Randy 10 yr. old Sheltie now has Lymphoma & Cushings

[coopersmom]

Hi, my sheltie Randy (10 y.o) was just diagnosed with Cushing's Disease. He's had a steady weight gain, steady increase in ALK, increase in drinking, weakness. After a thorough liver workup, my vet tested for Cushing's and we came up positive. Here are his numbers:

On March 24 he had a Combined Dex ACTH test.
Baseline Cortisol: 307
Cortisol low dose dex 2h: 22
Cortisol 2hr post ACTH: 753
The interpretation was mixed, with normal suppression of cortisol in response to the dex, but response to ACTH was exaggerated.
A Low Dose Dex Suppression was suggested.

On April 25 he had the Low Dose Dex Suppression.
Baseline Cortisol: 236
Cortisol low dose dex 5h: 6 (yes, 5 hrs is correct)
Cortisol low dose dex 8h: 69
Interpretation was results support a diagnosis of Cushing's.

Our vet started him on Anipryl 20mg. He's been on that for six days, way too short to tell if it is helping him.

I understand pretty much what happens to cause Cushing's. I also understand Anipryl is only successful in 20% of the cases and the reason behind this.

What I would like to know is more about the progression of the disease. For example, I know some of the other meds actually destroy the adrenal gland. If this happens and the cortisol isn't secreated any longer, how does that affect the Cushing's? Just millions of questions. I hope to learn a lot from this forum.

Kim & Randy

[littleone1]

Hi Kim,

Corky and I want to welcome you and Randy. You have found a wonderful group of very caring, supportive and knowledgeable people that have experience in dealing with cushings.

Others will be along shortly that will be able to answer your questions. I only have experience in using Trilostane, which has been very successful with Corky.

Terri

[apollo6]

Dear Kim and Randy and Cooper
Welcome. You have come to the right place. We will be asking a lot of questions about the tests Cooper had. Have you had a full blood panel to see how Coopers signs are. Also please be aware that there are three types of Cushings. Yes there are a few medication options out there. But first I will give you some links to read. Cushings is a difficult disease to explain. Each dog is different. They can live quality lives with medication.
http://www.vetinfo.com/canine-cushings-disease.html
http://www.peteducation.com/article.cfm?c=2+1597&aid=416
http://www.kateconnick.com/library/cushingsdisease.html
Hugs Sonja and Apollo

[Harley PoMMom]

Hi Kim and Randy!

Welcome to our family! I am so sorry for the circumstances that brought you here but glad you found us.

Lysodren works by destroying the cells of the adrenal gland that produce the corticosteroid hormones. Careful regulation of the drug determines how much of the adrenal cortex is killed so that some amount of the hormone can be produced. The therapeutic range for a dog being treated with Lysodren is 1-5ug/dl.

The problems arise when too much of the adrenal cortex is killed off. The animals may then need to be placed on prednisone and maybe florinef, either short or long term.

Trilostane works differently than Lysodren. It helps inhibit the enzyme 3-beta-hydroxysteroid dehydrogenase, which is involved in the production of cortisol. As with any medication, dosage is important. Different dogs have different sensitivity to Trilostane and thus must be monitored for low cortisol or Addisons.

You can find a lot of useful information here: Links to Cushings Websites (especially helpful for new members!). ( http://www.k9cushings.com/forum/showthread.php?t=180)

About Lysodren: Lysodren loading Instructions and related tips. (http://www.k9cushings.com/forum/showthread.php?t=181)

Trilostane/Vetoryl information: Dechra's U.S. Product Insert. (http://www.dechra-us.com/files/dechraUSA/downloads/Product%20inserts/Vetoryl.pdf) and Trilostane/Vetoryl Information and Resources. (http://www.k9cushings.com/forum/showthread.php?t=185
)

Ask all the questions you want and we will do our very best to answer them. ;):)

Love and hugs,
Lori

[Franklin'sMum]

Hi Kim and welcome to you and Randy,

Just popping in to say that cortisol is an essential hormone for dogs (and people). It helps with handling stress, whether that be good stress like playtime, or illnesses in the body or worried stress like a vet visit or fireworks or such.

The purpose of Mitotane (Lysodren) is to erode some of the adrenal cortex, so the body can't overproduce cortisol, but can produce some.
As Lori said, Vetoryl (Trilostane) inhibits the production of cortisol in a different manner. Last time I looked at the literature, there was a tiny percentage of risk with trilostane that it may cause spontaneous adrenal necrosis. Which would leave the pup with Addison's disease, the opposite of Cushing's.

Addison's might be temporary, or permanent in some cases. In some parts of Europe, the vets actually destroy the adrenal glands by over-medicating on purpose, with the belief that Addison's is easier controlled. The adrenals however also produce a number of other essential hormones, and if the adrenals are destroyed completely, and unable to re-generate, supplementation with cortisone and hormones daily, for the life of the pup is the treatment for Addison's.

I hope I haven't confused the issue :o,

Jane, Franklin and Angel Bailey xxx

P.S- we have a few members that have had success with anipryl, Jeff (Jrepac) and Leslie (Squirt's Mom) to name two :). Hopefully they'll be along shortly to give you their experiences.

[addy]

Hi and welcome from me as well,

Wow, you have gotten a lot of good information already, I can't even add to it:D

Sometimes, vets will start with Anipryl, if symptoms do not improve after 30 days, up the dose and try for another 30 days. At that point, if it is not working, they will move on to another drug.

Keep reading. Knowledge takes some of the scariness away.

Hugs,
Addy

[coopersmom]

Thanks for all the good info. I'll be doing lots of reading. What about stressful situations. Do they negatively impact Cushing's? We live in Kentucky and we're had rough weather for about 10 days: thunder, torrential rain, tornado warnings & watches. Thunder terrifies Randy. He's very stressed when storms come calling.

[Harley PoMMom]

Cortisol is a corticosteroid and is released in response to stress. When I was giving my boy, Harley, melatonin it seemed to really help him with his anxiety of thunderstorms. As with any medicine/supplement/herb it is always best to get approval from one's vet.

[coopersmom]

Guys, anyone want to offer some insight into what we can expect going forward with Cushing's? I've read about diabetes, high blood pressure, associated with the disease. Do those things come on if the disease isn't well controlled? What effect on the body does the continuous onslaught of cortisol have?

Moderator's Note: Kim, I have merged your new post into Randy's original thread. Normally, we like to keep all posts on a pup in a single thread, that way it's easier for other members to refer back to the pup's history, if needed.

[mytil]

Hi and welcome to our site.

Untreated Cushing's brings about a lot of issues - here is a link for further reading - http://www.k9cushings.com/forum/showthread.php?t=195.

The problems, in lay terms is that excess cortisol is being produced by the body and over time it breaks down tissue, can cause heart problems, kidney and liver issues etc.

Once the cortisol levels are within a range suitable for the system to handle, these issues are for the most part resolved. Having said that we have many here with both Cushing's and Diabetes and in many cases these developed separately.

I hope this answers some of your questions.

Terry

[MBK]

Hi Kim and Randy,

I am also new here, so I will not try to give you any advice. What I can tell you is that the people here are amazingly knowledgeable and extraordinarily kind. They truly understand how awful you feel when you learn that your baby has a serious illness and they will help you through it all. My 13 year old, Jack Russell Terrier, Alivia, was recently diagnosed with an adrenal tumor, causing Cushing's and this site has been a saving grace while I sift through all the information to try to decide what the best course of treatment for her will be.

So sorry you are dealing with such serious storms in addition to this. My non-Cushing's dog, Maxwell, is also TERRIFIED of thunder. He shakes uncontrollably, even with a mild vet prescribed sedative.

Stay safe.

[Harley PoMMom]

I know first hand the effects of uncontrolled Cushing's has on a dog. Kidney disease was first discovered in my boy, Harley, while trying to use Vetoryl. I chose not to treat him for the elevated cortisol because of the kidney disease.

Around 5 months later Harley was diagnosed with liver failure and 1 month after that heart failure. I just released my precious boy on the 18th of April.

Cushing's if not treated and controlled will wreck havoc on a dog's internal organs and leaves them prone to many other illnesses.

If one can treat their furbaby for Cushing's with either Lysodren/Mitotane or Vetoryl/Trilostane then their furbaby has a chance to live out their normal life expectancy.

Love and hugs,
Lori

[Franklin'sMum]

Hi Kim,

Cushing's also increases the risk of pancreatitis, a number of our pups have had bouts of it or chronic pancreatitis. Thyroid issues also seem be fairly common. If you google 'endocrine disorders in dogs' you will come up with some amazing stuff that explains what the endocrine system consists of and how it all interacts. (My computer went kaput and I lost all my bookmarks).

I had to resort to using valium for Franklin's thunderstorm phobia, desensitizing with cd's didn't work, homeopet anxiety lost it's effectivness for the big storms, and I found rescue remedy could only go so far. One note- the vet told me the dosage for him (3/4-2 tablets), and we tried 1 tablet. Too much :eek: I had a little stoned pup stumbling around and tripping over his feet and bumping into the furniture. We found a half tablet did wonders and really helped with relieving the terror.

Jane, Franklin and Angel Bailey xxx

[addy]

Hi Kim,

My Zoe is also afraid of thunderstorms but her melatonin is helping with that. When the storms are in the evenings or when I am not at work, we pop the melatonin and do a lot of cuddling on the bed and I turn on the TV and up the volume.

Not sure what happens when I'm at work:eek::rolleyes::D I always wanted to get a doggie cams but then I would spend my whole day watching the dogs instead of working;)

Hugs,
Addy

[Squirt's Mom]

Hi Kim,

Welcome to you and Randy! :)

My Squirt was on Anipryl (Selegiline) for about 9 months when she was first diagnosed. Her cortisol was borderline, her signs almost non-existent. Anipryl worked great for her as long as she took it. The only problems we had were digestive - she would get nauseous particularly at nite. We used Pepcid AC at first but it stopped helping after a few months so we switched to Tagamet and that worked. She still takes it from time to time.

I was very comfortable with the Anipryl even tho I was repeatedly told it would not work....for Squirt it did help to control the few, mild signs she had for as long as she was on it. The biggest benefit to Anipryl for us was that it gave me the time to learn about Cushing's and it's treatments, and to have her thoroughly tested before we moved on to stronger drugs.

That testing revealed a splenic tumor and once it was removed, her cortisol returned to normal and has remained within normal range since. The testing also proved she was Atypical - meaning her intermediate, or sex, hormones were elevated but the cortisol is normal. This condition can have the same signs and same damage as true Cushing's . True, or conventional, Cushing's is when the cortisol is elevated whether the intermediates are or not.

I will always be grateful for the Anipryl, for the way it worked for Squirt, for allowing me time to learn, and for the time it gave us to get a handle on what she was really dealing with. For PDH pups with mild signs, in the very early stages of the condition, or for pups who cannot handle the Trilo or Lyso, Anipryl can give them back some quality of life. (PDH = pituitary based Cushing's; ADH = adrenal based Cushing's) Anipryl will not help pups who have ADH. An ultrasound can go a loooong way in determining which type a pup has - and can also save lives by finding other problems like Squirt's tumor on her spleen.

If the Anipryl seems to be helping Randy, then use it as long as you can. Use it to take time to have him thoroughly tested, to learn all you can in order to help him. Keep in touch with us and tell us what is going on with him and we can help you decide when it is time to move up to another med. Anipryl seldom works as long as it did for Squirt. We have been incredibly blessed on our journey.

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

Hang in there!
Hugs,
Leslie and the gang

[coopersmom]

Thanks so much for all the good information. We're going to have a "sit-down" with our vet Friday. I waited a few weeks to learn a little more about Cushing's. I've got some good ideas from you guys.

[Squirt's Mom]

Hi Kim,

You're doing great! :) I invite you to "use" us as well - ask any question you may have and we will do our best to help you understand. There is some really great info in our Helpful Resource section as well.

Several of us have made lists of questions we had that we wanted to discuss with our vet as we began this journey. That helped me as it made me feel a bit less over-whelmed when I talked with Squirt's vet about all of this...I felt as if I were an active partner in her care, even tho at the time I knew nothing. Having that list, having at least heard the terms, gave me strength and allowed me to discuss Squirt's care without crying hysterically. :rolleyes:

I also took copious notes during visits. Our vets got used to seeing me come in with my notebooks and files. :p For the first several visits, I took a friend with me as well to make sure there were two sets of ears to hear things as mine didn't seem to work well at the time.....hysteria can do that to your ears, ya know. ;)

We are here to help you and Randy so don't hesitate to ask questions or just vent if you need.

Hugs,
Leslie and the gang

[coopersmom]

Hello again. Randy is 18 days on Anipryl, but last week our vet said she will probably stop the Anipryl and begin either Lysodren or Trilostane. Anyway, got a question about the panting. Our vet said the panting is in no way related to Randy being hot. She said it's an internal thing. It's been hot here in KY the last few days and Randy doesn't want to be outside at all. How do you guys handle heat and your cushing's dogs?

[littleone1]

Hi Kim,

Our temps get over 110 in the summer. I always have a washcloth soaking in a container of ice water that I use to cool Corky down when he's been outside. I put ice-cubes in his water bowl. When we go for a walk in the morning, I always have a bottle of cold water for him, and when we get home, I put him on the top step of the pool and wet him down. I also turn the sprinklers on for the grass, and he'll run under them. When he's in the house, I have the ceiling fans on. He'll lay on the floor under the fans.

Terri

[Franklin'sMum]

Hi Kim,

With Cushing's, the liver usually becomes enlarged, which then takes up more space in the body. It can then kind of squish the lungs, causing panting.

In summer, I have the A/C on, fans in the bedroom, I soak a towel with water and put it on the bathroom floor so Franklin can lay on it, he wears a thingy around his neck (filled with some kind of non-toxic crystals that puff up and become soft after soaking in the sink for a couple of minutes) that helps to keep him cool. I also use a face washer and mist him with water from a spray bottle.

All the best,
Jane, Franklin and Angel Bailey xxx

[lulusmom]

Hi Kim,

Please be sure that you read up on whichever treatment your vet prescribes for Randy. We have lots of information in our Helpful Resources section. Anipryl is benign in comparison to Lysodren and Trilostane and you will need to monitor Randy much closer for possible side effects. Once you know the name and dosage of the treatment, please post it here, as well as Randy's current weight. Here are some handy links to Lysodren and Vetoryl (Trilostane):

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

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

[addy]

Hi,

We are here for you whatever route you take:)

I can't help with the cooling, Zoe does not yet have the panting, but I just wanted to say hi and offer moral support.

Hugs,
Addy

[Squirt's Mom]

Hi Kim,

You might consider shaving Randy during the summer months. A hair-less Sheltie would certainly look odd but it would help him cool. ;)

Hug,
Leslie and the gang

[Harley PoMMom]

Everyone has given you excellent advice with trying to keep Randy cooler. With my furbabies I do keep their bellies shaved as this does seem to help keep them cooler. I also spray water on their shaved bellies! Also, when they were outside and especially when it was hot I made sure they always had fresh water available to them. If we were taking a walk I would carry a water bottle so they could have a drink of water.

Love and hugs,
Lori

[coopersmom]

Thanks for all the advice and encouragement. Talked to my vet today and now since Randy is not drinking as much or having to go potty during the night, she plans on increasing Anipryl to 30mg for a month and then see how he is. It's a hard place to be in. I know the Anipryl is much safer for him but I worry that it is only masking symptoms and not stopping the Coritsol. Then I worry and all the read about Lysodren & Trilostane. Between a rock and a hard place. Let me ask something else. If the Lysodren or Trilostane are working, does the panting stop? If the meds are controlling the Cushing's do all symptoms go away?

[coopersmom]

Got another question: We've not seen an Internal Med Specialist yet. Would it be advisable to do so? There is one in Lexington that we've seen before for his Extramedullary Plasmacytoma.

[littleone1]

Corky's been taking Trilostane for 19 months now. His clinical signs did go away with the Trilo. His dosage has had to be adjusted, as some of the clinical signs started to return. This is actually normal, as Corky was started on a low dose of Trilo.

I am going to an IMS that is very experienced in treating cushings with Trilostane, even though his vet is experienced in treating cushings. Corky's IMS can do an U/S right there, as Corky has had several done since he has an adrenal tumor. His vet doesn't have that capability at his facility, and would have to have someone come in to do it.

Terri

[lulusmom]

I have two dogs with cushing's and they are treated exclusively by an internal medicine specialist (IMS) and it's at least an hour drive one way. I highly recommend that anybody with a cushdog consider consulting with an IMS.

[Squirt's Mom]

Hi Kim,

Your vet is following proper protocol with the Anipryl. Typically, it is used for 30 days at X dose; if signs are not improved then it is increased for another 30 days. Some vets will increase again at 90 days if the max was not met with the second increase. Usually, if the Anipryl is going to help, you will know by the 90 day mark. If signs are becoming stronger in spite of the Anipryl, then you can be assured it is not and will not work, and moving on to a stronger med is called for. Here is where your knowledge comes in handy - watch her for signs as you know him best of all.

If there is something GOOD about Cushing's it is this - it is a very slowly progressing condition. So the 60-90 days on the Anipryl shouldn't cause much of a set back or allow much damage to occur in such a short time. As with any of the treatments for Cushing's, their signs are our guide.

I understand your fear of Lyso and Trilo. When I first started learning about all of this, they scared the crap out of me, especially the Lyso. But as I continued educating myself, talking with vets all over the place, and reading the threads of other members, my fear about Lyso became much less. Today, it is my choice of the two, the one I am most comfortable using. Others feel just the opposite. But the bottom line is these drugs are life-savers for our cush babies and properly administered and monitored they are no more dangerous than aspirin. Aspirin can be fatal if not used properly. ;)

You are doing a good job so keep it up! Randy is lucky to have you on his side.

Hugs,
Leslie and the girls

[coopersmom]

Thanks for the advice. I'm going to ask my vet for a referral to the IMS. I dwardled requesting a referred for my liver dog and regret doing so. My vet seems to be knowledgeable but there is no way she could know as much as the IMS.

[coopersmom]

More questions. Last night I read an entire thread on Toby. He went in multiple times for ACTH Stim testing when he began the Lysodren. When Randy had his ACTH Stim, our clinic had to send it off to Michigan State for processing and I guess we were about one week hearing back on it. I'm thinking that if a dog is having the ACTH Stim done to measure correct medicatin doseage, one week would be too long to wait for results. How does this work with you guys? Do your vets run the ACTH Stim at their own clinics?

Kim & Randy

[lulusmom]

You are absolutely correct. When using the acth stim test to monitor treatment, waiting any longer than two to three days is unacceptable. Very few vets are capable of doing the acth stim test inhouse as the equipment is very expensive. All of my vets in the last six years, including our internal medicine specialists, sends the blood out to a lab. I believe IDEXX and Antech Diagnostics are the two labs who do most of the analyses in So California.

[Harley PoMMom]

Two-three days is the most I've waited for ACTH test results. My vet uses IDEXX Laboratories here in York, Pennsylvania.

[littleone1]

I also do not wait that long for Corky's test results. I usually have them the next day. Corky's IMS also uses Antech here is AZ. His vet uses IDEXX, and I also get his test results within 2 days. The only time I had to wait 5 days was when Corky had the FreeT4 for his thyroid.

Terri

[frijole]

Kim, Most of my acth tests were sent to Idexx but for some reason the last one I had done went to Michigan State and it DID take a week. I couldn't believe it. I'd ask the vet why they chose to send it there and if they could phone and ask for results so you could resume treatment depending on the numbers. Kim

[coopersmom]

Thanks guys. My vet has used Antech for other send-out tests. I will definately ask her about this. My regular vet has never used Vetroyl, only Lysodren. I imagine the IMS uses Vetroyl but we haven't seen him yet. I may call tomorrow to see if she can refer us to Dr. Rad. From what I've read here it's important to go with something your vet is familiar with, which would be Lysodren. In the best of worlds the Anipryl would work for Randy. I talked to regular vet Stacey on Friday and told her he was a little better with drinking and urinating. Just as soon as I tell her that, he's been drinking more this weekend and had to get up last night. Figures, doesn't it.

[marie adams]

Hi Kim,

Welcome to you and Randy.

My Maddie used Lysodren with no side effects. She didn't have any digestive problems along the way. Once she was on her maintenance plan I saw her bad elbows clear up, the fur returned, and almost right away her eating and drinking improved. She still continued to pant, never regained the muscle tone she once had in her hind legs, and her energy levels never really got a lot better. Was she in a better place than before treatment--yes. I think we didn't catch Cushings in time to help with everything, but her quality of life was better. Cancer took her from us. :(

Everyone here will give you wonderful information and advice. You will also fry your brain with information, but that is a good thing. You will learn more than you ever thought you could about so many different areas for Randy. You will learn more about diets, foods, natural ways to treat other problems like yeast infections, immunizations, etc. :p

I found myself telling people about the disease so they would not be in the dark as to why their dog started having problems like the panting, drinking, ravenous appetite, losing fur, etc. At least they would think about the crazy lady who told them to look for this disease online when you are being told by the vet "your dog is getting older and this is just part of it"---sure....your know when something isn't right.

Cushings doesn't seem like a great adventure, but you will get to know everyone here and that is a good adventure...:)

[coopersmom]

Taking Randy to IMS Monday. Not that I doubt anything my vet told us, just want to get all the information I can. Any vital questions I should ask? I don't anticipate any test being run.

[coopersmom]

Saw the IMS today. He wants to start Randy on Trilo after another ACTH Stim. Question for everyone: Who handles care of your pups Cushings--The IMS (if you have one), or your regular vet? Right now our plan is to have the regular vet draw the stim & the IMS get the results and "drive the bus" so to speak. We're only five minutes away from our regular vet so it's easier to get there but she doesn't have any experience with Triol. So I'm kinda worried if we're doing the right thing by having her involved. In the past she & the IMS have played phone tag with other things involving Randy and I don't want that to happen with the Cushings.

[lulusmom]

My dogs treat exclusively with a specialist but only because I parted ways with our gp vet over their rigid policy on annual vaccines. It will save you money if your gp vet does the acth stim tests so go for it. However, I went back through your thread and see that your vet sends the blood to Michigan State who takes a week to get results back. This would be okay for the test before you start treatment but not after you start giving Randy Trilostane. If your vet can't find a lab that can turn things around within a day or two, I would recommend that you let the IMS do the tests.

Glynda

[littleone1]

Hi Kim,

I take Corky to both his vet and his IMS. I take him to his vet for his shots, which he is no longer getting, for dental work, infections, and surgeries, as his vet is also his surgeon. Corky goes to his IMS for his stim tests, blood chem panels, U/Ss, and anything else that might be internal.

Terri

[coopersmom]

I'm leaning towards letting the IMS handle all things Cushings. I am concerned about communication problems btw my reg vet/staff & the IMS/staff.

[coopersmom]

Randy will be starting Trilostane on Saturday and go for an ACTH Stim on June 13. He had an ACTH Stim on May 27 and results were:

Pre-ACTH 6.9 ug/dl
Post ACTH 28.1 ug/dl, with greater than 22 being consiscent with HAC. Testing done by IDEXX.

I'm not good with the HAC numbers yet. Are his numbers excessively high?

[Harley PoMMom]

Randy will be starting Trilostane on Saturday and go for an ACTH Stim on June 13. He had an ACTH Stim on May 27 and results were:

Pre-ACTH 6.9 ug/dl
Post ACTH 28.1 ug/dl, with greater than 22 being consiscent with HAC. Testing done by IDEXX.

I'm not good with the HAC numbers yet. Are his numbers excessively high?

Not excessively high but remember Randy's cortisol, with treatment, needs to be within the therapeutic ranges of 1.5-5.5 ug/dl and can go up as high as 9.1 ug/dl as long as the clinical symptoms are controlled.

Wishing you both the best of luck. Keep us posted, ok?

Love and hugs,
Lori

[addy]

Hi Kim,

I just wanted to tell you, you will have company as my nine year old Zoe will be starting Vetoryl on Saturday and will have her ACTH test on June 13th.

How about that for coincidence?????:D:D:D

We can be a tag team;);)

Wishing you luck,
Addy

[coopersmom]

Addy-how about that! I am glad to know we'll have company on the journey. I'm scared but anxious to get started so he can get much needed help. It's been cooler tonight so he was able to "help" me mow the lawn. Looking forward to sharing our journey.

[addy]

Good luck tomorrow!!!!!:D:D:D

Are you okay???

Hugs,
Addy

[coopersmom]

I'm a little scared to begin the Trilo but from reading posts I believe that is a common feeling to be scared. I know I'll be watching him like a hawk. I'm the kind of person who imagines the absolute worse but we've got support here.

[littleone1]

You'll be okay, Kim, and so will Randy. It doesn't matter which med we use. They do scare us. I wasn't as afraid of Trilostane as I was of Lysodren.

After Corky's 2nd dose he seemed to be lethargic, but that was due to the cortisol level going down. It was like someone coming down from a high or off a binge. I know you'll watch Randy like a hawk, as I still watch Corky.

We're here for you and Randy.

[Harley PoMMom]

What dosage of Trilostane is Randy starting on?

[coopersmom]

Randy is starting on 100mg. He weighs 44 lbs. He is getting his Trilostane from a compounding pharmacy. First dose today went well. He took it at 7:30 and by 8:00 I was already afraid something was wrong as he wasn't following me in the yard, but he's been fine, just his "mom's" anxiety. Not so worried right now, but in a few days when the cortisol is falling and I'm imagining all the bad things, then I'll be worried:)

[Squirt's Mom]

Tad nervous, are we? :p That's a common state of affairs around here so you are in the right place for sure! :D My Squirt has lost weight since starting the Lyso and I felt her mammary glands for the first time in ages a couple of weeks ago. By morning, I had diagnosed cancer. :rolleyes:

Never hesitate to ask any questions. Even if you just need to talk, someone is just about always on.

Keep in touch and let us know how it's going!
Hugs,
Leslie and the gang

[coopersmom]

Leslie-glad to know others project illnessess on their dogs! I do it also to the neighborhood dogs. If I don't see one for a few days, I worry myself that it has went to Rainbow Bridge. Can't count the times I've had one dead, only to see it a day or so later a picture of health.

I am not nearly as nervous with Randy since I found this forum. Thanks everyone for the encouragement.

[addy]

Checking in to give you moral support.;););)

We are fine, hope you and Randy are too.

Hugs,
Addy

[labblab]

Randy is starting on 100mg. He weighs 44 lbs.
Hello from me to you and Randy!

I want to join the others in sending you well wishes as Randy begins his trilostane treatment. I am sorry to inject a "question mark" into things :o, but I just wanted to caution you that 100 mg. is a pretty big starting dose for a dog of Randy's weight. According to the dosing chart contained in the U.S. Product Insert published by Dechra (manufacturers of brand-name Vetoryl), 44 pounds is just on the cusp between a starting dose of 60 mg. and 120 mg. However, through conversations that several of us have had with the veterinarians who serve as technical advisers at Dechra, we have learned that Dechra has revised their recommendations and are now verbally recommending an initial dosing formula of no more than 1 mg. per pound. So that would be significantly lower than the 100 mg. with which Randy is starting out.

If you've not already seen it, here is a link to Dechra's Product Insert:

http://www.dechra-us.com/files/dechraUSA/downloads/Product%20inserts/Vetoryl.pdf

Aside from the somewhat outdated dosing chart, this Product Insert contains a lot of other useful treatment and monitoring information. And if you or your vet would like to speak directly to one of the technical reps at Dechra's Kansas office in order to discuss their most current dosing recommendations, here's their contact info:

http://www.dechra-us.com/Default.aspx?ID=365

I truly hope that Randy will do well on this starting dose. But since it is higher than we've come to expect, I do encourage you to watch Randy closely for any indications that his cortisol may be dropping too far too quickly.

Marianne

[coopersmom]

I was hoping Randy's starting dose would error on the low side and work up, instead of being high and coming down. Now I'm worried. Tonight he was extremely hot when outside. We brought him in early. If the cortisol comes down too quickly were looking for nausea, diarrhea, lethargy, not eating well, right???? Is there any difference in in the Vetroyl (Trilostane) and Trilostane that is compounded by a pharmacy?

[littleone1]

Corky's been taking compounded Trilo for just about 20 months now, and hasn't had any problems with it. His IMS started him at the low end of 1mg per pound, and as time has gone by, he's now a little over 3mg per pound.

I would give your vet or IMS a call Monday and express your concerns.

Terri

[lulusmom]

When my two dogs were being treated with Trilostane, their meds were compounded and they did quite well on them. I agree with Marianne and am concerned with the large dose Randy is getting. Dogs are usually quite sensitive to the drug in the first few days and cortisol can drop like a rock. A cushdog is used to living in a sea of cortisol and when it drops so quickly, it can cause cortisol withdrawal and make a dog feel pretty crappy for a while. With such a high dose, it could easily drop too low so please watch Randy very, very carefully for the symptoms you listed.

[coopersmom]

Thanks for the help. I'll watch Randy very closely. I will call Monday about the doseage. Do all the dogs feel bad in the first few days on Triolo due to the drop in cortisol? Randy is pretty lethargic in general so that sign will be difficult to monitor. He is a chow hound so if he goes off feed that will be a biggie. The IMS is handling this, not our regular vet. We have gone to our regular vet for 10 years and know her very well. She is easy to talk to. On the otherhand, the IMS is hard to talk to because he talks so fast you absolutely cannot get a word in. I guess he would call me back if I asked him to. When I called up there Wednesday with a few questions, receptionist had to go twice to ask him. At our regular vet, the receptionists know as much as the vet techs. Now I'm thinking I made a mistake letting the IMS handle this instead of Stacey. Stacey, our regular vet, only uses Lysodren, which the IMS wasn't too fond of. Worries, Worries

[littleone1]

Corky was a little lethargic after his second dose, as his cortisol level had dropped. When I called his IMS, she told me not to give him his next morning dose until I saw how he was in the morning, and she wanted me to call her before I gave it to him. He was fine in the morning, and I was given the go-ahead to give him the next dose.

Terri

[labblab]

Hi again,

I'm so sorry to have prompted you to second-guess your treatment plan. There is every reason to believe that Randy will do well on trilostane. And who knows, it may turn out that this dosage is perfect for him. There really is a great deal of variability in the amount of medication that each individual dog requires in order to maintain a therapeutic level. My own dog required a whopping big dose in order to bring his cortisol down properly. But Randy will be in good company if he requires some dosage alteration -- that is common. The important thing, as you already know, is to carefully watch his behavior so as to nip any problems in the bud. If he appears to be overdosed, you will definitely want to withhold any additional medication until you've had a chance to consult with your vet.

One recommendation I would make to all vets, however, is to prescribe initial trilostane doses in smaller units so that it is easier for owners to make changes -- either up or down. So in the event that Randy does need a dosing change, I'd encourage you to ask that the prescription be written in the form of smaller units (let's say, 35 mg. rather than 100 mg., so that you can add or subtract dosages more easily. You can always give Randy one, two, or three 35 mg. capsules, but you cannot safely open or divide a single 100 mg. capsule. Just a suggestion for the future!

Marianne

[coopersmom]

Randy is feeling ok today. He took a little walk and went to Petsmart. Day two on Trilostane has been uneventful so far and hoping for more of the same.

[coopersmom]

Day four on Trilostane and all continues to be well. Poop is fine, he's eating fine, in fact, he's really hungry again at meal time. Does that mean anything? How long does it take for the appetite to calm down a little bit? Still nervous and worried but keeping fingers and paws crossed and praying for my Randy.

[littleone1]

I'm glad Randy is continuing to do well.

[addy]

Hi,

Glad to hear Randy is doing well.

Zoe's appetite is unchanged too. IMS said that would take a few weeks or more. Her water consuption has gone down. She never drank buckets, just more water for her.

You are doing a great job!!!!

Hugs,
Addy

[Squirt's Mom]

Mornin',

Glad to hear that Randy is doing so well! :D We just love good news! ;)

I wouldn't worry too much about the appetite right now. He's probably starting to feel better than he has in a while so he is burning up a bit more energy than before and needs to refuel. You might tell him, tho, that he is doing this a bit backwards....most cush pups have a big appetite before treatment which slacks off once treatment starts. But we have several pups here who seem to like to do just the opposite of what the rule book says. :p

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

[coopersmom]

Randy's always been a chow-hound, but when we started suspecting something was wrong was when he actually cried for more food. The one this he is doing now, is about 8:30 a.m. he seems to just give out for a few house. He takes his Trilostane between 6:45 & 7:00 am, before I go to work. I don't think the Trilo peaks for 4-5 hours so I don't guess it has anything to do with the Trilo.

[labblab]

Actually, according to Dechra's U.S. Product Insert, "...maximal plasma levels of trilostane occur within 1.5 hours, returning to baseline levels within 12 hours, although large inter-dog variation occurs." So it could very well be the case that Randy's behavior is related to the trilostane. If so, it will remain to be seen whether this is just a temporary response as his body adjusts to the new decrease in cortisol levels, or whether it is an indication that he may ultimately feel better on a lower dose.

Marianne

[addy]

Hope Randy's day went better than Zoe's:rolleyes::rolleyes:

We are home now waiting for stim results. She threw up in the car on the way there, was hiding and shaking in the room, would not allow the tech to take her temperature and snapped at her:eek::eek:

OMG, the vet visits for her are getting worse, she is not happy.

Crossing our paws that you and Randy had a better vet visit.

Hugs,
Addy

[coopersmom]

Randy's results are in. THe pre, and I believe the tech gave me wrong info, was .20 and the post was 4.2, measured in ug/dl. He's staying on same dose for a month then doing retesting. I know if the pre is correct, that seems a little low, but I'm going to call tomorrow to clarify. He is feeling good today.

[littleone1]

Corky has had a low pre of .09, but as long as his post was in the reference range, his dosage wasn't increased or decreased.

Terri

[coopersmom]

Terri-Thanks for that bit of information. I'll sleep better tonight knowing the low number for Randy isn't too bad. His post number was in range.

[addy]

Glad to hear things went well. Your pre was low and my pre was high:confused::confused::confused:

Zoe has the almost same time frame as Randy where she seems like she feels yucky. Saturday, I am going to try a Pepcid for her to see if she is sick to her tummy. I noticed more calming signals from her, lip licking and yawning, though they are getting a bit less now.

Is Randy doing any lip licking and yawning during his "yucky" feeling time? Just wondered.

You are doing a great job. Be proud!!!:):)

Hugs,
Addy

[coopersmom]

Well, today when I received Randy's lab report, the numbers were not what the tech gave me yesterday. His numbers actually are:

Pre: 1.3
Post: 3.3

Doesn't make me feel good that we received incorrect numbers last night.

One BIG question: Does the cortisol level out or will Randy's dose of 100mg keep pushing the levels lower? How does that work? The tech today said Dr Radhakrishnan doesn't worry about the pre level unless it gets below 1. Randy's is close to that now.

Addy-Randy's not showing any signs of stomach upset after his pill. He wasn't too droopy Sat or Sun.

[addy]

Well, Dr. Peterson told me that they have found the cortisol can go down for a month. He said "check at 2 weeks to make sure she does not go to low and then check again 2 weeks later as the cortisol can continue to drop."

Hopefully one of our moderators or experienced Trilostane users will come along and shed the proper light on it for you.

It may depend on the pup.

Hugs,
Addy

[frijole]

Hi! I treated my dog for almost 5 years and those numbers are about as good as they get! Celebrate! You are over 1.0 on the pre and the post is what really counts and that is a good number.

Trilo works differently than lysodren. Lysodren could make that number go lower but trilo should not. If the dosage remains the same theoretically the post number should too... That said... we have seen strange things happen where all of a sudden a dog on trilo goes low, is taken off the drug and miraculously never has to go back on it because the cortisol stays within range. But most likely you are good to go.

Manage/monitor by keeping an eye on the symptoms. Great job. Kim

[Harley PoMMom]

Those are really good stim numbers! But I did want to caution you that we have seen some members dogs cortisol decrease when given the same dosage over a period of time. So with Randy being 44lbs and receiving 100mg of Trilostane I would watch for any signs of his cortisol going too low. These signs could be lethargy, vomiting, diarrhea, and/or Randy not just acting himself.

Great job!!! Please keep us updated! ;):)

Love and hugs,
Lori

[lulusmom]

I'm with Dr. Peterson on this one. We've seen cortisol continue to drop in the first month and in some rare cases, even longer. Randy's stim results are exactly where he needs to be but I think it's possible it will drop further and there isn't a whole lot of wiggle room. Just keep a very close eye on him for the adverse reactions Lori has listed for you.

[mypuppy]

Hi,

I have never posted to you. Belated welcome from me and my Princess.

Princess was started on 120mg of vetoryl in November 2009 and her stim results in December were very low. pre: 1.0, post 1.1. I saw results within 3-4 days immediately after starting her treatment. I was recommended by my ims to stop for one week and lower to 60mg, however thanks to this forum I took a different path and waited until Princess's symptoms rebounded. she was off treatment and without symptoms for a nice 5 full months. it was a very nice break. Princess is down to 20mg right now but with full blown symptoms so her dose may need to be increased again. I just want to wish you well with treatment, and please realize all our babies are unique in how they respond to treatment. What works for one may not for another. Keep a close watch and make sure you keep up with the stims. best of luck and hoping you have a very successful outcome.

Warm regards and love. Xo Jeanette

[coopersmom]

Randy's been on the Trilo for 15 days now. His panting is basically unchanged. Otherwise he seems to be doing o.k. I was hoping to see some improvement in his energy level. He is a little brighter, but still isn't walking. I really think part of his problem is he is bored. He's not really able to do much although he did play a few minutes tonight. It's going to get hot again. Boo.

How long did it take your Cushpups to show improved energy? Randy is 10 and overweight as well so I don't expect him to run circles around the yard all day.

[lulusmom]

My dog, Jojo, was a mess before treatment and it was a good two months before I saw a spring in his step and a happy disposition, which I'd never seen. He was a rescue so I have no idea what he was like before cushing's. Hang in there...Randy will get there.

Glynda

[addy]

Don't get discouraged yet. Zoe is still slowly walking outside but she has taken to grabbing Koko's soft toys when the kids come over or when I come home from work and throwing them in the air and shaking them like no tomorrow. She has never played with soft toys before. I have only known her for 4 years and always wondered why she was such a coach potato. Maybe she had Cushings all this time.

Did Randy have trouble with his balance? Zoe's balance is improved.

Hugs,
Addy

[coopersmom]

Well, Randy wasn't lacking for energy tonight. He "help" us mow and I let him get too hot. He was having a good time but I was a bad mom for letting him get too hot. To make matters worse, I accidently hit him in the head with a weedeater battery. Now I'm going to spend the night worrying about both those things. To get the day started, we had storms at 3:30am until about 6:45am and he didn't get his breakfast so I was afraid to give him the Trilo without eating. So he missed the Trilo today. Storms for three straight days have him stressed out.

[addy]

Don't beat yourself up;);) We are having those storms too. Uggg!!!

I think it is wonderful Randy was helping you mow the lawn.:D:D:D:D It is so nice to seem them having fun.
They do overheat pretty quickly, don't they? That's kind of what happened with Zoe a few weeks ago. It was 95 and she did not want to come in. I finally had to insist. it was hard to force her in the house because she was having so much fun and seemed fine.

You are doing great!!!!

hugs,
Addy

[coopersmom]

Randy has been doing an unusual thing this week. I get up early to walk him but eat my breakfast first. Every morning this week about 5:15am he just starts walking through the house barking. Take him out, he goes potty then he comes back in and barks more. He has walked the last two mornings. Is eating fine and poop is fine but the barking behavior is out of character for him.

[addy]

Is he barking for his breakfast? Just a thought. Otherwise I have not a clue:confused::confused:


Hugs,
Addy

[BestBuddy]

Good thinking Addy.

Buddy used to bark (nearly a scream) about an hour before meals, morning and night ONLY to me. If hubby was around he wouldn't do it. He stopped as soon as the food was down.

I think that shows who was under the thumb.:o

No other ideas either.

Jenny

[coopersmom]

I gotten myself in a mess with our regular vet. She has no experience with Trilostane. When I requested a referral to the IMS I told myself I would not go with Trilo; I would go with Lysodren b/c that's what Stacey was familiar with. Well, once at the IMS, he pitched a good line for the Trilo so that's what I went with. We've been on it since June 4th. Friday I called regular vet (Stacey) and said we were ready to do the ACTH Stims with them now. We did the first ones with IMS for obvious reasons: He used Trilo and Stacey doesn't. Our regular clinic can draw the ACTH Stim & then fax the results to IMS who will call me with doseage instructions/changes. Well, I could tell by talking with Stacey that she was not thrilled that we had went with the Trilo & IMS handling the monitoring of the meds. Her unspoken words were, We can handle Cushings too, you know. I would like to kick myself for getting in this mess. Stacey has always been very good to me & my dogs; however I felt it very prudent that IMS get us started on the Trilo. I guess I've hurt the feeling of reg vet, but I had to do what I thought best for Randy, and I do want the reg clinic to begin handling his case, but am scared b/c they don't use Trilo.

As for Randy, he's still panting a lot, drinking a lot this morning, and pacing/barking off & on during the night.

[addy]

Dr. Allen at Dechra would most likely be willing to help your regular vet interpret your ACTH results if you like. I had emailed him about using Vetoryl (Trilostane) for Zoe and he told me if my IMS needed help with dosing and test results she could email him. We have his email address here. I'll look for it if you are interested.

Hugs,
Addy

P.S. How is Randy feeling?

[lulusmom]

You did the right thing in consulting with an IMS so please do not feel bad for being an excellent advocate for Randy. There is absolutely no reason why your vet should be upset that an IMS, a board certified specialist,who has completed extensive education and training in all matters of the endocrine system, has prescribed a treatment she is unfamiliar with. I suspect that your IMS is like a good number of specialists, including my dogs' IMS, who once treated exclusively with Lysodren but now prescribes Trilostane to most of their patients.

Not all dogs can tolerate every medicine so most cushing's savvy vets are pretty happy to have two effective treatments in their arsenol. What would your vet have done if Randy couldn't tolerate Lysodren? Our old gp vet did not know anything about Trilostane but when I wanted to treat my dogs with it, she called an internal medicine specialist, as well as read up on the drug, before prescribing it to my dogs. I'm not sure why your vet wouldn't want to do the same. It's called continuing education.

Dechra, the manufacturer of Vetoryl, makes it super easy for veterinarians to learn more about the disease, how to diagnose it and how to monitor treatment. They offer Webinars for veterinarians and a number of very prominent and well published endocrine specialists are major contributers to the teaching material. Since your vet is not family with Trilostane, she may not know this is available to her so you may want to providie her with the URL: http://thewebinarvet.com/dechra-webinars/.

Also, if she has any questions about the drug, she can go online to Dr. Mark Peterson's blog and ask. Dr. Peterson is an unquestionable authority on cushing's and it's treatments. He treated his patients with Lysodren for decades but I believe he now prefers Trilostane for a number of reasons. Here is the URL for Dr. Peterson's blog.

http://www.drmarkepeterson.com/insights-into-veterinary-endoc/

[coopersmom]

Randy hasn't felt well today. He's been drinking a lot of water; pacing, and didn't eat well at supper. He is super stressed from the fireworks and just before his supper it thundered two large clashes. I'm worried about him. His stools are o.k. and he did finally eat most of his supper but it took him a long time to do so, which is not his usual feeding style. I stay in a slight state of stress, afraid the Trilo is going to drop his cortisol too low.

[frijole]

Do you have any melatonin? It is great for calming the nerves - relaxes them without being a narcotic. You can buy it at health food/vitamin stores - even Walmart has it I think. I give my gal 3 mgs and she weighs 14 lbs. I hate fireworks for the same reason. Kim

[mypuppy]

Hi again Coopersmom,
My Princess has been acting exactly the same way as Randy lately, specially with the thunderstorms and fireworks. Last night she paced all night I think--all I heard last night was the clickety clap of her nails on the hardwood floors and her slurping water. This is way out of character for her since she has never had a problem with storms or fireworks until just recently. Right now Princess is on 20mg of Vetoryl and her symptoms are not resolved, so I highly believe this is all related to that. I just want to say how I understand your impatience and uncertainty with all this since I am there also. Sometimes it takes longer to see the results we want, but eventually we will get there. I also can relate to your fear of her dropping too low--that's how I was when I initially started treatment 1.5 years ago but again luckily with the stim we were able to avoid that from happening. hang in there as easy as it sounds and give Randy a gentle belly rub from me.

Warm regards, Jeanette

[addy]

If you are anxious about Randy going to low and he is acting unwell for any reason, when in doubt, withhold the pill. My IMS stressed that to me repeatedly. I kept telling her, I know, I know, don't worry, I know.

From what I have read, Cush dogs on treatment are not able to handle stressful events as well as they used to. If Randy is super stressed from the fireworks and storms, he may be having a harder time coping.

I have used melatonin for Zoe's thunderstorm fears. It really works. Don't buy extended release, just plain melatonin. I believe it is 3 mgs for thunderstorms. I'll have to double check.

Hang in there, when is your 30 day stim? We go Wednesday.

Hugs,
Addy

[coopersmom]

Addy-we go next Monday, the 11th I think is the date. we actually did hold the pills for two days last week per vet instructions. He's had a fairly good day today but of course nightfall is upon us and the fireworks are heating up. He's just been really hot for a few days and drinking a lot of water. I will be the first to admit he has a weight problem that existed before the Cushings ever began. Now of course he isn't able to exercise much. Gotta cut down the food. He did actually take a good walk this morning, and I'm thankful for that.

[addy]

I'm glad Randy is feeling better.:):):) It can be a tiny bit nerve wracking, can't it?

You are doing a great job.:D:D:D:D:D

You can ask about the melatonin when he goes for his stim. If your vet okays Randy to have it, you can give it a try. It really did help Zoe.

The last couple thunderstorms, she has not been shaking so I did not give her any. I thought that was weird and wondered if it was because her cortisol came down. WHO KNOWS;):rolleyes::o

Hugs,
Addy

[coopersmom]

Randy is feeling better firecracker wise. He is still panting a lot, and has been drinking more water lately. I question how much the Trilostane is helping him. His cortisol is better but symptoms don't seem any better. He has his ACTH Stim Monday so we'll find out where we stand with that. I hope to see him regular vet also. This is the first time they have done the stim. IMS has been doing the stim. Regular vet unfamiliar with Trilo, which is not a good situation for us to be in. She will fax results to IMS.

[addy]

I hope your ACTH test goes well Monday. We get our results tomorrow. IMS was too busy to call me today with them:(:(:( I hate waiting.

Zoe has been up and down with the water. Maybe it has to do with the air conditioning, I can't figure it out:rolleyes::rolleyes:

Sending hugs,
Addy

[coopersmom]

As if Randy needs anything else wrong, last night I found a swelling on his neck. It feels somewhat like a lipoma. But I am quite worried because last August he was treated for Extramedullary Plasmacytoma of the tongue. A cancerous lesion that if it spread, would probably go to lymph nodes. He's going to the vet Monday for an ACTH Stim and i'll ask her to look at his neck. Please pray for him that this is nothing serious.

[frijole]

You got it. Will keep you both in my prayers. Hugs too. Kim

[addy]

Saying many prayers for you and Randy. Positive thoughts shining your way.

Love,
Addy

[Squirt's Mom]

Hi,

Sending positive thought, healing white light and prayers your way.

Hugs,
Leslie and the gang

[Harley PoMMom]

Keeping you both in my thoughts and prayers.

Love and hugs,
Lori

[addy]

Thinking of you and Randy today. Saying prayers for both of you.

Love,
Addy

[coopersmom]

Randy had his ACTH Stim yesterday. Haven't gotten the results back yet. Maybe a bigger problem though. Thursday I found a swelling under his jaw. When Stacey looked at it yesterday she said it was a submandibular lymph node. This big issue with this is, he had an Extramedullary Plasmacytoma last August on his tongue. These usually don't spread, but when they do they often go to regional lymph nodes. If it is still swollen Monday he is going to have to have it biopsied.

[Squirt's Mom]

Please let us know how Randy is doing. I hope the swelling goes down and it turns out to be nothing.

Hugs,
Leslie and the gang

[coopersmom]

The swelling in Randy's throat (lymph node) hasn't went down any so he'll most likely have a biopsy this week. Do you guys think he'll have to go off the Trilo?

[addy]

Hi,

I can't answer your question about Randy having to go off his Trilostane.

Have you noticed any change in his symptoms?

Sending hugs and prayers everything turns out okay. Zoe's salivary glands are larger than normal. At first the regular vet thought they were her lymph nodes and aspirated them. Found nothing. IMS said it is not her lymph nodes but her salivary glands.

Hugs,
Addy

[coopersmom]

Addy-I have read about how difficult it is to tell salivary glands from Submandibular lymph nodes. I'll ask my vet. Surgery won't be until next week. Does anyone know how to tell the salivary glands & lymph nodes apart?

[addy]

Needle aspiration -- taking a small needle, inserting it into the lump, and aspirating cells or liquids is a very useful diagnostic tool for many situations, including salivary cyst. The characteristic aspirate is a clear, sticky or stringy fluid (saliva) that may be tinged with a little blood. It is important to look at the sample microscopically too, to rule out other diseases, such as cancer or infection. It will also help differentiate between a salivary gland and other tissue, for example, a swollen lymph node (also in the area).

I found this, not sure if it helps.

Hugs,
addy

[coopersmom]

Haven't been on here for a while. Randy was dx with Cushings in the spring. Last month he was diagnosed with Lymphoma. He is now doing chemo and taking 10mg of Pred daily. Of course the Pred is wrecking the Cushings but his life is at stake. We're just wondering if anyone here has a similar situation?

Moderator's Note: I have merged your update on Randy into his original thread. I have also changed the title of the thread to reflect the new lymphoma diagnosis. If you would like a different title, please feel free to contact me or one of the other administrative staff.

[StarDeb55]

My first boy Barkley, was also diagnosed with lymphoma, after he had been successfully treated for Cushing's for about 6 years. We did do chemo, but I elected to use only a single agent protocol, doxyrubicin. If you are using pred, it sounds like Randy may be on the multi-agent protocol that is given over a number of months? I was given multiple options for treatment when he diagnosed including just giving pred. I was told that the pred would probably give him about 2 months, but when he relapsed, nothing else could be done as the pred makes the tumor resistant to any other chemo. With the 5 round of doxyrubicin, B had another 20 months with a good quality of life. If there is anything I can do to help, including explaining anything about chemo or lymphoma, please let me know.

Debbie

[bkdice]

Hey Kim! Small world. It might be worth it to talk to your vets about taking him off the pred and just backing off of the cushings meds some. I know different vets have different protocols. Mine did not want Niko on any pred, but just wanted us to back off the Lysodren to let the natural cortisol rise. It is SO hard to find a balance in fighting cushings and lymphoma - and then keeping it once you find it. Our chemo was like Debbie's - just doxo and we were conservative in the dosing due to Niko's age. For me, the most important thing was quality of life - even if his life was a little shorter than it might have been with aggressive treatment. I was lucky my boy was an old boy that lived life to the fullest, so it was easier to make that choice than it would have been if he was only 10.

I so remember wanting cut and dry answers. I kept a daily log of how Niko did each and every day while undergoing treatment. I also had open dialogs with our vets, oncologists, and holistic staff at least weekly. Constant tweaks to meds, acupuncture, and supplements.

Sending you strength and peace. While I may not have the answers, I offer my support ANY TIME.

[coopersmom]

Randy is on the CHOP chemo program. He gets Vincristine one week, cyclophosphamide on week, Doxyrubicin one week, then has an off week. The vet hopes to take Randy pred in the future. Between the Cushings and the pred, Randy is starved all the time, drinking lots of water also. That is good on his Cyclophosphamide week b/c that agent is very irritating to the bladder, so he keeps his flushed out. We had good control of the Cushings before the Lymphoma hit. Now this double whammy.