. Max has always had a touchy tummy, from the time I got him when he was 3. He is now on a preventative dose of tylin (1/8 tsp) twice a day which has kept the issue under control. When the gastric issues occurred, he would get the runs, but have no other symptoms at all. He is not having loose stools or gas. This in combination with his ever rising ALP caused my vet to run all sorts of tests, for liver and other issues but they were always negative. The ALP has been up on the rise for over 3 years and the ultrasound showed a couple of nodules in his liver but nothing that alarmed the vet that did the ultrasound, who said it was not uncommon with senior dogs (this is his speciality, it's all he does). It was only after all this that the vet tested for Cushings and was surprised with the results of the LDDS tests and advised that we just monitor him as he was not drinking or urinating excessively. I do not know if the adrenal glands are enlarged or not but will ask when I take him for his shots later in April. As this has been going on for several years now, it seems unlikely that there are major issues with his liver etc. At the moment I'm most concerned with his thinning coat.

[marie adams]

Hi Debbie,

Welcome!!! My Maddie Girl was an Aussie so your Mr. Max and her have similar fur types. Maddie had most of the classic symptoms before I knew what they were. The vet kept saying she was getting older. She was diagnosed a little over a year ago by me from finding a link on the internet. I first noticed the panting, then the shaking of her hind legs, then she became lethargic, then the under fur was gone--she always had thick beautiful fur. After I finally found Cushings Disease and she was diagnosed I noticed then how evenly she lost fur on her belly, her feathers on her hind legs were gone, under her front legs (arm pit area)---all bald spots. At one point--I guess you would call this her blow out before the fur came back all her fur became very thin. She still had great coverage on her head and paws. When the fur came back it was more tan/gray in coloring--she wasn't the black/white/tan dog I knew before the journey started. It was also different somewhat in texture. I called her a grizzly bear....

I gave her Milk Thistle for the liver, flax seed oil and yogurt for her skin and fur. These all seem to make a great difference. Her skin and fur did not seem to be as dry looking. She loved the yogurt!!! Also I was giving her fish oil to help with her hind leg weakness because once I started treatment I feel the arthritis appeared. She stopped jumping up on the bed, but climbing the stairs got better once she started treatment and got to the maintenance period--that is also when the fur came back.

Good luck on this journey...everyone here is wonderful, caring, and so knowledgeable--you are in good hands!!!

[lulusmom]

Hi Debbie,

I noticed that Mr. Max is on Tylan. I'm not sure if you know this but it can cause elevations in ALT. Has your vet run a new blood chemistry to check the liver enzymes lately? If so, can you please post the results and if not, you may want to talk to your vet about doing one.

I've been meaning to tell you that I totally understand why you are so concerned about Mr. Max's thinning coat. He is a stunning dog and his coat and coloring are absolutely gorgeous! If you could see my Lulu, you'd understand why I no longer fret over her coat. There's not much coat left to fret about. She still has hair on her head and feet so she lives in sweaters. I'll start to fret when she starts to look like Montel Williams, without the pierced ear. :p

[mr. max]

Thanks for the feedback. Mr. Max is on milk thistle etc for his liver and I'm given him fish oil (which he hates) and melatonin for the coat/skin.

His hind leg shakes slightly but it always has because he has metal plates in it---he was a rescue and had been badly abused; they snapped his leg. He is definitely having more trouble on the stairs and likes to know I'm behind him when he's going up. He won't jump on the bed anymore so I give him a boost. But having said this, he has always been reluctant to jump because of the bad leg.

I was not aware that the Tylan causes an increase in ALT but my vet is going to run liver numbers at the end of April when he goes in for his shots. His ALP has been nuts for several years. I will certainly discuss all this with my vet.

The fur isn't any worse. Like the Maddie the Aussie, I've noticed the undercoat has disappeared or thinned out. He had an ultra sound and they shaved his belly etc. It grew back but it took ages and it is not as thick as it was. At this point he has no bald patches but the fur on his tail is quite thin---my partner, David, calls him "rat tail" as while it isn't down to the skin you can see it. He has always been a very handsome dog so it is distressing that his coat is so different.

It is really very difficult to know what to do about medication. While he does have symptoms; panting, lethargy, thinning hair---he does not have increased thirst, appetite or urination. He has had really bad reactions to meds in the past and I am very reluctant to start unless it is absolutely necessary. On the other hand, I don't want to put him at risk by not medicating. At my last visit to the vet a couple of months ago, they still wanted to do a watch and wait.

He still seems to be a happy dog; likes to go play to the park to see the other dogs and chase the squirrels. Cushing's is quite difficult to get a handle on.

[mr. max]

Hi folks,

Thought I would update you on Mr. Max. We just went to the vet for the annual check up and as Scott hadn't seen Mr. Max for six months (Scott was in Australia, another vet filled in) I decided it would be a good way to judge the changes. Hard for me as I see the dog every day so it's gradual.

Scott felt his fur was definitely thinner and Mr. Max was panting more but o/w he is not exhibiting any of the classic symtoms. He felt that there might be a thyroid issue so ran a T4. This morning the results came in and his thyroid levels are very low so we are running a more sophisicated blood test to determine if he indeed has a thyroid problem or if the reading is skewed because of the Cushings. His ALP which was 1400 (already high) is now 4750. Horrifying but just a number indicating cortisol production. Mr. Max's water intake is still well within normal range and he is not ravenous, etc. Scott spoke to a colleague who is an endocrinologist, ran through the numbers and he agreed that we should not medicate Mr. Max yet (not really symptomatic) as long as his blood pressure is okay and he doesn't have too much protein in his urine. So I'm going to collect a sample and take it in early next week. Should have the results of the thyroid by then as well. If the thyroid is an issue it would help to explain the thinning coat.

Feedback appreciated.

Debbie

[Squirt's Mom]

Hi Debbie,

Hypothyroidism can cause many of the same signs as Cushing's. That and diabetes are two conditions we always question to be sure they have been ruled out when beginning the Cushing's diagnostics. You may find that the signs you are seeing will start to improve once his thyroid levels get back to normal. Hypothyroidism is easy and inexpensive to treat. :)

The high liver values could be due to any number of things - it indicates the liver is working extremely hard at something - but not necessarily due to Cushing's. Has Mr. Max had an abdominal ultrasound? If not, it might be worth discussing it with your vet. This test will tell you many things, including giving another clue to whether or not he could be dealing with Cushing's since the adrenal glands are usually visible. This test found a tumor on my Squirt's spleen, saving her life. ;)

How are his signs, in particular his appetite and drinking/peeing? Have you noticed an increase or decrease in any of the things you have been seeing?

Thanks for checking in....you are doing a great job!

Hugs,
Leslie and the gang

[mr. max]

The only liver number that is "off" is the ALP. It was the Low Dose Dex test that confirmed the diagnosis of Cushings. Mr. Max did have an ultrasound (before the LDDT) but at that point they were really looking at his liver but I will confirm with the vet that the adrenal glands were examined and reported on.

The thing is that all this has been going on for so long now that if it was a tumour/cancer somewhere else he would be really sick or worse.

I'm waiting to hear the results for thyroid and urine tests this morning.

[Squirt's Mom]

Any word on Mr. Max's tests yet?

[mr. max]

Yes, results in yesterday on Mr. Max. Urine and blood pressure are fine. Thyroid is not, extremely low so we've started him on medication to raise it up. We are hoping that this explains why the his fur is thinning and he is so lethargic and the Cushing's symptoms are still not really present. My vet, Scott consulted with an endocrinologist to confirm all the results and treatment. Mr. Max will go for blood work in three weeks to see how the levels are doing.

Has anyone had any experience with flax lignans for Cushings? Would it be worth trying this to see if it lowered the ALP reading in Mr. Max. I've sent a link to my vet and he is checking into it but I thought I would as here to see what the experience of others might be.

Any thoughts would be welcome.

Debbie

[mr. max]

Yes, results in yesterday on Mr. Max. Urine and blood pressure are fine. Thyroid is not, extremely low so we've started him on medication to raise it up. We are hoping that this explains why the his fur is thinning and he is so lethargic and the Cushing's symptoms are still not really present. My vet, Scott consulted with an endocrinologist to confirm all the results and treatment. Mr. Max will go for blood work in three weeks to see how the levels are doing.

Has anyone had any experience with flax lignans for Cushings? Would it be worth trying this to see if it lowered the ALP reading in Mr. Max. I've sent a link to my vet and he is checking into it but I thought I would as here to see what the experience of others might be.

Any thoughts would be welcome.

Debbie

[Squirt's Mom]

Hi Debbie,

I sure hope the thyroid is the problem and the new meds do the trick! :)

Many of us here use lignans as part of a treatment regime for Atypical Cushing's. After reading your question, I did a little bit of research and found the following info on flax lignans. It seems there is some indication they can help in liver disease treatment and prevention.

http://healthlibrary.epnet.com/GetContent.aspx?token=e0498803-7f62-4563-8d47-5fe33da65dd4&chunkiid=21714

I also saw several reports from The National Institutes of Health in which lignans had proven effective in several studies on the liver - but the ones I saw were very specific about the causes of liver damage/risk/disease.

Hope this helps!
Hugs,
Leslie and the gang

[addy]

Hi,

My Zoe has typical Cushings with elevated intermediates. She also has colitis. We were treating her colitis before treating her Cushings as her symptoms were mainly hair/coat/skin when we started. I put her on melatonin and lignans while working on her colitis. Her ALT was slightly elevated in June 2010 along with her cholesterol. It took me awhile to get to the right dose of lignans and melatonin so maybe she was on the right dose about 3 months. She got sick with a bad colitis flare up, lost 2 pounds and she went on metronidazole daily. We rechecked her blood in January 2011 after the flare up seemed controlled. Her ALT and cortisol were normal. All her blood work was normal.:confused:

I always thought her ALT was elevated due to her colitis and the fact we had it controlled perhaps was why it was then normal. But perhaps not.

I guess when we redo blood work in July, we'll see where it is now:)

Hugs,
Addy

[Roxee's Dad]

Update on Mr. Max. Thyroid function fine. A couple of weeks ago herefused to eat his food We assumed it was the meds (tylan) and tried various ploys, nothing worked. Vet was concerned but when he offered him a bowl of canned, Mr. Max ate it. He ate it for four days and then refused. I can now get him to eat BG beef with some kibble mixed in but I have to heat it up and coax him. If I put some on my finger, he'll eat it and then eat what's in the bowl. The vet is now wondering if he is having cognitive issues either age related or caused by the pituitary tumour. He is also stumbling a bit. Blood was all normal except his ALP which remains elevated. His blood pressure a bit high but he gets very anxious at the vets so it is not a concern. Has anyone else had any of these problems? He is still not exhibiting the excessive drinking and urination, though he is drinking more. We are reluctant to medicate for Cushings given the lack of severe symptoms and low appetite.


Mod note: Copied from a visitors message.

[frijole]

Update on Mr. Max. Thyroid function fine. A couple of weeks ago herefused to eat his food We assumed it was the meds (tylan) and tried various ploys, nothing worked. Vet was concerned but when he offered him a bowl of canned, Mr. Max ate it. He ate it for four days and then refused. I can now get him to eat BG beef with some kibble mixed in but I have to heat it up and coax him. If I put some on my finger, he'll eat it and then eat what's in the bowl. The vet is now wondering if he is having cognitive issues either age related or caused by the pituitary tumour. He is also stumbling a bit. Blood was all normal except his ALP which remains elevated. His blood pressure a bit high but he gets very anxious at the vets so it is not a concern. Has anyone else had any of these problems? He is still not exhibiting the excessive drinking and urination, though he is drinking more. We are reluctant to medicate for Cushings given the lack of severe symptoms and low appetite.


Mod note: Copied from a visitors message.

Did you do a sonogram of the adrenal glands? These signs are all very similar to Annie's. Stumbling that comes and goes , high blood pressure, appetite swings - periodic inappetence, atypical cushings like symptoms... Kim

[mr. max]

My vet is sure it is pituitary Cushings given the fact the ultrsound was okay (adrenal) and the results of the Dex. Supression indicated that--he supresed at 4 hours and rebounded at 8.

[mr. max]

Sorry should also have added that cortisol levels don't usually elevate as much and Mr. Max's are through the roof.

[mr. max]

Update on Mr. Max. Thyroid meds have helped a lot. Energy levels and appetite much improved. Fur also better but that could also have something to do with the melatonin. Mr. Max is still having periodic intestinal issues---he has always had a very sensitive system and the current heat wave here has not helped matters. He is eating a grain free kibble mixed in with Wellness venison and salmon. It's the first time he's had canned food but at this point, I'm happy to have him eating. He is taking probiotics which have helped stablize his digestive issues. We go to the vet next week for a re-check. Cushing's symptoms still not severe. I ordered flax lignans and am about to add those, cautiously.

[Squirt's Mom]

Hi,

Thanks for letting us know how Mr. Max is doing! Sounds like things are improving with the thyroid treatment and I'm glad for both of you. :)

Have the seemingly cognitive issues you were seeing improved as well? Is he still stumbling? These could all be tied to low thyroid function so I hope these are better, too.

I'm glad he is eating better now, too. I know that is a big relief! You can start adding the lignans in very slowly to help his system adjust if you are concerned about digestive upset. Addy took that approach with Zoe, who has colitis and later switched to a powder form of lignans.

Keep in touch and let us know how things are going!

Hugs,
Leslie and the gang

[mr. max]

Thanks for yours. The cognitive issues are better--he is much more like himself and the stumbling is pretty much cleared up. The fact that he is now interested in eating is a great relief. I think much of the problem was caused by the thyroid on top of Cushings. I've started sprinkling the contents of 1 lignans capsule on his dinner. Don't want to cause intestinal issues. I will report again after we see the vet next Tuesday for a recheck.

[mr. max]

Hi Folks, Recheck on Mr. Max went very well--my vet could not believe the change in Mr. Max. He is more alert, much more like himself and the vet doesn't need to see him unless there is an issue. Max is responding well to the new food, flax lignans and melatonin. Cushing symptoms are still very moderate---mostly panting. Intestinal issues have completely resolved. So for the moment we watch and wait. His thyroid function is fine. Only down side is he is getting cataracts which explains some of his reluctance on the stairs, particularly in the evening. However, for a 13 year old dog with Cushings, he's doing just fine.

[addy]

That is a great report. Good for you and Mr. Max:D:D:D:D

Just enjoy him!!!!!!!

Hugs,
Addy

[Squirt's Mom]

Wonderful report on Mr. Max! :D I know you were happy to hear what the doc had to say, as am I!

Keep up the good work and do stay in touch!
Hugs,
Leslie and the gang

[mr. max]

Hi folks, Need some help. We thought we were going to have to put Mr. Max to sleep as he stopped eating and was lurching about. Took him off metronydazole and he improved greatly but vet does think he is having some cognitive issues. (for one thing he refuses to eat dog food of any kind--he never has been given people food, but is currently eating beef meatballs--vet just wants him eating). We started him on Anipryl ---he still has none of the classic Cushing signs but my vet is hoping it will help with the cognitive issues. Mr. Max has had a couple of poop accidents in the house---over night so today I started feeding him in the morning. He seems happy enough but still not himself. Has anyone had experience with cognitive problems?

[addy]

Hi,

I don't have any experience with cognitive problems. My Zoe lost her hearing and sometimes it seems she has a problem but then we remember she can't hear. I am sure others will be stopping by to give you some input.

I do know Zoe has had that drunken sailor gait more than once from metronidazole. It can cause neurological problems even at lower doses. Sometimes they will go away once the drug is stopped and sometimes the problems are permanent. Zoe has been on it for a long time, I keep decreasing the dose in hopes to one day stop it.

I hope the Anipryl gets Mr. Max feeling better. Have you had any blood work done? I seem to remember he wasn't happy about eating when he was on the Tylan.

Hang in there,
addy

[Harley PoMMom]

When cognitive dysfunction syndrome (CDS) arises in an elder, Anipryl, I believe, is the only rx medication there is to help with this. I don't have any experience with CDS but found an article that has a lot of info regarding CDS including traditional and alternative ways in treating this issue plus dietary supplementation and behavioral enrichment. Here's a link to this article: http://www.whole-dog-journal.com/issues/11_12/features/Caring-For-An-Older-Dog_16086-1.html

Hope this helps.

Love and hugs,
Lori

[mr. max]

Hi Folks,

It is with great sadness that I have to tell you that I had to put Mr. Max to sleep last week. It became clear that he was in distress so I had to do what I had been dreading for some time. Not the first time I've gone down this path with a dog----never easy. But I wouldn't have missed one minute with the incredible Mr. Max; he was special; the dog that was meant to be mine.

I would like to thank everybody for their support and advice over the last couple of years when we were coping with Mr. Max's atypical Cushings.

Debbie

[Squirt's Mom]

Dear Debbie,

I am so sorry to hear about Mr. Max. We all know how hard you worked to help his life be the best it could. Max lived a wonderful life with you, one that was nothing but love and trust. When the time came that nothing more could be done to make his days better, you gave him the greatest gift of all - freedom from his failing body and mind.

Today, Mr. Max is young, strong, and full of energy once again, his mind sharper than it ever was. He will watch over you just as you have him until that glorious day when he is reunited with you.

Please know we are here for you and your family as you travel through the days ahead.

Our sympathies,
Leslie, Squirt, Trinket, Brick and our Angels, Ruby and Crystal


May I Go
Do you think the time is right?
May I say goodbye to pain filled days and endless lonely nights?
I've lived my life and done my best, an example tried to be.
So can I take that step beyond, and set my spirit free?
I didn't want to go at first, I fought with all my might.
But something seems to draw me now to a warm and living light.
I want to go, I really do; it's difficult to stay.
But I will try as best I can to live just one more day.
To give you time to care for me and share your love and fears.
I know you're sad and afraid, because I see your tears.
I'll not be far, I promise that, and hope you'll always know,
That my spirit will be close to you wherever you may go.
Thank you so for loving me. You know I love you too,
And that's why it's hard to say goodbye and end this life with you.
So hold me now just one more time and let me hear you say,
Because you care so much for me, you'll let me go today.
by Susan A. Jackson

[marie adams]

Dear Debbie,

So sorry for your loss of Mr. Max. I know how hard it is to make that decision. As you said it is not the first time for you, but each time it is with a special buddy.

Take care and please come back to visit--as you can see I haven't left and it has been over a year since I lost my special buddy, Maddie. I have Ella now who is almost a year--this Sunday. I cannot believe I have made it through the awful puppy stage with her, but I have survived--haha!!!

Best to you and many (((((hugs!!!!))))) You are in all of our thoughts and prayers!!!

Mr. Max is running free and happy at the Rainbow Bridge with all our Angels.:)

[Sabre's Mum]

Debbie

I am so sorry to hear that Max has crossed the bridge. My thoughts are with you.

Hugs ... and take care
Angela and Flynn

[jmac]

Debbie-

I am so sorry to hear about Mr. Max. I know that is never a difficult decision, but one that we must make to help our pets and end their suffering. I am so glad you are able to find some positive in this-that you enjoyed lots of wonderful times together with your special guy made just for you.

Thinking of you...
Julie & Hannah

[Cyn719]

Debbie

I am so sorry for the loss of Mr. Max. It is always a very hard decision but you did what you had to becaus of how much you loved him. You will always have beautiful memories to hold in your heart.

Run free Angel Mr. Max

Hugs xoxo

[frijole]

Debbie, Sorry to hear the news - I know it is a tough decision. May all the great memories you have sustain you as you heal. RIP dear angel Max. Run free. Kim

[Casey's Mom]

Debbie - so very sorry to hear the news about Mr. Max. He was a very beautiful boy - run free sweet boy.

Love and hugs,

[Harley PoMMom]

Dear Debbie,

I am so sorry for your loss and my heart goes out to you at this most difficult time. Please know we are here for you and do understand the pain you are feeling.

Godspeed sweet Max

With Heartfelt Sympathy,
Lori

[k9diabetes]

I am so very sorry for your loss of Mr. Max... I was just looking at his pictures in your album. What a beautiful and handsome boy Max was. His coat had the most incredible mix of black and white.

He was obviously a cherished member of your family, which means everything to a border collie.

With deepest sympathy,

Natalie

[Leena]

I am truly sorry for your loss...It is a difficult thing to deal with and takes time for the heart to mend. Know that your baby is playing and happy and with a whole lot of doggy friends in heaven! Hugs to you!

[mytil]

I am so very sorry to read about your Max. I know the decision is a very difficult one but one we promise them if their quality of life fades. My heart is with you.
(((hugs)))
Always remembering your boy
Terry

[bgdavis]

Debbie,

I'm very sorry for your loss. Mr. Max had a wonderful life and a wonderful care-giver.

Bonnie and Angel Criss