Vetoryl / Cushings Disease - Dear Penny has passed

[Cyn719]

Hi my name is Cindy and my dog Penny has Cushings and was diagonsed at 8 years old - she is a shephard - akita - pit - lab and ?? she is now 11 and 85 lbs. She had all the symptoms excess very very excessing drinking thinning of fur and tail thining of her head pot belly and wanting snacks all the time - so the vet said it was time to put her on meds we waited as long as possible - her urine was totally diluted also - she has putitary tumor - ok so we did right befor Christmas - 60 mg a day - and yes the drinking stopped down to a bowl a day - not asking for snacks all the time and not asking for breakfast and dinner everyday like she use to now she just eats when I give it to her and the urinating has slowed down her coat is better she looks better BUT she just wants to lay down and sleep all the time - that spunky Penny is gone - the vet said she is not hyper cause the meds are doing what they are suppose to - but now she is having tremors I think her eyes blink her head shakes then she shakes like a mini seizure - vet said shivering is normal but I think this is more - said if tumor get big enough it will cause seizures but doesnt think this is the case - so when she had her first blood test after being on med for i think 3 weeks it was 2.4 vet said good - now yesterday 3 weeks later test again now 8.8 at 9 the push up the dose so why isnt it working at 60? I do not want to increase the dose with her sympotms and how tired she is and also she had arthritis and shes on rimadyl which was working great but now on these meds its like shes not taking rimadyl at all she can hardly stand - vet said its because when she was getting to much cortisol it was like a high and she didnt feel all the pain and now shes getting less cortisol shes feeling the pain - so now what - did I do right by putting her on meds - before I felt like I had a dog now I dont!!! What do i do now?? I would appreciate all your help Thank you so much!! Cindy and Penny

[Casey's Mom]

Good morning Penny and welcome to our forum. Glad to have you here with us but sorry that your dog has cushings. There are others on this site that will be along shortly and address the shivering issues - I know that it has been discussed here before.

My dog also had the arthritis issues show up after her cortisol was under control - what your vet told you is correct about the cortisol masking the symptoms. You should not give a cushings dog rimadyl because it affects the liver however there are lots of other things you can do to help the arthritis. My dog gets a daily dose of L-Glutamine, Glucosamine Chondroitin and Salmon Oil and monthly Adequan shots from the veterinarian. Speak to your vet about these and see if they will help your dog - my dog will be 15 in March and runs every day so there is hope. It does take a while for the strength to return to their back legs, I think with Casey it was about 4 to 6 months.

Hugs,

[frijole]

Hi! Perhaps the shivering is from pain from arthritis? There are things you can do. Many of us used Adequan which are shots for treatment of arthritis. Google it and you will see some good things. My dog Haley was 16 1/2 and she was on it for about a year prior to passing.

My other dog Annie has had shivering and back leg weakness and I have her on a homeopathic alternative to steroidal anti inflammatories. It is called Duralactin and has helped her alot. Its a chewable tablet and you can buy it online without an rx. I learned about it from the head of the small animal science department at Kansas State Univ. Here's a link with info:
http://www.k9cushings.com/forum/showthread.php?t=2635

It is not well known in the vet world fyi... google it too!

Hope this helps. Kim

[Squirt's Mom]

Hi Cindy and welcome to you and Penny! :)

We are going to play 20 Questions for minute, ok? This is so we can get a clearer picture of what is going on with Penny and be able to offer you the most meaningful feedback. We won't get really nosy until we get to know you a bit better! :p

Does Penny have any other health issues that you are aware of?

Is she on any meds other than the Trilostane (Vetoryl)? any supplements or herbs? If so, what and how much?

Is she spayed?

Has Penny had an abdominal ultrasound? If she has, would you mind posting those results?

Were diabetes and hypothyroidism ruled out when she was first being diagnosed?

Has she been tested for diabetes recently (in the last month or less)?

Do you ever notice her eyes rapidly shifting from side to side when she has the episodes you described as a possible mini seizure?

Does she circle - not circling to lay down but just going in circles for no apparent reason?

Does she press her head against things like walls, cabinets, furniture? Not pressing against you to be petted but just pressing her head against things.

How long after her last dose of Trilo was the last ACTH done in which the numbers had risen?

Have you had enough questions for a while? :D

Now for a bit of info - cortisol is a natural anti-inflammatory so when a cush pup has issues like arthritis or other inflammatory conditions often we see these conditions come to the surface once the cortisol is back to normal levels. Your vet was almost right...they aren't really on a high with the cortisol, but they are self-medicating in a sense. ;)

Cortisol is the body's NORMAL response to any stress - internal or external. Anytime the body is under stress, processes happen that cause more cortisol to be released until the stress is handled and then the signal to release the extra cortisol is shut off. In a cush pup, that signal cannot be shut off so they continuously produce excess cortisol. In this was our babies are "self-medicating" because the excess cortisol their bodies are releasing mask inflammatory conditions like arthritis.

Ellen gave you some excellent suggestions for addressing the arthritis. She is right on the mark about the Rimadyl! :eek: I would add one thing to what she had to say - anytime you give oils of any kind, including fish oils, you need to add Vitamin E as well. Vit E is an anti-oxidant and will prevent oxidization of the fish oils in the body which allows the body to fully absorb and use the oils as intended without causing free radicals.

One of the unfortunate side effects of Trilo is tremors. We have seen this with other babies on Trilo but most of them adjust in time once the dose has been tweaked to the correct amount and scheduling. Some of our Trilo parents will be along to share their experiences with you I am sure. Here is a link to a file in our Helpful Resource section about Trilo:

http://www.k9cushings.com/forum/showthread.php?t=185

If you have, or will get, copies of all the testing done on Penny to diagnose her and the monitoring testing since being on Trilo, and post the actual results along with the units of measurement (ug/dl, nmol/l, ect) and the normal ranges for that lab here for us, that will help a great deal! Your vet should be glad to give you a copy of her testing results. Most of us keep a file at home of tests on our babies so if we should ever have to see a different vet, we have all their records in hand right off the bat.

Ok, I think that's enough from this old broad for now! I am sure others will be along to offer their input soon.

For now I want you to know that you and Penny are not alone any longer. You have found the very best bunch of folks to help and to support ya'll on this journey. We will walk every step with you. Don't hesitate to ask questions and we will do our best to help you understand. The collective knowledge and first-hand experience found here is astounding and you simply cannot beat the old-fashioned hand-holding should you ever need it. I don't know what Squirt and I would have done these past 3 years without these wonderful, loving folks here. I know you will find the same to be true for you and Penny.

I am glad you found us and look forward to learning more about the both of you as time passes.

Hang in there!
Hugs,
Leslie and the girls - always

[zoesmom]

Hi Cindy and welcome to you and Penny -

The early days of treating cushings can be so stresful, but you have come to the right place - for your questions and for moral support.

My girl Zoe was treated with trilostane for 4 years, but the first few months were full of ups and downs (for her) and worry (for me.) She was lab, pit, boxer mix and about the same size as your Penny. If it makes you feel better, she ended up on a much higher dose - 180 mg. of vetoryl twice a day. So for a dog Penny's size, she has a lot of upward wiggle room, if her cortisol is not being well-controlled. She also responded much like you describe for Penny in the beginning. The shivering/tremors scared me but many dogs do experieince that, when the trilostane first kicks in. It eventually went away and should for Penny, too. As for the listlessness and sleeping all the time, that also was how Zoe was. It was extreme at times, but it also improved. One time, she wouldn't even lift her head, and seemed not to care about anything I mentioned - like tr eats, bye-bye. She'd even go off in corners where she never went and just laid there. That could be from what we call cortisol withdrawal syndrome. Many dogs go thru that. They're so used to the excess cortisol and its 'feel-good' effect. It was almost like Zoe was extremely depressed. That too, passed.

That being said, it is crucial to monitor their cortisol closely in the first few months. Sounds like your vet is doing that, just as required. However, could you please get and post the ACTH test results for those first two tests you mentioned. The one with 2.4 and 8.8 numbers. There should be two numbers for each test. That will help us to understand the results better. Also, results for any of the tests done during diagnosis would also be a big help.

Your Penny started on a modest dose for her size and that IS the best approach, IMO. But since that's the case, she may need one or more dose increases in the coming weeks/months to bring her cortisol to a therapeutic level and keep it there. Some dogs will settle in quickly on the right dose. Others, like my Zoe did, require more frequent dose adjustments. I won't give you the whole history, but there were times when all of a sudden her cortisol would go up or down, after being stable for awhile, and w'd have to adjust the dose. Most dogs will need very few if any dose adjustments. Just depends on the dog. So hope that helps you feel a bit better about what's going on. Treating is the very best option, but as a cush mom, you must always be on your toes, watching for possible clues as to how she's doing. And if ever in doubt, even the slightest bit, it's good to check with your vet. I promise, you will get so that you can read Penny like a book. Sue

PS - one thing that worked well for me was keeping a record of Zoe's daily water intake. That gave me a good idea of how hercortisol numbers were doing. If the water intake went up and stayed up, then that was a pretty good indication that her cortisol was on the rise (or that she had developed a urinary infection, which she did often and, of course, that's something that would also need to be addressed quickly.)

[Cyn719]

i can really relate to zoemoms situation - sounds so much like Penny - when her ACTH was 2.4 she drank very little and now that it is 8.8 she is drinking more - where should the ACTH be?? She has more energy at 8.8 but is that to high? She was so much better today - energy - jumping aroung - like her old self - but she groans so much - dont know if its the arthritis or not?? I dont like the groaning or the tremors but we will see where that goes - The vet said not to test her again for 3 months but that seems too long - but if the drinking increases then I have to call her - I hate to increase the meds cause then she is so lifeless -- this is not an easy situation at all plus Penny broke her K9 tooth and now thats another issue - the bottom quarter broke off and shaved a piece off the side - vet said right now not in pain but its a huge surgery to remove it better with a root canal??????? so confused - this girl has been through so much - she has both kneess done over also!!!

[apollo6]

Welcome
My Apollo was on Trilostane since June, had the trembling mouth and still has weakness in legs. I stopped Trilostane/Vetroyl in December to see if that caused weakness, but he still has weakness, so I will be putting him back on the medication, because symptoms are coming back. Hang in there. It is a long tough road. But a lot of us are still here so that is a positive.
Hugs Sonja and Apollo

[Cyn719]

zoesmom

- sorry I had to get out of my post quickly before - Penny was really groaning and I had to tend to her - I just wanted to say thank you because I could relate to what you said and I feel better knowing you (and everyone else) if there for me - this is crazy - so much is going on with her at once - the broken tooth - the cushings - the arthritis - and strange but a pin hole cut above her hock on her lets say elbow that started bleeding before Christmas and still was bleeding up to two days ago! Vet gave antibiotics and wrapped and because its on her elbow nothing with stay over the cut and went exposed and she lays on run the scab opens again - I bandage her 15 times a day!! Today I am alittle nervous cause she is wanting more water and thats not good with a 8.8 ACTH - at 9 meds get increased - will get results and post - thanks for keeping in touch - Cindy

[Cyn719]

Hi everyone - Penny is laying on the couch and just had two episodes 2 mins apart. to discribe it her head started to jerk - eyes were flickering - and mouth twitching!! He body also shook alittle. Do you thing it was tremores - shivering - or mini seizures???? I never noticed this before the Cushings medicine. I could use your thoughts!! Thank you - kind of getting me nervous. Thanks Cindy

[zoesmom]

Gosh, Cindy - it's hard to know from a simple description what was going on with Penny. If you have a video cam or can video it using a cell phone, then the best thing would be to try to capture one of those episodes on video so you can s how it to your et.

My Zoe had seizures as well and those were definitely different than the tremors from the trilostane. But there are many different kinds of seizures and not all of them look like the classic version that we usually think of. The twitching eyes could also be a sign of canine vestibular syndrome (an inner ear thing).... Is she having any trouble keeping her balance? Zoe went through that too - a severe case - but it can be milder in some dogs. How did she seem afterwards. Because seizures are usually followed by a period of disorientation, where they seem generally out of it for sometimes, hours.

The ACTH goal for a dog on trilo is 2-ish to 5.5ish. But if symptoms are being controlled, they can go up to 8, or in a few cases, 9. And all dogs are different - Zoe did much better when her cortisol was running somewhere between 5 and 7-ish. Above 9, probably too high for any cush dog. But 8 might be ok, if the drinking is not bad and that would also help with the arthritis that tends to worsen, the lower the cortisol. That was another reason we let Zoe's numbers run a little higher - big dogs and arthritis, not a pretty thing to watch. As for the drinking, the norm is about 1 cup of water for every 10 lbs. of weight OR 1 oz. for every lb. of weight. I measured Zoe's water all the time, just because it's hard to estimate what they drink. So if you measured Penny's water and she's drinking less than 9 c./day, her water consumption is in a good range. That might determine whether she really needs a dose increase or not.

On the leg thing, there's some really good products for dogs' leg joints. I bought something called LEGGS for Zoe's front elbows. Not cheap but they really helped her raw and oozing, scabby mess on the front elbows. Plus that also kept her from licking at them and making matters worse. There's a picture in her album here (click on my name to go there) which shows her wearing the LEGGS. I wish I'd found them sooner. Somebody here recommended them and she wore them for her last three months. I'll see if I can find a link to their website. Like you, I was getting tired of the constant bandaging and re-bandaging. Sue

[zoesmom]

Here's a link to that website. They have lots of products for lots of problems. It sounds like maybe you're talking about a hind leg?? If so, not sure they have anything for that, but they do have suggestions for dealing with that area. Look on their menu down the left side of the page for "rear legs".

http://www.dogleggs.com/index.cfm

Sue

PS - If you are talking about front elbows, here's a link to Zoe's album. The 2 DogLegg pictures are in the top row towards the right. You probably will need to enlarge (just click on those particular pics) in order to see the detail 'cause the DogLeggs are black and so was she.
http://www.k9cushings.com/forum/album.php?albumid=51

[Cyn719]

Hi I have not been on in a long time - I have posted alittle about my dog Penny who has cushings disease -- Penny was the one with leg problems and mini seizures?? maybe ?? Penny is having big problems -- I have not been on because my cousin has liver cancer and my aunt who has Addisions has been sick and we have our hands full -- Penny was not acting right -- very tired -- starting to drink water more often again - not being able to get up -- panting and panting and panting!! Not getting comfortable -- not eating well -- I would call the vet every week and sometimes twice a week to tell her this and asked to check her ACTH levels and she said her last one in March was 2.3 and she did not need another one until September -- do I kept doing this for the month of June and finally on Monday she finally agreed to do it and of course she is in Addisons Crisis - OMG 0.8!! She would not listen - now penny is acting really acting strange -- she is panting - drinking more- groans - gets up and down like she isnt comfy - diging in her bed - and wants to be in the basement and still having ?? seizures - my vet is not on and when I called tonite to ask to explain these results more the two vets on said they think I should only discuss this with my vet! What???? They are the vets on now?? My vet is off till Tuesday so were they told they couldnt talk to me?? Why cause she knows she should of listened to be 3 - 4 weeks ago?? I am sooooo upset - and I have the predisone and I dont even no when to give it to her if need!! So she was on 120 mg of vetroyl a day now they told me to stop the medicine for 3 days and go back on the vetoryl at 90 mgs a day -- I am sooooo confused -- now I feel like her tumor on put gland is enlarging so much it may be putting pressure on her brain - what do I do??? I really need some advice quickly -- I dont want her to suffer!!!

[frijole]

You need to give Prednisone NOW. Does the container tell you the dosage? If not, please tell us how much your dog weighs and the mgs of the pills! Is there an animal hospital in your area - who cares if it is with the same vet. Kim

[frijole]

The emergency dosage is .25 mgs of prednisone per kg of weight. If your dog still weighs around 85 lbs then that is 9.75 mgs of prednisone.

[frijole]

The prednisone I have is 5 mgs. I don't know that it is all the same but if yours is 5 mgs then give 10 mgs. Please also describe the symptoms. I'm trying to determine if you need to get into the car and go to a hospital. Sending hugs and love, Kim

[frijole]

Your vet was wrong not to put your dog on prednisone when the results were at 0.8. I am sorry but right now your dog is the only thing I care about. Some vets don't think trilostane can be harmful but it can if the dose is too high.

No more trilo until we can get you to a vet with experience ok?! :)

[StarDeb55]

As Kim said, give the pred immediately. It will act fairly quickly, you should note improvement in an hour or so. If you don't, you need to get Penny to an emergency clinic tonight. Giving a little more pred than the calculated dose will not do any harm. Above all, please do not restart the vetoryl after the 3 day waiting period. You can't restart either vetoryl or lysodren in a situation like this without another ACTH stim documenting that the cortisol levels have risen, the return of clinical signs, or both. We have had several members whose pups have dropped extremely low on vetoryl & have ended up on a holiday from the medication for a number of months.

I, also, agree with Kim, you need to find another vet or even better ask for a referral to an internal medicine specialist. Getting Penny feeling better, & the medical attention she needs is the first priority.

Debbie

[Cyn719]

i am so nervous I dont know how to post -- so when I type something i hit submit and how do I go to your responses I just found your responses by accident -- she was 87 lbs now 80 -81 lbs -- I am going to get the pred now upstairs -- so at 0.8 she needed it - WTH is wrong with this vet!!!!!!!!!!!!!!!!! I will be right back

[frijole]

Don't worry. Like Deb said, you should see results within an hour or two. Kim

[Cyn719]

penny pred is 20 mg says to give her one table is there is lethargy -- but its not jus lethargy now its nervousness - panting - drinking - up and down ???? It was lethargy and eating less and weakness of legs for 4 weeks now she has been off med wed and today now its the pacing and panting which goes on for a long time now she is sleeping prob from exhaustion

[Cyn719]

so should i give it to her? why did this vet say she doesnt need it - she screwed up and knows it if no other vet will talk to me from that office!! so do i give it and once or???

[frijole]

I would NOT give 20 mgs as the emergency dosing is slightly under 10. I would give 1/2 of a pill.

I am trying to grasp the symptoms you are describing. Normally a dog that has too much trilostane will be very lethargic, sometimes struggle to be able to stand, sit, hold their head up - people think their dogs are dying. They don't eat. Sometimes shaking.

Panting, drinking and up and down sound like too high of cortisol and that has me scratching my head. I find it hard to believe that if two days ago you were at .8 you could now be too high so if it were my dog I would give the prednisone. kim

[Cyn719]

She sleeps alot - eats less - have to put roast beef in to make her eat - pants every second she is awake - gets up slightly better - but when awake she doesnt know what to do with herself - she goes in every room lays down gets up goes somewhere else - she did this for an hour now she came in basement and dug - paced and finally layed now and now is out like a light!! Ok I just called her name and she opened her eyes -- I dont get this neither???? But most of June she was lifeless - so tired - had to help her off floor - looked like she was so weak -- Could her tumor be so big she is now acting strange??

[StarDeb55]

Give the pred, it will not hurt her. The drinking may be due to her electrolytes being messed up. If there is too much drug given, it can not only affect the cortisol but the aldosterone which is made by the adrenals. Aldosterone is extremely important as it controls the electrolyte balance in the body which is the sodium & potassium. Another easy way to check to see if there is an electrolyte issue is to offer Penny a pinch of salt in your hand or even a bite or two of saltine crackers. If she eats either of them, this is usually a clear indication of an electrolyte imbalance, & she needs to be seen by a vet TONIGHT! Severe electrolyte imbalances may be life threatening. I don't want to scare the daylights out of you, but Penny's situation is nothing to fool around with.

Debbie

[frijole]

I am assuming your dog has a pituitary (not adrenal) tumor because 85% of cushing's dog have pituitary tumors. These are tiny tiny little tumors that very very rarely cause issues with the brain. I would bet money that for the last month your dog's dose was just plain too high and so the appetite was reduced and the dog was just 'off'. Low cortisol will do that. You were right to push for an acth.

My guess is the vet just doesn't have alot of experience treating cushings - we see it alot so you aren't alone. Happened to me too. I agree with Deb. After we get thru this episode the key is to find an internal med specialist if at all possible to help you moving forward.

Where do you live? (We can look for you or maybe someone has a vet they'd recommend)

Hang in there - Kim

[Cyn719]

I live in North Providence RI - I will give her 10 mg and see how she does and I will call the office at 8am - I think she said the electrolytes were ok - I got the blood work today and they forgot to give me the work up only gave me the ACHT results - I will get them tomorrow - just something else they screwed up!!

[StarDeb55]

If she doesn't improve within about 2 hours, I'm afraid this can't wait until you can call your vet's office in the morning. The thing that concerns me is that it's a long holiday weekend, is your vet's office even open?

Debbie

[frijole]

OK, give the prednisone - force it down if you have to. Did you do the salt test? Sorry but I'm not trusting your vet a whole lot. :o You could run out and get some pedialyte which contains electrolytes and put it in her water. That said, as Deb said if the electrolytes go low dogs can die. Typically they would put her on an IV and keep her at least over night if they are low. You are going to have to go by how she is acting. I would not worry about going to the same vet but rather an emergency hospital and just tell them what the last acth test results were and that you gave prednisone.

I'll look to see if there is a specialist in Providence.

[Cyn719]

Yes Kim I pushed and pushed and it took 3 - 4 weeks - She should of listened to me - I am with this dog everyday - I know when she is not right!! I should of gone to a specialist then!! :( And I had her at Tuffs like the 3rd week of May - she had 4 teeth pulled - one being her upper K9 - she did very good - I guess I should of had them take care of her Cushings too!!! So could the surgery of caused any problems

[Cyn719]

She does not want the salt - so that is good??? I thought she said electors were ok my husband had bloodwork hes at work - the 2 numbers were 0.8 and 0.9 on the ACTH test thats all he had right now

[frijole]

This list isn't 100% but its a start - I see one in East Greenwich and one in Wyoming.

http://www.acvim.org/websites/acvim/index.php?p=228

Is there a teaching/vet hospital in your area? They are typically very good. And less expensive. kim

[Cyn719]

ok gave her the 10 mg of pred - thank you all for being there - i am home alone and this just got toooo much for me - my husband is a firefighter/rescue and works alot in the City of Providence and of course hes working tonite!! lol and my 18 yr old son is out of course but will be home soon so if I need to go the the emer clinic he will be here

[Cyn719]

East Greenwich must be Ocean State - thats where she had her knees done - I do know a vet there - I can try him tomorrow or Tues he calls right back all the time

[frijole]

No problem. I see you went to Tufts. I'd find out who their endocrine specialist is / internal med and get in there asap and go pick up my records from the other vet. I doubt the dental work is to blame. Plus it was too long ago. Low cortisol can really whack out a body and I would guess that is the situation.

The fact that your vet didn't tell you to give the prednisone AND didn't help you tonight would be the reasons I would move on. You and your babe deserve much better treatment.

Glad your son will be home soon to help you out. Give Penny a hug from us. And you have to give us an update tomorrow ok? :D Kim

[Cyn719]

Son is home - so I have backup - I hope this helps so is the pred a one time deal or do you give it again?? or I go by how she is??

[frijole]

East Greenwich must be Ocean State - thats where she had her knees done - I do know a vet there - I can try him tomorrow or Tues he calls right back all the time Yes, Gary Block and David Hunley are the two that are board certified specialists. You would want to see them at least for this incident due to their expertise.

[Cyn719]

kk i will call them - I took her to Dr Sweet or her knees - I no if I need to get in quicker he will help for sure!! Thank you so much!! :)

[frijole]

Son is home - so I have backup - I hope this helps so is the pred a one time deal or do you give it again?? or I go by how she is??

Typically vets will have you give the prednisone a couple times a day and then you must wean off of it. It depends on how she reacts really. I would see how this works, try to get to a vet in the a.m. If you can't get in very early see how she's doing and if she seems to revert it just means her cortisol is low again so give her another. Keep track of when and how much you give so you can report to the vet.

Prednisone mimics cortisol so it replenishes what she is missing so it really is a neat drug. But you can't be on it a long time without needing to wean off of it. The vet will cover all of this with you. :)

[Cyn719]

ok I understand so 10 mg is ok for a 81 lb dog?? Why did she give me 20 mg?? She gave me 5 tablets

[StarDeb55]

With the pred, go by how she is doing. If she perks up, but then kind of falls by the wayside in a few hours, give her another dose. I want to stress that if Penny does not improve after the first dose of pred, you will need to get her to a vet tonight.

Yes, those ACTH numbers are Addisonian type numbers. Your vet should have given you pred immediately or have you bring her in for a steroid replacement injection based on those numbers. Also, just because her electrolytes were ok a few days ago, doesn't mean they're ok now.

Debbie

[StarDeb55]

You may have been give the 20 mg. tablets because that may be all the office had available. As Kim said, just give her 1/2 tab.

Debbie

[frijole]

ok I understand so 10 mg is ok for a 81 lb dog?? Why did she give me 20 mg?? She gave me 5 tablets
:confused: I have no idea. Maybe she meant for you to cut them in half? They are only to be used in emergencies and most don't ever use them.... I just happened to know the emergency dosage from having participated on this board for 5 yrs. Hang in there.

[Cyn719]

ok so in a few hrs i will check her - yes i will call at 8am - now she takes tramadol for her pain in legs would you skip it tonite??

[frijole]

ok so in a few hrs i will check her - yes i will call at 8am - now she takes tramadol for her pain in legs would you skip it tonite??

Good.. i agree with Deb - any doubts whatsoever take her in.

Re the tramadol.. if she is used to it and has taken it for a while then I see no reason why you can't give it.

My cush dog Haley was prescribed a dose that was too high and my first experience with tramadol was like something out of a Steven King novel - awful. She was doped to the point where she was walking into walls and then just standing there looking at them, would not stop pacing, so I went to bed and let her 'walk it off' only to wake up at 2 am to a house covered in diarrhea from the tramadol. Awful. I cut the dose in half. :eek::D Worked great from then on out.

[StarDeb55]

Does tramadol have a tendency to make her kind of "dopey"? If it does, I would skip it as you won't be able to tell if it's the tramadol or she's getting in trouble, again. I ask about the tramadol because my Lhasa along with a couple of other pups on this board have had bad reactions to tramadol. Kim has another pup who doesn't do tramadol well.

Debbie

[Cyn719]

yup same here she dose not do well on it at full dose and her dose says 1 -1/2 tables up to 3xs a day - i gave her one at nite and she was the opposite - it was like she was in a coma and could barely walk when we got her up so I give her a half -

[Cyn719]

yeah i agree - I will hold off cause I wont know what is going on

[frijole]

Good! That's why I asked. Good memory Deb! OK I am off to bed. Sending positive vibes your way.

[Cyn719]

nite everyone - its midnite and Penny just got up - walked up the stairs ok - is outside now - its been an hr since pred so seems ok - when any of you respone now our tomorrow can you tell me if it is normal for her to be panting every second she is awake?? is that the Addison Crisis???

[Cyn719]

It 1:52 am Penny was good - the panting stopped and she seemed really relaxed - went outside - came in and wanted treats - sat with me and my son till 1:15 then she seem like she couldnt sleep so i gave her a 1/4 of her tramadol - shes sleeping now - the pred seemed to calm her - I will speak to the vet after 8am just wanted to give an update and say thanks to everyone again for being there for us!! Also does everyone agree I should not put her back on the medication until she has another ACTH test - the vet said leave her off the meds for 3 days then put her back on the 90 mg instead of the original 120 - I am kind of nervous to start this medicine again tty all in the AM

[frijole]

The trilostane would only send her back into crisis mode. IT lowers the cortisol. You won't know if 3 days is enough until you do another acth test. That is another reason to switch vets. This is basic stuff that they should know. You must wait until Penny's cortisol levels have risen to resume treatment. As Deb mentioned, we've seen it where dogs remain low for quite some time. No two dogs are alike so you must test before resuming.

Longggggg story short - no more trilo indefinitely. This will allow you time to find another vet. It will save you money to collect the tests and records from your current vet.

I'm sure others will chime in with their two cents, but this is mine. Glad she did well last night. Kim

[StarDeb55]

Glad to hear thing went ok last night. Absolutely no more trilostane until you can find a vet with more experience. As I mentioned last night, after a situation like this, you can't restart the meds making a simple assumption that in a certain specified period of time, (3 days), the cortisol will have recovered enough to require medication. You need to look for a return of her Cushing's symptoms, & at that point, you do an ACTH to verify the cortisol is now high enough to require meds. We have had several pups on trilo in this group who have dropped very low, as Penny did, end up being on a trilo holiday for a number of months.

Could you also let us know what Penny's current weight is? Dechra is currently recommending a starting dose of 1 mg/ lb. of body weight. I'm asking because 90 mg. might end up being too high.

Debbie

[Cyn719]

Penny is 81 lbs when she started meds she was 87 spoke with office this am had me give her 10 more mg of pred and call them at 1230 - she is still panting but not was bad as yesterday - still drinking alot maybe a bit less than yesterday - I gave her just a 1/4 of tramadol last nite to sleep - shes outside now ate half her breakfast only - is walking around barking at people - I will not start the meds without a test - the meds come in 60's and 30's and 20's?

[Cyn719]

Waiting for vet to call gave her pred at 930 shes panting alot - drinking alot and not walking well - prob take her in for iv

[StarDeb55]

It sounds like she needs to go in to the vet. I would insist that her electrolytes be checked, if you do take her in.

When it comes to the meds, you aren't necessarily limited to what Dechra makes. You can go through a compounding pharmacy, & get any dosage you might need.

Debbie

[lulusmom]

I am glad to see that Debbie and Kim were here to help when you needed it. I do hope that you are taking steps and calling new vets to have Penny asap as in an emergency. The panting can be due to pain, respiratory problems, enlarged heart or liver and trouble walking is definitely not normal and should be considered an emergency. If you have contacted your vet and explained the situation to him/her and you weren't instructed to bring Penny in immediately, then I wouldn't walk away from that vet, I would run. I don't know how else to say this but you need to get Penny to a vet to find out exactly what is going on with her. If her electrolytes are off, she could die.

[frijole]

Checking in to see how Penny is doing tonight. Hope all is well. Kim

[Cyn719]

Sorry i didnt get to give an update - we had to go to a graduation party- my brother came to take care of penny - vet told me to give penny 10 mg of pred 2xs a day until monday then I will take her in on tuesday to check her levels - she is quite perky tonite and seems very happy - the only problem is that she is still panting alot and drinking alot - do you think the panting is the Addisions and the drinking also from Addisions?? When she had the Cushings she drank bowls and bowls of water a day and now shes doing it again. I am still confused on the symptoms of which is Addisions and which is Cushings - and does the 10 mg of pred sound right 2xs a day for a 83 lb dog?? Thank you for your concern and help!! Cindy and Penny

[StarDeb55]

Her cortisol levels were so critically low, that the dose of pred sounds ok. The problem is that her electrolyte levels have still not been checked. Since you say Penny seems to be feeling a lot better, the electrolytes may be ok. I would definitely demand that her electrolytes be checked when you go in on Tues. The other thing you need to ask the vet about is the fact that prednisone given within 24 hours of an ACTH will read like cortisol on the test. In other words, the result will be higher than it would without the pred.

When it comes to symptoms, an Addisonian crisis will usually show up as severe lethargy & weakness, nausea, vomiting, diarrhea, to name the major ones.

Debbie

[Cyn719]

I have a call into the vet again - I understand what you are saying about the test results and I guess I should have her off it before she has the test again??? that would affect the ACHT test not the electo test right?? So the panting and drinking is not a usual sign for Addisons Disease???? She is walking well very alert eating - Vet will call back soon maybe they will do the electro test today

[Squirt's Mom]

Hi,

The panting and drinking could be a side effect of the pred, too. It is supplying a synthetic corticosteroid, which will mimic Cushing's signs. ;)

Hang in there! You are doing a great job of watching Penny.

Hugs,
Leslie and the gang

[frijole]

I have a call into the vet again - I understand what you are saying about the test results and I guess I should have her off it before she has the test again??? that would affect the ACHT test not the electo test right?? So the panting and drinking is not a usual sign for Addisons Disease???? She is walking well very alert eating - Vet will call back soon maybe they will do the electro test today

Panting and drinking alot are cushings signs. When you give your dog prednisone you are giving a drug that mimics cushings. So basically this tells me that the prednisone is working and making her feel better. It does NOT mean that her numbers are normal yet.

Addisons can be temporary or permanent depending on how bad the cortisol got. I wouldn't worry about Addisons - I'd just worry about making sure the electrolytes are OK. Like I said, you can put pedialyte (flavorless) in the water and help increase electrolytes.

If the panting and drinking levels increase I would cut the prednisone dose down by 50% so you are effectively weaning the dog off the prednisone. Frankly this should be discussed with a vet but if you haven't switched vets yet they won't know this. ;)

Is your appointment with the new vet (specialist?). Deb is right - when a dog is on prednisone, that drug mimics cortisol so the acth test results will not be accurate. So what you need to do is use the prednisone to make Penny feel better and get her back to normal. You wean her off the pred. and then you do the acth test. There should be no rush to get back onto the trilostane.

Hope this helps. Kim

[Cyn719]

Taking Penny in for electro test latert this am - they did say she had to be off the pred for at least 48 hrs to do the ATCH test - she is on 10 mg 2xs a day and said to wein her off it - I just have to ask how cause he is suppose to be on this dose thru monday - they also mentioned a stomach xray to see if there any liver tumors or ?? Do you think I should do that??

[Squirt's Mom]

An xray to look at organs will be a waste of money and time, plus added stress on Penny. To see the organs she will need an abdominal ultrasound performed with a high resolution machine - something very few GP vets have. I would ask for a referral to a hospital or IMS who can do an ultrasound.

This is one of the most valuable tests, IMHO. Not only will you get to see the adrenal glands, but also the liver, kidneys, intestines, stomach, bladder, gall bladder to name a few. My Squirt had 2 ultrasounds and after the second one I was told she had a splenic tumor. Without the U/S, we would have never known and it could have easily ruptured, killing her quickly. I cannot recommend this test highly enough as a result! ;)

Hugs,
Leslie and the gang

[Cyn719]

So skip the xray and have the ultra sound --- she has had them but not recently -- so just a regular ultra sound to check all the organs??

[Squirt's Mom]

You got it! :) I think this will be the best thing to let you know if there is something else going on with Penny causing the panting and discomfort.

Hugs,
Leslie and the gang

[Cyn719]

Went to get pennys electros tested

Penny's results

Sodium 149 141-152
Potassium 4.4 3.8-5.3
Chloride 102 102-120
Na/K ratio 34


Vet said she was ok -- anyone have any imput

[StarDeb55]

Those electrolytes look good. The important one is the Na/K ratio, & that's well within normal range. When the sodium/potassium ration drops too low, it may be a good indication of an Addisonian crisis.

Debbie

[Cyn719]

so these results look good - oh good!!!! so you are saying if they drop thats an indication of Addisions - but shes in addisions crisis with a 0.9 ACHT result right????? Thats what they told me so i am just tryinig to grasp all this -- Thanks for answering all of this -- looking forward to your answers on this

[StarDeb55]

Yes, with her results so low on her stim, it is considered to be an Addisonian crisis, as far as I know. What is the vet telling you? As long as her electrolytes remain normal, Penny is in decent shape. When an Addisonian crisis gets so bad that the aldosterone is affected, it may be life-threatening. Aldosterone is also made in the adrenals. In crisis the cortisol drops first, then the aldosterone. As I mentioned when you first posted that Penny was ill, aldosterone is critical as it controls the electrolyte balance in the body. You are replacing the cortisol that Penny's adrenals can't make right now with the pred. If her electrolytes had been affected, there are other medications that can be used to help control that problem. What did the vet say about continuing the pred, weaning her off the pred, & scheduling an ACTH? I wouldn't be in too big a hurry to do all of this. It might be best to see how she does when you start weaning her off the pred, then discuss with the vet when to do an ACTH. We have seen dogs in this group go through a crisis like this, they seem to be doing better with the pred, but the minute you try to taper the dose, the pup starts feeling bad, again.

Seriously, have you considered finding another vet or asking for a referral to an IMS? It's unbelievable that with stim numbers this low that Penny wasn't put on pred immediately, & a plan discussed with you as to what to look for if she was truly getting critically ill. There is a distinct possibility that Penny may be on what we call a trilostane holiday meaning she is taking no medication for a good period of time.

Debbie

[Cyn719]

yes they said to continue to pred at 10 mg - until Sunday and start to taper off - I need to recheck how to taper I believe he said like 5 mg am 10 pm for a day then 5 mg am and pm and keep breaking it down but I was also told that since it is only 10 mg 2xs a day you dont need to taper?? Yes needs to be off pred 48 hrs to have the ACHT test -Now I hear different stories like she should be on pred a week then taper then testing - some say 3 days of pred then off 48 hr and test?? Is there kind of like a standard most of you have used????? I will look into a vet on tuesday -- this vet has alway done good with my dogs I had 2 goldens one had a brain tumor and she was great through all if it and so far she has done really well with penny - until now - thats why I stayed but if she really doesnt have knowlege in this area I will have to move on. I am just trying to understand why at 0.9 she didnt say to use the pred - what was she thinking or not thinking?? So if i didnt start the pred i can only imagine what would of happened!!

[frijole]

Glad to hear the electrolytes are ok! Regarding tapering... you have only been on it a few days so it isn't such a big deal. Its a steroid and you just can't cease giving it.. I'd do what they said and see how she acts. Once you've had a couple days off of it I'd do the acth.

Regarding your vet - I understand it is tough to switch - I had to do it a couple of times. It boils down to what Penny needs and right now she needs a vet that has more expertise at cushings than your current one does. My biggest issue was not just the fact you weren't given prednisone right away but that you had to beg for an acth test to begin with AND no one would see you when you were in crisis. That is totally unacceptable. I would run, not walk to a specialist.

I stuck with a vet for a long time that was over his head. He treated my dog Haley for cushing's and I had to tell him every single thing to do (with help from people here).... 5 yrs later my cush dog passed away (not from cushings) and my other dog got ill. He misdiagnosed her with cushings and I went thru a year of pure hell switching from vet to vet until finally I got into my car and drove to Kansas State - 5 hrs each way so that I could figure it out. The story is long and sad... but the vet was over his head and threw up his arms and quit on us both. My point is I stayed way longer than I should have and it cost me time, peace of mind, and a whole lot of money. Hang in there and you will find a wonderful vet to help you.

Meanwhile you are stuck with us. :p;):eek::D Kim

[Cyn719]

Being stuck with all of you is the BEST thing that happened to me and Penny - If it wasnt for all of you I dont know what would of happened!!!!! I didnt know she needed that pred when she did so thank God I had all of you!!!! At least shes on pred and her electros are good -- I have her Chem results too I will post them my scanner is giving me a prob but my husband will get it to work tonight - these results look scarey -- the liver results are really high - I am assuming that goes with the cushings???? You understand it more than I do so I will post soon - Thank you again for all of your help and concern - it means so much to us!!!!!!!!! :) ps when any of your dogs were on pred for Addision Crisis do you remember how many days of pred you gave??

[BestBuddy]

My doctor's rule for pred is if it is taken any more than 3 days then it needs to be tapered off.

My Buddy had an addison crisis and he had actually collapsed so when he was rushed to the vet he was give a dexamethasone injection (fast acting) and we had pred tablets to take home if he started to have more symptoms. He never needed the pred tablets and we were not to start the trilo until the ACTH testing and symptoms showed he should.

It should only take a few days to taper the pred down and then off. As long as you take it slow penny should be fine but if she starts to go backward then it's time for another vet visit.

Good luck

Jenny

[Cyn719]

ok more than three days I will taper off - thank you - and she will not begin the trilo until she is tested for sure!! Has anyone used the pred tablets and if so how many days did you give the for?? Penny is ok tonite - she ate - had treats - drinking alot but not as much as the last few days - still panting but alittle better - her walking is slow but I not its her age and her leg pain - that cant be feeling to good - now what about the rimadyl - I not it doesnt sit well with alot of people but what can be used in place of it?? She is off it now because of the pred. :confused:

[Roxee's Dad]

Very glad to see that Penny is feeling better, haven't posted to you but have been watching closely. Regarding Penny's pain, we were doing Adequan shots for our Mickee, It worked really well for him over the last year or so. We could really see a big improvement in his walk after about 3 weeks of treatment.

For the first month, he got 1 shot per week, then once a month thereafter. Some vets will let you give the shot yourself at home.

[frijole]

I just started my Annie on Adequan and had used it for Haley during her last year and it does seem to help. No side effects either. I am just finishing up the first month and she is on it twice a week. Probably varies by case. I would definitely check into it. Kim

[Cyn719]

Still giving penny 10 mg of pred - I was told to stop when I see her getting better - but what is better - she is still drinking and panting and wants to be alone -- she is holding her own and able to get around - but I am afraid to stop it --- it is frustrating and confusing for sure:confused:

[frijole]

The drinking is a sign that the prednisone is working. It mimics cushings and so as you keep giving it the water intake will increase. Panting is also a sign of cushings. You gave the prednisone because of the lethargy, lack of hunger, stumbling. It sounds to me - I could be wrong - that those have gone away. If so, start the decrease because the longer you give the prednisone the more careful you have to be with withdrawing it.

So start like the vet said by giving 1/2 of what you gave this morning this evening ( 5 mg) . Tomorrow give that same amount twice (5 mg each time). As you do this the drinking should be reduced because the prednisone is being decreased.

Again, the vet should have been explaining this to you. We are delighted to fill in and help. I'm just pointing out that your frustrations and worries would be alleviated if you were working with a vet that was involved. This isn't your fault at all. Hang in there and keep posting and we will continue to check throughout the weekend. Hugs, Kim

[Cyn719]

It figures this would happen on a long weekend! Tuesday cant come fast enough!! I will be call vets on Monday - starting with Ocean State in East Greenwich - I appreciate the help to get us through the weekend - tonight I will give her 5 mg and same tomorrow and see how she does. She does sleep alot but I guess that goes with everything - hopefully. :confused:

[Cyn719]

I have a question may sound stupid but i have to ask would pred make them sleep more cause Penny slept all day today - not sure what it is maybe just the day - i am very concerned because she always wants to be in the basement and she use to lay in her bed now she is always on the floor and I read somewhere that could be a brain tumor?? any comments on this?? :confused:

[Squirt's Mom]

Cushing's makes our babies have a harder time with heat, the least little bit can really effect some of them. It could be that Penny simply finds it cooler in the basement and on the floor than on her bed where she usually lays. One of the classic cush signs is seeking out cool spots to lay. ;) The pred is probably playing a role here, too.

Keep up the good work!
Hugs,
Leslie and the gang

[Cyn719]

Happy 4th!! Penny started weaning off pred did 5 mg yesterday and same for today - the drinking is alittle better - shes still panting so thats prob the Addisions/Cushings - shes getting some air now outside I wont leave her to long - it hot today so I will get her back into the air conditioned house soon. I never asked but do you think putting her back on Vetroyl is good or should I switch her?? I no the vet will have to help me decide that but with all these dogs on this forum do that seem to do better on one over the other?? Again I cannot thank you all for all your love and concern!!! xo Penny and Cindy

[frijole]

Happy 4th! Glad the weaning is going OK.

Cush dogs don't tolerate heat well so that is smart of you to watch that. Thats why they tend to lay on the floor near a/c vents on on tile.

Both trilostane/vetoryl and lysodren are effective even though they work differently. The reason Penny went too low (cortisol) is probably because the dose was too high. That is easily tweeked but NOT until after you get an acth test done and her cortisol levels have risen.

There is no reason to switch at this point in time. Please note that per the manufacturer you cannot just switch drugs. You must wait 30 or 45 days (I can't remember which) so that all of the drug is out of the system. So if your vet suggests this have them call Dechra and they will confirm what I said.

Meanwhile, enjoy your holiday... heading to my mom's right now! Kim

[Cyn719]

Thanks Kim for the information -- It was hard to decide with one to put her on from the beginning - I will look into everything if we have to switch - Enjoy your day!! ttys Cindy:)

[Cyn719]

Hi everyone - quick post - my dad sat with Penny tonite because we had a 4th party - she is doing ok - still drinking and I also noticed her appetite has increased - I was eating a cheese stick and she came over and just took a bite of it and Penny wouldnt ever do that ever!! So I guess the appetite is increased because the pred is making her feel like shes back to having Cushings?? She had 3 doses of 5 mg of pred - down from the 10 mg -- so hopefully she will be almost off all of it so she can wait the 48 hrs and have the ACTH test -- do you suggest any kind of diet for her?? Thank you for your advice and again it is so much appreciated!!!!!!!!! xo Cindy and Penny:)

[StarDeb55]

Yes, pred causes Cushing's like symptoms. This is probably what you are seeing. Our pups are very prone to pancreatitis, so a high protein, low fat diet is almost a must. If you want some help picking a good quality commercial food, you might try this link.

dogfoodanalysis.com

Debbie

[Cyn719]

does anyone have suggestion for dry and wet food for penny - what have you had good luck with so far?

[addy]

Hi,

Glad to hear Penny is better and holding her own.

As for the food, each dog is so different, food that might work for one may not work for another.

You want a food with a high quality protein, low in fat, moderate in fiber. Dogaware and Dogfood Analysis are good websites to start. Dogaware also has information of various illnesses and what you need to look for in the way of food. Other illnesses Penny will have to fit into the equation as well. So it is best to research for your individual dog's needs. Price can be a factor. I feed Honest Kitchen to both my dogs but it is pricey.:eek: I do like the company.:) Zoe also gets a commercial raw diet mixed in to hers. Zoe is my Cush pup. She also has colitis and a sensitive stomach so food for her is an issue and I cannot change her food very often without it being a drama.

Whole Dog Journal reviews raw, canned and kibble foods each year so that is also a good source of information. You can purchase back issues. Take your time and do a bit of research. You really have to try a diet out and see how it works for a few months and then decide if it is right for Penny.

Sorry to ramble on, I always ramble when it comes to food, I have had to research so much for my Zoe and her troubles.:rolleyes:

You are doing a great job. You will pick a good food.;)

Hugs,
Addy

[Cyn719]

Penny is holding her own but has me worried - she just lays in the basement all day - not that no one is down there wash dryer is there my son has a small den area of its part of the house not just a basement but she seems to want to be alone and the first and second floor is central air!! She just lays there on her side and sometimes you cant tell if shes awake or asleep cause her eyses are basically open - I know the pred causese weird things - but..... so I am trying to get into Ocean State on Thurs they are calling me back but my reg vet said to wean her off the pred till next monday and restart the Vetroyl tomorrow at 90 mg cause she will still have the pred in her wait 2 weeks and restart - and I am NOT going to do that of course but had anyone done this?? Has anyone heard of Dr Burke or Dr Noolan at Ocean State??

[Cyn719]

just a correction the two drs are Dr Block and Dr Nolan at ocean state

[lulusmom]

I can't personally vouch for either of the specialists you named but I checked their bios on the Ocean State website and their credential are pretty darn solid.

[Cyn719]

I am happy to see that penny is acting the most normal she has been since before she went on the cushings medicine vetoryl. She is up and down the stairs on her own - shes eating well - and has spunk!! I no this is the pred and he prob being more in the Cushings mode but its nice to see!!!!! My prob now is I cannot afford to go to Ocean State its 120 to get in there and the ACTH test is 300 compared to the 198 at my vet! I am in a very tight spot right now - so my question is can this wait like a week - she will be off the pred by mon and will be on nothing at all - Am I hurting her by waiting - I feel like I am in a panic all day long:confused:

[Cyn719]

Yes both doctors are very good - I looked it up

[Cyn719]

Because Penny is drinking constantly (this is a question from my husband who lets her out 2 to 3 times a nite now) is that a sign she is back in Cushings/pred ? The spunk is there like I said and we like seeing it but its prob not good right? Prob just the adrenal going crazy! Its so awful making decisions and some people make me feel quilty giving her this medicine telling me its just killing her and dont put her on anything but I know that is not the answer - My mind just keeps going and going! I am trying to paint my bathroom and I cant even pick a color cause my head is so consumed with this!! Why cant these poor animals just live a good long healthy life!! :confused:

[addy]

Deep breaths, always remember to breathe:):):) you have been through quite a bit.

Deciding to treat Cushings is rarely an emergency, if your question is will withholding Trilostane for a week hurt her, in my opinion, I would rather get it right with an IMS experienced with treatment, but I don't know all the details and you know your dog best. I am sure others will come along to chime in.

It took me a year to treat my Zoe. Her cortisol was really high, higher than most dogs here but her symptoms were not strong except for her hair/coat issues and then hind leg weakness started. She had ongoing colitis issues I wanted to improve prior to treatment. I also wanted very strong symptoms. I followed my gut and made the best decisions I could.

Follow your gut, you know Penny best.

Hugs,
Addy

[StarDeb55]

It really is the pred. I can tell you from my own experience. I have asthma, & get horrible asthmatic bronchitis occasionally which has to be treated with high dose prednisone. I am on pred for something like 3 weeks as the dose has to be tapered down before you can stop. When I initially start taking it, I am in the bathroom constantly, it makes me crazy. I don't know if pred affects our pups this way, but I also get a horrible case of pred induced insomnia.

There is no rush to resume treatment, especially after the episode the Penny is still recovering from. Right now, you need to focus on getting her totally over this, then get her to a specialist who can review the whole situation, & help you to develop a game plan so you can move forward with Penny's treatment. For the people who are telling you that treating Cushing's, you're killing your pup, tell them that if she's not treated, she will most definitely die from the effects that uncontrolled cortisol has on her internal organs in the long run. To help you understand the effects of uncontrolled Cushing's, you might want to take a look at the following link for our important information section.

http://www.k9cushings.com/forum/showthread.php?t=195

Debbie

[jmac]

I know pred definitely makes them very thirsty. Good luck!

[labblab]

I agree with the others that prednisone increases thirst. But as you have wondered yourself, it may also be the case that Penny's own cortisol level is rebounding to the point that she may need to restart trilostane treatment. For some dogs, this can happen quickly even though a previous level was quite low. But the trick is, you won't know whether or not this is the case until she is weaned off the prednisone and an ACTH test performed. So no matter who ends up doing that testing, I do believe you are doing the right thing by withholding her trilostane for whatever length of time it takes to complete the weaning and the testing. Even though it is hard to see her drinking and peeing so much, the only safe thing to do is to wait and see whether her natural cortisol level has risen prior to starting back with the medication -- at a lower dose.

Marianne

[Cyn719]

Thank you for all your comments and help - the only problem is the vet still thinks I need to start the medication tomorrow and she still has pred to finish - like what? she said she needs to take med tomorrow for two weeks then do the ACTH test -- she said not necessary to do it now -- so it is like I am stuck with her for now because of the high cost at Ocean State but its my call how we do things - so the question is do I start it over the next week or wait and then start it or I have to do the ACTH test then start it - she said she is trying to help cause it cost so much for the test and if we just start it and do the test in two weeks we will know if we need to adjust it - so confused again:confused:

[frijole]

What this vet is suggesting further proves she does not understand cushings. Sorry but I just have to say it like it is. Your dog just overdosed on trilo because the dose was too high, she didn't know enough to tell you to give prednisone, she gave you the wrong emergency dosage amount, no one on their staff could help you during what was truly an emergency and now she is saying to wean off prednisone while resuming trilostane?!

I know this is all new to you but that is like telling an alcoholic to wean off the booze slowly but take a shot of whisky twice a day. :D Does not compute.

What Deb and Marianne said - and I agree with is to continue the weaning. You don't have to ever go back to this vet. Wait a few weeks. You should almost be down to almost zero prednisone anyway. So no prednisone OR trilostane.

Wait a few weeks and then go to the new vet. But get all copies of your tests you have done so you don't start all over again. It will help the new vet.

I know the other vet is more expensive but remember when I told you my story about hanging with a 'loser vet'? Well... I had about $5000 worth of wasted tests. He wasted not only my money but my time and my stress level!!!

If costs are still an issue - just find another local vet that has more experience than this one. Meanwhile - get up to speed on what cushings is (resource section link that Marianne gave you). REad up, ask us questions and that way you can be Penny's voice and better able to guide the vet/converse with the vet in the future. Trust me... if I can do it you can too! :p;)

Hope this helps! Kim

[StarDeb55]

You absolutely can't start the trilo without an ACTH prior to starting. And with the prednisone, I can't stress enough how important it is to wait to restart the trilo. I grievously afraid that if trilo were restarted at this point, it would be a total disaster for Penny & you. I'm have pussy footed around, trying not to badmouth your vet, but not any longer. Your vet absolutely has no idea what their doing when it comes to treating Cushing's, using trilostane, & proper treatment of a pup in an Addisonian crisis. The first thing that would have made me absolutely run to another vet was when I wasn't given any pred immediately when Penny's numbers came back so low. Everything else that has transpired, & what this vet is telling you to do, I'm going to tell you right now, that if you choose to follow his/her instructions, I'm terribly afraid for Penny. As Kim as said, there is no urgency to jump back in on treatment. Let Penny get fully weaned off the pred, feeling better, then try to get her into a specialist ASAP.

I'm thinking from the sounds of it that you are in the NY/New Jersey area? If so, you might want to look into getting Penny into to see Dr. Peterson in the NYC. He is a vet endocrinologist who is known all over the world. Several of our members have taken their pups to see him, or have had phone consults with him. All of them have had high praise for him. Here's a link to his clinic's website.

http://www.animalendocrine.com/

Debbie

[Cyn719]

Thank you Deb and Kim for all your support - Penny is skipping todays pred having 5 mg tomorrow skipping friday and last one on sunday - at this point I will leave her off the trilo until i find a vet - besides the panting and the drinking oh and wanting tons of treats lol she is like her old self - How come when she was on the trilo she seemed like she just existed? She didnt really have any life to her? Does the trilo do that? As of March 2011 her ACTH was 2.3 so she should of been ok then? I understand about what just happened at 0.9 and why she felt like she did - I just always meant to as that question if others have seen a big difference on the trilo? I live in RI so NY and NJ is alittle hike but if they do phone consults that would be great!! I am going to call Tufts today where I took her to have her teeth extracted a few months ago and see what they have to say. Keeping Penny happy for now - water - treats - staying cool - again with all of your help!!!!!!! xo Penny and Cindy PS Still working on a dog food for her - she is soooo fussy with that - in the meantime should I be adding protein to her food - like our meats of??

[Cyn719]

As of right now penny is still panting but more relaxed - not drinking to much yet today - went out for 40 mins - ate her breakfast but maybe only half of it ?? alittle sleepy maybe cause I gave her a half of tramadol last nite late cause she could not seem to relax - so as the day goes on and it wears off I will see how she is - update soon :)

[addy]

Sometimes when a dog's cortisol drops with treatment the pup goes through a period of feeling crummy until they get used to the lower cortisol. Think of withdrawal type symptoms. It could be Penny's cortisol dropped fast because Trilostane will drop it fast those first days and she felt icky and then of course she ended up going too low.

What you may have seen at first was a cortisol withdrawal. One way to minimize that is to start at a lower dose and work up. If a dog goes through cortisol withdrawal ( and does not go too low) sometimes an IMS will take them off the dose for a bit and restart at a lower dose to minimize that.

Hugs,
Addy

[Cyn719]

Thanks - I know my vet should of started lower than 120 mg for an 84 85 lb dog but I did not know that then and I did tell her how sick penny was!!! I mean flat out on her side and could not move!! Trying to get phone consult with the dr in New York - hope this helps

[addy]

FYI- if you are worried about cost- ask how much for the telphone consultation with Dr. Peterson. It will depend on how long he speaks with you. But ask.

Hugs,
Addy

[jmac]

I totally agree with the others. DO NOT go back to this vet. She definitely doesn't know what she is doing, and although the meds for Cushing's can be extremely successful in helping the dogs live a normal life, they can also be deadly. Please don't listen to this vet and look for another one. Like others have said, not treating her for a little while is not going to kill her. Find someone who is more familiar with Cushing's and then start over, but bring all of your other results with you. I ask my vets lots of questions, and although I believe they do an excellent job, if I ever feel that they are out of their league, or area of comfort, I will pursue a specialist here. I already talked with my vet about this and just said I want the best possible care for my Hannah. He was fully supportive. Good luck to you and your little one!
Julie & Hannah

[Cyn719]

Thank again for all your suggestions and thoughts!! So much appreciate it - the forum is what keeps me going and gives me hope!! I just came home - only left penny for an hour but when I came in she went crazy and brought me a toy!!! She was so happy jumping and crying I had to calm her down!!! She has not done that in months!!!!!!!!!!!!! I guess she is feeling better - so no pred today and 5mg tomorrow and no pred sat and 5 mg sun and done! I did call Dr. Peterson today and the girl said 250 for a phone consult. So I am going to discuss it with my husband tonight - she didnt say how long that was for or ?? I guess I should call her back tomorrow and I should of asked how long one he received the information will it take to get back to me - I just had to post - she is just looking like the old penny again (well almost lol just with alot of panting and drinking) Going to get this girl her dinner - still have to work on the food thing - anyone have really good results with a certain brand or adding extra protein to their food? Thanks again:):D:)

[frijole]

A piece of advice... if you are going to do a phone consult you had better go to your current vet and get copies of every test done... publish them here so we have time to prep you for what to ask. This way you don't repeat tests you already did and we can get you up to speed on what the disease is cuz he might talk over your head and we can't have that. :D Kim

[Cyn719]

Thanks Kim I will post what I have - Cindy

[Cyn719]

When I post her results do I just scan them and insert them since there are so many?? Thanks Cindy

[frijole]

When I post her results do I just scan them and insert them since there are so many?? Thanks Cindy

You could do that OR you could do something like this (note this is just made up and not real data :D)

Jan 2011 blood panel (just post the high or low results)

alk phos 1200 (80-150 normal)
tri 500 (xxx-xxx normal)

add any comments on the test as well

Jan 20 2011 acth test
pre 1.5 post 25.8

Feb 1 2011 low dose dex suppression test
1 hr 1.5
4 hr 0.2
8 hr 5.0

Started trilostane on Feb 2nd at a dose of 80 mgs per day

May 2 2011 acth test
pre 1.8 post 2.0

------------------
In other words chronologically list the tests that were done and the results and put the medication/dosing info that occurred in order as well... so if a dose was changed you would put that AFTER the test that caused the dose to change etc. You are telling us the medical story :D This is what any new vet will need as well.

I have a 10 page document of my Annie's story and its the only way I could keep it all straight!!

Hugs,
Kim

[Cyn719]

Hi Penny was good yesterday I did not give any pred yesterday I gave 5 mg today and now she is panting more and drinking more so is that from the pred? just 5 mg will do that? Also around Christmas time penny had a tiny tiny hole in her skin like what would be her elbow on back leg above the hock area - it bled and bled and bled for months and month - the blood would just pour out of this tiny hole - so it was not healing - so the vet opened to up and cleaned it out to make sure nothing was stuck in there and it finally healed up after stitching it - it was awful - and I read with cushings they dont heal well - so that prob was the reason - now on the side of her elbow hind leg above the hock she had a dry patch there and she must of scraped it so its bleeding and i am not oh no here were go again!!!! Any suggestions?? I am going to post the bloodwork in alittle Thanks Cindy and Penny

[Cyn719]

Spoke to Dr. Petersons office today - going to have Pennys records sent to him and then he will call me -- may not get records sent till next week - vet will not be in until Monday. I am going to post results I have tonight - just have hands full with Penny and my cousin is getting married tomorrow - so hands are full -- This was her last test --

ACTH response-
Tube Pre
Tube Post
Cortisol Pre 0.8
cortisol 2 0.9

Normal respone to ACTN 5.5 - 20.0
post Lysodren 1-5

Bun 14
Creatine 0.7
Phosphorus 4.2

Albumin 4.1

ALT 378
AST 38
GGT 993 but really higher in lab only goes to 993

Triglycerides 353

[lulusmom]

Can you please post the normal reference ranges for these:

Bun 14
Creatine 0.7
Phosphorus 4.2

Albumin 4.1

ALT 378
AST 38
Triglycerides 353

[Cyn719]

Sorry I forgot -here they are -- thank you so much for looking at them - I will post the rest - she has so much bloodwork

BUN 9.0-29.0
Creatinine 0.4-1.4
Phosphorus 1.9-5.0

Albumin 2.5-4.0

ALT 0-80
AST 0-60
Triglycerides 30-130

[Cyn719]

I was going to metion penny arthritis and hip pain this morning and I was reading some other post and came across addy's post saying to let the levels run alittle higher while on the trilo for the pain and sure enough that is exactly what I said to my vet cause at 2.3 and 2.8 she could barely walk bet at 7 she was better - of course sh said it couldnt stay that high - another thing I question about the vet -- plus penny is on no meds for the arthritis cause of the pred - That was a really good thought addy - i agree -- I dont understand the blood work to well yet but how did the one I posted look? Thanks

[lulusmom]

The bloodwork you posted is not what you are used to seeing in a cushdog. With GGT that high and high triglycerides, I would think your vet would have mentioned gall bladder problems. Did the vet do a bile acid assay?

[Cyn719]

no she didnt test for gall bladder - would I see any other signs? What kind of test is that? So she doesnt have the results for cushings?? So the 0.8 may be from taking meds she should not of been taking?? But supposely she tested for cushings in the beginning - had the heavy panting - drank 12 bowls of water a day -- so that may of not been the cushings?? OMG now I am really confused - so is there a certain test I should post that will help you?? I have pages and dont know what to post unless i type all of it which i can do tomorrow - I scanned them but cant get them into the reply box:confused:

[Cyn719]

And she told me liver results were off the chart due to the cushings/medication??? :confused:

[Squirt's Mom]

Hi Cindy,

Several folks have had luck using Google Docs for info. I haven't used it myself, but apparently you put your docs on their site then post the link here and we will be able to see all the results without you having to type.

Here is a link to GD (:p) where you will register then go to work!
https://www.google.com/accounts/ServiceLogin?service=writely&passive=1209600&continue=http://docs.google.com/&followup=http://docs.google.com/&ltmpl=homepage

Hang in there! You are doing a fine job and we are right by your side. Keep talking and reading and asking! Penny is ok for right now and we will help you try to keep her that way.

Hugs,
Leslie and the gang

[addy]

Your are forgetting to breathe:D;)

In my opinion and I am new at this but if a dog's other symptoms are controlled with trilostane, depending on what the other health issue is the pup was self medicating with his/her cortisol, a pup may do better with a bit higher numbers. It isn't about numbers, it is about how does the dog do at those numbers. I am confused by your vet as Dechra's in sert states that if clinical signs are controlled and the post ACTH serum cortisol is 5.4 to 9.1 ug/dl you can continue on the same dose.

The gall bladder and the accuracy of the tests are another subject all together that I am sure Glynda and the others will comment on.

Breathe!!!!!!!!!!!!!!!!!1:):):):):):)
Hugs,
Addy

[frijole]

Glynda is right - those liver values are close to normal. A dog that is having a bad day could have them. Off the chart would be numbers in the THOUSANDS which my dog had. And just because the liver nos are high doesn't mean it's cushings. If the dog has another illness that causes cortisol to be high (because the dog is fighting the disease) then the acth can be a false positive too.

That is why we always ask for every test done and the results.. so we can see if perhaps it is something else.

Giving a dog that doesn't have cushings could explain why she went low. Either that or the dose was too high.

Thats what I mean about saving money by going to someone with experience. You can do all these tests multiple times and get false answers. I had SEVEN false positive cushings tests. Kim

[Cyn719]

I will try to relax lol I will post every result tomorrow - even if it takes 2 hrs!!! I am confussed at one point she said her liver was in the hi thousands - so confused!! Yes I agree she should of kept lever high like at 8 - she was better then she got it to 2.3 and she was awful and she said it had to stay there!! So what the heck - so as right now I am having all her stuff sent to Dr Peterson on Monday and tuesday so I will post so you all can help me with the questions I need to ask. So going to a wedding where I will try to relax and again I will post tomorrow - thank you all again:)

[Squirt's Mom]

After the wedding, take a nice hot bubble bath with a good book and glass of CHOCOVINE! :D

[Cyn719]

I asked the exact date Penny stated med - she didnt give to me but I believe it was Dec 13 2010


Pennys results 3/24/10

Alkaline Phosphatase 2378 5-31
GGTP 23 1-12 vet made a note next to the first two results Cushings

T4 0.9 1-4

Penny 9/17/10

Cortisol (3Samples)

Tube Labeled Pre
Tube Labeled 4hr
Tube Labeled 8 hr
Cortisol Pre 4.4
Cortisol 2.5
Cortisol 4.2

normal response to ACTH canine 5.5-20.0
post-lysodren 1-5

12/23/10

ACTH Response (2samples)
Tube Labeled 11:30
Tube labeled 12:30
Cortisol Pre 1.2
Cortisol 2 2.3

4/8/11

ALT(SGPT) 154 12-118
alk Phosphatase 3063 5-131

GGTP 17 1-12
Triglycerides 392 29-291
Platelet count 432 170-400
Platelet EST Increased
Differential Absolute
T4 0.3 1.0-4.0

MARCH 2011 results was 2.3 - they didnt give me the lab work

4/13/11

TSH 0.21 0.00-0.60
Free T4 Diaktsis 10 8-40


6/22/11

Albumin 4.1 4.0
ALT 378 0-80
ALP 993 0-140 - I believe she said this was extremely higher cause in lab could not calculate above the 900
Triglycerides 353 30-130


6/28/11

ACTH Response (2samples)
Tube Labeled Pre
tube Labeled Post
Cortisol Pre 0.8
Cortisol 2 0.9

Sorry if it is messy - I was rushing -- Penny is off pred --- very quite today - tired Cant wait for your feedback!! Thanks Cindy and Penny xo

[Cyn719]

Correction on pennys results for June 22, 2011 it read >993 thats why she said it was way over 1,000

[Cyn719]

I forgot to say that Penny is on no meds now and today she ate but does not want to get up - just lays in basement - no energy - really having trouble walking - have to weight her - she looks very skinny from stomach to hips?? So off the pre will do this? Not panting to much but not getting around neither :(

[Cyn719]

do you know if i can restart rimadyl since penny is off pred now - she can barely walk - not sure what to do - requesting her papers to be sent on monday so not sure how long until i speak to Dr peterson

[lulusmom]

This is definitely not normal and unless you know exactly what is going on with Penny, do not give her Rimadyl. I highly recommend that you get Penny to the nearest emergency clinic.

[Cyn719]

i did not start rimadyl - pred done - not trilo - so if she was in a addisions crisis and i stopped meds she would most likely go back to cushings - but they doenst seem to be the case - right now I cant take her to vet - husband working - son away for weekend - I think she is ok - do you have an idea what it could be

[labblab]

How long ago did she have her last prednisone? It may be the case that her natural cortisol level still has not rebounded sufficiently, and that she is still in need of prednisone supplementation -- that she is still in an Addisonian condition. Do you have any more prednisone on hand?

When was she scheduled to have her ACTH test once weaned off the prednisone?

Marianne

[Squirt's Mom]

Hi Cindy,

It is possible that her cortisol is still too low to be without the pred but you really need to get an ACTH asap first so you KNOW where it is now. Honey, this is not something you can wait out...if her cortisol is too low her body cannot function as it should and the pred was supplying what she needed. Please, get Penny to an ER asap to check her cortisol and electrolytes.

Let us know how things are going.

Hugs,
Leslie and the gang

[StarDeb55]

Cindy, I don't want to repeat what you have already been told, but Penny needs to be seen by a vet, this can't wait. There is a small possibility that the trilo overdose may have done some damage to her adrenal glands & she simply can't make enough cortisol at the present time, & she will have to be on pred for an extended period of time. The only way to know is an ACTH, along with a check of her electrolytes. If you have any pred left, I would suggest you give her a dose is she still seems to feel bad this morning.

Debbie

[frijole]

do you know if i can restart rimadyl since penny is off pred now - she can barely walk - not sure what to do - requesting her papers to be sent on monday so not sure how long until i speak to Dr peterson

No Rimadyl! :confused: I thought you were using tramadol... sorry if I am confused. If so, use tramadol as it is not as hard on the liver.

Can you describe what you mean by "can't walk"? Does it appear she is lethargic and not able to get up and move or does it appear she has joint pain and trouble walking? Because it could be her cortisol is still low OR it could be something else is wrong with her.

That said - Rimadyl can have some serious side effects in a healthy dog and it can spell real trouble for a dog with uncontrolled cushing's. Rimadyl is tough on the liver and can elevate liver enzymes as well as the pancreatic enzymes. Given the blood tests you just posted the liver enzymes are very high and your dog should not be given Rimadyl.

Have you been giving Rimadyl recently? (up til she went too low on the acth test?) Rimadyl can mimic some cushing's symptoms such as excessive drinking and peeing, exercise intolerance and general lethargy. As I mentioned before, it can cause some of the same blood abnormalities such as high liver enzymes.

Now I'm wondering if what you saw was a reaction to Rimadyl and she really doesn't have cushings?!

This is why you absolutely need to go to a vet with experience and provide that vet with a FULL list of all tests and ALL meds Penny has been on...

I know we told you that you could hold off on the acth test at the specialist you phoned but you might have no choice because the only way you are going to know if Penny's cortisol is still too low (and if so she'd still need more prednisone) is to do that test.

Here is a link that simplifies what cushing's is that might be helpful.

Kim

http://www.lifewithdogs.tv/2011/07/cushings-disease/

[Cyn719]

Penny had her last pred on Thurs and I do have 10 mg left - I didnt want to start it back because I wanted the vet to do a ACTH test tomorrow and she has to be off the pred for 48 hrs for the test - the vet doesnt even know I did not start the trilo back - she insisted that i did!! So I also am having her results sent to Dr Peterson tomorrow and hope I get some results - She ate really good today still drinking alot but the panting basically stopped!! Hope thats good?? Kim did you get to review her results or anyone else have any input?? Thanks as always I appreciate all your suggestions and concern xo Penny and Cindy:)

[Cyn719]

Sorry Kim I posted before I read your post she has been on Rimadyl for a long time so now I wonder the same - i have more to say - just walking out for Grad party -- will post when I get in Thank you soooooo much:)

[frijole]

If you are going to a graduation I have to ASSume that Penny is better today and that is why you didn't respond to the people that said to take her to a vet asap? It is hard to help online because we are trying to interpret what is written and don't have the ability to SEE Penny. When you tell us she is having a hard time walking we get worried because when dog's prednisone goes low like hers did - dogs can and do DIE. Sometimes they just need the prednisone. Sometimes they can be weaned off the prednisone. We thought there was progress until you mentioned the inability to walk.

Again - if she can't walk - she needs to go to a vet. If that was last night and she is normal today then so long as she stays that way I'd hold off on prednisone ASSuming you have an acth test scheduled for tomorrow. Please get that done and please do have everything ready for Dr Petersen's consultation. Dr Petersen cannot work with just the acth test results - he's going to want everything that is abnormal from all tests previously done. He will want to know a complete time line of symptoms, tests, meds taken. Hopefully he can put the pieces together. Kim

[Cyn719]

Its weird because penny does seem to have a bad day then a good day ?? As soon I get really worried she seems to get alittle better - yes I am going to have ACTH test tomorrow and have the vet send Dr P whatever she has - What I posted is what I have and I posted just was abnormal on her results. So basically if her numbers are not up she would need to resume the pred - and Dr. P will beable to tell me if she truly has cushings which I was told she had since she was 7 1/2 - this will be interesting for sure!! I am hoping her numbers are up since she is eating good - still drinking alot - but not panting? I could not take her to ER last night my son was away and husband worked so I was without a car but if she was really bad I would of had my husband come home and this am she did seem better. One thing I noticed is those little episodes she was having seem to of disappeared - the twitching back of her head - fast blinking of eyes and quivering of her mouth - so I can only assume it was the trilo?? Alot to consume - I am breathing!! lol Going to feed her now - my dad came to stay with her awhile - he said she was quiet but seemed okay. Tomorrow cant come quick enough!! Hate weekends when waiting to have something done!! :)

[Cyn719]

Penny ate very well at dinner - today she ate the best she had in weeks!! I hope her numbers are ok - I hope the problems walking is the arthritist and not addisons - I just saw her getting up and she pushes herself into a sitting position then she struggles to get back end up so maybe its just because she is not taking any medication for her arthritist - besides the shots some of the dogs get what medication is safe for this??? Also in my last post I talked about pennys episodes - has anyone elses dog had this - maybe from the trilo? Thank you for keeping me on top of all this - dont know where I would be (or penny) without all of you!!!!! I had Hodgkins Lymphoma years ago and I know I would of NEVER gotten thru it with the love and support of family and friends - and I know I would of NEVER got thru this with Penny if it was not for all of YOU!!! If you didnt tell me to give Penny the Pred I know now she could of die!! Thank you to all my new forum friends!!!!! xo Penny and Cindy

[Cyn719]

I could not get on this am - our internet was down!!! What else could go wrong!!!! Vet told me she could not do the ACTH test today because the dog has to be off the pred for 2 weeks to get an accurate ACTH result and she said she checked this with another vet too - Is this right??? at this point I dont know if what she tells me is right or wrong and probably mostly wrong??? Papers to Dr P are being sent out sometime today from her office?? Advice???????:confused:

[littleone1]

I don't really know, but in one article I read, it said that a stim test could be done 24 hours after the last dose of Prednisone, and that the electrolytes should be checked.

Terri

[lulusmom]

Vet told me she could not do the ACTH test today because the dog has to be off the pred for 2 weeks to get an accurate ACTH result and she said she checked this with another vet too - Is this right???

No it is not right so if your vet's two week time frame was confirmed by another vet, I believe you have the blind leading the blind. You may want to suggest to your vet that she consult with Dr. Mark Peterson or read his blog. She will pick up a lot of good information, including how long a dog needs to be off of prednisone before doing an acth stimulation test. Or she can pick up a veterinary book which she can refer to called Quick Reference to Veterinary Medicine. Here is a link to an excerpt that deals with your question. As long as Penny has been off of pred for 24 hours, you can have an acth stimulation test done and I would recommend that you push your vet to do so.

http://books.google.com/books?id=1ziEbRYWNbwC&pg=PA462&lpg=PA462&dq=acth+stimulation+test+prednisone&source=bl&ots=nCJRJAPBFc&sig=YkgA8raakZ8x41y4MCc0xlWhAZQ&hl=en&ei=gC0bTq7FDeKxsALawb37Cg&sa=X&oi=book_result&ct=result&resnum=10&ved=0CD0Q6AEwCTgo#v=onepage&q=acth%20stimulation%20test%20prednisone&f=false

[Cyn719]

they re getting papers ready to be sent to dr peterson - i read the link saying 24 hrs!! omg i really need to breath!! I called dr peterson and spoke to a nice woman Carol - she will call me as soon as papers get there!!! Waiting again!! These have been some long days and night!!! xo always!! Penny and Cindy:confused::(

[Cyn719]

Penny has a huge appetite for sure (maybe and hopefully back to Cushings) eating all her food - I put a bowl of watermelon down and when I came back it was gone!! She doesnt take food unless you tell her it is okay so I assume the Cushings is causing an appetite?? the big work ASSUME - really dont know for sure - believe me she is a rare case!! I think shes down for the count and then I come downstairs in the basement in my sons den area and there is Penny bouncing up and down on the couch!! Like a puppy! Then 5 mins later shes on the floor out like a light!! It is so weird I can tell you one minute she seems so out of it and then she perks up for alittle!! Just will feel much better when these papers are read - I know my vet probably did not like my request for her file - I can just tell my her tone with me this morning when I was upset about not doing the ACTH test!! Oh well!!! I am not saying she is a bad vet because she really has been there for me for so much with penny - but when you do not know enough about Cushings just say so and send me off to a specialist - do mess with her life!! :):confused:

[Cyn719]

Vets office called - the results were sent to Dr Peterson - Thank you Debbie for letting me know about him - the receptionist said the vet knew about him - he wrote books - does lectures etc sooooo she couldnt tell me about him?????? I hate when a doctor thinks they can handle everything!!!!!! I have one of the best oncologist in RI and I told him I wanted to go to Boston and he totally agreed and even made my appt!! So they both worked together and I still see my oncologist every year here in RI for the past 21 yrs!!!! I was 28 then and didnt know where to turn - thank God I had a doctor who respected other doctors opinions!! They only sent 6 months of her chart so I just told them I wanted the last couple of months sent also form 2010 - when she started the meds - I think that was important too!? :rolleyes: Fingers crossed I hear from him soon!!!:D:)

[addy]

I hope you get to the bottom of things for Penny and I am so glad she ate today even if it was stealing watermelon;);););).

Crossing my fingers, toes, paws, basically EVERYTHING:D

Hugs,
Addy

[Cyn719]

hahahaha yes Addy she loved the watermelon!!! She had a great dinner too!!!!! Wow its nice to see her eat again!!! It would be great to get to the bottom of things finally!! Thanks for the good wishes!! Really appreciate it and so does Penny!!! xo:):)

[frijole]

I am so relieved that Dr P will be looking over all of the records. I know you feel like you are going crazy but trust me... while your vets might be great at general practice it was evident early on that cushing's was beyond their scope... and that is fine after all they are gp vets. You were right though... just refer when over your head. I had the same experience and couldn't believe my vet would give up on my dog and do nothing (she'd have died) before telling me to go to Kansas State. Unreal. I felt like it was all about keeping "all of my vet bill money" as opposed to helping my girl out.

Keep us posted on what Dr P says. Do you have any idea when you will hear from him? I'm excited for you. Kim

[Cyn719]

Thanks Kim!!!! I have to call the office tomorrow to set up a time that he will be able to call me - hopefully in a few days - OMG I have given this vet sooooo much money - we had 2 goldens before Penny and one had a brain tumor which I went to Tufts for but she took care of both of them and then Penny - Penny had 3 thick files alone in that office on her!! Yes we spent alot of $$$$$$$$ there for sure! When Penny needed two knee operations she insisted that she could do it - but I took her to Dr Sweet at Ocean State - He was wonderful!!! From when you got Penny at 8 weeks old she had bladder infections over and over and over then that went away then she had a non canceous tumor on her lip - had that removed - then the two knees were done - then was bleeding from stomach from an antibiotic - then she tore her hock!! Thank God Penny got good parents!!!! lol But I am kicking myself that I did not take her to a specialist for the Cushings!!! I just thought she had it covered!! She lead me to believe she had it all under control - I cant think of what I didnt do I just have to go forward and see what I can do now or I will drive myself crazy!! Thanks for the support!! xo Penny and Cindy

[addy]

I think it would be good to have a list of questions for Dr. Peterson, just in case. Granted the conversation won't probably go the way you plan for; he will ask you a lot of questions. But I think you should have some of the really important questions written down to ask so you don't get side tracked and you are sure of getting those questions answered. Penny has quite a bit of ground for him to cover.

I say this because it helped me with my consultation with him.

Kim- what are the most important questions?



Hugs,
Addy

[Cyn719]

Thanks Addy - in one of the post it did mention that after I posted the results for Penny they were going to give me questions for the doctor - so I welcome any questions to get me through the consultation - as I am typing Dr Petersons office just called - I have phone appt tomorrow afternoon!!!! :) She is calling me back with the time soon. WOW Start sending those questions!! I didnt think it was going to be that quick but I am so glad it is!! :):D:) xo Cindy and Penny

[Cyn719]

ok her appt is at 3:00 tomorrow!!!!!!! Its weird cause now I am nervous and excited at the same time!!!:):confused:

[addy]

I felt the same way;)

Hugs,
Addy

[lulusmom]

Addy can confirm this but I think Dr. Peterson might be asking most of the questions. I think what you need to do is to clear your mind of everything and think really hard about all of the things you have observed in Penny that are not normal for her and for which you have no explanation. Remember that Dr. Peterson doesn't have the benefit of observing Penny up close and personal so include even the smallest details. What you think might be trivial could be a major piece of information for Dr. Peterson.

In going back through your thread a few pages, I noticed that you made a correction on the abnormal blood values. I now see that you made a mistake when you originally posted the GGT as being 993. I almost fell out of my chair when I saw that number and was deeply concerned about gall bladder disease. Now that you corrected that number to read as the ALKP, I feel much better. Whew!

[Cyn719]

LOL Sorry I made that mistake - yeah that looked bad!! I am going to sit and write things down tonight so I have it all in front of me - Cant wait for this call!!! The girl is still drinking and oh what an appetite!!!! But still tired but she is 11 yrs old (not lethargic at all - right now) Thank you Thank you :):):):) xo Penny and Cindy:)

[Cyn719]

It is weird and funny at times how penny is sooo down and then feels good - she goes back and forth so quickly but I do love seeing he happy! She is in yard rolling on her back - kicking her feet - coming to me to scratch that special spot right above her tail!! lol (cant stay out to long - to hot!) but I just feel so good to see her happy and......she stole food again!!! My son put his dish on tv tray which was next to couch and of course he came back and she was having a feast!!! He was done just his left over beef - so I feel she is back into Cushings - Cushings is a happier place than Addisions for sure!!!!!:):D:):D

[frijole]

:) Be sure to tell him you have been giving rimadyl and the dosage and for how long.

[Cyn719]

Thank you I will put the rimadyl on my list right now - just sitting here making some notes - alot to remember for sure!!

[frijole]

Thank you I will put the rimadyl on my list right now - just sitting here making some notes - alot to remember for sure!!

I want to make sure he is aware of it since taking it can result in cushings like symptoms.

I know it is alot to do and this is all new to you but trust me you will save time, money, and alot of stress if you spend a few minutes collecting all the facts so he can then put the pieces together. Good luck.

In times of need we become "cush angels" and we flutter over your shoulder so you aren't alone. You will probably hear us or feel our wings tomorrow. ;) Kim

[addy]

Hey There,

Big day to today. Remember to breathe:D:D

He will ask many questions so if there is anything important you want to know that is what I meant about writing down questions. I was weighing treatments so I had specific questions I wanted to discuss in addition to his overall review.

So as Kim pointed out make sure you discuss the Rimadyl. Have your test copies handy too.

Good luck!!!!
Addy

[frijole]

Also... do not be afraid to tell him "Sorry but I am new to cushings and don't understand your question" or "What do you mean by that" etc. Take good notes so you can remember what was said. Its easier said than done I know. You will do just fine. Kim

[Cyn719]

Thanks Kim and Addy!! I wrote down everything you both said include saying sorry I am new to Cushings - and I wrote down about the mini like seizures she had on the trilo and now off I havent seen one!! My vet insisted it wasnt the trilo - so why isnt she having any now?? So another thing to bring to his attention. OK She said he would call around 3ish or a little later - So I will get back to everyone later today!!! Thank you for all the help and good wishes!! xo to my cush angels!!!!! xo Penny and Cindy

[newman]

does anyone have suggestion for dry and wet food for penny - what have you had good luck with so far?

Royal canin lf

[Cyn719]

TO ALL MY CUSH ANGELS!!!!!! Dr Peterson called - OMG he is soooooooo nice!!!!!!!!! Thank you again for putting me in touch with him - basically he said he wants the ACTH test now!!! I told him I would of had results today but she refused to do it - so I just left them a message saying he wants it now!! Was glad her electrolytes were good - wants me to work on a low fat diet cause triglycerides are so high - said we will probably have to keep her numbers high since at 2.3 and 2.9 she cant walk and has the mini seizure episodes - (none since off meds) have pred on hand again - put her on 5 mg a day - if needed - hold off on rimadyl - will have to go back on if cant walk - he will put her back on vetroyl at 60 mg not the 90 she wanted and he said may have to increase but start low - I told him I feel like i have not had a dog since Dec 2010 - this med did her in - he said she needs to be able to still be a dog but be on the meds - not put her in a lethargic stage - he cant believe she left her like that for 6 months!! I told him I called and called and she said this is how she was to be to be treated!? So test tomorrow for Friday and results will be faxed to him then he will call me back on what to do next. Penny is so so so happy today - like he said yes cause med is out of system and she feels better in Cushings stage cause shes not feeling her pain and he said we would like to leave them like that cause they are happy but unfortunally it will kill her so you keep them on the LOWEST dose possible to control the symptoms - even if it is an 8. Need to work on the food now - so relieved!!!! I feel so much better!!! Thank you all so very much for all your help and advice - I truly dont know where Penny would be right now if it wanst for all of you!!!!! Now I have to see what the vets or local pet stores carry for food - xoxoxoxoxoxoxox Penny and Cindy :):):):):):):):):):):)

[lulusmom]

Awesome report!!!!

[Cyn719]

Forgot to say vet mention Royal Canine food has anyone used that? Or another suggestion - He just said low fat - Penny is kinda fussy and I got her to eat Purina One weight control with Merrick wet food ???? Thanks :)

[Squirt's Mom]

Hi Cindy,

So glad the chat with Dr P went well and that you are feeling better about things! :)

I feed Royal Canin to my babies - they are all on the Chihuahua 28 formula but they make several different types. Read the labels and watch the fat content. You can give treats like green beans, carrots, and any fruits she likes to help as well. ;)

Hugs,
Leslie and the gang

[lulusmom]

Hi Cindy,

In my opinion, Purina One Weight Management food is pretty crappy stuff and if you do the math, you'll see that it's pretty high in fat. In order to determine the percentage of fat, you have to calculate on a dry matter basis, which is equal to 28% fat. That's pretty fatty. Royal Canin has a low fat prescription formula with just 4.5% fat so if Dr. Peterson want Penny to get the weight off fast, you may want to get the prescription diet. Otherwise, you can buy the Labrador 30 which is 12.7% fat. The Royal Canin is a few notches above Purina One in regards to ingredients and I've met very few dogs who don't like it. I'm a small dog rescuer and if I have a fussy eater, I can usually get them to eat Royal Canin Mini Special 30. I believe the food that Leslie feeds her babies is also good for picky eaters. I keep a bag on hand for rescues, plus my own dogs love it as a treat. If Penny will eat it, a better non prescription choice for Penny would be Natural Balance Duck and Potato. The ingredients are much better than either of the other two and it is 11% fat. I know that Petco carries it as do most pet supply stores. You can mix the kibble with the canned duck and potato.

[addy]

Cindy, I am so happy you have clarification for Penny.

Hip, Hip Hurrah!!!!!!!

Good Job!!!

Hugs,
addy

[frijole]

:D:D:D:D:D:D:D:D:D:D:D:D:D:D

Wonderful report and update. Now you know we weren't making it up about your vet being confused. So I gotta ask... who is doing the acth test? The vet that you put you thru this or a new group? Just asking... :D Kim

[Cyn719]

yup i knew the purina wasnt great but didnt know how it affected cushings uggg - I will look into the food tomorrow - she is 84 lbs he didnt say she had to lose the weight - even though she could drop a few pounds - he was just concerned about having her on a low fat diet - so the Labrador is considered the low fat dry food for her and yes she needs alittle wet food in her food to eat - never would eat just dry food - He said my vet wanst to off base - except should of listened to me when I said she was not doing well - and should of pushed pred earlier for sure -- My vet is doing the test because Dr Peterson said he wants it asap so he said just let her do it and sent him results and we will go from there. He said he will monitor it so he will get her under control then go from there - nothing will be done without his approval - one thing I forgot but will tell him is her T4 was low but THS was ok - suprised he didnt mention it - it was sent to him -- so she is going tomorrow - results by friday - so waiting again but thats ok - she is better so the waiting is easier!! :):)

[frijole]

OK.. so long as Dr P is still driving the bus.. ;) FYI all cush dogs should be on low fat diets. They do not tolerate fats. My Haley girl just loved to eat and would eat anything and everything.. for real. As time went on it was amazing and she could not eat any people food without getting sick. I mean even a small piece of white meat chicken and she'd chuck it up within minutes of eating it. So low fat but you want to make sure there is enough protein in the diet.

I gave my girls Solid Gold Jundenflocken for many years. I could really tell the difference when I switched them to it. Livelier, hair was healthier and they had much more energy. I had them on a prescription Science Diet that a previous vet had put them on and they were doing poorly - losing teeth etc. Not a fan of SD any more.

There are lots of good foods out there whether they are Solid Gold, Merrills, Royal Canin. My dog Annie who is the queen of not eating has all 3 of these brands on the shelf right now :D

[Cyn719]

Oh dont worry Dr Peterson is driving the bus the plane the ship etc etc lol lol - cant wait to see how her levels are - I will drop her off at vet and go to the pet store to check out the foods - thanks!!! :)

[Cyn719]

Does this seem any good - Someone I know said they use this one but one of you did mention Labrador 30??

Royal Canin Maxi Aging Care -

Maintaining healthy joint cartilage and optimal digestive function are top concerns for maturing large-breed dogs. A diet with glucosamine hydrochloride and chondroitin sulfate, vitamin E, vitamin C and an optimal amino-acid profile will help maintain large-breed mature dogs health and vitality. It is important that their diet be fortified with fructo-oligosaccharides to help maintain optimal digestive function resulting in small, firm stools.

Ingredients: Chicken, rice, brown rice, corn gluten meal, chicken meal, oatmeal, chicken fat, natural chicken flavor, anchovy oil (source of DHA), dried beet pulp (sugar removed), dried brewers yeast, dried egg product, soya oil, potassium chloride, calcium carbonate, sodium silico aluminate, sodium tripolyphosphate, salt, fructo-oligosaccharides (FOS), choline chloride, taurine, Vitamins [DL-alpha tocopherol acetate (source of vitamin E), L-ascorbyl-2-polyphosphate (source of vitamin C), biotin, D-calcium pantothenate, pyridoxine hydrochloride (vitamin B6), vitamin A acetate, niacin, thiamine mononitrate (vitamin B1), riboflavin (vitamin B2) supplement, folic acid, vitamin B12 supplement, vitamin D3 supplement], glucosamine hydrochloride, L-lysine, Trace Minerals [zinc proteinate, zinc oxide, ferrous sulfate, manganese proteinate, copper proteinate, copper sulfate, manganous oxide, calcium iodate, sodium selenite], tea (green tea extract), chondroitin sulfate*, marigold extract (Tagetes erecta L.), preserved with mixed tocopherols (source of Vitamin E) and citric acid, rosemary extract.

Guaranteed Analysis: Crude Protein (min) 26.0%, Crude Fat (min) 17.0%, Crude Fiber (max) 1.2%, Moisture (max) 9.0%, Glucosamine Hydrochloride* (min) 780 mg/kg, Chondroitin Sulfate* (min) 220 mg/kg, Vitamin E (min) 500 IU/kg, Vitamin C (min) 200 IU/kg, Lutein (min) 5.0 mg/kg.

Calorie Content: (ME on as fed basis)
4,045 kcal/kg
364 kcal/cup

Made in the USA.

30 lb bag.

[frijole]

17% fat seems high to me. Look at the fat content.... its been a while but seems like 10-15 is more like low fat.

[frijole]

http://www.dog-nutrition-advice.com/how-much-fat-is-low-fat.html

here you go :D

[Cyn719]

oh that is high this was the Labrador 30 -this is also high??

Supreme formula that meets the special nutrition and health needs of Labrador Retriever. Includes an exclusive amino acid and vitamin complex that protects the surface of the skin and keeps the coat healthy and shiny. Formulated to contain just the right balance of calories and fat content to reduce excess body weight. MAXI also protects joints and reduces inflammation, thanks to the incorporation of chondroitin sulfate, glucosamine, omega 3, manganese and an a superior antioxidant complex. MAXI also has a smell, taste and texture that Labradors love.

Ingredients: Chicken meal, corn gluten meal, chicken fat, oatmeal, barley, brown rice, chicken, natural chicken flavor, cellulose, dried beet pulp (sugar removed), soy isolate, dried brewers yeast, anchovy oil, potassium chloride, calcium sulfate, soya oil, fructo-oligosaccharides, DL-methionine, choline chloride, salt, borage oil, sodium tripolyphosphate, taurine*, Vitamins [DL-alpha tocopherol (source of vitamin E), inositol, niacin supplement, L-ascorbyl-2- polyphosphate (source of vitamin C*), d-calcium pantothenate, biotin, pyridoxine hydrochloride (vitamin B6), riboflavin supplement (vitamin B2), thiamine mononitrate (vitamin B1), vitamin A acetate, folic acid, vitamin B12 supplement, vitamin D3 supplement], L-lysine, L-cystine, Trace Minerals [zinc proteinate, zinc oxide, ferrous sulfate, manganese proteinate, copper proteinate, copper sulfate, manganous oxide, sodium selenite, calcium iodate], glucosamine hydrochloride, L-Carnitine, tea (green tea extract), chondroitin sulfate, marigold extract (Calendula officinalis L.), preserved with natural mixed tocopherols, rosemary extract, and citric acid.

Guaranteed Analysis:

Crude Protein (min) 30.0%
Crude Fat (min) 20.0%
Crude Fiber (max) 5.9%
Moisture (max) 10.0%
Lutein* (min) 5 mg/kg
Zeaxanthine* (min) 5 mg/kg
Omega 6 Essential Fatty Acids* (min) 4.5%
Omega 3 Essential Fatty Acids* (min) 0.6%
* Not recognized as an essential nutrient by the AAFCO dog food nutrient profiles.
Made in the USA.

Supreme formula that meets the special nutrition and health needs of Labrador Retriever. Includes an exclusive amino acid and vitamin complex that protects the surface of the skin and keeps the coat healthy and shiny. Formulated to contain just the right balance of calories and fat content to reduce excess body weight. MAXI also protects joints and reduces inflammation, thanks to the incorporation of chondroitin sulfate, glucosamine, omega 3, manganese and an a superior antioxidant complex. MAXI also has a smell, taste and texture that Labradors love.

Ingredients: Chicken meal, corn gluten meal, chicken fat, oatmeal, barley, brown rice, chicken, natural chicken flavor, cellulose, dried beet pulp (sugar removed), soy isolate, dried brewers yeast, anchovy oil, potassium chloride, calcium sulfate, soya oil, fructo-oligosaccharides, DL-methionine, choline chloride, salt, borage oil, sodium tripolyphosphate, taurine*, Vitamins [DL-alpha tocopherol (source of vitamin E), inositol, niacin supplement, L-ascorbyl-2- polyphosphate (source of vitamin C*), d-calcium pantothenate, biotin, pyridoxine hydrochloride (vitamin B6), riboflavin supplement (vitamin B2), thiamine mononitrate (vitamin B1), vitamin A acetate, folic acid, vitamin B12 supplement, vitamin D3 supplement], L-lysine, L-cystine, Trace Minerals [zinc proteinate, zinc oxide, ferrous sulfate, manganese proteinate, copper proteinate, copper sulfate, manganous oxide, sodium selenite, calcium iodate], glucosamine hydrochloride, L-Carnitine, tea (green tea extract), chondroitin sulfate, marigold extract (Calendula officinalis L.), preserved with natural mixed tocopherols, rosemary extract, and citric acid.

Guaranteed Analysis:

Crude Protein (min) 30.0%
Crude Fat (min) 20.0%
Crude Fiber (max) 5.9%
Moisture (max) 10.0%
Lutein* (min) 5 mg/kg
Zeaxanthine* (min) 5 mg/kg
Omega 6 Essential Fatty Acids* (min) 4.5%
Omega 3 Essential Fatty Acids* (min) 0.6%
* Not recognized as an essential nutrient by the AAFCO dog food nutrient profiles.
Made in the USA.

This one is over 15 also


Royal Canin Maxi


Large breed dogs are subject to the effects of early aging. MAXI is specially formulated to manage body weight, digestive safety and joint care. Highly digestible protein sources provide optimal assimilation and a reduced food volume associated with beet pulp extracts for good digestion. The moderate fat content (16%) and the high protein content (26%) limits weight gain while maintaining the muscle mass. Rich in the antioxidant vitamins E and C associated with natural sources of Glucosamine and Chondroitin also helps protect the joints.

Ingredients: Chicken meal, rice, brown rice, corn gluten meal, oatmeal, chicken fat, natural chicken flavor, dried beet pulp (sugar removed), anchovy oil (source of DHA), rice hulls, salt, potassium chloride, calcium carbonate, choline chloride, dried egg product, dried brewers yeast, glucosamine hydrochloride*, Vitamins [DL-alpha tocopherol acetate (source of vitamin E), L-ascorbyl-2-polyphosphate (source of vitamin C*), biotin, D-calcium pantothenate, vitamin A acetate, niacin, pyridoxine hydrochloride (vitamin B6), thiamine mononitrate (vitamin B1), riboflavin (vitamin B2) supplement, folic acid, vitamin B12 supplement, vitamin D3 supplement], Trace Minerals [zinc proteinate, zinc oxide, ferrous sulfate, copper proteinate, copper sulfate, manganese proteinate, manganous oxide, sodium selenite, calcium iodate], chondroitin sulfate*, preserved with mixed tocopherols (a source of vitamin E) and citric acid, rosemary extract.

Guaranteed Analysis:

Crude Protein (min) 25.0%
Crude Fat (min) 16.0%
Crude Fiber (max) 1.8%
Moisture (max) 9.0%
Glucosamine Hydrochloride* (min) 390 mg/kg
Chondroitin Sulfate* (min) 110 mg/kg
* Not recognized as an essential nutrient by the AAFCO Dog Food Nutrient Profile.
Made in the USA.


Available in 7 lb. and 35 lb. bags.

I will more tomorrow

[frijole]

You can also check out dogfoodanalysis.com

[Cyn719]

Innova low fat dog food dry


Ingredients:

Turkey, Chicken, Barley, Brown Rice, Potatoes, Rice, Pea Fiber, Chicken Meal, Herring, Natural Flavors, Chicken Fat, Flaxseed, Apples, Carrots, Herring Oil, Sunflower Oil, Eggs, Cottage Cheese, Alfalfa Sprouts, Pumpkin, Dried Chicory Root, L-Carnitine, Direct-Fed Microbials, Lecithin, Rosemary Extract, Vitamins/Minerals

Guaranteed Analysis:


Crude Protein (min) 18 %
Crude Fat (min) 7 %
Crude Fat (max) 9 %
Crude Fiber (max) 5 %
Moisture (max) 10 %
Vitamin E (min) 925 IU/kg
Ascorbic Acid (Vitamin C) (min) 500 mg/kg
Total Microorganisms (min) 90000000 CFU/lb
DHA plus EPA 0.1 (min) %
L-carnitine 250 (min) mg/kg
Calorie Content:

3,340 kcal/kg

374 kcal/cup

Available in 6, 15

[Cyn719]

I will check that website out tomorrow - thanks - I just found that one on line - all these dog foods are new to me - so I will check out the ones that my cush angels had luck with - all suggestions welcome!!! :):):):):)

[labblab]

Here's an article that I found to be super helpful in terms of explaining the principles of a lowfat canine diet. It also discusses home-cooked diets and also has a table giving comparative info for various commercial foods ("Healthy Low-Fat Diets for Dogs"):

http://www.dogaware.com/articles/wdjlowfatdiets.html

My non-Cushpup, Peg, recently had an acute attack of pancreatitis, so we are having to carefully control her fat intake. I am currently feeding her the California Natural Lowfat Rice and Chicken kibble that is listed in this article. Like Innova, it is also made by Natura. But it has more limited ingredients that the Innova, which is a plus for us because Peg also suffers from allergies that may or may not be related to food...

Marianne

[addy]

Hi,

I will butt in with my two cents but I sure would like to see a food with more quality protein and not corn as a second ingredient. You can also go to Dogaware and check out different foods. Of the ones you listed the only one I liked was the Innova and you may be able to do better than that as that also has a large amount of carbs in it. The problem with the commercial "diet" foods for weight lose is they pump up the fillers so the dog feels full and you are not getting quality protein. Would it not be better to not pick a weight loss food and just feed less food? Most of the guidelines on the bag are off and the pups don't need as much as they say, sometimes up to 30% off.


My Thursday two cents worth;):D:D. I do admit to being really anal about food so that two cents might only be worth minus a dime:p:p:p

Hugs,
Addy

[labblab]

Since Peg's pancreatitis attack, I've been obsessing about lowfat food WAYYYYY more than I'd like. Addy is rght that most commercial lowfat foods have a higher proportion of carbs than protein. In Peg's case, that is probably OK for the time being, because the recommendation for a dog recovering from pancreatitis is to eat a diet that is higher in carbs. And for her, the absolutely critical part is to keep the fat low. From what Dr. Peterson has said, he is wanting you to feed a lowfat food, as well. So I do think you are somewhat limited as far as commercial products -- you really do need to look carefully at the analysis. And you may end up with a compromise of sorts, by adding some lean home cooked protein to a commercial lowfat food.

Interestingly, lowfat commercial food does not necessarily equate to low calorie food. The kibble that I'm feeding Peg is one of the lower fat foods that I could find: 7-8 percent fat. But due to the carbs, it actually has more calories per cup than the much higher protein, grain-free food that I was previously feeding her. The high protein food was also very high in fat, though, so it is no longer a viable choice for her. And unfortunately, most all of the higher protein commercial foods also have a fat content that is not suitable for a fat-restricted diet.

I strongly encourage you to take a look at that dogaware link, because it tells you how to accurately evaluate the fat content in both wet and dry food. It is not always as simple as just glancing at the numbers printed on the package. And it's true that the total daily fat intake will be affected by the amount of food that you feed. If you give your dog a large quantity of lowfat food, the total daily fat intake might exceed a small amount of higher fat food. So you have to pay careful attention to both the analysis and also the amount of food that you are feeding -- that article comes in very handy as far as figuring that out. And unfortunately, I've now learned the hard way that an otherwise excellent food may be a poor choice if you are trying to limit fat intake. I was feeding Peg top-of-the-line, high quality, higher protein grain-free food -- and almost killed her as a result...:(

Marianne

[Squirt's Mom]

Hi Cindy,

Addy makes a very good point about low-fat, "light", or "diet" feeds. Most of the time when they lower the fat content they add more carbs - which are often just as fattening - or junk as filler.

Choosing a high quality feed with a low fat content and feeding less will often be enough. What are high-quality feeds? A good guide line is they are not sold in WalMart, KMart, grocery stores, or feed stores (where you buy grain, ect.). They will be found only in pet feed stores. PetCo has started carrying some of the better feeds recently. I was really pleased to see Innova in our local PetCo last week. :) Innova and Solid Gold are really good feeds. Innova and several other great feeds were recently bought out by Proctor and Gamble and I hope they don't mess with the formulas of these feeds. :rolleyes:

I fed Innova, Solid Gold, Wellness, and California Natural when we lived in TN but these weren't available when we moved back to AR. PetCo has since picked up Wellness, Solid Gold, and Innova. Steer clear of feeds you are familiar with - like Eukanuba, Purina, Science Diet, Iams and certainly store brands like Old Roy. You don't even want to know what is in store brand feeds. :eek:

You are doing a great job, Mom!

Hugs,
Leslie and the gang

[labblab]

I'd suggest you clarify with Dr. Peterson the amount of protein and fat that he thinks is suitable for your dog. One higher protein kibble that may be OK is the "Wellness Core Reduced Fat Formula." The fat content is still too high for my Peg, but it may be acceptable to Dr. Peterson. But since he is wanting to lower your dog's triglyceride level, the type of protein content may be an issue as well as fat. Lean protein is usually a very good thing for most dogs, and is healthier than a low-protein, high-carb diet. But kibble manufacturers are not using filet mignon, they are using fattier meat and tissues. I suspect this is why the fat content is also typically fairly high for high-protein commercial kibbles. Grains/carbs are typically lowfat or fat-free, and that is a reason why they are the primary component of lowfat kibbles. In order to keep fat content down but increase the amount of protein, you may choose to add lowfat protein that you have prepared yourself to your dog's commercial lowfat food. You can also look for higher protein commercial foods that primarily contain fish as the protein source. But even that can be deceiving -- I've found plenty of high-protein "fish" foods that are still also high in fat.

I just want to stress again that there is a difference between a weight reduction diet and a lowfat diet. A lowfat food may actually have more calories per cup than a higher fat food, depending upon the composition and source of the nutrients. If a dog needs to restrict fat intake for medical reasons, you really have to pay attention to the listed nutritional analysis and calculate the ratio of fat to calories rather than just the straight percentage of fat content that is listed for the food. The Dogaware article tells you how to do that. My Peg also has seizures in addition to having had pancreatitis, and I've now learned that elevated triglycerides can actually trigger both of those problems. So I'd recommend that you really pin down Dr. Peterson as far as the overall composition of the food that he wants you to be feeding.

Marianne

[Cyn719]

Thanks so much for all the info about the feed!! All Dr Peterson sayid was low fat diet and mentioned Royal Canin but said there are others out there - so when I speak to him hopefully tomorrow (Penny had her ACTH test today) I will ask him about low fat and weight loss foods - and how much fat and protein he wants her to have. She is still having good days - lots of energy - walking well - eating and drinking alot (lol) -- shes just having issues with her callous on her "elbows" which are pretty big - they are so dry I am finding blood on the floor when she lays down and I just check and they are alittle bloody - Ouch any suggestions - she is a big girl with big dry elbows!!! Thanks again xo Penny and Cindy :)

[Cyn719]

Vet just called results are in for Penny

pre 3.5
post 9.6

results are being sent to Dr Peterson now I assume he is going to start her at the 60mg like he mentioned -- Awaiting phone call

[addy]

Hang in there, you are doing a good job. I hope you were able to speak with Dr. Peterson. Let us know.

Hugs,
Addy

[frijole]

How many acth tests have you had done and when were they done? I don't think I have a handle on the history from day one but it just seems strange to me that your dog is going from 9 to 0.8 in a matter of days and then after going so low is back up to 9. I am scratching my head.

Do you have copies of all the acth tests? HOw many? When? What were the results? Luckily dr P will have all of this too right? I'm just curious :D

[StarDeb55]

I agree with Kim, I don't understand all the timing here as to how Penny was at 9, then basically dropped like a rock, & now is back up to 9. Please post all ACTH test results along with the dose of trilo at the time of the test, & when the test was done. Last question, how long has Penny been off the pred when the most recent ACTH was done?

Debbie

[Cyn719]

I spoke to Dr Petersons office - they received the bloodwork she said he would call but he didnt - maybe he had a busy day?? Hope he calls tomorrow if not prob Monday - so some imput the results clearly show Cushings now??? Still learning all this stuff - lol so when I got the results from my office they say normal range is 1-5 so she is up there?? Thanks - xo Penny and Cindy --- She had an ok day - drank alot as expected but didnt eat to good - maybe so much water?? and very tired today too:):(

[Cyn719]

sorry we were posting at the same time - i am reading the posts now

[Cyn719]

I posted all the ACTH test I had the other day - I just looked at them and I seee she was 4.7 in september and she started her on 120mg of trilo end of november???? She must of based this on symptoms?? I really can kick myself - I didnt understand this and I trusted she did??? she went of the pred I belive the 6th and had the test yesterday which I posted today ????

[Cyn719]

she was on 120 mg from the end of November until she crashed when I started speaking to all of you in June 30th

[Cyn719]

All her results were posted on June 9th so she started at 4.7 and went down to 2.3 the bottomed out at 0.9 now is at 9 --- so thats not good??

[Cyn719]

CORRECTION I MEANT JULY 9TH:o:o

[labblab]

Cindy, I'm a little confused because in your very first post in January, you told us that Penny had started on 60 mg. right before Christmas. Her first ACTH test result was 2.4, but three weeks later it had gone up to 8.8 so her dose was increased at that time (to 120 mg.?). When you rejoined us in June, you wrote that her last previous ACTH was performed in March, with a result of 2.3. It sounded as though that was the last ACTH that was performed prior to the .8 result. Is that info correct?

Marianne

[Cyn719]

Yup u are so right - I just looked back at my posts - its so hard to keep up on everything - her bloodwork and mine is so much!! At Christmas Penny and I were both sick!! I am 49 I feel 99!! Penny has been sick since the day we got her - Yup thats what she did - she upped her to 120 cause it went to 8.8 -- I said leave her at 60 she said no had to raise it she would just get sicker -- Yup last one was in March - AND from then I called her ALL the time (twice a week from may till she finally did the test showing 0.9) telling her Penny was not right - she said it was the medication - it had to be like that!! :mad::(:confused::confused:

[labblab]

I just want to add that since it has now been over two weeks since Penny last had any trilostane, I don't think it's surprising that her cortisol may now have rebounded back up to approx. 9. Some dogs do take longer to bounce back after the costisol has dropped too low. But for the most part, the effects of trilostane leave the system pretty quickly.

[Cyn719]

Well I just made some notes for Dr P cause he didnt mention the 8.8 and her doubling the meds (she said she sent 6 months worth - ummm wonder if he has that??? They called Dr P and he told them what to sent but I am going to tell him about the 8.8 because since she was ok symptom wise couldnt she stay on just the 60 mg?? Yes she overdosed the dog and just because the directions said to up it she needed to go by the dog herself - ugggg and should of listened to me and did the test sooner!! I wasnt educated enough neither :(:(

[frijole]

Well you are getting educated now! And that is a good thing. I had a clueless vet and the fine people here helped save her life. That's why I still hang around to help others. I didn't know squat and the first thing i learned from the mess was that I was my dog's voice. She couldn't speak so I had to get smart enough to speak for her, pay attention to her symptoms and learn enough about the disease to have an intelligent conversation with the vet. That is why the resource section is here.

I bet you are right that the vet did not send all the records and the ones that were the most important are the ones not sent. That is why we say to keep a log of every single test so YOU can track it. I have had to switch vet a few times and it saved my sanity. Annie's medical history is like 5 pages typed.. I could never remember all of that.

So now you know. Make sure the good doctor is told as I'm sure it will impact his dosing decision. Don't beat yourself up - you learned from it and that is what counts. Onward and upward! Kim

[Cyn719]

Thanks Kim - I wrote everything down so when he calls I will go over it again with him making sure he has it all since 9/10 on mentioning how it went to 8.8 and thats when she doubled the meds!! Double it she couldnt of just gone up alittle at a time - or I didnt know better then but now!!!! I will be on top of it all for sure thanks to you and all the cush angels!!!!! Hope he calls tomorrow - I will post as soon as I hear!! Thanks again - Sleep well - xo Penny and Cindy:)

[Cyn719]

Dr P is not in today -- when I called the girl seemed like he did not see the results and she didnt know he was calling me back - I said well we talked for a half hr and he said to bring her asap for the ACTH test then we will talk more -- so she said she will make sure he sees it monday and I told her I was emailing her some notes that I wanted to talk to him about so if he needs anything from my vet you can get it before our conversation. Keep you updated - I guess she is still doing good - eating well - drinking alot and panting is actually alittle better!! She getting along well without the Rimadyl - not great but way better than before - I just hate that its going to get worse on the trilo -- but we will deal with that then - I asked Dr Peterson he said its not his field but he has dogs on the Rimadyl.... ???

[Cyn719]

Got a phone call at 600 last nite from Carol at Dr Petersons office - she said he called in and she asked if about Penny - she said he said he told me to start to 60mg -- umm he said I will probably start her sst 60 but do the test and I will call you back -- she said hes busy forgets what he says - I told her I only spoke to him for 20 mins - and I had more questions and he said we would cover it when he called me back?? So I told her I would start meds today but I still had questions so she or he needs to call me monday - So I gave her the first pill this morning and I am soooooo nervous!!!!!!!!! Because now she is soooo perky and alert and eats her bones and walks good but does drink and eat way to much - I am up all night letting he to the bathroom- so the meds will stop the drinking and panting and make her not as hungry but I am so afraid of her not walking and those mini episodes!! so much has happened over the last seven months I forget things but when starting the trilo what side effects will I see - does the meds make them feel yucky?? Just need alittle Sunday morning encouragement from the cush angels!!!! :confused::(

[addy]

Hi Cindy,

Perhaps the first time Penny did 60mgs her cortisol dropped like a ton of bricks and you saw that cortisol withdrawal. Perhaps this time around it will be easier for her. If you ever have any doubt about seeing side effects withhold the pill. Also remember that the cortisol helps inflammatory issues. You thought Penny seemed better at 7ug/dl than at 2.5 ug/dl. It may be she needs her cortisol to run higher if her other symptoms are controlled. If she is walking better but still having you up all night that is not got either.

Sometimes it is a balancing act. Are you giving the 60mgs one a day?

You already went through Penny going to low. You will know if it happens again. Have faith in your gut and yourself:):)

Someone is around so post away if you get nervous.

hugs,
Addy

[Cyn719]

thanks Addy - Yes today I restarted pill at 60 mg once a day - I would like to get her to where she is drinking alot less - less panting but still able to walk - so it will alot of adjusting - hope she handles it ok - awful we dont know exactly how they feel in this pill!!! Well going to church - I will be back in an hr to check all post!! Thank you:)

[Cyn719]

Dont understand this to good but Penny had one pill today and she is really out of it?? I got her up and she stumbled and layed back down - could one pill do this?? It there a loading period like there is for the other drug?? Just need Vetroyl 101 - its really a confusing drug and disease. Thanks for the imput xo Penny and Cindy:confused:

[Squirt's Mom]

Hi Cindy,

Is Penny able to walk? Is she showing any signs of nausea (panting, licking the air)? Any diarrhea or loose stools? Can you describe "really out of it" - how is she acting?

[Cyn719]

Very tired - sleepy - doesnt want to get up - my son got her up before and she was just stiff and just took a few steps and laid down again - now thinking back to when she went on it the first time in 2010 she did the same thing!! We were suppose to our friends house in NH for New Years and I could not leave her with my Dad because she wasnt right - now I remember she laid on her side for weeks - here we go again - did anyones elses dog do this?? I am sending an email to Dr Peterson to make him aware of this also. Its like I had one dog this AM and another one now ??:confused:

[Squirt's Mom]

Hi Cindy,

I think if it were me, I would withhold the Trilo until you get to talk to Dr. P. Penny may be one of those pups who cannot handle Trilo or she may be super sensitive and need a lower dose. If you see any signs of nausea or if she has diarrhea or if she become lethargic, give her some of the pred.

Hang in there!

Hugs,
Leslie and the gang

[frijole]

I agree this is not right. One dose should not do this. I would not give it tomorrow and I would be a pest until Dr P was on the phone. I would also find out how you are supposed to communicate with him if there is an emergency. You know the drill.. prednisone if you need to. and if you do you might only have to give one to get her back to normal. Kim

[Cyn719]

Yes i agree - i was soooo excited to see her walking - and barking and asking for treats -- she was chewing her bones whcih she has not done in six months!! She went to her toy box and dug them out!!! So perky - and I know it was cause the Cushings levels are high but now to see this - what a downer!! Yes one 60mg pill for a 84 lb dog knocks her right out - yes I sent him an email - hopefully they will call in the AM -- I do have the 30 mg trilo maybe he will say try that -- but last year this went on for weeks and weeks - maybe you are right and she cannot handle this drug????:confused::(

[Cyn719]

I got her up - my poor back!!! She ate laying down (but she usually does that) she drank BUT is very unsteady on her legs - she has that hock injury so that leg is weak but this last week she had control over it - but now that she is weak that leg keeps giving out to the side. Its like she it drunk - shes wobbling - so we know its the trilo but is it normal for one pill to react like that - what did your dogs do on the medication in the beginning??:confused:

[Cyn719]

Thanks Addy Leslie and Kim - I take in everything you said and there is an email waiting for Dr Peterson - I will hold off on the meds in the AM until he calls - She went out got around on her on but still not to steady - back to sleep - tired - Wow this med is potent for her!! She must be very sensitvie!! Hope the night goes ok I am a nite hawk so I will be checking on her thru the nite xoxo Penny and Cindy

[addy]

Hi Cindy,

How is Penny this morning?

Thinking of you,
Hugs,
Addy

[Cyn719]

Hi Addy - She seems alittle better - late last nite she started to come out of it - this am she ate good - still alittle trouble walking - didnt hear from the vet - going to give him just alittle while more then I will call him - obviously she is so sensitive to this medication like you said -- if just one pill put her in that state -- thanks for checking on us - hope I have an answer soon!! xo Penny and Cindy

[addy]

I am glad she is better. Hope you hear from Dr. Peterson today. Otherwise be the "squeaky wheel.";););)

Sending hugs,
Addy

[Cyn719]

I called Dr Peterson - his other office answered the phone - said he is extremely busy today so his office isnt answering - I said I sent an email she said Carol got it but dont know if they can get back to you today ?? I said well someone has to tell if I continue the pill at 60 or can I go to 30??? Really?? This dog was so off after that pill - she was dazed - weak - wobbling - you could see it in her eyes she didnt look right - how can I give it to her again - today yes he is better but not as good as when she was off everything - this is going to get more confusing since she seems so sensitive to this pill ?? :(:confused:

[Squirt's Mom]

Hi Cindy,

Just continue withholding the Trilo until Dr. P can talk with you. You are doing your part, we just have to wait til he can get to you.

Quite often with this disease, I have felt like that vulture in that poster about patience we have all seen....:o:p

Hugs,
Leslie and the gang

[Cyn719]

ok question to all cush angels -- opinion on switching her from trilo to lysodren (?spelling) my vet said Dr Peterson might want to switch her since she is sooooo senitive to trilo - I dont know much about the other med - side effects how it works etc ?? any imput will help!! Thank you - just want to be prepared for him when and if he calls - Thanks!!!!!!!!:confused::confused::confused:

[lulusmom]

It is possible that Penny may be one of the few dogs who just can't tolerate Trilostane and if Dr. Peterson should recommend that she be switched to Lysodren, there is no need to panic. You have lots of experienced hands here to help you. My dogs have treated with Lysodren and Trilostane so I've researched both drugs to death and am no less comfortable with one than the other.

P.S. If you ultimately need to educate yourself on Lysodren, I can provide a bunch of reading material for you.

[addy]

There is a wash out period before switching, you can't do it right away. He will explain that to you if he suggests it.


How has Penny been today?

Hugs,
Addy

[Cyn719]

Did your dog respond to trilo like penny did - what side effects did you see

[Cyn719]

Today she is better - a little tired but she is 11! lol She was more alert than yesterday for sure!! She wanted to eat dinner and let me know about it - she smelled chicken cooking!!! haha No up and around alot - seems like the arthritis is bothering her for sure. Did your dog act really different on trilo or anyones else dog have different side effects - no call form Dr Peterson - My vet said hold off till I speak with him and see if he says you should switch - she said most of her dogs are on lysodren and do well - I dont know why she put Penny on trilo (hope not just to try it out????) :confused:

[addy]

Hi Cindy,

Glynda used both drugs with her pups but I don't believe it was because of any severe reaction while on Trilostane. It was more about trying to alleviate symptoms.

I am glad Penny is feeling a bit better and wanting to eat:):)

Sending love and hugs to both of you. I hope it is a better day.

Love,
Addy

P.S. I thought I read that when a pup has side effects on Trilostane, you go off it for a week and restart at half the dose. I sure wish I could remember where that info was. I will look for it at lunch today. Maybe one of our other members will know.

[Cyn719]

Carol from Dr Petersons office called He said to try 30 mg a day - see how she does with that??? He said what I described he hasnt heard of???? So I will give it a try - any suggestions??? do you all give your dogs meds in the AM or PM???? Looking forward to imput and suggestions!! Thank you!! xoxo Penny and Cindy:):confused:

[addy]

Hi Cindy,

That seems consistant with what I was refering to this morning, cutting the dose in half after a week off.

I believe most of us give the one dose in the morning with breakfast. It has to be given with food.

Hopefully the others will come along and voice their opinions.

Hang in there.

Hugs,
Addy

[Cyn719]

Just to update she has been off the trilo since July 6th or 7th but took just one 60 mg trilo on sunday then I stopped because of the side effects - so in the AM I will give 30 mg - I dont wanna be negitive but i do not thing the 30 mg is going to make her have less side effects - I just think for some reason she cannot take this drug - but we will try!! I do give it to her in the AM with breakfast -- right now her eyes look nice and clear and alert - compared to the day she took the med - her eyes were droopy and sick looking -- I have to admit I have a knot in my stomach giving her this tomorrow:confused::(

[frijole]

Can't say I blame you but you will certainly know once you give it. If you see any signs of distress give her a prednisone (1) and she should be feeling fine quickly and then you can move onto another solution. Sending positive vibes your way! Kim

[Cyn719]

Thanks for the positive thoughts!! It just kills me to see her face look so sick when she takes the pill!! But we have to try it - He also said I could put her back on Rimadyl but holding off on that for now. She was outside on her back kicking her legs and groaning - that means shes having an ok day - hope she can do that tomorrow!!! :)

[jmac]

Good luck tomorrow! I've been following along with your posts, but unfortunately don't have any helpful advice to offer. I would be nervous to give the pill as well, and I hate that dreadful feeling, but you do know what to watch for and can give the pred if needed. Hoping for the best for you both!!!

Julie & Hannah

[Cyn719]

Thanks cush angels!!! It feels good having you all here for us!!!!! OMG Cushings is really keeping her at a high!!! She is bouncing - barking for treats - digging up her bed - very puppy like - but I know its the Cushings but it is kinda cute to see her old personality back!! I just know its not healthy to be at 8.8!! Hope we find a happy medium!! Will post tomorrow!! :)

[Cyn719]

Leslie - What kind of dog do you have?? My son fell in love when he saw the picture!! So cute!!!!!! Of course hes said lets get another dog- one like that!! OKK I have enough to deal with right now!!! I would love to have ten - but right now Penny is a hand full and needs all our attention -- We love our girl!!!!!! My son was 19 today so he thought he could get a four legged birthday gift!!! Good try!!!!:)

[Squirt's Mom]

Hi Cindy,

If he is talking about the one in my avatar, that is Squirt, my Sweet Bebe. She is half Cairn Terrier and half Long Haired Chihuahua. She looks much more like the Cairn, tho. Both her parents were show dogs who got together by accident and made a litter of exceptional babies. Squirt is probably the smartest, most intuitive dog I have ever had the privileged to share my life with. I used to know where 2 more of her siblings were, but they have moved. When we were talking, they felt the same way about their babies as I do Squirt - the best "breed" in the world! ;):D Tell your son THANKS! I think she's pretty special, too!

Keep a close eye on Penny after the dose this morning and don't hesitate to give the pred if she has the same reaction on the 30mg. And don't worry about that 8.8...the numbers are only a part of the deal. The bigger part is how the pup is doing, whether or not the signs are controlled.

Hang in there!

Hugs,
Leslie and the gang

[Cyn719]

Leslie all your dogs are and were beautiful - bless Ruby - she was beautiful (my penny looks kinda like her:)) What kind was she? Penny is pit akita shepard lab and?? Mike didnt see those pictures he just saw Crystal ?? - the pic when you post -- He loves that dog-- but then mike loves anything from a tea cup dog to a giant dog!! He is just a dog lover like his parents!!!! Ok I gave Penny 30 mg at 11am - she was tired this am didnt want to eat so I fed her late - fingers and paws crossed - I will post shortly xo penny and cindy

[Squirt's Mom]

Ahhhh....I forgot I still had Crys up as my avatar! Crystal was a Pit or Pit mix. I put her pic up in honor of her anniversary in June. She passed in June of 2010. Rube was just a big red dog - we had no idea what she was but I think she had some lab, chow, shepherd in her. They were both great dogs and I miss them!

I'm anxious to see how Penny does on the lower dose today so I look forward to the next post...hopefully saying there has been no effect seen at all! ;):D

Hugs,
Leslie and the gang

[Cyn719]

Yup thats why Michael was attracted to your dog - he loves pits!!! I know they are missed so much - I had two goldens - mother and son and I miss them soooo much - they both went throught chemo with me and were right by my side - especially the male!! Could not get him off my bed they days I had chemo and he was 103 pounds!!! Now I have my precious Penny!!!!!!! Okay gave pill at 11:00 my son came in at 1:30 said she had trouble getting up and walking - he left came back at 2:30 said she would not get up at all -- I came in at 4:00 she got up - was happy - went out - but back laying down so I have to observe alittle more -- Seems like she had trouble the first 4 - 5 hrs -- but I am going in kitchen now so I will be with her and see how she acts -- she is lounging on the couch right now!! -- will check in after dinner -- and I do have the pred on hand!! Thanks!!!!! xoxo Penny and Cindy

[Cyn719]

wasnt giving an update till after dinner but she just seems uncomfortable - explanation of that she is lying on couch one way getting up turning the other way -- when she in on floor very hard for her to get herself up -- making little groaning noises -- the pill causing this -- pill causing her to feel her arthrithis?? one pill -- so I guess I need to continue and see how it goes?? we need to just bring the drinking to normal and also the panting - the vet said we could prob leave her levels on high side if these things get better ?? more to come!!! Thanks for listening everyone!!!! :confused:

[frijole]

I gotta ask and I apologise because you have told us your story... but my memory isn't all that great ;)... how long was Penny on trilostane before she crashed.. like days, weeks, months? I still scratch my head and wonder if she even has cushings... I remember thinking it originally and that would be a reason she can't handle a small dosage. That's why I'm asking how long she was on it this last time? Thanks. Kim

[Cyn719]

hi - she went on it the end of november and crashed July 6th 7th - 60 mg to start then 120 in January?? I have to look at my papers - so maybe shes not really cushings?? Would dr peterson of seen this by looking at her paper work? she is ok now but like I said the j4 to 5 hrs after the test she was not getting around good and was sleepy - she ate - she is actually chewing her bone which is a good sign - so I guess I should give it tomorrow ?? wow confussed stage again - but you make a good point for sure!!

[Cyn719]

yes 120 in Jan cause she went to 8.8

[frijole]

:confused: Sorry.. I didn't mean to confuse you... I just scratch my head wondering what it is that isn't quite right... you were on it 2 mos w/no major problems, doubled the dose in January and the crash didn't occur until July? If the dose was too high you'd think she would have crashed immediately... and now she can hardly manage the original dose. Weird. Surely she has cushings because if she didn't and you were on it that long she'd have crashed for sure... Something is not normal... but I guess you know that. :D

When was rimadyl added to the mix? Thanks

[Cyn719]

Thanks okay you can confuse me - by doing that we might get to the bottom of this - She was rimadyl long before she went on the trilo for sure - in my eyes she didnt handle the medication right from the beginning - she was flat out on her side and not right and walking weird right from the start - but the vet said that was an ajustment period and this was the awful side effects - but I had to take the bad to make her better!!?? then in Jan she said we HAD to increase the medication because it would hurt her more to stay at the 8.8 - but then in Mar she was 2.3 and she was happy with that but the dog was not at her best but my vet was just happy with the numbers - I dont know how long her levels were low cause we did not check them again until the end of June when I demanded it - she didnt want to recheck until September!!!!! Penny was better after the first 4 to 5 hrs today BUT not right for sure - its hard to explain - like she stares into space - to licking the air - cant seem to really focus - and tired - I guess I have to do this again tomorrow and really watch her!!!! So if her levels are 8.8 now it that a true sign of Cushings?? I have to give Dr Peterson an update tomorrow - Any suggestions?? xoxo Penny and Cindy :confused::):(:eek: hate seeing her like this -- after thought -- then I think does she need to get it into her system to do its job??? But awful if she has to look and feel awful??

[frijole]

Maybe you should video her when she's like this and email it/put on utube for the vet to review? It is really hard without the visuals for anyone. Please just be sure that Dr P knows all of this. Kim

[addy]

licking the air caught my eye. licking the air can sometimes be a sign of being sick to their stomach. Is she yawning a lot, licking her lips, burping?

sometimes they just lay their when they are sick to their stomach.
I seem to remember Squirt doing that when she started her Lysodren and Leslie then started giving her pepcid.

Not saying to give her pepcid as I don't remember all her health issues and other meds.

just a thought,
Addy

[frijole]

Just wanted to point out that if you give Pepcid give Pepcid AC - there are different types. Your vet can give you the dosage. I cut a little pill into quarters for Annie. Kim

[Cyn719]

I forgot where I posted about licking - but it should of said she was not licking the air but did lay flat out on side alot -- but when she went on the trilo the first time I did see the licking of the air and didnt know what it meant and yes yawning and burping alot first time around to - what is that - also upset stomach??? She was taking pepcid before I guess she should go back on it -- I am sending email to Dr Peterson now so I will ask that - she ate and took pill at 1100 its now 115 and she is sleepy and moving slow so when she wakes up and I get her out then I can get more of an idea how she really is - xoxo Penny and Cindy

[Cyn719]

Penny basically slept all day - i know its a bad weather day - she was in air conditoning all day - just tired and mush -- She does eat her breakfast and dinner - but does not want to be bothered - she goes into the basement or if you pet her she gets up and walks away - wish they could talk -- so I guess I just continue and see how it goes?? Pred on hand!!