New to this board & desperately seeking help

[LisaNRiley]

Hello,

I'm new to the board but unfortunately not new to Cushings. Someone from another list gave me this link because I need some help and advice.

My dog has Atypical Cushings. He was diagnosed last year though it took a long time to get a final diagnosis. He is a male Maltese, 5 years old (6 next month) and his name is Riley.

He Alk phos has been between 200-628.
628 is his most recent number and quite a jump. His other blood work is normal.

His bile acids are all over the place. The last one was pre 15.1 and post 79. This is his highest ever.

His ultrasound of his liver showed a healthy, benign liver however slightly enlarged.

He was put on Melatonin and Flax lignans about 4 months ago. We started at 3 mg daily because he is so sensitive to meds. Because of the recent increases in his test we upped the dose to 6 mg daily. He slept a lot. So we went back down to 3 mg and we are currently at 4.5 mg. We are trying to slowly ween him back up to 6 mg.

His ACTH has his Andesteroine (sp), Estradiol, and Progesterone elevated.

His Andesteroine went from 5.16 to greater than 10.
Greater than 10 being the most recent.

His Estradiol went from 69 to 76.
76 being the most recent.

And his progesterone went from 2.6 to 1.9.
1.9 being the most recent. I'm wondering if this is from the Melatonin.

Because of his increasing ACTH results this is why we wanted to up the Melatonin.

He has also recently been on Ursodiol.

The doctor now wants to do Lysodren.

I'm petrified of this drug. I'm petrified of the side effects. I'm petrified of him going into an Addisonian (sp)? crises.
She said she would start him on a VERY CONSERVATIVE low maintenance dose and not a loading dose and work our way up.
But what if on this low dose he gets these horrible symptoms?
His cortisol is NORMAL! Doesn't Lysodren lower cortisol?????

I don't know what to do. I"m having a nervous breakdown. I'm just SO upset! I never thought it would get to Lysodren. I thought the flaxseed lignans and melatonin would work.

Then there's the cost. She said every two weeks we'd have to do an ACTH Stim test until we get him regulated. That's $400 dollars for each test. That's not even including the pills. She said that we'd have to get the pills compounded because he's only such a small dog!

I'm on disability and only make $536 dollars a month. I have Cystic Fibrosis and I can't work. How am I supposed to afford this?

I really want to treat him and prolong his life. I couldn't live with myself knowing that he progressed faster without medications and I could have treated him.

But I am absolutely PETRIFIED of Lysodren!!! He's only 10.8 pounds so what's the normal dose for a dog his size? And once he gets regulated isn't it possible after a certain amount of time that the dose needs to be changed and more Stim tests?

I hate this! I just want him to be a normal dog. I hate bringing him to the vets all the time and watching him shake like a leaf and clutch me.

Please someone help me!

Lisa

[StarDeb55]

Lisa, I'm on my way to bed for the night, but wanted to let you know that I had to manually approve your post. Please check your e-mail, especially your junk mail or spam box for a note from us that you should respond to so we can get your membership approved. There doesn't seem to be an administrator on right now, or I could ask them to go ahead & approve you.

I will give you a quick word about lysodren. It is a very strong drug but a lifesaver for our pups. I have now successfully treated 2 pups with lysodren. My last boy, Harley, was a 12 lb. Shih Tzu, so a little guy, too. He was on lysodren for 2 1/2 years after his diagnosis. He did have an elevated cortisol, but an across the board elevation in all of his intermediates. In your situation, you would not be loading, it would only be a maintenance dose which should lessen the risk considerably of an overload & Addison's. I'm sure there will be a number of other members over the next couple of days who will step in with their advice. We're glad you & your little Maltese are here, & we're here to help in any way we can. One last thing, $400 is atrociously expensive for an ACTH. Are you taking your boy to an internal medicine specialist or your general practice vet? If it's the specialist, perhaps you can have your regular vet do the testing, & the specialist guide treatment with your regular vet.

Debbie

I forgot, your boy is on the young side for this diagnosis, but it's not impossible. Is he neutered?

[frijole]

Hi from me also! I just wanted to calm you down on lysodren. It has been around a long long time and many dogs have lived because of it. Mine included. My Haley was diagnosed at 12 and used it for 4 1/2 yrs. It saved her life. She passed away of other causes in May of 2010 at the age of 16 1/2! So deep breaths.

Aspirin is dangerous if you don't use it right and the same is true with lysodren. Your vet and we will help you thru using it. Not to worry at all.,

Meanwhile $400 for an acth test is insane. I pay $124. Where do you live and is this a specialist? Perhaps we can help with alternatives...

You are wise to reach out to this group - they saved my dog's life a long time ago and I will forever be grateful. Together we have a whole lot of first hand experience.

Best to you and your dog. Kim

[addy]

Hi Lisa,

I know Leslie will be along to chime in to tell you about her Squirt. She just started her on maintenance lysodren dose. I think Squirt weighs 14 pounds.

The lysodren can lower the other hormones not just cortisol which is why Dr. Oliver and UTK will suggest it as part of their treatment plan for certain dogs.

Melatonin and lignans can sometimes take six months to work and you need the right lignans. UTK has a list of different lignans they suggest. I took my Zoe up by 1mgs on the melatonin until she got used to it. She weighs 16.5 pounds. I just upped her nighttime dose to 4mgs. She gets 3mgs during the day until she is used to the evening dose.

We have other atypical pups. Their moms will be here soon.

The $400 seems high. Lori had her Harley on maintenance dose. I am sure she will share how often she tested.

We have so many caring and really smart members. It will all get sorted out.:)


Glad you found us.

Hugs,
Addy

[Dakota]

I feel your pain. I am kinda in the same situation and several vets I have called all quote the same price $350 just for the test, not including their office visit, etc. I just had Missy retested again and now they want to increase her Vetoryl dosage from 60 mg. to 90 mg. a day. and they want me to retest her every month to check level. My husband is having a fit on the cost. Like you we want to do everything possible to get our babies healthy but the cost is so out of my range. There has to be a more cost effective way to test our dogs. I am in the Washington DC -Richmond, VA area. Still calling around to see what more vets are saying. Wish I could help more.

[missbeagle]

Lisa -

I found this a while back on another thread. If you search for liquid gold you will find it.

I am going to show this to my vet as well and see what he says. I'm his second Cushing's pup (person) and what can it hurt?

You're right the cost of stim tests are not cheap and having two cushdogs, I cry a lot. . Since your vet has not had a lot of exposure to cushing's, she may not know about the little gem I'm going to tell you about that will save you money. Most vets use a synthetic acth stimulating agent called cortrosyn for the acth stimulation test. This stuff is liquid gold. Instructions from the manufacturer says to use the entire .25mg vial; however, studies have shown that you only need to use 5mcg per kg of the agent. In Chloe's case, you would divide her weight of 30 lbs by 2.2 which equals 13.63kg. Chloe would need 68mcg (13.63 x 5) per stim test. Since there are 250 mcg in a vial, your vet should easily have enough cortrosyn for three acth stim tests from one vial. Tell your vet that she can split the remaining agent in tuberculine syringes and label them with Chloe's name. She can store the syringes for 30 days in the refrigerator and up to six months in a frost free freezer. Dr. Mark Peterson, a world reknown specialist in endocrinology was involved in the study, so if your vet has any questions on how to reconstitute or store, she can contact Dr. Peterson. His contact info can be found on his website.
http://www.drmarkepeterson.com/

The thread that this is located at is here.....

http://www.k9cushings.com/forum/showthread.php?t=2666

Hope this helps. My pup Rusty the Beagle has had one ACTH stim test. It was the one that was sent to UTK for Dr. Oliver to review. It cost me $365.00 for it. I'm hoping after I start trilostane and am just doing an IDEXX test for cortisol levels that it won't be nearly as much.

Paws crossed.

Gretchen and Rusty in NC

[Squirt's Mom]

Hi Lisa,

I am glad to see you and Riley! :D

Ok, first off....stop whatever you are doing and just take a deep breath then slowly let it out. Do it again....and now again. Roll your head around on your shoulders first to the left....now to the right. Get up and take a good long stretch then come and sit back down.

Now...don't you feel much better already? :p

Scared of Lyso, are you? Well, join the club! ;) When my Squirt was first diagnosed I simply lost it and then when I read up on Lysodren, which is what her vet recommended, that scared the CRAP out of me! :eek::eek: Now, nearly three years later, Lyso no longer scares me. Why? Simple. I educated myself and listened to these wise, kind folks here. Their experiences and first-hand knowledge taught me there was nothing to fear.

The key to treating with Lyso, or any, of the traditional meds for Cushing's is education and diligence on the parents part. The fact that you are here and have been trying so hard to find help for Riley tells me that you have the diligence part down already! ;) Having a vet that is cush savvy helps a lot, too, but what YOU know is more important than what the vet knows. ;) In this, we can help you a great deal! :) The collective knowledge and first-hand experience found here is astounding and it is yours for the asking.

My Squirt is also Atypical tho her cortisol has been creeping up over the last 2 years. On her last UTK panel, her cortisol and andro were higher than I was comfortable with so she has started on a maintenance dose of Lyso as of 3 weeks ago. She weighs 14lbs and takes 125mg 2x/week. The first two weeks on her dosing day, she would be kinda off but this week, she has shown no difference on the days she gets her dose.

(I had to go see my doc this morning for a shot to relieve muscle cramps so my little synapses are really not firing right at the moment but I am going to try to work out the dose for Riley. If you smell smoke, don't worry! ;):p )

Ok, here is the recommendation for maintenance dosing:


The maintenance dose is usually 25 to 50 mg of Lysodren per kg of the dog's weight per WEEK (25-50 mg/kg/week) and can be given in divided doses.

Riley weighs 10.6 lbs which converts to 4.82 kg (10.6 lbs/2.2 = 4.82 kg). So at a conservative dose of 25mg/kg/week that would work out to - 120.5 mg/week. For easy division (the Lyso pills come in 500mg), that would round up to 125 mg/week...or 2 pills a month. At this dose, 12 pills would last him 6 months! :)

Using Lyso as a maintenance treatment greatly reduces the chances of an overdose that would result in an Addisonian situation. I think it would be highly unlikely for you or I to see this reaction in our babies on a maintenance dose. ;) So try to put that worry out of your mind.

I am fading fast so I will shut up for now. I want you to know that I am so glad to see you here but even more importantly, I want you to know that you and Riley are not alone any more. Ya'll now have a family here who will do all we can to help you on this journey we have all been asked to take. Someone is here 24/7 so never hesitate to ask questions or to just talk if you need.

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

[jrepac]

First, $400 for an ACTH test is blackmail!:mad:

I've always paid between $180 and $225 for it...what part of the country are you in? Some docs in some areas get away w/crazy pricing.

I am not a huge fan of lysodren either, but some dogs have done very well on it. If your pup's cortisol level is not elevated, you'll need to watch him carefully when on the drug. It WILL lower cortisol along w/the other hormones you are trying to lower. But, you are not dealing w/high doses here, so the risk of a problem is much lower.

You may want to read up on Atypical Cushings a bit before proceeding; there are various options for treatment. The UTK is a great resource for information. I had one of those cases where my dog's cortisol was elevated along w/the other hormones, so it was slightly different. I took the UTK treatment information sheet to my vet and we discussed the options. You may want to do that as well.

I also question if your pup was on the right dose of melatonin and lignans for a long enough time....

Hopefully things will work out for you and your pup!

Jeff & Angel Mandy

[LisaNRiley]

Thank you to all that have posted. I so appreciate it and have never felt so welcomed.

First, someone posted that I needed to check my email to confirm activation? I thought I did this? I don't have any emails. I'm hoping I didn't delete this accidentally.

Secondly, I live in MA and they are very pricey over here. My vet that cost $400 for the ACTH Stim Test is a specialist. I called his primary vet and they are even more at $525. This is ridiculous! I asked his specialty vet if I could run the test at another vet that is less expensive. She said she'd prefer it with her. She has done that in the past and it hasn't worked and she said it backfired. There was a lot of miscommunications and discrepancies on how the test was run.

It would have really helped me to go have the test done at another vet. Now I'm REALLY stuck! I live in Massachusetts.

She also mentioned a liver biopsy which I DEFINETELY can't afford and DON"T want to put him through. It would cost $2500 and I would have to leave him there overnight.

She wants to rule out other liver diseases. I don't want to put my dog through this nor can I afford this plus all the other pills and tests. I don't want a liver biopsy.

He's had a ultrasound where everything looked healthy except for a slightly enlarged liver. He definetely has atypical cushings but she wants to rule other things out in case the cushings isn't causing the liver problems and Lysodren is not needed. But he definetely has atypcial Cushings with his hormones being elevated. I just don't want a biopsy. I'm dead set against it.

I asked about volunteer work at the vets which she said no. I asked about some kind of plan. She said I can sign up for some kind of card that is interested free for 6 months then the interest starts. The interest is probably sky high and there is no way I would have all this paid off in 6 months. I only make $536 a month.

Does anyone have any other suggestions? I need some help?

Lisa

I am writing another post below with questions I have. Sorry it's long!!!

[LisaNRiley]

Here are some questions that are on my mind.

These are the symptoms Riley is experiencing. He has been drinking more than usual but it's not even near excessive. I've talked to the doc about this. And he tires out easily and sleeps a lot. However, he has been doing this since he's a puppy. The sleeping a lot could possibly be boredom. If I get a new toy or take him for a walk he perks right up. I've also explained this to the doctor. That's about it.

My second thing is only 3 hormones are high. The progesterone went down to 1.9. The Estradiol went up to 76 and the Andensteroine (sp) went to greater than 10. Are all these numbers extremely high?

Now could the progesterone have gone down because because I give him the Melatonin?

I read the Lysodren does not help reduce the Estradiol.

So the most alarming number (I think???) is the Andensteroine (sp). So is this really worth to treat with Lysodren?

Now I give Riley 4.5 mg of Melatonin daily. I was giving him 6 mg daily but it was making him too tired. If I inched up to the 6 mg of Melatonin again and do it slowly do you think this will help the numbers go down without lysodren?

I have also read that a drug called Ketaconaziole (sp) is used to help reduce hormone levels and is safer than Lysodren. Has anyone tried this with success?

Does Ursodiol help lower hormones?

I have already written the above questions to my vet and also needed your advice.

I am getting mixed responses on Lysodren. Some have said to stay away from it that it's too dangerous and some have said it is essential. I am so confused.

I want to treat Riley. But I'm petrified of this drug. If it comes down to it and I have no other choice. I will do it. But I need to do more research and need more info from other people before I start. And the cost? I must find something!

Is there anyone out there that hasn't treated their dog with Lysodren?

The dogs on this list who are on Lysodren....do they normally or occasionally have any symptoms???? I'm not talking about crises. I'm talking about just from the pill, day to day stuff.

How many had Addisonian crises and what was your experience like?

The vet said she would put him on 40 mg 3 x a week. Is this a VERY LOW dose? Should I go lower?

Please keep the responses coming. I need all the advice I can get.

Thank you from the bottom of my heart.

Lisa

[frijole]

Lisa, If you know for sure that your dog has cushings then your vet must have sent the test out to the Univ of Tennessee at Knoxville and this test does more than just measure cortisol. Also on the bottom of the test results that come back from UTK are drug recommendations from Dr Oliver (at UTK). It would be helpful if you could get a copy of that test and any others done. You could then tell us what the expert is suggesting for dosing.

Normally if a dog has atypical cushings the lysodren dosage is much lower and so you don't treat the same way nor test as frequently.

We have had members before from Boston and I don't remember those ridiculous prices. I am hoping someone from Boston sees this and gives you a name to contact.

Whatever you do - if you buy lysodren don't buy it from that vet! You can get it way cheaper from drugstore.com or Costco.

Kim

[LisaNRiley]

Leslie (Squirt's mom),

Was wondering what you meant by saying that Squirt was off for two weeks on her dosing day of Lysodren. Can you explain that?

I don't want Riley to be off at all. I want him to act completely fine.

Lisa

[LisaNRiley]

Kim,

My vet did send it off to University of Tennessee as well as the one that was just done. I know on the first report it recommended flax lignans and melatonin. I don't know what this most recent once recommended.

I am also hoping for a name to contact.

My speciality vet said 40mg three times a week would be the initial maintenance dose.

Now about buying Lysodren...she said I would have to buy it at a special pharmacy because it needs to be compounded.

I wish she was willing to work with me about me going to another vet to run the test. She is not willing.

Lisa

[frijole]

Lisa, The reason you are paying so much is because they are doing the UTK panel (acth) and marking it up. It isn't a standard acth test.

My question to those who have dealt with an atypical dog - how often does she need to do the test? I don't remember it being very frequent.

Lisa - just an idea if costs continue to be an issue - you can get copies of all tests (which you should do anyway because you'll want to refer to them in the future) and if you want you can change vets.

How much does your dog weigh? Must be small if you are compounding. We have owners that have it compounded at reasonable prices so hopefully they will chime in.

When you are reading the 'lysodren horror stories' trust me you are reading about dogs who had vets that gave them too high of a dose OR owners who didn't pay attention to instructions. Any of the alternative drugs you mentioned can cause problems if instructions aren't followed.

Normally atypical dogs are given a dose that is so low that the dog could not get too much and have a reaction. I'm curious as to why the vet is recommending lysodren if Dr Oliver didn't recommend it.

Hang in there Lisa -we have lots of people here with atypical cush dogs. You will be just fine. You mentioned Ketaconaziole - I don't think its used for atypical cushings. It can be helpful for dogs with adrenal cushings. Not used much for pituitary cushings.

Kim

[addy]

Hi,

Me chiming in. When I asked what the maintenance dose is for a pup without loading, the information I got was 25 mgs per kg. 40mgs 3 times a week is 120 mgs. How much does your pup weigh? There are 2.2 kilograms in a pound. Example: dog weighs 10 pounds = 4.54 kgs x 25mgs=113.4 mgs of lysoden per week.

If you go to the University of Tenn website, they have the treatment option sheet listed for you to review for atypical.

If improvements take 4-6 months and you are only at 4 months, could you not try increasing melatonin, slowly, till you pup gets adjusted to it?

I understand your need for a cost effective approach. Regular water consumption is appx 1 ounce per pound. Is you pup drinking more than that? Sometimes it is also a matter of drinking more than what is normal for the dog but not excessive.

I don't believe you need to jump into additional treatment if you are not yet ready. You have time to figure it out and the treatment should be something you are comfortable with.

Hugs,
Addy

[LisaNRiley]

Addy,

Riley weights 10.8 pounds and the vet said his dose would be 40 mg three times a week.

I was thinking of increasing the melatonin slowly to 6 mg total a day too. The problem is I'm afraid that he'll get worse in the process. I guess from not being on Lysodren???

I guess my problem is him getting worse and me not treating him the "right way." I couldn't live with myself if I knew I could have done something and I didn't.

But then again is there harm in waiting another 4-6 months? Could he get so worse that it's too late to treat? That's what I'm nervous about.

He's definetely not drinking 10 ounces of water. Although I recently switched him from wet to dry and he's drinking A LOT more.

Lisa

[LisaNRiley]

Hi Kim,

Your post made me feel a little better about Lysodren though I don't know if I'm fully comfortable with it. Maybe I should print it and read it over and over again until my brain fully memorizes it.

I'm sure Dr. Oliver made a recommendation though I forgot to ask my vet what it was. When I speak to her on Monday I will ask her.

Lisa

[frijole]

Hi Kim,

Your post made me feel a little better about Lysodren though I don't know if I'm fully comfortable with it. Maybe I should print it and read it over and over again until my brain fully memorizes it.

I'm sure Dr. Oliver made a recommendation though I forgot to ask my vet what it was. When I speak to her on Monday I will ask her.

LisaPlease get a copy of the actual test results where Dr O makes the recommendations so you can see for yourself. It will show you what the options were and you can then see what he selected.

You asked valid questions regarding whether or not you should even treat yet and I'm hoping the atypical parents will chime in as they are more experienced than I am. I had a pituitary cush dog and I have another one that they can't decide if she's atypical or has a pheochromocytoma (adrenal tumor) that intermittently sends cushings symptoms... bizarre.

I just don't want you to fear lysodren. It'd be like a cancer patient fearing chemo. You have to look at it as the cure and not the demon. You are trying to get rid of the demon. And like a chemo drug, you need to respect it by simply following the time proven instructions on how to use it. But I admit I was afraid at first too.

There are alot of forums out there where people offer opinions but you have no idea how deep their knowledge is. When I first found this group I wasn't sure but they seriously saved my dog's life. I stuck around to help pay it back. That's what this group is all about. We aren't vets but unfortunately we have more experience than alot of them simply by the number of cases we see.

You are doing great just by trying to figure this out and ask questions. Keep it up. Kim

[Squirt's Mom]

Hi Lisa,

I am going to try to answer some of your questions. My replies are in blue:


Here are some questions that are on my mind.

These are the symptoms Riley is experiencing. He has been drinking more than usual but it's not even near excessive. I've talked to the doc about this. And he tires out easily and sleeps a lot. However, he has been doing this since he's a puppy. The sleeping a lot could possibly be boredom. If I get a new toy or take him for a walk he perks right up. I've also explained this to the doctor. That's about it.

As Addy said, normal water consumption is 1c per every 10 lbs or 1oz per lb - either is within normal range.

My second thing is only 3 hormones are high. The progesterone went down to 1.9. The Estradiol went up to 76 and the Andensteroine (sp) went to greater than 10. Are all these numbers extremely high?

Would you post the normal ranges for these values from your results sheet? I know what they are on Squirt's but it seems we have seen some variance lately so I want to be sure of the normal ranges before commenting if these values are "extremely high". As for the number of hormones that are out of range, that isn't the factor for treatment. Cortisol, estradiol and androstenedione are the ones that will cause the most signs and damage in the body.

Now could the progesterone have gone down because because I give him the Melatonin?

The mechanism of exactly how the melatonin and lignans work on these hormones is a bit complicated and not completely understood. What is known is that they work in unison. Just melatonin or just lignans won't have the same effect on the intermediates. Melatonin by itself does have the ability to lower cortisol just a tiny bit, tho.

I read the Lysodren does not help reduce the Estradiol.

Lyso does not always lower estradiol. This is where the melatonin and lignans come in.

Estradiol can be produced in areas of the body outside the adrenal like fatty tissues, hair follicles, to name a few. Lyso works only on the adrenals so if another part of the body is producing and releasing estradiol, the Lyso cannot reach it.

So the most alarming number (I think???) is the Andensteroine (sp). So is this really worth to treat with Lysodren?

Again, seeing the normal ranges for the andro and the estradiol will help answer this question. Squirt was treated for nearly 3 years with the melatonin and lignans only. Her values slowly lowered to normal range except for the andro and the progesterones on the last test. Her cortisol has also been creeping up. These values on her last test plus the fact that I was starting to see signs made me decide it was time to put her on maintenance. Squirt has NOT been displaying any signs until recently. If that signs had not appeared, she would probably have remained on just the melatonin and lignans. So you have to look at the whole picture - the numbers plus your baby.

Now I give Riley 4.5 mg of Melatonin daily. I was giving him 6 mg daily but it was making him too tired. If I inched up to the 6 mg of Melatonin again and do it slowly do you think this will help the numbers go down without lysodren?

It is possible. What kind of lignans are you giving him and how much each day? Squirt weighs 14lbs and she take 3 capsules of lignans that are 120mg each per day. This amount provides the correct dose of SDG which is what makes the lignans work for our Atypical babies. So, if Riley is not getting the full amount of either the melatonin or the SDG, then they have not been able to work on the intermediates as intended. So a bit more info here, too, please. Never ends, huh? ;)

I have also read that a drug called Ketaconaziole (sp) is used to help reduce hormone levels and is safer than Lysodren. Has anyone tried this with success?

Keto is sometimes used to treat true Cushing's in which cortisol is involved but not very often as it is extremely hard on the liver and most cush pups already have stressed livers. UTK does say that it can be used to treat the intermediates, but I don't recall anyone doing that here. Someone with a better memory than mine might, tho.

Does Ursodiol help lower hormones?

No. This is a med to treat liver problems.

I have already written the above questions to my and also needed your advice.

I am getting mixed responses on Lysodren. Some have said to stay away from it that it's too dangerous and some have said it is essential. I am so confused.

Lysodren is a life-saving drug and no more dangerous than aspirin when used properly. For pups with true Cushing's, involving elevated cortisol, the only real choice is to use a drug like Lyso. For Atypical pups, who have only elevated intermediates and normal cortisol, the first approach is usually melatonin and lignans for 4-6 mos. Then if the values are not controlled and the pup is showing signs, a maintenance dose of Lyso is added. So for us Atypical parents, we have more options and we look at Lyso a bit differently.


I want to treat Riley. But I'm petrified of this drug. If it comes down to it and I have no other choice. I will do it. But I need to do more research and need more info from other people before I start. And the cost? I must find something!

Until Riley has been on the correct dose of melatonin and lignans for several months and you see signs appearing or strengthening and his values continue to climb...I wouldn't worry about adding the Lyso immediately. From what you have said, Riley is not displaying the usual cush signs. I will provide you with a list of signs normally seen in cush pups at the end of this post so you know what to look for.

Is there anyone out there that hasn't treated their dog with Lysodren?

The dogs on this list who are on Lysodren....do they normally or occasionally have any symptoms???? I'm not talking about crises. I'm talking about just from the pill, day to day stuff.

How many had Addisonian crises and what was your experience like?

On a maintenance dose of Lyso, it is HIGHLY unlikely that we will see anything like an Addisonian episode, much less a crisis requiring pred, etc. The adrenals glands themselves have to be damaged in order for that to occur and a maintenance dose is so small it has very little chance of causing damage.

The vet said she would put him on 40 mg 3 x a week. Is this a VERY LOW dose? Should I go lower?

This works out to 120mg/week which is a good starting range - not too high, not too low. Just as with the melatonin and lignans, the dose has to be right in order to do it's job. I am not sure why she wants 3x a week dosing, tho there is nothing wrong with that schedule. But for cost purposes, it might be less expensive to get the pills (500mg) and give 2 doses/week of 125mg (1/4 tablet) VS a compounded amount to be give 3x/week. That would be worth looking into for sure.

Please keep the responses coming. I need all the advice I can get.

Thank you from the bottom of my heart.


Was wondering what you meant by saying that Squirt was off for two weeks on her dosing day of Lysodren. Can you explain that?

For the first two weeks on the day she got her Lyso, she would have an upset tummy, usually at nite. The first time I gave it to her, I forgot that it can cause this kind of upset and didn't give her anything for it. She got quite nauseated but didn't vomit...just gagged. Since then, she gets 1/2 of a Tagamet about 30 min. prior to her meal. She has always been prone to some indigestion at nite and it would be a bit worse on those days. She was also apt to sleep more and be less interested in things, like going outside just for the heck of it or playing. This Wed. started her third week on maintenance and she acted no differently than she has on any other day. No upset at all, wants to go out and nose around, and playful. She is also much more involved this week. More so than she has been in a while, in fact, so I think the Lsyo is helping her. I had to go get parts this morning and when she heard the keys rattling, she got up and started dancing to go for a ride and she hasn't done that in ages without expressly being asked if she wanted to go. Today she was demanding to go! :D

I hope this helps. Keep asking questions and keep reading. You are doing a GREAT job!

Hugs,
Leslie and the girls - always


***The info on cush signs from Kate Connick:

http://www.kateconnick.com/library/cushingsdisease.html

The most common symptoms include:
• increased/excessive water consumption (polydipsia)
• increased/excessive urination (polyuria)
• urinary accidents in previously housetrained dogs
• increased/excessive appetite (polyphagia)
• appearance of food stealing/guarding, begging, trash dumping, etc.
• sagging, bloated, pot-bellied appearance
• weight gain or its appearance, due to fat redistribution
• loss of muscle mass, giving the appearance of weight loss
• bony, skull-like appearance of head
• exercise intolerance, lethargy, general or hind-leg weakness
• new reluctance to jump on furniture or people
• excess panting, seeking cool surfaces to rest on
• symmetrically thinning hair or baldness (alopecia) on torso
• other coat changes like dullness, dryness
• slow regrowth of hair after clipping
• thin, wrinkled, fragile, and/or darkly pigmented skin
• easily damaged/bruised skin that heals slowly
• hard, calcified lumps in the skin (calcinosis cutis)
• susceptibility to infections (especially skin and urinary)
• diabetes, pancreatitis, seizures

[happydogs]

Hello Lisa,

So sorry you have to go through this with Riley. The others here are much more knowledgeable about managing Cushings dogs on Lysodren and have given you great information. I just wanted to say, though, that my dog was initially started with Lysodren and did great on it through the loading phase and then for the first few weeks of maintenance.

Then the problems started. Basically he ended up with very severe liver problems (his bile acids test results were MUCH worse than Riley's, and his ALK were around 2000). We will never know what caused it but we were told by our internist/IMS that we weren't to give Lysodren to a sick dog. So we stopped.

Perhaps you could ask your vet if Lysodren is the best therapy for a dog with potential liver issues like Riley.

If it's any consolation (although probably not!) we also paid close to $400 for an ACTH stim test. Cushings is a very expensive disease to treat.

Hope you find the answers you need for Riley. Sorry I can't help more...

Angela

[LisaNRiley]

Hi Leslie,

Thanks for responding.

I don't have the actual sheet in front of me. I didn't get one but will ask the vet to mail it to me.

As for flax lignans...He gets the NSI Flaxseed Lignans. It says on the bottle 40 mg and it's standardized at 20 percent SDG. I was giving him 1 capsule and a 1/4 but have increased it to 1 capsule and a 1/2 a couple days ago.

His Melatonin is from Nature Made that I get at Walgreens.

Lisa

[LisaNRiley]

Hello all,

I hope you are not getting sick of me yet. I compiled a list of questions today about Lysodren. So I thought I'd post them to see what you guys have to say. I'm going to ask these questions to the doctor too on Monday. I apologize that this is so long but I have a ton of questions. I also apologize in advance if these questions are repeated or sound stupid:

The vet said she wanted Riley on 40 mg 3 times a week. If this dose proves too low could I still keep him on this dose without going up? Would it still be effective?

It seems from the majority of people that have emailed me that every dog with Cushings has some sort of side effect (not crises). This scares me. Do you know of any dog with absolutely no side effects? I thought side effects are rare with a maintenance low dose?

Because Riley's dose needs to be compounded, does anyone know of inexpensive specialty pharmacies?

I was given Riley 3 mg of Melatonin daily. I was giving him 6 mg of Melatonin for a few days but he was too tired. If I wait three more months and try again to inch up to 6 mg of Melatonin do you think this would help? Would I hurt him if I waited three more months for the Lysodren to wait and see if the 6mg of Melatonin works?

He also just started Ursodiol. Would this lower is Alk. Phosphatase?

Does each ACTH Stim test we test to see if the Lysodren is too much or too little...does this always go to University of Tennessee?

Riley is a very stressful dog. He gets stressed with cars and people walking by the house. He also doesn't like strangers and will bark and bark until they leave. Would this affect his corisol while on the Lysodren since if the cortisol is too low he won't be able to handle stress?

If he does have a reaction to the Lysodren at what time would this reaction take place? For instance, if I give this to him at 9 am when would he get a reaction if he were to get one?

How long does Lysodren last in the body? Hours? Days?

Would I need to give him Pepcid before he takes the Lysodren? What about having Prednisone nearby?

Okay, these are all the questions I have right now.

Whew!

Thank you,
Lisa

Moderator's Note: Lisa, I have merged your latest post into Riley's original thread. We, normally, like to keep all posts for a pup in a single thread so it makes it easier for other members to refer back to the pup's history, if needed.

[StarDeb55]

Lisa, my responses are in blue.


It seems from the majority of people that have emailed me that every dog with Cushings has some sort of side effect (not crises). This scares me. Do you know of any dog with absolutely no side effects? I thought side effects are rare with a maintenance low dose?
Any medication, human or animal, if used improperly, runs the risk of causing side effects. Neither of the 2 medications commonly used to treat Cushing's, lysodren or trilostane, are side effect free, especially if they are used against standard protocols. The chances of any side effect with a lysodren maintenance are extremely small, since the dose is so low. This low dose wouldn't actively be eroding any of the adrenal cortex.


Does each ACTH Stim test we test to see if the Lysodren is too much or too little...does this always go to University of Tennessee?
Normally, no. If your vet is only wanting to monitor the cortisol level, a simple ACTH test can be done at the local vet lab that does your vet's regular labwork. If your vet wishes to monitor the levels of any of the associated hormones, then this would have to be done by the UTK. IMO, I would not think it would be necessary to run a UTK panel as frequently, if you are only monitoring intermediate hormones, but you would need to discuss testing frequency with your vet. You might e-mail Dr. Oliver at the Univ. of Tenn. & ask him what his suggestion would be for monitoring a lysodren maintenance dose when used to control the associated hormones. Dr. O is the expert. He is, also, one of the most caring individuals as he is prompt in responding to e-mails from concerned owners. He is very willing to consult with attending vets when there are questions.



Riley is a very stressful dog. He gets stressed with cars and people walking by the house. He also doesn't like strangers and will bark and bark until they leave. Would this affect his corisol while on the Lysodren since if the cortisol is too low he won't be able to handle stress?
Probably not. The maintenance dose is probably not going to affect the cortisol levels all that much, since the adrenal cortex isn't being actively eroded. The concern for a cushpup is that during times of major stress, such as acute illness, injury, or surgery, they may not have sufficient cortisol to handle an acute situation.


If he does have a reaction to the Lysodren at what time would this reaction take place? For instance, if I give this to him at 9 am when would he get a reaction if he were to get one? How long does Lysodren last in the body? Hours? Days?
I'll answer these 2 together. Lysodren stays in the system about 48 hours. If there is going to be a problem, the cortisol will drop too low on the 2nd day after a dose is given. You would have plenty of time to pick up on a problem, & act on Riley's behalf.


What about having Prednisone nearby?
With maintenance dosing, having pred immediately available is probably not a necessity. IMO, when using lysodren, no matter what the dose, I would insist on having pred immediately available, in case of emergency, simply for my own piece of mind, if nothing else.

I know I haven't answered all your questions, but the ones I skipped are because I have no personal experience with using the medications you asked about.

Debbie

[addy]

Hi Lisa,


40 mgs 3 x per week =120 mgs.

Riley weighs 10.8 pound=4.9kgs=25 mg per kg=122.5 maintenance dose if you use 25mgs per pound. So your vet is under the dose a tiny bit.

My Zoe has high intermediates and high cortisol. She was diagnosed the end of May 2010. She also has colitis and her symptoms were minor, mainly hair/coat. We were waiting to treat until symptoms were stronger. and to see if her colitis could stay controlled. It did not and her symptoms are stronger.

I worried too that if I waited would she get some terrible disease. I came to the conclusion that there are no guarantees in anything and you can't beat yourself up about it. Complications could arise if you don't treat yet or if you do. All drugs have side effects. We don't know how our pups will do on a drug and what if any side effects they may have. You do the best you can and don't look back.

No one can tell you that nothing will happen if you wait another few months because no one can predict that. Reasonably thinking, it would seem you could wait but that has to be your decision along with your vet. Don't talk your self into symptoms but don't talk yourself out of them either.

I was so worried that Zoe's hind leg weakness was from diabetes because it worsened so suddenly. Now, I think perhaps it was from her metronidazole. Of course I won't know it was not her cortisol until I get her adrenal panel back. Point is- we deal with symptoms we don't always know the cause. But since I cut back on her metronidazole, she is walking better.:confused:

I am so sorry you are in this position but I think you should have time to read and discuss and not jump in to Lysodren. But I can't guarantee it.

Some members have used Diamond back in AZ but hopefuly some others members will be along to give other suggestions. I was looking at compounding also so if I see something, I'll let you know too.:)

Leslie gave you good input. Deb too. Their knowledge always amazes me:)

Hugs,
Addy

[LisaNRiley]

Okay... I may have come to a temporary decision. I say temporary because I keep changing my mind every few hours. However, I've been thinking about this for awahile.

So Riley has not been on the usual dosage of Melatonin. He was on 3mg daily for 4 months. Because of the recent testing, we moved him to 6mg total. After two days, he was sleeping too much so we cut back.

Since then I have been slowly moving him up to 6 mg daily. Right now we are on 3 mg at night and a little over 1.5 mg in the morning.

Is it reasonable that once I have him on the 6 mg daily to wait 3-4 months and retest all his blood work, bile acids, and ACTH Test? If it is still high after 3-4 months then I would definetely start the Lysodren?

I know nothing is a guarantee and no one has the answers but I would like to hear what you think even if you disagree with me.

Do you think I will be harming him if I wait another 3-4 months? His Alk doubled from 320 to 628 in four months. Though not terribly high do you think I have 3-4 months to wait?

His Andesteroine (sp) doubled from 5 to greater than 10, Estradiol went from the 6s to the 7s, and his progesterone went down?

His bile acids increased also. His pre was always 8 and now it's 15. Post has always been in the 30s and now it's 79. Was started on Ursodiol.

Given all this information, Do you think (I know no one really knows) but do you think he's okay to wait 3-4 months to see if the full dose of Melatonin helps him? Or am I just prolonging the inevitable? Like I said if everything is the same or higher in 3-4 months I would definetely start the Lysodren.

Please offer your opinions.

Thanks,
Lisa

[Squirt's Mom]

Hi Lisa,

Since Riley does not have elevated cortisol and only has elevated intermediates, then yes, his ATCH will always go to UTK as they are the only lab that can test the intermediate levels.

Riley should be on 2 full capsules of lignans and 6 mg of melatonin daily in order to treat his intermediates. Until he has been on these dosages for 4-6 months, then it is not possible to say at this point Riley really needs to be on Lyso. So if I were you, I would let the Lyso ride for now and get him on the correct dose of lignans and melatonin FIRST. If after a few months, his levels have not started coming down, OR they are continuing to rise AND he is showing signs then think about adding the Lyso.

Again, without the normal ranges for the values you post, we cannot know how high or how low they are so please provide the normal ranges when posting a value you are questioning. That will help us help you. ;)

So this is my advise:

1) get Riley on 3mg BID melatonin
2) get Riley on 2 capsule of lignans SID
3) wait 4-6 months to see how his values do on the correct doses
4) stop stressing over Lyso - you have time to learn about it while you wait to see how he does on the right treatment doses

Keep your chin up!
Hugs,
Leslie and the girls - always

[addy]

Hey, I second that, Leslie!!!!!!;) I would do same thing:D

Hope that helps, Lisa
Hugs,
Addy

[Squirt's Mom]

Hi Lisa,

So for right now we are going to forget about the Lyso, right? You can relax on that front - you DO have time before you need to think about adding it to the mix.

Ok, sweetie, I need you to help us now. So take a seat, stop thinking and worrying just a minute and please, please try to give us some more information on Riley. We really do want to help ya'll but some things just aren't adding up and hopefully that is because we don't have enough info yet.

* Would you please post both UTK panels that Riley has had done. List all the info provided with the results so it looks something like this example-


Baseline and normal ranges:

Cortisol ng/ml 78.6* (2.1-58.8)
Androstenedione ng/ml 1.5* (0.05-0.57)

Post ACTH:

Cortisol ng/ml 121.6 (65.0-174.6)
Androstenedione ng/ml 2.16 (0.27-3.97)

* Can you tell us what signs Riley is displaying?

* Can you please post the bile acid tests results with normal values included?

* Does your vet feel that the elevated ALKP is a result of the bile acids?

* Did your vet discuss aspiration to do the biopsy of his liver? It is not as invasive and well worth discussing.

If you will answer these questions, that will help us a great deal!

Thanks!
Hugs,
Leslie and the girls - always

[LisaNRiley]

Okay guys,

One, I think the decision to do the 3mg of Melatonin BID and the 2 caps of flaxseed lignans and wait 4-6 months makes me feel more comfortable. If his results are still the same or worse then I will go with the Lysodren.

This makes me feel better knowing I have a plan. However, I feel horrible that I haven't been giving Riley the right dosage. I never really got help with the lignans because my vet wasn't sure. Another list told me how much to give. I was giving 1 pill and a 1/4. I will now give two. About the Melatonin, I will definetely inch up to the 6mg a day. I just feel that I was the cause of all the elevated numbers because I wasn't giving him the right dose. And I also hope he doesn't get even more elevated by me waiting.

I don't have the results sheet. I never asked for a copy. I will call on Monday and ask them.

I know for sure that the Alk Phosphatase shouldn't be above 131. I know this because I remember my vet saying this a million times to me. His has usually been between 200-325 and the most recent showed 628.

She did tell me that his cortisol is normal.

She did mention liver biopsy. I don't want to put him through that. Plus I just can't afford it. I think she said he'd need to stay overnight or something. I just can't do it.

He did have an ultrasound and it showed a benign, healthy liver except for it being slightly enlarged.

So if I start on the 6 mg of Melatonin and the 2 caps of lignans, about what month should I check? Does 4 months sound reasonable?

Thanks,
Lisa

[LisaNRiley]

Signs Riley is displaying: he is only displaying an increase in thirst but it is definetely not excessive because I have measured the water and reported it to my vet.

Like I said I don't have all the info on his tests. I will call Monday.

I know his pre bile acid was 8 and now it's 15.9 His post bile acids have been in the 30s and now they are 79.

He has just been started on Ursodiol to see if Alk Phos and bile acids go down.

Lisa

[LisaNRiley]

Leslie,

I was wondering how you came up with two caps a day? I would like to know how to do this.

The only other sign I can think Riley has is he sleeps a lot. This I think can also be due to boredom. If I get a new toy or go for a walk or go out to the store he perks right up.

My other concern is how do I get over the guilt of not giving him the right dosages for about 6 months. Do you think I made him worse?

That's about it for now.

Lisa

[Squirt's Mom]

Hi Lisa,

Thanks for the reply and we can wait til you get copies of the test results from your vet to go over them. One of our members is a lab tech and she helps us a great deal in interpreting all those values.

No, sweetie, I do not think you have made him worse by not quite having the doses right. You have been doing the best you can with what you knew and that is all any of us can ever do. So many parents would have simply let nature take its course when they got the diagnosis. So, no, you have not harmed him and he is lucky to have you as his mom.

The lignan dose is arrived at by first seeing to what standard the lignans have been prepared to - in the case of NSI they are standardized to 20%. That means that each 40mg capsule contains 20% of SDG. So there are only 8mg of SDG in each 40mg capsule. UTK says that our pups need 1mg of SDG per each lb of body weight. Because there is no way to divide the capsule content and determine exactly how many mg of SDG are in the divisions, the amounts are rounded up to the next full capsule. So at 10.8 lbs, Riley needs 10.8mg of SDG/day which rounds up to 2 capsules. He would be getting a total of 16mg of SDG per day. SDG has shown no toxicity so the excess is not an issue.

Now, I have one more favor to ask. For the rest of the weekend, shut your computer off and do some things that are fun and relaxing for you. Forget about Cushing's, about Lyso, about us, about everything but what puts a smile on your face and a song in your heart. You have been stressing over all of this for weeks now but you have a plan now so it's time to take a breather. ;) Mon. you will be able to contact your vet about copies of Riley's testing and we can start fresh there. But for now, you deserve a rest and some fun. Go to a movie, go shopping with a friend, or out to dinner then come home and snuggle with Riley while you read a good book. Anything as long as it has no connection to Cushing's. ;)

Hugs,
Leslie and the girls - always

[frijole]

:D I agree with Leslie. Time for a break. It is so much brain damage and we have all been thru it. You are doing great. You have a plan. That alk phos number is not very high. Alot of cush dogs are at 2000+. It can fluctuate due to things besides cushings so... I agree with Leslie - relax and go hug your furry friend. We'll be here when you need us next. Kim

[addy]

Chiming in because if you are like me I know you are peeking at this instead of taking a break:D

I third the plan and this advice is coming from a known obsessive worrier - ME::rolleyes:

I like this plan and Leslie is exactly right about the lignans and not dividing up the capsule which I did not know at first either:o All capsules have filler in them so when you try to divide a capsule, you don't know how much actual "medicine" verses filler you are giving and according to Dr. Oliver you can hope they get the right amount after a couple of days, but the lignans don't really work that way so not optimal.

Amazing how much we learn.:)

Take a break, play with Riley or go to the movies. Put Cushings in the drawer and do not take it back out until Monday is really good advice. You have a plan.

Hugs,

Addy

[apollo6]

Welcome
Like everyone said try take a break over the weekend. This is a very complex disease. My Apollo has the pituitary gland cushing and is on Trilostane. We are hear to help
Hugs Sonja and Apollo

[LisaNRiley]

I tell you...my mind never rests. I worry incessantly over my dog. Maybe because he's all I have. I have Cystic Fibrosis and I don't get out much. I have a ton of treatments I have to do so I'm always home. Riley's my best friend.

I had a little worrying episode earlier. I worried that by me posting his test results someone would recommend a different plan of treatment for him. Then my mind started racing again. I hope I can stick to the plan of waiting 4 months to start Lysodren even when I post his numbers.

I had one question. I know I said Riley was not excessively drinking and he's not. He's 10.8 pounds and drinks less than a cupmof water a day. With a lot of activity he will drink a cup but day to day he usually drinks under a cup. He also eats canned food. Is this normal? I don't think it's excessive????

Well, anyway I just want thank everyone for the support given on here. It is very much appreciated.

My mind is running away from me on thoughts of Riley's condition so I'm going to lie down, relax, and take a few Tylenol. I'm getting a migraine.

Lisa

[LisaNRiley]

I wanted everyone to get another idea on his drinking. Riley drinks anywhere from 6-8 times a day depending on the day. When I measure how much he drinks it's always between 1/2 - 1 ounce. Like I said he eats wet food. Hill's prescription z/d ultra. He has a ton of allergies.

Okay I'm off for the night unless I peek and see something bad.

Lisa

[frijole]

:D:D:D

Laughing because my dog never drank much either and I did what you did posting details and they finally said "Kim when we are talking excessive drinking we are talking buckets and buckets". So no need to watch the drinking unless you notice a change. Cush dogs tend to drink gobs. Mine never did though. Consider yourself lucky because they pee in the house after drinking all that. ;) Now go back to that tv set! Kim

[LisaNRiley]

Hey all,

I called the vet to get his test results. I wrote them on a piece of paper and placed it on the couch to run and get the phone. By the time I came back, Riley ate half of his test results!!! LOL!!! I haven't laughed for quite some time.

Anyway, I called the vet AGAIN and we were both in a rush. She didn't give me all the test results but I will post what I have.

Alk Phosphatase 620 - Normal up to 131

Andestroine (sp)
Pre 1.46
Post > 10
(Normal is less than 0.36)

Estradiol
Pre 76
Post Normal
(Normal is less than 55)

The Progesterone was 1.9. That's all I know.
I don't know if it's pre or post.

Bile acids
pre 15.1
Post 79
His pre was always normal and post used to be in the 30s.

Anyway, I did have all the results but Riley ate them :p
He's been very fresh today. He even got my father's sneaker and took out the sole and ate it!!! I love it when he's fresh though!

I told the vet my current plan and she said it sounded very reasonable. I'm not 100 percent comfortable. I don't think I'll ever be but I'm okay with this plan for now...unless he becomes worse.

I was going to ask when should I test again once I give him the 6 mg of Melatonin???? Does anyone know? Does 3 months sound reasonable???? I'm slowly inching him up.

I am so hoping not to see or contact the vet for 3 months.

Whenever I do his tests again I will get the normal values while I'm there so I can post everything to the list when I get the results.

I just want to stay far away from them as long as I can.

Lisa

[LisaNRiley]

I added two pictures in my Albums of Riley for you all to view. Hope you like them.

Lisa

[frijole]

Thanks. I was laughing so hard at the facial expressions in the coat and the sweater photos. It was like "all of this just so I can go pee?" I know that look firsthand. :D The one on the rug with the head tilted is my absolute favorite. Kim

[addy]

I love the photos but my favorites are Riley ready for winter;)

I will have a smile on my face all day. Thanks for sharing them. I cracked up when Riley ate the test results.:D

Addy

P.S. I have read retest in six months but you could retest in four. Three might be alittle soon. You have to let Riley have some say in it. See how he is acting, new symptoms, no symptoms, etc.

[Squirt's Mom]

Hi Lisa,

Hope you had a restful weekend! ;) Thanks for getting the info!

Those pics are GREAT! I loved 'em all! Riley is such a handsome fellow. :) When I read about him eating his test results, I howled with laughter! :p:p: "My dog ate my homework, Teach! No really, he did!" LOL :p:p

As for testing the intermediates....I would wait at least 3 months, probably more like 4-5 even. UNLESS you see Riley developing more signs...then he would need to be tested asap. I, too, am on disability and know how difficult it is to make ends meet. My meds cost more than I get each month and the most expensive ones are not covered so I do understand. With Atypical, testing isn't quite as pressing as it is with true Cushing's. For one thing, we don't have to load our babies and minutely erode the glands that true cush pups need; for another, it just takes time for the melatonin and lignans to work. So start putting your pennies back today and get him tested 3-5 months after he has been on the full doses of melatonin and lignans. Just remember that the signs are KEY to the testing.

You sound better this morning so I hope that means you have found some peace with Riley's diagnosis and treatment plan. I also hope that means you have found a family here that you are comfortable with. I am certainly glad to have ya'll with us! :)

Keep up the good work! and HIDE the homework from now on! LOL

Hugs,
Leslie and the girls

[LisaNRiley]

Glad everyone liked the pictures!

So I guess I'll wait 3-6 months depending on him. That's what everyone seems to say.

I just hope he doesn't get any new symptoms. I would like to stay away from the vet for awhile.

What new symptoms should I watch out for? Excessive drinking? Excessive urinating? Hair loss? All the Cushing's symptoms?

I'm getting nervous just thinking about. I'll stop here.

Lisa

[LisaNRiley]

I give Riley pepcid because he has a lot of acid. I was wondering if I could give this with his Melatonin or do I have to space out the Melatonin?

I also wanted to say that I am so glad I am here. Someone from a another list gave me this link and I'm so glad she did. Thank you!

I would like to think of you all as my new family.

Lisa

[jrepac]

Great pictures! Very cute outfit on Riley!

and, he ATE the test results?? that is just hysterical...:D

the stuff our fur babies do sometimes! the other day, I went into the kitchen and my new puppy was having a ball with the paper towels...they were on a dispenser on the kitchen island and the roll happened to be low enough for my little bugger to reach...and well, you can imagine how that turned out! ;)

Seriously tho', just keep an eye on him in terms of eating, drinking, sleeping patterns. Plus, fur and skin quality as well. It will become clear to you if/when he exhibits symptoms actively.

Best wishes!

Jeff, Angel Mandy & Puppy Pebbles

[frijole]

Lisa, do you give Pepcid or PepcidAC? Thanks

[addy]

Hi Lisa,

Leslie's list of symptoms for you:


The most common symptoms include:
• increased/excessive water consumption (polydipsia)
• increased/excessive urination (polyuria)
• urinary accidents in previously housetrained dogs
• increased/excessive appetite (polyphagia)
• appearance of food stealing/guarding, begging, trash dumping, etc.
• sagging, bloated, pot-bellied appearance
• weight gain or its appearance, due to fat redistribution
• loss of muscle mass, giving the appearance of weight loss
• bony, skull-like appearance of head
• exercise intolerance, lethargy, general or hind-leg weakness
• new reluctance to jump on furniture or people
• excess panting, seeking cool surfaces to rest on
• symmetrically thinning hair or baldness (alopecia) on torso
• other coat changes like dullness, dryness
• slow regrowth of hair after clipping
• thin, wrinkled, fragile, and/or darkly pigmented skin
• easily damaged/bruised skin that heals slowly
• hard, calcified lumps in the skin (calcinosis cutis)
• susceptibility to infections (especially skin and urinary)
• diabetes, pancreatitis, seizures __________________

I think Kim is checking on the Pepcid for you.

I bought the 1mg melatonin and took Zoe up slowly to 3 mgs BID. I think in the beginning it might of made her sick to her tummy as one day I gave her her morning dose and then we went for a car ride and she threw up. She never throws up. But since she has been on it awhile she has adjusted. I just never take her in the car right after her dose, I wait an hour at least.

Have a great day!!!

Hugs,
Addy

[LisaNRiley]

Riley gets pepcid AC original strength

Thanks,
Lisa

[LisaNRiley]

Thanks for the list of symptoms. You guys are such a great help.

Lisa

[LisaNRiley]

I was wondering what hind-leg weakness was?

Riley is always slipping and sliding on the hardwood floor. He just started doing this. He doesn't do this on the rugs though. Just thought hardwood floors are more slippery than rugs. Am I just being paranoid?

Lisa

[Squirt's Mom]

Hi Lisa,

"Hind leg weakness" typically will show up as a reluctance to jump on the couch or bed, or in the car, or other things they used to leap up on or into. On walks, they will walk more slowly, tire more easily and want to stop much sooner than before. Some will have a bit of leg trembles after exercise. As the Cushing's progresses, they will refuse exercise and the pup will start to lose control over the back legs - they will simply give out on them. The reluctance to jump and changes on walks are usually the first things noted, tho.

Squirt has had both her knees done - the right one was re-done this past summer because a pin had come out. Since her first knee surgery, I have been cautious about letting her run on floors that are not carpeted because of the risk of damaging those joints. Since her surgery in July, I have put down non-skid rugs all in the camper because it is not carpeted anywhere and I don't want her to hurt herself. Also, cush pups are prone to ligament damage in their legs - the ACL and cruciate ligaments in particular. So you might want to take precautions on the hardwood floor areas for Riley's sake....and your pocketbooks! :eek::)

Hugs,
Leslie and the girls - always

[LisaNRiley]

Anyone have a remedy for paranoia???? :p

Hi Leslie,

Thanks for the response. Riley jumps a lot and I always worry because he has luxating patellas (Grade 1-2 as of right now). He's had this since a pup. I can't be with him 24/7 and follow him around every single time he jumps!!! Ugh!!! He loves to jump! I sure try to catch him before he jumps when I can.

I have another dog, a cocker spaniel who has a ligament torn. He was recommended surgery but was put on a pain pill and three days after he was fine. Go figure!

They are both on Cosequin DS. It's such a lifesaver for both dogs.

Sorry for the paranoia!! I'm not as crazy as I seem!!! LOL! :p

Lisa

[Squirt's Mom]

LOL Around here we call it "twitching"! :p Trust me, my twitcher has gotten stuck more times than I care to remember! :D For at least a year after Squirt was first diagnosed, every time I noticed something as simple as a new hair, I FREAKED! "OMG! What does THAT mean?!?!" :p She got to where she hated to see me coming 'cause she just knew I was gonna poke and prod and snoop all over her!

Hugs,
Leslie and the girls - always

[frijole]

Riley gets pepcid AC original strength

Thanks,
Lisa

Perfect, thanks. Not all Pepcid is created equally. :D:)

[addy]

Hi Lisa,

Just stopping in to say hi and hope you and Riley are having a good day.

How is he adjusting to the melatonin? He is so darn cute!!!!!:D

Keep the "twitcher" off. It is so hard to do!!!!!!

Hugs,
Addy

[apollo6]

Dear Lisa
Welcome and thank you for the comments on my Apollo. Your Riley is a cutie. You are not paranoid at all. We are all going through the same with this awful disease. We are hear to encourage , support and help in anyway possible.
Hugs Sonja and Apollo

[lulusmom]

Hi Lisa,

I've been following your thread but have just now had the time to really go back and let everything you've posted sink in. So now I'm ready to give you my uncensored and totally unsolicited comments. :D

I'll start by saying that of all the posts you've made, the most informative one is this one:


Signs Riley is displaying: he is only displaying an increase in thirst but it is definetely not excessive because I have measured the water and reported it to my vet.

Like I said I don't have all the info on his tests. I will call Monday.

I know his pre bile acid was 8 and now it's 15.9 His post bile acids have been in the 30s and now they are 79.

He has just been started on Ursodiol to see if Alk Phos and bile acids go down.

Based on this information, I am going to assume that your vet recommended a UTK adrenal panel, not because of the the usual symptoms that drive an atypical diagnosis because Riley doesn't have any symptoms, but rather he wanted to find the cause for elevated Alkp liver enzyme and high bile acids. Is that correct? A good number of dogs with cushing's do have high bile acids but from everything I've read and lectures I've listened to, a post meal of 79 is a bit too high to be attributed solely to cushing's and other causes should be investigated. Of course it is always possible that because Riley is a Maltese, his bile acids are normally high to some degree and that the elevated intermediates are causing higher bile acids but I'm not so sure that's what is happening.

For purposes of diagnosis, atypical is no different than typical cushing's in that symptoms are a huge component of the diagnosis. Riley doesn't have any symptoms so I'm not sure why he was diagnosed with atypical cushing's or why he is being treated for atypical. Drugs used for atypical and typical cushing's do not cure the disease, they control the symptoms. With no symptoms, how do you know if they are effective? It is well known that perfectly healthy dogs can have elevated intermediates with absolutely no ill effects so in my not so expert opinion, if you or your vet have no idea whether those mildly elevated intermediates are causing the blood abnormalities, I think that paying to have adrenal panels run every 3 to 6 months to see if melatonin and lignins have reduced the intermediates is a big waste of your money. By the way, melatonin and lignans are not highly effective....I believe the efficacy rate is something like 40% to 50%. I personally would never give Lysodren to an asymptomatic dog without a really, really good reason and neither should you. That's not because I fear the drug, it's simply because it's not necessary and not cheap.

You said that Riley seemed to drink a bit more but not really in excess. Dogs with cushing's drink to keep up with the frequent urination so if Riley isn't also peeing a lot more than usual, I'm pretty sure you can rule out the only possible symptom he had. That is unless your vet did a urinalysis and found that his urine was dilute and urine specific gravity was low. Did your vet do a urinalysis?

It really saddens me that you have been beside yourself with fear and frustrations over the possibility of having to treat with Lysodren and the worry of having to spend money on additional adrenal panels. In my opinion, there is nothing for you to worry about until Riley tells you to start worrying. By telling you I mean showing symptoms that are the norm for atypical. Skin issues, loss of hair, brittle hair, change in skin pigmentation and overt polyuria/polydipsia (excessive drinking and peeing).

I hate to say "in my opinion" again but I have a lot of opinions and I'm not afraid to share them. :D So, in my opinion, I think the best plan is to put atypical cushing's on the back burner and rule out other causes of the elevated Alkp such as gall bladder or liver disease. To my knowledge atypical cushing's has never killed a dog but liver and gall bladder disease can. If it were me, I'd talk to the vet about putting Riley on liver support in addition to continuing the Ursodiol. If The Alkp and bile acids have improved when you do a recheck in a month or so, I think you can safely assume that atypical is not an issue for Riley. If bile acids are higher, you may want to consider spending the money for a liver biopsy to rule out steroid hepatopathy.

Sorry for the length of this post but if you ask anybody that knows me, they'll tell you that I don't know the meaning of brevity. :D

Glynda

[LisaNRiley]

Hi Lisa,

Just stopping in to say hi and hope you and Riley are having a good day.

How is he adjusting to the melatonin?

Keep the "twitcher" off. It is so hard to do!!!!!!

Hugs,
Addy

Hi Addy,

I am slowly increasing the Melatonin. I think he's up to 5 mg now. I'll wait a few more days and put him up to the 6 mg. He doesn't seem sleepy. Today he wanted to go out and play in the snow. He ate so much snow he came in shaking like a life and as soon as he warmed up in the house he wanted to go back out! Go figure!

Lisa

Thanks for asking about Riley.

[LisaNRiley]

Dear Lisa
Welcome and thank you for the comments on my Apollo. Your Riley is a cutie. You are not paranoid at all. We are all going through the same with this awful disease. We are hear to encourage , support and help in anyway possible.
Hugs Sonja and Apollo

Thanks Sonja! I love this board so much. You guys are so welcoming and supportive.

Lisa

[LisaNRiley]

LuLu's mom,

Thanks so much for your comments. So glad you wrote.

First off, I had no idea some dogs normally have increased hormones. Is this a normal occurrence?

Riley is on liver support. He's on Denosyl and Marin. He takes Denosyl on an empty stomach (or at least I try) and then an hour late he eats. He takes Marin after he eats. We just started him on the Ursodiol.

When all of this first started, there was a question about him having MVD (Microvascular Dysplasia) since it's common in toy dogs.

I did opt out of the biopsy. I was told a biopsy or even an ultrasound guided biopsy may or may not tell if there was liver disease present. If they don't take the sample out of the liver that is diseased then it may be negative even if he may still have liver disease.

My vet did recommend (the internist) that she does this invasive liver procedure where they make two incisions and go in the liver and biopsy that way. I don't remember what it all entails but I do remember she said he'd have to spend a night there. She said this ways was the more accurate.

I opted out of the biopsy because I didn't want to put him through that and I just can't afford the cost.

So as I go back to the previous paragraph, the MVD was initially suspected. She didn't want to put him on a liver friendly diet because he had no symptoms.

Also, during some time taking bile acids (he had this done about 4 times) one time his bile acids were high, then normal, then high again. She said with MVD bile acids would never return to normal. And it wasn't likely he'd have MVD and it wasn't ruled out. She said only a biopsy would tell if there was MVD but even if Riley did have MVD she wouldn't necessarily change anything. She said no matter what's wrong with his liver we are doing everything possible and with a biopsy she probably wouldn't change anything anyway regardless of diagnosis so that is why I opted out of biopsy.

The vet also said that when a dog has MVD more than one of the liver enzymes are elevated like the AST or the ALT not just the ALKP. So this again pointed to more unlikely of MVD.

When Riley was tested negative for typical Cushings, she wanted to try the adrenal panel just to rule it out. We weren't even thinking his hormones would be high. She just wanted to rule it out.

Riley does not urinate a lot at all. It's funny! I actually have to go outside with him and prod him to urinate. He can go 12 hours without urinating, sometimes 14 hours. This dog doesn't urinatate. I get frustrated because I think he'll end up with a UTI.

I got kind of nervous when you wrote that bile acids post 79 are too high for it to be related to Cushings. But yes, he is a Maltese and Maltese are known to have really weird bile acids. Still this concerns me.

The vet doesn't think Riley needs a low protein diet yet. He has a ton of allergies so finding a low protein diet is hard and she knows it.

Thanks again for chiming in.

Lisa

[LisaNRiley]

Hi Glynda,

The vet did not do a urinalysis.

We did an ultrasound of his liver. It showed a healthy liver except for it being slightly enlarged, which the internist said is typical with cushings.

The gallbladder is healthy and normal.

Lisa

[LisaNRiley]

Does anyone else want to chime in about post bile acids of 79 being to high to be solely cushings?

I'm starting to get paranoid.

Lisa

[addy]

I would if I could but I don't know anything about it. Don't get worried, Lisa.

Breathe in, breathe out when you get paranoid, It works;)

Hugs,
Addy

[apollo6]

Dear Lisa
You sound like so many of us. First off get a copy of all the lab work done the ultrasound report to look at yourself. Post what the readings say for the medical tech wiz's on our forum. And don't be afraid to ask your vet what all the readings mean.
Also a correct ultrasound would have been of the abdominal area-kidney, liver, pancreas, adrenal glands,etc. If your baby has Cushing many of these organs would be somewhat enlarged and if it is the pituatory form of Cashing both adrenal glands would be enlarged similarly. Also I am not sure if you did a urinalysis. I agree about any invasive procedure. Sometime Vets start fishing around when they are unsure. Listen to your gut feeling and when you get overwhelmed take a break and don't make a decision until you feel confident about it. So breath. The hind leg weakness could be from muscle wasting due to overproduction of cortisone. First you need to differentiate which cushing it is before you even jump at any treatment option and when you know you don't have to make a decision right a way. It took me a long time to do so.
Hugs Sonja and Apollo

[LisaNRiley]

Hi Sonjia,

Thanks for your reply. The ultrasound that Riley did checked everything. It was an abdominal ultrasound that checked liver, gallbladder, kidneys, adrenals...Everything was normal and healthy.

It only said that the liver looked benign but slightly enlarged.

I'm not rushing into treatment at the moment.

Everything is just very overwhelming. I worry about my dog incessantly. I don't want anyone to think I'm crazy or too paranoid though.

So glad I'm here though.....so glad!

Lisa

[Franklin'sMum]

Hi Lisa,

My little boy Franklin (also a maltese) is on Ursidiol because he has gall bladder sludge. the sludge is not hard, but mushy and moveable when his IMS checks with the ultrasound, so the idea is to disolve it before it solidifies and causes a blockage.

From reading about MVD ages ago, doesn't it say that it's usually a problem and diagnosed within the first couple of years of the pup's life? Or am I confusing the condition with liver shunt?

Oh, before I forget, I think the reason that we see varying 'normal's on the hormone panel is due to the age and sex (and neutered/spayed status) of the pup.

Jane, Franklin and Angel Bailey xxx

[LisaNRiley]

I was wondering if anyone knows if I can give Riley pepcid AC with Melatonin or do I space it out and how much time do I space it out for? I thought someone was supposed to get back to me.

Lisa

[Squirt's Mom]

Hi Lisa,

In checking the interactions for melatonin on Drug Digest, I do not see where Pepcid AC should be a problem. However, things like Pepcid, Tagamet, etc. are usually taken before a meal. So if you give Riley his melatonin and lignans with his meals, you might want to try giving the Pepcid AC about 30 min. prior with a little peanut butter or cream cheese. That way it has time to work before food or the supplements hit his tummy.

Hope this helps!
Leslie and the girls - always

http://www.drugdigest.org/wps/portal/!ut/p/c1/dY1bDoIwFETXwgruBQzUz0JUykPEIiI_BIUQBAshSJXVqwtw5u 8kcwYy-FYUc1MXU9OLooMUMiPXcYe4s9kJt0xHRpyA-PT4pSqcfwsjxz-hCHunf1Rwgcz86yEaJKIfH7-_uakkxJDiKuf39xDG_OUtdf30bmPA19Vh2eh7zhd3IXOAsvRcX qRZeBXGqbQ7Zm2aduK2ZpHOZEGeSH-lSlqbdJtGigJDK6SMqPIBfKk6-Q!!/dl2/d1/L0lDU0dZcHBpZ3BSQ2dwUkNncFJBL29Ob2dBRUlZSWdHRUFJUk FNSWhSaEVBd2dGT1FZRGdwQ2tyQ0FZUUxSdEdWcXpyT1ZZQSEv NEEwYWNVWEpNbTRvZVNaTHhSOGt5ZmlnRUEhIS83XzMwRzAwR0 NJVTBGSTMwSThITThMQVIzMDgyL2hlcmJzL2R2aG5hbWUvTWVs YXRvbmluL2R2aGlkLzQwNjAvbWV0aG9kL2ludGVyYWN0aW9ucw !!/

[maish costello]

awh Leslie...you are right on !!!...I sure do like you....I realize your message was for another lady but I sure benefited tooo..............you ppl are awesome...ty :)

[LisaNRiley]

Hey all,

You haven't heard from me because I was in the hospital for two weeks. I went in because I had a kidney infection and had a partial blockage from an 8 mm kidney stone. I had two surgeries and was also treated for my Cystic Fibrosis and just came home yesterday.

Needless to say, my mom was taking care of Riley. I was supposed to up his dose to 6 mg. He was so close to taking 6mg anyway. I was giving him 3 mg at night and in the morning I was giving him 1.5 mg plus half of 1.5 mg (.75) plus a half of a half of 1.5 mg (.375). So as you can see I was inching him up very slowly. I hope this all makes sense. All in all he was getting like 5.6 mg a day give or take.

Anyway, my mother gave him the entire 3mg pill in the morning while I was in the hospital and she said he slept almost the whole day until the pill wore off. She didn't feel comfortable giving the pill and told me to do it when I came home.

So I started this morning. I was wondering if he would be sleepy for a couple of days until his body gets used to the pill???? He was already so close to taking 6 mg a day though so him sleeping all day on the entire 3mg in the morning is confusing to me.

I'm sort of kicking myself here because this was two weeks ago and I should have told my mother to just give him the pill in the morning this way he has at least two weeks in his system already, you know? Now I have to wait 4 months from this day to get all his blood work done, which would be June to see if the pill worked.

I'm afraid that when June comes his blood work will be even higher (if the melatonin didn't work) and I will be blaming myself for not bringing him in sooner. I have such worries over this...that it's my fault. But I was told to wait at least 4 months until the full dose of Melatonin kicks in.

Just a nervous parent...any words of wisdom?

Thanks,
Lisa

[Squirt's Mom]

Hi Lisa,

You came to mind last nite so I am glad to see you posting tho I am very sorry to hear about the troubles you have had. :eek::( I hope the hospital stay didn't set you back too much and that you are soon back to full strength.

Squirt has had periods of being really sleepy on the melatonin but as time passed that occurred less and less. For us, there is a difference in her being sleepy from the melatonin and her sleeping when she has not been on it - without the melatonin, she would start sleeping in her hiding spots, under furniture and such, which told me she didn't feel well. With the melatonin, she will sleep by my side if she is so inclined but she never hides and sleeps. And, no, the melatonin doesn't make her so sleepy she just passes out where ever she is. :p

She did sleep more when she first started the melatonin than she does now; we started with the full 6mg/day. I think Riley will adjust, too.

Good to hear from you! Take care of yourself, ok?

Hugs,
Leslie and the girls - always

[addy]

Hi Lisa,

Sorry to hear you were in the hospital and I hope you are okay.

Don't worry about the melatonin, Zoe was sleepy too and she adjusted. Sometimes she still gets tired from it when she has an off day. In the beginning, she slept a lot.

Riley will adjust, you are still giving the lignans right?

Hugs,
Addy

[LisaNRiley]

Yes, I'm still giving the lignans...two caps each.

I'm just kicking myself and feeling guilty that I didn't give him the 3mg morning dose while I was in the hospital. My mother was nervous about it but I should have done it so he'd be used to it by now.

Plus the vet said she didn't want to wait 6 months to recheck Riley. This was in December. I just started the full dose of Melatonin today so if I wait four months from now it will be June. But December to June is 6 months. Then if his blood tests are worse in June I will blame it on myself that I didn't bring him in sooner. But I want to give it a full 4 months to see if it will work. I'm really stressing over this.

Lisa

[addy]

Honey you can only do the best you can and do not blame yourself if things don't work out because it won't be your fault.

I was supposed to retest Zoe in early November but she had a terrible colitis flare and we ended up not retesting until January. Sometimes, things just go the way they go.

Waiting two extra months should be okay, would rather you gave medicine a chance to work then test too early unless your vet is concerned about something else.

What reason did your vet give for not wanting to wait? I have to tell you, I started with an impatient vet, she scared me half to death about Zoe. Well, we are still here and Zoe's hair did not "ALL FALL OUT" and we working on things at our speed not hers.

Whether that is good or not in the big picture, I can't say, but it is what feels right to me and I am not looking back and questioning the path we chose no matter how it turns out. What will be, will be.

You just went through a alot. I am giving you permission to just start the melatonin full dose:D:D Today I am on a "giving ourselves permission" kick. I think we need to do it more. We expect us to be superwomen and it is okay if we are not.:)

Try not to worry, sweetie, it will be okay.

Hugs,
Addy

[Harley PoMMom]

I have an e-mail from Dr. Oliver in which he states to me that I shouldn't re-do the panel before 6 months.

Hoping you are feeling better.

Love and hugs,
Lori

[LisaNRiley]

Okay guys I need your help again.

I just can't seem to stop worrying about this dog. I'm a worrier in general, as if you couldn't tell already, and just worry incessantly over Riley.

So every time he goes to his water bowl my heart skips a beat. I don't know why this is. Before the cushings he never used to drink. Then he started drinking maybe 4 times a day. Now it's about 6-8 times a day. He never drinks a lot, it's usually .5 to 1 ounce when he drinks.

I guess maybe today was an off day for him. I had day surgery and wasn't home but my mother told me when I came home that he went to his water bowl a lot. As of now I think he went to his water bowl like 10 times BUT he doesn't drink a lot. He's still drinking that .5 to 1 ounce of water.

Could it just be him? Could he just be wetting his palette? Could he be a habit drinker? Don't dogs with Cushings drink tons and tons and tons? Should I be worried about this?

I don't want to take him to the vets again. I really can't afford the money and wanted to wait a good 4 months for the melatonin and flaxseed lignans to kick in. That would be until the first couple weeks of June.

Can someone please help me stop worrying!!!! I'm really driving myself crazy over this. I'm measuring and looking at the water everytime to make sure it's not excessive. I'm going nuts! :eek:

Lisa

I'm worrying myself sick here.

[lulusmom]

Dear Lisa,

STOP WORRYING! There! Did that work? :D:D:D

I have a cushdog with diabetes insipidus which means he will never concentrate his urine. He drinks voluminous amounts of water and pees lakes about every half hour. If drinking and peeing was gonna kill a dog, my Jojo would be a goner. The reason cushdogs drink too much is because they are peeing too much and they need to keep hydrated. So forget about how much water Riley is drinking and tell us how much he's peeing. Is he peeing a lot more than usual? Is he asking to go out a lot more? Is he having accidents in the house? Is his pee clear like water? If the answer to all those question is no then STOP WORRYING AND DRIVING YOURSELF NUTS!

Hugs,
Glynda

[Harley PoMMom]

9 - 10 ounces of water a day is normal for Riley to be drinking for his weight.

Sending big hugs!!! ;):)

[addy]

Stop worrying:) Maybe the melatonin is making his mouth dry or something. Could be:D

A dog drinks on average about one ounce per pound.

I used to do the same thing. I think I even posted whenever Zoe would go get a drink I would throw my hands in the air and say "Oh no, she is DRINKING WATER":eek: My hubby would reply "So what? Can't she get a drink?":rolleyes:



Like Glynda said, worry about if he starts peeing more and it is clear.

Hugs,
Addy

[LisaNRiley]

Hey all,

What a comfort this board is! Sometimes I just need reassurance! His urine is dark to light yellow....darker in the morning when he first gets up but then medium to light yellow. I haven't been home much today to see his urine but on average he doesn't urinate excessively. I would say 6-8 times a day and sometimes I even have to urge him to urinate because he can go like 14 hours without urinating. But on a day to day basis it's like 6-8 times. He doesn't usually urinate in the house. Sometimes he has accidents but I don't think they though are I think he just wants to be fresh and wants attention and he'll lift his leg up and pee somewhere. This has been since he's a puppy so it's nothing new and it happens every once in awhile.

I just need A LOT of reassurance!!!

Thanks,
Lisa

[LisaNRiley]

Was wondering if sweet potatoes are good for dog's with liver disease and Cushings? Just bought Riley new cookies with sweet potatoes in them?

Lisa

[jrepac]

It's pretty normal for Cushpups to drink water several times throughout the day and pee a lot. I'd be worried if the pee was both clear and excessive in quantity, and maybe if he was draining the entire water bowl. It does not sound like that is the case :)

I'm not aware of sweet potatoes being problematic in any way; I used to give them to my dog...naturally, if diabetes is a concern, I'd shy away from them. Maybe some of the others will weigh in on this.

Jeff & Angel Mandy

[LisaNRiley]

Hi everyone,

I have a couple questions. I have been noticing Riley going to his water bowl more. He isn't excessively drinking or nearly emptying the bowl. He goes to it and takes a few laps. I just been noticing he's been doing it more...his usual is about 6-8 times a day and he's been drinking 8-10 times a day, more so 8-9. Again it's nothing excessive just a few laps every time he goes to the bowl. He doesn't seem to make much of a dent in his water bowl. His urine is still yellow.

I was thinking a couple of things here:

1. I started feeding him dry food at the end of December. I saw him drinking a lot so I cut back to just one time a day. This was in mid January. He only gets a little snack of it at 7 pm. I was wondering if this could be causing it. He seems to be drinking more in the morning between 9am - 12 pm. Riley doesn't usually drink in the middle of the night and mostly sleeps through the night without drinking or urinating. Sometimes he wakes me up so he can do his business and he'll take a little lap of water...but he doesn't do this every night.

2. Someone here said Melatonin may be making his mouth dry. Does anyone give their dog melatonin and see them drink more? I was giving him 5 mg before and he was drinking his usual 6 times a day so I'm wondering if 1 mg more would make a huge difference.

I really can't take him to the vet until his 4 month follow-up which is late May or early June. He just had the ACTH testing last month. He is acting fine otherwise..no other symptoms. He's playing, barking, eating fine and seems very lively.

Lisa

[addy]

Hi Lisa,

It has been my experience that dry food will make a dog drink more water than if the dog is fed a wet food as the canned food has a lot of water in it. When my Koko was on kibble, he went to the water bowl frequently. He is on a wet food now and the difference is night and day.

Usually the little dogs do better fed twice a day. If he is receiving most of his dry food in one meal, you most likely have your answer as to why he is going to the water bowl more often.

Why did you switch to dry food? What was he previously eating?

I do not know for sure that melatonin makes a dog's mouth dry which is why I said "could be" with a smiley face. I just did not want you to worry.

Hugs,
Addy

[LisaNRiley]

Hi Addy,

I was afraid someone was going to post that I needed to take him to the vet right away so I am freaking out a little.

Okay I only feed him dry around 7 pm. I seem him go to his bowl more frequently between 9am and 12 p.m. and also from 1p.m.-2pm. But like I said before..it's not excessive.

I switched to dry and was giving him that and saw he was drinking too much and just gave it to him once a day at 7 p.m.

I was just wondering if this was due to the dry, especially in the morning from 9-12.

I gave him dry to try something new. But I think he likes the wet and now I'm paranoid every time he goes to the water bowl that I just stopped it -- the dry. I was hoping it wasn't due to his cushings.

[addy]

I feed both my dogs twice a day. If that would work for you maybe you could try feeding him his canned food twice a day and see if you see a change. Is he on any new medication other than the melatonin that could make him thirsty? Any new supplement? Is he urinating more?

I know it is hard and we worry every thing we see is Cushings. I am learning that I can't blame everything on Zoe's Cushings. We had the panting issue which turned out to be from a lamp. Now I am wondering about some of her leg weakness may be from her colitis or metronidazole. My point is, let's explore other reasons before we freak out. Zoe was licking her potty after peeing I thought she had a UTI. I took her for tests and she did not. Now that it is winter, she is not licking her potty. I wonder when Spring comes and the grass is green and wet with dew if she will again lick.

I ask again, is he peeing more?

How is he doing on the melatonin?

Hugs,
Addy

[LisaNRiley]

Hi Addy,

He is not peeing any more than usual. And not meds. He seems to be doing well on the 6 mg of Melatonin a day. He gets tired every now and then but is quite lively and playful.

I am going to stop the dry food and see if I see a change and go from there. I really hope it's the dry food.

Riley licks himself all the time. This could be due to allergies too.

Lisa

[lulusmom]

Hi Lisa,

I'm sorry to see that you are still worrying yourself sick about Riley's water intake. The last time I asked, Riley was not peeing more than usual and his pee was still concentrated. Has that changed? I think we've already mentioned that dogs with cushing's drink more because they pee more and need to drink to stay hydrated. If you want to know for sure if cushing's is causing Riley to drink more, take him to the vet and have him check the urine specific gravity.

Glynda

[LisaNRiley]

Hey Glynda,

Thanks for responding. His urine is still concentrated.

Lisa

[lulusmom]

Well then STOP WORRYING! :D:p:D

[addy]

Lisa, are you sure you are not my long lost sister? I swear we are related, we are so much alike;):D

I just love the sweaters Riley has. I bought Zoe a sweater for Spring from a shop on Etsy called Fifime. Have you ever been on Etsy? Well, let me tell you girl, Fifime has about 250 sweaters on line to look at and they are all hand made to your dogs measurements. The sweaters are beautifully made. You should go look. :D

Shopping, even if it is window shopping is a wonderful distraction!!!!

Hugs,
Addy

[frijole]

Well then STOP WORRYING! :D:p:D


:D:D:DWHAT SHE SAID!!!:D:D:D

Kim

[LisaNRiley]

Hey Addy,

If worrying is your middle name then we must be long lost sisters. LOL!

I will check out the store you told me about. I need a distraction!

Lisa

[LisaNRiley]

Hello all,

Riley is on Ursodiol and I'm doing bile acid testing tomorrow. My vet said nothing about stopping the Ursodiol but I just read on the internet that I should stop using Ursodiol three days before doing bile acid testing. I can't call my vet because they are closed. Anyone know anything about this?

Lisa

Moderator's Note: Lisa, I have merged your new thread concerning Riley's bile acid testing into Riley's original thread. We, normally, like to keep all post on a pup limited to a single thread. This way it's easier for other members to refer back to the pup's history, if needed.

[Squirt's Mom]

Hi Lisa,

I don't know the answer to your question but I think I would check with my vet before I took him in today just to make sure.

Hugs,
Leslie and the gang

[LisaNRiley]

Hi Everyone,

I haven't been on this board in awhile. Riley, my 6 year old Maltese, has atypical cushings. His weight ranges to about 10-11 pounds. I get him Vitacost's NSI Flax Seed Lignans, 40 mg, 120 capsules, standardized at 20 percent. He takes two pills everyday.

When I called Vitacost to order more, they said they have discontinued this and now have Flax seed Lignan Extract same amount of capsules, doses the same, and standardized the same. Is this as good as the one as I used before for Riley? As effective? And would I give him the same doses of 2 pills daily?

Thanks,
Lisa

I have merged your post about lignans with Riley's original thread. We like to keep all info about each pup in one place. That way it is easier to keep up with, and look back at, the history for Riley.

[Squirt's Mom]

Hi Lisa,

In doing a bit of research, it looks like NSI may have discontinued this in favor of an oil product. I couldn't find anything under a search for "flax seed lignans" or "flax seed" but under "flax lignan" I found the oil. http://www.gonsi.com/search.cfm

Flax oils are not the best for our cush pups since they are prone to pancreatitis so if the oil is all that NSI is going to offer from now on, I think we need to find a new source! NSI is what we have been using for years so hopefully if others are using another product they are happy with, they will be along to share. And I will be searching and will pass on what I find, too.

Thanks for the heads up!

Hugs,
Leslie and the gang

[Squirt's Mom]

Ok...here's two that are worth considering...


http://www.vitacost.com/productResults.aspx?ss=1&x=5&y=21&ntk=products&Ntt=Source%20Naturals%20Lignan%20extract

http://www.iherb.com/Source-Naturals-Lignan-Extract-70-mg-60-Capsules/4536?at=0

[Squirt's Mom]

Here is a link to companies that use LinumLife lignans, which is what is in the NSI we have been using -

http://www.linumlife.com/consumer-products-p3729-en.html

[LisaNRiley]

Just found this on the UTK website. I'm getting so confused with the numbers and mg and the math.

1.Vitacost (www.vitacost.com/NSIflaxseedlignans). Low SDG flax hull lignan product. Each capsule contains 8 mg of SDG lignan. A LinumLifeTM product.
2. Vital Nutrients (www.vitalnutrients.net). Each capsule contains 78 mg of SDG lignan.
3. Barlean’s (www.brevail.com). The SDG flax hull lignan product is called BrevailTM. Each capsule contains 50 mg of lignan. Available in most health food stores.
4. Kordial Nutrients (www.kordialnutrients.com). A 5.3 ounce container of SDG flax hull lignan product. Each 5 grams contains 215 mg of SDG lignan. Standard-sized teaspoons hold 5 grams. One-half teaspoonful would be approximately 100 mg of SDG lignan.
5. Heartland Natural (www.heartlandnatural.com). Capsules/Powder. 90 Capsules per container. 33 mg of SDG flax hull lignan per capsule. 5.3 ounce concentrated SDG flax hull lignan powder. 6 grams of this product contains 223 mg of SDG lignan. One standard-sized teaspoonful contains 5 grams, or approximately 185 mg of SDG flax hull lignan. One-half teaspoonful would contain 93 mg of SDG flax hull lignan.
6. Badmonkey Botanicals (www.badmonkeybotanicals.com). SDG flax hull lignan concentrate that uses the LinumLifeTM extract. Each container contains 200 grams of product. One gram of product contains 50 mg of SDG flax hull lignan. One standard-sized teaspoonful contains 5 grams, or 250 mg of SDG lignan. One-half teaspoonful would contain 125 mg of SDG lignan.HMR Lignan Product Sources. (Lignan content can be determined). 1. www.hmrlignan.com). Click on the BUY NOW TAB for a listing of companies that sell HMR lignan (e.g.
Swanson’s; Life-Tree; drdavidwilliams).
2. Swanson Vitamins (www.swansonvitamins.com). 7-HMR lignan. 60 capsules per container. 40 mg per capsule of HMR lignan. Be sure to read the write-up on HMR lignan on this web page.
3. The above products can give different dosing levels depending on the number of capsules used, but total doses of 10 to 40 mg daily should be adequate for small to large dogs.
Further Notes:

Lignan. Lignan has phytoestrogenic activity, and competes with estradiol for tissue estrogen
receptors, with less biological effect. Lignan also inhibits aromatase enzyme (lowers estradiol) and 3- beta HSD enzyme (lowers cortisol). Use either FLAX HULL (SDG) lignan, or HMR lignan. See LIGNAN at our website under TREATMENT for details. DO NOT USE flax seed oil as the lignan content is very low, and the flax oil can increase triglycerides. SOURCES OF APPROPRIATE PRODUCTS are listed at the website. Lignans are safe, so doses don’t have to be exact. Suggested doses: SDG lignan; one milligram/lb B. Wt./day. HMR lignan; 10-40 mg/day for small to large dogs.

[LisaNRiley]

This is the stuff they are replacing with the NSI:

http://www.vitacost.com/Vitacost-Flax-Seed-Lignan-Extract/?ntt=nsi%203002498

[LisaNRiley]

With the above link I just posted...is it okay to use that?

[Squirt's Mom]

Here is a link to UTK's site where the Treatment Option sheet can be opened...unless one is using MY computer! :mad: It was revised in July 2011 and this may be why. If you would, please, look and see if they are recommending anything new for the lignans now that may be where we find our answer.

http://www.vet.utk.edu/diagnostic/endocrinology/treatment.php

Thanks! I think another trip to the Geek Hospital is soon in order for this @)#)#(%#) laptop of mine. :rolleyes:

************************************************** ************

oops! You were posting as I was asking!

[Squirt's Mom]

That one looks fine to me. The only difference I can see is the Kosher capsule with NSI - tho I have no idea what that means.

[LisaNRiley]

Are you going to switch Squirt to that? I just called Vitacost and gave them the Item # for NSI one and the new one on the link I just posted came up on the same Item number.

If I use this would I give Riley the same dosage as before? He is 10.6 pounds and I was giving him 2 pills a day.

[Squirt's Mom]

The thing that is important in the lignans is the amount of SDG. SDG is what does the work on the hormones we are trying to control. If a product says it is 40 mg, like the NSI, but standardized to 20%, then only 20% of that 40 mg is actually SDG.

UTK broke out the SDG in mg so we didn't have to do the math. Those SDG mg are what we need to know in order to know how many capsules/pills/spoons/dips to give.

Since the VitaCost brand you found has 40mg standardized at 20%, you would give the same number of caps as you did with the NSI.

Hope that helps!

[LisaNRiley]

Vital Nutrients (www.vitalnutrients.net). Each capsule contains 78 mg of SDG lignan.

Swanson Vitamins (www.swansonvitamins.com). 7-HMR lignan. 60 capsules per container. 40 mg per capsule of HMR lignan. Be sure to read the write-up on HMR lignan on this web page.

If I chose to do one of these two can someone please figure out how many capsules I give him? I have been doing this for an hour and I have no clue how to do this.

Riley ranges from 10-10.8 pounds

[LisaNRiley]

Is the 20 percent a good amount or is it too low? Should I use something stronger?

[LisaNRiley]

sorry for all the questions

[Squirt's Mom]

The percent amount doesn't matter. What matters is how many mg of lignans the percent means when determining the dose. If you were giving 2 NSI capsules then you were giving 16mg of SDG. (20% of 40 = 8, so each capsule contains 8mg of SDG) Unless it specifically states how many mg of SDG are in each capsule, we have to figure that based on the percentage of standardization. If NSI were standardized at 10%, then each capsule would contain 4mg of SDG.

You want to give Riley as close to 16mg a day, just like you have been, with the new lignan so the one from Vital is much too high for him at 70 mg of SDG. I think the HMR lignans are pure SDG (not standardized) so at 40mg/capsule, you are getting 40mg of SDG.

[Squirt's Mom]

Heavens, don't apologize! :) It takes me forever to understand things sometimes....and then they change and I'm lost again! We are learning together, which is the best way to go. Never hesitate to ask, and ask, and ask til you understand....I sure don't! :p

[LisaNRiley]

My goodness, I really don't understand all this. I was never any good with math and numbers...Consider myself to have a learning disability in math.

If you were me what would you give Riley? You have more experience than me and I have no idea how to calculate all this stuff. Would you put him on the new lignan extract from vitacost with the same dose of pills?

What are you going to give Squirt?

[addy]

Hi Lisa,

i just wanted to stop by and say hi:D How is Riley and how are you?

When I had to take Zoe off the Vitacost lignans i switched her to Heartland Powder Flax Naturally concentrated lignans. She received 1/8 teaspoon of powder per day. Previously she took 2 capsules of the Vitacost. I had to switch because of the fiber in the Vitacost. It bothered her.

The HML lignans are from a spruce tree so they are a different type of lignan.

Hugs,
Addy

P.S. I looked at the new Vitacost product and it is standardized 20% and has the same 8mgs of SDG lignans as the old product so you should be able to use it.

[Squirt's Mom]

LOL What I understand about the math was hammered into me over about a 3 day discussion a few years back. :o:p

The VitaCost brand should work just fine and you would give Riley the same number of capsules - two - of it as you did the NSI. Both brands contain the same amount of SDG per capsule.

[LisaNRiley]

Hi Addy,

I am doing okay and so is Riley. He's 6 years old now. We have him on the 6 mg of Melatonin a day, flaxseed lignans, Denosyl, Marin, and Ursodiol. His Alk Phos went from 600s to the 400s so I am very happy about that.

The cost of all the meds was killing me. I am on disability and I do not work so I am just doing blood work for liver enzymes every six months. If they are worse or his symptoms are worse then we will do bile acids and the ACTH panel.

I got scared when they discontinued the vitacost brand. I hate changing him and deciding how much to give and the calculations and such.

How are you and your little one doing?

[LisaNRiley]

Squirt's mom, thank you for all your help. It is so much appreciated!

[addy]

Hi Lisa,

We are doing well, thanks for asking. I started Zoe on Trilostane a few months ago. It has been a slow road, tinkering with doses so we don't bother her colitis but we are making progress.

I know what you mean about having to re figure a medicine or supplement when something changes.:):) and boy, I sure understand the vet bills sure can get high. Zoe has had 4 stims in 2 months and we are looking at 2 more this month:eek::eek:

Hang in there and it sounds like you are doing a really good job with Riley. Good to hear your update and have a chance to gab with you.:):)

You will have to update Riley's album. I love all his photos with his pretty sweaters.

Hugs,
Addy

[LisaNRiley]

Hi Addy,

That's a lot of tests for Zoe. It has to be done though. I am not looking forward to that when I have to go down that road for Riley.

I will update his album next weekend. I have some great pictures to add.

Thinking of Zoe and praying the Trilostane is at the right dose.

Lisa

[Squirt's Mom]

(Moderator Note - Lisa, I apologize but I goofed up in trying to merge your post with Riley's thread. So now it shows up as a post from me and not you. :o

This is a post from Lisa, Riley's mom.)

Hey everyone,

I haven't posted in awhile. Just a recap -- Riley has atypical cushings. He's on Marin, Ursodiol, Melatonin, and Flaxseed lignans. I took Riley to the vet yesterday for blood work. His alk phosphatase is really up there. Last time it was in the 400s. This time it's in the 900s. His ALT, AST, and all other liver enzymes are normal. Lysodren, right now is not an option for me. I am scared of giving it to him and plus he is not showing any new symptoms except drinking a little more than usual but not excessive. He's 11 pounds and he drinks about 8 ounces of water a day. I'm wondering if because of his Alk Phos level does this mean he is getting worse? I know his level will always be high but I was just wondering if there are dogs with very high Alk Phos that are okay? Also is there any other pill I can give him (besides Lysodren) that will help him? Has anyone heard of Ketacondizole (sp)? for their atypical cushing dogs?

Thanks,
Lisa

[Cyn719]

Hi lisa

Just saw your thread...never posted with you before.....but we are neighbors .... I am in Rhode Island. For a reg ACTH test you pay 400 still? Where do you go?? Just curious about the prices.

Sending you and Riley love and hugs:) xo

[LisaNRiley]

Hi,

I go to Mass Vet Referral in Woburn for his ACTH Stim Tests. They are $400 there and at his regular vet they are $500.

Lisa

[k9diabetes]

Have they arranged to set aside the stim agent so it can be used for the next test?

With small dogs, I know you can save some money by having the stim agent stored for you and used for multiple tests - it is a big part of the expense. I believe somewhere here at the forum, perhaps in the Resources section - there is a protocol for doing that.

Natalie

[k9diabetes]

Here is Dr. Peterson's blog entry on how this is done.

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

Natalie

[Harley PoMMom]

If this were me, before starting any medicines for Cushing's I would have an ACTH stimulation test done to confirm elevated cortisol.

If high cortisol is confirmed then Ketoconazole would not be my first choice because Ketoconazole is hard on a dog's liver. Vetoryl/Trilostane or Lysodren/Mitotane would be my first picks. Please do not be afraid of Lysodren/Mitotane, it can be a life-saving drug for our cush-pups as long as the protocols are followed.

The ALP is not liver specific as the ALT, so an elevated ALP would not concern me much.

Love and hugs,
Lori

[LisaNRiley]

Hi Lori,

He had a ACTH Stim test...many in the past and his cortisol is normal but his sex hormones are elevated.

Lisa

[labblab]

Lisa, are you having the full UTK adrenal panel performed with each ACTH test? From what you wrote above, I'm assuming that's the case. And I know that also contributes to a higher cost than what would be charged for an ACTH test of cortisol alone.

Marianne

[LisaNRiley]

Hi, Thanks for responding. So here's the present full story. The last time I tested his blood work (june 2011) when he just started Ursodiol his Alk. Phos was in the 400s. We tested his blood work yesterday....just a regular wellness blood work and everything was normal except the Alk Phos which was in the 900s. His ALT and AST and all other liver blood work was normal.

I have not done an ACTH test on him since last year or a bile acid test since last year. I cannot really afford either PLUS if we are not going to start any new treatment then I say why bother to pay this much and then just get nervous. His last ACTH test showed his sex hormones were up. Bile acids are always all over the place.

I'm just nervous about the the jump in the Alk Phos. from 400s to 900s. I'm giving him 70 mg of Ursodiol a day, marin, Melatonin, Denosyl, and Flax Lignans.

I am petrified of Lysodren. I've read more bad stories than good. I feel like why should I give it to him if he's only slightly drinking more than usual (not exessive) and seems more hungry than usual? I read not to give Lysodren unless the dog had symptoms that was interefereing with his life. I don't have the money for Lysodren and testing him to see what dose was right for him unless ABSOLUTELY necessary. Do you think slightly drinking more than usual and hungry more than usual and alk phos in the 900s is abosolutely necessary?
Is there something else I could give him beside the Lysodren that is not "potent" or "could be dangerous." ?

Does an Alk Phos in the 900s with not many symptoms mean is Atypical Cushings is getting worse?

Sorry for all the questions. Just sooo sooo sooo confused.

Lisa

[LisaNRiley]

Other things I wanted to address. Currently Riley is 11.5 pounds. He's gained a little more weight probably because it's winter and I haven't been exercising him. He drinks 8 ounces, sometimes less, a day. Is this considered excessive?

Should I try Flax Hulls instead of Flax Lignans from Vita Cost?

The Melatonin I give him (6 mg total a day) is from Nature Made at my local pharmacy. Should I try the Melatonin at Vitacost?

He's 11.5 pounds. He takes 70 mg of Ursodiol. When my doctor first got him on Ursodiol he was 9 1bs. Should he take more mg of Ursodiol since his weight went from 9 to 11.5 lbs.?

Do all dogs get side effects on Lysdren? I'm not talking crises I'm talking just regular side effects? Could I put my dog on Lysodren and he have no side effects at all? FYI: He's very sensitive to meds.

Again, sorry for the questions. Please bare with me. Just worried about my dog.

Lisa

[Harley PoMMom]

Hi Lisa,

I responded to your questions in blue!


Other things I wanted to address. Currently Riley is 11.5 pounds. He's gained a little more weight probably because it's winter and I haven't been exercising him. He drinks 8 ounces, sometimes less, a day. Is this considered excessive?

On the average, a healthy dog drinks about 1 ounce of water per pound of body weight per day. So I believe Riley's water consumption would be considered normal.


Should I try Flax Hulls instead of Flax Lignans from Vita Cost?

The ingredient to look for is the amount of the SDG - this is what is in the lignans that works with the melatonin.

The Melatonin I give him (6 mg total a day) is from Nature Made at my local pharmacy. Should I try the Melatonin at Vitacost?

As long as the melatonin is the regular kind, not the fast-acting or rapid-releasing kind.

He's 11.5 pounds. He takes 70 mg of Ursodiol. When my doctor first got him on Ursodiol he was 9 1bs. Should he take more mg of Ursodiol since his weight went from 9 to 11.5 lbs.?

Found this info:
The recommended dosage of ursodiol is usually 5 to 15mg/kg per day. Some vets recommend splitting this total dosage into two smaller doses and giving the medication twice a day. A 15 lb. dog weighs about 7kg, so the dosage recommendation would be 35 to 105mg per day, which puts the current dose in the middle of the range, which is usually a good place to be. It might help to split the dosage although we have always used ursodiol once daily in our practice so I don't actually have any experience to suggest that is the case. http://www.vetinfo.com/deffect.html Scroll to Ursodiol side effects


Do all dogs get side effects on Lysdren? I'm not talking crises I'm talking just regular side effects? Could I put my dog on Lysodren and he have no side effects at all? FYI: He's very sensitive to meds.

Lysodren is known for gastric upset so many members give Pepcid AC. Many dogs do well on Lysodren without any adverse side effects.

Again, sorry for the questions. Please bare with me. Just worried about my dog.

We are always here for you and do understand the love and concern you have for Riley...please ask any and all questions. ;):)

Lisa

Hope this helps.

Love and hugs,
Lori

[Cyn719]

I don't know if you have other things done with the ACTH but it cost me $200 at Ocean State in East Greenwich.....wow $400-$500 is a lot!

Hugs to you and your little baby!! Xo

[LisaNRiley]

My dog has atypical cushings and just developed a slipped disc in his back. He only has a high alk phos of 938. He needs an anti-inflammatory. Is there one that is safe?

Also is Prednisone an option to give to him if it's every other day? I read there is a pill that can lessen the effects of Prednisone.

Any opinions?

I've merged your question into Riley's thread so we can keep all information in one place.

[Harley PoMMom]

Since Riley doesn't have elevated cortisol, I believe a NSAID would help him. The only NSAID I would NOT use is Rimadyl. I had to give my non-cush dog a NSAID for a time and I'm pretty sure it was Metacam. If this were me, I would add a joint supplement such as Cosequin and/or Chondroitin.

Hope Riley is feeling much better soon and please do keep us updated. ;)

[goldengirl88]

Lisa and Riley:
Welcome to the forum. Sorry your Riley is having problems, but you are at the best place for information and support. Hang in there it will get better. The initial cost and testing is very expensive, but once you get the correct dosage the cost decreases quite a bit. Good luck and God Bless you and Riley.

[addy]

Hi Lisa,

Welcome back though I am sorry to hear about Riley's current problem. Have you done any recent UTK panels?

Would Tramdaol help instead of an NASID? Just wondered. I thought I read it had anti inflammatory properties in dogs. Zoe had a really hard time on Rimadyl, I would stay clear of it, as Lori suggested.

I am really not sure about a short course of prednisone. Maybe someone else will have some input.

Hang in there!