Pippen...13 year old Pommie boy.

[Trini]

I am a new member and wanted to say hello to everyone and introduce my little old guy, Pippen.

Two years ago we adopted an 11 year old rescue Pommie boy, Pippen, who was an owner turn in and had been shuffled between 3 different rescue groups over a period of a year+ with no one showing interest in adopting him. I had our vets do a full workup as soon as we got Pippy home which showed several health issues: hypothyroid, enlarged left side of his heart, severely infected teeth and jaw bone (all his teeth and a tiny portion of his jaw bone had to be removed) and atypical Cushing's disease. We have had Pippy for just over 2 years now...so he is 13+. He is on Lysodren, Selegiline, Melatonin and 7-HMRlignans for his Cushing's, Soloxine for his low thyroid and Enacard for his heart. Although there has been significant improvement in his blood work, his Cushing's is not under full control. Due to his age and other health issues our vets don't want to increase his Lysodren dosage and I agree with them on this. Overall, he is doing OK, he does have urinary accidents and I have 2 rooms slated for him where the floors are easy to keep clean....so this is really not a big issue. My husband and I are both retired and home full time and can catch any needed clean up immediately. I don't really have any pressing questions, but am hopeful that by listening to others (who are going through or have been through this) that maybe I can get some good pointers and/or share with others what has worked or not worked for us. We know at Pippy's age and with his other health issues that we are on borrowed time, but as long as we can make him comfortable and give him reasonable quality of life that is the bottom line. He is such a character and loves life! :) Oh...I almost forgot to add that Pippy is pretty much totally deaf...a condition which serves him just fine since he can't hear me tell him to pipe down when he goes into "talkative mode"...which is OFTEN!! LOL

Trini and our "Constant Comment" Pippy Boy

[addy]

Hi and welcome to you and Pippen,

I am so glad you found your way here. if you have been looking through the threads at all, you probably noticed we play 20 questions with new members. The more you can tell us about what tests were done and what the results were to diagnose Cushings, symptoms, current lysodren dose, weight of Pippen, anything at all.

We are always here to help however you may need. By the way, I love the name Pippen:):):):):):)

[labblab]

Welcome to you and Pippen! We are so glad you've joined us! :)

As Addy has already said, it would help us a great deal if you could give us some of the specifics regarding Pippy's actual test results -- both diagnostic and also monitoring tests now that he is being treated with Lysodren. You mention that he has been diagnosed with Atypical Cushing's. Does this mean that his cortisol is not elevated, but he does have elevations in other adrenal hormones? Or does he have elevated cortisol, too?

Since you mention that his Cushing's is not under full control, it makes me wonder whether his cortisol is elevated as well. If that is the case, then I'm thinking there might be a benefit to increasing his Lysodren dose after all. In fact, some of his other health conditions might actually improve and other medications could perhaps be discontinued. For some dogs, thyroid supplementation becomes unnecessary when cortisol is in desired range. Pippy's heart condition might be more easily stabilized. Plus, I see you are giving him Selegiline (Anipryl). Is this for canine cognitive disorder, or is it in hopes of better controlling the Cushing's? If it's the latter, then a higher dose of Lysodren could eliminate that med, too.

I may be totally missing the boat here, plus elevated cortisol may not be in the mix at all. Even if it is, there may still be other totally valid reasons as to why your vets don't want to increase the Lysodren. But either way, it will be very helpful for us if you can fill us in on some more specifics regarding Pippy's testing. One of our other administrators, Glynda, has a wealth of experience with senior Poms treated effectively with both trilostane and Lysodren. So I'm hoping she'll also have a chance to stop by and share her thoughts and suggestions.

In the meantime, bless you and your husband for rescuing Pippy. And again, we're so pleased to have you with us.

Marianne

[Trini]

Hi Addy...Pippen and I thank-you for the welcome.

Pippen is an oversized Pom, weighing in at 24 pounds. He is not fat, but very big boned and built like a fire plug! He really looks like a miniature red Samoyed, but he is a purebred Pommie.
Symptoms: excessive drinking, urinary accidents, always hungry, heavy panting, and that look of discomfort in his eyes that every dog owners knows all too well if they have had a sick doggie. Unlike many Cushing's doggies, Pippy has a super thick full coat and he doesn't have the pot bellied look that often goes with this disease.
Dx: Low dose dexa and ACTH (U of Tenn), ab X-rays, ab ultrasound.
Pippy's alkaline phosphatase levels are high...have been as high as 1,300 (5-131 reference range) and as low as 430. Currently his Alk-Phos is tested every 3 months and he gets a full senior blood panel every 6 months. I can always tell when his Alk-Phos levels are rising by his increased panting and urinary accidents.
Cushing's meds: Lysodren 250 MG given once a week with food. Selegiline HCL 5 MG once daily. Melatonin 3mg given 2x daily. 7-HMRlignans 40mg once daily. On days when his discomfort level is high he gets Tramadol...but thankfully he hasn't needed any for several weeks now.
Other meds: Soloxine 0.2 mg 2x daily for low thyroid
Enacard 15MG daily for heart.
Pepsid daily...Pippen is prone to heliocobactor infections of the stomach lining which induce the stomach to produce excessive levels of acid as it tries to combat the infection (unfortunately heliocobactor is not responsive to acid which spurs on the production of even more as the body tries to kill the bacteria). He has had to go through two 30 day courses of Baytril to get these infections under control and he will be on an acid controller for the rest of his life.

Trini and The Pipster

[Trini]

Hi Marianne,

Pippen's cortisol has always been within reference range...Alka-phos levels are his only indication of Cushing's...hence it is referred to as atypical Cushing's (which was dx'd at the U of Tenn). The Selegiline was indicated for Pippy since he does display symptoms of canine cognitive disorder and our vet mentioned that it might have the desired side effect of helping with his Cushing's too. Our vets combine both traditional and holistic meds if they feel there might be a benefit involved and the addition of the 7-HMRlignans, which is an enterolactone enhancer, seems to have helped produce better results...whether this is coincidental or not I don't know.

Thanks for the welcome...it is good to find this group.

Trini and Pip

[labblab]

Hi again, Trini!

Thanks so much for all this additional info. But I do still have some additional questions (one question often seems to lead to two more around here :o). But in order to warrant a diagnosis of Atypical Cushing's from UTK, the testing profile needs to exhibit elevations in one or more of the adrenal hormones other than cortisol. So even though elevated liver enzymes (like Alk Phos) accompany Cushing's, it would be hormonal elevation that would signal the diagnosis. That's why it will be so helpful for us to see the actual LDDS and ACTH test results, in order to see how Pippen's adrenal profile arrayed itself. Also, how long ago did Pippen have the UTK testing? If it was some time ago, he may now have elevated cortisol even if he did not originally. We have seen instances when that has happened, and therefore the treatment choices ended up changing, as well.

From your description of Pippen's symptoms, unfortunately it sounds as though he is a pretty uncomfortable little boy. So I'm still wondering whether some of that discomfort couldn't be alleviated with some med changes. Given his weight, I believe he is currently taking less than the weekly maintenance dose of Lysodren that is typically recommended even when cortisol is not elevated (a typical weekly maintenance Lysodren dosing formula is 50 mg. per kg., or approx. 25 mg. per pound). So even without elevated cortisol, you may still have quite a bit of lee-way in terms of increasing his weekly Lysodren dose without jeopardizing other aspects of his health.

But once again, all this is purely conjecture without seeing Pippen's actual diagnostic testing results. Do you think you could get them for us?

Marianne

[marie adams]

Welcome Trini and Pippen!! :)

I am so glad you have found us, but sorry you had to find us. :D You are now on the Cushing's journey and everyone here has now become your family.

I see Marianne is already starting to help. The experts are wonderful; so keep asking as many questions as you have and please, ask for all the advice you want! :)

Take care and know that you are not alone on this journey!! :)

[Trini]

Thanks everyone...and Marianne I will get back to your questions in a few days. We just had to say good-bye to our oldest sheltie boy. He had been battling congestive heart failure for some time and in the last few days Lasix could no longer keep the fluid build up from his lungs and around his heart...he was struggling and it was time. He was a great doggie...a rescue who graced our lives for 9 wonderful years. Our home and our hearts feel pretty empty right now.

[labblab]

Oh Trini, I am so sorry to read this news! Absolutely, we understand that your head and heart are both focused on the loss of your little sheltie boy. We will be here for you at any time that you are ready to return. And also please know that our "In Loving Memory" forum would welcome a thread honoring your little boy should you ever wish to add one. Your whole family is our family now.

Sending many hugs to you all,
Marianne

[WhisperPntr]

Thanks everyone...and Marianne I will get back to your questions in a few days. We just had to say good-bye to our oldest sheltie boy. He had been battling congestive heart failure for some time and in the last few days Lasix could no longer keep the fluid build up from his lungs and around his heart...he was struggling and it was time. He was a great doggie...a rescue who graced our lives for 9 wonderful years. Our home and our hearts feel pretty empty right now.

I'm so sorry Trini, but after reading about you and your husband's kindness and generosity, I have to say you're doing an amazing job. Your angel was blessed to have you as a mom and so is your new rescue.

[Trini]

Again, my thanks for being so warmly welcomed into this "family" and for the sympathy on the loss of our Rascal. I am trying to go through my typical morning routine today for the sake of our other little doggies who are all looking for their "brother" who is no longer with us physically. They all had a chance to say good-bye to Rascal before we buried him, but they still don't understand why he is not here this morning. It will take time for all of us to "let go" and go on with life.

Rascal was a rescue who came to us at 4 years old from a local shelter where he had been taken to be PTS for biting his abusive owner who had kicked 7 teeth out of Rascal's mouth. The shelter staff didn't think he was an aggressive dog and begged me to give him a chance...off record...since legally they couldn't adopt out a dog with a bite history. I was a foster home for NESR at the time and that is why the shelter staff had contacted me before putting Rascal down. Due to his bite history, sheltie rescue couldn't adopt him out either so we knew he would have to become a member of our family. It was our lucky day! He was one of the gentlest, sweetest dogs we have ever had...never once did he show any sign of aggression to anyone or to any other animals. He was truly a joy and we will miss him terribly.
Trini

[Squirt's Mom]

Rascal was so, so lucky to be in your loving care. The day the shelter called you about him was the best day of his life to that point, I have no doubt. Once he was home with you, he realized there truly was kindness and love in this world just for him. A wonderful gift that he carried with him the rest of his life and when that life was ebbing away, you gave him the greatest gift possible - freedom.

Today, he is strong and whole once again, watching over you and his family with all the love he learned from you. When your job here on Earth is done, I firmly believe you will be reunited with Rascal, never to be parted.

Our sympathies,
Leslie, Squirt, Trinket, Brick, Tasha, and our Angels, Ruby and Crystal


Time to Go

The time has come I think you know
the Lord is calling so I must go
I love you so much; I wish it wasn't so
I wish I could stay; I don't want to go

You're the best family a dog ever had
so kind and gentle, never mean or mad
I'll never forget the day that we met
I was so lucky to become your pet

You opened your door and showed me your heart
I'll never forget you; we'll never part
You loved me and cared for me over the years
you taught me everything and took away my fears

The Lord is calling now I must go
but before I go I want you to know
I know it hurts to lose a friend
but I'll always be with you even to the end.

Written by John Quealy

[marie adams]

Dear Trini,

I am so sorry to hear of the lost of your Rascal. You were both blessed to have had each other. How do these little furballs have a way of getting into your heart? I love it, but hate it when they leave us.:(

He is now with all our babies at the Rainbow Bridge.:)

((((HUGS))))