Aussie, Mandy - *Appetite Decreased* (Mandy has Passed)

[jrepac]

Can someone advise me on how to go about getting the screening for Atypical Cushings? I know the blood has to be sent to U of Tenn? Knoxville?
I spoke to my vet about this and he agreed to having this test done.

Most of this info. was on the old site which is in limbo now.

My Aussie is going to get an ACTH in about a month and I want to get screened for both atypical and typical cushings...

Her bloodwork came back with high liver enzymes (again) and high cholesterol. Everything else looked good and she continues to have pretty minimal symptoms while taking selegiline. But, the high liver enzymes (over 3000) are troublesome.

I am really wondering if she is atypical....if I get the urine cortisol: creatine test done first, would atypical register on that?

Thanks!

[StarDeb55]

http://www.vet.utk.edu/diagnostic/endocrinology/general.php

You can print this out & give it to your vet. Make sure that they send the samples directly to UTK & not to the lab that does your vet's general labwork. All the regular lab will do is forward UTK, & tack on their handling charges which can substantially increase the price. Turnaround time is about 2 weeks.

Debbie

[Harley PoMMom]

Here is the link to UTK http://www.vet.utk.edu/diagnostic/endocrinology/index.php. Sorry I can't post the link right. Hope this helps.

harley and Lori

[gpgscott]

I am really wondering if she is atypical....if I get the urine cortisol: creatine test done first, would atypical register on that?

Thanks!

I am glad you are going forward with this screen, your name is Jeff, right?

Debbie has provided a good link.

All the UC:CR will tell you about is cortisol not the other five hormones and it is not diagnostic for cortisol just good as a rule out.

Best to you both. Scott

[jrepac]

Thanks for the quick responses!

Jeff & Mandy (the Aussie)

[Squirt's Mom]

Hi Jeff,

Here are some more links about Atypical:

Atypical Cushing’s*
http://veterinarynews.dvm360.com/dvm/article/articleDetail.jsp?id=485128&sk=&date=&pageID=1

http://www.vetcontact.com/en/art.php?a=132&t=

You are wise to have this done for Mandy! This is a test I think all cush pups should have as part of the initial diagnostics. It could save so much stress on both pup and parent!

How is Mandy doing these days? I was reading some abstracts about Anipryl the other day that said studies had shown it prolong life in some animal, dogs included. But they were from the the 1990's; I wonder if any more studies have been done recently to support those? Interesting anyway.

Hugs,
Leslie and the girls

[jrepac]

Thanks for the links Leslie...very interesting. I think it is very possible that Mandy has Atypical Cushings. It has been 1 yr since her ACTH test...but several other tests were in-between (ultrasound, thyroid, blood work [multiple], urinalysis, etc.). She was 'high normal' for cortisol on the ACTH test last year. Of the 5 vets who saw her, a few felt she was cushingoid, regardless of the ACTH #.

My regular vet suggests we do the ACTH again, but if she has to go thru it again, I'd prefer to do the full screen from U of TN. I was able to download all the info...it will cost a bit more, but I think it is more thorough. I may do the urine cortisol:creatine test first, to see what it says re: cortisol levels...it is only $40 and a good pre-screen.

Mandy is doing pretty well, all things considered and will turn 12yrs in May. She has been on anipryl/seligiline since September and her symptoms are well controlled/minimal. No UTIs either. She gets the 10mg of anipryl daily along with her other supplements (cranberry, sam-e, milk thistle + a blood glucose vitamin). I had hoped her liver counts would come into line with the milk thistle & sam-e, but no luck on that. At least her blood sugar was AOK (it had been high in Jan and diabetes was a concern, so I started giving her the blood glucose vitamin). I'd like her to lose weight; she is stuck at 25lbs, despite being on low-fat dog food, limited portions and lotsa veggies since january! (LOL! I DO spoil her...nibbles of pizza last nite!)

I had been sifting thru the net re:anipryl and saw some of the same things you did....possibly extending lifespan, slowing tumor growth, etc. It is a pretty mysterious drug, I think. It works for some cases, but no one can really explain why! It has clearly helped Mandy, relative to where she was before starting on it; it was a big help. But I'd like to make sure her cortisol levels and liver enzymes are not off the charts...

I'll keep you posted!

Jeff

[jrepac]

Thought I'd seek out some opinions here on the UCCR screening test. As my Aussie had multiple tests last year that were of mixed conclusions we are doing some new tests in 2009. I had planned on gettting the Atypical Cushings Test (ACTH/full adrenal panel) done, but on a lark wanted to do the UCCR as a prescreen. I figured it might tell me if I was dealing w/"regular" cushings or not? Well, the test came back with a reading of 23, and my vet said that indicated presence of cortisol and cushings. It was not the first urine sample of the am, but the 2nd...(only one I could catch)...wondering if that would make a difference? And, how "bad" is a result of 23? I have not found much guidance on this out there. Here are the options I am discussing w/my vet:

1. get new ACTH test done ('regular' version)
2. get LDDS test done
3. get "combo" ACTH & LDDS done
4. get ACTH/full adrenal panel test done....

Any thoughts on the above? My Aussie's condition is pretty stable...her ACTH from March last year was high normal and her ultrasound last august showed nothing. She is on Anipryl and various supplements (milk thistle, sam-e, flax and melatonin). She is pretty good overall, my only concern from last month's blood test are the high liver values (over 3,000 on the ALK, which suggests too much cortisol). So, we may be ready to move onto stronger meds, but I am curious to find out about experiences with UCCR and opinions on which test makes the most sense (#3 seems like a waste to me!)

Thanks!

Jeff (and Mandy)

[gpgscott]

Hi Guys,

I would have the full adrenal panel.

I would not mess with the permutations.

My 2 cents.

Thanks for sticking around, and hoping you find the right answer.

Scott

[StarDeb55]

Jeff, I have merged your latest post into the thread you have started previously for Mandy, as we like to keep all information for one pup, on one thread. I have also modified the title to alert other members about your UCCR questions. If you would like the title modified to something else, please feel free to PM one of the mods or administrators & we would be happy to do that for you.

Now, when it comes to UCCR testing, it will simply take a look at cortisol which I think you already know. It will not show anything concerning the other adrenal hormones. Since it appears that Mandy may have had an elevated result, this simply means that Cushing's is a possibility, further testing required. I'm not sure about the effects that the sample collection might have on the results, but I do know that in mammals, cortisol usually rises as the day goes on. I'm in a similar position with Chewbacca as his UCCR was perfectly normal last Christmas. His PU has gotten quite bad, & now he has suffered some pretty drastic hair loss. It looks like he will need a UTK panel done at this point to rule out Atypical, but I need input on this from both my GP & derm vet.

Debbie

PS- I just looked at Chewy's labs, & the normal range for a UCCR for that lab is <13. Please keep in mind that normal range do vary from lab to lab, but based on that value, 23 is fairly elevated.

[AlisonandMia]

I think I remember reading somewhere that "other hormones" can affect the UC:CR as in the urine these other adrenal steroids can read as cortisol. In blood tests they don't read as cortisol but it looks as though in the urine they can.

I'm off to do some research and see if I can find the reference....

Alison

[labblab]

I just wanted to provide you with a link to a reply that was given on another thread by Dr. David Bruyette (a member of our forum who is a veterinary endocrinologist in Los Angeles):

http://www.k9cushings.com/forum/showthread.php?p=5051#post5051

As you will see, Dr. Bryuette has this to say about UCCR testing:


Urine cortisols can be a problem. Many studies have shown that the only way to accurately gauge urine cortisol levels is to obtain the first morning voided urine sample on 3 consecutive days and then pooling the urine to run a UCCR. When done in this fashion it is likely an accurate test. Otherwise there is likely too much day to day variation to make a single random cortisol very helpful.

So for what it's worth, it sounds as if Dr. Bruyette would caution against drawing firm conclusions from your single, "2nd" sample of the morning.

Marianne

[jrepac]

Thanks for merging the thread; I simply forgot about the other one I had started! So, the UCCR may be of dubious value...aside from NOT screening out Cushings. I'm thinking: Cushings is likely[as has been suspected all along], and atypical is also possible (they CAN have both, right?).

I had to chuckle reading the doctor's comment about catching urine for 3 consecutive days and pooling it....it took me 2 weeks to manage to catch what I did! HAAAA!! Well, certainly no harm done w/UCCR. Too bad it is not more reliable...it is certainly an "easier" test than the others (ACTH, LDDS). Yes, my doc also said if over 13, than that is high. Yet, I did not realize the degree of variation possible, or that cortisol can rise thru the day. I was happy to get the 2nd am catch! Yes, getting excited about catching dog urine..what a life! Re: variation of cortisol levels, I often feel that Mandy has some days that are better than others...maybe that is the variation at work. Overall tho', I cannot complain too much...her quality of life is pretty good. I know how severe Cushings can be.

I think I will just invest the time and $$$ into the ACTH Full Adrenal Panel to see what it reveals and take it from there..

Thanks Everyone!

Jeff & Mandy

[StarDeb55]

Indeed, they can have both. My Harley is both PDH + Atypical.

Debbie

[jrepac]

Indeed, they can have both. My Harley is both PDH + Atypical.

Debbie

Thanks for confirming! I definitely want to get the full adrenal panel this time, just to be sure!

Jeff

[SasAndYunah]

I really have to jump in here and "defend" the UC:CR test... :) The UC:CR test is really a very reliable test...when performed correctly. I often read here that vets in the USA propose/do an UC:CR test, using just 1 urine sample. That is the wrong way! Done in this way, it is indeed unreliable and with no diagnostic purpose at all...waste of money and effort.

But to write the UC:CR test off as unreliabe is not doing justice to a good, effective, reliable, certainly much easier (on the dog and owner) and cheaper diagnostic tool than the HDDS.

The way an UC:CR test should be performed is as follows:

On day 1 you collect some first morning urine and put the sample in the fridge. On day 2 you again collect some first morning urine and again put it in the fridge. After this second sample, you start giving dexamethasone tablets, every 8 hours. And finally on day 3, you collect the third and last first morning urine sample. Put it in the fridge too till you can bring all 3 samples to the vet. This is the correct way to diagnose (yes...diagnose, not only a "rule out" test) Cushing's by UC:CR. This is the way Cushing's is diagnosed in The Netherlands, Belgium and many more European countries. (Of course a bloodtest to check for liverenzymes, cholestrol etc, is also done...usually before the UC:CR test and a (grrrrrrr...can't think of the word right now :D ) imaging of the adrenals, usally after the UC:CR)

But it really saddens me when I read such "negative" comments about the UC:CR test when it could be such a valuable tool in diagnosing Cushing's. It just should be done in the correct manner.

Dutch literature says the following about testing for Cortisol levels:

"Because Cortisol levels rise due to stress, Cushing's can not be diagnosed by once meassuring the Cortisol levels in the blood. Cortisol is being excreted in the urine. By meassuring the Cortisol levels in the urine, we can diagnose Cushing's in most cases. The Cortisol levels in urine aren't the result of one single moment (as it is when you draw blood) but they are the result of the excretion of Cortisol over a longer period of time which gives a much better impression of the average Cortisol excretion. Also, stress increases the Cortisol levels. This is more likely to happen drawing blood and not when collecting an urine sample at home."

Then it continues by describing the manner I explained above. The Dexamethasone tablets are to distinguish between pituitary and adrenal based Cushing's. Just as done in the USA, only you guys have to bring the dog to the vet clinic and the dog will get injections and blood drawn.

So, the problem isn't with the UC:CR test, it's with the way it is performed that makes it unreliable.

Saskia and Yunah :)

[AlisonandMia]

I think we are talking about two different "UCCR tests".

One is the straight screening where urine is collected in the morning and is tested for high levels of cortisol - which is the one that Jeff is talking about, I believe. With this version of the UCCR there is no dexemethasone given as the aim is not to test for suppression but just to look at the average "dose" of cortisol that is running through dog's body during the night hours. If the levels are below a certain level then that rules out Cushing's - if they are higher than that cut-off point then Cushing's is a possibility and then further testing is done. Dr. Bruyette's preferred variation on this one is to collect three samples over three days (in the fridge) so as to get a "pooled sample" that will be more representative of the true picture than any single sample. Stress of any kind in the preceding hours can result in a high reading even in a normal dog - unless you and your dog live in a very isolated rural situation and you're in the US you would never collect the urine on the morning of July 5 for example.:D

The other one that Saskia is talking about is the LDDS (Low Dose Dexamethasone Suppression) test using UCCR as a means of measuring the response to dexamethasone over a period of time. This is meant to be an equivalent test to the 8 hour LDDS that is done at the vets and where the dexamethsone is give IV and there are three blood draws done.

To my way of thinking the LDDS using UCCR (as done in Europe) does look superior as it would have to be way less likely to be skewed by stress (which is a really big issue particularly with some dogs) - the only disadvantage would be is that it must be pretty easy for the owner to mess up the timing of the dosing and collecting of urine - however good really communication between a motivated client and the vet should make that less of a problem. The LDDS using UCCR is, as far as I can see, the only way in which the test is ever run on humans in any country - presumably because of the psychological stress of the 8 hour test on a human - fear of needles, hating hospitals and knowing so much hangs on the results of this test etc. etc.

Having said that I can't imagine having done the LDDS test that way with Mia. She was such a "low-rise" small dog that collecting a cleanish sample of urine would have been a real challenge - I guess I'd have had to try to slide an ice-cream container lid underneath her or something. Just contemplating collecting urine from that little dog always made me think of that joke: "Q: What's the hardest thing about milking a mouse? A: Getting the bucket underneath it." I suppose we'd have managed it somehow but it would have taken a few days of perfecting the technique before actually trying to do it as part of a test - when she was cushingoid there was certainly no shortage of opportunities to collect pee.;)

I think we have seen one dog in the US where the vet did the LDDS via UCCR - Saskia will no doubt remember if I'm right about that one as she would have been thrilled! Louise (MiniSchnauzerMom) wanted to do it this way with Munchie because he has a complete melt-down at the vets and can be relied on to give a positive LDDS simply because of stress but her vet at the time (an IMS) flat out refused!

Alison

[SasAndYunah]

I probably wasn't clear...sorry :)

To diagnose Cushing's (here in The Netherlands) a bloodsample is taken to look for, for example, elevated liverenzyms (such as AF, AST, ALT) but also to check for diabetes and thyroidfunction. Depending on the results, they do the 3 day urine collecting, without the Dexamethasone. If the 3 urinesamples show certain Cortisol values, the diagnosis of Cushing's is made. (the UC:CR test)

"Dr. Bruyette's preferred variation on this one is to collect three samples over three days (in the fridge) so as to get a "pooled sample" that will be more representative of the true picture than any single sample."
That's exactly my point. Any vet that uses just one urine sample is throwing away your money. It has to be 3 samples to be accurate. But it's rather peculiar, I more often see this "1 sample" UC:CR test done by vets in the USA and wonder why this is. How come they don't know it have to be 3 samples?

Next, here in The Netherlands, they do another 3 day urine sample collecting...with the Dexamethasone tablets added, after collecting the 2nd sample. This is to determine whether it's pituitary or adrenal based Cushings. (the HDDS test) I accidentally mentioned the LDDS test in my previous piece...appologies for that.
This can be followed by an ultrasound...

It sounds to me as a lot less poking, stress, vet visits and less money to come to the same diagnosis. It still puzzles me why this method isn't used in the USA. As far as I know, this method isn't less accurate but yet has a lot of advantages for both owner and dog (and bankaccount ;) ).

Hope this has helped to clear some of the confusion...

Saskia and Yunah :)

[Squirt's Mom]

I have to say that I wish this UCCR method of diagnosing was used more often in the US. It sounds like it would be much less stressful for the pup for sure!

[gpgscott]

I think its pretty clear that the veterinary profession does not think they can count on the participation of the owner and this is why they resort to the blood draw.

There is also the issue of fees the UC:CR is undoubtably a less costly diagnostic.

Scott

[jrepac]

Interesting stuff...the UCCR only cost me $90 (which I thought was high relative to what I pay for an oridinary urine screen). However, it is still less that the $200++ for ACTH and definitely less stressful. The only "stress" is trying to catch the urine...hhmm, ice-cream lid, why didn't I think of that;)

I'll likely do the full adrenal panel w/ACTH next, but will keep the "3 day" version of the UCCR in mind for the future.

[StarDeb55]

Jeff, the problem with trying to do a UCCR on a 72 hour collection, I'm afraid, is going to be that the great majority of US vet labs do not have the normal ranges for this test set up for this type of collection scheme. The other thing is going to be most US vets are probably not familiar with this type of UCCR.

Debbie

[gpgscott]

Jeff, the problem with trying to do a UCCR on a 72 hour collection, I'm afraid, is going to be that the great majority of US vet labs do not have the normal ranges for this test set up for this type of collection scheme. The other thing is going to be most US vets are probably not familiar with this type of UCCR.

Debbie

Deb, do you think the ranges figure into it. I do not, what has been pointed out is that one UC:CR is unreliable as the number in a vacuum is inherently unstable and that is why three consecutive days collection seems to be a UK/EU protocol. I see it as a collection/averaging issue and not a diagnostic range issue.

Scott

[StarDeb55]

There's no argument that a 72 hour collection will give you a more stable picture of what is going on. In my lab, & granted this is for human testing, there are 2 sets of normal ranges for say a urine protein, & urine creatinine. One set is for a random urine sample collected at any point in time during a 24 hour period. There is a second set of normal ranges for urine testing that is done on a timed sample which for humans is usually all urine collected over a 24 hour period is pooled, & tested as one sample. I would almost bet the same is going to apply in this situation.

Debbie

[labblab]

There's no argument that a 72 hour collection will give you a more stable picture of what is going on. In my lab, & granted this is for human testing, there are 2 sets of normal ranges for say a urine protein, & urine creatinine. One set is for a random urine sample collected at any point in time during a 24 hour period. There is a second set of normal ranges for urine testing that is down on a timed sample which for humans is usually all urine collected over a 24 hour period is pooled, & tested as one sample. I would almost bet the same is going to apply in this situation.

Debbie
Out of interest, I will go ahead and pose this question to Dr. Bruyette. I will add a link here once he has responded. But since the 3-day pooled UCCR sample that Dr. Bruyette is referring to is not a full 72 hour collection -- but rather just a "pool" of the first urine sample of the day on three consecutive mornings -- I am thinking that there may not be as much of an issue regarding alternative ranges as in the extended collections that you are describing in your human samples. But it will be interesting to see!

Marianne

[jrepac]

Well, search the web and you shall find....here is an explanation from Cambridge Specialist Labs in the UK on the 3-day UCCR with dexameth tabs.....interesting approach; it should be offered here in the US. I think some pet owners would go this route. Here is the link...just scroll down to "Urine Cortisol:Creatinine Ratio & Dexamethasone Suppression Test"

http://www.cslabs.co.uk/canine%20adrenal%20page.htm


Jeff

[David Bruyette]

Cortisol levels is some species are diurnal (higher in the AM, lowest in the evening). This does not seem to be the case with dogs. We use the AM sample due to activity and excitement which can lead to increased cortisol secretion. I agree that is the UCCR is elevated then you are not dealing with atypical disease.

Dave Bruyette DVM DACVIM

[David Bruyette]

FYI:

Life Sci. 1997;61(11):1037-44.
Treatment with L-deprenyl prolongs life in elderly dogs.

Ruehl WW, Entriken TL, Muggenburg BA, Bruyette DS, Griffith WC, Hahn FF.
Deprenyl Animal Health, Overland Park, KS 66210, USA.
Eighty two beagle dogs ranging in age from 2.8 to 16.4 years and in weight from 6.3 to 15.8 kg were allotted to 41 pairs and administered placebo or 1 mg/kg L-deprenyl orally once daily for 2 years and 10 weeks. When survivorship for all dogs in the study was analyzed there was no significant difference between the L-deprenyl and placebo treated groups, most likely due to the (expected) survival of virtually all young dogs in both groups for the duration of the study. To assess whether L-deprenyl treatment begun in later life might enhance canine longevity in a fashion similar to that documented in rodents we also examined survival in a subset of elderly dogs who were between the ages of 10 and 15 yrs at the start of tablet administration and who received tablets for at least 6 months. In this subset, dogs in the L-deprenyl group survived longer (p < 0.05) than dogs in the placebo group. Twelve of 15 (80%) dogs in the L-deprenyl group survived to the conclusion of the study, in contrast to only 7 of 18 (39%) of the dogs who received placebo (P=0.017). Furthermore, by the time the first L-deprenyl treated dog died on day 427, 5 placebo treated dogs had already succumbed, the first on day 295. Specifically with respect to dogs, the findings reported herein suggest daily oral administration of 1 mg/kg L-deprenyl prolongs life when begun in relatively healthy dogs 10-15 years of age and maintained for the duration of the individual's life, but in any event for no less than six months.

[labblab]

Here is Dr. Bruyette's response to my earlier question regarding reference ranges for pooled screening UCCR samples. My question:


Dr. Bruyette,

Another follow-up question has come up regarding the 3-day pooled UCCR analyis. Our experience here has been that our U.S. vets who perform UCCRs typically test using only a single day's sample. If we, as owners, wish to bring in pooled samples for analysis, would the laboratory ranges that our vets normally rely upon still be accurate? Or are the "norms" different for pooled samples than they are for single samples?

Marianne

His answer:


The reference range would be the same.

Dave Bruyette DVM DACVIM

[jrepac]

good 2 know that the reference range would be the same for a pooled 3 day sample.....I may get adventurous and try it next time!

[jrepac]

In reading the list of possible treatments for Atypical and "regular" Cushings disease on the UTK website, they mention combination therapies being possible, and cite some, such as Ketoconozole (low dose) + Melatonin and Lignans. They also mention combination therapies under their listing of Anipryl as a treatment approach. I would be interested in knowing if anyone has tried keto or anipryl (or both) as part of a combination therapy.

Thanks!

Jeff

[4Mikeydog]

Hi Jeff,

I am currently considering this path of treatment for my Mikey because his vets do not feel he would be a good candidate for combination therapy with Lysodren at this time due to GI and appetite issues.
I have him on 3 mg melatonin BID and the 40 mg flaxseed with lignans capsules once daily. His vets now want to introduce anipryl, as his cortisol is still high and causing symptoms.
Have you contacted Dr. Oliver yet regarding this treatment? I am emailing him this morning. The protocol sheet from UTK says that "different mechanism may allow combination treatments with experience". I'm not sure what that means. Hopefully we will get more information.

best wishes,
Dorothy and Mikey

[Squirt's Mom]

Hi Jeff,

A while back when Squirt was still on Anipryl, I wrote to Dr O asking about using it with the melatonin and lignans. This is what he had to say:

Response from Dr O about Atypical and Anipryl

"Hi Leslie,
I don't think there would be any reason that Anipryl could not be used with melatonin or lignans. They have different modes of action, and possibly would work well together. There's just not been any studies done to look at this, and I don't know of anyone that has tried the combination. Basically, Anipryl increases dopamine levels in the brain which inhibits ACTH release from the pituitary, while melatonin and lignans inhibit enzymes in the adrenal pathway. There shouldn't be a problem in using them together.
Hope that helps. Regards, Jack."

I didn't ever use them together as her cortisol went down and the signs disappeared after the surgery, but I was glad to know it is an option.

As for a combo with Keto, I don't know if anyone has tried that or not. I do know that some have used the Keto with good results but not sure about the combo.

Hugs,
Leslie and the girls

[jrepac]

Thanks for sharing, Leslie & Dorothy!

I am going to get the UTK full panel test done soon, but I know that my Aussie's cortisol is on the high side right now (based on UCCR and on ALK Phos #s). She has been taking the anipryl since September '08...it has helped I am sure, but maybe not enough. Recently, I added the melatonin and flaxseeds to her regimen, but was unsure if that was an "approved" combo therapy. On the UTK site, they are kind of ambiguous about Anipryl, but are more specific about combining keto+melatonin+flax. Since Anipryl does have a different mechanism of action, I kinda figured it was ok, but good to see that Dr. Oliver has answered the query before.

I really want a therapy that is not overly aggressive and maintains good quality of life...she is very spunky thus far and I'd hate to lose that!:)

My dog takes more vitamins and supplements than I do...it is pretty funny when I stop and think about it.:D

[Harley PoMMom]

Hi Jeff,

It seems Zoe is doing great on all three (Ketoconozole, Melatonin and lignans).


Well after a rocky start with Zoe following her diagnosis in January this year she has done extremely well on treatment. We've had no issues with excess drinking, food stealing, hyperactive, excess panting or incontinence of urine and biggest was EATTING(stealing as well) and her ears have been clear. All her blood results to monitor her liver are all within normal limits. We had to reduce Dr. Olivers recommended Melitonin to start but she is doing great on all three meds........we have kept her on the Ketoconizole but a 200mg dose but the combination is perfect for her. Been years since Zoe has looked this good and other then showing her age with long walks she is amazing the old girl. Being in Canada it was a challenging task to try and get Flax with lignans but we did find the oil and have since found a powder but can't figure out how much powdered flax hulls to give:confused:. A nice thing also is we have found a dog food which is made with flax with lignans.
Well I think that is it in a nut shell for Zoe and all this is possible thanks to the support I got and the tools to get to the source of the problems. Thanks everyone and can't wait to hear how you all are doing yourselfs.

Puppy hugs and kisses from Zoe Claire (and hugs from me):D

Give us something to hope and think about, huh!?

Lori

[Squirt's Mom]

Thanks, Lori!! :) Good job!!

[jrepac]

Thanks for finding that quote Lori; I remembered seeing at least 1 keto user on the board. Sounds like a real promising treatment possibility.


Jeff

[gpgscott]

Hi Jeff,

Zoe is a unique case. But I have gained new respect for Keto based on her treatment.

Endocrines are a little understood and much disputed area of medicine in humans and even more poorly understood in canines.

I know you have a bad experience, but I think you are trending in the right direction with a full panel before beginning any sort of treatment.

Scott

[jrepac]

I am hopeful that the full adrenal profile will finally bring some clarity to my situation (hope, hope, hope)...on some level, I believe I recognized Mandy's condition (likely Cushings) before it fully manifested. But, after many tests, and differing opinions (yes it is, no it isn't, do this, do that) and a mild course of treatment at my insistence (anipryl + supplements + observation ) I would like to have a final verdict, as they say. Her recent bloodwork and UCCR point in the obvious direction, but the UTK test will also check her out for atypical cushings, which I think is also possible here. We shall see in a few weeks.

[Harley PoMMom]

Hi Jeff,

I am so thankful to these people on this forum (especially Glynda), for insisting that I get the full adrenal panel done on Harley.

Harley's estradiol hormone is very elevated, and his cortisol level is only mildly elevated at the baseline.

His symptoms are of a dog with typical cushings, he hasn't gotten any relief as of yet, but Dr. O. says this type of treatment (melatonin, lignans) takes at least 2-3 months to show improvement. He's only been on this treatment for one month.

I wish you luck and anxiously wait for the results of the full panel.

Give Mandy a belly rub from Harley and me.

Lori

[hfurlotte]

Hi Jeff and Aussie,
I have been away and have got back into reading the forums. Just a few things I would like to say but it is just for your information. Our Zoe Claire was diagnosed in January this year with Atypical Cushings. The test was done only because I was able to get input from the wonderful people here. Our experience with Zoe went like this.....
She was showing signs of increased urination....excessive panting...agressive behavior around food which was new for her...recurrent skin sores and confirmed yeast infections in her ears. Our vet did some routine blood work which showed an elevated liver enyzme which took us by surprise...we did ultrasound of her kidneys and open liver biopsy....as well we did urine Creatinine ratio's 3 times and all times her first morning urine was elevated but not enough to rule out Cushings....her ACTH stim test was done and came back normal range (I am convinced though it was not done properly) finally I found the Canine Cushings site and from there things went very well for us (diagnostic wise anyway) I was given the links to U of Tenn and Dr. Olivers name came up so many times I almost felt I knew him personally. Being from Canada I contacted the University of Guelph in Ontario to see if this "Full Adrenal panel" could be done there and it was the head pathologist that told me the only place that does the full adrenal panel was the U of Tenn. We decided to approched our vet with the idea of sending Zoe's blood to the states. I was insistant that the blood draw be done according to the guidelines specified by the U of Tenn. As Zoe had already been on Ketoconizole for treatment of the recurrent yeast in her ears we had to take her off of it for two weeks prior to testing. The day arrives for the inital testing and we had to suspend testing as they did not collect 3 mls of spun down serum (in other words they did not take enough blood :(
A week later we went for retesting and this is what we did:
At 730 am we took Zoe in and they drew her blood
At 800 am they injected her with Dexamethasone IV and we came home
At 1PM we returned to the vet for a blood draw and then they injected her right away with Synacthen and we came home for I do recall about one hour and returned for the final draw.
Both tests were done the same day which I am glad we did and one week later we got the results from Dr. Oliver confirming Zoe had Atypical Cushings and because of her symptoms and tests he does feel it is pituitary dependant condition and recommended the Combination therapy for her.
We have tried her on each individual however the best for her has been 200 mg Ketoconizole (we do regular liver enzymes on her to monitor and they are actually better now then prior to treatment) plus she gets 6 mg Melatonin twice a day and 1/2 tsp of powdered flaxseed with lignans or if I use the oil which has high lignans she gets one capful which is approximately 1 tsp and that is once a day.
It did take about 2 months to see some really remarkable changes in her but I would not change anything about her treatment right now :)
I hope you have a vet that will work with you because that certainly helps the situation. Dr. Oliver has consulted with our vet with Zoe and we would not be here today if not for the wonderful team that is working to help animals with this disorder.
As with humans what works for one does not necessarly work for others but the information and tools we have help give us the best possible outcome. Good luck Jeff and you have come to the best place to get the information and tools to help you out.
This is only our personal experience and do not necessarly reflect the opinions of others in this forum....you have to gather the tools and in conjunction with your vet make the choices necessary to help Aussie out. Good luck and keep me posted on how you do.
Sending puppy hugs,
Heather and Zoe Claire

[jrepac]

WOW....thanks Heather! You and Zoe have been thru a lot....now I don't feel quite so agitated about my own experiences with vets! Well, I think it is time to schedule that Full Adrenal Panel--pronto! My Mandy has had similar symptoms, with UTI and ear infection as well...but has been real good since September when I added the Anipryl to her regimen. But, I think I do need to get this new ACTH done to make sure Atypical Cushings is not present....it does seem possible.

Thanks everyone!

[StarDeb55]

Jeff, I'm not sure about this, but you may want to investigate as to whether or not Mandy needs to be off the Anipryl for a certain period of time prior to having the UTK panel done. I would hate to see you spend all that $$$, & the panel not be valid because of medication.

Debbie

[hfurlotte]

Hi Jeff,
What Debbie said is very true because with the Ketoconizole and Zoe she was doing fairly well (or as could be expected at that time) Dr. Oliver spoke with our vet when we asked for this testing to be done and it was recommended that we stop her medications in order to get the best results possible. With zoe it was recommended 3-4 week prior to testing but when we discovered she regressed really quickly our goal was to have her off 2 weeks minimum, I think we made it to 18 days off and just could not swing another day as she was getting lots of break through symptoms. Have your vet contact the U of Tenn for their suggestions.......you really do want to get the best (most accurate possible)
Good luck and please let me know if there is any other questions or even just chat.
Take care and puppy hugs always,
Heather and Zoe Claire

[Squirt's Mom]

Hi Jeff,

I am glad to see that you have decided to pursue the UTK panel for Mandy. :) This will give you an excellent insight to what is going on with all six of the hormones that play a major part in Cushing's. AND, Dr O will give you the best recommendations based on those results.

As for Anipryl and testing, when Squirt was to have her first ACTH she was on the Anipryl and I asked her GP doc plus her IMS if we needed a wash-out before hand. They both said no, but we weren't looking for Atypical at that time, just the cortisol. In spite of their input, I felt better knowing she was having the test done in her "natural", untreated state just in case. It just didn't make sense to me to have any diagnostic testing done at that point while she had things in her system that were supposed to help. Once the diagnosis was made, then testing was needed with the treatments on board to see if they were actually doing what we hoped. So, even tho I am a supporter of Anipryl, I would stop it plus everything else she has been on, give her system time to clear out, and then have the testing done. Just MHO. :)

Hang in there!
Hugs,
Leslie and the girls

[jrepac]

Ah, good point re: current meds. I had not thought of that...I could not see going 4 weeks without, however, w/out symptoms totally getting out of hand. I will have my vet touch base w/UTK to see what the minimal acceptable time frame is...I could see up to 2 weeks being manageable...

Thanks!

[Squirt's Mom]

Hey Jeff,

Just be sure to let Dr O know everything Mandy has been taking just to be sure. It won't be easy but it may be best for you both.

Hugs,
Leslie and the girls

[hfurlotte]

Hi Jeff,
Just checking into see how you are doing? Did you get the adrenal panel done? Zoe has just had a little set back here with some new sores starting on her mouth. Before we play with her meds we are doing a new injectable antibiotic that is good for 2 weeks and then she will get another one. Other then that she is doing well. Let me know how you guys are doing.
Heather and zoe claire

[Harley PoMMom]

Hi Jeff,
Just checking into see how you are doing? Did you get the adrenal panel done? Zoe has just had a little set back here with some new sores starting on her mouth. Before we play with her meds we are doing a new injectable antibiotic that is good for 2 weeks and then she will get another one. Other then that she is doing well. Let me know how you guys are doing.
Heather and zoe claire

I was wondering how you and Mandy are doing too.

Hugs to you and Mandy.
Lori

[jrepac]

Thanks for asking Lori! I sent all of the UTK info. on the ACTH full adrenal panel to my vet for his review; he is willing to draw the samples and send them off to UTK, no problem. I've been dealing with some family stuff right now, so I likely won't get the ACTH done until next week. Fortunately, Mandy's condition is pretty good/stable on her current regimen of anipryl (selegiline) and various supplements (a counter full). I'll have to pull back on the meds once I schedule the test so we can get a "clean" read. I do notice that some days are better than others for her....makes me wonder how much variation in cortisol levels is possible? Someone should come up w/an easy way of daily testing for this disease...like diabetes test strips. Anyway, I will be glad to get the ACTH test done so I can know for sure if I am dealing with "regular" or atypical Cushings...:)

[Harley PoMMom]

Hey Jeff it's been awhile... :eek::D How are you and Mandy doing?

Hugs.
Lori and Harley

[Dollydog]

We're checking up on you too!!
Jo-Ann & Lady :)

[jrepac]

Hi there....

Thanks for checking in.

I'm in a holding pattern waiting on the UTK results...we had the ACTH stim for full adrenal panel done last Wednesday. My regular vet wasn't there so it took quite some time for me to explain to the other vet (the practice owner) what I wanted....$300 to boot! I knew it would cost a bit more, but yikes...BTW, is is normal for a vet to use a catheter for the stim test? Struck me as odd, but maybe there was a reason (other than him charging me an extra $50).

So, Mandy is back on her generic Anipryl for now and her various supplements...she's not having a good day today, which is kind of upsetting. Very shaky on her feet and 2 pee accidents...which has not happened in some time. guess I've been spoiled with more good days than bad ones.....she has been hopping on sofas and going up and down stairs nonetheless today, so who knows? Maybe the Anipryl ---not the cortisol level--is causing some of the shakes, which I know is possible. You need a crystal ball for this stuff, it is maddening.

I am hoping that the test will bring some more clarity to her condition and I can then decide what next steps are best for her...

Thanks!

Jeff

[Dollydog]

Hi Jeff,
After 10 or 11 months on Anipryl Lady became depressed and very down. At first I thought it was a reaction to my being depressed about our move but she did not pick up when I did. I don't remember if she was shakey or having any accidents. But our vet suggested that it could have been from the Anipryl. We switched her to trilo shortly after this happened.
Hope Mandy is feeling better and that the test results come as quickly as possible.
Jo-Ann & Lady :)

[gpgscott]

BTW, is is normal for a vet to use a catheter for the stim test? Struck me as odd, but maybe there was a reason (other than him charging me an extra $50).

I am hoping that the test will bring some more clarity to her condition and I can then decide what next steps are best for her...

Thanks!

Jeff

Hi Jeff,

Thanks for updating us.

I think you may be referring to an IV or port which was inserted once and the blood draws came from it.

Actually if this is what it is I think it is a good idea as any time you traumatize tissue you get blood clotting which can affect labs. Doing the port minimizes this and is easier on the pup.

Looking forward to the results.

Scott

[Harley PoMMom]

Hi Jeff,


I am hoping that the test will bring some more clarity to her condition and I can then decide what next steps are best for her...
We are anxiously waiting with you and are hoping too that the UTK panel will find out what's going on with Mandy.

Please keep us updated.

Hugs to you and Mandy.
Lori

[jrepac]

Thanks for the info on the port (catheter) Scott....I was actually there with a friend...we both had our dogs at the vet that day. The vet used a catheter for his dog as well...she had a slightly different procedure where they had to administer Benadryl. Just was wondering what the rationale could be.

Jo-ann, thanks for letting me know re: Anipryl. There are some days where she does seem a bit "down"...yesterday was really an off day for her. Today she seems much better....

I keep thinking about at home testing for cortisol...maybe I'll patent a kit for it....just need a good pee-catching device! And some science to get the test to work! You should be able to test daily for this disease just like diabetes, if you ask me..

[Dollydog]

Wouldn't an at-home testing kit be awesome :D ....I can remember Beth wishing for exactly the same thing!! Good luck,
Jo-Ann & Lady :)

[hfurlotte]

Hi Jeff,
Just catching up to see how things are going with you. I have gotten pretty good at catching pee and all I use is a "plastic lock and lock container" you can normally buy them at the dollar store or grocery store cheap, then go out with Zoe first thing in the morning, stay really close to her .......when she squats I quickly place the container under her and I have been lucky each time to get more then enough for testing:D:D Don't know what the neighbours think when I go out in rubber boots, flannel pj's running behind the dog but we get the job done:D

I like the idea that your vet used at port for the blood draws, I think I am going to have that done when Zoe goes for her rechecks especially if we need to do the ACTH or Dex again. We are just waiting for Dr. O to contact us as to what blood needs to be drawn for follow-up.
Take good care,
Heather and Zoe Claire



I keep thinking about at home testing for cortisol...maybe I'll patent a kit for it....just need a good pee-catching device! And some science to get the test to work! You should be able to test daily for this disease just like diabetes, if you ask me..

[Squirt's Mom]

Hi Jeff,

Have you heard from UTK yet?

Waiting with ya!

Hugs,
Leslie and the girls

[jrepac]

I'm going to call my vet on Monday....it's been over 2 weeks now...

[jrepac]

Well, vet called me this am and confirmed what I had suspected...cushings disease. UTK came back w/212 count and 174 is normal? (they use different units than I am used to seeing)...BUT, sounds like atypical is present too...I think my vet needed some more time to look it over, but he said all of the hormones except estrogen were high...does that sound right?

Going to meet w/the vet end of day today to get the details straight...


Jeff

[Harley PoMMom]

Hooray the results are in....well almost. :p

On Harleys paper for the cortisol the Normal ranges are for post ACTH 70.6-151.2.

And if Mandy estradiol hormone is not elevated, that's great news.
We'll have to work on the other ones. :eek::D

Will be looking for the updates.

Hugs to you and Mandy.
Lori

[Squirt's Mom]

Hey Jeff,

YEAH! The results are in! I can't wait to see them! That is great if the estradiol is normal...it is the booger of Atypical.

Hugs,
Leslie and the girls

[gpgscott]

Jeff,

Very glad the results are in.

Please post them as soon as you have them.

Now on to a treatment for Mandy.:D

Scott

[StarDeb55]

UTK results are usually reported as ng/ml, to get them to ug/dl, divide by 10. So the results you posted, which I assume are the cortisol results, are 21.2 ug/dl & 17.4 ug/dl. Which one is the pre & which the post?

Mandy does, indeed, appear to have Pit Cushing's + Atypical You are very lucky that the estrogen is not elevated. My Harley not only had an elevated cortisol, but all of the other 5 were severely elevated. Along with posting the results for us, UTK should include a treatment recommendations sheet, please post those recommendations, also.

Debbie

[gpgscott]

UTK results are usually reported as ng/ml, Debbie

Not all of them Deb,

estradiol and aldosterone are reported as pg/ml

Scott

[StarDeb55]

Oops, thanks for catching that Scott. I was actually looking right at Harley's report when I was typing & simply missed it.

Debbie

[jrepac]

Well, went over to the vet and got the results. This was all new to him as well...he never went thru UTK before...he was impressed w/the test detail, thanked me, and said he'd use them for his more difficult cases. HAA! Well, Mandy blew the doors off the test, I'll list the post #s and the upper limit in () to keep it simple:

Cortisol 212.8 ng/ml (174)
Androstenedione ng/ml >10 (3.97)
Estradiol pg/ml 92.9 (69.2)
Progesterone ng/ml 3.02 (1.50)
17 OH Progesterone ng/ml 3.80 (1.62)
Aldosterone pg/ml 332.3 (398)

So, aside from the last one--aldosterone--she is significantly above normal levels. This test was done after 5 days of no meds or supplements.....so, should be a reasonably clean read (i could not bear to keep her off for a whole 2 weeks, it would be cruel, I think). Knowing that the 212.8 on the cortisol converts to 21.2 on the other scale makes me feel a bit better (as it is just outside the normal range), but with all these other numbers sky high, only a bit!

SO, is this a case of "regular" AND atypical Cushings? Seems that way...[or is it simply considered regular due to the high cortisol???]

The UTK treatment sheet has changed again...the doc was reviewing it w/me and I said "yes, I am very familiar w/it". I no longer see the 1/2 tsp of flaxseeds on there. Anyways, we talked thru the options and Mandy's current state...despite high numbers on the test, she's been doing pretty well on her generic anipryl + supplements; I had also added in the melatonin and flax seed a couple of months ago (maybe 2 or 3?) and I understand it can take up to 4 months to see a response. One of the treatments UTK suggests is melatonin + lignans + Ketoconzole at a lower dose....perhaps a viable option, as I prefer to avoid the lysodren, if possible. My vet is going to touch base w/the UTK to see what they say (oddly, they did not make any reccos, just sent the treatment sheet along).

I take it I should avoid trilostane given these results?

well, I am kinda sad that she really has this disease (my 2nd Aussie in a row now), but kinda glad I finally have a proper diagnosis....I have been "chasing" this diagnosis since Dec 2007 based on her symptoms....and, not regretting that I started treating somewhat prematurely (Sep '08), given the circumstances..

Jeff

[StarDeb55]

The treatment recommendations sheet is what we are looking for, Jeff. The following should be pretty much what is on that sheet. The treatment option sheet should have the flaxhulls on it as Dr. O given his strong support to the use of flaxhulls because they have a higher lignan content than even a purified lignan product.

I would be more fearful of using Keto, than lysodren, as the Keto is well known to be very harsh on the liver. There is such a borderline elevation in the cortisol that I would give the melatonin +lignans plenty of time to work as melatonin is also known to suppress cortisol, though not as well as lyso or trilostane.

http://www.vet.utk.edu/diagnostic/endocrinology/treatment.php

Debbie

[StarDeb55]

Actually, Jeff, Mandy is considered to be standard Cushing's, even with the elevation in the intermediates. I had forgotten that it was Dr. O, I believe, who corrected our view on how these types of results are interpreted. Any time there is elevated cortisol, I'm pretty sure it's considered to be standard Cushing's, no matter what else is elevated. Trilo is not a first line choice in Mandy's situation as it will eventually cause further elevations in a lot of these already elevated intermediates.

Debbie

PS- I just rechecked the copy of the treatment considerations sheet from UTK that I keep on my computer. Under number 4 which discusses the use of flaxseed oil + lignans, does strongly endorse the use of the flaxhulls.

[AlisonandMia]

I would second what Debbie said about keto being more hazardous than Lysodren. Lysodren is very safe and effective when dosed and monitored correctly. Keto gives me the willies, quite frankly, although it is sometimes necessary to add in to control estradiol if other measures fail. Keto is no longer used as a systemic med to treat fungal infections in humans and I believe it is largely because of its potential liver toxicity. It is still used in humans occasionally for short-term control of certain hormones, though, I think.

In virtually every case, when there is an adverse outcome, it can be traced back to human error. It is not an easy drug for vets to use and understand - which is the source of its bad reputation - but used correctly it really is very safe. It is vital that both the owner and the treating vet have a thorough grasp of the peculiar way this med works before embarking on treatment however and that the vet is familiar with the established protocols for its use.

My vet was not that experienced with Lysodren (or treating Cushing's at all) when Mia was diagnosed but he did a lot of study (and made sure I did too!) before we started treatment. He followed the protocols and consulted with a specialist and her treatment went smoothly and she got her life back and did really well (could run rings around poor old me!) until something totally unrelated to her Cushing's took her at the beginning of this year.

Alison

[Harley PoMMom]

Hi Jeff,

It is a relief to finally know isn't it...I know it was for me.

That dratted estradiol.:mad::mad: If it makes you feel any better, Harley's was 132.2 on his last one, I am still waiting for his results from last Monday. :eek:

The recommendations should have been on the bottom of your test results paper...hmmm.

And yes you are right about the Trilostane, not a very good option when the hormones are elevated.


My vet is going to touch base w/the UTK to see what they say Please let us know what they have to say.

Harley has improved "outwardly" within 2 months, like I said I am waiting for his estradiol results to confirm that "inwardly" that he is improving also.

Hugs to you and Mandy.
Lori

[jrepac]

Yes, Debbie, that is the new treatment sheet. I quickly noticed it was slightly different from the one I had...mine clearly listed the 1/2 tsp flaxseed dosage SID...the new one does not. I'm finding the standard vs. atypical cushings a bit confusing now....so once the cortisol goes past the mark, it is no longer considered atypical? Weird.

Yes, her cortisol level is not crazy high...but above normal for sure. I'm uncertain how much to "worry" about the others....I'd like to see all of these come down. Along w/her liver #s and cholesterol level...which have been consistently high for some time.

Her symptoms really are on the mild side, and have been very stable/well controlled since I started anipryl/selegiline late last year. She has a few off days here and there, but honestly, she is pretty good and pretty spunky. We've had no UTIs, skin problems, or other infections, and her blood sugar and kidneys are good. I don't want to do anything drastic if I don't have to....and for me, lysodren would be drastic. Too bad trilo is not a good option here...my vet recently had a very good experience with Keto which he discussed with me. UTK suggests using it in a lower dosage (25% of regular dose) in tandem with melatonin & lignans.

I'll be curious to see what UTK comes back with...it may simply be "keep giving the melatonin & lignans"

[jrepac]

Hi Lori,

LOL! I looked for the reccos at the bottom of the test sheet and they were not there! It merely said "Various treatment option considerations are attached"....I felt a little bit cheated!

Well, let my vet do a little legwork...I suppose I could also email UTK directly, if I needed/wanted more info. My vet is a bit unfamiliar with this, so he is learning as well...

[AlisonandMia]

I think the lower dose of keto that you mention is when it is being used to control estradiol - Susy (Wylie's Mom) is looking at needing to add that to Wylie's regime because of estradiol that has not responded to flax, melatonin and Lysodren. When you are trying to control cortisol too then the higher dose is usually necessary.

Whether it will affect the liver catastrophically seems to be an individual thing - some individuals are more vulnerable in this regard than others. What worries me is that there is no way of knowing whether an individual dog is one of the vulnerable ones - most handle it ok (although their liver function will change a bit and it needs to be regularly monitored) but the occasional dog just doesn't seem to handle it at all. I had to use it on a bird (cockatiel) a while back for a fungal infection (it's the only systemic antifungal as yet tested in birds) and it absolutely gave me the willies - it looks like it did affect her liver somewhat (you can tell by the color of their plumage) but it appears her liver has forgiven us as she is doing well now. I think the risks of drastic liver damage are dose related so the lower the dose you can get away with the better.

Because of this unpredictable risk, for me long-term keto is something I'd only use when all other options had been exhausted and the treatment was really necessary - this is the situation that Susy and Wylie are in.

Alison

[StarDeb55]

If there is no elevation of cortisol, then it is simply Atypical Cushing's. The elevation of cortisol is what makes these results standard Cushing's.

Jeff, lysodren is not a drastic drug as several of us have told you over these past months. I have successfully treated 2 dogs with lysodren over the past 10 years. A large part of that success is because I was working with 2 GP vets who are very Cush savy, along with an IMS who is pretty good. Not to beat the subject to death, but lyso is a very safe, effective drug for our pups as long as standard protocols are strictly followed. Also, if the melatonin + lignans isn't effective in controlling everything, you would probably only be adding a maintenance dose of lysodren, & would not have to do a full out loading on Mandy.

Debbie

PS- Jeff, I'm respectfully disagree with you about flaxhulls not being included on the UTK treatment option considerations. If you will go to the second section under "treatment considerations" of the link I posted which is treatment information. Treatment information is an embedded link which will download the current information, #4 does state flaxseed hulls.

[jrepac]

Well, I will have to consider my options.....while many of you have had good success with lysodren, and that is good thing, I swore I would never use it again. One truly bad experience was enough for me...vet's expertise level regardless. So, I classify it as "drastic".

With most of these drugs, it becomes a real trade off on risk and side effects versus possible benefits.

[Squirt's Mom]

Hi Jeff,

Well, this removes all doubt, huh? :( I know you were hoping for better results but as Lori said, at least now you know. Mandy has true Cushing's with elevated intermediate/sex hormones (because of the elevated cortisol), and Hyperestrinism (elevated estradiol).

I am a bit confused tho...

I had also added in the melatonin and flax seed a couple of months ago (maybe 2 or 3?) and I understand it can take up to 4 months to see a response.

If Mandy was already on the melatonin and flax when the UTK panel was done, then the results may be skewed...even if she had only been on them for a few months. So it is possible that those intermediate/sex hormone levels could be even higher in an untreated state. :eek::eek: The Anipryl shouldn't have had any effect according to my understanding, but I'm not sure whether the herbs, etc that you are using would have or not. So Mandy may in worse shape than those results show even tho her signs are currently controlled. Remember, these other hormones can cause as much damage as the cortisol can. :(

I, for one, do understand your fear of Lyso. I felt that way myself for a long time even without having any prior experience with it. Today, after some educatin', I am MUCH more scared of Trilo than Lyso - a 360 degree turn-about for me. Unless Trilo is the ONLY option left for Squirt, she will never take it. But, that is MHO only. ;) Based on her last UTK, Lyso may well be in her future and I am comfortable with that now. Still scared, but comfortable thanks to all I now know about it.

Since, for the moment, you cannot consider Lyso then Keto is about your only pharmaceutical option, along with the melatonin and lignans. I have no experience with Keto but some here are using it...just can't remember who right now. :rolleyes: I know Beth did with Scooter under Dr O's guidance.

Jeff, from the beginning your approach has been a bit different from what we usually see here. I don't see this as wrong, just as being very, very cautious based on what you have previously experienced with Cushing's. Understandable. I don't blame you at all for wanting to find something, anything, that will provide better results for Mandy. Different can make some folks nervous and a bit leery so they don't know how to respond, or are afraid of offending with their responses. Some here have tried other approaches with negative results so aren't open to those methods for the same reasons you are hesitant about Lyso. We all operate on what we know to be true in our lives and based on our own experiences. Just don't let past experiences dictate what is best for Mandy now. Let Mandy dictate that for you. No other pup has ever been like Mandy so there is no reason to believe she will react like any other pup has before her.

I know you love her beyond reason and will continue to so. Let this love be your light and Mandy be your guide.

Hugs,
Leslie and the girls

[jrepac]

Hi Leslie!

I know I 'cheated' a bit, as Mandy had been on anipryl, flax and melatonin up until 5 days before her test. So, I suppose, yes, maybe the flax and melatonin skewed it a bit positively? Anipryl runs thru the system pretty fast I think, so I was not worried much about that. Just could not bear to take her off everything for 2 weeks.

Yes, I am following a rather non-traditional course with many herbs and supplements combined with the anipryl. It is "different" for sure. But, in some respects, it seems to have been helpful. I can't see myself giving Mandy lyso anytime soon, unless I have no other choice...having said that, all of the 3..lyso, keto and trilo, have some risk involved...

But, I will take things one day at a time...

[gpgscott]

Hi Jeff,

As you know all of the treatments vary in terms of trade off. The neat thing about Lysodren is the focused manner in which it works on the adrenal cortex which is where the bulk of the cortisol is produced.

Keto is not nearly as focused, it ablates a broad range of hormones.

Based on the labs if it was me I would seriously consider a maint only dose of Lysodren in addition to the melatonin/lignans.

Best to you and Mandy.

Scott

[jrepac]

Thanks Scott;
yes, in hindsight, her lab results are not terrible.
they align with the mildness of her symptoms and the ability of anipryl to help control them...

I'll see what UTK says about the keto & lyso options....I could not see her needing a full lyso loading either...would be like taking a sledge hammer to a fly

[Harley PoMMom]

Jeff,

I do see the treatment sheet has been revised as of July 28, 2009 and the 1/2 tsp of flax hulls...etc is not listed on there. This is what is listed on the sheet for lignan.

4) Lignan. Lignan has phytoestrogenic activity, and competes with estradiol for tissue estrogen receptors, with less biological effect. Lignan also inhibits aromatase enzyme (lowers estradiol) and 3-beta HSD enzyme (lowers cortisol). Use lignan from FLAX SEED HULLS (or HMR lignan). DO NOT USE flax seed oil as the lignan content is very low, and the flax oil can exacerbate pancreatitis in dogs (triglyceride levels may increase). Search for standardized products (via Google or health food stores) that allow determination of lignan content. Available products allow for flexible dosing, and the suggested approximate daily dose of lignan is one milligram (mg) per pound of body weight.

This caught my attention and got me worried...why are the hulls I brought for Harely no longer listed on the treatment option sheet...hmmm...so I had to ask Dr. O. and this was his reply. My questions in blue, Dr Oliver's in Black.

Dear Dr. Oliver:

I see from the revised treatment option sheet (July 2009), concerning the flaxhulls, the website www.FLAXHULLS.COM is no longer listed, are you no longer endorsing their product? Is their product not standardized? I bought this product because it was on my dogs treatment option sheet, and have been giving it to my cushing dog that has very elevated estradiol hormone levels, should I switch to another product?

Hi Lori,

The product you bought should be fine. I'm just trying to move away from essentially endorsing a given product.
Companie's should be able to tell you how many mg's of lignan is in their product per a given amount of flax hull lignans. If they can't, then you may want to consider a switch. I know this company is trying to improve on this point. I'll attach our latest Treatment Option Sheet. We should have a result on the estradiol to your veterinarian's office by tomorrow at the latest.

Regards, Jack

Now I don't know if I will switch or stay with them...hmmm..always something to think about. :confused::eek:

Hugs.
Lori

[jrepac]

Thanks for checking up on that Lori. I too, was wondering why the hulls had suddenly vanished? I am halfway thru my bottle of flaxseeds....maybe I will switch to standardized lignans, if I can get the capsules. Mandy kind of likes the seeds...it is her little snack each nite: 2 tablespoons lowfat vanilla yogurt + 1/2 tsp flax seeds + L-glutamine capsule [contents mixed in]....she laps it up! then she gets her melatonin tab and shortly there after it is snoozeville! LOL!:D

So, guess I can finish the flax seeds w/out too much worry....

Thanks again!

Jeff

[Harley PoMMom]

Hi Jeff,

It's been a while since we heard anything about Mandy...how are things going?

Love and hugs.
Lori

[jrepac]

Thanks for asking Lori...

I still need to f/up with my vet who has not gotten back to me after our last discussion. I did email Jack Oliver directly, however, and he suggested that I consider adding a maintenance dose of lysodren OR a low dose of ketoconozole, if we don't see enough improvement via the combination of melatonin + flax seed + anipryl. I think I am going to stay the course thru end of September then try to get a read on her cortisol levels from a UCCR test (using 3 day pooled sample)....that should at least give me an idea if things are getting better/worse compared to earlier in the year.

Mandy seems to be doing quite well, observationally speaking and based on symptom control. Been very spunky the last few weeks (after a few "off" days)....running, jumping, flinging toys and going up and down stairs several times a day. So, from that vantage point, I have to be satisfied.

I have been reading up on Phosphatidylserine and have to wonder if anyone has tried that to suppress cortisol in animals? It supposedly blocks/blunts cortisol. That and Rhodiola, which from what I have read, seems to have a similar action to anipryl and is supposed to calm the adrenals. Wish there was more R&D out there on some of these possible treatments.

Have a good weekend!

[acushdogsmom]

I have been reading up on Phosphatidylserine and have to wonder if anyone has tried that to suppress cortisol in animals? It supposedly blocks/blunts cortisol.

Phosphatidylserine was just recently discussed here.

See:
http://www.k9cushings.com/forum/showthread.php?t=878

And I think you actually replied in that thread, Jeff. :)

[jrepac]

LOL! guess that's why it sounded familiar to me...one more "big word" among many....someone should maybe come up w/a pill that combines some of these cortisol blockers....those with cushpups would appreciate it....got to be feasible to combine melatonin + lignans + Phosphatidylserine into 1 pill.....

seems like several of these more "natural" remedies have a mild blocking effect....perhaps combined it is cumulative?

but, since no money in it for the pharma companies, we can only count on vets doing clinical research to test these sorts of things..

Thanks!

[gpgscott]

but, since no money in it for the pharma companies, we can only count on vets doing clinical research to test these sorts of things..

Thanks!


That's for sure Jeff, it is all profit driven.

Glad Mandy is doing well, it seems you have a number of options to further tailor her treatment.

Scott

[jrepac]

Can anyone offer some sense of how much a cush pup's appetite should drop back after several months of treatment?

In the past month or so, I've noticed that my Aussie is eating about 1/3 less than usual. Her 3 meals a day are down to about 2...maybe a tad more, on occasion. Plus, she is eating a bit less on her main AM meal to start with.

This comes after 3 months of flax + melatonin treatment have been added to her longer standing anipryl/selegiline regimen....

Not sure if it's a good sign or a bad sign, frankly! I do know that anipryl has appetite suppressive properties...but she has been on that for some time and I had seen the effect when she first started it in 2008 [basically going from wanting to eat at all hours to her balanced 3 meals daily].

Her water consumption seems to have come down a bit too, so maybe I am anxious here about a good thing?

Just curious to hear what others may have experienced.

Jeff

[Wylie's Mom]

Hi Jeff,

I merged your last post with Mandy's regular thread and changed the title to reflect your current question. The title can be changed again... just let one of the mods or administrators know via PM.

I can't help much with your question... I don't think Wylie's appetite will ever decrease (he was a piggy long before Cushing's). Is the amount that Mandy's eating now within the range for her size?

-Susy

[forscooter]

Jeff,

We were using Lysodren but I wanted to try and answer your question and hopefully calm some of your fears. Even when the dogs were within range, their appetite definitely changed. It dropped significantly. I know Sharon (Ventilate) has this same issue with Nike. And I remember from the old site it coming up as an issue repeatedly. We will resort to all sorts of tricks sometimes just to get them to eat.

I know melatonin does have some effect on cortisol as well as the other intermediate sex hormones. The combo of the medications you are using I would think could absolutely effect appetite.

As long as Mandy is eating the recommended amounts for her size and age, and I would also double-check with your vet when anything of big significance changes, I think you are OK.

So yes we many if us have had this issue come up but I always like to let the vet know if it is a huge change....never can be too careful imo.

I think the others will chime in about this too to help you....

Many hugs, Beth

[Harley PoMMom]

Jeff,

Right now Harley is on just the flax hulls and melatonin, and his appetite is still like a little piggy, or maybe it's bc we switched foods, he used to get Innova senior but now he gets the Blue Buffalo...he always got the boiled rice, boiled chicken, pureed vegs and now he gets yogurt too. He's more of a piggy now. :eek:

Love and hugs.
Lori

[Squirt's Mom]

Hi Jeff,

How is Mandy's weight? If she isn't falling below a good weight for her size, then I wouldn't worry overly much about the decrease in appetite. The Anipryl can cause the appetite to drop, especially over the long term. When the Lyso starts to kick in, the appetite may drop as well, but it is supposed to with treatment. ;) So, if I were you, I'd keep an eye on the weight and not worry too much about the amount she is eating right now.

Hugs,
Leslie and the girls

[jrepac]

I'm likely over-reacting...it just was such an obvious decrease, I was surprised. She is not underweight, for sure...losing a few pounds helps. She has ranged between 20-24lbs over the last few years, which is heavy to begin with...I'm guessing she is 22'ish right now, down from 24 last year. I need to get her weighed again.

She is eating an amount that is more aligned with when she was younger...2 small meals a day, but without a lot of treats on the side.

Much of last year she was a "piggy"....worse prior to getting on the anipryl...

I'll just have to keep an eye on her.

Thanks

[jrepac]

Thought I'd share a tidbit of what I thought was good news. Mandy got her UCCR numbers back and the ratio came in a 15...still high (because she has cushings) but much lower than the 23 reading from April...yay! I HOPE that is a good sign. I did the 3 day/3 sample catch routine, carefully measuring equal amounts of pee over 3 days into a vial and popping it in the fridge! LOL! Getting very good at the pee catching routine.

I've been doing the anipryl+melatonin+flax regimen for several months now, along w/other supplements, so perhaps I am finally seeing some good results (based on lab #s, as opposed to mere observation). About 2 months ago, again based on observation, I decided to add an extra dose of melatonin to her regimen, so 3mg, 3 times a day, am/noon/pm. I think that may be making a difference.

[jrepac]

Question for the group/users of flaxseed hulls, lignans, etc.

Has anyone come across standardized lignans in a capsule or tab that is less than 70mg? I think I only need about 40mg a day, but the caps I just bought (and were hard to find) are in 70mg. I may have to open the caps and try to divide the contents into her meals, I suppose. I thought the caps would be easier to use/administer than flaxseed/flax hulls, and they offer more certainty around the lignans content, but the dosage is too high. I'm coming to the end of my flaxseed and will be ready to switch to the caps soon. Wondering what others have encountered on this [I've actually been using ground flaxseed, not the hulls, but I figure the hulls are in the mix when it is ground up]

any insights are appreciated!

thanks!

Jeff

[Squirt's Mom]

Hi Jeff,

First, hulls and seeds provide different things - the seeds are high in omega oils but low in lignans, the hulls are high in lignans but low in oils and the lignans are what helps in Atypical Cushing's. The seeds have their own value as flax oil can be beneficial. So in my thoughts, the mix you have been using for flax has been providing much lower lignans that the capsules or hulls would. Something to think about...

I used the hulls with Squirt until the jar ran out then because I have several bottles of capsules, I went back to them but instead of 1 40mg cap, she is getting 3 caps for a total of 120mg VS 40mg. I don't understand the math and percentages and what-not well enough to explain why, but the 120mg of purified lignans is supposed to provide very nearly the same percentage of the hulls, perhaps a bit more. It isn't the hulls or content of the caps that are important in this calculation, it is the actual percentage of lignans provided.

Digestively and anecdotally, she has had no problem with the switch or increase. When we are able, she will have another UTK panel so we can see where her levels are now, especially the estradiol and progesterones which were still elevated last time.

As for where to get the caps...try Vitacost. The NSI brand is a very good one and one many here use. Here is a link for you:

http://www.vitacost.com/NSIFLAXSEEDLIGNANS

How is Mandy's appetite these days? Is she eating more like her usual self? Has her dose of Anipryl increased any since starting? How much is she taking now?

Hugs,
Leslie and the girls

[jrepac]

Thanks for the link Leslie, along w/the advice. Yah, I realized that the ground up seeds included the hulls, but was not exclusively hulls, so I was likely shorting her on the lignans. By how much, who knows. I am getting to the end of the seeds and bought a bottle of lignan extract, but it is 70mg...which I think is much more than needed. But good to hear that extra is not necessarily harmful.

Mandy's appetite is a bit up and down, but I think, overall she is still eating a bit less than 6/9 months ago. Otherwise she seems fine. We just have those days where she is a little shaky/twitchy and I am never sure if it is the cortisol or the anipryl causing it (which is kind of aggravating). I felt good about the UCCR numbers coming back lower, so in early spring we'll get it checked out again along w/a full blood work panel...So, for now, we will stay the course w/our alternative treatment and no other changes....other than replacing flaxseeds w/lignans.

Jeff

[jrepac]

In looking at UTK reccos, they say 1mg per pound, so my dandy Mandy would need at least 20mg. Looks like Vitacost has 40mg...that is the smallest I have seen. Tho, I may take my 70mg capsules and sprinkle them across her doggies meals, which I make 3 at a time....

ah, the stuff we endure!

she will miss her flax seeds in yogurt I bet...a yummy PM treat.

[Harley PoMMom]

Hi Jeff,

Looking at the Vitacost link that Leslie gave you, those capsules actually will only give you 8 mg lignans per capsule.

The main lignan from flaxseed is secoisolariciresinol diglucoside (SDG).
http://www.raysahelian.com/lignan.html

NSI Flax Seed Lignans.

One 40 mg capsule contains 20% flax lignan extract (standardized).

40 mg capsule = 20% lignans.

20% is 1/5 of 100% (or 100 divided by 20 = 5).

40 mg divided by 5 = 8 mg lignans.

Each 40 mg capsule contains 8 mg lignans.

So Mandy would need 2 capsules if she weighs 16# or 3 capsules if she weighs 24#.

Love and hugs,
Lori

[lulusmom]

Lori, before switching to the pressed flaxhulls, I used to purchase the Flax Seed Lignans from vitacost.com and I was under the impression that there was 40mg of standardized lignan per capsule. I just checked and Vitacost is pretty clear in their product description that each dose offers 40 mg of standardized lignan extract. As I recall, UTK had this product listed as having 40mg lignans as well on their old treatment sheet. I am so mathmatically challenged it's not even funny so I'll never be able to figure out how we went from a whopping 40mg of to 8mg. If your formula is correct, Vitacost has some splainin to do to me and Lucy. :confused: Here is the link to Vita Cost and their description which clearly states;
Your best sources of flax seed lignans are fresh ground flaxseed and our quality formula! NSI Flax Seed Lignans are better because they:. Offer 40 mg of standardized lignan extract per dose.

http://reviews.vitacost.com/4595/23839/reviews.htm

My brain hurts now....I really shouldn't have taxed myself by trying to figure out some big old formula when I already know that each 1/2 tsp of pressed flaxhull is equal to 66.8 mg lignans.

Glynda

[Harley PoMMom]

Hi Glynda,


Plant lignans come from sources such as flax seed, whole grain cereals, rye, legumes, seeds and nuts, berries, vegetables and fruits. Several hundred individual lignans have been discovered but the main research has focused on lignans from flaxseed (Linum usitatissimum). The main lignan from flaxseed is secoisolariciresinol diglucoside (SDG).
http://www.raysahelian.com/lignan.html

To me it says "standardized at 20% SDG: Flax lignan extract (LinumLife Extra) (standardized at 20% SDG)(seed) 40 mg".
So to me one capsule contains only 20% SDG lignan extract. I am pretty sure the formula is correct.

So for a 40 mg capsule, the 32 mg of lignan extract is from another plant source other than flax seed, only 8mg is coming from the flax seed. And I believe the lignan from the flax hull/seed is what is best. JMO.

Love and hugs,
Lori

[jrepac]

Shoot, I work w/numbers every day, and I think this is confusing! But, I think Lori is right...you have to factor in the 20% standardization to get to the true amount of Lignans. In looking at the bottle of Source Naturals Lignans I bought (which are also sub-branded as LinumLife from Acatris, Inc.), the front of the bottle says "70mg, 30 caps".

BUT, on the back of the bottle it says:

"High Lignan Flax Hull Extract 20%" "700mg per serving (2caps)"

and "Yielding 140mg of Lignans"...

which implies that a 70mg capsule is actually 70mg of lignans...

ho-ho-ho...which is it?? :confused:maybe I need to stick w/my ground flax seeds and yogurt :rolleyes:

[jrepac]

per my last post, here is the link to my brand of lignans

http://www.sourcenaturals.com/products/GP1822/

in reading this again, I do think Lori is right...you'd need 700 mg...or 10 capsules to get 140 actual mg of lignans...

True or false?

[Harley PoMMom]

Hi Jeff,

Actually there on that site they did the math for you. :) So for 2 of their capsules you would get 140 mg of lignan.



Serving Size: 2 capsules ~ High Lignan Flax Hull Extract 20% (LinumLife™) (Yielding 140 mg Lignan) 700 mg

What they are telling you is "20% of 700 is 140," so for one capsule this is 70 mg of lignan.

Is this making sense? or am I confusing everyone. :eek:

Love and hugs,
Lori

[Squirt's Mom]

Hi Jeff,

Gonna hitch-hike your thread here a sec....

TADA!! That made perfect sense to me this morning, Lori! :D I am mathematically challenged and have not been able to make sense of this formulation until just now. :o geez...

So if the bottle says a certain herb has been standardized to, let's say, 10% and the bottle says the delivery package (capsule, pill, etc) has 60mg of XYZ herb, then 10% of 60 is 6 - so one would actually be getting 6mg of XYZ herb per dose...correct?

By wording the content the way it was on Jeff's bottle, i.e. "yielding", that company is telling you the actual amount of XYZ per dose. Am I on the right path with this? Makes sense, but that can be very dangerous in my little world. :o:p;)

Jeff, since I cook for Squirt I open all 3 of her lignan capsules plus the melatonin cap and sprinkle them all on her food along with the drops of Burdock and Astragalus. She never knows they are there! This is much easier for both of us than trying to give 4 capsules at one time.

Interesting discussion for me and quite informative...IF I've understood this correctly! ;)

Hugs,
Leslie and the girls

[Harley PoMMom]

Hi Leslie,


Hi Jeff,

Gonna hitch-hike your thread here a sec....

TADA!! That made perfect sense to me this morning, Lori! :D I am mathematically challenged and have not been able to make sense of this formulation until just now. :o geez...

So if the bottle says a certain herb has been standardized to, let's say, 10% and the bottle says the delivery package (capsule, pill, etc) has 60mg of XYZ herb, then 10% of 60 is 6 - so one would actually be getting 6mg of XYZ herb per dose...correct?

Yes...Good job, it is confusing! and the 10%, 20% etc are specifics to something, so that's why Vitacost had to put 20% SDG because lignans come from many different plant sources and I/we want the SDG (flax seed/hull) kind of lignans.

By wording the content the way it was on Jeff's bottle, i.e. "yielding", that company is telling you the actual amount of XYZ per dose. Am I on the right path with this? Makes sense, but that can be very dangerous in my little world. :o:p;)

This "yielding" is tricky too, I look to see what it is standardized at first, then I look at the ingredients, then usually have to do the math.

Jeff, since I cook for Squirt I open all 3 of her lignan capsules plus the melatonin cap and sprinkle them all on her food along with the drops of Burdock and Astragalus. She never knows they are there! This is much easier for both of us than trying to give 4 capsules at one time.

Interesting discussion for me and quite informative...IF I've understood this correctly! ;)

Hugs,
Leslie and the girls

Hope this helps. :o:)

Love and hug,
Lori

[jrepac]

mighty tricky
so my original read on this WAS correct
one 70mg capsule = 70mg of lignans...:D

whew!

I may try divvying up the cap since she only needs about 25mg a day....the taste is awful! maybe I'll mix in something sweet like the vanilla yogurt I've been using

[gpgscott]

Thanks for this discussion, we have been on auto pilot for so long I have not paid that much attention. Two years ago the recommendation from UTK was 1 40mg cap per day under 30 lbs and 2 over 30 lbs.

Dr. Oliver has updated this several times and I just called him to confirm. The most current recommendation from UTK is 1mg SDG/lb of body wt.

And Lori is correct that in the case of the NSI product the 40mg cap only yeilds about 8mg of SDG.

If you are using a bulk product you will find ranges of SDG from .5% to 1.5%. a calculator I found translates this into 50mg SDG@ .5%/rounded tablespoon and 150mg SDG@1.5%/rounded tablespoon.

Jeff your 70mg tab @20%SDG is 14mg SDG/tab.

Scott

[jrepac]

OK...so now I am back to the 20% multiplier....and I would need 2 capsules per day

[Harley PoMMom]

Thanks for this discussion, we have been on auto pilot for so long I have not paid that much attention. Two years ago the recommendation from UTK was 1 40mg cap per day under 30 lbs and 2 over 30 lbs.

Dr. Oliver has updated this several times and I just called him to confirm. The most current recommendation from UTK is 1mg SDG/lb of body wt.

And Lori is correct that in the case of the NSI product the 40mg cap only yeilds about 8mg of SDG.

If you are using a bulk product you will find ranges of SDG from .5% to 1.5%. a calculator I found translates this into 50mg SDG@ .5%/rounded tablespoon and 150mg SDG@1.5%/rounded tablespoon.

Jeff your 70mg tab @20%SDG is 14mg SDG/tab.

Scott

Scott,

Here I beg to differ: Since Source naturals is using flax hulls as their ingredient, the hulls contain the lignan, this is SDG, and therefore one of their capsules contains 70mg of lignan.


High Lignan Flax Hull Extract 20% (LinumLife™) (Yielding 140 mg Lignan) 700 mg
http://www.sourcenaturals.com/products/GP1822/

Love and hugs,
Lori

[gpgscott]

Scott,

Here I beg to differ: Since Source naturals is using flax hulls as their ingredient, the hulls contain the lignan, this is SDG, and therefore one of their capsules contains 70mg of lignan.


http://www.sourcenaturals.com/products/GP1822/

Love and hugs,
Lori

Lori, their information is not well stated, it does state clearly a 20% concentration of SDG which is the highest percentage I have seen anywhere. The reference to 140mg is obviously 2, 70mg caps which is the serving size notated. I do not think it is possible to have a one to one ratio of lignans to SDG, SDG is a component of lignans.

Supplement Facts for 70 mg Capsule
Serving Size: 2 capsules
Amount %DV
Total Carbohydrates 1 g <1%
Calcium 64 mg 6
Sodium 10 mg <1%
High Lignan Flax Hull Extract 20% (LinumLife™) (Yielding 140 mg Lignan) 700 mg †

[jrepac]

the wording is tricky, I have to say....:eek:
the front of the bottle clearly says "lignan extract" and 70mg

I think Scott is right because when you look at the back it has the 20%
and under serving size of 700mg as indicated, it says it yields 140mg of lignan. ;)


High Lignan Flax Hull Extract 20% (LinumLife™)
(Yielding 140 mg Lignan) 700 mg †

[Harley PoMMom]

Yes, this one is a tricky one indeed. :p:)

[gpgscott]

I think Scott is right because when you look at the back it has the 20%
and under serving size of 700mg as indicated, it says it yields 140mg of lignan. ;)
[/B]

Not exacty Jeff, there is a distinction between lignans and SDG, which is the component in lignans which are active for our Atypical pup's.

To be technically correct, I think this should state 140mg SDG @ a serving of 700mg. They need to rework their information. Thing is it is presented for people who have no idea and are taking the lignans without a complete understanding of why. I think. Also we need to remember that most of these supplements are being recommended for humans which metabolize at a MUCH lower rate than canines. It is important to refer to animal studies, and UTK is one of the best in my opinion.

What we all who administer lignans need to understand is that SDG is the active component of flax seed which helps our pups. It is present in flax and other organic materials but the flax lignans have the greatest concentration. The way the lignans are processed affect the concentration of SDG.

A capsule of lignans will have varying concentrations of SDG depending on the processing. Also bulk lignans will have varying concentration of SDG depending on processing.

A capsule of 100mg lignans is in fact 100mg of lignans, but depending on the lignans contained within the capsule the important SDG componenet can vary by a factor.

The important number according to Dr. Oliver @ UTK is 1mg SDG/lb body wt. regardless of the particular product used.

I hope a lot of people are looking at this because it is very different than my previous understanding, and I think others as well.

Scott

[jrepac]

Just got some updated test results that are not looking so hot......my vet was kind of non-committal on treatment....other than saying "keep giving her the medicine" well, yes, obviously I should not stop treating, but should I CHANGE treatment? Here are some of the lab report excerpts:

UCCR results based on a multi-day sample:

CORTISOL (URINE)
Cortisol (Urine) 7.6 normal? ref range= 5-55 ug/dl
CREATININE (URINE)
Creatinine (Urine) 68.0 (LOW) 100-500 mg/dL

CORTISOL/CREATININE (URINE)
Ratio 35 (HIGH)

This is up from 6 months ago...when the cortisol was under 5.0.
+++++++++++++++++++++++++++++++++++++++++++
The stuff that "bothers" me relates to liver and kidney results vs. reference ranges:

Total Protein 8.7 (HIGH) 5.0-7.4 g/dL
Albumin 4.8 (HIGH) 2.7-4.4 g/DL
Globulin 3.9 (HIGH) 1.6-3.6 g/dL
Albumin/Globulin Ratio 1.2 0.8-2.0 RATIO
AST (SGOT) 105 (HIGH) 15-66 U/L
ALT (SGPT) 105 12-118 U/L
Alkaline Phosphatase 1725 (HIGH) 5-131 U/L
GGTP 30 (HIGH) 1-12 U/L
Total Bilirubin 0.6 (HIGH) 0.1-0.3 mg/dL
Urea Nitrogen 24 6-31 mg/dL

Please note new reference range for BUN
Creatinine 0.3 (LOW) 0.5-1.6 mg/dL
BUN/Creatinine Ratio 80 (HIGH) 4-27 RATIO
Phosphorus 7.5 (HIGH) 2.5-6.0 mg/dL
Glucose 6 (LOW) 70-138 mg/dL
Calcium 12.9 (HIGH) 8.9-11.4 mg/dL
Magnesium 2.7 (HIGH) 1.5-2.5 mEq/L
Sodium 168 (HIGH) 139-154 mEq/L
Potassium 6.3 (HIGH) 3.6-5.5 mEq/L
Na/K Ratio 27
Chloride 117 102-120 mEq/L

ELECTROLYTE RESULTS MAY BE INACCURATE DUE TO DILUTION OF SPECIMEN.
Cholesterol 384 (HIGH) 92-324 mg/dL
Triglycerides 1242 (HIGH) 29-291 mg/dL
Amylase 729 290-1125 U/L
Lipase 402 77-695 U/L
CPK 1122 (HIGH) 59-895 U/L

+++++++++++++++++++++++++++++++++++++++++++
URINALYSIS
Collection Method
Not stated
Color Yellow
Appearance Clear *Clear
Specific Gravity 1.025 1.015-1.050
pH 7.0 5.5-7.0
Protein 2+ (HIGH) Neg
Urine protein verified with 3% sulfosalicylic acid.
Glucose Negative Neg
Ketone Negative Neg
Bilirubin Negative Neg To 1+
Blood Negative Neg
WBC 2-3 0-3 HPF
RBC None 0-3 HPF
Casts None Seen LPF
Crystals None Seen HPF
Bacteria None Seen None HPF
Squamous Epithelial 2-3 HPF
URINE MICROALBUMIN (CANINE)
Microalbuminuria 27.6 (HIGH) <2.5 mg/dL

++++++++++++++++++++++++++++++++++++++++++
All the CBC stuff came back good, so not posting that.

Aside from "keep giving her the medicine" and keep her on a low protein diet, my vet did not seem overly concerned. Was hoping for lower alk phos #s and I am not wild about what I am seeing from the urinalysis. My vet feels that the Cushings is behind the high protein in the urine. Well, sure, but the Microalbuminuria is very concerning to me...do not want to risk renal damage, if it can be avoided.:(

Would be curious as to what others think of these results. Perhaps I am over-reacting...which is possible, since some of the #s are just outside of the acceptable range. I get freaky when I see everything coming back w/"HIGH" on it.:confused:

Seriously wondering if it is not time to "graduate" from anipryl to trilostane...but, otherwise, Mandy seems to be doing quite well...symptoms are very, very stable and pretty mild. :)

Apologies for the lengthy post; but, I know that many of you like to see all the #s. I've asked another vet tech to take a look at it as well for some thoughts.

Thanks in advance!
Jeff (and Mandy)

[Harley PoMMom]

Hi Jeff,

Was Mandy fasted for her blood work?

[jrepac]

actually, no! did not even cross my mind as I've been running ragged these days! She ate her breakfast (main meal) at 7am w/her Anipryl and usual supplements. She may have eaten a bit at 11:30 or so; I was not home at the time; there was kibble in the bowl. She usually only nibbles at lunchtime, then eats more in the evening.

She got her blood drawn at 2pm, so that would be 7 hours after the main meal, I suppose.

What impact might that have, if any?

[Harley PoMMom]

I know Debbie will know more than me but with my other Pom. Bear I just had to have his blood work reran...his calcium came in high at 11.8 (not fasted). His vet said to fast him and rerun the panel, his calcium came back at 10.6. I do believe the lipids in fat can make it hard for the labs to test the blood, that is why they like ones pup to be fasted. Like I said, Debbie will have a better explanation on this than me. ;):)

Love and hugs,
Lori

[jrepac]

thanks Lori!

[jrepac]

Well, the mom of one of my co-workers is a vet tech and took a look at Mandy's labs; her vet did too. They basically told me that the labs were run on a useless/bad blood sample...whose poor quality was noted on the lab report. They suspect the sample sat too long or was not "spun out" properly. Would have been nice if my vet realized this as well :(

They would place little to no value on the results

Sent him an irate message yesterday, demanding a fresh blood test...we shall see.

The crap we have to go thru to make sure our pets our taken care of properly is ridiculous at times...

[Roxee's Dad]

Well, the mom of one of my co-workers is a vet tech and took a look at Mandy's labs; her vet did too. They basically told me that the labs were run on a useless/bad blood sample...whose poor quality was noted on the lab report. They suspect the sample sat too long or was not "spun out" properly. Would have been nice if my vet realized this as well

:eek:

Sheesh, It's not like we don't have enough to worry about. Good catch!!!!! I hope the retest comes back good. :)

[jrepac]

Oh, and Lori, you were spot on regarding the lipids...my co-worker's Mom said the very same thing!:)

[gpgscott]

Hey Jeff,

Sorry to hear about the useless results and resulting delay.

Hope you learn more soon.

Scott

[Dollydog]

Jeff, I know that clinics can make it up to us financially but they can never make it up to our pets with what their mistakes put them through.
When we first went for the LDDS test in 2005 the clinic "forgot" to do the 4 hour draw but didn't catch it till I went to pick Lady up at the 8 hour point. She sat all day in a little cage (hell for her) no food, no me and no results. I was just sick! :mad: :(
They never charged me for the test but I had to take another 2 days during the next month to get the test done. We live 3 hours away from the clinic and the re-test involved another overnight stay at a motel. PLUS she had to go through the whole ordeal all over. I came back to the clinic at the 4 hour point to make sure that the draw was done. They told me that I didn't have to but there was no way that I was going to trust them after the first mess-up!

Hope all goes well with the next draw,
Jo-Ann & my Dollydog angel :)

[Harley PoMMom]

Oh Jeff,

Poor you and poor Mandy...:( Gosh darn it!! :mad: The lipids in the fat, I'm pretty sure I got from Marianne! So a BIG THANK YOU to Marianne for providing that info! We sure do learn alot from each other...the beauty of this forum! :D

Will be looking for your results of the next panel, and wishing you and Mandy the best of luck.

Love and hugs,
Lori

[jrepac]

To all of my fellow Cushpup colleagues and supporters...it is with great sadness I have to tell you of my sweet Mandy's passing.:( It was very sudden and unexpected. And, sadly, I was not with her at the time when she crossed the Rainbow Bridge. I was away on vacation and she was at her usual boarding "resort" when she passed away in her sleep Weds night/early am Thursday (Nov 4th). I found out about her passing on Friday and it was devastating, to say the least.

Ironically, during the first week of October we found a new vet and had a full round of blood work, urinalysis plus a urine cortisol reading (3 day sample, as recommended!). Her numbers came back better than earlier in the year...some still high, but much better across the board. The cortisol reading was quite low and the vet said to "stay the course" with her alternative treatment protocol of generic Anipryl, melatonin, lignans and other supplements. At 13.5 years of age, I was optimistic about her making it to the new year. The vet felt she was in very good condition, all things considered.

But, one week before my departure, she had a very nasty, wheezy cough..it kept us up all night Saturday. On Sunday, I got her some homeopathic, honey based cough syrup. By week's end, it subsided and she was her usual spunky self when I dropped her off for her 1 week stay at the "resort" on 10/30. God knows I would not have left her if I thought she was ill in ANY way! I am racked with guilt over leaving her--it is impossible to know if it would have made a difference, but this will eat at my conscience forever.:(

I don't have all the details as of yet, but it appears she had some sort of relapse in my absence. I suppose I will find out more tomorrow when I see the vet and the owners of the boarding facility (I just got home on Sunday 11/7; the last few days of my trip were quite miserable, as you might imagine).

It's been 3 days of tears with more to come tomorrow, I am sure. Tomorrow I will say my final goodbyes to her. My heart is broken, to say the least. I have been through this before, but it never gets any easier. My only solace is that she was in relatively good health until she passed; her quality of life was excellent and she was with people who loved her dearly. And, she did not suffer any extended illness, nor did I have to make that decision we all dread...she went on her own terms.

When I am better composed I will come back and post a portfolio of Mandy's pix...as they bring me many happy memories. I am just rather shattered and dysfunctional at this point. She was a sweet, brave terrier and she endured a lot over her 13 plus years. For the past 2 years, we battled the Cushings demon with great success and I am proud of that...

I want to thank everyone on this board for their willingness to share insights and information about their experiences. I found it incredibly helpful and wish I had this resource when my last Aussie had Cushings...your willingness to share information, knowledge and experiences led to Mandy's extended life span, I have no doubt. I did not think she would make it this far, quite frankly, back in 2008.

Thanks to all of you from Jeff and Mandy in Cushpup heaven...:o

[Rudy's Mom]

Jeff, Rudy and I are new over here on the Cushing's board, but unfortunately not new to the heartache you are going through. I'm terribly sorry to read about Mandy, and especially sorry you weren't able to be with her when she passed, but from reading your note it's obvious how much you loved her, so I'm quite sure you WERE with her when she went to the Rainbow Bridge. Truthfully, sadness is all you'll be feeling for quite some time, but in time that will be replaced with all the memories you've shared...those win out, they always do.

Laura and Rudy <3

[BestBuddy]

Jeff,
I am so sorry to hear off Mandy's passing. She was obviously much loved and I'm sure she knew.
Jenny

[Altira]

I'm new here too. Last Thursday I found out my seven year old husky has liver and lung cancer. At first they said it was cushings. I know how you feel. I'm so sorry.

Janis

[Carol G]

Jeff,

I'm so sorry. My thoughts are with you.

Carol

[Spiceysmum]

Jeff,

So sorry to hear the sad news. Thinking of you.

Linda

[mytil]

Oh Jeff,

I am truly sorry to read about Mandy's passing. I know your heart is breaking into a million pieces, especially since you were not with her. The hardest part is when it is their time to go and you have been such a wonderful dad to Mandy, she knows she was one lucky girl. Please do stay with us Jeff.

Always in loving memory of Mandy
(((hugs)))
Terry

[littleone1]

I'm so sorry to hear about Mandy, Jeff. My thoughts and prayers are with you. I know she was loved very much, and you did everything you possibly could do for her. I know you will really miss her.

[frijole]

Jeff, I am so very sorry. May all the memories of good times sustain you as you recover from your loss. RIP dear sweet angel Mandy. Kim

[Casey's Mom]

Jeff I am so very sorry to hear of Mandy. I must have been heartbreaking for her to go while you were away. Please try not to feel guilty - she was with people who loved and cared for her.

Love and many hugs,

[labblab]

Oh Jeff, I am also so saddened to read your news. There is never an easy way to lose our pups, but I do understand your deep pain from being separated at the time that Mandy passed. But the hours that you were apart were just the blink of an eye out of a shared lifetime of love. Nothing can change the fact that you cherished her and she always knew that.

Please remain with us during these days of sorrow. We are here to listen and to offer our support, just as you have offered your support to so many others. And we are also here to help you celebrate the life and spirit of your precious girl ~ always.

In loving memory of your sweet Mandy,
Marianne

[happydogs]

Jeff,

While I'm new here and didn't get a chance to 'know' your little Mandy, it's clear from your post that she was very well loved. I'm so very sorry for your loss.

Angela

[bgdavis]

Jeff,

I'm so sorry to read about Mandy's passing. Be thankful that she went peacefully, without pain, to wait for you at the Bridge. You provided everything you could for her.

Bonnie and Angel Criss

[horsemum2]

So sorry for your loss! We are new here and didn't have a chance to get to know you but we feel your heartache.

Bela and her family (Dave, Mary and Diamond)

[Roxee's Dad]

Dear Jeff.
I am so sorry to hear of Mandy's passing. My thoughts and prayers are with you during this very difficult time.

Rest in Peace sweet Mandy.

[Squirt's Mom]

Dear Jeff,

My heart just aches for you. You fought so hard for Mandy to help her feel better and keep her that way. You always put her well-being first in all your considerations and it was obvious through all your posts. Mandy was so lucky to have you by her side and I know she is looking down on you now with all the love and gratitude she has for all you have done for her.

Jeff, please don't let guilt reign in your soul because you weren't there with her in her final moments. You had no way of knowing her time was close. Instead, try to focus on the fact that you gave her much more time of quality living and loving than she would have had without you. Mandy knew your love was with her at all times no matter where you were or where she was. She was not alone; she was surrounded by your love then as always and that is what matters, my friend.

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

[judymaggie]

Jeff -- I am so sorry to read about Mandy's passing. My thoughts and prayers are with you.

[Sabre's Mum]

Jeff
I am so sorry to hear about Mandy. My thoughts are with you.
Take care
Angela and Flynn

[sunimist]

Dear Jeff,

I am so sad and sorry. You two fought such a valiant fight but sometimes the battle just can't be won no matter how hard we fight.
You will be in my thoughts and prayers....be good to yourself.
RIP dear sweet Mandy.

((((HUGS))))

Shelba and Suni~~

[k9diabetes]

I'm so sorry to learn that Mandy passed away... it seems very unlikely given her sudden passing that there is anything you could have done to prevent it. Most likely she passed away quietly in her sleep.

You did all that you could for her health and, more importantly, loved her deeply. That's all that any of us ask.

With great sympathy,

Natalie

[John II]

Jeff,

I am so sorry to hear of Mandy's passing.
You did everything you could for her and Mandy knew how much you loved her.
Mandy got to choose her own time, and in the end that is what we all hope for.
Don't beat yourself up about anything.
I know that's easier said than done.
My thoughts and prayers and tears are with you.

:(

[Harley PoMMom]

Oh Jeff,

I am so, so sorry...my heart goes out to you, my dear friend, at this most painful time. I wish I had more than just mere words to help comfort you at this time but please know we are all here for you and always will be.

You were a phenomenal Daddy to Mandy, the exceptional care of Mandy and your deep love and devotion for Mandy was evident.

Again, I am truly sorry.

With Heartfelt Sympathy,
Lori

[zoesmom]

Jeff - I am so sorry to read of Mandy's passing. You were an incredible dad to her and I know that she knew that and that is the most important thing to focus on. Keeping you in my thoughts and prayers. Sue

[SachiMom]

Jeff,

I am so sorry.
You carried Mandy in you heart, so she was not alone.

Godspeed Mandy.

Hugs ~ Mary Ann

[marie adams]

Jeff,
I am very sorry to learn of your loss of Mandy. It is good to know that I am not alone with an Aussie who has Cushings--There are so few of us. People ask me all the time if it is common in this breed--because I am fairly new to this (a year in Feb) it hasn't seemed like it and not listed in my readings.

They are a special breed of dog and companion--bless you and Mandy because you will always be together....

[Truffa's Mom]

Dear Jeff

I am terribly sorry for your loss. I can't contain my tears and my heart is aching for you.

Sweet Mandy, Godspeed little angel, please from your new beautiful rainbow paradise send your dad a lot of strength, your always unconditional love and soothe his aching heart; and please reassure to him and all your loved ones that you weren't alone, thanks to your love for each other, you were always connected, and thanks to you also you were always surrounded by people that truly care about you.... so the resort was just another little step to heaven, and whatever you did was always giving to her the best of what she deserved til the end.

Jeff you were an amazing dad, and it never gets easier. I will keep you in my prayers.

Marcela, my choco angel Truffa and Nina

[apollo6]

I am so sorry to hear of your loss.
May your Mandy now be at peace.
Love and prayers Sonja and Apollo

[addy]

Dear Jeff,

I pray you find the peace sweet Mandy found. I am so sorry. I know my words cannot ease your pain but please know you are in my prayers.

I still remember you were one of the first to answer my desperate post for my Zoe last Spring. Thank you for that. Please don't go away, we would miss you terribly.

Love,
Addy

[Tobias]

Hi Jeff: I have not posted before to your posts because I know so little about Cushing's. But I do know about the sadness of losing a dog. My dog helped me to see about myself that I am a better person than I thought. I know when I die I will see my dog, that I will be closer to God for having lived with my dog, and that my dog was an angel sent by God to help me grow and feel good about life. When my dog passed, he earned his wings, just as your beautiful Mandy earned hers. When a love like this is no longer physically present in a body we are so devastated, but I try to remember that love is never lost. Your Mandy was so loved--I know this because if you posted on this list you are a guardian who wanted the best for your girl and went out of your way to get her that. I light a candle every Monday night with the millions of others who do the same thing to honor the memory of their sweet angel dogs. Next Monday when I do this to honor my Zorro's passing as I have every Monday for what will be one year on December 21st, I will pray for your healing and light, too. Mandy was blessed to have such a loving human as her caretaker. Hugs from Linda and Toby--I hope you can feel us trying to love and with deep understanding of your grief.

[Bichonluver3]

Dear Jeff,
I was heart sick when I read your post about the loss of Mandy. In the cush family, we all share your tears. I am captivated by Mandy's sweet little face and she will be one of the prettiest little angels in cush heaven.
I know it is easy to say but a lot harder to feel but you, in no way, should feel guilty about not being there. You have to find peace in knowing that Mandy left on her own terms. If she had wanted it any other way, she would have done it that way.
We all know that one day our furbabies will join sweet Mandy and she will be there to welcome them.
We send our prayers and hope that you will find the sunshine of wonderful memories to replace the sadness. She had a long life and was blessed to have shared it with you as you were to have shared it with her.
To Mandy - Run free, precious Mandy,with all your friends through the sunny fields of heaven. God speed. I will look at the sky tonight to find our newest, brightest star.
Our love and prayers go out to you, Jeff.
Carrol & Chloe

[Dollydog]

Oh Jeff....I'm so sorry....can't post much now....too many tears...so will come back later when I'm more composed. My Lady has another buddy to play with now.
I'm looking forward to your pictures. As for the guilt....you couldn't haved known....
(((HUGS)))

[mypuppy]

dear Jeff,
I am so saddened for your great loss and deep pain. But I do pray that as time passes you will remember your precious baby with more laughter and less tears. your memories of Mandy will remain like photographs in your heart and you will keep them for the remainder of your life. I wish you some positive comfort in all this. Tight hugs to you and God Bless Mandy. Jeanette and Princess

[Franklin'sMum]

Dear Jeff,

I am so very sorry to hear of Mandy's passing. You are in my thoughts and prayers. I so hope you can find some comfort in this time of heartbreak.
It is clear how much you love her, and when one is loved like that, they carry that love around with them, always. While you may not have physically been with Mandy, you were right there in her heart, and probably her dreams.

With love and sympathy,
Jane

[Rebelsmom]

Jeff, I'm so sorry to hear of your loss. You were and are a great dad to her. My thoughts are with you. And as other have said please don't feel guilty, she knows how much you love her.

[jrepac]

To everyone...thank you for your heartfelt comments, thoughts and prayers. I hope Mandy is romping with Lady up in Heaven and that they've met up with my last Aussie, Dolly...who I think is Lady's long lost twin sister! Oh, to own an Aussie! They are such special little creatures.:D

I have heard from many friends and colleagues over the last few days, with thoughtful notes, cards, even gifts. Mandy's breeder and I exchanged notes; she too has had her losses. Mandy's Mom Suzy passed away in January...she was over 17 years young! God Bless her for giving me such a sweet pup.:)

My return from vacation on Sunday, Nov 7th was a rough one, as you could tell from my post. Coming back to a home without its funniest, most lively member was awfully hard, with reminders all over.

On Monday (11/8), I got myself together and went over to the boarding resort to speak to the owner/manager. She was very upset and shocked by what happened. Mandy had stayed there several times over the last few years and had been there 3 times over the last 6 months for grooming..she was used to the place.

They told me she was perfectly fine up until her passing; she was playing with the other dogs, barking and being her usual nosy self. She was not coughing they told me, which was a great relief to me. But, on Thursday morning, when they went to give her the usual meds and feed her, she was non-responsive. They rushed her to the vet, but she had passed. They think she had a heart attack; whatever happened, it was sudden/quick. Oh, my poor baby, at least you did not suffer. She was doing SO well, but I guess it was her time. And, I keep reminding myself that she had a very high quality of life until the end...which ultimately was my goal in regards to managing her Cushings.

I gathered her things and next went to the vet to see her one last time. First, I made the arrangements for an individual cremation and I ordered a nice cherry wood urn for her in which you can place a favorite photo. Something warm and nice that suited her bubbly personality was appropriate!

I then went in to say my final farewells; it was hard, but I could not let her go without seeing her one final time. I didn't care that she was a bit of a frost pop...she was MY frost pop! I told her how sorry I was not to be there, how much everyone loved her and would miss her; she got lots of final pets and kisses...:(

She's back with me already and I've found a nice place for her to rest in my bedroom...where I can talk to her every morning. The mornings are terribly hard right now...we had such a routine...she'd awake, then come get me with a bark and a nudge; we'd then do meds, food and a quick spin in the yard. I've been all out of sorts this week. I know this will pass in time, but you know how it is ;) It's the little things that hit you like daggers too...ordering Chinese and seeing the Fortune Cookies she so loved! Or pizza...she just loved the crusts! LOL! It's going to take some time to re-adjust..but I will try to remember all the happy, fun times we had. She was such a spunky pup...one of a kind!

I've gathered a collection of her recent photos and placed them in the "In Loving Memory" Gallery. They do warm my heart. I will continue to visit the Cushings Board from time to time...people w/Cushpups need a resource like this where both experienced and new owners can interact, share information and offer guidance. I wish I had this the last time.....God Bless You All and God Bless my Mandy Angel...one day we will be together again.:)

[Roxee's Dad]

Dear Jeff,
Thank you for sharing Mandy's life with us through your words and wonderful pictures. I know the pain is still so very raw. Knowing what you are going through makes the tears flow for the sadness you feel. My heartfelt sympathies are with you and your family.

Mandy, you are home now, Rest in Peace Sweet Girl.

[Bichonluver3]

Hi Jeff,
Thanks so much for your reply and pictures. I am so sorry that you are suffering but glad that you are able to think of all the good times. Mandy, being the special pup that she was and still is, would want you living your life as happily as she lived hers. That is the real tribute.
Take care of yourself and come back often. We need you here!
Carrol & Chloe

[littleone1]

Hi Jeff,

These are such beautiful sentiments. You have so many wonderful memories of Mandy. I love the pictures.

Take care.

[gpgscott]

Jeff,

I have only this evening learned of your loss of Mandy.

Your care for her had such intensity and you have always been there for others.

Blessings to you and comfort in your memories of your little one.

Scott

[Dollydog]

Hi Jeff,
I was getting out Christmas decorations today and found my Australian Terrier Christmas tree ornament---an Aussie standing in front of a palm tree. In the box was the little saying from the Australian Terrier Club website which has always said it all for me.

"To own an Australian Terrier is to say you have a friend.
A tenacious little warrior, faithful to the end."

Thanks for coming back to let us know what happened to Mandy and for sharing her adorable little habits and routines. They really are the most amazing little characters.
Jo-Ann

[jrepac]

Hi Jeff,
I was getting out Christmas decorations today and found my Australian Terrier Christmas tree ornament---an Aussie standing in front of a palm tree. In the box was the little saying from the Australian Terrier Club website which has always said it all for me.

"To own an Australian Terrier is to say you have a friend.
A tenacious little warrior, faithful to the end."

Thanks for coming back to let us know what happened to Mandy and for sharing her adorable little habits and routines. They really are the most amazing little characters.
Jo-Ann

Yes, I've seen that quote before as well! It is oh so true...I always referred to Mandy as "my friend" and it hurts not to have her with me right now in the holiday season. :( I've been out looking at the little pups here and there in the various shops, just to lift my spirits a bit. They are so funny when they are little, regardless of the breed!:D

I've been snooping around the various Aussie terrier web sites as well and thinking, "well, maybe we'll start over again with number 4", but I do know you can never quite replace what you had. Each Aussie has a unique personality, even if they share certain breed characteristics. And, Mandy had QUITE the personality (good and bad!) LOL!

Well, I am going to let some time pass for now; I have been in touch w/Mandy's breeder and she is planning on a litter for Jan or Feb 2011. I may just wait until then and see if she has any little red girls for me...:o

Jeff & Angel Mandy

[addy]

Oh Jeff,

A little red girl might be just what the doctor orders:) When you are ready.

I am glad the puppies perk you up. It is so hard to lose a loved one and then have to face the holidays.

Thinking of you,
Addy

[Casey's Mom]

Jeff I am so glad Mandy didn't suffer and that you now have her at home with you. That must be some comfort for you.

I hope you get a new little pup and that you stay with us. Thanks for coming back and letting us know.

Love and many hugs,