Shadow 9 yr. old Shepard/Chow (treatment with trilostane) Shadow has passed

[Shadow's Mom]

Hi Everyone,

Let me start by saying I'm glad I found you all. This forum has been a great help to me and I was beginning to think I was going to have to go it alone.:eek::eek: Thanks Nat for making room!!

I got Shadow's 1 month ACTH results back Wed. Her pre-draw was 1.2 and post 1.4. Does anyone think that is getting a little low??:confused: She was on Veteroyl 120 mg once a day and the last 4 days before the test she began taking Trilostane but only 118mg once a day. We ordered from Diamondback drugs because the price was much better but for some reason we could only get either 59mg or 61mg capsules. Our vet decided to go with the lower dosage and said that she is not going to change anything right now to just keep an eye on her to make sure it doesn't get to low.

Anyway Shadow seems to be doing better than she was one month ago. She's getting little tufts of hair growing and water consumption is down but she still eats alot. Not sure if this is just a habit now or she's really hungry. If anyone has any thoughts please let me know.

Thanks,
Karen

[labblab]

Hi Karen!!

We're so glad to have you and Shadow back with us. I'm also really glad to hear that Shadow is showing improvements since beginning treatment. :)

However, I'm afraid I do worry that Shadow is at risk of going too low if you keep her on her current dose. According to the treatment and monitoring guidelines of Dechra (manufacturer of Vetoryl), their trilostane treatment goal is an ACTH "post" result greater than 1.45. Per their published flowchart, even if a dog appears clinically well, a result lower than that ought to result in a brief break from the trilostane and resumption at a lower dose. :(

Here is a copy of Dechra's treatment flowchart: http://www.dechra-us.com/File/vetoryl_Treatment_and_Monitoring_Flowchart.pdf

After taking a look at it, I'd encourage you to print it out and discuss Shadow's results further with your vet. The awkward part is that, if you only have 58 mg. capsules on hand, there is not an easy way to "tweak" her current dose a little bit lower. You may want to bite the bullet and order some capsules in a lower dosage strength so that you will always have them on hand in order to make gradual dosing changes as needed.

Oh, and the reason why Diamondback is not supplying 60 mg. capsules (or 30 mg. capsules) is because those are the Vetoryl dosage strengths that have received FDA approval. Due to marketing legalities, compounding pharmacies are not selling a product that directly competes with the FDA-approved brand. Therefore, once the FDA approves 10 mg. and 120 mg. capsules later this years, compounders will no longer offer those dosage strengths, either.

Marianne

[BestBuddy]

Hi Karen,
I am so glad Shadow is doing well but like Marianne I am a little concerned that those ACTH numbers are getting too low. If you continue with the same dose be watchful and stop the trilo if you have any little sign that shadow is not well.
Jenny

[Squirt's Mom]

Hi Karen,

Glad to hear that Shadow is showing some improvements and hope you see many more! Let us know how things are going when you can.

Hugs,
Leslie and the girls

[Shadow's Mom]

Hi All,
Thanks everyone for the advice. I too thought it was getting a little low but for some reason our vet wants her to stay with that dose and have her tested in another 2 weeks. I think she feels that since the dosage is 118mg instead of 120mg a day that her numbers will be up some when we go back next time. We have been taking Shadow there ever since she was a pup but I've been thinking maybe it's time to start looking for another vet. Someone more experienced with Cushings.
Shadow seems to be a little tired (nothing to out of the ordinary) but her appetite is good and her bowel movements are solid and she hasn't been nauseated but I'm a little worried that if these symptoms start it will be to late so we are watching her very closely.
We're all going camping Saturday for a couple of days and will be out of the state and that is making us a little nervous. We bought a motor home when Shadow was just a pup because we couldn't NOT have her with us always!:o This pup loves to go camping, especially all the walks we go on. We're going to start out slow because I know she hasn't gotten all of her strength back but I'm sure some exercise will do her good.Maybe build some of the muscle back up.
Is there anything else I should be looking for besides the symptoms mentioned above? Also I have noticed that there seems to be some darkening on her stomach, it almost looks like some kind of bruising. Could this be from the medication?:confused: I'll wait to hear from you all. Any suggestions or opinions are all greatly appreciated. God knows I can use all the help I can get!:D
Thanks Again!
Karen

[Roxee's Dad]

Hi Karen,

You have a lot of good advice from the others. I would look on line for an emergency vet somewhere close to where you will be camping just in case.


We're all going camping Saturday for a couple of days and will be out of the state and that is making us a little nervous. We bought a motor home when Shadow was just a pup because we couldn't NOT have her with us always!

Now this made me laugh, now I know my wife and I aern't the only ones that are nuts and purchased a motorhome for our pups.:o We never had the heart to leave them in a kennel. They just love it and the 2 little ones sit on the dashboard and look out at the world:D at least until the windshield wipers come on:eek::eek: then they scramble for cover.

Have fun and enjoy your time with Shadow on your camping trip, hope all goes well.
John (Roxee's Dad)

[lulusmom]

Hi Karen,

I'm a Lysodren mom now but both of my cushdogs treated with Trilostane previously. I personally don't think 2mg per day is going to make a marked difference one way or the other. Unlike Lysodren which has a cummulative effect for up to 48 hours, Trilostane has a short half life, meaning that it's enzyme blocking abilities start to diminish any time after 8 hours. This is a good thing because if Shadow starts to show signs that her cortisol is too low, she should bounce back rather quickly after withholding the dose. This is why most cushing's savvy vets don't feel it necessary to prescribe Prednisone. Of course, that doesn't mean that you can't overdose a dog so you should stay ever vigilant.

Stop the Trilostane if Shadow loses her appetite, vomits, has diarrhea, starts trembling or is acting extremely lethargic. When either one of my pups acted the least bit sick, I withheld the Trilostane for a few days or until they were back to normal...whatever that is in this house. :D

Pigment change is common in cushdogs and those with hypothyroidism. You are not the first member to mention darker pigmentation on your dog's stomach. I think the pigmentation is probably occurring elsewhere on the body but because the stomach is void of hair/fur, that's usually the first place people notice it.

You and John are very lucky to be able to hit the road in your RV with your furbabies. I've always fallen in love with defective units so I've made it possible for my vets to buy RV's but alas, it's a little cramped in the Yugo for me and my five furkids. :D

Glynda

[Roxee's Dad]

Hi Karen,

Just checking to see how Shadow is doing, hope he had a nice camping trip.

John (Roxee's Dad)

[Shadow's Mom]

Hi All,
I know it's been a while. We've been emptying out a college dorm room so that we can bring home our baby WITHOUT fur and with her all the drama that follows. :eek::eek:
The camping trip went surprisingly well, thanks for asking John. Although our walks were much shorter than before this disease got her , Shadow enjoyed heself very much. She would have walked her legs off if we let her but as you all know her energy gets zapped pretty fast these days.
We just passed the 2 month mark for Trilostane and she is so much better than she was. This last month we haven't seen much more improvement but we are greatful for what we have gotten so far.
Shadow is still on 118mg once a day, her drinking is back to normal, panting is gone, appetite is still very healthy and her hair is making slow progress. She seems to be better in the morning before taking her medication. We dose her at noon and shortly after she seems to be grow more tired as the day wears on and by 9pm she is exhausted. I know this seems backwards and she should be perking up by 9pm since the Trilostane should be wearing off. We were considering dosing her twice a day to see if that helps. Maybe a steady 59mg dose would be better.:confused:
Shadow turns 10 years old next month and we have been so blessed to have had her this long but the truth is she is getting older and she will never be that pup we had before she got sick. We are greatful for every day we are given with her and pray that she keeps improving. ACTH test scheduled in 3 weeks. Hope the numbers are good!:)
Sorry I've been so long winded today, I'm pretty sure that I shouldn't have watched that movie Marley & Me last night, it really broke my heart. I think I cried for about an hour afterwards just holding onto my pup.:o Well I guess I'll close for now.
Hope eveyone had a great weekend!
Karen

[MiniSchnauzerMom]

Hi Karen,

Glad to hear that Shadow has successfully passed the two month mark on her Trilostane treatment. With her drinking back to normal, panting gone and the progress with her hair, well those are some pretty positive results. Congratulations!

Will be interested in knowing the outcome of her ACTH testing in three weeks. Hope you had a great weekend too!

Louise

[Shadow's Mom]

Happy 4th Everyone!!!
Shadow just had her 10th birthday the end of June :D:D. We also got her results back Friday for her 3 month ACTH test, actually it was about 2 weeks late but the results were good. Pre 1.1 and Post 1.8. We had a full blood panel and urinalysis done and everything looked excellent :) Urine read was good, potassium levels are good and all her organs are functioning great.
We did have one issue and that was the fact that my girl seems to have gained a bit of weight 11 lbs :eek: in 3 months. Not sure if it's the medicine or her Mom causing this gain. I came home, and as per the vets instruction, started measuring out her food instead of eye balling the amount. Let's just say there didn't seem to be very much on her plate compared to the amount before measuring. Hope she doesn't starve to death!! :o
I also spoke to the vet about how Shadow seems to have a hard time climbing the steps at night and she said it may be because of the weight gain or it could be the onset of arthritis. We're going to try an anti inflammatory for a month and see if that helps.
Other than that she seems to be doing great. Her hair has really grown back which is probably why we didn't notice the weight gain. Water consumption is about 6 cups a day and she always leaves something in the bowl now. She will actually look up from her food when you call her name now which to me is amazing. No late night bathroom runs or accidents so it seems like we may have this under control for now.We're keeping our fingers crossed.
Well I better close now because the fireworks are starting around here and it makes my girl very nervous.:eek::eek: Hope everyone has a great holiday!!!

Karen

[Harley PoMMom]

Hi Karen,

Happy Belated 10th Birthday to Shadow.:D:) So happy she is doing well. The only comment I have is on the anti-inflammatory, you might want to watch out for the NSAIDS (Nonsteroidal anti-inflammatory drugs), some of them can be hard on a cush-pup, especially their liver and their stomache.

I see from your post that Shadow is getting a girlish figure (11# in 3 mths) :) Hey it happens to the best of us. :eek::D I'm pretty sure Harley has put some weight on, but hopefully since he's more active now he'll be able to take it off.

Best of luck to you and Shadow.
Lori

[Shadow's Mom]

Hi Everyone,
Just a quick question, not sure if this has anything to do with the trilostane or the heat wave we are experiencing here.Shadow's breathing has seemed labored to me for the last day and a half. Alot of panting and when she's relaxed it isn't an even breathing pattern. We usually keep her shaved and this is the first time in forever that she has had a full coat. Everything else is okay, her appetite is good, drinking is normal, bowels are OK. Any ideas what this might be? Should we stop the trilostane until we get her to the vet? Greatly appreciate any suggestion as to what this could be!! Seems like we're always the paranoid pup owners now:eek: Just when you think everything is going good, something happens to let us know just how sick our girl really is.:(

Thanks,
Karen

[AlisonandMia]

If her appetite is good and all else seems fine then I doubt very much it is the Trilostane. I bet it's the heatwave. I've found that wetting down the belly can help cool a dog down and make them feel better. Wetting them on the back of the neck/head area is also very effective (especially if they get hot on a walk) but you need to be careful not to get water in the ears if you do this (ear infection can result). Maybe she needs another shave - in the belly area at least as this seems to really help them keep cool.

The panting could actually get worse if you were to stop the Trilostane which, in turn, would likely result in her cortisol rising.

My perception was that my dog panted more readily after she had had Cushing's (even though all her other symptoms had resolved completely). Now I don't know if this was really the case or if I'd just become very "panting sensitive".

Panting can also be a sign of pain.

Alison

[Shadow's Mom]

Admin note: Copied from "Checking in for October 2009" thread. (http://www.k9cushings.com/forum/showthread.php?p=16235#post16235).



Hi All,
Thought I would check in for October. Shadow just got her 6 month test results back and eveything is looking great.:D She's still needs to get rid of a couple of pounds but other than that she's doing so well. The irregular breathing problem turned out to be all that hair. We took her to get shaved shortly after my last post and all that hair was causing her to be over heated. We really hated getting it shaved off since it grew in so beautifully for the first time in a few years but it made a world of difference.
I can't explain how blessed we are to have found this site and for the excellent results Shadow has gotten since beginning Trilostane. Thank you all for the great advise and for the support when I thought I was going to go crazy dealing with this. What a difference 6 months makes, not perfect but not far from it ;).Well we will all be loading up in the motorhome and heading to the mountains in a few weeks to see some fall colors and take all those walks our pup loves so much, must be the new smells:o.
Wishing All Of You The Best !!!
Karen

[MiniSchnauzerMom]

Karen,

Great news that Shadow's 6 month test results were excellent and very happy to read that the shave (and less hair) took care of the Shadow's problem.

Hope you and the pups have a wonderful motorhome trip to the mountains. Enjoy those fall colors and walks!!

Louise

[Shadow's Mom]

Hi Everyone,
I know it's been awhile and I was pretty sure until about 2 weeks ago that everything was going great with Shadow and then I notice some skin irratation on her belly and hind legs after we gave her a bath.Not exactly sure what it is but it seems to be Scabby:eek: is the only way to describe it. No other symptoms have appeared that would suggest her medication needs to be adjusted. She's not due for another test until Feb 20th. but I'm taking her in on Monday to have it checked out before it gets any worse. Any ideas what this could be and how it would be treated.:confused:
Thanks,
Karen

[Shadow's Mom]

Admin Note: This post has been copied from the Checking in for July 2010 thread:

http://www.k9cushings.com/forum/showthread.php?p=35241#post35241

______________________________________________

Hi All,
I know it's been awhile. Shadow has been doing great in her battle with cushings but 3 weeks ago we had a set back. Seems she has an ACL injury in her back leg. It's so sad, I'm not sure how much this dog is going to have to go through in her lifetime. She is a bit over weight and the vet said with her age and the cushings that surgery probably isnt a very good option. For now we help her get outside and my husband has built ramps so she can get around easier. Also she is on pain medication. No anti-inflamitory medication apparently it doesnt mix well with Trilostane. It breaks my heart to watch her, she is such a trooper.I swear that tail never stops wagging:D The vet says it may take several months and there may be the possibility of the other leg giving out.Well hope everyone is doing fine. I'll keep you posted on her progress. Anyone know of any supplements that may help and not interfere with the Trilostane?
Karen

[Shadow's Mom]

It is with a broken heart that I post here today but I felt that I should let everyone know that we had to end Shadow's suffering last Monday 1/10/11. You all were so much help and comfort to me when she was first diagnosed with Cushings that I thought it only fitting to post her passing here. Shadow became sick, throwing up, diarrhea and we thought that her trilostane dosage was to high since she had lost some weight. We stopped giving her the medication for a couple of days and and her symptoms seem to improve. After about 3 days she stopped eating and was vomiting so we took her to the vet. Blood work showed her kidneys were failing so we left her for 48 hrs of IV fluids to get her numbers down. After that time the numbers only came down a little so we brought her home to be with us for her final days.
We had 3 good days with her after that always with hope in our hearts that maybe just maybe she would be okay for a little while longer. It was only a matter of time before the toxins built back up in her blood and passed what they refer to as the blood/brain barrier and we had no other option but to end her suffering. We prayed that God would come for her so that we wouldn't have to do this terrible thing to her but our prayer unfortunately went unanswered. Now we are left with an emptiness so unimaginable that each day is a struggle for our family.
Thank you all for your support, knoweledge and help I would have been lost without you. Hug your Fur Babies and keep them close ALWAYS!!!
Karen

[Squirt's Mom]

Dear Karen,

I am heart-broken to read your post this morning about Shadow. :( You were such a good mom to her and worked so hard to give her the best possible life. Your love for her was obvious in every word you wrote.

Praying that our babies will be taken in their sleep is a prayer I think we all have raised at least once. Too often, tho, it falls to us to make "the decision" for them. That decision is made out of love, out of a desire to spare them more pain and suffering, even tho it tears our heart out to do so. Someone once said we take their pain and make it ours - and that is so very true. But it was not a "terrible thing" you did for Shadow - it was the greatest, most loving gift you ever gave her. You set her free from her failing body, a body that would not recover. For this and for everything else you did for Shadow, I know she is grateful beyond expressing and will be watching over you with the same love and devotion you showed to her.

Shadow's name has been added to our In Loving Memory list for 2011 where she will always be remembers and honored by her cush family.

http://www.k9cushings.com/forum/showthread.php?t=2865

Candles can be lit for her at:
http://www.gratefulness.org/candles/candles.cfm?l=eng&gi=K9C

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

[mytil]

Oh Karen,

I am so very sorry to read this - your Shadow will always be remembered by us.

I know exactly what you have gone through - happened to my Mytilda as well. You have been such a good mom to her and my heart is with you.

Please do stay with us. These coming days will be really tough and we are all her for you.

((((((((((hugs)))))))))))
Terry

[marie adams]

Dear Karen,

I so know your pain and felt that same as you did to have my Maddie leave us at home. The decision was so hard and didn't want to have to make it, but as they say it was the best gift we could give them. The emptiness sooo hard also, but I do remember the good times and know she is back to her old self running and playing without the sickness.

You did everything you could for Shadow and she did everything she could for you--remember the most wonderful time you got to spend with her and she with you.

Take care!!!

[BestBuddy]

Hi Karen,

I am so sorry to hear Shadow lost this last battle.

Godspeed Shadow.

Jenny

[loshie]

I am so deeply sorry Karen. We'll pray for you and your family for strength.

Melanie
xox

[Roxee's Dad]

Dear Karen,

I am so very sorry for your loss. Shadow knows she was loved and will be watching over you.

Rest in peace sweet girl, you are our newest and brightest star in the sky.

[John II]

Dear Karen & Family,

I am so very sorry for your loss.
My thoughts and prayers are with you.
:(

[frijole]

Karen,

I am sorry to hear the news but glad you came home to tell us. You and Shadow will always have a home here and we will honor her memory along with our other babies. RIP dearest angel Shadow. Kim

[Tobias]

Hi Karen: I send you and yours thoughts of love and healing. You made a brave and honorable choice for your shadow. How deep the valleys sorrow carves in our heart...sometimes we feel we will never be happy again. The more we love (and from reading the posts from the beginning of the thread I see how much you did love Shadow) the more we hurt, it seems. Yet we are always better people, I think, for having lived with dogs. How Shadow's light shines in the posts about the RV, the trips, the walks, although shorter, as you mentioned. I pray for light to show you the way through this sad time. Blessings and hugs and love from Linda and Toby.

[jrepac]

So sorry to hear of Shadow's passing. It's never easy to let them go :(

Jeff & Angel Mandy

[Casey's Mom]

Karen, I am so sorry that you are dealing with the loss of your Shadow. You were a great mum and gave Shadow the greatest gift at the end - truly. Please do not feel badly in any way. Stay with us please and we will help you get through this most difficult time.

Love and hugs,

[Spiceysmum]

Karen,

So sorry to hear about Shadow, my thoughts are with you.

Linda

[k9diabetes]

Hi Karen,

I'm so sorry to learn of Shadow's passing. I know she would thank you for having the courage to release her and prevent her from suffering - that final act of love is so hard for us but such a profound gift to your dog.

With great sympathy,

Natalie

[Bichonluver3]

Dearest Karen,
I have been away from the site for a while and returned to find your sad posting. I am heartbroken to hear about Shadow's passing. I was so impressed with the picture of her incredibly beautiful face. The tears are falling and I am crying with you as I write this. I read in one of your postings that you were hoping God would intervene and that "unfortunately" He did not. But you see, sweetheart, He did answer your prayers by giving you the courage to do what you had to do. You were just the best mom and Shadow was as blessed to have you as you were to have her. Because of the great love and times you spent together, God will grant another favor - that of eventually replacing the unbearable pain with smiles at all the happy memories. I hope, when that happens, you will share stories of life with this precious soul. I send all my love and prayers to you.
To Shadow: Run healthy and free, sweet princess, with all your new-found friends across the rainbow bridge. May the sun light your face and gentle winds blow at your back. I will look tonight for our newest angel star in the desert sky. You will be forever with us. God bless and godspeed.
Love, Carrol & Chloe

[caroleh]

Hi Karen:

I am so sorry to hear about your sweet Shadow. We are grieving the loss of our Schnauzer to Cushings. Fritz was having the same problems as Shadow in climbing the stairs and we found that he had diabetes. He was almost 11 years old and we had him for 7years. I invite you to email me at caroleahenry@gmail.com if you need someone to commiserate with. I am having a difficult time in relieving myself of guilt in the loss of Fritz. I keep thinking if I had acted sooner or done something differently it could have saved him. He had been to four different vets yet I still feel the guilt. Time will heal you as well as me sweet Karen and all I can say is I know that God also counts the hairs on our furry friends heads and we will meet up with them again and we will rejoice in eternal life.

Carole

[Shadow's Mom]

Thank you all for your kind words and prayers for our family.It really means alot to us. My heart breaks over and over when I read all of the posts knowing many of you have experienced this pain our family is going thru.We brought Shadow home Monday 1/17/11 or should I say her remains. Picking her up was unbearable but we have her home with us now and in a way that is very comforting. It seems that this pain and sadness will never stop and we have cried a thousand tears. My husband isn't doing very well thru all of this and we seem to be very short with one another some days but I know it is just the grief we are feeling. Shadow was after all his girlfriend for many years :(. I never thought that we could hurt or miss her so much and we pray everyday for God to take away this emptiness.
We will always remember her beautiful spirit, always loving, gentle and accepting. Her trust in us was never ending, but when she needed us most we were unable to help her and make everything okay and that seems to be the hardest part to over come. My tears are flowing now and I better end this post before they get out of control.

Hoping I can return soon and post all the beautiful memories of Shadow without so much sadness.
Thank you all again.

Karen

[Bichonluver3]

Dearest Karen,
We all feel your incredible pain and grieve for our Shadow. Such a beautiful face can never be forgotten. Please find strength in knowing that she is still watching over you, just from a little greater distance. Take care of yourself and hubby. Give each other some leeway - we all grieve differently. If we can help, in any way, we are here. If you need us but are not up to posting, just post your name and we will be there. I send all my love and prayers your way.
Tight hugs,
Carrol

[Squirt's Mom]

Dear Karen,

You and your husband did help Shadow when she needed you most - you set her free from suffering. You loved her with all you had to give every day of her life, including that last one - especially that last one and Shadow knows that better than anyone.

The kidneys are sneaky organs; they don't tell us they are in trouble until it is usually much too late to do anything about it so please don't let guilt eat at you. In the midst of our grief, it is so easy to convince ourselves of things that simply are not true - and in this situation, neither you nor your hubby had any control. What you could control, you did every time and with abiding love.

Please know we are here if you need to talk.
Hugs,
Leslie and the girls - always

[apollo6]

Dear Karen
Our prayers are with you and your family in this time of sorry. So sad to hear of the loss of your beloved fur ball, Millie.
Sonja and Apollo