Maxwell, 8 year old Boston Terrier (Sweet Maxwell has passed)

[Nikki]

Hi everyone!
I'm new to this forum. My dog Maxwell, an almost 8 year old Boston Terrier was just diagnosed with cushings disease. We suspect he may have had it for 2 or more years now. In his younger years he was a food aggressor, would always love to meet new people and jump on them. If cats came anywhere near him he would chase them and bark at them non stop. Around 3 years ago he stopped barking, he became very quiet and uninterested in anyone or anything. He never wanted to play with the other dogs, a cat could come lay on him and he wouldn't even look their way. My mom brought him to the vet's multiple times and they couldn't really find anything wrong with him. Finally about 2 years ago they diagnosed him as having hypothyroidism. He went on medication, but he never really changed. Around November I noticed his butt was red and swollen so I brought him into the vets, and was told he most likely had a food allergy. The vet noticed a few red bumps in between his shoulder blades that he said were hives. He gave him a shot of prednisone, sent us home with instructions to cook him chicken and rice (He said dog food had so many ingredients in it so home cooking would help if he was allergic to something). He continued to get worse, so he was prescribed prednisone pills for awhile. His "hives" swelled up, spread and eventually his fur starting falling out. He had allergy testing done and we found out he was allergic to rice,pork,duck and yeast. I started buying him specialty food that did not contain any of that. He still got worse, continued suffering from skin infections and was constantly put on antibiotics and prednisone. His infection would go away but his skin only got worse. In the beginning of January I had blood work and an xray done, and it showed that his liver was enlarged and his liver enzymes were 480, and I guess 100 is a high number for those. As all of his fur continued falling out we were bringing him to the vet almost weekly. We finally had a biopsy done 2 weeks ago and it came back that he was most likely suffering from cushings disease. Last Thursday we brought him in for some kind of blood work test that required we leave him at the vets all day long. It came back that it was definitely cushing disease. After looking up all of the symptoms, I am very frustrated that it wasn't caught earlier because he has almost every symptom I've seen! Also, his skin problem is calcinosis cutis and we have DMSO 99% liquid to put on part of his skin every night. We started him on 20mg of vetoryl last Thursday, but he doesn't seem any better yet. Anyways, I'm sorry this post is so long I am just trying to be as thorough as possible!! I have skimmed through some posts and it looks like this is a great community full of helpful and amazing people :)
-Nikki

[Sabre's Mum]

Hi Nikki

Welcome to you and Maxwell!

Calcinosis cutis is pretty much a definitive diagnosis of cushings. Our dear Sabre had calcinosis cutis (he has now passed on) and pretty much presented exactly like your Maxwell. I word of warning ... it does get worse before it gets better BUT once the treatment has kicked in, and the cortisol levels come down to what is the acceptable range for a "cushings" treated dog, things get better. Until this point in time my advice is to try and manage any potential infections - so place on antibiotics if infection appears to be coming on. Some use shampoos every few days, but other people have found that this only irritates the areas. We were unable to use DMSO in NZ but my research at the time pointed to this as being an effective treatment for calcinosis cutis. We used antihistamines to try and control his itchiness and jackets or t-shirts to stop him from trying to get at it.

I will pop in later on and give you some links of other threads where this condition and suggestions have been discussed .... kids coming home from school soon.

Angela and Flynn

[Nikki]

Thank you for taking the time to reply! Another bit of information I wanted to add was that Max was diagnosed with Calcium oxalate crystals awhile back. I want to say maybe over last summer (2011) and had to go on a special diet and have his urine tested somewhat frequently- is this in any way associated with cushings disease or is this just a totally separate problem he was experiencing? And also, he has been shaking so badly lately. I try to cover him with blankets but I am not sure if he is necessarily cold or if he shakes from pain. The vet did prescribe me tramadol for him to take every 12 hours, but it doesn't seem to do much but drug him up(he gets kind of weird on it.. like he looks spaced out and when he gets up from laying down he walks crooked).

[lulusmom]

Yes, uncontrolled cushdogs are predisposed to calcium oxalate crystals/stones. My little one had two surgeries for stones within 11 months of each other prior to being diagnosed.

What kind of pain does your vet think Maxwell is having? Dogs with high cortisol usually don't experience any arthritic/joint pain because the cortisol is the body's natural anti-inflammatory. It is not until the cortisol is brought down to a more normal level that arthritis is unmasked.

Dogs with cushing's are usually more sensitive to heat so the tremoring could be from pain or it could be from the muscle wasting caused by the catabolic effects of the cortisol. If this symptoms is strictly cushing's related, it should resolve with treatment. My second cushdog trembled constantly but that vastly improved within a few months of stabilizing on treatment. Gaining muscle mass is not instantaneous and can take several months to notice improvement. Hang in there and keep us posted.

Glynda

[Nikki]

She had originally prescribed the pain med because of his swollen liver and because I told her how he could barely even walk up the stairs(this came on quick.. within a few weeks he couldn't jump on the bed and barely could walk up stairs.) So the pain med is from before I ever even heard of cushings disease. It's so frustrating that my poor guy is in such awful shape and has had all these issues the last few years and it wasn't until 2 weeks ago that he was tested for cushings. Luckily for me Max is technically my mothers dog, so we have been able to split vet costs (over $1200 spent since November 2011). Hopefully with the treatment we started he will finally start to improve.

[Sabre's Mum]

Hi Nikki

Here is a link to a thread which calcinosis cutis was discussed.

http://www.k9cushings.com/forum/showthread.php?t=3765

Angela and Flynn

[Nikki]

Thank you for the link!! Max and I went to the vet this morning to have his stitches removed (From when he had his biopsy) and the vet said she can definitely see an improvement in his skin already. I guess since I see him every day I don't realize it, he still looks absolutely awful to me. But I guess it is good that she is seeing an improvement!

[jmac]

Hi Nikki-

I just had a chance to read your thread. I am so sorry to hear it took so long to find out what was going on with poor Max. As you already know, this is a wonderful place; there are so many knowledgeable, kind, helpful people, dedicated to helping others along their "Cushing's journey."

I am so glad to hear that your vet felt that Max was doing better. That is great news! You are doing a wonderful job doing whatever you can to help him, and I'm hopeful that between your vet and the help and support you will get here, Max will be doing better soon.

Julie & Hannah

[lulusmom]

She had originally prescribed the pain med because of his swollen liver and because I told her how he could barely even walk up the stairs(this came on quick.. within a few weeks he couldn't jump on the bed and barely could walk up stairs.) So the pain med is from before I ever even heard of cushings disease. It's so frustrating that my poor guy is in such awful shape and has had all these issues the last few years and it wasn't until 2 weeks ago that he was tested for cushings. Luckily for me Max is technically my mothers dog, so we have been able to split vet costs (over $1200 spent since November 2011). Hopefully with the treatment we started he will finally start to improve.

Hi Nikki,

I just realized that you mentioned Prednisone several times in your first post. Is Max still on Prednisone and was he on it when the cushing's testing was done? Long term use of prednisone can cause iatrogenic cushings and the cure is to wean them off the drug.

Please round up all of the testing that was done to diagnose Max and post the results here.

Dogs with cushing's, whether naturally occurring or due to prednisone, have enlarged livers because of glycogen accumulation in liver cells due excess cortisol. The enlargement may contribute to panting and the pot bellied appearance but it is not a painful condition. If, in fact, Max has been showing signs of cushing's for two years, it would not be surprising that muscle wasting, caused by the catabolic effects of excess cortisol or prednisone, is in an advanced state. However, this is also usually not a painful condition so I'm not sure pain meds are necessary for Max. Unless Max has something else going on and prednisone has been ruled out as the cause of all of his problems, treatment will eventually resolve most, if not all of his symptoms.

Glynda

[Nikki]

Max was taken off all of his meds for a week and a half before testing. Also, he was taken off prednisone in the beginning of January and switched to atopica.(I'm not sure of what size dose it was, he was on it for 30 days and then discontinued). The vet originally thought that the prednisone had caused the swollen liver so she said he couldn't ever be put on it again. I will post the test results I have, and I'm sorry if don't post the correct things.. I'm still not really sure what a lot of things mean but I will try my best.
His ALT was 459 in January and as of two weeks ago they were down to 318. The skin biopsy was done on February 17 and it showed that he had calcinosis cutis. I feel really guilty because we were holding off on doing the biopsy because of the cost, and at the time we thought it just showed if he had cancer or not, and we really didn't think it was cancer. Had I known that the biopsy could check for so many different things, we would of had it done back in December and my poor guy wouldn't of suffered so much :(.
On February 22 he has a low dose dexamethasone test done.
Pre dexamthasone- 5.8
Post 4 hr dex- 3.8
Post 8 hr dex- 5.5
Apparently this shows that he is most likely suffering from pituitary-dependent hyperadrenocorticism.
For now he has been taken off of his thyroid pill, the vet said it is quite possible that was a misdiagnosis and that once we get his symptoms from cushings under control we can figure out if he needs that pill anymore. So as of right now he is on one 225mg tablet of denosyl a day. He also takes two 10mg Veteroyl pills with dinner every night. Also I have been giving him half of a Clairitan pill every day to help control his allergy symptoms. We put DMSO on him every day (We have to rotate, we do 1/4 of his affected skin each night). I haven't been giving him the pain med since it didn't seem to help him at all. The vet had said last Thursday that the shaking is most likely from muscle wasting. He was originally about 24lbs and over the last 2 years he dropped down to 19lbs(He was back up to 20.7 at his last appointment a few days ago), and he literally looks like we had starved him, you can see all of his ribs and he is just SO skinny-looking especially when he is next to my moms other bostons (He used to be the largest, now he is the smallest). Within the last 4 months he went from moving normally to not being able to jump on the bed, sometimes he can jump in the car sometimes not. For awhile there before the diagnosis he couldn't walk up the stairs at all and there were a few times he totally wiped out trying to get into the house (Its a really low step up).
Anyways, he goes back for another check up this Thursday. The vet said about 6 weeks after that he will need to have a ACTH test done to make sure the medication is the correct dose and that it is working. He has been on the vetoryl for 10 days now and already I've noticed him drinking/urinating less and also he doesn't act starving. Since he was so skinny the vet had said we could feed him as much as he would eat so we were up to feeding him almost 4 times a day(When he was eating was the only time he didn't seem to be miserable and suffering). Now he is perfectly happy with his half a can of wet food in the morning and half a can for dinner. Sorry this is such a long post, I was just trying to be as thorough as possible!!

-Nikki and Max

[lulusmom]

Hi Nikki.

The LDDS is consistent with cushing's but unfortunately, it does tell you whether it is pituitary or adrenal. Most cushing's savvy vets would have done an abdominal ultrasound or an endogenous acth test to make that differentiation, as well as validate the LDDS.

An acth stimulation test should be done 10 to 14 days after starting Vetoryl, followed by a second stim test at 30 days. If any dosing adjustments are made, another acth stim test should be done 10 to 14 days after starting the new dose. The acth stim test must be done within 4 to 6 hours after dosing so giving Maxwell his dose at night is going to be problematic. Unless your vet is open during late evening hours, you will need to switch his dosing to the am. The safest way to do that is to skip the dose and give it the following morning. ACTH stimulation tests are not cheap so the first 30 to 60 days of treatment can be expensive, depending on dosing adjustments. If your vet is using cortrosyn as the stimulating agent for the stim tests, you can save some money if your vet is cooperative. Instructions on the vial of cortrosyn says to administer the entire vial but studies have shown that only a fraction of the vile is needed for small or medium sized dogs. With Max weighing just 19 pounds, your vet can get several acth stim tests out of one vial. Cortrosyn is called liquid gold for a reason. It's the reason why most of us pay so dang much for a stim test. You have nothing to lose and lots to gain by discussing this with your vet. I am providing a link to one Dr. Peterson's blogs which provides vets with information on how to reconsitute and store the cortrosyn for future use. My cushdogs treat primarily with a specialist but I have a gp vet do their bloodwork. I talked to him about splitting the cortrosyn vials and he was totally agreeable to helping save me money. My gp vet, as well as a number of members' vets, were unaware of this fact. Believe me, with two cushdogs, it has saved me a bundle.

http://endocrinevet.blogspot.com/201...cortrosyn.html

I'm sorry that your vet did not explain this to you but I'm glad you provided the information so that we could prevent you from paying for an acth stimulation test that would be of no value and quite possibly put Max at risk if a dosing increase were to be prescribed. Please take a look at the Dechra guidelines for monitoring treatment in our Helpful Resources section for which I have provided a link below. You may want to print out the monitoring recommendations and share them with your vet so that s/he follows proper treatment and monitoring protocol.

http://www.dechra-us.com/files//dechraUSA/downloads/Client%20Literature/47902_VETORYL_10mg_Treatment_and_Monitoring_Brochu re_Update_3_2_ps.pdf

[Nikki]

Thank you for the information. The first link you posted does not work for me, I've tried it several times on different computers :(.
Max seemed to be doing better but the last few days he has gotten worse again, peeing in the house constantly even when I let him out(he refuses to pee outside and then 5 mins later he pees on the floor). The vet thinks she may have started him on too high of a dose so he is going down to 10mg of the Vetoryl. Also, he has a pretty bad eye infection going on, not sure if its related to the cushings disease at all. On the plus side, the vet and all the vet techs said his coat looks great and that his fur is starting to grow back, so at least we are having some positive results.

[StarDeb55]

I haven't posted to you & Maxwell before, so here's a belated welcome! I saw that you posted that Maxwell has a pretty bad eye infection. Repeated infections that are difficult to heal are also a sign of Cushing's as Cushing's depresses the immune system in our pups. My 2nd cushpup, Harley, (yes, I've been through this twice), had a repeated corneal ulceration that we couldn't get to clear up which was one of his major Cushing's signs. My GP vet would put him on eyedrops, & the other necessary meds, the eye would clear up, & we would stop the meds. Within about 3-4 weeks, his eye would look all nasty, again. After the 3rd time, we got sent to a vet opthamologist. Just prior to that trip, I was sitting in an exam room at my IMS office for the appointment to get Harley's diagnosis confirmed, I happened to look at his eye & son of a gun, if it wasn't nasty at that point. I asked the IMS about the repeated corneal ulcerations/infections being a symptom of Cushing's, she said absolutely.

Debbie

[Harley PoMMom]

Thank you for the information. The first link you posted does not work for me, I've tried it several times on different computers :(.


Try this link: How to Extend Your Supply of Cortrosyn and Lower the Cost of ACTH Stimulation Testing (http://endocrinevet.blogspot.com/2011/03/how-to-extend-your-supply-of-cortrosyn.html)

Just wondering, has an ACTH stimulation test been done recently?

Please do keep us posted.

Love and hugs,
Lori

[labblab]

I'm sorry to hear that Maxwell is having problems with increased urination after having originally been better. Typically, we'd think a symptom rebound would signal the need for an increase in trilostane rather than a decrease. Do you know why your vet decided that the dose might be too high?

By any chance, is Maxwell getting eyedrops to treat his infection that contain a steroid? If so, that could account for the increased urination.

And like Lori, I'm curious about any monitoring ACTH testing. In reading back through your thread, it sounds as though Maxwell has now been taking the trilostane for about three weeks? If so, it's time that he be tested, especially if your vet has concerns about the appropriateness of the dose.

Originally you were giving Maxwell his trilostane at night with dinner, but I'm hoping that you had a chance to read Glynda's reply and have switched him to morning dosing -- for a couple of reasons. First, in order for the ACTH monitoring test to be accurate, it must be performed 4-6 hours after dosing. Secondly, trilostane only remains really active in the body for 12-18 hours. So if you are giving the medication once daily at night, the effect is probably already starting to wear off by the time he wakes up the next morning. In and of itself, that could be a reason why you'd see symptoms rebounding during the day.

Any additional info you can share about Maxwell's trilostane dosing and also his eye infection will be really helpful to us.

Thanks!
Marianne

[Nikki]

He has been on the medicine 2.5 weeks now.. he has never had the acth test done and the vet doesn't want to do it for another 6 weeks... I really wish I had better options for vets because while I do like this vet, she obviously doesn't have much experience with cushings disease. I had mentioned cushings as a possibility a few months ago because my boyfriends friend is a vet tech and she mentioned it and said it was somewhat common among Boston terriers. When I mentioned it my vet brushed it aside. Then months later it turns out that was the problem the whole time. All I said to her was about his symptoms seeming to reappear and she said oh I think his dosing could be too high let's drop him down to 10mg. His eye drop box says "neomycin and polymyxin b sulfates, bacitracin zinc and hydrocortisone opthalmic ointment usp"

[Harley PoMMom]

Here is a link to Dechra's product insert which states that an ACTH stimulation test should be done 10-14 days after the initial starting dose is begun: http://www.dechra-us.com/files/dechraUSA/downloads/Product%20inserts/Vetoryl.pdf Please feel free to copy out this literature to show to your vet.

I see his eye drops do contain a steroid which is hydrocortisone, all steroids, whether topical, drops, or oral form can cause Cushing like symptoms.

[Nikki]

Just a quick question, Maxwell has been having some pretty bad diarrhea (Since Tuesday morning, several times a day and it is very mucus-y looking). I found online that for a 20lb dog I can give him 1/4 of a pepto bismol tablet. But it also says that is for a "normal healthy" dog. I just was wondering if anyone knew of any reason to not give him the pepto.
Also an update, as of today max is back to a 20mg dose a day of veteroyl, since he has went downhill pretty quick the last 5 or so days. He is scheduled for the ACTH stimulation test in 2 weeks.

[Harley PoMMom]

Diarrhea can be symptom of cortisol going too low. If it were me, I would have an ACTH stim test done just to be sure that the cortisol isn't too low.

I would also stop giving the Vetoryl until Max is feeling better.

Hoping Max is feeling like himself real soon.

Love and hugs,
Lori

[Nikki]

Cortisol going too low would be from too high of a dose of vetoryl, right? He is 20lbs and it says the recommended starting dose is 30mg, and he has been on only 10mg up until this morning, and his diarrhea started yesterday. I felt like the 10mg was too low of a dose because he started peeing nonstop in the house, and red bumps appeared farther down his back and his skin started to peel away (First time a new "batch" of skin problems has shown up since before he was diagnosed). So I'm just a little confused I guess. The ACTH test is going to cost $350 so I was hoping to do it after the 2 weeks@20mg rather than doing it @10mg, upping the dose to 20mg, doing the ACTH test again, etc. Overall I care most of all about Max's health but at the same time, money has become very tight lately with all my vet bills and his special food I have to buy him :(.

[frijole]

Hi! My first thought was low cortisol also but we could be wrong! Is he acting real lethargic?

I have a cheap fix for the diarrhea though! Canned pumpkin. Not the kind with spices - just plain pumpkin. Get a can of it and only give a tablespoon or LESS twice a day. I put it on top of my dog's food and she loved it. It plugs them up and fast. Too much of it and it causes diarrhea so just stick with the lower dose. :D

Take the left over (assuming you won't need the whole can) and put it in plastic bags and freeze it... that way you have it on hand for future bouts of diarrhea.

We can all relate to crazy prices for services. ACTH tests are out of control. Just keep a close eye out for extreme lethargy and if he seems out of it - just take him in and demand a test. Trust me on this. Keep us posted!! Kim

[Harley PoMMom]

You are right as this can be confusing! I believe that 20 mg of Vetoryl would be an appropriate dose for a 20 lb dog and no adverse reactions would be seen but all dogs do react differently and hypoadrenocorticism can occur at any dose of VETORYL.

Is Max experiencing any vomiting or lethargy? If not, then maybe the diarrhea is from IBD, colitis or just the increase in dose from 10 mg to 20 mg. I would still stop giving the Vetoryl and see if Max feels better...JMO.

[Squirt's Mom]

Hi Nikki,

How is Maxwell this morning?

Another good thing to have on hand for diarrhea is Slippery Elm Bark - it is a wonder herb in my book!

Hope he is feeling much better this morning!
Hugs,
Leslie and the gang

[Nikki]

Thanks for the pumpkin idea! I'll have to go to the store today. He is acting lethargic, laying around a lot and his eyes are pretty red. he looks so miserable. The vet said it's most likely from something he ate, but since he has food allergies he only eats his special canned food and boiled shredded chicken. We have a strict no table food rule, since so much stuff contains so many ingredients (He is allergic to pork, duck, rice and yeast!) I also was recently diagnosed with a yeast allergy and it amazes me how much stuff contains yeast!! Between that and my egg allergy, I can barely eat any processed foods!! So I don't think its from food, since he is only eating what he has always ate. The calcinosis cutis on his chest was pussing the other day too, when the diarrhea started but the vet said she didn't think it was related and to just put a warm compress on it for 10 minutes a day.

[Nikki]

So Maxwell went in for his ACTH stimulation test last Wednesday. The vet called to say everything looks great, and she wants to keep him on the 20mg dose a day of vetoryl. She said in 2 months he will need some blood work done but besides that he should be good for another 8 months or so. His "eye infection" from early March never totally cleared up. Then 2 or 3 weeks ago we noticed that he was drooling REALLY bad out of the right side of his mouth almost constantly, and I've never even seen him drool before (Weird, because his right eye was the one infected too, so it was the same side of the face). So when I dropped him off for his ACTH test I mentioned it, and told them that sometimes his pills would could out of his mouth in the drool too. Apparently he has something called horner's syndrome, which has no cure and it's just "cosmetic". Has anyone had any experience with this?! It almost seems to me like he might have suffered a small stroke. A lot of times he starts walking sideways, or he will almost fall over. The whole right side of his face is weird. His eye looks like its bulging, and sometimes it looks like its floating away into the back of his head. It's very weird. Anyways, on a positive note his calcinosis cutis is definitely improving! We are only doing the DMSO every 2-3 days but his skin is definitely improving very slowly. Hope everyone else is doing well :)

-Nikki&Max

[addy]

Hi Nikki,

I dont know much about Horner's syndrome but perhaps someone else will have some input. Did the vet give you Maxwell's numbers and copies of his ACTH test?

Usually the ACTH test is done again in about 3 months, I am not sure why the vet said 8 months. I know money is tight and they are expensive but that seems like a long time without an ACTH test for a pup on Vetoryl.

Glad to hear the cutis is improving and hope the poos are too:D

hugs,
addy

[Nikki]

Hi Addy!
I did not get any of the actual results from the test. The vet just said everything looked "on track" (I didn't even talk to her, she just left a voicemail since I was at work when she called). I know she waited a lot longer than people on here have suggested to do the first ACTH test, so I'm not sure exactly why she wants to wait so long in between tests. I do know that my vet has basically no experience with cushings before Maxwell, so maybe that has something to do with it.

[addy]

Hi Nikki,

Most of us will ask our vets to mail or email us copies of the tests done so we can keep them in our files. It might be a good idea to call the receptionist and ask if they can send that test copy to you. Don't feel funny about asking. I usualy have to call five times and hound everyone in the office and then the receptionist does it. I was so grateful when Zoe's eye doc asked ME for my email address and said he would send out the report via email. He's a keeper:D:D:D

How is Maxwell today?
love,
addy

[Nikki]

Ok! I will definitely try to get a copy of that soon. We have to buy him special dog food at the vets, so I'm there about once a week anyways!! Max seems to be doing okay. The last few days he has been walking into things (Walls, chairs, etc). I'm not sure if it's a side effect of his meds, or maybe he is just really really confused because we moved over the weekend into a new place. It's really hard these days to tell how he is feeling, because he has become such a different dog over the last few months. Sometimes I think I worry too much about the little things.

[addy]

http://www.k9cushings.com/forum/showthread.php?t=1902&highlight=vestibular+disease

Nikki, maybe read through this thread and see if it is similar to Maxwell.

Just a thought.

hugs,
addy

[lulusmom]

Ok! The last few days he has been walking into things (Walls, chairs, etc). I'm not sure if it's a side effect of his meds, or maybe he is just really really confused because we moved over the weekend into a new place.

Are you sure that Maxwell has not lost his eye sight? I ask because there is a condition called SARDS wherein dogs go blind rather quickly. This loss of vision is usually preceded by cushing like symptoms.

[Nikki]

I'm not sure if he is losing his eye sight. I know the horner's syndrome affects his eye, but I'm not sure if it affect's his sight. When he walks into things its more like he is dizzy.. he doesn't walk straight into them, rather sometimes when he walks he walks almost sideways or crooked (Like a drunk person, lol!)

[Nikki]

So I read the thread on the vestibular disease, it sort of sounds like Max but his isn't constant, maybe just half the time. Also I have another question. Max was diagnosed with hypothyroidism about two years ago. When he was diagnosed with cushings, the vet said to take him off the thyroid medication and wait until we had the cushings under control and then we would take it from there. So he has not been on his thyroid meds for over two months now. The vet doesn't seem to think its a big deal, does this worry anyone on here? When I googled the vestibular disease, one of the things that came up was "nerve damage from hypothyroidism...."
Also he was just diagnosed with horner's syndrome because of his eye being weird(its always wide open, and looks like its floating away in his head sometimes..) and the drooling, but those both come up with the vestibular disease too....

[addy]

Sometimes the pups test on the low side for hypothyroidism but once their Cushings is controlled their T3 and/or T4 become normal. That is the case with my Zoe.

Did you google Horners Syndrome? Does it say anything about hypothyroidism and that condition? Do you know what his results were when he was diagnosed?

hugs,
addy

[Nikki]

I haven't found anything with horner's and thyroid being connected. I am not sure of the results from when he was diagnosed as being hypothyroid (he was still my mom's dog at that point). I do know that she kept telling then vet SOMETHING had to be wrong with him, because his personality had changed so much. So after all types of testing he finally said he could check the thyroid, and it ended up being low but Max didn't have any symptoms of hypothyroidism so they found that very weird (I guess weight gain is a sign, and he had lost weight which we know now is from the muscle wasting associated with cushings). Anyways sorry to be writing so much in these last posts!!! So many different things/signs/symptoms have happened to max in the last 2-3 years, its crazy!! I feel like every week there is something new or different about him physically or his personality. My boyfriend doesn't believe me when I tell him stories about how Max was the first 5 or 6 years of his life!!

[addy]

Anyways sorry to be writing so much in these last posts!!!

Post away!!!!!:D:D:D:D:D:D That is what your thread is for;);)

hugs,
addy

[Squirt's Mom]

Hi Nikki,

I would want that thyroid checked asap. It isn't a guarantee that the levels will return to normal as the cortisol is controlled. So I would want to know where it is now that he's been off the meds for a while.

SARDS has crossed my mind as well so I would want to have his vision checked, too.

A couple of other possibilities for what you are seeing are CDS and a macro tumor in the pituitary. CDS is Cognitive Dysfunction Syndrome. To quote Long Beach Animal Hospital -


Growing old is a natural process and a fact of life, for all of us, including our four-legged family members. Although dogs age faster than humanoids, their life expectancy is continually increasing. Family members will probably be the first to notice the subtle changes of Cognitive Dysfunction Syndrome or CDS. It may be more than just "getting old." Dogs with CDS may show signs of confusion, forgetfulness, less responsiveness, and/or other various behavioral changes that are not a normal part of aging. These subtle signs may not be exhibited in the examination room so we may not see them during an examination.

I will give you a list of links on CDS at the end of the post.

Breeds with the smush-face profile, called Brachycephalic, like Pugs, Boxers, and Bostons are for some reason more prone to developing macro tumors than dogs with a longer skull profile according to statistics. Many of the signs of a macro are similar to signs of cognitive issues. We have a thread in Everything Else where members who have dealt with macros have shared their experiences. It would be a good thing to read through to see if you recognize anything they saw as something you also see in Maxwell. That thread can be found here -

Macro tumor thread
http://www.k9cushings.com/forum/showthread.php?t=3567

My first step would be to have the thyroid and his vision checked out, tho, then go from there.

Let us know how things are going and keep up the good work. Max is lucky to have you on his side.

Hugs,
Leslie and the gang

CCS info
http://www.cpvh.com/Articles/4.html
http://www.lbah.com/cds.htm
http://www.cdsindogs.com
http://www.veterinarypartner.com/Content.plx?P=A&A=2549
http://www.innovet.it/en/public/prodotti/1/neuroprotection.pdf

[Nikki]

Just wanted to post an update!
Thank you for all of the information on the macro tumors. I read through it when you first posted it. Now, a week later, Max seems fine. I don't know if it sounds silly, but when he started walking weird and running into things, it was when we first moved into our new place. It was almost like he was just really confused and it was making him act weird. He is all settled in now, and he's been walking normal (even making it up the steps on his own!-most of the time at least)

Anyways, I have two concerns now. Max's calcinosis cutis is spreading and it seems to be getting worse. The areas he had previously are staying the same, but he had a big patch show up on his side and when I was laying in bed this morning I realized it seems like its moved to his ears, and parts of his face, as well as his front legs now. Does this mean that the cushing's isn't being controlled properly? My boyfriend is really upset, he doesn't understand why Max is at best staying the same (I don't necessarily want to say getting worse, but he doesn't seem to be better) His personality used to be very spunky and energetic, and all he does is sleep all day. He doesn't even acknowledge me when I get home anymore :(. (My second concern is him not seeming to be going "back to normal")
I know this doesn't just happen over night, but I just wish he showed small improvements and that the old dog I remember would come back.
Here's a picture I'll try to post: (I've never posted one, so lets see if this works!)
http://www.k9cushings.com/forum/picture.php?albumid=474&pictureid=3698

[labblab]

Hi Nikki,

In order to give you helpful feedback, we really do need to find out what the actual numbers were on Max's monitoring ACTH test. Since your vet does not have much experience with Cushing's, I do feel concerned as to whether or not she is shooting at the correct "target" range for Max. The desired ACTH result for a Cushpup being treated with trilostane is much lower than the "normal" lab range for a dog without the disease. So if you can find out those ACTH numbers for us, it would be a great help!

Marianne

[Nikki]

I am bringing max in to have his thyroid checked today, so I will request a copy of his acth test!

[Nikki]

Okay, so I'm a little aggravated! I went to the vet and she gave me a hard time about wanting to get Max's thyroid levels checked out. She did okay it, but I don't understand why she doesn't want me to have it checked. I mean if I'm paying for the test, why does it matter?!?! I had to tell her how lethargic he has been the last few days, and how I pretty much carry him out to pee and anywhere we go and then she said "ok, we know the cushings is under control so lets try this out and see"

Anyways, these are the results from the ACTH stimulation test he had on 4/12/2012

Pre-ACTH Cortisol- 1.3 Reference Range -ug/dl
Post-ACTH Cortisol- 14.1 Reference Range - ug/dl

I should get the results from his thyroid test tomorrow.

[Squirt's Mom]

If your vet thinks the Cushing's is well controlled with a post number of 14.1, they are sadly mistaken. :( The highest the post should be with a pup on Trilo is 9.1 and that is ONLY if all signs are well controlled. The usual reference range for a Trilo pup is 1.5 - 5.5 ug/dl so 14.1 is well over the acceptable level.

Something you might want to let you vet know about. ;) The following link has a good flow chart you could share with them.

http://www.dechra-us.com/files//dechraUSA/downloads/Client%20Literature/47902_VETORYL_10mg_Treatment_and_Monitoring_Brochu re_Update_3_2_ps.pdf

Hugs,
Leslie and the gang

[Nikki]

Thank you for that link!!!!! I printed out that chart, and I now have information to present to them. Another thing I found on that link is that the starting dose for a dog between 10 and 22lbs is 30mg a day. Max is 20lbs and only on 20mg a day. And I really wouldn't say he has shown any improvements since starting Vetoryl.
Even today when I brought him in, everyone was talking about how great he looks. I just don't get it.. My family and I see no improvement but all the vet techs swear he looks awesome. The only thing I can think of is before the Cushing's diagnosis, his skin was pussing bad and swelling and falling off by the clumps, so maybe if you went from seeing that to seeing him now you could consider it better. But the poor guy barely walks, barely lifts his head, he is always shaking and just SOOOO pitiful looking!! I may have to get a second opinion from another vet. It just makes me so sad and frustrated that my little baby is suffering so much and its possible that its just because my vet isn't experienced with this disease :(

(He has been looking so pitiful lately that my mom keeps talking about his quality of life, and if he will ever even get better. As selfish as it is, even if his quality of life sucked I don't think I could ever consider putting him down)

[Nikki]

Oh an they suggested today that I should start splitting his dose. He usually gets 20mg in the morning, and the morning is always when he seems to be the best. So starting tomorrow I give him 10mg in the morning and 10mg 12 hours later. I wish i would of gotten the ACTH stim results sooner and posted them on here, because now I feel like checking his thyroid might of been a waste of time and money.

[lulusmom]

I don't understand why your vet wants to split a dose that is already inadequate for once daily dosing. Twice daily dosing is for dogs whose post stimulated cortisol is within the therapeutic range of 1 - 6 but whose symptoms are not getting better. That's not where Maxwell is at all. His cortisol is still too high and his symptoms aren't getting better. The normal progression would be to up the daily dose; however, I personally believe that if a dog has diabetes or calcinosis cutis, they should probably be on twice daily dosing so that you can insure that cortisol is being adequately controlled throughout the day. When you switch to twice daily dosing, you don't just split the existing dose, you up the dose a bit and divide by two (am and pm). For instance, instead of splitting 20mg, you up to 30mg and split into two 15mg doses. To be perfectly honest, I'm not sure that Maxwell won't eventually require 20mg twice a day.

I highly recommend that you talk to your vet about this and suggest that he contact Dechra and discuss Maxwell's case. He definitely needs to tell them about the calcinosis cutis and ask them what an appropriate twice daily dose would be for Maxwell. I have included a link to the contact information for Dechra below:

http://www.dechra-us.com/Contact-us-1.aspx

[Nikki]

How bad is it for a dog to be on too low of a dose of Vetoryl? (in the short term). I feel like every day Max seems worse, and we have been trying to get a hold of the vet and still have not had a phone call returned. Now, the vet is closed for the whole weekend. We were told Wednesday that we would know the results of his thyroid test the next day, and we have been calling and they just say the vet will be calling us back.
Maybe Monday I will start looking for a new vet.
P.s. Today is Max's birthday, he is officially 8 years old now!!! :)

[Harley PoMMom]

Happy Birthday, Max!!!!

I would rather see a dog on too low of a dose that too high of a dose...a dose that is too high can cause an Addison's crisis. So, giving a dose that is not adequate for a short period of time is just fine. It can take a while to find the correct dosage that will control the elevated cortisol, it takes patience and a lot of worrying plus frustration! ;):)

Hope this helps.

Love and hugs,
Lori

[Nikki]

Thank you!!
That does make me feel better. I worry about him so much and I feel like I've just been glued to him the last few days watching his every little move!

[mytil]

Happy Birthday sweetie pie Max from me too!
Terry

[addy]

Happy Birthday Maxwell!!!!!!

It will get straightened out but I think Glynda is right with her oberservation about twice day dosing for a pup with calcinosis cutis.

Sometimes we have to push the vets;);););)

hugs,
addy

[jmac]

Happy birthday to Max!

I am so sorry to hear you are having such a tough time with your vet. How frustrating! I hope you can get things worked out, but otherwise it really may be time to start looking for another vet. Hopefully you'll get some better answers soon on how to help your little guy feel better!

Julie & Hannah

[Nikki]

Thank you for the birthday wishes to Max :)!!!
I was very sad when my mom bought him some marrow bones as a birthday gift (He used to fight with the other dogs in the house and steal all the marrow bones) and he showed absolutely no interest in it!! He sniffed it once and laid back down. I'm hoping he regains some of his "old self" sometime soon!!

[Squirt's Mom]

I'm so sorry we missed Max's birthday :o

Happy Belated 8th Birthday, Maxwell!

Belly rubs and butt sniffs,
Leslie, Squirt, Trinket, and Brick

[lulusmom]

OMG, I missed Maxwell's birthday too. :mad:

Happy Belated Birthday Maxwell!

[Nikki]

Thanks for the birthday wishes :D
So apparently Max's thyroid is supposed to be around 1, and its 0.4 so he will need to go back on his medication. But the vet wasn't in yet so we have to wait for her to call later, and then we can get more info on why his dose wasn't raised on the Vetoryl after his last ACTH test.
No wonder my poor guy has been so pitiful and sad the last week.. he must really be feeling crummy :(

[Nikki]

Does anyone know if calcinosis cutis can spread internally? Such as on the throat? Max has been having trouble swallowing and its making me nervous because his calcinosis cutis has been spreading all over his body. And still can't get ahold of the vet to find out why his dose wasn't raised... I'm starting to think she is blowing us off.

[mypuppy]

Hi Nikki,

I too wanted to wish Maxwell a happy belated birthday. He is a cutie! I also wanted to welcome both of you. I haven't been on here for some time now, but I always do check in from time to time just to catch up on all my precious furbabies and their moms/dads.

I pray and hope he will soon be feeling back to his old self again. Be patient with all of it, and take care of you.

Tight hugs, xo Jeanette and Princess

[lulusmom]

Does anyone know if calcinosis cutis can spread internally? Such as on the throat? Max has been having trouble swallowing and its making me nervous because his calcinosis cutis has been spreading all over his body. And still can't get ahold of the vet to find out why his dose wasn't raised... I'm starting to think she is blowing us off.

I don't believe calcinosis cutis is the cause of Maxwell's difficulty in swallowing. This sounds serious and if your vet is not responding to you, I would recommend that you find another vet, preferrably one that has a lot of experience with cushing's.

[labblab]

Have you looked into Maxwell's mouth, and been able to see anything abnormal? I, too, wouldn't really expect calcinosis cutis to be the problem. But when I just now Googled it, I discovered that the mineralization of C.C. can affect soft tissue elsewhere in the body, such as the mouth and airways, and also even blood vessels. So whatever the cause of the swallowing problem, I agree with Glynda that you have plenty of reason to find a vet who is responsive to you and who is well-versed in Cushing's.

Marianne

[Nikki]

I really appreciate the support from everyone on this site!!
Max WILL NOT let me open his mouth to look into it. He can still eat and drink, but he just does this weird swallowing thing that I don't know how to describe. It's almost like he has something stuck in his throat and he will just keep swallowing over and over again for a few minutes and it makes me nervous, and then he stops.
I was just worried about the calcinosis cutis because it has really been spreading lately, everywhere. It seemed under control for awhile and now its new "patches" of it all over him. I'm afraid he will have absolutely no fur soon!!!!
Anyways, we have an appointment with a new vet on Monday to get a second opinion on his treatment so far, and I've heard this vet is really friendly and awesome and listens to everything you say, so I'm feeling very optimistic!!
Hope everyone out there is having a good day :)

Nikki&Max

[Nikki]

So Max had his vet appointment today with a new vet to get a second opinion. He confirmed that my old vet read the post acth stimulation number wrong, and he said that for a vet that doesn't deal with cushing's disease a lot, its a mistake thats bound to happen. He agreed that not only does Max need a higher dose, but he doesn't understand why he wasn't started on 30mg to begin with.
The problem now is that this vet charges almost twice as much for Vetoryl. So we are considering sticking with our old vet hospital, but seeing a different vet that works there. We have an appointment there on Friday, so we will see how that goes.

[labblab]

The purchase price of Vetoryl shouldn't be the reason for you to have to shift to a different vet if you feel comfortable with this new one. You can buy brandname Vetoryl online for a cost that may be even less than what your first vet was charging. If you Google "Vetoryl," you should see several different internet pharmacies for which you can compare prices. Ask your vet for a prescription, and then you can order from whichever source you choose.

You will also see options for ordering compounded trilostane for even a less expensive price. Trilostane is the active ingredient in brandname Vetoryl. Some vets are OK with prescribing compounded trilostane for their patients. Others prefer that their patients stick with the brandname product when they are taking a dose for which Vetoryl is available. But either way, you will likely be able to find a better price than what you are now paying.

One word of warning: don't ever use an internet pharmacy that doesn't require a prescription for trilostane/Vetoryl. This is a huge red flag that you may be dealing with a black market operator who may not even be supplying the genuine medication.

Marianne

[Nikki]

Thanks for the info!!!
I had actually tried looking up Vetoryl online before, and our original vet still was the cheapest (I haven't asked them why, because I'm afraid since we were the first cushing's dog that they somehow priced it wrong and that's why we are getting it so cheap!! Haha :) )
The 30ct of 10mg is $43 while the 30ct of 30mg is only $47
The new vet said the 30mg is what Max needs, and they charge $83.
Most of the online ones that I found were between $55-$90
I do have to say that Max's original vet, is the vet we are going to see on Friday. Before he was diagnosed, his calcinosis cutis was so bad that his skin was pussing and green, and falling off in chunks.(they kept prescribing prednisone for it, so it just got out of control) So there were several occasions where we had to call and get him in the same day, so we got shifted over to the less popular vet, because she was the one with the openings and eventually she just took over his case, and became "his vet"
So, we are going Friday to talk to the original vet (Who has always been extremely nice, willing to listen, etc) and as long as he looks at the post ATCH # and agrees it is too high, we will be sticking with him!!
Sorry for such a long response!!!!
P.s. Since starting the thyroid med, Max is like a new man!!! He has been getting in and out of the house fine, moving around great! He has probably walked more in the last week than he has in the prior 5 months!!! Woo-Hoo!!!!!!

[addy]

I'll do a wooohooooo with you because that is really good news about Maxwell.

I hope you finally get the Vetroyl straightened out. I'll go look to see what we just paid for Zoe's 30mgs. I thought it was less than that.

Hugs,
addy

[Nikki]

I'm so happy Max is finally getting better!! He has been SO cuddly the last few days!!! I forgot what a pain in the butt he is to sleep with when he is cuddly though!! I slept awful the last two nights; woke up with him sleeping on my head, snoring away in my face, then I woke up with chest pain because he was laying right on top of me!!
At least he is feeling better though!! I missed my little cuddlebug! :)
Now I really want to get him on the 30mg of Vetoryl and see if he starts feeling even better!! Yesterday it almost looked like he was going to try to jump into the car on his own, but he didn't (thankfully, he probably would of fell and hurt himself!!)

-Nikki

[Nikki]

We got the go ahead to start 30mg of vetoryl tomorrow. This vet also said.14.1 is right on track and was saying the 1.5-5.5 is only for lysodren users, not vetoryl. And when I showed him the insert from the vetoryl saying otherwise he didn't seem to agree. Oh well, we will see how max does on his new dose.

[Nikki]

So Max has been doing GREAT on the 30mg of vetoryl!!!!!! He is moving so great, he even tried jumping into the car yesterday and he tried jumping up onto the porch today!! He is so perky and full of life, it makes me SO happy!! Also, I'm pretty sure he has had cushing's disease for about 3 years. Up until he was about 5, he was the alpha male, he would be very territorial, he would bark and growl at other dogs (Even dogs 4x his size!!). He would play very rough when we played tug of war, etc. etc.. Well he mellowed out big time around 3 years ago and we assumed it was just him getting older. He would barely even look at other dogs, he stopped chasing cats etc. Well I told my friend the other day it'd be no problem if she brought her dog (who is at least twice Max's size) to our cookout. Max not only went after the dog repeatedly, but he was growling and nipping at it, and his eyes were bulging out of his head!! I couldn't believe the way he was acting!!! We put him in the house and towards the end of the night we let him come back outside and he was okay with the other dog. So now all of a sudden he is acting like he used to 3 years ago. It makes me feel bad that he was probably suffering and felt so awful all this time!! I wish he would behave better around other animals though, I'm afraid he will get his eyes clawed out by my moms cats now!! Haha. Anyways, just wanted to post a little update!! Hope everyone's dogs are doing good :D

Nikki

[Hstaff]

how much does max weigh?

[Nikki]

I would guess he weighs around 21lbs now. Last vet visit he was up to 20lbs and we have been feeding him 4+ times a day, and his face is definitely looking fuller!! So he has put some more weight on. Before getting sick he was around 24 or 25lbs.

[Nikki]

Just wondering if anyone can recommend a good website to buy milk thistle off of? Our vet recommended we give Max milk thistle in the liquid form to help with his liver, when I google it, a million different items come up. He said to make sure we get it from a good source.

[Harley PoMMom]

I've purchased many supplements from "The Vitamin Shoppe"...here's a link for milk thistle: http://www.vitaminshoppe.com/store/en/browse/sku_detail.jsp?id=VS-1546

Love and hugs,
Lori

[Squirt's Mom]

I use Mountain Rose Herbs and trust their products completely -

http://www.mountainroseherbs.com/

[Zoe'sMom]

Hi Nikki -- I can relate, I have an 8yr old female Boston Terrier (Zoe) who was just diagnosed. We have spent over $2500.00 so far and I am so scared of what these meds do as far as side effects. I am looking forward to reading more (just discovered this forum today). A member of "WOOF: A Boston Terrier Board" sent me here.

[Nikki]

Oh hi!! I just posted over on your board saying hi :). I know the meds can sound scary, but between the vetoryl and his thyroid pill, Max is like a new dog!! At one point he couldn't get up any stairs, he couldn't walk straight and he would run into walls. All he did was lay around and looked so miserable. Now he is full of energy once again, and he tries jumping into the car!!! Ps... I heard Max bark for 3 minutes straight the other day... It's been 3 years since he barked so I'm taking it as a sign he is feeling alot better :D

[lulusmom]

I am thrilled to hear that Max is doing so well. I know how elated you must feel to have your sweet guy back after all this time.

[Nikki]

Yes I'm SO happy!!! I've been gushing to all my coworkers and family about how much better Max is doing, how he is playful again and is showing his old spunk. I'm sure they must think I'm crazy, because it's all I talk about, all the time!!! Haha. He is my little baby :). I've been giving him the milk thistle with his food, so hopefully his liver enzymes come down a little, and we are still working on the skin-- it's still pretty bad but it doesn't seem to be getting any worse at this point- just not any better either!

[Nikki]

So I'm just looking for some advice. Max has been acting a little odd the last day or two. It's almost 3am and we just woke up to him peeing in the bed (he was still sleeping) what should I do? Should I ask the vet to check his urine for a bladder infection? Is this a symptom of something else? Any advice would be appreciated!!!

[labblab]

Aside from the peeing in bed, has Max been acting odd in other ways?

Marianne

[Nikki]

Well the last two days he has been quieter. It may sound silly, but we live in my father inlaw's inlaw apartment next to his house. Max LOVES my father in law, every morning when I let him out I have to go pick him up from my father in law's front steps, Max just tries to get into his house to go see him whenever he can. Well the last two days my father in-law had to be checked into the hospital, and while he was gone Max was acting weird and we were joking saying he must miss him. But I'm sure it was just a coincidence. It's nothing too major that makes me say he is acting different, other than he was pacing around and being quieter than usual. Last night I brought him home from my mom's around 4pm and he absolutely would not pee at all all night long(He usually goes out at least every 2 hours if not more). And then this morning he peed on the kitchen floor, and it was yellow! He has had clear pee for as long as I can remember.

[Nikki]

Oh! I just remembered what started me thinking that Max was acting "odd". He always has his accidents in the kitchen. Monday night I tried to let him out, and he wouldn't go out. So I fed him dinner and told my boyfriend to let him out as soon as he finished eating. Well Max finished eating, went into our bedroom, peed on the bedroom floor and then ran and hid in the very very back of our closet. He pee's on the floor all the time, and never looks guilty or tries to hide. Then after that I noticed him pacing around a lot, and he wouldn't lay down for long. It was like he couldn't get comfortable, and he kept getting up and then laying down and then getting up. And when we went for a ride Monday night, he was kind of whimpering.

[Jenny & Judi in MN]

when was his last ACTH? peeing on my husband's pillow one night was one of our signs when Jenny was first diagnosed with Cushings. Could his cortisol be up?

[labblab]

I really encourage you to consult your vet ASAP. I don't know a lot about urinary issues, but perhaps Max has some kind of obstruction which would be both very painful and also a source of serious infection. Please do let us know what you find out.

Marianne

[Nikki]

I realized that this is how he acted before, when he had the calcium oxalate crystals (That was before we found out he had cushing's). So I went and picked up a sterile cup at the vet and caught some urine in it, and I am on my way to bring it to them. I'm not sure how they would fix this if that's the case, because last time they put him on a special dog food (Which we later learned he was allergic to). Thanks for the input, and I'll keep you updated!!

[Nikki]

So max does not have any crystals in his urine. The vet called to say they found blood in it and he has to start amoxi/clav drops, 2ml twice a day until gone. They also gave some tramadol for his pain. He wouldnt even walk this morning and made me carry him to his breakfast. Im not sure if it is his kidneys or bladder but he is hunched over in pain, and he even growled at a lady that tried to pet him today!!!!! I couldnt believe it, he never growls!!! So he is in a lot of pain, hopefully whatever it is clears up quickly!!!

[labblab]

Don't the vets want to actually give Max a physical examination in the office? Given the amount of pain he is in and the bloody urine, it would seem to me that Max may actually be suffering from kidney stones which I don't believe can be ruled out by a urine sample. It would take some sort of imaging to see the stones. Kidney stones are excruciatingly painful and I'd hate to think that they may be going undiagnosed. :(

Marianne

[Squirt's Mom]

I agree with Marianne - those stones can be present even when the urine doesn't show crystals...at least that was my understanding when Crys had issues. She did have struvite crystals but never developed stones but her vet said we needed to do an Xray regardless whether crystals were present or not. So I would insist on a thorough exam if I were you. ;)

Let us know how Max is doing. The growling certainly indicates he does not feel well at all. :(

Hugs,
Leslie and the gang

[Nikki]

So, I need some advice. We are on vacation 8 hours away and left max with my mom. We just found out he started having seizures last night, multiple times and every time he wet the bed. My mom is bringing him to the vet today for medication. She said when she called the emergency line the vet said it was definitely a growing tumor. He doubted the seizures and dry heaving were from his medicine being off or his electrolytes being off. I'm so distraught and don't know what to do. We packed up and are driving home now. Does anyone have any advice? I'm really hoping this could be related to his medicine being off, or something. I can't bear to think of putting him down, which is what my mom thinks is going to happen. :(

[Jenny & Judi in MN]

oh Nikki how scary. I know some other people have been able to get some medicine to combat seizures to maybe buy you some time?

please keep us posted. hugs, Judi

[Squirt's Mom]

Hi Nikki,

I am so sorry this has happened and such awful timing, too. :(

Seizures are possible with a macro tumor but we typically see other signs first like circling and head-pressing. That doesn't mean seizure as a first sign isn't possible, just that it is more often the case that seizures are found to be unrelated to Cushing's...if a cause for them can be found at all. Has Max been diagnosed with a macro? Have you seen, or your mom seen, any other odd behaviors recently?

There are medications that can help seizures so putting him down now is not something I would worry too much about just yet. ;) I know that is hard to do but keep the faith that there is a way to help your sweet boy. We have members who are coping with seizures and Cushing's, and I hope they will be along soon to share their experiences with you.

For now, Max is at the vet's where he needs to be and they will good care of him until you can get there, I'm sure. Please, please travel safely and know that we ride with you, wrapping you in our prayers, positive thoughts and healing white light for all.

Hugs,
Leslie and the gang

[Nikki]

Thank you so much for replying, it makes me feel better!! He has been doing this weird thing lately where he hides behind things... Coat rack, a couch, etc. And we never yell at him or give him a reason to be scared, so we definitely thought it was odd behavior. He seems to pace a lot. I feel like he always does 'weird ' things, so its hard to describe them all. Ever since he got sick and started taking all these meds he has been so different. I do know when you try to pet his head he moves it, so we thought maybe the top of his head hurt.

[frijole]

I'm sorry this happened with you on vacation. Please know my cush dog (not a macro) had seizures on a couple of occasions and they were scary but they went away quickly and did not recur for a very long time.

Also please be sure the emergency vet knows what drugs your dog is on because phenobarbitol is not tolerated well with trilo and lyosdren. There are other alternatives and hopefully Marianne or someone else with this knowledge can post it. Find out what he is given and post it here so someone can look it up ok? Hugs, Kim

[labblab]

I, too, am so sorry!!! Given your description of Maxwell's recent odd behavior, I do think that a macro is a possibility. But it may also be the case that there is some other issue that has prompted these neurological abnormalities and that the seizures can be controlled. I am strongly hoping that you will be able to have the time to sort this out.

If Maxwell is having ongoing multiple seizures, however, first finding a way to control them is going to take top priority. Kim is definitely right that in the long-term, phenobarb is probably not the best choice for a Cushpup because of its effect on the liver and its ability to affect the metabolism of trilostane and Lyosdren. One of the bromides (potassium or sodium) does not act on the liver in the same way, and is probably preferable for seizure contol in a Cushpup. Unfortunately, the bromides take a relatively long time to reach therapeutic level in the bloodstream (weeks). So the decision may be to start Maxwell on phenobarb initially in order to get control of the seizures and then wean him over to a bromide once he is stabilized.

Sending many healing thoughts your way, in hopes that you will find your little boy feeling much better.

Marianne

[molly muffin]

oh no. How horribly scary. I second the opinion of trying to find out for sure if this is a marcro or what and if the seizures can be controlled.

Check in when you can. We'll all be very anxiously awaiting word.

Hugs,
Sharlene

[jmac]

Hi Nikki,

I'm so sorry to hear about Max. I can imagine how horrible that phone call was, and how devastating it was to be so far away. My thoughts are with you, and I hope they can figure out what's going on with Max. Please let us know what they find out and how he's doing.

Julie & Hannah

[Nikki]

Thank you everyone for the support. Max and I are safely home now.
The vet gave Max an IV because he was dehydrated. They ran a few blood panels (Electrolyte and CBC) and put him on Phenobarbital 16.2mg twice a day.
His meds currently are:
Vetoryl 30mg once a day
Levothyroxine Sodium 0.2mg once a day
Claritan 5mg once a day
And a few drops of Milk thistle extract with his meals

So during our drive home, my mom called multiple times asking how far we were because she was totally freaked out by Max and she was scared being home alone with him. Now that I'm with him, I see what she meant. He is making both my boyfriend and I nervous. He is pacing non stop around our apartment, from room to room (Lately Max sleeps, pees, eats, and sleeps a lot more) I don't know where all of this energy is coming from!! And he keeps hiding. He was almost behind the stove, he got behind the toilet somehow. He keeps trying to hide behind doors, in corners, etc. My mom said he got stuck behind her washer and then stuck again in some junk in her garage. This is such weird behavior and I don't know what to do!! I tried picking him up and cuddling him, but he is just so restless. She said he also kept walking right off of her bed, and since our bed is so high up it looks like he will have to sleep on the floor tonight :(. Does anyone know what this weird behavior means?! I guess we have to wait for the blood work results to come in before the vet tells us anything more.

[Squirt's Mom]

Hi Nikki,

I am so glad you and Max are home.

Mixing Phenobarb and Trilo is not a good idea, sweetie. If I were you, I would stop the Trilo for now. These two drugs do not mix well and the most important thing right now are the seizures. So he needs the Phenobarb the most.

As for the behavior, it could be from the seizures, I'm not sure. But I have seen humans with seizure disorders behave similarly - confused, anxious, frustrated, almost dazed. It could also be a macro manifesting itself. Unfortunately, dogs with skulls shaped like Boston's and Boxer's are among the breeds that more often get the macro tumors. One of our members who dealt with a macro set up a thread in Everything Else about it and others have added their experiences, too. You can read about it here -

http://www.k9cushings.com/forum/showthread.php?t=3567

Do think seriously about stopping the Trilo for now. Phenobarb will mess with how the Trilo works and the combination is extremely hard on the liver.

Please keep in close contact and let us know how our sweet boy is doing...and his sweet mom.

Hugs,
Leslie and the gang

[labblab]

While I do share Leslie's concern about the combo of phenobarb and trilostane, I'd encourage your vet to contact Dechra (manufacturer of brandname Vetoryl) before discontinuing the trilo. Your vet can call or email Dechra directly and ask to speak with one of their technical representatives:

http://www.dechra-us.com/Default.aspx?ID=365

A few months ago, I spoke with a rep about the combination of these drugs and that is where I received the info that phenobarb is probably not the best longterm choice. However, having said that, the rep told me that Dechra is aware of dogs who are being treated successfully with both. In that instance, though, the vet needs to be aware of the dosing implications associated with the fact that both drugs have an effect on the liver. Dechra may recommend some dosing changes.

I wouldn't stop the trilo entirely, though, before your vet has had the chance to talk with Dechra. There may be reasons why a return to uncontrolled cortisol may not be in Max's best interest right at this moment.

Marianne

[labblab]

I wanted to pop back to also warn you that phenobarb can initially cause side effects that very much look like Cushing's symptoms: excessive thirst/urination/appetite, and lethargy. I've now had both a Cushing's dog and also a dog being treated with phenobarb, and I can tell you that until the phenobarb side effects wore off (after a couple of weeks), I wouldn't have been able to tell you which dog suffered from what. They looked that much alike! :(

That may also be a reason why you don't want to suspend the Cushing's treatment entirely for Max right now. The cumulative effect of both the phenobarb and uncontrolled cortisol might be pretty horrendous. I just don't know, and therefore would defer to Dechra's recommendations.

[molly muffin]

How is Max today?

Sharlene

[Nikki]

Max seems a little better today. My mom had mentioned he seemed to be in the worst shape during the night. My boyfriend stayed up all night with him because he was pacing and hiding and just would not lay down. My boyfriend went to sleep around 8am and I got up and took Max for a car ride. He fell right asleep, and we are back home now and he is still sleeping. It seems he sleeps all day and then get anxious at night and that's when he starts pacing and hiding. The vet that prescribed the phenobarbital is a different vet (But in the same practice as our regular vet), so I'd assume she knows he is on trilo since he has such a thick medical file. Also, the on-call vet that my mom talked to the first night he had the seizures had mentioned that since he has calcinosis cutis, he was quite sure that meant a tumor on his pituitary gland was growing. For now we are just patiently awaiting his test results, and I haven't changed his medicine yet.

[lulusmom]

Hi Nikki,

I'm glad to hear that Maxwell is doing better today. Yay!!! For those member's dealing with calcinosis cutis who may be alarmed by the er vet's statement that calcinosis cutis is indicative of an enlarging pituitary macro tumor, please know that this is not the case. High levels of cortisol are responsible for this skin condition and even dogs with iatrogenic cushing's, due to long term use of prednisone, can experience calcinosis cutis.

We're keeping fingers and paws crossed that Maxwell continues to improve. Please keep us posted.

Glynda

[addy]

Hi Nikki,

I dont post often but I always read your posts. I hope Maxwell is feeling better today.

Sending love and hugs and support.

[Nikki]

So last night was the worst night I've ever had. I woke up to Max throwing up (Like a foamy yellowish thing). I tried bringing him outside, but it was almost like he was drunk. He couldn't stand straight, and kept falling over. When he could stand, he would lower his head all the way to the ground and be in this really weird awkward position. I woke up like 5 times in the night to him walking in circles, running into things. It was just so awful to see him like that. He isn't himself at all and I feel like he is in pain :(. I did notice a phenobarbital on the floor, and I know it had to be the one from yesterday morning. So I'm wondering if that medicine is making him feel weird? He just slept all day yesterday (That would of been after the pill he missed). We gave him a pill around 10pm and after that is when he started acting all weird again. And he acted weird after my mom gave him the first pill. The only time we thought he seemed "better" was when we didn't realize he didn't eat that morning pill. We are still waiting to hear from the vet, we are playing phone tag. It's so awful to have to go through this, I feel like I could never own another dog again because it's so heartbreaking :(

[Steph n' Ella]

Hang in there Nikki! I don't have any advice but I hope you hear from the vet soon! Or pick up and sit in the office till you can talk to someone! Don't go through another night of this kind of misery!

[labblab]

Nikki, phenobarb can definitely cause dogs to act groggy and uncoordinated until they develop a tolerance for the drug. This can take several days through a couple of weeks. But depending upon how severe the effect is, your vet may want to cut back on the phenobarb dose right now at the get-go. My seizure dog was very dopey and unsteady on her feet to begin with, and we were on the fence as to whether or not to lower the dose. We didn't, and luckily for us, she soon showed improvement. But given Max's response, lowering the initial dose is definitely an option that your vet may advise you to do.

I do have to say, though, that I remain worried alongside you that the pacing, circling, and getting stuck in places may be the result of an enlarging tumor. The only way to know for sure is through very expensive imaging of his head, which may or may not be an option that you wish to think about, or even will have time to think about. It sounds as though Max is in a really bad way right now, and it may be hard to sort out what is causing all this. My husband and I believe our own Cushpup developed a large tumor, and it caused lots of problems that were very painful for us to watch -- endless pacing, circling, stumbling, similar to what you are describing. Given all these complications, maybe your vet can refer you to a neurologist. He/she would be an expert both regarding seizure disorders and also tumors in the head, and therefore may be able to draw some conclusions just by physically examining Max.

However, if Max seemed better after missing the phenobarb tablet, your vet may think that the first place to start may be just lowering the phenobarb dose to see if that helps.

Sending many hugs to you. I know this is so hard.
Marianne

[Nikki]

So the vet is having us split the phenobarbital pill in half, so he will get one half twice a day. He seems to not be worried at all, and said that the way Max is acting is from the meds. He also said to continue giving him all his other meds. My problem is that Max will not eat or drink anything. He wont even move on his own, unless he is spazzing out and then his movements are very uncoordinated. So how am I supposed to give him meds? We tried forcing it down his throat, but he fights it so bad. He won't drink so we have been giving him water through a syringe I had leftover from when he was on liquid antibiotics. He actually peed all over me today when I was trying to feed him the water. It was kind of funny, because normally that would make us so mad but he is just in such bad shape that all I could do was laugh. I am more than happy to be spending every waking moment trying to feed him, trying to get him moving outside, but in the end it just absolutely breaks my heart to see him like this. He used to love food and now its like he is just a zombie, he isn't even anything like the Max that I left a week ago when I went on vacation. I can't imagine how people can deal with the loss of a close loved one, because he is just a dog and I've been crying nonstop and just such a mess. I just keep praying something will change and he will get better. He's gotten so much worse in just the last 36 hours :(

[frijole]

I'm clueless but I care so I'm just posting to tell you that. Sending love, Kim

[jmac]

Oh Nikki,
I am so sorry. I can't imagine what that's like. I really hope something will improve soon. Sending lots of positive vibes and thoughts your way.

Julie & Hannah

[labblab]

Nikki, did your vet know that Max is not eating or drinking at all when he said to continue with all other meds including the trilostane? I know I said earlier that I would not discontinue the trilo without first talking to Dechra, but that was before I knew that Max is not eating or drinking. Neither of those are typical responses to phenobarb -- in fact, it is the opposite. Phenobarb often causes excessive appetite, thirst and urination. So when you add in Max's vomiting earlier, the picture of what may be going on with him changes and I now agree with Leslie about withholding the trilo. Dogs can go for quite a long time without eating. But going without drinking is another matter entirely, and they can quickly become seriously dehydrated. Getting fluids into Max will be priority #1.

Everything that you are telling us makes me feel more and more worried that Max has an enlarging pituitary tumor. In addition to the other weird behavior, my own Cushpup stopped eating and drinking, too. For us, the changes came on much more gradually over a period of several weeks rather than several days. But he did reach a crisis point quickly at the end. Your vet needs to know ASAP that Max is no longer eating nor drinking. These issues really change the whole ballgame and require attention just as soon as you can arrange for it. I am so terribly sorry. I know how awful it must be to see him this way.

Marianne

[lulusmom]

Hi Nikki,

I just wanted to jump in here and support both Leslie and Marianne. Do not give Maxwell any more Trilostane for the time being and most certainly not until he starts eating again. If he does start eating again, it may be that Trilostane is the sole cause of his problems.

I've gone back through your thread and as difficult as it is to say this, I believe Maxwell has a macrotumor. He's a breed that is over represented in the studies I've read and the fact that seizures started 60 days or less after you increased his Vetoryl dose to 30mg, is a red flag for me. Until that time, which I believe was the latter part of May, Maxwell's cortisol was well out of range at 14+ ug/dl. This increase in dose would have dropped cortisol levels and increased levels of acth which can be a problem for a dog with a macrotumor.

Studies have been done that show that reduced negative feedback due to the inhibition of cortisol secretion by trilostane or lysodren may increase the risk for accelerating growth of a pituitary macroadenoma. In this particular study healthy dogs were administered a low dose of 5 mg/kg trilostane twice a day every day for 8 weeks in one group and 16 weeks in another. After starting treatment with Trilostane, ACTH concentrations were increased remarkably and imaging (MRI) during treatment showed that the pituitary became enlarged. If a normal dog's pituitary gland enlarges, it stands to reason that a dog with an already expanding tumor will see an acceleration in growth. In Maxwell's case, the timing is right, the subtle behavioral changes leading up to the seizures with increasing neuro like issues worsening all fit.

After rereading your thread, I saw that your vet never did admit that he was wrong about Maxwell's cortisol being too high, despite reading it in the Dechra product insert and hearing it from the vet you went to for a second opinion. His statement that stimulated cortisol of 14 ug/dl is perfect for a dog on Vetoryl and that 1 to 5 ug/dl range is only for dogs being treated with Lysodren is absolutely ridiculous. If he is that stubborn about his own ignorance, I seriously doubt that he knows much about the mechanisms of Vetoryl or its effect on the pituitary. He may be right that Maxwell's current and very serious condition is due to the medication but did he tell you which medication is the problem? I believe he has no idea but based on the timing, he's probably guessing it's the phenobarbital but I, a layperson, would put her money on Vetoryl based on supporting evidence.

My heart is absolutely breaking for you because in my mind's eye I see you sitting on the floor with your precious Maxwell, worried sick and feeling like your going to explode from the worst anxiety you've ever experienced, knowing in your gut that you have to get him to eat, drink and swallow his pills and praying that he'll give in and do it. :( I've been there so I know how awful it is and for your vet to simply tell you that Maxwell's dire condition is just the medication and instruct you to keep giving him all the meds makes me want to shake him until his teeth rattle. Please get Maxwell to a specialist asap and if I were you, I'd print out a copy of the study and take it with you. I've provided the url below.

http://www.2ndchance.info/cushingsteshima2009.pdf

If you don't know any Internal Medicine Specialists in your area, you can search for one using the link below....or you can ask your vet to give you an immediate referral to one. If you let us know where you are located, we may have members who can provide name(s).

http://www.acvim.org/websites/acvim/index.php?p=3

I'm here pulling for you and Maxwell and praying that your boy finds some comfort soon.

Glynda

[labblab]

Nikki, how is Max doing this morning? I've been thinking about you guys all night. My heart just resonates with you, because what you are experiencing is so similar to those painful days we spent with our boy. I totally endorse Glynda's suggestion that you seek out a specialist to help guide you. I'm also glad she's given you these additional specifics about the possible link between Max's treatment and a growing tumor to discuss with your vet or a specialist.

For the benefit of all our folks who are using trilostane to treat their dogs, I just want to add that if Max's treatment has indeed accelerated his tumor growth, it does not mean that they should be switching to Lyosdren to avoid this risk. Even though research studies have not yet documented the same risk with Lysodren, it is hypothesized that the same risk should be associated with Lysodren. In other words, it is the disruption to the ACTH-feedback loop (via either treatment) that fuels the increased growth, and not the specific drug itself.

If it is an enlarged tumor that is truly causing his problems, then discontinuing the trilostane may not help normalize his appetite or thirst at this point. Max may need supportive assistance, regardess of whether or not the trilo is suspended right now. And even if a specialist does suspect that the tumor is the problem, it may actually be the case that the trilo is reinstated again, along with supplemental prednisone. As counter-intuitive as this may seem (the combo of trilo and a steroid), the goal may be to offer Max a very well-controlled dose of steroid supplementation to ease the ill effects of the tumor's pressure on the brain. As you can imagine, these decisions really take the knowledge of a specialist who has extended training re: these types of issues.

Once again, I am so sorry for what you all are going through. I will be anxiously awaiting updates today.

Marianne

P.S. I see that my reply has started a new page in your thread. Please be sure to go back and read the reply that Glynda previously posted last night.

[Squirt's Mom]

Hi Nikki,

Like Glynda, my heart is breaking for you and for Max. :( I can barely imagine the emotions that are constantly washing over you. In reading your post, I wanted to sit in the floor and hold you as you held and cried for your boy.

Let us know how he is this morning and if you see an IMS, what he has to say. Know we are right by your side during those long dark moments. You and Max are never alone but surrounded by the love and support of your family here always.

Hugs,
Leslie and the gang

[jmac]

Hi Nikki,

Just checking in on you and Max. Leslie is right. We are here with you-thinking of you and hoping for the best for Max. I can try to imagine how you are feeling, but I hope I will never have to know.

Julie & Hannah

[Nikki]

So last night was the first time we gave Max the half dose of the phenobarbital. This morning he was able to sit up on his own, and kind of walk a little. He only woke me up twice in the night with his "episodes". He still isn't eating or drinking. I've been throwing his pill wrapped in a little piece of chicken into his mouth when he yawns, and then I make him swallow it. I managed to get the phenobarbital and his thyroid in him this morning.
As far as the IMS, at this point what could be done? I mean, keep in mind I love Max so much but I've already maxed out my credit cards with vet bills. Is there something that can be done that would make him feel better? If he is just going to be in this suffering stage, where he isn't even himself, then eventually I will have to come to terms with it and have him put down. The thought of it is so hard to think about, but I just feel like the poor guy has suffered so much already. My boyfriend and I are just hoping that he will start to feel better soon :(.
Thank you everyone for your support, it means a lot to me right now.

Oh, and I live in Putnam, Connecticut. The bigger cities near me are Worcester, Massachusetts and Providence, RI

[Jenny & Judi in MN]

I'm glad the medication change is making a difference. I have definitely been thinking of you and Maxwell. Judi

[Tina]

Nikki,

I was thinking of you and Max throughout the night last night (couldn't sleep). I am praying that the med change makes a difference for him and that he feels better.

Hugs,

Tina

[addy]

I hope so as well. I hope Maxwell starts feeling better real soon. Sometimes it is so hard and so hard to keep up hope.

I am sending hope and strength and love and prayers for you and for Maxwell.

[labblab]

Hey Nikki,

I'm so glad to hear that Max is doing better on the reduced dosage. I'll keep my fingers crossed that he continues to improve from this point onward, and that he soon starts eating/drinking again. Even if so, though, I'd still really press your vet re: contacting Dechra to determine whether his trilostane dosing should be changed in order to accommodate the effects of the phenobarb.

As far as the referral to the IMS, I do understand that you may not choose to proceed with involved, expensive, and/or invasive diagnostics at this point. But it is possible that Max's situation may not involve an enlarging tumor and that his seizures can end up being well-controlled, especially if the cause for the seizures can be determined without a lot of involved testing. And as I've said above, if Max does need to remain on anti-seizure medication, it may be better if he is shifted to something other than phenobarb due to the trilostane. These are all examples of questions that a specialist may be able to field more knowledgeably than your regular-practice vet, and may only involve a short-term consultation or two.

As seriously ill as Max was sounding yesterday, I would just hate for something dire to happen that could actually have been preventable had the right treatment been applied. And if it's not preventable, I am thinking that it might bring you comfort down the road to know that at least you left no major stones unturned as far as seeking out answers. I am influenced here by the regret that I felt at the time that I lost my own Cushpup. Things turned very badly very quickly, and I was haunted for a long time with a lot of unanswered questions -- first and foremost, what exactly went wrong and could we have changed the outcome had we only had more information? I just hate for anybody else to go through the same regret that I experienced. And if Max doesn't start eating and drinking soon, you'll be pressed to make critical decisions based on whatever info you have on hand.

But whatever you decide, I know how much you love Max and how much you hate to see him suffering. And what might seem like the right path for me may not at all be the right path for you and Max. So you have my hugs and support in whatever decisions you end up making.

Marianne

[Squirt's Mom]

Hi Nikki,

Just checking in with you and Max this morning to see how the night went.

Hugs,
Leslie and the gang

[Nikki]

I just want to start this off by saying,
THANK YOU EVERYONE!!!! For your thoughts, and prayers. I know we aren't out of the woods yet, but I am SO happy right now!!
I have to add in that we had a really hard time giving Max his phenobarbital last night, it kind of got in his mouth and dissolved, but then parts were coming out of his jowls. So maybe all this is linked to the phenobarbital.
So, he didn't wake me up with any episodes last night (I built him a little fort on the floor on my side of the bed, lined with pillows and blankets, so whenever he would start spazzing out I would wake up immediately.)
So we woke up this morning, and I brought him out to pee. He walked around normally for a bit, then peed (Last night, twice I brought him out and he couldn't stand up and he laid on the grass and peed all over himself :( ). So we were excited by that. Then we realized he was more responsive today. The last few days it was kind of like he was a zombie, he had no reaction when we called him or anything like that. Today just the look in his eyes was different!! So we brought him back outside, syringed some water in him. Then we had the hardest time trying to get pills down his throat. We bought this plunger thing for giving dogs pills, but we just can't get his mouth open. So after about ten minutes of frustration, we gave up. We brought him back inside and just for the heck of it, I put a little piece of chicken in front of him. He sniffed it and looked really interested, and was trying so hard to eat it. After about two minutes, he just ate it!!!! So I just kept feeding him chicken, and he just kept eating it out of my hands, almost ravenously!! (He hasn't had solid food in days!! Just this nutrient gel stuff we bought at Petco yesterday). So I easily got him to take all of his pills by wrapping them in the chicken. He still can't drink water out of his bowl, or eat out of his bowl. I am just so happy right now, I could do a little dance!! Now, if he starts getting worse again (Just took his phenobarbital) I'll definitely be asking the vet if we can try out a different med. Anyways, sorry for the long rant. I'm just so happy and I wanted to share with everyone, since everyone was so supportive and kind when I was so upset the last few days.
Max and I send our love to everyone!!!!!!!!!!!!!!

[Squirt's Mom]

Oh, I am so happy for you all! :) I so hope Max has turned the corner and you will see continued improvement!

Hugs,
Leslie and the gang

[addy]

I am holding my breath for you. I sure hope we have turned a corner.

Hang in there.

[molly muffin]

Hi Nikki,

Just got home checking in on everybody. Glad that Max had a good night! yay. Hoping for many more good nights to come.

Sharlene

[Nikki]

So we are still doing pretty well. Max is still eating, and now he is drinking out of his water bowl on his own! I'm still uneasy about the phenobarbital though. I've noticed that Max is the worst about 10-15 minutes after he takes it. I definitely noticed it last night, and then this morning he was great and normal. I gave him his phenobarbital, and he is pacing nonstop and trying to hide. And the worst part is today is my first day back to work (I took yesterday off too because I didn't feel comfortable leaving him alone for 8 hours). Luckily I only work a 4 hour shift today, but with him pacing the way he is it will be so hard for me to work!! We never put him on a leash when he goes outside to pee, and he never goes more than 10 feet into the front yard. Last night he was practically in the road!! In the 2 years I've lived here, he never comes even close to the road! (We have a very big front yard). Of course I'm always right there when I let him out, so I kept picking him up and moving him closer to the house, but he just kept trying to walk towards the road. Looks like its time to start leashing him!
Does anyone else have experience with phenobarbital making their dogs do weird things? (I swear he only paces/hides etc, for about 2 hours after he gets his pill). One thing I noticed is when he does this, enclosed spaces comfort him. Last night I made him a little bed in a laundry basket next to the couch and he slept in it while I watched TV. Right about now I'm wishing that we had crate trained him as a puppy, that would be helpful for when I leave for work!

[molly muffin]

It sounds like Maxwell has a certain sensitivity to phenobarbital. Just like humans, not all medicines work the same on everyone. I think that a chat with the vet and a look at other possible medications might be something to check out.

Hugs. Glad you only have a 4 hour shift today!

Sharlene

[Nikki]

That's what I was thinking!! My little brother had seizures when he was a baby, and he was on phenobarbital. He kept having seizures and my mom said that they were accusing her of not giving him the meds. It turns out they just didn't work for him! They switched him, and he never had a seizure again. I'll definitely be talking to the vet about his meds. Also, someone recommended an IMS to us, its about $120 for a consult. So hopefully in a few weeks I'll have the money and be able to make an appointment :).

[molly muffin]

That is an excellent example. Obviously phenobarbital doesn't work for all humans and probably doesn't work for all dogs either. :)

Sharlene

[jmac]

Hi Nikki,

Glad to hear Max is doing a little better, and I also agree that a chat with the vet about the med is a good idea.

Also, I just wanted to mention Care Credit to you, in case you haven't heard about it. It's a credit card that you can use for veterinary and human medical bills. I had to use it when my boy Bailey needed lots of emergency care before we had to let him go. We had $1,000 in vet bills. They work out a monthly payment for you with no interest, as long as you pay it on time. (They determine the payment based on the amount you charge). It was a little more than the minimum payment on a credit card, but I loved the fact that there was no interest. That might be an option if Max has to undergo more procedures, etc.

Julie & Hannah

[Nikki]

I actually have a Care Credit card from when I had a tooth pulled. Do all vets accept it, or is it their choice? I'm not sure if mine accepts it. Something I'll definitely have to look into.
We called today to talk about changing meds and were told that this is all normal and we should give it a few more weeks. :(
Max was pacing in circles in my bed at 5am this morning, and he was so high strung nothing would calm him down. Then when I got home from the grocery store today, he was stuck behind the stove!! I thought I was going to squish him trying to get him out, I have no clue how he got back there in the first place!! I brought him out, and he just kept trying to go into the woods (He's never went into the woods before in our back yard!!) I was getting nervous because some of it is very thick, and I don't even know if I could of gotten to him through all the bushes/trees/etc!! I kept carrying him back to the house, and he would charge down the hill towards the woods. So strange. Sometimes I wish he could talk to me so I knew what was going through his mind!!! :confused::confused::confused:

[molly muffin]

Oh poor Max, stuck behind the stove. You might have to limit his area or try blocking items off so he won't get stuck while you are at work.

The vet thinks this is all normal? really? Poor guy. It really sounds like that pheno is messing with him. What about lowering that dosage, would the vet talk about that or switching at all?
argh, it is so frustrating. Did the vet say if the symptoms would start to go away that he is exhibiting, since he thinks this is normal? like will they lessen over the coming days? that would be good!

hugs,
Sharlene

[Squirt's Mom]

Hi Nikki,

How are things with our Max? Does he seem to be adjusting to the meds?

I could just feel your panic over the woods. Squirt got out of our fence about a month ago and there is a strip of woods right next to us where I was terrified she had gone. That is such a helpless feeling thinking our little babies could be in a place where they could be hurt so easily.

Let us know how things are going.

Hugs,
Leslie and the gang

[Squirt's Mom]

Hi Nikki,

How is Max doing?

Hugs,
Leslie and the gang

[Nikki]

Max seems to be doing okay. Overall, he is much better. There's at least once a day though where he starts pacing frantically, or getting stuck in a corner, and I'm not sure if it's "seizure activitiy" and we should be upping his meds, or if it's the meds making him act weird. We bought a baby gate, and strategically placed some things around the apartment so we can safely leave him in the kitchen now without worrying he will get stuck behind something. When I got home from work the other day he was frantically scratching and panting because he had gotten stuck between our bathroom vanity sink and the wall (It's the smallest space ever, I still have NO idea how he even got in there!!!) It made me so upset! He is still going into the woods, and going towards the road which is so weird to me because he never ever went that far in the 2 years we have lived here!!

[molly muffin]

That is strange. I don't know why he would do those things either, but it's great that you are making a safe place for him.
You know when there is thunder, molly will get behind anything she can possibly squeeze into. The other day she managed to get under my desk, to the plat and then behind the plant. That area was no way big enough for her body and it was a dickens of a time trying to get her out. I wonder if anything wide open is scary for him. Not sure how that would anything to do with the roads, but the tress would be a safe place.
It is sooo hard to try and figure out what is going on our with little ones and this crapola disease that just will not conform to standards no matter how hard we try to figure it out. :(

Glad that Max is doing alright. That is good news and maybe as he continues to get better, the strange behavior will go away too.

hugs,
Sharlene

[Nikki]

So Max went to the vet's today!!
He was past due on some vaccinations, when he went in April he was so sickly they only felt comfortable giving him his rabies vaccine (They said if it wasn't required by law they wouldn't even give him that).
I told her how he is very hyperactive on the phenobarbital and she said that's very unusual, and she wants us to bring it down to just one half of a pill in the morning, and see how he does with that. His liver enzymes were up (in the 500's).
He also tested positive for anaplasmosis, and is on doxycyline for 28 days. This will hopefully clear up his skin infection on his belly/penis area too (I had to point it out to her, I was like I'm not quite sure what this stuff is....) turns out its a bacterial infection of some sort.
He has good days and bad days, but lately I feel like he is doing good. Today was the first time he walked into the vet's, walked from the waiting room into the exam room in months (Maybe a year!!) he usually makes me carry him. He even sniffed some other dogs butts!! Normally he totally ignores other animals and people, even when they give him attention!!
Oh, I almost forgot to add in, he lost 2lbs!!!! He is down to 19.2lbs. The vet didn't seem too concerned, but I was like oh I knew he lost weight!! He is SOOOO boney, I can feel every one of his ribs!! He looks like I starve him!!! (But really he eats like a king!!! :P)

[molly muffin]

I'm happy to hear that Max seems to be doing okay. I wonder if lowering the dose of phenobarbital will have anything to do with this behavior and wanting in closed spaces.

Good news is always welcome and it doesn't get much better (in doggie land that is, not in my Land necessarily) than sniffing doggie butts. ROFL! We did get pretty excited when Zoe bit KoKo's butt too, but I think sniffing overall is the preferred activity. hahahaha

Hugs,
Sharlene

[Squirt's Mom]

Hi Nikki!

I meant to come ask about Max all day yesterday and just didn't do it but was so glad to read your post last nite! It sounds as if Max is doing much better than he was - walking and sniffing at the vets! :D To me, that is a good sign! ;)

As for the vaccinations - I wouldn't even worry with them at all right now unless Max is boarded or spends time with other dogs on a regular basis. If he is pretty much at home these days and not exposed to things, I would just forget about vaccinations. ;)

We have a thread in Everything Else about Satin Balls that can be made to help pups gain weight if you'd like to look into that for Max. The link is....(let me go find it, be right back!).....(here we go!) -

http://www.k9cushings.com/forum/showthread.php?t=4081

Hope you and Max have a wonderful day!
Hugs,
Leslie and the gang

[addy]

Im going to chime in with a

"I'm soooo glad Maxwell if feeling better. You know it is funny, I went to a dog show last year and all the dogs looked so skinny to me. When I first brought home Koko everyone commented how thin he was. His vet said he would rather he be on the thin side then too plump. Maybe it is okay he is a bit thin:o:confused:

Anyway, just trying to make you feel better:D:D:D

[Nikki]

Thank you for the advice on making Max plump up :). I'll definitely have to try out that recipe!!! I'm currently in the hospital, had my appendix out this morning :(. I miss Max so much and my boyfriend said Max peed in the bed last night twice, he thinks he is stressed out because I haven't seen him since Friday night. Last night was the first night in over two years I slept ALL alone, no Max and no boyfriend :(. Hoping to get discharged tomorrow!

[Squirt's Mom]

WOW, Nikki! Glad to know you are alright and hope you are back home in your own bed very, very soon. I know Max will be glad to see you, too. It wouldn't surprise me one bit that he peed because you weren't where you were supposed to be. Squirt knows our routine to the T and will allow very little variance these days without letting me know in no uncertain terms! (Queens can be that way, ya know! :p) I bet Max will be just fine once he sees you are home.

Thanks for letting us know and keep in touch! Prayers and healing white light flying your way.
Hugs,
Leslie and the gang

[Steph n' Ella]

Nikki, good luck on your recovery from surgery! I am sure Max will help you get better.

[Nikki]

I'm so happy I got to come home today!!! Max's eyes were so big and he just kept sniffing me, I think he must of thought I abandoned him!!! Haha :). I'm happy I have him to cuddle with while I'm out of work the next few weeks. The only thing is that I cannot lift anything over 10lbs, and Max is so stubborn so I have to try to "herd" him outside to pee, and "herd" him back inside, since I can't pick him up :-P

[winston's mama]

Hi Nikki, we're happy you are home & recovering form your surgery! I'm sure Max missed you & is so happy to be snuggling with you now! Winston knows when I am not home & although he loves my husband & our son, he knows he is MY dog!!! He loves ME & wants to be in whatever room I am in!!!n I love him so much...he's been on a very low dose of Trilostane for 10 days now, & his Cushings symptoms seem to be getting progressively worse so I'm going to up his dosage tomorrow & hope for the best. He's been on Pheno (just like Max) for seizures for 6 years now & he's had no problems with it. We had to add Potassium Bromide also to get his seizures under control, but with the combo, it's been 3.5 years that he's been seizure free! I'm just hoping the Trilostane doesn't have some weird reaction with his current drugs. Also, you mentioned Max's liver enzymes were high (500's) well, Winston's are way high too, his ALP is over 2000. His ALT is 334 (which is also high) but the vets tell me that's all normal for a dog who is on Pheno...Plus his liver is enlarged verified by ultrasound...(I suspect he may have liver disease but at this point I don't think there's much we can do about it.) Anyway, that's just food for thought for your situation...Winston is in no way the happy little pup I've know for the last 8yrs, but he does seem to be making a slow improvement since he came home from the ER animal hospital about 2 weeks ago.
Best wishes to you & Maxwell!!! We hope you are both feeling good very soon! Take care...

[molly muffin]

YAY! Glad you are home! The perfect place to recover, with max and the guys. Ohmy, herding, that's got to be something to see!

Hugs,
Sharlene

[Squirt's Mom]

Hi Nikki,

SO glad you are HOME where you belong! :) And I know that Max was ecstatic to see you again...and your boyfriend probably was, too. ;) Be very good to yourself the next few days especially - then take every advantage you can for the following time. :p;)

Tasha, my little Boston, also needs "herding" at times. She's deaf so calling won't work, picking her up is often uncomfortable for her, and if I don't make her come inside she will eat rocks! :rolleyes::) So I find myself walking along behind her, touching her butt when she turns toward a dirt spot to keep her going the right way. And, when she is feeling pretty good, this is a grand game to play - you dawdle and wait for Mom to touch your butt then DASH away with a goofy grin! :p

I hope your recovery goes very smoothly and I know with Max there to keep an eye on you things will be just fine.

Hugs,
Leslie and the gang

[Nikki]

I'm starting to feel burned out!!!!!
Ever since I went into the hospital, Max has been having accidents SO much. He just keeps peeing on the floor and last night he peed in the bed :(. I can only walk around for a few minutes before I get really tired, so I feel like trying to clean up after him is sucking up all of my energy!!! To make matters worse, I think Max is in some kind of pain. I was pushing at his butt to try to get him to walk into my moms house (Very gently of course) and he tried to bite my foot!!!!!!!!! So then I had to get my brother to come pick him up and carry him inside for me, and when my brother picked him up Max started growling at him. He never growls :(. So obviously something is hurting him. I had my boyfriend come pick him up later, and he growled again when he was picked up. I'm not sure what his weight is at, but he is looking skinnier than ever!! You can feel in between every one of his ribs... he looks gross :(. Like those sad starving dogs you see on TV. But we feed him so much! I've already went through a whole roll of paper towels in 24 hours just from cleaning up all his messes. It's so frustrating, but at the same time I feel bad for him because I don't know what to do to make him feel better!!

[labblab]

Nikki, can you remind us whether Max is still taking any trilostane?

Marianne

[Nikki]

He is on 30mg of Vetoryl a day. The last two days I found his pill crushed up on the floor, so I'm not quite sure he got any of it in his system. He wasn't as bad last night but he did pee in the living room right after we spent 20 minutes outside waiting for him to pee and he wouldn't. Normally I have so much patience but with my surgery I'm am feeling very worn down :(.

[labblab]

If Max went for 48 hours without any trilostane now (and perhaps wasn't getting it as consistently when you were in the hospital?), I'm guessing that could account for an increase in his symptoms. Also, do you know whether your vet has checked with Dechra or done any further investigation about the interaction between trilostane and phenobarb? Max may need some changes to his trilo dosing in addition to finding a way to make sure that he's actually swallowing his pills.

Marianne

[Boriss McCall]

I don't have any answers for you & Maxwell since I don't know enough about Cushing's yet. But, I am rooting for you & your baby. Like they say Its always darkest before the dawn. You can do this!! I hope you start feeling better soon. I know worry is a stress for your still healing body.
Hang in there Nikki..

[Nikki]

I doubt my vet has looked into anything. Whenever I ask questions they seem to brush them aside, and also Max rotates between seeing the 3 different vets that work there. The last one I saw kept saying how Max was so old and he hit a point in his life where he can eat whatever he wants, we shouldn't worry about weight control or anything like that. (He just turned 8?!?!?!) I mean I know he is older, but I wouldn't consider him on the edge of death. I think the problem with the pills is that my boyfriend has been feeding him and giving him the pills, and he is always rushed to get to work. When I give Max pills I do it one at a time and make sure he swallows them, and if he doesn't I pick them up and try again. Thank you for your input, I get so worried all of the time and coming on here really makes me feel a lot better. I'm going to try to take back over feeding and giving him pills, and see if his symptoms get better!! He is definitely due for an ACTH stimulation test, but with being out of work I'll be lucky to pay my bills, never mind the vet bills. So unfortunately he will have to wait a few weeks before I can get him in to check his levels.

[Steph n' Ella]

I'm buying stock in paper towels :) :D If I'm in the middle of doing a million loads of laundry, I just use one of the towels that's already dirty and about to go in the washer... no use in filling up the trash can and wasting more paper towels!

[Boriss McCall]

That is what we do. We have a pee towel that pretty much stays on the floor & gets used at least once a day to clean the pee.

[Nikki]

Good idea!!! We are in need of new towels, perhaps ill buy a few and retire the old ones to be 'pee towels' :D.

[molly muffin]

Molly use to have what I call attitude peeing issues. She'd get irritated about something and go pee on the floor. (brat) This has lessened over the years, thunderstorms though can cause an accident, especially if I'm not home. I got one of those little green bissel machines. Love it! I bought it before the grandbaby came to visit, thinking she'd cop an attitude about the baby getting all the attention. phew, it didn't even phase her and not an accident to be seen. Course they leave, she immediately has one, so still glad I got it.
pee towels are a good idea. I've heard putting a towel down and using a heave book to hold it down and soak it up works well on rugs too. (carpet cleaner guy told me that)

okay back to regular scheduled programming now! Hope you are feeling better.

hugs,
Sharlene

[Cocoa's Mom]

Sharlene, I am totally going to look into one of those Bissell cleaners. Where did you get it?

Nikki, I totally feel your pain on the peeing. I am so tired of it! I bought a jumbo pack of absorbent pee pads which do help IF Cocoa hits them. Haven't tried the dog diapers, but am half-seriously considering it!

Donna

[molly muffin]

Found it at Walmart! Little Green Machine, or even check online for a place that carrys them.

hugs,
Sharlene

[Nikki]

I feel like there are so many up and downs lately :(
Max has been on doxycycline since August 20th. All of a sudden, the last four nights after he takes it (like 30-45 minutes after) he throws up. Last night he threw up so much! I don't even know how so much came out of a little dog :(. So then today he snuggled under the blankets and fell asleep. I just went to check on him and he is really overheated, he was panting and breathing weird and his eyes were just freaking me out. I turned the ac on and syringed him some water and he still isn't really responding :(. I tried to pick him up and make him stand and he just kind of fell over. I feel like maybe he had another seizure, because this is how he was acting when I got home from vacation and the last few days he has been pacing around the house A LOT more than usual. I left a message with the vet, hoping they call me back soon. I hate seeing him this way, it makes me feel like he is dying and I am so helpless because I don't know what to do for him :(.

[labblab]

Oh Nikki, I'm so sorry!!!!! It's so hard to know what is going on. Is your vet far away -- can you just bundle Max up and take him in on an emergency basis if they don't get back to you quickly?

Marianne

[Nikki]

They are only like 15 minutes away. But my boyfriend says I worry too much and I should just give him some time and he'll cool down and be fine. But I don't know, he is really freaking me out :(

[Boriss McCall]

Poor little guy.. :(
I hope he feels better soon.

[Maya]

I feel for you....I really do. We seem to be going through a similar experience. I hope Max feels better soon...
Hugs from Leah and Maya

[Nikki]

Thanks everyone! He seems a little bit better. Now when I stand him up he can stay standing for a bit... his back legs start to slide and then he falls... he isn't trying to walk at all. But I feel better knowing he can at least hold himself up somewhat. I'm thinking he probably had a seizure, and hopefully after a few hours he will come back to normal. It makes me feel SO much better being able to come on here and talk to you all!! Thanks again!!!!

[lulusmom]

Hi Nikki,

It's been too long since I've visited your thread and now that I've updated myself, I have a lot to say.

In one of your posts you mentioned an anaplasmosis diagnosis in passing, like it was incidental to everything else going on with Maxwell My hair stood on end because anaplasmosis can be fatal if not treated effectively and it can explain every one of Maxwell's symptoms that I assumed were probably due to a macrotumor. The Dogs with anaplasmosis usually respond to doxycycline rather quickly but not if they are taking phenobarbital. Phenobarbital can and does render doxycycline ineffective, which could very well explain Maxwell's continued decline. I am mortified by your vets' ignorance of the diseases they have diagnosed and the drugs prescribed.

Phenobarbital is hard on the liver but it's impact is nothing compared to what anaplasmosis can do. It can cause orgain failure, especially if a dog has more than one infection. When was the last time your vet checked Maxwell's liver and kidney values? Has any of your vets mentioned that Maxwell's seizures were probably brought on by anaplasmosis so phenobarbital isn't needed if you treat and remedy the anaplasmosis? Did any of your vets mention that every symptom, except the skin issues, you explained to us can be attributed to anaplasmosis? Did any of them tell you that it is causes very painful joints and neurological problems which is probably why Maxwell whines and has difficulty moving and walking? I have so many questions of your vets but they need go on the back burner along with everything else right now.

Nikki, if Maxwell were my dog, I would be out the door with him in my arms running to the first specialist I could get an appointment with. If anaplasmosis is his real problem, he is in pain and it's going to get worse because the doxycycline isn't working because of the phenobarbital. Your poor guy has suffered enough.

Glynda

Glynda

[labblab]

Glynda, that's a great catch re: Max's symptom profile and the anaplasmosis diagnosis! I have just one "sidebar" comment to offer, and that comes from the fact that my Peg is treated with phenobarb, too. Some antibiotics should not be given at all with phenobarb. Doxycycline is one that CAN be given, but higher dosages may be required:


Phenobarbital speeds up liver activity and, when used with other medications that are normally broken down by the liver, may cause them to be metabolized more rapidly, therefore requiring them to be given at a higher dosage. Some of these drugs include antibiotics like chloramphenicol and doxycycline, heart medications like digitoxin, corticosteroids and antiparasitic drugs such as metronidazole (Flagyl). It is also reported to decrease intestinal absorption of the commonly used anti-fungal product, griseofulvin.

We've successfully used doxycycline on a couple of occasions to treat UTI's in Peg. So it may remain the antibiotic of choice to treat anaplasmosis in a dog who is suffering from seizures that continue to require phenobarb treatment. But the dosing may need to be altered. This has been my concern all along with Max's trilostane dosing, too -- that the trilo dosing may require changes of which Max's vet may be unaware. So this is now all the more reason to seek out an expert's opinion as Glynda suggests.

Marianne

[Nikki]

Thank you so much Glynda, for what you posted. When I was told Max was positive for anaplasmosis, it was as I was cashing out and walking out the door. They just said it was kind of like Lyme but a different disease, and added the antibiotic onto my bill. I had googled it briefly when I got home, and saw one website that said in some cases it can cause seizures. I was wondering to myself if that was linked to Max.
The vet did call back today. They said they don't think it is the doxycycline making Max sick because he has been on it since August 20th, so if it was making him sick it should of started right away, not just a few days ago. I told them how odd he has been the last few days (He is the energizer bunny, he paces NON stop and he jumps on the couch and knocks things off the table, and is just constantly moving! We had to start crating him all the time just to keep him safe!!) And then today he is so lethargic and barely moving. She mentioned something about it being humid the last few days (or something about air pressure?) and that can make seizure dogs act weird. Anyways they have me going in for a checkup at 11:30 tomorrow and I will definitely be spending tonight looking into anaplasmosis, so that I am armed with a lot of info. On a happy note, they did schedule me with my favorite vet. He always listens to all of the things I have to say, he always explains things very well and although he is always running late, I know he will spend as much time is needed with me so that I feel comfortable with his diagnosis. Thank you again ladies for posting :) Your such a great support group!!

[molly muffin]

Oh my gosh, poor Max. I hope that they can figure this out tomorrow and take into consideration the concerns that some have mentioned here. It is all very worrying. :(

hugs,
Sharlene

[Nikki]

So Max is now down to 17lbs :(. The vet said I could try adding egg to his diet for some healthy fats. Maybe I'll make him a chicken omelet minus the cheese? haha
I brought up the anaplasmosis and he assured me that is not the problem. He said that only turns into a big problem when left untreated for years, and Max was tested for it last year. He is quite certain that Max has a pituitary tumor growing, and that is causing the seizures, pacing, excitability, etc. He said the only way to know for certain is with a CAT scan, but we are better off just assuming that is what it is. He also said that phenobarbital can affect how doxycycline is absorbed, but not enough for us to have to worry about it. He took Max off of the doxycycline saying that is what has caused the vomitting (which makes sense, we skipped giving it to him last night and he didn't throw up for the first time since Saturday.) He thinks Max had enough of the doxycycline to kill off the anaplasmosis.:confused:
He said Max's allergies were really bad today (from the way his eyes and skin looked) so he gave him some kind of a shot.
So, along with stopping the doxycycline, he said to try giving Max a quarter of a phenobarbital every night (along with the half pill we give him every morning) and see if it helps. He said a lot of my concerns were all "seizure related activities"
I really do want to get Max into a specialist, but with me being out of work from surgery it's just not possible right now. (Luckily the vet waived the visit fee today, saved me $44!!)

So for now I will try the increased phenobarbital, and feeding Max 3 times a day and hopefully getting some meat back on his bones!!! Right now you can literally feel every rib, and I'm afraid one is just going to poke right through his skin!!!! Before sickness he was around 25lbs. 2 months ago he was down to 22lbs, 3 weeks ago it was 19lbs and today its 17lbs. I don't think he can possibly lose anymore weight at this point, he is just skin and bones.

-Nikki

[Boriss McCall]

oh Nikki.. what a hard time you & your baby are having. :( Poor Max:(:(:(:(:(

I hope his tumor is not growing & this is something that will be helped with his seizure. :(

I can't even imagine how you must be feeling. I know to see a crazy full of life Boston Terrier get so lethargic must be awful. Especially at his age. Your story makes me cry...

I hope he starts feeling better with the medicine change.

Has he always had seizures or was that all new with this cushing's stuff?

Hang in there.. I wish I had medical advice.. I just don't know enough about it.

HUGS girlie...

[Nikki]

Thank you Amy!!
He never had seizures before. As far as I know he has only had two; one in the beginning of August when I was on vacation so I had to come racing home. And when I described what happened yesterday, the vet said it was a seizure. I didn't actually see the seizure happen, but the vet was pretty sure that's what caused Max's sleeping all day/not moving or standing up. The vet said the seizures are from the tumor growing. He did not mention if we should be worrying about it growing fast, but I really hope things don't get any worse for my poor guy!
It's especially hard to see because my mom has two Boston's. One is less than a year younger than Max, and the other is 2 years younger than Max (She is his puppy we ended up keeping). They run around like lunatics, are always jumping on visitors, and just the normal crazy Boston Terrier. So to see them four or five times a week, and then see Max the way he is is so sad :(. When I bring him to her house he distances himself from the other dogs and wants nothing to do with them.
But, he loves snuggling with my boyfriend and I and he absolutely loves being our only dog. So at this point I think he is leading an okay life with all things considered. I don't want to make him live in pain, and my vet assures me that his quality of life is okay right now. I'm not ready to let him go because he is like my child. I am one of those crazy dog lovers :) Hahaha. But then again I'm sure all of us on this forum are crazy animal lovers :D:D:D

[Boriss McCall]

I know what you mean. dogs melt my heart.. I love them all. Boriss will still play with my bulldog when he feels like it. but, not as much as he used to. Pearl is really bummed about that.

But, He is like Max he LOVES LOVES LOVES to cuddle. That has always been his favorite thing to do.

My dog that recently passed away they thought she was having seizures. Turned out it ended up being something totally different. But, at the time I decided to go to a different vet closer to my house that was not as expensive. He SUCKED! excuse my harshness.. but, I feel like he was one of the main reasons we lost her so quick. Don't get worried it is nothing like your babies story.. ;) Plus she was 11 almost 12 years old.

What happened was is she started having spells where she just got really still & fell over. I could see when they were about to happen. Usually when she was hot from being outside & normally only a couple times a year. Then few months ago it happened twice in one month. Then I was getting ready for work one morning & I heard this awful whine sound & she was laying on the ground on her side.

I rushed her to the crappy/cheaper vet & he didn't even take 2 seconds to check her out & look at her. He just immediately put her on Phenobarbital. A week later she was in the ER at my normal vet & dying.. She wasn't having those kind of seizures but heart failure. She might have possibly had a heart murmur that was never caught. He didn't even check that kind of stuff. It made me so sad that I wasted my time going to that vet.

That is why when Boriss started peeing in the house I didn't go back there. I am sure they would have never discovered his Cushing's.

Sorry.. I am just venting here on your thread.

What would make a dog who has never had seizures like Max suddenly have them? Will he have to take that medicine forever now?

I hope you get some good cuddle time in today & he starts feeling chipper soon.

[Nikki]

Unfortunately he will probably be on the medicine forever. The vet mentioned that cushing's dogs and hypothyroid dogs have a tendency to have seizures, so it could be from either/both of those.
On another note, I feel SO bad right now!!!
I had mentioned to the vet how Max hasn't ate much the last few days, he will sniff his food and kind of lick it and then walk away. He said sometimes with seizures/leading up to seizures they can have trouble eating. So last night for the heck of it, when he wasn't eating his dinner I grabbed a spoon and tried to feed him off of the spoon. His eyes got SO big and he was gobbling it all up!!! So he is probably down to 17lbs because he has literally been starving!!!! This morning my boyfriend fed him his normal breakfast with a spoon. I wanted to give him a little treat so I just fed him about a quarter of a pound of turkey (deli meat). He ate it all really fast. So I warmed him up a bowl of his chicken/egg/oatmeal mush (gross, I know!!). I spoon fed it to him and he ate every last drop of it. I'm about to try feeding him some more in a few minutes. Hopefully now we can really start to pack some weight on him!!! :)

[Boriss McCall]

yay! I was just thinking about you guys last night. I hope you are feeling better.
How is Maxwell today?
I hope he is getting fat!:D
So he will eat off of a spoon? but, not his bowl?

[Nikki]

Max is doing okay today. He was doing some circling, which worries me. But at least he isn't pacing non stop!!
Yeah, don't ask me why or how, but Max can eat off of a big spoon no problem. I don't know if it hurts his neck to bend down and eat out of his bowl? Or maybe the way he "licks" up his food is hard from the bowl? He will not eat out of his bowl. He is eating SO much when we feed him by spoon. It makes me sad that he could of been so hungry this last week and unable to eat. But then again, I would think he would of tried to tell us. All he did was stare at his food bowl and walk away so we figured he was losing his appetite.
I'm a bit nervous, I go see my surgeon tomorrow to get the okay to go back to work. I'm 99% sure he will let me. I've been spending SO much time with Max, and feeding him from a spoon takes FOREVER. I'm afraid that Max will be lonely home all alone, or that it's going to turn into a big pain to feed him. I guess I should just look at it as "I'm lucky I had the last two weeks off to give Max so much love and attention".
Anyways, I'm off to the vet again today! But this time it's to help my mom bring her Boston's and a cat. She has trouble keeping them all under control since they are wild!! :)

-Nikki

[Boriss McCall]

I bet it will be so hard finding the want to go back to work after spending so much time together.

I am glad you found a way to get Max to eat. Sounds like he has some catching up to do.

When our bulldog had Meningitis a couple of years ago he could not drink water or eat food out of the bowl when it was on the ground. We ended up putting it on a step so it was more at his level.
It is so hard trying to figure out all the things that we need to do for them. Don't beat yourself up. Wish they could talk!!

But, you figured it out & now he is on his way to good nutrition & chubs.:D

Have fun at the vet. I know if I try to take both of my dogs alone it can turn into a circus in the blink of an eye.:eek:

[Bo's Mom]

Hope Max finally decides to enjoy his food out of his bowl again. I too am in the same situation as you. I go back tomorrow after being off all summer healing from surgery. I hate to leave my babies and know that they are going to be alone all day especially with Bo not drinking.
Good luck at the vets and let us know how Max is doing.

[Bo's Mom]

Just one more thing, Bo loves sweet potatoes. I cube them and make them for his treats and he can't have enough. Maybe, you can add some to Max's meals mixed with his regular diet to see if that would also entice him to eat.

[Nikki]

Max actually LOVED sweet potatoes!! But then I was told to limit how much he ate because something about them could lead to the calcium oxalate crystals he was forming before (I don't really know why, but there was something in sweet potatoes that helped form them). So that's why we had switched to oatmeal. I just bought a bag of regular potatoes today and I am going to try that out for a few days instead of the oatmeal. Maybe he just needs something new to eat!!
You mentioned Bo isn't drinking. Do you know why? I can't say for sure that Max isn't drinking, but it looks like the last few days his water bowl has stayed the same and I haven't actually seen him drinking out of it at all. I don't know if I should be worried? Or trying to force water into him?? He gets a little bit of water with his food.

[Bo's Mom]

You should be worried if Max is not drinking. Dogs just like to drink and should be drinking quite a bit. The vet showed me how to check for signs that he may be dehydrating. I have to pinch his skin between the shoulder blades and see if it quickly bounces back. If it does then he is probably okay. Also, checking his gums for pasty/feeling is also signs. If Max is showing that, please get him to the vets for hydration. With Bo he just one day refused to drink and I had to start forcing water down him with syringes full of water. I have tried everything(even showing him with my own head in his bowl how to do it :p) to get him to drink again to no avail. He did drink once out of his bowl but that was the last time and since then I have had to keep giving him his syringes. Today I bought him the rabbit feeder that holds water. I have had some luck with that using peanut butter all around it. It is a bit messy though but I am desparate.
Oh no...don't tell me that about sweet potatoes. Bo loves them and it is the only way now he eats his food. He has also become quite the picky eater. He went from only wanting Cheerios, to pinto beans, to now sweet potatoes. I did try peas today and he loves them too. He has definitely challenged me when it comes to figuring him out. But, I will keep trying because I love my guys. :p
Good luck with Max...

[Bo's Mom]

And, Max is surely one cute dog!!

[Nikki]

So it has been a long week since I posted last! We got Max eating and drinking out of his bowls again on his own. He had bad diarrhea 4 or 5 nights in a row after our last visit, and we realized he must be sensitive/allergic to fish oil. We started giving it to him per the vets advice, and he was sick every night for a few nights until we decided not to give it one night, and he was fine. So we have stopped giving it to him for now.
I'm hoping to get Max to the vet's soon to hopefully change/alter his seizure meds. He has one or two days where he is so bad. I mean to the point where I think he is suffering so bad and maybe his time is coming to an end. He paces/gets stuck behind things and frantically claws at the wall. Today he was even crying/whimpering. It breaks my heart. Then eventually he tires himself out (Or maybe has a seizure? The vet says this activity is how they act leading up to a seizure but I still haven't actually witnessed him having a seizure, ever.) So I got him home around 4pm today and he was literally sleeping standing up outside!!!! He was just standing there, so still finally, with his eyes closed. So I carried him inside, laid him on the couch and covered him with a blanket and he has been snoring away ever since. This had happened a few weeks ago and the vet said not to worry, they can feel a seizure coming on and that is why he acts weird. He says that he isn't in pain, he might just be a little uncomfortable and that is why he gets stuck in small spaces. But it is still really hard for me to see him like this, to me it seems like he is suffering and in pain. Luckily it only lasts a few days and then he bounces back and seems to be happy again. I hope tomorrow he is eating a lot and walking around normal!
Anyways, I hope all of you and your dogs are doing well :D

-Nikki&Max
p.s. I went back to work last Thursday so I'm also thinking that him being home alone all day is making him sad. I've worked every single day since last Thursday and it seems he has been his worst ever the last few days.

[addy]

I dont have any experience with seizures but I can understand how scary it is for you to see Maxwell as you describe. It is so hard to leave them when we have to work. I had to rearrange my hours when Zoe was having so many problems. I was lucky my boss allowed it.

I am glad you were able to figure out the fish oil was causing the loose stools and I am so happy removing it solved that whole problem, you have enough going on:(

I hope you are able to sort things out. Sometimes a miracle seems to happen for us and we can figure it all out. I'll keep praying that happens for Max and you.

[Boriss McCall]

Nikki,

When my Cleo had her seizures I always knew when they were coming. She would stand in the yard & not move a muscle. Then she would just tip over on her side. Not a "normal" seizure where they shake & eyes roll. So, maybe you have seen Max have one. But, it was so subtle you didn't realize it?

I am glad Max is eating & drinking again. :) I hope things are getting better this week.

[Boriss McCall]

How long was Max on Trilostane before he started having seizures?

[Nikki]

I believe Max started Vetoryl in February, and we were on vacation the first week of August when my mom called us and we rushed home. Today my boyfriend had to call out of work because he was up all night with Max. He is becoming more and more restless, to the point where we can't soothe him. We have tried crating him at night, but he either pees in his cage or had diarrhea and steps all in it, making an awful mess to wake up to at 3am!!! He only seems to sleep when he is cuddled in bed between my boyfriend and I, but he never sleeps through the night and he ends up moving around and getting stuck somewhere.) My boyfriend was so upset because he couldn't find Max anywhere today, but he could hear him making noises. He had somehow crawled underneath our recliner and up into it and got stuck. My boyfriend said he flipped the recliner over and had to rip the fabric off to get Max out. He didn't seem to have any injuries, thank god.
We called the vet and he called me while I was at work and left a voice mail. He pretty much said at this point the quality of life is completely gone and really euthanizing is the only thing to do.
I absolutely am not ready to let go of Max. So we got on the phone and made an appointment with an internal medicine specialist in Rhode Island. We go Thursday at 11am. It's $150 for the consult, and they take Care Credit (woo-hoo!!!). I am really hoping to get answers. I hope he has at least a few more years left in him :(:(:(:(

[Boriss McCall]

oh no!! I am so sorry. Sounds like Max & you guys have had a hard day.

I am so glad you are going to a specialist. I would be so lost if Boriss didn't have such a great IMO & of course this smart people on this forum.

You CAN'T give up hope just because your vet has. I hope you get better results from a more experienced doctor.

hang in there.. I know you guys have had a hard time lately.

[Boriss McCall]

I will be saying a little prayer for you guys on Thursday.:)

[Maya]

I'm sorry to hear that little Max hasn't been well lately. It's a heartache to see them that way.... it really is, I know! I hope you get some positive feedback from your consultation with the specialist. Do you think Max has a macro tumour?
Hugs from Leah and Maya

[Nikki]

After reading a link someone had left me awhile back, it seems like he might have a macro tumor :(.
I really don't know anymore, he is on so many different meds and has so much going on. I don't know if it's one thing causing him issues, or a ton of different things causing issues. I personally feel like the restlessness and pacing started when we put him on phenobarbital. My mom says that it started a few days before then. I just find it hard to believe that there is "nothing left to do".

[Boriss McCall]

I do know that when I put our min pin on phenobarbital it was TERRIBLE. I think mainly because that is not the medication she really needed. She ended up dying a week or so after we started it.

From the way you describe Max looking like he is asleep while standing up sounds just like her supposed seizures.

I hope the new doctor can help you figure out what Max needs. Even if it turns out the be a Macro (which I am praying it is not) seems like there are other ways to treat it to make him more comfortable. I think there are several people on here using Preds to help with the swelling. :(

But, for now I am just hoping he needs his meds sorted out to make him feel good again. I know Cleo was so confused, clumsy & like a little zombie when she was on the phenobarbital.

Keep your chin up & I hope your house gets some rest tonight.

[Maya]

I know, love...it's not easy. The reason I asked you about the macro tumour is that many things you have written in your thread, unfortunately indicate that this could be the problem. My Maya has one too, so your posts sounded very familiar. Maya is now on prednisone which is probably reducing the swelling and giving her a better quality of life, for the time being....
Hugs from Leah and Maya

[Boriss McCall]

Leah how long were you treating Maya before you found out she had a macro? :( I really hate hearing that. It makes me so sad..

[labblab]

Nikki, I am so glad you're taking Max to consult with the specialist. Please be sure to mention the recent anaplasmosis diagnosis to the IMS. I know your regular vet has basically blown that off as a possible causative factor, but I'd sure like to hear the specialist's thoughts about that.

Marianne

[Steph n' Ella]

Good luck Nikki! Hope lil Maxie does well at the vets!

[molly muffin]

Oh I am so sorry to hear that Max is having a hard time. I certainly wouldn't be ready to be told there is nothing left to do either. I hope the specialist can come up with something to help. Max is such a little darling.

hugs,
Sharlene

[Maya]

Leah how long were you treating Maya before you found out she had a macro? :( I really hate hearing that. It makes me so sad..

I had been treating Maya with trilostane for about a year when she gradually started to have weird symptoms round about march this year. First it was her appetite-she just went off her food and water. I noticed she had an unusual expression on her face-a kind of dreamy look.....almost vacant. One side of her face looked very slightly different. Her left eye seemed to bulge out a bit and her pupils seemed bigger. I realized that she couldn't see out of it. I would go to poke her in it (just testing, obviously) and she wouldn't even flinch. She started to circle and pace the house constantly, especially at night and she would pant heavily. She would pee constantly everywhere and anywhere. She started to lose her balance, crash into things, miscalculate corners, doors. She would stagger all over the place as if she were drunk I could see that at times she wanted to eat and drink, but she was not able. It was like her tongue didn't work anymore. I'd give her a biscuit and she's just hold it in her mouth and slobber before just letting it fall out onto the floor. She would try to drink but her tongue wouldn't reach the water. I had to hand feed her and hold the water bowl right up to her mouth which helped a little, but her water intake was almost zero.She had this weird kind of shivering across her shoulder blades-kind of like a cringing. Her condition worsened and she became very weak and lethargic to the point were she actually collapsed and was totally out of it. All this had been going on for a couple of months and during that time we had taken her to the vets countless times. We had had blood work done and 3 ACTH tests all of which were perfect. We stopped and restarted her trilostane two or three times, then eventually just kept her on a half dose because we all thought that it was that which was making her ill. I had a bad feeling about the trilostane and took her off it all together a couple of weeks later. She seemed to be getting better, then one night she just crashed. I had to carry her into the vets the next morning in a comatose state. The vet started to assume Addisons and gave her a huge dose of prednisone and sent us home. over the nest couple of days she got better-lot's better. It was incredible! She started acting almost normal, so we carried on with the pred. I wanted to have more tests done to see what the hell was going on, so Maya was scheduled for an ACTH and more bloodwork. We withheld the pred for 48 hours before the test, just as were instructed to do. The vet called and told us that her levels were that of a normal dog (without Cushings) This was very weird as she hadn't had any trilo for a month. No more trilostane for Maya!
We went to see a specialist who reviewed Maya's whole case file. The first thing he said was she most definitely had a macro tumour. It was a textbook case. That would even explain the odd ACTH readings, all symptoms etc. To be honest he didn't tell me anything that I didn't already know. My gut told me it was a macro right from the beginning....guess I was just in denial...
He was a decent guy, and told us that ,yeah...... we could do an MRI blah,blah, but he would bet his house, car and money on it. He'd seen it so many times before, same story! Maya is too old to go through that and to be honest I don't think I'd go down that road even if she wasn't. We have no pet insurance and that kind of grueling treatment costs thousands-which we haven't got. We are keeping her on the pred for now-she's doing pretty alright..I suppose! No more testing-I think she's had enough.
I think you are doing the right thing going to see a specialist...at least to get a second opinion. It could well be Max's other health issues bothering him. I hope he feels better soon..
Hugs from Leah and Maya

[Nikki]

Thank you so much for posting Leah! It helps to hear from people who have been through similar situations. I thought way back that it could be a macro, and I wanted to bring Max to a specialist. My boyfriend talked me out of it, said I was overreacting and that it was too early on to be worrying that much. When I read your last post, I felt like you were telling me about Max. Almost everything you said sounds like how he has been lately. I just hope he sticks it out until Thursday. He seemed SO bad today, and when he woke up earlier he was making these weird yelping noises (He almost never barks) and they sounded like he was in so much pain :(. I just keep checking to make sure he is still breathing when he is sleeping, I'm so scared he will just pass away on me suddenly :(.
Thank you everyone else for posting too, its nice having so much support :)

[jmac]

Nikki,

I'm so sorry to hear Max is struggling, and I am so glad to hear you have an appointment for him on Thursday. I, too, hope he will be okay and until then and make it to the appointment. I hope they will have some good advice for you Thurs. too. Keeping you and Max in my thoughts and prayers!

Julie & Hannah

[Nikki]

Last night was so awful. Right before bed, Max was sleeping on the couch. He started having a seizure (First one I have ever witnessed). It was so scary and I didn't know what to do. We put him in his cage and he ended up having 3-4 seizures during the night. We could hear him thrashing around and it was so sad because we don't know how to help him. It sucks, I feel like he is getting so much worse so quickly :(

[Squirt's Mom]

Aw, Nikki,

I can barely imagine how awful that is to see and how helpless you must feel. :( We are all with you, honey, right by your side, sending many prayers and much support for you all.

Hugs and gently belly rubs,
Leslie and the gang

[Boriss McCall]

Nikki I am so sorry.. It breaks my heart to hear this about little Max. :( I hope he gets rest today & tomorrow the IMO will be able to help ya'll.

[jmac]

Oh, Nikki, I am so sorry. I can imagine how horrible watching that and feeling so hopeless and unable to help. Your appointment can't come soon enough. I hope he will have a better night tonight. Maybe you can call somewhere and ask what to do if that happens again today/tonight? We are all thinking of you and hoping your little guy has a better day today and gets some help tomorrow. Sending lots of hugs and hope your way!

Julie & Hannah

[3bostons]

Hi Nicki, Im so sorry to hear Max is having a hard time, it breaks my heart when these guys are not feeling good.
Kona and I hope he feels better soon,
hugs
deb and kona

[addy]

Nikii I am so sorry to hear all of this. I hope the specialist can help in some way.

Saying alot of prayers today.

[Jenny & Judi in MN]

thinking of you

[molly muffin]

Oh Nikki, that must have been sooooo scary and heartbreaking to feel so helpless. I really do hope the specialist can come up with something to get control of the seizures. Those seizures make the cushings sound not half as bad in comparison. If it is one of the medications causing this, then maybe they can start to replace or minimize some of them. Lower the dosage until he's off them, one at a time and try something else. Anything is a possibility. Maybe it isn't a macro tumor.
I hope you guys can make it through tonight more peacefully.

Hugs,
Sharlene

[Boriss McCall]

Nikki,
You & Max have been on my mind all day. I hope tonight is better. I know how stressful & scary it is to see your dog have a seizure. It is almost unbearable.

((hugs))

[Tina]

Nikki, I too am so sorry to read all of this about Max. I just got a chance now to post, but I have been thinking about you guys all day. I hope you all can get some rest tonight and that the specialist will be able to provide some answers and help tomorrow. Prayers to you.

Hugs,

Tina and Jasper

[Nikki]

Thank you everyone!!!!!!
It is so great to have so many caring and awesome people!!!!!!
I will update everyone as soon as I get back from the specialist. Whether it be good or bad news, I will feel a lot better with it coming from a specialist rather than my vet. Who by the way still insists that a 13 on the ADHD stimulation test is just fine.

[Boriss McCall]

Good Luck! Boriss & Max are both at the IMO today. fingers crossed for happy pups. :)

[jmac]

Hi Nikki-

Just want you to know I'm thinking of you and Max today! I can imagine how anything will be better than what you've heard at this point! I can't wait to hear how things go.

Julie & Hannah

[Squirt's Mom]

Mornin' Nikki,

You have a whole host of folks with you and Max today, standing right by your side. Let us know what you learn when you can.

Hugs,
Leslie and the gang

[Maya]

Yep! I can second Leslie's post. Thinking of you both today......
Hugs from Leah and Maya

[Nikki]

So it wasn't good news. Max has a macro, they gave me some prednisone to buy him some time but she said maybe a month at most. If I hadn't brought him in today they said I most likely would of witnessed a seizure that ended with him in a coma or dead in less than a week, he is progressing so fastly. His brain stem is compromised from the swelling. I'll post more when I feel up to it. Thank you everyone for your support, it really means a lot to me.

[Boriss McCall]

:(:(:(:(:(:( I am so sorry.. I was so hoping it would be something else. I hope you get a lot of good love & cuddles in with your baby. Spoil him rotten.. I am praying the preds will keep the seizures & pain away.

big hugs Nikki

[labblab]

Nikki, I am so terribly sorry to hear this news. Please know that we are here beside you, and here is where we'll stay no matter what.

Sending enormous hugs to you all,
Marianne

[jmac]

Nikki,

I am so very sorry for the bad news. My heart is breaking for you. I was hoping it would be something else. I am glad that you did get some prednisone to help him for a little while. Although it must be so hard to know that his time is very limited, I am so glad you got him in and didn't witness the horrible seizure they described. Make the most of your time with him and spoil him rotten. Thinking of you on this tough day...

Julie & Hannah

[mypuppy]

So terribly sorry for you and for your precious little boy Max. Ughhhhhhhhhhhhhhhhhhhhhh.

May you find the strength to get through this. Please give him some tight hugs from me and my girl, and take some for yourself.

Xo Jeanette

[Steph n' Ella]

Poor little Max! You have worked so hard getting to the bottom of his medical issues, in some ways it is good to have a dx, in other ways it must be so terribly difficult. He will be so happy to be with you and in your arms with the time he as left. Lots of love and prayers to you and lil Max.

[Maya]

Awwww, God bless you darlin!:( I was afraid it might be that.... I'm so sorry....The prednisone should help keep him more comfortable. Maya takes anything from 7 to 15 mgs per day. It depends on the severity of her symptoms. At least she can eat and drink now! We are spoiling her with all kinds of treats that she has never been allowed to have. At the moment, she is with my husband eating ice cream. Cherish the moments you have left.....

Hugs from Leah and Maya

[addy]

Sending love and hugs



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

we are always with you.

[molly muffin]

I am truly so sorry to hear this diagnosis. I hope that the prednisone will help him and ease the seizures. Enjoy the time that is left. It is never ever easy to lose one of our sweet pups, it is even harder to be in that waiting zone of knowing it will come sooner rather than the years later that one hopes for.
You aren't alone though. When you feel that need to vent, to cry, to scream at the unfairness of it all. We're here.

Hugs,
Sharlene and give that Max guy and extra belly rub from me and molly tonight too.

[frijole]

Sending love and strength to you and dear Max. Kim

[Nikki]

Thanks everyone :)
Max was given a shot of prednisone today, and he seems so much more peaceful already. He has barely been pacing and only circling a little bit. Actually, he has pretty much been sleeping all day!! It's so sad to see him pacing so I am just glad he is relaxed at the moment.

[Tina]

Oh Nikki, I am so sad to hear this news. :( I was so hoping it would be something else. Glad to hear he is resting at the moment, and I hope you can do the same tonight after such a tough day. Love and hugs to you and precious Max.

Tina

[Boriss McCall]

I am glad your sweet guy is getting some rest.;)

[Nikki]

Poor Max is so sedated that he just rolled off of the couch and continued sleeping!!! Tomorrow I start with a higher dose of phenobarbital, the prednisone and then a new seizure med he has to take 3 times a day!! Keppra I believe it is called. We keep him on all of his other meds too until Monday. Then I call and update her, and she said we will see how he does over the weekend and adjust the meds as needed.

[Boriss McCall]

:(:(:(
I hope all the meds balance out soon. I wish I had a magic wand for all these sick babies. Life is so not fair sometimes. We are here for you...

[frijole]

Nikki, I've been on this forum for close to 8 years and we are seeing more macro tumors than we've ever seen. We have alot of experience but really the newer members who are going thru the same thing are really your best source for info. Sadly I can only offer warm thoughts and positive vibes sent your way. Hoping that the meds all give Max comfort and you figure out a comfortable dose for him.

From your photos I can tell he is surrounded by love and that is what counts. Keep dishing that out and enjoy every minute. They are so precious. Take care, Kim

[Squirt's Mom]

Mornin' Nikki,

We hear people say no one knows when any of us will be taken, we only have this moment, and that is true but when handed a definite verdict and a time limit those moments become even more precarious. We watch with our eyes peeled, our hearts in our throats, our breath seemingly catching, any time they do something out of the ordinary. That thought, "is this it?" readily flies through the mind.

Then there are those moments when we see some of their old personality shining through, a goofy face, taking up a toy, a good roll in the sunshine, a look of love in their eyes as they lay their head on our lap - these moments mean more than anything...and for just a second we can forget what lies ahead.

All of these moments, the good and the bad, make up the stories of a life, of a journey uniquely ours, of a soul deeply cherished. One day, we will be able to look back on these days and see the strength, the grace, the amazing fortitude our babies displayed and we will know once again how very blessed we were the day that baby came into our lives.

Treasure those moments, honey. And never doubt Max's love for you.

Hugs,
Leslie and the gang

[molly muffin]

This is so hard on all of you. I hope that the prednisone might relieve some of the pressure that has built up with the tumor. That would alleviate some of the neurological symptoms I'd think.
That is a pretty deep sleep to fall of the couch and just keep sleeping. :(
I know it is all worrying, but you know, belly rubs and cuddles are the best medicine of all at this point. Now if you could just figure out how to get Max to rub your belly, :)

hugs,
Sharlene

[3bostons]

Nicki, we are so sorry to hear the news, the news we all hope not to hear. I hope the meds can help him some and give both of you a little rest. You are in our thoughts, hugs kona and deb

[Maya]

Dear Nikki, I'm glad that Max is now on prednisone. This will help him feel a lot better. Sharlene was right, the pred reduces the swelling and eases the pressure. This in turn will help alleviate the symptoms- unfortunately this is only a temporary fix:(
As you have noticed, prednisone does make them sleep a lot. Maya sleeps all day and comes 'back to life' in the evening when my husband comes home from work. I think it's best if you make a little bed up for Max down on the floor. Like Maya, his spacial awareness and balance has probably been impaired by the macro-hence him falling off the couch. You may notice him panting heavily at times, usually at night. This is a common side effect of the prednisone, so don't be alarmed.
You know....when my suspicions about Maya having a macro were officially confirmed. I felt like a huge weight had been lifted from my shoulders. Even though the news was bad, I could finally let go. I could stop obsessively trawling the internet 6 hours a day looking for possible causes, illnesses she may have, poking and prodding at her. I was bugging her so much and even though she was so weak, she would haul herself up and stagger off somewhere else just to get away from me! I had been sucked up into this never ending cycle of testing....her illness had completely taken over. I had hardly been out of the house in weeks! Now things are different. I feel calm- I have entered that stage of acceptance and can now concentrate on enjoying some quality time with my baby -taking each day as it comes. Even Maya seems more calm and happy now. I did not realize just how much my tears and anxiety were effecting her in such a negative way! I am thankful for this new state of mind which allows me to enjoy this time left with her and at the same time prepare myself -instead of being filled with fear and dread and missing out on these precious moments.....
Hugs from Leah and Maya

[Boriss McCall]

Leah your post is so heart warming. I am so glad you & Nikki have each other to comfort one another. We are ALL here for both of you. But, I can only imagine what you both are going thru. I am so glad you can stop & enjoy the moment. I know it must have been really hard to get to that point. Both of your stories stab me in the heart. I feel so connected to you both & hate seeing the hard times. I try to only cry when I am alone. My husband thinks I am crazy sometimes. I don't think he realizes how much all of you & your dogs mean to me. I am sending both of you hugs & prayers..

[Maya]

Thank you Amy...you are a sweetheart!:)

[Nikki]

Thank you Leah, I'm so glad I have someone who is almost exactly in the same shoes that I'm in to talk to. I have been going up and down. I cried for 2 days straight. Then I thought I was coming to terms with the fact that his days are numbered. Then I cried more.
Today, he slept most of the day. He just woke up a little while ago and he is eating SO much. The prednisone makes him feel so much better. He is alert, and appears to be doing better than he has in.... maybe six months or even longer. He is no longer pacing, even the look in his eyes is brighter and happier. He is my old Maxwell. It breaks my heart, first of all because I'm now realizing how much pain he must of been in these last few months. And it breaks my heart because he no longer seems to be in pain and I don't want to lose him :(. I want to go be crazy and spend the $5000 on radiation even though it's most likely too late since he progressed so far before we got to a specialist. I'm so sad and angry. I wish I had went to a specialist months ago, I would of spent the money and hopefully bought him a few more years. I can't imagine my life without him, he has been with me most of my adult life :( I spend all my free time around him, he is like my baby.

[Squirt's Mom]

Dear Nikki,

Please don't beat yourself up, honey. This is a possibility we and our babies all face when the diagnosis of Cushing's is handed to us. This disease is a bit like 7 Card Draw in poker - sometimes we are dealt a crappy hand and pull crappy draws. And unless we can afford to have multiple MRIs that will show the growth of the tumor, none of us can know if we will be the next to hear that our baby has a macro. Before hearing that word, Cushing's, the vast majority of us would have never considered that our baby could have a tumor of any kind unless blatant signs were present - and Max didn't have those so there is no reason that you are at fault in anyway. You did NOT neglect getting him the care he needed as soon as you could. You have NOT let him down. You did nothing to cause this.

From the moment you knew sweet Max was ill, you have done everything you could for him. No one - not us and certainly not Max - can find any blame to lay at your feet. You are a wonderful, loving, caring mom. This is just one of those crappy hands. :(

Know we are here any time you want to talk, honey. Whatever you need to get off your shoulders, we can take and help you carry that burden. Our arms are always around you both, our prayers carry your names. You are never alone.

Many hugs,
Leslie and the gang

[Steph n' Ella]

Yes, Nikki, you've done eveything possible for lil Max. And he is happy in your loving arms and enjoying his time feeling like his old self. He looks like a lil baby in your avatar! I can see why you love him so!

[Maya]

Thank you Leah, I'm so glad I have someone who is almost exactly in the same shoes that I'm in to talk to. I have been going up and down. I cried for 2 days straight. Then I thought I was coming to terms with the fact that his days are numbered. Then I cried more.
Today, he slept most of the day. He just woke up a little while ago and he is eating SO much. The prednisone makes him feel so much better. He is alert, and appears to be doing better than he has in.... maybe six months or even longer. He is no longer pacing, even the look in his eyes is brighter and happier. He is my old Maxwell. It breaks my heart, first of all because I'm now realizing how much pain he must of been in these last few months. And it breaks my heart because he no longer seems to be in pain and I don't want to lose him :(. I want to go be crazy and spend the $5000 on radiation even though it's most likely too late since he progressed so far before we got to a specialist. I'm so sad and angry. I wish I had went to a specialist months ago, I would of spent the money and hopefully bought him a few more years. I can't imagine my life without him, he has been with me most of my adult life :( I spend all my free time around him, he is like my baby.

Good Morning Nikki, I know that you are in an agonizing situation which is very difficult to deal with. I know how many tears you have shed and the heartache you are feeling. I'm right here with you....
Right now, the best thing that you can do is enjoy the time you have left with him and concentrate on that and that only. Could ofs and should ofs are absolutely useless....they only cause grief, upset by creating feelings of guilt and resentment. It's nobody's fault!!
Leslie is right, we have been dealt a crappy deal and we just have to suck it up:(. There is really nothing we can do about it except, love them, spoil them and give thanks for enrichment they have brought into our lives. Look at little Max now, he is feeling better. He is enjoying his food again, he is peaceful and more like his old self. Try and focus on this for now.....
Regarding the radiation treatment, I have done quite a bit of research on this-just for my own curiosity. I have come to believe that it is just not worth having done! Not only is it ridiculously expensive-in Los Angeles, the whole packet including the MRIs and various medication can cost anything up $10.00O! Prices probably vary, depending on where you live. There are also too many risks involved. Dogs have to anesthetized for every radiation session. The treatment only shrinks the tumor, therefore it will come back-maybe even in a matter of a few months, but generally a year. Some dogs even die during treatment! There are dogs who are lucky and they do quite well, but on the whole, it seems that these dogs are very few. I personally would not go through all of that, just to keep Maya alive for a few more months and then have to deal with this all over again further on down the line. I think it would be very hard on her too! This is my own personal opinion and I'm not in any way against those who do decide to treat their dogs.
Bottom line- you have done everything you can for little Max, so don't be hard on yourself, O.K?

Sending many hugs your way, Nikki...

[molly muffin]

Day by day, moment by moment. Just try to live in that space. Not before, not after. It is all you can do and perhaps, it will enable you to enjoy now for what it is. Sometimes, that is all we can hope for, good moments.

HUGS,
Sharlene

[Boriss McCall]

:(
I hope this is a good week for you & Max. I am glad the preds are making him feel like his old self again.
I agree with Leah.. I talked to my IMO the other day. When she explained everything that had to be done for the MRI & Radiation it just seems like it would be so hard on a sick dog. The fact that they have to go under anesthesia every time they have a treatment just doesn't sound good. :(

You shouldn't feel bad or responsible for what is happening. I know it has to be extremely hard & you are probably having so much anxiety.

I hope you can breath.. relax, cuddle & love on Max in the months to come.

((hugs))

[Nikki]

Thank you for the kind words everyone. I just keep going up and down. One minute I am okay, and I want to enjoy my time left with Max. The next minute I feel so awful and depressed :(

The specialist called me back today. Since Max seems to be doing well she wants me to lower his dose of prednisone, and call her back in a week and we will discuss his medication/condition then. He started pacing a little more than usual an hour or two ago. I'm not sure if maybe all of his meds didn't go down, or if maybe it's just not a good night for him. I have him all cuddled up and sleeping on the couch now :).

Hope everyone and their pups are doing well :)

[molly muffin]

It's okay Nikki. I don't think there is really any other way that it is reasonable to Be, other than up and down. Poor little guy having a rough night. :(

HUGS!
Sharlene

[Maya]

Hiya Nikki. Glad to hear you're hangin on in there! How much pred is Max taking at the moment?

[Tina]

Hi Nikki, thinking of you and Max tonight. Glad he is resting now. I totally get the minute by minute roller coaster, I am the same way about things. I struggle with taking one day at a time, and have to constantly work at it. You are doing a great job with him.

Tina

[Nikki]

It's liquid prednisone. I believe its 7.5mg that he was taking and now it will be 5mg. I'll double check that in the morning. He seems very dazed and weird tonight :/

[Nikki]

Max seems to be having another bad day :(. We were up all night, he was restless. I ended up sleeping on the couch with him. This morning I tried to bring him out to pee. He wouldn't stand!! He kept sitting, and then his front end was being weird. It's like he can't support himself :(. At one point he was in such an awkward position I had to run over and fix his leg because it looked like it was just going to snap in half!!! Poor guy :(.

[Maya]

What I have found with the prednisone is that some days it seems to work better than others. Maya has bad days too, in fact we had one just the other day. Unfortunately we have never had any great days where Maya is completely symptom free. Even on hefty doses of pred, she is still very unsteady on her feet and is a little disorientated. All pred does is lessen the symptoms,stimulate appetite and makes them feel a little better. When Maya first started on pred. The vet prescribed 20mgs a day (Maya weighs 43 pounds) The results were incredible! Obviously, she could not stay on such a high dose and had to tapered off down to 5mg which was definitely not enough. Within days she was declining fast, so I upped her dose to 7mg. I'm trying to keep it down to a minimal, but I have to admit to giving her a bit more at times because I know that if I don't she will crash. She's been getting 10mg for the past couple of days. I'm going to watch her and see if I can back to 7mg, but it's looking highly unlikely. I'm not really being monitored by the vet at the moment, because I was just sent home with a bottle of prednisone and I was told that if she got any worse, I could give her a bit more. The vet said that dogs can do quite well for quite a while on large doses of prednisone and let's face it.... Maya is getting near the end of her life, so....... The aim now is to keep her as comfortable as possible!:)
Maybe if little Max has had such a bad night, it wouldn't be wise to lower the dosage just yet. Call the vet and see what the vet thinks....Maybe you'll get the o.k to give Max a little more. Sounds like he needs it! Sorry to hear he's had a bad night...God love him:( Hopefully today will be better! Hang on in there, darlin, be brave....
Thinking of you and little Max today, manyhugs to you both!
Leah and Maya

[molly muffin]

Maybe you can ask the vet about on days when Max is not having a good day, if upping the dose on those days would help or not.

It hurts to think of Max not having good days :(

hugs,
Sharlene

[3bostons]

Thinking of you and Max this morning, hope you both are doing ok
hugs, kona and deb