Wylie - 12 yr. old Alaskan Malamute, PDH/Atypical (Wylie has passed) [Archive] - Canine Cushing's Information and Support Forums

Wylie's Mom

04-13-2009, 07:55 PM

Leslie,

I like my current vets, but I don’t think they are that familiar with the zinc deficiency thing. I’ve tried other things for the scabs that show up, but nothing seems to work like the Animax. I started using Animax from the suggestion of the former vet (pre-cushing’s dx) and have been supplementing with Zinc gluconate ever since. I think the recent bad flare-up happened because I had started to give him yogurt, as suggested by his IMS because of the gall bladder attack. Yogurt has a lot of calcium & calcium competes with zinc. I stopped the yogurt and am now giving him a probiotic instead. I wanted to avoid giving him the Animax, but the scabs got so bad, I felt I have to do it for a more immediate relief. During that time, I had researched different zincs. It seemed that Zinc Methionine was more absorbable than Zn Gluconate, so I am trying that, but any Zinc will take a while to have an affect on these scabs. Because the Zn Methionine is more absorbable, I am giving him less (60 to 90mg/day) than I did for the Zn gluconate (200mg/day). I don’t want to give him too much, because it can be toxic – I feel like its similar to figuring out the right Lyso maintenance dose - :confused:!

What type of zinc are you using?

Scott – Leslie & I are just keeping you on your toes:D:D.

-Susy

Wylie's Mom

04-13-2009, 08:04 PM

Hi Sharon,

Again, thank you so much for the information you shared before Wylie’s mini-load. I started him off doing the 500mg BID. About 3-4 hours after his first dose (am Sun), he nibbled on a little grass and that usually means an upset tummy. I knew he couldn’t be loaded on this first dose, so I just watched him carefully, examining his poops, looking for signs of discomfort – none. I gave him the second dose (pm Sun) and he seemed fine. The next day, after the third dose (am Mon), again he nibbled on grass around lunchtime. Skipped the pm Mon dose. Then thought maybe there wasn’t enough of a food buffer in the mornings (he gets lots of snacks in the evening after dinner). Next day, gave him 250 mg (am Tues), no grass nibbling, and gave 500mg (pm Tues). Wed, gave 250mg in the am, he took one nibble on grass around luchtime, then figured maybe because he his now on 3-4 small meals a day (instead of the 2 meals per day during the initial loading), maybe he just can’t tolerate 500mg for any of these small meals. So I gave him 250mg pm Wed and 250mg am Thurs and then just stopped. That totaled 3000mg over 5 days (initial load was 4250 over 3 days). Other than the grass nibbling, there were no signs of overload. I didn’t take him in for a stim after the loading – he had one 3 weeks previous & I wanted him to have a little more time. I gave him 250mg BID on Sun, Tues & Thurs, before the Saturday Stim.

I have to look back at my notes to see how much Animax I used – I definitely used a lot less before this last stim. The steroid in Animax is supposedly very powerful. I used quite a bit of it for the big flare-up, but hopefully now I can catch the scabs earlier and can zap them with a little bit of Animax before they get worse.

-Susy

Squirt's Mom

04-13-2009, 09:27 PM

Hi Susy,

This is zinc citrate I am using. I know so little about the differences between citrate, gluconate and so on. Her nutritionist recommended this so that is what I use. :D I trust her to know as she is the one with the degrees and initials after her name...tho we all know how little that can really mean sometimes. So far, she has done wonders for Squirt, tho.

It may be that you will just have to walk a very fine line between the Cushing's and using the Animax, if that is what helps him most. Kinda like a high-wire artist in a circus! :p

Hugs,
Leslie and the girls

MiniSchnauzerMom

04-13-2009, 10:02 PM

Quote:
Originally Posted by Squirt's Mom View Post
You didn't bring that hammer over her did you?!?!

Depends on Louise and her blender:cool:

Ohhhhhhh, those are fightin' words, Mr. Hammer!!!!

Sorry for the hijack, Susy! Glad to see you over here and congratulations on Wylie's great numbers.

Louise

Wylie's Mom

04-14-2009, 03:58 PM

You can hijack my thread...just tell everyone that this thread is where all the action is:D!
-Susy

Squirt's Mom

04-14-2009, 04:56 PM

And fire that blender up, my dear friend!!! :D We'll just hide that dang hammer!! :p

Barney's Mom

04-18-2009, 05:41 PM

:o:o:o:o yes, sir :o:o:o:o

You didn't bring that hammer over her did you?!?! :eek: :D

:eek: Don't speak too loudly!

Wylie's Mom

04-21-2009, 07:28 PM

Sorry this is long, but I don’t feel like editing it:p.

Here’s an update: last Wednesday evening (Tax day), I was trying get my taxes done, when Wylie hacked up a little liquid. While cleaning it up, I heard a little whimper/whine. I took him outside(in the rain) and he started munching on some grass. He went back inside and wanted to eat. I know I shouldn’t have, but he wanted to eat – I offered him a piece of banana, he refused, I offered a Lamb nugget, he ate it, but not as greedily as he usually does. His stim on Saturday was post-3.6 and I then thought maybe he should have had a little Lyso break after the mini-load. I gave him 10mg of Prednisone just in case. He settled down, but about 1-1/2 hours later, he wanted to go outside (still raining). He thought of munching on grass, but he just peed instead. Back in the house, then 10 minutes later, he vomited (the vomitfest started). Half hour later…outside in the rain again, vomit, eat grass, vomit, eat grass. He went back inside and demanded more food – this time I refused. I was worried that he might be having another gall bladder attack. 20 minutes later…back outside for vomit, eat grass, vomit, eat grass. Scr*w the taxes, I took him to emergency.

He seemed to be feeling better while we were at emergency.

Heart rate: 140
Weight: 79 lbs (he’s gained about 3)
No signs of abdominal pain.

I told the vet of his meds, supplements, raw diet, cushing’s, previous gallbladder attack…

They did bloodwork, out of range items that were tested:
Albumin – 4.0, RR 2.20 - 3.90 (he’s usually within range)
Alk Phos – 1428, RR 23 – 212 (has been trending upward, was 1231 a month ago)
ALT – 407, RR 10 – 100 (he’s usually within range)
Cholesterol – 395, RR 110 – 320 (he’s been trending downward, was 428 a month ago)
Amylase – 379, RR 500 – 1500 (he’s usually within range, has been low before on another in-house screen)
Electrolytes – within range

I’m not sure why his Alk Phos was still high (with the good stim he had a couple days ago) and why his ALT was so high. I did stop his Milk Thistle on Sunday, just for a one week break. I have never done this before (the break) and I have been giving him Milk Thistle for 2 or 3 years now.

He did not have diarrhea previous to vomiting. Vet checked to see if diarrhea was to come, but she said there were no signs of it.

She suggested an ultrasound, but he would have to be fasted and wait till tomorrow. I would rather his regular IMS do this because they know his history and have records to compare to. Again, he seemed to be feeling better. I decided against having them keep him overnite with IV fluids and opted for the SubQ fluids & Anzemet & taking him home instead. I notified the IMS office.

The IMS’s office called me Thursday around noon and said Dr. C could not see him soon, but Dr. B, could see him Friday around noon. (Dr. B did one of the ultrasounds when Wylie was being monitored after the October GB attack.) Friday, he had the ultrasound done and she said things look the same compared to his January ultrasound (check-up) that Dr. C did. She said it didn’t look like a GB issue or Pancreatitis, he wouldn’t have recovered so quickly & kept his appetite. Since the stim the Saturday before, he had 250mgBID of Lyso on Sunday & Tuesday & got sick Wed, so no Lyso on Thurs. She recommended I revise his maintenance dose from 250mgBID 3x/week, to 250mgBID on Sun & Thurs, and 250mgSID on Tues.

The next day, Saturday, after the IMS visit, he did have some softer stool, pumpkin colored, with a splash of French’s yellow mustard looking stuff:confused:. He also had a little nibble of grass.

He has been improving since and I did start the new maintenance dose on Sunday.

-Susy

ventilate

04-21-2009, 08:16 PM

Susy;
With a stim of 3.6 post, after the miniload and a week of maintenance it does not sound to me like it was overload. Did Wylie show any other signs? weakness in the hind end? Could he have gotten into something he shouldnot have? at 3.6 stimed on Sat and you gave the last lyso thurs its possible that level dropped a bit more but at 3.6 that is giving you a nice cushion. As well you didnt see much improvement post pred, that should have helped some. I am thinking it was something else. With the small meals are your giving the pepcid? maybe ask your vet about trying that? You are not giving any NSAID or anyother med that could cause the upset?
Nikes ALK Phos didnt drop down for a year and half once treatment started. on one stim it was high then on the next it was normal. My vet told me her labs were normal, I said what about her ALkPhos and he said that it was normal, then said that is strange.. and she has been normal ever since it was when I did her miniload a year and half ago and she dropped to 0.3, it normalized her labs, go figure.
Sorry Wylie hit a speed bump, I am sure with a mom like you watching over him it will be short lived and he will be back on the road full throttle again soon.
Sorry about the taxes, I am sure if you explain to uncle Sam what happend he will give you an extension:rolleyes::rolleyes::rolleyes: Yup I am sure of it
Hugs from me and mine
S,N and K

frijole

04-21-2009, 09:18 PM

Another question. Is the raw diet a new thing? I only ask because I tried that with my 2 dogs and boy did I have a mess. Vomit and diarrhea everywhere - one ended up with pancreatitus. I learned later that adding probiotics is supposed to help with the switch.... just sharing in case.... Kim

MiniSchnauzerMom

04-21-2009, 11:23 PM

Susy,

Just catching up on Wylie's thread. Hope he continues to improve on his revised Lysodren maintenance schedule.

Hmmmmm, pumpkin colored with a splash of French’s yellow mustard and a grass snack on the side. :eek: :eek: Sounds all too familiar!

Louise

Wylie's Mom

04-22-2009, 06:43 PM

Sharon,
Other than refusing the piece of banana, eating the Lamb nugget less viciously & the vomiting (all within the same time frame); Wylie didn’t show any other signs of possible overload. He also did not show the inability to get comfortable and the back arching that he did with the GB attack in October. Wylie’s hind legs have been shaking for quite a while – getting slowly/progressively worse over the last approx. 1-1/2 years. I have a note for the Friday before the stim that they seemed to be more shaky than recent times (last couple months). The shakes are not constant – I don’t know what to make of it. I don’t think he ate anything out of the norm or found stuff while on walks (I watch him, and if he gets something & I can’t stop him from gobbling it up, I usually jot the incident down in his log).

The only other time he stimmed this low was just before he had the GB attack in October. He regularly gets Pepcid AC at only his lunch meal – maybe he should get it before his dinner instead or in addition (both vomitfests happened in the evening). Wylie does not get any NSAIDS – not after he got really, really sick on Rimadyl in 2006.

I don’t understand about Nike’s Alk Phos – did it drop to a normal range when her cortisol dropped to 0.3, or did it normalize sometime after the cortisol level was normal for a while? I did apply Animax (has steroids) on a few small bear spots on his muzzle (where zinc deficiency scabs were) for the previous week – that may have caused the liver enzymes to increase some, but I don’t think it would have done too much. He also wasn't fasted (unless you count the vomitting:))before going to the ER, don't know if that matters. I guess I’ll just have to wait till we do more bloodwork just like I’ll have to wait and see what Uncle Sam does:confused:!

Kim,

Wylie has been on a mostly raw diet (Primal brand) since December. I had been giving him alittle raw green tripe with his meals since before the Cushing’s dx (about 5 months before the switch to raw diet). After his GB attack in October, he was given Baytril & when we were finished with that, the IMS wanted Forti Flora or yogurt added to his diet. So, the yogurt happened to be part of his diet while he transitioned to mostly raw. I don’t know if that helped or already being used to raw tripe helped, but I saw no problem during the transition. I did end up replacing the yogurt with B-naturals Ultra Probiotic (instead of Forti Flora) in mid-February after he had many zinc deficiency scab flare-ups. Yogurt has lots of calcium and calcium competes with zinc absorption.

Are your pups still on a raw diet? What is the diet & how are they doing?

Louise,

I was not familiar with the bright pumpkin color & splash of French’s yellow mustard:eek:! If I had a camera with me, I would have taken a picture. Thank god, his poops are looking more normal now.

-Susy

gpgscott

04-22-2009, 06:57 PM

Susy,

Man it is scary when we don't know.

I remember a bout of gastroentonitis. It was sudden onset and it was horrible. This was me not Moria.

It is going to take a bit for the ALKP number to go down.

I have started giving Moria tummy meds every morning and I also changed her diet. She gets ranantidine and it works well.

They can develop chronic digestive issuses.

Scott

Squirt's Mom

04-22-2009, 07:43 PM

Hmmmmm, pumpkin colored with a splash of French’s yellow mustard and a grass snack on the side. :eek: :eek: Sounds all too familiar!
Louise

Poop Salad!!!!

:D:D ROFL!!!! :D:D

ventilate

04-22-2009, 08:21 PM

Susy;
Nikes Alk Phos stayed elevated for about a year and half with her cortisol very well controlled, never above 5. She got down to 0.3 when I first loaded her (alk phos stayed elevated,) then the IMS wanted her down to below 1 when we were trying to figure out why her water uptake was not dropping and she got to 0.7 (alk phos elevated) but the last time when I did the miniload I think she was down to 0.5 maybe, that was in Oct off lyso till her next stim and lytes in Dec her AlkPhos was normal, If I am remembering it correctly. We tried the SAMe for a few months and that never made any difference so I quit giving it as it was an added expence that we, I, didnt need so all she was on was her pain meds and lysodren. Dont know but they have stayed within the normal range for the past year and half.with me doing nothing. Thats my one in a million dog.:D
Kenai eats dishrags if you remember and I have no idea where he gets them from but I do identify them as mine once they come back up again. Nike did have a bout with gastrointeritis when she was way younger. Do you know how much wall 20ccs of pepto will cover, I can tell you. The vet had me give 20ccs of pepto everytime she had loose stool. I would put the syringe in her cheek and squirt the pepto in, close her mouth thinking she was swallowing it then I would let her go, she would open her mouth and shake her head, dont need to say more other than I started giving it to her in my garage and had the only dark blue pink speckled jeep in anchorage. She probably ate some of the treats the moose would leave in my yard is what the vet thought and she was given antibiotics and was better very quickly. Sorry for the book.
Very discriptive poop leaves nothing to the imagination, good job, we become poop experts here one on my famous sayings is "Poop doesnt lie"
Hugs to Wylie and you
Sharon

Wylie's Mom

04-23-2009, 07:17 PM

Sharon,

Dont know but they have stayed within the normal range for the past year and half.with me doing nothing. Thats my one in a million dog.:D

I just realized that Wylie seems to be taking cues from Debbie's Harley, I am going to insist that he take his cues from Nike from now on!

Do you know how much wall 20ccs of pepto will cover, I can tell you...had the only dark blue pink speckled jeep in anchorage.

Note to self - "no pepto for Wylie";)

Leslie,

Poop Salad!!!!
:D:D ROFL!!!! :D:D

Oh, no – don’t tell Wylie that it’s “salad”.

Scott,
I might go ahead and give the Pepcid AC before his dinners instead of lunches.

-Susy

Wylie's Mom

05-29-2009, 07:14 PM

Well, I'm overdue on an update.

Wylie was scheduled for a stim tomorrow, but I emailed my GP vet to see if she could look at a couple other items and she informed me that she wouldn't be there this Saturday - but could see him during the week or next Saturday. I rescheduled for next Saturday so she could see him - I think she is best at finding Wylie's vein for the stim. I want her to also look at the following:

- I found some weird spots (4 or 5 of them) along Wylie's spine – they either look like little bruises or if they have a brownish stain & I can wipe it off, there is bruising underneath. Don't know what they are, but they don't seem to bother him.
- Wylie had a lump on his butt, first noticed in January. Vet wanted to wait & see. (I didn't write about this issue before because I had been battling with his zinc deficiency, starting Atypical Cush treatment, then faced the Lyso re-load.) In March, it looked like it was going to pop, I scheduled an appointment - when I got home, it had already popped. His reg. vet was not in that day, so another vet saw him post-pop - she said she couldn't tell what it was, listed off things it could have been, and told me to just keep it clean & put neosporin or bacitracin on it. It eventually stopped bleeding & healed. In April, a small nodule started to form in that same location. It looked like it was fluid-filled. He was due for a stim April 11th, so the vet got a sample from the nodule and sent it to the lab. Here are the results:

Cytology
Microscopic Description: 1 smear from mass on anus; Cellularity is low consisting of clusters of epithelial cells admixed with neutrophils, macrophages and blood. The cells have a moderate amount of basophilic "hepatoid" cytoplasm. The nuclei are round with stippled chromatin.

Microscopic Findings: Perianal gland tumor.

Comment: These tumors are typically benign however they can become quite large and ulcerate.

After she took the sample, the nodule bled and just broke apart a day or so later. Since then, it kept cycling through stages: 1) forms & grows, 2) starts to bleed a little, 3) completely comes apart & bleeds a lot, 4) stops bleeding & heals up, then back to 1) forms & grows.

We are now contemplating having it removed:(. He doesn't act like it bothers him, but I don't see an end to this cycling.

-Susy

gpgscott

05-29-2009, 07:43 PM

We are now contemplating having it removed:(. He doesn't act like it bothers him, but I don't see an end to this cycling.

-Susy

I am against surgery as a rule if there is a medical treatment, and you have not mentioned such. Have you asked. (I know you have:o, but I had to post the question)

Scott

Wylie's Mom

05-29-2009, 08:02 PM

No, I have not asked... I explained to her in an email, what has been going on with it since she saw him last month - she mentioned in her email reply that we may want to consider removing it. It didn't occur to me that something like this may be medically treated... I will ask her about that at our appt. next Saturday - thanks, Scott;). Now that he's older, it worries me to have him under.

-Susy

Buffaloe

05-29-2009, 10:23 PM

Hi Susy,

Is Wylie intact or has he been neutered? Perianal adenomas are common in intact male dogs, much less so in neutered ones. These tumors like their testoserone and thus don't occur frequently in neutered males. In any case, they are almost always adenomas (benign) rather than carcinomas (adenocarcinomas) which are malignant. Sometimes they just neuter an intact male with a perianal adenoma and it remedies the problem although they usually remove the tumor at the same time.

You can google and find lots of information about these perianal adenomas and the recommended treatment. As I understand it, they need to be surgically removed. Some are inoperable and in that case the dog is put on two or three different medications to try to control the tumor growth.

The board certified surgeons have various kinds of anesthesia that gp vets do not; pretty dogonne safe, I think. I think you should do some research and then discuss Wylie's perianal tumor with your vet. Personally, if Shi ever has any kind of surgery again, it will be performed by our board certified surgeon. Good luck.

Ken

forscooter

05-29-2009, 10:55 PM

Hey Susy,

I'm sorry Wylie has this issue...it sounds like Ken gave you some great info on it. It sounds painful....does Wylie seem to be pained by it?

Bailey has so many lumps and bumps I have had to pick my battles...but I think I would consider the surgical option if it can't be managed medically just bc I would imagine that area would be hard to keep clean and if there is any discomfort with it too.

Hugs to you both! Beth, Bailey and always Scoobie

fivebichons

05-30-2009, 12:58 AM

Hello Susy,

Hoping all the tests turn out well for Wylie next week. :)

We are thinking of you.

Hugs,
Heidi
Marco & Sophie
...and Friskie, Lucky, Cheri and Snicky from Heaven....

Wylie's Mom

05-31-2009, 07:40 PM

Hi Ken, Wylie was neutered before I adopted him. I recall reading about perianal adenomas on someone else's thread a couple months ago... I believe they had mentioned that there may be a link with them and Atypical Cushing's. He actually had a lump removed in 07/06 - this was on his right side, the current one is on his left side. Thanks for mentioning the anesthesia... I know his dentist uses the really safe one... I will discuss this with the GP vet and his IMS vet.

BTW, this is the Biopsy report of the removed lump in ’06 - perianal adenoma was mentioned at the bottom of it, but I don’t understand the statement… when my (former) vet wanted the sample rechecked, I had the feeling that he was doubting the surgery was necessary:

Biopsy
Microscopic Description: Perianal skin contains abundant perianal (hepatoid) glands without hyperplasia or neoplastic change. Portions of surrounding dermis exhibits mild inflammatory edema and contain moderate to marked infiltrates of lymphocytes, plasma cells, eosinophils, and lesser number of neutrophils.
(8/1/06) RECUR FOR REEVALUATION: The recut is similar to the original.
(8/4/06) ADDITIONAL SECTIONS (ALL WAS PROCESSED, 5 SECTIONS EXAMINED): Perianal section exhibits mild epidermal acanthosis with normal to slightly hyperplastic heptoid glands, mild to moderate stromal edema, and mild to marked perivascular and periadnexal to interstitial infiltrates of lymphocytes, plasma cells, and neutrophils with focally intense infiltrates of eosinophils. A few apocrine glands contain small amounts of purulent exudate. A few lymphatics contain abundant fibrin with mixed inflammatory cells including eosinophils. There is mild periadnexal fibroplasia.

Microscopic Findings: chronic-active lymphoplasmacytic eosinophilic mildly neutrophilic perianal dermatitis.

Comment: The lesion is inflammatory. No infectious agents are seen, but their previous or current presence cannot be excluded. If inflammation recurs and is not antibiotic-responsive, differentials include yeast dermatitis, dermatophytosis, and demodicosis.
(8/1/06) ADDITIONAL COMMENT: I AM REQUESTING SECTIONS OF THE REMAINING TISSUE TO FURTHER EVALUATE THE SPECIMIN; AN AMENDED REPORT WILL FOLLOW
(8/4/06) ADDITIONAL COMMENT: The remaining tissue contains inflammation similar to, but slightly more sever, than that previously described. The cause is not apparent. No infectious agents are seen, but their presence cannot be excluded. Possible causes of focal eosinophilic dermatitis include arthropod bite, Staph pyoderma, and dermatophytosis with fururiculosis (no intradermal hair seen to support this diagnosis). If inflammation at the site persists, antibiotic/steroid therapy may be beneficial. The previous cytology result which suggested perianal adenoma apparently sampled normal or slightly hyperplastic hepatoid gland.

-Susy

Wylie's Mom

05-31-2009, 07:49 PM

Hi Beth & Heidi!

Wylie doesn't act like he's bothered by it, but he could be acting! Beth... yes, I know what you mean about all the lumps!!! And yes, it's hard to keep clean after it pops, the blood oozes out slowly and sometimes I find a clump of dried blood stuck in his fur - lots of moist paper towel wipeings.

-Susy

Wylie's Mom

06-04-2009, 07:11 PM

Well, Wylie had the squirts yesterday and hasn't pooped yet today (at least I hope not, I don't want to find another mess to clean when I get home:eek:). I noticed last night that his tummy was unusually warm (almost hot) to the touch. I don't know if that means anything:confused:. I'm going to wait to see what happens tonight before I start to worry. He's acting normal, otherwise.

His 12th Birthday is tomorrow and he's due for his stim on Saturday - bad timing... gonna have to be fasted for part of his b-day (bad mom!). The vet will also check the nodule on his butt. I hope the diarrhea at least clears by then. I wonder if the stim should be postponed because of the diarrhea (but I've already postponed it by a week). Anybody, any thoughts?

-Susy

haf549

06-04-2009, 08:15 PM

HAPPY BIRTHDAY WYLIE:DI hope you feel better soon

Heidi & Kira

lulusmom

06-04-2009, 08:27 PM

Susy, if I were you, I would definitely put off the stim for another week. Either of the two problems (gastro intestinal & perianal abscess) can skew the results. Make sure both issues have totally resolved...sooooo, let your baby eat his cake on his special day. :D

Glynda

gpgscott

06-04-2009, 08:29 PM

Hi Susy, and,

Happy B'Day to Wylie from us also

Scott

Please make a calendar entry so we all remember. Hope he gets over his issues soon.

ventilate

06-04-2009, 10:16 PM

Happy Birthday to Wylie, shame on your mom, making that appt for the day after your birthday, hope the squirts resolve and you can enjoy a big T bone or what ever your mom has made for you special.
hugs from us
Sharon, Nike and Kenai

Harley PoMMom

06-05-2009, 08:08 AM

:D Happy Birthday Wylie :D

Hope you are feeling better today :)

Harley and Lori

Wylie's Mom

06-05-2009, 10:23 AM

Thank you all... he didn't poop yesterday, but had soft, pick-upable, poo this morning. I will email my vet to discuss the stim.

-Susy

Roxee's Dad

06-05-2009, 10:56 AM

:D:D:D Happy Birthday Wylie :D:D:D

Hope Wylie has a great day today! (with solid poops:D)

nikkismom

06-05-2009, 11:23 AM

HAPPY BIRTHDAY, WYLIE! Hope your tummy feels better on your birthday. Love from Sharon and Nikki

Squirt's Mom

06-05-2009, 11:48 AM

Happy Birthday, Wylie!
Hope you had a great day, great goodies to eat, and great bodily functions! :D

Wylie's Mom

06-05-2009, 04:20 PM

I called the IMS office, my vet was not there but another vet answered my question regarding whether to do the stim test in light of the “popping” perianal gland tumor & recent diarrhea episode. They asked if this morning’s poo was “soft, but firm” or “cow pie”. I was happy to report “soft, but firm”. They said then if he is eating well & acting well, these should not skew the results much, if at all. So, unless anything looks worse before the stim, we are going through with it (sorry, Wylie… we’ll extend your birthday & celebrate it for a whole week:D).

Tomorrow @ GP vet, we will be discussing what to do about the perianal gland tumor. In an email, my GP vet mentioned the possibility of having it removed. I’m making a list of concerns/things to ask about and trying to prioritize the concerns. I need help with this because the knowledge & experience of you all will help me to make better decisions.

1. Ask if this can be treated medically.
2. Anesthesia for senior pup (Major concern) – may have to seek Board Certified surgeon (as Ken suggests), the IMS office said they have BC surgeons on the other half of their shared building.
3. The procedure (??Minor concern???) – Does anyone think I’m taking this portion too lightly??? I’m thinking its not a big deal, the lump is on the surface & benign. I just hope they get enough out so that it doesn’t reoccur (the removed lump of ’06, did seem come back a year later, but went away within a month).
4. Post-op (Minor concern) – I’ll make sure he gets something besides Rimadyl (NSAID) for pain. I’m used to wiping his butt & keeping it clean;).

Thank you all for the birthday wishes (and great bodily functions wishes, Leslie)! I will go home early today to be sure that he gets his dinner and a larger-than-normal chicken & rice meal before the 8pm fasting deadline! With a full belly and “light’s out” by 9pm, he should pretty much sleep through the fast.

-Susy

Wylie's Mom

06-08-2009, 02:38 PM

Talked to GP vet on Saturday… the tumor cannot be treated medically. From what they know from the Cytology report, she said I could leave it alone, but she highly suggests that we do a Biopsy to be sure, since the cytology sample is so small. By doing the Biopsy, she would go ahead and remove the whole lump. I want to go ahead with this because when a new nodule grows back, it seems to get bigger… like its growing on top of or next to reminants of previous nodules; and, I don’t like him having this open wound so often, especially in this location. She said she can use the same anesthesia as the one his dentist used in December (Propofol). She says he would be sedated for a short period of time (like around 10 minutes) and the tube down his throat will not be necessary. She said that while he’s sedated, she can also get a sample of one of those bruised spots that are on his back. I haven’t scheduled the biopsy yet. I’m guessing we’ll have to do bloodwork first. It seems like its not a big deal… if anyone thinks differently or has any suggestions, please let me know.

Expecting stim results this evening…

-Susy

gpgscott

06-08-2009, 04:27 PM

Hi Susy,

Verterinay surgery is becoming as sophisticated as human. They used to use some archaic meds on dogs. This one you are citing Propofol, appears to be a modern med without many of the bad side-effects. And He is not going to be intubated, this is what is referred to as consious sedation and I think is state of the art.

Scott

Squirt's Mom

06-08-2009, 05:03 PM

Hi Susy,

Sounds like a good plan to me, but I know nothing about this. :)

I do like the idea of doing as much as needed while he is under and also like no intubation. Squirt coughs for days after they do that. :(

Bless his heart. Wylie has had enough to deal with. It's time for him to have some good times!

He is in wonderful, loving hands so I know he will be just fine.

Hugs,
Leslie and the girls

MiniSchnauzerMom

06-08-2009, 05:55 PM

Suzy,

Your plan sounds good to me too. I'd also want that lump gone!

Somehow I managed to miss Wylie's birthday. :( However, since you were planning on extending his birthday celebration for the entire week because the poor guy had to spend his special day in the vet's office....

Happy Belated Birthday, Wylie!!!

Hope excellent stim results are part of your extended birthday celebration. :D

Louise

Wylie's Mom

06-08-2009, 08:32 PM

Thank you Scott, Leslie & Louise... I feel better about removing the lump;). And belated birthday wishes are appreciated:D.

Just got the latest stim results here with all the past stims:
04/03/08 Pre – 3.4, Post – 21.9 original test with Cortrosyn by former vet that said it didn't look like Wylie had Cushing's
(a compound was used for remaining tests by new vet)
09/18/08 Pre – 3.3, Post – 17.6 baseline before Lysodren treatment
09/27/08 Pre – 1.2, Post – 3.6 Couple days after 3 days lyso loading @ 750mg BID
10/01/08 Pre – 1.4, Post – 4.5 To rule out addison's for reason for vomit & diarrhea (had a little pred within 24 hrs)
10/22/08 Pre – 3.5, Post – 10.3 new baseline, no lyso for 4 weeks
12/03/08 Pre - 1.3, Post – 7.0 after no lyso for 5.5 weeks, then 4.5 wks lyso @ 375mg 2x/wk, very low dose
01/24/09 Pre - 2.3, Post - 7.4 after 2 more wks @ 375mg 2x/wk and 5 weeks of 250mg 2x/day, twice a week
03/14/09 Pre - 2.8, Post - 9.2 after 7 more weeks @ 250mg lyso 2x/day, twice a week
04/11/09 Pre - 2.4, Post - 3.6 after 2 more weeks @ 250mg lyso twice daily 2x/wk, and mini load of 3000mg total over 5 days
06/06/09 Pre - 3.4, Post - 6.7 after 8 week maintenace dose of 250mg twice daily 2x/wk plus 250 mg 1x/wk (1250 mg/week), 1 missed dose just before stim

It's gone up, but I think its still low enough that we won't have to re-load... maybe add two 250 mg doses for a week or two and then maintain at 1500mg per week... just thinking aloud. I need to discuss with the 2 vets. Then again... he may have to miss a few doses for the biopsy...ARRRRGH!!

-Susy

Kiska'smom

06-09-2009, 01:02 AM

Hi Susy and Wylie!

I missed the birthday, so I'm sending you belated best wishes! You'll both be in my thoughts and prayers. I know that the procedure will go well! Hang in there!

Hugs,

Jeanne, Kiska and Sammie

ventilate

06-09-2009, 01:07 PM

Susy
Propofol ( diprivan) we use all the time in the unit. It is a sedative and works wonderfuly, Its half life is very short. Once turned off within a few minutes the pts start to wake up. Good luck with the biopsy. Any surgical procedures are tough on our cush dogs but they get through it, and probably better than we do:p. You may want to find out about giving pred or W/H lysodren before surg as I am sure Wylie will get stressed some, as well as after due to the pain. You sure dont want him sick due to low cortisol.
Hugs from me and mine
HRH Nike, Kenai and me

Buffaloe

06-09-2009, 06:01 PM

Hi Susy,

As you know, I've been going through a similar situation with Shiloh and I wanted to keep you up to speed.

Brief history: About a month ago I felt a bump near Shiloh's anus when I'd lift her into the SUV. I was in denial and didn't pay much attention. Shi visited the groomer (much needed) 3 weeks ago and she pointed out the lump to me and said it should be looked at. Took her to my vet and he diagnosed it as a perianal adenoma, said it needs to come out and sent me to our bc surgeon. Dr. G (surgeon) did a serious biopsy and sent 5 good slides to the pathologist. The results from the pathologist were complicated but indicated it was totally benign and lots of inflamation, etc. Surgery to remove it was scheduled for this afternoon. Today, Dr. G said the results of the biopsy showed lots of inflamation, etc. and said it may not even be a tumor, she may have just gotten something in there. He said we could go with surgery to remove it or there is a medical treatment which he thinks has a 50% chance of total success. Shi's been cut on enough, I chose the medical treatment. So, she's on alot of prednisone and alot of the antibiotic cephalexin for two weeks. I am 100% delighted; a week ago I was afraid she had a perianal carcinoma. Her bump, tumor, whatever has not changed in the past 10 days and I am pretty confident the medical treatment will work. I am so thankful we have such extraordinary veterinary care with both our gp vet and our surgeon.

Susy, I don't know if anything here will help you with Wylie but I hope his turns out to be as benign and harmless as Shiloh's apparently is. Dr. G said to keep it clean by squirting it gently with the garden hose, expecially after she goes, no rubbing and not even any blotting. It is a very vascular area.

Shi and I also send a happy belated birthday to Wylie.

Ken

Wylie's Mom

06-09-2009, 06:44 PM

Thanks, Sharon for the info on the Propofol & I will ask the IMS about the pred and/or lysodren withholding if/when it gets removed.

Ken, I hope the medical treatment works for Shiloh... I'm glad you mentioned the "no rubbing and not even any blotting"... even before he had this lump, I've been wiping his behind after he leaves his 'gifts' for the last several years! I'll have to ask the IMS about this. And yes, unfortunately, I see that it is very vascular area:eek:.

After reviewing the April cytology report, the IMS responded with:

The adenoma is likely secondary to the hormonal influences from the sex hormones (likely testosterone) from his adrenal glands. These will likely continue to pop up and recur.

I've asked the IMS if they think it should be removed... haven't heard back yet. In the meantime, I'll read this article:

http://www.k9cushings.com/forum/showthread.php?t=215&highlight=perianal

-Susy

forscooter

06-09-2009, 10:55 PM

Ack! I missed a birthday???I'm so sorry!!!! Can he have two this year???

Happy Birthday, Wylie!!!!!!!!
:D:D:D

Susy, it sounds like the surgery is a possible go. I also gave Bailey some pred before his last surgery "just to be sure". I did let the vet know and he had no problem with it and was glad I did it.

Will be waiting to hear! Please give Wylie an extra treat or two from me for his birthday! I hope he forgives me for missing it!
Hugs, Beth, Bailey and always Scoobie

Wylie's Mom

06-10-2009, 12:16 PM

Thank you, Beth... since the mean mom here had Wylie in for a stim test the day after his b-day, his b-day is being extended for a week;).

-Susy

Wylie's Mom

06-10-2009, 01:35 PM

Again, I’m conflicted about removing the perianal gland tumor. In light of the thought of it possibly being caused by sex hormones I’ve narrowed it down to two routes…

Option 1 - have the lump removed now and then get a full UTK adrenal panel done.
Intent: to remove the lump now, before it gets even bigger, and then see where his other hormone levels are at and try to control them to prevent new lumps from reoccurring (if it is believed that elevated sex hormones are indeed what is causing them).

Option 2 – get the full UTK adrenal panel done first to have a better indication of whether elevated sex hormones may be the cause. If it is believed to be the cause, try to control the hormone levels and wait & see & hope :o the lump finally goes away. If it is not believed to be the cause, have the lump removed.

I have a feeling that the other hormone levels aren’t that bad, based on Dr. O saying that if cortisol is controlled, the other hormones (other than estradiol) are likely to be controlled. Although Wylie’s cortisol levels aren’t textbook ideal for a treated Cushnoid dog, I don’t think they’re that bad. But Dr. O did say ‘likely’. Either route, I plan to do the full UTK panel, eventually, to find out.

Does anyone think I should try to contact Dr. O? I don’t want to bother him unless I really need his help and think he can really shed some light.

-Susy

ventilate

06-10-2009, 02:00 PM

Susy;
I think I would contact Dr O. The problem with getting the UT panel is that they have to be off their meds for a long time in order to clear them before the panel is done, I recall that you had to do a reload of Wylie not that long ago and I would hate to see you hold his meds then have to reload him again after the UT tests. Dr O may have a better answer for you that will not involve holding his lysodren. Just my thoughts.
Sharon

Buffaloe

06-10-2009, 04:43 PM

I think the first thing my surgeon said to me about Shi's perianal mass was, "as you know, these are largely driven by testoserone and also probably by progesterone in females." Also, yesterday when he was giving me the choice of treatments he said, "it would be just fine to take it out now, there's nothing wrong with that or you can try the medical treatment."

The garden hose is working really well in keeping Shiloh all clean back there. I wish I'd have known about it earlier. They shaved her closely in that area and it's clean as a whistle after I use the hose. I use it gently for 20 seconds or so and hit it from all angles.

Ken

MiniSchnauzerMom

06-10-2009, 05:06 PM

I think contacting Dr. O is a good idea too.

As far as the tumor removal is concerned...when in doubt and feeling conflicted, IMO that's not the time to make a decision, especially when this is not an emergency situation. Maybe after checking with Dr. O your head and gut will be in agreement and you will know without any doubt/question in your mind how to proceed.

Louise

Buffaloe

06-10-2009, 05:47 PM

Susy,

I agree with Louise. It's not like Wylie has some bad tumor that is getting alot worse and causing him trouble. It's probably pretty darn innocuous. I don't think you should get stressed out over it and I don't think you have to do anything too soon. The veterinary professionals see these things quite often and I think you should just listen to them and follow their advice. Just FYI, when my surgeon did Shi's biopsy he took a bunch of samples (smears) and looked at them closely to be sure they were good before sending them to the pathologist. There was no mention of removing the mass at that time.

I was all upset about Shiloh's because at one point I thought there was a good chance it was a carcinoma. Then, the biopsy report came back saying she possibly had a ruptured anal sac and a possible fistula. My professionals explained to me that the pathologists commonly throw out alot of things, possibilities and they did not buy into any of it (fistula, anal sac rupture). My vet and my surgeon were exactly right. I needlessly worried alot about all of those things...now I know it's either a harmless adenoma or an infection from something getting in there. Wylie is gonna be fine and you will get him the best care possible. I don't see any downside to shooting off an e-mail to Dr. Oliver.

Ken

Wylie's Mom

06-10-2009, 07:35 PM

Thanks Sharon, Ken & Louise - I'll start composing something for Dr. O.

-Susy

gpgscott

06-10-2009, 08:29 PM

Hi Susy,

You have had good input from a number of members.

You have a situation which is not clear cut. I am glad you are going to post email to Dr. O. He lives for it.

Please let us know what he has to say.

Best wishes and hugs.

Scott

Wylie's Mom

06-11-2009, 08:23 PM

Thanks, Scott.

Well I just sent Dr. O a long email, I'll post what he says when he responds.

-Susy

Wylie's Mom

06-12-2009, 02:53 PM

Wow, I aready hear back from Dr. O:

Perianal adenomas have traditionally been described as androgen-associated tumors, but I've seen several dogs with these tumors that have elvated estradiol levels. We almost never see increased testosterone levels in these dogs, but maybe increases in androstenedione from the adrenals. I think it would be helpful to do our canine adrenal panel first, before surgery, to see which hormones are increased, and how much. Then treat medically to get the hormone levels down and see if that doesn't control the problem. That would be my recommendation. Hope that helps. Regards, Jack.

So, I guess I'll be doing Option 2... but the tumor is looking worse (biggger & red) - I'll try to measure it and monitor it in the meantime. ARRRGH:mad:.

-Susy

MiniSchnauzerMom

06-12-2009, 03:01 PM

Susy,

Good luck with your measuring and monitoring on Wylie!

Louise

gpgscott

06-12-2009, 05:34 PM

Hi Susy,

Sorry you and Wylie are having to deal with this. I also would like to see you find a medical solotion and hope you can before his state requires surgery, it sounds like even if surgery is ultimately indicated that you need a course of meds to start with.

The problem I see here is that it takes two weeks for the results from the adrenal panel which you are planing for anyway. But Wylie needs some relief NOW!

So, as much as I appreciate Dr. O and his professional, theoretical advice what do we do to get Wylie some relief in the interim?

Scott

Wylie's Mom

06-12-2009, 06:14 PM

Thanks, Louise.

Scott - yes, that is my concern... although he still doesn't act like it bothers him, it's looking worse to me. It's not just the wait on UTK results... if there's somthing medically that can be done, I'd have to wait & see on that - plus, what else am I supposed to do medically if it is the hormones, when I'm already trying to control the estradiol & other hormones (via mel & lignans & lysodren for the cortisol):confused:?? Double ARRRGH!!!

-Susy

Wylie's Mom

06-12-2009, 06:27 PM

OMG - I just looked at the UTK treatment options sheet online to see what else can be done for the other hormones - it now says...

for the 40 mg. lignan caps:

Give SID: 1 capsule for dogs <30 lbs; 2 capsules for dogs > 30 lbs.

I checked the bottom of the sheet... Revised 05-22-2009

-Susy

gpgscott

06-12-2009, 06:45 PM

Interesting,

I have not noted that previously and we have been administering 40mg once daily.

I really think the lignans are not harmful at all, they may present a gastric issue as they are roughage.

The phyto-estrogens which they contribute are supposed to be good, in particular for females, to my understanding.

Scott

forscooter

06-12-2009, 09:55 PM

Susy,

I wish I had some great insight to offer you, some advice, some answer...but the only thing I can think of to say is this....take all the advice, all the opinions and then listen to what your gut tells you to do. Is there nothing that can be given to Wylie to give him some relief while you wait for the panel? If Wylie needs some immediate relief, then I think I would opt for the surgery and then do the panel....even if it is against what Dr. O says. I have to agree that I think if the relief is the more pressing issue, then you go with that.
Well, that was a big help I'm sure!:o
Hugs to you and Wylie! Beth, Bailey and always Scoobie

Wylie's Mom

06-15-2009, 06:57 PM

Thank you, Beth... I agree with what you said, so that is helpful;). Wylie is not acting bothered, but when I see the bulging redness:eek:... his butt is telling me something different!

He is scheduled for the full UTK adrenal panel this Wednesday. I guess I'll have her do bloodwork, while she's at it. After she sees how it's gotten worse, I'll probably tentatively schedule the removal for next Tuesday. I don't think I'll be waiting on the UTK results, but I'll be monitoring the area. If there seems to be any improvement or if bloodwork says to hold off on him being sedated, I will cancel/postpone the removal. I did up the lignan dosage starting last Friday.

-Susy

Wylie's Mom

06-18-2009, 06:59 PM

Bloodwork results back today (Thank you John for the idea of using Google docs;)):

http://spreadsheets.google.com/ccc?key=rsu8RvtWvAS_s9HYsHUtqWQ&hl=en

- Alk Phos still high, but lower than before.
- ALT went back to normal.
- Cholesterol still high, but trending down.
- T4 creeped back up

Lots of bleeding... will talk to GP vet on Saturday, I'm thinking that she'll probably try to squeeze him in for a removal on Tuesday. (Yesterday, she said she thinks it should be removed, but wanted to wait for the bloodwork results... she's not there today or tomorrow.)

-Susy

Roxee's Dad

06-18-2009, 07:36 PM

Hi Susy,

Actually, I have to give credit to Alison, she talked me thru it when I first joined to publish Roxee's very long bloodtest history.:D

I tried to view your doc's but apparently it is not shared. You need to share it with the world or publish it as a web page.

Yeah, it took me a while to figure it out too.:o

Wylie's Mom

06-18-2009, 07:46 PM

Thanks, John. Yeah... that Alison is familiar with alot of stuff... Thanks, Alison:p.

I just changed the Share option, but I don't know if I did it right... I'll just wait & see if someone else comments about not being able to access it (before asking you or Alison for help:D).

-Susy

Squirt's Mom

06-18-2009, 07:56 PM

Hi Susy,

I couldn't see it at first but figured it was just my dumb butt. :rolleyes: But it's up and easy to read now!

Hugs,
Leslie and the girls

Wylie's Mom

06-18-2009, 07:58 PM

Great - thanks for letting me know, Leslie:D!

-Susy

lulusmom

06-18-2009, 08:16 PM

Good job on the Google Docs, Susy! Google Docs works great and is the best way I've found to share a document that you can actually read with others. It is easy enough to follow the instructions; however, sharing with the world takes an extra step. In the event other members may want to give it a try, here's the information provided to John that hopefully helped him when he was trying to share Roxee's test results with us:

If you want to share the doc you posted on Google with the world, you have to do the following:

Sharing a document, spreadsheet or presentation with the world
Publish any doc to the Web by clicking the Publish tab in the upper-right corner of the Edit page. For documents, click the Share drop-down menu and select Publish as web page. You'll obtain a URL that allows anyone, with or without a Google Account, to access and view your published document.

Wylie's Mom

06-29-2009, 07:04 PM

Well, it looks like Wylie's butt lump & nodule cluster growth may very well be linked to high estradiol levels (see Dr. O's comment on post #63)

Here are the UTK panel results for 06/17/09:

Cortisol ng/ml
(baseline) 25.3 Normal range 2.0 - 56.5
(post ACTH) 71.7 Normal range 70.6 - 151.2

Androstenedione ng/ml
(baseline) 0.11 Normal range 0.05 - 0.36
(post ACTH) 1.46 Normal range 0.24 - 2.90

Estradiol pg/ml
(baseline) 142.1 Normal range 23.1 - 65.1
(post ACTH) 130.2 Normal range 23.3 - 69.4

Progesterone ng/ml
(baseline) 0.23 Normal range 0.03 - 0.17
(post ACTH) 0.85 Normal range 0.22 - 1.45

17 OH Progesterone ng/ml
(baseline) 0.16 Normal range 0.08 - 0.22
(post ACTH) 0.83 Normal range 0.25 - 2.63

Aldosterone pg/ml
(baseline) 39.8.0 Normal range 11 - 139.9
(post ACTH) 128.2 Normal range 72.9 - 398.5

His baseline Estradiol levels have increased tremendously since January - been on melatonin & the 40 mg lignans since then:

Baseline Estradiol level on 01/21/09
Estradiol pg/ml
(baseline) 80.4 Normal range 23.1 - 65.1

I had increased Wylie's lignan dosage about 5 days before this UTK panel was done (from 40mg SID to 80mg SID, based on revised UTK treament options sheet). I'm not sure if I should continue with this higher dose and wait & see, or if I should try the Flax Hulls:confused::confused::confused::confused:.

Either way, the lump & nodule cluster keeps increasing in size and he is scheduled to have them or a portion of them removed tomorrow... but, of course, (I spoke with the vet a few minutes ago)... she said she will evaluate the current condition of the surrounding tissue of the lump & nodule and then determine what, if anything, will be removed. (The nodule cluster is a growth on the lump.)

-Susy

Harley PoMMom

06-29-2009, 07:33 PM

Susy,

Harley's estradiol levels are high too, his baseline ~ 129.4 pg/ml and his post 132.2 pg/ml, this done 5/1/09.

He started his melatonin and pressed flax hulls on 5/16/09.

Monday, 6/22/09, his pee was YELLOW..:) and I believe this means that his estradiol has to be down bc his cortisol wasn't elevated at the post and only mildly at the baseline (61.6 ng/ml.) He has more energy and one can see it in his eyes that he just feels better.

I really believe this treatment is working for him and I wish you the best of luck with Wylie.

Lori

Wylie's Mom

06-29-2009, 07:52 PM

Thank you Lori:)!

I think I'm going to flat out ask Dr. O whether he thinks the Flax Hulls work better on estradiol than the 40 mg lignan capsules... but it will have to wait till tomorrow.

And I'm glad you are seeing such improvements in Harley;)!

-Susy

JFBMaine

06-29-2009, 08:59 PM

Hi Susy, all of this is still confusing for me and I am sorry that it is such a difficult now right now with your Wylie. Hugs to you and Wylie

gpgscott

06-29-2009, 09:45 PM

Susy,

You may need to ask Dr. Oliver about additional treatment.

There are two other synthetic hormones which address estradiol, I looked at them nearly two years ago and don't even remember the names of them, but they are supposed to be quite effective, but as you might imagine much more difficult to dose and regulate than melatonin/lignans.

I can't look right now but I will try to before I leave on Wednesday morning.

Scott

Buffaloe

06-29-2009, 11:01 PM

Hi Susy,

I just wanted to wish you good luck tomorrow with Wylie. One way or another, that lump and nodule will be taken care of. I truly think it's probably something innocuous but I know it needs attention.

With Shiloh, her anal bump was biopsied and everything. My surgeon had me put her cephlaxin for 10 days and prednisone for 7 days. It shrunk the bump alot. He said it shrunk it by 50% but I think it shrunk it by 80%-90%. After her treatment he said it's a perianal adenoma, 90% chance it is benign. Her biopsy showed it to be completely benign but he said no biopsy is foolproof.

I'm sure your vet will proceed the best possible way for Wylie. They see these anal bumps quite often, I'm sure.

Ken

Harley PoMMom

06-29-2009, 11:47 PM

Scott are you talking about ArimidexTM and AromasinTM?

Susy,

You may need to ask Dr. Oliver about additional treatment.

There are two other synthetic hormones which address estradiol, I looked at them nearly two years ago and don't even remember the names of them, but they are supposed to be quite effective, but as you might imagine much more difficult to dose and regulate than melatonin/lignans.

I can't look right now but I will try to before I leave on Wednesday morning.

Scott

If so, I had emailed Dr O about them not to long ago and here was his reply. And if not, so, so sorry for the hi-jack. :o

I e-mailed DR.O about the ArimidexTM and/or AromasinTM and here was his response. My questions in blue, his answers in black.

Dear DR. Jack Oliver:
I was just wondering about Treatment #10 listed on Treatment Option Considerations for hyperestrinism? It says:
10) Specific hyperestrinism treatment. ArimidexTM and AromasinTM. Indicated for treatment of hyperestrinism in dogs, but kinetic studies are lacking – they inhibit aromatase enzyme.
>>>These treatments are so expensive (human anti-cancer drugs) that they are prohibitive to use in dogs. Also, melatonin and lignan both inhibit the same enzymes as these two drugs, and are much more affordable.
As my Harley was diagnosed atypical via UTK panel case # EN 09-3017 (5/1/09) with Estradiol baseline of 129.4 pg/ml and post ACTH of 132.2 pg/ml.

>>>These estradiol levels are very elevated. But, you would still treat with melatonin and lignan as you are doing. Also, these high estradiol levels are sometimes seen when owners are using hormone creams, so if you might be doing this, consider being extra-careful with application as the hormones are readily absorbed across the skin of people and pets.

He is currently taking the Melatonin and the pressed flax hulls with lignans prescribed from the UTK option sheet.
>>>Give this treatment some time, as it may take several months for the estradiol levels to come down.

But if these do not bring his Estradiol down, I was wondering if the ArimidexTM or
AromasinTM could be an option for Harley.
>>>It's an option, but a very expensive option, with extremely limited experience in dogs. I only know of one dog that these drugs were used in (a bixhon that weighed 12 lbs) and it cost the owner about $250 per month, and took 6 months for estradiol levels to come down.

>>>Hope that is helpful. Regards, Jack.

I don't know, the $250 doesn't scare me as much as the "extremely limited experience in dogs." :eek:

Lori

Hugs to all.
Lori

PS
I just looked, and Arimidex and Aromasin are not listed on the treatment option sheet anymore.

AlisonandMia

06-30-2009, 12:09 AM

Thanks for posting that Lori - I remembered the conversation from a week or two ago and was going to chase it up.

The other possibility if melatonin/lignans are not cutting it is the addition of ketoconozole:

Ketoconazole, Melatonin and Lignans
In cases of Atypical Cushing’s disease with elevated estradiol levels, consider using ketoconazole at a conservative dose (e.g., SID treatment) plus melatonin and lignans. KETOCONAZOLE inhibits the 17-alpha-hydroxylase enzyme early in the adrenal pathway, and the 11-beta-hydroxylase enzyme late in the adrenal pathway; thus, the serum cortisol level decreases. MELATONIN inhibits the 21-hydroxylase enzyme midway in the adrenal steroidogenesis pathway (cortisol level decreases), along with the aromatase enzyme (which converts androstenedione into estradiol, and thus estradiol level declines). LIGNANS inhibit the 3-beta hydroxysteroid dehyrogenase enzyme early in the adrenal pathway (cortisol level decreases), along with the aromatase enzyme (estradiol level decreases). Because of these multiple sites of enzyme inhibition with KETOCONAZOLE and MELATONIN; or KETOCONAZOLE and LIGNANS; or with KETOCONAZOLE and both MELATONIN and LIGNANS, you should be able to lower the dose of ketoconazole needed, with less chance of liver toxicity occurring. Maybe use 5 mg/kg of ketoconazole once daily (SID), plus either melatonin or lignans or both according to our TREATMENT OPTION SHEET (see items 2 or 3 and 5).

This is from here: http://www.vet.utk.edu/diagnostic/endocrinology/treatment.php

I remember there was a dog at cc.net that was treated with keto because of hyperestrinism that wasn't that responsive to initial treatment with melatonin/lignans(?). I think it was a beagle called Maggie - but there were a couple of beagles called Maggie though as I recall. I think the estradiol was really knocking her liver about as well as affecting her in other ways as well. Hopefully Glynda, with her interest in atypical, has some recollection of this one too. (I'll see if I can find something in Google's cache too.) Heather's Zoe is also on keto as well as melatonin/lignans and is doing well (http://www.k9cushings.com/forum/showthread.php?t=620). I believe her main "problem hormone" is estradiol(again,???).

Alison

PS: Found Maggie the beagle's thread: http://74.125.95.132/search?q=cache:um7IxR3MxYYJ:www.caninecushings.net/forums/archive/index.php/t-2413.html+site:+caninecushings.net+maggie+estradio l&cd=1&hl=en&ct=clnk&gl=au (search for "keto" when you get there.)

Wylie's Mom

06-30-2009, 10:56 AM

Felice – thank you – hopefully, you and Finnegan will have an easier journey! Keep watch of his estradiol, his Alk Phos and … his BUTT:p!

Scott & Lori – I do remember the A’s and that they were cost prohibitive (but heck, I’m getting used to using my HELOC now:o). I don’t know what I’ll do right now, but I may look into them – since they are cost prohibitive, I don’t know if many have used it for pups and am guessing there might not be much info on it’s effectiveness in this regard:confused:.

Ken – I’m hoping Wylie can get similar results… I’m afraid that Dr. O’s hunch is correct - that it is being caused by the high estradiol levels, which may be similar to Shiloh’s bump. Hopefully, if a portion does get removed today (still waiting), it will at least help.

Alison – I had dismissed Keto in the past because Wylie already has an enlarged liver with lesions. However, based on how well Heather's Zoe has been doing, maybe the lower dose of Keto will help without harming his liver. Thank you so much for finding Maggie’s story… I’m about half way through it and finding it very interesting. I didn’t know (according to Dr. O) that high estradiol levels could be a major reason for high alk phos levels – and Wylie’s alk phos has been trending upward again. The milk thistle & SAMe didn’t seem to be helping one darn bit :mad:and now, I potentially know why:rolleyes:. I have to finish reading it!

THANK YOU ALL!!!

-Susy

Wylie's Mom

06-30-2009, 05:08 PM

Well, they called around 1:15, said the surgery went well, but they don’t want me to pick him up until after 5pm… they probably used some other anesthesia instead of or in addition to Propofol. I did discuss this with her yesterday – that it may have grown to be a bigger task for Propofol alone. I don’t know how much of it was removed yet. I’ll focus on his recovery for now and think about how to control the estradiol.

I re-read the thread that Debbie had started: http://www.k9cushings.com/forum/showthread.php?t=540

And I re-read Dr. O’s “STEROID PROFILES IN THE DIAGNOSIS OF CANINE ADRENAL DISORDERS”

And I’m looking into Keto… I’ll start an email to Dr. O...
flaxhulls better than lignan caps?
given Wylie's enlarged liver with lesions, suggest Keto?
keto in conjunction with lyso? or keto & stop lyso?
5mg/kg SID of Keto as stated on UTK site?
no washout time between the two?....

-Susy

Harley PoMMom

06-30-2009, 06:16 PM

Hi Susy,

So happy that your handsome boy's surgery went well and am sending healing thoughts for a quick recovery.

FWIW, Harley's ultrasound showed an enlarged liver w/metabolic changes, hyperplasia and hyperechoic. His ALP is 416 U/L and his ALT is 208 U/L , not threw the roof, but high.

I have also noticed that his belly is not as distended as it was, so I'm thinking that, maybe his enlarged liver might be shrinking. I won't know until I get the ultrasound done next month.

Let us know what Dr O says, I'm very curious as to what he has to suggest.

Glynda is right in calling estradiol the "demon sex hormone." :eek: I sure hope and pray Dr O has answers for you.

Hugs to you and gentle hugs to Wylie.
Lori

gpgscott

06-30-2009, 08:33 PM

Hi Susy,

Glad it went alright and best wishes to Wylie.

Yes it was the two mentioned by Lori, and I had no idea that they were so expensive and I also was not aware of the lack of knowlege of use of these in dogs, I guess the expense is the major factor.

Alison makes a good point, Lysodren while it does diminish all of the adrenal hormones has its greatest effect on cortisol as it effects primarily the adrenal cortex. I do know from my personal research in humans that keto effects multiple hormones and rapidly. We have also seen the happy result with Zoe.

So yes I think very good to ask Dr. O about Keto.

Best wishes. Scott

MiniSchnauzerMom

07-01-2009, 12:25 AM

Susy,

Glad Wylie's surgery went well and hoping he has a rapid recovery.

Louise

Squirt's Mom

07-01-2009, 10:57 AM

Hi Susy,

Hoping Wylie is doing ok today and has no issues with the surgery or recovery. Poor baby. :( Is his butt sore? When we met his tummy was all upset and now he has a booboo on his behind.

Take care of yourself, too!
Hugs,
Leslie and the girls

Harley PoMMom

07-04-2009, 06:12 AM

Hi Susy,

Was checking to see how Wylie is doing.

Will continue to send healing thoughts your way.

Hugs to you and Wylie.
Lori

MiniSchnauzerMom

07-05-2009, 05:17 PM

Susy,

Just wanted to find out if Wylie is doing ok. Haven't seen a post since his surgery. Hoping it's because you're busy elsewhere and that everything is alright.

Louise

Wylie's Mom

07-06-2009, 02:15 PM

Wylie is doing okay – the recovery wasn’t as good as when he had his dental surgery in 12/08, but went better than when he had a butt lump removed in 2006. Sorry it’s taken so long for an update… I will have to post the details later this afternoon/evening.
-Susy

MiniSchnauzerMom

07-06-2009, 02:51 PM

Susy,

I'm breathing a sigh of relief and glad that all is ok with Wylie.

Louise

Squirt's Mom

07-06-2009, 03:23 PM

~~whew~~

I'm breathing a sigh of relief and glad that all is ok with Wylie.

Louise

Me, too!...What Louise said!

Hugs,
Leslie and the girls

acushdogsmom

07-06-2009, 04:04 PM

Good to hear from you Susy. We worry when we don't hear any news. :)

Wylie's Mom

07-06-2009, 07:36 PM

I am so sorry I didn’t update sooner… I’m giving the following description of what happened so that if someone else decides to have the procedure done, they won’t assume it would be a breeze, keeping in mind that things could have been much worse than what Wylie (and I) experienced. The “should have’s” are bolded. NOTE: My memory isn’t the best for those days that seem to run into each other and I don’t have my notes with me right now…

So, I picked Wylie up Tuesday evening at 5pm (surgery was done at 1pm). They didn’t give me any pain meds – they know he can’t have an NSAIDs, but they also didn’t think he needed them. No cone needed – he can’t reach back there – if he did need a cone, I would want to have one of those soft, comfy cones at hand. They gave me discharge instructions – I wish I had asked for the generic instructions before he had the procedure done – I could have at least had the slippery floors covered before he came home. When I saw the stitched area, it dawned on me that he hadn’t pooped that morning… I usually walk him around and have him poop before dropping him off for his stim tests in the mornings… I walked him around that morning but he didn’t poop – I should have made sure he did his morning poop before dropping him off – I think he would have been more comfortable before & after surgery. He seemed fine when we walked out of the clinic.

But when I got home, he had trouble getting his hind legs on the first step (the steeper of two steps) of my front stoop. His hind legs looked funny – they looked crooked and his stance reminded me of a German Shepard’s where the back end is lower than the front shoulders. He wanted to eat – gave him about 2/3rds of his dinner (vet said ½ a meal was okay, but since he gets 3-4 small meals a day, I thought 2/3rds of a small meal would be about ½ of a regular meal). He seemed like he was still dazed and loopy from the anesthesia (Isoflurane & Propofol). He was fidgety, would not sit or lie still – and he made short little whining/whimpering noises. He stumbled a few times and had difficulty on the foyer tile and kitchen vinyl flooring. He couldn’t keep his hind legs from sliding. I scrambled and put a non-slip bath mat in the kitchen and borrowed a non-slip mat from my neighbor for the foyer. There was one point where he looked like he was going to just collapse – I was hovering over him at the time and was able to keep him from falling. I called the vet about the whining and asked for some Tramadol. I had my neighbor watch him while I went back to the clinic to pick-up the Tramadol – I should have asked for this before bringing him home. He got 50mg of Tramadol at around 6:30/7pm. He started to settle down, but still did some of the short whines. He was hardly drinking. There was no vomiting and nothing coming out the back end. The next morning, Wednesday… diarrhea. I stayed home from work. The little whines decreased & his coordination & stance were improving. I boiled a batch of chicken breasts and then had to make room in the freezer because his order of nasty raw tripe arrived. He still wasn’t drinking much so I spiked his water with chicken broth and he finally had a good drink. By late afternoon/evening, no more whines and he seemed okay, other than the 3 diarrhea episodes that day. He stopped drinking water –even the spiked water. He was being so good about letting me know if he had to go outside – no accidents in the house. Then in the evening, around 9pm my mom called me, complaining that hours ago, their car had broken down, they didn’t have their cell phones, they used someone else’s phone and called me at work, at home, my cell phone… ranting about how they couldn’t reach me…. Meanwhile, as I’m listening to this, Wylie’s acting funny trotting around the house kinda panicked… then I yelled (into the phone) “Oh, No!, Wylie just had diarrhea on the carpet! ”. My mom said, “Oh no, I’ll let you take care of that” and hung up. I tried to pick up what I could with paper towels, but it was no use. I had to get the Hoover Steamvac out (thank God I had it)– I got it years ago, pre-piddle pad, for when he would pee downstairs and for his occasional vomits. About 11:00pm, after about an hour & a half of going over and over the area with the steamvac, I got it picked up pretty well & the house didn’t stink (I did go over it again on Saturday because it still smelled if you had your nose close to the carpet). I took a shower and when I was drying off, I hear Wylie barking & pacing, I run downstairs in my pj’s and my hair wrapped in a towel. I take him outside (in my pj’s with my hair wrapped in a towel) & he just keeps walking & I’m hoping no one sees me… another diarrhea episode. We go back home, try to sleep, using the Steamvac reeked havoc to my elbow (I’ve had tendonitis for the last 8 weeks). I hardly slept that night – he wanted to go outside every hour or two, mostly because of diarrhea – I got maybe 5 to 15 minutes of sleep between each of the outings. Thursday morning, 6 am, after a diarrhea episode, I patted his butt with a wet paper towel and he sat down and scooted! There was a little blood and it looked like he might have torn one of the sutures. I was going to wait for the clinic to open at 7:30 am. Wylie let me have about 2 hours of sleep and I called the clinic at 8:30, Dr. R wasn’t there, but another vet (who had helped with Wylie’s procedure), said to bring him in for a look. She said that it looked okay and prescribed Flagyl for the diarrhea. I was a zombie and did not go to work on Thursday either. Wylie wanted to go on several walks, but only had one or two more diarrhea episodes that day. We had an uneventful night. His water consumption was coming back by Friday morning and finally, Friday evening, he had a normal poo:D.

Overall, I'm still debating whether I would have him go through this if I could turn back the clock. I won't know the answer to this until we try harder to reduce the estradiol levels, if we can even get them lower. The nodule/cluster was removed, but most of the underlying lump is still there. I read that Keto with Cyclosporin work pretty well on Perianal fistulas, but I think fistulas are different than what Wylie has. My vet had emailed Dr. O about Keto - she was informed that he will be out till mid-July. I will probably go ahead and order the flax hulls tomorrow.

-Susy

MiniSchnauzerMom

07-06-2009, 07:50 PM

Oh, Susy....poor Wylie and you have really been through it! Sounds like you could have used some of his Tramadol yourself. :D I'm glad he is doing better and hope you're able to catch up on some rest.

I'm just glad you're both ok!!!

Take care,
Louise

Wylie's Mom

07-06-2009, 08:06 PM

Sounds like you could have used some of his Tramadol yourself. :D

Hmmm, my elbow still hurts and she did give me much more Tramadol than he needs:rolleyes:...:D:D

Harley PoMMom

07-06-2009, 08:25 PM

OMGosh Susy, I can see why you couldn't update, You and Wylie were put thru the wringer! I'm glad things are getting back to normal and hopefully you'll be able to catch up some well deserving rest.

My vet had emailed Dr. O about Keto - she was informed that he will be out till mid-July. Darn it, I was anxious to hear his reply, as I know you were too. We can try to be patient waiters for his reply :eek::D

Take care of yourself Susy and here's hoping for more normal poos :D

Hugs to you and Wylie.
Lori

frijole

07-06-2009, 09:16 PM

:eek: holy cow. poor you, poor wylie! glad you are back to "normal". hugs from us, kim

nikkismom

07-06-2009, 09:37 PM

Wow, Susy, I'm sorry you have been through so much!And poor Wylie!:( At least the surgery is "behind" you. I don't know anything about atypical, except what I have read here, so don't know if it's related.But I do know what it's like to pray for normal poo! Wylie's been through alot and surgery always seems to cause stress related problems. Hang in there!

Roxee's Dad

07-06-2009, 10:53 PM

Hi Susy,
What a difficult ordeal....so glad that Wylie and you are doing better.

4Mikeydog

07-07-2009, 11:43 AM

Hi Susy...

I'm so sorry to hear about what you and Wylie have been through..
I'm glad you and Wylie are doing better.

Hope things continue to improve!!!

Dorothy and Mikey

gpgscott

07-07-2009, 12:06 PM

Hi Susy,

I have been out for nearly a week and was thinking about you both.

I am sorry it was so bad for the both of you and am hoping the worst is done with.

Looking forward to Dr. Oliver's recomendations.

Scott

Wylie's Mom

07-07-2009, 07:13 PM

Thank you all… Wylie seems to be feeling quite well :D... occasionally squeaking his squeak toys and sometimes chasing his tail - he rarely does these nowadays.

Lori & Scott – I didn’t email Dr. Oliver – since my GP vet had already emailed him (while I was tending to Wylie), I’m going to wait till she hears from him.

Sharon – you’re so punny:p. Yes, we believe the atypical (specifically the estradiol levels) could be the cause of the tumor.

I just ordered the Flax Hulls. I really, really hope it does the trick on the estradiol levels, but I'm sure it will take time. If Dr. O does suggest Keto, hopefully we can use it on a temporary basis.

-Susy

Harley PoMMom

07-10-2009, 05:56 PM

Hi Susy,

Was wondering how Wylie is doing, does he go back for a check-up?
Are his stitches the dissolvable kind?

Sending healing and positive thoughts your way for a speedy recovery for Wylie.

Lori

Squirt's Mom

07-10-2009, 07:09 PM

Me, too, Susy....:o

Wylie's Mom

07-10-2009, 07:14 PM

Thank you Lori & Leslie!

Wylie seems to be feeling fine, but the underlying lump (under the removed nodule cluster) has gained territory. His GP vet is not in until Monday, so I am waiting till then to have the stiches removed, so she can see how the lump has grown. I'm also waiting to see if Dr. O will recommend Keto in addition to or in lieu of Lysodren.

I had expected the Flax Hulls shipment today, but hadn't received it went I went home to feed Wylie his lunch... hopefully I'll get it tomorrow - it would at least make me feel as if I might be doing something to reduce his estradiol levels:rolleyes:.

-Susy

Ann and Wylie

07-11-2009, 08:40 PM

Just reading about Wylie - I'm so glad to hear the surgery went well, what a tough time afterward though. Happy he is feeling better. He is so gorgeous! I've always loved Malamutes, especially those eyes. Happy Tails from my Wylie to your Wylie :D.

Wylie's Mom

07-13-2009, 08:18 PM

Thank you Ann!

Wylie had his stiches removed today - it was uneventful:D.

There maybe some good news... on Saturday, I took a good look at Wylie's butt and the lump isn't as big as it was a few days previous. I had doubled the lignan capsule dose about a month ago, according to the revised UTK treatment sheet. Maybe the 2 per day lignan capsules are finally starting to take affect:rolleyes:?... I will never know. I happened to get the flax hulls order later that afternoon and have switched to the hulls. Theoretically, I believe the hulls may be better... they supposedly have a higher lignan count, are processed mechanically (as opposed to chemically**, which I am assuming is the case for the lignan capsules), and it looks like it has much more fiber, which I read may also help lower estradiol levels (not sure if this is because fiber helps to lower cholestrol, the start of all these hormones).

If my recollection is correct, his butt has never looked the same since he had a butt lump removed in '06... that one was biopsied and was not malignant either. Where the current lump is residing is just outside the dark pigmented anal area. Before the '06 lump appeared, this area of skin used to have fur... but has remained furless ever since. I don't care if it's furless, I just want the lump to go away.

-Susy

**ADDED: I’m adding this note for clarification… I do not want to sound like I’m knocking the lignan capsules… I think the new dose may have done much good for Wylie. I do believe the “chemically processed” comment; however, I think it’s okay in moderation… in light of all the other (chemically processed) supplements he gets, I like the idea of switching at least one of them to something with less chemicals. For example, I believe of the 9 types of supplemental capsules/tablets he gets, 7 of them contain magnesium stearate!

Harley PoMMom

07-13-2009, 09:41 PM

Hi Susy,

Wylie had his stiches removed today - it was uneventful So glad to hear that.

There maybe some good news... on Saturday, I took a good look at Wylie's butt and the lump isn't as big as it was a few days previous. YIPPEE!

I hope the hulls work on that butt lump and make it go away too.

Hugs to you and Wylie.
Lori

forscooter

07-13-2009, 10:21 PM

Susy,

Just trying to get caught up...and I have no idea what to say! Poor Wylie!! But I am glad the surgery is over and I am keeping my fingers crossed that the hulls do their magic!

Hugs, Beth, Bailey and always Scoobie

MiniSchnauzerMom

07-13-2009, 10:54 PM

Susy,

Glad Wylie's stitch removal was uneventful and hope his "rump lump" continues to shrink.

Louise

lucygoo

07-13-2009, 10:56 PM

Hi Susy...
I'm glad the stiches removal went well, too, and hoping the butt lump shrinks:)

Gina

nikkismom

07-13-2009, 11:00 PM

Me too! Butt lump be gone!!

Wylie's Mom

07-24-2009, 07:01 PM

Hi All,

Well a few days after the sutures were removed, the lump did go further down in size:D, but then no decreases since:(. That's okay, I'm content with this size... it doesn't look uncomfortable at all.

I started what I would call a "gentle mini-load" after suture removal - 250mg Lyso BID for 5 days straight. It was a total of 2500mg. (We did uneven doses totalling 3000mg last mini-load - decreased the doses because of a little grass nibbling.) I didn't do a stim right after this last mini-load, and started a maintenance of 250mg BID twice & 250mg SID twice a week for a total of 1500mg/week. He'll be having his stim done tomorrow. His last stim was 5 weeks ago (UTK) with a 7.17 post (up 0.47 since a regular stim 1-1/2 weeks prior). I withheld several Lyso doses after the surgery, so I thought for sure this mini-load and maintenance dose would be fine and possibly not enough. But he had diarrhea this morning. I'm still going to go ahead with the stim to see if low cortisol levels may be the cause of the diarrhea - but he's acting fine otherwise and I doubt this would be the cause. I was thinking of having only his estradiol checked and if it was possible to cheaply check Alk. Phos only, but I'll skip them for now.

We have a feral cat at work... you know what I just caught myself doing? - I was checking out her butthole, thinking, "my, that's so small compared to Wylie's"... GOOD GRIEF what's happend to me!

-Susy

gpgscott

07-24-2009, 07:07 PM

Hi Susy,

I missed the post a couple weeks ago and glad the the surgery is over and mostly healed.

I am not even going anywhere near the comment on the cat's ***, except to posit, does a cat have one?:rolleyes:

You are in danger of becoming another 'Sharon' in terms of minute treatment:p not a bad thing:D

Harley PoMMom

07-24-2009, 07:39 PM

Hi Susy,

Glad to hear the lump on Wylie's rump went down, and that it doesn't seem to bother him.

Sorry to hear he has diarrhea...but like you said, he's acting fine, so that's good news too.

Will be looking for the results of Wylie's stim. Best of luck to you both.

Meow:D
Hugs.
Lori

AlisonandMia

07-24-2009, 07:47 PM

Hi Susy,

I am not even going anywhere near the comment on the cat's ***, except to posit, does a cat have one?:rolleyes:

I don't know why but I find my self thinking of this one:

So, I'm on my way home yesterday and I decide to stop at a bar. Okay, so I'm on my way home from another bar, but what does that have to do with anything? So, I stop at this bar, and I'm trying to get up onto the barstool, and the bartender says, "Hey, buddy, I can't serve you, you're already drunk!"

Now, this is only the third bar I'd been to--or was it the 4th?-- so how could I be that drunk? So I says to the bartender, "Oh, yeah? Well, if I'm so drunk, how come I can see that cat coming across the street's only got one eye?"

"Because," said the bartender, "that cat's going, not coming...."

Alison

Wylie's Mom

07-24-2009, 07:48 PM

Scott,

You are so observant... Sharon's thinking was a big influence behind the strategy of Wylie's first mini-load. Since it went well that time, I'm sticking to it. I'm just having the darndest time figuring out a good maintenance regime (it seems that the IMS' suggestions are always a bit too cautious and his levels creep up again). If he has a good stim for tomorrow, I will stick to the increased maintenance dose (just 250 mg/week more than before) and do periodic micro-mini-loads by giving an additional dose here & there:rolleyes:.

But we'll see... gotta go home to see if Wylie's left any runny presents... I found one when I went home for lunch this afternoon... he left it on a piddle pad - what a good boy, he doesn't deserve dealing with this!!

-Susy

Wylie's Mom

07-24-2009, 07:57 PM

Lori, back at ya - I'll be waiting for all of Harley's results too;).

Alison, :D - that joke reminded me of a dog show I saw on TV where the judge was checking out an old english sheepdog... the commentator actually said something like, "well, I hope he doesn't find just one eye".

-Susy

AlisonandMia

07-24-2009, 08:01 PM

You feed a raw diet don't you? Are you giving the Lysodren with a standard meal or do his meals vary from day to day?

I fed Mia a raw/homecooked diet and found the variability of that (combined with the fact that being such a small dog she needed substantially more food during the cooler months) meant that amount of fat in her meals varied and this, in turn, caused her effective Lysodren dose to vary and that caused a problem. In her case she actually overloaded on maintenance but it could just have easily gone the other way.

I eventually went to giving her her doses of Lysodren in a dedicated "Lysodren meal" which had a fixed fat/oil content (started with ultra-low-fat kangaroo mince and added a precise amount of fish oil and gave the Lysodren in a certain amount of cream cheese). I always gave this meal at least 2 hours clear of any other food.

We've also seen people have problems due to the variability of commercial diets too - and with switching from one brand of kibble to another.

Alison

Wylie's Mom

07-27-2009, 06:21 PM

Hi Alison,

Yes, I do feed him raw and he gets Lyso in his “standard” meal. His standard meal has changed during this journey, but he’s always had either FO or FSO…
- Sept 08 initial load - he was on kibble, little canned & dollop of raw tripe – Fish oil was one of his supplements
- Nov 08 started maintenance very late because of gall bladder attack & recovery (had stim post of 10.3 before starting maint.) – this time soaked Lyso in the Fish Oil before giving it with his meal
- started to crush the Lyso & soak in Fish oil at some point
- Dec 08 switched to Primal (Chicken)
- mid/late-Jan 09 switched from Fish oil to Flaxseed Oil
- Apr 09 switched to compounded Mitotane
- May 09 tried to switch back to Fish oil to help with joints, but new “high quality” Super Omega-3 Fish oil I got seemed to cause mucousy stools, so I give it intermittently in lieu of FSO.
- July 09 Reduced amount of Primal & added some raw tripe for lunch & dinner meals.
- Future – may switch to coconut oil in lieu of FO or FSO?

I don’t think I would be able to do a separate “Lyso meal” apart from his regular meals – it’s hard enough for me to schedule the 3-4 small meals that I’ve been doing since his gall bladder attack. He gets his Lyso/Mito and FO/FSO during his breakfast (100% Primal) & dinner (75% Primal, 25% tripe) meals.

YOU GOT ME TO THINKING AND I DID THE CALCS... LOOKS LIKE HE HAS TOO MUCH FAT:eek:!

Primal chicken: Crude Protein (min) 13%, Crude Fat (min) 7%, Crude Fiber (max) 1%, Moisture (max) 72% - some of the fat is from chicken, but they also add ground flaxseed and coconut oil to their meal formula, but if you convert the 7% fat to dry matter = 25% fat (46.4% protein).

Place for Paws green tripe: Protein (min) 15.8%, Fat (min) 11.2%, Ash (max) 1.2%, Moisture (max) 71.3%, again converting the 11.2% fat to dry matter basis = 39% fat (55% protein).

I just don't know what to make of everything... there are just too many variables. It looks like his cholesteral & tryglycerides were trending down with the switch to Primal, but now that I've re-introduced the tripe, maybe they'll start trending up again:confused:?

Still waiting for the stim results...

-Susy

Wylie's Mom

07-28-2009, 07:05 PM

Well the "gentle mini-load" didn't work. His last two stims:

06/17/09 Pre - 2.53, Post - 7.17
07/25/09 Pre - 3.9, Post - 7.00

At least I know where he's at now. I'm sure the cortisol crept up before the mini-load because of the maintenance dose given, plus, he didn't have any lyso for a week because of the surgery. Another possible factor - I did put some Animax on a few zinc deficiency scabs the week before, including the day before the stim - if this increased the cortisol, I don't think it did by much. I believe I'll have to hit those adrenals harder with 500mg doses... he nibbled on grass at that dose last time, but didn't vomit (until two weeks later - so there probably isn't a connection).

Wylie hadn't had any zinc deficiency scabs for over 3 months. I had forgotten that fibre & phytates decrease zinc absorption and flax has alot of both. I noticed a little scab about 5 days before starting the Flax Hulls :confused: and then found 2 new scabs about a week after starting the Hulls. I may have to alternate between the lignan caps and the hulls or stop the hulls altogether... or increase his zinc supplements. I'm going to alternate between them for now.

Oh yea, he's on Flagyl again, since Saturday.

-Susy

Harley PoMMom

07-28-2009, 07:30 PM

Oh Susy,

You two just can't get a break here can yous. :(:eek: My heart just sank reading your post...I am so hoping Wylie can tolerate the hulls, or at least the switching between the lignan caps and them.

You both are in my thoughts and prayers.

Love and many hugs.
Lori

Squirt's Mom

07-28-2009, 07:42 PM

Hi Susy,

My goodness...I, too, was hoping for better news on the results. But there was some slight improvement. :o

I really should know this, but is there something that will enhance the absorption of zinc that might be added to his regime so the need to decrease the lignans might not be necessary? Just thinking out loud here. :) You may already know this but I will look into it and get back to you.

Hang in there!
Hugs,
Leslie and the girls

Wylie's Mom

07-29-2009, 01:27 PM

Hi Lori,

I feel like I’m in a maze… so many things to consider, so many possible paths, no certain path to take, hitting dead ends, hoping another path will lead me out… there are times that I just want to give up… but there has been some progress and I still have some hope and that’s what will keep me going:). I now think, at least in Wylie’s case, maybe the 250mg doses are just little slaps to the adrenals and they recover quickly from slaps. I’m hoping that the 500mg doses are more like punches to the adrenals:D.

I think he tolerates the hulls okay, but I don’t know if it had anything to do with this latest bout of diarrhea. I usually give him a zinc supplement for each of his 3 regular meals, but I’m going to start give him 1-1/2 caps each for breakfast & dinner to separate the zinc from the hulls/lignan caps that he gets during lunch.

Your thoughts and prayers are appreciated;).

Hi Leslie,

After his big zinc deficiency scab flare-up in January/February, I stopped the yogurt because of the high calcium content and switched to a powdered probiotic. Since calcium competes with zinc I really believe that was the main issue at that time, but another factor may be that I didn’t notice them early enough to do something about them before they got really bad. The scabs are not so easy to detect in the early stages – they quietly hide under perfectly normal looking patch of fur:mad:. I regularly feel around his muzzle now to see if I can feel them and then zap them with the Animax before they get really bad:D.

I had been supplementing with Zn gluconate for years - it seemed to work okay… still had minor flare-ups every now & then, but after that big flare-up, I looked for a better zinc. I found claims/studies that certain Zincs were more bioavailable than others. I decided to try Zn l-methionine (BTW- methionine is the M in SAMe). I was giving him 200mg Zn gluconate/day and went down to 90mg/day with the Zn l-methionine.

But to answer your question:rolleyes:, here is a summary I found:
http://www.micronutrients.net/Animal/tbzc.htm

Several dietary factors can affect the absorption efficiency of Zn. Zinc absorption is enhanced by: 1) low Zn intake, and 2) Zn consumption with cysteine or cysteine-containing peptides (e.g., glutathione); also with ascorbic acid or other organic acids such as citric acid and picolinic acid. The cysteine-glutathione effect is thought to account for the high RBV of Zn in meat and meat by products. Factors that reduce Zn absorption are: 1) excess Zn intake, 2) consumption of Zn with phytate, particularly when excess calcium is also consumed, 3) consumption of Zn with oxalates (e.g., foods such as spinach, berries, chocolate) or tannins (e.g., tea), and 4) major trauma (stress) such as pain, surgery and burns.

Leslie, I’m so glad you asked that question – I find that I only remember a small portion of things I’ve read in the past. I need to keep re-reading things (like Glynda does:p)… I forgot about the stress issue… maybe these recent scabs were due to the surgery… plus, he probably didn’t absorb any Zn when he had diarrhea:rolleyes:.

If you find anything else, please let me know!

-Susy

Squirt's Mom

07-29-2009, 08:14 PM

Hi Susy,

Look at this one:

http://bulletin.piwet.pulawy.pl/archive/51-2/17_brodzki.pdf

Didn't give it a good reading but it may give some info you don't already have.

Hugs,
Leslie and the girls

fivebichons

07-29-2009, 10:38 PM

Hello Susy,

I'm sorry to read that you and Wylie are going through such a maze right now. Like you said, there are so many paths. But, all you have to do is look at Wylie' face. Give up? Not a chance! We all know you feel the same way! And besides, there are way too many cheerleaders here! :p

Lots of positive thoughts and prayers to you both!

Heidi, Robin, Marco & Sophie
...Friskie, Lucky, Cheri & Snicky from heaven...
P.S. I still want to make a beautiful porcelain ornament of Wylie for you!

Wylie's Mom

08-03-2009, 11:27 AM

Leslie,
Thanks, but I don’t know what to make of the article, I think it’s over my head:confused:. I have never had his zinc or copper levels actually tested, however, I do believe, based on the scabs, his zinc levels are not too high:o.

Cheerleader Heidi,
Yes, you’re right I won’t give up – I’m just weak at times;). Wylie has been keeping me on my toes and I had forgotten about the ornament… Maybe I can get to it this year???:rolleyes:

-Susy

Wylie's Mom

08-03-2009, 12:06 PM

My vet heard from Dr. O on Friday… She didn’t have the updated/correct supplement & medication regime, so I’m not including all she wrote. The product Dr. O is reffering to is the 40mg lignan capsules:

…the dog is still has signs of cushings (hair loss). In the last few month he has developed perianal gland tumors. I assume from the uncontroled hormones. What else can I do to control the estradial?

>>>I'll attach our latest treatment option sheet, which has new information on Lignan (item 4). I'm suggesting 1 mg/lb of lignan now, and the product above probably only has 8 mg total. So the dose for this size dog is very low. You can get the higher contrnt lignans by googling flaxhull products on the Internet. We do see dogs with high estradiol levels that have perianal adenomas. Not sure of the mechanism, as you think of androgens causing this. The haircoat usually takes at least 3 months to improve. Many veterinarians have told me that a melatonin implant works better for improved haircoat response. You could consider giving that a try (item 3 on the treatment sheet). Use the 18 mg size.

>>>I hope this helps, and forgive the late response. Regards, Jack.

The lignan capsule information is interesting… the label says it’s 40mg, but 20% SDG (secoisolariciresinol diglucoside – the booklet that came with the flaxhulls disussed this), so that must be where he came up with the 8mg. His comment on the melatonin implant is also interesting.

Did another mini-load last week with 500mg doses (5 total) – he had significant decrease of water consumption, did stim on Saturday morning, but water consumption went back up on Saturday, so I gave him a 500mg dose Sat. evening. Just got results… pre-3.1, post-5.5:).

Wylie's Mom

08-03-2009, 03:41 PM

Can someone check my calculations? I basically want to figure out how much SDG there is per 1 teaspoon of Flax Hulls:

Hulls info:
1 container = 1/3 lb
Serving size = ½ Tbsp.
Servings per container = 32
SDG = 35mg per 1 gram

conversion measurement facts:
1/3 lb = 151 grams
1 Tbsp = 3 tsp or 1/2 Tbsp = 1.5 tsp

How much SDG per 1 teaspoon of Flax Hulls?
32 servings/container x 1.5 tsp/serving = 48 tsp/container
151 grams = 48 tsp
1 tsp = 3.1458 grams
1 tsp = 3.1458 grams x 35 mg SDG/gram = 110 mg SDG

gpgscott

08-03-2009, 04:52 PM

The problem here is weight vs volume.

Gram is a measure of wt, teaspoon, tablespoon etc... are measures of volume and the weight will vary with the substance being measured.

Given the information provided of SDG@35mg/1gram of lignans, (which I presume is from the supplier) your math is correct.

I have tried to find the volume/density of lignans to cross check this and cannot find this figure.

I know many of us are now using the lignans but I just want to say that I prefer the capsule. It is standardized and if it is swallowed you know the dose was given. Lignans stick to everything and I would advise anyone giving them to give more because you can't be sure the pup is getting it all and I don't think bit more hurts a bit.

Just my opinion.

Scott

jrepac

08-03-2009, 05:04 PM

Is SDG the active ingredient in the flaxseed? I'm finding this all a bit confusing as well...I've been doing 1/2tsp of flaxseeds daily and wondering if i should be switching to the lignans capsules?

Jeff

StarDeb55

08-03-2009, 05:22 PM

I'm somewhat confused, now, too. I have downloaded the updated UTK treatment recommendations, & nowhere do I see anything that states about the amount of SDG. All the recommendations state is 1 mg lignans per lb. of body weight. Based on flaxhulls.com stating that 1gm of hulls = 35 mg. of lignans, I have calculated the following for Harley based on 13 lbs.

1/2 tsp. = 52.5 mg. lignans

I had been giving the 1/2 tsp of hulls since I switched from the purified lignans capsule. If I were to cut the hulls down to 1/4 tsp., that would be 1 mg. lignans per lb. body weight. Since Scott has brought up an excellent point about uncertainty about the amount consumed, I'm going to stick with the 1/2 tsp. As we all well know, sometimes Harley eats, sometimes he doesn't, so I figure if he's getting double the amount, he might end up getting close to what he needs.

Susy, could you tell me where you got the info about the specific amounts of SDG?

Debbie

Wylie's Mom

08-03-2009, 05:54 PM

Debbie,
The label on the Flax Hulls container says 35mg SDG per 1gram.

Jeff,
I'm confused too... according to Dr. O's email, he believes the lignan caps only contain about 8 mg. I looked at the label and it says, "Flax lignan extract (LinumLife Extra) (standardized at 20% SDG)(seed)". So, for the 40mg capsule, I figured he got the 8mg by multiplying 40mg by 20% = 8mg.

Scott,
I agree about the calculation problem, I've emailed the FlaxHulls guy and asked him to review my calcs... I could only use the information provided on the label. As for mixing the hulls with food, Wylie licks the bowl clean;).

-Susy

StarDeb55

08-03-2009, 06:03 PM

Susy, I don't know if this will be helpful, but I e-mailed flaxhulls earlier today. This is the response.

There are 35 mg of lignans per gram of product.
A 35 pound dog would get 1 gram of product (35 mg per gram).
A 70 pound dog would 2 grams of product (70 mg per 2 grams pf product).
A 17.5 pound dog would get 1/2 gram of product (17.5 mg per each 1/2 gram of product).
A 52.5 pound dog would get 1 1/2 grams of product (52.5 mg per each 1.5 grams of product)

Debbie

Wylie's Mom

08-03-2009, 06:06 PM

BTW - I'm trying to read about the HMR lignans that Dr. O mentions on the revised Treatment Sheet... comes from spruce knot wood, claims of higher lignan content than flaxseed, claims that HMR is more bioavailable than SDG... I found myself reading threads on male hairloss forums - I just don't know what to think of it all:confused:, some of the men had tried SDG lignans, too.

-Susy

Wylie's Mom

08-03-2009, 06:21 PM

Thanks, Debbie...now, I know with cooking (& dosing), it is more accurate to weigh the ingredients (grams on a scale), but I'm not going to weigh his flax hull doses every day... I was trying to use the info that I had to figure out how much to give him in teaspoons (or fraction). From the calcs., it looks like about 3/4 teaspoon for Wylie (80lbs) - with his weight, I'll eyeball just below a teaspoon:rolleyes:.

-Susy

jrepac

08-03-2009, 07:18 PM

Guess I am "safe" with 1/2tsp for a 22/24lb Aussie..

LOL!

Wylie's Mom

08-03-2009, 07:49 PM

Hi Jeff,

I don't know what to tell you... I just got off the phone with the Flax Hulls guy, he said that the scoop that comes with the container is 1/2 a Tablespoon (as the label states for one serving for human doses). He said that when he measures out one of the scoops and dumps the contents on his scale, its more or less 5 grams (1 teaspoon = approx. 3.33 grams). This will vary depending on how compact the contents are. Another variation, as stated on their website,
http://www.flaxhulls.com/lignan.htm

NOTE!! that in the calculations above, I use 35mg SDG per gram of flaxhull.
Actually the SDG can vary from 30 to 60mg per gram of flaxhull.
This is dependent on the flaxseed that is being processed.
So in doing some rounding and more calculations we could have 30mg SDG times 150 grams is equal to 4500mg SDG per container or 4500 divided by 30 human servings equals 150mg SDG per human serving as the low figure. AND a high figure of double that.

Until I hear further, I'm going to stick to somewhere between 3/4 to 1 teaspoon for now. If I use the lignan caps, and it is indeed 8mg each, that would be 10 capsules for Wylie per day :eek:. I do think that each dog is different, I will probably have his estradiol level checked at the next stim test.

-Susy

gpgscott

08-03-2009, 07:58 PM

I will probably have his estradiol level checked at the next stim test.

-Susy

Susy,

It is not necessary to stim for estradiol in most cases.

Scott

AlisonandMia

08-03-2009, 07:59 PM

Another thing to remember is that there are teaspoons and teaspoons. The average kitchen teaspoon (at least the ones we use in Australia and I imagine yours are the same) hold about 3.5ml whereas a teaspoon measure (as when a recipe calls for a teaspoon of something, or a medicine spoon) is actually 5ml. When you are discussing "teaspoons" (especially over the phone) you need to make sure that you both of you mean the same thing by the term "teaspoon".

Alison

Wylie's Mom

08-03-2009, 08:08 PM

Nope, didn't know that Alison...

I give up! I'll look for a decent scale... I'll ask my vet or local pharmacy if they have a scale and ask them to weigh a couple samples of my teaspoons of hulls:p;).

-Susy

AlisonandMia

08-03-2009, 08:17 PM

I think a pharmacy would be your best bet re tracking down a set of scales that measures small amounts with precision. Years ago I got my local pharmacist to weigh something for me like this although for the life of me I can't remember what it was or why...... I only remember that I needed to know what a certain amount of something looked like in a certain measure - which is what you want to know, isn't it?

Alison

Wylie's Mom

08-03-2009, 08:24 PM

Oh Scott,

What did you mean by testing estradiol levels not being necessary in most cases?... I understand if you mean that you would go by symptoms rather than estradiol serum levels. My problem is that I haven't steadily controlled his cortisol levels (and don't know if I ever will:rolleyes: - and same with the estradiol for that matter:mad:), and since they have many of the same symptoms, I was thinking that knowing the levels may help direct on treatment/dosing.

-Susy

Wylie's Mom

08-03-2009, 08:27 PM

Yes, Alison, that is exactly what I'm looking for. There is still the variable of actual SDG lignan content per gram, but at least I can get the variable of measuring/weighing out a gram straightened out!

StarDeb55

08-03-2009, 08:55 PM

Susy, Scott was saying that you don't have do a stim to get an estradiol level done. Estradiol can be checked at any time without doing a stim.

Debbie

Harley PoMMom

08-03-2009, 09:59 PM

Hi Susy,

The little red scoop inside the hulls container, it has a ring that goes the whole way around the inside of it, when I filled the hulls with my kitchen 1/2 teaspoon, then dumped them in that red scoop, the hulls went to that inside ring. That's what I've been giving Harley these past months. I hope it's right. :eek: Now you got me thinking. :confused:

I'll be watching your thread and see what you come up with. :)

Hugs.
Lori

Wylie's Mom

08-04-2009, 10:49 AM

Debbie & Scott... oooh - thanks, now I understand... I meant that since they would draw blood for the stim anyway (pre-stim), I would just have them draw extra blood at that time to send to UTK for the estradiol baseline only - I try to "bundle" these tests whenever I can and I'm sure he'll be in for another stim in 6 weeks.

Lori - I eventually did think of that last night... I used my kitchen 1 and 1/2 teaspoons and the contents matched... I didn't think to see how much that ring was at - if I recall correctly, the ring on my scoop is kinda high (maybe 3/4 up from the bottom), are you sure the ring isn't at 1 teaspoon?... Maybe there's another ring I didn't notice?

-Susy

Harley PoMMom

08-04-2009, 11:28 AM

Lori - I eventually did think of that last night... I used my kitchen 1 and 1/2 teaspoons and the contents matched... I didn't think to see how much that ring was at - if I recall correctly, the ring on my scoop is kinda high (maybe 3/4 up from the bottom), are you sure the ring isn't at 1 teaspoon?... Maybe there's another ring I didn't notice?

-Susy

I will recheck that Susy to be sure bc here lately I don't know which way is up or down. :eek::)

Love and hugs.
Lori

Harley PoMMom

08-04-2009, 05:44 PM

Hi Susy,

I did recheck my 1/2 teaspoon measurement with the inside ring and the hulls fall right before that inside ring, now there is an outside ring too, which is thicker on the scoop I have, the ring inside the scoop is a fine line which is hard to see.

Love and hugs.
Lori

Wylie's Mom

08-04-2009, 06:09 PM

Yes, Lori... I looked at the scoop when I when home for lunch and saw the ring you were talking about;).

Harley PoMMom

08-04-2009, 06:25 PM

Thank God you seen that darn ring, Susy...I thought that a trip to the eye doctor was the next step for me. :p That maybe I was seeing rings that weren't there. :eek:

Love and hugs.
Lori

Harley PoMMom

09-09-2009, 04:03 PM

Susy,

Was just checking in on you and Wylie, wondering how you both are doing...rereading your thread AND how did I miss this!!

Did another mini-load last week with 500mg doses (5 total) – he had significant decrease of water consumption, did stim on Saturday morning, but water consumption went back up on Saturday, so I gave him a 500mg dose Sat. evening. Just got results… pre-3.1, post-5.5:). :) 3.1 and 5.5 :) Such good numbers, so sorry I missed this. :(

How are you both doing? Haven't heard from you in a while...miss ya and worried.

Love and hugs.
Lori

Wylie's Mom

09-09-2009, 07:12 PM

Hi Lori,

I've been really busy with work lately so I haven't been around much. Wylie seems to be feeling well... for the last 5-6 weeks, he's been pretty perky in the evenings. He has the same coat & skin issues, but he's acting like he feels good. Someone even noticed & commented that his butt looks so much better now:p (lump has gone down & there's fur growth where the lump was). I wish I could get a handle on his skin issues... his fur used to be so dense that I couldn't even find his skin!

Wylie's going for a stim this Saturday... haven't decided yet whether to add CBC, chemistries, T4 and/or estradiol tests also. I think I might want the IMS to check up on him soon, too.

-Susy

forscooter

09-09-2009, 07:36 PM

Hi Susy,

Skin issues are so completely frustrating but I am wishing as hard as I possibly can that you will find a way through them...which is pretty darn hard!!!:D

Love and hugs, Beth and the crew

Harley PoMMom

09-09-2009, 07:50 PM

Yep, I'll second that, them skin issues are buggers to get a handle on, I've been using the Aveeno oatmeal body wash, (big thank you to Beth for telling me about it), and it is helping, Harley's IMS seems to think once we get him on the Lysodren, that it will help too. I think it's the excess estradiol in him but what do I know...we shall see. :)

So glad Wylie is doing so well and his lump is going down and hair is growing back there. YAAA!! But we would of loved him bared butt or hairy butt. :D

Best of luck on that stim on Saturday and this time I won't miss those results. :eek::D

Love and hugs.
Lori

Kiska'smom

09-10-2009, 03:15 AM

Hi Susy,

I was just checking in! I'm so happy to hear that Wylie's furry butt is back! I sure wish that Kiska's was doing better. Like you, I remember when I couldn't even find her skin under all of that fur!

Hugs,

Jeanne, Kiska, and Sammie

MiniSchnauzerMom

09-10-2009, 06:51 PM

Hey Susy -

I was wondering where you were! I'm happy to hear you've been busy at work and not hit by the flu bug. :D Perky, feeling well and furry rump all sound in Wylie's favor. Glad he's doing well and good luck with his stim on Saturday.

Louise

Harley PoMMom

09-11-2009, 04:30 PM

Hey Susy,

Been thinking about the fur issues...as we all know...Lysodren lowers progesterone, androstenedione and 17 OH Progresterone...right...ok...so if the androstenedione hormone is really low, this hormone is a pivotal adrenal steroid that is a precursor to testosterone.

Androstenedione and testosterone are responsible for growth of hair, maybe Wylie is low in testosterone? Just a thought.

Love and hugs.
Lori

gpgscott

09-11-2009, 09:27 PM

Hi Susy,

Glad he is feeling well and that his butt is looking better.

I don't think you can get other than cortisol unless you submit to UTK.

The nordics are difficult.

Scott

Wylie's Mom

09-17-2009, 06:58 PM

Sorry... still busy with work and was sick for a couple days (no flu;))...

Got good news & not so good news... Wylie's last couple stims:

06/17/09 Pre - 2.53, Post - 7.17
07/25/09 Pre - 3.9, Post - 7.00
08/01/09 Pre - 3.1, Post - 5.5
09/12/09 Pre - 3.8, Post - 5.3:D:D:D

I did bloodwork & had his T4 tested:
http://spreadsheets.google.com/ccc?key=0AiOUaokkctlPcnN1OFJ2dFd2QVNfczlIWXNIVXRxV 1E&hl=en

his Alk Phos has crept back up - 1326:mad:
his Lipase is higher - 1602:(
his T4 has dropped - 0.8:(

I'm not terribly worried about the T4 yet because it can easily vary and because of a few things I read in this article:
http://rivercitypetwatch.com/files/Diagnostic_dilemma.htm

...Ironically, truly hypothyroid dogs have more stable and less dramatic total T4 fluctuations. (Fortunately for diagnostic considerations, in hypothyroid dogs fluctuations into the normal range are rare and transient.)...
...For example, an older dog is more likely to have lower total T4 than a younger dog. And normal levels tend to be lower in large and giant breeds, higher in smaller breeds. German Shepherds, Cocker Spaniels, Boxers, Beagles, Labrador Retrievers, Alaskan Malamutes and Siberian Huskies may have normally lower total T4 levels.

Wylie's previous T4 was in the normal range at 1.2 (RR 1.0 - 4.0 mg/dL).

I found the article to be very helpful... I wish I had found it earlier. It was written in '95, but it gave me a better understanding of which testing was important in Wylie's case... (that I shouldn't place too much emphasis on the T4) and that a free T4 by equilibrium dialysis (not by radioimmunoassay) is the better test to use for distinguishing between true hypothyroid & sick euthyroid...and Wylie had this done earlier this year. BTW, I read that the Long Beach Animal Hospital uses the free T4 by equilibrium dialysis to help distingush this also. So, I'm not going to fret about this right now.;)

I'm happy that we've found a maintenance dose for Wylie, for now:D:o:D, the Alk Phos & Lipase continues to elude me... oh yeah, can't forget the estradiol, too (skipped testing this time around).

Lori, I only have post-Lysodren numbers for Wylie:
06/17/09
Androstenedione ng/ml
(baseline) 0.11 Normal range 0.05 - 0.36
(post ACTH) 1.46 Normal range 0.24 - 2.90

He had the most of the coat issues before Lyso, but your thoughts can't be ruled out. The main post-Lyso coat issue are some reddish-brown areas (looks like dried blood) along his back - he doesn't seem to be bothered by them (except when I try to clean them).

-Susy

Sabre's Mum

09-17-2009, 08:02 PM

Hi Susy

Fantastic about his ACTH numbers!!! Wahooo.

Now, with regards to his reddish-brown areas ... are these raised or just more a ... I can't think of the correct terminolgy at the moment ... brain dead ... but "freckle" for want of a better word! Sabre has calcinosis cutis and some bad areas have this reddish-brown appearance on the top of them. The hair growth in these areas is pretty much ziltch.

Angela, Sabre and Flynn

Wylie's Mom

09-17-2009, 08:18 PM

Hi Angela,

I remember reading your reply on another thread about this... at that time I didn't think it was calcinosis cutis in Wylie's case (after I saw some pictures on the web)... but maybe it is:confused:. The areas don't look raised (to me) - they can get crusty and I can wipe some of it off, but the color stays lodged in the pores. I should take another look and try to get pics.

-Susy

Sabre's Mum

09-17-2009, 08:26 PM

Susy

It may be just something else .... the areas that Sabre has the calcinosis cutis and has the reddish area are the worst areas he has and the are raised and hard - they are basically plates.

Angela, Sabre and Flynn

Harley PoMMom

09-17-2009, 08:37 PM

Hi Susy,

So glad it wasn't that nasty flu and you are feeling better...which you are...right?

09/12/09 Pre - 3.8, Post - 5.3YAHOO!!! Look at those numbers...Great job. I'm so happy for you and Wylie.

Thanks for sharing the thyroid article, I didn't know the part about:
that a free T4 by equilibrium dialysis (not by radioimmunoassay) is the better test to use for distinguishing between true hypothyroid & sick euthyroidI haven't had Harley checked yet, but tomorrow I was going to schedule his appt. for it, and this article has come in time. I was just going to have Harley's vet send his blood sample/s to Dr. Jean Dodds.

He had the most of the coat issues before Lyso, but your thoughts can't be ruled out.Susy, anything I post it is researched, not just something I thought up in my feeble head :eek: :o but sometimes I believe I think too much and read too much and maybe I should keep my thoughts to myself. But please know that when I do post it does come from my heart, because I really do care.

Love and hugs.
Lori

Wylie's Mom

09-17-2009, 08:44 PM

Wylie's aren't hard, but I wonder if it could be a mild version? I had a puch biopsy done a couple months ago... don't remember what the report said... have to go look at it again... the weird thing is, the little biopsied area now has thick dark guard hairs growing out if it!

-Susy

Wylie's Mom

09-17-2009, 08:57 PM

But please know that when I do post it does come from my heart, because I really do care.

I know Lori;)... and feel free to let your researched thoughts loose... I appreciate it!

I was thinking about Harley's recent T4, too... the others did suggest the free T4... I believe your vet uses Antech - they can also do the T4 by equilibrium dialysis. Wylie had his done through Mich. State U in January. It does seem that Dodds would give more feedback than Antech or Mich State, but if you just need test results, I'd be comfortable with any of them.

-Susy

Wylie's Mom

10-20-2009, 07:34 PM

Update on Wylie:

Well, the reddish-brown spots along his back are increasing in number, plus what looks like blisters (some dry, some pus filled), and crusting, scaling & discolored spots. His rear right large foot pad also had something that started to bleed a little. I took him to the vet on Saturday... from looking at them (& not running any tests), she said all of them were staph infections (pyodermas). She said they weren't that bad (:eek:I would diagree). She prescribed Cephalexin 500mg TID for 2 weeks. She believes all the stuff on his back would clear up quickly. I have to keep her updated... she warned that he could possibly need more antibotics and the infection on his foot is deep and will definitely take longer to heal. I asked for some medicated shampoo, too, but I'll hold off on using it... I had washed his back just a week ago with Chlorhexidine shampoo... he was NOT happy.

I wouldn't have expected this outbreak being due to Cushing's since (I believe) his cortisol is now controlled. However, from what I've been reading, it could also be an allergic reaction to flea bites... and I did find a flea on him last week - the first one I've ever seen on him (really!), plus I found a recently embedded tick the next day :eek::mad:.

-Susy

AlisonandMia

10-20-2009, 08:01 PM

Sounds like it's very likely a bacterial infection secondary to some sort of allergy. My daughter (human) is prone to eczema that responds very well to topical antibiotic cream plus a little bit of concurrent steroid (usually only one application) to just get the inflammation under control initially. I believe the allergic reaction and the breakdown of the skin barrier that goes with it sets things up for infection - the skin is a very important part of the immune system after all.

I'd definitely hold off on the shampoo - wetting could spread the bugs and also wetting the skin can further break it down. If and when you do wash you'd certainly want to dry him off quickly and thoroughly with a hair drier. Has the vet given you any topical antibiotic cream or anything? Actually, hydrogen peroxide (weak so as not to burn) is very good for staph infections as staph hates oxygen. Maybe you could ask the vet if you can use that too so the infection cops it from the inside and the outside - especially for the one on his foot.

Alison

BestBuddy

10-20-2009, 08:15 PM

I once had a dog that was allergic to flea bites. Just one bite and the saliva gets into his system and he would break out all over with small pimple like spots. Once we were sure the fleas were gone he was put on antibiotics to clean it up because the vet said it was an internal reaction not external.

Poor Wylie.

Jenny

Harley PoMMom

10-20-2009, 09:18 PM

Hi Susy,

So sorry to hear about Wylie and his skin issues. :( I do hope that this clears up fast for him.

I will be keeping you and Wylie in my thoughts and prayers.

Please let us know how things are going, ok.

Love and hugs.
Lori

Squirt's Mom

10-21-2009, 10:24 AM

Hi Susy,

Man, Wylie has had some problems, huh? As far as I'm concerned, it's time for him to get to feeling better and stay that way. Bless his heart and yours, too. I hope the antibiotics and shampoo helps him.

Hugs,
Leslie and the girls

Wylie's Mom

10-22-2009, 07:23 PM

Alison, what you've said sounds like what I've been reading... the last time I washed his back, I did use a hair dryer. The vet only gave me the Cephalexin - no topical creams... & I asked for the shampoo (she suggested & gave me Vet Solutions Sebozole Medicated Shampoo). I plan to use the shampoo this weekend to clean his back - since the infections are all along his back, I can't really do the spot cleanings easily.

Jenny, I was a little late on the flea prevention last time... and I think the last time I applied it, he lied on the bed and the blanket soaked some of it up instead of his skin!

Lori & Leslie, thank you for your thoughts & wishes;).

For anyone who wants info & PICTURES of this stuff (I couldn't get good pictures of Wylie's infections):

http://www.itchnot.com/images/_4_Pyoderma.pdf
http://www.ukvet.co.uk/ukvet/articles/dermatology_c.pyoderma%20pt%202.pdf

-Susy

Squirt's Mom

10-22-2009, 08:06 PM

Oh Susy,

That looks awful! I hope it doesn't feel like it looks! Poor Wylie. :( I hope the meds and shampoo do the trick for him. Bless his little heart!

Hugs,
Leslie and the girls

gpgscott

10-22-2009, 08:09 PM

Hi Suz,

I wish I could help.

I did love the video.

Hoping the shampoos and other meds help Crazy, crazy dog!

Scott

Squirt's Mom

02-07-2010, 04:35 PM

Hi Susy,

How are you and Wylie doing? Haven't seen hide nor hair of you in a while. I certainly hope things are ok with you all!

Hugs,
Leslie and the girls - always

Wylie's Mom

03-18-2010, 07:01 PM

Hi All,

I have been gone for so long...I don't know where to start and still don't have much time. We moved our office the middle of last month. I've started a new position, but still have issues to deal with regarding the move...

Wylie seems to be doing ok. He still has coat/skin issues, been on Cephalexin for several months (infections get worse if I stop the Ceph), last stim a couple months ago was 4-something post. His last two T4's (2-3 months apart) were at 0.8 - since his cortisol levels have been good during this time, we decided to go ahead and give him a little Soloxine - 0.3mg BID. This brought his T4 to 1.4 from what I recall.

I'll try to do some catching-up, but I'm still so busy at work:(.

-Susy

Squirt's Mom

03-18-2010, 07:15 PM

Hi Susy!

Thanks for checking in! I was getting really worried about you and Wylie! Please take care of you both and let us hear from you when you can. We miss you!

Hugs,
Leslie and the girls - always

Harley PoMMom

03-18-2010, 07:46 PM

Hi Susy,

I am happy to see your post, as I was getting worried too...you know us...the worry warts! ;):D

And I am glad that Wylie is doing well but I am so sorry your work has you so busy...we do understand my dear friend, just try to check in when you can, ok. :) and try not to work so hard!

Love and hugs,
Lori

lulusmom

12-05-2010, 12:18 AM

I received an email this evening from Susy, Wylie's mom, and she asked me to post this for her. It is with great sadness that I honor her wish.

I let Wylie go today. I don't think he suffered much. I took him in for routine bloodwork, stim, t4 and urinalysis this morning and when I picked him up, he seemed very slow and tired. I thought/hoped he was weak from the fast or he was dehydrated (he didn't drink much water last night). A tech was able to coax him up the ramp, into the Jeep. I drove him home and let him stay in the car. I brought him some chicken and water, hoping he would gain energy to leave the car and go inside. He ate the chicken, but refused the water. I brought chicken broth to him and he even refused that. I looked at his gums and they looked pale so I called his vet. She went ahead and ran the bloodwork in-house instead of sending it out and called me back saying that the bloodwork looked good. She said he might be bleeding internally and that sometimes takes a while to show up in the bloodwork or it could be something that started after the blood draw was done. The pale gums could also indicate low blood pressure. She offered to look at him right away and warned that if he is bleeding internally, they don't have the equipment to do anything about it.

I brought him back to the vet instead of going to the ER vet. She saw him right away and brought equipment out to my car so Wylie wouldn't have to be moved. She looked at his gums, then felt his abdomen. It was hard to tell much because of his potbelly. She stuck a needle in his stomach and was able to draw alot of blood quickly (she mentioned something about the spleen, but I don't recall if that was one of the possibilities of where the blood could be coming from). She said it could be that a tumor that had ruptured - and a large tumor in his liver was detected in an ultrasound last spring. She gave me the options: possible it may clot and the blood can be reabsorbed or take him to emergency where they can do an ultrasound to see if something could be done surgically.

I did not want to put him through surgery and I didn't want him to go through any or anymore suffering, so I decided to let him go. I'm hoping he hadn't suffered much.

I will try to post something this week, I don't think I can do a memorial type post.

I miss him, I'm sad and feel kinda lost. Please hug your pups for me.
Susy Lee

BestBuddy

12-05-2010, 12:56 AM

Dear Susy,

Really sorry to hear that Wylie lost his battle. We are lucky enough to be able to care and love for these animals for a time, sometimes too short but we also have the heartbreaking task of letting them go.

You know (and so did Wylie) how much you loved him and did all you could and that's all we can do.

Jenny

Sabre's Mum

12-05-2010, 02:46 AM

Susy

I have often thought of you and Wylie and am so sad to hear of the latest news that Glynda has kindly passed onto us. You were such a great Mum to Wylie ... treasure the memories.

Hugs from me to you and take care
Angela and Flynn

mytil

12-05-2010, 06:30 AM

Oh Susy,

My heart is breaking, I am so very very sorry to read about Wylie. Your big boy had the most wonderful mom and life and you made the most unselfish decision to let him go.

My ((((((hugs))))))) are coming to you along with my healing prayers
Terry

Casey's Mom

12-05-2010, 09:16 AM

I am very sorry to hear of Wylie. We love them so much and it is truly heartbreaking to lose our dear pups.

Love and many hugs Susy,

Squirt's Mom

12-05-2010, 11:39 AM

Dear Susy,

It is with great sadness I read about your beautiful boy. I remember when you and Wylie first to us and you both quickly became so special to us all. Like Angela, I have often thought of you and Wylie since you left.

Susy, you are a great mom and did everything in your power to make sure Wylie enjoyed every day he was granted. I know he will continue to watch over you with the same love and devotion you gave to him.

Our deepest condolences,
Leslie, Squirt, Trinket, and our Angels, Ruby and Crystal

Squirt's Mom

12-05-2010, 11:40 AM

The Fourth Day
by Martin Scot Kosins

If you ever love an animal, there are three days in your life you will always remember.
The first is a day, blessed with happiness, when you bring home your young new friend.
You may have spent weeks deciding on a breed. You may have asked numerous opinions of many vets, or done long research in finding a breeder. Or, perhaps in a fleeting moment, you may have just chosen that silly looking mutt in a shelter ... simply because something in its eyes reached your heart.
But when you bring that chosen pet home, and watch it explore, and claim its special place in your hall or frontroom - and when you feel it brush against you for the first time - it instills a feeling of pure love you will carry with you through the many years to come.

The second day will occur eight or nine or ten years later.
It will be a day like any other. Routine and unexceptional. But, for a surprising instant, you will look at your longtime friend and see age where you once saw youth.
You will see slow deliberate steps where you once saw energy.
And you will see sleep where you once saw activity.
So you will begin to adjust your friend's diet - and you may add a pill or two to her food.
And you may feel a growing fear deep within yourself, which bodes of a coming emptiness.
And you will feel this uneasy feeling, on and off, until the third day finally arrives.

And on this day - if your friend and God have not decided for you, then you will be faced with making a decision of your own - on behalf of your lifelong friend, and with the guidance of your own deepest Spirit.
But whichever way your friend eventually leaves you - you will feel as alone as a single star in the dark night sky.

If you are wise, you will let the tears flow as freely and as often as they must. And if you are typical, you will find that not many in your circle of family or human friends will be able to understand your grief, or comfort you.
But if you are true to the love of the pet you cherished through the many joyfilled years, you may find that a soul - a bit smaller in size than your own - seems to walk with you, at times, during the lonely days to come.
And at moments when you least expect anything out of the ordinary to happen, you may feel something brush against your leg - very very lightly.
And looking down at the place where your dear, perhaps dearest, friend used to lay - you will remember those three significant days.
The memory will most likely be painful, and leave an ache in your heart -
As time passes the ache will come and go as if it has a life of its own.
You will both reject it and embrace it, and it may confuse you.
If you reject it, it will depress you.
If you embrace it, it will deepen you.
Either way, it will still be an ache.

But there will be, I assure you, a fourth day when - along with the memory of your pet - and piercing through the heaviness in your heart -there will come a realization that belongs only to you.
It will be as unique and strong as our relationship with each animal we have loved, and lost.
This realization takes the form of a Living Love -
Like the heavenly scent of a rose that remains after the petals have wilted, this Love will remain and grow - and be there for us to remember.
It is a Love we have earned.
It is the legacy our pets leave us when they go -
And it is a gift we may keep with us as long as we live.
It is a Love which is ours alone -
And until we ourselves leave, perhaps to join our Beloved Pets -

It is a Love that we will always possess.