New Member (9 y/o Boston Terrier)

[jenhorn88]

Hi my name is Jennifer and I just signed up as I just found out this morning that my 9 year old Boston Terrier has Cushing's. We suspected she did but tests confirmed it this morning. For the next couple of days we have to keep track of how much water she is drinking (which is tons) and by Friday the vet will get her started on meds. Even though we suspected she had it, hearing it confirmed from the vet today really hit home. She has been through so much if her life and we just want the best for her. :)

[BestBuddy]

Hi Jennifer,

Tell us more.:D

It's always good to get copies of the tests to keep so you can track changes. What other symptoms other than excess water drinking. Do you know which medication your vet is looking into?

Welcome

Jenny

[Squirt's Mom]

Hi Jennifer,

Welcome to you and your baby! :)

Things are kinda scary at first but with a bit of "learnin'" about Cushing's you will feel much better in no time - and you have come to the right place to learn about this condition. You will find that the members here know a great deal about Cushing's as well as many other diseases and conditions. You will also find the best good old-fashioned hand-holding in the world right here! ;)

As Jenny said, test results are invaluable and help us give you more meaningful feedback. In fact, we just love details! :D So the more you can tell us about your sweet girl, the better. Don't worry about writing a book - wait til Glynda or I get fired up! :p

Please, don't hesitate to ask any question you may have - we will do our best to help you understand. Read all you can, then ask more questions. You will find some great info in our Helpful Resource Section:

K9C Resource section:
http://www.k9cushings.com/forum/forumdisplay.php?f=10

You and your baby girl are not alone on this journey; we will be with you every step of the way. In no time, you will be an old hand at this! ;)

Hugs,
Leslie and the gang

[Cindy Thoman]

Hi Jennifer and welcome to this forum. I am also a new member. My nine year old Pom was just recently diagnosed with Cushing's so I have an idea of how bad you are feeling right now. Alex is on his 6th day of Trilostane 10 mg. and so far so good. I was a wreck prior to finding this forum. I now have many less teary episodes and feel good with our decision to try Alex on medication. I am so thankful to have found this site and look forward to making many new friends.

Cindy and Alex

[jenhorn88]

Hi everyone, thanks for writing to me. As far as other symptoms besides the excessive drinking and urinating, she has hair loss, acts like she is hungry 24/7, some hind leg weakness but not too bad, muscle loss that looks like she's lost weight. She acts like nothing is wrong though.

She has been through so much and no matter how sick she is sometimes you would never know it. When we first got her (bad breeder) she got two infections where we almost lost her, she's had surgery on both her back legs for her luxating patellas, heart murmur, high blood pressure, and a dog fight that resulted in her losing her eye. I am sure there are some other things I am forgetting. She has been a trooper through it all, even her eye surgery.

I think the vet is looking into Lysodren. This Friday I have to go in and pick it up and we'll go from there. He is going to give her something else along with it to make sure her levels don't change too drastically. I'll have to find out that name of that one though.

Thanks again to all of you. Jen

[frijole]

Hi Jen, I've never posted to you before but my dog used lysodren so I thought I'd say Hi and give you a link to some information that might be useful. I used it as my guide during what is called the loading phase.

Your vet is most likely talking about giving you prednisone to give at the same time with lysodren. Some feel this helps reduce the chance of the numbers going too low. The problem ironically with this theory is that when you give prednisone with lysodren it actually hides the symptoms you need to see in order to know that the dog has had enough lysodren. Most of the specialists in the field do NOT recommend doing it this way because of this. I mention it so that you have time between now and when you start the lysodren to get up to speed and ask questions.

Here is the link on lysodren. Within that Resource Section are tons of articles that might be helpful to you. But please know that many of us have been active here for many years and while we are not vets we have 'seen it all' and most important want you to know you aren't alone on this journey. So read a bit, ask us questions and we will help you thru the process.

Kim
http://www.k9cushings.com/forum/showthread.php?t=181

[Squirt's Mom]

Hi Jennifer,

Kim is probably right in that your vet is talking about using prednisone along with the Lysodren. This is a method some vets use but not one that makes much sense to me. Prednisone should be used in an emergency situation when the cortisol has gone too low - it will raise the levels. The purpose of the Lyso is to erode the adrenals so they do not produce as much cortisol - so to me it is undermining the job of the Lyso when they are given together. But, some vets do follow this protocol.

It is very important that your vet provide you with pred when treating Cushing's with either Lyso or Trilo but that is just in case the cortisol drops too low.

Your little girl has been through quite a bit but that just tells me she is a real trooper!

Be sure to get copies of the test results when you go back to vet...that will help us a great deal to help ya'll.

Hang in there!
Hugs,
Leslie and the gang

[jenhorn88]

Thanks Kim and Leslie for the info. For some reason Prednisone doesn't sound like what he said over the phone. I will find out for sure tonight because I go in to pick up her meds. She drank 56 oz in almost a 48 hour period. No wonder when she goes to the bathroom it's clear. I know part of her testing number, he said the resting number is normally 5 and hers was 5.2 and he said if they just did that part of the test he wouldn't have thought much about it but the other part numbers are normally 20 and hers was 42. So extremely high. Thanks again.

[lulusmom]

Hi Jen and a belated welcome to you.

While you are waiting to pick up the medication from your vet, can you tell us how much your dog weighs? When you get the meds, please let us know what they are and what doseage has been prescribed.

Glynda

[jenhorn88]

Hi Glynda, I talked to the vet a little bit ago. Maggie weighs around 16 lbs. He is putting her on Lysodren and Florinef. She will be getting 1/2 tablet of the Lysodren for up to 10 days.

Jen

[Squirt's Mom]

Hi Jennifer,

PLEASE do not give the Florinef to Maggie until some of the gurus here have checked in. That is a drug used to treat Addison's - a condition that is the opposite of Cushing's. I have never heard of using the two together in treating Cushing's. In fact, in humans Florinef has been said by some who use it to cause Cushing's-like symptoms - which could cause the same masking of loading signs as prednisone.

I am not clear whether you already have these meds in your possession or not, but if so don't rush into giving the Florinef, please.

Hugs,
Leslie and the gang

[Squirt's Mom]

Bumping up.......

[StarDeb55]

Jennifer, Leslie is absolutely correct. Florinef is used to treat Addison's, where the body is making little or no cortisol. It is used to replace the cortisol, but more specifically it helps in controlling the electrolytes, (sodium & potassium), which can become a serious problem with Addison's. Use of Florinef with Cushing's is highly questionable on your vet's part, & it could very well lead to an electrolyte imbalance in your pup.

Debbie

[lulusmom]

Hi Jennifer.

Did your vet tell you to give 1/4 tablet Lysodren in the morning and 1/4 tablet in the evening with meals? What is the dose of Florinef to be given and when. It is rather strange that your vet prescribed Florinef as opposed to prednisone as florinef is usually given as a rescue remedy when the lysodren has eroded to much of the adrenal resulting in low aldosterone levels. When this happens, electrolytes are most definitely thrown off and florinef, as a mineralcorticoid, is needed. Prednisone, on the other hand, is a gluccocorticoid that is used when cortisol is too low or to offset the signs of cortisol withdrawal during the loading phase.

While it is an accepted protocol to administer "prednisone" concurrently with lysodren, it's not a protocol that is condoned by experts in their field. The problem is that the prednisone not only masks any sign of cortisol withdrawal, it also masks any sign that the dog is loaded so the pet owner continues to give lysodren until the dog stops eating and becomes quite ill. With Maggie loading for 10 days before a stim, I would be very concerned. We have had a number of members over the years whose vet prescribed concurrent dosing, and it was those members' dogs who were more likely to overdose and a good number of them did.

My dogs are half Maggie's size and they loaded at the full 50mg/kg while your vet has only prescribed 34mg/kg. Unless a dog has other issues and is not otherwise healthy, a low loading dose and concurrent use of steroids is a sign that a vet may not be experienced nor comfortable with lysodren. Does Maggie have any other underlying issues and do you happen to know how much experience your vet has? No matter what, we are here to help you and Maggie in any way we can.

Before you start loading, please be sure to read the Lysodren Loading Instructions and Related Tips in our Helpful Resources section. I used this over and over again when loading both of my dogs over the years. You notice that it says that you should have a small amount of prednisone to use for emergency. Here's a handy link:
http://www.k9cushings.com/forum/showthread.php?t=181

Glynda

P.S. Here's a link to a member's thread whose vets prescribed a low loading dose so you have an idea as to typical results.

http://www.k9cushings.com/forum/showthread.php?t=3085

[frijole]

Jennifer - I too am trying to figure out why the vet would prescribe Florinef along with lysodren and the only time I saw it used was in treating adrenal tumors. Can you please tell us if your vet ever told you what KIND of cushing's has? If you don't know we could figure it out with tests results if you have copies of those. Thanks. Kim

[Tetsuo]

Hi Jen, I have a BT too! My BT is 24 lbs. tho so she must be a little thing. I'm new here, but have read almost every post for the past 5 months, so when the Dr was telling me her plan of action yesterday, I understood it 95% or so. This forum is filled with extremely helpful and knowledgeable people. I am waiting to find out the results of his cushings test as I type.

Leon

[jenhorn88]

Hi Leslie, I picked up the Lysodren from the vet Friday and the Florinef from the pharmacy on Saturday. I am so confused on what to do for Maggie. I want her to get better but I don't want things to get worse by any means by giving her the Florinef. She did already have the meds this morning as I was not able to get logged onto this site from home for some reason and I just got everyone's messages this morning.

Glynda, no my vet did not say to give her 1/4 in the morning and a 1/4 at night, it was just 1/2 pill per day along with one of the Florinef. Maggie doesn't have any other underlying issues that we know of and my vet is very experienced as he has known me since I could walk and so he has been in practice for well over 40 years. As far as dealing with Cushing's I don't know. I did talk to vet tech that works in the office and her dog was just diagnosed and being treated and is doing fine.

Kim, he never said which cushings it is, I guess that is something I need to find out.

Hi Leon, thanks for writing me and I wish your BT well :)

[frijole]

Glynda, no my vet did not say to give her 1/4 in the morning and a 1/4 at night, it was just 1/2 pill per day along with one of the Florinef.

Kim, he never said which cushings it is, I guess that is something I need to find out.


Jen, Both the dosing 1 time a day vs 2 and the Florinef are not regular protocol for treating cushing's with lysodren. That is why I asked what type of cushing's - perhaps there's a reason. I'd simply ask. I'm linking you to a document that can help you understand how lysodren works and what to look for. Kim
http://k9cushings.com/forum/showthread.php?t=181

[lulusmom]

Kim,

Please read the Lysodren loading instructions in our Helpful Resources section. It was written by Dr. Edward Feldman at UC Davis. He is a reknown specialist in endocrinology and pretty much sets protocol at UC Davis for anything endocrine. These instructions are proper protocol used by experienced vets as well as other well published endocrine specialist such as Drs. Mark Peterson and Dr. David Bruyette.

My dogs treat with an internal medicine specialist because their gp vet was not just inexperienced with cushing's, I don't think he knew how to spell it. I have loaded both of my tiny dogs twice at max dosage twice with no prednisone and certainly no florinef. My specialist's instructions, as well as others' specialists, pretty much follow Dr. Feldman's paper. Since your vet has prescribed a combination of drugs that we've never seen here, can you ask him why he has chosen to prescribe florinef as opposed to prednisone? As I mentioned giving concurrent steroids isn't usually done and if it is, the drug is Prednisone. You are giving your dog a very serious drug so don't be afraid to ask your vet questions.

Glynda

[Squirt's Mom]

Hi Jennifer,

It can be so very confusing when our vets, whom we are geared to trust, tell us one thing while those who actually live with and have spent years researching Cushing's tell us something different. Especially when that vet is one we have known and trusted for years to care for our babies. Unfortunately, even the best vet can be woefully unprepared to successfully treat Cushing's.

We recently moved back to my home area and I was so excited that Squirt would be able to see the vet who treated her most of her life. When she was first diagnosed with Cushing's, I called him and counted heavily on his advise because I trusted him. What he told me early on was right for my baby but when we came back here and I sat to talk with him about Squirt's continuing treatment, I knew within 5 min. that my beloved vet would NOT treat her Cushing's. I knew based on what I had learned here over the last 3 years that what he was telling me he would do was wrong for my Squirt....and he was not willing to listen to me. So I swallowed the lump in my throat, said "thanks" and started the hunt for a new vet.

Cushing's is one of, if not THE, most difficult condition in dogs to diagnose and treat properly. For this reason, we always ask to see the test results, the weight of the pup, which med and the dose prescribed - so we can try to help head off problems that we ourselves have experienced....many at the loving hands of most trusted vets.

What you may not yet realize is that you are unique among pet "owners" - you want to do whatever you can to help your baby live with this condition and get the most out of her life possible. You have made the effort to start learning about Cushing's, you have reached out to the world for guidance and understanding. All of which says you are the exception, not the norm. MOST folks when they hear their baby has Cushing's throw in the towel - no testing, no treatment, no nothing. They simply let nature take it's course - or they put the dog down. Vets see more of this type owner than they do parents like you and everyone else here. So they are not really prepared to deal with someone who INSISTS they do things correctly, that they follow established protocols, that they listen to us when we say something isn't right, who studies and researches so they can learn what is happening to their baby.

When confronted with someone like us, vets either say, "oh, ok, let's get to work together!" or they get their feathers ruffled and refuse to listen or work with us. Which category your vet would fall into is something you will have to determine. You may find that working with an IMS for the Cushing's and everything else being handled by your GP vet works best for your baby. Or you may find yourself looking for a new vet. Hopefully, your vet will fall into the first category and be willing to work with you as a team to help your little girl. We have had several members whose vets support our forum, even sending other patients to us. ;)

The saving grace for you right now is that Cushing's is slowly progressing condition which means you have time to take a deep breath. You can stop the treatment until you are convinced that what is being done for her is right - you won't lose any ground and it won't harm her to take a few days to try to understand what we are saying as opposed to what your vet is saying and make up your own mind as to the correct course to follow for your baby. Delaying the start of treatment is vastly preferred to facing a crisis. None of us want that for you or your baby.

We are here - use us til we can't hold our heads up from exhaustion...which will take some doing as some of our members are now sleeping, getting all rested up to relieve those who are awake now. :p Our ONLY goal is to help you make the best decisions for your baby so you both can start to enjoy your lives again.

Keep your chin up! You are doing just fine!

Hugs,
Leslie and the gang

[jenhorn88]

Well it's day 8 of Lysodren and she is still drinking 32 oz in a 12 hour period of 6am to 6pm, not as much is consumed during the evening hours, maybe just a couple of ounces. So she is still well over what she should be drinking. I called the vet this morning and he is not in today and will call me tomorrow. What else is there to do if the Lysodren doesn't work? Or is it too early for it to be working?

[jrepac]

It's been some time since I've used Lysodren, but it is certainly possible that the dose may need adjustment; not all dogs "load" successfully on the first try, so you may need to be patient. The fact that Maggie is drinking less in the evening is likely a sign that it is working to some extent. Keep an eye on her eating, drinking (and other symptoms) and speak with your vet when he gets back.

I'm sure some of the others will weigh in w/their personal experiences; many pups respond differently to the supposed "standard" treatment protocols of the various Cushings drugs and require very personalized/customized adjustments in dosing, frequency, etc., etc.

Jeff & Angel Mandy

[labblab]

Jennifer, have you been able to clarify why your vet is having you give your dog florinef during the Lysodren loading period? The florinef is really a wild card for us here, and makes it difficult for us to provide the same assessment and feedback that we would normally be able to offer. I, for one, am totally uncertain as to how the florinef may affect or "mask" the behavior that usually signals the completion of a successful loading phase...

Marianne

[StarDeb55]

Jennifer, I agree with Marianne, until we know more about the reasoning behind giving the florinef, we just can't offer a valid opinion. I am concerned that with florinef being used as a steroid replacement in an Addisonian situation, using it while loading is simply replacing the cortisol that the lysodren is trying to slow the production of cortisol in the adrenal glands. If this is indeed the case, you could easily mask the real signs of loading, & end up in an overload situation.

Debbie

[lulusmom]

Hi Jennifer,

I was hoping that you would not be giving the florinef concurrently with Lysodren but if you are, then I too have some real concerns as to whether you will be able to determine when Maggie is loaded. If you are giving florinef, your vet should understand the complications that can arise from this and 1) he should have instructed you to load for no more than 8 days and bring Maggie in for an acth stimulation test and 2) he should never be unavailable while he has a patient loading on lysodren and if he has to be out of the office, he should have provided you with an alternate contact and/or instructions on what to do in the event of an emergency. Did your vet provide any instructions similar to the ones that are on the Lysodren Loading tips we provided you?

Glynda

[labblab]

Jennifer, how is Maggie's appetite? Has she exhibited any hesitation in eating since starting the Lysodren? If so, her appetite may be the more accurate signal re: her loading status. Some Cushpups do not exihibit resolution of excessive thirst for quite a long time into treatment.

Marianne

[jenhorn88]

Hi everyone, sorry for being MIA for awhile, just been crazy lately. Okay update on Maggie. Her loading phase is done and she is getting Lysodren once a week (1/2 a pill). He wants to retest her in about 4-5 weeks. No more Florinef either. She is however still drinking and peeing tons. I thought after the loading phase it might ease up but it hasn't. How long does it normally take for the drinking and peeing to subside? Also the past few days I keep coming home and she has poo'd in her crate. I don't know if that is old age or what but we just can't seem to catch a break. Thanks for listening.

[StarDeb55]

Jennifer, when you say loading has been successful, was an ACTH done to confirm loading? If so, could you please post the results. Normal protocol does state that after loading is confirmed successful, you need another stim at 1 month to confirm the maintenance dose is good.

Now, onto the maintenance dosing schedule your vet wants. I'm very concerned that only dosing once a week will cause you to lose control quite quickly. Dr. Edward Feldman at UC-Davis, one of the world's foremost experts on Cushing's, alway wants maintenance dosing broken up into 3-4 doses per week minimum. This is due to the fact that some dog's adrenal gland simply regenerate in the blink of eye, literally. I believe you loaded on 250 mg. daily? Please correct me if I'm wrong. Using the 250 mg, that could be broken down into doses of 100 mg, 100 mg., & 50 mg., for example. You would probably have to get the lysodren compounded to get these small doses. My Harley was a little guy, so I always had to get compounded lyso. His maintenance dose was 275 mg. weekly, so I broke this down into 100, 75, & 100 mg. on a Mon., Weds., Fri. schedule. You might want to discuss this with your vet as you don't want to have to do a re-load in a month's time, since loading is very stressful on both Maggie & you.

Debbie

[jenhorn88]

Yes he did another ACTH and her levels were right where they should be according to him. I will have to find the results as I don't have them with me right now. He is going to retest in about 4-5 weeks. It's just getting so expensive. Yes right now he is only suggesting 1/2 tablet once a week and maybe after he retest he will change that. Okay so you are saying to break down the medicine to several times a week instead of just once. I will definitely ask him about this. Everyone in the office says that they are and have treated several dogs with Cushings so I want to believe they are doing the right thing but I keep hearing and reading different things. This is so confusing.