Max's "sister" may have Cushing's too.

[Mackey's Mom]

Both Max and his sister, Sophie, had a vet visit this morning: Max for removal of a lesion on his upper lip (looks good but gone to pathologist) and Sophie for elevated liver enzymes. She has been exhibiting an increased appetite, drinking more, some weakness. She had an ultra-sound, x-ray, and urinalysis...lots of protein in urine, liver looked good, but kidneys were "thick," adrenals were high-end of normal in size. Urine went out for c:c ratio for possible Cushing's. She's 11-1/2, Plott/Pit/Retriever mix.

Max is still in remission...and I've thought maybe Sophie was exhibiting signs of Cushing's but everything looks like Cushing's to me since Max's diagnosis. She's a tough girl, but the kidney issue bothers me. She is on Cephalexin 2x a day for the kidney issue, and then we'll discuss further tests and treatment. Any suggestions on the kidneys?

Thanks -- Lori, Max and now, Sophie Jean :(

[Mackey's Mom]

They are also looking at glomerulonephritis -- sorry forgot to add. I was exhausted after we got home having had to take everyone out in a snow storm and drive 1-1/2 hours to our vet.

Worried about my girl :( -- Maxwell Joseph seems to be doing fine though :)

Thanks...

[lulusmom]

Hi Lori,

Did your vet do a blood chemistry for Sophie? If so, can you please post the abnormal values, to include the reference ranges and reporting units...i.e. ug/dl, nmol? Proteinuria is quite common in cushing's and if the BUN, creatinine and everything else is normal, it is possible that Sophie has cushing's and the proteinuria is secondary to the disease. Proteinuria can be very serious and the cause should be determined and addressed. However, with cushing's a good number of dogs will have proteinuria but it doesn't mean that the kidney's are failing. The more information you can give us, the better able we will be to understand what is going on with Sophie and offer you more meaningful feedback.

Here is a link to another thread with discussions regarding proteinuria which you might be interested in.

http://www.k9cushings.com/forum/showthread.php?t=2708&page=3

I am happy to hear that your Max is still in remission. I'd give anything if my two cushdogs were in remission. :(

Glynda

[Mackey's Mom]

Hi Glynda,
I have a call into the vet to get everything faxed to me. I completely forgot to get copies of everything...yesterday was so stressful between the weather, having the 3 dogs with me, and worrying about Max and Soph. They allowed me to stay and wait for them rather them leave them for the entire day, so I had two staggering, sleepy dogs to bring home and one anxious Dingo little brother who couldn't figure out what was wrong with his sibs.

For the past month she has been begging for food, which is not like her at all -- she doesn't eat meals at times, and is pretty picky. She's been drinking more as well. I have a dog door so hard to tell if she's urinating more because they choose to stay out a lot of the time. Sophie loves the cold weather so can't tell about being too warm, but she has been having a tougher time with exercise, and is more tired that I've ever seen her. Still feisty though...she's an independent character.:) This vet practice believes that you only treat Cushing's if the symptoms are making your dog uncomfortable...I don't agree, I think it should be treated no matter what affect it is having on them.

Maxwell's been doing really well...his ears are in good shape, he's not begging for food (well, not out of the ordinary for him ;) ) and has lots of energy. I know it could all change tomorrow, but for now okay. He is due soon for blood work so will see how his #'s are. Hopefully the growth that was removed is non-cancerous...so far, it looks that way. Will hear from Cornell in a week.

Thanks again and again...:o

[Mackey's Mom]

Here are the results we have so far -- waiting for the vet to call me as part of the faxed report is difficult to read:

Cortisol:Creatnine Ratio: 40 (YIKES!)

Total Protein: 6.5 (5.0-7.4) g/dL
Albumin: 3.4 (2.7-4.4) g/dL
Globulin: 3.1 (1.8-3.6) g/dL
AST: 44 (15-66) U/L
ALT: 100 (12-118) U/L
Alkaline Phosphatase: 256 (HIGH) (5-131) U/L
Total Biliruin: 0.1 (0.1-0.3) mg/dL
Urea Nitrogen: 18 (6-31) mg/dL
Creatnine: 0.9 (0.5-1.6) mg/dL
BUN/Creatnine Ratio: 20 (4-27) Ratio
Phosphorus: 4.1 (2.5-6.0) mg/dL
Glucose: 95 (70-136) mg/dL
Calcium: 9.7 (8.9-11.4) mg/dL
Corrected Calcium: 9.8
Magnesium: 1.7 (1.5-2.5) mEq/L
Sodium: 1.47 (139-154) mEq/L
Potassium: 4.7 (3.6-5.5) mEq/L
?/K Ratio: 31
Chloride: 111 (102-120) mEq/L
Cholesterol: 432 (HIGH) (92-324) mg/dL
Triglycerides: 666 (HIGH) (29-291) mg/dL
Amylase: 462 (290-1125) U/L
Lipase: 729 (HIGH) (77-695) U/L
?PK: 325 (99-895) U/L

Hemoglobin: 16.5 (12.1-20.3) g/dL
Hemalcrit: 47.6 (36-60) %
WBC: 10.6 (4.0-15.5) 10 (??/L)
RBC: 7.06 (4.8-9.3) 10 (??/L)
MCV: 67 (58-79) ?L
MCH: 23.4 (19-28) pg
MCHC: 34.7 (30-39) g/dL
Platelet: 579 (HIGH) (170-400) 10 (??/L)
Platelet Estimate: Increased (Adequate)
Differential: Absolute
Neutrophils: 9010 (2080-10600)
Bands: 0 (0-300)
Lymphocytes: 1060 (650-4500)
Monocytes: 424 (0-840)
Eosinophils: 106 (0-1200)
Basophils: 0 (0-150)
Blood Parasites: None
T4: 1.0 (1.0-4.0) ?g/dL

I can't read the u/s report due to fax quality. Waiting for our vet to call me later today to go over everything.

Thank you for interpreting these for us...her triglycerides have me very concerned...going to go read now.

Lori and Sophie Jean :)

[lulusmom]

Hi Lori,

Thanks so much for posting Sophie's bloodwork. I am certainly far form a lab technician and I hope that Debbie, our seasoned lab technician of 30 years will come by and check my work. :D I will tell you that Sophie's high values are not the usual abnormalities seen in a cushdog. To me these look more like gut issues. Please see my comments below:


Here are the results we have so far -- waiting for the vet to call me as part of the faxed report is difficult to read:

Cortisol:Creatnine Ratio: 40 (YIKES!)

Because the blood abnormalities below are not what I am used to seeing with cushdogs, nonadrenal illness or even stress could easily have yielded this high UC:CR ratio. Stress is more likely to be the culprit if you did not collect the urine sample at home.

Total Protein: 6.5 (5.0-7.4) g/dL
Albumin: 3.4 (2.7-4.4) g/dL
Globulin: 3.1 (1.8-3.6) g/dL
AST: 44 (15-66) U/L
ALT: 100 (12-118) U/L
This is a liver specific enzyme that is often mildly elevated with cushing's and moderately to severely elevated with primary liver disease and kidney failure. So yay!!!

Alkaline Phosphatase: 256 (HIGH) (5-131) U/L
This is a liver enzyme that can be triggered by steroids, bone and the gut. This is considered a mild elevation. I've seen ALKP in cushdogs as high as 4,000 to 5,000.

Total Biliruin: 0.1 (0.1-0.3) mg/dL

Urea Nitrogen: 18 (6-31) mg/dL
Creatnine: 0.9 (0.5-1.6) mg/dL
BUN/Creatnine Ratio: 20 (4-27) Ratio
Phosphorus: 4.1 (2.5-6.0) mg/dL

These are all important values in determining kidney function. Looking really good here.


Glucose: 95 (70-136) mg/dL

This is all good. :D You can see mild elevations due to stress or moderate elevations due to cushing's, pancreatitis, kidney problems, pancreatitis, most certainly diabetes mellitis and some drugs.

Calcium: 9.7 (8.9-11.4) mg/dL
Corrected Calcium: 9.8
Magnesium: 1.7 (1.5-2.5) mEq/L
Sodium: 1.47 (139-154) mEq/L
Potassium: 4.7 (3.6-5.5) mEq/L
?/K Ratio: 31
Chloride: 111 (102-120) mEq/L
Cholesterol: 432 (HIGH) (92-324) mg/dL
It is common to see high cholesterol in cushing's; however, this mild elevation can also be due hypothyroidism, a high fat meal or eating a meal right before the blood draw.

Triglycerides: 666 (HIGH) (29-291) mg/dL
This is also a common finding in cushing's; however, with so few other abnormalities found in cushing's, I'd have to include a recent high fatty meal, pancreatitis and even hypothyroidism as suspects.

Amylase: 462 (290-1125) U/L
Lipase: 729 (HIGH) (77-695) U/L
This is a pancreatic enzyme that can be elevated in cushing's or pancreas inflammation or gastrointeritis. Lori, Harley's mom, knows a lot more about Amylase and Lipase. Hopefully, she'll weigh in.

?PK: 325 (99-895) U/L

Hemoglobin: 16.5 (12.1-20.3) g/dL
Hemalcrit: 47.6 (36-60) %
WBC: 10.6 (4.0-15.5) 10 (??/L)
RBC: 7.06 (4.8-9.3) 10 (??/L)
MCV: 67 (58-79) ?L
MCH: 23.4 (19-28) pg
MCHC: 34.7 (30-39) g/dL
Platelet: 579 (HIGH) (170-400) 10 (??/L)
Platelet Estimate: Increased (Adequate)
Differential: Absolute
Neutrophils: 9010 (2080-10600)
Bands: 0 (0-300)
Lymphocytes: 1060 (650-4500)
Monocytes: 424 (0-840)
Eosinophils: 106 (0-1200)
Basophils: 0 (0-150)
Blood Parasites: None

T4: 1.0 (1.0-4.0) ?g/dL
This is a thyroid hormone and it is pretty low. Hypothyroidism could be the reason most, if not all, of the other blood values are abnormal. Please check out this post that Lori, Harley's mom, posted to another member's thread. It has great info on thyroid issues.

http://www.k9cushings.com/forum/showpost.php?p=47134&postcount=145


I can't read the u/s report due to fax quality. Waiting for our vet to call me later today to go over everything.

Please see if you can obtain a cleaner copy from your vet so you can post the findings here. I would be very interested to hear about the conditions of the liver, adrenals and any possible identifiable pancreas problems.


Thank you for interpreting these for us...her triglycerides have me very concerned...going to go read now.

I think with respect to triglycerides, you should strive to stay under 500 mg/dl. An appropriate low fat food should definitely be discussed with your vet. Some breeds are predisposed to hyperlipidemia so depending on Sophie's breeding, the hyperlipidemia may genetic as opposed to secondary to an underlying illness?

Lori and Sophie Jean :)

[Mackey's Mom]

Thank you, thank you, thank you!!!

I have a call into the vet and haven't heard back yet. When he went over the ultrasound with me at the office, he didn't mention the pancreas -- said the adrenals were "high-end of normal" in size and that the liver looked fine. Kidneys were "thickened." I'll try to get a better copy of the report, even if I have to drive there to get it.

She is definitely more tired than I ever remember her being, and has refused to go hiking out back...which isn't like her at all. Her back legs have been shaky, especially the one side. She had torn ACL's 10 years ago, in both knees, and had TPLO surgery 6 months apart. Other than that, she's been healthy and doing great. I do cook for them, but they also eat Health Extension dry food sometimes mixed with beef or chicken or fish. I just switched to Health Extension about 4 months ago. She just seems as if she has aged overnight.

I'll look at the link you sent and do more reading today. Any other input would be greatly appreciated! :)

Lori and the kids

[lulusmom]

Lori, what is Sophie's breeding?

[Mackey's Mom]

Well, she's a rescue from West Virginia...came here from a high-kill shelter to rescue when she was about 10 months old. Best we can tell, she's Plott Hound/Setter/Retriever mix (she has a setter tail and points!). May also have some Pitt but who knows. She weighs 95 lbs (up from 82 last year), is dark brown brindle with white nose, chest and tummy. She has the tracking drive of a hound and the tenacity of a terrier...she has always been and continues to be a very independent girl. We were kicked out of obedience class when she was 1 because she "refused to focus on anything" and ignored the trainers no matter what they used to get her attention. I was kinda proud on the way home of my independent, stubborn girl...she's tough, and we love her all the more because of it (or in spite of it!:D )

She's not been a big eater, ever...lots of days she refused breakfast (my dogs are fed twice a day). Until about 2 months ago...she started begging for food, crying for treats, looking for more food after she was done with her meal. Her drinking increased as well. And lately she has not been able to keep up with hiking -- she was always ahead of the pack, but I noticed her slipping behind, and her back legs being shaky. I thought orthopedic issues at first, but then she quickly slowed down, start making lots of groaning noises when she would lie down, and just seemed uncomfortable and not well. She also seemed to be breathing heavy at times...like she was "sucking" air in. Her tummy is big and hard too. She also has a sway back...her back legs go straight up and down causing her hips to be higher than her shoulders.

Thanks for being there...to all of you. It makes us all feel like we have a little more control and are able to help our kids in ways we wouldn't be able to without you all.

I'll post a picture of my girl later...and another of my Cushboy...and maybe one of their pointy-nosed big-eared brother. I love them with all my heart :)

Lori

[Mackey's Mom]

The vet called -- they want her in for the 8-hour LDDS test to confirm or rule out a diagnosis of Cushing's. I told him I wanted to retest her UC:C ratio with a sample taken at home, and he felt it wasn't necessary to do that since her clinical symptoms point in that direction. Hmmm.

Also something else we noticed that I forgot to mention...Sophie has been exhibiting a "mounting" or "humping" behavior when she sniffs her brothers' penis'. She has never done that before. I just read the article about sex hormone elevated Cushing's, and that symptom is there.

I'm thinking of bringing her on Wednesday for the test...I hate leaving her at the vet...she gets so nervous.

Lori

[Squirt's Mom]

Hi Lori,

To check the intermediates, Sophie will have an ACTH blood test at your vets but the sample is sent directly to UTK (University of TN in Knoxville). This is the only lab in the world we know of who is testing these hormones. If this is something you would want to know about concerning Sophie, I wanted to make sure you understood the intermediates are tested for a bit differently than the usual Cushing's tests.

Hugs,
Leslie and the girls - always

[Mackey's Mom]

He said an 8-hour LDDS test is the next step, is that correct? They did not do an ACTH stim test yet.

She went out with me (and the boys) to fill the bird feeders and chased a squirrel through the snow...she was huffing and puffing when she came back. She wants so to go for a hike, but she isn't up for it. My husband's taking her out for a ride to the store later so I can take the boys out for a short hike and she won't know about it. :(

[Squirt's Mom]

The UC:CR, LDDS, HDDS, and standard ACTH will test for cortisol levels and are the tests used to diagnose true Cushing's in which the cortisol is elevated. None of these tests will test the intermediate hormones - which are estradiol, aldosterone, progesterone, OH17 progesterone, and androstenedione.

So to test for cortisol only, yes, the LDDS is a good next step. The LDDS is a suppression test to see how well the adrenals can suppress the signal to release more cortisol.

Hugs,
Leslie and the girls - always

[Mackey's Mom]

The vet just called with Sophie's LDDS results -- she has Cushing's. He said her results were "off the charts" and fears she may have an adrenal tumor, although her ultrasound showed adrenals on the high end of normal in size.

I'm starting her on 120 mg. of Trilostane tomorrow, once per day. The vet wants her back in 2 weeks for an ACTH test and then we'll "go from there."

I asked for the specific numbers and he said they would fax them to me on Monday. Wondering what the tumor issue means...he said that surgery was needed as the Trilostane would "burn out the adrenals." Need to do some more reading.

I asked about re-testing Max to see if his numbers were still normal, and he said there was no need if he had no symptoms; I still feel like I want him tested to make sure. It's funny...he went into remission about the same time she started exhibiting symptoms.

Some good news...the growth removed from Max's lip was benign. Phew!

Lori and the kids

[labblab]

The vet just called with Sophie's LDDS results -- she has Cushing's. He said her results were "off the charts" and fears she may have an adrenal tumor, although her ultrasound showed adrenals on the high end of normal in size.

Lori, that's great news that the pathology on Max's lip came back "OK"! Also, I'm including a quote that should help you make sense of Sophie's LDDS results when you receive them on Monday. This comes from Dr. Edward Feldman (http://www.k9cushings.com/forum/showthread.php?t=209)of the UC Davis vet school:


Low Dose Dexamethasone Test (LDDS)
The protocol utilized for this test is obtaining plasma samples
for cortisol before and 4 and 8 hours after I.V. administration
of 0.01 mg/kg dexamethasone. The 8-hour plasma cortisol
is used as a screening test for hyperadrenocorticism, with
concentrations >1.4 μg/dl being consistent with (not confirming)
the diagnosis of Cushing's syndrome. This test is relatively
sensitive and specific, but not perfect. Approximately
90% of dogs with Cushing's syndrome have an 8 hour postdexamethasone
plasma cortisol concentration >1.4 μg/dl
and another 6 to 8% have values of 0.9 - 1.3 μg/dl. The
results of a low dose test can also aid in discriminating PDH
from ACT, using three criteria: 1) an 8 hour plasma cortisol
>1.4 μg/dl but <50% of the basal value; 2) a 4 hour plasma
cortisol concentration <1.0 μg/dl; and 3) a 4 hour plasma
cortisol concentration <50% of the basal value. If a dog has
Cushing's and it meets any of these three criteria, it most likely
has PDH. Approximately 65% of dogs with naturally
occurring PDH demonstrate suppression, as defined by these
three criteria. A dog with Cushing's that fails to meet any of
these three criteria could have either PDH or ACT. However,
if it has two relatively equal sized adrenals on abdominal
ultrasonography, it most likely has PDH.
I am somewhat confused by your vet's comment that he fears Sophie may have adrenal Cushing's due to her "off the charts" test result. Per Dr. Feldman and other authorities, there is no LDDS result that specifically points to the adrenal form of the disease. Certain results DO correspond with pituitary Cushing's. But in all other cases, it takes further diagnostics -- most commonly an ultrasound -- to aid in the determination. And since Sophie already has had an ultrasound that is consistent with the pituitary form of the disease (two equally enlarged adrenals), I don't know of any LDDS result that would contradict that finding. So this is something that you'll want to clarify once you have the test results in hand.

However, the adrenals are not easy to visualize. So it takes state-of-the-art, high resolution ultrasound equipment to obtain results in which you can place confidence. General practice vets often do not have equipment that is sophisticated enough to provide reliable imaging of the adrenals, and that is why referrals to specialty clinics are often made. If a dog's Cushing's is being caused by an adrenal tumor, then the ultrasound will likely reveal a mass in one enlarged adrenal gland whereas the remaining adrenal gland will often be smaller and even atrophied. If an adrenal tumor is indeed causing the Cushing's, then surgical removal can be considered as an option. And successful surgery will cure the disease.

Please do post the LDDS results when you receive them. And good luck with starting the trilostane. Trilostane is approved for treatment of both forms of Cushing's. However, if there is truly reason to suspect an adrenal tumor in Sophie's case, you may want to consider the option of surgery as a permanent cure.

Marianne

[frijole]

Just wanted to "second" what Marianne said. Your vet's comments about 'off the chart' didn't make sense to me too.. not for the ldds test. So post the numbers and we'll help figure it out. Kim

[Mackey's Mom]

He said, if I can remember correctly, that at the 4 hour and 8 hour tests, her levels went way, way up and that's why he suspects and adrenal tumor. It didn't make sense to me either, because I know that Max had the HDDS test after to determine what was causing the CD. (By the way, Max's adrenals were normal in size according to the radiologist, but he was also 3 or 4 when diagnosed and we may have caught it relatively early.)

This practice is a large practice, one of the few that do stem cell treatment. But, I'm not sure that this vet is all that versed in Cushing's Disease. I asked if they were going to do an HDDS test and he said it wasn't necessary. I asked about surgery and he didn't have an answer to that.

I'll call on Monday to make sure they fax the results of the test and see if I can get more information. She is so tired, which isn't my girl at all, and she moans and groans where she gets up and down. I'm worried about her. :(

Thank you for guiding us through all this again...we so appreciate it.

Lori and Sophie Jean Dorry

[zoesmom]

Poo-poo. I was so hoping it might be negative for Sophie. Maybe you can also have them fax a copy of that u/s report and find out what kind of equipment it was done on. Because if the adrenals are only slightly enlarged and still of equal size, I'd place my bets on PDH. If the equipment wasn't hi-resolution, and you want to know for sure what it is, then maybe get a better u/s done, rather than an HDDS. Or not, if it's inconvenient. (Meaning a long drive involved.) Plus, if you're going to treat with trilostane, regardless, and surgery is not an option, then I probably wouldn't do either one.

Also, a little confused by the vet's comment about trilostane 'burning out the adrenals'. Sounds like he was talking about lysodren, not trilostane. Has a different vet been in charge of Max's case for the most part. Or is it this vet? Sue

[Mackey's Mom]

I finally got received the faxed test results for the LDDS:

Cortisol Pre = 4.0 (verified by repeat analysis)

Cortisol Post 4 hr. = 4.7 ug/dl (verified by repeat analysis)

Cortisol Post 8 hr. = 5.2 ug/dl (verified by repeat analysis)

They want to do an ACTH stim test in 2 weeks. I started her on 120 mg. of Trilostane on January 22nd. I've noticed very little change in her as of yet, but she did snark at her brothers' running around the living room, which is more like my girl (she's been ignoring them both). (Fun is not allowed...unless she starts it. :D )

This is a new vet, a large practice, 1 hour away. They have (supposedly) state-of-the-art equipment. I have asked for a copy of the ultrasound by haven't received it as of yet. The vet I see specializes in eastern medicine, and consults with the other senior vets at the practice. He did not feel it necessary to do the HDDS due to her LDDS results. ???

Another question: My friend's dog was just diagnosed with chronic active hepatitis...they are giving her the "don't expect much" lecture. Any suggestions...I know someone here must have experience with it!

As always, THANK YOU ALL! (PS -- Big Mack says "Hi!" and wants you all to know that he will be 10 on March 4th and he tried to climb the maple tree to catch a squirrel last night. He has a "waist" and his fur is shiny, no dryness, and his ears are clear. Even if this only lasts a few more months, I am enjoying every second of seeing him happy and healthy and full of "p**s and vinegar." :D

Lori and Sophie

[labblab]

Lori, thanks so much for those LDDS results. However, now having seen them, I remain puzzled by your vet's conclusion that they point towards adrenal Cushing's. Applying Dr. Feldman's interpretation from above, the LDDS falls in the category of not confirming either type of Cushing's -- and requires further diagnostics such as an ultrasound. I'm not surprised that your vet is not gung-ho regarding an HDDS, because that test seems to have fallen out of favor. But since Sophie's ultrasound was consistent with PDH, I'm still confused by your vet's comments to you. It will definitely be interesting to see the actual ultrasound interpretation. But either way -- adrenal or pituitary -- I'll keep my fingers crossed for ongoing improvement now that Sophie is being treated.

Thanks for this update! Big hugs to both your "kids!"

Marianne

[Mackey's Mom]

Hi all,
Sophie had her ACTH test this past Wednesday and I just got the results:
Pre = 4.2
Post = 4.6
Her symptoms have gotten a bit better...no more begging for food, water consumption is down, she did go for a short hike with me this past Sunday which she hasn't wanted to do. She is still much more subdued than she was, groans a LOT when she is laying down. She is 11-1/2, and a big dog, but the changes came on so suddenly.

Waiting for the vet to call me back -- my hubby spoke to him -- I want to find out if he re-tested her liver function and what he thinks about her kidney issues.

Maxwell Joseph continues to be medication free...and his symptoms are still fairly in control (it's hard to say...he's a Lab after all :D )

Thank you everyone! Hugs to all the Cush-pups out there...

Lori, Sophie and Max (Big Mack)

[Mackey's Mom]

Oh, forgot to add...her test was done at 8 a.m. after she had had her breakfast and her 120 mg. of Trilostane. The next blood test was drawn at 10 a.m. (2 hours later).

[Mackey's Mom]

Sophie had a bad night...and seems uncomfortable today. She wouldn't take her capsule this morning, no matter how we tried to hide it, and we cannot open her mouth to push it in. Going to try later. We feel as if there is something else going on with her...can't wait for the vet to call. I'm hoping he might be able to see her today.

Lori and Sophie :(

[Squirt's Mom]

Hi Lori,

If Sophia isn't well this morning then don't worry about getting the meds in her. One of our mantras here is don't give Trilo or Lyso to a sick pup. I hope she is better soon. :( When you say she had a bad night, what was going on with her?

Let us know how things are!
Hugs,
Leslie and the girls - always

[Harley PoMMom]

Oh, forgot to add...her test was done at 8 a.m. after she had had her breakfast and her 120 mg. of Trilostane. The next blood test was drawn at 10 a.m. (2 hours later).

Could you tell us exactly when you gave Sophia her 120 mg of Trilostane in the morning...Thanks!

Love and hugs,
Lori

[Mackey's Mom]

Sophie had her Trilo at 6:45 in the a.m. the morning of the test -- it takes us an hour to get to the vet, and they pulled her blood at 8:15 on the dot and then gave her the injection.

Her tummy is very bloated still...and just doesn't act like herself. She woke myself and my husband up 4 or 5 times during the night last night, and just wanted to be pet and talked to. She seems to be favoring her front left leg...shoulder it looks like to me. The only way I can explain it is she seems very, very old all of a sudden. I never heard back from my vet today, and I want answers about her kidney situation. They didn't look good on the ultrasound.

I cooked her chicken, noodles, and broth tonight, and she ate everything. I am so worried about her...she's always been a tough stubborn girl, with a mind of her own...to see her like this is sad.

Lori

[Mackey's Mom]

No breakfast today for Sophie...so no pill. We can't force her mouth open, she will clamp down. And if you're lucky enough to get it open she will bite or spit it out. If she doesn't want something, it ain't happening. (That's my girl. :o )

She is awful bloaty...call into the vet, and hopefully will hear back from him soon.

I'm thinking another bloodwork and ultrasound may be in order? :confused: Going to ask him, and may ask for a referral to the IMS we took Max to.

Thank you just for the opportunity to vent and put my concerns out there.

[Harley PoMMom]

We are always here for you so please vent all you want, ok? ;):)

Does Sophie act like her tummy hurts? Will she let you touch around her tummy? And when/if you do does she wince or anything?

[Mackey's Mom]

Sophie does let me touch her tummy and it doesn't seem to hurt her, but it's hard to tell with her as she doesn't like you to poke around.

I did put in a request for a referral to the IMS. I just strongly believe that there is something else going on, along with the Cushing's.

My husband tried to get the Trilo into her tonight with no luck. He hid it in everything, and she wouldn't go for it. He tried to pop it in, also to no avail, so no pill today. It's not going to be easy with her. :(

Lori and Sophie (Bean)

[Mackey's Mom]

Update: Sophie has been refusing to take the Trilostane -- we hide it every way we can, but she refuses to eat her food if the capsule is anywhere near it, even in a meatball! She is a big girl, and trying to get it down her throat is impossible. I had to hand feed her this morning, pot roast, noodles and broth. She will not go near her dish.

We see the IMS on the 23rd, and I'm trying to get into my vet before then. She went hiking with me yesterday, was excited to go, but had trouble getting into the truck. When I wrapped my hands around her lower belly to help boost her, she yelped. I massaged her last night, which she loves, and rubbed her belly. Her bloating has gone down, but she also hasn't been eating as much. I am so hoping the IMS can tell us something other than what we've already heard.

Her brother (known here as Big Mackey) spent all night panting on my bed, having a weaker hind end and wanting cookies. I think his remission has come to an end, and am scheduling an ACTH test for him. :(

If you have any suggestion about what I should ask the IMS, it would be appreciated.

The very broke and tired Lori, and the kids :o

[Mackey's Mom]

Newest Update: Spoke to the vet last night, and after reviewing her x-rays again while I had him on the phone, he noted she has spondylosis in the lumbar region. This probably explains why she is so uncomfortable, and it would've been nice to know that when she had the x-rays done a while back. :(

He felt her kidneys, although they look "funky" (is that a medical term?), were nothing to worry about as her blood work and urinalysis were good. He was not concerned about her blood work.

She will be starting anti-inflammatory medication in hopes that it relieves some of her discomfort. We did get her Trilostane into her last night...liver, gravy, mashed potatoes is what it took. Sigh...what's a mom to do! :o

[Mackey's Mom]

Update on the Sophtress:

She is eating little, being very picky, even for her. She is not begging for food, and her belly has shrunk quite a bit. No panting either. She has wanted to go out for short hikes (my rule, not hers) -- and we have at least 14" of snow here. Needless to say, she has not been getting any medication because of not eating.

She's also been waking us several times during the night crying. It seems she just wants attention, and will go back to sleep, until you go back to bed. Then she cries. She won't get in bed with us either...even though she is allowed. She wants us to come out into the living room and sit. I worry there is some dementia or something. She does look around the room, looking a little confused. She does not do this during the day. She is getting Dermaxx once a day...which is probably helping with her activity level.

So, we're taking it one day at a time...trying to get her to eat something, and give her attention when she needs it. I don't know what else to do. Taking her to another vet for a second opinion -- had to cancel the IMS due to a conflict with Max's appointment, and my being needed to assess a dog at the shelter.

Thanks for "listening" ... thhis really does help me to gather my thoughts, and release some of the worry. :o

Lori

[Mackey's Mom]

Hello friends!

Well, Sophie has had no medication at all (Trilostane, Deramaxx) and she seems to be doing fine. Her belly is down, her activity level is up, not begging for food -- she is eating more like herself (picky...picky...picky), but eating. She has tried to play with her brothers a few times, and is playing with her marrow bones.

I just don't understand it...she tested positive for Cushing's (LDDS) and now, without meds, doing okay. Max is still in remission too. Do I have a radiation leak at my house, or is my new vet not doing this testing correctly? Max IS exhibiting some signs of Cushing's but his test was normal as well.

I'm so confused!!! :confused:

Lori

[frijole]

Hi! I didn't read back to the beginning but I noticed that you mentioned spondylosis. My Annie was misdiagnosed with cushing's last year and she had false readings on 5 tests. :(:confused: L O N G story when the body is in pain such as spondylosis can cause it will produce cortisol to fight the pain.... maybe that's what was going on? Take the positive dx and RUN! :D Kim

[Mackey's Mom]

Kim, I never thought of that but it makes perfect sense! I am so hoping that is what happened.

Thank you! :)