Precia has gone to Heaven

[Leena]

Hello:
Was wondering if any other dog had this reaction to Vetoryl...
My dog is a black lab, and was put on Vetoryl 60 mg a day. After about three weeks at that dose, her skin became very flaky and she started losing her hair! I did research and read that this was a rare side effect in some dogs. My vet, however, had never heard of it. I cut her dose way back, and the symptoms went away! Back to her full beautiful black coat! (thank goodness!)
Her current dose is so low (at one 60 mg tab twice a week!!) in order to keep the reaction from coming back, but amazingly her Cortisol levels and ALP have been normal. Her symptoms, however, are just as bad as always with the panting and water drinking.
Has anyone else had this problem?????
Thanks!

[frijole]

Hello:
Was wondering if any other dog had this reaction to Vetoryl...
My dog is a black lab, and was put on Vetoryl 60 mg a day. After about three weeks at that dose, her skin became very flaky and she started losing her hair! I did research and read that this was a rare side effect in some dogs. My vet, however, had never heard of it. I cut her dose way back, and the symptoms went away! Back to her full beautiful black coat! (thank goodness!)
Her current dose is so low (at one 60 mg tab twice a week!!) in order to keep the reaction from coming back, but amazingly her Cortisol levels and ALP have been normal. Her symptoms, however, are just as bad as always with the panting and water drinking.
Has anyone else had this problem?????
Thanks!

Hi and welcome! I never used trilo so I won't answer your question but could you please tell us how much your dog weighs? Just want to check the original dose out.

Regarding the comment I bolded above - you said the cortisol levels are normal. What do you mean by that - do you have the actual test results? I am wondering because what is 'normal' for a regular dog is not the same as the desired range for a cush dog. Sometimes labs that do these tests make mistakes and so it looks like your dog is 'normal' when in fact the cortisol is still too high for a cushings dog. The goal is to get the 2nd number on the acth test to around 5. Whereas a 'normal' dog would have a cortisol reading of closer to 15. If the dog is still drinking and panting and cortisol is normal then either something else is causing those symptoms OR the test results are for a normal dog as I described. Hope that makes sense. ;):D Kim

[BestBuddy]

Hi and welcome.

I just wanted to comment on the hair loss/flaky skin.
After Buddy started trilo his hair and skin looked worse. His skin was so flaky it was like constant dandruff and he seemed to loose more hair then after a few months the skin cleared and the hair grew back thicker and more colorful than before. Our specialist said often it gets worse before it gets better.

Jenny

[apollo6]

Welcome Lena
I am Sonja and my little Apollo is on Trilostane. It take a while for the symptoms to go away. Apollo did have the flaky skin for awhile, but his coat is coming back. The excess thirst and urinating should have gotten better. Apollo pants also. I feel is that our little cushing fur balls overheat very easily. They have a hard time tolerating any heat at all. I have a squirt bottle with cool water and squirt Apollo to cool him down, or take a wash cloth dipped in cool water and wrap it around your baby.

How much does your dog weigh that is very important as to the right dosage. I would start very low to start. Also does he/she have the pituitary Cushing's?
Hope this helps.
More will post shortly.
Hugs Sonja and Apollo

[Maya]

Hello and welcome Lena:)
I have to agree with Kim. If you dog really has Cushings, as far as I know his/her lab results shouldn't be like that of a 'normal dog' Are you sure you've had an acurate diagnosis?
Regarding the flaky skin and hair loss my dog Maya had this problem for about a month as her body ajusted to the Vetoryl. Now her fur has grown back and there is a lot less flaky skin. Maya weighs 20kgs and is on 60mgs of Trilo a day. 30mg in the morn and 30mg in the eve.Her lab tests have confermed her Cushings to under control. I have never heard of twice a week dosing with Trilo. Somebody correct me if I'm wrong. I think you need to have a good talk to your vet. Hope you get things sorted soon!
Best wishes from Leah and Maya

[BestBuddy]

Good pick up Leah about the twice weekly dosing.

I didn't notice this when I read the post. It is unusual that the trilo is not given as a daily dose.

The specialist who treated my dog actually was experimenting with different doses and had a couple of dogs on every second day so I suppose it can work but it is not the norm.

Jenny

[addy]

Hi and Welcome from me as well,

According to Dr. Peterson, a respected endocrinologist, it is not unusual for a Cushing dog to have flaking skin and thinning coat durring the first six weeks of treatment with either drug, Trilostane or Lysodren. This usually will resolve after a few months.

It would be helpful for you to post all test results as mentioned.

Glad you found your way here.

Hugs,
Addy

[labblab]

Welcome from me, too.

As the others have said, several of us have experienced massive fur loss after Cushing's treatment has been started. Our speculation is that once the cortisol level is lowered into a therapeutic range, the hair growth cycle for the dog is normalized once again -- resulting in the shedding of the old "stagnant" coat and the regrowth of a fresh new coat. Here is a link to the thread of another member who asked this same question. As you will see, her dog was treated with Lysodren rather than trilostane. But the dynamic seems to be the same, regardless. And the longterm solution to the hair growth issue is not to back off from a therapeutic dose of Cushing's medication, but instead to maintain it so that the cortisol remains consistently controlled from that point onward.

http://www.k9cushings.com/forum/showthread.php?t=2527

Marianne

[Leena]

Wow...thanks for everyones comments! Okay, Precia weighs about 74 lbs. What started this whole thing was back in December she had a really bad nose bleed. So, I took her to the ER vet who did lab work and found her ALP to be over 9000! She thought she was in liver failure. Long story short, she suggested a Stim test for Cushings so I took her to my vet who confirmed with testing that she did indeed have Cushings. I do not know which kind. I do not know the number value or reading. He also thought her ALP may have been elevated for another reason as well, not necessairly all Cushing related. Her ultrasound he was was okay. So, we started the Vetoryl at 60 mg, 1 a day. She started with the hair loss and I decreased her dose, as I knew this was a side effect. I backed her all the way to the one twice a week schedule. My vet did not suggest keeping her on the daily dose and riding out the hair loss issues. He in fact had never heard of that reaction before. A Cortisol test in April was less than one...He told me 1 to 5 was normal. Her ALP was in the one hundreds. Cortisol in June was 2.2 and ALP at 245. So, that is where I am at! Confused for sure! She pants a lot, and does not tolerate heat well at all. She is a big drinker. Those are her major symptoms. Well, she also does not have much energy. But, she is also 12! I appreciate any advice! I have been doing research, but am so glad to have found this board! It helps talking with others who know what this is all about!!!

[Harley PoMMom]

Hi Leena,


Wow...thanks for everyones comments! Okay, Precia weighs about 74 lbs. What started this whole thing was back in December she had a really bad nose bleed.

Elevated blood pressure can sometimes cause nose bleeds, has Precia's BP been checked recently?


A Cortisol test in April was less than one...He told me 1 to 5 was normal. Her ALP was in the one hundreds.

According to Dechra, (the manufacturers of brand-name Vetoryl), dogs that are being treated with Trilostane should have a post-stim cortisol reading of 1.45 ug/dl - 5.4 ug/dl. If a dog's cortisol results are less than 1.45 ug/dl then treatment should be discontinued until clinical signs are seen and test results return to normal (1.45-9.1 μg/dL). Only after both of these are achieved then may treatment of Trilostane (Vetoryl) be re-introduced at a lower dose. Has your vet explained this to you? Here's a handy link to this information and more: Dechra's U.S. Product Insert. (http://www.dechra-us.com/files/dechraUSA/downloads/Product%20inserts/Vetoryl.pdf)

Please know we will help you and Precia in any way we can so do not hesitate to ask us any and all questions. ;):)

Love and hugs,
Lori

[Leena]

Thanks so much! I need help understanding this all! Her BP has not been checked.(how do they do that with dogs? I can with people!) The thing with Precia is, even when she was less than one on Cortisol testing, she still had the symptoms of Cushings! I don't get this! (She was on the twice weekly dose then too). When she was on the daily dose, her symptoms seemed better, but then she also was massively losing hair! Sigh...it never ends..

[Harley PoMMom]

Checking blood pressure:
Your veterinarian may need to clip a small amount of hair on the underside of the paw of either the front or back leg over the site of an arterial pulse. Conductive gel is then placed on the shaved part of the paw, and a sensor is then placed on the paw, with the gel being used to conduct the vibrations of the pulse. The technique for measuring pressure varies somewhat depending upon the instrument used. A blood pressure cuff is placed above the sensor, which is attached to a machine used to amplify the sound of the pulse. Animal legs are too small for a stethoscope, so the amplifier and sensor is used instead.

As when you get your own blood pressure taken, the cuff is inflated until the beating pulse is no longer heard. Then air is slowly allowed to escape the cuff. At the point the beating pulse is heard again, that is the blood pressure. In people, the first sound of the pulse is called the systolic pressure. As more air is let out of the cuff, there is a point when the sound of the pulse suddenly becomes louder. This is the diastolic pressure. However, when using a doppler in animals, it is often difficult to detect this volume change. For this reason, the blood pressure is often expressed as a single value. Other non-doppler blood pressure machines use electronic methods to detect the blood pressure. These machines can determine both systolic and diastolic pressure.

Most normal systolic values range from 110 to160 mmHg and most diastolic values range from 55 to100 mmHg. Hypertension is defined as pressures > 170/110 mmHg. Hypotension is defined as pressures < 90/50 mmHg in the awake animal. Normal MAP pressure is usually calculated as the average of systolic and diastolic pressures. Trends in repeated pressures are more significant than results of single measurementshttp://www.petplace.com/dogs/blood-pressure-in-dogs/page1.aspx

You can find more information about high blood pressure in dogs in our Helpful Resources: http://www.k9cushings.com/forum/showthread.php?t=200

If a dog is in an Addison's crisis they can share some of the same symptoms as a dog with Cushing's such as excessive drinking and urinating. Only an ACTH stim test can tell if a dog is in an Addison's crisis.

Love and hugs,
Lori

[lulusmom]

Hi Leena,

Can you please tell us which tests were done to diagnose Precia? Can you please gather up those tests and post the results here? I noticed that you said the vet was okay with the ultrasound. Dogs with cushing's most often have either one or both enlarged adrenal glands and an enlarged liver. With Precia's ALK being 9000 (WOW!), I would think the liver would not have been normal on imaging. Is there any mention in the ultrasound findings about this? If you don't have a copy of the findings and/or the testing that has been done, your vet should be happy to provide you with copies. We usually recommend keeping all records in a folder. It comes in handy if you ever have to go to an after hours vet hospital.

Did your vet do a full urinalysis? Did your vet check the urine specific gravity. Most dogs with cushing's lose their ability to concentrate their urine and have low specific gravity. Was a culture done to check for a urinary tract infection? A regular urinalysis may not pick up the bacteria because the urine is diluted out. That's why a culture should be done for all dogs suspected of having cushing's.

I won't repeat what others have told you about the flakey skin and shedding but I will say that I am wondering how much experience your vet has with diagnosing and treating cushdogs. Most vets with experience know about the flakey skin and hair loss and also most vets with experience don't prescribe twice weekly dosing. Vetoryl has a short half life meaning it's enzyme blocking abilities are short lived, usually no longer than 12 or so hours. Most dogs do well on once daily dosing but some require twice daily dosing to insure proper control of cortisol throughout the day. I can't imagine that twice weekly dosing is providing proper control but then again, we've seen a lot of weird stuff, so who knows. Seeing the results of the tests and getting your response to questions will really help us understand your vet's rationale.

Welcome to the family. Looking forward to hearing more about your precious Precia.

Glynda

[Leena]

Hi and thanks for the replies! I am going to call my vet tomorrow and get copies of all blood work sent to me. I may just go to the vet internist for Precia now. I am confused and now am questioning my vets capability on handling Precia's illness! In answer to a few questions, Precia did not have a urine test done. And, I looked back at her notes, and the ultrasound did show her liver to be enlarged. I have to wonder right now if I should even be treating her due to the very low dose she is on. The only follow up testing she has had since starting the Vetoryl is to have random Cortisol blood levels checked, and her ALP checked. (I am assuming the random Cortisol is not the same as having another ACTH stim test done. That cost about 200 and this Cortisol test does not). I know some elect to not treat their dog at all. Sigh...I don't know what to do. I just want to do the best for her!

[Leena]

Hi guys:
I got some test results from the vet today.
She had the ACTH stim test in December to dx Cushings
Her resting Cortisol was 13.9 and post ACTH was 38.7 with normal being 8 to 20. Thats when he said..yep, she has Cushings.. sigh..

[Maya]

Awwwww Leena...I'm sorry to hear that.... It's surprising how well they do on the medication though! I sometimes find it hard to believe that Maya has Cushings as she has responded so well to the Vetoryl. She is soooooo much better in herself. Point being that once under control our furry babies can have a good quality of life just the same...
Hugs from Leah and Maya:)

[Leena]

I am taking Precia to the "doggy specialist" this week to try and figure out what to do about her Vetoryl dosing! I am not satisfied with my vets knowledge about Cushings and the medications. So, off to the specialist and hopefully get a better handle on things! She pants a lot, but then again she is only on one 60 mg Vetoryl every four days! But, too much of it made her lose her hair so badly I was afraid she'd go bald! And so far all of her Cortisol tests have been within normal range. Sigh...I just don't get this disease!

[addy]

I am glad you are seeing a specialist. A dog's coat can get worse before getting better. My pup's coat is thinning and her shin is flaking off and our IMS said that was positive. I don't know that I have ever heard of giving Vetoryl every four days especially since it usually clears a pups system with 8 hours or so. I don't understand the benefit. That sounds more like a maintenance dose of lysodren schedule.

Hugs,
Addy

[Squirt's Mom]

Hi Leena,

I'm very glad to hear you are seeking a specialist as giving Trilo (Vetoryl) once every four days is a waste of your money and time...and probably not helping with the cortisol at all! Trilo is designed to be used daily, the dose adjusted as needed up or down, but always given daily.

The hair loss you saw is fairly normal for a pup who is starting treatment and it seems to be especially common in Trilo pups. But once the old coat has been "blown", a new coat usually comes back in. Sometimes the color or texture is different but the pups seldom become bald from treatment. ;) It is a bit disconcerting to see, tho! :eek::)

You say her cortisol has been within normal range. Would you mind posting the actual results of her recent ACTHs? Unfortunately, we have seen too often that a vet says the result was "in normal range" only to learn the vet didn't know how to read the results for a treated pup - they are read differently from an untreated pup - and read differently for pups on Trilo VS Lyso. With a dose every four days, I will be completely amazed and astounded to find the cortisol is actually normal for a Trilo pup. ;)

Hugs,
Leslie and the gang

[littleone1]

Hi Leena,

I agree with the others about giving a Trilo dose every fourth day. Corky has been taking Trilo for almost 2 years, and never once was it suggested to skip a dose.

Also, as Leslie mentioned, there are many vets that go by the labs range of 8-17. This range is for a furbaby that is not being treated for cushings. A cushpup's range on Trilo should be between 1.5 and 5.5. However, there are some cushpups that do better when their test results are slightly above that range.

I also am glad that you are going to go to a specialist. It really is important to have a vet or IMS that is experienced in treating cushings.

I hope that you will be able to find out what is really going on.

Terri

[Keiko's Mom]

Hi. My dog, Keiko, is a Siberian Husky. She lost all of her undercoat and had flaky skin over her entire body. Her fur looked and felt terrible for awhile. I gently combed the loose hair and bathed her with clarifying shampoo. Her coat has come back thicker than ever and no flakes. The color and texture of her hair had even changed. I think that it is the Cushings disease and not the treatment that caused it, but I'm no expert. Please be careful about changing her doses....I'm having trouble with adjustments, but I'm doing it slow and with help from Dr. Allen at Dechra (look thru my posts). I wish the very best for you and your dog, but please be careful....don't let just the hair change you mind....got to get those blood tests.

[Leena]

Thanks guys...I will let you know what i find out! I have read also that some people do not even treat their dog at all...saying the treatment has more side effects than the disease itself! I really just want to do what is best for her. She is twelve and has been just the absolute best lab!!! I sure hope that the internist can put me on the right path!!!!

[Squirt's Mom]

Hi,

Please don't take what you read about the side effects to heart. Yes, these are powerful drugs - but they are also life-saving drugs. Without treatment, these babies suffer a long, slow, tortuous death as organs fail due to the raging cortisol. There are those pups who because of other health issues cannot be treated, but they are the exception. For an idea of what happens to an untreated cush pup, here is a link from our Helpful Resource Section -

http://www.k9cushings.com/forum/showthread.php?t=195

When you read about a pup suffering horrible side effects, I can just about promise you it was because of 1) an inexperienced vet, 2) misdiagnosis, 3) improper administration of the med, 4) improper monitoring on treatment, and/or 5) lack of diligence on the parents part during treatment. This is where you are lucky! Unlike those you are reading about, you have us on your side to walk with you through this adventure. ;)

Keep talking, sharing your thoughts, asking questions, and filling us in on vet visits and tests, and we can help you overcome the fear and confusion you feel today. How do I know this? Because I was probably the most frightened, angry, frustrated, confused person to ever show up here and I am quite comfortable with Cushing's today because of the folks here who took my hand and taught me what I needed to know.

Hang in there and let us know what the IMS has to say!

Hugs,
Leslie and the gang

[jrepac]

Interesting, this is the first time I have heard of someone NOT giving trilo daily (or twice a day). It wears off relatively quickly; I believe it's something like 12 hours. Having said that every dog responds differently to the various treatment options.

Lysodren is the drug, that after initial loading, winds up being a weekly dose.

If you are not happy with your vet's knowledge of the disease--which shockingly, many vets are CLUELESS about---do get another opinion. Get multiple, if you see fit. It's not uncommon for people to "shop" vets when this condition arises, or go to a specialist, if one is available.

But, it really is best to treat the disease, regardless of which drug(s) you choose. NOT treating it will result in some nasty symptoms and make your baby plain miserable.

Best of luck!

Jeff, Angel Mandy, Pebbles & Pepper

[Leena]

Precia and I saw the internist today....now, I am not even sure she has Cushings! While he agreed, that she MIGHT have it due to her ACTH stim test being high in December, he wanted to do an ultrasound of her adrenals...Okay, so he did, and no tumors on them...but, SLIGHTLY enlarged. Her liver was a little enlarged. Her only symptom really, is the panting. Yes, she could eat her way through a bag of dog food, but so could my other pups if I let them! She drinks moderately, but not like bowls and bowls full. She is not too pot bellied, has no hair issues...a little flaky, but she has been off and on throughout her life. So, he says, lets do the low dose dex test ...to be sure..But, on the flip side, he said the ACTH test could be a false high due to the stress of being in the hospital...so, it seems to me this low dose test will also possibly be false, as again, she will be in the hospital...all day and stressed out!
I feel lost. I am stopping the Vetoryl right now...(only twice a week anyway!) I need to figure out what to do! I don't want to keep testing her and spending lots of money for a "maybe" answer. So far, it appears that that is exactly where I am at! Maybe she has it based on her ACTH test and todays ultrasound...Sigh..
Then, to top it off, he says some do not treat as their pets are not symptomatic..So, now I am wondering about that as her biggest thing is panting...and she mostly does that upon rising, and of course exertion..like taking a short walk.. I really am wondering about liver disease right now with her ALP's being high. I know that is also a Cushing symptom too. Sigh...Help!!!!! I am lost...bummer..

[frijole]

I reread your thread and earlier you mentioned she drank alot and had hairloss in addition to panting. YOu mentioned eating a bag of food ;)...sometimes helping over the internet is tough because we don't know what 'alot' means and so let's start over to see if we can help you.

Water intake - dogs drink on average one oz per pound of weight. So a 10 lb dog averages 10 oz of water a day. Measure your dogs water intake. Measure it in the morning and at night and figure out how much is gone. If you have more than one dog still do it and you can at least guestimate. Does she urinate in the house or go out more than normal?

Food - describe how your dog eats. Fast? Chew food or not? Look for food on ground? Knock over trash cans?

Pot belly - can you post a photo in the album section for us to look at?

Hair loss - how much, when, where?

Panting - all the time, at night? Does she pace?

The thing that stood out to me with your acth test results was the HIGH resting cortisol number (the first one). It was 13 or 14. This could mean the dog was stressed due to being at the vet. I had similar reading 5 times with my dog who was misdiagnosed with cushings... I remember you had alkp reading of like 6000 or some crazy number... have you redone the bloodpanel to see if it is down?!!!

It appears the IMS did not feel the swelling in the adrenals was significant enough to rule out or in cushings. That would be the reason for doing the ldds test. Another option is to do the UC:CR urine test. It can rule OUT cushings and is quick and inexpensive and reliable.

Anyway... deep breaths.... I know it is frustrating as I have been there. We are here to help. Take a stab at answering my questions above and we'll all chime in with our opinions and see if we can be of help. Take care and just remember that if it is cushing's you do not have to rush treatment. Hugs Kim

[Leena]

--------------------------------------------------------------------------------Hi! Thanks so much for quick response! Okay...looking back, I always thought she was a heavy drinker...I have never measured but it just seemed to me that she was at the bowl longer than the others. Then watching her the past few days, it did not seem so bad! Today after her short walk, she didn't drink at all! She never had hair loss at all until the Vetoryl med. Then she lost it pretty heavy! Other than that, her coat is very pretty and shiny (with a few flakes here and there).
As for eating...well, I am quite sure if I gave her three, four cups at once, she'd eat it all! But then again, so would my other girls...except the greyhound who doesn't want to eat. She is a begger, but always has been. She cant get to the garbage can but I don't think she'd try really. She has been a poop (yuk) eater. But she really doesn't look around for food 24/7. She chews her food, not a gulper.
I have never seen her urinate inside,but, I leave piddle pads down when I go to work as I work long shifts, and one of the girls has peed on them. ( I suspect my grey as I did catch her over there once.) Precia does not go to the door to go out anymore than usual..and really, I have to make her go out usually!
I will try to post a pic. How do I do that here???
She does not pant all the time, and is not a pacer. She pants when rising from lying down to go out, and after her walk. Occasionaly she will by lying there and lift her head up and pant a minute or so then quit.
The ALP has been restested several times since Dec. It did come down.Once to normal range, and last time like 300 and something.
I will ask him about the Urine Creatinine test. Thanks!
I so appreciate your help! This is a confusing disease!!!! And I just love my little girl so very much..I want to do the best for her!

[Leena]

I did ask the IMS about the urine test and he said we could do that and if it was neg., then that would rule out cushings. But, if positive, then we need to do the LDDST test. I am starting to wonder just how many tests my dog has to have to diagnosis this??? The stim test, the ultrasound x 2 now, the urine test and maybe the LDDST??? And so far, no definitive answers... This is frustrating!

[Squirt's Mom]

Unfortunately, it takes usually takes several tests to even start to confirm a diagnosis of Cushing's. It would be so nice if there was one test that could yes or no! But Cushing's is one of, if not THE, most difficult condition to diagnose because it shares signs with many other conditions plus other conditions can cause false positives on the tests when it really isn't Cushing's. So it often takes a battery of tests to form any conclusion that you are, in fact, dealing with Cushing's.

Keep your chin up, you're doing a fine job!

Hugs,
Leslie and the gang

[lulusmom]

It's been awhile since I've checked in so just got done reading your thread so I could catch up. I didn't remember seeing that Precia's ALP was 9000 in December. That a huge elevation, even for a cushdog, so I'm not surprised your vet was thinking primary liver disease. With ALP having dropped to almost normal, I'd say the danger has passed and I'm not talking about cushing's. It's very possible Leena had something going on in December that has resolved since then. Yes, it could be cushing's but based on so few symptoms, I'm not sure anybody would know for sure.

Cushing's is a graded disease, moving at a snails pace in its progression. There is no rush to treat or even pursue further testing if the symptoms don't warrant it. The true purpose of treatment is to remedy the symptoms so if the symptoms aren't bothersome and there is no non adrenal underlying condition that is being exacerbated by excess cortisol, I personally would opt out of testing until more overt symptoms are observed. Did your IMS feel the need to do additional testing?

Glynda

P.S. I just wanted to mention that Trilostane does cause the adrenals to enlarge so I'm wondering if your IMS took that into consideration in interpreting the abdominal ultrasound???

[Leena]

Hi guys:
When Precia's ALP was over 9000 in Dec (which that appt. to vet started because her nose was bleeding!), my personal vet thought that something else must have been going on at the time as well...Her ALP's as of late have been between 100 and 500.
My IMS basically said even though I have done several tests, to be sure, we should do the LDDST. I have decided to do the urine test first, and then, I may or may not do the LDDST. I am thinking of not treating her right now until or unlesss symptoms worsen. Panting seems to be her biggest one, and that is not all the time....Frequently, yes...but not every minute of every day...
I did not know the Vetoryl caused the adrenals to enlarge. My IMS did not mention that to me either.
I will keep you all posted! Your words help me! Thank you!

[marie adams]

Hi There and Welcome,

I was reading thru your thread and wanted to add in my experience with Cushings. My Maddie had just turned 12 this past December, but was diagnosed in February of last year. She weighed in about 70lbs.

Her symptoms started out with the panting, her energy slowed done quickly, and then the under fur was gone. We started to see her going after food on the table, in the kitchen licking the floor, rugs; she even snorted like a pig. We didn't notice her eating other than she always seemed hungry; it wasn't until I found a link to Cushing's Disease that I saw the symptoms and she had most of them. There was no doubt she had it. The only tests we did were the urine and ACTH.

I treated with Lysodren. She did go thru the losing her fur and it was a pattern--her belly, under her front legs or leg pits, and the feathers on her hind legs (she was an Aussie) were gone and she was bald there. When she finally got Cushings under control is when she blew her coat (all her fur became very thin, even around her collar and chest which were always thick and full). When it came back it was thicker, coarser, and a different color. She did have flakey skin and her elbows were sore and red from always getting up or down on them because she had a hard time with moving somewhat. She lost so much of her hind leg muscle mass.

I so hope Precia doesn't have Cushing's but I can tell you treating Maddie made a big difference for her in a good way. She didn't die from the disease--she got cancer.:mad:

Take care!!! Everyone is such a great help here so keep asking questions because they knew far more than the vets I had.:)

[Leena]

Thank you for your words Marie. I am sorry for your loss also. I too had a dog die of cancer this past June. (cancer sucks!) I will be doing the urine test this week for Precia, and then see what happens next...It is a process!!!!
Take Care

[marie adams]

Hi Leena,

I am so sorry for your loss in June---I never knew how hard it would be and lonely. I have a new little one - 5 mos old now - Miss Ella, but I still have moments when I miss Maddie, which I am sure you do also.

It makes it hard with Precia going thru the not knowing stages...I so hope they will have some firm answers for you soon!!!

((Hugs))

[Leena]

It has been very hard and frustrating to say the least. But, we press onward!
I understand how you feeling losing your baby. I still cry over Brindy, and I still can't believe she is not with me. My dogs are my children, as I'm sure yours are, and losing them...its crushing....
I am so scared I will lose another baby too soon..I have several seniors with problems...I am grateful for boards such as these where there are kind people to help and understand!!

Hugs back!
Sandy

[Leena]

Mad!!! The vet did not return either of my calls on the second about Precia's urine test!!! The receptionist assured me he would call, or that he would call over the weekend! I am mad! Wait til I get ahold of him on tues! GRRRRR!

[Leena]

So I FINALLY TALKED to the IMS and Precia's urine test came back at 8. He said that definitely means no Cushings for her! So, I am glad to hear that, but of course I do wonder why her ALP was so high and has been elevated even at her last draw in June. His advice was basically to get her labwork redone in Nov., start some vit E , and maybe change her diet. I so wish my own vet had recommend this urine test from the beginning! I could have saved money, but more than that...worry!!!! Also, I was giving Vetoryl to a dog that did not have Cushings! Sort of annoys me about my regular vet! I guess unless you have a really great vet, they are only good for "routine things." Otherwise, SEE THE SPECIALIST!
From here, I suppose I will keep an eye on her and recheck her blood in Nov. Sigh...I sure have learned a lot from all this!
Thank you to all here for great advice! I will keep you posted on Precia...I guess at this point, I am not 100 percent sure of any diagnosis...or misdiagnosis!

Moderator's Note: I have merged your new thread concerning Precia's apparent misdiagnosis into Precia's original thread. We normally like to keep all posts on a pup in a single thread so other members can refer back to the pup's history, if needed. I will also modify the title to reflect that she doesn't have Cushing's

[Squirt's Mom]

Hi Sandy,

Great news for Precia! :D And for Mom! ;) You can relax a bit now and just enjoy your baby girl. Priceless! :)

Do keep in touch and let us know how things are going. Ya'll are family now and we want you to stay in touch.

Hugs,
Leslie and the gang

[marie adams]

Hi Sandy,

Great news about no cushings!!!! I so know what you mean about not getting the call back and you keep calling getting more and more mad!!! Been there and done that with Maddie--it just adds to the stress you are already going through. I think I might finally have a good vet now with Ella--we will see....

I changed Maddie's diet her last year to no grains and a frozen raw chicken diet with a little yogurt. That is what I am now feeding Ella and I can tell by her poop that it is agreeing with her so far. The vet said she looks good and not gaining too much weight too fast. I hope this helps with a new diet plan.

Best to you always!!! ((HUG))

[Leena]

This is a great site. Had it not been for the things I read on here, I never would have known about the urine test for Cushings! I will stay in touch and keep you posted on Precia. Thanks so much for everyone here!

[Leena]

Hi guys:
As you might remember, I had the urine test done on Precia a few months ago and it was negative! So, the internist said it was very unlikely that she had cushings. We repeated her chem panel and her ALP is 875! Oh no! I have a call into the internist, who of course didn't return it and now its the weekend! Boo!!! Precia is the same...drinks more than the rest of my gang, pants more than them, and less energy. She is an old gal at 12 1/2..
Sigh....Why is the ALP up??? All other labs were fine..Alt, sugar, kidney function, etc. I am at a loss...

[lulusmom]

Hi Sandy,

I have merged your last post with your original thread so we can keep Precia's information in one place.

It's wonderful that all of Precia's bloodwork was normal with the exception of the ALKP. If the ALT was elevated, I'd be a lot more concerned. It is not uncommon for a senior dog to have unexplained elevated ALKP. The ALKP isoenzyme is not always triggered by steroids. Infections in the mouth, GI inflammation and certain medications can cause elevations. Does Precia take any medication? You mentioned that she drinks more than the others. Does she pee more than the others and is her urine dilute? Cushdogs drink more because they pee more due to lack of concentration and therefore have to drink more to stay hydrated. Is she having accidents in the house? Can you think of any other reason why Precia would pant, such as arthritic pain? Chubby dogs will pant more and are less active. Is Precia at a good weight? Sorry for all the questions but I'm trying to figure out if the symptoms you are seeing and the ALKP could be attributed to something other than excess adrenal hormones.

Glynda

[Leena]

HI! Thanks so much for response...Lets see...yes, her urine test I just had done came back that it was indeed dilute! ( All else was normal...no sugar, etc.) Of course, she drinks a lot, so I suppose it would be that way. I am not sure on the panting...she does not seem to be in pain. I give her a joint pill and fish oil and occasional aspirin or anti-inflammatory because I am sure she probably does have some arthritis at her age. With her symptoms, you would think Cushings..but urine test was neg for it...sigh...
And, of course, the internist did not return my call friday so now i have to wait until monday..!

[Leena]

Precia's weight is about 70...she really isn't chubby...maybe a few pounds overweight if that.
As for accidents, well, I have five dogs...and over night a few nights ago, one of them had an accident..but, I just don't know who...
Could have been her, but might have been my greyhound...So, I'm not sure! I need a little video camera to record the action! lol.

[lulusmom]

Hi Sandy,

Anti-inflammatory meds will elevate liver enzymes. Did you happen to give Precia any before her last bloodwork? It is possible that Precia has atypical cushing's. Dogs with atypical have normal cortisol but elevations in one or more of the other adrenal hormones, called intermediates or sex hormones. Symptoms as well as abnormalities on bloodwork and urine are pretty much identical to those associated with typical cushing's. The only way to diagnose this is to have a full adrenal panel done by the University of Tennessee Knoxville (UTK). If Precia is treating with an internal medicine specialist, s/he should be familiar with this test. If not, all of the information can be found on the UTK website http://www.vet.utk.edu/diagnostic/endocrinology/index.php

Also worth mentioning is that an adrenal tumor is a possibility. These tumors have random secretory patterns and they don't always secrete cortisol. This is why if the UTK results should show hyperadrenal activity, with normal cortisol, it is suggested that an adrenal tumor be ruled out. You may want to consider talking to your specialist about an abdominal ultrasound. This would give him/her an opportunity to check the adrenals and the surrounding internal organs for the usual abnormalities seen in cushing's as well as other nonadrenal issues that could be causing the symptoms you are seeing.

Glynda

P.S. I understand about not being able to identify the responsible party when you find an accident in the house. All four of my kids have poker faces....no shame, no guilt.

[ventilate]

Hi, just wanted to add that diabetes insipidus may also be a differencial diagnosis. That in its self would not raise Alk phos but would explain the drinking and peeing and the low Specific gravity. I had 2 dogs with it both required DDAVP eye drops one had. Us hints which made the diagnosis a tad harder. It it was done. this is a fabulous site and these people have tons of experience with cushings as well as other conditions associated with cushings. Good luck
Sharon and forever my angles HRH Nike and DS Kenai

[Leena]

Well, if my internist ever returns my call (grrr!) I will mention the atypical Cushings and diabetes to him. He did an ultrasound back a few months ago and saw no adrenal tumors, but said that they were a "little" enlarged.
Sigh....frustration! Very frustrated that he has not returned my call...all the while I worry about my girl!

[Squirt's Mom]

Hi Leena,

When you ask about the diabetes, be sure to ask about DI - diabetes insipidus. DI is a rare form and does not show up on blood work like the common form DM - diabetes mellitus.

Hugs,
Leslie and the gang

[Leena]

So, I took Precia to see the internist to discuss lab results. He was not overly concerned about high ALP. (Hers has been much higher before). He said that she did not have diabetes. He said her cholesterol was high at 494, but that was drawn one hour after eating too! He mentioned doing the test for atypical cushings, that it was a possibility. So basically that is where we are. I am questioning several things however. Her only real symptoms are ...big drinker...pants with exertion. Thats it. And, she has been a big drinker for many years now. She is 12 and a half. Do I do the test for atypical cushings? Do I do nothing? Can I just keep an eye on lab tests and AlP levels? The other thing I have to consider is will I treat if it is atypical cushings...No sense doing the test if I am not going to treat. (I worry about Lysodren) Hard questions...
She is happy and gets excited about walks and car rides..Does she have a lot of energy...NO! But at her age, who would???
Proceed or not....

[Squirt's Mom]

Hi Leena,

If your vet is saying she does not have diabetes based on a blood test, he cannot know that where diabetes insipidus is concerned - it is not tested via blood. Sorry if I wasn't clear on this in my other post, but the common form of diabetes, diabetes mellitus (DM) does show up on blood labs. DI, diabetes mellitus is tested by other means. So unless your vet did the test specifically for DI, he cannot rule this form out. Here are some links on DI -

• Diabetes Insipidus
http://www.petplace .com/article- printer-friendly .aspx?id= 3258

• Diabetes insipidus
http://www.provet. co.uk/health/ diseases/ diabetesinsipidu s.htm

• Diabetes Insipidus
http://www.merckvet manual.com/ mvm/index. jsp?cfile= htm/bc/40507. htm


As for treating Aytpical, you start with very benign supplements - lignans and melatonin - for 3-4 months. Then if the levels have not come down, a maintenance dose of Lysodren is added. There is no loading phase, which is the scary part of conventional Lyso treatment. So there is no need to fear treating Atypical at all. ;)

You are doing a good job of trying to make sure of what you are dealing with, watching you baby, and asking questions. Hang in there!

Hugs,
Leslie and the gang

[Leena]

I am thinking the internist was referring to DM and not Di now. The thing with Precia is she has always been a big drinker/pee-er...years back I can look at her records and see that....always a dilute urine.
So, the drinking, peeing, elevated ALP, and pants when exerts..thats all...Sometimes I think I should just quit testing, check labs, and let her just be happy! I don't know....still researching!

[Leena]

When Precia tested for Cushings with the ACTH test, it came back elevated so they said...yes, she has it! Then the urine test came back neg! So, they said,no...she is not Cushinoid! The vet said the ACTH came back high most likely due to the stress she was under being at the vets office for a few hours, etc...She hates the vet and gets very nervous!!! So, no surprise there. So, now, thinking about another test at the vet for an hour or so if I do the atypical Cushing test ,which is the same procedure as doing the Cushing test, won't those results possibly also be off due to stress? Any knowledge about this? I realize it is testing different hormones, and not just Cortisol, but was still wondering if stress will affect the results.

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

[lulusmom]

Hi Leena,

Yes, stress can yield a false positive acth stimulation test but it is more likely to skew the LDDS. Since Precia has so few symptoms, you may want to sit tight and monitor her. If her symptoms worsen or you see additional symptoms, then pursue further testing. Regarding the ALP, has the specialist mentioned putting Precia on liver support such as milk thistle and SamE? You can buy these over the counter and both are also in a prescription medication called Adenosyl. In your shoes, I'd put her on liver support and if everything stays status quo, check the liver enzymes in three months.

Glynda

[Polkaroo]

What we do to minimize stress during the ATCH is we take him in for the 1st blood draw then we take him back to the car and go park someplace quiet like a side street. He naps for an hour then we take him back for the 2nd blood draw. Only way we ca get accurate numbers as putting him in a cage completely freaks him out.

[Jenny & Judi in MN]

My Jenny doesn't stress at the vet but for her first ACTH after she went blind, I hung out in the waiting room with her. It is a very large space. I held her on my lap, we went for very short walks, and she had plenty of water.

The vet said to keep her as calm as possible so I did. I like your idea of going away to someplace more natural better!

[Leena]

Hi, thanks for replies! So, stress will indeed affect the adrenal panel they do for the atypical cushings tests???? Well, then, I sure would hate to spend 350 dollars on it! I suppose I could try taking her out for a walk, as a cage would freak her out also! But, she gets stressed walking in the door to the vet!
Maybe I will just monitor her symptoms, but I would like to try something for the ALP. What dose of milk thistle and /or SamE??? I read too much milk thistle is not good???
Thanks so much for advise!!!!

[Leena]

Tonight Precia way lying there and I looked down and she was peeing all over herself... She's never done that! I'm thinking I may have to spend $350 dollars for the adrenal test, and then I worry how accurate it will be if she is stressed! I am worried... :(
Is there anything I can start her on? I started milk thistle due to the high ALP.

[lulusmom]

Hi Leena,

I would recommend that you give the specialist a call and tell him about this peeing incident. He may want to do a urinalysis to rule out causes other than incontinence. I wish I could be more helpful but I don't have any pearls of wisdom for you at the moment.

Glynda

[Squirt's Mom]

Hi Leena,

I would rule out UTI and other causes before going for the LDDS or ACTH. Our Ruby did this once and she had a horrific UTI that seemed to come out of nowhere. So think "small" first and have her checked out then if no cause can be found and other indications support it, start looking at Cushing's again.

Let us know what you learn!
Hugs,
Leslie and the gang

[Leena]

I have read that melatonin is for sleeping? How does that affect dogs? Do you just buy it at the store? I have seen it. Is that the right one? And the flaxseed Lignans...buy at a Vitamin Shoppe? I have not done the adrenal panel test but was wondering would it hurt Precia to start some of these treatments???

[Leena]

It seems as if Precia is drinking even more lately, and is becoming more incontinent. She usually has a slightly wet bottom pretty often right now. She always acts starved to death too! I am worried she really truly feels starved! (Of course, our little daschund is a huge begger also!) I have not done the adrenal testing yet (IT is a huge expense also!) I was wondering if it would hurt Precia if I treated her with the melatonin and flaxseed anyway??? Does melatonin make a dog sleepy????

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

[Leena]

Hi guys:

I bought some flaxseed powder to give to Precia...since I really don't know what else to do! It says there is 150 mg. Lignan per serving with that serving size being 1 tablespoon. How much do I give a 70 lb Lab! She is still drinking and peeing and panting like usual...no hair loss or pot belly. She has elevated ALP, Cholesterol, 1 plus protein in urine and of course, dilute.
I can't afford the atypical test, and I really don't think I'd trust the results anyway if stress is a factor. Seriously wondering if the UCCR test was correct...Could it have been neg...at that point in time, but she still have cushings??? it is a mystery!!!Any advice would be totally great!
Thanks!!!
Oops...sorry, just realized I should have put this on her page...

[Squirt's Mom]

The dose for treating Atypical is 1mg/pd/day. So at 70 lbs, Precia would get 70mg a day, so to make things easy I would give her 1/2 tbsp per day - that will be about 75 mg/day. To have any benefit, tho, she will also need to take the melatonin. At her weight, that would be 6mg 2x a day (6mg morning and 6mg evening). Use the plain melatonin - not time released, controlled release, or any other special form, just plain melatonin. And, yes, it will make her sleepy especially at first. But they do adjust to it and aren't as sleepy during the day. Melatonin helps them get their circadian rhythms going again, too, as these hormones can put them off the normal cycles of sleep and wakefulness.

Hope this helps!
Hugs,
Leslie and the gang

[Leena]

Thanks so much for the info...I have to try something to help her!!!

[Squirt's Mom]

Be patient - if she does have Atypical, it will take 3-4 months for the melatonin and lignans to have an effect. That is 3-4 months for the combination. ;)

Let us know how she does! I hope this helps.

Hugs,
Leslie and the gang

[Leena]

I had the vet recheck her liver values, and also do a thyroid panel..Thyroid was normal. Alt is 98 and Alp is now at 1220 from 864 in Oct...
I have heard that if the dog does not have hair loss or pot belly, that most likely is not atypical so don't do the test. I am also wondering if she could have diabetes insipidus??? I have emailed the IT to check on this.
Should I try and do the atypical test????
Help...

[lulusmom]

II have heard that if the dog does not have hair loss or pot belly, that most likely is not atypical so don't do the test. I am also wondering if she could have diabetes insipidus??? I have emailed the IT to check on this. Should I try and do the atypical test????
Help...

Hi Leena, I don't know where you heard this but that is an incorrect statement. Atypical cushing's can cause identical symptoms to those associated with typical cushing's, including a pot belly, hair/skin issues and excessive drinking and peeing.

Diabetes Insipidus is a rare condition and until your vet has ruled out every other possible cause, I personally wouldn't pursue DI. I had inquired previously about whether or not your vet Did your vet did a full urinalysis, including checking urine specific gravity. If Precia's problem is diabetes insipidus, atypical cushing's or typical cushing's, the urine would be dilute with low specific gravity. If the urine is concentrated and no UTI, you may be looking at incontinence.

[Leena]

Hello:

I have had several ua's run on Precia's urine. She is ALWAYS dilute. I have even dipped her urine here at the house on different occasions and its dilute...every time...1.010 or so.
I have gone ahead and scheduled the adrenal panel...I just don't know what else to do... I am concerned with her increasing ALP levels. Thanks so much for response!

[Leena]

Will the adrenal panel also check a cortisol level as well? My only fear is she will be stressed again and mess up the results :(

[lulusmom]

Will the adrenal panel also check a cortisol level as well? :(

Yes, the full adrenal panel includes cortisol. Test is the same as the standard acth stimulation test but they test all adrenal hormones. Stress can elevate cortisol but the acth stim test is less likely to be effected by stress than the LDDS so try not to worry.

[Squirt's Mom]

Hi Leena,

Yes, typically the UTK panel will look at the cortisol as well as the intermediate hormones but that is a good thing. ;) If you are concerned about stress affecting the results, keep her with you between blood draws. Go for a walk, to the park, for a ride, ect. Most clinics will allow you to do this VS keeping her in a cage between draws. :)

This test is done very similar to the ACTH - there will be two blood draws a few hours apart. This link tells how to do the test; you can print it off and take it to your vet just to be sure things are done as they need. UTK calls this a "full adrenal panel".

Don't panic about the results. Atypical is very easy to treat with lignans and melatonin, and sometimes a maintenance dose of Lyso - but there NO LOADING with Atypical. ;) If the Lyso is added, it is typically started 4-6 months after being on the lignans and melatonin since it can take that long for them to work.

Hang in there, you are doing a fine job, Mom!
Hugs,
Leslie and the gang

[Leena]

Thanks guys! I don't know what i would do without you all! I absolutely do plan to stay with my girl during the test to hopefully keep her a little calmer! The cage would totally freak her out! She can hang with her mom awhile :) I know she will still be stressed, but, I guess we will do the best we can! I will keep you guys posted. I know that they draw blood, and then give her a shot of Cortrosyn...(thats what is listed on my paper from the vet anyway), and then a draw an hour or so later. I hope the shot doesn't bother her. She seemed fine after her first stim test a year ago, but, I worry more these days for her as things "progress." !!! Fret...fret...fret..:(

[Leena]

So, I didn't know there were two types of lignans until reading it here. I don't know which I have...I can't find it anywhere on the bottle. I bought the ground up stuff that you just scoop out and put on the food...She doesn't seem to mind it...probably because it has no taste. Shoot, it even says you can bake it into muffins! Was wondering if I am messing up her dose though since I don't know if it is HMR??? or SDG??? (is that right??)

[Harley PoMMom]

So, I didn't know there were two types of lignans until reading it here. I don't know which I have...I can't find it anywhere on the bottle. I bought the ground up stuff that you just scoop out and put on the food...She doesn't seem to mind it...probably because it has no taste. Shoot, it even says you can bake it into muffins! Was wondering if I am messing up her dose though since I don't know if it is HMR??? or SDG??? (is that right??)

Here's a handy link with info about lignans from our Resource Thread:http://www.vet.utk.edu/diagnostic/endocrinology/pdf/20100810-LIGNAN-Write-Up-Revision03.pdf

Regarding the dosing: According to the UTK treatment sheet:
Suggested doses: SDG lignan; one milligram/lb B. Wt./day. HMR lignan; 10-40 mg/day for small to large dogs.
http://www.vet.utk.edu/diagnostic/endocrinology/pdf/TreatmentInfoAtypicalCushings201102.pdf

This excerpt is from the lignan article that I provided you the link to:


SDG lignan, having fiber as a component, can cause increase in stool frequency (and occasionally diarrhea). HMR lignan contains very little (if any) fiber, so this side effect should not be seen with HMR lignan.

No adverse effects to the use of SDG flax hull lignan have been reported to our lab, based on suggested doses to use (one mg/lb of body weight daily). We only have limited feedback (at this time) on the use of HMR lignan. In human studies with HMR lignan, single doses of 1,200 mg did not have any side effects

I really do not think any ill effects will be caused if one is giving more than is suggested.

Hope this helps.

Love and hugs,
Lori

[Leena]

I could not get the link to work.But, based on the quote you had in there, I am thinking it is the SDG lignan...Looking again at the bottle saw flax hull on there as well. Now, I know why my girl has beening pooping more too! Thanks for update. She goes on 12/30 for her test...She will stress, i will stress...sigh...

[Harley PoMMom]

Hi Leena,

I just tried the treatment option link and I do see that the link I provided does not work, I apologize for that.

Try this link and then scroll down to where the attached files are at and click on the one for the treatment option sheet: http://www.k9cushings.com/forum/showpost.php?p=1270&postcount=1

[Squirt's Mom]

Don't panic about the UTK pages. Their site is down for maintenance right now so nothing is visible. It will be back up soon, I'm sure. ;)

[Leena]

Well, my girl had her testing done today for atypical cushings. She was a trooper :) She rested on the exam room floor between blood draws so hopefully, stress won't be so much of a factor this time! When she had her stim test done, I left her and picked her back up. I have NO DOUBT she was stressed in a crate... (bad on me :( Results in a week...I hope!

[Leena]

Hi all...Still waiting on blood test results...been 9 days! Seems like forever! In the meantime, Precia is still drinking a lot, and seems to be more incontinent. I think she breathes "heavier" than my other dogs...Has anyone else noticed that in their Cush dog??? The vet has said it could be due to some liver enlargement presssing on her diaphragm???
I want answers!!!! Darn results....

[Squirt's Mom]

Hi Leena,

Your vet is right about the panting - Cushing's causes the fat in the body to redistribute, causing the pot belly, which causes the liver to push against the diaphragm causing the panting because the lungs cannot fill as fully as before.

It typically takes around 2 weeks for the UTK panel to come back so you are almost there! Of course, with patience I'm a bit like those two buzzards in that poster who are waiting for their dinner to come wandering by. :rolleyes::D

Hugs,
Leslie and the gang

[Leena]

Thanks Leslie...I am totally freaking out today though! Twice tonight after work I noticed Precia lying in a pool of her pee..even after she had been out. Very recently she is having more trouble getting up. I know her rear end is getting weaker. (obviously she has more trouble getting up on the slicker kitchen floor). I am worried to death I am going to lose my girl and I feel HOPELESS! i DON't know how to help her and it is killing me! If those results don't come back soon, I will SCREAM!!! Yep, I am a mess...:(

[Squirt's Mom]

Hi Leena,

There is a product called Paw-Pads that some of our members have used with success for their pups who had difficulty getting up and moving on slick surfaces. Here is a link -

http://pupgearcorporation.com/Products/Paw-Pads

They stick onto the paws and give them traction, helping prevent slipping.

As for the urine - has she been checked for simple incontinence? Sometimes as females age, they start losing control of their bladder...like an old human I know well. ;):o:p A med called Proin is used for incontinence and I'm sure there are others, too.

Did you notice a strong odor to the urine, or a dark color? Has a UTI been ruled out recently?

Hang in there sweetie, you're doing a good job for your girl!
Hugs,
Leslie and the gang

[Leena]

I recently had Precia on an antibiotic just in case she had a UTI, even though her urine dip showed nothing (but dilute..of course )...there is no odor to it at all.. I think I will collect a specimen from her and check color, etc...(looked clear on kitchen floor) I will also dip it again for white cells, etc... I guess she certainly could have incontinence due to age, but I am sure if she didn't drink a gallon of water each time she passes the water bowl, she might not have so much to leak out:o
Thanks for your support. I will check out the paw pads also...I guess I am just freaking out because I love her so much and so want to help her! I am using the flax and melatonin too, because figured it can't hurt her at this point!
I had a dog pass last June of cancer, and the thought of losing another so soon is unbearable...
AGain, thanks so much for being here for me!!!! I might go crazy otherwise!

[Leena]

So, its been two weeks...no results. I called U of T and they told me results should be to my vet on Friday the 13th...I emailed the IT who sent me a rude email back saying I needed to be more patient and that he had told me he would call me when the results were in! etc. etc. Geez! It's not HIS dog that he is watching with all these issues so I guess its no big deal to him! GRRRR! I emailed him back and I said I wanted a copy of the results when they came in and also a copy sent to my regular vet! And, I intend to call U of T and tell them the same! Then, whenever the IT decides to call me, I will probably switch to his partner in the group! I am not happy! In the meantime, Precia and I are trying to muddle through..Poor dog, she barks and barks anytime anyone is in the kitchen with food...God, is she starving all the time? That doesn't seem good :( I wish I knew how to help her...:(

[Harley PoMMom]

Fresh or frozen green beans are great fillers for dogs and carrots can be given too but very moderately if the dog has diabetes.

[Squirt's Mom]

Hi Leena,

Kongs are great distractions! ;) You can put banana, peanut butter, carrots, apples, green beans, sweet potatoe...any fresh, healthy goodies she likes and can have. Pack them in there pretty tight then freeze the Kong. Remember the contents will expand when they freeze so leave a little room. Once it's frozen, give it to Precia. It will occupy her for a while and reward her with things that are good for her and filling.

A cush appetite is an awful thing to witness. Squirt has always been a Miss Piggy and I just knew her appetite would never be a good sign for us. Man! Was I wrong! :eek::( I think the look in her eyes was the most heart-breaking part of it. She was begging me for food with her precious eyes, telling me she was in pain from starvation, that she was dying for lack of food...this was as she turned from her empty dinner bowl. :( Her every waking moment was spent searching for food, begging for food, fighting for food. This was nothing like my Miss Piggy and it was terrible to see. I had to keep reminding myself it was just the disease lying to her, that she was getting plenty of food, and that it was a temporary phase. Once the treatment started, she would stop feeling like she was starving...and she did.

Keep your chin up! You're doing a good job for your girl!

Hugs,
Leslie and the gang

[Leena]

Thanks guys...I do feed her apples, carrots, and other fruit and vegys, but have not tried the kong yet..Will do!
I just want some answers....I feel like i"m losing my mind...lol..I am sure I am! My poor girl...I think shed eat the couch if I coated it in gravy! sigh... :(

[Leena]

Oh wow...Questions!!! So her final diagnosis on the adrenal panel was Hyperfunctional Adrenal Syndrome
"The adrenal hormone panel is compatible with an increase in sex hormone and intermediary corticosteroid hormone levels both pre and post ACTH. This is indicative of an adrenal hormone hyperfunctional state. "
Is this code for ATYPICAL CUSHINGS???? My IT said it didn't really classify it as Cushings or atypical.
Some results:
cortisol baseline 46.3 post 231.6
Androstenedione baseline 1.63 post 10.0
Estradiol baseline 92.3 post 103.8
Progesterone baseline 0.52 post 14.42
17 OH Progesterone baseline 0.38 post 25.5
Aldosterone baseline 55.9 post 158.5

So, we are starting with the melatonin and lignans.
Can someone explain these results to me???
I'm just finally glad to have an answer!!!! of sorts!!!:eek:

MODERATOR NOTE: I have merged your latest post about Precia's test results with her original thread. We like to keep ALL info about each pup in their own thread so members can look back through the history if needed. Thanks!

[Squirt's Mom]

Ok, Leena,

Results are in but we need to see the normal ranges listed beside each value posted - ie the normal range for cortisol and for the estradiol and so on. Be sure to include the little letters that follow like ug/dl or nmol/L. This will help us give you more meaningful feedback.

What were the specific recommendations from UTK? You should have received a sheet that gave recommendations as numbers, like - "some vets would treat with #s1, 2, 3, and/or 5."

Thanks!
Hugs,
Leslie and the gang

[labblab]

Leena, as Leslie has asked, it will be great if you can post the "norms" that were listed on your test result sheet. However, I just glanced back at the UTK results given for another member. And per those listed norms, Precia is elevated on EVERY result except for aldosterone. If your norms are the same, this means that Precia now has abnormally elevated cortisol, too (The normal "post" cortisol range that I saw was 70.6 - 151.2 ng/ml. Precia's result was 231.6).

As such, I would think this means she has progressed to a point that will call for reinstituting treatment aimed at lowering the cortisol in order to obtain symptom relief. Melatonin and lignans will have no significant effect on the cortisol. So I am a bit confused, too, regarding the path forward. Like Leslie, I will be interested to see what treatment recommendations were made by UTK, if any.

Marianne

[lulusmom]

Hi Leena,

I agree with Marianne. It appears that your Precia's does have naturally occurring (typical) cushing's. This is pretty evident in reading the lab interpretation, "The adrenal hormone panel is compatible with an increase in sex hormone and intermediary corticosteroid hormone levels both pre and post ACTH." The bolded text would not have been included had Precia's cortisol been within the normal range. Most of us are familiar with post stimulated test results in ug/dl and in Precia's case, her post stimulated cortisol would be 23 ug/dl. When cortisol is elevated at levels consistent with typical cushing's, the results cannot be interpreted as atypical.

As Marianne has already pointed out, melatonin and lignans will not be effective in treating typical cushing's. In my layperson's opinion, your IM should be pursuing a typical cushing's diagnosis at this point.

Glynda

[Leena]

Hi guys:
The email that I got from my IT did not have the norms listed...I too went back and looked at anothers normal results. I will call Uof T and see If i can get an exact copy of the lab results (or my IT office) . (I wondered why the norms were not on there ).
Now that I am looking at this, it looks like a letter he sent to me and copied my regular vet on. So, the recommendations could be his own and not UofT's. (I don't know if he copied U of T's notes onto this letter or it is his own recommendations) He (or UofT) recommended the melantonin and flax lignans with a follow up in about a month to see how she is doing. He is holding off on Lysodren until we see how her symptoms do on this.(and again, I don't know if UofT said to go with this and no LYsodren currently, or just what) So, I guess until I find out more with the ACUTAL Copy of results, I will go with this. But hey, its a start! I will keep you all posted! Thanks!

[Leena]

Having NO luck getting a copy of Precia's actual test results! Had a not so pleasant conversation with her IM vet regarding getting these! He and I are not having a good vet/client relationship! If I get nothing in the mail soon, I will have to contact him again. This, is very annoying!

[Leena]

Still trying to get the actual test results from U of T on Precia...Now I am told they were mailed to me on the 23rd! WE shall see!

[Leena]

sO, here is what U of T sent:

Cortisol baseline: 46.3 normal 2.1-58.8 post: 231.6 norm: 65.0-174.6

Androstenedione baseline: 1.63 normal 0.05-0.57 post: greater than 10 normal: 0.27-3.97

estradiol baseline: 92.3 normal 30.8-69.9 post: 103.8 norm: 27.9-69.2

progesterone baseline 0.52 norm: 0.03-0.49 post: 14.42 norm: 0.10-1.50

17 OH Progesterone baseline 0.38 norm: 0.08-0.77 post 25.5 norm: 0.40-1.62

aldosterone baseline 55.9 norm: 11-139.9 post 158.5 norm: 72.0-398.5

Results indicate presence of increased adrenal activity (significant)
Some vets may consider items 1-6 if symptomatic

So...this is where we are....
Melatonin and flax lignans..I hope it helps!
I worry every day about her..I sometimes question her quality of life.
She loves to eat though! (too much!)..and still goes out to do her thing and takes short walks...I worry about her breathing..but, I watch it maybe too much...Sigh...This is hard...
Any thoughts???

[StarDeb55]

Leena, I'm afraid that Precia has Cushing's, now, based on those results. With the increased cortisol, it naturally follows that all adrenal based associated hormones will show varying degrees of elevation. The problem will always be the estradiol as it can be produced outside the adrenals in other tissues of the body such as fatty tissue, & hair follicles. Melatonin & lignans is strictly aimed at controlling the non-adrenal produced estradiol. Did the vet say anything about starting your baby on either trilostane or lysodren? The full panel result, IMO, indicate that it's time to start one of the medications aimed at Cushing's.

Debbie

[Leena]

He mentioned Lysodren if no improvement after a month on flax and melatonin. I guess they would not use Trilo as it can increase the other hormones? How can she go from an ACTH stim positive test to a UCCR NEG test now a positive Cushing test again? Does she have Cushing and atypical also???

[Cyn719]

Leena

I can't answer this question but I know the others will but I just wanted to say hang in there! It's a lot to take in but you will get through it... The members here will help you for sure!:). Sening you lots of strength support and hugs to you and Precia. Xo

[StarDeb55]

As Glynda said in her post on 1/17, Precia has typical Cushing's. If her cortisol was not elevated, then it would be classified as Atypical. Melatonin will have a mild effect on the cortisol, but I must warn you it usuially takes 3-4 months to show any effect. T

There are many, many pups who have elevations in the associated hormones that are being treated with trilostane with no harmful effects. I know that Dr. Oliver would have never suggested trilostane with these kind of results, but there are well-know IMS vets, like Dr. Peterson & Dr. Bruyette, who don't to hesitate to use trilostane with elevated associated hormones. Cortisol is a building block for all of these other hormones as I understand it, so if you control the cortisol, you should control all of these other hormones.

Debbie

[jmac]

Hi-
I have no advice to offer you, but just wanted to stop by and offer support since you're going through a tough time. I can understand your confusion, but as others have said, it sounds like you are definitely dealing with Cushing's. I would also think you might want to start thinking about a drug to treat. I would take the suggestions you get here and talk with your vet about it (and or get another opinion), and hopefully everyone can help you to make the best decisions for Precia.

Julie & Hannah

[Leena]

Thanks guys...I am supposed to touch base with my IM in the next week or two to let him know how she is doing...thus far, no change..
The paper from U of T even mentions about Trilo increasing the other hormones. The odd thing is...when I look back at my notes on her when she was on Trilo for her brief time...I noted that I thought her drinking seemed less....so, I don't know...It's all trial and error and confusion,..and all I want to do is just help my baby!!!

[addy]

Hi Lena,

My Zoe had a similar UTK profile. She also has IBD so I did not want to go the Lysodren loading route with her. We tried melatonin and lignans and that brought her estradiol to normal in 3 months but her cortisol went even higher. Dr. Allen from Dechra told me 80% of dogs with a profile like my Zoe will do just fine on Trilostane. Dr. Peterson told me to use Trilostane. I thought well, if the intermediate hormones do become a problem I can always stop the Trilostane and switch. Dr. Oliver had told other members they could use melatonin and lignans with Trilostane.

Zoe did just fine for six months and now we are having an allergy problem that could be unrelated.

Hang in there.

addy

[Leena]

Thank you for that advice! I suppose I will cross that bridge when we come to it...and I think that will be soon!

[Leena]

Hi guys:
A question...Precia seems less active than she was before...which wasnt a lot. She used to be more excited to take her walks and would like to run around my legs (well, walk around them!) Now, she doesn't do that at all. She sleeps, and eats, and goes potty and takes a very short walk...and barks to eat! Could this be the melatonin??? She seems...weaker... :(

[Harley PoMMom]

Hi guys:
A question...Precia seems less active than she was before...which wasnt a lot. She used to be more excited to take her walks and would like to run around my legs (well, walk around them!) Now, she doesn't do that at all. She sleeps, and eats, and goes potty and takes a very short walk...and barks to eat! Could this be the melatonin??? She seems...weaker... :(

Hummm, really don't know. I do believe some dogs on the forum getting a bit "loopy" from the melatonin but do not remember if any dogs got weaker.

[Leena]

I'm scared I'm losing her...I don't know what is going on or how to help her. She doesn't seem "right." Weak, breathing seems "harder"...still eats, barks, goes out, but falling more. IM said could be melatonin but I think the only way I will know is take her off of it...then what...

[Harley PoMMom]

Oh sweety, I am so sorry Precia is not feeling like herself. If the symptoms seemed to start after the melatonin was introduced then I would stop it and see if Precia improves.

Keeping you both in my thoughts and prayers.

Love and hugs,
Lori

[Spiceysmum]

Hi,
Sorry that Precia is not doing so well . Have they made a decision on whether to start her on the Trilo again yet? I don't know anything about melatonin or it's effects but alot of her symptoms seem to be cushings related. When you say her breathing is harder do you mean all of the time even when resting or does she have episodes of very hard panting? Before my Spicey was diagnosed she used to pant and breathe really heavy sometimes and I used to think she would have a heart attack! It all stopped once she was on the medication. If it is more general laboured breathing I would probably take Precia to the vet so they could listen to her heart. Thinking of you both and hope you get some answers soon.

Linda

[Cyn719]

Checking in on Precia So sorry she isnt doing so good Maybe go off the Melatonin like Lori said and I will be looking for the answers to Lindas questions --and same here Penny use to pant so hard but when she went on the trilo it stopped??

hugs xo

[Squirt's Mom]

Hi Leena,

I am so sorry Precia is having such a difficult time. The melatonin could be the cause, especially if she got worse after starting it like Lori said, tho I've not heard of this reaction to it before - not that that says just a whole lot. ;) If you think it could be playing any role, stop giving it. But I wouldn't stop there.

If you feel she is truly weakening and rapidly enough that you fear losing her, she needs to be seen by her vet asap. Heavy panting could be Cushing's, could be her heart, her lungs, liver, pain, or due to any of a number of other causes.

Is she taking anything else other than the melatonin? supplements, herbs, meds, etc? Is the melatonin you are giving just plain melatonin and not time released, extended, etc?

Let us hear from you when you can!
Hugs,
Leslie and the gang

[Leena]

Hi guys:

I did not give her any melatonin today...I am going to cut back her dose and see if there is any difference. The vet is coming out Wed and I will have him check her over then. She does take some other things along with the melatonin and flax..vitamin, joint pill, NSAID as needed, fish oil, vit E, milk thistle, (some are daily, others not) I hope its just the melatonin..
I have put the question to the IM regarding starting trilo or lysodren. I do not think he will suggest trilo since all the hormones are elevated...I have heard mixed things regarding trilo and it possibly affecting the other hormones...Personally, lyso scares me a bit and I'd rather do trilo..but, I don't know.
Will see what tomorrow brings....
Thanks so much for the support!

[lulusmom]

Hi Leena,

If all dogs diagnosed with typical cushing's (elevated cortisol) were to have a UTK adrenal panel done, none of them would have normal intermediate hormones. Most, if not all hormones would be elevated so if one were to discard Vetoryl (Trilostane) as a treatment because of those elevations, then it should never prescribed and it should never have been approved by the FDA. Every dog here who is treating or has been treated with Trilostane had elevated intermediates when they started treatment and they probably still have some level of elevations but studies show that this does not cause any problems. My dog is a perfect example of that. She had elevated intermediates before starting Trilostane and they were higher when we took her off of it, yet she had no symptoms. I've learned a lot more about Trilostane since then and in hindsight, if I had a chance to do it over again, I probably would have kept her on it.

If you are more comfortable with Vetoryl, then talk to your IMS about it.

[Leena]

Why did you take your dog off Trilo???
What you say makes sense. I swear when Precia was on trilo (for her first Cushing test that was positive before the UCCR was negative!) she was not drinking as much...Now, I had that horrible issue with a HUGE amount of hair loss!!! But really, if all dogs that test positive for cushings and start trilo and don't have the adrenal panel...how do those people even know if the other hormones are elevated!??!!! You are right, then NO one should be on trilo without an adrenal panel..but, that is not the case...so maybe i'll try the trilo first...confusion!

[lulusmom]

I switched my dogs to Lysodren because I thought Lulu may grow some hair. Jojo got switched because it's easier to keep track when both are on the same drug, plus he has chronic pu/pd and thought I'd give Lysodren a try again to see if it made a difference. Unfortunately, Lysodren has made no difference in Lulu's ability to grow hair so Trilostane was not the problem. I took Dr. Bruyette's advice and solved the problem with sweaters. :D It also made no difference in Jojo's pu/pd as he remains a big pee bucket. Aside from those symptoms, which neither treatment helped, I've been very fortunate that both dogs have done exceedingly well on both treatments.

[lulusmom]

But really, if all dogs that test positive for cushings and start trilo and don't have the adrenal panel...how do those people even know if the other hormones are elevated!??!!! You are right, then NO one should be on trilo without an adrenal panel..but, that is not the case...so maybe i'll try the trilo first...confusion!

The answer to your question was answered by Dr. Bruyette who said if a dog has elevated cortisol, the intermediates will always be elevated. Therefore, you don't have to do an adrenal panel to know that. A UTK adrenal panel is only recommended when symptoms are consistent with cushing's but the usual diagnostic tests (acth stimulation test and LDDS) yield normal results, meaning cortisol is normal.

[Leena]

I am worried about my girl. She is a little better since decreasing the melatonin, but she still seems weak. It takes so much effort for her to do the smallest of things...like even a very short walk...She gets winded easily. Her lungs were clear per the vet, but she does indeed have to take a deeper breath...I imagine due to liver enlargement pressing on her diaphragm??? Is an enlarged liver common with her messed up hormones??? I don't know what to call it since everything is elevated...
Will Lysodren help with some of these symptoms and make her feel better?
I am at a loss.... I worry about her quality of life... :(

[Spiceysmum]

Hi,
Sorry Precia is still not well. What did the vet say about her breathing and did they decide on whether to start her back on Trilo? An enlarged liver is common with Cushings. Their quality of life is always a worry but I think you need answers from your vet as to what they think is causing her problems and what treatment to give her.

Linda

[Squirt's Mom]

Hi Leena,

Is there some reason you and/or your vet don't want her on the Lyso? I think it could certainly help Precia as long as there are no other complications that would make treatment especially hard on her. I haven't looked back through your thread here this morning so I will just ask - has she had blood work recently? an ultrasound recently?

Lysodren will address all of her hormones that are elevated with the possible exception of the estradiol, which can be produced outside the adrenal glands where the Lyso cannot reach. This is where the COMBINATION of melatonin and lignans comes into play - they can reach and treat the estradiol where ever it is being produced. Melatonin alone will only help her sleep and calm her down a bit. ;)

Since Precia's cortisol is elevated, she is considered to have true, or conventional Cushing's, not Atypical. As such, she would need to undergo the loading phase before going into to maintenance.

Please stay in touch and let us know how Precia is doing...and what the vet says if you take her in.

Hugs,
Leslie and the gang

[Leena]

The IM wanted to try the melatonin and lignans first...I have emailed him over the weekend explaining the situation and inquiring about starting Trilo or Lyso.(terrified though I am!) I have to do something more than what we are doing...because its not helping! I know it takes several months to help on the lignans and melatonin...but she needs help now...
Her last bloodwork was in Oct., and he didn't want to repeat until April..Her u/s was in Aug. I have been wondering about doing another one, or even an x-ray to see what Liver looks like. I will ask him about that as well.
All I know is I have to try these meds. If something doesn't help her, I fear she will keep going downhill...and I want her to be around as long as possible! But, I also want it to be a good quality of life too!!!
Sigh...Love her so very much...My baby...

[Cyn719]

Leena

Hang in there .... You are doing all you can .... I know it's hard


Sending you support strength love and hugs xoxo

[Wendy Tillotson]

Not sure I am correct - but sounds like your dog is having liver issues. Did you ask the vet about Denosyl or Denamarin or Marin?

They are all nutroceuticals made for the liver by Nutramax. You can buy them online without a prescription altho all vets seem to sell some of them.

Denoysl is Sam-e, Marin is milk thistle plus zinc and vit E and denamarin combines the two. All are good for the liver and specifically made for pets.

[Harley PoMMom]

Is an enlarged liver common with her messed up hormones???


An enlarged liver can be due to elevated cortisol and/or the immediate hormones being high.

When was her last chemistry panel done? The ALT is more specific to the liver than the ALP. Is Precia's ALT abnormally elevated?

Love and hugs,
Lori

[Altira]

Wishing you good luck and hoping your baby feels stronger soon!

[labblab]

Leena, I am very glad you've emailed your specialist about Precia's increasing deterioration. At this point, I cannot think of any reason nor explanation for holding off on starting either Lysodren or trilostane to lower Precia's elevated cortisol. No matter how many months she takes the melatonin and lignans, I do not think they will ever be capable of lowering Precia's cortisol sufficiently -- that will require either Lysodren or trilostane to prevent further damage from this point onward.

Good for you for emailing the vet, and please let us know how he plans to move forward in order to give Precia some relief.

Marianne

[Squirt's Mom]

Hi Leena,

I just saw your question on Squirt's thread about the herbs I give for her liver and posted a response. Just wanted you to know the info is there now so you can check it out. Any questions, let me know!

Hope this info helps!
Hugs,
Leslie and the gang

PS. Please note the addition, too

[Leena]

Hi all....I am heartsick ....I am in shock and don't know what happened...I had Precia to the IM on Friday. He did labwork and a chest x-ray to see how things were and why her breathing was "harder"..She had been "deeper breathing" for a little while now, but still regular rate and rhythm..did not seem distressed. Lung sounds were clear by my regular vet earlier in week.. Even on the IM's exam, lungs were clear. But, the x-ray was bad...infiltrates all over...He said she had a respiratory inf...maybe equal to pneumonia. So, as we had discussed Lysodren...he wanted to hold off on that until this cleared up. He gave me antibiotics and pentoxyfylline (aka..bronchodilator) and was to call me monday with lab results. As the day went on, her breathing got worse...Up to 40 times a minute..harder to breathe...she did not have the air to drink much or eat...I knew we were in big trouble...I took her to the ER clinic where she was diagnosed with fluid on her lungs now and becoming cyanotic...she was struggling for air and I could no longer watch her suffer. The vet told me they could try treatment but no guarantee..With her age, and her Cushings (and who knows about her liver values)..that she could be suffering thru treatment with no good outcome...I couldn't allow that and I had to let her go...I AM CRUSHED..... I cannot grasp this...I look for her everywhere...Why didn't I get an x-ray sooner?? What could have happened so fast from vet visit to evening...My vet never suggested an x-ray because we both thought breathing was Cush related...liver enlargement..and she was not struggling then...What happened....I feel like I failed her...All I could do was hold her and talk to her while she crossed over...I am devastated....Please, can anyone help me understand this...I miss her so much...I tried to save her....I am just destroyed...

[frijole]

I am so sorry for your loss. We lost our girls on the same day so I guess God wanted two very special angels. I am sure they are running together and looking down on us. I can't explain what happened - I can only say I understand the pain and the loneliness. Bless you. RIP dear Precia. Kim

[Casey's Mom]

Leena, I am so very sorry to hear of your loss of Precia. How horribly unfair this is for you and your pup. To me it sounds as if there was not much you could do and you did the best thing by letting her go and ending her pain. The angels are with you now my dear and we will be right here with you as you go through this difficult time.

Love and hugs,

[BestBuddy]

I am so sorry to read that Precia has gone. Letting her go when the battle could not be won shows how much you loved her. Do not blame yourself because sometimes there is no reason.
Another angel has their wings.

Jenny

[jmac]

I am so very sorry to hear of your sudden loss. I can't imagine how difficult it must be. Please know that it is not your fault. You didn't fail her, and there was probably nothing you could have done, even if you found out sooner. Sometimes things just happen. At least she did not have to suffer long. You did the right thing by not making her suffer and be in pain. She is free now and can breathe easily, eat whatever she wants, and run and play all she wants.

You loved her very much and did everything you could for her. That is what matters.

Julie & Hannah

[Spiceysmum]

Leena,
I am so sorry to hear about Precia. I know you are heartbroken but please don't feel guilty. You did your best for her and took her to the vets last week when you knew she was struggling so there was not much more you could do. My thoughts are with you.

Linda

[Altira]

sob 8::::

[Jenny & Judi in MN]

I am so very sorry for your sudden loss. You say you feel like you failed her but you loved her, hugged her, had her in to vets and specialists. Please try to focus on her happy life with you and be kind to yourself.

hugs, Judi

[addy]

I am so sorry to read about Precia. It is so hard to understand why things happen the way they do. But I know from reading your thread you never failed Precia.

I am so sorry for the shock and anquish you are going through.

Love,
addy

[Squirt's Mom]

Dear Leena,

Oh, honey, I am so sorry to hear this...and was so shocked. I can barely imagine how you much feel. :(

But, listen to me honey - whatever it was that caused her to leave us has probably been there for some time, causing the signs that looked like Cushing's yet didn't show up on any of the testing done for her. It is entirely possible that no matter how many tests she had, no matter how far you traveled to find an answer, no matter how much money you spent - an answer may never have been found...and nothing would have changed the outcome. The canine system is just as complex and confusing as the human system and answers can't always be found nor fixed.

I know you can't see it right now through your pain but I can see that you did all you could for your precious Precia. You came here fighting for her, you have stood by her side always, and when she was in crisis you did everything possible to save her, everything honey. But Someone knew it was time for her to come Home, that it was time to save her from worse suffering to come, that our puny human knowledge would not be enough to help her.

Today, her pain has ended and she is once again whole and strong, running in the Rainbow Fields, her lungs filling with sweet clean air, her heart singing her love for you. She knows that your final gift to her causes you immense pain and grief...and she is grateful that you were willing to take her pain and make it your own, as a dear friend her once said. There is no greater love than this, Leena, none.

We are here for you any time, sweetie.

Our deepest sympathies,
Leslie, Squirt, Trinket, Brick and our Angels, Ruby and Crystal

[Roxee's Dad]

Dear Leena,

I am so very sorry for your loss.... Rest in Peace sweet Precia, You are our newest and brightest star in the sky.

[marie adams]

Dear Leena,

I am so sorry for your loss of Precia.

My prayers are with you at this time of saddness.

((((Hug))))

[Lady's mom]

I haven't been here for awhile, so just now catching up. I am so very, very sorry for your loss of your sweet Precia. I know how you feel, and my heart aches for you.

[k9diabetes]

Leena... I'm so very sorry about Precia. It is especially painful and difficult when it is sudden and unexpected.

Please do not beat yourself up. I have found, after spending many years on forums for dogs with various conditions, that when something like this happens there was probably some underlying and unknown thing happening and very often all of the medical diagnostics in the world won't find it either. That I know from experience.

Our dog Chris was diabetic and during his last year his health was steadily deteriorating. We treated what we knew about but also felt that something else was going on with him. And we did all of the noninvasive tests that could be done - x-rays, abdominal and cardiac ultrasounds, blood panels... we didn't find a cause. And didn't find out he had cancer, had probably had cancer for some time, until a chest x-ray meant to tell us whether he was suffering from congestive heart failure turned up cancerous masses in his lungs instead, almost certainly secondary to some kind of cancer elsewhere in his body that we never found.

If we hadn't happened to do that x-ray when we did, we would not have had any idea why he suddenly went rapidly downhill and started to bleed internally two weeks later. We let him go 48 hours after he started failing. But for that chance timing, we would have been utterly confused and mystified, as you feel now.

My years of experience tell me that when these things happen it usually is the result of something that could not have been treated. It would have given you some explanation for what happened but not changed the outcome. And that even if you looked with every test available, you might not have found the cause.

Again, I'm so very sorry. Sending you a hug and a kiss skyward to Precia.

Natalie

[Cyn719]

Leena


I am so very sorry about Precia. Don't doubt yourself, you did all you could and Precia knew that. I know it's hard...I'm doing some doubting now cause I'm losing my girl also. But deep down I know I did all I could. Precia did not want to suffer, and you knew that so because you loved her so much you set her free. Nothing will stop the pain you feel, but try to focus on the beautiful memories you will always have.

Love, hugs, prayers, support and strength is being sent to you.

Xoxo

Run free Angel Precia xo

[Leena]

Thank you all so much for your words and support...they do give me some comfort...And Cindy, I will keep you in prayer with your girl....My heart aches for you and others who have gone thru or are going thru this...I miss Precia every second...and continue to look for her when I am "counting the kids"..as I do when I let my girls inside or outside...I still count biscuits out..and include one for her...It hurts horribly and I question everything..but I know she is with God and the angels and so many fur kids to play with :) I can only take one minute at a time and one tear at a time right now.
God Bless all of you...You have been such support for me and my sweet Precia girl...
Leena