Corkster - adrenal tumor/3x daily trilostane (Corky has been released)

[littleone1]

Hi everyone. I just wanted to give you an update on Corky. His Cushings symptoms are still in remission. He had his US, and the masses on his right kidney and liver are still about the same size. They don't seem to be giving him any problems, and the IMS isn't going to do anything at the present time. He was in the hospital 2 weeks ago, as he was having respiratory distress. They had to keep him in, as he was on oxygen for several hours. With all of the tests they performed, they didn't really know what caused it, but thought it might have been heat related because of the high temperatures that we had. Since he's been home, he's been doing very well. He is now back to walking over an hour every morning.

I want to thank everyone for all of the support and links you gave me. There is still the possibility that his Cushings symptoms might return.

I wish all of you the best with your babies. I will keep in touch.

Terri and Corky

[Spiceysmum]

Hi Terry,

How long has Corky been in remission and do you still have regular ACTH tests?

Spicey has been off Trilostane for 7 months now with no return to any Cushings symptoms. I am reluctant to start testing again as I think it will start it all off again! Also her first ever ACTH test was negative so do we go by what is a normal result for a Cushings dog, ie 5 or under, or a non cushings dog? It was the ldds test that diagnosed her as well as all of the typical symptoms which have now gone.

Glad Corky has recovered from his recent ordeal and is now well again.

Linda and Spicey

[littleone1]

Hi Linda,

Corky has been in remission for about 2 1/2 months. They didn't do another ACTH Stim. test, but they did check his blood creatinine and BUN levels, and his urine creatinine and cortisol levels. They were all in the normal range in the beginning of March. Corky never did begin his treatment with Lysodren, as he had 2 UTIs when he was suppose to start his treatment. Nobody seems to know why the symptoms went away and his levels are now in the normal range. His first ACTH was above the normal range. I'm not going to do another test as long as there are none of the clinical signs.

I'm glad that Spicey has been in remission for 7 months. That's really great. I hope she can stay that way.

Terri and Corky

[littleone1]

Corky was diagnosed with Cushings today. His clinical signs were in remission for 7 months. About 3 weeks ago he started exhibiting the signs again. He had an ultrasound and biopsy done then, and his right adrenal gland was enlarged. They did the tests yesterday, and confirmed that he definitely has Cushings. Because of his age and all of his other medical problems they chose not to remove the right adrenal gland. Originally, he was being put on Lysodren, but because of all of the other issues he has, his IMS is going to be treating him with Trilostane.

For those of you that were on the Cushings network, I was the one that submitted that my vet recommended not treating this disease, and I got a second opinion. Even though I had the Lysodren and Prednisone, we couldn't start treating Corky as he had 2 UTIs. Before I was going to start his medication, his clinical signs started disappearing. He was then not given the medication.

I would appreciate any input that you might have regarding the use of Trilostane.

Thank you.
Terri and Corky

[gpgscott]

Hi Terri,

I am going to stay away from the Trilostane question as we have plenty of folks here with both a better understanding as well has first hand experience.

It would be useful for you and everyone here if you would post the names of the tests and the results. It would also be good to know about Corky's wt. the dose of Trilo being prescribed and any other meds he is taking.

Check back frequently, I am sure we will hear from some of the Trilo people soon.

Best to you and Corky. Scott

[Harley PoMMom]

Hi Terri,


Because of his age and all of his other medical problems they chose not to remove the right adrenal gland. Originally, he was being put on Lysodren, but because of all of the other issues he has, his IMS is going to be treating him with Trilostane. What are all of Corky's medical problems? And what other issue does Corky have?

The more information you can provide the better we all can answer your questions, ok. :)

Love and hugs.
Lori

[Squirt's Mom]

Hi Terri,

Good to hear from you and Corky again but am sorry to hear he has been confirmed as cushinoid.

I have a few questions...of course! ;) Like the others, it would really help to see the results from the tests he has had recently that led to this diagnosis. The U/S showed only one adrenal enlarged? Did they tell you whether he has ADH or PDH (adrenal or pituitary based)? Did the IMS tell you anything along the lines that Trilo was "safer" than Lyso? If so, please don't be lulled into thinking Trilo cannot harm Corky - it is just a powerful a drug as Lyso but works in a different way. It has the ability to necrose the adrenals just as Lyso does and Addisonian crisis are possible with Trilo just as with Lyso. Some dogs do really well on Trilo while others do better on Lyso. Also, what other meds is he on at the moment? Some meds are not recommended to be mixed with Trilo.

Hang in there!
Hugs,
Leslie and the girls

[littleone1]

Hi Scott, Lori, and Leslie,

Thank you for your responses. Corky does have a tumor on his right adrenal gland. The last biopsy report is now showing the mass as a tumor. Based on this he was given the LDDS test yesterday. The results of this test along with his clinical signs confirmed Cushings. I will be getting a copy of the results tomorrrow, and I will post them.

At the present time Corky is only taking Soloxine for his hypothyroidism. He was taking allergy medicine for his breathing, but he started having very loose stools, and I stopped giving it to him. I also have Torbutrol which is to be given to him only as needed for his respiratory problems, and Acepromazine, which is only given to him when we have storms, if needed. He is terrified of them, and really pants heavily, and shakes very badly.

Along with the hypothyroidism, Corky has renal stones, has had several UTIs, allergies, collapsing trachea, enlarged right side of the heart, arthritis, occasional seizures, and a mass on his liver. He was in the emergency hospital in April and May for respiratory problems. He had to be put in an oxygen cage over night on both occasions. He was also taking Metronidazole towards the end of September. In the past he has had several ear infections and masticatory muscle myositis. He also has pins in both of his hind legs. He had several growths removed last December. The poor little guy has been through an awful lot.

Corky's IMS did explain to me that there could be problems with the Trilostane. He will be starting on 20mg a day for one-two weeks. Then he will go back for an ACTH Stim test to determine if this is the proper dosage. At the present time, Corky weighs 20.6 lbs.

He is now on a bland diet of boiled chicken or boiled hamburg, rice, pumpkin, and fat free cottage cheese.

I'm sorry for being so long winded. Thank you again. You were all so very supportive back in Jan. and Feb.

Terri and Corky

[Harley PoMMom]

Hi Terri,

I never used Trilostane either...heck I haven't used Lysodern. So the information/advice I'm giving you is just things I've been reading or my opinion, ok?

Now on the Dechra's U.S. Product Insert it says "Do not use VETORYL Capsules in animals with primary hepatic disease or renal insufficiency."

So why exactly does your IMS not want to use Lysodren? Now I'm not saying she is wrong, I would just want to know why.

Now as far as you being long-winded...no way :D...the more information the better.

Love and hugs.
Lori

[littleone1]

Hi Lori,

Corky's IMS wants to use the Trilo because she believes it will be easier on Corky because of all of the issues he has.The liver was enlarged when he had x-rays taken last Dec. At that time his vet stated that this was consistent with Cushings. I spoke with his IMS and she doesn't think there is anything to be concerned about with Corky being on Trilo. I appreciate the information.

Terri and Corky

[littleone1]

I just got a copy of Corky's LDDS test.

Results Reference Range Units
Cortisol Sample 1 7.3(High) 1.0-5.0 ug/dl
Cortisol Sample 2 Dex 6.2(High) 0.0-1.4 ug/dl
Cortisol Sample 3 Dex 5.7(High) 0.0-1.4 ug/dl

[gpgscott]

Hi Terri,

Although you cannot tell conclusively from an LDDS this one tends to make me think adrenal as there is no sign of supression.

I just need to say that many Drs. seem to believe that Trilostane is 'easier' on the pup and there is just no objective fact to that position. In fact with multiple health issues I veiw Lysodren to be superior due to the singular manner in which it addresses the issue of overproduction of cortisol. Problems attributed to Lysodren are almost always related to low cortisol which is not a side effect of Lysodren administration but a side effect of Lysodren over-administration. I am not a Dr. but I have heard from many members and know that the action of Trilostane is very complicated compared to Lysodren. Please continue to be open to Lysodren if the Trilostane does not bring about relief for Corky.

You have not mentioned that a stim will be done prior to beginning treatment. It is my opinion that any dog which is going to be treated with Trilostane should have the UTK full adrenal panel to baseline the 6 adrenal hormones which Trilostane affects. You can find out more about this in our Resources area, follow this link, http://www.k9cushings.com/forum/showthread.php?t=198

You might also ask your Dr. about trying melatonin instead of the acepromazine. My mom has a bichon which is terrified of storms also and she reacts very well to the melatonin and it does not place burden on the liver like the ace.

Scott

[littleone1]

Hi Scott,

Thank you for the information about Melatonin. Since July 1st, Corky has only had 1 3/4 pills of the Acepromazine. I believe that one of the reasons for the lower amount this year is that Corky is losing his hearing. I'm really glad you let me know about Melatonin.

Along with the biopsy, he also had an U/S which, on nine sides, did show an adrenal tumor. The first choice was to do an adrenalectomy, which the IMS did not feel was feasible for Corky, with everything else that he has going on. I'm going to give the Trilo a shot, but I still have the Lysodren, which I will use if the Trilo doesn't help. He isn't going to have another ACTH Stim test until he's been on the Trilo for approximately 10 days. I'm keeping track of how much water he drinks daily. I've been measuring the amount of food he gets every day, and watching how he is eating.

I really appreciate your input. Even though I got so much valuable information earlier this year, I really feel that I'm starting all over again. I just want to do what's best for Corky, so that he can live the rest of his remaining time with a good quality of life.

Terri and Corky

[Harley PoMMom]

Hi Terri,

Scott gave you alot of really good advice, especially about the UTK full adrenal panel, Trilostane will raise one or more of these intermediate/sex hormones.

I had the full adrenal panel done on my boy Harley, he is Atypical and PDH, but his estradiol hormone is very elevated. I was considering starting him on Lysodren then I had a ACTH stim test done on him, he stimmed within the normal ranges so as of right now Harley's treatment consists of melatonin and flax hull with lignans.

Harley used to be terrified of thunder storms too, since he's been on the melatonin he's not afraid of them any more. :) He's not zoned out from the melatonin, I guess it just calms them.

Love and hugs.
Lori

[littleone1]

Hi Lori,

Thank you for this information. I need to take a little time to digest all of this information. My brain doesn't function as well as it use to. I'm starting to get very confused. I'm just not sure what to do! Corky has been to his regular vet and an IMS. I was hoping that his IMS would know the best procedures.

Terri and Corky

[Harley PoMMom]

Hi Terri,

I know this is alot of information to digest, it was for me also...so let's both take a deep breath...whew!:eek::p:D

Now, Harley's regular vet didn't know about the UTK full adrenal panel, heck I don't think she was familar with the intermediate/sex hormones and their "play" within the cushings, especially when it comes to ADH.

Lets see if I can explain this right and if not I do hope someone will interfere...Corky's adrenals secrete 6 hormones, cortisol of course being one of them, but there are 5 other ones and they are Androstenedione, Progesterone, 17 OH Progesterone, Aldosterone, and Estradiol. Now estradiol can be secreted else where besides the adrenal glands but the other ones are primarly secreted by the adrenals only.

When a cushpup has an adrenal tumor, this tumor can make the adrenals secrete these hormones more and these hormones become elevated. Trilostane, the way it works, blocks these hormones , for lack of better words, pathways, and then these hormones build up in your pups system.

Lysodren, on the other hand, has the opposite effect, it lowers cortisol, progesterone, androstenedione and 17-hydroxyprogesterone levels but not estradiol. That is where the melatonin and the flax hull with lignans come into play, they help to lower the estradiol.

OHGosh, I hope I didn't confuse you more. :eek::confused:

If you have any questions, please, please ask. There are people here much more knowledgeable then me here that are more than willing to help you.

Love and hugs.
Lori

[Buffaloe]

Hi Terri,

I think you are doing an outstanding job of taking care of Corky. My dog, Shiloh, had a very large, malignant adrenal tumor surgically removed from her left gland three years ago. She'll be 15 in less than two months and is doing well and enjoying her senior years.

My surgeon owns two wonderful facilities in Phoenix and I think he is just as sharp as they come. I decided way back then that he's the one I'm trusting to take care of Shiloh for the duration. He has Internists (IMS's) at his facility and I'm sure they are involved with the adrenal tumor cases that are treated medically. I've picked his brain some and here are some things he has told me:

Tumors in the right gland are more difficult to remove than in the left.

At any given time, they are treating about six dogs medically (either Lysodren or Trilostane) for adrenal tumors at his facilities.

There are about five things they look at to determine whether to treat the adrenal tumor initially with Lysodren or Trilostane.

They always do a full adrenal panel prior to treatment because one of the five things they look at is the situation with the intermediate (sex) hormones. If some were elevated (in which case he'd probably choose Lysodren), he likes do have a second adrenal panel done after a few months of treatment.

The younger Internists tend to prefer Trilostane, the older ones Lysodren.

Every adrenal tumor is different and no two respond to medical treatment the same.

The medicines just treat the symptoms of an adrenal tumor. But he added that you just never know. (miracles, anyone?)

If a dog has elevated aldosterone (one of the five sex hormones) the bad effects of high aldosterone can be counter-acted very effectively with an anti-aldosterone drug.

They will start with Lysodren or Trilostane and then switch to the other drug if the dog isn't showing good improvement in symptoms.

Personally, I think it is good that you are starting Corky on Trilostane. I'm sure your Internist has good reasons for doing so. I strongly agree with Scott and Lori that you should have a full adrenal panel done on Corky at some point. It is very valuable to know what is going on with the intermediate hormones. It doesn't cost alot more than the ACTH test and it gives you the cortisol reading, plus the other five hormones. Maybe after this next ACTH test you have the adrenal panel done instead. The downside is that it usually takes 8-10 days to get the results back. I agree with your choice to treat Corky medically rather than having an adrenalectomy. I think you just want your boy to be as happy and comfortable as possible for as long as possible. Bottom line, you're doing great with Corky and if he doesn't respond to Trilostane as well as you had hoped, you can switch to Lysodren.

All the very, very best to you and Corky.

Ken

[littleone1]

Hi Lori,

Thank you for this information. I will talk to my IMS about it. I will also inquire about the UTK full adrenal panel. This really helped me get a better understanding of what could be going on with Corky.

Terri

[littleone1]

Hi Ken,

Thank you so very much for your words of assurance. I really appreciate it. I know there is so much to learn about Cushings and the treatments. I am going to ask my IMS about having the full adrenal panel done. I have been reading all kinds of information about Cushings and the treatments. It does get mind boggling at times. I've been trying to sift through the information to get to the point where I can have a good understanding of what's going on. The information you gave me does help.

If you don't mind me asking, Who is the IMS that you go to? I noticed that you are in Phoenix, and I'm in Scottsdale. I actually live in the Phoenix boundaries, but I have a Scottsdale mailing address.

Thanks again.

Terri

[Harley PoMMom]

Hi Terri,

I, too, wanted to comment on the excellent job you are doing in taking care of Corky.

I really do feel that Ken has more experience and knowledge with cushings and the effect that Trilostane will have on it. Ken and his beautiful girl Shi have, shall I say, "been there." I only have my opinions.

I truly do believe tho, once you've read and read :eek::) you'll know what to do...go with your gut feeling and your heart. You can't go wrong.

I don't want you to think that I'm trying to sway you away from using the Trilostane, because I'm not, ok, I think both Trilostane and Lysodren are very excellent and powerful drugs to use for cushings, it's just they work in different ways, and alot of people don't realize that, I didn't at first.

Love and hugs.
Lori

[littleone1]

Hi Lori,

I really do appreciate your help and reassurance. I know there is so much to learn, and I do know that you really are trying to help me. I don't think that you are trying to sway me away from Trilo. You are giving me information that I need to know. I know my decisions would be easier if my husband was still living. I never had a pet before. Corky is my first baby. I never realized how many things my littleone would encounter. Thank you again.

Terri

[Squirt's Mom]

Hey Terri,

You are doing just fine, honey. You have us to help you anytime, in any way we can, so you are not alone with this tho I know it must feel like it at times.

Keep asking questions, reading and talking. This is the best way to learn and with knowledge comes power and confidence. I was a real basket-case when I got here a little over a year ago but these wonderful folks led me along in their gentle ways and I am much better now. :eek::D:p;)

Keep up the good work. Corky is lucky to have you as his mom!

Hugs,
Leslie and the girls

[littleone1]

Hi Leslie,

Thank you so much for your kind words and support. I will keep reading and asking questions. Corky is my life right now. I'm afraid I'm just getting too old for the stress. I hate to admit it, but I'm pushing 64. Everyone on this site and the previous Cushings network have been very supportive. I have gotten so much valuable information and kind thoughts. It helps to ease my mind a little.

I got Corky's Trilo today. He will take his first pill in the morning. I'm really hoping that he doesn't have any bad reactions to it. I feel more at ease giving him the Trilo instead of the Lysodren, even though I know that there could be problems and complications with both of them. I have been keeping in touch via e-mail with a former member of the Cushings network. Unfortunately his girl really had a bad time with Lysodren, and is now constantly on Prednisone.

I'm thinking positive thoughts that Corky's condition will improve.

Thank you.

Terri

[Harley PoMMom]

Hi Terri,

I was just wondering how much does Corky weigh and what is he dosage of Trilostane and how often will he get it?

Love and hugs.
Lori

[Roxee's Dad]

I got Corky's Trilo today. He will take his first pill in the morning. I'm really hoping that he doesn't have any bad reactions to it. I feel more at ease giving him the Trilo instead of the Lysodren, even though I know that there could be problems and complications with both of them. I have been keeping in touch via e-mail with a former member of the Cushings network. Unfortunately his girl really had a bad time with Lysodren, and is now constantly on Prednisone.

I'm thinking positive thoughts that Corky's condition will improve.

Thank you.

Terri

Hi Terry,
I haven't posted to you so first I want to welcome you back.:) Just a quick question or two. How much does Corky weigh and what dosage of Trilo was prescribed?

I'm sure you know what signs to look for and you will do fine.:) We will also be keeping you and Corky in our positive thoughts. Please keep us posted on Corky's progress. :)

[littleone1]

Hi Lori,

Corky weighs 20.6 lbs. He will be taking a 20 mg capsule once a day. He needs to take it in the morning with his food. Right now it is easy to give him his medication, as he will eat anything and everything if I would give it to him. Even though I feed him at the same time as I eat, he finishes eating so much faster than I do, and then he sits in front of me looking for more food. I measure the amount of food I give him everyday, especially since he needs to be on a bland, fat free diet. His name is very fitting for him. He is a little corkster!

Terri

[littleone1]

Thank you John,

I just now posted this information for Lori. Corky weighs 20.6 lbs., and will be taking a 20mg capsule once a day in the morning. I think you were posting while I was replying to Lori.

Thank you so very much for welcoming me back and for your positive thoughts. I know back in February, I was so relieved to see his clinical signs disappearing. I know that his IMS told me that the signs might return in 6 weeks or 6 months, etc. I really thought that he was "out of the woods". Then, after 7 months, all of the signs started to reappear. He's a strong little boy and has been such a little trooper that I believe he will get through this.

Thank you again, John.

Terri

[Harley PoMMom]

Hi Terri,

Usually they follow the The UC-Davis current recommendation which is 1 mg/kg once daily, but Corky's is just alittle higher. According to UC-Davis he should start out at 9.36 mg.

Just a reminder...The ACTH test should be 4-6 hours after the Trilostane, no longer than that and when they do the stim they should also check Corky's electrolytes.

You are doing an super job, you're a wonderful mom, don't doubt that, ok.

Will be keeping you and Corky in my thoughts and prayers...sending positive vibes your way.

Love and hugs.
Lori

[littleone1]

Thank you so very much, Lori. I did ask Corky's IMS about his electrolytes, as he definitely had a bad reaction to the gel that his vet used. He had to be rehydrated twice, and I had to give him pedialite. I do keep this on hand in case he needs it. Corky's IMS does not use the gel for the ACTH Stim test, which helps relieve my mind. I know that I was afraid that he might have a reaction to the IV when he had the LDDS test, but he was fine.

Thank you so much for your thoughts, prayers, and positive vibes. I just wish that I could help others, the way that everyone is helping me.

Terri

[littleone1]

Hi Lori,

You just confused me. Is it 1mg per pound? I know that before you edited your reply, you told me that the dosage was excellent for his weight. Please let me know.

Thanks,

Terri

[Harley PoMMom]

Hi Terri,

I am so sorry about that, The UC-Davis current recommendation which is 1 mg/kg, and I forgot to get my calculator out first :eek: you see you have to divide your pups weight, if in lbs, by 2.2 to get it in kgs. So, Corky weighs 20.6, 20.6 / 2.2 = 9.36 kgs. So by UC-Davis, they would start Corky at, I would say, 10 mg at the most.

So sorry for the mix-up...my feeble mind....:confused::eek:

Love and hugs.
Lori

[labblab]

Hi Terri,

I just thought I'd go ahead and give you some additional thoughts regarding dosing. Lori is correct that the UC Davis recommendations are very conservative re: starting doses. However, worldwide, probably the guidelines that are followed most frequently are those issued by the manufacturers of Vetoryl (the brandname veterinary version of trilostane that is manufactured in the U.K.). And for a dog of Corky's weight, Dechra (the manufacturer of Vetoryl) recommends a starting dose of 30 mg. So the 20 mg. that your vet is starting Corky on actually seems to be a nice compromise between the two protocols. :)

Of course, the proof will be in how Corky responds, and also in the results of his first monitoring ACTH test. So we will all be anxious to hear your updates all along the way!

Marianne

[BestBuddy]

Hi Terri,

There are quite a few thoughts on trilostane dosage. The original Dechra info stated that 2-10mg per kg was recommended and UCD talks about dosages as low as 1mg per kg. I am not sure there is a right or wrong because every dog is different but it is a good idea to start with a low dosage and you have been advised just over 2mg per kg so I would think this sounds fine.

Once you start the meds it is then important to keep a close eye on any strange behaviors such as slow or not eating and checking ACTH levels at day 10. If you are really concerned about any problems Corky has while taking the trilo then just stop the drug and contact your vet.

You have probably read a lot about problems while treating with trilostane but believe it or not there are some that don't have any problems and I am wishing you are one that joins that group.:D

Jenny

[Harley PoMMom]

Hi Terri,

Now from my calculator :) this comes out to 2.2 mg/kg, which I think will be ok. Like I said before, you are a wonderful mom, and you know what signs to watch for.

And remember we are here for you...always.

Love and hugs.
Lori

[Roxee's Dad]

Hi Terry,
Lori is referring to the Treatment and Monitoring Recommended by University of California at Davis which is a bit different to the Dechra's Vetoryl recomendations. You can find this info in our resources section.

http://www.k9cushings.com/forum/showthread.php?t=185

Post # 1 toward the bottom of the page, there is also a link there that will take you to the UC Davis article.

The 20 mg dose for Corky is a bit higher than the UC recomendation but a bit lower than the Dechra's Vetoryl recomendation.

My Roxee was about 14 pounds and we started her at 30 mg and eventually after proper monitoring via the ACTH stim testing she was raised to 35 mg.

Just need to know what signs to watch for.

[littleone1]

Hi Lori,

Not a problem. I was searching web sites for info on the UC-Davis. I know, my mind is getting feeble, too. Even though it's early in AZ, I'm going to try to get some sleep, which has not been a word in my vocabulary this week! Have a good night.

Terri

[Harley PoMMom]

Hi Terri,

You go get a good nights rest, Corky's going to do great...he's got a wonderful mom by his side who loves him very, very much.

Sweet dreams...

Love and hugs.
Lori

[Buffaloe]

Hi Terri,

I hope you got yourself a good night's sleep. It sure is good sleeping weather. Shiloh loves these cool evenings and refuses to come inside until about 10:00 am. I put her doggie bed outside on the patio with her bowl of water and she's a happy girl.

I think your starting dose of Trilostane sounds reasonable. Be sure to give it with food. It is very important that you have some prednisone on hand just in case Corky shows signs that he's had too much Trilostane.

I am confident that he will be feeling a whole lot better before long. He is not an old dog and I expect he will live for a long, long time with an excellent quality of life. I say, thank goodness for modern veterinary medicine. Of course you need to keep your eye on him but try not to worry. I'm glad you're getting him started on the Trilo today and you are doing everything exactly right.

Ken

[littleone1]

Hi Marianne, Jenny, Lori, John, and Ken.

I feel much better today. I actually got about 6 hours of sleep last night. I know the mornings and evenings here have been great.

Thank you all for your input, links, and encouragement. I feel better about his dosage. Corky had his first pill with his breakfast at 7:30 this morning. With the way he's been eating, it's not a problem getting him to take his medicine with his food. He's a little character! There were many times before, when he had to take antibiotics, that I could have sworn he swallowed his pill, only to find it somewhere in the room later!

You have all been so very supportive. It's good to know that there is such a wonderful site where you can get so much information and help, with very caring people.

I'm hoping that Corky will get back to his normal self soon. He always use to walk 2 1/2-3 miles a day. During the past few weeks, there have been many times that he only wants to walk around the block. It seem that after a long walk one morning, the next morning, he just walks around the block. Thursday and today, he did take long walks.

Thank you all again. Corky also thanks you because he knows that you're helping me to help him.

Terri and Corky

[Harley PoMMom]

Hi Terri,

I am so glad you were finally able to get some sleep...can not have mommy sleep deprived. :eek: :D

I give Harley his pills in cream cheese, but of course Harley eats anything! Harley is a little piggy. :eek::p


I'm hoping that Corky will get back to his normal self soon.I am sure soon you will see Corky feeling much better and I'll be waiting with the others for them updates. ;):)

Love and hugs.
Lori

[littleone1]

Hi Lori,

Thank you. It was so nice to get some sleep for a change. Corky seemed to be a little agitated today. He didn't get his normal nap. He finally settled down after he ate his dinner. I really feel that this was due to his first dose of of the Trilo. On a brighter note, he didn't have any accidents in the house today. He's such a good boy. His breathing has been much better today. He's actually sleeping right now. I really do feel that he will get back to his normal self. He's been such a little trooper with everything that's happened in his life.

Terri and Corky

[Harley PoMMom]

Hi Terri,

I am so glad you got some sleep, you most definitely deserve it. :)

Also happy to hear Corky's breathing better and no accidents in the house today...Awww, that has to make him feel so much better too.


He's been such a little trooper with everything that's happened in his life.It just amazes me how they just bounce back after all they go thru, ya know, truly amazing.

Give Corky a gentle belly rub from Harley and me, and you try and get some more sleep.

Love and hugs.
Lori

[littleone1]

Hi Lori,

I did get more sleep last night. Corky actually slept all night. He didn't even have to get up to go to the bathroom. This is a first in a long time. That did my heart good.

You are absolutely right about our amazing babies. There are many people that wouldn't bounce back the way they do. I know that Corky doesn't give up. Not only is he a little trooper, but he is also a fighter when it comes to his health.

Terri

[Squirt's Mom]

Hi Terri,

Good to hear that you and Corky got some rest finally. I hope the Trilo puts him back on track real soon and you both can get back to a more normal life.

Hugs,
Leslie and the girls

[littleone1]

Hi Leslie,

Thank you. It really felt good to get some sleep the last two nights. Corky seems to be doing better today. He went for another long walk, and was walking faster. When we got home, I fed him and gave him his second dose of Trilo with his food. He did follow me into the kitchen and stood behind me when I was getting his breakfast ready. A couple of hours later, I was getting myself something to eat. This was the first time in almost a month that he didn't follow me into the kitchen. It was also the first time since then that he didn't sit in front of me looking for more food while I was eating. I was actually able to enjoy a meal. His water intake was down 1/2 a cup yesterday. Is it possible to see these kind of results with only 2 doses of Trilo?

I have a much more positive attitude and outlook.

Terri and Corky

[Harley PoMMom]

Hi Terri,


Is it possible to see these kind of results with only 2 doses of Trilo?IMO, yes, so just keep watching him, as we know you have been watching him like a hawk. :D Any signs of lethargy, vomiting, diarrhea, not eating, trembling, or fever, any signs of any one of these, I would stop the Trilo and call/take Corky to your vet.

Corky has to be feeling so much better, that "I am always hungry feeling," has to be the pits. This is probably the first time in a while for Corky that he has filled full after his meal. 

Keep up the great work, Terri, and give Corky some head scrunchies from me and Harley.

Love and hugs.
Lori

[littleone1]

Hi Lori,

Thank you for the information. I am definitely watching Corky like a hawk.

I do believe he is now starting to feel full after he eats. This afternoon, we both ate together. He still eats very fast. Before, when he would finish eating, he would always sit in front of me looking for more food. He didn't do that today. He went and got a drink of water, and the I gave him his two treats.

I gave Corky bigs hugs and kisses from you and Harley.

Thank you again.

Terri and Corky

[littleone1]

Hi,

I just wanted to let you know that Corky had his third dose of Trilo this morning. So far he seems to be doing fine with it. He seems to be content with his regular size meals and treats. He is not sitting in front of me looking for more food after he finishes eating. His water intake for yesterday was down to just a little less than 2 cups, which is just about the normal amount of water he drinks when it's cooler.

I just got a call from my IMS. She wanted to see how Corky was doing with the Trilo. I really feel that this was very thoughtful of her. He goes in for his ACTH Stim test next Monday. At the same time they will also check his urine cortisol and creatinine levels. We will also be discussing the UTK full adrenal panel.

So far, so good. I know I keep reading various information about Trilostane. I want to learn as much as I can. I even got a posting from the old cushings network and the yahoo group, along with the links on this site.

Thank you all for your support.

Terri and Corky

[gpgscott]

Hi Terri,

Your Dr. sounds first rate, looking in on you and being concerned.

Thanks for letting us know.

Looking forward to further reports.

Scott

[littleone1]

Hi Scott,

Thank you. I do feel very confident and comfortable with her.

I will definitely keep you posted as to what is going on with Corky.

[Harley PoMMom]

Hi Terri,

I agree with Scott, your IMS sounds top-notch! :D Corky has 2 very wonderful women looking after him.

I can't express how happy I am that Corky is doing so well. :D


We will also be discussing the UTK full adrenal panel.I think this is a really good idea.


I know I keep reading various information about Trilostane. I want to learn as much as I can.Great job...Knowledge is power!! The more we know about this dratted disease and the meds that help combat it the more we can help our beautiful furbabies fight it themselves.

You're doing a wonderful job Terri, I hope you realize that.

Love and hugs.
Lori

[littleone1]

Hi Lori,

Thank you so much for your positive comments. I really want to do what's best for Corky. I am trying to do the best I can.

There's another good thing about this. When I was taking Corky to his regular vet, even though he's been going there for over ten years, he would start to shake and pant, go in one door and pull to get out of the other door. When he goes to his IMS, he actually will walk up to the door. He'll stand in front of the door once he gets inside, but he doesn't try to pull to escape! This is really a good thing. He really likes her and her assistant, even though they've done more poking and prodding, especially with all of the tests, U/Ss and biopsies.

Terri and Corky

[jrepac]

all sounds very promising!

[littleone1]

Thank you. I'm keeping everything crossed that I possibly can. I don't want Corky to go through anymore than he's already been through.

Terri and Corky

[haf549]

Hi Terry:

I haven't posted to you before, but I've been following your thread. I'm glad that Corky is doing well on the trilo. Kira started on trilo almost a year ago. We had a bit of a rough start, but finally stablized her last spring. Since then, it's been nothing but up. Over the summer, she slowly got her enthusiasm back, to the point that she is once again protecting the backyard against squirrels:D You are already seeing good results after a short time, so I am keeping my fingers crossed that things go as well for Corky as they did for my Kira.

Heidi & Kira

[littleone1]

Hi Heidi,

Thank you. I'm glad that Kira is doing so good on the Trilo. It's always nice to see them get back to their normal selves. I'm also hoping that Corky does good. He went for another long walk this morning, but he was moving much slower than the last three days. I'm hoping it's because he's not use to taking his long walks every day. It's about a month since he's walked so long for so many days. When he came home, he ate good and is drinking water. Yesterday he drank about 1 1/2 cups of water. I'm really keeping any eye on him because I know there can be problems from the Trilo.

I hope Kira continues to do well.

Terri and Corky

[haf549]

Terri

Yes, keep a close eye on him. Kira did well the first couple of days and then became lethargic and had the runs. We started her on 120mg once a day. When she became lethargic, we changed it to 60mg twice a day. It didn't help much. By January I wasn't sure what was up with her, but we decided to cut down the meds to 40mg twice a day. After that, there was no looking back... she's gotten better by the month, to where she's almost herself again (she is 12 after all). Not sure if anyone on the forum asked you this... did the vet give you prednisone? That's in case of an overdose of the trilo. In the beginning I gave Kira pred 3 times. In hind-sight, I think I panicked because her breathing was kind of ragged. It turns out she had a mild bronchial infection; it wasn't a result of the trilo. But, you panic over everything in the beginning. It gets better with time.

Heidi

[littleone1]

Hi Heidi,

I just got off of the phone with Corky's IMS. He started acting a little strange this afternoon. He seems to be lethargic. She told me to watch him tonight and then call her first thing in the morning to let her know how he's doing. She doesn't want me to give him his dose of Trilo in the morning until I talk to her. If he still isn't himself in the morning, she said that we would skip the dose tomorrow to see if he improves. Then I will have to call her the next morning. She doesn't want me to give him prednisone just yet. She said he could just be having an off day.

Terri

[AlisonandMia]

Your vets advice seems right on from what I've seen here - you certainly don't want to give any more if he isn't absolutely fine tomorrow. I've noticed that a lot with a lot of dogs the dose of Trilo seems to really "kick in" around the day 3 - 5 point. With some this means that it doesn't seem to start working (having any good effects) until around that time but with others it can result in them going a bit low after doing well initially.

You may want to discuss going to a lower dose for a while even though he may well end up on the dose he's on now after a few weeks or months. The general rule with Cushing's meds is "if in doubt (even if it is something you can't put your finger on), hold the dose".

Alison

[BestBuddy]

Hi Terri,
Great advice to just watch and not give tomorrows dose if he still seems off. It may just be the lowering of cortisol that is giving Corky the yukkies. It is best to go slow and stop if there are problems.
Jenny

[littleone1]

Hi Jenny,

Thank you. This could very well be what is going on with Corky. She did ask me if he was showing signs of any other side effects, which he isn't as of right now. This is probably why she gave me the advice she did. I trust her judgement.

Terri

[gpgscott]

Hi Terri,

I have no personal experience with Trilo, but it makes sense to just hold for a bit before continunig treatment.

Trilo is fast and short acting this is why it is best administered twice daily.

After being 'high' on cortisol it is no suprise that Corky would be a bit off being denied his 'drug'

I bet it goes better as you go forward.

Please continue to post.

Scott

[littleone1]

Thanks Scott.

I really think that Corky will be okay. I know this has to be hard on him. Since December he's had so many different medications that he's had to take. There are a lot of changes that have occurred in his system. This one, I'm sure is so much more drastic than the others.

Terri

[Harley PoMMom]

Hi Terri,

I see you got alot of really good advice, and I just wanted to add that the extra cortisol that Corky had in his body was helping his arthritis, so you said "he was moving much slower than the last three days," is probably due to the drop of the cortisol in his body.

If his arthritis seems to bother him once you get his cushings under control there are meds. other than NSAIDs (non-steroidal anti-inflammatory drugs) that you can use for Corky, like Adequan, and Glucosamine and Chondroitin. The reason we try to stay away from the NSAIDs is they are hard on the liver and our pups already have a liver working harder than it should.

You're doing a wonderful job Terri, please keep us updated.

Love and hugs.
Lori

[littleone1]

Hi Lori,

Thank you so much for reminding me of this. I know earlier this year, when it was colder, Corky wasn't holding his one hind leg up when he started walking as he use to do in previous years. This is when he was originally diagnosed with Cushings. I learned then that the excess cortisol was actually helping his arthritis. This really helps me put things into perspective. I noticed that both of his hind legs seemed to be very stiff today. It's all starting to make sense now.

I'm glad to know that there are other medications that he can take for his arthritis. I still have Metacam, which I don't really like to give him. I was also using baby aspirin instead of the Metacam.

I'll definitely keep posting. It really helps me get a better understanding of what's going on and what and what not to do.

Terri and Corky

[Casey's Mom]

Hi Terri, my dog Casey had the same problem with arthritis once we had the cushings under control. Thanks to Scott on this site and some others that mentioned Adequan I gave it a try and even though Casey has not completed the loading dose after two weeks she was running up and down hills on the weekend! I call it a miracle. I am also happy it is not aspirin or NSAID because from what I understand they are not the best for their liver.

Good luck and a warm welcome to this site. You are not alone,

[AlisonandMia]

The reason we try to stay away from the NSAIDs is they are hard on the liver and our pups already have a liver working harder than it should.



This would be part of the reason but I think the main reason is that high cortisol by itself makes bleeding and ulceration of the stomach more likely and so do NSAIDS (particularly aspirin), so the combination can be really risky.

Some vets believe even when a Cushing's dog's cortisol is thought to be under control there is still a risk in giving regular NSAIDS as you can never know if the cortisol isn't going to rise at times because a dose adjustment is needed or a dose missed. A dog on Trilostane, especially with once-a-day dosing could also be having a few hours of highish cortisol too. Other vets are ok with giving NSAIDS once the cortisol is under control and quite a few dogs here are on NSAIDS, often on an as-needs basis, ie if they seem to be having a bad day and don't seem to have problems.

Some dogs seem to have done ok with untreated (and often, at the time, unsuspected) Cushing's and regular NSAIDS. Mia was sort of in that situation once when she was, looking back on it, in the early stages of Cushing's and she needed to take NSAIDS for 2 or 3 days following an injury. She didn't appear to suffer any ill effects. Did give me the willies though when I realized what we'd done down the track!

Non-NSAID options that people here often use are Tramadol, Adequan and fishoil and glucosamine - any combination of all or any of those.

The other thing with arthritis and Cushing's is that with Cushing's the high cortisol causes muscle weakness and wasting especially around the back and hindquarters and this throws additional strains on the joints. So although the high cortisol "treats" the arthritis it does so at a price. Many dogs' arthritis improves a lot once they start to rebuild their muscles once their cortisol is controlled with treatment. The difficult stage is where Corky is now - suddenly deprived of that nice excess cortisol but still with the muscle weakness.

Hope he feels better soon!

Alison

[littleone1]

Hi Alison and Ellen,

Thank you for the information about treatments for arthritis. I've been doing some research and have learned that Adequan should not be used on dogs with hepatic disorders. Since Corky has an enlarged liver with a mass on it, I don't feel that this would be a feasible treatment for Corky. I'm going to check on the other alternatives, but I will have to do this tomorrow.

Thank you again.

Terri

[haf549]

Terri:

Not sure if you mentioned this or not, but does Corky get the trilo once a day or twice. Trilo has a half life of anywhere between 8 and 12 hours. Giving him his meds twice a day, at half the dosage each time might be the answer. Since you will be talking to your vet today, you might want to touch base about the dosing. I know the lethargy seemed to go away once we went to twice daily dosing. But make sure that if you go that way, that the dosage is also cut in half. When the vet and I first discussed this, she suggested we go to twice a day dosing, with the full 120mg each time. I dug my heals in on that because I already thought that Kira's lethargy was due to over-dosing. She checked with an IMS who confirmed that the dosage should be cut in half, not doubled. Just wanted to point that out because if I hadn't dug my heels in, Kira would have over-dosed seriously.

Heidi

[jrepac]

treating arthritis is tricky....in late 2007, before my Aussie's cushings was confirmed, but was suspected (by me), my vet put her on Rimadyl for arthritic joints....this caused some real problems....her liver was already out of whack from the cushings and the Rimadyl made things worse. Poor thing was staggering around the house. The 2nd vet at the practice took her off it immediately (and felt she should not have had it in the first place).

Since then, I have been relying on daily glucosomine supplements (sometimes w/MSM as well)....I usually buy/use the various crackers/treats that are out there, once I find one that she likes, I'll stick with it. Petco had joint squares (crackers) that she loved, but stopped making them!

Only if I think she is having a hard time getting around, or seems to be in pain, then I may use a doggie aspirin for 1-3 days, as needed. Have not needed to administer in a long time, thankfully. I know the NSAIDs are not great for them.

Jeff

[littleone1]

Hi Heidi,

Corky is taking 20 mg once a day. I did give my vet a call this morning. Corky has been acting like himself this morning. He slept most of the afternoon and all night. When he got up this morning, he was fine. He ate his breakfast, is drinking water, and went for a walk. He's back to following me everywhere I go. He was half way across the kitchen floor as I was getting his breakfast. He even rolled in the grass after he ate. Since he was doing so well this morning, she told me to give him his dose of Trilo. I'll give her a call back to ask about giving him half the dosage twice a day.

Terri

[littleone1]

Hi Jeff,

I know I don't like to give Corky too much medication, especially since he's taken so much recently. When I do have to give him something for his arthritis, I also give it to him only if I see that he's having any kind of pain.

Terri

[littleone1]

Corky did well on taking his Trilo this morning. He continued to follow me whenever I made a move. He ate good today, and has not had any other side effects. Yesterday could have been Corky's having withdrawal symptoms from not having so much cortisol in his body. I'm still constantly watching him, and keeping track of how much he eats and drinks, and how fast he eats.

Terri

[Harley PoMMom]

Well it seems Corky had an "off day" yesterday...well..we'll allow him one :eek::p:) but that's it!! no more scaring us like that!! :eek::)

Seriously, I am so happy he is feeling so much better...ain't nothing worse than your baby feeling yucky. I had to chuckle when I read about him rollin in the grass...Harley likes to do that...but usually it's in something stinky. :eek:

Our furbabies! Gotta love em!

Love and hugs.
Lori

[littleone1]

Hi Lori,

I know he scared me yesterday. He was so much better today. I think its okay if he has one off day! I'm so happy that he was better today. I know that even talking to his IMS, I was afraid to give him his Trilo this morning, but he did very well on it today.

I also had to chuckle when you said that Harley likes to roll in the grass. I'm thankful that Corky doesn't go potty in the grass, but right now the grass is very dry and he'll come in the house full of dried grass. Sometimes I think he does this for more attention, as he knows I tell him to go outside so I can brush him, not that he doesn't get any attention!!!

Terri

[littleone1]

Corky had the UTK adrenal panel done today, as well as a CBC. His IMS used Cortrosyn instead of the gel. Due to the reaction Corky had to the gel, I was wondering if anyone has heard of any reactions to Cortrosyn?

He had quite the appetite this afternoon, but I know that's due to the IV he had. He had been drinking less water and had been finicky about his eating the last few days. He wanted to eat what he wanted to eat. I feel that the Trilostane is helping, as before the last few days, he had no problems with eating his bland, fat free diet.

I would appreciate any input anyone might have.

Thanks,
Terri and Corky

[haf549]

Terri:

Kira just had her 6 month ACTH stim test on last Tuesday and she had a mild reaction to the injection. She was fine when I got her home, but around 8 in the evening she got up from her nap and drank 2 bowls of water. Then she lay down again and started some serious panting. She panted all night, even when she was sleeping. But by early afternoon on Wednesday, she was back to her normal self. I was really concerned Tuesday night so I check with the vet and she told me that it happens quite often. The injection elevates their cortisol levels and the symptoms come on gang busters. She said to watch for vomiting and diahrea and if the symptoms continue for more than a day. It is scary though.

Heidi

[littleone1]

Hi Heidi,

Corky had such a bad reaction to the gel, and that's why I was wondering about the Cortrosyn? I know I have to watch his reactions, especially when these symptoms occur, and that's why I have pedialite on hand to help balance his eletrolytes.

Thanks Heidi. I'm just a little worried right now.

Terri

[Buffaloe]

Hi Terri,

It sounds to me like Corky is doing well with the Trilostane. Shiloh had the adrenal panel and a couple of ACTH tests although I don't know if she had cortosyn or the gel. Anyway, as I remember she didn't have any problems/reactions.

That is great that you had the full adrenal panel done today. You will get Corky's cortisol number and the extremely valuable information about his intermediate hormones. Like my old english teacher said, "ya done good." Hopefully, you'll have the results sometime next week.

Ken

[littleone1]

Hi Ken,

Thank you so very much! "I'm glad I done good!" I would like to speak with you, especially since you are so close, and have a baby who had an adrenal tumor. I'll send you a PM with my phone number, if you would like to give me a call.

Thank you again,

Terri and of course Corky.

[littleone1]

Hi Ken,

I tried to send you a PM, but it wouldn't register. I'll try again tomorrow. I've been up most of the night with Corky, and I need to get some sleep.

Terri

[labblab]

Hi Terri,

I'm so sorry you were up all night with Corky, and I sure hope he's not having any ill effects now from the Cortrosyn!

I know you'll be anxious to get the results of the full adrenal panel. I just have one quick suggestion in that regard. And that is to make sure that your vet lets the laboratory at UTK know that Corky has been diagnosed with an adrenal tumor, and that he has already been treated with trilostane for about ten days now. Your vet has undoubtedly included that info with the blood sample. But because trilostane itself always increases the levels of some of the intermediate hormones (and it does this quickly -- within the first couple of weeks of treatment), Dr. Oliver at UTK will want to know that Corky is being actively medicated and for how long a time. That will help him to make the most useful interpretation of the panel, since the effect of the trilostane can "confuse" the results.

Please give Corky a big hug for me, and I'll be anxious to hear what you find out from the testing.

Marianne

[littleone1]

Hi Marianne,

Corky and I slept good last night. He got up twice to go to the bathroom and went right back to sleep. I gave him a big hug from you. I don't think he will have any reaction from the Cortrosyn. I'm really glad about this. At least I know that he can be tested with this and not get sick.

Thank you for this information. I will check with my IMS to find out if she did mention Corky's adrenal tumor and that he has been taking Trilostane. She should have the results from his CBC today. I will ask her when she calls.

Terri

[Harley PoMMom]

Hi Terri,

I am so relieved and happy that Corky had no ill effects from his Adrenal panel with the ACTH test. I am also so very happy you had this done, Dr Oliver who is the head of this lab, and in my eyes, is the Guru of the intermediate hormones. He will discuss Corky's case with your IMS and you via email if you want. I have sent him sooo many emails regarding Harley and he always responds back in a timely manner, he is a wonderful, wonderful man.

Let us know any abnormal results on the CBC test and just a reminder the full adrenal panel can take 10-14 days to get results back. Hopefully it won't be that long.

Love and hugs.
Lori

[labblab]

I agree with Lori whole-heartedly -- Dr. Oliver is a wonderful resource and a genuinely kind man! Here's his direct contact info, should you wish to communicate with him directly, either before or after receiving Corky's test results. Many of us have emailed him, and that is probably the easiest way to contact him. If he is available, he always answers very promptly.


For clarification regarding test results, Contact Dr. Jack Oliver (865-974-5729; Email: joliver@utk.edu).

I have had a couple of email "conversations" with him myself within the last couple of months, and it is for that reason that I do believe it will be helpful to him to know the specifics about Corky's diagnosis and trilostane treatment. My understanding of what he has told me is that, for the purposes of his own test interpretation, it is always easiest for him to draw conclusions about the naturally-occuring status of a dog's intermediate hormones if the dog is not being actively treated with trilostane. This is the case regardless of whether a dog suffers from the pituitary or adrenal form of Cushing's. For this reason, I usually try to "catch" people here before they have started trilostane treatment and I encourage them to run the full adrenal panel in advance.

This is not to say that you will not learn helpful information about the function of Corky's adrenal tumor by testing at this time. Dr. Oliver has told me that as the testing becomes more widespread and also as more is learned about adrenal tumors, generally, the information gained may become increasingly valuable. And of course, any individual vet may have their own reasons for wanting the testing performed at any given time. Here is a related excerpt from my emails with Dr. Oliver (my questions are in black, and his answers are in red):


...are there occasions or purposes for which you recommend performing the extended panel while a dog is being actively medicated with trilostane?
>>>I would say no, because the intermediate steroid levels will be increased, and this is confusing. But cortisol levels should be monitored as per my statement above.

If a dog has been diagnosed with ADH as opposed to PDH, would it make any difference as to whether or not there is value in performing periodic tests of intermediate hormone levels for "monitoring" purposes throughout the course of trilostane treatment?
>>>I don't think so. The intermediate steroid levels will be increased, but it will be difficult to know what they mean; that is, is the increase partly due to increased adrenal activity, or just the effect that trilostane has of increasing the intermediate steroid hormones.

However, Dr. Oliver elaborates further by saying:

>>>I shouldn't totally dismiss the idea, since very few veterinarians are doing this yet. With experience, it may turn out to be very useful. I just know that trilostane increases the intermediates, and it makes it difficult to know if it's due to disease or the drug. It probably would be of value to do it with ADH maybe one time, just to see what's going on with the ADH condition. Trilostane has mostly been used for PDH, as I understand it.


I know we will all remain very interested in Corky's test results. And since he has not been on the trilostane for that long a time yet, the medication effect may be less pronounced. But it is for the reasons above that I'm guessing it would be helpful for Dr. Oliver to know the specifics about his situation.

Marianne

[littleone1]

Hi Lori,

I was also so relieved that Corky didn't get sick. He's doing very well today. He's a bit tired. Going through these tests is very stressful for him. When he went back for his second blood draw, his IMS also checked some other things that weren't related to Cushings. He was really happy to get out of there yesterday afternoon.

Thank you for the information about Dr. Oliver. It's so nice to know that I can actually be in contact with him on a personal basis. I am going to e-mail him this morning.

Terri

[littleone1]

Hi Marianne,

Thank you so much for providing me with Dr. Oliver's contact information. I am definitely going to e-mail him this morning. It is really nice to be able to contact him. Knowing that he gets back to you is great, as I'm sure I'll have many questions to ask him. Thank you for the additional information. I have been reading so much lately. I do feel that I am on the right track.

Question? Is there any reason that the UTK adrenal panel is only done at this one location? I'm just curious.

Terri

[labblab]

Hi Marianne,
Question? Is there any reason that the UTK adrenal panel is only done at this one location? I'm just curious.

Terri
I do not have the answer for that, other than it is clearly a specific research interest of Dr. Oliver. But I think somebody here recently mentioned that another university lab here in the U.S. may be starting the testing, too. For the life of me, I can't remember where, though...(maybe UC Davis?????)

Marianne

[littleone1]

Thanks Marianne. I'm going do so some research to see if I can find anything.

I did e-mail Dr. Oliver to let him know about Corkys's adrenal tumor and his treatment with Trilo. I also asked him if it makes a difference if the treatment was short or long term.

Terri

[Harley PoMMom]

Hi Terri,

If you wouldn't mind, would you post his answers along with your questions, I am always sooo interested in what he has to say, it seems I learn so much from anything he writes.

Thanks so much.
Love and hugs
Lori

[littleone1]

Hi Lori,

I received an e-mail from Dr. Oliver. In his words: "You may still see some increase in the sex steroid levels from the 10 days on the Trilostane. I'm not sure what effect Trilostane may have on a primary adrenal tumor. It may not work very well for primary tumors. We'll see what the hormone levels look like."

In other words, we don't know! I'm sorry if this sounds negative. It wasn't meant to be.

Terri

[labblab]

Terri, good for you for emailing Dr. Oliver, though. This way, you've already established a connection with him, and he'll be knowledgeable about Corky's situation when he interprets the results. And see, we told you he's incredibly prompt with his responses...! :)

Marianne

[littleone1]

Thank you again Marianne.

Sometimes I think the more I learn, the more confused I get.

Terri

[Squirt's Mom]

Hi Terri,

Dr. O's response is just further proof of how complex Cushing's is and how many factors can come into play. He is a wonderful man and will always tell you the facts, and since he is the premier researcher in the area of Atypical, that says alot! :)

I am so glad you talked with him; like Marianne said, he will now be aware of some of Corky's background when he gets the sample. You done good, darlin'! :D

Hang in there!
Hugs,
Leslie and the girls

[labblab]

Thank you again Marianne.

Sometimes I think the more I learn, the more confused I get.

Terri


Welcome to the club!!!!!!!!!!!! Believe me, you've got a lot of company...! :o :o :o :o :o

Marianne

[Squirt's Mom]

Boy! Ain't that the truth!!!! :D:D:D:eek::D:D:D

[littleone1]

Hi Leslie and Marianne,

Thank you for your responses. I realize that Corky's adrenal tumor could be malignant. I will deal with this if and when it occurs.

Terri

[mypuppy]

Linda, I'm fairly new to this website. Not sure if you have read my posts at all. My almost 7 year old lab was just diagnosed last week with Cushings, and since then I can't manage to think straight and am still confused about further work up just to reconfirm the diagnosis and how to proceed with treatment. I noticed your post and was curious to know which test confirmed Cushings for your pup? What is a ldds? Is it the low dex test? My pup's diagnosis was based on the ACTH stim test. But now since I have received various views on this forum to do further work-up just to make sure she is treated properly, I don't know which way to go. If time permits, would you be able to elaborate a bit more on all tests performed on your pup to confirm Cushings, and also since my internal medicine specialist is ready to treat with Trilostane would also love to know what type of side effects your pup had, if any while undergoing treatment on Trilostane. Any info. you can provide would be greatly helpful and much appreciated. Thank you....Jeanette


Hi Terry,

How long has Corky been in remission and do you still have regular ACTH tests?

Spicey has been off Trilostane for 7 months now with no return to any Cushings symptoms. I am reluctant to start testing again as I think it will start it all off again! Also her first ever ACTH test was negative so do we go by what is a normal result for a Cushings dog, ie 5 or under, or a non cushings dog? It was the ldds test that diagnosed her as well as all of the typical symptoms which have now gone.

Glad Corky has recovered from his recent ordeal and is now well again.

Linda and Spicey

[littleone1]

Hi Jeanette,

Believe me, I am not an authority on this subject. Corky was originally diagnosed with Cushings with his blood creatinine and bun levels, and his urine creatinine and cortisol levels. He then had the ACTH Stim test. When his clinical signs started to dissapear, Corky was not treated for Cushings. His signs started to reappear after 7 monhts. His IMS did the Low Dose Dex Suppression test on him, which showed that he had Cushings. He also had Ultra Sounds 3 different times, and 2 biopsys . The last U/S and biopsy he had done, showed that he does have an adrenal tumor. He just had the UTK complete adrenal panel done yesterday. He has been on Trilo for 11 days now. After 2 or 3 days, he started to get lethargic, but he soon snapped out of it. His IMS started him on a lower dose of the Trilo due to his age and his current and past medical problems.

I know there is no one single test that definitely confirms Cushings and what type it is. There is so much valuable information to be gained on this site as well as other sites. I know it is definitely mind-boggling as to what and what not to do. If you have confidence in your vet or IMS, I feel that you need to trust their opinions. I know it gets very confusing with all of the information and input you get from others.

I'm sure this is not helping you to make your decision, but I went with my gut feelings, as I knew it would help Corky to live a better quality of life for his remaining time.

Terri

[Harley PoMMom]

Hi Lori,

I received an e-mail from Dr. Oliver. In his words: "You may still see some increase in the sex steroid levels from the 10 days on the Trilostane. I'm not sure what effect Tilostane may have on a primary adrenal tumor. It may not work very well for primary tumors. We'll see what the hormone levels look like."

In other words, we don't know! I'm sorry if this sounds negative. It wasn't meant to be.

Terri

Oh Terri,

I did not in any way take that in a negative way...This is one of the many tributes that I admire of this man, his honesty...if he doesn't know the exact and truthful answer to your question he will tell you instead of telling you some vet medical jibberish that you won't understand. Thank you so much for sharing your email with us.

We are all waiting with you for those UTK results...remember there will be a summary of his comments below the results, so if you would, ask your IMS for a copy of this and the treatment option sheet.

Love and hugs and confused too.:D
Lori

[littleone1]

Hi Lori,

Thank you for the love and hugs and confused, too. Thank you for making me chuckle! It is a good thing that he is being honest. I know that nobody really knows everything there is to know about Cushings. If anyone did know, it would be so much easier on all of us and our babies. I know I am taking everything one day at a time. As I see improvement in Corky, it really brightens my day.

Terri

PS. I corrected my spelling error.

[labblab]

I know I am taking everything one day at a time. As I see improvement in Corky, it really brightens my day.

Terri
And that's certainly the most important thing of all -- how Corky is actually doing! All of the "numbers" and "facts" become meaningless unless Corky is feeling better. So hearing that he IS doing better brightens the day for all of us, too!! :) :)

Marianne

[littleone1]

Thank you Marianne. He ate normally today and left some of his dinner. I know he's feeling better. When he's full now, he burps, and I tell him that's all, no more, and he doesn't eat any more. He looks at me as if to say "okay".

Terri.

[littleone1]

Hi Marianne,

I contacted UC Davis this morning. After being transferred to different areas several times, I was finally directed to a voice mail in their veterinary department. I left a message inquiring if they would be starting to do full adrenal panels. I'm suppose to get a response with 72 hours. I'll let you know what I find out.

Terri

[Harley PoMMom]

:D:) Way to go Terri

Thanks for doing that! :):D

Love and hugs.
Lori

[littleone1]

Hi Lori,

You are very welcome.

Corky's CBC tests results are back. I will be talking to his IMS this afternoon. I will also be getting a copy of the results, and will post any results that are not in the normal range. I know that when he had blood work done a month ago, his ALT (SGPT) was 151, with the reference range being 12-118 IU/L, and his Platelet count was 571 with the reference range being 170-400 10 3uL. His ALT (SGPT) was one of the reasons he had a CBC on Monday.

Terri

[littleone1]

Hi,

I just got a copy of Corky's CBC. His ALT (SGPT) is now in the normal range.

Results Reference Range Units

BUN 57 (High) 6-25 mg/dl
BUN/Creatinine /Ratio 48 (High) 4-27 mg/dl
Platelet Count 600 (High) 170-400 10 3/ul

All of the rest of Corky's results are in the normal range.

I checked back on blood work from over a year ago, and on most of his tests, Corky's platelet count has been high.

He has to go back to taking 1/2 a tablet of Pepcid AC once a day. We're going to see if this helps to lower the BUN, as he might be having an issue with his stomach.

Terri

[littleone1]

I want to thank everyone for all of your input, but it's now time for me to concentrate on Corky. Thanks to all of you that have been helpful.

Terri

[labblab]

Dear Terri,

I definitely understand the guilt feelings that can come from being a "k9cushings.com addict" :o (my own puppy is locked in her crate right now while I'm typing this! :(). But I surely hope that you are not leaving us for good, and that you will keep checking in and giving us updates on Corky's progress. You have become a part of our family, and we will miss you both so much if we don't continue to hear from you.

So please do remain with us, even if not as often!!!
Marianne

[Harley PoMMom]

Dear Terri,

I definitely understand the guilt feelings that can come from being a "k9cushings.com addict" :o (my own puppy is locked in her crate right now while I'm typing this! :(). But I surely hope that you are not leaving us for good, and that you will keep checking in and giving us updates on Corky's progress. You have become a part of our family, and we will miss you both so much if we don't continue to hear from you.

So please do remain with us, even if not as often!!!
Marianne

I totally agree with what Marianne has said, and remember Terri you have my cell # so call me. :D

Love and hugs.
Lori

[littleone1]

Hi Marianne and Lori,

Thank you for your thoughts and concerns. I'm not leaving the group. I was just feeling very down.

Everyone has been great. I just get depressed at times, especially when I think about everything that Corky has been through. I'll still be around!

Terri

[littleone1]

Hi,

I got a call back from UC Davis. They do not do the full adrenal panel. They are not going to start doing it. They send theirs to the University of Tennessee. She doesn't know of anyone else that does it.

Terri

[Squirt's Mom]

Hi Terri,

Thanks so very much for doing this bit of research for us! You have been a big help and answered a question many of us have had. ATTAGIRL!!!!! :D:cool::D:cool::D:cool:

I hope your spirits are better today? Depression is something I understand all too well and know how it can effect us from day to day, sometimes minute to minute. Please know we are here for you as well as for your sweet Corky. You will find there are some really broad, strong shoulders here, friendly ears willing to listen, and hands ready to hold yours as long as needed.

Hang in there, sweetie!
Hugs,
Leslie and the girls

[Harley PoMMom]

Hi Terri,

I want to thank you too for calling them up and finding that out, all information is helpful.

I totally agree with Leslie, we are always here for you...always.

Love and hugs.
Lori

[littleone1]

Hi Leslie and Lori,

Thank you so much. I know that you are very caring people. I am in much better spirits today. I just have some down times once in awhile.

I know that earlier today, Corky had me a little scared, as he wasn't eating very well. I did have to chuckle though, as we were at my best friend's and Corky's best friend's this morning. I mentioned Arby's, and his ears perked up. I gave him an Arby's this afternoon as a special meal, and he ate the whole thing. This is a special meal for him once in awhile. Tomorrow he's back to his bland, fat free diet.

I was more than happy to do some research to find out if there were any other places that did the full adrenal panel, especially since CA is so much closer to me and I could get results of the panel sooner.

Since I am retired, I would definitely be willing to research other areas. Please let me know.

Terri

[littleone1]

Hi,

I just spoke with Dr. Oliver about Corky's adrenal panel. He will be faxing the information to my IMS this afternoon. Corky's cortisol level is down. There are a few hormones that are slightly elevated, but he feels that is probably due to Corky's adrenal tumor and the Trilo. He is working on the final analysis.

He asked how Corky was doing, and I told him that Corky is doing much better. I gave him all of the details. He did mention that he hadn't heard of anyone treating an adrenal tumor with Trilo, but since Corky has really improved, depending on what my IMS says, we are most likely going to keep him on the Trilo.

When I get a copy of the test results, I will post the numbers. I will also let you know if we are going to continue the Trilo.

Thank you everyone for your input and concern. I know we still have a long way to go, but I do have a reason for very positive thoughts.

Terri

[Harley PoMMom]

Hi Terri,

I think it's just awesome that you spoke with Dr Oliver. Isn't he just wonderful. :D

Please do post the UTK results with the reference ranges and units too, and Dr Oliver's summary comments that will be below Corky's test results.

You're doing a great job Terri, remember that, ok.

Love and hugs.
Lori

[labblab]

Oh Terri, I think this initial report sounds very hopeful! :) :)

From the sound of things and since Corky is doing well, I wouldn't think there would be any reason to switch away from the trilostane right now. But of course, like you, I'll be anxious to hear what your IMS has to say after reviewing the complete report from Dr. O.

Thanks so much for updating us right away with this news!

Marianne

[mypuppy]

Hi Terri,
I've been pretty active on my posts, but I have peeked in here and there on yours, and as I read this message from you, I felt your pain because I too am experiencing the same feelings of depression since my pup Princess was diagnosed merely two weeks ago. I have been breathing Cushings for these last two weeks, breaking down about this dreaded condition and wondering what Princesses life will be like and on treatment. It really stinks. One day you have this wonderful, healthy, normal pup and next day she develops these symptoms you know nothing about leading up to the final diagnosis. I spoke to my specialist today, and the trilostane is "in the mail", which means treatment will begin in a day or two, and it simply scares me. I hope Corky is doing better these days, and will certainly be peeking in more often to get updated on his progress. Hang in there, easier said than done I know, believe me. I guess we should all hope for the better for all our pups. I send you some warm hugs and best regards. xo Jeanette...

Hi Marianne and Lori,

Thank you for your thoughts and concerns. I'm not leaving the group. I was just feeling very down.

Everyone has been great. I just get depressed at times, especially when I think about everything that Corky has been through. I'll still be around!

Terri

[littleone1]

Hi Lori,

Dr. Oliver was so nice. When I called he answerd the phone. We talked for about 10 minutes. I really appreciated the fact that he was willing to spend the time discussing things with me.

I will definitely post the results when I get them.

Thanks, Lori. You are an awesome mom!

Terri

[littleone1]

Hi Marianne,

Corky really has been doing so much better. Shortly after he started taking the Trilo, he started going for his long walks again. This morning I almost had to jog to keep up with him! He took his 18th dose this morning. For a while, he would walk very slowly and only go around the block.

His water intake is just about normal for his weight. He recently has been very finicky about his food. It's now hard to get him to his bland diet. He has cut back on the amount of food he's been eating, but when he gets something he wants to eat, he eats good. Some of the other clinical signs have also started to show improvement.

I have a feeling his IMS will keep him on the Trilo since he is doing so well.

I'll keep you posted.

Terri

[littleone1]

Hi Jeanette,

I know it's a difficult thing to deal with. I actually went through this back in January, but for some odd reason, Corky's clinical signs started to disappear and his tests were in the normal range.

I think what really did me in was when I started to see the clinical signs start to reappear after 7 months. The tests proved positive for Cushings, and I then found out that he had an adrenal tumor.


Thank you for your concern and wishes. I wish you the best. I know I do feel better about his treatment since he has been showing improvement. I know that both treatments still scare me. I do feel better about Corky being treated with the Trilo instead of the Lysodren.

Terri

[littleone1]

Corky's IMS just called. He will be staying on the 20 mg of Trilo a day. She also said that the slightly elevated levels are most likely due to his being on Trilo. She has seen this in others that were on Trilo.

I will be picking up a copy of his results in the morning. I'll post them then.

Corky won't have to go back for any other tests for a month, unless I start to notice something that isn't quite right.

Terri

[labblab]

Corky won't have to go back for any other tests for a month, unless I start to notice something that isn't quite right.

Terri
YAY!!!!!!!!!!!!!!!!!!!!!

Congratulations to you both!
Marianne

[BestBuddy]

Great news Terri.
All these little successes soon add up to a really big success.:D Enjoy the next month.
Jenny

[Roxee's Dad]

Hi Terry,

Very happy to hear the good news :D:D:D and glad Corky is feeling good. :D:):D

Great job! :)

[mypuppy]

Terri, I accept with any treatment we should prepare ourselves for a relaspe at some point. How did they find the adrenal tumor? ultrasound? Is it operable and is Corky a good candidate to remove the tumor? And I'm sure you are aware of this, but did I read on one of my posts today that if a pup is classified with adrenal tumor, surgery may possibly get rid of this condition altogether. I'm not trying to open a can of worms for you here as I feel you are pretty content where you are right now with Corky's treatment, but it's worth mentioning. Just the same, I am happy for Corky's improvement. It's always nice to hear good news about these precious pups of ours. In the meantime, I spoke to my IMS today and discussed the commencement of Princesses treatment with trilostane. In fact, she shipped out two month's worth today, so chances are she will begin sometime this week, if I don't chicken out, but I think I feel pretty good about it now that I've been informed on a lot of positive experiences on this forum. I will keep everyone posted. Take care and licks to Corky from Princess-lol! xo Jeanette


Hi Jeanette,

I know it's a difficult thing to deal with. I actually went through this back in January, but for some odd reason, Corky's clinical signs started to disappear and his tests were in the normal range.

I think what really did me in was when I started to see the clinical signs start to reappear after 7 months. The tests proved positive for Cushings, and I then found out that he had an adrenal tumor.


Thank you for your concern and wishes. I wish you the best. I know I do feel better about his treatment since he has been showing improvement. I know that both treatments still scare me. I do feel better about Corky being treated with the Trilo instead of the Lysodren.

Terri

[littleone1]

Thank you Marianne. I feel that we made it over the first hump.

Terri and Corky

[littleone1]

Thanks Jenny. I know that with Corky doing so well, I really feel that he will continue to improve.

Terri

[littleone1]

Hi John.

Thank you. I really need to thank everyone for their help and support. Without this group, I would have been totally lost.

Terri

[littleone1]

Hi Jeanette,

I know it's possible for relapses to occur. However, Corky was never treated when he was diagnosed the first time. He was taking 2 antibiotics for 2 UTIs, and we couldn't start his treatment until he had been off of the antibiotics for a while. This is when his clinical signs disappeared. I still have the Lysodren and Prednisone which my vet was going to put him on. Nobody knows why the symptoms went away, but my IMS said that it was possible that they might reappear in 6 weeks, 6 months, etc.

Corky's adrenal tumor was found with his third U/S and biopsy. Back in February, he had the first U/S and biopsy done. There was a mass on his liver and his right kidney. His right adrenal gland was not visible, but his IMS thought that the mass could actually be the adrenal gland. The results from the lab showed that there was inflamation. About 2 1/2 months later, he had an other U/S. The masses remained about the same size. When this last one was done, the report came back that he did have an adrenal tumor.

I know that my IMS said that the first option would be to do an adrenlectomy. However, she did not feel that this would be the best option for Corky, due to his age, his current health issues, and past health issues. This is why she is treating him with Trilo.

I'm sure everything will go well for you and Princess. I don't think you will chicken out. I know I was glad that I started with the treatment for Corky. He's almost back to his normal self.

Take care, and I'll be looking forward to reading your posts.

Corky sends his love to you and Princess.

Terri

[Harley PoMMom]

Corky won't have to go back for any other tests for a month, unless I start to notice something that isn't quite right.

Terri

Terri this is great news and I am so very happy for you and Corky. You are doing an outstanding job taking care of Corky, and you should be so very proud of yourself.

Love and hugs.
Lori

[littleone1]

Thanks Lori,

I feel so much more confident now. I know I still watch him like a hawk. I've been logging everything on a daily basis, which makes it so much easier for me to monitor.

Love and hugs back to you and Harley.

Terri and Corky

[littleone1]

I got Corky's adrenal panel tests results. When I post, I try to space everything, but it doesn't show up that way on the posts.

The first number is the baseline followed by the normal range. The next set of numbers are the post ACTH followed by the normal range.
The normal range are the range values for neutered male dogs

Cortisol ng/ml <10.0 2.0-56.5 21.0 70.6-151.2
Androstenedione ng/ml 3.97 0.05-0.36 8.56 0.24-2.90
Estradiol pg/ml 80.9 23.1-65.1 59.3 23.3-69.4
Progesterone ng/ml 0.07 0.03-0.17 1.89 0.22-1.45
17 OH Progesterone ng/ml 1.58 0.08-0.22 9.93 0.25-2.63
Aldosterone pg/ml <11.0 11-139.9 <11.0 72.9-398.5

The results indicate presence of increased adrenal activity and indicate presence of adrenal hypofunction.

Dr. Oliver's comments are as follows. I am quoting his words. "The cortisol and aldosterone levels are low, and are likely due to the trilostane. Adrenal tumors also often cause aldosterone levels to be low. The 17-OHP level usually is increased in dogs on trilostane, but part of this is due to cross-reactivity in our assay with pregnenolone precursors that build up in dogs on trilostane. But, estradiol and androstenedione tend to increase when dogs are given trilostane. So, it's difficult to say if the hormone changes are due to the trilostane, or to hypersecretory activity of the tumor. Removal of the tumor would seem to be indicated, but you probably want the dog off of the trilostane for a couple of weeks or so before this is done."

Unfortunately, surgery is not an option for Corky. I know I was concerned about his cortisol levels being so low, and called the IMS when I got home. Since Corky is doing so well, and since Corky was already taking trilostane when the panel was done, unless I see any type of reaction starting to surface, we are going to stick with our plan. Corky even ran during part of our walk this morning. This was the first time he ran in quite a long time.

Is anyone else confused?

Terri

[Harley PoMMom]

Hi Terri,

First, to convert ng/ml to ug/dl, which is what we are used to seeing, divide the ng/ml value by 10, so Corky's cortisol pre of <10.0 ng/ml = <1.0 ug/dl and his post of 21.0 ng/ml = 2.1 ug/dl, which is very low. I would want him restimmed. This is JMO, hopefully others more experienced than me will be along to share their advice.

The thing about Trilostane is that it can and alot of time it does over time keep dropping those stim numbers...so, I know you are watching Corky like a hawk, but maybe the low numbers are a indicator of too low cortisol for Corky and that's why he is being so picky about eating?? Just throwing that out there, ok.

Now about his Aldosterone pg/ml <11.0 11-139.9 <11.0 72.9-398.5, I believe I would get his electrolytes rechecked.

Dr Oliver knows his Cushings, so if he is saying that Corky's cortisol and Aldosterone is low, trust him.

Just keep watching Corky like your doing, bc you're doing a wonderful job, ok.

Love and hugs.
Lori

[littleone1]

Hi Lori,

I was just looking back at Corky's last cortisol levels. The reference ranges in ug/dl on his LDDS test between the the 3 draws are : 1st 1.0-5.0, 2nd 0.0-1.4and the 3rd 1.0-1.4. Corky's pre was low on this last test, but the post seems to be highbased on ug/dl. I am going to give her another call about both issues for clarification.

Terri

[StarDeb55]

Terri, you really can't compare an LDDS normal range to a ACTH normal range, it's basically comparing apples to oranges. ACTH normal range for cortisol is 1-5 ug/dl. I agree totally with Lori that a post of 2.1 for a pup on Trilo is pretty darn low, so it's a good idea to check with the vet. With that post being low, have Corky's electrolytes been checked lately?

Debbie

[littleone1]

Hi Debbie,

Corky is going in next Wednesday for a stim test, to have his electrolytes and also his kidney values tested, as this was an issue on his last blood work. I know Dr. Oliver didn't mention having these tests done, but I'm glad I got this information. I've been doing tons of research, and I know that I would feel better having these tests done. It's amazing that you can feel so good one day about Corky's treatment, and down the next. He's been doing so much better.

Terri

[labblab]

As far as Corky's cortisol level, a post-ACTH result of 2.1 is actually fine according to Dechra's "Treatment and Monitoring Flowchart," and within their desired therapeutic treatment range. With this ACTH result, their recommendation would be to remain at the current trilostane dosage level. Their cut-off point of "concern" is a result lower than 1.45. Here is a link to that flowchart:

http://www.dechra-us.com/File/vetoryl_Treatment_and_Monitoring_Flowchart.pdf

So I am guessing that is the reason why your vet is fine with Corky's current status. However, you will definitely want to have him re-stimmed again at the 30-day mark -- or certainly sooner if you notice any negative changes. As the others have said, the tendency that we've seen has been for levels to continue to drop, at least a bit. And it is true that Corky does not have a lot of downward "lee-way."

Marianne

P.S. I see you've gone ahead and scheduled a stim for next week. Do take a look at the Dechra flowchart, though, so you'll have a better idea as to what they consider to be OK vs. problematic. I'm thinking that perhaps Dr. O's comment about Corky's cortisol being "low" is just in terms of the norms for a non-treated dog. Your hope is that the trilostane is indeed lowering Corky's cortisol to the therapeutic range for a Cushpup. So I think you still have every reason to feel encouraged.

[littleone1]

Thank you so much Marianne. Sometimes I wish I never saw the actual numbers and just went with my vet's judgement. I know she has seen this many times before, and everything was okay. Right now, I just feel that I need the reassurance that Corky's is okay.

Terri

[Harley PoMMom]

It's amazing that you can feel so good one day about Corky's treatment, and down the next.I think you still have every reason to feel so very good about his treatment...you have Corky's cortisol lowered...you just have to find the right dosage of Trilostane now, that's all...the dosage he's on might have to be lowered...the stim test next Wed. will tell you this and Corky will be able to tell you too, one has to treat the pup and go by how the pup feels, sometimes one always can't go by numbers alone.

I know this is tough, but hang in there, and remember we are all here with you, supporting you, and keeping you and Corky in our thoughts and prayers.

Love and hugs.
Lori

[labblab]

Thank you so much Marianne. Sometimes I wish I never saw the actual numbers and just went with my vet's judgement. I know she has seen this many times before, and everything was okay. Right now, I just feel that I need the reassurance that Corky's is okay.

Terri
Terri, for your own peace of mind, I think that's fine that you went ahead and scheduled a stim for next week. But you can see how he's doing, and if he looks great next week, you could always cancel and hold off for a while longer. Once again, that result of 2.1 is not a problem according to Dechra. I usually would be telling folks "Congrats!" with that kind of a result.

Marianne

[StarDeb55]

Thanks for the Dechra info, Marianne. The post value just sounded somewhat low to me, & I was just sitting down to look up the Dechra info when I saw your post.

Debbie

[littleone1]

Hi Marianne,

I looked at the chart again, and I really studied it. Since Corky has been doing so well, and doesn't show any negative signs, I will see how everything goes this weekend, and if all is well with him, I think I will wait for his next stim test. He wasn't suppose to have his kidney values done until next month, either. I know he had a problem with his electrolytes being totally out of whack back in January, but I'm not seeing any evidence of this as was seen before.

Thank you again,

Terri

[littleone1]

Hi Lori,

I just posted to Marianne, that depending how Corky does this weekend, I might just wait if there are no visible signs of any problems.

Terri

[mypuppy]

Hi Terri, How about a great big hug for you and lots of licks for Corky from Princess....We love you both....easier said than done, but hang in there! xo Jeanette


Hi Lori,

I just posted to Marianne, that depending how Corky does this weekend, I might just wait if there are no visible signs of any problems.

Terri

[littleone1]

Hi Jeanette,

Thank you from both of us for the hugs, love and kisses. We're both hanging in there. Corky did really well today. He ate his dinner without any fuss. I really feel that he is fine where he's at.

Love and hugs for you and Princess.

Terri

[Buffaloe]

Hi Terri,

I think it is very valuable that you had the full adrenal panel done on Corky, you now have a quasi baseline for his intermediate hormones. As my surgeon explained it to me, Trilostane does a great job of blocking off the pathway for cortisol but does not block the pathway of most of the intermediate hormones.

The post cortisol # of 2.1 is very good for a cushing's dog. I think you can hold off on his next ACTH test for a little while if you want.

As I'm sure you know, his Androstenedione and 17 OH Progesterone are elevated quite a bit and his Aldosterone is low. You should have his electrolytes checked next visit. These are certainly things to discuss with Dr. H. She'll know.

Perhaps the biggest thing is that Corky is feeling so good. He even ran some on his walk today, that tells you alot. You're doing an outstanding job with the Corkster. Continued success. Shi sends kisses.

Ken

[Harley PoMMom]

Hi Lori,

I just posted to Marianne, that depending how Corky does this weekend, I might just wait if there are no visible signs of any problems.

Terri

Terri, nobody knows Corky better than you, trust your gut and your instincts and you're going to do fine...like Ken said the most important thing is that Corky's feeling good. YAHOO!! So lets celebrate to that. :D;):):D:)

Love and hugs.
Lori

[littleone1]

Hi Ken,

Thank you so much. I really think I'm going to hold off on the stim test, since Corky is doing so well. I know he's finicky about what he wants to eat, but when I give him something he really likes, he really eats good. He's been eating two meals a day, as he always has, but he hasn't been eating quite as much. I know I went through this about a year and a half ago. He had to be on a diet of chicken, rice, green beans and sweet potatoes. I really believe that he was tired of a bland fat free diet for every meal. I am now giving him something else to eat for one of his meals, and he's really enjoying it. I still am sticking to fat free or very low fat foods.

I'm glad I had the adrenal panel done. I just got a little uptight when I saw some of the results, especially since Corky is doing so well. I do trust Dr. H's judgement and knowledge.

Hugs and kisses to Shi from the Corkster and me. Keep me posted as to how Shi is doing.

Terri

[Buffaloe]

Terri,

I just think it is good to know everything you can about Corky. I have absolutely no idea if the high intermediates/low aldosterone is any problem whatsoever. It sure doesn't seem to be in light of how well Corky is doing. I'm certain your Internist knows all of this inside/out and will go over it with you. All of this attention and knowledge about the intermediate hormones is pretty recent and a result of the great work done by Dr. Oliver.

Both of the professionals that see Shiloh (surgeon and gp vet) are totally into a healthy diet, nothing but strictly healthy food. But after she recovered from her adrenalectomy, I told her she was going to get a really good, special dinner every single day. I always mix in some Costco chicken, a couple bites of hamburger, something she really likes. And anytime I have a bowl of vanilla ice cream at night (which is too often) Shi always gets just a little. What the heck, everything in balance and moderation. When I told my vet about this he said, "ya gotta have a little fun." I'm not advocating this for Corky or anyone else but I want Shi to find lots of joy in life every single day.

Ken

[littleone1]

Hi Lori,

I'm sorry. I missed your post. I agree that I do have to go with my gut feelings about Corky. He is doing great right now.

I was doing some research on electrolytes and found that the most commonly measured ones are sodium, potassium, chloride, bicarbonate, phosphorus, and calcium. When Corky had the adrenal panel done, he also had a CBC. These are the results on these electrolytes, except for bicarbonate:

The first number is his test result, followed by the reference range.

Sodium 149 - 139-154 mEq/L
Potassium 5.3 - 3.6-5.5 mEq/L
Chloride 115 - 102-120 mEq/L
Phosphorus 5.3 - 2.5-6.0 mg/dL
Calcium 10.2 - 8.9-11.4 mg/dL

I'm glad I did this research.

Love and hugs,

Terri

[littleone1]

Hi Ken,

Dr. H does not feel that the results are a problem. She also feels that they are a result of Corky's being treated with Trilo.

I'm glad to hear that you also give Shi a special meal every day. I think they deserve it. I made Corky a T-bone the other day, since Fry's had them on sale. I put it on the grill for a short time to get the flavor, and then I put it in a frying pan just with water. This way, he's not getting the grease and the fat has been trimmed off. Corky use to like ice cream, but since I only buy the fat free frozen yogurt, he does enjoy this once in a while. His favorite treat is strawberry twizzlers. He didn't have one for over 3 weeks. I gave him one yesterday and he really devoured it.

Terri

[mypuppy]

Hi there Terri, Long time no speak, Was just thinking of you and Corky as I look at my precious Princess....Hope all is well. We're doing ok. Waiting for the LDDS this coming Thursday and hopefully begin the trilo next week. Take care and licks to Corky. lol. Best regards, Jeanette


Hi Lori,

I'm sorry. I missed your post. I agree that I do have to go with my gut feelings about Corky. He is doing great right now.

I was doing some research on electrolytes and found that the most commonly measured ones are sodium, potassium, chloride, bicarbonate, phosphorus, and calcium. When Corky had the adrenal panel done, he also had a CBC. These are the results on these electrolytes, except for bicarbonate:

The first number is his test result, followed by the reference range.

Sodium 149 - 139-154 mEq/L
Potassium 5.3 - 3.6-5.5 mEq/L
Chloride 115 - 102-120 mEq/L
Phosphorus 5.3 - 2.5-6.0 mg/dL
Calcium 10.2 - 8.9-11.4 mg/dL

I'm glad I did this research.

Love and hugs,

Terri

[littleone1]

Hi Jeanette,

Thank you. That is so sweet of you. Corky and I doing very well. Corky has continued to show improvement. Friday morning, Corky saw my best friend, who is his best friend's mom, and actually jumped up and put his front paws on her leg. She can't believe the change in him. She said that this was the first time that he's done that in a long time.

I am going to cancel his appointment for Wednesday, and keep his scheduled appointment later this month, especially since he's doing so well. He's stiill eating good, even though he is still finicky about what he "wants" to eat.

I'm so relieved to see the difference in him. I feel like I got my little "Corkster" back.

My thoughts and prayers are with you and Princess. If you ever feel the need to talk, I'll send you a private message with my phone number.

Love and hugs to you and Princess.

Terri and Corky

[mypuppy]

Awwww Terri, I am SOOOOOOOOOOO thrilled for you and Corky. Thanks for sharing that little "jumping" story. I can only imagine what awe you were in at that particular moment, and I know what you mean when you say it felt as if you got your "little Corkster back". That is what I look forward to with Princess. There is no worse feeling in the world than to watch your once very energetic/happy pup mope around all day and all night....It breaks all our hearts I know. Thanks so much for your prayers--believe me I've got a lot going on already, and welcome even more. And yes, I would love to talk soon--I mean this forum has been such a wonderful resource and I feel so connected to a few people here that it almost makes me want to meet up with them and start a Cushing's support group. Wouldn't that be ideal, but tough since I know we are all in different locations. Nevertheless, a phone conversation with someone who can relate would be real nice as well. How would I retrieve a private message? I've never done it. Look forward to hearing your voice and maybe hearing some Corky barks in the background-lol! Best regards, luv and hugs, Jeanette


Hi Jeanette,

Thank you. That is so sweet of you. Corky and I doing very well. Corky has continued to show improvement. Friday morning, Corky saw my best friend, who is his best friend's mom, and actually jumped up and put his front paws on her leg. She can't believe the change in him. She said that this was the first time that he's done that in a long time.

I am going to cancel his appointment for Wednesday, and keep his scheduled appointment later this month, especially since he's doing so well. He's stiill eating good, even though he is still finicky about what he "wants" to eat.

I'm so relieved to see the difference in him. I feel like I got my little "Corkster" back.

My thoughts and prayers are with you and Princess. If you ever feel the need to talk, I'll send you a private message with my phone number.

Love and hugs to you and Princess.

Terri and Corky

[Harley PoMMom]

Hi Jeanette,

Friday morning, Corky saw my best friend, who is his best friend's mom, and actually jumped up and put his front paws on her leg. She can't believe the change in him. She said that this was the first time that he's done that in a long time.

I'm so relieved to see the difference in him. I feel like I got my little "Corkster" back.

Love and hugs to you and Princess.

Terri and Corky

I believe I have to ditto Jeanette's response...Awww. I am so very happy for you and the "Corkster." You both have been on that rollercoaster ride looong enough and now it's time to get off and relax a bit, ain't? :D You both have some fun and give Corky some special hugs and kisses from Harley and me, and to his mom also, you're doing a fantastic job with Corky.

Love and hugs.
Lori

[littleone1]

Hi Jeanette,

It really does feel great seeing Corky come such a long way. I'm looking forward to the day when I can read your posts about Princess getting back to her normal self. They do break our hearts, but they are well worth everything.

This group has been very supportive, and it's true, you do feel more connected with some members of the group. Even though everyone has been great, it's always nice to speak with someone who's been going through the same experiences.

To retrieve a private message, in the upper right hand corner of the page where it says welcome mypuppy, there is a place that says Private Message. Click on that, and it will take you to your messages. I did send my number to you, but it doesn't show as a sent message. Please let me know if you didn't get it, and I will resend it.

Love and hugs to you and Princess,

Terri and Corky

[littleone1]

Hi Lori,

Thank you. It has been a roller coaster! I feel so much better now. You have been so helpful and caring. Special love and hugs for you and Harley.

[mypuppy]

Hi there Terri, so nice to have finally heard the voice behind the forum - lol. I enjoyed our long conversation this morn...yes, it does help to exchange with others who can relate to what our pups are experiencing. Thank you once again for reaching out to me the way you did, and was very glad to hear your voice. Sorry I disappointed you with my age! LOL........Best to you and the Corkster from me and Princess (Luv,xo).....


Hi Jeanette,

It really does feel great seeing Corky come such a long way. I'm looking forward to the day when I can read your posts about Princess getting back to her normal self. They do break our hearts, but they are well worth everything.

This group has been very supportive, and it's true, you do feel more connected with some members of the group. Even though everyone has been great, it's always nice to speak with someone who's been going through the same experiences.

To retrieve a private message, in the upper right hand corner of the page where it says welcome mypuppy, there is a place that says Private Message. Click on that, and it will take you to your messages. I did send my number to you, but it doesn't show as a sent message. Please let me know if you didn't get it, and I will resend it.

Love and hugs to you and Princess,

Terri and Corky

[littleone1]

Hi Jeanette,

I also enjoyed our long conversation this morning. It does help to be able to talk to others about our precious pups. You are more than welcome. I know how frustrating and upsetting it can be when you think that you're going through something "alone". I'm really glad you found this group. There are so many wonderful people here.

I wish you and Princess the best tomorrow. I know it's going to be a long day for both of you. I'm glad that you're going to an IMS you know and trust. I hope you get the answers that you are looking for.

You didn't disappoint me with your age. I just wish I was your age !!!

[littleone1]

Hi,

Corky is still doing very well on his Trilo. He's at the point now where he doesn't want to eat the foods in his bland diet. I've had to start making him some of his old favorites and mixing his rice, pumpkin, and cottage cheese in with those.

I have a question. Corky's skin is getting very dry. I was wondering if anyone has any suggestions on anything I can do to help this? Today when I bought his Science Diet treats, I got the one that is suppose to help avoid dry, flaky skin.

Thanks.

[Squirt's Mom]

Hi Terri,

The Omega's will help with the skin dryness; salmon oil is a good source. I'm not sure if he can have that in his diet so be sure to check with your vet before starting him on any oils. :)

Oatmeal baths can help with dryness as well and there are some products out there that can be sprayed on the skin or used as a rinse and left on. I use a product called "efa HyLyt" by IVX Animal Health that I got from a vet a while ago when I first got Crys. It did help her skin and I still use it from time to time on all of them when they have a bath.

Inappetence is something I have noticed with some pups on Trilo from time to time...not all but a some. According to the Dechra US product insert:


The most common adverse reactions reported are poor/reduced appetite, vomiting, lethargy/dullness, diarrhea, and weakness.

If it becomes a real problem, I would talk to my vet about it and see if there isn't something that might help stimulate his appetite a bit. Of course, mommy cooking tempting meals won't hurt either! :p:cool:

Good to hear from you!
Hugs,
Leslie and the girls

[gpgscott]

Hi Terri,

I have stayed away since I have no expericene with Trilo.
He should want to eat. If he does not there is an issue.

It may be that he is just at the point that he is not willing to go on; but in the presence of a profound treatment, I think it requires a second look.

I think it is widely held that any dog on treatment with Trilo which refuses to eat should be taken off the meds. In fact the manufacturers of the med promote this.

I would not continue to administer any meds to Corky while he will not eat. I would also ask the Dr. about a general antibiotic. Cushpups have suppressed immune systems and are prone to infections.

Scott

[littleone1]

Hi Leslie,

Thank you for this information. I will check with his IMS to see if he can have the oils in his diet. I will try the oatmeal baths and the spray first.

Corky doesn't really have inappetence. As long as he can eat some of his favorite foods, he really eats good. He eats two meals a day and usually finishes what I give him. He is eating approximately 2 cups of food a day, which also includes 3 treats.

I appreciate the information you gave me.

[littleone1]

Hi Scott,

Thank you for your concern. I really appreciate it. It's not that Corky doesn't have an appetite, he just doesn't want to eat his bland, fat free diet. When I cook some of his favorite foods, which I have been doing, he eats his two meals a day. I don't have any problems trying to get him to eat. He eats approximately 2 cups of food a day, which includes his treats. I am still able to get pumpkin and fat free cottage cheese in him. He usually finishes everything I feed him.

I went through this about a year ago with him, when he was suppose to be eating chicken, rice, sweet potatoes, and green beans. He did very well with this for quite a while, and then he started to get finicky. Once I started giving him other foods, I didn't have anymore problems feeding him.

He does go in on the 23rd for his stim test and blood work. Everything else is fine with him.

Thanks again, Scott.

[littleone1]

Hi Scott,

I didn't mean any offense to you on my post. Corky is still eating good, even though he's getting pretty much what he wants to eat. I'm trying to stick to his diet as much as possible, but I am including his favorite foods.

Corky is not about to give up the ship. He's back to his normal long, fast walks, and even running. His arthritis does bother him when our morning temps get in the low 40's. But that doesn't stop him. He'll start off running on three legs until he gets going.

I really do appreciate your concern. I feel that I wasn't very clear on what I meant to say.

In addition, congrats on becoming an administrator. I know you have lots of valuable information to offer. You are also a very caring person.

[gpgscott]

Terri,

No offense taken.

I have had many bostons and have loved them all much. They are Cindy, Mitzi, Duke, Boots, Mitzi, and Chipper. We brought Moria home after losing Mitzi and Chipper was an old guy. We have photos of Moria at 4 weeks with Chipper who was not a large boston standing astride her.

The Adaquan is a good med, I have used it on two bostons and on Moria. It brings them much relief.

They all take their own path, it is up to us to help guide them.

Thanks for directing a post to me, I and the others are here for you.

Scott

[littleone1]

Thanks Scott,

Thanks for this information. I will check with Corky's IMS about treating his arthritis when I take him in for his tests. I have a whole list of questions to ask her about this and other things. I make a long list which I give her everytime I take Corky in.

I would love to see a picture of your Bostons and the one with Chipper and Moria. I think they are so loving and so adorable. I think all of our babies are so precious.

Thank you for being here for me.

[gpgscott]

I would love to see a picture of your Bostons and the one with Chipper and Moria. I think they are so loving and so adorable. I think all of our babies are so precious.

Thank you for being here for me.

Those photos are all positives (slides).

I do have them in a shoebox and will try to find the one I am talking about, but it does exist.

Wish I was there right now to give Corky a hug and kiss.

Scott

[littleone1]

Corky would love that, Scott. He loves his hugs and kisses. I'll give him a big hug and kiss from you.

That would be great if you found the slides.

[littleone1]

Corky is really doing good. He's been taking the Trilo for a month and a half now. Since I slightly changed his diet, I've had no problems with his eating. He's really been sleeping good at nights. Some nights, he even sleeps all night. He's now going for a walk around the block after he eats his dinner. He's back to his normal self.

He goes to the IMS on Monday for his first stim test and blood work since he had the adrenal panel done. I'm hoping that all of the results will be in the normal range.

[mypuppy]

Awesome to hear Terri, and the sleeping better through the night does make a huge difference for both of you. I hope he continues on this path so you can enjoy him to the fullest--I know you are anyway, but it's a lot more pleasant when they are their normal selves. I'm so very happy he's doing well. Keep up the great work...Luv and licks, Jeanette and Princess


Corky is really doing good. He's been taking the Trilo for a month and a half now. Since I slightly changed his diet, I've had no problems with his eating. He's really been sleeping good at nights. Some nights, he even sleeps all night. He's now going for a walk around the block after he eats his dinner. He's back to his normal self.

He goes to the IMS on Monday for his first stim test and blood work since he had the adrenal panel done. I'm hoping that all of the results will be in the normal range.

[labblab]

Terri, I'm so glad that Corky is doing so well! Thanks for updating us, and for sharing your good news. :) :)

Marianne

[Harley PoMMom]

Hi Terri,

This is great news about Corky, and we really love hearing great news! :D

I am so happy that he is back to being, as Ken has said so well before, his "Corkster" self. :D:D

Wishing you and Corky the best of luck on your visit with the IMS on Monday.

Love and hugs.
Lori

[littleone1]

Hi Jeanette,

I am enjoying my little one. It has been so nice seeing him this way and also getting sleep lately.

I hope Princess is continuing to do well.

[littleone1]

Thanks, Marianne.

[littleone1]

Thanks, Lori.

It is nice to have the "Corkster" back. Thank you for your well wishes for Monday.

I hope Harley is also doing well.

[MiniSchnauzerMom]

Terri,

Very glad to read that Corky is eating well again and also getting some good sleep in. So happy for you that he's back to his normal self. It is such a worry to us Moms (and Dads too) when our babies are out of sorts - and a huge relief when you see "your pup" return!

Well wishes from me also for an ACTH and other labs within range on Monday.

Louise

[littleone1]

Hi Louise,

Thank you for your well wishes about Corky's tests on Monday. I really am anxious to see the results. I feel very hopeful that the outcomes will be in the normal range, especially since I have been seeing how well he is doing.

I know our babies are such a worry, and it feels so good to see them improving and being themselves.

[Squirt's Mom]

Hi Terri,

Great news on Corky's return! :p I hope you continue to see improvement and that the testing goes well Mon.

Hugs,
Leslie and the girls

[littleone1]

Thanks, Leslie. I know I really feel good about the way things are going for Corky. I'm thinking positive thoughts that his testing will go well.

[mypuppy]

Terri, All uphill for Corky and Princess right now. It feels great, and I am so happy we can both finally say we are enjoying them again, even a little! Princess had her birthday celebration, gifts and a lot of outdoor play. She played soccer with us and even jumped up for her ball a couple times. I didn't want to overdo it with the jumping, so I told my girls not to throw the ball up too much. Anyway, have a great weekend and we'll talk soon. Best regards...Jeanette

QUOTE=littleone1;19455]Hi Jeanette,

I am enjoying my little one. It has been so nice seeing him this way and also getting sleep lately.

I hope Princess is continuing to do well.[/QUOTE]

[StarDeb55]

Jeanette, I'm not saying this to worry you, but when it comes to jumping & racing around, I would suggest that Princess does need to slow it down. This is because it appears that cushpups seem to be prone to cruciate ligament ruptures in their knees. Barkley suffered from one immediately prior to his Cushing's being diagnosed, which actually had to be repaired twice. In fact, abnormal pre-op labwork for the ligament repair is what started us on the road to a Cushing's diagnosis. John's Roxee had a cruciate ligament blowout, & I have lost count of how many pups on this board have had this problem either prior or post Cushing's diagnosis. A number of us figure that this injury is related to the muscle weakness & wasting from high cortisol levels. Our consensus seems to be that if muscle tissue is being affected, then it's very likely that ligament/connective tissue is affected.

Debbie

[littleone1]

Hi Jeanette,

I'm so glad that Princess is doing so well. I agree with you about not wanting her to jump up too much. Even Corky still won't jump up to get into the car, and I usually lift him out of the car. I know he still feels a little insecure about doing this since he wasn't able to do this before.

I'm glad Princess had a good birthday. She deserved it!

We're both going to keep going uphill with our babies. I will talk to you soon.

[littleone1]

Hi Debbie,

I have a question for you. I read your response to Jeanette. Corky is at the age where he isn't jumping up to get balls, etc. He'll jump up to give kisses. Do I need to be overly concerned about this, especially since Corky has pins in both of his hind legs? He's had the pins for nine years. Thanks.

Terri

[AlisonandMia]

I think it is probably the rapid changes of direction that go with bouncing around that really strain the cruciate ligaments. I'd think that sedately just hopping up on the hind legs to get/give a kiss would be fine. But definitely ask the vet. Just as a matter of interest, are Corky's pins for luxating patellas?

Once the cortisol is controlled well and has been controlled for a while the risk of a cruciate ligament tear because of high cortisol should diminish and eventually not be an issue. But before treatment and early on in treatment or if treatment isn't controlling the cortisol well the risk would be considerably higher. And of course, dogs without Cushing's can tear cruciates, too. You'd think conformation and breeding could make some more prone to the problem than others.

Often a torn cruciate is, in retrospect, possibly the first sign of Cushing's and we've seen more than a few that tore a cruciate ligament (often both!) in the months before they became really symptomatic for Cushing's and were diagnosed.

Alison

[littleone1]

Hi Alison,

Thank you so much for this information. I will check with Corky's IMS when he goes in on Monday.

I couldn't really tell you if the pins are for luxating patellas. I would have to check with the vet that did the surgery. Corky had started to hold his left hind leg up first. His vet mentioned something about the bone popping out of the socket. He couldn't tell if it was hereditary, or if it was because he had been abused as a puppy. We got Corky when he was 14 months old, and it was shortly thereafter that he had the surgery. Now I'm curious. I will get a copy of those records from "Corky's book".

Terri

[StarDeb55]

Terri, my whole philosophy is better safe than sorry, especially since Corky has a pre-existing problem. Just to show you how little it can take to cause this injury, Barkley was running into the kitchen to chase a toy I had thrown for him. He sort of slipped on the linoleum, didn't out right fall, & immediately started limping.

Debbie

[littleone1]

Thanks, Debbie.

I will definitely check with his vet and his IMS. In the past, his vet thought that he might have to remove one of the pins, as he felt that the pin might also have been popping out of place. Corky would keep stretching his leg out and would crawl in the grass until it went back in place. It's been a little over a year since this happened. The pins were placed in the knee areas.

Terri

[StarDeb55]

From you description, I think Alison could very well be right that the Corkster has luxating patellas.

Debbie

[Roxee's Dad]

Terri, my whole philosophy is better safe than sorry, especially since Corky has a pre-existing problem. Just to show you how little it can take to cause this injury, Barkley was running into the kitchen to chase a toy I had thrown for him. He sort of slipped on the linoleum, didn't out right fall, & immediately started limping.


And Roxee just jumped off of the 2nd step, something she's done a million times. Next thing I know, she was 3 leggin it.:eek: Off to the vet, surgery and pretty much bed rest for 3 months. Dx'd a few months later with PDH. :(

[littleone1]

I appreciate the input, John. When Corky started having problems jumping up in bed, I removed the frame from one of the other beds, and I just have the spring and mattress on the floor. This way he doesn't have to jump or down. I also have a low day bed in the family room for him. He doesn't have to jump up on this either. He can put his front paws on it and go right up on it. I'm glad now that I put him in the car, and except for a few times, I lift him out of the car and put him on the garage floor. I don't have any steps, which is a good thing.

Terri

[littleone1]

I am calling the vet's office Monday, to get a copy of the report as to what was actually wrong with Corky. It's been so many years ago, that I can't remember. Back then, I never got copies of anything, except for the bills. Because of everything that has been going on with the Corkster since last December, I have been getting copies of everything.

On a lighter note, I should have my thread renamed "The Corkster". This, in addition to how well he is doing, brings a smile to my face.

Thanks Debbie.

Terri

[littleone1]

Hi all,

I just to had to laugh. I don't know which one of you did it, but I'm still laughing. I love it. Corky has so many nicknames, but this one really fits him. Thank you. You made my day!

[mypuppy]

Wow Debbie! I do try not to over exert Princess because I know they have the muscle weakness with the cushings, but I never imagined that could happen so easily either. Something else I guess to watch for with her. So basically should I even be running her at all or merely just allow her to go for walks? I don't want to risk her hurting herself, and at the same time do want her to get appropriate exercise. Either way, thanks for letting me know. I again have learned something new. Best regards...Jeanette
ps: Terri, Im so sorry to use your thread to post about Princess, but I wanted to reply to Debbie's post. Hope all is well with you and Corky. Will try to call soon....xo Jeanette


Jeanette, I'm not saying this to worry you, but when it comes to jumping & racing around, I would suggest that Princess does need to slow it down. This is because it appears that cushpups seem to be prone to cruciate ligament ruptures in their knees. Barkley suffered from one immediately prior to his Cushing's being diagnosed, which actually had to be repaired twice. In fact, abnormal pre-op labwork for the ligament repair is what started us on the road to a Cushing's diagnosis. John's Roxee had a cruciate ligament blowout, & I have lost count of how many pups on this board have had this problem either prior or post Cushing's diagnosis. A number of us figure that this injury is related to the muscle weakness & wasting from high cortisol levels. Our consensus seems to be that if muscle tissue is being affected, then it's very likely that ligament/connective tissue is affected.

Debbie

[StarDeb55]

Jeanette, when I posted this info, I actually thought I was on Princess' thread, shows you how much I was paying attention.

Anyway, my opinion & it's similar to Alison's is that for now taking things kind of easy would be a good idea. Give the trilo a chance to do it's job, & let Princess regain some muscle mass which, also, probably means her ligaments/tendons are getting stronger, too. After several months, if she wants to run every critter off the block, it would probably be ok.

Debbie

[littleone1]

Not a problem, Jeanette.

[littleone1]

Hi Debbie and John,

We just got home from having Corky's tests done. I asked her if the jumping up that Corky does to give and get kisses would cause any more stress on him since he has the pins in his hind legs. She believes that he should be fine. He has been on the Trilo for 45 days now, and I know from the way he is walking, etc., that his muscles are stronger. Hopefully this continues.

Terri

[MiniSchnauzerMom]

Terri,

I am glad Corky is doing well and that his legs are getting stronger. That's good to hear. Even better is that your vet feels those jumps to get and give kisses are ok. Moms and pups both need those special kisses!!! :D

Louise

[lulusmom]

Hi Terri,

If the pins in Corky's leg is in the knee area, I would bet a dollar to a donut that he had a luxating patella. I've shared my life with toy breeds and this is common so I've been through a few of those surgeries with my babies in the past. The patella is simply the knee cap and the knee cap fits into a groove. Whether it be from a hip abnormality that causes an unusual impact on the kneecap or like one of my tiny Pomeranians, the groove was just too shallow, the kneecap slides out of place. The vet uses pins to fasten the bone into place and the voila, the kneecap stays where it's supposed to be. These are usually permanent pins that aren't removed. My three little ones went through the rest of their lives with no further trouble, with their knees anyway. :D

G.

[littleone1]

Thanks Louise. You are absolutely right. We all need our kisses.

Terri

[littleone1]

Hi to everyone that said that the Corkster probably had luxating patellas. I just got off of the phone with his vet. He went back through Corky's records. He definetely confirmed that Corky had luxating patellas. You were absolutely correct. I thought it was nine years ago, but it was actually ten years ago in October. We discussed Corky for 20 minutes.

He will see his regular vet on Dec. 18 for his dental check up and his Thyroid test. I know Corky's IMS has been faxing all of Corky's tests results to him. I definitely want to stay in the loop with him.

[littleone1]

Hi Glynda,

That was what was happening to Corky. I know at times he does have problems with his left hind leg. The senior vet where I go is the one that mentioned that it's possible that the pin might have to be taken out of that leg. He said that it is possible that the pin might be slipping out and that's why Corky does seem to be in pain when that happens. As I mentioned in a previous post, or at least I think I did, this hasn't happened for quite awhile.

Thank you for this information.

Terri

[littleone1]

I got Corky's test results back.

BUN 43(High) Range 6-31 mg/dl This has improved. In Oct., it was 57.
Urinalysis Protein 1+(High) Range Negative
Occult Blood Trace(High) Range Negative
Platelet Count 473(High) Range 170-400 This is down from 600 in Oct.

ACTH
Cortisol Sample 1 0.3(Low) Range 1.0-5.0 ug/dL
Cortisol Sample 2 2.7Low) Range 8.0-17.0 ug/dL

Even though these were low, his IMS is not really concerned, as the 2nd sample is in the range she is looking for. Corky will be continuing on his 20 mg Trilo dosage. He goes back for a stim test in 3 months. He will be able to take baby aspirin for his arthritis, as long as I continue giving him half a tablet of Pepcid AC. I can also give him baby aspirin and Cosequin.

All of the rest of the results were in normal range, including his electrolytes.

Terri

[StarDeb55]

Terri, just be aware that the normal ranges you have posted for the post sample are the ranges for a healthy dog. The normals for a cushpup on the post are still 1-5, so the Corkster is right where he should be.

Debbie

[littleone1]

Thank you so much Debbie. This makes more sense to me now as to why Corky's IMS said that the results were in the range she was looking for. Now I really feel good about all of his results.

Terri

[labblab]

Oh Terri, these results are super! I am so happy for you and the Corkster!! Good job, and thanks for letting us know...:) :D :)

Congratulatory hugs to you both,
Marianne

[StarDeb55]

This is not the first time this has happened lately. Since your here in town with me, do you know which vet lab your IMS uses? I ask because, normally, the paperwork will state a normal range that is for a healthy dog, the ranges that are consistent with Cushing's, & then the 1-5 range for a cushpup under treatment. My vet uses Antech Diagnostics on Cave Creek Rd. & that is the way they post their ranges for an ACTH, don't know about IDEXX, though.

Debbie

[littleone1]

My IMS uses Antech. My vet uses IDEXX. I know I get confused at times, but this really helped ease my mind.

[littleone1]

Hi Marianne,

Thank you so much. I'm sitting here with tears of joy. I know I was really concerned about what the Corkster's test results would be, especially his kidney values. He has improved so much in the past month and a half.

Thank you for the hugs.

[Harley PoMMom]

Oh Terri, I am so happy for you and Corky too. It's about time that you and Corky are allowed off that rollercoaster and are able to enjoy yourselves...geez, it's been a while, huh?

Big congratulatory hugs from Harley and me too.

Love and (((hugs)))
Lori

[littleone1]

Thank you so much Lori. It does feel better to be off of that rollercoaster! It has been a while. I know I've watching everything since his clinical signs disappeared the first time. It's been a long year, but at least now I know that he is really getting the proper care. I still say that he is such a little trooper and will do everything he can for his health.

How is Harley doing today? I've been thinking about him. I hope everything gets back on track for him, and also of course for you.

[littleone1]

Hi Everyone,

I have a question. I thought Corky took his Trilo this morning, only to find it on the kitchen floor a little while ago. I called the emergency hospital to ask for advice on whether to give it to him now. The vet said that since I couldn't be absolutely positive that it was this morning's dose, the recommendation was not to give it to the Corkster until tomorrow morning. Even though I'm pretty sure it was this morning's dose, I'm not going to give it to him now. My question is, will this have an effect on his treatment and cortisol levels? Will this cause a setback?

Thanks.

Terri

[labblab]

Hi Terri,

I do not think you need to worry about Corky having missed just one day's dose. This short a time without the medication shouldn't have any major or long-lasting effects at all. You may just notice him back to drinking a bit more water, etc. by this evening. But that should quickly stabilize again after his dosing tomorrow.

The little scamp! I'll bet he thinks he really pulled a fast one on you by "unloading" that capsule! ;)

Marianne

[littleone1]

Thanks Marianne.

I call him a little turd when he does this. He's done it before with other meds. I like the little scamp. I know he feels like he's pulled a fast one on me. Usually I catch it shorly after he does it, but we had company today, and I missed it.

I feel relieved now. I really appreciate all of the help you and others have given me.

[jrepac]

One day missed is usually not a big problem....coincidentally, I found a broken capsule of milk thistle in my living room this am...I'm thinking to myself "I THOUGHT I saw her swallow it!"...then wondering if one of the other dogs took off with it (and upon tasting it, said 'uggh")...

A few times, Mandy has held the pill in her mouth for a bit, then would turn away from me, drop it, and take off!

what a wiseacre....

best for me to bury the pill in cold cuts somehow; stuffing from Turkey was very handy this week for making my own little pill pockets! LOL!

Jeff

[littleone1]

Thanks Jeff.

Our babies are smart. They have a way of making you believe that they took their meds, only to find them later. I don't know how they do it.

I don't get too concerned if Corky does this with his Soloxine, but I wasn't sure about the Trilo. I did see a difference at dinner time. After he ate his dinner, I set my plate down to answer the phone. Corky proceeded to eat some of my dinner. I will watch him very closely this morning to make sure he doesn't spit the Trilo out.

Terri

[Roxee's Dad]

Hi Terry,

Our Rozee is infamous for spitting out pills even when buried in peanutbutter or cream cheese. :( So I have learned to give her 2 small treats. I bury the pill in the first treat and hold the 2nd treat in my hand so she can see it. Being the little piggy that she is, she wolf's down the first treat, pill and all so she won't lose out on the 2nd. :D

Works every time. ;):) It's your turn to pull a fast one on the Corkster. :D

[littleone1]

Hi John,

This made me chuckle. The Corkster is very smart. Sometimes I think he's too smart for his own good. It's amazing that they can hide a pill and it is later found some place else.

In the morning before our walk, I give Corky his Soloxine and his Pepcid AC. I put a little mayo on my finger and he does take those pills now, without any problem. I also did this with his Trilo this morning. I gave him the Trilo as the second pill and then gave him his Pepcid AC. I was using yogurt, but he won't eat that now. I use to use mayo with him before, so I thought I'd try it this morning with his Trilo. It worked! I think I got him back!

Terri

[gpgscott]

No more tricking Momma you little troublemaker:D

[littleone1]

This is great, Scott! You guys and gals are super! I'm still laughing about the little Corkster. He's a little character!

Terri

[gpgscott]

I find pills also on occasion Terri,

In our case they are not near as important as yours.

I still berate the furry ones who spit them out.

Scott

[littleone1]

Hi Scott,

Corky tried to spit his Trilo out again this morning. I put it in with his food to see what would happen. I was watching him very closely. He actually spit it out three times. I kept putting it back in his food, and he finally swallowed it. I'm going to go back to the mayo plan.

I still don't know how they manage to spit their pills out somewhere else in the house. They must somehow hold it inside of their cheek, and when you're not watching, they spit it out.

[lulusmom]

Hi Terri,

I don't have any problems getting pills down any of my four turdlets as long as I roll it up really good in peanut butter or cream cheese. Both of these things are goopy and it's a lot harder to separate it from the pills. I've found that my kids are more likely to swallow it after working a bit to extricate the gob from the rooves of their mouths. :D

[gpgscott]

Terri,

My boston's where the worst.

They always found the pill.

I really think in certain cases, it is best to just poke the pill and then give them a treat.

Corky may be one of these cases.

Just sayin'

Scott

[littleone1]

I might have to do that, Scott.

It seems like it's only certain pills that I have problems giving him. I had to do that with one of the antibiotics he was taking about a year and a half ago. The one antibiotic, I didn't have any problems with. The other one was bad news. I know the vet said that it had a horrible taste. I did have to put it down his throat, and then I would give him a treat. I hate the thought of having to do this for the rest of his life. I'm hoping that this will be just a short phase he's going through.

These little ones do give us a challenge at times. But they are well worth it. I know I wouldn't trade him in for anything in the world.

[Harley PoMMom]

Hi Terri,

Cream cheese is my preference, I can mold it around any amount of pills I need to give to Harley, and it need not be that much of cream cheese to hide them pills either. But if the mayo will work with Corky...then hallelujah! ;):D

Love and hugs,
Lori

[littleone1]

Hi Lori,

Corky's always liked mayo. When we first got him, and I had to cook for him, I always gave him a little mayo with his chicken. That's the only way he would start to eat. He loved it. Mayo is about the only thing that I can rely on him taking with his morning pills. Before he started on the Trilo, I was able to use plain yogurt. Sometimes he will eat cheese, and sometimes he won't. This is why I'm back to using mayo for his other pills.

He was doing good when I put his Trilo in with his food. It's just recently that I started having problems with him.

I'll see what happens tomorrow. I'll try it with the mayo again, and then let him have his breakfast. I don't want to put any more stress on him.

[gpgscott]

Terri,

Once they put the pill in conjuction with the paste, whatever it is they will reject it.

In our case the pb works because Moria does not find the pill objectionalbe. She ain't that smart. She is a Lab.

In your case you have a young boston. This one is looking for the pill. I say this is a case of poke and choke. You put the pill down and then give a treat.

I would not expect Corky to take a pill willingly. Do you?

Been there, and missing them.

Scott

[Franklin'sMum]

Hi Terri,

Back in July when Franklin started the trilo the first time, I gave it on an empty stomach. Day 4 He was completely off of his food. Giving it with food makes it more easily absorbed.

I wrap Franklin's trilo in a little bit of ham:o. He's at the point now where he finishes his food, then wanders over to me and says "Finished, Mum. Where's my ham?" So now, when he has lunch (no trilo dose then) he still asks for his ham. Just to keep him in the groove, I give him a little bit more.

Sometime he still manages to eat the ham, and spit out the tablet, though. So I wrap it up again. His current record for spitting it out is three times :rolleyes: Ours aren't the only kids who do it.
One of my friends has 2 pups who spit out anything they're given (and she cuts a piece of steak or something and crams the tablet in).


But they are such sweet little boogers :)

Jane and Franklin xx
________
Letizia (http://www.girlcamfriend.com/cam/Letizia/)

[littleone1]

I'll see what happens in the morning, Scott.

I have a feeling that I really might have to to put it down his throat. He is smart. As I look back, when he started to get finicky about his eating, it was probably because he knew the Trilo was in it. If I just have to give him a tablet, that's when I don't have any problems with Corky. But since his Trilo is a capsule, it does make a difference. When he did get so finicky, there were a few days when I did have to put it down his throat to make sure he took it. Then he would eat. I thought it was because I changed his diet.

There are definitely things that Corky doesn't do willingly. He is very strong-willed. I think you're right about his Trilo.

Hopefully, I'll be able to resolve this issue.

I know he hates getting his ears cleaned and his nails cut, but he doesn't try to run away when I have to do it. His little head goes down, and his ears go back, but he lets me do it. He does the same thing if I have to put a pill down his throat.

I really appreciate your help with this.

I'm sure you miss them. They are all very precious.

[littleone1]

Hi Jane,

They are definitely little characters. I think Corky set his record of three today.

I know it is definitely recommended that they take the Trilo with food. This is why I put it in his food. When he started spitting it out, that's when I gave it to him with mayo yesterday, and then he ate right after that.

I think I'll try it with some meatloaf tomorrow. Corky really likes that, and since it's so soft, he doesn't have to chew it. It just slides down his throat. I'm willing to give anything a try right now, especially since it's now happening frequently. If that doesn't work, I'll probably have to put it down his throat.

It is nice to know that our kids aren't the only ones that do it. Thank you for your input.

[BestBuddy]

Hi Terri,

Apart from one of my dogs (Nelson) they have all been very naughty pill takers and more often than not it would mean poking the pill down the throat if I wanted to be sure it went in and stayed that way.

Nelson would eat the most nasty tasting and smelling pills from my hand because he knew it was what I wanted. What a dream but back to the nightmare ones....

I have discovered that soft cheese is the best pill hider I have found. I use a cheddar cheeststick (not sure if you have these) and just use a tiny bit, maybe 1/4 teaspoon or less and mold it around the pill/tablet and it gets swallowed without a problem.

Good luck and I hope you can find your solution.

Jenny

[littleone1]

Hi Jenny,

Thanks for the information. I haven't seen cheddar cheese sticks out here, but we do have the string cheese that Corky will eat every so often.

I will try different things until we can get this resolved. The Trilo is the only one that really concerns me. I know that when Corky has had to have any kind of surgery or was hospitalized for his respiratory problems, I was always told that missing one day of his Soloxine wouldn't make a big difference in his hypothyroidism. His other meds, except, for the Pepcid AC, are only given to him as needed.

I will be starting the trial and error period in the morning.

[mypuppy]

Hi Terri, This is so common for our little characters to pull. In the past when Princess had to get any type of med for her ear infections, I'd hide them in her food only to watch her eat around the pill, spit it out, etc. That's when I just started wrapping whatever meds necessary and wrapped them in a slice of cheese or ham. That is what I've been doing with the trilo...Princess sucks the ham with the pill in it in one gulp. Gosh, she doesn't even chew. It's like a the vacuum cleaner effect she does, and hey, it works for me because she doesn't even get to taste the pill and spit it out. So try the ham. If you don't feel comfortable feeding Corky the table food, even half a slice of cheese or ham will do to wrap the pill in. But it seems to me from what you've said, he actually chews his food first, unlike Princess so I guess what works for me may not for you. It really is frustrating, specially when you feel you have to shove it down his throat. Ughhhhh.....I'm sure there's got to be some food out there to hide his pill in that he won't chew up. Good luck and let me know how you make out....Best regards, Luv and licks to you and Corky....xo Jeanette


Hi Jenny,

Thanks for the information. I haven't seen cheddar cheese sticks out here, but we do have the string cheese that Corky will eat every so often.

I will try different things until we can get this resolved. The Trilo is the only one that really concerns me. I know that when Corky has had to have any kind of surgery or was hospitalized for his respiratory problems, I was always told that missing one day of his Soloxine wouldn't make a big difference in his hypothyroidism. His other meds, except, for the Pepcid AC, are only given to him as needed.

I will be starting the trial and error period in the morning.

[haf549]

Hi Terri:

I give Kira her Trilostane in small cream cheese cubes. Here in Canada, they're called 'Party Cubes'. They are the perfect size for the pill. All you have to do is push them in. Cheese sticks also sound like a great idea.

Heidi

[littleone1]

Hi Jeanette,

I gave Corky a piece of ham this morning without putting his pill in it. He does kind of chew it, and rolls it around in his mouth. I knew that wasn't going to work. I did try the meatloaf, and that did work today. He just swallows that. I'll keeping using this until I start having problems again. Then I'll try something else. If this keeps working, I'll have to make another one.

Corky only eats food that I cook for him. When we got him, he was about 14 months old and very thin. He wouldn't eat any kind of dog food. We tried just about everything. I've been cooking for him for just about 11 years.

Hugs and kisses to you and Princess.

[littleone1]

Hi Heidi,

Thank you for this information. Corky did take his pill this morning with meatloaf. If that stops working, I'll see if I can find cheese cubes. Corky's not a real big fan of cheese, but he will eat some once in a while. If I do start using cheese, I'll have to try different kinds to see which one he will eat. He's not too spoiled!

Terri

[Squirt's Mom]

Hi Terri,

Every now and then, one of mine will decide to hunt for pills in food and treats, and usually find one. :rolleyes: Once that happens, they get very suspicious of all foods for a bit...even Squirt, Miss Piggy. :p One trick that has never failed with mine is baked sweet potato. I put a dollop of potato on a plate, push the pill down in it, and the potato and pill are gulped in one bite every time! I have even been able to crush, or break-up, large-sized antibiotics, mix it in, and down it goes.

You can bake the potatoes, fill ice-trays with the meat, and freeze. Once frozen, you can pop the cubes out, put them in a bag or container in the freezer, thaw and use as needed. They will keep for several weeks that way!

We got to find a way for you to keep Mr. Corkster on his toes! :p

Hugs,
Leslie and the girls

[littleone1]

Hi Leslie,

That's a great idea. Corky does like sweet potatoes. I actually give him sweet potatoes or pumpkin with his rice, green beans, and ground beef or turkey. He eats this in the morning after his walk. That's when I give him his Trilo. I'm going to try this.

The Corkster does live up to his name! You're right. We definitely have to keep him on his toes!

[lulusmom]

Sounds like the Corkster has Thanksgiving dinner every day. :D

[littleone1]

He basically does, Glynda. He's just spoiled a tad!

Terri

[littleone1]

Hi Everyone,

It's me again with one more question. Since Corky's Trilo has been compounded, would it be feasible for me to just open the capsule and mix the Trilo in with his food?

[StarDeb55]

No, you do not want to open those trilo capsules. This is a quote from the package insert on vetoryl from the important information section of the forum:


Wash hands after use. Do not empty capsule contents and do not attempt to divide the capsules

Debbie

[littleone1]

Thanks for the info, Debbie.

Terri

[littleone1]

Hi,

The Corkster has actually taken his Trilo three days in a row without spitting it out. I have been using meatloaf as long as it is still working. I give him two pieces and then I put his Trilo in a 3rd piece. So far, So good.:)

[Harley PoMMom]

Way to go Terri :D:) Out-smarting the Corkster!! We knew you could find a way to get him to take his Trilo without spitting it out. Him loves his mommy's cookin!!! Good Boy! ;):D

Love and hugs,
Lori

[littleone1]

Hi Lori,

It feels good to finally out-smart the Corkster.:D I know I've tried so may different things, and this finally worked!;) He definitely has developed a taste for things that taste good.

Give Harley a big hug and kiss from Corky and me.

[mypuppy]

Hi Terri, I am certainly no expert in the field, but I read somewhere that this is not recommended because if they do not eat their entire meal then you risk them not taking their entire recommended dose. Also, I remember trying this with Princess many years ago when she had to take antibiotics, and she detected the smell of it and refused to eat her food at all, so I guess they know something different they don't like is in there. Is the Corkster still giving you a hard time about taking his pill? Wow, he's really stubborn huh! None of the great tricks given here were helpful. Like I said, Princess sucks up her pill wrapped up in her ham with no problem. I wish Corky would do the same for you because it is one less stress to deal with knowing they took the med. Let me know how you make out. We'll just have to find a way for that little stubborn mule to take his medicine. Hey, have you tried "a spoon full of sugar"...like Mary Poppins sings "makes the medicine go down"...lol....I guess that only works for kids....lol. Best regards and lots of luv, Jeanette and Princess


Hi Everyone,

It's me again with one more question. Since Corky's Trilo has been compounded, would it be feasible for me to just open the capsule and mix the Trilo in with his food?