Coco, Miniature dachshund - sweet Coco has passed

[waalaa]

Hi everyone,

My mom has a mini doxie (Coco) who was just diagnosed with Cushings. He is 10 years old and has had minimal symptoms of excess thirst and hunger, which prompted the vet visit. He has had a lot of blood work, a planned liver biopsy (which they did not do because the ultrasound they performed made it unnecessary), and finally a urine cortisol/creatinine and a low dose dexamethasone suppression test, which gave them the diagnosis. Here are his LDDS results:

Pre Dex - 16.5 mcg/dl
Post 4 hr - 10.0
Post 8 hr - 15.5

And his urine cortisol/creatinine results:

Urine cortisol - 44.4 mcg/dl
Urine creatinine - 30.9 mg/dl
Urine cortisol/creatinine ratio - 448

The vet told us his results were "off the chart." He said he usually treats with Lysodren and told us Cushing's will shorten Coco's life. We have scoured the internet looking for good information and advice, and have found a lot - most on this website. My question is what do we do now? For the past week or so, Coco's thirst seems to be lessened and his hunger more normal, and his energy level is up. He has had no treatment yet. My mother is concerned about the medication actually making him worse rather than better (which I know can happen particularly during "loading") and is unsure what to do. Any advice that any of you might have would be greatly appreciated. He is very precious to us, and we want to do everything we can to ensure he lives as long and as healthy as he possibly can.

Thank you all in advance, and thank goodness for this website!

Leesa

[infoviewer]

My ten year old dachshund has been tested for Cushings, no symptoms. ALT 509, ALKP 1509, CHOLESTEROL 520, BILE ACID NORMAL, ACTH NORMAL, ULTRASOUND REVEALED ADRENAL GLANDS GENERALLY AND MODERATELY ENLARGED, MODERATE BILATERAL ADRENOMEGALY, CONSISTENT WITH PITUITARY DEPENDENT CUSHINGS, HYPERECHOIC HEPATOMEGALY, MILD, PROBABLE VACUOLAR HEPATOPATHY. DEXAMETHASONE SUPPRESSION, PRE DEXAMETHASONE 16.5, POST 4 HR DEX 10.0, POST 8 HR DEX 15.5. VET SAYS PITUITARY CUSHINGS AND WANTS TO TREAT WITH LYSODREN. DOG HAS NO SYMPTOMS. WHAT DO YOU SUGGEST. THANKS

[mytil]

Hi Leesa,

Welcome to our site - I am sorry you and your little Coco are having to deal with all this.

Here is a good link on the basics of Cushing's http://www.kateconnick.com/library/cushingsdisease.html - take a read through.

The LDDS test results does point toward Cushing's. And the ratio is high for the UC:CR. Did the ultrasound show any enlargement of the adrenal glands?

IMO, a diagnosis of Cushing's does not necessarily mean a shorter life. We have had many here who have treated for years successfully.

I also would like to point out that with the recent decrease in drinking and eating is more normal, I would be suspect something else may be going on. Has your vet mentioned anything else (another condition) that may be causing these test results? Especially with no medication.

Is Coco on any other medication for any other disease or condition? I ask this because it could give false positives.

Keep us posted.
Terry

[labblab]

Hello "infoviewer," and welcome to you, too!

I am guessing that you may be Leesa's mom and the owner of the little doxie whom she has already written about? I see that the LDDS test results that you have given are identical, and I don't think that can be a coincidence. As a result, I am going to "merge" your two threads together so that we can all talk about your dog in one place :).

Marianne

[infoviewer]

Thank you so much for your input. You are right, mother and daughter concerned about CoCo. We are both medical transcriptionists so know a lot about human problems, but not so much about the animal problems, but this forum is a big help and we so appreciate any help we can get since we all love our dogs and want the best for them.

Thanks JoAnne

[addy]

Hi and Welcome,

We have many knowledgeable members who will be along soon to comment and ask questions.

I want to say that I am glad you found this site but am sorry to hear Coco is having some troubles. History and symptoms are a big part of diagnosing Cushings since no one test is perfect. The goal of treatment is to alleviate troublesome symptoms and bring down high cortisol. Elevated cortisol can affect other organs.

With proper treatment, a dog can live out her normal life span so it is not a death sentence. The drugs used are powerful and they can be scary but when administered properly and monitored by a experienced vet and knowledgeable mom or dad, they can work wonders for our pups.

I know it is overwhelming at first. Cushings is usually not an emergency so you should have time to learn and think about the approach you want to take.

My Zoe was off the charts too. Her symptoms were mild, her blood work was pretty good so I waited a year to start treatment. I always wondered how could her numbers be so high and her symptoms not off the charts to match.:confused: I never did get an answer to that.:)

Please start reading some of the articles in our research section. The more you learn about this disease, the more in control you will feel.

What is most important is that you are no longer alone. we are here for you in any way you may need us.

hugs,
addy

[labblab]

Coco's situation does sound like a bit of a puzzle. Aside from the normal ACTH, all of the other lab results are indeed consistent with Cushing's. But now the outward symptoms seem to have lessened?Can you tell us more about the excessive thirst and hunger? Since Leesa says these are the problems that initially prompted the vet visit, they must have seemed abnormal for at least some period of time -- and may resurface again. But if it were me, I would hold off on starting treatment until they do so, both for confirmation of the accuracy of the diagnosis but also so that you have some observable markers by which to judge the Lysodren loading proces.

The ACTH results vs. the LDDS results do muddy the waters somewhat. The thing is, the ACTH does have a fairly high failure rate in accurately identifying dogs who truly have Cushing's (a high "false negative" rate). But in the reverse, the LDDS has a higher likelihood of returning a "positive" result when a dog is actually suffering from a disease other than Cushing's (a higher "false positive" result). So when the two tests give oppositve results, the other testing and the symptom profile become all the more important in arriving at a judgement about the presence of the disease. For the sake of interest, can you tell us what the actual numbers were on the ACTH test?

And as I say, please tell us more about Coco's history of thirst and hunger.

Marianne

[waalaa]

Hi Marianne,

Thanks so much for merging our posts - great minds think alike!

My mom first noticed that Coco's energy level was decreased, and he seemed to have trouble jumping up on the couch, about six or eight months ago. He had increased thirst (seemed to drink all the time) and was extremely hungry (ate like he was never going to get food again, really didn't even chew his food). He was always the type of dog that would eat 24/7 if given the chance (my dogs are like that too - lol), but this seemed abnormal to my mom because he just seemed like he was starving all the time. She took him to the vet and they began with senior blood work (since he is 10 years old). The first abnormal lab was his ALT, which was slightly abnormal, and the vet took a wait and see approach. At that time, his ALT was 156. At his next blood work in December, his ALT was 509, and his ALKP was 1,509 (which was previously not elevated). His cholesterol was also elevated.

After these blood test results (and his continued symptoms of excessive thirst and hunger and decreased energy), the vet suggested a liver biopsy. During prep for this, he performed an ultrasound which showed hepatomegaly (moderately enlarged liver) and moderately enlarged adrenal glands. He did not do the liver biopsy because he felt that Coco had Cushing's. Then, this past Monday, he performed the low dose dexamethasone test and urine cortisol/creatinine with the above results. His symptoms of increased thirst and hunger have lessened as of last week (before the dex test), and his energy level is up (he is chasing squirrels like a nut again).

My mom does not have the ACTH results in hand - this test was done several months ago, along with a bile acid test and blood sugar. The vet called her and told her that he ran two ACTH tests, the first inconclusive, the second only slightly abnormal. His testing for diabetes and his bile acid tests were both normal. She doesn't have the paperwork for this to have the exact numbers though.

Could his improvement in symptoms just be a fluke? Should we wait to see if his thirst and hunger comes back, or would waiting to put him on medication be a bad idea, since he has probably had Cushing's for at least 6-8 months or longer? We have read so much about the medication (and probably know too much about "people" medicine for our own good), and we are just scared to start a medication that might harm Coco - he's so small, and the side effects seem so bad.

Thanks so much for your advice so far, and for anything you can tell us - it is such a wonderful comfort to know we are not alone!

Leesa

[labblab]

Leesa, thanks so much for all this additional info. From what you've written, I do think the whole picture does indeed point to Cushing's. And as you've suggested, I'll bet his current symptom "break" is a fluke and the hunger and thirst will return. :o

If it were me, I would still probably hold off on starting treatment until you see an uptick in the hunger and thirst again. Not so much because I still have big doubts about the diagnosis, but more because you really do want observable symptoms to monitor when you begin Lysodren loading. It is often only a very subtle change in appetite, for instance, that will signal that the Lysodren loading is complete and no more medication should be given at that time.

I am guessing that Coco's symptoms will rebound again pretty quickly. And waiting a few days or a couple of weeks shouldn't make a big difference. As you already know, Cushing's is a slowly progressing disease and Coco has probably already "had" it for some time. So my personal opinion is that there will be no great additional harm in waiting a little bit, until the situation is optimal for starting the loading.

And please don't fear Lysodren! We have so many success stories to share...

Marianne

[waalaa]

Thank you Marianne, Addy and Terry so much for your encouraging words and great information. We have been reading everything we can get our hands on since the suspected diagnosis, so we are probably a little crazy with information at this point - lol

It's good to know that we have a little time before he has to start treatment. I think the more we know about the medication(s) he will have to have, the more at ease we will feel.

I have another question, if you don't mind. Is there any standard dosage, based on weight, for the Lysodren loading phase and/or the maintenance dose? Or for the Vetoryl? Coco's vet seems knowledgeable and experienced, but it would be great to know a standard dosage to compare to whatever he prescribes, just to be safe.

Thanks again so much to all of you!

Leesa

[labblab]

Yes indeed, here's a link that will fill you in on Lysodren dosing and the loading/maintenance process. When you read it, I think it will become clearer why it is important to be able to monitor any drug-induced changes in appetite or thirst.

http://www.k9cushings.com/forum/showthread.php?t=181

Also, here's a thread that contains a lot of helpful info about trilostane. In terms of dosing, I would just add the following: even though the published materials issued by Dechra (manufacturer of brandname Vetoryl) suggest an initial dosing range of 1-3 mg./lb., a number of us have been verbally told by Dechra technical reps that it is best to start at the lower end of that formula -- at 1 mg. per lb.

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

Marianne

[Cyn719]

Leesa and Joanne

Sorry for the reason you had to come to the forum but you certainly have come to the right place - Welcome:) - As you can already see we have may knowledgeable members here to help you through this to make sure CoCo gets the proper treatment - Just to let you know my Penny was 8 when we found out she had Cushings and she is now 12 - we did not start her on the meds until she was eating - drinking - and going to the bathroom alot - so she was without meds for awhile - so like the others said waiting will not be a problem -- Hang in there - it is alot to absorb but the members here are so helpful!

Sending you support strength prayers and hugsss xo

[waalaa]

Thanks so much for the encouraging words and great links - it is such a great comfort to get information from those of you who have gone through what we are going through now!

Thanks so much again! We will keep you posted when we begin Coco's treatment :)

Leesa

[Squirt's Mom]

MODERATOR NOTE: I moved this post from the Helpful Resource section to Coco's original thread. We like to keep all info about each dog in their own thread. That way, it is easier to look back through the history if needed.

This is infoviewer, my dog is coco diagnosed with Cushings a few weeks ago. Mild symptoms. I have not posted anything in a few weeks. Was going to post when I started him on Lysodren. I have just been putting it off since his only symptoms are greedy which he has always been and his water drinking seems to be better. I measure it every day and he drinks about 15 or 16 ounces and he weighs 14 pounds so I don't think that is too much. I have noticed that he has thin hair on the top of his head, so I don't know if that is a symptom, since his hair is growing back on the belly where he was shaved for the ultrasound. Another thing I am concerned about is that he has so much smelly gas and has had this for about 3 months, but the doctor did not seem to think this was concrning. Seems to me he would have some kind of gastro thing since every thing he eats causes it and he never had it before. Just wondering if this has anything to do with Cushings. I have not started him on the Lysodren since he seems fine and don't want to do any harm until his symptoms get worse. I was wondering also if it was better to start the medication when the symptoms are mild. Thanks for any info. JoAnne

[Squirt's Mom]

MODERATOR NOTE: To keep things in chronological order, I have copied your post, Cindy, to Coco's thread as well.

Hi JoAnne and Coco and welcome to the forum. So sorry for the reason you are here but you have come to the right place. The members here a wonderful and so knowledgeable. Yes you will get asked tons of questions but don't get overwhelmed. This is so they know everything about your baby so they can give you the best advice. So to get started tell us about Coco. Breed, age ....can you give aliitle more history, can you post the test results and bloodwork results......looking basically for the results that are abnormal. The members will be along soon to help. Hang in there. You and Coco will get through this.

Hugs. Xoxo
__________________
xoxo Cindy & Penny
Edit/Delete Message

[apollo6]

Dear leesa welcome.
My Apollo is 13.5 years old,started symptoms around age 10 also

Before you start any treatment please know there are three types of Cushing: pituitary ,adrenal,or atypical
It is important that you know which kind,because that wil determine what course of action/medication you decide on. Each case is different.
Hugs Sonja and Apollo
Read up on it first.

[alan]

Hi My dachshund developed cushings at 8 years and lived to be 16 nothing to be frightened of, good luck they are a lovely breed. Alanxx

[infoviewer]

Hi all this is an update on CoCo, 10 year old dachshund with new diagnosis of Cushings. He had such high numbers that the vet recommended Lysodren, but I decided to wait a few weeks and watch him. His only symptoms were excessive drinking and hearty eater (always) and peeing excessively because of excessive drinking. His excessive drinking of water decreased over the past couple of weeks and his hair that was shaved for ultrasound has started growing back. I went to talk to his vet yesterday and reported that his symptoms had decreased to the point that I did not believe I could tell when he was loaded with the Lysodren. CoCo also has a bald spot on his head and thinning hair on each side of his head. The vet said this was not Cushngs. The vet agreed that his symptoms were not severe enough to start the Lysodren and we would just watch him. I hope I am doing the right thing for him. Any thoughts on food or supplements for a Cushing dog. Thanks for your help. JoAnne

[labblab]

Hi again, JoAnne!

Thanks very much for your update on CoCo. I saw you had posted it on Leslie's thread about her Squirt, and I went ahead and moved it over here to rejoin CoCo's own thread. Once again, that will permit folks to respond to you directly. I'm hoping that Leslie and others will offer you some suggestions about food and supplements, as you have asked.

As far as the Cushing's treatment, I still agree with you that it makes sense to hold off on the Lyosdren for the time being. Since CoCo's symptoms actually seem to be improving right now, it seems hard to justify launching into treatment.

I'm glad to hear that the little guy seems to be doing better,
Marianne

[Squirt's Mom]

Hi JoAnne,

I, too, agree with holding off on treatment just now and am so glad he seems to be improving on his own - which sure don't sound like Cushing's! :D

As for diet, if he is eating a high quality feed now and is not having any issues, I'm not sure I would change. Cushing's dogs generally need moderately higher proteins and definitely lower fats in their diets. What is he eating now?

When was his last blood work done, as in a chem panel or wellness/senior panel? Has his thyroid been checked recently? I'm not positive that his hair-loss pattern fits with thyroid issues or not, but hair loss in general does.

Melatonin will help hair regrow but it is important to know what is causing the loss before trying to address it. Addressing the underlying cause, if there is one, would be the first step in addressing the hair loss - if that makes sense. :p

So some more info for us and for you will help decide what food would be best and what, if any, supplements would help.

Hugs,
Leslie and the gang

[infoviewer]

Hi: CoCo has been on Eukunuba all his life, he is on 7+ senior now and has been for a year or more. He does have a lot of gas which I do not understand since he has always been on Eukunuba. His hair loss on his head was gray to begin with and he now seems to have a small bald spot and thin on both sides. The vet said this is not Cushings, maybe age-related. He will be 11 in 9/12. His symptos are so mild that the vet decided not to start Lysodren for fear we would not know when he was loaded. He said it only gave them a better quality of life and did not prolong life. Just wondering if I have done the right thing by holding off on medication. I do give him a little plain yogurt thinking he may have some gastro thing, but he seems fine most of the time, just is slower than usual and seems to hop with his running with a stiff gait and really likes to be in the house where the food is, that is a dachshund. I have probably posted wrong again. Thanks, JoAnne

[labblab]

JoAnne, you have posted "right"! This is exactly the right place! :) :)

I am not sure I agree with the long-held belief that Cushing's treatment does not extend life, because surely it is healthier for a dog if we slow or halt the progression of related health problems (like possible effects on the liver, kidneys, blood pressure, cholesterol, etc.). But having said that, all these effects advance slowly over time. So no, I do not think you are making a mistake in holding off on starting the Lysodren until you see more obvious symptoms. I know you are watching CoCo very closely, and when you see bigger changes in his thirst, urination and appetite -- it will be much easier and safer to monitor the treatment.

Marianne

[infoviewer]

Thank you so much Marianne. My vet is a general practitioner so I do not believe he knows that much about Cushings, but did know all the tests to perform and only uses Lysodren. There are not any IMs close by to my area so I am just trying to read all I can and trust what he says. He has been in practice a long time. Coco is doing fine, if I had not been reading a lot of info, you would just think his symptoms were age-related. Thanks again, JoAnne

[Squirt's Mom]

Hi JoAnne,

Yes, this is the right place to post about Coco! You done good! :):cool:

About the feed - if it were me, I would be getting off the Eukanuba asap. It is not a high quality feed anymore, if it ever was. I have been searching to find the ingredients but have had no luck (even on the Eukanuba site) other than a few blurbs which mentioned chicken by-products. By-products are items from animals that are "not fit for human consumption" and even tho they can include things like organ meat, that organ had problems or it would have been used elsewhere that would have made more money than it would in dog feed. Chicken by-products include things like feathers (that are "unavoidable"), feet and beaks - which have no nutritional value but are cheap fillers, like corn. However, because the FDA does not list by-products or corn as "fillers", manufacturers can legally claim their feed has no "fillers" when in truth it does. By-products are ways to increase the product volume/amount without increasing the nutrients OR their cost - which is the most important thing to manufacturers. The fact that Eukanuba makes it difficult to learn exactly what is in their feed on their own site would be reason enough not to feed it. If they were putting a nutritionally solid feed out there, why wouldn't they want everyone to immediately see what was in it?

There are many high quality feeds out there and reading the labels will let you know a great deal about what you are feeding. The first four ingredients listed are the ones you pay most attention to as they are the ingredients that the feed contains the most of. If corn is listed first, that feed is primarily made up of corn - and dogs are not omnivores nor herbivores, they need meat. If it says by-product of any animal tissue anywhere in the list of ingredients - chicken, beef, lamb, etc - put it back on the shelf. Meals are ok as long as they are specific - chicken meal, beef meal, etc. - but "meat meal" or "poultry meal" is not. If the front of that pretty package says that feed is lamb and rice then lamb should be the first ingredient and rice the second - if they are not listed in the first four ingredients, then lamb and rice are not the primary ingredients.

Higher quality feeds are generally more expensive to purchase BUT they don't cost more in the long run to feed because the pup uses the feed therefore there is less loss through bodily waste and the pup needs less feed overall. With cheaper feeds, there are less nutrients that the pup's body can actually put to use so it is passed through quickly and often, leaving the pup hungry more often, needing more feed.

A general rule that seems to apply everywhere I have lived is this - if a feed can be found in WalMart, KMart, Target, etc, or the grocery store, it isn't worth feeding. BECAUSE these type businesses are in the business of making money only - they are not in the pet business so they simply stock what is the most popular regardless of the quality of the feed. Search places that specialize in pets and pet food, read labels, research and ask questions. Most companies are glad to send a sample for your baby to try before you purchase their feed, too. ;)

I hope this helps!

One question - had he had his thyroid checked lately?

Hugs,
Leslie and the gang

[Squirt's Mom]

Hi,

Me, again! :p

Here is a link on how to read labels -

http://www.animalhealthcarecenterofhershey.com/medical%20handouts/How%20to%20Read%20a%20Pet%20Food%20Label.pdf

[Wendy Tillotson]

Hard to know what to feed your dog - but as stated Eukanuba is no longer considered the best food - which it was many years ago.

Lately, Blue Buffalo has been one of the better ones - and my vet recommended it for one of my dogs - but he wouldnt eat it - much to her surprise. HOWEVER, if you buy it at PetSmart, you can return it. He is now on a special food - Z/D - which I don't particularly like, but his stomach does.

I use Natural Balance Duck and Potato for my greyhound who has IBD.

Katie, the wire doxie (also a mini) who has Cushings is on Wellness senior.

If you change, do so gradually.

[infoviewer]

Thanks so much for the info on dog food. I had read the ingredients on Eukunuba and noticed that it was not the same food that it used to be, and I had tried Blue Buffalo and several natural foods, but they seemed to upset his stomach. I possibly added too much to the Eukunuba. I do supplement his food with boiled chicken breast. I was concerned that he had developed a gastro problem with so much flatulence, since I had always fed him the same food, but possibly they had changed what they were putting in it over the past six months. It could possibly be that I am feeding him more because of the Cushings, but I measure his food and water, but he does beg a lot and we give him a piece of his dog food. Again, thanks for the info. JoAnne

[Harley PoMMom]

Here's a link to a website that rates dog food and with ratings from 1-6, they give 6 stars for ones that they feel are the best.

http://www.dogfoodanalysis.com/dog_food_reviews/

[infoviewer]

Hi everyone: Sorry to ask so many questions since my doxie still has such a mild case. He has a small bald spot on his head and I noticed he is losing a little hair on one ear, the vet says this is not related to Cushings, but I suspect that it is. Is there anything that I can put him on that would help until his symptoms get worse. They are not bad enough that I could do the loading of Lysodren since his water drinking has decreased and the appetite is the same. His hair is thinning on each side of his head also. I am just trying to catch things early if I can. Thanks for your help. JoAnne

[addy]

Hopefully others will stop by. It was my understanding that Cushings usually spared the head but maybe another member will have more input on it. My Zoe has hair loss on her trunk, her tummy, her inside back legs, under her tail and her tail, but her mop of hair on her head and face and ears is still there, The only spot on her face affected is her nose.

hugs,
addy

[lulusmom]

Addy is correct. The usual hair loss pattern in cushing's does not usually involve the head. Did your vet do a skin scraping?

[infoviewer]

My vet did not do a skin scraping, just said it could be age related and it does seem to be like a man would bald, strange, it was gray hair, but now a small bald spot. Thanks, JoAnne

[infoviewer]

Hey All: My sweet CoCo now has diarrhea. I think it is because I tried to change his dog food from Eukunuba to Blue Buffalo and went too fast with it. I had also given him carrots as his treats and maybe too much fat free and sugar free yogurt. I have been giving him Pepto-Bismol and no food, he is drinking water and still wants to eat. This is the second day for it. Hate for him to be so miserable. I am wondering if the Cushings is also part of this and if there is something else I should do before calling the vet. I do have boiled chicken and rice for him when he quits the diarrhea. Thanks for your help. JoAnne

[addy]

Hi,

My Zoe has colitis/IBD for years now and Cushings. When she would have watery squirty poos, the best thing to do was to leave her system rest. I would skip one meal and then cut her next meal in half, then slowly work our way back up.

Also pumpkin helps, pure canned pumpkin, not pumpkin pie filling but the amount can get tricky, too much can cause loose stools. I gave Zoe 1 tablespoon. She weighed 20 pounds then. You can also try a rice mixture, overcook the rice in water and feed the soupy mixture, no meat.

Depending how many times Coco is going, you would not want it to go on too long as Coco could get dehyrated. Since it sounds like you already skipped a meal, maybe the rice mixture and some pumpkin today and call the vet for Flagyl tomorrow if no better. Just some thoughts.

Hugs,
addy

[infoviewer]

Thanks so much Addy. I think I had also given him too much pumpkin and carrots as a treat day before yesterday as well as trying to change his food. Hoping he will be better today. Thanks again, JoAnne

[addy]

I'm checking back through your thread. I am assuming, hopefuly correctly;) that Coco has not started any Lysodren or Trilostane correct?

Just making sure:D:D;)

Hope Coco is better.

hugs,
addy

[infoviewer]

Hey Addy: No I have not started the Lysodren, his symptoms have been so mild so far that I have just been watching him for new symptoms before starting and I was afraid the diarrhea was a new symptom. He has had so much gas with his Eukaunuba for the past 8months that I decided to try to change his food, tried once before and the same thing happened. I think he just has a sensitive stomach and I tried to do it too fast along with giving him treats of carrots and yogurt. He has always had carrots, apples and sweet potatoes as treats, but think I overdid it. I just gave him the rice mixture you suggested and he ate most of it, but knew it was not his regular food. Hoping this helps, if not off to the vet we go. Thanks again, JoAnne

[infoviewer]

Hey Addy: I took CoCo to the vet on Saturday since his diarrhea was getting so bad. His regular vet was not there, but another vet he had seen before was there. She did an x-ray to make sure he was not obstructed. So that was a real worry when she called me to the back to show me the x-ray that had something on it that looked like he had swallowed something, but I could not imagine what since we really watch him, but dachshunds like to dig so did not know for sure. She gave me an antidiarrheal and antibiotic, but I waited to give it to him, I fed him and made sure he did not start vomiting, which he did not so I figured he was not obstructed and started the medication. On Sunday he was better and on Monday his stool was normal. She had said that possibly what we saw on the x-ray was calcinosis cutis. I think it would be where he was shaved for the ultrasound. I have felt and find nothing, but guess it could be under the skin. His skin in that area is very dry and mottled and I thought the hair was growing back, but do not know now. If he does have the calcinosis, I am thinking about going ahead with the Lysodren, but everything else is so mild, I hate to compromise him. I am supposed to take him back to the vet for another x-ray to see if they can tell what it is. Possibly his losing hair on his head is a symptom of it also. I am so happy he was not obstructed, but another symptom to deal with. Seems like things are progressing so fast, but guess he could have had Cushings for some time and we just did not notice it. Thanks for all your help. JoAnne

[Squirt's Mom]

Hi Joanne,

I would certainly make sure there is nothing stuck in the intestines before I did anything with the Cushing's. The treatments can cause some digestive upset and it is critical to know if any upset is connected to the meds or something else. So, IMHO, this is important to investigate. ;)

Also, hair loss on the head is not typical for a cush pup. They lose hair on the tail, legs, flanks - the lower/back end, not the head, shoulders, neck, chest, etc. So if he is losing hair on his head, it might be worth having his thyroid checked out if it hasn't been recently.

Hugs,
Leslie and the gang

[infoviewer]

Thanks for the info. When I take CoCo back to the vet this week I will ask for a thyroid test and another x-ray to see if they can tell what they saw on the first. Thanks again, JoAnne

[infoviewer]

Hey all: I took CoCo back for a repeat x-ray, and whatever she saw on the first x-ray had not changed and said she thought it was the calcinosis and it was on the skin of the intestine, who knows. He really has no other symptoms, does not drink much water and has always had a good appetite. His hair on the top of his head still continues to shed and I believe he will be bald soon, just like pattern baldness symmetrically. They are general practitioners, but she says she has had a lot of cushing dogs and does not sleep at all for a week until the dog gets loaded on Lysodren. I have not started him on medicines yet since his symptoms are so mild. Has anyone every heard of the calcinosis being inside. Thanks, JoAnne

[addy]

I did just read an article about the plague from calcinosis cutis building up inside in places like the arteries. It did not mention the intestines, but that is an interesting theory.

I just started researching cutis. I am trying to remember the article source. If I come across it again I'll send you the link.

hugs,
addy

[addy]

Hi Joane,

Just checking on you and Coco. I have a Koko:D:D

I still have not found that article but I have not forgotten:):)

Hope you and Coco survied the rains.

hugs,
addy

[infoviewer]

Hey Addy: Thanks for looking for articles on the calcinosis inside. I have not been able to find any either, so will wait a month or two and have CoCo x-rayed again. I started giving him 1.5 mg of Melatonin 4 days ago to see if the shaved hair on his sides from the ultrasound would do better and also the hair loss on his head. I have read that dachshunds have pattern baldness and that is what it looks like. That is the only symptom he has so far and the bad habit of begging for food which he has always done. Here is hoping your puppies are doing well this week. Hugs back to you. JoAnne

[addy]

Stopping by to say hi. :D:D

Also wanted to add the HMR lignans usually do not have that "fiber effect" so that would be a good choice if you decide to add that to the melatonin.

It might be a few months before you see any hair growth. The hair follicles have to go through a cycle. We know melatonin can grow hair, just how much and when may be in question depending on the pup:):) I remember Leslie saying it also made Squirt's nails grow like crazy!!!!! I think Zoe's cortisol was too high for me to see much of an improvement with her coat when she was on melatonin and lignans.:confused:

How's the weather been? It has turned back to winter here in WI. It feels sooooo cold!!!!! I had to haul out the coats again for Koko and Zoe.

I hope your Coco is good!!!:):):)

Have a wonderful rest of the week.

hugs,
addy

[infoviewer]

Hey Addy: Thanks so much for all your info. CoCo is actually doing fine, except for the hair loss, does not drink too much water and he is a chow hound, so he always remembers when he is supposed to eat and his treats. I actually am just giving him 1/2 of a 3 mg Melatonin at night, do not know if that is the right amount. He weighs 13 pounds. I have looked on line for the lignans, but the ones I see for dogs are derived from Spruce trees, so I did not think those were the right ones, so I am still looking for the right ones. The weather has been great in Nashville, but we had a chance of frost last night, got down to 39 so I think I covered flowers for no reason. Going to be cool again tonight, but then back to the 80s. We had no winter this year, so I think we will have a lot of bugs. Hope your Zoe is better today. Stay warm. Hugs to all. JoAnne

[Squirt's Mom]

Hi JoAnn,

There are two forms of lignans that can be used to treat our Atypical babies. Those are the flax lignans and spruce lignans. The flax lignans provide SDG, the spruce lignans provide HRM and both will work. With the flax lignans, we usually have to give more than one pill/capsule to get the recommended dose while with the spruce lignans less are given to meet the same recommendation.

Using just one or the other in doses less that recommended, won't address the intermediate hormones so the combination of lignans and melatonin is used. For a pup Coco's size, you would probably use 40mg of lignans and 6mg of melatonin per day - giving the melatonin twice a day in 3mg dose AM and PM. Here is a link about this treatment from UTK (University of Tennessee in Knoxville).

Treatment Option Sheet
http://www.vet.utk.edu/diagnostic/endocrinology/pdf/TreatmentInfoAtypicalCushings201107.pdf


Hugs,
Leslie and the gang

[infoviewer]

Hey Leslie: Thanks so much. It was confusing to me about the Melatonin and lignans, I will check out the site you sent and maybe learn the correct amount to give my CoCo. He has such a mild case, just hair loss really and I am wondering if it is possibly thyroid related rather than the Cushings. I have to take him back soon for a checkup and will ask for a thyroid test then. I don't think the vet did one, he did one for diabetes which was normal.

I was reading the threads this morning and saw your doggie Squirt had her 14th birthday, Happy Birthday to her. Gives all Cushing parents hope when we see how long our dogs can live. My daughter had a mixed breed dog that lived to be 18 which seems amazing and wonderful. Have a good day. Thanks again, JoAnne

[LillyMae]

Hey All: My sweet CoCo now has diarrhea. I think it is because I tried to change his dog food from Eukunuba to Blue Buffalo and went too fast with it. I had also given him carrots as his treats and maybe too much fat free and sugar free yogurt. I have been giving him Pepto-Bismol and no food, he is drinking water and still wants to eat. This is the second day for it. Hate for him to be so miserable. I am wondering if the Cushings is also part of this and if there is something else I should do before calling the vet. I do have boiled chicken and rice for him when he quits the diarrhea. Thanks for your help. JoAnne

Wanted to advise on the sugar free yogurt, the sweetner in sugar free yogurt can be toxic to dogs depending on what is used . Zylotol (SP)? is highly Toxic to dogs. The sugar free yogurt could be causing the diarrhea.
Deb & Mae

[Squirt's Mom]

Oh, good catch, Deb! :cool::) That could certainly cause some problems so I would opt for a low-fat yogurt instead. Not fat-free but low-fat.

Xylitol is also a toxic sweetener that is now being put into quite a few liquid meds our dogs take. Most of these are also human meds and the sweetener has been added to make the taste more palatable for humans...but they didn't tell vets about the change and they continued to prescribe meds to pets that were toxic. I think most are aware of this now and choose meds designed for pets that do not contain Xylitol or other artificial sweeteners.

Hugs,
Leslie and the gang

[infoviewer]

Hey All: I actually knew the artificial sugars were toxic for dogs, I was giving him plain yogurt with nothing in it except milk and the active bacterias, of course sometimes milk is the cause of diarrhea in dogs. I had actually tried to change his dog food along with too many fibrous veggies and fruit and pumpkin I believe, just did not go slow enough. He has a pretty sensitive stomach. Thanks so much for caring. He is fine now, just seems to be losing a lot of hair and that is the only Cushing symptom he has except I noticed yesterday that he was really slow trying to run a squirrel. Thanks again, JoAnne

[Squirt's Mom]

:o:o I'm a major worry-wart... :o:o

[addy]

Hi JoAnn,

I came over to your thread to talk about your worries posted on my thread.

Melatonin can make some dogs feel tired. It can take a good 3-4 months before you may see any benefit from it as far as new hair growth, especially because the hair follicles have a cycle they need to go through. One thing I find curious is Coco having hair loss on the top of his head. I thought Cushing's usually spared the head. Maybe others can chime in about that.

The hoarse barking is something I see and I think Sonja saw in her Apollo. For Zoe, it comes and goes.

Perhaps with the melatonin and then company, little Coco just got tuckered out from all the todo? I know Zoe tires out a bit faster now when company comes. We had the kids over for dinner a few weeks ago and she ran back and forth from the kitchen to the dining room so much that after 2 hours, she had to go to bed!!!!!:rolleyes:;)

The thing is, if you start treatment without strong symptoms, it may be hard to gage the response which is why most vets will tell you to wait.

Hang in there JoAnn,hugs to you and Coco.

love,
addy

[infoviewer]

Thanks so much Addy for your quick reply. My family had not seen CoCo in a few months and were surprised that he looked so old. Seems like he just looks bad when 6 months ago he still looked like a puppy. I have been on the fence about the Lysodren, and am going to take him back to the vet for another lab panel as soon as my husband gets over his spell. I am wondering if it his thyroid that is causing him to age so quickly, since I have read that thyroid disease will cause them to lose their hair on their head and ears and I have read that dachshund also have the pattern baldness on their head. Cushing is such a heart breaking disease and I read on this panel that others have so many more problems than CoCo and I am thankful for every day that he lives. Have a good day with your dogs. It is beautiful in Nashville today. Thanks again. Hug your doggies for me, mine is at my feet looking for more food. JoAnne

[addy]

Hi JoAnn,


Dosage
The initial recommended dose is 0.1 mg/10 lb (4.5 kg) body weight twice daily. Dosage is then adjusted by monitoring the thyroid blood levels of the dog every four weeks until an adequate maintenance dose is established. The usual maintenance dose is 0.1 mg/10 lb. (4.5 kg) once daily.


I'm glad Coco was able to see the vet. I found the above info on Soloxine and also that it should be given on an empty stomach.
I hope Coco starts feeling better. That could explain the hair loss on his head.

Did the vet do a full thyroid panel? Just wondered. Thanks for checking in with us and give Coco abig belly rub from me.

hugs,
addy

[infoviewer]

Hey all: Thanks so much for the info. I gave CoCo his first Soloxine this morning. Hope his hair on his head starts to grow back and he starts feeling better. Take care of all those sweet puppies. Hugs JoAnne

[Squirt's Mom]

Hi JoAnne,

I think, and hope, you will see a major improvement in Coco in several areas with the thyroid treatment. :) Keep in touch and let us know how it goes, ok?

Hugs,
Leslie and the gang

[infoviewer]

Hey all: After I gave CoCo the 2nd Soloxine yesterday, he had two very soft stools, so this morning I gave him a 1/2 tablet of the .1 mg. I don't know if was the Soloxine or something else. Seems like everything gives him diarrhea, so just going slow with this and see if I can build up to one q12h. Thanks so much for your concern and help. Hope everyone had a restful night and puppies are doing well this morning. Thanks again, JoAnne

[infoviewer]

Hey all: This is the third week on Soloxine for CoCo, no hair regrowth, but he does seem to feel better. We went to Tunica on last Thursday and back on Monday because of storm warnings. We did not want to be caught on the road in a motor home. Yes, we have a motor home so we do not have to leave our dog in a kennel, which he has never stayed in. When he was very small, my son-in-law stayed with him. I was just wondering if you could give the Soloxine with Lysodren. His only symptoms seem to be losing hair on his head, which supposedly is not Cushings, great appetite and no hair regrowth where he was shaved for the ultrasound and seems to have soft stools by the end of the day. He ran like a pup at Tunica, but is not as energetic at home and his back legs do seem weak. His vet said it might be time to start the Lysodren, but has not done the cortisol in awhile. He did a wellness test along with the thyroid and the only abnormality was the thyroid and liver enzymes. He had already done all the other tests that suggested Cushings. Just wondering what to do about the Lysodren. He weighs 13.5 pounds and will be 11 in September. Thanks, JoAnne

[addy]

Hi Joanne,

I think it is great to have a motor home so everyone can go along. Our neighbors have one and I just said that last week to hubby:D:D

As for the Soloxine, it is my understanding the thyroid levels have to be rechecked periodically. Did the vet expect hair growth in 3 weeks? I do know the hair follicles go through cycles. My first thought is to give it more time before going to lysodren. Sometimes pups will have low thyroid because of their Cushings which, once controlled, the thyroid levels do improve.

Zoe's thryoid was borderline and a holistic vet treated it with Armor. That was before we knew she had Cushings. I had to bring her in for rechecks after starting the drug and then every 3 months.

Hopefully others experienced with Soloxine will come along to comment.

Give Coco a big belly rub from me and the kids!!!!!

[infoviewer]

Hey Addy: Yes we love the motor home. This is the third one we have had. Got it for our 50th wedding anniversary in 2010. CoCo goes everywhere with us. I have to take CoCo to the vet next week to check on the Soloxine. I really did not think he would have hair regrowth in that length of time and the vet did not say he would, I was just hoping I could see some difference. He does seem to feel better. His main problem is food, but dachshund are always hungry and I think maybe a lot is habit. I am just dreading starting the Lysodren, afraid it will make him worse, but will probably make him feel better. Hope Zoe and KoKo are doing okay. Thanks again for all your help and info. Love, JoAnne

[addy]

Hi JoAnne, I was thinking maybe you should clear up the worms before starting the Lysodren. I also was wondering how Coco is feeling? Did the thyroid meds help at all? I know you are going for a test so make sure you let us know what the results are.

It is always something with our pups, you are so right. I had a friend who's favorits saying was "You know dogs, always something!!!":D:rolleyes: Boy is she right!!!!

I know the worms are scary but I am sure it will be just fine after Coco gets his meds. Zoe does not get a rabies shot either and I stopped her Heartguard as it caused her loose stool. I did read though, you can get one of the heartworms meds, compounded to the exact dose of your pup. I ws thinking about that for Zoe, rather than giving the one size fits all dose of Heartguard. Maybe something you could consider for Coco.

[labblab]

JoAnne, for how long a time has Coco been without heartworm protection? Did your vet advise you to stop the Heartgard? I am not aware of any general reason why a Cushpup should not be given heartworm medication, and therefore I am wondering whether your vet had a specific reason for you to hold Coco's. If not, your vet may think it important to perform a blood test to see whether Coco is now heartworm "positive.". Other types of worms can usually be dealt with fairly easily. But heartworm can be lethal, and the treatment is much more involved. So If your vet is unaware that Coco has been unprotected, I'd definitely let him know if I were you.

Marianne

[infoviewer]

Hey All: Since the rabies shot and Heartgard are poisons and since his system is already compromised, we just decided not to give the poisons and the vet checks him for heartworms every 3 months and did a fecal flotation in may, but it evidently does not show the eggs, and of course I have read everything I could find on the internet since I saw them yesterday since I was completed horrified and still am. I know it is a common thing, but not in my dog, haha. Like my husband says, he is a dog and eats anything he can find (true). We have to take him to the vet today for a thyroid check, and they are open on Sunday, so I called them and they just said bring in a stool sample today. I suppose I will start him back on the Heartgard if that is what the vet thinks. Oh well, always something. Guess we will wait to start the Lysodren until this is cleared up. He is feeling some better since starting the Soloxine, but he looks bad because of his sparse hair on the head and not much regrowth where he was shaved for the ultrasound. His only symptom seems to be the slow hair regrowth, greedy eating and weakness in his back legs. Thanks so much for this forum and all the good info and caring people here. Thanks again, JoAnne

[Squirt's Mom]

Hi Joanne,
Before you go back to the Heartgard, here are some links concerning the effectiveness of that and other products. I had used Heartgard for years and years but have switched mine to Advantage Multi. Just more info to keep you busy learning! :D

http://www.k9cushings.com/forum/showthread.php?t=3579&highlight=heartgard

Hugs,
Leslie and the gang

[infoviewer]

Thanks so much Leslie for the info oh HeartGard, my vet uses something called Trifexis I think is the spelling. I quit giving it to CoCo when he was diagnosed with Cushings. He probably has tapeworms and I don't think HeartGard prevents them, but may prevent fleas, which he has never had, but we have a lot of squirrels, so he either ate squirrel poop or the fleas off the ground. I am really concerned about giving him the poison to kill the worms and concerned about giving him heartworm medicine again, but feel like I must and also will start the Lysodren when all this is cleared up. Another scary thing. Again, thanks so much and hope your puppies are okay this morning. I love this forum. Hugs, JoAnne

[infoviewer]

Hey all: CoCo had a good report on his thyroid. It was 2.8 from 0.8 so it is normal and I am to continue on the Soloxine. Doctor gave me Drontal Plus and the worms were gone in one day. I don't think this kills the larvae, so may have to deworm him again. The vet suggested that I start the Trilostan since his symptoms are still so mild, mostly hair loss on head which is probably not Cushings and where he was shaved 6 months ago, not much regrowth and he seems to be turning gray on his back, he is a black dachshund. He is a greedy eater, not a big water drinker. He seems to really feel bad, no barking and when he does it is hoarse and he is just not the same little dog he was a year ago. I am thinking of starting the Lysodren, but am still just undecided. Trying to do no harm. Hope all doggies are doing well this morning. JoAnne

[addy]

Hi JoAnne,

Well that sounds like good news for Coco's thyroid and his worms!!!:)

I know how you feel about the hair loss, Zoe's gets worse every day and she is on Trilostane. Of course I know it gets worse before it gets better and takes time but I think when they look so bad we feel their other symptoms are magnified, at least that is my hubby's theory;););););)

It took me a year to decide between the two drugs so take your time.

[infoviewer]

Addy, you are so right, CoCo looks so pitiful with his bald head and his gray hair on his back and where he was shaved for ultrasound, very little growth. He is just not the spunky dog he was a year ago, does not notice much. Nothing could get in his territory without hysterical barking and running them out of the yard until the fences stopped him. He will be 11 in 9/12, but he just seems to be so old now and sad. Hope Zoe and KoKo are okay this morning. Love JoAnne

[infoviewer]

Hey all: I am so undecided about starting CoCo on medicine. The vet said perhaps we could start him on Trilostane since his symptoms are so mild. He mostly has hair problems and no problem with water and he is very greedy which is a doxie thing, but I control his food and measure his water, so really not a problem for me. He is not the spunky dog he was a year ago and does seem to feel bad most of the time. He has a hard time climbing steps, but he has a ramp since we had a doxie with a broken back before him. I want to do what is best for him and am wondering if it is best to start the medicines early when they do not have many symptoms or wait until and if they get worse and which medicine would be best for a dog with mostly hair problems and weakness. I have read this forum until I feel like I know the people and puppy problems, but just cannot decide the best approach to take with my CoCo. Thanks a bunch for any input. JoAnne

[Harley PoMMom]

I truly believe that one should not treat a dog for Cushing's unless there are strong and obvious symptoms. A renown Cushing's expert, Dr. Feldman, shares this opinion as well...here's a quote from him:
The key in deciding which dogs to treat is to only treat dogs with obvious and bothersome clinical signs.
http://veterinarynews.dvm360.com/dvm/Endocrinology/Cushings-disease-and-other-adrenal-gland-disorders/ArticleStandard/Article/detail/672663

It is heart-breaking when your furbaby is not feeling or acting like they used to, I completely understand but the drugs that are prescribed to treat Cushing's are very strong and should only be used when the clinical signs are obvious.

Sending huge hugs and love to you both, Lori

[infoviewer]

Hey Lori: Thanks so much for the article by Dr. Feldman. My vet seems to feel the same way, but has noticed that CoCo is not the same dog as a year ago. He will be 11 in September, so I guess dogs get old just like people. He looks bad because of his hair loss on is head and gray hair on his back, which I suppose neither could be the result of Cushings. He does seem to feel better since the thyroid medicine. I appreciate this forum so much, I had never hear of Cushings in dogs. I have worked for doctors for 30 or more years and know it is a people disease, but I suppose our puppies can have most anything a human does. I am reading everything I can about the disease and medication before I make the decision to treat. Thanks again, JoAnne

[infoviewer]

Hi everyone: Could someone tell me the correct amount to give my 13.5 pound doxie of Lysodren or Trilostane and where do you purchase either. My vet has the Trilostane and my druggist has the Lysodren for $180.00 for 30 pills. I am trying to decide which to start CoCo on. My vet suggests Trilostane since CoCo has such a mild case so far, hair loss and weakness. Thanks, JoAnne

[addy]

Hi Joanne,

Stopping by and saw we never got back to you about your question. Did the vet ever give you doses? For Trilostane, we usually start low and go up, start low, go slow. 1mg per pound is sometimes a good starting place. Vets dont always like to start at that low dose.

Cant answer about the Lysodren.

Did you decide to start treatment? Wondered what is going on with little Coco. I hope you are all okay.

hugs and love,

[infoviewer]

Hey Addy: CoCo is doing about the same, we had another ACTH done last week and his pre was 9.5 and post cortisol was 43.7 which is really high, so I talked to the vet about starting Trilostane and we decided on 10 mg a day to begin with which will probably have to be increased, but the vet said we could go to 10 mg twice a day if the 10 mg did not lower the Cortisol. He is ordering the Trilostane and will let me know when he gets it. I am still concerned about starting it since most of symptoms are still mild, still has the bald head, weakness in back legs and seems to feel bad and great appetite. We have tried to see if there was some other disease causing this, but have not come up with anything. His hypothyroid is stable now that he is on medicine and he seems to feel better after medication for this, He is back more alert and barking at people again. I see that Zoe's eye ulcers are some better. Hope KoKo is doing okay and you and your husband have your hours worked out so you can take care of your doggies. I work at home so my puppie is usually asleep behind me or gets up and follows me when I leave the computer. Thanks so much for your concern. JoAnne

[infoviewer]

Hey Addy: Well the vet just called and said the Trilostane was at his office for me to pick up along with the Prednisone. I won't start CoCo until Monday since my husband is home on Monday. It is only 10 mg and the vet does not think we will have any problem with a dose that low, but you never know, I am real apprehensive about it, but am hoping it will give him a better quality of life. He usually just sleeps most of the day until he knows it is time to eat, so maybe he will be more interested in playing with his toys. Hugs to all. JoAnne

[addy]

You will both be just fine.

If you get scared, just come here and post as many times as you have to.

We'll be here for you.

[molly muffin]

Hi Joanne, Definitely let us know how it goes. I'm hoping that the 10mg will be just the right dose to start at. It should be from all I have read.
Hugs
Sharlene

[infoviewer]

Thanks so much guys. Just picked up the Trilostane, but am going to wait until Monday to start so my vet will be in the office when I take CoCo back for the ACTH in 10-14 days is what the brochure says. The Medical Clinic is a 4 vet clinic and they are scheduled at different times. Hope all puppies are okay tonight. Really hot in Nashville today, heat index of 107 I believe. Hugs to all. JoAnne

[infoviewer]

Hey all: I bought beef pill pockets to put the Trilostane capsules in and thought I would try the pocket before starting the medicine since he has such a sensitive stomach. Of course he has diarrhea. I gave Pepto-Bismol which usually works pretty good. Any suggestions on giving the Trilostane capsules since I have read it causes diarrhea also. He has such a sensitive stomach that I cannot even give him a little more dog food. Thanks, JoAnne

[addy]

You cant just put it in his breakfast? Zoe eats soft food so I just throw two capsuls in her food and true Cush pup and Hoover vacum cleaner Lhasa that she is, she scrafs it all down:):)


Would cheese bother Coco?

[infoviewer]

Thanks Addy, I guess I will just try putting it in with his food, although he spits out his thyroid medicine if I do that and they are tiny and I have to just put it in his mouth and close his mouth. I think I can just put the capsule in a soft treat that he likes, but I am worried that the Trilostane will also give him diarrhea since that is one of the side effects. I won't start it until Monday, I was just trying the pill pockets to see if he could eat them without having diarrhea. Oh well I will just wait until Monday and see how it goes and if the Trilostane gives him diarrhea, will do something else. I appreciate the information you give me. How many mg does Zoe take of Trilostane and how much does she weigh. I hope Zoe and KoKo are doing well today. Love JoAnne

[molly muffin]

My dog will eat the pill pockets and spit out the pill. ROFL! She spits All medicine out, even if it's in her food. She's a brat.
Hopefully Coco will be okay on the Trilostane with no upset tummy.

Sharlene

[infoviewer]

Hey Sharlene, that is funny and I need a laugh, as you know Cushing dogs are a real worry. Thanks for the laugh, JoAnne

[addy]

Well, Zoe's colitis flared when she first started her Trilostane but she takes metronidazole very day to control her colitis/IBD, but we have been cutting back the dose.

Zoe is 18 pounds and started on 10 mgs once a day of Vetoryl (name brand Trilo). Her cortisol dropped like a ton of bricks those first 10 tens but she would pogo back up. She is currently on 40 mgs once a day. We started treatment one year ago June.

I know how worried you are, sweetie about starting this. I was a nervous wreck and took vacation days so I would be home when hubby left for work.

It will get easier. Starting is hard.

What about some soft bolied or roasted no fat chicken breasts, boneless, skinless? Would that bother him? Is he allergic to chicken? You woul d just need a small piece and you can frreze them and take them out as you need it.

[molly muffin]

Agreed we all need some laughter when going through this. Luckily Molly supplies an abundance, so just let me know if you need more. :)

Sharlene

[infoviewer]

Hey Addy: I am just thinking i will give it in with his food and see if he will just grab it and swallow it, I am concerned more about him having diarrhea and not being able to take the Trilostane. I don't know if Lysodren causes diarrhea also. CoCo cannot seem to eat anything except his dog food lately without upsetting his stomach. I am sorry Zoe has so much trouble with the colitis. Hard to get a control on that. I usually just give CoCo one dose of Pepto and no food for awhile and he is okay. Hope you get the colitis controlled quickly on Zoe. Thanks for your concern.

I think we need something to laugh about every day Sharlene, just keep them coming.

Hugs, JoAnne

[infoviewer]

Hey all: Just gave CoCo his first Trilostane. Took it with cheese wrapped around it along with his dog food. No problems, he just thought it was a treat since he never gets cheese. Hope all puppies are well this morning. Hugs, JoAnne

[addy]

We are here with you Jo Anne. He will be just fine. Just remember, when in doubt, withhold the pill.

[infoviewer]

Thanks Addy. He is doing fine so far. The vet did not expect him to have any problems with 10 mg, but you can never predict those things. Glad Zoe's eyes are doing better. She seems to be the alpha dog, jumping on KoKo's butt, that is so funny. Hugs, JoAnne

[molly muffin]

Yep, we're all here with you! Wow, cheese huh. Molly loved the cheese, *sigh* spit the pill out (this was for a previous antibiotic)
Her latest adventure is the 3 month old Newfoundland pup up the street, who thinks Molly is the be all end all of the block. Molly just seems to think "annoying furball" it's been a hoot to watch the two of them interacting.

HUGS

Sharlene and the molly muffin

[infoviewer]

Hey Sharlene: Your Molly seems like a fun dog and does her own thing. CoCo is the boss here especially since he has been sick. He has always been a barker and protector of his yard, but for about 3 months he quit barking and just did not notice anything, not even cats. Since he has been on the thyroid medicine he has started his rambuctious ways again and we let him bark. The thyroid medicine helped him tremendously, I hope the Trilostane helps his hair loss, and his urinating buckets sometimes. I hope Molly is still doing okay. Hugs, JoAnne

[molly muffin]

Oh JoAnne, I can just see it now. I'm so glad that CoCo is back to being the boss. It just doesn't feel right when they aren't doing what you Know is natural for them, for their personalities I should say. LOL I'm sure your heart does a little dance every time he makes sure that Everyone knows exactly whose yard is whose. :)
yes, molly is doing okay. She'll have to start the Trilostane at some point, but we haven't decided when that will be yet. Alot depends on the next test. I bet all our pooches are very tired of drated Tests!
You have got to get a picture of CoCo up at some point. :) Dying to see the cutie. (my neighbor had a Dachshund, just cutest little guy. He'd been abandoned in an airport of all things!!)

Hugs,
Sharlene and molly muffin!

[infoviewer]

Hey Sharlene: I know we hate for our furbabies to have all those tests, but guess it can save their life or at least give them a better quality of life if we find out they have the Cushing's soon enough. I know some vets are not as familiar as others with Cushing's so I am so thankful for this forum since I had never heard of Cushing's in animals, only in humans since I have worked in medical for maybe 40 years and still have a medical transcription company. Even after the dogs start medication, they have lots of tests. Oh well, we do what we can to help our animals. CoCo is our only one and I guess that is why he so spoiled, but aren't they all. It would be great if Molly's tests revealed she did not have Cushing's. I am sending good thoughts to you. Hugs, JoAnne

[addy]

Hi JoAnne,

How's Coco doing? I hope you are having smooth sailing right through to his ACTH test.

Thinking of you

[infoviewer]

Hey Addy: Thanks for asking about CoCo. He seems to be more alert. He was not a big water drinker. He still begs for food if we are eating and comes and tells me when it is his time to eat, but seems like he is not quite as bad about it. I don't take him back for his ACTH until 8/12 and since he is only on 10 mg I expect the vet to want to increase it to twice a day. He is wanting to go farther on his walks and is barking a lot more and I am glad to hear him bark. Maybe the hair on his head will start growing back, seems like it looks some better already, which is mostly cosmetic and I am sure he does not even notice it. I am glad to hear that Zoe's eye is better. Have a good weekend with your puppies. Here is hoping your husband gets home safe. Hugs, JoAnne

[molly muffin]

Good for CoCo! Great news that he seems more interested in his environment and taking charge of things via his barks once again.

Sharlene

[infoviewer]

Hey Sharlene: Hope you and Molly Muffin are okay this morn. CoCo seems ok this morn. Had some diarrhea a few days ago, but I gave him Pepto and I just read what it has in it, Saccharin sodium which would probably be toxc for dogs, but guess it does not have much since I have given it to CoCo several times, but freaked out when I read the ingredients and Sucralose may be a sugar substitute also, I really don't know. I am sure my vet would say don't give it, but don't know that the Flagyl would be so good for him either. Oh well, always something. Love JoAnne

[Squirt's Mom]

Hi JoAnne,

Slippery Elm Bark has worked very well for Trinket with her colitis...and for me with IBS. Worth looking into...

Hugs,
Leslie and the gang

[infoviewer]

Thanks so much Leslie, I had been reading about the Slippery Elm Bark after I had seen you talking about it on the forum and was going to order it, but CoCo is so sensitive was concerned about giving it to him, but I did not think about it for myself since I do have IBS also. I am going to check into ordering it. I had been giving him the Melatonin and his hair does seem to be looking better. He has only been on the Trilostane 10 days and I can already see a difference in him. The Soloxine really helped him. I ordered some Flax Hull Lignans, but could not figure how much to give CoCo. Label states 1/2 tsp 5 grams, full spectrum lignans 4950mg, SDG lignans 223mg per serving. It was Greek to me so I was afraid to give it to him. I think it is the one from the Spruce trees and does not have fiber. It is a fine powder. Any info would be appreciated. Hope all your puppies are well this morn. Love, JoAnne

[infoviewer]

Hey Leslie, I am wrong, the HMR are from the Spruce tree and no fiber. I hope that is right. Love

[molly muffin]

Hi JoAnne,
Top of the morning to you and Coco. We're doing a-okay here. Thanks for checking in. I need to start looking into liver supplements for Molly I think. Her LDDS test came back as normal, which is weird since her ACTH test came back as cushings. Tricky disease. You know, if I want tricks, I can wait for Halloween, no need to go introducing it into our daily lives too. Sheezzz
Glad that CoCo is doing well on the trilo and the melatonin. Good news is always a Yippeee moment.

hugs,
Sharlene and the molly muffin

[Squirt's Mom]

Hi JoAnne,

My understanding is that HMR lignans contain very little if any actual fiber. The main difference is that the body breaks down the HMR in one step VS two steps with the SDG lignans (flax hull lignans) which makes them more readily and completely absorbed, and causes less digestive upset.

Hugs,
Leslie and the gang

[Squirt's Mom]

I used the capsule form of flax (SGD) and it was standardized to 20%, which meant that to get the amount of SDG she needed each day (40mg) she had to take 3 capsules. If the powder isn't standardized and each 1/2 tsp has a full 223 mg of SDG, then you will be giving individual grains to Coco, not scoops! :p There is a flax hull product that is crushed hulls that some of us use and it is measured in that manner (by the scoop) but the container tells you how much SDG is in each scoop and it doesn't seem like it had as much as the powder you have.

Any time it says "flax" it will be the SDG, not the spruce HMR. The HMR lignans come from the spruce tree while the SDG lignans come from flax.

The melatonin will help with hair, nails and relaxing but it will not address the hormones involved in Atypical Cushing's without the combination of the lignans. The combination is what works - individually they have different actions. Since Coco is on the Trilo, I wouldn't worry about the lignans right now. Make sure he is handling the Trilo well then we can look at adding other things. Don't want to rock the boat and get a confusing picture at the beginning of treatment. So don't worry about anything but that sweet boy and how he is doing on his new med right now.

You are doing a fine job, Mom!
Hugs,
Leslie and the gang

[apollo6]

DEar JOanne
Apollo has stomach issues also, reacuuring pancreatitis. I give him some slippery elm occasionally, I have ordered from Amazon, not sure of cost. I have used the powder as the receipe says:
Syrup-place a 1/2cup of cold water and 1 teaspoon powdered slippery elm bark. Whip with fork. Bring to simmer over low flame,stirring constantly. simmer 1 or 2 minutes or until slightly thickened. cool and refrigerate. keeps 7-8 days. Give a teaspoon of syrup for an 10lbs., 5 minutes before a meal to minimize diarreha, for digestive tract.
I give melatonin 3 mg, and health concerns Nulignan( from Norwegian spruce tree) 1 tablet of each daily for the elevated hormones. but always check with a vet before using. the Tennessee university veternairen web sites has some great articles on Cushing, endorolgy (forgot the spelling)
Apollo weighs 9.4 to 10. 4 lbs and is on 10 mg Trilostane. But once again each Case is different. Always get copies of all Reports/Labs to compare. And you can always run any questions you have by us.
I hate to say this but don't assume the vet is always right. Trust your gut feeling.
Hugs Sonja and Apollo

[infoviewer]

Hey Guys: Thanks so much for the information. I was looking into the lignans since I had read it lowered some of the hormones and CoCo had mild hyperkalemia and I was thinking this was caused by one of the hormones and also think Trilostane might cause it to even go higher. My vet did not really say anything about it, I had asked for a copy of his medical history and saw it on one of his lab reports. Sometimes vets don't seem to catch everything. I have learned you have to watch everything medical for yourself and your pets. CoCo has his first ACTH Friday after starting the Trilostane and I asked for electrolytes also so I can see what his Potassium is. I have a feeling he will want to start him on a higher dose of Trilostane, but I have control of that so we will see. I so appreciate this forum. I have learned so much. Thanks again. Hugs and kisses to all cushpups tonight. JoAnne

[addy]

JoAnne, just remember the cortisol can continue to drop for the first 30 days.

You are doing AWESOME:):):):)

[infoviewer]

Thanks so much Addy. CoCo is so anxious when he goes to the vet that I suspect everything is higher. The staff calls him the biter, I am hoping that he really has not ever bitten anyone. Maybe his cortisol will be lower. All his numbers have been so high, but not many symptoms. I am glad you reminded me that his cortisol will still lower for 30 days. Hope Zoe does well at the vet today. I am sure she will be fine. I will be thinking of her. I hate leaving mine at the vet's office, but I am sure they take good care of them. Hugs to you and your puppies. JoAnne

[addy]

Hi JoAnne,

I am sure the ACTH test will go really well.

I'll hold your hand while we wait for the results:):)

Belly rubs to Coco

[apollo6]

will be praying for you. go on the Dechra site to read about dosage and ACH stim readings as to wether to keep, lower or increase dosage. I have not been over confident with some of the vets. LIke you said, they do not always see the big picture but often stick to text book info.
HUgs Sonja and Apollo

[infoviewer]

Hey all: Took CoCo for his ACTH test. Vet will call when it returns in 3 or 4 days. His electrolytes were normal. He had lost a pound and the vet was concerned because he looked so thin. He said to start feeding him more and gave me some Metronidazole since he has such a sensitive stomach. I meant to have another stool checked, but forgot. I can take one if I feel I need to. CoCo is fine today, he just gets really stressed and scared when he goes to the vet. He has lost his muscle and fat so his spine is showing, so makes him look really thin and he is a pretty small doxie. Hope all puppies had a good Friday night. Hugs, JoAnne

[molly muffin]

Hey JoAnne,
Good on the electrolytes. Hope the ACTH comes back good too. Maybe the Metronidazole will make CoCo want to eat more or tolerate food better.

We had a good night here. A clap of thunder around midnight sent molly under my desk, but that was it and she went to bed, same as always. (procedure: crawl in, clean feet, roll over onto back, belly up, look to see if anyone notices how cute she is and comes over to rub the belly, scoot around to get everything comfy, pass out)

Hugs,
Sharlene

[infoviewer]

Sharlene: That is so cute when they roll over for you to rub their belly, CoCo does that with all 4 feet just moving and saying "come on people, don't you see me". Since I started CoCo Melatonin, he is not as scared of storms unless it is really bad. Hope you find out the diagnosis on Molly, the not knowing is the hardest part, but she seems to be doing well. Have a good weekend. Hugs, JoAnne

[addy]

Good Morning JoAnne,

Waiting for ACTH tests can drive a person to distraction!!!!! If you cant stand it just come here and we will sympathetically gripe with you:D:D

Metronidazole really helped Zoe when she had repeated chronic colitis flare ups. I have weaned down the dose to a fairly small one now but every once a while (like yesterday) the stress from surgery threw her for a loop so I just increase it a bit and hopefully that is the end of it.
IMS thought if we controlled her cortisol, it would help her tummy and bowels.

I hope Coco is okay and you both have a good weekend. Thanks for checking in on us.

[apollo6]

thinking about you and Coco
Hugs Sonja and Apollo.

[infoviewer]

Just wondering what could cause CoCo's weight loss. I know that is one sign of Trilostane sensitivity, but he has none of the other symptoms, no vomiting or diarrhea, mostly real soft stools. He does sleep a lot, but he always has and has never really played much, always got bored quickly, had to have toys that did something like talk or cried so he could kill them. No chew toys unless they had food in them, so his sleeping is not unusual. He is mostly an arrogant dog that ignores other animals. Love JoAnne

[molly muffin]

Well I don't know what would be causing CoCo to lose weight, other than his tummy being on the sensitive side and not eating as much food. That can cause some weight loss I'd think.
Hopefully the stomach will settle down and that will take care of the weight loss issue.
Have a good Sunday.

Hugs,
Sharlene

[infoviewer]

Hey all: The vet just called with CoCo's ACTH report.
His ACTH before Trilostane was Pre 9.5 ug/dl, post 43.7 ug/dl.
After 12 days of Trilostane 10 mg, he weighs 13 pounds.
Pre 6.7 ug/dl, post 13.2 ug/dl. The vet wanted to start him on a higher dose, but I said no. He wanted to test him again in 15 days, but I said lets wait 30 days from now. What do you folks think? JoAnne

[addy]

Hi JoAnne,

How is Coco feeling? That was a big drop for the little guy, similar to Zoe's when she first started. Has he shown any improvement in anything?

Usually we recheck again 30 days after start of treatment, so 15 days from today would be right. We know cortisol can continue to drop those first 30 days. From what I have read, no dose adjustment unless numbers high above ideal. Not sure what they consider "high":o:o:o

I am sure the others will come along with their opinion. Each dog is so different in how they respond. Depends also which "flow chart" we go by:confused::confused:.

Start low, go slow is the usual mantra 13ug/dl still gives you a ways to go to get down where he needs to be.

I'll defer to the experts;););)

Ya did good though!!!!!:D:D:D:D:D:D:D:D

[molly muffin]

Yep, I'll wait on the experts advice too, but from what I've read 30 days for initial drop.

It's really good that his numbers are looking better though. So, very happy for you and CoCo!

Go ahead, you can happy dance around the house all you want. LOL

Hugs,
Sharlene and molly muffin

[infoviewer]

Hey Addy and Sharlene: I thought it was a pretty good report for 10 mg in 12 days. I was really short with my vet. One of my computers had just gone done and one of my doctors needed a complicated lawyer letter before he left in an hour, so I was really frustrated and just did not agree with the vet about anything, but I did call and apologize to him. CoCo does not have many symptoms, his water drinking went down about 1/2 and he was only drinking about 14 oz. His food begging has slowed and he seems some stronger in 12 days and is running again. His poops are really good. His hair loss is not better, but I did not suspect that in 12 days. The doctor suggested 10 mg in the morn and 10 mg at night. He gets so stressed when he has the test that I hate for him to have it. Thanks for the info. Love, JoAnne

[molly muffin]

whoo hoo, that is good to hear. CoCo seems to be responding really well. I've heard it takes longer for hair to start growing back, so no worry about that not happening yet.

Oh well, we can all have those moments with our vets. Luckily they are usually pretty understanding.

Wendy (my vet) knows I get freaky and can be argumentative about molly. I apologize and say, you know I get freaky if anything is wrong with molly and she always says, yes I know, it's molly. LOL
Computer problems ugh, that is one of the most irritating. I can get that way over my computer desk even. (sends hubby into full blown hiding mode) ROFL

Take care JoAnne and belly rub for CoCo!
Sharlene and Molly muffin

[infoviewer]

I have meaning to ask, but keep forgetting. Do Cushing and hypothyroid dogs have a terrible odor. CoCo is bathed often and smells terrible in a day even with dog cologne. He does have a flaky skin, no sores. Thanks, JoAnne

[Steph n' Ella]

When I first picked up Ella in January she smelled bad. Soon I figured out is was coming from her ears...no infection just lots of oily wax. She is now on soloxine so her skin is less oily and I clean her ears regularly. She smells much better!

[molly muffin]

Yep, I agree, check the ears. I had that problem with my golden too.

[infoviewer]

Thanks all, I checked his ears, clean as a whistle. The vet said it may be hormonal, Cushings and thyroid I guess.Taking him back for another ACTH and electrolyte in 15 days. Maybe it will be lower and I will not have to increase the Trilostane. At least it is working, 43.7 down to 13.2, just not low enough. Hope all cushpups and people are well this morn. Hugs, JoAnne

[infoviewer]

Hey all: I was wondering what a good liver supplement would be. I give CoCo a senior Multivitamin and Joint Health Plus and Salmon Oil. His liver values were ALKP 1946 ul and ALT 526. I don't want to over-vitaminize him (if that is a real word). Thanks, JoAnne

[molly muffin]

My vet is going with hepato support which is basically milk thistle. There is one that is prescribed via a vet called Denamarin.

Hugs, Sharlene

[infoviewer]

Thanks Sharlene: Have a good weekend with your Molly and family. Love JoAnne

[addy]

Stopping by to wish you a great weekend!!!!

I hope you and Coco get some quality snuggling in:):)

[molly muffin]

Have a good weekend JoAnne and Coco!

hugs,
Sharlene

[addy]

Hi JoAnne,

How is Coco? I bet we will both have stims next week almost on the same day:D

Zoe's is Thursday, August 30th.:):)

Have a great weeek and thank you for checking in on us.

Hugs,

[infoviewer]

Hey Addy: Coco's is Monday, the 27th. CoCo seems to be doing well, his hair seems to be growing back and he is much stronger, still remembers all his eating times and treats, especially if I forget. I really don't know what his ACTH is supposed to be and don't understand why he should take more Trilostane if he is not having that many symptoms. So glad Zoe's bandage came off and the surgery site is healing. CoCo likes to actually walk in the street so that is mostly where we walk. He is back to trotting like a walking horse, so he is getting some strength back I believe. I hope Zoe gets to walk down the driveway today. Take care, one more problem taken care of for you, the growth is gone and without too many problems. Maybe Zoe will not have any problems for awhile. Hugs to your family and furpups. JoAnne

[addy]

http://www.dechra-us.com/Files/dechraUSA/downloads/Case%20Studies/Clinicians%20Brief-trilostane.pdf


I found this explanation easy to read and understand. It is an update listed on Dechra's website. :) That does not mean Dechra has changed their recommendations.

Thank you for checking in on us. I hope you and Coco enjoy your day!!!!:):):):):)

[molly muffin]

Hope you and Coco are having a good day! Coco with a full coat again. Wouldn't that be nice! LOL

Hugs,
Sharlene

[infoviewer]

Thanks Sharlene, not yet, but his head does seem to be looking better. He is definitely getting his spunk back, just went for a walk and he trotted up the hill and back down the hill like a walking horse, which is what we call him. We do live in Nashville, Tennessee, the walking horse capital along with country music. Hope Molly Muffin is doing well and maybe only has a mild case of Cushings. We are headed to Tunica next weekend. We take the dog with us. Maybe we will win. Hope you and yours have a good weekend. CoCo has another ACTH Monday, so hopefully his cortisol will be down further. I watch the symptoms more so than the cortisol numbers. Hugs, JoAnne

[molly muffin]

I'll wish you "good luck" and have fun!
That's awesome that you can CoCo with you.

Have a good weekend, will keep fingers crossed for monday.

Hugs,
Sharlene

[addy]

Crossing paws for Coco's stim today!!!!!!!!

Hope you had a great weekend!!!

[infoviewer]

Thanks guys. It will be fine. He is a trooper, never complains, just sticks that tail up and says "the biter is here, everyone bow". That is a male doxie for you. All male. Good day to all. Hugs, JoAnne

[molly muffin]

A doxie with attitude?! ROFL! but of course.

Hope all went well and everyone survived intact.

hugs,
Sharlene

[infoviewer]

Hey Addy and Sharlene: CoCo did great at the vet office. Electrolytes were all normal. Will get the rest of the report in a day or two. Vet said he probably won't increase the Trilostane since CoCo seems to be doing ok, hair is growing back in slowly and everythng else seems better unless the numbers are lots higher. CoCo has so much trouble with loose stools and lots of mucus which the vet thinks is Trilostane related. He thought the Metronidazole would stop it, but it has not. I have started giving him some slippery elm, but has not helped. I am wondering if some furbabies take the Metronidazole all the time. He only took it a week and it did seem to help, but now back to the soft and mucus stools. Hope all puppies have a good week. Hugs, JoAnne

[Steph n' Ella]

Poor Coco! Mucus poo is the worst. Metronidazole and Slippery Elm worked for Ella. Vet thought the strong, long term antibiotics for her bladder infection killed too much of the good bacteria in her system. Has she had a stool sample tested for parasites?

[addy]

I used to have to wean Zoe off Metronidazole or her mucus stools would come right back. I could not do it for 5 days and then stop. Eventually, she had to take it everyday. I was able to cut her down to about 45mgs once a day. Cant seem to get lower than that with her.

Glad things are going well and Coco survived the vet visit:):) Pawsd are crossed for good numbers:):)

[molly muffin]

YAY! Hoping for good numbers!

We used the powder FortiFlora with Molly when she has her diarrhea. (quite often after being on an antibiotic too much good bacteria can be killed too)

Hugs,
Sharlene

[infoviewer]

Hey Guys: I have tried to wean CoCo off the Flagyl, but in a few days, soft again. The vet thinks it is the Trilostane and said maybe we should not start him on a higher dose. He had a fecal flotation about three weeks ago and all was clear. I meant to get one done yesterday, but forgot. CoCo was so rambuctious, barking at every cat and dog in the office. I am going to try slippery elm consistently and see if that will help. Since it looks like mucus I was afraid that was part of the problem. Oh well, always something to have to watch about these furbabies. Good day to all. Love JoAnne

[molly muffin]

Could be that CoCo's body just doesn't like the Trilostane, upset tummy and all. I don't think I'd raise dosage either if CoCo is still having soft mucus stools.

Have a good day!

Sharlene

[infoviewer]

Hey All: The vet just called with CoCo's ACTH, a little worse than before, but since he thinks it causes the diarrhea and he does not have many clinical symptoms other than hair loss on head and ears and he is not able to jump like he did, he thinks I should just keep him on 10 mg a day for now.

Before Trilostane:

Pre 9.5 ug/dl
Post 43.7 ug/dl

After 12 days on Trilostane:

Pre 6.7 ug/dl
Post 13.2 ug/dl

After 30 days on Trilostane:

Pre 8.6 ug/dl
Post 14.5 ug/dl Hugs, JoAnne

[molly muffin]

Well I'm not the numbers person here, so that being said, I probably wouldn't want to increase the dose either as long as there is diarrhea or mucus in the poops.

[addy]

Hi JoAnne,

Did Coco have stool issues before treating him with Trilostane? Does the vet think he will adjust to the Trilostane and the mucus and soft stools will stop? Coco is nowhere near controlled at those numbers. He would at least need to be down near 9ug/dl.

Sorry for all the questions. :o I have been in similiar circumstances with Zoe so I sure can relate.:):):);)

Hopefully Marianne or Glynda will have time to stop by. They are such a wealth of info about Trilostane and everything else.:):)

Hang in there

[labblab]

Hi JoAnne,

Addy has asked a great question -- whether or not CoCo had GI issues even before starting the trilostane? Also, have you changed anything else re: CoCo's food or medication since starting on the trilo?

Marianne

[infoviewer]

Hey Addy: No CoCo never had problems with diarrhea and mucus before the Trilostane. Dr. Gross said lets start him on 10 mg in the morning and 10 mg at night until he started with the diarrhea and then just said leave him at the 10 mg in the morning. CoCo does not have many symptoms except the hair loss and is so much better since starting the thyroid medication and Trilostane. The vet said normal is 8-17 for a dog that does not have cushings and on Trilostane should be 1.5-9.1 ug/dl which is optimal control, but I guess the vet is taking into consideration CoCo's clinical symptoms. This is all so new to me and confusing. Thanks for your help. Hugs JoAnne

[labblab]

Hi JoAnne,

In looking back through your thread a bit, you told us earlier that CoCo has a sensitive stomach and apparently that predates his trilostane? Can you tell us more about what that means?

Also, I just want to make sure that you haven't made any other changes to his diet or supplement regimen since starting the trilo? You were considering adding in the flax/lignans at one stage, I believe.

If there truly is nothing else that could account for CoCo's diarrhea, then I would probably hold off on a trilostane increase for the time being, too. Addy is definitely correct that his cortisol level is not yet in a range that is generally recognized as being desirable for long-term control in a Cushpup. But since he is still early in his treatment, if he was my dog, I'd probably give him another couple of weeks to try to straighten out the GI issues. Assuming he does stabilize, though, I'd probably want to try to increase his trilo dose at that time so as to get closer to the optimal treatment goal.

Marianne

[infoviewer]

Marianne, you are right I did report he has a sensitive stomach. I had tried to change his food about 6 months ago I believe and never could do it. Then he had a real bad case of diarrhea awhile back, but I felt like I had given him too many vegetables and pumpkin as treats, but it always firmed up. He had never had any trouble before the Cushings, so this just may be Cushings, but the vet thought it could be the Trilostane and most of his symptoms are hair loss and he is not able to jump like he used to do. His water drinking is half after starting Trilostane and he has always been a hungry dachshund. He weighs 12 pounds and is 11 years old and takes 10 mg and am wondering how much more he should take to get in an optimal range. Thanks so much for all the help you give people. Love, JoAnne

[molly muffin]

How is CoCo doing today? Any solid poops? (does that sound like a funny question?)
you know molly had a bad bout of diarrhea before her ALT's went up and cushings was brought up again. It might have to do with the higher cortisol levels.

hugs,
Sharlene

[infoviewer]

Hey Sharlene: Off to Tunica this morning. My sweet CoCo wanted something to eat before I start getting ready. This is a habit, he gets fed as soon as he gets up. He has had firm poops for a day or two, no mucus, strange. I have been giving him slippery elm, maybe it is healing to his intestines. I am still on the fence about increasing the Trilostane. My vet is really cautious about things. CoCo is raring to go this morning. He loves to ride in the RV. Hope we don't hit bad weather. If we do we will just turn around and head back to Nashville. Hope all have a good weekend and happy Labor Day. We will be back on Tuesday, Lord willing. Love JoAnne

[molly muffin]

Have a good trip! Fair weather and all that good stuff. :)

hugs,
Sharlene

[infoviewer]

Hey Sharlene: Hope you are back from your trip. I know you are having a blast. No bull fighting I hope. I don't like to see the violence on the humans or animals. I know it has been going on for many, many years and I suppose they have rules just like in other sports. Football is pretty violent, but those big boys seem to be able to take care of theirselves. Nashville has the Titans and it is a big football town and country music which everyone knows. Hope Molly Muffin will be okay when she gets back home. She has probably been spoiled at her home away from home. CoCo is doing okay, just the hair loss and cannot jump like before. Love, JoAnne

[Steph n' Ella]

Sounds like the poops are going good for Coco! Yay for slippery elm! :D :D :D

[infoviewer]

Thanks Steph, yes CoCo is doing better with the soft stools if I really keep a watch on what he eats and give him the Metronidazole 1/4 tablet in the morn and 1/4 at night most days. I am concerned about giving it to him so often, but I am more worried about the diarrhea and having to hold his food for a day and he is pretty thin anyway, so don't want him to get too thin. The vet told me to start feeding him more since he thought he was too thin and you know a cushpup loves that. Hugs, JoAnne

[addy]

Hi Joanne,

Zoe was on twice a day Metronidazole for a very long time before I could wean her down to once a day. It also has anti inflammatory properties so it can help a lot. I grilled our IMS repeatedly because I did not want Zoe on it but we had no choice and our IMS insisted she had dogs on it for years. I am hoping it will be okay for Coco, as it sure helped Zoe and she started on much higher doses for BID. Zoe was so sick and just kept losing weight and I thought I was losing her but she finally turned the corner with the metronidazole. It was a very scary time back then and I agonized a lot about the metronidazole.

I hope it keeps on working for Coco and he is able to put a few pounds on. I know how hard it is when they have such a sensitive tummy.;););)

Have a great night!!!!!

[molly muffin]

Hi Joanne,
We just got home. I'm not even close to being brain agile yet. Trying to stay awake so I can do some work for the office tonight, but it's tough, it's 1:30am Barcelona time. We've been flying all day as we had to come home via Geneva. I won't get Molly till tomorrow morning since our flights were too late getting in to pick her up tonight. I can't wait to see her though! I missed the muffin. :)

Glad that Coco seems to be doing well. Hopefully over the next few days I'll find time to get caught up on everyone and how things are going. Unfortunately a reorganization at work that happened while I was gone is going to take some of my attention for a bit. :(

hugs all
Sharlene

[infoviewer]

Sharlene: So you'll got back home safe. I know Molly Muffin will be glad to see you. I know you are glad to get back home and back to work, well maybe back home. It is always fun to go on vacation, but always good to get back home. Hugs, JoAnne

[molly muffin]

LOL, so true Joanne. Although today I feel like I am so off time wise. I was up at 3am, then 4am, finally just started working at 5am to try and get caught up. Had over 1400 email from work to go through. Ugh!
Molly got groomed while I was away and looks absolutely adorable. She is loving being in her own home (along with her mommy and daddy) and is causing trouble wherever she can find it!

hugs,
Sharlene and Molly muffin

[infoviewer]

That is great Sharlene. I know Molly Muffin is so happy to be back so she can rule the roost. We call CoCo Little Boss Man. He has got so bossy since we have been catering to him. I will be doing my transcribing with the headset on and he will come up behind me and bark really loud and I will nearly jump out of the chair. It will be time for him to eat or go outside and I have not noticed the time. Evidently he has learned to tell time. As you can see he keeps us hopping. I hope Molly Muffin is doing well. Maybe she won't have to start on the Trilostane or Lysodren. CoCo has done well except his hair looks bad. The thyroid medicine seemed to make more difference in him than the Trilostane. Hope you have a good night with your family and Molly. Good to see you on line. Love, JoAnne

[Steph n' Ella]

The synthetic hormones for thyroid problems are a miracle drug! Such a change for my Ella girl too! Good luck Coco!

[infoviewer]

Hey all: Hope all furbabies are okay this beautiful fall morning in Nashville, TN. My CoCo seems to be doing okay. No problems except with white flakes on his black hair like dandruff. I have tried Vit E on him and he takes Vit E, but nothing seems to help. I am happy that is about all he has, his hair seems to be growing back, but the white flakes do not look very good. Just wondering if anyone has any ideas to remedy this. The vet says he has flaky skin which is not much help since I can see that. Thanks, JoAnne

[Steph n' Ella]

Ella's had fits of bad dandruff since her hypothyroid diagnosis. It is really weird dandruff since the skin is flaking off but it is very waxy/oily at the same time. During these periods I just give her lots of baths...but she loves her baths so it is an easy remedy. Only problem seems to be ring around the tub :p

[infoviewer]

Hey Steph: That is funny, ring around the tub, but you are right, except CoCo hates baths. We just have to pick him up and head for the bathroom. He knows the word bath so we have to spell it. Hope he does not learn to spell. Bathing seems to just cause more flakes on the black hair, guess the flaky skin comes off. I susected it was the hypothyroid rather than Cushings, since your puppy has thyroid problems also. Thanks, JoAnne

[addy]

Hi JoAnne,

Our IMS suggested using a doggie moisturizing conditioner on Zoe after her shampoo to help her dry skin. I am not sure which one the groomer used, but she did have one. I cant say I noticed a difference but Zoe's hair/skin/coat are really not good so perhaps you will have better luck with Coco.:):):)

Hugs!

[infoviewer]

Hey Addy: CoCo's hair looks pretty bad, where he was shaved for the ultrasound has never really filled in and his head is partially bald. The hair on is back has flecks of what looks like dandruff. I guess he is lucky that is about all he has, except I have to watch what he eats to keep him from having diarrhea. I think the skin loss and dryness is caused by the thyroid disease, but I guess the diarrhea is caused by Cushings or the Trilostane. He is doing pretty good, otherwise. I keep watching his eyes since they do seem to have a lot of sleep in them sometimes. I hope Zoe is doing okay. I have been reading the posts and I have not seen that she has had any problems lately. Hope it stays that way. Love, JoAnne

[molly muffin]

Okay Joanne, too long without hearing from you :).

How is CoCo doing? How is the dry skin and hair doing?

hugs,
Sharlene

[infoviewer]

Hey Sharlene: CoCo seems to be doing well. Hair seems to be coming back in and dry skin is better. He is just as bossy as ever. He rules the roost as my husband says. He still has weakness in his back legs, but that seems to be better also. Still runs the squirrels. We went to Tunica last week and he loves walking in the RV park. I am so thankful he is doing so well. Hope Molly Muffin is still doing well and you and family also. Hugs, JoAnne

[molly muffin]

Hi Joanne, that is wonderful. That bossy, in charge attitude is so funny. Glad CoCo seems to be doing so well.
Molly seems to be doing fine for now. I have to take her Wed for a recheck of her ear. So cross fingers. She's been very playful so always love to see that.
Take care!
hugs,
Sharlene

[infoviewer]

I know what you mean, when the dog feels well, all is well with the world. Since CoCo is 11, he does not play that much any more and really never did. He only plays with toys that do something like cry like a dog or baby, then he tries to kill them. He is a typical doxie. Glad we don't have any badger holes in the yard, he would be down in it and we would never get him out. I can just see Molly running and sliding and you'll laughing, which is what I would be doing. Have a good day. Cold in Nashville this morning and CoCo woke me up with a yap at 3:30 as usual, ready for his morning outing. Yikes. Love, JoAnne

[molly muffin]

Well fiddle sticks. I thought molly's ear was cleared up so yesterday I skipped putting the meds in to see if it would stay pink. This morning she scratched at it, so I put meds in again. It doesn't look to be really clearing up. I'll keep the meds in going and see what the vet says on Wed. She has an appointment at 3pm Wed for a recheck.
*sigh*

It's chilly and was rainy here yesterday, but think today will be clear.

hugs,
Sharlene and Molly muffin

[infoviewer]

Poor Molly, maybe it is an allergy since she was scratching it, but could also be getting well. Lets hope that is the case. Always something with these furbabies. I feel lucky that CoCo seems to have a mild case of Cushings, which is a good thing since I don't always give him his medicine at the same time. Seems like I am always doing something for him with the Cushing med, thyroid med, vitamins, melatonin, watching to make sure he does not eat something that will give him diarrhea and then there is the going out and also the walks. Of course I do not mind it at all. Hugs to Molly and you and your family. Love, JoAnne

[apollo6]

Dear JOanne
don't worry about Coco being on such a low dosage, 10 mg. Apollo was on Trilostane for almost 3 years, and never got higher than 10mg. I took him off a few times due to some other issues. If Coco is doing okay,just leave it be. Apollo was also on thyroid medicine and melatonin. he lived to barely making it to his 14th birthday. Remember each patient has different needs. Cushing is such a complicated disease.
Hugs Sonja and Angel Apollo

[infoviewer]

Thanks Sonja, that is what I have been thinking, just treat the symptoms. He seems to be doing well. He also takes thyroid medication and Melatonin. The Melatonin has really calmed him down, has always been afraid of storms, but does well now. So sorry you lost Apollo. You took such good care of him. CoCo is my third doxie. They are such special dogs. This one is so independent and bossy. We just laugh at him. I so appreciate this forum. It has helped so many people with dogs. The people on it know more than the vets since they have experience with many Cushing dogs. Thanks so much for your input, I know you are still suffering from the loss of Apollo. Love JoAnne

[apollo6]

Dear Joanne
Thank you for your kind words. You are right about the forum. There is so much knowledge,resources, and experience here to support, guide you through this awful disease. Too many of us had bad experiences with vets and specialists and listened to our own gut and did better caring for our fur balls. Glynda is very knowledgeable.
Hugs Sonja and Angel Apollo

[infoviewer]

Sonja: I hope you are doing better. I know it never leaves you, but it does get bearable. I have lost two doxies, one was only seven years old and the grief was unbearable for a long time, but time heals. After a year I was given CoCo and I love him dearly, but you never forget the grief you felt when the others passed. Time is the only thing that allows the grief to be bearable and you wake up one day and that is not the first thing you think about. Love, JoAnne

[molly muffin]

Hey JoAnn, hope you and Coco are doing well! Staying out of trouble (sometimes anyway) :)

Hugs,
Sharlene and Molly muffin

[infoviewer]

Hey Sharlene: Trying to stay out of trouble, but sometimes I think trouble is this Cushing dog's name. I made the mistake of feeding him as soon as he got up so now it seems he gets up earlier and earlier. Luckily my husband usually gets up by 4 am so we are all early risers any way. Hope Molly's ear is completely healed. CoCo's hair seems to be growing more in some spots and getting thinner in others. Of course doxie's don't have much hair anyway so they don't have much to lose. It seems like we have to watch everything with these dogs, he is having gunk in his eyes like sleep, but not a lot so not treating it yet and have to watch his stooling, the vet just says give him a little pepto bismol, and that usually works. I have tried the Slippery Elm and pumpkin and neither help that much, so I just watch and never let the stool get too loose. These things seem to be minor compared to a lot of trouble the pups on this forum have. I hope Molly stays well and you don't have to start medication for the Cushing's and maybe she will never develop it. Hugs, JoAnne

[addy]

Hi JoAnne,

Boy, do I know that early riser pup thing:D:D Last year it took Zoe a month to adjust to the time change. This year a month beofre I started making her wait to eat in 15 minute increments, longer and she adjusted in a week. 4:00 am is soooooo early:rolleyes::rolleyes::rolleyes:

Glad to know the Pepto is helping Coco. Keep up the good work.

Can you believe it is almost Thanksgiving? Thankfully, we have not had any snow yet. I think I am in denial about winter. It was 65 degrees yesterday.

[infoviewer]

Hey Addy: Hope your puppies are doing okay. I cannot believe it is almost Thanksgiving, it was 75 in Nashville today, but getting colder next week. Time seems to pass so fast, Christmas is not far away. I hope the people in New York and New Jersey get some help before really bad weather sets in.

I don't like to give CoCo the Pepto Bismol, and don't give it to him much. I did give him the Metronidazole some, but have run out of the prescription. We just really watch him, just call it poop patrol and eye patrol and anything else that we see that is not usual with him. Hope you and your family and furpuppies have a good week. Love, JoAnne

[molly muffin]

4 am!!!! I really do not even want to know that time exists. Thank you very much, back to bed CoCo!

I should have tried what Addy did with the time change. I am having a dickens of a time getting little miss up out of bed so she can go for her walkies and I can get off to work. So, on Mondays, Tuesdays and Thursdays, I'm usually yelling up the stairs for her to get her hiney out of bed and get downstairs to go out, at 8am. Normally at 7-7:30 she'd be up, but not with the time change. It's like having a 2 year old.
I would be in big trouble if she had to take early morning meds.
Enjoy the nice weather JoAnne. We had a good sunny day here today, hear tomorrow will be rainy and then Brrrrrrrrrrrr cold again. :(

hugs,
Sharlene

[infoviewer]

Sharlene: You are so funny. I guess these little dogs cannot tell time. The only time CoCo knows is his time which we all go on. Whatever CoCo wants he gets. I think we are just working for the doxie. He is sitting on my foot now waiting for me to do something for him. It is raining this morning so no outside for CoCo. If he gets desperate, out to the carport we go or covered patio. Thank goodness for the water hose on the patio. Hope Molly has a safe and healthy week and the furparents also. Love, JoAnne

[molly muffin]

Yes they seem to know Their time very well. LOL Raining here today also. Molly is undecided if she wants her walk or not when it's raining. She goes though, as long as there is no thunder or lightening. She's all alpah potty manners, so need about 6 or so trees to for her to let all the other dogs know she has been there. *shakes head. She's something alright. Just not going to say What! LOL
You and CoCo have a good week too. Hugs, Sharlene and Molly Muffin

[infoviewer]

Hey All: Hope everyone has had an uneventful week. We are still holding our own. I am still concerned about CoCo losing so much hair and wonder if I gave him more Vetoryl if it would cause it to grow back. He looks pretty bad, but is still is his happy tail wagging little destructive dog. I tried to put a T-shirt on him, thinking it would keep him warmer on his treks outside, but he had it torn up before I could get it on him, so just gave up and another one of his coverups bit the dust. He actually does the same thing with toys, so mostly I make him toys that he cannot tear up so quickly. He loves the empty water bottles with tape around them and about 5 thick socks. It takes him awhile to tear the socks up and I just put another sock on it. He can still hear the crinkle of the water bottle and thinks he has to kill it. He is still the typical dachshund hunter. I am just watching and waiting for more symptoms before upping his 10 mg Vetoryl and trying to do no harm. Here is hoping for a beautiful Sunday and beautiful Thanksgiving. Love JoAnne

[addy]

Hi JoAnne,

Happy Thanksgiving, we are supposed to have 60 degrees, cant believe it.

When my IMS spoke with a vet at Dechra, he told us if all of Zoe's symptoms were controlled we could leave her dose, if we wanted to see if we could improve her hair loss, we needed to drop her cortisol down further.

Keep in mind, their coat can get worse before getting better, it can take 6-9 months to get their coat back sometimes, the hair follicles have their own cycle and some dogs never get their coat back.

IMO, to improve their coat, we would need to be under 9ug/dl, most likely under 5ug/dl post. But that is just what I surmise:);)

Happy Turkey Day!!!!

[molly muffin]

Wow, Thanksgiving already. Time flies.

Coco is sooo funny. My friends dog, a cockapoo, tears up all her toys too, just shreds them! I have to put Molly's toys away when she comes to visit and only leave a few out for tear up. Molly doesn't tear her toys up thank goodness. I'd have to get inventive too. As you can see in her photo she is much more inclined to carry them around in her mouth, want you to play tug and get away with her, or throw them and she'll bring them back to you till She decides she is done. Aren't our little monsters just adorable! ROFL

I've read that some never get the hair back, some do later, some do right at the beginning. It's hard to say, but I bet Addy is right and it has to do with where the cortisol levels end up at.

Have a good holiday week!
hugs,
Sharlene and Molly muffin

[lulusmom]

When my IMS spoke with a vet at Dechra, he told us if all of Zoe's symptoms were controlled we could leave her dose, if we wanted to see if we could improve her hair loss, we needed to drop her cortisol down further.

IMO, to improve their coat, we would need to be under 9ug/dl, most likely under 5ug/dl post. But that is just what I surmise:);)

Happy Turkey Day!!!!

Addy, Dr. Edward Feldman would agree with you, or at least he did before Vetoryl was approved. I'm not sure it's actual monitoring protocol at UC Davis, Dr. Feldman does not believe in treating the symptoms vs the numbers. In one of his lecture audios he said if you want a dog on Trilostane to be "normal", you have to get the post stimulated cortisol below 5 ug/dl. Lulu and Jojo's pre and post stims were always in the mid twos and Lulu never grew hair and Jojo never quite drinking and peeing buckets. Neither of their symptoms resolved with lysodren either so they are definitely not the norm. Not every dog does well with lower cortisol but if my dogs could tolerate levels under 5, that was our goal.

[infoviewer]

Thanks everyone. I know his Cortisol needs to be lower, but it seems like the hair loss bothers me more than it does him. He just goes on with his cocky, bossy wayl like he is the cock of the walk and everyone get out of my way. He is a funny little dog. We just call him "boss dog" instead of Boss Hog , the guy that was on Dukes of Hazards. I appreciate all the information I get on this forum. Happy Thanksgiving to all. Love JoAnne

[molly muffin]

Boss Dog! ROFL, I like it!

Happy Thanksgiving! have an enjoyable one!

hugs,
Sharlene and Molly Muffin

[infoviewer]

Hey all: CoCo goes for his test again today. I don't have much hope that his cortisol will be lower on just 10 mg of Vetoryl, but he seems to be doing fine for an 11 year old dog. He is just about like he always was, except for the hair loss which makes him look a lot worse than he is. He attacks toys and his food and everything like he was attacking a badger in a hole. His eyes do look a little watery in the mornings, don't know if that is Cushings or old age. He really has no symptoms other than the hair loss. I am just concerned whether I should treat the symptoms or the numbers. He has a real good vet that lets me make the decision what to do and he just tells me what he thinks and listens to me, which I appreciate. I don't want to do any harm, but I do want to keep him from having more problems. I appreciate this forum so much. I am just writing my concerns this morning and know I have to make the decision myself. Hope all furbabies are doing well today. Love, JoAnne

[molly muffin]

Wait and see what this number is JoAnne. If it is right about the same, the symptoms are controlled, then I probably wouldn't mess with it. If the numbers are going up again, then likely you'll start to see more symptoms and at that point you can make the decision to raise or not.

And by the way! Hello! LOL Glad to see you again. Hope everyone is fine in your household.

hugs,
Sharlene and Molly Muffin

[infoviewer]

Hey Sharlene: Thanks, everyone is fine and my grandson that just got his RN degree just got a job at a hospital today and my granddaughter just got her exit interview for her teacher's degree today, so that is a real good day. CoCo had a few things that were high or low on his CBC, but vet was not concerned. His thyroid was low again so he increased the dosage and we won't get the cushing panel for a day or two and he thought everything was okay, but we will see when the panel comes back. It was very expensive, 352.00, but he did a complete blood study, thyroid, electrolytes and cushing panel so maybe he won't have that again for a few months. These pups are expensive, but they are worth it. Thanks for asking. Love JoAnne

[molly muffin]

Isn't that the truth. I work for my dog. LOL I agree, hopefully won't have to do that very often. Crossing fingers that the cushing panel comes back good and you and the vet are happy with it. ;)

Congratulations, sounds like the grandkids are doing really well. A nice early holiday gift.

hugs,
Sharlene

[addy]

Hi JoAnne,

Wishing you luck with Coco's stim today. You seem to be in a similar place as I was with Zoe when we first started minus the IBD. All I can say is follow your gut and listen to your pup.

Thinking of you.

[infoviewer]

Thanks Addy, it is really heart wrenching trying to figure out what to do about these sweet pups. I did start CoCo on a higher dose of thyroid medicine this morning, maybe that will help his skin and hair. He looks so pitiful, but does not know it himself. Just waiting for his cushing panel and have to go back in 3 weeks for another thyroid test. Oh well, like Sharlene says I work for the pup. Just hoping we have a few more years with him. Love, JoAnne

[addy]

Zoe looks pretty pitiful too though she sure does not know it;);)
She goes right after the holidays for her stim and I will be increasing to 60mgs, I cant even think of "shocking her system" as the IMS said:eek::eek::eek:

Take it one day at a time. Wait for the stim results. Dechra told us that if we wanted a shot at improving Zoe's coat, she should be under 5 ug/dl. Her coat is the least of my worries right now. I had pretty sweaters made from the Etsy shop.:D;)

[infoviewer]

Hey Addy: That is funny, my daughter sells antique jewelry on Etsy, I guess Etsy is in business like Amazon. The technology today is amazing, not much interaction except with these electronic marvels. If my electricity goes down I am lost, since I work at home for doctors. If we could only zap our furbabies healthy again. I think that is coming sooner or later. I hope Zoe does well on the 60 mg. I am so afraid to even start CoCo on 20 mg. He has this scaly skin that looks like he has dandruff and hates baths and brushing and tears up any clothing you put on him, so we just call him Speckled Pup. Hard to see him not able to run and jump like he used to, but he knows the low places on the deck that he can get up on and we have a ramp for another dachshund that broke his back and he does fine. It is us humans that it bothers. Seems like Zoe and KoKo are doing pretty good these days. Keep up the good work. Love, JoAnne

[infoviewer]

Hey all: The vet called on CoCo's Cortisol. Pre was 10ug/dL higher and 11.9 post lower. Last stim was Pre 8.6 ug/dL and post 14.5 ug/dL. The vet recommended going up to 20 mg rather than the 10 mg, but always leaves it up to me. What difference do you think it will make in CoCo's wellbeing to go up 10 mg. He is not having much trouble except the skin and hair. I know the post can be 8-17 ug/dL if no symptoms. Love, JoAnne

[addy]

Hi JoAnne,

The thing is they can bounce around on the same dose so if you stay at 10mgs the next time Coco may possibly be higher again. Zoe bounced from 11 down to 9 then up to 12 on the same dose.

Dechra states no more than 9.2 ug/dl if symptoms are controlled so I am not sure who mentioned to you 8 to 17, that is not for a Cushing dog being treated with Trilostane.

I know where youa re coming from from what I have been through on our journey. I am worried that it may be you start to see Calcinosis cutis somewhere down the road and that the hind leg weakness will get worse. That is what happened to us and I know no two dogs are a like but that is what I would be worried about.

You know, I did 10 mgs Vetoryl and 5mgs compounded with Zoe. The only reason I stayed higher with Zoe was because of her IBD and minimal symptoms. The symptoms started though, little by little and I knew she should be no more than 9ug/dl. I left her this time because I did not trust the numbers, I felt the test was in error some how.

If Coco's coat and skin is getting worse and his hind leg weakness is getting worse, IMO, you need to be under 9ug/dl.

(((((((((((((((((((((hugs))))))))))))))))))

I know it is hard.:(:(

[infoviewer]

Thank you so much Addy. His skin looks so bad, his head is bald and his shaved spots are not filling in and he has this dandruff on his black hair that looks awful and he just prances around like always. You are right I am afraid he will get something worse. The vet does not know if his hair will get any better, but thinks giving him 10 mg more might keep him from diabetes or pancreatitis. He does not trust compounding and said we might try halfing the capsule, but it is not recommended, but leaves it up to me. I wonder what the problem is with halfing a capsule. It is really so worrisome to try to figure out what to do. His thyroid was low so I have to give him more medicine for that. Oh well, just happy there is something that can help our furbabies. I know you are so concerned about Zoe and giving her more medicine. Maybe her next stim will be good and you won't have to. Love, JoAnne

[addy]

You cant half the Vetoryl capsule. Dechra tells you not to. Not sure why. Alot of members use Diamondback. If you pick a trustworthy compounding pharmacy it should be fine. Coco would probably handle the 20mgs. How much does he weigh? Most dogs are controlled between 1 to 3 mgs per pound. (Not my Zoe:rolleyes:)

Think about it ((((((((((((((more hugs)))))))))))))))))))

[labblab]

Hi JoAnne,

Is there a reason why you are especially worried about increasing Coco's trilostane dose? I think I remember some transitory diarrhea back in the summer, but has he had any other bad reactions to the med? From what I am seeing, his cortisol has never been lowered into a therapeutic range. So in a sense, he is already being subjected to the risk of potential side effects but without the benefit of true gain. :o

If you don't want to increase by 10 mg., it's true that you will need to turn to a compounding pharmacy because the manufacturer of Vetoryl publishes specific warnings against owners opening and dividing capsule contents themselves. I suspect it's partly to protect owners from exposure to the raw chemical themselves, but also because the activity of the drug may be totally altered if it is removed from its original packaging (not metabolized properly, impossible to divide the active and inert ingredients with precision, etc.). But unless Coco has exhibited ill effects from the trilostane thus far, I would want to gain better control of his elevated cortisol if he were my own dog. So whether or not you opt to inrease by a full 10 mg., I would want to at least add another 5 mg. to the dose he's already taking.

Marianne

[infoviewer]

Hey Addy and Marianne. Thank you so much, I decided last night that I would start him on the 20 mg. I have to take him back for his thyroid test in three weeks so I am waiting a few days so he can have the thyroid and stim at the same time, since you have to do the ACTH again in 12-14 days if I remember right. You are right he did have the diarrhea, but I got that under control in the last few weeks, I will just deal with that if it happens again. I did notice that the end of one of his ears was really dry and had a little piece hanging and I asked the vet to take it off and he said it would be okay. I put Vaseline on it when I got home and this dry black skin or hair or something fell off. I just figured it was because he is a dachshund with the long ears and he flops them around hitting the floor with them, but it probably has something to do with Cushings. Oh well, it looked better after a day or two. The vet told me to try Selsun Blue Shampoo on his hair and see if that would help and Genteal Eye Drops for his eyes that look watery. Has any one ever heard of the ear thing and using human products for dogs. Sorry this is so long. Love, JoAnne

[infoviewer]

Oh by the way, CoCo weighs 12 pounds, which is about the same as always, but looks thin because you can see his spine all the way down his back. This is a terrible disease, but aren't we glad that we can treat them somewhat. Love, JoAnne

[infoviewer]

Oh well, CoCo has vasculitis, his ear is the only thing we have found that is bothered by it so far and steroid seems to be the best medicine for it, but he cannot use that. Glad I discovered it on his ear. Anti-inflammatory is supposed to help, guess I will start giving him a Baby Aspirin more often. Hugs, JoAnne

[infoviewer]

Pray for the families of newtown, ct,

[molly muffin]

Oh CoCo. If not one thing it's another. Glad you caught it!

Hugs,
Sharlene and Molly Muffin

[infoviewer]

Hey Sharlene: Glad to see you. Hope you had a good and safe trip and Molly Muffin is doing well. CoCo seems to be okay, just more testing and he takes it like a little man. They have to put in the cortisol and take the blood out of his neck, since he is so small, but I never hear him make a noise. I will start 20 mg instead of the 10 mg the day after Christmas so he can have the thyroid test and cortisol on the same day. Really concerned about upping the Vetoryl, and this vet does not trust compounding so I guess it will just be two 10 mg pills and twice the price, don't really know until I start the extra Vetoryl, and get another prescription for thyroid medication since his thyroid was low. This vet seems to try to keep the cost down, so who knows, we just do what we have to and glad we are able to. Again, glad to see you. Love, JoAnne

[molly muffin]

MERRY Christmas! Hope you and Coco are having a wonderful holiday. Lots of joy and fun.
Stay safe!

HUGS,
Sharlene and Molly Muffin

[infoviewer]

Thanks Sharlene, we had a wonderful Christmas. My son is spending a few days with us and it is wonderful to have him. Just seems like old times when he was home. It is raining in Nashville this morning and we will possibly get snow. I love your pictures of Molly, such a great looking family. Molly is so beautiful. Hope you'll have a wonderful New Years. Love, JoAnne

[molly muffin]

Awww thanks. So glad you had a good christmas and now have son hanging out at the house for a few days too. Good times!

hugs,
Sharlene and Molly Muffin

[addy]

Stopping by to see how things are going in your neck of the woods:D:D

Hard to believe Christmas is over and we are rapidly approaching the New Year. I love the holiday lights this time of year because they help with all the dang darkness.

I hope Coco is well and you are okay with starting your new dose. I have resigned myself to the thought of changing Zoe to 30/30 and not seeing much of a drop in her cortisol.:rolleyes::rolleyes: Maybe we both will get a good surprise!!!!!!!:D:D:D:D:D

[infoviewer]

Hey Addy and Sharlene: CoCo seems to be about the same. Losing more hair. I just call him the hairless wonder. I have tried the Melatonin, but he does not seem to be getting any more hair. I am dreading starting the 20 mg of Vetoryl, I am afraid his walking will get worse, of course I will just take him off of it if it does. He does not walk well any way, such tiny short little legs. Luckily we have the ramp or we would have to carry him in and out of the house. He has this terrible odor and I do not know if it is from the Cushings or hypothyroidism. He is very clean, but still has the odor even after a bath. I do spray dog cologne on him, it is mostly water. Hope all had a Merry Christmas and here is hoping for a Happy New Year. Maybe the new year will produce a better medicine for our puppies. Love, JoAnne

[apollo6]

Dear JoAnne
Just do the best you can, listen to your gut. this disease is so cunning. Apollo was on thyroid medication also. I did take him of the Trilostane a few times .
Not much else to say. Hope you have a nice New Years with your son. Enjoy Coco. Can't give any input about the smell.
Hugs Sonja and Angel Apollo

[infoviewer]

Hey Sonja: Hope you are doing okay and had a good Christmas with your new puppy. I will start CoCo on 20 mg of Trilostane on 1/2/13 so he can have his thyorid and ACTH on the same day. He seems to be doing okay except for the hair and I don't think the medicine will help that, but maybe it will keep him from having something else. Who knows, we all do the best we can. Happy New Year to you and yours. Love JoAnne

[addy]

Checking on you and sending you moral support. It will be okay, JoAnne. I know you are so worried. Come, hold my hand.;):)

[molly muffin]

JoAnne, you are a good mommy and you can do this. I know it! Plus you have all of us here :)
eeek..I hear a dog with a shoe! Molly thinks that if she hides behind the Xmas tree I won't know she has my shoe. Brat!
Now where were we. You are just looking to bring the cortisol down so I know that you can do this. All the same procedures as when you started out on the first does. Keep an eye on Coco. Not eating, vomiting, diarrhea, stop the dosing and get an ACTH test, that post number is what you'll be looking for.
So there you go, you're ready. It'll be okay. Nothing different or scary, not nearly as much as when you first started out on this journey. HUGS

Sharlene and Molly Muffin

[infoviewer]

Thanks Sharlene. I know you are right, but still scary. Hope you found your shoe, just enjoy the playing. CoCo hardly every plays, but he never did play much even when he was young, just liiked to fetch and us throw the toys and does like to tear up the toys, but never shoes or anything we dropped on the floor like the other dogs. He always seemed like an old dog. Hope you are enjoying the holidays. Happy New Year. Love, JoAnne

[infoviewer]

Hey Addy: Yes I am worried about giving CoCo more Trilostane. I wish they could talk and tell us how they are doing. I feel so bad for CoCo since he cannot jump any more. He is smart and knows he cannot jump anymore so does not even try that much. He is really careful even walking over the threshold to come in the house. I hope Zoe will do okay on the 30/30. Hope you had a good holiday and have a Happy New Year. It is so cold in Nashville. I don't think we are going to do anything. Love, JoAnne

[infoviewer]

Hey all: Started CoCo on 20 mg of Trilostane. Really no difference so far. His hair is so thin. I was hoping I would see some new growth since it is so cold in Nashville and he will not wear doggie clothes, tears them up trying to pull them off. He is still the spunkiest little dog in the world. Hoping the increase in the Trilostane will help his weak back legs, but he handles it very well. Hope all furbabies are ok this morning. Love, JoAnne

[addy]

Hi JoAnne,

The hair follicles go through a cycle so you may not see any new growth for a few months or more. Just depends. Glad to hear Coco seems to be handling the new dose. I know how hard it is to see the hair loss. Zoe had the most beautiful coat and tail.

Hoping for a short winter for Coco.:D:D:D:D An early Spring would be nice.

[infoviewer]

I know what you mean Addy, CoCo was the most beautiful sleek black dachshund. Of course we love him dearly and he does not know his hair is gone, he just realizes he cannot do the things he used to do and takes it in stride. So far I cannot tell any difference in the 20 mg of Trilostane. He still sleeps, eats. pees and poops as usual. Of course I don't know if it will make any difference in anything, but maybe he won't get any worse for awhile. I really don't know if the hair loss is the Cushings or hypothyroid or alopecia X that dachshunds get. He has not lost the hair on his tail, has lost the hair on his head, some on ears and thin on his back and where he was shaved for ultrasound has never regrown. I hope Zoe does well on the 30/30 and she does not have any more problems. Love, JoAnne

[molly muffin]

Yay, glad that everything is going well with the new dosage. :)

hugs,
Sharlene and Molly Muffin

[infoviewer]

Thanks Sharlene. Maybe his cortisol will be in the normal range. He actually seems to be getting around better which is good since sometimes the high cortisol helps arthritis, so maybe he is just weak from the Cushings. Hope Molly is okay this morning. Love, JoAnne

[addy]

We are all here, cheering you both on with fingers crossed for a good stim. I know it is nerve wracking.

Have a wonderful Monday!!!

[infoviewer]

Thanks Addy. Hope Zoe and KoKo made it through Christmas and New Years without any problems. The holidays are great but a lot or work, mostly putting the decorations up and then taking them all down, but I love them. Hope we all have a happy and safe 2013. Love, JoAnne

[molly muffin]

Just got our tree down yesterday. Molly not a happy camper, but she'll survive. Trish suggested I get her a tree plant. LOL

Hope CoCo's stim gives us good results!!

hugs,
Sharlene and Molly Muffin

[Simba's Mom]

My 10 year old mini doxie Simba has cushings, he takes trilostance 25mg. His pot belly is gone, and his panting and thrist has quieted down. However he still acts like he's starving, and the symptoms are starting to return I'm afraid. I just don't know what is good either.

[molly muffin]

Awwww, another doxie for you JoAnne :) We have a lot of doxie lovers here Letti. :)
They are just so darn cute!

Sharlene and Molly Muffin

[milosmom]

hey there...patty here with meka (her brother milo my 6 yr doxie went to puppy heaven 3 wks ago) just wanted to send hellos and know that we are all here watching about your little one coco.know that you have foud a fabulous forum(as i have) for info,love,support and xoxoxo....patty(milo)meka xoxox reach out here... there are many to respond :)

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Hey Sharlene, that sounds like a good idea for the tree, maybe Molly thinks she is outside, lets just hope she does not start marking it like my CoCo would.

LettLett you have come to the right place. The people on this forum are wonderful and have so much experience with Cushings. CoCo has been taking Trilostane about five months and he still begs for food, probably habit. His hair is still bad, still weak in back legs, but seems to be doing ok.

So sorry for your loss of Milo, Patty. I know Meka is a comfort to you and the people on this forum are so great and willing to listen to all your thoughts and worries. I have learned so much just scanning around and reading the experiences these wonderful people have had. Doxies are great little comical and bossy dogs. Take care. Love, JoAnne

[Simba's Mom]

My Simba is weak in the back legs too, it's so hard to see them struggle but good to know its part of the cushings and not something else. He has a few areas of hair loss, but otherwise looks good. Thank you!

[milosmom]

very kind of you joanne..thank you !!! and yes meka truly is a comfort and everyone here is truly amazing... patty(milo) meka xoxox :)

[molly muffin]

Hey JoAnn,
How is CoCo doing on the new dosage? Hopefully still doing well. When is the stim test? :)
Did you get that blast of warm air this week?
hugs,
Sharlene and Molly Muffin

[infoviewer]

Hey Sharlene: Thanks for asking about CoCo. He seems to be doing okay, seems stronger, hard to tell. i just dropped a sack of dog food of the floor and had to throw something over it to keep him from eating it all. I am sure he got an extra meal. He seems to be begging for food more, which is strange since he is getting twice the Vetoryl. He has always been a typical dachshund and would eat until he was sick if we let him. I am expecting him to have diarrhea, but I will know what caused it. I have to take him in Monday for his stim and thyroid test. I am hoping that he is pretty close to normal, but you never know. Hope you and your family and Molly have survived the holidays. Love, JoAnne

[addy]

Hi JoAnne,

I sure hope this warm weather found its way to you. What a wonderful winter thaw, our snow is all gone and the pups dont know what to do;););););)

How is little Coco? Stim time should be coming up soon. I'll cross my fingers for ya, Zoe and Koko crossing their paws;);););)

Hopefully, this mild winter will continue:D:D:D:D:D:D Just think a few more weeks and we will still see daylight at 5pm:D:D:D:D

[molly muffin]

I'm pretty sure that it is lighter already at 5pm! I'm just positive that it was just a teeny tiny bit lighter when I was driving home from work the other night.

Pfffttt Amy is down there in Texas, they probably have beach weather :(

we're suppose to be warm here tomorrow too and then that is it, back to freezing and below freezing temperatures and snow. *sigh*

Molly is wishing Borris and Zoe happy Stim results too!!

hugs,
Sharlene and Molly Muffin

[infoviewer]

I cannot believe it is 72 degrees here in Nashville in January. It is supposed to get colder this coming week. I always dread CoCo's stim, they take the blood out of his neck since he has such tiny legs, but he never cries at the vet's office. He usually whimpers all the way to the office since I guess he knows where he is going. My clumsiness in dropping his dog food and his possibly getting an extra meal or more did not seem to hurt him. Hope everyone has a restful and safe Sunday. Love JoAnne

[molly muffin]

Oh glad the extra food didn't do any harm. Did you see I mentioned on Addy's thread, that Borris is getting his stim on Monday too. 3 for Monday! Anyone else on here getting on? Speak up now, dog treats all around afterwards.

72!!! You're killing me! It's nice here but not That nice. I'd take it through and be happy dancing all over the yard! hahahaha

hugs,
Sharlene and Molly Muffin

[addy]

wait a minute, did you say 72? I'm pea green with envy:D:D:D

Zoe comes out with red stretchy bandages on two legs after her stim. I would be freaking too if they drew it from the neck, ouch!!!

[infoviewer]

It is scary when they take him to the back in the hospital. I always wonder what they are doing to him. They used to put a muzzle on him because they called him the biter, but he is better about the aggression now than when he was a puppy. I wonder how they know where the medicine is going when they put it in his neck, but I guess they know. I saw Boris was having the stim also. Hope all of us are happy campers later on this week. CoCo also has to have his thyroid checked and I guess they always do the electrolytes. Another rainy day in Nashville this morning, glad we have a covered patio and carport or I would be walking in the rain with an umbrella, although this little fellow refuses to go out in the rain. He just stops at the door and turns around and waits for the leash. Yikes what a dog. Love, JoAnne

[addy]

That's funny that Coco wont got out in the rain. My Koko wont poo in the rain, he waits till he just cant hold it anymore:rolleyes::rolleyes:

Our weather was short lived, this morning everything is covered in ice:eek::eek::eek::eek::eek:

I'll be thinking of you tomorrow:D:D:D

[infoviewer]

Wow Addy, that is amazing ice again this morning. We are having torrential rain, flood warning everywhere. I live on a hill so don't have to worry about that unless it gets in the basement. Yes my dog is an alpha dog and runs the show it seems like. He will not even go out with my husband unless I get up and follow him or tell him it is okay. Good thing we only have one dog and children and grandchildren are grown, but I guess he would not get all the attention and would learn to cope. I will be thinking about Zoe and Boriss also in the morning for the stim test. Poor little doggies, I hate for them to be hurt. CoCo will be so mad that his eyes are so black and he is just glaring at us for letting someone take him away. Good luck. Love, JoAnne

[molly muffin]

Ice and floods ugh. Well, that is probably what we'll have by in the morning. I see the temp here is suppose to be warm all day and then drop below freezing over night. :( If it's icy, I'll be working from home tomorrow. I might be in Canada, but I don't do ice and snow driving. Well, snow I'll do more than ice. LOL
We'll be thinking of all of you getting your stims tomorrow.
Stim Monday!
hugs,
Sharlene

[infoviewer]

I know what you mean Sharlene. I don't drive in ice or snow. I work at home so don't have to get out in it. I am dreading the stims for the furbabies, but I guess it is a good thing (I am sure furbabies would disagree). Terrible rains and flooding in Nashville now and my daughter and her husband are traveling from Gatlinburg. I am hoping they get home before dark so they can see the water on the road. They are in a truck so should be okay. Take care. Love, JoAnne

[Tina]

Hi JoAnne, I just wanted to let you know that I will be thinking about you and Coco and wishing you luck with his stim test tomorrow. My Jasper is not getting a stim test, but is seeing the vet tomorrow and getting a Percorten injection as show of solidarity for Coco, Boriss and Zoe's stim tests. :D Hope you all have good results.

Hugs from me and Jasper