We adopted Bree, but now we have new problems

[purpledachshunds]

Hi everyone,

We joined the forum a couple years ago when we were deciding whether or not to adopt a dachshund who had Cushing's. We got lots of advice (which we appreciated), and we did go ahead and adopt him. We didn't continue to post about him because before we adopted him, we learned that not only did he have Cushing's, but a heart condition and terminal cancer (which we posted) which had already metastasized to his lungs. Between that, my crazy schedule and my wife's health problems, we just didn't stay in touch. Anyway, his prognosis was 2-4 months. He was something though, poorly sighted, deaf, Cushing's and dying from cancer and still he was the life of the party. What a character. We were very blessed and had him for 11 months. Due to his cancer, the vet didn't find it necessary to follow the normal retesting cycle, so long as he remained asymptomatic, as you normally would with a Cushing's dog, so that is why we didn't do any follow-ups on his condition.

We thought that would be the end of our Cushing's experience. Apparently we thought wrong – way wrong.

We have had a family group for more than a decade now. The momma will soon be 15, her daughter is 12 and the youngest male is 10. The vet is pretty sure 2 have Cushing's and we think the 3rd might too. Ugh. We are starting the testing this Tuesday, 8/30. Our vet wants to start with an ACTH to get a baseline. Should we use the more expensive one, Cortrosyn, for the baseline test or can we use the gel, or at least use the gel on the later tests? Our vet only does the LDDS if the ACTH comes back negative.

Any advice on our new problem(s) would be appreciated.

Roger and Myrna

[Harley PoMMom]

Hi Roger and Myrna!

So happy to hear from you but so sorry for the circumstances that brought you back.


Our vet wants to start with an ACTH to get a baseline. Should we use the more expensive one, Cortrosyn, for the baseline test or can we use the gel, or at least use the gel on the later tests?

You most definitely want to use the Cortrosyn as the stimulating agent, the gel may not give you the most accurate readings. Here is a link about this from Dr. Mark Peterson's blog: What ACTH Preparations Should Be Used For Stimulation Testing? (http://endocrinevet.blogspot.com/2011/03/what-acth-preparations-should-be-used.html)

Here is another link to his blog about how to lower the cost of an ACTH stim test: How to Extend Your Supply of Cortrosyn and Lower the Cost of ACTH Stimulation Testing (http://endocrinevet.blogspot.com/2011/03/how-to-extend-your-supply-of-cortrosyn.html)

Has an UC:CR been done on any of your furbabies? The UC:CR is the least stressful way to rule out Cushing's.

Can you tell us more about your furbabies; their symptoms, test results, are they on any other herbs/supplements/medicines?

We are here for you all, ok? ;):)

Love and hugs,
Lori

[purpledachshunds]

Hi Lori -

Thanks for the info. I feel really bad today so I will keep this short.

Hercules – 10 year old male: polydipsia, polyuria, polyphagia, huge pot belly, thinning hair, and ALT (SGPT) of 391 (normal 12-118 U/L), Alk Phosphatase of 1251 (normal 5-131 U/L), and specific gravity of urine of 1011 (normal 1030 or 1035—the vet said this means his urine is very dilute).

Sassy – 14 year old female: adrenals showed up extremely enlarged in ultrasound. She may have to go to vet on a day other than Tuesday. We will try to post more of her symptoms later this week, but basically all has been ruled out via blood work besides Cushing's.

Tazmyn – Is going in Tuesday for extensive testing relating to her epilepsy. Curious to see what blood work shows because rest of family seems to have Cushing's.

Thanks again!

Roger and Myrna

P.S. Is UC:CR Urine Cortisol Creatinine Ratio?

[Harley PoMMom]

Hi Lori -

Thanks for the info. I feel really bad today so I will keep this short.

Hercules – 10 year old male: polydipsia, polyuria, polyphagia, huge pot belly, thinning hair, and ALT (SGPT) of 391 (normal 12-118 U/L), Alk Phosphatase of 1251 (normal 5-131 U/L), and specific gravity of urine of 1011 (normal 1030 or 1035—the vet said this means his urine is very dilute).

So sorry to hear that you are not feeling yourself today and I hope you are feeling much better soon.

Hercules does seem to have almost all the symptoms of Cushing's and strong symptoms are a huge part of the diagnosis.


Sassy – 14 year old female: adrenals showed up extremely enlarged in ultrasound. She may have to go to vet on a day other than Tuesday. We will try to post more of her symptoms later this week, but basically all has been ruled out via blood work besides Cushing's.

Although PDH can cause the adrenals to be enlarged, any Chronic non-adrenal illness can cause this too. Will be looking forward to hearing more about Sassy.


Tazmyn – Is going in Tuesday for extensive testing relating to her epilepsy. Curious to see what blood work shows because rest of family seems to have Cushing's.

Is Tazmyn on any medicine for her epilepsy? Drugs like Phenobarbital, which is used to help control seizures, can cause Cushing like symptoms such as polydipsia, polyuria and usually the liver enzymes will be elevated.

Thanks again!

Roger and Myrna


P.S. Is UC:CR Urine Cortisol Creatinine Ratio?

Yes, the UC:CR is the Urine Cortisol Creatinine Ratio test. This test is a good way to rule out Cushing's but false-positive elevations can occur if a dog is suffering from an illness.

Love and hugs,
Lori

[apollo6]

Dear Roger and Maria
First sorry for the reason you have come. And know that your little angel had the best 11 months ending to his life.
Welcome. Ask all the questions you need and below is a simple link about cushings to get you started.
http://www.peteducation.com/article.cfm?c=2+1597&aid=416
http://www.kateconnick.com/library/cushingsdisease.html
Most important see the list of symptoms, then find out which form they have if they even have it. Then take your time to decide what kind of treatment you want to pursue.
My Apollo, a dachshund, was diagnosed 20 months ago and will be 13 in October. There is hope.
HUgs Sonja and Apollo

[purpledachshunds]

So sorry to hear that you are not feeling yourself today and I hope you are feeling much better soon.

Hercules does seem to have almost all the symptoms of Cushing's and strong symptoms are a huge part of the diagnosis.



Although PDH can cause the adrenals to be enlarged, any Chronic non-adrenal illness can cause this too. Will be looking forward to hearing more about Sassy.



Is Tazmyn on any medicine for her epilepsy? Drugs like Phenobarbital, which is used to help control seizures, can cause Cushing like symptoms such as polydipsia, polyuria and usually the liver enzymes will be elevated.

Thanks again!

Roger and Myrna



Yes, the UC:CR is the Urine Cortisol Creatinine Ratio test. This test is a good way to rule out Cushing's but false-positive elevations can occur if a dog is suffering from an illness.

Love and hugs,
Lori

Lori,

You've brought up a couple of interesting questions. In reading the links you provided, why does ACTH testing cost so much when using cortrosyn? The vets blame it on drug cost, but that cost can be very low according to the articles.

Tazmyn is pretty heavily medicated I'm afraid. She takes 6x15mg tablets of phenobarbital, 3 in the morning and 3 in the evening. She is also on 120mg of potassium bromide per day.

She has always had seizures, even on the medications, and at rates which have really concerned our vets. Going more than a week or two without one used to be rare and having one for more than an hour was not unusual. When we added the potassium bromide she backed off on both the frequency and duration of her seizures, but over time she had gone back to having them more often.

We adopted another dog, Sully, who is allergic to grains, and started feeding her his food as well. We are feeding Natural Balance duck and potato. She is now seizing much less, sometimes going for more than a month between seizures so we're starting to wonder if we can get her off of some of the medication. Perhaps her seizures are allergic reactions? We'll have to talk to the vet and get back to you on that part.

Roger and Myrna

[purpledachshunds]

Dear Roger and Maria
First sorry for the reason you have come. And know that your little angel had the best 11 months ending to his life.
Welcome. Ask all the questions you need and below is a simple link about cushings to get you started.
http://www.peteducation.com/article.cfm?c=2+1597&aid=416
http://www.kateconnick.com/library/cushingsdisease.html
Most important see the list of symptoms, then find out which form they have if they even have it. Then take your time to decide what kind of treatment you want to pursue.
My Apollo, a dachshund, was diagnosed 20 months ago and will be 13 in October. There is hope.
HUgs Sonja and Apollo


Hi Sonja,

Apollo looks like a cute little guy. We appreciate the links and we'll get back with you after we read them.

Roger and Myrna

[purpledachshunds]

Hi Everyone!

Looks like we are only taking Tazmyn tomorrow (for her testing related to her epilepsy) – the Cortrosyn our vet has frozen is right at six (6) months so she wants to order a new vile.

Lori – The links you provided for Dr. Mark Peterson has viles of Cortrosyn for $72.00 per vile. The cheapest we can find it so far is $149.95 at Diamondback Drugs. Our vet wanted us to check with the forum on two (2) items:

1. Does anyone know where to buy Cortrosyn for less than $150.00? (She was shocked at $72.00 per vile!!
2. Does anyone know of a good article for dosing? Dr. Peterson does list his recommendation, but our vet says some current data shows even a half of an entire vial being used to test small dogs under 15 pounds. She is checking with IM doctors with whom she works, but she wanted us to see if anyone on the forum has heard of wide variations in dosing recommendations when using Cortrosyn.
Our vet plans on having the Cortrosyn in hand by the end of this week/beginning of next so Sassy and Hercules can be tested for Cushing's next week. As always, any info. is greatly appreciated.

Roger and Myrna

[Harley PoMMom]

Hopefully this article will help: Evaluation of a low-dose synthetic adrenocorticotropic hormone stimulation test in clinically normal dogs and dogs with naturally developing hyperadrenocorticism. (http://www.ncbi.nlm.nih.gov/pubmed/10340075)

This excerpt comes from that study:
CLINICAL IMPLICATIONS:

Administration of cosyntropin at a rate of 5 micrograms/kg resulted in maximal stimulation of the adrenal cortex in clinically normal dogs and dogs with hyperadrenocorticism.

[lulusmom]

Please give your vet the link below which provides Dr. Peterson's source for Cortrosyn, as well as information on amounts to use when reconstituting and how to store for future use.

http://endocrinevet.blogspot.com/2011/03/whats-best-protocol-for-acth.html

I have two cushdogs and one that needs to be tested so I hope that you and I can make those folks with one cushdog feel better knowing that it could be a lot worse. Try one stim times three on for size. Oy!!!

[purpledachshunds]

Hello everyone,

We'd like to thank everyone for the links and advice on how to deal effectively with our Cushing's dogs. Between my schedule and my wife's difficulty in sitting at the computer for lengthy sessions, the links you all have provided have been a Godsend. We can't thank you enough for the help.

Lori and Glenda, we are really appreciative of your links for lowering the ACTH Stim testing costs. We gave our vet the links and the charge went from $350/test down to $100 for the bottle of Cortrosyn, and then $112 for the blood work for each test until the bottle runs out (or 6 months). We could get up to 10 tests from a bottle. That is a tremendous savings and we wouldn't have had that without your help. We're sure it will also help others who use our clinic. Glenda, we're sorry you're going through this with two dogs. How is the testing going for the third? It is quite a battle, both emotionally and financially.

Sonja, the links were very helpful. Since we've been through the trials of a Cushing's dog when we adopted Bree a couple of years ago, it was much easier to understand everything in the articles and it painted a much clearer picture for us. It provided a very nice “refresher course”!

The results from the ACTH Stim test for Hercules was 21.2 and Sassy was 8.5. Given Hercules' symptoms, our vet decided to start him on 20mg Vetoryl, BID, without an LDDS. Hercules last weight at the vet's office was 12.8 pounds (5.81Kg). From reading the UC-Davis data, we're not sure about that high a dosage from the beginning for Hercules, what do you guys think? It is slightly over the high Dechra dosage suggestions. We surmise our vet is starting him on a higher dosage because he is very symptomatic in many areas. We are, however, asking her to review the Dechra and UC-Davis data to alleviate our concerns.

Tomorrow, Sassy is getting an LDDS and we'll update you with her results.

Thanks again for everyone's help,

Roger and Myrna

[labblab]

Hi again, Roger and Myrna!

I have only a few moments to post right now, so I will cut right to the chase. My personal opinion is that 20 mg. BID is a much higher starting dose than I would feel comfortable with, especially since Hercules' diagnostic ACTH result is really only borderline "high." Even though Dechra's published literature states an initial dosing range of 1-3 mg. per pound, for quite some time now, the vets who serve as their technical reps have verbally advised that it is generally best to start at the very lowest end of the range in order to minimize the risk of overdosing and/or unwanted side effects: using a formula of 1 mg. per pound. It is not the severity of the symptoms that determines the initial dose -- it is solely the weight of the dog.

The fact that you are dosing twice daily also increases my concern re: the size of the dose. Even though Dechra recommends starting out with a once daily dose and only shifting to twice daily dosing in the event that symptoms rebound later in the day, I do realize that there is continuing disagreement about this, and some specialists prefer to use twice daily dosing from the get-go. However, we have been told by at least one nationally-known veterinary endocrinologist that dogs who are dosed twice daily often actually end up requiring a LOWER overall daily total due to the cumulative effect of the medication over a 24-hour time period -- and thus, they need to be monitored even more carefully to avoid overdosing.

For these reasons, I strongly encourage you and/or your vet to call Dechra directly in order to receive the benefit of their most current dosing recommendations. Many of our members have spoken with Dr. Tim Allen, who has been a great help to us here and is happy to talk with owners and vets alike. Here is the contact info for Dechra's Kansas office:

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

If it were me, until the dosing issue is resolved, I would ask my vet if I could at least knock back to either 20 mg. once daily in the morning, or 10 mg. BID.

Marianne

[purpledachshunds]

Hi Marianne!

Thank you so much for stealing a moment to respond this morning. Hercules has yet to start his Vetoryl regimen. We have leftover pills from Bree that are 30mg (and still in date). Our vet has a local compounding pharmacy that will take existing Vetoryl capsules and divide them into smaller doses. We will pass along the information you provided this morning so our vet can contact Dr. Allen for the most current dosage recommendations.

Again thank you for taking what little time you had. We really appreciate the advice!

Roger and Myrna

[purpledachshunds]

We took Sassy in for her LDDS today, as we missed our opportunity to do so last week. We'll list her results as soon as we get them. Thanks to everyone for all your help.

Roger and Myrna

[Squirt's Mom]

Hi Ya'll,

Looking forward to the results!

Hugs,
Leslie and the gang

[purpledachshunds]

Hi Everyone,

We got Sassy's results back from her LDDS.

Time 1 Pre

Time2 12:55

Time3 4:55

1900 4.6

1902 .8

1903 <.7

Normal result, not supportive of Cushing's. (Normal: Cortisol level less than 1.4 mg/dl 8hrs post-dex. Hyperadrenocorticism: Cortisol level greater than 1.4 mg/dl 8hrs post-dex.)

Her last two (2) Thyroid tests came back .7 and .3 (normal is 1-4). In order to properly diagnose hypothyroidism even with low test levels all other diseases must be ruled out first because low thyroid can also be indicative of other diseases. Our vet finally feels we are at that point and Sassy has been “officially” diagnosed with hypothyroidism so she will start taking .1mg Soloxine twice daily soon.

We are hoping to be able to pick up the Vetoryl for Hercules tomorrow. We are starting him out on a very low dose of 5mg AM and PM and creeping him up slowly. I am very anxious to start his Vetoryl because for the past few nights he has been making me feed him every two (2) hours. It is like he has an internal clock that tells him every two (2) hours on the dot, “Time to wake up mom!” Oddly, he can usually go throughout the day with only one (1) small extra snack and that is close to his normal dinner time. (I guess he is too tired in the day from his lack of sleep at night!) Sleep? Who needs it!

Also the rescue group from which we adopted Bree and Sully (a chiweenie) had me forward them the information we learned about lowering the cost of the Cortrosyn ACTH Stims. If their vets can purchase the Cortrosyn from Butler-Schein (what used to be Henry Schein) at the lower price and pass the savings on to them it will enable their donations to go further so they can rescue more doxies! Both they and we say a huge thank you to all of you who have shared this information with us. It was tremendously helpful and sincerely appreciated. [It might even allow us to adopt another baby from DREAM (the doxie rescue) and free up another space for them to rescue another baby!]

May God bless each and every one of you!

Roger and Myrna

[Harley PoMMom]

So happy to hear that Sassy does not have Cushing's but sorry to hear that Hypothyroidism is an issue although I am sure the Soloxine will definitely help with that.

So very happy to hear that our information about the stim testing has helped!

It is just wonderful that you give these sweet furbabies such a wonderful and loving forever home, Bless you!!!

Please keep us posted, ok? ;):)

Love and hugs,
Lori

[purpledachshunds]

Hi everyone -

We finally have some Vetoryl back from the compounding pharmacy for Hercules! It is a long story, but suffice it to say this particular pharmacy was very busy and there were some misunderstandings about the protocol (since the vet's office is involved by taking it to them), but we finally ironed out enough wrinkles to bring some of the pills home tonight.

Hercules will be starting very slowly on 5mg with breakfast in the morning and another 5mg with his dinner in the evening. It is highly possible this small dosage will fail to relieve (or might barely relieve) his symptoms, but after all of the advice and information we gathered we feel it is safest and easiest on him to go very slowly. Dr. Tim Allen from Dechra said it is “smoother” for the dog to start out with a low dose.

We are so very thankful for all of the advice. Each and every one of you deserve a special place in heaven!

Lori, we are the ones who are blessed by adopting our fur babies from DREAM. Bree came to us with an estimated two to four (2-4) months to live by the time he was finally in our home. He had Cushing's, metastatic follicular thyroid cancer, and a IV/VI heart murmur. We were extra blessed and had him for 11 months! He was the life of the party and had no idea he was sick. When he passed it was hard on us because we expected him to wind down and give us some warning, but it was easier on him because it was very obvious it was time...he arose one morning vomiting bright red blood from where the cancer had eaten through his esophagus and/or windpipe. We were happy for him that he suffered very little before we took him to the vet's office for our final goodbyes. We were talking the other day that if we could adopt a dog like Bree every year we would happily do so. If anyone is out there and on the fence about adopting an older/sick dog, please go ahead...we had no regrets whatsoever and our lives were truly enriched! After Bree passed we adopted Sully (a chiweenie) from DREAM. He has no health problems, but is scared of his own shadow. His foster mom worked so hard with him for a year to even make him adoptable and she did a great job! He learned from her that humans can be kind...it is obvious he had a difficult life before finding DREAM. We can see him trust more and more each day and that is exciting!

We will keep you posted on Hercules' progress.

God bless each of you,

Roger and Myrna

[Harley PoMMom]

I totally agree with what Dr Tim Allen has said. When a dog is started on either Trilostane/Vetoryl or Lysodren/Mitotane they may go through corticosteroid withdrawal syndrome and I believe starting the dose at the lower end helps to avoid this or at least this makes the adjustment to the lowering of the cortisol easier on the dog.

Please do keep us posted!

Love and hugs,
Lori

[purpledachshunds]

Hi everyone -

Anyone ever heard of overdose after just five (5) full days of Vetoryl treatment? Hercules started his Vetoryl on September 30, taking 5mg with breakfast in the morning and another 5mg with his dinner in the evening. We expected this to be a very low dose and the next stim test would probably advocate increasing the dosage. Obviously, since he has only been taking the drug for five (5) days, no stim test has been done other than the initial stim before dosing.

Tonight he refused to eat his dinner! (Remember this is the dog that has been making me feed him extra especially in the middle of the night or he would vomit.) Instead of eating his food in his crate as usual, he did vomit a mouse-sized lump of hair, grass, twigs, etc.--doxies are true billy goats and eat whatever is in sight! He had eaten his Vetoryl in his cheese, but I saw no evidence of the pill or any cheese in the mouse lump. So...as far as overdose symptoms...he is refusing to eat, vomiting, is lethargic—but no more than has been caused by the disease in the first place, and is weak—but again no more than has been caused by the disease in the first place. I have yet to see Hercules eliminate, but have seen no diarrhea in general.

At first I was very excited when Hercules started the Vetoryl because I could eliminate the extra day time meal and was able to cut the night time meals in half from three to five (3-5) to one to two (1-2)--although he does awaken me still several times a night and is confused if I refuse some of the extra meals. Unfortunately tonight I am sick and therefore addle-brained and am unable to reach my husband for his opinion. I think his belly is just upset because he was a true doxie billy goat today obviously eating a good bit of trash.

I assume it is best to withhold a second dose of Vetoryl tonight (since I am unsure if he vomited after eating it or before) and just resume dosing tomorrow...and obviously keep an eye on him to see if he becomes more lethargic, but otherwise just call the vet in the morning? I was just wondering if since he responded immediately to the Vetoryl by allowing me to reduce the extreme amount of extra food he was receiving to keep him from vomiting before starting the Vetoryl if an overdose at this early point and at such a low dose is really possible. He was 12.8 pounds when he last saw the vet.

Any advice is appreciated!

Thanks!

Roger and Myrna

[Harley PoMMom]

So sorry to hear that Hercules is not feeling well and with-holding the Vetoryl until he is feeling better, meaning no vomiting and eating normal again, is the best idea.

According to Dechra's Product Insert: "Hypoadrenocorticism can develop at any dose of VETORYL Capsules." If Hercules is not feeling better by tomorrow I would call the vet and see if an ACTH stim test should be done. Do you have prednisone on hand?

[purpledachshunds]

Yes, we have prednisone, should we give him some if he can keep it down?

[Harley PoMMom]

What time exactly was his last dose of Vetoryl given?

[purpledachshunds]

Around 7:15 eastern time tonight. He started throwing up shortly thereafter and has now gotten to a point of repeatedly throwing up every few minutes. We have withheld water and are considering 1mg/lb of phenergan to help settle his stomach. We have 5mg prednisone pills.

[Harley PoMMom]

The vomiting repeatedly concerns me as this could be a sign of pancreatitis or too low cortisol, also dehydration can be issue. Since Hercules is not able to keep anything down, if this were my dog I would take him to a vet ASAP.

[Cyn719]

How is the dog doing now - did the vomiting stop -

[purpledachshunds]

He is resting now. He snuck a drink around 12:30AM when I set the water in the floor for the other dogs to drink and thought my husband was holding him. So far he has kept that water down!--and the water bowl is back on the counter!! Please keep us in your prayers. Thanks. Roger and Myrna

[purpledachshunds]

Hercules is at the vet. Barring performing exploratory surgery they have ruled out an intestinal obstruction and have him on IV fluids because his numbers are all over the place—pretty much because he is severely dehydrated (which we already knew). While the vet thinks the Vetoryl played no role, he wants to withhold it until he stabilizes enough for the vet to perform a steroid test (Roger spoke to him and never said if it will be LDDS, stim, or both???). His red blood cell count is really high (probably due to his dehydration) and his glucose is very low. The vet is to call Roger after lunch with an update. Hopefully, we will have some numbers from the tests to post tonight. Thanks for keeping us in your prayers.

Roger and Myrna (and Hercules!)

[Nika'sMom]

Roger and Myrna...I just wanted to let you know how sorry I am that your Hercules is having such a rough time right now. I am glad that he is in the care of your vet at this time and I am hoping you get some answers soon. I am sending many prayers your way. Will continue to look for updates on your boy...many hugs,
Lynda and Nika

[Cyn719]

Myma and Robert - my prayers and thoughts are there for the two of you and Hercules - being on trilo is a tricky thing for sure - ups and downs - but you have him being taken care of and the test will tell you where the numbers are at - they could of dropped fast or maybe hes right and the trilo didnt have anything to do with it - I will be checking on all of you later tonight - sending love and support

[lulusmom]

Dear Roger and Myrna,

I'm so sorry to hear that Hercules is having a rough go of things. Paws and fingers are crossed and prayers are being said that the vet and IV fluids will get him back on his feet.

I am assuming you were withholding water because you thought it made Hercules vomit, right? Vomiting alone will dehydrate a dog quickly and a dog with PU/PD, deprived of water and vomiting, is in serious danger of dehydrating very rapidly. Dogs with PU/PD don't pee a lot because they drink huge volumes of water, they drink too much because they pee huge volumes of urine. I share my life with a cushdog who has incurable and untreatable diabetes insipidus. He drinks gallons and pees lakes 24/7 so I make sure there are full bowls of water for him. I also have a dog on diuretics so my husband and I are always filling water bowls. My dog's vet and groomers know that if either of my boys are to be kenneled for more than an hour or two, they absolutely must have water in their kennels at all times. Until Hercules' PU/PD has totally resolved with treatment, I would recommend that you do not withhold his water without instructions from your vet to do so.....and even then, I'd question the wisdom of doing that outside of the vet's office.

Hugs,
Glynda

P.S. I'll be checking in frequently during the day in the hopes of seeing an update from you.

[purpledachshunds]

Hi Everyone-

We have a non-update update. I say that because basically nothing has changed. The vet called Roger and said that Hercules is still on IV fluids. The vet just did a simple cortisol check and the levels were “within normal limits” so he is still fairly confident that the Vetoryl is ruled out. Hercules did have diarrhea so that further helped the vet rule out any obstructions. He also vomited?! This confused me because to Roger's knowledge he has had no fluids orally—only IV fluids.

Glynda (and the rest of you wonderful sages on the forum), please feel free to have a hearty chuckle, but is “PU/PD” persistent upchuck/persistent diarrhea? Just a guess—how far off am I? (Yes we are showing our naivete!) We will check with the vet about withholding water. All of our dachshunds have always been billy goats and we have always withheld water when their tummies are upset because if we keep it readily available their tummies never settle. In the past we have always been able to offer tiny amounts of water and if they keep that down very tiny amounts of rice cooked in chicken stock. When Hercules kept his water down from 12:30AM to 3:20AM I was just thinking I was going to give him a little water and maybe some of the rice I had cooked for him. I was very cognizant that this was the first time I had withheld water from a Cushing's dog and was concerned about those ramifications—probably part of the reason I stayed up all night with him! Besides a dog who has long since passed at 17y3m who was once diagnosed with Hemorrhagic Gastroenteritis (died years after this) that I was unable to pull out with my judicial doling of food and water, Hercules is the only other doxie that has given me an uncontrollable challenge. Since we do have so many that crave water (our 8 1/2 pound epileptic dog drinks them all under the table!) we will ask the vet how to handle the situation next time, especially if it is like this time and we are unable to take them to the emergency clinic.

Also, Glynda, you mentioned a Cushdog who has incurable and untreatable Diabetes Insipidus. We were waiting until we have more information from DREAM but we have been in talks with them about adopting a little 14yo girl with Diabetes named Nicole. We are very early in the learning process and have asked if it is Mellitus or Insipidus and if it is Mellitus is it Type I or Type II. They are also suspecting she may have Cushing's and this is the response I received from a person involved in her vetting when I asked about when Nicole had been tested for Cushing's and when to expect the results: “Nicole has not had either test for Cushing's yet. The doctor has just noticed that some of the blood work results seem to suggest the possibility and since they are having difficulty getting her blood glucose levels down, that also suggests the possibility. They won't actually test for Cushings until it is determined that Nicole is insulin intolerant (which wouldn't be for a few more weeks if that happens) or if there are other changes in her weekly blood work results.” We have also asked if we could have copies of her vet records. Usually this is done much later in the adoption process, but I was hoping to post some of her results here to gather opinions since Cushing's and Diabetes go hand in hand so often. Like I said we are very early in the process, but I thought I would give you a heads up that hopefully you will soon be bombarded with Diabetes/Cushing's questions!

As far as Hercules goes, the vet is going to continue to monitor him and push IV fluids. They gave him fluids with glucose until his blood sugar stabilized then switched him to regular fluids (I assume the normal “saline” solution) and his blood sugar crashed again so they put him back on the fluid with the glucose. The vet will call Roger again later tonight and at that time they will make the determination if Hercules is “safe” enough to be monitored by a vet tech at their clinic overnight or if he needs to be taken to the emergency clinic for overnight monitoring by a veterinarian then brought back to them in the morning. He says it is highly possible he just ate something that was better left alone and it caused a chain reaction that will take some time to balance. While he says he is a very sick dog he also says he is in no imminent danger.

Thank you so much for your continued prayers. We really do appreciate them and each and every one of you.

God bless you,

Roger and Myrna (and Hercules!)

[purpledachshunds]

Hi Everyone-

Another update...the vet called Roger and said Hercules is doing much better. His glucose has stabilized and he is up and walking around. (He was pacing the floor all night here.) Roger said the vet's voice had changed and he seemed more upbeat. He had been impressing on Roger all day that the only way he would allow Hercules to stay with them and be monitored every two (2) hours by their vet tech was if he felt he had improved. Apparently, he is comfortable enough with the results they have been seeing since their last conversation because Hercules is staying overnight with their head vet tech.

I spoke with a friend who reminded me about their puppy who had a blockage. They knew what this puppy had eaten, but no blockage or pockets of gas were showing on the x-ray and her glucose levels kept crashing. She also had diarrhea. To make a long story short, the vet's office waited too late to perform the surgery and the puppy died! She told me if Hercules' glucose continues to bottom out to ask for a sonogram. It should show more detail than the x-ray. It would be the final step before exploratory surgery....that being said, Roger said the vet really feels he just ate something that highly disagreed with him, especially since he is finally stabilizing.

They are taking blood from him every hour to monitor his progress. I have requested all information relating to testing be faxed to us today if possible. They will see if Hercules is ready and willing to eat tomorrow and they will then decide if they will opt to keep him a second night based on his continued blood monitoring and appetite.

Again, thank you so much for your continued prayers. We really do appreciate them and each and every one of you.

God bless you,

Roger and Myrna (and Hercules!)

[Cyn719]

Glad to hear Hercules is doing better - we are praying for both of you and Hercules - hoping tomorrow Hercules eats and is home soon - hang in there - its hard but your are doing all you can - our thoughts are with you!!!! Keep us posted

[purpledachshunds]

Hi Everyone-

I just had a call from the vet tech. Hercules is moving around a bit in his crate, but it may be because the crate is cold and he is uncomfortable. She is trying him with a blanket and he feels so bad he shows no interest in chewing it. No vomiting, but a small amount of bloody diarrhea. Temp was normal at 10:00PM at 100.3.

Roger brought home the blood work done thus far on Hercules. I will post the abnormal results even though it is late and I have had no time to research them. I know what some of them are and mean and others I still have to look up. Hope it makes sense as I have only had about 10 minutes of sleep last night and a very short nap today.

9:00AM Glu 76 PCV done w/ chem.
11:30AM Glu 389 PCV 59%
1:00PM Glu 36 PCV 70%
1:15PM Glu 287
5:00PM 201 PCV 54%

Cort 7.6mg/dL This falls into the category if taking Vetoryl might wish to “consider changing dose based on clinical signs” if between 7.2-9.1 (either 8.1 or 9.1—the fax messed up here)

GLU 60 mg/dL Normal 74-143
CREA 1.9 mg/dL Normal 0.5-1.8
PHOS 9.6mg/dL Normal 2.5-6.8
TP 8.5 g/dL Normal 5.2-8.2
ALT 181/U/L Normal 10-100
ALKP 1434 U/L Normal 23-212
GGT 36 U/L Normal 0-7
CHOL 343 mg/dL Normal 110-320
AMYL >2500 U/L Normal 500-1500
K 3.4 mmol/L Normal 3.5-5.8
RBC 11.27 M/mL normal 5.85-8.87
HCT 77.8% Normal 37.3-61.7
HGB 26.5 g/dL Normal 13.1-20.5
RDW 22.8% Normal 13.6-21.7
RETIC 109.3 K/mL Normal 6.6-100.7
EOS 0.02 K/mL Normal 0.06-1.23
PLT 142 K/mL Normal 148-484

Most of the rest of the values were just inside high or low normal. Precious few were comfortably within normal limits. For example, his BUN was 25 mg/dL Normal 7-27. Some values (a few are ratios, I believe) just had a number with no reference. Like I said I am hoping for some sleep before researching them, but they are as follows:

BUN/CREA 13
ALB/GLOB 0.7
Na/K 44
Csm Calc 294 mmol/kg no normal reference given
%RETIC 1.0%
%NEU 64.3%
%LYM 31.1%
%MONO 4.5%
%EOS 0.1%
%BASO 0.0%
A note at the bottom says “WBC Abnormal Distribution”.

Also five values had dashes for example, –,--% or –,--mg/dL. They are:
CA
LIPA
MPV
PDW
PCT
I am unsure if these failed to read for Hercules or were just a part of the normal test that was skipped.

A couple of years ago when we were considering adopting Bree and I was able to stay at the computer longer and look at other posts, I saw a comment that caught my attention and I was planning on asking about it in the future. The gist of the comment was that every Cushpup owner should have Dexamethasone on hand, be able to recognize the signs of when to use it, and know how/when to properly administer it. I thought I had some time to pose this question after some more research since Hercules had just started Vetoryl, but then Lori asked if we had any Prednisone on hand (which we did) regarding his current situation. The vet did tell Roger he gave Hercules a steroid because he was afraid of his brain swelling. Sorry—too tired to remember which steroid he gave if he even told Roger. From our very naïve perspective it appears that if a Cush dog is vomiting uncontrollably, refusing to eat, and is lethargic a dose of Prednisone or some other steroid may help (if I remember correctly from a couple of years ago even save their life) until they can be taken to a vet. We would love to be set straight on this issue and learn more about when to administer steroids in a dog where it is quite obviously normally contraindicated.

I also have been trying to read bits and pieces of other posts now...it is just so very difficult to sit with my medical conditions. Am I correct that an elevated Amylase level is an indicator of Pancreatitis and that is the AMYL >2500 in Hercules' blood work above refers to Amylase? The vet never mentioned Pancreatitis to Roger nor have we asked yet. Of course the vet may have just been waiting to give Hercules' current condition a name as far as we are concerned. Hercules was seen by a different vet (the owner, actually) in the practice because his usual vet is off on Wednesdays.

We really do appreciate your continued prayers and yes, Roger and I need them as well as Hercules! We hope to be more active on the board someday and actually make posts to other threads we read, but we do keep all of you, your Cush pups, and your families in our prayers. Thanks again!

God bless you,

Roger and Myrna (and Hercules!)

[purpledachshunds]

Hi Everyone-

I spoke with the vet this morning. Hercules is doing much better. They gave him water this morning and if he holds it down until noon they will try him on a little food. His blood tests this morning were much improved from yesterday's values which were all over the place. He said his hydration is back in line and the Chem. Panel looks better. He said they will wean him off of the glucose (Dextrose) drip today and monitor him closely to see if his sugar crashes again. He said overall Hercules' attitude is significantly better. (I learned earlier this morning from the staff that he was wagging his tail.) The vet still feels this episode is less likely to be related to the Trilo. Hercules had a bowel movement with a lot of hair, which makes everyone feel much better concerning a possible blockage. He said Hercules has a very severe form of Gastritis called HGE (Hemorrhagic Gastroenteritis). I let him know that we were familiar with HGE as the only other dog I was unable to pull out of a severe vomiting spell had HGE. He said it is probably NOT technically Pancreatitis. His Amylase is under 1000, so he MAY have just a touch of Pancreatitis, but NOT true Pancreatitis. His Lipase was too high to read yesterday (thus the –.-- for values) and today it is 1/3 higher than normal, but obviously reduced from yesterday. He said he had severe dehydration which causes hemo concentration which is where the blood gets so thick it fails to circulate properly. He said his liver enzymes are into the normal range and his pancreatic enzymes are significantly improved. He said there is a night and day difference with Hercules' overall attitude. He said that true Pancreatitis usually has elevated enzymes for a longer period of time. He also said whether the dog has Gastritis, HGE, or Pancreatitis the treatment is the same. He will update us again later today.

Thanks again for your prayers and support!

God bless you,

Roger and Myrna (and Hercules!)

[Harley PoMMom]

Dear Roger and Myrna,

So sorry to hear that Hercules is not feeling well and I hope he is feeling much better soon.

There are a couple values on his lab report that do concern me which are his phosphorus, glucose, and the amylase.

An elevated phosphorus will make a dog feel ill and not want to eat. Has the vet mentioned a phosphorus binder? With his creatinine just outside the normal limit and an elevated phosphorus this could be a indicator of kidney problems.

Almost anything can cause an elevated amylase but with the glucose not stabilizing I am wondering if pancreatitis could be a culprit. One of the jobs of the pancreas is to produce the hormone insulin and secrete it into the bloodstream in order to regulate the body's glucose or sugar level. The "gold standard" test for pancreatitis is the cPL and this test only measures the lipase that comes from the pancreas. The only drawback is Hercules would have to be fasted for 12 hours to have a cPLl test done.

When a dog is suspected of too low cortisol an emergency dose of prednisone can be given but if vomiting is occuring the dose of prednisone might not be ingested. When I was treating Harley, I had his vet make up shots of Dexamethasone for me. Dexamethasone is not supposed to interfere with cortisol assays like prednisone will.

This dratted disease sure can create gray hairs! But please know we are here for you all and are keeping you all in our thoughts and prayers.

Love and hugs,
Lori

[Cyn719]

Glad Hercules is drinking - I am sitting her praying Hercules will eat at noon!!!!! fingers and paws crossed!!! :) I will check back

[purpledachshunds]

Hi Everyone-

The vet called with an update. Hercules has been drinking water and is holding it down. However, he refused the wet food they offered him. This is highly unusual! As evidenced by the garbage he has been vomiting and eliminating Doxies do literally eat anything! Plus since his Cushing's has yet to be controlled he remained hungrier than normal. They weaned him off of the glucose drip and his blood glucose level is in the low normal range. The vet would like it to be higher. They will continue to monitor his glucose and try to entice him to eat. He said he is not out of the woods yet, but is much improved from yesterday. (Apparently by the time Roger drove him to the vet yesterday Hercules had become extremely lethargic to the point he was unable to stand up and move! He had paced with me the entire night here and was just starting to become lethargic when we put him in his crate to go to the vet's office.) The doctor is pleased that he is up and moving around today.

I did ask about the cPLI test since Hercules has been fasting since Tuesday night anyway. The vet basically said its diagnostic value would be negligible as no changes would be made in the course of treatment. Besides, he emphasized earlier that he is confident it is NOT true Pancreatitis because Hercules' pancreatic enzymes came down so quickly even though they are still elevated. Also, it is abnormal to have bloody diarrhea with Pancreatitis while it is a strong sign of HGE. Nice to know there is a reliable test out there specifically for Pancreatitis...sounds like with a Cush pup we may need it in the future, though we obviously hope against it! No mention was made about a Phosphorus binder. Hopefully, we will receive a fax with today's numbers since the vet said that most of the numbers are much improved. Thanks for the tip about the Dexamethasone shot. I guess we are too tired and frazzled to think about it, but we have a shot we keep on hand (though I believe it needs to be updated) for Tazmyn because she can sometimes have really adverse reactions to bug bites and we live where fire ants are prevalent). I believe our syringe is filled with Prednisone instead of Dexamethasone. We will be sure to ask our vet about keeping some on hand.

As far as the eating goes, we thank you for your continued prayers. The other dog I mentioned earlier who had HGE was sent home to die after the vet had him stabilized and had offered him all they had available to eat and he refused. He really did look like a dying dog when we saw him. The vet said to continue to offer various food and see if we could coax him into eating. We made some rice in chicken broth (I may have even put some finely chopped and shredded chicken breast in too—it has been so many years ago) and were able to feed him a tablespoon at a time every two (2) hours or so until he finally began actually wanting to eat. The vet was absolutely amazed that he lived. God really blessed us—he died at 17y3m of old age!

Yes, we do feel the gray hairs sprouting! However, the prayers and support we receive from everyone is a comfort. Thanks!

God bless you,

Roger and Myrna (and Hercules!)

[Harley PoMMom]

Besides, he emphasized earlier that he is confident it is NOT true Pancreatitis because Hercules' pancreatic enzymes came down so quickly even though they are still elevated. Also, it is abnormal to have bloody diarrhea with Pancreatitis while it is a strong sign of HGE.

I'm confused by what the vet means by "true Pancreatitis," a dog either has pancreatitis or a dog does not. There are different types of pancreatitis such as acute and chronic. My boy, Harley, had pancreatitis which was confirmed with the cPL test, however, his amylase and lipase were within the normal ranges. The amylase and lipase results can not be used to diagnose pancreatitis in a dog, only the cPL test can.

Bloody diarrhea is definitely one of the symptoms of HGE but also can be seen with hemorrhagic pancreatitis.

Sending huge and loving hugs and keeping you all in my thoughts and prayers, Lori

[Harley PoMMom]

Glynda (and the rest of you wonderful sages on the forum), please feel free to have a hearty chuckle, but is “PU/PD” persistent upchuck/persistent diarrhea? Just a guess—how far off am I? (Yes we are showing our naivete!)

Polyuria (PU) and polydipsia (PD) are the medical terms for excessive urination (PU) and drinking (PD) in dogs. Don't you worry one bit about not knowing these medical terms, it takes a while to learn the lingo!! I remember when I first came to this forum and Glynda asked me if Harley was intact, I thought what in the heck does that mean!!!:eek::)

[purpledachshunds]

Hi Everyone-

I am beyond exhausted so this is going to be an extremely short, basic update.

Right now they are most worried about DIC (Disseminated Intravascular Coagulation) which in very tired layman's terms means his blood would form small clots until it had used up all the available elements to form clots and then he would bleed to death internally. No cure exists. They are checking for patechiae which would be an indicator of DIC.

Yes, I was confused by terminology such as “touch of Pancreatitis” and “true Pancreatitis”. I did ask his regular vet who has taken over his care about the cPL/cPLI test. She said that he is so unstable right now that they want to refrain from drawing any more blood plus it would take about four to five (4-5) days to receive the results. If his blood glucose keeps dropping (they had to give him more 5% Dextrose solution today) she will entertain this test, but for right now they are most worried about stabilizing him and doing their best to keep the DIC from taking over and killing him.

Like I said I am beyond exhausted and have been crying through my research of DIC. It is a horrific way to die. I will try to post more details tomorrow.

Thanks again for the prayers, support, and advice.

God bless you,

Roger and Myrna (and Hercules!)

[StarDeb55]

Roger & Myrna, I have been kind of keeping up with what is going on with Hercules. I am a lab tech with 30+ years experience, & am very well versed in DIC & its diagnosis. This is, indeed, a life threatening problem for both humans & pups. I know you are worried sick & exhausted, but can you answer a few basic questions for me. What did the vet say is causing the concern for DIC? Did the bloodwork that has been done include a CBC, complete blood count? If so, I'm looking for a platelet count. A critically low platelet count would be a strong indicator of DIC. I believe it is possible to do a prothrombin time &/or partial thromboplastin time in our pups. These are 2 basic blood clotting test that if they come back elevated would, also, be a strong indicator of DIC. Also, on the blood count, was a blood smear checked for the presence of fragmented RBCs which are called schistocytes? Again, the presence of these fragments is another strong indicator for DIC. These are all questions to be asking the vets taking care of Hercules.

Now, in humans with a diagnosis of DIC, they are treated with heparin. I know it sounds weird to give an anticoagulant when the illness can cause bleeding, but this really does work for humans. If the vets are convinced it's DIC, you might ask about treating with heparin. I, simply, do not know if it's done for our pups.

Hope this information helps. Please keep us posted.

Debbie

[Harley PoMMom]

Hi Everyone-

I did ask his regular vet who has taken over his care about the cPL/cPLI test. She said that he is so unstable right now that they want to refrain from drawing any more blood plus it would take about four to five (4-5) days to receive the results. If his blood glucose keeps dropping (they had to give him more 5% Dextrose solution today) she will entertain this test, but for right now they are most worried about stabilizing him and doing their best to keep the DIC from taking over and killing him.



The spec cPL test from IDEXX will usually have results in one day.

Oh Roger & Myrna, I am definitely keeping you all in my thoughts and prayers.

Sending huge and loving hugs, Lori

[StarDeb55]

I was doing some further research on canine DIC, & found the following link:

http://www.marvistavet.com/html/body_canine_pancreatitis.html

This is a quote from the above link:

Pancreatitis is one of the chief risk factors for the development of what is called “disseminated intravascular coagulation” or “DIC” which is basically a massive uncoupling of normal blood clotting and clot dissolving mechanisms. This leads to abnormal simultaneous bleeding and clotting of blood throughout the body.

I know your vet seems to feel that pancreatitis is not the main issue & treatment would not change. In light of their concerns about DIC, & the above, I would still be asking further questions about pancreatitis, & getting a cPL test done, IMO.

Debbie

[purpledachshunds]

Lori -The forms we have been receiving via facsimile say IDEXX on the bottom so now I am confused as to why it would take them more than a day to receive the cPL results too.

Debbie -

Thanks for taking the time to share your knowledge with us. I did ask the vet about doing an APTT and PT simultaneously while looking at his thrombocytopenia as recommended by Purdue University. She said if she sees any petichiae they will but otherwise they will hold off. She seems concerned because his PCV (Hematocrit) was 77% and at that point tissues are usually damaged. His Platelet count was 142 and which while low, she said they are unconcerned until it reaches 50 or 40. Today his Hematocrit was 57.3% and his Platelet count was 167. The way I understand it is when a dog presents with a PCV of 77% fluids must be pushed immediately and while the 57.3% may look good on paper pushing fluids this quickly can shock the body. I believe a combination of feeling there are likely a breakdown of tissues in his bloodstream along with the fact that he was in shock when he arrived at their office plus they shocked the body with a quick influx of fluids is causing her main concern. I posted yesterday's abnormal results in post #35 if you wish to view the many other values that were abnormal. I am planning on posting today's abnormal results tomorrow unless there are values you need right now. I really am so exhausted that I am questioning my ability to relay the information you seek correctly so please bear with me.

The link where I read about DIC at Purdue is http://www.addl.purdue.edu/newsletters/2005/winter/dic.htm.

I also read another link at Cornell University: http://ahdc.vet.cornell.edu/clinpath/modules/coags/dic.htm. This article addresses the use of Heparin in animals and while it exists it does appear a consensus has yet to be formed on the benefits.

I will ask about the blood smear. Thanks for the link about DIC being connected with Pancreatitis.

My husband has a couple of questions you may be able to answer for us, since one of them is about Hercules' fluctuating glucose levels, I will post the results from the glucose readings taken today and yesterday first:

Yesterday
9:00AM 76
11:30AM 389
1:00PM 36
1:15PM 287
5:00PM 201

Today
7:48AM 178
11:00AM 93
1:30PM 84
2:30PM 74 – started 5% Dextrose + LRS
5:00PM 134.

Okay—here is Roger with his questions.

My questions are pretty simple. What would cause his glucose drop in this manner, other than the obvious fact that he isn't eating and is only getting what they are providing him intravenously. Secondly, would it be accurate to say that every hour that passes without signs of DIC is a good thing and makes its occurrence more unlikely?

Todays values are:

GLU: 173mg/dL normal 74-143
BUN: 5mg/dL normal 7-27
ALB: 2.3 g/dL normal 2.3-4
ALKP: 530 U/L normal 23-212
GGT: 14 U/L normal 0-7
LIPA: 2245 U/L normal 200-1800 (note: yesterday was unreadable probably extremely too high)
K: 3.2 mmol/L normal 3.5-5.8
LYM: 5.19K/mL normal 105-510
MONO: 3.78 K/mL normal 0.16-1.12
EOS: 0.04 K/mL normal 0.06-1.23
PCT: 0.2% normal 0.2-0.5 (graph shows this in low end of low level, but numbers look like it is low normal)

Thanks again to everyone for the prayers, support, and advice.

God bless you,

Roger and Myrna (and Hercules!)

[StarDeb55]

I will say up front that I the chemistry is not my really special area of labwork, I'm the hematologist, but I can offer some ideas with the glucose. I think Lori may have already mentioned this, but if you are dealing with pancreatitis, your boy's insulin levels may be fluctuating quite markedly since the pancreas is where insulin is produced.

His platelet count is pretty darn good, that's a good thing. The real worry as your vet indicated is if the count drops to the 40-50 range. With his current plt. count, I would doubt that petechiae would be present, it's possible, though. That PCV (hematocrit) is extremely high, so I can totally understand your vet's course of action. Of course, this is a clear indication that Hercules was critically dehydrated, thus the need for the big bolus of IV fluids he was given. Absolutely, every hour that passes with no signs of DIC is a good thing. Most of the time in human patients, DIC treatment, other than heparin, consists of supportive care such as IV fluid, blood products such a platelet transfusions, or RBCs if there has been active bleeding. I don't believe plt. transfusions are available for our pups, but I do know that blood transfusions are.

I will give a quick explanation about the fragmented RBCs. When DIC is triggered, platelets which are the first step in the blood clotting process, are activated. They form a sticky spider like web in the small blood vessels. When RBCs try to pass through this "web", they are literally ripped apart forming fragments. Normally, a CBC will include the examination of a blood smear where a drop of blood is placed on a slide, smeared, then stained. The stain allows the tech to look at all of the blood cells that are present. The RBCs should be ovoid or discoid in shape. Fragments will appear as just ripped, jagged irregular pieces of an RBC rather than their normal shape. We are trained to take a careful look a blood smears in our human patients who have show a sudden, significant drop in their platelet counts to look for the presence of schistocytes as their presence is almost diagnostic for DIC.

Debbie

[Harley PoMMom]

Lori -The forms we have been receiving via facsimile say IDEXX on the bottom so now I am confused as to why it would take them more than a day to receive the cPL results too.


Dr. Jörg Steiner, who is affiliated with Texas A&M University, is one of the developers of the cPLI. The cPLI is a diagnostic test for pancreatitis and one can send their sample to Texas A&M University which does take 5 days for results.

The spec cPL test was created by IDEXX scientists that worked with Dr. Jörg Steiner and Dr. David Williams (Texas A&M University GI Lab). The spec PL test from IDEXX will usually have results back in 1 day.

Harley's first pancreatitis test which was the cPLI that was sent to Texas A&M did take 5 days for results. All his other pancreatitis tests that were sent to IDEXX only took one day.

Here is a link about the spec cPL test:New IDEXX Spec cPL® Test(canine pancreas-specific lipase) (http://www.idexx.dk/animalhealth/laboratory/speccpl/)

[purpledachshunds]

Hi everyone -

I may give short updates today and I want to respond to some posts, but last night I noticed some real scary adverse reactions in my own health (from staying vertical with hardly any rest) that may land me in the hospital! What good would I be to Hercules then?

Please feel free to post, but it may take a day or two (or a few) to respond...just depends on how my body responds.

Quick update – the vet just called. She is really excited. She said Hercules looks fabulous and it is nothing short of a miracle. As long as he can maintain his glucose when taken off of the Dextrose drip and eats he can come home this afternoon! I will post details at a later date.

Thanks again to everyone for the prayers, support, and advice.

God bless you,

Roger and Myrna (and Hercules!)

[lulusmom]

Yay!!! Way to go, Hercules Take care of yourself, Myrna.

[Harley PoMMom]

So happy to hear that Hercules is feeling much better!!! Myrna, please take care of yourself and get some rest.

Love and hugs,
Lori

[StarDeb55]

Myrna, I am very pleased to hear that Hercules has greatly improved & seems to have turned the corner.

Debbie

[purpledachshunds]

I went to pick Hercules up tonight and the vet is still calling him her miracle dog. He isn't 100%, but he will eat and drink and is keeping everything down. His glucose is stable and he seems to be on his way to recovering.

We'll continue to update everyone on his condition over the next few days.



Thanks again to everyone for the prayers, support, and advice.

God bless you,

Roger and Myrna (and Hercules!)

[Squirt's Mom]

Hi Roger and Myrna,

I am so, so glad that Hercules is home and doing so much better. Miracle dog for sure! :)

Myrna, now it's time for you to worry about yourself for a bit. Please rest as you need to, and know you and yours are never alone.

Hugs,
Leslie and the gang

[Cyn719]

Hercules is home - that is wonderful!!!!!!! Now you take care of yourself and get some much needed rest!!! When you can check and and let me know how the two of you are doing!!!! And Roger too!!!!:):)

[purpledachshunds]

Hi Everyone,

Everyone here is pretty tired. Hercules is much improved but is a bit weak and still has bad diarrhea with some blood in it. Our vet had us add a small dose of sucralfate twice daily to help with the diarrhea. Myrna and I are trying to catch up on rest. Hercules had us pretty busy for a while. He is quite a ways from being well, but at least he is home and is much improved.

We'll keep everyone posted.

Thanks again to everyone for the prayers, support, and advice.

God bless you,

Roger and Myrna (and Hercules!)

[purpledachshunds]

Hi Everyone,

Hercules had his abdominal u/s and EKG today. We assume that no news is good news because the vet that performed the tests was supposed to have the results sent to our vet by late this afternoon...we thought we would hear from her today. She is off tomorrow so hopefully we will know by Thursday. If the vet who ran the tests saw any urgency with the results we feel we would have heard by now.

Hercules finally started doing a little better today. Until today he has been a little puny every morning where he only eats a few bites of chicken and acts like his tummy hurts, his respiration has been increased, and his hackles have been up. He was so upset this morning because he could only have a few tiny bites of chicken because of his tests. Normally he will only eat about three (3) bites in the morning anyway, but today he was upset that so little was offered! (Normally he would have been fasted since 10:00PM the night before a test, but he is eating tiny meals frequently so we had to adjust the fasting per his vet.) He still has fairly bad diarrhea with some blood in it. We are all still trying to catch up on rest; with the frequent meals Hercules has me up around the clock. Today is the first day I gave him a larger meal, though it was still small by normal standards. He ate chicken and rice cooked in chicken broth (had only eaten this once thus far; otherwise refused) and he loves either baked turkey breast or rotisserie chicken breast so he had a little of that, too. Maybe now he will eat the chicken I slow cooked (boiled all day Saturday on the stove on low) in chicken broth. He has refused this, too!

At least he seems to have made some more strides today toward total recovery. We will provide updates when possible.

Thanks again to everyone for the prayers, support, and advice. It is truly appreciated!

God bless you,

Roger and Myrna (and Hercules!)

[Harley PoMMom]

Thanks so much for the update and I do hope you all are catching up on some sleep. So glad to hear that Hercules is improving even if it is slowly, remember baby steps are very important too. ;):)

Take care of yourselves and please keep us posted when you can.

Love and hugs,
Lori

[Cyn719]

Just checking in on Hercules - praying that he eats more and more each day - hope you can get alittle more rest xo Hugs and support!

[purpledachshunds]

Hi Everyone,

Sometimes no news is good news and other times, well...

The vet called with the results of Hercules' abdominal u/s and EKG today. The EKG was good – only very, very mild mitral valve degeneration which is normal in an older smaller dog. No heart murmur and normal cardiac function. However, the abdominal ultrasound was wrought with abnormal findings. His vet told me his gall bladder was abnormal. It was enlarged and the color on the ultrasound went from bright to a deep color especially around the outside edge. The color should be homogenous throughout. This could be sign of a infection or tumor. She said the ultrasound definitely supports Cushing's: his liver and both adrenal glands were all huge and glowing. She said the Vetoryl may have interacted with the gall bladder and neither she nor the doctor who performed the tests wants him back on the Vetoryl until he is completely stable (and then I think they may still question it since this happened so close to his initial dosing). She said the Pancreas was inflamed but not horribly and there is a lymph node nearby (near the gall bladder, I believe) that is irritated.

The actual findings are outside in our vehicle and it is raining very hard tonight so it may be a day or so before we can post them. (Plus of course I am looking up dogs and gall bladder problems, etc., and am hurting again, so I need to pace myself. Aggghhhhh! I want to research instead of rest. Yes, I am frustrated!)

I did read that an inflamed pancreas can put pressure on the gall bladder creating problems. (Yes, this is a tired, watered-down version of my research.) Has anyone else ever had gall bladder problems with their Cush pup?

Since going to the vet on Tuesday for his testing he has been more tired. He was just starting to show signs of recovering a bit more. He is more picky again with his food. He still has very runny diarrhea, but the blood appears to be gone. His respiration has remained high since his trip to the vet (between 36-53 beats per minutes, hanging out a little over 40 bpm generally). His tongue is blue a good bit of the time and he has had difficulty breathing. (He had difficulty breathing a couple of years ago and was put on steroids for a short period of time. “Allergies” and well before being diagnosed/showing signs of Cushing's.

The vet is putting him on a very low dose of Prednisone [2.5mg twice daily for two (2) days, then 2.5mg once daily until I call her with an update on Monday]. He is still taking 1/4 tablet of Sulcralfate 1gram dissolved in broth BID, 1/3 tablet Metronidazole 250mg TID, and 1/4 table Famotidine 20mg BID. The vets want him to continue his Metronidazole and also start a new antibiotic, Clavamox 62.5mg BID for a month and then do another abdominal u/s. The vet who does the u/s said if it is gall bladder he could need surgery in as little as two (2) weeks thus changing the course of treatment. The ultimate treatment would be exploratory surgery and removal of the gall bladder if necessary and he is a poor surgical candidate.

Does any of this sound familiar to anyone?

Needless to say we are very concerned again both because he has taken a few steps back and because we are hearing the “C” word. The vet said if his gall bladder does have cancer it has most likely already metastasized to his liver, pancreas, etc.

We appreciate everyone's continued prayers, support, and advice.

God bless you,

Roger and Myrna (and Hercules!)

[purpledachshunds]

Hi Everyone,

Hercules is at the vet today. He was showing signs of respiratory distress (blue tongue, respiration of 88 breaths per minute, a tiny bit of panting twice, unable to become comfortable, and once especially gasping for air while his blue tongue was hanging out—after he ran to the dog room with a grin on his face waiting to be fed). I looked up pancreatitis and respiratory distress and just sat here and cried and prayed. It looks like respiratory distress is often a complication of severe pancreatitis and the prognosis on most of the sites looks pretty bleak. I know with God all things are possible and while I am so thankful that we had any additional days with Hercules, I selfishly pray for many, many more! Has anyone else ever experienced respiratory distress related to pancreatitis. I tried to look it up on the forum and maybe I am so green I am clueless but I found no posts with direct connections, but, like I said, I found many scary articles on the web!

On the good side while he had a horrible night he looked and acted much better when preparing to take him to the vet. His tail wagged last night and he tried to eat (while gasping for breath between bites). He just shows many of the signs Bree showed in the weeks right before his passing, but of course Bree's respiratory distress was caused by the cancer that had metastasized to his lungs. Hopefully, we have caught it soon enough and the vet will be able to treat it.

We continue to be thankful for everyone's prayers, support, and advice.

God bless you,

Roger and Myrna (and Hercules!)

[Squirt's Mom]

No answers but prayers and healing white light flying your way.

Hugs,
Leslie and the gang

[lulusmom]

Dear Roger and Myrna,

I wish I had some words of wisdom for you but I don't recall any members whose dogs have experienced respiratory distress in connection with pancreatitis.

I'm with you in spirit and praying like crazy that your little buddy, Hercules, will prove again that his name is befitting.

((((Huge Cyber Hugs))))
Glynda

[Harley PoMMom]

I found this abstract:


Abstract

Chronic model experiments on dogs showed that the development of respiratory distress syndrome under acute pancreatitis conditions is correlated with violation of metabolic processes in the lung tissue, which is caused by activation of the coagulation/lysis system and changes in the lipid metabolism. It is established that remaxol limits the development of inflammatory processes in lungs, produces correction of the lipid metabolism, and introduces positive changes in the coagulation system lung tissues under acute pancreatitis conditions.[Studying efficacy of remaxol in the treatment of respiratory distress syndrome under endotoxicosis conditions]. (http://www.ncbi.nlm.nih.gov/pubmed/20597366)

Sending,love, hugs, positive energy, and healing thoughts.

[lulusmom]

I can't find any drug in the U.S. named Remaxol. I even checked the FDA website. It seems all of the studies I found were done in Russia so I wonder if it is even available here. I was driven to find out what the heck this drug or supplement is used for and I finally found a blurb that I've shared below.


remaxol a drug intended for the treatment of patients with liver dysfunction caused by acute intoxication was performed. Both medicines belong to the 5th class of practically non-toxic drugs. Their administration to experimental animals for 30 days did not cause toxic effects on the functional and morphological state of main systems and organs.

[purpledachshunds]

Hi Everyone,

The vet called with an update. She saw no fluid in his chest on x-ray and the rattling we feel in his chest is upper respiratory referred, which we thought was a possibility. She did say he may have a bit of metabolic acidosis (he has been fairly asymptomatic today at the vet) but he would need to be referred to an IMS because they are unable to place the arterial catheter to monitor his blood gases at their clinic. She also said that since he is such a complicated little dog it would be a good idea to take him to an IMS. She said this would cost thousands; probably $2,000 just to walk in the door, they will keep him for a few days, and they will want to do an MRI and/or CT just for starters. (She will call for exact prices but they will probably be gone today because they all leave early Friday.) Plus the closest IMS is at least two (2) hours away and Roger is already having trouble juggling work and taking Hercules locally. Additionally, the “thousands” will be an issue. I clicked through the ACVIM links and even called the 800 number to see if there was an IMS closer other than those on the website. I was told the website was up to date.

Also, do you know if the clinics at colleges are cheaper, more expensive, or the same as doctors in private practice? I looked at the website for UGA [which is over four (4) hours from us, but we do have friends in the area] and they offer no payment plans. In general, do all of you who see an IMS make payments or pay “thousands” up front and/or each time you go?

Unfortunately, Roger is going through a particularly bad day at work amongst several weeks of bad days and is too stressed to discuss the matter rationally right now (plus he lacks the time while at work to devote to such a discussion). I was just hoping since so many of you have been seeing an IMS you may have suggestions to offer that I can present to him when he feels like talking instead of just saying we must spend “thousands” to treat him and possibly, at this point, save him.

Also, here are the results of the abdominal u/s:

Liver/Gall Bladder: Abnormal. Enlarged subjectively increased in echogenicity. While portal vasculature is present and identifiable it nears the echogenicity of the hepatic parenchyma. The gall bladder wall is mixed in echogenicity and thickened circumferentially. There are multiple foci within the wall of the gall bladder. These foci are identifiable on both sagittal and transverse images. Once focus measures approx. 0.80x0.49cm on sagittal section and is hypoechoic (nearing anechogenicity) and is located within the craniolateral wall. On transverse image this focus measures approximately 0.64x1.12cm and has a hyperechoic outer cortex. This focus does appear to distort the lumen of the gall bladder. Additional foci within the gall bladder wall range in size from 0.30cm to 1.07cm in diameter on transverse section. Field within the gall bladder is predominately anechoic. There is no evidence of bile sludge or bile duct dilation.

Spleen: Normal. Moderately sized, medium level echogenicity. The parenchyma is uniform. The capsule is smooth & intact.

Left Kidney: Normal. Approximately 4.35cm sagittal section. Moderate corticomedullary distinction.

Right Kidney: Normal: Approximately 4.57cm sagittal section. Moderate corticomedullary distinction.

Urinary Bladder. Normal. 0.09 craniodorsal bladder wall thickness, anechoic urine.

Adrenal:
Left: Abnormal. 1.90x0.59cm sagittal section, “peanut” shape, increased medullary density.
Right: Abnormal. 1.76cm sagittal section, 1.16x0.52cm transverse section, increase in medullary and cortical density.
(NOTE: I checked at there is a “d” on “increased” with the left, but no “d” on “increase” with the right.)

GI: Normal. Duodenum 0.46-0.49cm transverse section; additional loops of bowel examined measure approximately 0.30-0.31cm in thickness.

Pancreas: Abnormal. Generalized increase in mesenteric and soft tissue density within the area of the body and left lobe of the pancreas. The patient was more uncomfortable when this area was aggressively scanned. An area measuring approx. 1.47x0.10cm on sagittal section in the area of the medial body or proximal left lobe of the pancreas was increased in echogenicity and moderately well defined. On transverse image this focus covered an area of at least 3.65 cm in width and a depth of 1.56cm. This was immediately adjacent to the pylorus of the stomach. The area of the proximal right limb of the pancreas was also increased in echogenicity and on transverse image measures approx. 1.28x0.77cm. See also the findings under lymph nodes.

Lymph Nodes: Abnormal. There was a single hypoechoic ovoid focus in the cranial right abdomen adjacent to the area of the pancreas and slightly medial to the inflamed areas previously described. This is in the area of gastric or messenteric lymph nodes. This focus measures approximately 0.81x0.47cm sag by 1.06x0.51cm transverse. The focus is well-defined and has small capsule.

Prostate/Uterus: Abnormal. Bilateral prostatic lobe enlargement. Right lobe sag 2.80x1.63cm, trans 1.93x1.62cm. Two hypoechoic foci within body of prostate measure 0.58x0.37cm sag by 0.37x0.48cm trans and 0.35x0.24 sag by 0.41x0.24cm trans. Left lobe 2.91x1.78cm sag by 1.80x2.16cm trans. Single hypoechoic focus identifiable on sag section only 0.56x0.24cm.

Opinions & Recommendations: Mixed echogenic foci within and thickening of the gall bladder wall,. The significance of this finding is unknown; however, infection and neoplasia should be considered rule-outs. In addition, the areas of the body and proximal right and left limbs of the pancreas are inflamed and seem to be sensitive to examination. There is also an enlarged ovoid, soft tissue focus in the cranial right to medial abdomen adjacent to the pancreas which may represent an enlarged lymph node. Bilateral adrenal gland enlargement. Hepatomegaly – generalized with generalized increase in echogenicity. Unfortunately, further examination of the gall bladder would not be possible without an exploratory laparotomy. This is a very unusual finding and may represent significant pathology; however, secondary disease related to pancreatic disease cannot be ruled out.

Interesting finds on the Remaxol. Roger researched pancreatitis and respiratory failure briefly at lunch and I have looked too. The findings I was reading before the vet called were so scary I was just trying to read through my tears! Roger said all of his findings were related to hemorrhagic pancreatitis. Our vet previously said (and we may have previously posted) that Hercules had something else going on in addition to the HGE. I wonder if it could have been hemorrhagic pancreatitis since no tests were performed to specifically diagnose pancreatitis and he did have bloody diarrhea. The damage to the gall bladder on the u/s seem to support this as a possibility. However, he lacked some of the symptoms of hemorrhagic pancreatitis.

We continue to be thankful for everyone's prayers, support, and advice. How do people go though this without you!!!!????

God bless you,

Roger and Myrna (and Hercules!)

[labblab]

Dear Myrna and Roger,

I am so very sorry that Hercules is having such a rough time! I know you are somewhere in Georgia, and I am in the metro Atlanta area. So here are a couple of thoughts. My own Cushpup was treated at a private specialty clinic here in the Atlanta area. He received excellent care and it made things a lot easier for us, logistically, by his being treated at a nearby facility. However, he became acutely ill, and we reached a cross-roads as far as further diagnostics. Specifically, he would have needed a head CT or MRI (leading to possible radiation therapy) as well as supportive care. We decided against further diagnostics and treatment in his case, and sadly we lost him. But in the course of investigating costs, I did find that the imaging would have been less expensive at the Auburn (Alabama) vet school than at the private facility (we had a specific interest in Auburn because we knew they had an outstanding radiation oncology program). Depending upon where you live in Georgia, Auburn might be even a closer option for you than UGA. And Auburn also has an outstanding vet school. So I just wanted to throw that out for your consideration.

Also, if you do decide to pursue specialty diagnostics and consultation, many vets will accept a payment option called "Care Credit." Upon application approval, you receive a credit card that is dedicated specifically and solely to healthcare costs. And as long as payments (and pay-offs) are made according to specific schedules, no interest or penalties accrue. Here's a link to the "Care Credit" website:

http://www.carecredit.com/

I am so sorry that you are facing such tough decisions right now. I will keep checking in, and I will hold you and little Hercules in my thoughts.

Marianne

[Cyn719]

Sending thoughts and prayers your way xo

[labblab]

Myrna, I just checked, and both UGA and Auburn accept "Care Credit." Our private specialty clinic did, too. So if you do choose to go forward with specialized consultation, that may be a helpful option wherever you go.

However, I do want to add that I will support you no matter what decisions you and Roger ultimately make. It is very daunting to be told that thousands of dollars may be at stake for only a few days of diagnotics and care, even when a total recovery is thought likely. In a situation of so many question marks, it is even more painful and heartbreaking a decision. It sounds as though little Hercules is a very sick little boy. So whatever you and Roger decide is the best for him and for your whole family, I know it is a decision based on your love for Hercules and also the other furbabies who are in your care. Whatever you decide, I am here to support you.

Sending many hugs,
Marianne

[ShannonJ92]

Hi Roger and Myrna,

I'm pretty new to the whole Cushing's things too (diagnosis came for my Yorkie Pebbles just over a month ago) but I was thinking I might be able to offer an answer for your question about respiratory problems with pancreatitis. It's safe to assume that all dogs are different so I can only share what I've been through personally. Pebbles had her first bout of pancreatitis the day before her first birthday - she's 9 now - and has had several bouts a year (very random bouts several times a year every so many months). I can't say that I ever remember her having respiratory distress while in a pancreatitis flare (knock on wood). Sometimes she smacks and licks her lips but I think that likely has to do with the upset stomach and unwell feeling. We end up taking her to the vet's right away or further away to the ER vet if need be when our office is closed. Sorry if I missed it but have you had his Amylase and Lipase levels checked? If elevated, they're a good indicator of pancreatitis. So is bringing up yellow bile repeatedly, a hot feeling (Pebbles' back and nose get hot when in a flare, and runs a temperature), loose stools and tender abdomen. Again, each case is likely different but this is just our experience.

Makes it even harder to figure out how to try to treat the Cushing's when underlying health problems already exist. Some of what you describe is over my head in terms of being able to comment but I hope I helped even a little.

My best wishes to you and Hercules. It's very overwhelming but support does help some and at least we know we're not alone.

~Shannon

[purpledachshunds]

Hi Everyone,

Marianne – Thanks for the information. We are just outside of Savannah, Georgia. I just spoke with my friend in Atlanta and she had suggested Auburn University, too. I did a quick mapquest just from city to city and Gainesville is closest, followed by Atlanta, and then Auburn. I mentioned Care Credit to Roger earlier because I saw it on UGA's website, but investigated it further with your link. I will need to see what he thinks. He is working late tonight and has to work tomorrow.

Marianne, God is the only one who knows how desperately I needed to hear your last post! THANK YOU!! This decision is very difficult. We know even good stress exacerbates Hercules' symptoms because he was doing much better Tuesday morning before excitedly going bye-bye with daddy in the crate to have his u/s and EKG. We really need to weigh if the value of further testing will offer enough information to outweigh the stress of a long car ride and more procedures. It is quite likely that the only way to know what is ultimately happening in his tiny abdomen is via exploratory laparotomy which is very questionable because he is such a poor surgical candidate. We also know that you made the right decision about the care of your fur baby, too. It is so hard to lose them, and, yes, some of the decisions we make along the way are agonizing. We are truly sorry for your loss. We know you took the very best care of him and loved him and we know he knew that too.

My friend in Atlanta used to live in Savannah and she still knows many of the vets in our area. Roger and I had already briefly discussed a second opinion before driving all over the country to see specialists and she suggested the same idea with the same doctor we had in mind. We have so many details to discuss!

Shannon – Thanks, yes your support and experience does help! We did post all of Hercules abnormal values from his hospital stay and both his amalyse and lipase were extremely elevated. His lipase went from too high to read to low normal in three (3) days! This is why his vet calls him a miracle dog because she has never seen or even heard about a lipase level dropping so quickly.

Thanks again for everyone’s prayers, support, and advice...it is truly a Godsend!! We continue to keep all of you and your Cush pups in our prayers, too.

God bless you,

Roger and Myrna (and Hercules!)

[labblab]

Dear Myrna and Roger,

I totally understand the considerations with which you are struggling. They are very similar to the ones that we faced with our Barkis, and it is so very difficult to arrive at a decision. I second-guessed myself each step of the way (and long afterwards), and that is a burden that I hope you and Roger will be spared. So I think the notion of getting a second opinion from a local vet is an excellent one. I think it's impossible to have too much info or too many opinions when you are faced with a decision that is this involved and important.

Wishing all of you ongoing strength and comfort,
Marianne

[purpledachshunds]

Hi Everyone,

Hercules has started his Clavamox to go along with Prednisone, Metronidazole, Sucralfate and generic Pepcid. He isn't eating as well today, but that may be due to the Clavamox. We may have already posted this, but one of the options we have is to keep him on Clavamox and Metronidazole for one month and then do another abdominal u/s. He can stop the Sucralfate if his stool firms up. For now, we're going to get a second opinion, but put off seeing an IMS unless his respiration gets worse. It is still elevated, but seems relatively stable. He does seem to do better at home, perhaps the stress and/or excitement of going to the vet's office makes him worse, and that is why we are deciding to take the longer treatment option. We'll look into the pricing at the various universities in case we go that route. Our vet quoted us $170 for a consultation with the IMS in Jacksonville and $1700 to have them do a C/T scan. Does this sound typical in pricing?

Marianne, we're sorry you had to go through that second guessing situation. We've been there before as well, and seem to be there again, and it is very painful. Barkis is a great name.

We'll keep everyone informed on Hercules condition.

Thanks again for everyone’s prayers, support, and advice...it is truly a Godsend!! We continue to keep all of you and your Cush pups in our prayers, too.

God bless you,

Roger and Myrna (and Hercules!)

[Cyn719]

Hi I got a price of $900 for a CT and 1500 for a MRI but I will know for sure on Wed when we go the the IMS - cant wait for wed!! Continued prayers and support for you and Hercules!!!!

[frijole]

If there are any teaching vet schools in your area you might check them out as they are usually less expensive. The closest IMS to me is in another state - 5 hrs away, Kansas State Vet School. I had multiple MRIs, a cat scan, blood work, an endoscopy and paid $1700 total. Kim

[labblab]

Wow, Kim, that seems unbelievable that you got so much done for only that much cost! Maybe imaging of different parts of the body carry different price tags? My recollection as to what the cost for a head CT or MRI for Barkis would have been was more in line with what Cindy is quoting, both at the private clinic and also the vet school (although the vet school was somewhat cheaper)...

Marianne

[purpledachshunds]

Hi Everyone,

Wow! Glad we asked about pricing differences! We are planning to email Georgia, Florida, and Auburn (all several hours away) for prices. Sounds like it may almost be cheaper to fly him to Kansas State—I had to read that twice—what wonderful pricing! We will post our findings.

Thanks again for everyone’s prayers, support, and advice! We continue to keep all of you and your Cush pups in our prayers, too. We will be praying for great results on Wednesday, Cindy and Penny.

God bless you,

Roger and Myrna (and Hercules!)

[frijole]

:D Marianne - I couldn't believe it either. The MRI I had done in Omaha (where they missed the adrenal tumor) cost be between $400 and $500 and the vet wouldn't even talk to me about the findings - she forwarded everything on to my incompetent vet (at the time). K State was $160 and they did a ton of images because they wanted to make sure it wasn't cancerous.

Hopefully GA, Auburn or FL come thru for you with affordable prices! K State was remarkable and Annie had the head of the small animal science dept as the lead on her case.

Kim

[purpledachshunds]

Hi Everyone,

The vet called Roger today. She wants Hercules to continue taking his 1/2 tablet of 5mg Prednisone daily so he is going to be on five (5) medications for the next month or so! He seems to be eating better. For the past 24 hours it has been like it was when his Cushing's was so dominate (before his HGE/pancreatitis) making him eat every few hours or he would vomit. He does seem to cycle between feeling well enough to eat and being finicky so only time will tell. It will be good if he continues to eat of course. However, eating every few hours will keep packing on the pounds and he is already about 3 1/2 pounds overweight! We must feed him to keep him from vomiting though so there is no good answer. We dread starting him on the Cushing's medication again whether it is Vetoryl or another drug, but we must gain control of his overeating. None of this will be done until after his follow-up ultrasound in about a month. The vet agrees with Roger that his girth from his weight gain coupled with his organs being so enlarged and inflamed is probably what is causing his shallow, rapid breathing and sometimes blue tongue.

Thanks again for everyone’s prayers, support, and advice! We continue to keep all of you and your Cush pups in our prayers, too. We will be praying for great results tomorrow, Cindy and Penny!

God bless you,

Roger and Myrna (and Hercules!)

[Cyn719]

So glad Hercules is eating better - thanks for the good wishes!:)