Angel update - treatment with trilo

[we3dogs]

Hi - Angel is off for a 5 mo ACTH. In November her results were so low they were unreadable. I really thought I was going to lose her in the fall. She had been off meds since Nov and when I tried to put her back on 30 mg (from her Oct/Nov high of 75 mg of trilo daily) she looked ill after 3 days. So...I started liquid trilo from Diamondback - first at 15 mg now she is down to about 9 mg/day. We'll see what today brings. Take care - Joyce, Pebbles & Angel

[Squirt's Mom]

Hi Joyce,

Good to see you here! I'm glad you have a giggle to take to the vet today. :p Maybe that will make things less stressful for you and Angel.

I am glad she is doing well still and look forward to those numbers on the stim.

Hugs,
Leslie and the girls

[labblab]

Joyce -- I am so glad you found us!!!!!!!!!!!!!!!!! :) :D :) :D

We'll be anxiously awaiting your test results. ;)

Big welcoming wishes,
Marianne

[mytil]

Joyce,

I sure am glad you found us too.

Keep us updated
Terry

[we3dogs]

Well, first off, I told the 3 gals at the front desk about Leslie's Leslie 'n' Squirt search - they were schreeching with laughter!
Angel did not have her stim today. Dr. Berger wants her to be on a consistent dose :o for 30 days before testing. I had been doing the "15 mg is too much, let's stop for 2 days then try 12 mg" As soon as I started her on the 15 mg liquid her symptoms disappeared in 3 days. Drinking/peeing reduced and appetite abated slightly. Hey, she's a beagle so I expect her to always be excited about food! :p She did start with the shaking of her front half when inhaling as she was resting and then it stops when she enters a deep sleep - this was something she did when over-medicated in the fall. Over the past 2 weeks when her appetite noticably decreased and the shaking increased I would not medicate the next day or two then I decreased the dose on the 3rd day. I am thinking it's the only way to find the proper dosage. So...going forward it will be 6mg every morning and a stim test in 30 days. I can't believe it is 6mg for a dog who was at 60mg daily when I got her 2 1/2 years ago! Talk to you soon - Joyce, Pebbles & Angel

[gpgscott]

Hi Joyce, Waiting to hear more. Scott

[MiniSchnauzerMom]

Hi Joyce,

I'm waiting too!!!

Louise

[we3dogs]

Oh God - I just discovered something - Angel is doing that upper body shaking thing on the inhale, and I was stoking her outer right thigh to calm her. For some reason I felt the inner thigh and the vibration in the vein - I'm thinking her pulse - is off the charts. I checked the same spot on Pebbles and it is lubdub, lubdub...lubdub, lubdub on Pebbles. For Angel, it is dumdumdumdumdumdumdum. (I think anyone reading this is shouting "rush her to the hospital"). I've done some quick reading and dogs do not get herat attacks. Her blood pressure needs to be brought down - IF IF IF this is the problem. The shaking happened in the fall when she was on 75 mg of trilo and 1omg of enalapril for HBP. When things got whacky in Nov we took her off everything. It has to be related to HBP - I emailed my vet but he just got back from vaca and is probably asleep altho he worked today. I am giving her 10mg of enalapril now. Cross your paws and say a prayer for us!

[Rusty's Mom]

Gosh, do you have a 24-hr. facility you can call? Have you counted the beats?

I'll keep you both in my thoughts and prayers.

MJ

[frijole]

Hi Joyce. I agree - I think the vet is the best contact right now. I will say prayers for you and Angel. Hang tough. Hugs, Kim

[we3dogs]

Hi MJ - thank you so much for the thoughts & prayers!! Angel is my rescue beagle who came to me with cushings 2 1/2 years ago. She had a strange medical year in 08 with her dosing and in the fall she had this shaking thing going on. At the time she was on 75 mg trilo and 10 mg enalapril for HBP/hypertension (are they the same?) She has been mostly off meds since a few weeks ago, so at least 3 months of no cushings meds until the pee/drink/eat/belly symptoms reoccured. I tried to restart her on 30mg but it seemed too much so 2 wks ago she started the 15 mg of liquid trilo. But - after 3/4 days on trilo at any dose she gets this shaky thing in her uper body on the inhale. Last fall my husband amd a recording of it and my vet posted it to a group of canine neurologists who of course said it is a neuro thing. However - given her history of HBP and that being a secondary "disease" if you will in cushings dogs, I think it could be her pulse and it is so rapid I don't know if I could count it! So, I did give her 10mg of enalapril which was the HBP meds she had been on in the fall. I am a bit calmer now than I was an hour ago. I remember now the vet said to keep her on the enalapril and I think Marianne mentioned it as well months ago, but I wanted her off everything as long as she was fine (and she truly was!) and then see where it all went from there. Well...now I know! Off to check on the beag and sneak a small glass of pinot grigio.

To answer your question (oops! :o). There is a 24 clinic an hour from me but I have not used them since Angel's disc surgery 2 years ago so I am sure they would just say bring her in. I am reading up on HBP on marvistavet.com now and feel that because I have the meds I will give her the dose she as taken before.

HI KIM - Just saw your post - I haven't heard from my vet and it is way too late to call his cell - he has 2 or 3 small children. He probably forgot I even have the number - it was for Zee! 2 yrs ago when he had his heart issues and was slowly dying. (Poor Zee!) I am going to hang tough as you say and speak to the vet at 8am. She has had this shaking before and has made it through so I pray for grace for 1 more night.

Note to self - post to Beth about the shaking think and possible link to HBP.

THANK YOU! Joyce

For now, I want to get her thru the night. Thank you again for listening and for chiming in! Joyce, Pebbles & Angel (we3dogs at the Bridge - Ed, Zee! & Concho)

[forscooter]

Hey Joyce,

Must be ESP bc here I am and saw your note to yourself. I have to get ready for work in a second and will try to get back more later but I wanted to get to you as much as I could right now.

The shaking thing and the vibration....have you placed your hand on her chest? With Scooter, you know, I was kicking myself...still am. It wouldn't have changed things for him but I did notice months before that his heart always felt like a bam-bam-bam...and his HR seemed kind of high to me. I was up a few nights months before he passed counting his respirations which also seemed to be high. Everyone told me I was just nuts basically and he was fine. Not the vet, more my friends who knew him. Anyway, I remember lying my hand against his chest and feeling like there was a brick in there pounding away.

At the end, that's when he lost the control over his back legs. He collapsed a few times trying to walk through the house. He did more of an rigid stretch and that's why we thought possibly seizure.

The chest x-ray showed his heart to be very enlarged, like a backwards "D" shape, almost against the ribs and his trachea was pushed straight across instead of the normal slightly downward angle. The vet noticed he was breathing loudly, I never noticed that. I thought he was just panting in the nervousness of being at the vet.

The feeling I was feeling was the heart murmur!

Please do NOT freak out bc I am NOT saying Angel is at her end!!!!!! But I do think you need to have the vet evaluate her bc it could be a murmur and it could very well be controlled with medication but maybe she needs something different than the enalapril...or something in addition to it. For Scoobie, it was too late....but that doesn't mean it is for Angel. Not at all.

Bailey does this jumping thing when he is going to sleep. Where his mouth slaps open and closed. As much as the vet thinks it is normal falling asleep stuff, I know it isn't. it isn't right or normal and as we always say, I KNOW my dog. He has never done this except recently. And it really looks neuro to me. Plus all the crankiness he is displaying and personality stuff. I know the clock is ticking for him too but I refuse the go there again right now. And eh is comfortable so I prefer to live in my state of denial of what is to come.

I'll be checking back later on Angel. But please see if you can get her to the vet, At least ask for a chest x-ray to get an idea of the size and shape of her heart and then go from there.

I am sending all of my very best to you as always and will be watching. Hopefully I can get on tonight....Love ya! Tons of hugs!!!
Beth, Bailey and always Scoobie

[we3dogs]

Hey Bethy! I know what you mean about the denial - that is how I felt the last few months. It was "wow she is doing great and she isn't on meds!" But things are rushing back now.
Angel is doing fine this morning. That rapid beat in her inner thigh has slowed dramatically so now I will wait for the vet. He did take a chest xray in November so if we do one today it can be compared to that one.
Angel is supposed to get her trilostane in the morning but I am holding off on it. The tremors only occur when she is on the trilo. I'll post an update later! Thanks so much! Love and hugs - Joyce & the girlz

[we3dogs]

So of course I have been sitting near the phone and computer all day waiting and waiting...just called the vet's office at 2pm and Dr. Berger went home sick! The new receptionist, Kelly, is on day 2 (altho she has worked at vet's offices before), and my regular receptionist/vet tech Stephanie is at lunch. So I continue to wait! Hopefully if Dr. B did not have a chance to check Angel's file then the newer vet in the practice, Dr. Steiner, can look and call me later today. I am being optimistic in that it is good for a 2nd set of eyes to check things out (well, a third including mine and infinity including all of yours ;) - whom I would be lost without!)
It's funny, last week Steph told me that Dr. B's love is surgery and Dr. Steiner's is medicine so maybe we'll learn something new about Angel. In treating Angel my way (like some others who shall remain nameless Sharon and Beth :rolleyes:) I am keeping her off trilo and giving her 5 mg of enalapril tonight and 5 mg in the morning - her original dosage last year at this time was 10mg daily. Anyway - I'll post again later. Joyce & the girlz

[labblab]

Hey Joyce!

I am so anxious to hear how Angel is doing, and so sorry that I haven't had the chance to give you a proper welcome...:o I am so glad that you have made your way to us, and am worried about our Angel. But I am packing to head out of town for a trip, and won't be back until next week. So I haven't had the chance to post to people as I would have liked. Anyway, I'm surely hoping that Angel will be settling down now, and that she'll BEHAVE HERSELF until Auntie Marianne is back in town next week!!!!

As always, big (((hugs))) to your whole family,
Marianne

[Rusty's Mom]

I'm hoping you're busy at the vet's, that's why we haven't heard later this afternoon. Please let us know how all is when you have a chance!

MJ

[forscooter]

Me too! I barely have a nerve left and I am anxious to hear! I'll take care of the wine while you tend to Angel!

Sending all our very best!!! Lots of hugs and kissies!!
Beth and the crew

[MiniSchnauzerMom]

Hi Joyce,

I've joined the crowd of those who are watching and anxiously awaiting to hear how Angel is doing.

Fingers and paws are crossed for Angel and prayers are being said.

Hugs,
Louise

[we3dogs]

Hello! I had a meeting last night that ran longer than expected - sorry to make you all wait and worry!

So...Angel is doing good! I have her off trilo (again) and on 2.5 mg of enalapril in the AM for HBP/hypertension. Dr. Berger called late yesterday afternoon from his sick bed (stomach flu) as he wanted to check on Angel. He is suggesting a conservative approach, which I actually agree with. He trusts me to watch her symptoms :eek:, and wants me to start on the lowest dose possible of trilo later this week and let him know daily how Angel is doing. I have the liquid trilo and will give her .1 of the 1 ml which would only be 3 mg! He thinks that she is an odd case :rolleyes: in that the trilo has really helped her and reduced the symptoms (drink/pee/belly) when they returned last month but even 15mg now is too much. Because she is a cushpup, he does not want to play games with a few days on then a few days off but would rather try to find a steady maintenance dose. The only thing we disagree on is he doesn't think the ACTH is as effective a test if she is not on trilo for a consistent period. Gee, a vet trying to save me money - I should shut up and say thank you! And be thankful that he trusts me to know my beagie best!
I hope that the enalapril wil regulate the other issue(s) then she can tolerate the trilostane. It seems that the trilo exasperates the other symptom which is something I need to continue to research. As we know, the HBP is just one of many secondary diseases (?) that result from cushings.

Marianne - you cautioned me back on Dec about just stopping the enalapril if it was being used for HBP and I should have been more careful. I wanted to be in that blissful state of denial!! Anyway, I feel like we may be back on track.

More later! MJ, Louise, Kim, Leslie, Terry, Scott and ALL who are following us - thanks for the prayers, thoughts & love!

Beth - Is it too early for wine?? Love ya! Joyce & the girlz

[forscooter]

Joyce....It is NEVER to early for wine!!!;)

So glad you have a plan...although using Lysodren, I am doing my own thing with Bailey too. It isn't necessarily "right", but when someone shows me the rule book and a dog who follows them, I'll reconsider my position! I know you know Angel best, and if you see a difference with the trilo, then I say you tweak and tweak until it works as it needs to for her. Have you tried Lysodren ever for her? I can't remember. Only reason I ask is bc if she has other hormones out of whack that could be contributing to the issue, then the Lysodren would address those as well, it effects everything but estradiol. It may be something to try if you haven't...but you'd have to do the washout period first. If you have, and she can't tolerate Lyso, then I say tweak tweak tweak....and you can too be "tweakers" like Sharon and I!

So glad she is doing better!!!! Still sending many positive wishes and kisses to you both.....with some wine!!! Beth, Bailey and always Scoobie

[we3dogs]

Thanks all! Angel is on the 2.5 mg of enalapril at night and I will start trilostane tomorrow morning at the unbelievably low does of 3 mg. I have never tried lysodren with Angel; she came to me a trilo dog.

I need to post in Sharon's thread as well that I did not mean to be so flip about the tweaking of the dosing and treating by visual symptoms. I too have been treating Angel for over 2.5 years and have a good relationship with my vet and have tried to read up on everything and see how it all affects my dog. I do not recommend or suggest that anyone do what I am doing! So please forgive me if I sounded too flippant or loosy-goosy about it all! OK...:o:o?

I'm on vacation this week with my almost-11-yr-old son. We are relaxing, doing some cleaning and having a Wii and Godzilla DVD fest. It is so much fun! And the bonus is getting to keep a close eye on Angel.

Take care - Joyce & the girrlz - Pebbles & Angel (&we3dogs@Bridge: ED, Zee! & Concho)

[Barney's Mom]

Enjoy your vacation! Hoping all is well with Angel!

Cheryl