View Full Version : 14 year-old Shih Tzu With Recent Cushing's Diagnosis
Hi,
My Shih Tzu, Hannah, who will be 12 tomorrow, was just diagnosed with Cushing's Disease this week. She went into the vet for her yearly dental cleaning, but her bloodwork was concerning and led my vet to suspect Cushing's, so we postponed the dental procedure and he instead did the low dose dexamethasone suppression test. On her regular blood test, everything was in the normal range except for PLT (which I figured out is platelets, and the vet never mentioned this, so he must not be concerned-should I be?) and ALKP. The normal range for PLT is 175-500 and her reading was 618. The normal range for ALKP is 23-212 and hers was 1770. (Last year it was a bit high at 263, but we let it go).
He told me he suspected Cushing's and asked if I have seen any symptoms. She has maybe had a slight increase in drinking (although I never thought she drank enough compared to other dogs previously) and occasionally seems to urinate more. This seems to come and go. Over the last couple of months I have noticed that she seems to eat more quickly and is more often trying to sneak into my other dog's bowl. I increased her feeding amount a little bit since it is winter here, but also noticed that she has lost some weight. She was 10.8 pounds at the vet this week and was 12 pounds 9 months ago.
These are the results he gave me over the phone on the second test: The level he measured at the start of the test (I didn't write down what level this is as I was writing quickly at work, so hopefully you know) was 3.7. After four hours it was 1.9. After 8 hours it was 5.4. He said this can basically confirm the pituitary form of Cushing's. He told me he thinks she is in the beginning stages, as she is showing no major signs, and that it may be a good idea to just watch and see how she does/progresses for now. The medication he recommends we try first (when/if we decide to) is Anipryl because of the low side effects. If that doesn't work he recommends Trilostane. He said the point is really only to treat symptoms and that nothing will add length to her life, which seems to match up with what I read.
I am wondering if you all agree with this diagnosis, and if you think it is smart for me to wait before trying Anipryl since symptoms seem very slight, or if you would start it now. The only other thing that she has started in the last year or so, but has become more frequent is occasional barking at us like she is trying to tell us something (her tail is wagging and she will paw at us), but we can't figure out what she wants-we try letting her out, playing, petting her,etc. Sometimes I wonder if it is old age, and now if it is connected to this. But it also only happens sometimes. She is also a poop eater-she was rescued from a puppy mill and had many litters, and sometimes I think she just wants to go outside because she will dig around in the snow trying to find poop (even though we pick it up). Sometimes this behavior happens more after she or the other dog have recently pooped.
I do like the idea that if there is any cognitive stuff going on the Anipryl could help that too. She doesn't have any hair loss or the pot belly stomach, and no skin infections. She has had allergies for years, but seems to still lick/itch in the winter, and we thought it might also be nerves/mental, as she is a somewhat nervous dog. I now wonder if this could have anything to do with Cushing's...but again, there are no visible signs of problems in terms of coat/skin.
Any advice/opinions you can share will be greatly appreciated. I love my Hannah very much and she is the sweetest most loyal dog I have even known. I want to make the right decisions, but don't want to jump into anything too quickly. I trust my vet, but would like to hear from others too. Sorry this is so long, but I wanted to share everything.
Thank you for reading!
Hannah's Mom
labblab
03-05-2011, 02:51 PM
Welcome to you and Hannah!
You have done a wonderful job of summarizing Hannah's situation and your questions. I can often be pretty long-winded in my replies, but given how well you have laid out Hannah's information, I can pretty much leave it at saying that I believe your vet's current recommendation makes a lot of sense. Given the lack of overt symptoms, I believe that most experts would agree with holding off on treatment for the time being. None of the screening tests for Cushing's are fail-safe (it looks as though your vet performed the LDDS test), and until or unless overt symptoms manifest, I believe that a firm diagnosis always remains somewhat in doubt. If and when you do wish to treat, there is probably no harm in starting off with Anipryl, as long as you recognize that only a small percentage of Cushpups respond favorably to it and most do end up requiring a shift to trilostane or Lysodren for effective control of elevated cortisol.
I would make one departure from your vet's comments, though. And that is to say that our experience here has been that many younger dogs who are effectively treated for Cushing's go on to far outlive that "two-year" life expectency that is often quoted. I think that statistic may result from the fact that so many dogs are already older when they are first diagnosed. But for younger dogs, I cannot help but think that their lifespans are extended if the chronic internal organ damage that can be associated with Cushing's is slowed or halted through effective treatment.
At Hannah's age, though, I know her comfort and quality of life are your highest priorities. So I know you will monitor her very closely for the increase in symptoms that would prompt further intervention (or even alternative diagnostics if any problems were not consistent with Cushing's). One additional test that you might wish to consider, now or later, is an abdominal ultrasound. Visualization of the adrenal glands can lend helpful support to a Cushing's diagnosis. And visualization of the other internal organs can help identify any other disease processes that may be going on in addition to, or instead of, the Cushing's.
In the meantime, you may want to consider giving her some benign supplements that support liver function. If others don't beat me to it, I'll stop back by with info in that regard that you can discuss further with your vet.
Marianne
frijole
03-05-2011, 04:26 PM
Hi and welcome from me as well. I agree with Marianne - it doesn't appear that there is a need to rush in treating as there are no problematic symptoms. My girl Haley was diagnosed at 12 1/2 and treated for over 4 yrs... she passed in May of 2010 but not from cushing's. We used lysodren.
The other thing I disagree with your vet on is anipryl. There are pluses and minuses to all drugs but it really hasn't been used much in years because it does not work for most dogs. I would read up on it before going there. Most now use trilostane or lysodren. They work differently but seem to be equally effective.
But for now I'd just take it slow because you really don't have any symptoms to treat. You could use milk thistle to help with the alk phos/liver enzymes. It brought Haley's numbers down from 2000 to 700's. Cush dogs typically don't have normal liver enzymes even after treatment.
Glad you found us. Keep us posted on whatever you decide and feel free to ask questions. Kim
Harley PoMMom
03-05-2011, 06:05 PM
Hi and welcome from me and my boy, Harley.
An increase in drinking, urinating more frequently, and weight loss even though one has been feeding more, can be symptoms of diabetes in a dog. Was an Urinalysis done too? If so, were ketones or glucose found in Hannah's urine?
Lori
Hello All-
Thank you so much for your replies. I REALLY appreciate the advice and support of others who have been through this, or are familiar with what we are going through.
I do think I will wait to see what happens before moving forward with any treatment. I also talked with my vet about doing a urinalysis on Hannah, since she has a history of problems with crystals in her urine and has been on a prescription food (Royal Canin Urinary SO) for several years to control the issues, and I would like to see if she is doing okay in that area since now I may not notice problems if she is urinating more often due to Cushing's. Hopefully doing that will also show if there is anything else going on with Diabetes? I don't know if anything in the blood test he did pre-dental would show up if Diabetes was an issue?
My vet does not seem to use Lysodern at all. From what I have read, I have to say I would be a complete nervous wreck about trying it as well. Also, I am gone several hours each day at work (I am a teacher) and I would worry about missing concerning symptoms. I do know his other choice is Trilostane, but he seemed to think trying Anipryl first, to see if it did work in her case, would be less risky. I have to say I agree. I feel very nervous about adverse reactions and these Addisonian issues; however, if Anipryl didn't work, and her symptoms were there, I would try the Trilostane.
Where do I find the milk thistle? I think I ready other information about people trying supplements with some success and I would be open to that as well.
My vet said that Cushing's varies with each dog and each case is different, which makes sense to me. My parents' collie had Cushing's and had to be put to sleep when she could no longer get up and was leaking urine almost constantly. She went very quickly from the time of diagnosis-didn't even make it 6 months, but they determined she had a tumor on her adrenal glands which metastasized to her liver. To say the least, when I heard Hannah's diagnosis, I didn't have very high expectations. After being reassured by my mom and my vet, I realized that Hannah's situation is not as bad. My parents dog was drinking a bucket of water, panting constantly, leaking urine, having trouble with her back legs/end, etc. and everything progressed quickly. Anyway, I asked my vet to give me his best guess on how long Hannah might make it, as I was wondering if she even has a year. He guessed two to three. Does anyone else have any idea, based on her limited symptoms at this point? My concern is that it could progress really quickly, even though she doesn't seem too bad now.
Here are some other questions I have:
-Should I move forward with a dental? He said they can still do one when we are ready. I know Cushing's dogs can be more prone to infection, but I also don't want to spend tons of money not knowing what other treatment, procedures she may need. She doesn't have great teeth, but has had many pulled, and has had yearly dentals as long as I have had her (the past 8 years).
-Does it make sense that she is eating more and losing weight? She is 10.8 lbs. now and was 12.3 in June. (I am wondering if this could be due to muscle loss).
-Do Cushing's dogs lick/itch a lot, even without any visible skin conditions? This seems to be worse this winter (when her allergies have normally subsided in winter). And is the random, but somewhat incessant barking and pawing at us when we have no idea what she wants, something that could be part of Cushings?
-Do you think the LDDS test with the 4 and 8 hour checks does clearly indicate the pituitary form of the disease?
-Would the abdominal ultrasound show anything other than enlarged adrenal glands to show more evidence? Or were you thinking it might show a tumor there, which would mean it is not a pituitary issue?
-Is there any "typical" progression with this disease? Like how long it might be before Hannah shows worse symptoms? I realize all pets are different, but my vet said it is typically slow, and my only experience is my parents' dog, which was VERY quick.
I will definitely be following up with my vet with all of my questions and concerns to make sure I do the right thing for Hannah. I just don't have tons of money to do everything (my husband and I are both teachers) and want to make sure I prioritize my issues and only test what is necessary at this point...as I also still need to figure out if she will get a dental and I have another Shih Tzu to take care of as well. They are both due for their exams and vaccines in April. That is why I thought the urinalysis might be good and not too expensive.
Again, thank you SO much for your help and suggestions. I will check back often and keep you updated.
Hannah's "mom", Julie
Cushpup
03-05-2011, 10:59 PM
Welcome Julie.
Sorry to hear that your baby is having problems.
Hanna may have a while to go. Shih Tzus live long. My Shih Tzu Cushing girl lived to be 15.
Mine had more Thyroid symptoms than Cushings. She never drank a lot or peed a lot (it was only a little bit more), even before diagnosis. She was hungrier and gained weight... In retrospect, I felt that mine had Cushings for a few years before the diagnosis. There was some panting when I walked her for 3-4 years. Basically, I noticed that she was "getting older" and stopped more often during her walks and had some panthing, and hing legs shaking. That's when I took her in for bloodwork. She was diagnosed with Hypothyroid. Her liver enzymes were elevated, Cholesterol and Triglycerides. Then we did the ACTH and it was Cushings. Mine did very well on Trilostane once the adjustment period was done with (approx 4 weeks). Mine had the additional Thyroid which made things a bit tricky loading the Trilo and Soloxine at the same time. It doesn't mean that yours will be the same as any of ours, but you may see some similar symptoms and/or behaviors in Hanna.
Cushings is not a death sentence, but it complicates things; it mimics many other things going on. Many times the dog will have Cushings/Diabetes/Thyroid combos, two or only one of the three. Once the dog gets diagnosed with Cushings many times Vets think that Cushing is responsible for all of it's ills. Sometimes that's true, and other times it's not.
-Anipryl did not work well on my sisters' dog.
-if your Vet starts Hanna on the lowest dose of Trilostane 1mg/lb it may not be so bad. Check ACTH 14 days later to see if an increase is necessary...
-As far as Hanna pawing and barking...is she maybe begging for more food? That may be her new Cushings hunger call?
-Ultrasound will show if there is an adrenal tumor (I don't think LDDS is conclusive for deferentiating tumors. Sometimes there is tumor on the adrenals and pituitary-rare),and other organs like the condition of the Liver, and the bladder stones...
-Dogs need a dental because bad teeth can affect their Liver, kidneys etc. Cushings can affect those organs. In fact, from now on you will probably see some blood work adjustments.
-actually she shouldn't itch with Cushings because the extra cortisol pumped out should keep allergies in check, unless something else is going on...
-typical progression is what I've decribed with my Shih Tzu above. It may not bother some people, but the panting and stopping bothered me. As I said, a few years earlier she had 'some' panting, but that didn't bother me, until she had that depressed, oldish look, and walk. A Shih Tzu should not look or act old at 12. Mine was diagnosed at 13and was full of life until 15....and got cancer.
-IMO, a full chemistry profile, CBC, T4, UA and an Ultrasound is a good idea. You do what's comfortable for you.
You could ask your Vet for a copy of Hannas bloodwork so you have a file for future comparison.
frijole
03-05-2011, 11:45 PM
Julie,
I too am confused about the weight loss as it is the opposite of what you see with cushings. I would want to rule out diabetes. You should have a glucose reading from the blood panel if they did a complete one. If not I would go there next to be safe. Diabetes and cushings have similar symptoms.
I wish I could say that there is a natural progression with cushings but I've been here for 6 yrs now and there really isn't. The leading experts in the field all agree that it is not necessary to treat if the symptoms aren't there so I wouldn't start anything at this point in time. You will know if you see an increase in urination, etc.
You can buy milk thistle capsules at any health food/vitamin store. I just poured half a capsule over food in the a.m. and the other half at night.
Cush dogs do tend to lick alot and can have skin issues. (this is all covered in our important info section in great detail) Your friend's dog that passed had an adrenal tumor and sometimes they grow quickly which might be what happened. Your LDDS test result is indicative of pituitary cushings. It is the most common.
I would double check on the blood test to rule out diabetes. The LDDS test is not fool proof. My dog had a false positive on it and four false positive ACTH tests. :o Cushings can be tough to diagnose so you can't really feel comfy with only one test.
Hope this helps. Kim
labblab
03-06-2011, 09:01 AM
I see you've already gotten some great information from others. Here's a few more thoughts from me:
Hopefully doing that will also show if there is anything else going on with Diabetes? I don't know if anything in the blood test he did pre-dental would show up if Diabetes was an issue?
I'm guessing that Hannah's blood glucose level was part of the pre-dental labwork, and that it was normal. If that value had been elevated, your vet would have suspected diabetes. But you can double-check with him as to what Hannah's glucose level was on that test.
Where do I find the milk thistle? I think I ready other information about people trying supplements with some success and I would be open to that as well.
As Kim said above, you can buy milk thistle in health food stores. SAM-e is another supplement that is often recommended for liver support. Here's a link that gives more info about both these supplements:
http://www.k9cushings.com/forum/showthread.php?t=192
I would not waste my money on other supplements advertised on the internet as specifically "curing" or controlling Cushing's. There is no scientific evidence that they help.
-Should I move forward with a dental? He said they can still do one when we are ready. I know Cushing's dogs can be more prone to infection, but I also don't want to spend tons of money not knowing what other treatment, procedures she may need. She doesn't have great teeth, but has had many pulled, and has had yearly dentals as long as I have had her (the past 8 years).
As has already been said, you don't want infections to get out of control in Cushpups. The one reservation that I would have about a dental is the fact that most anesthetics can be hard on the liver, and we know from her lab results that Hannah does have some liver involvement going on. So in my mind, performing the dental would involve the judgement call as to whether her teeth are currently in a state where it is worth burdening her liver with the anesthetic. Again, something to discuss further with your vet.
-Does it make sense that she is eating more and losing weight? She is 10.8 lbs. now and was 12.3 in June. (I am wondering if this could be due to muscle loss).
While it is true that most Cushpups gain weight rather than lose it, my own boy also lost weight prior to diagnosis even though we even switched to a higher-caloric food in order to try to "beef him up." So I do know that weight loss is possible. He definitely did lose muscle mass during the pretreatment period.
-Do Cushing's dogs lick/itch a lot, even without any visible skin conditions? This seems to be worse this winter (when her allergies have normally subsided in winter). And is the random, but somewhat incessant barking and pawing at us when we have no idea what she wants, something that could be part of Cushings?
Again, while it's true that steroids can aid in controlling the manifestation of allergies in many dogs, my Cushpup was also a "weirdo" in this regard and licked his front paws incessantly for a long, long time prior to diagnosis at a time when his cortisol level was very high. As soon as his cortisol level was controlled with trilostane, the licking magically ceased. I have no explanation for what was going on, but it was a clear and definite change for him.
-Do you think the LDDS test with the 4 and 8 hour checks does clearly indicate the pituitary form of the disease?
The pattern of Hannah's LDDS test is consistent with pituitary Cushing's (suppression at the 4-hour mark with "escape" at the 8-hour mark). In terms of the numbers themselves, she is right at the borderline, because vets are generally looking for either a 4 or 8-hour result that is less than 50% of the baseline cortisol level. So with a baseline of 3.7 and a four-hour level of 1.9, she is hovering right there at the 50% mark that would be diagnostic of PDH. Here is a link to a thread that will give you more info about interpreting LDDS tests:
http://veterinarymedicine.dvm360.com/vetmed/Medicine/ClinQuiz-Interpreting-low-dose-dexamethasone-suppr/ArticleStandard/Article/detail/580093
-Would the abdominal ultrasound show anything other than enlarged adrenal glands to show more evidence? Or were you thinking it might show a tumor there, which would mean it is not a pituitary issue?
Yes, exactly right, the appearance of the adrenals could give further support for either the pituitary or adrenal form of the disease. But in the absence of overt Cushing's symptoms in Hannah, I was also thinking as much along the lines of making sure that there is nothing strikingly abnormal about her liver (other than the changes that are typical of Cushing's) or other internal organs that might account for her test elevations.
-Is there any "typical" progression with this disease? Like how long it might be before Hannah shows worse symptoms? I realize all pets are different, but my vet said it is typically slow, and my only experience is my parents' dog, which was VERY quick.
I agree with your vet's assessment that Cushing's is generally a slowly progressing disease in the absence of aggressive tumors, which are the exception rather than the rule.
Thank you all again for your helpful responses. I have done a lot of reading since Thurs. afternoon when I got this news. I was able to find information on the LDDS test and do feel better that Hannah's test is suggestive of PDH. Even though my vet explained it to me it took reading much more on the internet to understand it better.
She did have a CBC done and her glucose levels were normal. I have decided to have a UA done on her this week to make sure there is not a UTI. Also, her cholesterol was normal, as well as her BUN. (I read on some site that those levels typically are involved in Cushing's too; I believe it was high cholesterol and lower BUN). Her other liver level (ALT) was also normal. Everything was in the normal range other than her platelets and her ALKP. Should I post the complete result (I have a copy), or would it not help anything if the other levels are normal?
I will look more at the links you provided (I looked through them yesterday) to find out more info. about milk thistle. I'm hoping it would also tell me the dosage.
I have really paid attention over the weekend and am starting to feel that there are enough symptoms there-the increase in water intake and an increase in the amount of time she pees, as well as the crazy appetite-for me to do something. (I think I mentioned before that Hannah didn't seem to drink/urinate enough in my opinion, compared to other dogs, and it has definitely increased). Therefore, I think I am going to start with the Anipryl first to see if it does anything. I have read a lot and know that only 20-40% of people feel it is really effective, but with low risks, I would like to start there. Then if after that two to three month period it hasn't done anything I will move onto the Trilostane, my vet's other recommendation. Does that make sense to the rest of you, or do you still think I should wait until things get worse? I don't want to wait until she is peeing all over the place if I notice SOME changes. My vet said they have two doxies who are being very successfully treated with Trilostane right now. Is it correct that the main period you have to really be careful/watch your dog closely is that initial "loading" period the first few weeks (when you also get the blood tests done, etc.)?
I don't feel that she really shows any of the other symptoms of liver disease and assume that since her glucose is normal now and if her UA is done we should also be able to rule out diabetes and see if a UTI is present. I think I will talk with my vet about the dental and will maybe wait a little while before doing that. I always got nervous having her anesthetized anyway, and right now I know I would be worse. I feel like I am still a bit skeptical about her diagnosis, but at the same time, many pieces seem to fit at this point, and it sounds like each dog is different.
On a side note, today is Hannah's 12th birthday, so I'm going to spoil her like crazy and try not to think about Cushing's all day. I just want to be educated and make the best decisions for her. . I don't want to ignore the symptoms/changes I have seen, but I don't want to dive into anything either. That balance is tough, so I appreciate your advice.
Thank you again for your help! I GREATLY appreciate it!
Julie
labblab
03-06-2011, 11:54 AM
Oh Julie, Happy Birthday to sweet Hannah!!!!!!!!!!!! :D :D :D :D :D :D
I think you're absolutely right to take this day "off" from worrying and instead to totally focus on celebrating with your girl! :) :)
But as far as beginning the Anipryl, if your vet agrees, I don't see any harm in going ahead and giving it a try at this early stage. If Hannah's symptoms do continue to increase and you move on to trilostane down the road, ongoing monitoring via blood testing will continue for as long as she remains on the medication. However, once dogs are stabilized on an effective dose, the testing can become much less frequent.
Marianne
Hi All,
I just have a couple of updates on Hannah. First of all, I checked and her blood glucose level was normal. I also had a UA done on her today and she didn't have any infections or anything really strange. My vet did say her specific gravity was just slightly low. He said hers was 1.023 and normal is 1.025 or more. He said that dogs who are drinking more water have less concentrated urine, but that hers is still pretty good considering I have noticed an increase in drinking. (Sometimes she gets drinks every 15 min., but then she will go for hours without. She goes all night with no drink or trip to go potty).
He told me dogs should drink about 30 ml per pound per day. Hannah is 10.8 lbs. I am guessing she is drinking about 1.5 to 2 cups (which isn't WAY out of control), if my conversion is correct. My other Shih Tzu, Izzy, also drinks from the same bowl, so this is my best estimate.
Anyway, I am glad there was no infection present in the urine. I asked him more about her weight loss, rather than the typical gain. He said all cases are different and said it would be okay for me to feed her more to see if she beefs up at all. I asked him if he was concerned about other liver problems. He said at this point he would try the Anipryl and sew what happens. If it doesn't work in two to three months, then he would want to do an x-ray and abdominal ultrasound prior to starting treatment with Trilostane (or something else) to see how her adrenal glands and liver are looking. I asked why the x-ray was necessary and he said that specialists come in from the U of MN to do this and he would ask if the x-ray needed to be a part of it. (It would run about $615 for both). He said sometimes they see enough in an x-ray not to have to do the ultrasound, but he would look into it.
I asked him about milk thistle and Sam-e, since I have read about it on this site and another one. He said I could try something like that if I want, that it could help support her liver, but not treat Cushing's. I would like to do both, and like the idea of helping her liver. He mentioned Denamarin. Does anyone have any thoughts on this (or any of the others I mentioned)?
I am still debating when to do the dental. Knowing there could be the cost of the ultrasound/x-rays in the near future I am worried about cost, but I also know the dental is important. My thought is that it would be about June by the time we would do further testing (unless something changes), so maybe I will wait to see what happens with that, then get her teeth cleaned. She was only just due in Feb., so I won't be too far overdue. Plus, I teach summer school so we have a little extra income in the summer if there are more procedures.
I think I have calmed down a little in the past few days, but I still feel like I watch her like a hawk. There is always this worry that it is progressing before my eyes and that some new symptom will show up. Then there is the fear that there is something else wrong. Diabetes seems to be ruled out from the normal blood glucose test and the UA. She shows no other signs of liver problems at this point either, but does show signs of Cushing's. There is just the weird weight loss with the increased appetite. I guess at this point I am glad her symptoms are limited and she still seems like my happy girl who follows her mom everywhere.
I have to say again how happy I am to have this site and all of you to help me out.
Sincerely,
Julie & Hannah
My 12 year-old Shih Tzu, Hannah, with a recent Cushing's diagnosis is going to start Anipryl tomorrow (we are going to try it first for a couple of months before Trilostane or something else, if necessary) and my vet is also going to order the chewable Denamarin tablets for her. He said the chewable ones are nice because they are for dogs of all sizes and that Hannah, at 10.8 lbs., will take 1/2 a tablet per day (which is what I found online as well). Does anyone have experience with these tablets? Her ALKP level was 1770 (normal was up to 212, I believe) and I asked to try something that would support her liver. It says they are liver flavored and I'm hoping she'll want to chew them. Otherwise I'm not sure what to do...
Thanks!
Julie & Hannah
Moderator's Note: Julie, I have moved your post with Hannah's update into Hannah's original thread. We, normally, like to keep all posts on a pup in a single thread as it makes it easier for other members to refer back to the pup's history, when necessary.
Hello again...
I am looking for some other opinions about how to proceed with Hannah. (12 y/o Shih Tzu with recent Cushing's diagnosis). You can read my initial post to see Hannah's test results. The plan as of now with my regular vet is to treat with Anipryl (we started yesterday) for two months and to see if the symptoms have improved. I also asked about something to support her liver and he has ordered Denamarin. We would re-check liver values in two months as well. If the Anipryl is not working, he said he would then pursue other tests (first doing an ultrasound and x-ray) to see how her organs look,and if it still looked like Cushing's, he would then try Trilostane.
I feel good about that for a couple of reasons-the low risk of problems with Anipryl IF it works, and the fact that I am a teacher and this would then be about the time for our summer break and although I teach summer school, I will have more time to watch her closely, and I will also have more income for tests/treatment. However, I am a worrier and I have been wondering if this is a good decision or if I should do something now. I am so worried about not helping her enough, or doing the wrong thing, or her getting dramatically worse during this two month period. I am also still confused about if it for sure IS Cushing's. She did have high ALKP levels (my vet said this is often a marker), which led to the LDDS test, which my vet said showed she was positive for PDH Cushing's. A few of you also agreed; however, I do know that often more than one test is needed to confirm this disease.
I am wondering if you would question if does indeed have Cushing's, or if it could be something totally different....or if it is more that it is Cushing's and there could be SOMETHING ELSE too. She does not have diabetes, as her glucose is normal and her urine sample was as well. I know I have read about false positives, but she does have some symptoms (increased thirst/urination, but not out of control, and definite increase in appetite). She has lost weight in the past 9 months (1.5 lbs.) though, not gained, and has been eating more. She doesn't have the potbelly or skin issues. She has no gastrointestinal issues (I know this is another symptom of liver disease) or any other problems, except she does a lot of itching/biting (which she has always done, although it is a bit worse this winter and is usually only a summer allergy problem).
I did find out there is an IM specialist close to me and for $105 she will meet with us, examine Hannah, and review her other records and make a recommendation. I have spent about $500 this past week and have both dogs due for their exams/heartworm test/vaccines in early April(usually a few hundred for that trip), and still have to figure out when Hannah can/should get her yearly dental (usually about $400). Plus, I know the ultrasound/x-ray is likely in the future (about $650), as well as Izzy's (my other dog's) dental in August.
I can't decide if it is worth seeing the specialist now, or if I should wait out the two months and see what happens as long as we have already started something. My husband will support whatever I decide, but is concerned about how much money we may be spending. I am as well, and don't want to totally drive myself crazy doing everything and anything, but also don't want to NOT do something I should. I also realize the specialist could recommend additional tests, which it sounds like my regular vet might do this summer anyway.
Like I said, I am a worrier (and I analyze everything!) so I would love some other opinions. I am so worried about doing the "right" thing, but of course, I have no idea what that is. If you were in my position, what would you do?
Thanks!
Julie
frijole
03-14-2011, 08:09 AM
Julie, When you say increased thirst - can you tell us what you mean? Have you measured the daily intake? Normal intake is about an ounce of water per pound.
A couple of things stood out to me in your post - you said the urine test was normal and that Hanna doesn't have a pot belly, in fact has lost weight. None of these are indicative of cushing's. That said, was it the UC:CR test (urine). I am told that this test is very accurate and if a dog can concentrate their urine they don't have cushing's.
I'm not sure if I shared my story with you but my girl Annie (2nd dog diagnosed with cushing's) was misdiagnosed. I was sure she had cushing's - I'd already had one dog with it. She had a false positive on the ldds test. She had 4 false positives on the acth tests. I took her to Kansas State Univ (the closest IMS to where I live) and she even stumped them. Her urine is concentrated, she has no pot belly, she has lost weight. In her case, she had multiple things going on but she has an adrenal tumor that they believe emits signals resulting in cushings like symptoms.
Also if you read all the intl experts in the field you don't treat a dog without symptoms and that is why I asked about the water intake. Cush dogs drink 'buckets' of water so it is important before answering your question that we know what 'increased' actually is.
If the water intake is minimal I wouldn't treat with anything yet because there aren't enough symptoms. Also if water intake isn't significant I would invest my money in the teeth cleaning and save up to go visit the IMS if and when the need arises. These tests are costly as you know. I spent $8000 last year and still don't have a definitive answer as to what is going on with my little gal.
I'm sure others will chime in but I wanted to share my story in the case that it might help. I know its hard to make these decisions... take it all in but don't feel rushed into making a decision because you don't have to treat cushing's right away. Good luck! Kim
Julie, When you say increased thirst - can you tell us what you mean? Have you measured the daily intake? Normal intake is about an ounce of water per pound.
A couple of things stood out to me in your post - you said the urine test was normal and that Hanna doesn't have a pot belly, in fact has lost weight. None of these are indicative of cushing's. That said, was it the UC:CR test (urine). I am told that this test is very accurate and if a dog can concentrate their urine they don't have cushing's.
Hi-
I have not measured her water yet, as I am gone during the day and I have another dog. I don't think they would do too well separated. I will try that sometime on a weekend when I can watch them both closely. I would guess she is drinking about 2 cups or a little over (so 16-20 oz.)of water per day and she is 10.8 lbs.
I don't know if he did the UC:CR test. I think it was a regular UA because I wanted to see if she had a UTI. He did tell me that her urine concentration was 1.023 I believe, and that normal was 1.025 and above, so he said she was concentrating it pretty well, even though it was low.
So...I am thinking maybe continue with the Anipryl to see how she does. See if we can do the dental (but I am worried about the 1770 ALKP level) and then watch and wait and maybe check in with the specialist this summer (or when things progress)?
I want to start her on the Denamarin to help her liver, but I am worried about doing too many things at once. The vet thought that was a good idea and he ordered it and we're waiting for it to come in. He said that would be the only thing that would help change her liver values; the Anipryl would not.
Thanks again for sharing!
Julie
Just thought I would update all of you that we postponed the treatment with Denamarin (Hannah has been on Anipryl for a week) and have decided to move forward with an ultrasound on (and decided postpone the dental until we know what is going on with her). She will get the ultrasound next Wed. and hopefully we will know more about what is going on and what/how we should treat. I will let you know what the results are.
Julie
lulusmom
03-22-2011, 03:07 AM
Julie, we'll be standing by for our update.
Hello Everyone-
Hannah (12 year-old Shih Tzu) had her ultrasound done this morning. I am going to briefly review our situation so you don't have to go all the way back in the thread:
She had blood work done last month before her annual dental. Her Alk Phos level was 1770 and up to 212 was normal. Nothing else was abnormal except her platelet level was slightly high (which the vet didn't even mention). He asked if I had noticed increased thirst/urination and appetite. I had noticed a slight increase in thirst/urination and she definitely wants to eat and eats quickly.
We postponed the dental and tested for Cushing's using the LDDS test. Here are the results: The level he measured at the start of the test was 3.7. After four hours it was 1.9. After 8 hours it was 5.4. He said this can basically confirm the pituitary form of Cushing's. The following week I had him do a UA just to be sure things were okay in that area, as Hannah is also on Royal Canin Urinary SO (she had Struvite crystals in her urine about 5 years ago and has been on it since). He said everything was normal, with the exception of her urine concentration being just slightly low. Hers was 1.023 and that normal was 1.025 and above, so he said she was concentrating it pretty well.
So we decided to do an ultrasound to see what that would show. I don't have the full report yet, but my vet will be emailing it to me once he gets it from the specialist. (They did have a specialist come in to do the procedure because my vet wanted to ensure that it was done well). Basically, it was normal. The adrenal glands were within the normal size range, as was her liver. There was no sign of any tumors or anything abnormal.
While this is good news, I am left a bit confused. The specialist did say that since we don't have any sort of baseline data on Hannah, it is possible that her adrenals were smaller before, but there is still nothing remarkable about them. I asked if they still think she has Cushing's and my vet said yes-- based on the LDDS test and the clinical symptoms I have seen. He said she is probably at the very early stages. We talked about the current treatment (Anipryl for the past 20 days) and that I could finish out my two month supply and see if I notice improvement or I could stop. It makes sense to me to finish it out and see if I notice anything. He said he would not want to treat with anything else at this point and would just want to watch for clinical symptoms and the doctor who did the ultrasound agreed that he would not do anything else right now.
I was worried about her liver since that value is so high, but since it looked normal I guess that takes care of that. My vet said even a slight increase in cortisol can cause the Alk Phosphate level to go up quite a bit. Awhile back, we talked about trying Denamarin or something for her liver. He said he didn't think we needed to do that right now and that we can finish out the Anipryl and see if I notice anything and then go from there and possibly put her on Denamarin at that point. (I had read about some possible side effects with Anipryl and Denamarin and sent it to my vet. He had never seen or heard that but said it was up to me and we could wait and just try one thing at a time). He said that with a clean ultrasound he feels good about doing her dental whenever I am ready.
What are your thoughts about this? Do you think there could be anything else going on? Or is it possible that she is in the very early stages?
Thanks again for your input!
Julie & Hannah
labblab
03-31-2011, 01:45 PM
While this is good news, I am left a bit confused. The specialist did say that since we don't have any sort of baseline data on Hannah, it is possible that her adrenals were smaller before, but there is still nothing remarkable about them. I asked if they still think she has Cushing's and my vet said yes-- based on the LDDS test and the clinical symptoms I have seen. He said she is probably at the very early stages. We talked about the current treatment (Anipryl for the past 20 days) and that I could finish out my two month supply and see if I notice improvement or I could stop. It makes sense to me to finish it out and see if I notice anything. He said he would not want to treat with anything else at this point and would just want to watch for clinical symptoms and the doctor who did the ultrasound agreed that he would not do anything else right now.
Hi Julie,
I'm sorry it's taken so long to get a reply posted! But I'm very glad to hear that Hannah's ultrasound has not uncovered any worrisome abnormalities. And I do want to tell you that it is possible for a dog to have pituitary Cushing's but not exhibit adrenal enlargement on ultrasound. So I agree with your vet that that absence of enlargement does not rule out that diagnosis. The absence of any visual abnormality does make the adrenal form of the disease highly unlikely, however.
I do think that you have crossed all your "t's" and dotted all your "i's." And I agree with your vet's recommendations at this point. I do believe you have ruled out other obvious sources of trouble, and now the question will be whether or not Hannah ends up exhibiting additional clinical symptoms as time goes on. So at this point, I would carry on as your vet advises. :) :)
Marianne
Below is Hannah's ultrasound report (I knew things were "normal" after they did it, but thought I would post it anyway).
She was in for her yearly heartworm test/check-up on Sat. and I saw in her records that they want to do a NSAID monitoring profile and CBC in May. I was not aware my vet wanted to do another test so I've asked him to call to explain what that is. (She is on Anipryl-for one month now, and we have a two month supply, so maybe he wants to check something after being on Anipryl??? I don't know). If you know more about what this means, or if it makes sense, please let me know. Anyway, here are her results.
Julie & Hannah
forConsult Type: US, SIG: DOB: 20010330, Age: 10 Y, Sex: F ALTERED, Wt: 10.8 kg, Breed: SHIH TZU, Species: CANINE, Images: 1, Case Details: Dog has a history of Cushing's disease. Overall screen of the abdomen.
Findings
An abdominal US was performed (Travis Saveraid). The liver, gallbladder, spleen, and kidneys are normal. The adrenal glands have normal size (Left 0.4cm short axis, Right 0.4cm short axis), shape, and echogencity. The bladder has a mildly thickened cranial wall, but is incompletely distended. The stomach, GI tract, pancreas, and general abdominal cavity is normal.
Conclusion
1. The bladder wall thickening is likely from incomplete distention and less likely residual change from previous urinary tract infection (no current evidence of urinary tract infection). 2. Otherwise the abdomen is normal.
Recommendations
Occasionally patients with biochemical evidence of Cushing's will not have structural changes of the adrenal glands or liver on US. The biochemical testing is consider a more accurate test than US imaging.
Harley PoMMom
04-11-2011, 11:53 PM
According to IDEXX laboratories the NSAID Monitoring Panel tests the levels of the ALKP, ALT, AST, BUN, and CREATININE. This panel is usually ran when a dog is being treated with a nonsteroidal anti-inflammatory drug.
http://www.idexx.com/view/xhtml/en_us/smallanimal/inhouse/vetlab/nsaid-monitoring-panel.jsf?SSOTOKEN=0
What I am thinking is your vet wants to monitor Hannah's liver and kidney functions without doing a full Chemistry panel.
Love and hugs,
Lori
Hi,
You had asked about my Zoe's licking so thought I would stop by and answer. She has chewed her front feet ever since we adopted her. It stopped for awhile but came back when she was diagnosed with colitis. It seemed at first corn was the culprit. She is on raw turkey diet now and since her Cushing diagnosis, she has increased her licking and chewing. She wants to lick me or my husband all the time. She chews and chews on her Kong toy sometimes for an hour at a time then licks her front legs and sometimes will chew her front pads and dew claw. The last 4 months she has started to want to lick the tile in the bathroom. She has always licked on our sheets and pajamas if she has the chance. The licking and chewing has gotten worse the last six months. Zoe is a reactive, anxious dog, afraid of strangers and thunderstorms. Since her estradiol is now normal, she is less reactive in public.
Sorry to write you a book, just wanted to give you info;) If Hannah is chewing front and back legs it could be allergies.
Hang in there and I am glad you found us.
Hugs,
Addy
Hello,
Hannah is almost done with her two months of Anipryl and my vet wants to do another blood test this week to check some of her values. I am curious to see what they are, regardless, but for some reason, I was under the impression that even if Anipryl works that I wouldn't see a change in her blood work, and instead that I would be looking only for a difference in symptoms-eating, drinking, urinating, etc. Is that incorrect? Will there be a difference if it is "working?"
I am having a hard time telling if anything is different, so I'm not sure where we will go from her. Considering that her ultrasound was totally normal a few weeks ago, we figure she is in the early stages, with only slight symptoms...so I guess I'm not quite sure what to do. There seem to be people who tell me to wait until symptoms are worse and not to do any major treatment until then, and people who tell me I need to do something early, before any more damage is done. Any input about the Anipryl and suggestions on where to go from here would be great!
Thanks!
Julie (& Hannah)
lulusmom
05-01-2011, 11:55 PM
Hi Julie.
It is true that bloodwork in the way of an acth stimulation is not necessary with Anipryl but I believe your vet may simply want to do a complete blood panel so see if liver enzymes and other prior abnormalities have improved. Whatever the tests are, please be sure to post the results here.
If Hannah is not overtly symptomatic yet, then I personally would wait until she is before treating with more effective treatments like trilostane or lysodren. If you aren't seeing any improvements with anipryl by now, chances are you never will. Only a small percentage of dogs with pituitary tumors in the pars intermedia lobe will benefit from anipryl.
What is going on with Hannah at the moment that would prompt people to tell you that you need to start treatment right away?
Glynda
Thanks so much for your reply. I am curious to see if anything has changed with her blood work since early March. We also talked about getting her on a liver supplement (Denamarin or one of the other ones), so I bet he wants to see what her ALKP level is now. (It was 1770 in March) and that was the only thing that was really high. We also decided to try Anipryl alone first before adding anything to help her liver. As I said, her ultrasound earlier this month was normal, so he felt that was a really good sign. The adrenals and liver were not enlarged and looked good. She needs a dental done and he said he was not worried about doing it, even with the abnormal liver value, but after seeing the ultrasound, he said he feels even less worried about any complications.
Had her blood work not been abnormal in March before what was supposed to be her dental, I may not have really noticed anything was terribly wrong. I had noticed that she was pushing into my other dog's bowl more often and was eating a little more quickly. I also noticed a couple of days when she was urinating more and thought about getting her checked for a UTI (she has had struvite crystals in her urine in the past and a couple of UTIs, but it has been well-controlled for a few years on Royal Canin Urinary SO dog food). The other behavior that was new (but probably going on for the last 6 months) was this pawing/barking/vocalizing at us in the evening after she had eaten, been outside, etc. Now I am thinking that is probably her begging for more food. That is the one thing my husband and I definitely agree has lessened just recently-in the past couple of weeks. She may be eating at a slightly slower speed. She doesn't really have any other signs-no panting, no back end weakness, no hair loss (although I had to trim a tangle out of her ear while I was brushing her a couple of months ago and the hair has not completely returned, but she is growing some of her tummy hair back where they shaved her for the ultrasound), no weight gain. She might be growing hair a little slower and loves to eat, was drinking more (for her, but she used to drink very little, so it's not out of control), and seemed to be urinating more-having a couple of house accidents (but she holds it all day while confined to the kitchen with no problem).
Some people tell me that Cushing's is an insidious disease, and that I should not wait for things to get worse since we seemed to catch it early. I think my vet feels that we should be seeing stronger symptoms before he wants to treat with something more. Also, she is currently on 5 mg of Anipryl per day and she weighs 12 lbs. I believe he said we could increase the dose-maybe to 10mg per day and he might want to try that before giving up on it.
Thanks again for your help!
Julie
lulusmom
05-02-2011, 03:13 PM
Hi again,
Thanks for the additional information. It really sounds as though not only does Hannah not have any concerning symptoms at the moment, you are seeing some improvements. Regrowth of shaved belly coat usually does not happen in an uncontrolled cushdog so that's pretty impressive. I'm very interested in seeing what her new labwork looks like so please be sure to get copies of the results and and post them here.
If I were you, I'd keep doing what your doing and not worry about treating with anything other than anipryl until you see a marked increase in symptoms.
Glynda
Harley PoMMom
05-02-2011, 03:26 PM
I totally agree with Glynda, since Trilostane/Vetoryl and Lysodren/Mitotane are very serious drugs I would not treat unless Hannah was displaying some strong Cushing symptoms and her test results confirmed a Cushing diagnosis.
Please keep us posted ;):)
Love and hugs,
Lori
Eskimo'sMom
05-02-2011, 03:51 PM
WOW, this story sounds FAMILIAR!!!!! :)
So Hannah has been on 5 mg of Anipryl (she weighs 12lbs.) for 2 months now and we had her blood values checked yesterday. My vet did agree that often we don't see a change in lab values with Anipryl, and usually need to go by symptoms, but he said occasionally it can help so that's why he wanted to do it.
Anyway, there was good news. Things have improved! Last time her ALKP was 1770 (and normal is 23-212) and yesterday it was 689. Her ALT was fine last time (normal) and I don't remember the number, and this time he said it was even lower. Normal is 10 he said and hers was less than 10, but he said that was not a concern, and that he was only concerned if it was high. Therefore, we are going to stick with the Anipryl for now, since we have seem some possible improvements in her behavior and now this improvement in her blood work.
He said he would check again in 3 months to see where she is (and I should monitor symptoms and let them know if anything changes), but didn't think we even necessarily had to do something to support her liver right now. I am going to schedule her for her dental soon (while I know what her values are). I feel great about the change, obviously, but still would like to hear your thoughts. The only thing I am wondering now is if something should be done to help her liver, since 689 is still high.
Thanks again for your help!
Julie & Hannah
Harley PoMMom
05-05-2011, 01:40 PM
Such a great update! I am so happy that Hannah is responding to the Anipryl so well. As far as her liver is concerned, since her ALT level was normal, which is more specific to the liver than the ALP, I would not worry about starting any liver support supplements.
Please keep us posted! Great job!! :)
Love and hugs,
Lori
Cindy Thoman
05-05-2011, 07:56 PM
Wow, that is such great news. It is so nice to hear about positives updates.
xoxo
Cindy and Alex
Go Hannah!!!!!!:D:D:D:D:D
This is wonderful news. I am so happy for you both. Keep up the good work!!!!!
Hugs,
Addy
So Hannah and I are headed to the vet tomorrow because last night I noticed a pink area under her chin-can't tell if it is a bump or an irritation, but it looks to be about the size of the tip of my forefinger or thumb and she does not want me to touch it. It looks like there could possibly be a couple of very small scabs on it as well. The other side looks to be a little pink, but not the same as this.
She just got groomed on Sunday, so I don't know if this is new, or if I could just see it because she has a short haircut. I also don't know if it was irritated from the grooming. It could also be because she licks so often (her feet and front legs) and rubs her face on the carpet. She used to take a low-dose steroid (Triamcinilone)in the summer for allergies, but after I noticed licking in the winter and then found out she had Cushing's, we no longer do that. Much of the time I think it is nerves because she can go for long periods without itching and licking. We tried a couple of different diets to see if it was food with no change, and she is on a prescription food (Royal Canin SO) to prevent crystals.
Obviously we will be seeing the vet in a matter of hours, but any issue makes me so nervous, and I always assume the worst. Last time she was in for a little bump I found in her ear and they thought it was cancerous. Thank God, it was not, but that is my fear with this. I know Cushing's dogs can have skin issues, so I suppose it could be something to do with that as well. She does not have any hair loss in that area; I can just see this bright pink area through the white short hair. She has been itching that area on and off, now that I think about it, but on both sides of her mouth (this is more on her right).
Anyway, there is nothing I can do about it now, and worrying won't help, but I just thought I would post about it to get it out of my system, and to see if any of you have dogs who have had something like this.
Anxious for tomorrow,
Julie & Hannah
I will be anxious with you and the appointment for Hannah can not come fast enough. Most likely it is nothing serious, especially if she just came from the groomers.
My advice:
Breathe in, breathe out, big breath and a deep sigh. You need oxygen:D:D:D
Repeat as needed
Hugs and waiting with you,
Addy
Thanks, Addy. Good advice. Luckily, I was able to let it go last night. We are back from the vet and she thought it was some sort of dermatitis type irritation. She said it is kind of by a lip fold and it just looked a little inflamed and irritated. She thinks the grooming probably made it flare up. She also thought there was a hint of a yeast-like smell, but was glad it was dry, rather than wet. It does look better today then it looked on Tuesday night. We got some wipes that have a fungal med in them and I have to scrub the area twice a day for two weeks, and then as needed. She did not want to give a pill if she didn't have to because of the side effects (I guess they can be hard on the liver), so hopefully we can get it cleared up soon.
Feeling relieved!
Julie & Hannah
Squirt's Mom
07-14-2011, 01:44 PM
Hi Julie,
Glad it turned out to be nothing major and hope the scrubbies will heal it in no time! I know what a relief it was to hear what the vet had to say.
Awhile ago I found several lumps in Squirt's belly about 10pm one nite. By 11 it was cancer, by 8am it had metastasized. :o:rolleyes: It turned out what I was feeling was her BOOBS! :p She's lost weight since starting the Lyso and I hadn't felt them in years...so, of course, I panicked big time! LOL Our vets get quickly used to me flying in the door in tears over some silly little thing or the other. :o:D
Hugs,
Leslie and the gang
Leslie-
I am just like you! I totally go through the cycle of it's probably nothing serious, to it is the worst possible thing, with the worst prognosis. Luckily I didn't have enough time to get too worked up before the appointment. I really like the vet I saw today too. She just joined the practice a few months ago, but she seems to be really on top of research, and really wanted to think and talk about how many vaccines Hannah should get and how we should proceed from now on. I like my other vet too, but might actually try to see this one more often, since I know Cushing's is always at the front of her mind.
She also recommended a Thundershirt for my other Shih Tzu, Izzy, who is terrified of thunderstorms and fireworks, etc. and it has really helped! We went from constant shaking and panting and climbing all over us, to a calmer dog who still shakes occasionally or needs a bit of cuddling, but can pretty much lay down next to us and relax. I have my sanity back! So, if anyone else has issues, you may want to look into the Thundershirt. It has a money back guarantee too. Can't go wrong!
I hope the wipes will work too. I am concerned I am not doing it right. I don't know how much to scrub/wipe/etc., but I guess we'll see how it goes. Also, it is so close to her lip and she is always licking her feet, so I have to try to prevent her from rubbing it on her foot and then licking it. The vet assured me it should be okay and said I could wipe it with a washcloth after if I wanted to be extra safe. What can I say-I don't have human babies yet, so my dogs are my babies and I want them to be safe!
We go in the first week of August for her next blood test, so at least they can take a peek at it again then. I'm always waiting for the next result, as well as the next thing to go wrong...luckily there are usually a few peaceful weeks or months in between!
Julie & Hannah
Hello-
So we're treating the "chin issue" with the medicated wipes and Hannah lets me do that with no problem. My husband and I were out of town at his parents' house for a couple of days and my dogs stayed with my parents. My mom commented that Hannah doesn't seem to be able to/want to go up the two big steps to their porch. She went up them fine when we dropped them off and has always done it before. Then my mom thought maybe it was because she was tired from her walk.
Hannah's had difficulty jumping up on our bed for years, so I have a little stool type thing especially for her. Last night and today she seemed really resistant to use it. She usually just jumps right up and then onto the bed, but it was like she couldn't figure out how to get up there and wanted me to help her. Today I even had a tiny piece of sausage to see if that would make her jump right up (she is very food motivated) and it still took her a little while to do it.
This is a definite change since Thurs. Does the back leg weakness typically come on so quickly? I feel like it is a huge change. Nothing else is different. We haven't started any other new meds. She gets her Anipryl in the morning and now I do the chin wipes twice a day, which shouldn't affect her legs. She still doesn't pant or have the pot belly. Her eating has improved-she still loves to eat, but isn't begging or bugging us for food, or pushing my other dog out of her dish. She still gets a lot of drinks, and she usually gets up to get drinks at night now too, but she isn't going through bowls and bowls of water, and the peeing is still under control, just more often.
She is going to have another blood test in a couple of weeks to check her levels, since her ALKP level did actually drop significantly after being on Anipryl-I believe from 1770 to 680 or something (although that is still high, as I believe the high range was 212 at my vet's office). At this point I'll keep an eye on her and see what the next blood test shows, but I'm worried that we've moved into the next phase of issues with the back leg weakness (unless her legs hurt from something else? she does go up and down the steps willingly) and even maybe with this chin issue.
Just thought I would see if anyone has any other thoughts or recommendations.
Thanks!
Julie & Hannah
Hi Julie,
My Zoe's back leg weakness came on fast and worsened quickly. Of course you need to rule out any underlying problem. Hypothyroidism, arthritis, back problems just to name a few can cause hind leg weakness.
Do you see any trembling in her back legs?
Hugs,
Addy
Squirt's Mom
07-17-2011, 01:49 PM
Hi Julie,
I'm not sure how quickly the hind-leg weakness and hesitancy to jump can come on but I do know this - pups with elevated cortisol are prone to ligament damage, primarily the ACL and cruciate ligaments. These can tear suddenly. Since these pups are already prone to problems, it is best that they not be encouraged to jump, or climb stairs, etc. when they are hesitant to do so. Hannah knows how her legs are feeling and will act accordingly to preserve them under normal circumstances, ie, not in a fear or danger situation. So, if I were you, I would follow her lead and not try to make her jump or climb. ;) They can't speak to us in works but if we watch them, often we can still figure out what they are saying.
I remember when Squirt quit jumping up and down from things like she always had. I tried my best to keep her from jumping down period after her first knee surgery, but sometimes she did. :eek::rolleyes: It has been 2 years or more since she had jumped up on or down from anything. She does still climb up steps, not stairs, most of the time. Some days, her knees are bothering her so she patiently waits at the bottom for me to pick her up. She will occasionally go down on her own, but I usually make her wait for me to carry her. I look at it as giving my arms, back and legs some exercise, LOL, and more opportunities for hugs and kisses. ;)
...since her ALKP level did actually drop significantly after being on Anipryl-I believe from 1770 to 680 or something...
One of Squirt's wonderful vets in TN told me that she had consistently seen ALKP values lowered in all her patients who were on Anipryl. It had the same effect on Squirt. At the time, I couldn't find any scientific studies, etc. about it and Dr. W said she had never read anything in the journals. But she knew what she had seen over the years and Anipryl lowers the ALKP for some reason. :cool: Thanks for reminding me about this little quirk!
Hugs,
Leslie and the gang
Thanks, Ladies. I'll follow Hannah's lead and prevent her from jumping until she wants to do it on her own.
Addy, her back legs are not shaky, and she moves around at a normal pace with her tail up. She does seem a little awkward to me when she jumps off the one step on our deck (she chooses that path and jumps into the rocks by the fire pit before going to the grass to potty) that she looks a little awkward, but sometimes she is like that after having her toenails trimmed-slips around on the deck, tile floors, etc.
Do you agree that it is okay to just watch her at this point? She seems happy otherwise, still wagging her tail and moving around like normal. We were just at the vet on Wed. for the chin issue and we have an appt.8/1 for a blood check, so I'm hoping that if it doesn't get worse I can just watch her and keep track of her issues.
Also, I'm thinking ahead here, but assuming this problem persists or worsens, what do you guys think about changing treatment? I know my vet mentioned Trilostane as the other treatment he would try if things were worse. (And I also know I could go to a specialist for treatment or a second opinion). I don't want to not help her, but she also doesn't have really severe symptoms so I don't want to jump into anything too soon either.
Thanks again for your support! I really don't know what I would do without this forum!
Julie & Hannah
Hello Everyone-
I took both of my dogs to the vet today to get their anal glands expressed. I could smell Izzy's, and figured I would just get Hannah's done as well. We also made an appointment to see the vet since Hannah abruptly stopped being able to jump up onto the bed, furniture, etc. on Saturday. I talked to one vet Mon. and he told me to let her rest and prevent her from doing any jumping for 5-7 days and then to let him know. They decided to see her today.
First, both dogs had anal sacs that were completely full, but not infected or abnormal. I saw the vet I really like today and she manipulated Hannah's back, legs, etc. and said everything felt normal and she showed no pain or tension when the vet felt her back, and her legs had good movement, etc. She said they can usually tell when the dogs are in pain and Hannah didn't act like she was. She is otherwise normal at home too.
The only explanation the vet had was that it could simply be that her anal glands were so full that she was really uncomfortable. She told me to give it another 24 hours to see if anything changed. If not, they are going to have me go back Sat. and do an x-ray and some further checking. She said we could potentially try some NSAIDs, but she is always a bit hesitant with Cushing's dogs, and also mentioned something about a glucosamine supplement (I think???) but wanted to look over her blood work again.
I asked if she thought it could be anything that has to do with Cushing's, and she said that although the back end weakness is common, that Hannah doesn't have any signs of muscle wasting, (or have any other physical signs of Cushing's) and that usually it wouldn't be so sudden and abrupt. I just wanted to check in with all of you to see if you have any other thoughts.
She also took a look at the spot on Hannah's chin that we were in for last week and said it looks much better and thinks it is a combination of an irritation with the skin fold by her lip (so I should continue the medicated wipes once a day) with possibly a little lump or wart in it. She said it is mobile so she is not concerned and that I should just watch it to be sure it doesn't get irritated. I am relieved that is looking better, but I am always so unsettled when something else is wrong, that I can't quite shake my nerves/the bothersome feeling about this inability to jump. She seems fine on the stairs, and even going off and on the deck to go potty (which I had been limiting since Sun.). She is otherwise normal. I swear, it's always something. I always have this bad feeling that it is something terrible.
Anyway, thanks for listening, and let me know if you have any thoughts.
Julie & Hannah
Hannah still doesn't seem to be over the issue with jumping. Today she jumped up on the bed twice (using her stool) and then on the ottoman once, and then we were back to the point where she acts like she can't do it. She puts her front feet up and can't seem to jump. My vet and I discussed options of what to do. They think something is hurting and said we could try an NSAID-Metacam (he said it is more the kidneys than the liver that the drug impacts) or Tramadol. He feels that she might have some inflammation and recommended the Metacam-giving her a 12 lb. dosage (can't remember if that is ounces or what). He said they usually do the first dose at double, but thought for her we should not. He said the biggest issue would be GI upset with the natural steroids she produces mixing with the non-steroidal med. I just wanted to check in with all of you for any major issues/warning signs. I hate starting these things on weekends too!
Thanks!
Hannah & Julie
lulusmom
07-22-2011, 07:54 PM
Hi Julie,
If Hannah were on Lysodren and Trilostane and you knew for a fact that her cortisol was within the recommended therapeutic range, I'd say try the Metacam. I used to give my Jojo Metacam once his cushing's was controlled but I doled it out sparingly. I put him on cosequin and he gets his fish oil and he has done well without an other meds.
Honestly, I don't trust Anipryl to effectively reduce cortisol so until you know for sure, I believe giving Hannah Metacam is too risky. If Hannah has arthritis, ask your vet about cosequin. Actually you can purchase it online without a prescription. If Hannah doesn't have arthritis and you think she may have strained a muscle, you need to keep her from jumping up on or down from everything and give her Tramadol if she appears to be in pain. That's my two cents.
Glynda
Thanks,Glynda.
She doesn't have arthritis, that we know of. Like I said, she was examined yesterday by the vet I really like. She said Hannah showed no signs of tensing or being in pain and that usually Shih Tzus will. I told her Hannah may be an exception because she is truly the sweetest, most kind dog ever. I said I could probably cut her foot off and she would give me kisses while I did it. This started last Sat. and I rested her the whole time.
The other option he gave me was Tramadol, but then said she may need to reduce inflammation.
I don't know what to do. Should I call tomorrow and say I don't want to risk this? What is the greatest risk? I know it can cause death and kidney failure, etc., and a million other bad things that are always on medication, and obviously they have to tell you every possibility. I am most worried about her liver. Is that your concern too? He said I could also try a lower dosage than she needs. (She is 12 lbs. and they have me giving the 12 lb. dose). It just says in all caps to STOP IF SHE IS NOT EATING OR DRINKING.
How soon would I see a problem? UGH. I hate this. I don't want them to think I am crazy, and I want them to know I value their professional opinion, and he did give me options, but how am I to know what is best?!?!?!
Any other input you have I greatly appreciate. I can't seem to enjoy myself when things are not right with my girls.
Julie & Hannah
lulusmom
07-22-2011, 08:19 PM
Julie,
Jojo's internal medicine specialist, under no circumstances, would prescribe Metacam until an acth stimulation tests showed that his cortisol was where it needed to be. It is not only the adverse impact on the liver and kidneys that are concerning, the stomach ulcerations/perforations resulting in internal bleeding scares the stuffing out of me. Warnings on the label are very clear that NSAID should not be used in conjunction with corticosteroid hormones because the potential risk for side effects is increased. Cortisol is the same thing as corticosteroid hormones so the question is can your vet assure you that Anipryl has effectively reduced Hannah's cortisol levels?
Julie,
Cortisol is the same thing as corticosteroid hormones so the question is can your vet assure you that Anipryl has effectively reduced Hannah's cortisol levels?
I don't think he would say he is confident about that, no. He said Anipryl was a place to start, due to the fact that she did not have significant symptoms (as in I wouldn't have called the vet yet to say something was wrong) but that it was a place to start. She does seem slightly better--not begging for food. Water intake is the same, but it was only slightly higher, and she can hold her urine over night and during the day while gated in my kitchen, so we didn't want to move to anything stronger yet.
So, your suggestion would be to get the Tramadol? He did say that would eliminate my concerns about Cushing's.
Thank you so much again. I don't know where I would be without this forum. I call it my support group.
Julie & Hannah
Well, I'm on my way to pick up Tramadol for Hannah. The regular vets aren't there today, so there is a "sub." I told the person who answered my concerns, and she called back and said the Tramadol is ready. Anything I need to know about Tramadol or the dosage before we start? They said it is twice a day. Hannah weighs about 12 lbs.
Thanks!
Julie & Hannah
Squirt's Mom
07-23-2011, 11:52 AM
Hi Julie,
If it were me, I would start with 1/2 the recommended dose. It has been our experience that Tramadol can cause some pretty harsh side effects unless the dose is cut. For some reason, the recommended doses usually turn out to be too much and the pups are nauseous, dizzy, and lethargic. So folks who use it here, usually start with a much smaller dose.
Hugs,
Leslie and the gang
They gave me four 50 mg pills, quartered, and I am to give it to her two times per day. She is 12 lbs. so this would be 12.5 mg per dose. I'm not sure that I can cut the quartered pills, as they are already pretty small. My parents have two dogs that have been on it with no issue, but I don't know how their vet determined dosage. From your experiences, is this still potentially too high? Or is this about right? Again, not sure I can cut them anyway...
And maybe more concerning, what do you make of this?
[I]Contraindications include dogs who are being treated with L-Deprenyl for Cushings or cognitive disorders, or dogs taking serotonin reuptake inhibitors, monoamine oxidase inhibitors, or certain antidepressant medications.
I found it on this website when looking for dosage info. http://vettechs.blogspot.com/2005/04/tramadol.html
And yet another one:
I[I]nteractions with Other Drugs:
The beauty of this pain reliever is that it is compatible with all the COX -inhibiting non-steroidal anti-inflammatory drugs, possibly even synergizing with them. It is also compatible with joint pain neutraceuticals such as glucosamine, MSM, chondroitin sulfate etc.
Tramadol is NOT compatible with L-Deprenyl. Animals taking L-Deprenyl either to control Cushing's syndrome or to control senility may not take any sort of narcotic medication including tramadol. Similarly, tramadol is not compatible with other psychoactive drugs such as serotonin reuptake inhibitors, tricyclic antidepressants, or monoamine oxidase inhibitors. If you are not sure if your pet is on one of these medications, check with your veterinarian.
This time from this website: http://www.veterinarypartner.com/Content.plx?P=A&A=1815&S=0&EVetID=0
What in the heck?!?! HANNAH TAKES ANIPRYL! I am starting to wonder about my vet (although the woman today was a sub since the regular ones were both out, but my regular vet suggested this too). Does anyone know about this? Is this information old or inaccurate? I called and left a message for the regular vet to call me on Monday and have decided not to do anything before then, except to continue to prevent Hannah from jumping on or off anything (she has no problem jumping down and does if I don't catch her).
Again, I have been very happy with my vet for the past 5 years (and they are definitely really current with their care, procedures, technology, etc.), but he did ask me on the phone yesterday, "Is Hannah the one with Cushing's?" Granted Hannah and Izzy look very much alike, and he has many clients, and we talk enough that he probably can call me without needing to review records, but I found that to be a bit concerning.
I am starting to feel like a crazy person. I don't want to second-guess everything that comes at me, but I feel like if I don't thoroughly check things out and be an advocate for her care, then something could go wrong. (I have picked that up from reading so many stories on this site). I don't feel like I should be the one who finds these things!!! (Unless somehow this is incorrect). I am so frustrated right now, I can't even stand it!
Thanks again for the advice (and for listening to me rant)!
Julie & Hannah
Squirt's Mom
07-23-2011, 02:29 PM
Hi Julie,
If memory serves me correctly, Dr. David Bryuette was involved in studies on Anipryl and I bet he can tell you if Hannah should have the Tramadol along with the Anipryl. If there are any serious contraindications, he should know. Here is an email addy I found for him but am not positive it is good. I would try anyway, tho.
David.Bruyette@vcahospitals.com
He is also a member here so you might contact him via a PM. He is listed as David Bruyette in the members list....you will find this under the "Community" button above.
I think you are very wise to research everything. You are a great advocate for Hannah!
Hugs,
Leslie and the gang
hi julie,
if memory serves me correctly, dr. David bryuette was involved in studies on anipryl and i bet he can tell you if hannah should have the tramadol along with the anipryl. If there are any serious contraindications, he should know. Here is an email addy i found for him but am not positive it is good. I would try anyway, tho.
david.bruyette@vcahospitals.com
he is also a member here so you might contact him via a pm. He is listed as david bruyette in the members list....you will find this under the "community" button above.
I think you are very wise to research everything. You are a great advocate for hannah!
Hugs,
leslie and the gang
thank you!
Hello-
I thought you might want to know that I did email David Bruyette, and I got a response from him. He said that it should be okay in dogs, and that there was an adverse response with humans. I wrote him back and included the information I found, as well as the link, to see if he believed it to be incorrect or outdated. There is nothing listed on the Anipryl drug sheet, but there is on the Tramadol info., at least from what I have seen. I also read a couple of questions written online with people reporting an issue with combining those two medications. I will see if he responds. As of now, I am waiting and doing nothing.
Tonight when I was putting a load of laundry in the washer, Hannah raced down the steps to see me, and then wanted to go back up too. I have still been limiting this (unless she does something like this without me being right there). She also jumped up onto our bed again out of the blue. I don't know if I should just let her do things as she wishes, or still try to limit and jumping and stairs. The vet couldn't seem to find anything wrong, so I don't know if I should mess with any meds period, or what. She is such a mystery to me!
-Hannah & Julie
StarDeb55
07-23-2011, 09:47 PM
Julie, I don't believe I have posted to you before, but I have certainly been following Hannah's story. I do want to caution you about letting Hannah do much racing around like a "wild woman". Our pups seem to be very prone to cruciate ligament injuries in their knees. Whether this is due to the muscle wasting from Cushing's, I don't know. To show you, my 1st Cushpup, Barkley, ruptured a cruciate ligament simply chasing a toy that I was throwing for him through the house. I threw the toy up to the kitchen, B goes tearing up there, & has a bit of a slip on the linoleum. Bamn!! He comes up lame. He had to go to surgery to repair this injury, & the abnormal pre-op labwork is what put us on the road to a Cushing's diagnosis.
My Lhasa was given tramadol when he ruptured his cruciate a year ago, simply by jumping off the bed. I gave him the dose suggested by the ER clinic that night. I swear, it was like Chewy was "stoned", on drugs, or something, he was so out of it. Chewy is not a Cushing's boy, so I can't blame the ACL rupture on Cushing's with Chew.
Debbie
Thanks, Debbie. I just don't know how long I should try to keep her from doing anything, since I have no idea what hurt and she otherwise walks and acts perfectly normal.
This started last Saturday. Then on Friday (after having her anal glands expressed, which is what they thought might have caused her to not want to jump) she did jump on the bed twice before again seeming to be unable. Do you think I should try another week? I just don't know how to know when she is feeling better...since she makes it very clear when she does not want to/can't jump.
The vet manipulated her back legs around and said she had really good range of motion. She also said that Hannah didn't appear to have any muscle wasting yet, and otherwise looked very healthy. I just don't know what it is.
I guess for now I will continue to limit her jumping/stairs, and I'll wait to see what I hear from my vet on Monday. Maybe I can try to break off some of the Tramadol if we even end up giving it to her, but I just don't think I'll be able to evenly break a quartered 50mg pill.
Thanks for the information and for the advice. I truly appreciate it!
Julie & Hannah
Roxee's Dad
07-24-2011, 01:50 AM
Hi Julie,
A belated welcome from me :)
Just wanted to re-enforce what Debbie said about ACL ruptures. My Roxee ruptured her's shortly before she was diagnosed with cushing's.
Hi,
Just wanted you to know that I have been following along and am sending hugs. I think it is really good news that your vet does not seen muscle wasting yet and that Hannah has a good range of motion.
Zoe has a weak front paw that they never did figure out what was wrong with. It would bother her off and on. When it obviously bothered her, I limited her for a while. She had such a bad experience with Rimydal that I did not want to try anything else.:eek:
Keep up the good work!!!!
Hugs,
Addy
Hi Everyone-
I'm thinking of possibly taking Hannah to an IM specialist. I'm wondering with the confusion about the medications, etc. if it is time to just have her seen by someone else. I don't know if an IM would have any better idea about what is going on with Hannah's sudden inability to jump, but maybe they could recommend a better plan that won't interfere with her Cushing's issues.
My main concern would be cost. I am willing to spend money on my dogs, and I probably spend a few thousand per year (without even major problems), but I don't want to go crazy spending loads of money and do every test out there.
Aside from the jumping issue, she is doing relatively well with her other Cushing's symptoms (although I have noticed that she does not seem as interested in walking--tends to trot for awhile at a pretty quick pace, then really slow down, sometimes even stops, and this tends to repeat throughout the walk). I took her just down a couple of houses and back today and saw the same thing; however, I assumed that now something might hurt, so maybe it is worse.
For those of you who do see a specialist, do you then go there for almost everything, or do you still see your regular vet for other issues? I am assuming they could talk to each other about medications, or that I could then be calling to check out what my regular vet was prescribing.
Hannah is due for her next blood test on Aug. 1st. I believe he just checks the main things--not a complete blood count. I'm thinking maybe this would be one pro about seeing someone now...I could have the test done there and they would then have some fresh information.
I haven't checked the cost, but I do know there are options in my area, and that my vet even said he recommended one that is within 15 min. of us. (This is when we talked about me possibly getting another opinion).
Just wondering what you guys think.
Thanks so much!
Julie & Hannah
Hi Julie,
Right now Zoe is seen only by her specialist. The main reason for that is I did not have a regular vet that I had a positive relationship with that I could trust to take care of her other needs and work with her specialist.
Her specialist does not have convenient hours, I have to take off of work and it is a further drive for us.
I have a regular vet in town I would like her to start seeing. He is willing to work with me and her specialist. If I like him, I would start taking her to him more often for routine things as it is more convenient and I would not have to take off of work. We have not yet gotten to that point. Call me paranoid:D:D:D:D:D:D
Not sure if that helped you.
Hugs to you and Hannah, she is sooooo cute.
Addy
Hello Everyone-
I finally talked to my vet today, and he did review some studies and looked for more info. with using Metacam and with using Tramadol with Anipryl.
He said he understood my hesitation not to use them. He said most of the studies are with long-term use, but admitted that since we don't know Hannah's cortisol levels, the Metacam could be more risky. (Glad I spent $31.50 on it; I should see if I can return it, as it has not been opened).
He said the contraindications with Tramadol and Anipryl are mostly human studies (which is what Dr. Bruyette told me), but said he understood my concern because it could translate into pets, but that since it was only going to be a few days, he thinks it would have been okay.
I have given her nothing and she still isn't "normal." I limit her activity, but I know she does not want to jump on the bed most of the time.
My vet and I decided it is probably a good time to see an IM specialist. He has other clients who go to this place and have been very happy, and referred me specifically to the doctor who has dealt the most with Cushing's, and was able to get me an appointment on Friday (thinking maybe they would have more of an idea about the jumping issues and what med to try, if needed).
I am starting to wonder if the disinterest in jumping (or inability to do so) is related to Cushing's. She also really drags some of the time during walks, and it seems to be worse lately.
I guess we'll see what the specialist has to say. I have such mixed feelings about the appointment. It will be good to get a second opinion and see someone who is more familiar with Cushing's, but I also dread getting bad news too. I'll keep you posted on what we find out.
Julie & Hannah
logans mom
07-28-2011, 12:27 AM
Hi Julie,
I am glad you made an appointment with a specialist. I hope you can get some answers as to what is going on with Hannah's leg weakness. Please keep us posted.
Love
Debbie & Logan
Julie -
How is Hannah doing? I was just reading your thread and was glad to read she had a normal ultrasound. Hopefully, she will not progress and you won't have to treat her with anything else. It's always so hard to know what tests to have, etc., etc. It is nice to be able to come here and compare notes and realize we all love our dogs and are doing our best.
Hello-
Thanks, Mary Beth, for checking in. I took Hannah to an IM specialist yesterday. I really liked her and she took her time answering my questions and telling me what she thought, while also listening to my concerns.
Basically, she believes that the dog should not be treated with Lysodren or Trilostane until symptoms are severe and the dog's daily life is being affected. She said they are very effective drugs that can really improve a dog's quality of life and can greatly reduce symptoms, but unless the symptoms are significant it is difficult for the owner to know if the drug is working. I am with her on this.
At this point she didn't really think it was time to start Hannah on either of those meds. Her symptoms are an increased thirst and appetite (more peeing, but not needing to go at night or having accidents in the kitchen, which is where my girls are barricaded when we are gone). She is not panting, has no potbelly, and does not have skin or coat issues. The ultrasound looked normal, which she agreed probably means it is still in early stages. Recently (the last few weeks) she has occasionally really dragged on short walks, although she has never been a huge fan of walks, which I figured could be slowing down due to Cushing's. The IM said it could also be if she is having any pain.
She examined Hannah and looked at her chin issue, since I noticed a little lump and some inflammation a few weeks ago and took her to the regular vet. She agreed with my vet that it is some sort of lip fold issue-I can't remember the correct medical term, but like an acne. I have some wipes to use as needed if it is looking irritated. They want to prevent a yeast infection. It does look much better.
She didn't have the answer about the sudden inability to jump. She said sometimes dogs don't show their pain at the vet, and that she has had people bring in dogs who are apparently not moving at home, and then at the office they are bouncing around like puppies. She suspects that Hannah does probably have some sort of back issue, and that potentially her Cushing's is playing a role because her muscles could be just a little bit weaker. Or it is possible that she just has a back issue. She said the smaller breeds of dogs are prone to disc issues.
She also told me the only way to really know would be to do a CT scan of her back, which she felt might be aggressive at this point. At this point, I really can't spend the money on that either. She watched how Hannah came over to me and put her feet up on my lap to be picked up, and agreed that she can't be in severe pain based upon how I describe her acting at home, and from what she saw in the office.
Basically, the recommendation she gave me was to go ahead and try the Metacam my regular vet gave me last week. I asked about the issue with the cortisol interacting with the drug. She said she has had several other Cush dogs on the drug, and that for some reason the natural steroid does not seem to react the same way as a synthetic steroid, and that the dogs do fine. She suggested I try it for a short time, like three days, to see if I notice any improvements in Hannah. She told me to make sure she is eating and drinking, and that if any of that changes, or if she is having GI issues to stop. She talked about the other side effects (internal bleeding, major stomach issues, etc. but said they do not see that with Cush dogs like they would if they were given prednisone).
I emailed Glynda several times to get info. from her. I know there are risks and I am still a bit worried about it, but after talking to the specialist who uses it in other Cushing's dogs I feel a little better than just hearing from my vet. Glynda said I should know what to watch for (I'm going to review the link she sent me) in case something goes wrong. If Hannah shows no improvement, the IM said I should stop.
At this point I am thinking I will wait to give it to her until Sun. night, just because of the fact that if something does go wrong I am more likely able to get into the regular vet office, rather than the ER vet (where we have made way too many trips with our pets!).
Here is the one other thing I thought of: Hannah has a blood test on Tues. (just a smaller profile CBC) to see how her liver levels, and other major things are doing with her being on the Anipryl. Do you think there is any way the Metacam could interfere with that? If so, I don't want to give it to her before the test.
I talked to the IM about if we should continue the Anipryl (the main difference we noticed is that Hannah is not begging for food as much) and she said it wouldn't be bad to go off it and see if I notice a difference, but she thought I should get this blood test to see if her ALKP level was still down. She said if it has gone back up I know the Anipryl is not helping that at all. (In her first test, after a month of Anipryl, her ALKP went from 1770 to 680 or something like that).
I'd love to hear if anyone knows the answer to Metacam affecting the blood test so I know if I should wait. At this point, it has been two weeks since she has stopped jumping up on furniture and she has had no medication for it. She seems fine otherwise.
Thanks for listening, and for any input you have!
Julie & Hannah
Hi Julie,
i have been researching Cushing's Neuropathy in dogs. I have found a few links regarding it but am unsure of really how reliable the information may be so I will keep looking. From what I found so far you need to catch it early. Zoe's onset of hind leg weakness was my most pressing concern for her over all her other symptoms.
I thought you might want to research that for Hannah.
Thinking of you and wishing you well. Thank you for all the well wishes.:):):)
Love,
Addy
Hannah had another blood test today to see how she's doing. Her ALKP level has dropped again, thankfully. Back in March it was 1770, in May it was 689, and today it was 327 (with normal being 23-212). The only thing she is taking is Anipryl, so either that is causing the ALKP level to drop, or it is somehow dropping on its own. At this point, we'll continue the Anipryl.
Her platelet count was slightly high again (505 and 148-484 is normal), as was her PCT (.47% and normal is .14-.46), and her MCV and MCH levels were just slightly low (MCV was 59.4, with 61.6-73.5 being normal & MCH was 21.1 and 21.2-25.9 is normal). These were normal in May. The vet said he is not concerned about any of these, so I guess I shouldn't be.
Everything else was normal. I'm glad her liver is doing better, and now I just wish we could get the hind end issues figured out. It's hard to know if I should be limiting her activity entirely, or doing something to help her maintain some muscle strength (if that is the issue). She still does not jump up on anything, and I don't let her do steps, but I did take her for a short walk to try to keep those legs moving.
She otherwise seems fine and happy, so I guess I'll try to focus on that instead of worrying about her. I'd love it if her back end recovers, but I'll take an otherwise happy girl for now.
Julie & Hannah
Hi, Julie!
Just here today trying to catch up on everyone. First of all, I am glad to hear you found an IM that you like and who seems to be so thorough! Hannah's recent blood test results sound WONDERFUL to me!!! Sounds like you should just continue to do exactly what you are doing. As far as her not wanting to jump, during all of Alivia's testing, they found she has some pretty severe arthritis in her lower spine (an x-ray showed it). After all, she is 13 years old. Anyway, they said it could be painful and that she should refrain from jumping a lot. I give her a glucosamine supplement (Cosequin DS - available online and at pet stores). I also have put doggie steps to my bed and a small stool by the couch so she doesn't have to jump as much. Overall, she seems to be doing very well.
I hope Hannah continues to do well!
Squirt's Mom
08-13-2011, 12:58 PM
Hi Julie,
I am pleased to hear that Hannah's liver enzymes are dropping...and based on what our vets in TN told me, the Anipryl is the reason. ;) They told me every pup they put on it, the liver values drop. Is it still helping with her signs? Squirt did very well on on it for quite some time so I am an Anipryl supporter for sure!
Hugs,
Leslie and the gang
Hi Mary Beth & Leslie,
Thanks for checking in. Hannah's other symptoms seem about the same on the Anipryl-her begging for food decreased slightly (although recently she has had a few episodes) and her drinking seems about the same, but it is definitely not buckets. I measured what I typically put in the bowl (about 3-3 1/2 cups) and between Hannah and my other Shih Tzu, Izzy (7.5 lbs.), they don't quite finish it in a day (although Hannah is drinking much more of it than Izzy). There is another dish Hannah sometimes uses (and Izzy never does) and that one doesn't go down too much. She definitely drinks more water, but not crazy amounts, and still does not need to go outside overnight. In fact, she sometimes makes it close to 10 hours overnight. Still no panting, no pot belly, no hair loss, no skin issues. Just the new mysterious lack of being able to jump.
We went to the vet yesterday because Hannah had an ulcer in her eye (something we have a lot of experience with). Izzy seemed to get mad at her in the middle of the night when Hannah was moving around on the bed, and I assume a tooth connected with an eye. It showed up as a small spot in the center of her eye (with the dye) and did not appear to be deep, thank God. We are on the usual routine of pain meds and antibiotic drops.
While we were there I asked the vet (another fill-in vet) to check her over, as we talked about the jumping issue again. She also checked her anal glands again to see how they were (they were really full a few weeks ago) and they were empty. So that is not the issue. I mentioned that she seems to strain when she poops and walks around and drops a few turds in a few different places. A couple of times I have even heard her make a grunting sound. She doesn't always go daily (which can sometimes make them hard) and I asked if they thought it was tough for her due to not going enough, or if they thought that was related to the inability to jump.
She felt her back again and said she felt absolutely no tension or resistance anywhere, but that she felt that Hannah did resist when she moved her legs a certain way, so she feels it may be some arthritis in her hips. She said that could contribute to her not wanting to poop (which is sometimes how it seems), but it could also be due to straining. I have only fed her dry kibble (she is on an Rx food, Royal Canin Urinary SO), so I bought a couple of cans and we are going to try that. I have read on here I can also try pumpkin. How much would I give a 12 lb. dog?
We talked about possibly using Cosequin, but I believe my regular vet said that many dogs don't respond well to it. I am sure he will be willing to try it and the other vet and I decided I would talk to him about it next week. This vet said that Metacam is good for arthritis, but I really do not want to do that long-term with Hannah because of Cushing's. My parents use Tramadol for their collie with arthritis and my mom says it works great. The vet just said it doesn't do anything for the inflammation. I have not tried Hannah on the Tramadol at all because I was worried about what I read about the contraindications with Tramadol and Anipryl, although I was told that was only in humans.
We went for our short walk tonight, which is now about two blocks for Hannah. She stops periodically, but I am never sure if she is tired, in pain, or if it is all about having to poop. She sometimes walks and drops a turd and then seems to realize she has to go. She has always been a bit odd with her pooping, but this seems to be more bizarre. I can't tell if she doesn't want to squat or what.
Sometimes I feel pretty encouraged about how she is doing-that her blood work has improved, she has no other major Cushing's symptoms, she seems to be fine walking and moving around the house (even doing stairs). Then I get worried and discouraged about not knowing what the issue is with jumping, pooping, now her sore eye...she sometimes looks and seems like she is about 20 instead of 12.
She is still very happy to chew on her bone and still follows me around like crazy, and I can still make her wag her tail by talking to her, so she must be happy. I just have this nagging feeling that her time is limited. But who knows....my vet and the IM specialist seem to think she is doing quite well. She does just seem like she aged a fair amount in the last 6 months or so...but again, she does not have symptoms that warrant more aggressive treatment.
For now, I try to walk her as much as she wants to go, in order to keep her mobile. I am going to talk to my vet about trying something for joints. I know it can't hurt to try. I have wondered if constipation is an issue for Cush dogs from reading about several dogs having issues on here. Maybe the poop issue is not connected to jumping. I don't know. I just want her to be able to walk around okay and do her business. I can handle no jumping.
Any thoughts or advice is appreciated!
Julie & Hannah
Hi Julie,
Pumpkin can be a bit tricky; too much can cause loose stools. Maybe ease in to it with 1 teaspoon and see how that goes. It depends on how much other fiber (soluble and insoluble) is in Hannah's diet.
Zoe averages about 19 pounds and does not have a lot of fiber in her diet but even then sometimes 1 tablespoon would be okay and sometimes 1 teaspoon was enough. But remember, she has colitis.
When I used to research it I found dose suggestions ranging all over the place.
I waited to treat Zoe until her symptoms became a bigger concern for me. If you are comfortable where Hannah is now with her symptoms, I understand why you would leave things the way they are.:):)
Hugs and love,
Addy
apollo6
08-14-2011, 03:59 PM
Dear Julie and Hannah
You have been so kind to check up on me and Apollo. I wish I could give you a magic wand about Hannah's leg weakness. Like Apollo it could be cushing myopathy. Apollo has had back issues for years, but he never had the hind leg weakness like now. I have him on joint supplements, L-glutamine( can get in any drug store-500mg- I open the capsule and give Apollo about a1/4 of the powder) also Glucosamine-Chondroitin for dogs. My gut feeling is it is the Cushing causes the legs to be stiff, and hardly mobile. Apollo used to climb on the stairs and ramps to the couch. He can no longer do so. I try to make him do little walks around the house and cox him with treats.
Have you had Hannah's intermediate hormones checked this can cause the weakness. This disease is so complex.
Sending prayers and good thoughts your way.
Hugs Sonja and Apollo
Hello-
We're thinking of starting Hannah on a joint supplement to see if it does anything to help her back end. My vet told me about a few options and gave me brochures to look at. I think sometimes he likes to give me the choice, but I would also like his professional opinion. The choices are: Phycox, Synovi, and Cosequin. He seemed to think Cosequin offered the less friendly dosing option for her if that makes sense. The only thing he said was that Phycox says it blocks the COX-2 enzyme to reduce inflammation, which he said is sort of like what Metacam does.
We are going back tomorrow to have her eye checked, and I also might have him check her ears, as she's been itching a lot. I might also start one of these. Does anyone have experience with any of these?
Thanks!
Julie & Hannah
Hi, Julie -
What did your vet mean by "less friendly dosing option"? Both mine have taken Cosequin for quite awhile and seem to do well on it. Alivia is 13 and Maxwell is 11. Initially they started on one tablet a day and then after a week or so you cut back to 1/2 tablet per day. The tablets are large and supposedly chewable, but neither of mine will take them like that. I crush it in a pill grinder and mix it with their food. I'm not personally familiar with either of the other two so I can't offer any comparison. It is definitely worth a shot for you to try one but it will take a few weeks to see if there is any improvement.
Good luck!!!
Hi Mary Beth,
I think he just meant that the other options would last her longer...or that because I said she probably wouldn't chew the chewable ones he thought these would be better because they are soft chews??? I'm not sure what Hannah would or would not actually chew (eat). I will ask again tomorrow. He really seemed fine with me choosing whatever I wanted, and that I could get it there, or buy it myself (he said they don't mark it up). I have no idea which one to use and have only heard of Cosequin. I guess I'll wait to hear from others, and then ask for more info. tomorrow.
Where do you buy yours?
Thanks for your help!
Julie & Hannah
apollo6
09-04-2011, 03:24 AM
Dear Julia and Hannah
You have always been kind to check on me. As far as the Cosequin goes, I have been using it for years on Apollo.
I have used Nutramax-Cosequin-Double-Strength-Chewable-Tablets.
I would put the name in google search and see what you come up with. Petmart, Petco, Dr Fosters might have. I bought the last one from Trader Joe's their brand.
You must be sure it is for the right size of dog you have.
Hope this helps.
Hugs Sonja and Apollo
http://www.amazon.com/Nutramax-Cosequin-Double-Strength-Chewable-Tablets/dp/B00028ZLTU/ref=sr_1_1?ie=UTF8&qid=1315117351&sr=8-1
Hi Sonja (& everyone else too!)-
I haven't posted in a while, but Hannah has not had any major changes. I did put her on Cosequin (the same one Sonja is using) about 2 1/2 weeks ago, and I do think it is helping her a little bit. She has jumped up onto the couch and the bed a couple of times, but it is still not a regular thing. I know it takes 4-6 weeks before I am supposed to see a big difference, so we'll see. She does seem a little better while walking and going poop, so I'm pleased with that.
Hannah has had some issues with straining to poop when she doesn't go every day (which I'm not surprised about), so I am trying to see if I can stimulate her with short walks, but otherwise the vet told me to try the pumpkin. She has been barking at us and scratching at our legs at night, usually a couple of hours after she eats supper, and I assume she is telling us she wants more food. This stopped for a while after going on Anipryl (back in April), but seems to be picking up again and has been going on for the last couple of weeks. The eating and drinking are still not over the top, and still no coat or skin issues, no pot belly, no panting, so regardless we'll stick with the Anipryl for now.
I've been trying to just enjoy the uneventful times with her and to not worry about every little thing, as long as she is happy. I teach 3rd grade, so I know I'll have plenty of stress with the beginning of the school year.
Thanks for checking in, Sonja! Although I have not been on here as often because of getting back to work, I'll still be checking in. And I'll definitely be back to posting when I have questions about Hannah.
-Julie & Hannah
Hi-
I have been so busy with the start of a new school year and last night I came home with a horrible migraine and was in bed all night. Ugh! Anyway, I have wanted to check in and get some input about Hannah.
It seemed that her hind legs were improving (she was jumping up occasionally and walking a little faster/further) after being on Cosequin. We started Aug. 19th, so it hasn't been a month yet. Lately though, she has been struggling again. The other night she was going soooo slowly up the steps and stopped halfway up. I ended up telling her to stop and carrying her. I also noticed she was definitely using her front end more than her back to get up the step onto the deck. She also has not jumped up for several days, and was REALLY dragging on the last couple of walks. I'm not sure if this is a sign of Cushing's getting worse, or if it could just still be something she has done. I have not had a chance to talk to my vet yet, but the original suspicion was that she strained or injured something in her legs (back checked out okay from them feeling) and that is why she was hesitant to jump unless the reward was worth it. I'm wondering if maybe she injured herself again from overdoing it a bit...
She has also been vocalizing more in the evenings (not overnight), about an hour after dinner, usually from about 6:30 to 8:30. She barks at us, and sometimes will then scratch our legs if we ignore her. I assume she wants food and sometimes I give her a little more, as she is not at all overweight. Sometimes I give her a rawhide and that does the trick, but not always. She also has terrible allergies right now and is so itchy. It's terrible. I have a call into the vet about what I can do besides Benadryl. She used to take a steriod at this time, which is obviously not an option anymore. I also have that pheromone spray you can put on a bandanna and put around their neck to keep them calm. That seems to work well to get her to sleep. She just seems so miserable. I am sometimes wondering if the barking is due to being so frustrated with how itchy she is.
The issue is I am struggling with the thought of is this all Cushing's related, or not?? She still is not a voracious eater. She eats quickly, but doesn't totally inhale her food, and she will wait until Izzy walks away from her dish before digging in; she doesn't push her out. She does drink a lot, but not "buckets." She doesn't empty a water bowl (medium sized) in a day, and this is with Izzy drinking too. Still no other signs....
I got a message from the other vet that said I could try increasing her Anipryl to the full 10mg pill each day since I did notice a decrease in that barking behavior when she started back in April. I'm open to that, but the pills cost me $87 for 30, so that is significant. We talked about the other option being different treatment. I am open to that at some point, if necessary, but I don't feel confident that her symptoms are strong enough for me to be able to see a major difference. I don't know how I would measure the food thing because I don't think she eats THAT differently from how she ever did. She likes her food. I could TRY to watch how often she gets drinks, but after she licks and chews herself for awhile she always gets a drink, so that could be somewhat related to allergies. I am just worried about her back legs getting really weak. I guess my gut tells me it isn't time to move to something stronger because I don't want her to end up really sick or dead because of getting too much, but I'm not sure what to do.
Any input? When it comes to Trilostane or Lysodren do you usually just go with what your vet is familiar with? Is there any way to decide if one is better than the other for your dog? Is one any safer? How do you decide when it is time? I am such a worrier anyway, and so, so busy now that my husband and I are back to teaching. If I have to put her on something else I really think I would drive her to my parents' house (they are retired) so someone could watch her all day. I feel like maybe it is complicated by all of the allergy issues. And maybe the up and down is normal. How long do they usually need to be on Cosequin to see an improvement?
Sorry for the long, rambling email. It has been swimming around in my head for a few days now. I have been trying to read to catch up on all of you, and I'm always thinking and talking about my "Cushing's group." I really don't know what I'd do without you guys.
Any thoughts are appreciated.
Julie & Hannah
frijole
09-08-2011, 10:16 PM
I re read your entire thread to refresh my memory... couple things.. did you ever give the milk thistle? I ask because when I used it my dog's alkphos levels went down. I know it was recommended but not sure if you tried it. I throw it out there as if you are using it, maybe that is why the numbers are down and not the anipryl. I tend to agree with the others and your vet that maybe you should try not giving it to see what happens.
I see where you did the ldds test but never saw an acth test. I would be curious how high her cortisol levels are. That would tell you how 'advanced' the cushing's is. That would assist in deciding whether to treat or not.
I can see why you'd be asking questions about lysodren/trilostane but I still don't see enough symptoms that I'd go there yet. Of course this is the internet and I might be missing a whole lot of the picture so... you make the call there.
Regarding which is best - theyare equally effective but work differently. I think most go with what their vets are most comfortable with. I used lysodren and my gal did just fine.
Since you mentioned the itching - have you tried melatonin? It could be that the hormones are elevated (common in cush dogs) and as a result some dogs get skin issues which can include itching and licking. Melatonin is available at health food stores and I used it with my dog. She was a licker.
It seems like your biggest concern is the issue with jumping and stairs. Have you done xrays etc to eliminate those issues? If so it probably is cushings related.
I'm not sure I helped you a whole lot but those are my thoughts for now... Kim
Hi Kim,
Thanks for sharing your thoughts. I did not ever try the milk thistle, so it has to be the Anipryl. We decided not to try anything else just for that reason-so we would know what was causing what to happen. My vet has never done, nor suggested the ACTH test. I remember asking about it once, but I can't remember what he said. Do you think it would be worth checking, even if her symptoms are not that strong yet? I really still feel like we are not there yet. The main things I feel that I would be able to watch for are eating and drinking, and I'm not sure they are excessive enough. Should I test the hormone levels you talked about? I have heard of people using melatonin, but thought it was more to calm them. I will ask my vet about it when I talk to him. They have not done x-rays on her. Neither the regular vet nor the IM thought there was a point at the time it initially happened. They said they may not see anything and that a CAT scan might be better. I'm not spending money on a CAT scan at this point. I know my regular vet would do an x-ray in a heartbeat; he just didn't want me to pay for it if it was inconclusive. We had spent a lot at the time with her meds, visits, tests, and a $700 dental on my other dog. I am curious what her cortisol levels are. She doesn't have any skin issues yet, but I wonder if the Cushing's is making the itching worse.
You gave me lots of good things to think/ask about! Thanks!
Julie & Hannah
frijole
09-08-2011, 10:51 PM
I wouldn't waste money on testing the sex hormones. I throw it out because based on what you have shared I agree that your dog has early signs of cushings and you shouldn't have to treat yet. That said, some dogs are classified as 'atypical' cushings early on and they have skin issues, itching, etc. Melatonin is a cheap and easy and safe treatment. I was wondering if it might not help with the licking and itching but if you think its allergies then go down the benedryl path.
What the acth test should tell you is how high the cortisol is.... that is an indication of how far along into cushings she is. The more uncontrolled the cushings the longer she's probably had it and the more likely you need to treat. That is why I throw that out... but really you are the one watching her and you'll know when its time to throw out some more money towards tests. ;):) Kim
I know the struggle you are having, I went through it myself with Zoe, when to treat, how to treat, her symptoms, etc. I think agree with Kim that knowing the results of an ACTH test might shed some more light on it for you. If you feel you are not there yet to move to stronger treatment, then you go with your gut. You see Hannah every day and know her inside and out.
Zoe's hind leg is still a problem for her, I see it now, what she does with it, how she walks and will have new IMS check it out and since we lowered her cortisol somewhat, the arthritis in her front paw is flaring up again. Other than that, she is doing well.
You will know when to treat.
Love,
Addy
Jenny & Judi in MN
09-09-2011, 11:34 AM
Hi Julie: Over on the diabetes forum on Patty's thread about her dog Ali, Benadryl was not cutting it for her allergies and she started bathing her in Zymox.
Someone said the Zymox creme rinse is the key. Not to rinse it all out and it gives some relief.
I hope you find some answers!
Judi
Cyn719
09-09-2011, 11:55 AM
Hi Julie - I ditto what Addy said - I have been there to - its hard to make these decisions - but I agree an ACTH test is probably a good place to start then you will know where you are at - thinking of you and Hannah:)
lulusmom
09-16-2011, 12:26 AM
Hi Julie,
I've been trying to catch up when I can and have finally found a chance to post. Between you and I, this post is a very dry and not so suspenseful novel. :D Check out my contribution in blue below.
Hi-
I have been so busy with the start of a new school year and last night I came home with a horrible migraine and was in bed all night. Ugh! Anyway, I have wanted to check in and get some input about Hannah.
It seemed that her hind legs were improving (she was jumping up occasionally and walking a little faster/further) after being on Cosequin. We started Aug. 19th, so it hasn't been a month yet. Lately though, she has been struggling again. The other night she was going soooo slowly up the steps and stopped halfway up. I ended up telling her to stop and carrying her. I also noticed she was definitely using her front end more than her back to get up the step onto the deck. She also has not jumped up for several days, and was REALLY dragging on the last couple of walks. I'm not sure if this is a sign of Cushing's getting worse, or if it could just still be something she has done. I have not had a chance to talk to my vet yet, but the original suspicion was that she strained or injured something in her legs (back checked out okay from them feeling) and that is why she was hesitant to jump unless the reward was worth it. I'm wondering if maybe she injured herself again from overdoing it a bit...
I have a couple of thoughts on this. Hannah is 12 years old so she is a senior and older dogs, like most older people, can't do a lot of the things they used to do. I say most people because not all of us stay in tip top shape by working out regularly. A senior with cushing's, even controlled cushing's, shouldn't be expected to jump up and down. I can't remember the last time either of my cushdogs took a leap or jumped up on anything and if they did, I'd have a stroke....well maybe not a stroke. :p
If Hannah's problem is being caused by continued muscle wasting due to the catabolic effect of cortisol, you should be able to tell by looking at and feeling Hannah's hindquarters. The head, spine and hips usually feel and look bony. It's easier to visualize this on shorthaired breeds so with Hannah's longer coat, unless you've given her a summer cut, you'll need to feel. Has your vet mentioned loss of muscle mass?
She has also been vocalizing more in the evenings (not overnight), about an hour after dinner, usually from about 6:30 to 8:30. She barks at us, and sometimes will then scratch our legs if we ignore her. I assume she wants food and sometimes I give her a little more, as she is not at all overweight. Sometimes I give her a rawhide and that does the trick, but not always.
I almost lost my Buster to a rawhide. He swallowed a piece of it and it lodged in his esophagus. These do not dissolve and unfortunately, none of the local vets had a scope long enough to remove any foreign object below the trachea. I had to rush him to a specialty hospital 50 miles away. The surgeon told me they see this way too often and didn't know why rawhide chews haven't been banned. I was scared to death because the esophagus is directly in front of the heart wall which is a thin membrane. The rawhide can easily erode the wall and once it breaks through the heart wall, the prognosis is not good. I was in tears for three hours in the waiting room. They had to hydrate him with fluids before scoping him. Buster was fortunate that there was no damage nor was there any scar tissue on his check up a year later. That was the last time any of my dogs or my family's dogs saw a rawhide.
She also has terrible allergies right now and is so itchy. It's terrible. I have a call into the vet about what I can do besides Benadryl. She used to take a steriod at this time, which is obviously not an option anymore.
Hannah could be like Marianne's Barkis and experience itching with high cortisol but that is not the norm. For that reason, I'm not sure Hannah's cortisol is high. As others have said, the only way to know is to do an acth stimulation test. I have to admit that I have always been concerned about Hannah's diagnosis. As I recall, her original diagnosis was based solely on the LDDS and high ALKP. The abdominal ultrasound which was done a few months later showed normal adrenals and liver. With ALKP that high, I would have expected both to have shown some degree of abnormality.
Physical symptoms are a large component of a diagnosis and as I recall, your vet had to ask you if Hannah had any symptoms associated with cushing's. You didn't seem quite convinced in your first post that Hannah had any of the usual symptoms. I believe you said you thought that she may have been drinking a bit more and maybe had an increased appetite. If you had to analyze Hannah's behavior in retrospect because you hadn't noticed anything until your vet brought it up, I'm not sure that's enough evidence to confirm a diagnosis.
Given the lack of overt symptoms, I'm glad that your vet prescribed a benign treatment like Anipryl. ACTH stim tests are not necessary when treating with Anipryl because it's pretty well known that it rarely has any effect on cortisol. I've read studies that have shown efficacy rates as low as 20% but according to Dr. Mark Peterson, it is closer to 10%. I apologize for not asking before now but did your vet tell you that he was prescribing Anipryl to remedy symptoms, reduce ALKP or both?
As I recall, when the initial urinalysis was done, Hannah's urine was not dilute and USG was 1.023. Despite the various reference ranges used by labs, I believe it has been established that a USG of 1.023 falls within the normal range for a healthy dog that is adequately hydrated so I have to wonder if there was any urine abnormalities when Hannah was diagnosed.
I also have that pheromone spray you can put on a bandanna and put around their neck to keep them calm. That seems to work well to get her to sleep. She just seems so miserable. I am sometimes wondering if the barking is due to being so frustrated with how itchy she is.
The issue is I am struggling with the thought of is this all Cushing's related, or not?? She still is not a voracious eater. She eats quickly, but doesn't totally inhale her food, and she will wait until Izzy walks away from her dish before digging in; she doesn't push her out. She does drink a lot, but not "buckets." She doesn't empty a water bowl (medium sized) in a day, and this is with Izzy drinking too. Still no other signs....
I got a message from the other vet that said I could try increasing her Anipryl to the full 10mg pill each day since I did notice a decrease in that barking behavior when she started back in April. I'm open to that, but the pills cost me $87 for 30, so that is significant. We talked about the other option being different treatment.
Can I assume that the other vet thinks that perhaps the barking is due to cognitive problems as opposed to cushing’s so an increase in dose may help?
I am open to that at some point, if necessary, but I don't feel confident that her symptoms are strong enough for me to be able to see a major difference. I don't know how I would measure the food thing because I don't think she eats THAT differently from how she ever did. She likes her food. I could TRY to watch how often she gets drinks, but after she licks and chews herself for awhile she always gets a drink, so that could be somewhat related to allergies. I am just worried about her back legs getting really weak. I guess my gut tells me it isn't time to move to something stronger because I don't want her to end up really sick or dead because of getting too much, but I'm not sure what to do.
Sorry for being lazy and not going back through your thread but has Hannah seen an ortho or neuro vet for her hind leg weakness?
Any input? When it comes to Trilostane or Lysodren do you usually just go with what your vet is familiar with? Is there any way to decide if one is better than the other for your dog? Is one any safer? How do you decide when it is time? I am such a worrier anyway, and so, so busy now that my husband and I are back to teaching. If I have to put her on something else I really think I would drive her to my parents' house (they are retired) so someone could watch her all day. I feel like maybe it is complicated by all of the allergy issues. And maybe the up and down is normal. How long do they usually need to be on Cosequin to see an improvement?
According to Nutrimax Labs, Cosequin is a supplement that provides nutrients to maintain joint health, it works more gradually than drugs. Improvement can range from gradual to dramatic. Following the administration schedule on the label, for your dog’s weight, they recommend an initial administration period of four to six weeks. Some dog may show a response in a shorter period of time.
It is good to choose the drug that your vet is most familiar with but that’s only if the dog has symptoms. If I was quite sure my dog had cushing’s but was not yet overtly symptomatic, I wouldn’t treat unless I knew for sure that an accompanying condition was being exacerbated by high cortisol. Right now Hannah doesn’t really have the usual symptoms associated with cushing’s; you don’t know if her cortisol levels are abnormal and you don’t know if her intermittent weakness is being caused by high cortisol. If an acth stimulation test shows that Hannah has high cortisol and you choose to start treatment, I personally would not choose Lysodren as the absence of symptoms will make it difficult for you to tell when she is loaded.
Sorry for the long, rambling email. It has been swimming around in my head for a few days now. I have been trying to read to catch up on all of you, and I'm always thinking and talking about my "Cushing's group." I really don't know what I'd do without you guys.
You’re reading somebody's post who has mastered the art of rambling so you have a ways to go catch up with me. Besides, rambling is part of dealing with cushing's.
Any thoughts are appreciated.
Julie & Hannah
Hi Glynda,
Thanks so much for your response. I didn't find it dry at all! :D
I really appreciate your input.
I also realize that Hannah's age could be contributing to her hind leg issue, but the thing that alarmed/confused me about it was that it seemed like one day she just couldn't jump anymore. She couldn't use her little stool to get on the bed. That is why they assumed it was more of an injury than Cushing's or age. It sort of improved after about 10 days on Cosequin. She jumped up a couple of times, but now we are back where we started, or worse. Now she struggles with steps, which were no problem before. I have not seen any specialist other than an IM. I don't have tons of money (my husband and I are both teachers) to spend unless I feel like things are necessary. My husband already teases me about all the things we could do with the money we spend at the vet. I guess I am okay with her not being able to jump/use steps anymore, as long as I know she doesn't have some injury; however, I'm not going to pay for a CAT scan or MRI. I would be willing to pay for an x-ray, but my vet didn't know that it was worth it because he said sometimes they don't show what the issue is.
My regular vet and the IMS don't seem to think she has muscle wasting. I feel like her spine is a little more pronounced, but her head and hips feel the same.
I am VERY careful about rawhides. Hannah also had one stuck in her throat several years ago and it was the most horrible experience I've had with her. She got it out on the way to the emergency vet. I thought she was going to die in front of me. I watch her like a hawk with them and cut off the chunks that get soft. They should write on the packages about that so people are careful. The vet there said the same thing about seeing it all the time.
My other vet did not seem to think the barking was due to cognitive issues, and this is something she also did a couple of years ago, but I really never knew what she wanted. I now assume it is food because she is happy if she gets more. I think she just said if I increase the Anipryl dose that it might help her since the barking was the only real change I saw after the first month on Anipryl (and the drop in ALKP). I did not increase the dose bc of cost. I also want to see if she calms down after allergy season.
According to my vet's urine numbers, she had just slightly dilute urine. Normal was 1.025 or more. He was not too concerned about it.
Both vets tell me it is not worthwhile to do an ACTH because they say they can't really put a number on what "high" is or how "high" the level should be. They said it is just to monitor treatment. This is sort of confusing to me. He said we don't really have a reference because we don't know what her "normal" cortisol level is.
I do think she has some slight symptoms, and even had the vet not asked me, I was going to have him check her for a UTI because she was urinating more often. She will go about every 2 hours if I let her out, but she can still hold it for 8 hours while we are at work if she has to. I gate them in my kitchen with their water, beds, and food, as well as a potty pad. She hasn't used it. But, if I leave her loose, she will occasionally pee on the rug. (I have found stains). I would just say she has minor symptoms. Again, she doesn't empty a water dish in a day, even with Izzy using it too. She just drinks more often (and the drinks are longer). She wants to eat more often too.
The vet put her on the Anipryl specifically for Cushing's but it happened to significantly lower her ALKP as well. I can't figure out the normal ultrasound either. Their explanation, as well as guesses from others on here, is that she is in the early stages.
Where would you recommend I go from here? Would you push for an ACTH test? Will it tell me something? Would you do an x-ray to see how her back end is? Do you suspect it is just joints? I really don't think it is her back at this point because it has now been a couple of months and nothing is worse and she does not tense or show any pain when they examine it. The one vet said she felt some slight resistance with her hips, which makes sense.
Again, I really appreciate your help! I sure worry about my girl. Some days I really worry that she is close to the end, and feel so down. Then others I feel like she is pretty good, and I think she'll be with me for a while.
I'd love to hear your advice!
Julie & Hannah
At ER vet with Hannah. Can tell she is in pain. walking really slowly. Not sure if it is her hips or back. Cried the whole way here. Please keep us in your thoughts.
frijole
09-27-2011, 11:19 PM
Sending love, strength and prayers your way. Kim
We are back from the vet. She was very nice (I was pretty upset because we had to put our dog Bailey to sleep after being paralyzed from a back issue) and did feel that Hannah has a disc issue in her mid-back. She said an x-ray might show that, but might not, and the only real way to see was a CT scan, which she also felt did not make sense at this point since we would not plan to attempt surgery even if she becomes paralyzed. We went home with Metacam. I know many of you have concerns about using that on a Cush dog and I have now consulted with 4 different vets who say they have used it safely with Cushing's dogs because it doesn't seem to react the same with a natural steroid as it does with a manufactured one. I hope that is the case. If this doesn't work, our other option is Tramadol, which I've also heard can make the dog act weird.
The vet told me her reflexes are still okay, but she is definitely in pain (which I knew so that's why we went to the emergency vet instead of waiting) and that she may get better, may stay the same, or may get worse. She said it doesn't guarantee she will become paralyzed like Bailey, but she could. My biggest issue at this point is what to do with her tonight. She usually sleeps on our bed but I can't risk her jumping off (she gets down sometimes to get a drink). I don't know if we will sleep on the floor with her or try to get her comfy on some blankets and her dog bed.
I am so, so sad. It's my 3rd anniversary on top of everything, but I am so worried this could be the end for my Hannah. I dread the thought of not having her with me. I've had her for 8 years (my first dog on my own after leaving mom and dad's after college) and she is the sweetest dog I have ever known (and I love them all).
Please say a prayer for my little sweetie. I love her so much and I'm so worried about her.
Julie & Hannah
Casey's Mom
09-28-2011, 12:18 AM
Hugs and prayers being sent for you and dear Hannah. I have a little sweetheart of a Havanese and now a Shih Tzu - I swear the little ones are so sad to see when sick or in pain.
I think if it were me I would try her in a dog bed and blankets right beside your bed with your hand near for her to see and sniff or a pillow from your bed so it smells like she is with you.
Love and many hugs, happy anniversary too!
Harley PoMMom
09-28-2011, 01:30 AM
Keeping you both in my thoughts and prayers.
Happy Anniversary from me as well!
Sending huge and loving hugs, Lori
Hi Julie,
I am so sorry to hear about Hannah and her possible disc problem. I'm pretty sure Sonja's Apollo has a disc problem. You could ask her about it. I think she has been doing physical therapy and acupuncture. I just wondered if your vet had any thought on either of those options helping Hannah.
Kim is using a product called Duralactin (not sure of spelling) for Annie which was recommended by University of Kansas vet school, I think and also acupuncture and has found some relief for Annie's pain. You could ask Kim about it.
I am throwing this out there for you in hopes of finding some additional or alternatives for little, sweet Hannah.
Sending love and hugs and hopes to dry your tears that maybe we can find some additional help for Hannah.
Try to get some rest and yes, don't let Hannah jump so maybe a nice cushy big pillow on the floor right next to you may help. Zoe does not like her regular dog bed all that much but I found some big soft pillow beds and she will sleep in the middle of them.
Love you dearly,
Addy
Thanks so much for your messages. I really appreciate knowing I have a support group.
Hannah is the same. I am relieved she is not worse. I keep waiting for the dragging back leg, and praying that it will not happen. I barely slept last night and because Hannah has always been on our bed, she was not content even on a fluffed up comforter with my robe. She kept whining and looking at the bed. Finally, my husband and I decided to take the mattress from our spare bed and put it on the living room floor. That way she could either sleep on it or right next to me. She slept on the floor the whole night and I woke up every time she moved to itch or get a drink.
One thing the ER vet said I could try is acupuncture. I have never had that done on myself, but I am willing to try it to see if it will help. My vet also thought that was an excellent option, especially with her Cushing's. They can get us in tomorrow. It is $170 for the the consultation (and hopefully treatment as well) and then $80 for each treatment after that (they told me to plan on once per week for a month, but that all cases are different). I realize it might not end there, and there is no way I could keep up with that expense on a regular basis, but for now I will try it to see if we can get her feeling better.
They said this vet has a background in Chinese medicine and chiropractic. I am really worried about him wanting to do some sort of adjustment on her back. I have never seen a chiropractor and have a friend who is a physical therapist who is very against it. But I know many people think they are wonderful. It makes me really nervous.
Does anyone have any experience with acupuncture? Or a chiropractor vet?
I am holding it together, but barely. I'm SO terrified she will be paralyzed. I hold my breath every time she gets up to see if she will be able to stand. I hate it. I'm praying for the best.
Julie & Hannah
Jenny & Judi in MN
09-28-2011, 10:12 PM
Julie I am so sorry to see this. I think acupuncture is an excellent idea. I know some humans who have had marvelous luck with it and my secretary had a dog who couldn't use his back legs.
The vet gave him some kind of shot in his back and in 2 days they worked again. She didn't ask for details so I have no clue what it was.
big hugs to you and Hannah. It is so hard to concentrate when we know our babies are hurting.
Judi
Harley PoMMom
09-28-2011, 10:42 PM
One of Administrator's, Kim (frijole), is having acupuncture treatments done on her sweet girl, Annie, and I do believe it has helped Annie a lot. Hopefully Kim will stop by and tell you all about this.
Love and hugs,
Lori
frijole
09-29-2011, 12:00 AM
:D Ask and ye shall receive.
My Annie has an adrenal tumor and spondolosis and one of her back legs is almost lame. She has lost a ton of muscle mass.. if you really want to see how much check out my photo albums.. you will be shocked..
She is skeletal, very delicate to look at but I attribute the fact that she is even still alive to her weekly acupuncture visits. They give her B12 shots each week too. My vet went to the Chi Institute for certification (Florida) and she varies the treatment but Annie comes out energized and with a huge smile on her face every time. She loves going to the vet.
I am heading out of town for 4 days leaving tomorrow morning and I know I leave her in fantastic hands and that she won't be afraid because she loves them so much. So definitely give it a try.. I was desperate because the IMS did not want her on any pain meds... and frankly she isn't in constant pain... she suffers episodes when the tumor is active that drain her (HBP). Anyway... do give it a try! Hugs, Kim
Hi-
I just thought I would post a quick update on Hannah. I am relieved she has not gotten worse. We went to the vet who is licensed as a regular vet, but also practices Chinese medicine. Hannah got acupuncture. It was a little nerve-wracking and she did make a couple of little cries when he put in a couple of the needles. He said she is really tense in her back and the muscles were really hard so she is in a lot of pain. He did say that her reflexes are all good. I try to keep telling myself to focus on that-the positive-but I am still soooo worried it will get worse. I have not had a decent night of sleep since Monday because I wake up every time she moves, worried that she will hurt her back by itching/biting because of her allergies. We are supposed to go back next Thurs. for another session. Tonight she was a little more perky and was barking at me for more food, chewed on a bone, and wanted to move around a little more. I guess that is encouraging too, but she is still so stiff and has a strange gait. I know it could take a long time for her to get better, if she does...it is just so hard. I can't sleep on the living room floor forever, but I can't have her putting her front feet up on the bed, begging to get up. I don't feel like I can keep this close of a watch on her forever, so I sure hope she will get better. I know she shouldn't jump up or down or do steps ever again, even if she fully recovers, and that in itself will be a bit of a challenge, but certainly easier than me being worried every time she MOVES now.
The vet also gave me something to put on her food to make her stools a little softer since we determined the sore back is probably why she had such difficulty going poop. She was able to go much more easily tonight, so that was good.
Does anyone know of any good and safe calming agents? I am currently using a DAP spray on a bandanna, but wonder if there is something that will last longer. The diffuser didn't seem to do much. The spray works, but it is short lived.
I brought home my first cold of the year, a gift from my third graders, so I hope I can get some sleep tonight.
Take care,
Julie & Hannah
Harley PoMMom
09-30-2011, 10:31 PM
Melatonin seems to calm some dogs, I used melatonin for my boy, Harley. Harley was terrified of thunderstorms but while on the melatonin he no long had a fear from thunderstorms, it made him very calm.
Hi Julie,
Stopping by to give hugs and see how you and Hannah are doing.
Love,
Addy
Hi Addy,
Thanks for checking on us!
Hannah seems to be about the same. She had acupuncture last Thurs. and we have another appointment this Thurs. Last night was her last day of pain meds.
My problem is that I truly CANNOT relax. Each day when I get home from work I am so worried that something is wrong. Something seems wrong. Like tonight I am wondering why she is not chewing on her bone. She seems a little out of it too. She did poop tonight (the acupuncture vet gave me something to temporarily soften the stool to help so she doesn't strain her back as much) and she is still moving around (sometimes with a little more speed in the house--although then I want her to slow down), but I am always worried.
I wish I knew if I was "over the hump." We were at the vet last Monday, so it has been just over a week. She seemed to be in a little less pain, but now we'll see without pain meds. I still have not slept in bed. I've spent the last two nights on the floor by my bed, to try to get her to sleep in the dog bed. I intend to move to the bed each night, but it hasn't happened yet. I can't do that forever either, but last night she still wanted to be in bed because Izzy (my other dog) and my husband were there.
I just need something to get a little easier. I feel like I am a stressed out wreck at work too. I'm starting to think I might go crazy. I look forward to the appointment Thurs., but it makes me nervous at the same time. Ugh. I just want it to get easier...
Cyn719
10-04-2011, 09:49 PM
My aunt rubs her dog down with a dryer sheet - vet told her it gives them a calming effect:rolleyes::):cool::confused::D Dont really know - aunt said it worked on her pug - i hope things get better for you and Hannah - I know the feeling sleeping on the floor - the couch - when Penny could walk I didnt know where to put myself - and shes 82 lbs alittle much to lift - we are sending love and prayers to you and Hannah!!! The only thing that has helped Penny is going off Vetoryl and going on Rimadyl :eek::eek:I know!!!!
Oh Sweetie,
I am so sorry you ae so stressed. You are not going crazy, you just are filled with anxiety and not sleeping properly makes it worse.
There is nothing wrong with asking doctor for temporary help.
Love,
Addy
Hi Everyone-
I need a little help. I have questions about two things: 1)acupuncture and 2)Tramadol dosing.
1) Hannah had acupuncture treatment number 2 yesterday for her back problem. She has improved over the past week but still had pain on one needle insertion right in the sore area. This morning she seemed lethargic to me and when I took her out to poop this afternoon she seems to be moving more slowly. She is moving a little more slowly in general. I called the vet this morning and mentioned it and they said some pets will be tired after and I read online that they can initially seem worse. For any of you who have experience with acupuncture, have you seen the same thing? I mean she still walks, eats, wags her tail, chews a bone, etc., but she is moving more slowly. She was almost trotting around behind me in the house the past couple of days.
2) My regular vet and the acupuncture vet recommend Tramadol for pain if she needs it from this point on. My regular vet told me tonight (because I called and asked about why she seems slower) that I should give it tomorrow if I think she is in pain. They gave me 50mg tablets quartered, and it says to give the 1/4 tablet twice a day. Hannah is about 12 lbs.-she varies from 12 to 12.5 lbs. Does that sound okay to you? I know many of you have mentioned concerns about Tramadol and strange reactions.
Also, I am unsure if she is truly in more pain, or if this is a typical reaction after acupuncture. I suppose I can call them again tomorrow morning and ask them. I don't want to give meds if I don't need to, but I don't want her to be in a lot of pain either.
Thanks for your help!
Julie & Hannah
StarDeb55
10-07-2011, 09:42 PM
Julie, I would give 1/2 the dose the vet suggested. Several of us have initially used tramadol at the dosage that was suggested, & proceeded to watch our pups become so totally "stoned", they had absolutely no idea what was going on. This has happened to me twice, once with Harley, once with Chewbacca. Harley was my 12 lb. Tzu that the ER clinic suggested 1/2 of a 50 mg tablet after he ulcerated his cornea quite badly. I proceeded to watch a little dog who had no utter clue as to what was going on, wouldn't respond to my voice, get lost in the house, wouldn't eat or drink. It scared the crap out of me! After I cut the dose back, he did fine. I would not dose twice a day unless you were absolutely sure Hannah needed it.
Debbie
Thanks! So, do you think I should just give the 1/4 tablet once? I also read some stuff about not giving Anipryl with Tramadol, but Dr. Bruyette responded to my email and said it is okay in pets. I found a few places online though where people have reported negative reactions and it says not to. UGH.
Julie & Hannah
Harley PoMMom
10-07-2011, 10:10 PM
I used Tramadol with my boy, Harley, many times. He never had an adverse response to it but like Debbie has mentioned some member's pups have. Harley weighed about 25lbs and when he was acting uncomfortable he received 25mg of tramadol 2x a day with no adverse effects...like we say...all pups are different!
Cyn719
10-07-2011, 10:20 PM
Julie Penny has been using Tramadol for a long time - between all her knee surgries - teeth being pulled and her lumbar pain -- she is 82 lbs - she can take 1 1/2 tablets 2 - 3xs a day 50mg tablets!! OMG if I did that she would be in a coma!!:eek::) I give her 25 to 50 mg just at bedtime - she relaxes - sleeps well and the next day she is good to go - so start off low - the vet said Penny is just very very sensitive to the med but as other members are saying it does make some of them stoned!! So low does to start but it really really helps Penny - she relaxes and gets a good nites sleep and I can see the difference by morning - she moves alot better - but again every dog is different - low dose - and go from there - hope it helps - xoxo
Have any of you used Tramadol with Anipryl? So many things to think about...
Thanks!!!
Julie & Hannah
Cyn719
10-07-2011, 10:48 PM
Julie
Penny took tramadoly while she was on Vetoryl I dont like all these drugs but at this point in her life if the tramadol gives her a rested good nites sleep then I have to use it ---- Penny is on the dreaded Rimadyl too:eek::eek:I know but we took her off it and she ended up in the hospital in the worse pain last week when we thought we were going to lose her and shes back on it and she is doing good - so Addy put it well I am between a rock and a hard spot so right now I have to have her comfy - she is going on the Adequan Shots next week also so then I will start to cut back on Rimadyl - hope Hannah feels better xo
Cyn719
10-07-2011, 10:59 PM
http://www.marvistavet.com/html/body_tramadol.html
Julie I dont know how reliable this article is but it says not to use with Anipryl
INTERACTIONS WITH OTHER DRUGS:
The beauty of this pain reliever is that it is compatible with all the COX -inhibiting non-steroidal anti-inflammatory drugs, possibly even synergizing with them. It is also compatible with joint pain nutriceuticals such as glucosamine, MSM, chondroitin sulfate etc.
Tramadol is NOT compatible with Deprenyl. Animals taking deprenyl either to control Cushing’s Syndrome or to control senility may not take any sort of narcotic medication including tramadol. Similarly, tramadol is not compatible with other psychoactive drugs such as serotonin reuptake inhibitors, tricyclic antidepressants, or monoamine oxidase inhibitors. If you are not sure if your pet is on one of these medications, check with your veterinarian.
Tramadol may not be compatible with SAMe, a liver and joint support nutriceutical. Until further studies are performed, these two treatments should not be used together.
Tramadol can induce sedation when combined with amitraz, the active ingredient in the Preventic® tick control collar and also in Promeris Canine®, a flea and tick control product recently removed from the market. Amitraz is also sometimes used in the treatment of demodectic mange.
Harley PoMMom
10-08-2011, 01:30 AM
Hi Julie,
After doing some researching on the treatment of using Tramadol and Anipryl together, if it were my dog, I wouldn't do it. Anipryl (selegiline), also known as L-Deprenyl, is a monoamine oxidase inhibitor (MAOI.) When Anipryl and Tramadol are used together a condition known as serotonin toxicity may develop.
I found this excerpt from the British Journal of Anaestheasia:
Pethidine, tramadol, dextromethorphan and methadone definitely are weak SRIs (see Table 2), and may infrequently precipitate dose-dependant serotonin toxicity (when administered in conjunction with any type of MAOI), but perhaps only in large doses or susceptible individuals. Here is the link: Monoamine oxidase inhibitors, opioid analgesics and serotonin toxicity (http://bja.oxfordjournals.org/content/95/4/434.full#T2)
I am truly a big worry-wart when it comes to interactions like this so hopefully others will comment as well.
Love and hugs,
Lori
lulusmom
10-08-2011, 02:36 AM
Hi Julie,
My dogs have taken Tramadol as directed with none of the problems described by others. Apparently, dogs are like people....some are very sensitive to certain drugs and others aren't.
I think it is very interesting that more than a few websites state that Tramadol should not be given with Anipryl, yet Dr. David Bruyette, advised you that you can give both. I personally believe Dr. Bruyette would never tell you that it was okay to give both unless he knew for sure that it was safe, and who better to know than the developer of Anipryl himself. Having said that, I will say that I am with Lori on this one. I'm a worry wart too and to be perfectly honest, if my dog was experiencing chronic, severe pain, choose Tramadol over the Anipryl.
I sure am curious about where Hannah's cortisol levels are. If cortisol is elevated, Hannah would be getting a double dose of anti-inflammatories, one steroidal (cortisol) and one non-steroidal (Rimadyl). That's a major arthritic pain killing combination. Aside from being lethargic, what are you seeing in Hannah that makes you think that Rimadyl is not controlling her pain? Does she have trouble getting to her feet? Does she yelp in pain? Does she limp intermittently?
Thanks everyone! I found some of the same information and then Dr. Bruyette says it is fine. Here is the sentence he used:
Tramadol does not work in a similar manner to other narcotic pain relievers so I would not be concerned.
I am also a worrier, so that is why I am not thrilled about experimenting to see what might happen to Hannah.
Glynda-she is not on Rimadyl and never has been. She was on Metacam for a week (which I know would be the same concern) but I talked with 4 different vets: my regular vet, and IM specialist, the ER vet when Hannah went in, and now the acupuncture vet. They all say that for some reason the NATURAL steroid in combination with an NSAID does not produce the same things as for example, prednisone would with an NSAID.
After hearing it from four of them and knowing Hannah was in a really bad place at that time, we gave the Metacam with no issues. I asked what to look for, read about it online and in the insert, and remembered what Glynda had told me could happen. The Metacam did seem to help her.
Hannah is a pretty stoic dog. I only knew something was really wrong last week because she was moving SO slowly and her back end seemed to sway a little.
Now I don't really know how bad the pain is. She just seemed better before the acupuncture treatment on Thurs. and was a lot slower and sort of out of it yesterday. I read that dogs can seem a little worse initially after acupuncture and the vet told me she could be sleepy afterward, but I assumed it would be that night--not the next day. Yesterday she was walking really slowly when I took her for her super-short walk (like three houses down) to get her to poop and just moved more slowly in the house. She was almost back to a little "trot" when following me in the house on Wed. So, my only guess, was that maybe she is in pain.
At the acupuncture appointment on Thurs. she did not show tensing when he palpitated her abdomen and she DID the previous week at the first appointment, so we took that as a good sign that something was a little better. She still did a little yelp when he put in a needle in the main area that is sore. She did the same thing the first time. These are the ONLY times I have ever heard Hannah indicate she was in pain. Even at the ER vet she just breathed a little louder when they felt the sore area. She's sort of tough to figure out. I wish she could TALK to me!
At this point, I'm scared of Anipryl and Tramadol. I gave her Anipryl already this morning. Anyone know how long she should be off of it to take Tramadol? I think I'll call the vet (or both) and ask. I guess I should hold off today. I hope she'll just improve a little on her own.
Again, thank you SO MUCH for all of your help! I sincerely appreciate it and get so much information from here. I am the one bringing things to my vet much of the time, and it is usually from stuff I found out from all of you.
Keep your suggestions coming, PLEASE!
-Julie & Hannah
Cyn719
10-08-2011, 12:24 PM
Hi Julie - yup worry is my middle name to - thats why I gave you that link last nigth and said I dont know how reliable it is - every vet has his opinion - so if you trust in your vet then I would listen to him -it is really hard to know what to do and what not to do -- How is Hannah today?? Thinking of both of you always:)
Thanks for the link, Cindy. Like I said, I found similar info. online. I talked to the acupuncture vet office this morning and they said the same thing-in their books it says it can be in an issue in humans. She told me that if Hannah seems to be in pain I should give HALF of the amount they recommend to give her a little boost and they felt that would be safe. It is just so hard to know if she is in pain or how much pain she is in. She is walking around the house and is wagging her tail a normal amount of the time. She is eating, waiting patiently for some bacon to fall on the floor as my husband eats breakfast....some of the normal things she does. She is just slower. Maybe that is a sign for me to hold off until she seems really slow or worse. The vet said they don't want her to be in pain so if I think she is to give the Tramadol. I don't like going off of what I "think" when she is sometimes hard to read. And being an anxious person, I may think it is worse than it is. That's why I'm going to kind of watch for today and then see where we're at. I guess 1/8 of a 50 mg Tramadol probably won't put her at major risk of some complication with Anipryl. With so many issues it's just tough to know what to do sometimes! I know you all can relate to that!
-Julie & Hannah
Cyn719
10-08-2011, 01:48 PM
OMG Julie you are so right!!! Yup I can relate especially after her episode last week - it was easier for me cause she was in severe pain - loud groans - pushing her body into wall - doing the weird mouth things (they think that was she was in so much pain she felt sick to her stomach) but like I said I got my answers when we put her back on the Rimadyl and tramadol - she was 90 percent better! So I know what she needs - last night she took a tramadol and sleep but stll go up during the night to go to the bathroom - so it doesnt put her out cold - that was 50 mg (82lbs) so starting at 1/8 should be fine - let me know how it goes -- Penny is sending HUGS and KISSES to Hannah! That little face is just so cute!!!!!!!!!!!!:):)
lulusmom
10-08-2011, 02:14 PM
Hi Julie,
Please see my comments in blue below:
Thanks everyone! I found some of the same information and then Dr. Bruyette says it is fine. Here is the sentence he used:
Tramadol does not work in a similar manner to other narcotic pain relievers so I would not be concerned.
I am also a worrier, so that is why I am not thrilled about experimenting to see what might happen to Hannah.
I don't blame you at all, especially if you aren't for sure that Hannah really needs it.
Glynda-she is not on Rimadyl and never has been. She was on Metacam for a week (which I know would be the same concern) but I talked with 4 different vets: my regular vet, and IM specialist, the ER vet when Hannah went in, and now the acupuncture vet. They all say that for some reason the NATURAL steroid in combination with an NSAID does not produce the same things as for example, prednisone would with an NSAID.
Hi Julie,
After hearing it from four of them and knowing Hannah was in a really bad place at that time, we gave the Metacam with no issues. I asked what to look for, read about it online and in the insert, and remembered what Glynda had told me could happen. The Metacam did seem to help her.
Sorry I get my NSAID's mixed up. :D Of the four vets you talked to about Metacam, did any of them mention that dogs with high cortisol don't usually need an NSAID? It is when cortisol has been brought down to a normal level (normal for a cushdog) that the aches and pains of arthritis are usually unmasked. Were any of them curious about Hannah's cortisol levels or are they all assuming that since Hannah is in pain Anipryl must be effectively controlling Hannah's cortisol? I'm very confused about this but then, I am easily confused. :confused:
Hannah is a pretty stoic dog. I only knew something was really wrong last week because she was moving SO slowly and her back end seemed to sway a little.
Now I don't really know how bad the pain is. She just seemed better before the acupuncture treatment on Thurs. and was a lot slower and sort of out of it yesterday. I read that dogs can seem a little worse initially after acupuncture and the vet told me she could be sleepy afterward, but I assumed it would be that night--not the next day. Yesterday she was walking really slowly when I took her for her super-short walk (like three houses down) to get her to poop and just moved more slowly in the house. She was almost back to a little "trot" when following me in the house on Wed. So, my only guess, was that maybe she is in pain.
Are your vet(s) suggesting pain meds because you are guessing Hannah is in pain or has she been formally diagnosed with arthritis, dysplasia or spinal problems? Can you remind me if Hannah had Xrays that showed any abnormalities? I do remember that one of the vets manipulated her and she did not appear to be in any discomfort and the IMS said Hannah may possibly be in pain but didn't appear to be based on her behavior during the appointment and your description of her at home. Do your vet(s) know for sure that Hannah's issues are not due to muscle wasting caused by excess cortisol? Muscle wasting makes a dog weak but it doesn't cause pain per se. If it did, my wimpy Jojo would have been yelping in pain constantly.
At the acupuncture appointment on Thurs. she did not show tensing when he palpitated her abdomen and she DID the previous week at the first appointment, so we took that as a good sign that something was a little better. She still did a little yelp when he put in a needle in the main area that is sore. She did the same thing the first time. These are the ONLY times I have ever heard Hannah indicate she was in pain. Even at the ER vet she just breathed a little louder when they felt the sore area. She's sort of tough to figure out. I wish she could TALK to me!
This takes me back to the xrays. What is the main area of soreness and was this area xrayed to try to figure out what is going on? I wish I had nickel for everytime one of us said "if only they could talk". I honestly believe if they could talk, a lot of them would tell us to take a chill pill and go to bed because we are depressing them. :p I also believe that if our cushdogs felt every ache or pain we think they feel and if they suffered from the angst that gives us knots in our stomachs, they'd be big old hypochondriacs. :D
At this point, I'm scared of Anipryl and Tramadol. I gave her Anipryl already this morning. Anyone know how long she should be off of it to take Tramadol? I think I'll call the vet (or both) and ask. I guess I should hold off today. I hope she'll just improve a little on her own.
I don't have an answer to that question but if Hannah truly does have joint or spinal problems and Anipryl has actually decreased her cortisol, then you should see some improvement as cortisol goes up after discontinuing the dosing. If that is the case, you wouldn't have to worry about Tramadol.
Glynda,
Thanks again for your quick response. Hannah has not had an x-ray, but there has been a new development since my initial posting about her having either rear-end or back pain. A couple of weeks ago on Tues., the 27th, Hannah was walking VERY slowly, so slowly that I knew something was wrong. She was also wobbly with her back end and it was swaying a little as she would stand. I was instantly worried about a back problem and even did the test where you turn the toes under to see if they put them back. She did, but she definitely was not right to me. We went to the ER vet right away. They were able to determine easily that she has pain in her middle back just by feeling. She was tense in her back and abdomen when the vet manipulated and also breathed harder/made a little groan when she felt that area. She said we could do x-rays, but didn't really need to, since she was absolutely sure there was pain in that area and there was some sort of disc problem. She said the only thing she would do was a CAT scan if I would at some point be interested in surgery. Since I would not do surgery, even if Hannah became paralyzed (because of her age, issues, and our financial status) we didn't do them. She was definitely showing the pain this time, but still in her own little stoic way. That's when we went on Metacam for 7 days and she had acupuncture the following day, as they recommended it as a good way to help her heal.
She also indicated she was in pain in the same area for him when he manipulated the area. It is in her middle back. She also tensed when he manipulated her abdominal area that day. She even yelped a little when he put in one of the needles in that area (as she did again this week in the same spot). Therefore, we know it is a spinal problem.
She may not have any hip or arthritis issues at all. This whole thing could have been a sore back that just got significantly worse last week. That is my guess. I also think that is why she was having difficulty defecating. Her back hurt.
So......that is why we are talking pain meds. They are relying on me to know if she is in pain, which I appreciate, but then it is hard for me to now sometimes. Of course I don't want to leave her in pain, but I don't want to jump the gun either. That's what makes it hard. She did seem better, but maybe this is another little rough spot.
Do you know if I do stop Anipryl how long it would be to get out of her system? She takes a half of a 10 mg pill once a day and has been since April.
No one seems to want to check her cortisol. They say that it is hard to know what "normal" was for her and how high is "high." I don't think they believe cortisol is being controlled by Anipryl, just the symptoms. The one thing Anipryl HAS done is bring her ALKP down from 1770 to 317 since April. That is why we decided to continue. Her symptoms don't seem to be that bad and I do think we could try going off of it to see. The IM even said I could try that to see if symptoms got worse (so I know if I want to spend $80 every 2 months). I could also see if her ALKP rises from being off, I suppose. At this point, I am more concerned about her back. She may not be here for me to worry about Cushing's if we don't get this figured out.
Does this help you out any more with where we are?
Thanks!
Julie & Hannah
lulusmom
10-08-2011, 03:54 PM
Hi Julie.
I have to transport my little blind chi to his forever home and pick up a little Bichon with a broken leg at the shelter so I only have a minute. Lucky for you this is going to be one of my shorter posts so no eye strain. :D I did quick check online and see that Anipryl has about a nine hour half life. I have the FDA NADA number for Anipryl somewhere and will go back and check the clinical trials that were done to see if I can come up with anything else. Anipryl is not without side effects. Muscle pain and constipation is listed as a human side effects and I'm hoping to find something more about that for dogs when I have time to read. Did you happen to notice if any of Hannah's issues appeared after you started Anipryl?
Will be back later.
Glynda-
The straining while pooping was after Anipryl...but not immediately, and also coincided with when she stopped jumping, etc. (the back problem). I'll wait to hear more. And, for the record, I love your long notes. You are thorough, and I am too. I like that! :D So, thank you. I'll wait to hear more.
Julie & Hannah
k9diabetes
10-09-2011, 02:44 AM
Hi Julie,
I haven't written to you before but someone asked me to take a look at your thread because we have a larger dog who has back problems and have been down a pretty thorough diagnostic road with him over the past year and a half with the last step being that we did the MRI.
Took me a while to read it all that! :)
My immediate thought looking at your last couple of posts was the same as my overall thought after reading the whole thing:
I would have x-rays done - a good comprehensive set by someone who really knows what they're doing.
And then I would have the vet send those x-rays to a radiologist for a review.
I'll put my reasoning in a second post cuz I want to explain our dog's history and why I think x-rays would be a worthwhile investment.
Natalie
k9diabetes
10-09-2011, 03:18 AM
The main reason I would do a good set of x-rays is that it's noninvasive and relatively inexpensive and you might get good information out of them.
You might not too. But that's the risk you take with any diagnostic test.
What really concerns me is that there is a lot of medication that has a certain amount of risk being suggested for Hannah without anything like a diagnosis to go with it. How can proper medication be suggested when no one really knows what is being treated?
Cosequin, for example, would be good for arthritis in the legs and hips but isn't generally considered all that helpful for degenerative discs. And an NSAID like Metacam, which I've used in two dogs and our dog with the bad discs is taking daily, is a good medication but if inflammation isn't the problem, then you're stressing the liver and perhaps the GI tract for no good reason.
The x-rays have a chance of giving you a diagnosis.
Among the things the x-rays might show are signs of joint degeneration in her spine and/or hips, knee, ankle, inflammation from arthritis in any of those joints, bone spurs, or even that there's some entirely different issue completely unrelated to her hips or back and it only seems like it's her back that hurts.
My experience with x-rays comes from two cats, both of whom have hip dysplasia, and a dog with two degenerated disks at the thoracic/lumbar junction in the mid-back so sounds like about the same place that pain has been localized in Hannah.
In all three cases, there are signs of the problem apparent in their x-rays.
Our kitty Gus (he passed away this spring from cancer), for example, had obviously badly degenerated hip joints in his x-rays. As the last vet who saw his x-rays said, it hurt her just to look at how bad his hips were.
His sister Katie is not as badly afflicted but she was diagnosed with hip dysplasia when she was young and I can definitely see that her hips bother her more now that she's 15.
Our dog, Jack, is only four years old but started having apparent back pain in spring of 2010. The first time it happened, he seemed to recover with rest. But a few months later he was having problems again and he has had mild to moderate chronic pain since around September of 2010 and has been on daily Metacam since November of 2010.
His two bad discs - T13-L1 and L1-L2 - are clearly visible on x-ray because he has narrow irregular disc spaces there and bone spurs extending across them.
So I think there's a chance x-rays will tell you more about what - or isn't - going on with Hannah. If nothing else, they should be able to help rule out some things.
The main thing with the x-rays is to have someone really good do them.
To make sure they get all the needed views and take good pictures first. And then to provide an accurate and skilled interpretation of those pictures.
We are fortunate that our general practice vet has a particular interest in radiology and has taught radiology at the vet school. So he's particulary good at taking them and at reading them.
If he hadn't had that skill, then I might have asked to have a veterinary surgeon or radiologist do them. And even with our vet's extra experience, he sends many of the x-rays he takes out to a radiologist for review. We had x-rays done on Katie recently because she was feeling poorly and he asked a radiologist to review them to be sure that his interpretation was confirmed.
So I would also request that the x-rays be reviewed by a radiologist.
And depending what the vet does or doesn't see in them, there might be others who should review them, like a surgeon in the case of signs of soft tissue injuries, dysplasia, etc. or a neurologist if there are issues in the spinal area.
I recognize that lots of consults / reviews might not be possible. And it might not be necessary at all if the standard review shows nothing or screams something obvious.
If you can manage the comprehensive set of x-rays of the spine, hips, and full length of the legs - which in your small dog should cost less than in my 55 pound border collie! ;) - and a radiologist review, that would, to me, be the best investment of your money at this point. And hold off buying any more medicine until they find out what they are treating!
I would honestly forget about any relationship to Cushing's and leg problem.
First because from all you've said it sounds more like a bone or connective tissue problem - or something entirely different.
And because you can spend a lot of time trying to fit symptoms into the one thing you know she has and that may actually be blinding you or the vets to the actual source of the problem.
So I would let go of all of the assumptions all of the doctors have made and do what you can to do solid diagnostic detective work to find out what the problem actually is.
I know your experience with Bailey has made this terrifying for you but it's at least as likely and probably a lot more likely that she "just" has some chronic pain that will never get any worse. Borrowing pain from the future about an outcome that probably will never happen won't help you or her.
If you can find out more about what's happening with her body, you have a chance to stop worrying about nightmare outcomes from the past. And if there is a nightmare outcome, you won't be any worse off than you are now and you will know what you are dealing with.
Sending you a big hug - I know how frustrating this can be.
Natalie
k9diabetes
10-09-2011, 03:41 AM
Just by way of a short(ish) history:
Jack started showing signs of back pain after a five-day trip we took by car that involved a lot of driving and some hiking. But Jack's exercise tolerance had never been normal. When we adopted him at 1-1.5 years old, he was tired and ready to go home after 30 minutes of mild exercise at the dog park. Not at all typical for a young border collie.
After the trip, he was limping badly. Vet examined him and he showed signs of pain at the mid-back and also some poor reflex responses. The x-rays confirmed the two bad discs. He was put on Metacam and rest for a couple of weeks and seemed to recover.
A few months later, though, he started showing signs of pain again and his exercise tolerance dropped to just 15 minutes of walking, after which he acted like he'd run a marathon.
So we started exploring potential causes.
We knew he had the bad discs so we had a consult with a neurologist but at the time Jack wasn't showing much signs of pain.
Late fall it was worse and we tried some acupuncture, which seemed to make it worse still. Jack's an anxious dog and I don't know if it was the stress of the acupuncture visits or whether it was just getting worse regardless of the acupuncture. So we stopped the acupuncture and went back to the neurologist.
Given that we knew he had a couple of bad discs, we tried some medications geared more toward back problems. The first was gabapentin, which treats nerve pain. Jack was not better on Gabapentin than on Metacam. So then we tried him a course of prednisone. Unfortunately, he responded very badly to the pred. He was peeing a gallon every hour. We tried going to methylated pred, which can sometimes eliminate the urination. It was only slightly better than the pred and didn't seem to be helping his back any.
So at that point we just went back to Metacam and went back to more thorough diagnostics.
We had that comprehensive set of x-rays I'm suggesting for Hannah done. The vet x-rayed EVERYTHING! I'm tellin' ya! Our vet's only fault may be that he gets a little carried away with the x-rays! LOL
That told us that the only sign of a problem anywhere in his spine and joints was in the discs. No joint dysplasia, no arthritis, no bone cancer.
So then we went back to the neurologist. He did a very thorough exam after we had taken Jack off of the Metacam for a full week. Took him outside and watched him walk and run. Twisted and bent and extended and poked and prodded every inch of his spine, hips, knees, ankles. And he had the hospital surgeon also do an exam to try to identify any soft tissue injuries. Nothing found. No flinching, no obvious signs of pain, no tension.
At that point, basically the neurologist's feeling was he did not know why Jack's exercise tolerance remained limited and he was not necessarily in favor of doing the MRI. His approach is that by the time he does the MRI he generally knows what he's looking for and with Jack, he didn't.
But our approach was different. We had saved up the cash for it, had pet insurance that would help pay for it, and ultimately we didn't want to find out ten years from now that all along Jack had had some problem we could have fixed and prevented him from experienceing all that pain. We knew the chances were slim that would be true. But he's a young dog with a lot of days of chronic pain and chronic NSAID treatment ahead of him. So that's why we chose to do the MRI.
And the result was not conclusive as to what causes his pain. But we ruled things out. No discs pinching the spinal cord, no nerves into the leg that bothers him being pinched, no other discs that have problems.
We know there's no surgery that can cure his pain and we will just have to manage it. Which we are doing with daily Metacam. He tolerates it really well and it does provide some relief.
I haven't gone with Cosequin because his stomach didn't seem to respond to it all that well and he doesn't have any signs of arthritis or joint damage that are the kinds of issues that Cosequin is good at targeting.
We don't give Tramadol because Jack also takes Prozac and there is a concern, from human medicine, about seratonin syndrome when the two are used together. He's managed well with Metacam so no need to risk it. That could eventually change and if it does, we will reconsider it.
Jack's stable and is managing 20-30 minutes of mild to moderate walking a day. He gets a lot more sore if he does any running, jumping, or twisting so we don't do much of that - just chasing toys around the house, never out on walks. The neurologist wants us to avoid stressing his back because those discs could slip and start pressing on the spinal cord. So strenuous exercise is out for good for him.
I think it's the kind of thing that if he uses his back in certain ways it starts to really hurt for a day or so and as long as he doesn't do those things he gets by pretty well.
In the end, the MRI was really for our peace of mind. We sure were glad that we bought pet insurance! It's a medium policy. Didn't cover it all by any means but it helped a lot in making the MRI possible.
Natalie
(Okay, I've done my best to out ramble you! ;) )
Hi Everyone-
I just wanted to give a quick update on Hannah. She seems to be doing much better. She had her third (and last, for now) acupuncture appointment last Thurs. and he felt she was doing much better. She had much less tension in her back. He said he doesn't need to see her again and we can return if I feel she needs a "tune up." He encouraged me to take her for short walks (even if it is just a few houses) and to let her decide when she is done. He wants me to get and keep her moving. We are supposed to continue watching her carefully for the next 6 weeks or so and not allow stairs or jumping up or down. I plan to try to keep it that way forever. She is starting to trot more on walks and in the house, and doesn't seem to be in pain. She is not taking any painkillers.
I have also decided to slowly take her off the Anipryl to see how it goes. I am tapering her off over the next few weeks. We will also test to see how her ALKP level is (since it dropped so much when she started it). If it is higher and I am not noticing Cushing's symptoms worsening without Anipryl we will try something else.
My only real worry now is that she is desperately in need of grooming. She was due about 3 weeks ago when she hurt her back. The acupuncture vet does recommend she get groomed. I decided to take her to the groomer located at our regular vet office this Thurs., and I am paying for a vet tech to assist so they can be careful with her back. I am looking forward to her getting cleaned up, but I am definitely worried about her back. The acupuncture vet doesn't seem too worried-he just said they should use good common sense about a dog with a history of back problems. I'm hoping that goes well. I left a message for my vet, asking if he thought there would be any benefit in sedating her slightly to do it. I just want them to be able to clean her up since she licks so much. She has some small tangles on her tummy and inside her back legs and my regular groomer usually shaves that out. I just hope they can access the area without too much trouble.
Anyway, that's about it for us. I have been busy with parent-teacher conferences, but I try to read and stay caught up when I can. I always have you and your dogs in mind and am sending positive thoughts to all of you.
Julie & Hannah
Hi Julie,
I understand the grooming worry I just went through it with Zoe. I spoke with her regular groomer so she understood and actually Zoe did really well, no problems.;););)
I am so glad Hannah is feeling better and I hope your anxiety is better too.
Love you both,
addy
Cyn719
10-17-2011, 02:44 PM
Julie - just checking in - glad to hear Hannah is doing better!! Poor little ones with the back and pain issues - hope Hannah keeps improving everyday - Penny is finding it so difficult to walk - he back and legs alo - appt is on Wed - hope they can find some relief for her - I hope the grooming appointment goes well!!! Hugs!
Cyn719
10-17-2011, 02:45 PM
Natile - I read both the post to Julie - Penny has all those back and legs issues - I assume the Metacam is like the Rimadyl?? I am going to the vet Wed so I will find out exactly what the back issues are among other things - but bone spurs - arthristis and stenosis is for sure
Jenny & Judi in MN
10-20-2011, 03:14 PM
I hope it goes ok at the groomer Julie. Judi
Me too, I hope Hannah comes home clean and cute as a button with no ill effetcs.
love,
addy
Thanks so much Addy and Judi-and everyone else who checked up on us. Hannah survived the groomer and is still moving at a good pace, too! She was there for 4 hours, but the groomer gave her lots of breaks to rest. She looks good too! Now I think I can finally relax for the weekend!
Julie & Hannah
Cyn719
10-20-2011, 09:20 PM
Julie - So happy all went well at the groomers!! You enjoy your weekend and give Hannah a big hug for me and Penny is sending a big lick!!:)
Hi-
I thought I would post an update on my Hannah. I was so relieved she made it through her grooming appointment with no issues. She also made it through a jump onto the couch (she snuck up on me) so those two things were a relief. She did end up with a little skin infection near her groin. The groomer thought it was just irritated from some little tangles (since she has allergies and licks a lot and was overdue for a groom because of the back problem), but it was looking pretty bad so I took her in, and sure enough, it was an infection. Luckily, it is clearing up really well and we're on day 6 of antibiotic. I also have a medicated shampoo we use twice a week. She is feeling much better. I am so glad!
We are two weeks into the process of gradually taking her off of the Anipryl. She did every other day for two weeks, and now we're on every three days for a couple of weeks, then done. I have noticed no change in drinking, eating, or urinating. Also, she is trotting along at such a quick pace when we go for our 2 block walks! I am thinking her back must have been bothering her for MONTHS before it got really bad, based on how slowly she was walking. I just thought she was getting older...it's amazing to see how she moves now. The acupuncture really did help.
I am cherishing these good times because I know the roller coaster ride will continue. I am just ecstatic to see her doing and feeling so well. I keep the rest of you in my thoughts daily, and am always hoping for the best for your little ones as well.
Julie & Hannah
Julie, I am so glad Hannah is feeling so much better!!!!!!:D:D:D
Keep up the good work,
Addy
Squirt's Mom
11-01-2011, 11:35 AM
Woohoo!!!!!!
So glad things are looking up!!!!
Cyn719
11-01-2011, 05:52 PM
So glad Hannah is having some good days!!!! I know how much that means!!!!!! Hopefully the roller coster ride will calm down for awhile:)xo
Jenny & Judi in MN
11-02-2011, 11:10 AM
I love hearing when dogs are doing so well. Yay for you and Hannah!
Happy Thanksgiving to all of you! I am so thankful for the knowledgeable and helpful people on here who have helped me to make decisions for Hannah. Thank you most of all for all of your support. Without the people on this forum I would not have made it through all of this with my sanity! I am so thankful my little Hannah is still here with me and doing well today. I am thinking of all of you and your dogs, those still with us, and those who are not. I hope you have a peaceful Thanksgiving.
Julie & Hannah (& my non-Cush pup, Izzy)
Cyn719
12-01-2011, 12:40 AM
Julie - praying for good results for Hannah tomorrow - thanks for checking in on Penny - yeah better days - you never know with this disease - but she just looks so much happier - she use to have the dazed look now its a happy look - finger crossed it last --- let me known how Hannah makes out -- give her a kiss for me and Penny - love and prayers and hugssssssssssss xo
Hi Everyone-
So Hannah had a blood test today to check her ALKP level to see if it had increased since going off of Anipryl. I believe they call it an NSAID profile. Hannah's initial ALKP value was 1700 something when she was diagnosed with Cushing's. It then dropped to 300 something after Anipryl. I weaned her off of it and today it was 424. 17-220 is the normal range. So it has gone up about 100 since August (she went off Anipryl throughout the month of October-I weaned her).
My vet's recommendation is to check it again in January (about 6 weeks) to see if it is the same. If not, he would like to put her on Denamarin. I am fine with this.
He also said her BUN is slightly elevated. It was 33 and the normal range goes up to 27. He said he is not concerned because her Creatinine level is normal. Last time it was 1.4 and now it is 1.3. I'm not sure what the normal range is. He said if her Creatinine level was high he would be concerned about kidney disease. He told me that if she didn't drink much water this morning it could also be from dehydration.
I tried looking up some info. online, but I never know how valuable that is. Do you think this is something to be concerned about? It seems like some sites say this could be early kidney disease. My vet said I would notice increased drinking with kidney disease too.
Here's the thing. Hannah doesn't even seem like she has Cushing's anymore. Her water intake is normal for the most part, and she seems to drink a lot in spurts. Actually, I feel like she has decreased her water intake recently. Now I am a bit concerned about that. Should I be worried? I asked them to fax her results from her last two tests to the IMS we saw in June and put a call in for her to get back to me with her opinion.
I just don't want to let a new problem get worse before we do anything. I will see what the IMS says, but I am wondering if any of you have insight into this. Would you recommend another test? A urinalysis?
Thanks!
Julie & Hannah
lulusmom
12-01-2011, 05:24 PM
Hi Julie,
My dogs have had elevated BUN on their bloodwork and like Hannah, creatinine and everything else was normal so even though I pretty much knew the answer, I asked the IMS anyway. Like your vet, she wasn't concerned because the dogs were fasted. By the way, one of the dogs doesn't have cushing's but not sure that matters. By the time we get to the IMS they've panted their way into dehydration. :D I think you can rely on your vet's opinion.
There have been so many things about Hannah's diagnosis that don't add up for me. The lack of symptoms, a completely normal abdominal ultrasound and belly hair that started growing back rather quickly after the ultrasound. It's possible the diagnosis was correct but it's equally possible it wasn't. I think waiting until January and retesting liver values is a good idea. In the meantime, you could always catch a morning urine specimen and have a uc:cr done. If it's normal, then it is highly unlikely that Hannah has cushings.
Glynda
Thanks, Glynda. I'm concerned because Hannah also is on a Rx food for urinary issues (Royal Canin SO) because she had some crystals several years ago, so I am wondering if this could have anything to do with that problem. I'm not always sure my vet has her whole medical picture in mind (or even in front of him because we talk so often), and I didn't think of that until after. I'll talk to him, if necessary, after I hear from the IMS.
Also, Hannah's appointment was at noon today, and we were up at 7:00 and she had breakfast around 7:30. (I do put warm water on her food and mix it with a little canned food, so there is some liquid that way). There was no panting on the way there, so I am worried about why she would be dehydrated.
Here is the craziest thing of all....I have not seen or heard her get a drink today (although I have not been with her at every moment) and now I want her TO get a drink, whereas before I cringed when I heard her get a drink. I am worried that the drinking seems to have decreased. She did go potty this morning, at 1:00, and at 5:00, so I'm hoping that means she is okay.
There was one night this week when she didn't potty before bed (around 10:00) after going around 7:00 that night. That is uncommon for her. I tend to worry whenever something is off (in case you can't tell!) but I have told myself that she cannot have severe kidney problems if her kidney values have always been normal and were totally normal in August. There may be a problem, yes, but it can't be that bad. I have to talk myself through things because I tend to jump to worst case scenarios.
Anyway, I'm hoping I'll hear something from the IMS soon. If anything, I'm thinking I could have them do a urinalysis to be sure everything is okay.
Thanks for hearing me out (and offering your advice, if you have any)!
Julie & Hannah
Hi Julie,
I'm hoping you hear from the IMS soon and it is good news. Every thing that is "off" makes us jumpy, boy I know the feeling.;)
Here is a hug (((((())))))))) and prayer for good news!!!!!!
love,
addy
Cyn719
12-02-2011, 07:24 PM
Julie - I hear you - its never easy -either they are drinking to much or not enough - Penny was drinking so much I couldnt keep water and her bowl and if was empty she would head to the bathroom to try to flip the lid open on the toilet!!! Now its normal drinking - go figure - thanks for your post on my thread!! Nice to have good days - but you never know what tomorrow brings - so one day at a time - hope the IMS gets back to you soon - hugsssss for now - will check back x0
Hi Julie,
thinking of you and Hannah
love,
addy
Cyn719
12-05-2011, 10:33 PM
Julie - Just checking in - Hugsssssssss to you and Hannah xoxo
Hi,
Thanks for checking in, Cindy. Unfortunately, the IMS didn't get my message and doesn't work until Wed. so she will call me then with her advice on Hannah's blood work. I talked to my regular vet again and he said we could recheck her BUN/Creatinine again soon if I want to. Or we can wait about 4 weeks and recheck all blood work. Or we can do a UA. He said that a dog with kidney issues can't concentrate its urine. Since that is also the case with Cushing's, I'm not sure how much that helps us.
Regardless, Hannah has been licking her "privates" or vulva, I guess, frequently and I can see that it is really pink on the skin around there. She doesn't want me to look at it, so I know something is up. A few weeks ago we just finished a three week round of Clavamox because she had this rash all over her abdominal area. It did clear up entirely. Since it is pink again and she is licking a lot, we are going into the vet tomorrow. They want to do a UA this time too. Last time I remember them telling me if there was a UTI the Clavamox would clear it up anyway.
She was just acting off tonight and I was worried that her back was causing her pain again too. She was standing funny, had her tail down, just acting off. We went for a really short walk (it's freezing and the streets are snow and ice covered) and she wasn't moving very fast at all, but then trotted when I asked if she wanted to go home. I don't think she sees much at all, so I think walking in the dark is not appealing to her.
She did trot around the house when she couldn't find me, so hopefully the back is okay and it's just this rash that is bothering her. If I rub back there, she'll eventually let me peek, and feel the area. It does feel a little bumpy, like maybe there are some small pustules in the pink area.
Ugh. If it's not one thing, it's another. I guess we'll see the results on a UA now because of this, but I don't know what it will tell me anymore because now the potential lack of concentrated urine may not be indicative of Cushing's.
I just hope I can have two happy, healthy dogs for the holidays...
Anyway, I'll keep you posted.
Julie & Hannah
not sure if you have read everything i did with my little girl, and I am one who wants to make certain i have everything covered...everything....and if there is chance of one tiny spec being missed i want to do whatever i need to cover that. So sometimes i feel its better to just start over from scratch....do another complete cbc, biochemical, UA (cysto) pooh sample, UPC and creatine ratios, etc. and redo ultra sound and even full pancreas check. and even hormone check. Its like okay....lets see what we have, where we have been and where this is heading, i even went as far as to graph things out....(i know i know) and grouping symptoms together and then seeing what all these symptoms link back to, what do they all have in common. When i stress i cant sleep, the angels here can sure vouch for that one as the hours of my posts would come in at all times. lol
Hope you and your baby are doing okay.....sending warm hugs your way.
Hi Julie,
i am going through the same thing with Zoe with the vulva licking and her paw chewing has worsened much more that it usually is. She was cleared for UTI a month ago, we did culture too, nothing there. I think Zoe needs an anthistimine.
I'm telling you, I think Zoe and Hannah are related;););)
love,
addy
Jenny & Judi in MN
12-15-2011, 06:36 AM
Hi Julie I had missed your update. Is Hannah feeling any better? It seems to be an awful year for allergy type stuff. Judi
Hello Everyone-
I want to write an update about Hannah. First, she is scheduled to have another NSAID test in mid-January to see how her ALKP level is, and to see if her BUN level is normal (since it was slightly elevated a few weeks ago). I am also debating the UCCR test with her, since she doesn't show a lot of signs of Cushing's.
We were back at the vet today with another skin issue. A couple of months ago she created a skin infection from licking her groin area. It cleared up, and then came back again, just by her vulva and I caught it early. We treated that for two weeks (she was done with the antibiotic on Tues.) and last night I noticed a couple of scratches and scabs on her chest. There is hair missing in that small area (she scratched it off). She has been itching there lately. It didn't look too bad, so I was just planning to wipe it with the Chlorhexidine wipes I have.
Anyway, today, I noticed that she was bleeding on the back of her front leg. I couldn't find the source of it so we went to the vet. I suspected she scratched it until it bled, but the vet said it looked like an abrasion. I have no idea how she would have gotten that.
They cannot figure out what all of the itching is about. Since it hasn't been very cold here, we wonder if it is still allergy related. She has never scratched herself to the point of injury before. For now, the vet is taking a conservative stance and we are doing a different antibiotic for ten days (Clindamycin), Benadryl three times a day (we did that in the summer) , and the Chlorhexidine wipes twice a day on those two areas.
She said if she is still itching a lot tomorrow, she recommends Gentamed, an itch spray. It does have a steroid in it, but they said they feel comfortable using a little bit topically, in a Cushing's dog (especially one with very mild symptoms). Any thoughts on this?
The next suggestion is a skin scraping to see if she has mites, since they had a case of mites a few weeks ago without typical signs. She also suggested I get Hannah's thyroid tested when I have the NSAID done, just to see if she has any thyroid issues, since that can cause skin trouble.
Does anyone have any thoughts about this? Would this be any symptom of Cushing's (lots of itching and skin issues)? My vet said it really isn't.
Also, I noticed the Clindamycin says to use with caution in dogs with liver or kidney issues. They were not worried about the very slight elevation in her BUN, but I am wondering if this is concerning with an ALKP of 400-something. I am hoping not, since I have it, but we saw the vet that is less familiar with Hannah's Cushing's issues/blood tests.
I still have been trying to check in on all of you, and now that I am on winter break (from teaching), I hope to check in more often. I hope you are all doing well.
Thanks for any suggestions you have!
Julie & Hannah
Jenny & Judi in MN
12-22-2011, 09:18 PM
Julie: Jenny got kennel cough from her vaccine and it took 6 weeks of antibiotics to get rid of it. Her vet prescribed something stronger than amoxycillan then left for the weekend. When I googled it, it said it was not recommended for dogs with liver problems.
I got more amoxy from Jenny's regular vet and gave her that instead.
When I told this vet about my concerns he explained (and I already forget) that the liver warning are for dogs with chronic liver problems and the drug he had given me, doxycycline, would've been ok for Jenny and her elevated liver issues due to Cushings
When I started this post I thought I remembered what he said, obviously I"m losing my mind. these skin problems sound miserable though. I hope she gets some relief soon!
Thanks, Judi! I assumed it is probably okay, but now I am ALWAYS worried about my girl (who is currently barking at me and scratching my leg...why, I'm not sure...that's my Hannah). I appreciate the info.
Julie & Hannah
Hi Julie,
Sorry to hear about Hannah. We seem to be in the same boat though Zoe does not yet have the skin infections. Cush dogs can have frequent infections. My IMS discussed the use of topical creams with a steriod. She did not seem super worried about it if we have to resort to one down the road for awhile. We just have to know it may increase her cortisol.
I would wonder about the mites as well because in Cush pups they can be a problem. I have that in the back of my mind for Zoe. I had pretty much decided on my own to do what your vet just told you to do. I have some amoxicillin that I may or may not try depending if I can get a handle on Zoe without antibiotics. I think the night before Zoe had potty problems because the benadryl gives her a bit of dry mouth and she was drinking more water that night.
Does Hannah have dry skin? Our IMS wants us to use a moisturizer on Zoe. This morning I distracted her with a Kong. I let her chew and lick that when she started on her paws. She is better on the BID benadryl. I just wanted someone to be home to make sure it was not a problem for her taking it so close to her Trilostane.
I am hoping the wipes, the 3x benadryl and the antibiotic helps poor Hannah. Try distracting her with a chew toy too. It helps Zoe and if some of this is obsessive complusive chewing and licking along with allergies, it can't hurt.
Love and hugs,
Addy
P.S. OMG You are coming to Wisconsin? I wish it was close to Milwaukee, we could visit:D:D
lulusmom
12-23-2011, 01:39 PM
Hi Julie,
With so few symptoms commonly associated with cushing's, I personally wouldn't consider treating and if that would be your decision too, save your money for testing if and when Hannah developes more symptoms.
Per our PM's, I think it is a very real possibility that Hannah has Sarcoptic Mange and I personally would forego the skin scrape and get some Revolution on her and Izzy now. As a rescuer I've dealt with it a lot and am currently dealing with it with my own dogs. They were exposed two weeks ago to a friend's dogs who woke up one morning scratching and biting themselves bloody. It hit all four at the same time so my friend was going what the heck? My dogs spent the day with her dogs two weeks ago. No scratching yet but I contacted my IMS and my gp vet and both said get Revolution on them now.
This is the worst and most intense itch a dog can have which is why the lesions are usually from self mutilation which is also why it can easily turn bacterial from the dog's saliva. The carrier in my case is a little shelter rescue who had two skin scrapes by two different vets and no mites were seen. Unfortunately, more often than not, sarcoptic mites are tough to find unless you scrape their whole body. For this reason, it's usually recommended that you treat with something like Revolution and see if it helps. If it is scabies, you'll notice a small improvement rather quickly and within a few days, you'll see a vast improvement.
I realize Hannah has skin problems but there are too many coincidences to be an unseasonable allergy. As I mentioned, sarcoptic mites like areas that aren't too furry like the chest, abdomen, knees and ears. Hannah, has missing hair from her chest and a lesion on her elbow. Those are two primary areas of infestation.
Lesion on dog's elbow
639
Exposed dogs don't start scratching for a few weeks so the exposure at your vet's office, areas affected (lesion on the elbow and hair loss on chest) and the sudden intense itching all track. If I were you, I would contact the vet today and ask for some Revolution. If Hannah has scabies, it will get worse without appropriate treatment and I promise you that Izzy will start scratching at some point too so both need to be treated. All of my dogs and my new foster got Revolutionized last night. :D The day my friend's dogs started scratching was the day she did too. She had bites on her middle torso and behind her right knee. I'm hoping I dodge the bullet because I hate being itchy. With people it is self limiting and no treatment is necessary.
Good luck.
Squirt's Mom
12-23-2011, 02:08 PM
With people it is self limiting and no treatment is necessary.
I am going to have to respectfully disagree with this. Gia brought scabies home from school when she was in the second grade - we both required prescription shampoo and body wash. Everything washable has to be washed in extremely hot water and I used some of the shampoo as well. Things that are not washable need to be sprayed with the same things used for lice.
I have had scabies more times than I care to remember - all from dogs except for that first time. The last time I got them, I had picked up the only surviving puppy in a flooded drain ditch, held him close in my lap and against my chest to warm him up on the ride home. Within days, I was covered in the little boogers to the point I couldn't wear clothes. I spent 3 days naked on an air mattress with stinky crap all over me. :p Lucky recovered much more quickly than I did! LOL
Scabies in humans is usually easy to see. The mites move under the skin in a fairly straight line so you will see little red bumps in lines that itch like mad. I hope if this is scabies, you are spared the misery!
Hugs,
Leslie and the gang
lulusmom
12-23-2011, 02:39 PM
There are different types of scabies and the type humans can get from dogs is self limiting. Jenna's had it multiple times, I've had it once and now Brenda has it. We did not require any treatment and it went away within two weeks.
Excerpt:
In other animals
Main articles: Sarcoptic mange and Acariasis
A street dog in Bali, Indonesia, suffers from sarcoptic mange.Scabies may occur in a number of domestic and wild animals; the mites that cause these infestations are of different scabies subspecies.[3] These subspecies can infest animals or humans that are not their usual hosts, but such infections do not last long.[3] Scabies-infected animals suffer severe itching and secondary skin infections. They often lose weight and become frail.[9]
P.S. I forgot to include my friend, Ellen, who has had scabies multiple times from her rescues. Since the bugger that started our problems was her rescue, she reminded me that should I get them this time, it's not bad and will go away on it's own.
Excerpt from WebMD
Scabies in people can produce an itchy rash, typically found at the belt line. This rash is caused by insects that have transferred from the dog. Scabies mites, however, do not live on human skin for longer than three weeks. If the problem does not disappear in three weeks, look for a continuing source of infestation.
Hi again-
I talked to my vet's office today because they called to see how Hannah is doing. I asked about the mange. The vet tech said she thought the vet was more suspicious of demodectic (sp?) mange. Hannah has had some form of skin issue going on for over 8 weeks now and Izzy shows NO symptoms. I also frequently find chunks of Hannah's hair on the carpet (that come out when she scratches) and that has been for years--not new with this itching. She wasn't wearing her sweater for a few days after a bath and this is when I found clumps of hair and then a scratch/scab on her chest.
Anyway, they told me they could scrape her today if I wanted, but I said I wanted to try the weekend with the wipes, antibiotics, and Benadryl. She is so weird because she only itches at times. It is not constant. For example, I woke up with a headache this morning and had to go back to bed for three hours and she slept in her bed with no itching the entire time. The only thing she has done so far today is lick her front feet and rub her face across the floor (usual Hannah things).
Also, I can't even find the spot on the back of her leg anymore. How weird is that? Yesterday I couldn't see the origin either-just the blood on the hair, but I can find nothing today. I just wiped the whole general area with the wipe. The spot on her chest looks almost gone. I can't see the larger scab at all anymore. It looks back to normal color. I don't get it.
Glynda-I'm confused about what you mean about the timing of the vet saying another dog had mites. Do you think Hannah caught it from that dog being at the vet? Or you just mean it was in the area? That dog was a dog that goes into the woods, but we weren't there around the same time.
Thank you all for your input. Since Hannah seems pretty content and someone will be with her for the next 10 days (my husband and I are both teachers and are off for winter break) I am comfortable watching her habits for a few days before heading back to the vet.
Take care everyone-
Julie & Hannah
Cyn719
12-24-2011, 03:20 PM
Glad Hannah is content right now
Merry Christmas - love and prayers xoxo
Hi Julie,
I hope you had a wonderful time visiting Wisconsin. I also hope Hannah is fine.
I had a quick question. How often are you using the wipes a day?
Love,
addy
Hi Julie,
I am allergic to mold so I have been suffering as well. I had to double up my nasal spray, asthma meds, etc and I am just barely maintaining so I know what you mean:)
The wipes finally arrived today, HURRAH!!!!! So we will give it a whirl if she will let me wipe her potty:eek::eek::eek: Zoe is very, well, she deems what behavior is appropriate in her book and does not mind letting you know when she thinks you are out of line:rolleyes::rolleyes:
Koko, would not dream of that:rolleyes:;) Funny, how different the two are. I should have named them Spunkster (Zoe) and Sweetie (Koko).:D:D:D:D:D:D:D:D:D:D
Julie, did you use the wipes on Hannah's paws?
Have a great night,
love,
addy and the kids
Hello-
I am being my normal, worried self tonight. Hannah didn't go potty very much today...only three times: 8:00 a.m., 4:30 p.m., and 11:00 p.m. We tried to get her to go at 3:00 and she didn't want to, and then we were out with friends from 6:00-10:00 and let her out when we got home and she didn't want to go. It was like a fight to get her to go. We went outside three times, tried a walk once, and then she finally went. When I am working, she holds her urine during the day, but since we are on vacation this week, she would normally go more often.
Here are some possible reasons I can think of for why she didn't go at 10:00: she didn't drink while we were gone and just slept in the kitchen, she can't see very well and doesn't like to spend a lot of time outside in the dark, or....something is wrong. I don't know why this is bothering me so much, but it is. It makes me worried because I know her BUN level was high last time (I think 33 and 27 was normal), but her Creatinine was normal, as was her specific gravity, apparently. My vet thought this rise could have been due to dehydration, or the fact that she had eaten that morning (something about protein). She was not fasted before the NSAID monitoring because I wasn't told she should be. She ate at about 8:00 a.m. and we went in around noon. He was not concerned and said we would recheck in 6 weeks (so mid-January).
Well, I called the ER vet to see if there was any possibility that Hydroxyzine (for her allergies) or Clindamycin could cause her to urinate less, and the tech said that she didn't know of any reason that would happen. She then recommended that Hannah get checked by my vet tomorrow to see if her kidneys are working okay, and explained that with kidney failure, they eventually stop wanting to or needing to urinate. I assume that is when it is very advanced and not that it would happen all of a sudden one day, but I assume they want to be careful.
Hannah is otherwise acting normal, and I realize that she did urinate roughly every 7-8 hours, so maybe I shouldn't be panicking. She is sleeping a bit more (probably from the antihistamines), so maybe she is not drinking as much. It is so weird to go from worrying about the increased drinking/urinating to not enough urinating. She isn't drinking excessively either, and my vet said I would notice increased drinking and urination with kidney disease as well.
I don't know that I should actually take her in tomorrow if she urinates in the morning. The ER vet said they are concerned when it has been 12 hours, which we didn't get close to. For some reason, she now sent me into a panic. I read some things online that calmed me, and others that made me nervous. I did feel/push around on Hannah's abdomen before she finally did urinate, and felt nothing strange and she didn't react.
Am I just freaking out??? Ugh.
Thanks,
Julie & Hannah
Hello!
how is the weather there? is it raining cold muddy or are any strange sounds happening at time of potty breaks, or perhaps has a visitor been in yard that has her upset and not wanting to go?
could she possibly have UTI and that she is holding it because it hurt? (although they usually go more often than not...but you just never know) have you monitored her water intake? food intake?
check her capillary refill.......press on her gum and see it go blanch it should return to good color within 2 seconds and also see if her gums feel tacky.
have any stressors been happening at home? sometimes when they get stressed they cant go.
just tossing things out there for you............i am thinking of you and hannah...
and since she is going.......at least here is not an obstruction so that is a plus.
if you can catch a urine sample to check its color.....and oder
sending hugs and love
Well, Hannah had me in tears last night, both from worry and frustration. I think my husband thought I was ready to be committed. She did not want to pee. She went at 12:30 p.m. at my parents' house and then did not go again until 9:00 last night. I finally tried the front yard where the snow was not so icy and after SEVERAL trips out and me finally bursting into tears, she went. I was planning to take her to the vet this morning to just get blood work done (we were going to check again in a week or so anyway) and then see a vet if we needed to. I go back to work tomorrow and won't be able to let her out every hour until she finally goes, and I don't know if she would eventually go in the house or not.
Anyway, I got up about 7:00 this morning and put her out in the front yard and she went without much issue at all. At this point I was wondering if it was just the really cold weather, high winds, and icy snow. My dogs also take some time to adjust to the snow, and then back to the grass in the spring, but I've never seen Hannah do this.
She hadn't pooped since Sat., so about 11:30 I decided a trip to the pet store would probably prompt a BM. We went and wandered around the store, which both Hannah and Izzy love, and she happily trotted along sniffing everything and everyone, and she pooped AND peed again...with no trouble. Just squatted in the middle of an aisle.
So, I now am pretty convinced that there is nothing wrong with her, but that she does not like the cold weather and snow. In most of our trips outside, she was getting lots of little frozen snowballs on her feet, which I'm sure is not comfortable, and her feet would freeze up and she would hold one up and I would have to pick her up. We didn't go to the vet today since she seems fine. She is eating normally, drinking water, chewing on her bones, toys, following me around, etc. It's supposed to warm up in a couple of days, so I hope that will help thaw out some of the ice covering my deck and the grass in the back yard.
I'm really hoping I can get her to go out tonight and tomorrow morning because I cannot afford to go back to my 3rd graders stressed out and upset tomorrow. Man, she can sure drive me crazy. If only they could talk I keep thinking...
Julie & Hannah
Squirt's Mom
01-02-2012, 06:55 PM
Hi Julie,
Trinket HATES the snow. She is convinced it is aliens from another planet and any contact could be transforming in a very negative manner. :p I learned last winter that she requires a spot completely cleared of snow, down to the dead grass and mud - no snow, or she will not go outside. I lucked out in that the area by my brother's heat/air unit is close to the camper and the run-off from it keeps a small area snow-free. So she got carried over to that spot several times a day and nite. You might try finding or making a spot that you can keep clear of snow that is somewhat protected from the wind and see if that will help.
Squirt will get those little snow-balls all over her but could care less! She LOVES the snow! The more the merrier. She will drop her face down in it and start plowing through then raise her head and grin at me from ear to ear! :D
This may be Brick's first snow if we get any this year so I am looking forward to his reaction! ;)
Hugs,
Leslie and the gang
PS. Trinket wants me to remind you to remember that snow might be fatal if it touches you. ;)
Hi Julie,
Zoe will refuse to go out and poo if the snow and cold are too bad. How she held it so long, I could never figure out. She would sometimes poo once a day or none and I would get worried too.:o:o:o:o
Hopefully sweet little Hannah will adjust. I know it is easy to say don't worry because we all do worry anyway;);) I'm trying to be mad at Zoe for her impossible behavior today but I really am worried about her too.:o:o:o
So take a deep breathe, breathe in, breathe out, I am doing it with you:)Feel the stress go away? No? Ok, lets try a hot bubble bath along with some Chocovino. IF that doesn't work, I'll pass our Zoe's bottle of melatonin:D:D
love,
addy
lulusmom
01-02-2012, 08:43 PM
It was 81 degrees here today so I can't relate to the snow problem. :p
Julie, I suspect that there is probably nothing wrong with Hannah. A lot of dogs, including my current foster, think nothing of holding their pee for eight hours or longer. At first I was concerned but then I remembered that my foster dog is normal where my dogs are not. I have Jojo who has diabetes insipidous, Lulu who's cortisol is running high so she is urinating more often and Jasper and Buster are on diuretics so it's a peefest around here. I wash a load or two of hospital pee pads every day.
Squirt's Mom
01-03-2012, 11:08 AM
HIJACK!!!!!! :D
I wash a load or two of hospital pee pads every day.
Glynda, there are washable peepee pads? Where do you get them? Brick goes thru about 3 pkgs. of 18 pads a month or more. Washable might be less expensive to use! Thanks!
Harley PoMMom
01-03-2012, 11:30 AM
HIJACK!!!!!! :D
Glynda, there are washable peepee pads? Where do you get them? Brick goes thru about 3 pkgs. of 18 pads a month or more. Washable might be less expensive to use! Thanks!
I found out about these from Glynda, too! I used this type of washable pad for Harley: http://www.petco.com/product/8830/PoochPads-Reusable-Housebreaking-Pad.aspx
Not sure where Glynda gets hers.
Squirt's Mom
01-03-2012, 11:38 AM
Oooooooo, thank you, thank you, thank you! They are expensive to buy but will save $$ in the long run! Definitely going on my wish list!
Well, Hannah would not go pee for me this morning, or for my parents when they stopped over later this morning. They tried everything they could think of. She finally went about 3:45 when my husband came home. That means she held it from 9:45 p.m. to 3:45 p.m. the following day. I talked to my vet today and because she is otherwise acting normal and because she IS urinating they think it has something to do with the really cold temperatures and ice we have had after a very mild winter. It is hard to know...I was really hoping the potty pads or the rugs in my kitchen would be wet...but they weren't. I cannot understand how she held it that long. The vet said the worst they were worried about at this point is her getting a UTI. They seem to think she will go when she absolutely needs to. The vet said they could check her urine if I want, just to be sure. Both dogs are going in Thurs. to be groomed, so I thought maybe I could bring a sample then. I sure hope that when it warms up a little she will get back on track. I don't know what will happen when we have our really cold stretches. I would love it if she would just use a pee pad. UGH. This dog is killing me slowly...
Julie & Hannah
Killing me softly with this dog, killing me softly with----ok I am no Roberta Flack:D:D
Wow Julie, that is a long time to not pee. How the heck did she do that? Poor Julie, you must be a basket case with worry. I would be.
My little Kujo, oh, I mean my little Zoe was bouncing off the walls when I got home from work. I put her sweater on and took her out, she peed, tried to eat her night time snack of bunny poop ( she thinks they are cocktail peanuts before dinner) and when I brought her back inside and tried to take her sweater off she tried to bite me:rolleyes::rolleyes:
It is going to be a long January, BIG SIGH ICON HERE;););)
Maybe Hannah will come around. I think it is to get warmer later this week.
Great, baby Kujo just decided to go to sleep without going out to poo.
Julie, how about we take a cruise and leave the dogs with the hubbies?
love,
addy flack;)
by any chance can you get sod anywhere? or fake grass? put it in your garage....sometimes they will be apt to go out of the elements even though the garage is still cold not as pad as outside. or even grass clippings from yard sometimes will work.
at one point i had a little potty area with small little space heater so as i supervised we all didnt freeze. lol,
lulusmom
01-04-2012, 09:17 AM
I have a friend who buys sod for her dogs. She is gone for 10 hours a day and one of her dogs will bust before she pees on a piddle pad in the house. The sod worked!
Leslie, I bought my washable hospital pads on ebay. They are much cheaper.
:(:(:(:(:(:(
I am a mess. My mom stopped over to my house to let my dogs out. Hannah did pee and then they went for a walk, which she also enjoyed.
On the way home, a neighbor had a friend over, and the friend had a black lab. They were sniffing each other and the woman said the dog was friendly. All of a sudden, it picked Hannah up by her sweater and was shaking her like a toy. My mom yelled and tapped the dog's head and it dropped her. It didn't shake her a lot or throw her, but Hannah (with the back problem already) has trouble walking and resists lying down and is breathing heavily and groaning.
My mom called me at school (I teach 3rd grade) and I started crying, and of course felt that I needed to go home to be with Hannah. We called vets trying to decide where to go. We took her to the vet where she got acupuncture and they assessed her to see if she was stable. There are no puncture wounds (she was wearing a thick sweater and has long hair right now) and her temp. and heart rate were normal. We can't see the vet until 4:00 for the next step (acupuncture, x-rays, pain meds?). We came home to wait.
She wagged her tail to see me, ate treats here and at the vet, and walked to her blanket. She groans so much to sit down. They think it is her lower back.
I am so worried and upset. Please be thinking of me and my little Hannah...
Julie & Hannah:(
Squirt's Mom
01-04-2012, 04:53 PM
Oh, Julie,
How scary! :eek: Please let us know what the vet says.
Prayers and healing white light for Hannah, and you. I hope your mom wasn't too upset by the ordeal. Bless her heart.
Hugs,
Leslie and the gang
OMG Julie,
Praying sweet, little Hannah is okay.
Holding your hand,
love,
addy
Harley PoMMom
01-04-2012, 07:11 PM
I am here, too. Holding you both in my thoughts and prayers.
Love and hugs,
Lori
your probably on your way home.........dear God how horrifying. oh sweetheart....i am so very sorry, and i am so very sorry for your baby....omg i can not even imgaine how horrifying that was. so hope things are okay. ((((hugs)))
Hi Julie,
just checking back for news of Hannah. I hope you are both okay.
love,
addy
frijole
01-04-2012, 10:36 PM
Julie... wow that is scary. What are these people thinking? Poor Hannah. Sending warm thoughts and prayers your way. Kim
Hi Guys-
We are home and sort of situated. The vet said Hannah's back is injured again...basically in the same spot. She got acupuncture again and tolerated it a little better. The vet said she assumed that Hannah would improve again over time with acupuncture. She also is on Metacam again (for a short period only and she did tolerate it fine the last time for 7 days). She thought that Hannah could potentially improve faster because she has had acupuncture before and said that this is a little different because it is an acute injury. She thought it would be nearly miraculous if she was better after one treatment. She did come home and eat and wag her tail and walk around, but has been sleeping most of the time since. She does have a hard time lying down, and at times just sits. I feel like she is exhibiting more signs of pain this time than she did the last time. My mom reminded me that this is an injury, as opposed to chronic pain, so it might just be different.
I am trying to be encouraged by the fact that she wasn't more seriously wounded, that she went potty when we left the vet, that she ate supper, and that she is home. Heck, I am thrilled I didn't have to put her to sleep. I am still worried about her though. A lot. I am worried about her going potty tonight too.
My poor little sweetie. I feel so terrible. So does my mom. I have met the other dog before and it is nice, so I am sure it was a fluke. The woman admitted it was her dog's fault because it wasn't on a leash and gave me her name and number. I'm not sure if that was her saying she wanted to pay, or what. She has not called me back. I paid $99 today and will pay $80 for each additional acupuncture treatment. I will make it work to make my girl better, but it is already hard for us to keep up with all of the vet bills on two teachers incomes. Ugh. I just need her to be okay.
Thanks so much for all of your well-wishes and kind words. It means a lot.
Julie & Hannah
I'm so glad you posted, I rushed to my lap top this am hoping for news.
Thank God she is okay and it was not worse. I'm sure her back will get better. Just spoil the heck out of her:D;)
Poor little Hannah, she has had a time of it.
Get better soon.
Sending love and hugs (((((hugs))))
addy
Squirt's Mom
01-05-2012, 10:44 AM
Oh Julie,
I am so happy to read your post and know that Hannah wasn't hurt any more than she is. What a relief!
Her muscles could be very sore from simply tensing when the attack happened so you may be seeing some stiffness from that as well as the pain from the back injury. I know I would have tensed up if some big ole hairy thing yanked me up and started shaking me! :eek: Then I would have passed out. :p Some gentle massage might help her feel better and it would be a great bonding experience, perhaps relieving some stress for you both.
I hope the acupuncture does the trick in no time and she is back to herself soon.
So grateful it wasn't any worse!
Hugs,
Leslie and the gang
Hi Everyone-
Thanks again for your thoughts and well-wishes for Hannah. We are on day 3 now post-incident and she does seem a little better, but still hurts. I obviously don't want her to be in a lot of pain, but I am also unable to compare this to her last back problem, which probably came on gradually over time and was a chronic pain issue, as opposed to this acute pain from a traumatic event. She is walking better than she was on Wed. and much better than she was before the last acupuncture, but she is groaning more and showing pain, which she didn't at all the last time. She seems to be able to lay down a little easier, and she eats with her normal vigor, is able to go potty and poop, wags her tail at me sometimes, chewed on a bone on Thurs., and is trying to dig her little nest in her bed. She is also beginning to itch (from her allergies), which I'm sure is tough to do when you are so sore. She seems the most uncomfortable when I have to pick her up (we have steps off of our deck so I have to pick her up to get her outside).
Sometimes I wonder if the moaning and groaning is because she is itchy too. We are still doing Hydroxyzine for itching and Metacam for pain until Tues. The itching did seem to improve when we had a 4-5 day bitterly cold stretch, so it must all be allergy related.
I talked to the vet who did the acupuncture last night because I wanted to know if it was normal for Hannah to still be painful. I know it had only been two days, but needed some reassurance. She said that ideally she would be feeling better, but that it wasn't worrisome to her at this point. She did say we should definitely get in for another acupuncture treatment, which I had already scheduled for next Wed. before we even left.
I asked if she felt that Hannah would be able to recover (her best guess) and she said that since she responded so well to acupuncture the last time with great success, she felt pretty confident that she would improve.
I know it will take some time and it was a gradual process the last time as well, but I didn't have to see and hear the pain I can now. The one thing that seems better is that she isn't wincing/twitching as much. The Metacam is only once a day (at night), so maybe she is just a little worse then because it is wearing off. And, like I said, maybe the itching is causing some noises too. When I rub her ears or sides (her itchy spots), she groans, which maybe means it feels good. Her little voice/groans sound a little weaker and more raspy too, so it is hard to figure out.
I wish I could look into a crystal ball and just know that eventually she would be okay. That would provide so much relief. I know I can't do that though, so I will try to take it day by day and hope the vet is right that the acupuncture will help. I just don't want her to be suffering...but at this point she seems happy enough with her food and treats and her "mommy" that I need to push forward and try.
The owner of the dog who shook Hannah did come over yesterday and write me a $100 check for the initial vet visit. She said she and her husband don't have a lot of money, but that she wanted to do what was right and at least give me money for that. We agreed to keep in touch regarding how many treatments ($80 each) Hannah needs to feel better.
Please keep Hannah in your thoughts...I'm really hoping I see some good improvement soon.
Thanks,
Julie & Hannah
frijole
01-07-2012, 11:28 AM
Thanks for the update. I know acupuncture is what has kept Annie going and it is amazing the difference after a visit. I know what you mean about the crystal ball but with your love she will thrive. :D Keep the faith and know we send our love and prayers. Kim
Poor Hannah pain and itching:(:(:(:(
As Kim said, keep the faith, she is going to be all right. We have quite a few prayers going up to heaven so if you hear some thunder, it might just be all of us praying very loudly at the same time;);)
I can't imagine how worried you are, that merry go round just keeps on spinning. I hope this weekend you and Hannah get a chance to cuddle and rest.
love,
addy
well at least she did that. i would have told her if she cant continue to help with expense that i am sure she has jewlery, tv, ipod, computer, that you would take instead and sell them. LOL (sorry i am a bit of a smarta@# I am VERY protective of family friends and animals) i hope she continues to do well. I was thinking about the two day thing....you know on us, the 2nd is usually the worst, even if we miss sleep, the 2nd day is more difficult than the first. AND i dont know about you all....but as i continue to age things are more difficult to bounce back from...takes me while. so maybe with all that into consideration, progress will be made but slower. giving gentle hug to her, and shysie says grrrrArfArf (she is playing big dog body guard, lol)
Hello again,
I am so happy to report that my little girl finally seems to be showing some improvement (that even I can see). At about 7:00 last night I commented to my husband that she seemed to be walking around more, following us, not groaning, etc.
Today she also seems better. She is even trotting around a little. (Her walking was not as affected this time though). And she isn't groaning as much when I pick her up.
I am feeling really encouraged about this after having a really rough few days. I wasn't eating much or sleeping well. My biggest worry today was whether or not I should give her the Metacam tonight. The vet was hoping to only use it for a few days, but told me on Friday I could do it for a week if needed. Today was day 5. After agonizing a little, I decided to give it (but didn't give the full dose) and to call tomorrow to see if I should stop.
Hannah has also been itching her ears like crazy and I am fearing she might have an ear infection. It is hard to know though, as she itches them with her allergies. Hopefully it can wait until Wed. when we see the vet again.
It seems like we have turned a corner and I actually believe she will be able to get better.
Thanks again for all of your thoughts and comments. It is so nice to know there are people thinking of us.
Julie & Hannah
frijole
01-08-2012, 10:26 PM
Great news! I know you are relieved. Do you think the ear itching could be caused by the Metacam? I know some meds make me itch and tingle.. just throwing it out there.
Give Hannah a treat for me and get a good night's rest. You have earned it! Kim
Turning the corner is great news.:):):):)
We are to have warm weather again today but then to get colder. I am hoping you get the cold weather first. Like you, I am sneeizng like crazy:(
I will be sending continued healing thoughts and prayers your way. Thanks for the advice you took the time to give me while you are going through your own problems.
Hugs and love,
addy
Squirt's Mom
01-09-2012, 10:44 AM
Hi Julie,
So glad that Hannah seems to be responding to the meds. I hope she is back in full swing very soon. I can just imagine how worried you have been.
It was really nice of the other dog's woman to offer the help she has - many wouldn't have done that much. I hope they can see their way to helping you with the expenses resulting from this attack a little more...but even if they can't, they have acted with an honor seldom seem these days.
Hugs,
Leslie and the gang
Jenny & Judi in MN
01-09-2012, 04:22 PM
Julie: I've been gone and missed this. Poor Hannah. I'm so glad she is doing better. I will give the woman credit for bringing you a check. So many people are worried about lawsuits I've seen people not do anything.
hugs to all of you, Judi
Hi-
Hannah's back seems to continue to be better (yay!) and I am hoping the vet thinks the same thing at her acupuncture appt. on Wed.
I did have to have my parents take her into the vet for me today because her ears looked so bad to me this morning. Sure enough, she has a double ear infection. So now we're back on ear medication. There is yeast and some bacterial infection too.
Here's to hoping we don't have any more issues in the near future...
Julie & Hannah
aweeeeeee bummer, bless her sweet heart, poor little ears.
Okay, BUT the back is better??? so hope doctor agreed! thinking of you all. love and hugs
Thought I'd post an update on Hannah. She had acupuncture again on Wed. (my parents took her while I was at work). The vet said she was SO MUCH better. They could see her personality (thought she was so cute!) and she wasn't too into the acupuncture that day. They did it on the floor instead of the table and my mom said Hannah was trying to walk away. They finally distracted her with treats.
The vet said she may not need another one and that I should just watch her and see how she does. She suggested it might be good to get a maintenance treatment every 6-8 weeks in the winter, and that I should watch to be sure she doesn't slip on ice.
Hannah is happily trotting again on her short walks (about a block and back) and is following me around the house. She is going to be getting groomed this week (a week earlier than I planned) because the groomer at my vet (who has experience with dogs with injuries) has to quit grooming because of her own back problems. This is her last week. That stresses me out a little, but I am hopeful my other groomer can do it, as she has some experience with older/injured dogs too. She said she typically does all necessary areas (nails, pads of feet, sanitary area, face) right away, then does the bath and cut, and lets the dog dictate when to take breaks.
We are still treating the double ear infection, but both ears look much better. They just get so greasy and disgusting feeling. I am also going to check with my vet on if we could stop earlier than the 14 day recommendation on the bottle. She is still licking her feet a little bit and scratching her chin and sides from time to time, but it seems a little more under control. I am relieved that there is nothing resembling a rash near her vulva, and she has been leaving that area alone, except for a quick lick after she goes potty. We are still on Hydroxyzine 2-3 times per day, but when it was really cold this past week she was less itchy and fine with only two pills. It warmed up again yesterday, but it is supposed to be really cold again this week. Hannah has also been fine in the cold weather (even with a dusting of snow) and hasn't been resisting going outside (another relief).
Hopefully we'll have another calm period for a little while. I need to get her in for her NSAID monitoring sometime soon, and hopefully that will look good.
Thanks for checking in on my little Hannah!
Julie & Hannah
Sounds like a pretty good update. I am glad Hannah is feeling better. You deserve a nice long period of calm, happy dog time.
I know how you feel about having a groomer leave. I don't know what I would do if I lost the two I use. Mine have never seen anyone else since I adopted them.
Hugs,
addy
Hannah was finally groomed yesterday and it went well, so that is a relief. They also checked her ears while she was at the vet and the infection is gone so no more ear meds!
She was due for an NSAID monitoring so they did blood work as well. Unfortunately, her ALKP level has increased from 424 on Dec. 1st to 826 yesterday. My vet was okay with it if it stayed at 424 (she had only gotten as low as 320 initially, I believe, while she was on Anipryl) but since it has doubled in 6 weeks, we are no going to try Denamarin. Does anyone have experience with that? I wanted to try that rather than going back on Anipryl for now, since it will specifically target her liver. We are going to try a month and then recheck.
Her BUN was still slightly increased (at 32 and 7-27 is normal), but her Creatinine is normal, as is the ratio, so he isn't worried about her kidneys. There were a couple of other things just slightly off (low or high) but he wasn't worried and they seem to be consistently that way.
We actually got some snow today (maybe 2 inches) and Hannah was shivering a little when outside (probably from the haircut). She did go potty when I got home from work, but had no interest in pooping. I'm hoping we don't run back into the issue of her not wanting to go outside and holding it for hours on end. I'm going to cross my fingers and hope she just didn't have to go.
Hopefully we won't have to make any vet visits in the near future. Yesterday between grooming, ear check, blood work, etc. I spent over $200, and if I add in the acupuncture the last couple of weeks we have spent closer to $400. She's certainly worth it, but I can't keep that up on a regular basis. Both of my girls are curled up and sleeping peacefully on their blankets right now. It must have been a tough day for them today. ;)
Julie & Hannah
Cyn719
01-21-2012, 01:13 AM
Julie so glad its going better for Hannah and glad the ear infection is gone! Those are nasty and she must feels so much better now!! Hope the weekend goes well:)
love and hugs to you xoxo
frijole
01-21-2012, 09:20 AM
Julie - Thanks for the update and glad all is ok. Yep these little guys can get expensive.. but oh how we love them. :p Give Hannah a hug. Kim
Squirt's Mom
01-21-2012, 10:37 AM
Hi Julie,
Glad Hannah's back is improving and the ear infection is gone. :) And I hope you are able to stay out of the vet's office for a few weeks at least! :eek::p
I haven't used Denamarin but several here have and I'm sure they will be along to share their experiences. I remember the senior vet at our clinic in TN said she always saw liver values drop in her clients on Anipryl and that did happen with Squirt while she was on it, too. I can't recall if her values remained high after that tumor was out or not tho. :o After the tumor was out, we stopped the Anipryl, of course, as there was nothing for it to treat for sure then! I need to go to storage one of these days and try to find all her old records, huh? :rolleyes:
Keep up the good work, Mom!
Hugs,
Leslie and the gang
popping by to see how everyone is doing. sending love and hugs...........
Jenny & Judi in MN
01-22-2012, 10:27 AM
glad things are getting better!
Oh Julie,
I sure hope you dont get this warm front because now our yard is a wet, slimy mess- must be great for Zoe's paws!!!:eek::eek::eek: and Hannah will not be happy either. I hope you do not have to deal with it. Yuck.
I found I have to wipe Zoe's privates once to twice a day with the baby wipes to keep that licking at bay.
The paw thing is weird. With Zoe it just escalated so. She never chews the back ones.
Hang in there sweetie!!!!
love,
addy
Squirt's Mom
01-23-2012, 10:29 AM
Welcome as a Forum Host, Julie! :) We are all so glad you accepted and are proud to have you on board. :)
Hugs,
Leslie and the gang
whootwhoot!!!!! way to go Julie!!!!!!!! your passion and compassion will reach many.
high paw fives from the girls and hugs from me!!!!!
Thank you to those of you who have congratulated me or welcomed me as a forum host. I haven't really lived up to my "job" this week, as I have been feeling horrible (sick) and having a terrible week at work. I hope to return to the rest of my life and the forum this weekend.
Julie
Rebelsmom
01-26-2012, 02:38 PM
Hope you get to feeling better soon and Congrats. :D
Cyn719
01-26-2012, 02:43 PM
Julie
Hope you feel better very soon and hope work gets better also!!!!!
hugssssss xoxo
Harley PoMMom
01-26-2012, 02:51 PM
Taking care of yourself should be your first and foremost priority! Although we will miss you, come back when you are feeling up to it. ;):)
Sending lots of healing energy, hugs, and love...Lori
Jean Donaldson's Culture Clash opened my eyes to a new way of looking at Zoe. I read all her books. Pat Miller's too. I think "training" has to fit the dog. What works for one may not work for another.
Zoe is fearful. She also is very smart and wants to be a higher rank female.
I learned clicker training and free shaping- rewarding good behavior with food. She works for food and I don't apologize for it. My weakness is probably I do not cut back and pay her a reward as intermittenly as soon as I should. But she is always sick.:rolleyes:
I got both pups happy to go in the kitchen by happily calling them to the kitchen and spreading treats around the floor and then closing the door for short periods of time. Almost like a giant crate.
They now love being locked up in the kitchen. The have toys, a blanket and they pretty much settle on their blanket together and go to sleep. Sometimes they wait for us to leave because they want to go into the kitchen:rolleyes::)
The biting she is doing now is because she does not feel well. When she is well, she does not bite me like this.
The muzzle is going really well. Thank goodness I introduced it as a game. I have no problems putting it on her while I swab her feet. I am amazed at her willingness to put it on.
I can't trust Zoe with children unless she is supervised closely. When my youngest grand child comes over, I remind her to not go close, to ignore Zoe and never put her face near Zoe. I never leave them together alone. I know it is hard. But I need to protect both of them.
Not sure if any of this helps. It is what helped me.
love,
addy
P.S. I was typing this at lunch and ran out of time, Julie, did not mean to sound short but wanted to finish before boss came back :)
Hi all,
Here's an update on Hannah. Last Friday we went to my vet for a laser treatment on her back. (It has been fine since the shaking incident from the black lab, thank God!). She is walking fine and doing well, but I wanted to see if I would notice any difference from doing this treatment, or if it would perhaps relieve some pain I don't even know is there. It was only $60 for one treatment and it only lasted 4 1/2 minutes, as opposed to the acupuncture for $80 which lasts about 20 min. It is hard to know if anything changed, as she was already walking well and I no longer let her do steps or any jumping. She seemed much more relaxed with this treatment than with the acupuncture, however. The laser does a better job treating inflammation according to what I have read and to what they say. This vet actually said there is great benefit to using both, which I probably would if she has another issue. I know some vets combine the two. The laser can also be done a few days in a row, which is nice. The acupuncture vet had suggested doing some "tune ups" periodically over the winter, so I tried the laser as the first one. I'm glad it went well.
We have about a week left on the Denamarin before we need to check her liver values again. I'm hoping the ALKP comes down and we can continue on this, rather than going back to Anipryl, just because I like the idea of a supplement so much better. Then I don't have to worry about any interactions with other meds. She is also on Cosequin DS. I just ordered more, which also has MSM.
The itching is still bad at times. We ran out of Hydroxyzine and I am trying Benadryl for a few days to see if there is a difference. At this point, I do think the Hydroxyzine may be better. I would love to get the itching/licking under control, but at this point I am just glad we have gone about 6 weeks without any sort of infection.
The vet that did the laser treatment also does rehab. She said we could consider doing something to build up the muscle in Hannah's back legs. I mentioned that sometimes she seems to readjust as she is urinating (but not all the time) and that she sort of "marches" with her back legs when she poops. This has been going on for several months, so I have no idea if it is related to Cushing's or her back, or if she just does it. Her legs don't shake, and she trots around just fine, but I worry that they may be getting weaker. I watch her like a hawk, of course, so I may just be noticing things she has always done.
She did jump up on a couch with no problem at my parents' house a couple of weeks ago, even though I don't want her to. The vet said it is much worse for her to jump down, but that I am right to discourage both. We keep our throw pillows across the couches at all times, and the ottoman on our chair unless we are using it, just to prevent her jumping.
She still loves to eat and does bark at me at night until I give her a bone of some sort to chew on, but she seems content with that. Her drinking is not too bad; I notice she drinks more when she is licking or chewing a bone, but otherwise it is not out of control, and neither is the urinating. She has no problem holding it while we are at work all day or overnight. I leave potty pads out and they are always dry and I checked the rug for accidents and there are none.
So, all in all, I feel like Hannah is doing pretty well. She definitely is showing her age a bit, as she doesn't hear or see well, and we are obviously dealing with lots of health issues, but I am happy she is still with me and that she is happy. I'm hoping she will be stable for a while, and that we'll get some good news on the liver values.
Julie & Hannah
Altira
02-17-2012, 05:28 AM
Forum Host now... so you've joined ranks with the angels... Cool! My Kira might get laser treatments too. Glad to hear that went well.
((((((((hugs)))))))))
Another Hannah update:
She had her NSAID monitoring this week to see if her ALKP dropped from the month on Denamarin. It went from 826 to 437, so almost dropped in half. We are going to continue and recheck in a few months. Her BUN was normal too, after being just slightly elevated on the last two, so that is also good. She was a little low on MCV and MCH, but just barely, and a little high on BASO, but the vet said it is rare to get a completely normal result with an older dog and that he isn't concerned about any of this. Everything major looks good.
One thing made me a little sad though, and I'll have to ask him about it because maybe I was just interpreting wrong. I said something about maybe the blood work would coincide with her dental, depending on how she is doing. He just kind of went, "Eeehhh." I wasn't sure what that meant. I of course thought, "Does he think she doesn't even need a dental and won't be around long?" I realize that maybe it meant we don't want to hold on that long, or let's not worry about a dental now, etc.
I feel like she is doing pretty well: back is okay, blood work looks pretty good, very minor Cushing's symptoms, if any. She can't see or hear well at all and she licks/itches like a crazy lately, but she is happy as can be. Wags her tail, follows me around, enjoys a short walk, and chewing on her bones (and yes, I watch her like a hawk while she chews). She is almost 13 (in a few weeks), and not problem-free, but I feel like it could be much worse. I'm hoping that she might have a decent amount of time left...
Julie & Hannah
Altira
02-18-2012, 06:26 PM
LOL! My guess is the "Eeehhh" meant don't worry about it. My Kira is almost 12 and the vets never flinch at her teeth and they look terrible. The assistant said I could even just wipe some doggie toothpaste on them three times a week and that would help. I guess there is stuff in the paste that eats up the stuff on their teeth. As far as the blood test goes it sounds a lot like my Kira too. Not perfect but hey she's not young, she's been thru a lot. I was thrilled with her less then prefect result, it had improved. That means she is responding. I would not be suprized if I lost Kira in the next three months but she could live three more years too. This a good time to be happy. And greatful and give lots of specail attention because you never know.
Jenny & Judi in MN
02-18-2012, 06:33 PM
It sounds like she is feeling pretty good. I've been trying to get Jenny's teeth cleaned since her diabetes diagnosis last May. My vet always pushes it back while we deal with the bigger issues.
I hope that is what your vet meant too. You sound like me. I'm always trying to read into what they are saying.
Hope the warm weather isn't making her itchy! Judi
Hello All-
I just wanted to share that today is my sweet little Hannah's 13th birthday!
I am happy to report that she is currently happy and healthy! We are supposed to have a warm day today-in the 50's-so I am excited to enjoy a nice short walk with her when I get home, and then hopefully a special treat tonight. It's been a year since she was diagnosed with Cushing's, and I am happy to report that she seems to be about the same in terms of any signs. We are still medicine-free and doing well.
Thanks to all of you for your support and encouragement for the past year, as well. You have no idea how much I appreciate it!
Julie & Hannah
Harley PoMMom
03-06-2012, 01:02 PM
Happy 13th Birthday, sweet Hannah!!!
OH YOU SAY ITS YOUR BIRTHDAY!!!!!!! WHOOTWHOOT LETS GET THIS PARTY STARTED!!!!!!! YOUR SEXY AND YOUR KNOW IT!!!!!!! WORK IT ON OUT GIRL ON THAT WALK! Happy Birthday!!!!!!
Squirt's Mom
03-06-2012, 01:50 PM
Happy 13th Birthday, Hannah!!
Happy Birthday toooooooo youuuuuuuuuuu
Happy Birthday toooooooo youuuuuuuuuuuuuuuuuu
HAPPY BIRTHDAY DEAR, SWEET, MOST BEAUTIFUL HANNAH
HAPPY BIRTHDAY TOOOOOOOO YOUUUUUUUUUUUUUUUUUUU
Enjoy your day, your walk and the beautiful weather we have in your honor!!!!!
Love,
Addy
BARK, BARK, WOOFFF WOOOFFFF
BARK, BARK, WOOOF, WOOFFFFFF
WOOOF, WOOOF AND YIPEEEEE
BARK, BARK, WOOOOF, WOOOF WOOFF
Love,
zoe and koko
frijole
03-06-2012, 10:59 PM
Happy 13th you sweet thing.... major treats and belly rubs. Kim
lulusmom
03-07-2012, 12:09 AM
Happy 13th Birthday, sweet Hannah.
Roxee's Dad
03-07-2012, 01:22 AM
:D:D:D Happy Birthday Hanna :D:D:D
Altira
03-07-2012, 03:05 AM
Happy happpy birthday, Hannah!
Happy 13th sweetie!
labblab
03-07-2012, 08:08 AM
Oh no, I'm a day late :(, but there's still time to join the party, right????
:D :) :p :o :) :p :o :) :p :D :) :p :D
Happy Birthday WEEK, sweet Hannah!!!!!!!!
Marianne
Hi Julie,
Sorry you had such a scare. I hope Hannah is okay. The lazer treatments sound promising. Thank you for the link. MAybe they can zap Zoe's paws.;);) I'm glad they help Hannah.
Sure hope today is calmer and Hannah can have a birthday week celebration to make up for yesterday!!!!!!
love,
addy
Cyn719
03-07-2012, 05:59 PM
HAPPY BELATED 13 th BIRTHDAY HANNAH!!!ll:):):)
Love ya!
Cindy and Penny :D xoxoxoxoxoxoxo:D
Hi Everyone-
I have a question I have been meaning to ask before we get to early April when Hannah is due for her annual exam and vaccines. I have some anxiety about whether or not she should be getting vaccines. I have a feeling my regular vet would just give them without any discussion if I didn't ask, but I guess I don't know that for sure. When she had her exam/vaccines last year, the vet who worked part-time there was the one who saw her, and she was the one who talked with me about possibly opting out of some vaccines at some point in time, depending on Hannah's age and health. She is now the vet that does the laser treatment and rehab work, so I can still consult her prior to this appointment, and she is good about giving info. and pros and cons, but I don't know if she will steer me one way or the other.
First, she is due for DHPP-CV (it says it is a 2 yr. vaccine,. Is this one even negotiable?
She is also due for Bordatella. Do you think she needs this if I don't board her, and we go to an in-home groomer? The only place they come into contact with other dogs would be the vet, or the occasional trip the pet store. I adopted a dog with kennel cough and it was terrible, so we started vaccinating then.
I don't believe we got the Lyme vaccine last year, but I don't remember why that was (I'm not sure if she didn't think we should or if we didn't do it because Hannah is not outside for long).
She is not due for rabies until Nov. so I don't need to worry about that yet.
She will get her heart worm test then as well. We used Interceptor last year (switched from Sentinel and I think that was recommended by this vet because of something to do with the raccoons we frequently have in our back yard and the foxes and coyote we have seen in our neighborhood the past couple of years--and I live in a large suburb!) We use Frontline for tick prevention. I liked the Sentinel because I didn't have to do the Frontline, but I think she wanted my dogs to have some other parasite protection from the Interceptor.
Anyway, I just want to know what you think about all of this...it stresses me out. Hannah is doing well overall. We are not treating Cushing's and her symptoms are not terrible. Really, I would say that it is a desire to eat more, but she is not pushing into Izzy's dish or inhaling her food. She will just beg and bug me during the evening (while we watch t.v., etc.) and I assume she wants food. If I give her a bone to chew on, she'll be fine. She drinks more than normal probably, but she isn't emptying a water bowl in 24 hours. She can hold her urine all day while we are at work and all night. She has no pot belly, no panting, no weight gain, no hair loss. She has had some infections over the past year that may be related to Cushing's (ear and skin), but we have been able to treat them. She seems to have some rear-end weakness, but would go up steps if I would let her. I don't because of her back. She is also doing really well after the back problems. She happily trots around with a bounce in her step. Overall, her blood work looks good. The ALKP is elevated (was around 400 last time), but we are monitoring it and it has been higher in the past.
I don't want to give her something that will hurt her, but I don't want to leave her vulnerable with all of the wild animals we seem to have wandering around here. They have never encountered one, but we see the raccoons a lot in the summer by our mulberry tree, and they leave "presents" around the yard, which I hate. I'm ready to chop the dumb tree down.
Anyway, sorry for the long email. I just want some input and some time to think it over.
Thanks!
Julie & Hannah
Hi Julie,
Vaccines are hard, every pup has a different risk. Does your vet do titers?
I stopped bortella, Zoe and Koko have no need for it. They only go out on leash with me attached to the other end, I got Zoe a rabies waiver as I felt her risk was small. If I rememeber right, I thought I titered Koko's DHPP so he did not get another one. Zoe- well, it is just me, I refuse to give her any vaccine. She just has too many problems.
With Koko, I plan to limit vaccines as much as possible and titer when I can.
It is a hard call, Julie, depends what your pup is all exposed to.
Sorry I was no help:o:o:o
love
addy
Jenny & Judi in MN
03-13-2012, 09:27 PM
Since Jenny is only around her brother and dogs at the groomer, my vet was fine with no rabies last year. Because of the groomer he gave her the nasal spray bordatella, gave my other dog the same spray (in the past they always had the shot), they both got kennel cough from the stupid spray vaccine.
Took Jenny at least a month of antibiotics to get over it.
So, I have no firm answer except avoid the nasal spray! Judi
Altira
03-14-2012, 05:48 AM
We live the big city in Orange County California. Our vet stopped all of Kira's shots about a year ago. (She is 12 yrs old.) He said they have been over vacinating pets for years and it was time to put a stop to it. He was certain Kira would be fine.
My niece has worked as a vets reseptionist for over twenty years. I asked her if we really needed to dash to the vets the minute a shot is due. She said no!!! The vaccines actualy last a lot longer. Who would know better then she which dogs are getting these dreadful things and who isn't and what their history is... My vet gave me the impression that they could easily stay in effect for years. Surely for the length of time Kira has left. Rabies is the only one that we have to do.
Check out this web page:
http://www.healthyhappydogs.com/Article.PetVaccination
I have had multiple dogs for 34 years and I have long suspected that many of these vaccines have effected them badly......Check your records. If they have had even one shot of something it maybe enough. ]It's a risk of course. I love my dogs to peices, if I am wrong I'll never forgive myself.... but my Kira will get no more vaccines. That includes flee and tick prevention. Frontline and Andvantix are no better. Maybe I'll do that once or twice a year but no way will I do it every month! I never have. Please keep in mind that we do not live in a high risk area.
We also have a one and a half year old dog. She will get the basic shots now and then as seems reasonable and needed, becasue I think it makes a differance if they have never been vaccinaed for some of this stuff.... You are very wise to be stressed out over this... But as I said, I was told by my vet himself that pets are in fact being over vaccinated!!!
I too would like to know what others thoughts are on this....
labblab
03-14-2012, 08:06 AM
Hi Julie,
Since you are asking for thoughts about vaccination, here's a few more to add to the hopper :).
I think is sounds like a very good idea to consult with the vet with whom you had previously talked, in order to get her input and feedback about selecting the vaccination protocol that would be most appropriate for Hannah. My personal belief is that there is no single answer that is correct for all dogs, including our Cushpups. I think that a vaccination program should be tailored to the health and risk factors for each individual dog.
I do think there is general agreement that vaccines should not be administered to dogs who are acutely ill. Vaccine manufacturers include specific warnings about that. But as is the case for humans, I believe that dogs suffering from chronic conditions and compromised immune systems may actually be at a greater risk for contracting certain serious illnesses, and thus may genuinely benefit from certain vaccinations. However, for both humans and pets, the vaccines must be considered carefully in light of the underlying health status of the patient -- for instance, only vaccines prepared from "killed" viruses may be suitable for patients with compromised immune systems. And it certainly makes no sense to routinely administer vaccinations for illnesses that may not pose any risk to your pet due to geographic or lifestyle factors (such as bordetella vaccinations for a dog who is seldom exposed to others). Checking blood titers to explore the level of current immunity is also an option to be considered prior to automatically going forward with certain revaccinations. However, according to the American Veterinary Medical Association, checking titers does not yet offer a perfect solution, either: "Theoretically...serologic titers may help veterinarians determine the need for revaccination in some cases. Unfortunately, veterinarians cannot be certain that a specific concentration of antibody is always protective or that a lower concentration leaves an animal unprotected."
Since vaccination is a complicated issue, I do encourage people to discuss it thoroughly with their vets. If my own dog had just been diagnosed with Cushing's and had not yet been stabilized on treatment, I too would be very leery about moving forward with vaccination at that time. However, further down the road, if my dog's cortisol level had been lowered to a therapeutic level and his/her appearance and behavior had normalized, I would want to discuss selective vaccination with my vet. I would want to weigh relative risks and benefits based on my pet's lifestyle and risks of exposure.
I think it's true there is growing realization that certain vaccines confer immunity for a longer time than was previously known or documented. Ongoing research in that vein is helping to shape vaccination recommendations that are better informed. To aid in your decision-making, here's a link that may be helpful. It is a summary of the current vaccination recommendations of the vet school at U.C. Davis. The Davis recommendations are based on the combined input from a variety of current academic and clinical sources:
http://www.vetmed.ucdavis.edu/vmth/small_animal/internal_medicine/newsletters/vaccination_protocols.cfm
Marianne
labblab
03-14-2012, 10:08 AM
Now that I've given you my long-winded "philosophical" answer on the preceding page :o, here's a couple additional long-winded personal thoughts about the specific vaccinations you're wondering about :o :o. I think the DHPP-CV is a combination vaccination that includes "Corona virus" (that's the CV). You'll see that UC Davis is not big on vaccinating for Corona. And the remainder of the combination is now available in a 3-year version should you choose to revaccinate. Whether or not that's necessary or advisable at Hannah's age and given her health history -- I'd discuss that with the vet.
UC Davis is also not big on Lyme unless you live in an area where it's common. Bordetella, I would not worry about if Hannah is not routinely exposed to other dogs. I'm stuck with giving it to my dogs because our boarding kennel requires it on the very rare occasions when we leave the girls. But in December, I'm convinced Peg contracted an overt case of kennel cough from the intranasal version of the vaccination, which she promptly passed to Luna (who was supposedly already protected through vaccination). So neither girl could go to the kennel and I had to enlist my mom to stay with them while hubby and I were gone for a few days. I'm going to look into the bordetella shot next time around (I think it's killed virus instead of some form of live).
Rabies vaccines are killed viruses and are now available as a 3-year vaccine in many states. What you decide about rabies may depend upon a combination of factors: your state law, whether or not medical waivers/titers are accepted in place of vaccination, and also the incidence of rabies in your area. As I recently wrote on another member's thread, I live in a part of the country where rabies is knowon to be harbored among foxes, raccoons, coyotes, bats, etc. Within the last month, there have been three documented cases of rabies within 20 miles of me, including a stray kitten. So living where I do, until there's more conclusive research about the duration of rabies immunity, I would think long and hard before opting out of revaccinating my own dogs with the 3-year vaccine, even it was not required by law. All these factors are things that I'd discuss further with your own vet, though, to decide what's best for Hannah.
And one last thing, even though it's really fun to take dogs into the big pet shops, my vet cautioned me that it's one of the single worst places to take your animal if you're concerned about disease transmission. You have a million animals of unknown health history traipsing in and out and "meeting and greeting," with no genuine sterilization of floors and surfaces. So if you have a dog with a compromised immune system, that's probably not a good place to go :(.
Marianne
Cyn719
03-14-2012, 01:26 PM
Marianne
Good suggestion about the pet shops......never thought about that.....you are so right:) thanks!
lulusmom
03-14-2012, 04:43 PM
I'm glad that Marianne has provided you with UC Davis' Vaccine Guidelines and I highly recommend that you bookmark them for future reference. I think it is so important that we be the best advocates possible for our dogs, whether they are healthy or suffering with chronic conditions.....and how can we act in their best interest if we don't educate ourselves?
I personally have chosen to follow the advice of my cushdogs' specialist and not give any more vaccines to Jojo or Lulu. None of my dogs are healthy and because they have received multiple boosters throughout most of their lives and are total couch potatoes, I am comfortable with also opting out of any further rabies vaccines for my two Maltese boys, who have CHF. I do feel fortunate that I don't have the risk of rabies in my area.
These vaccine guidelines were not developed by UC Davis, based on their own studies, but rather they were adopted. based on guidelines established by the AAHA Canine and AAFP Feline Vaccine Task Forces. Dr. Ronald Schultz is the world's premier expert on vaccines and it was he who headed up these task forces and it was his years of research on vaccines that served as the scientific basis for these guidelines.
For anybody who would like to learn more about vaccines, I highly recommend that you 1) watch Dr. Karen Becker's interview with Dr. Ronald Schultz and 2) read Dr. Schultz' paper entitled What Everyone Needs to Know About Canine Vaccine and Vaccination Programs. The youtube video is almost an hour but it's worth the time invested. I've included links to both below:
Dr. Karen Becker interview with Dr. Ronald Schultz
http://www.youtube.com/watch?v=L1Xd5ghnlJ4
652
It is Dr. Schultz' work that has also been instrumental in getting various states to change their mandated rabies vaccine from one year to three years, as well as to accept medical waivers and/or titers. This is an ongoing campaign and hopefully most, if not all, states will eventually get on board. If your vet is insisting on annual vaccines, I would suggest you provide him/her with a copy of the UC Davis guidelines and ask for an explanation.
Dang Julie,
I had to go all the way to page 3 to find you!!!!!!!
Did the cold weather come your way? It is freezing today.
How's school? Do you have spring break soon? IF you do, I sure hope the warmer weather returns. Do you know what Hannah is allergic to? Derm vet said he found pollen bewteen Zoe's pads but he did not say what kind of pollen.
IMS has been sick -thats the offical story:rolleyes::rolleyes:
I think about you and Hannah a lot. My MN neighbors. We should really check on Judy amd Jenny too. More MN neighbors:):):)
I sure hope they aren't on page thirty-five:eek::eek::eek:
love,
addy
love,
addy
Altira
03-29-2012, 08:45 PM
So where do things stand as of now?
Hi Addy and Janis & everyone else, of course!
Sorry I have not been posting much lately. It has been a really busy couple of weeks. This is a busy time of year in schools and I am also planning a family literacy night later on this month. I am also in the process of thinking about a possible change in my job (from my current position as a 3rd grade teacher to more of a reading intervention teacher/reading coordinator for my school). It is a tough decision for me to make, so it has been consuming a lot of my free time lately.
Thanks for checking in on me. Addy, we have our spring break this week. I am excited for a break and hoping we will see the sun and have some nice weather! I don't know what Hannah is allergic to and we have not ever taken her to a derm vet. My parents had a dog that they did an allergy test on and then gave her injections, but I am not too keen on that at this point in Hannah's life.
We did go to the vet for the girls' yearly check ups. (The woman who does the laser treatment also does some weekend work at my vet and we happened to have her, which was nice). We got the heart worm tests done and got their preventatives. Since there is a limited supply of Interceptor I got the whole year for Izzy because she is really picky about what she will eat. Hannah is on Heart guard for now. They gave us a sample of Heart guard (without meds) in it to see if they would eat it. Hannah thought it was wonderful and Izzy wanted no part of it. She is a strange one! But of course I was not surprised.
I also got the Frontline and went ahead and put it on. She said that with all of the ticks we have around here that we really need to do it. She also said she felt it was very safe as long as my dogs have not had a reaction. It went fine.
We talked more about vaccines and I also got a message from the vet's office earlier that week after one of them had gotten back from a conference where there was a lot of talk about vaccinating. They said that they felt strongly that the distemper vaccine (or at my vet DHPP-CV) would last 3 years or more, so they said Hannah probably does not need it. They also said that many vets feel that it is not necessary to run titers and that I could probably assume she is fine at this stage of her life and after being vaccinated so often.
I talked to the vet we saw that day (laser vet) about it and she explained that titers are interesting because they can tell us whether or not a vaccine ever worked for a dog-she said they can run titers on some dogs who got a vaccine and it will show they are not protected, but yet the dog will never get that disease even though it was probably exposed at some point. She said that at this point with Hannah, she agreed, save the money and spend it on something else. She is only at the 2-year point for DHPP-CV, which is what my vet was recommending, but it sounds like they will change to 3. I am still unclear if that means the one Hannah got previously should last for another year or if it was only set up for 2 years, etc., but I don't think I will have her vaccinated.
I am going to have them both vaccinated for Bordetella. They are due on 4/9 so we'll go in that week. They do go to a groomer where there will be exposure to other dogs' germs and both vets feel that there may be more risk in Hannah getting kennel cough, both with Cushing's and because she is old, than if she was young and healthy. I think Hannah got the intranasal form in the past, and Izzy got the injection. I think I want them to get the injection this time, but I have an email to my vet to ask and get their opinion.
Both dogs will be groomed this week and it will be the first time Hannah returns to my "regular" groomer since she was groomed at my vet for a few months after her back injuries. That woman had to stop grooming because of her back, so now we're back to the other one.
I hope she'll do okay with the breaks my groomer will give her. (She'll rotate between Hannah and Izzy). She has been doing really well, so I'm sure she will. At this point I am just worried about her cut. The groomer recommends going short so she can use mostly the clippers if Hannah does have a hard time, and because she grows so fast and has a bushier, coarser coat, but I am worried that if Cushing's kicks in more she won't have any hair. We're going to hopefully start out trying the normal cut (about an inch) and if Hannah is having a hard time she can go short.
Thanks again for checking in!:)
Julie & Hannah
apollo6
04-01-2012, 02:52 PM
Dear Julie
You have been so kind to me. I have been so wrapped up in my own worries that I have selfishly not supported others. Please forgive me.
You go with your heart on your decision about your career.
I stopped vaccinating Apollo a while back because of his weaken
Immune system. He is more of an inside dog, never did care for long walks,etc. There is a lot of controversy about vaccines. Between the overuse of vaccines and medications ,I have my own opinion. All I know is Apollo felt sick after some of the combination one he got.
A very belated happy birthday to Hannah. Every birthday with a Cushing baby is a gift.
Hug Sonja and warrior Apollo
Altira
04-02-2012, 03:22 AM
I am so pleased vets are taking a better look at this vaccine thing. And a specail test that checks to make sure the vaccine took. Did i understand that correctly? "Titters?" That's a blood test? I don't know the vaccine it was testing for but the idea of checking on vaccines this way is so cool!!! Thank you for telling us about it all. Makes me hopeful. Vet medicine has come along way. Kira's Adrinalectomy was unheard of not so long ago.
Now we just need to get someone working on handling Cushings better and save so many from this nightmare!
Sounds like you have a good handle on what's really needed. Our senior doggies may have been vaccinated to death but they are high now too. Good job mom!!! And my praises to your vet too.
labblab
04-02-2012, 10:35 AM
Julie, I think your decisions about Hannah's vaccinations make good sense. FWIW, my vet and I have also decided to stick with the bordetella injections ("killed" virus) rather than the intranasal spray with both my girls from now on. Peg's immune system does not seem to be the greatest, so I want to try to limit "live" virus forms around her as much as is reasonable.
Marianne
Hey Julie,
Don't let my experience sway your decision to take Hannah to a derm vet. We have few choices here in Nohereville, oops, I mean Milwaukee:p:p:p:p
I hope you and Hannah have a wonderful Spring Break!!!!!
love,
addy
Hi there,
Just a quick update on my Hannah girl. She got her Bordetella vaccine today and they also drew blood to monitor her liver (ALKP), as well as her other organs. Everything (as far as organs go) was NORMAL! :D:D:D Even the ALKP, which most recently was down to around 400, but which had been over 1700 last March! The Denamarin is working amazingly well! I am so thrilled! She has a few little things just out of the normal range, but he said none of those are concerning and have always been a little off with her. It was so nice to get some good news about my girl for a change! Just wanted to share with you.
Hopefully I'll have more time to check in on everyone tomorrow; it's a busy week this week!
Julie & Hannah
Harley PoMMom
04-10-2012, 01:05 AM
What a wonderful update on sweet Hannah!! I am so happy for you both! You're doing an amazing job, time to celebrate! ;):D
Love and hugs,
Lori
Great update on Hannah, Julie you must be so happy and relieved about her liver values!!!!!:D:D:D:D:D
Thanks for the advice on the eye drops. I think about you and Hannah quite often too. I thought it ironic the derm vet did not think Zoe's allergies were that bad and that it was more ocd but the er vet thinks her bloodshot eyes are allergies besides the scuff. I hope you have better luck with the derm vet if you go that route.;);)
Have a wonderful day!!! Hope you are enjoying Spring Break!!!:):)
love,
addy
labblab
04-10-2012, 07:55 AM
Julie, this is wonderful news! Thank you so much for sharing it with us -- you've made my morning! :) :) :D
Marianne
Jenny & Judi in MN
04-10-2012, 10:03 AM
yay! way to turn the corner Hannah and Julie!!
lulusmom
04-10-2012, 10:45 AM
Congratulation Julie and Hannah on a job well done. Great update and great way to start my day!
Thanks everyone!
Does anyone know about using Atopica (Cyclosporine) for allergies in a Cushing's dog? I have not gone to a derm vet because my regular vet posted on a forum where she can get info. from derm vets. One said Atopica works really well for dogs with a lot of allergies and it would not have any effect on Cushing's. Another option was Claritin and I had not heard of the last option. Any thoughts?
Thanks!
Julie & Hannah
I am wondering the same thing Julie, so share any scoop you may find:D:D:D You always do, thank you.:):)
For some reason I thought one of Glynda's pups was on Claratin. Maybe I am remembering wrong. I thought I read you cannot give it though if the pup has liver or kidney disease, which Hannah does not have.
I always wonder what happens when they give warnings like that. What if you don't know your dog has kidney disease, then what?
Anyway, some of the IBD dogs on my IBD forum take the Atopica. And all I can remember and it may again be a false memory but something about a side effect of possibly having the gums grow funny.
But since I am on day five of an insomnia attack, who the heck knows what I am talking about:eek::eek::rolleyes::o:o:o
LOL Julie, sorry I am so weird.:rolleyes::rolleyes::rolleyes:
love,
addy
labblab
04-12-2012, 07:44 AM
Hi Julie,
My non-Cushpup, Peg, takes Claritin for her allergies. It is just another type of over-the-counter antihistamine, like benadryl, so it is basically benign. I wish I could say it has done great things for Peg's itching, but not-so-much. But neither has benadryl or chlortrimeton, which we had tried first. Not a huge percentage of allergic dogs respond to antihistamines, and you sometimes have to run through several in order to find one that does work. I feel like I may see a bit of improvement with Peg on the Claritin, so that's why I go ahead and give it to her during her itchier time periods.
Atopica (cyclosporine) is a whole different ballgame. It is a drug that suppresses the immune system, and is therefore used to treat conditions when the illness or problem is caused by an overactive immune system that is attacking the body's own cells. Human transplant patients take cyclosporine to keep their immune systems from attacking ("rejecting") their transplanted organs. Long-term use in humans has been linked to gum overgrowth and more seriously, certain cancers like lymphoma.
Having said that, I do think it is has been used successfully to treat dogs with severe allergies. Whether it's such a great idea for a Cushpup, I cannot say. Since Cushing's already tends to suppress the immune system, I don't know how desirable it is to add cyclosporine into the mix. Maybe if the Cushing's is being well-controlled, it wouldn't be an issue. I would really want the advice of a derm specialist as to that question, which is what it sounds as though your GP vet is trying to find out. Maybe it would be OK to use on a short-term basis.
I believe that Debbie ("StarDeb55") used Atopica with one of her Cushpups. I'll send her a message to see if my memory is correct.
Marianne
StarDeb55
04-12-2012, 03:16 PM
Julie, my first boy, Barkley, was treated with cyclo by my derm vet as he preferred not to use steroids. I PREFERRED he not use steroids. There was a second drug that was used in conjunction with the cyclo, but I do not recall what that was at the moment. I will say that this treatment did truly remarkable things for B's allergies. He was easily averaging 3-4 major ear infections yearly. After treatment started, he had an ear infection maybe once per year. At the time the derm vet started seeing him, he told me that B was not a candidate for allergy injections because of his Cushing's. Over the years, Dr. Lewis made the comment more than once that if he had it to do over, again, that he probably would have tried skin testing/allergy injections before putting B on such high powered drugs.
Marianne was spot on about the drawbacks of long term cyclo use. B had 2 strikes against him when it comes to a compromised immune system, the severe allergies & Cushing's. He did, indeed, develop lymphoma for which he underwent successful chemo. I have discussed this with the derm vet more than once since I lost B, along with the fact of losing Harley to some type of cancer. I think our babies immune systems are already compromised because of the Cushing's, & I would hesitate to use such a powerful immune suppressant drug ever again because of that. In the short term, it may not be an issue, if you simply want to try to get Hannah some relief. In the long term, you really want to think very carefully about this, & most definitely get the input of a derm vet.
Marianne is also right about OTC antihistamines. Not all of them will be effective for a pup. I used to have a list from the derm vet for the OTC meds & dosages, he always said to allow about 6-8 weeks on one of them before you decide it's not working, & move on to the next one. For Barkley, I had pretty good success with kid's Benadryl twice per day. Benadryl did nothing for Chewy, but Zyrtec does seem to help Chewy quite a bit. He gets the some dose that I take, one tablet daily. Of course, please check with your vet before you try anything new.
debbie
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