Molly, 13 yr, shih tzu - lhasa aspo - Molly has passed

[ShibaMom]

Oh wow, how scary!!
I'm so glad she's ok/stable. I hope things will level out soon for her.

Here's hoping for some warmer weather soon! Chip wasn't appreciative of having to walk across the ice-crusted snow, and having his feet cave in just as he thought he was good with each step. He managed, though... eventually.

Hugs!
Samantha

[flynnandian]

good luck at the vet's tomorrow for you and molly.
hoping for good test results!

[doxiesrock912]

Come on Molly. Good results! Mama needs less worrying.

[judymaggie]

Sending good vibes for Molly's tests today!

[molly muffin]

Molly went in for her blood draw and was a perfect doll, just sat there and let them take her blood then she was ready to go home. Easy peasy. (Who is this dog!!) I guess she's been through it enough in the last few months that this part doesn't bother her any longer.

So sorry I am not around much right now gang. We are fully immersed in wedding stuff. Seems to either be wedding or work every single moment these days. Hoping this will all be better once we get through mid April. I don't even know where this year has gone so quickly!

Molly is being a trooper though and hopefully this renal panel will show everything fine. Then on to the next ACTH and a repeat UPC to see if this dose is holding her.

hugs all,

[Squirt's Mom]

Fingers crossed for a good report!

[Dixie'sMom]

I'm just hanging out waiting for Molly's test results. I'm, hoping for good news. :D

[judymaggie]

Joining others in hoping for a good report!

[spdd]

Me too...... !!!!!

[Harley PoMMom]

Me three!! :D

[My sweet Ginger]

I'm here too, Sharlene. Please, Molly, please, please.

[Budsters Mom]

What's all this fuss about? This is Molly after all!;) Waiting anxiously along with the others, but not the least bit worried. :p

[pansywags]

Chiming in with good Molly wishes!

[molly muffin]

Still no news It always takes forever through the gp vet for results to come back because they are sent out. at the IMS everything comes back the next day as they are. Priority location. ( emergency hospital ER)

I'm sure it is fine. She is acting the same. Still will be good to have confirmation. Thanks for being here waiting with me.

I hate trying to be patient.

Hugs!

[Budsters Mom]

I have far too many headaches to be tactful, so I will apologize in advance. Here goes. She is acting the same. Sooooooo 😜😜😜 the test results!

Still holding your hand Sharlene. We are here.


She is acting the same.

[molly muffin]

Just a quick note, I just called the GP vet and the test results are back, but the vet is out of town until Friday, so they won`t give me the results. I did ask if anything looked out of range and the girl I spoke to said she didn`t notice anything, so I take that as a good sign and I reminded her to send the results to the IMS.

See, this is why it is better to get the tests all done via the IMS, but they are further away and I have to take off work to go there. Argggh, frustrating.

Anyway, that is where we stand. We won`t know anything till Friday and probably not until the following week if the vet is super busy on friday or saturday playing catch up.

hugs all, hang in there! We will eventually know.

[Dixie'sMom]

Dang... so frustrating. At least they said everything looked in range so that sounds good. Maybe you could ask them to email you "your" copy for your records and you could get them that way. :D :D :D

[kaibosmom]

Frustrating! I am sure everything is fine! Take care.

[doxiesrock912]

I agree Sharlene. Cornell had the results the following day at the latest.

[labblab]

Maybe when you do talk to your vet, you can ask him to put a standing note in your chart that permits staff to release results directly to you in the future?

[molly muffin]

I wish my vet would email the results but they don't seem to be able to get the hang of the scan and email.
I will be going over at some point prob Friday evening to pick up a copy of the lab results for the renal panel as I've booked molly in for a urinalysis, UPC and ACTH test on Wed next week. The Ophthalmology department called and said they'd like to take a look at her eyes and I said she would be in on Wed if they want to see her then.

I am divided on what to do after the wed acth results come back as I figure they will want to increase trilostane, but I am so swamped with work and wedding that I won't be able to get her in for another ACTH test I'm afraid and I don't like letting it go after a dose change. So, will discuss possibilities with the IMS when the results come back. No point in putting the cart before the horse, so need the results of everything first.

hugs all

[Dixie'sMom]

In this day of "everything" technology, you would think the vet's offices would be more up to date. My former vet couldn't do anything like that either. I think they are just used to faxing things and don't want to do anything new. Unfortunatley, we don't all have a fax machine attached to our telephone line. There are other ways to get around this, but it would take effort that I'm sure a busy office wouldn't want to deal with. Oh well... we tried, right?? ;)

I wouldn't want to change Molly's trilo dose either until all of the chaos and festivities are over. Since she's being her normal, sassy little self, I bet if she needs a dose change it will work to wait. Hugs!

[Budsters Mom]

I'm choosing to go with no news is good news, especially when you're so busy with the wedding anyway.;) Maybe our little muffin can help supervise the decorations or better yet, cake testing. Now that would be fun! LOL

[molly muffin]

Hi gang. Just spoke with my vet and molly's renal numbers are all very good and within normal range. So yay! Her kidneys are holding for now and doing well. We'll have to retest these pretty often to make sure that the medication doesn't start to affect them but for today and this month, this is good news.

I'll be picking up my copy this evening and they are faxing to the specialist too.

Whew. Now on to next weeks tests. She will stabilize at some point right, so we don't have to test as often :(

hugs all

[Dixie'sMom]

YAY MOLLY! I know you are relieved that all of your hard work and devotion is paying off. YAY SHARLENE!

[labblab]

WOOT WOOT!!!!!!!!!

Super good news to carry us into the weekend!

Way to go, Molly and Sharlene! :) :) :) :)

[Budsters Mom]

Love it!!!!!:p:p:p

[judymaggie]

What great news!! :D Big hugs to you and Molly!!

[Squirt's Mom]

WOOHOO!!! ~~whew~~ and WOOHOO!!!!!

[Blues people]

So glad for you Sharlene. Good news is always a mood lifter...

[pansywags]

Thanks for sharing the good news, I hope you and Molly have a great weekend!

[mcdavis]

Yay for Molly :D
Have a lovely weekend

[spdd]

Good news to hear.. so glad.

[doxiesrock912]

Wooohoooooooo Molly!!!!!

[beaglemom3]

Hi gang. Just spoke with my vet and molly's renal numbers are all very good and within normal range. So yay! Her kidneys are holding for now and doing well. We'll have to retest these pretty often to make sure that the medication doesn't start to affect them but for today and this month, this is good news.

I'll be picking up my copy this evening and they are faxing to the specialist too.

Whew. Now on to next weeks tests. She will stabilize at some point right, so we don't have to test as often :(

hugs all
That's awesome! So happy to hear this! HUGS to Molly (((()))))

[apollo6]

So glad to hear about Molly. Made my day. 3 cheers for Molly:D:D:D
Didn't realize many of you are from Canada. I was born in Toronto,Ontario,lived in Rexdale. Miss Canada,the accent I had, but not the cold.
Sonja and Angel Apollo

[kaibosmom]

I don't know if I said yay for Molly but if I didn't then...yay for molly! Have a great week!
Nikki and Kaibo
P.S. The snow is melting in Saskatoon! But it's pretty icy in spots so not that safe for unstable Kaibo to walk in...soon though :)

[Dixie'sMom]

Yay molly!

[molly muffin]

So, on Wednesday, back to the IMS for ACTH testing, UPC/urinalysis and the eye doctor to take a peek at her perhaps.

I sure am getting tired of all the vet trips, sure molly feels the same and I know most on here could echo that sentiment. I just want to find out the best combination of medicine to keep all her issues stable and carry on.

hugs all

[beaglemom3]

Good luck to you and sweet Molly tomorrow, prayers and good thoughts for good results, and I definitely can relate to all the vet trips, my boys won't even get into the car anymore without bribes of treats.

HUGSSS!

[beaglemom3]

Thinking of you and Molly!

[molly muffin]

So back from the vet's.
Molly's BP - good in the 140's consistently so that is Very good.

Eye doctor - Molly's retinal bleeds that she had previously have scarred over, with no retinal detachment (breath huge sigh of relief)
Some new smaller retinal bleeds
The small cataracts have not changed in size.
All of that is very good and I really do think that her Ocu-Glo eye supplement has helped to maintain the size of the cataracts as the eye doctor was explaining that is what it helps to do, keep them from growing too large, real fast.
If she gets red in her eyes, then she is getting irritation and we'll need to bring her right in for a topical treatment. If we can catch anything with her eyes early, it is better.

So, now we are waiting on the ACTH and the UPC results, which I should have tomorrow. The IMS will call.
You know two weeks ago I was in the same spot, everything was going well, and bham that UPC was high, so I'm almost afraid to get my hopes up that things are progressing well there too..nah..I'm too optimistic. I do have high hopes that things are well in the UPC deparment and hopefully the cortisol department too.

hugs all!

[Harley PoMMom]

Wow her BP number is great!!! Hoping with you, that you get excellent results from her other tests, however, we all know how that UPC can become falsely elevated, so if it is, we'll just not worry so much about that, ok? ;)

Love and hugs, Lori

[judymaggie]

So glad BP and eye exam results are so good--will think good thoughts for the UPC!

[Dixie'sMom]

Attagirl Molly!

Auntie Suzie is proud of you! <<< Doing the Happy Dance

[Budsters Mom]

Whew! What a relief! Such great news! Go team Molly!!! ;):o

[Blues people]

Sharlene,
I hope all goes well w test results, and so happy for you re: eye issues. Reminded me that some good news is better than no good news.

[Squirt's Mom]

YAY! I have no idea if this is valid or not but we are gonna say it is - with the BP good, the kidneys will have calmed down and that UPC will also be good. :cool:;)

[molly muffin]

Hi gang,

I don't have the written results yet but I have the call in numbers.

She isn't responding to the increase in her kidney medication, with her UPC going from 2.4 to 2.7. Not a significant increase, but considering the increase in medication, she should have gone down, they were hoping for a decrease of 50% not an increase.
So question, has anyone switched from benazepril to enalapril and seen a change? The general thought of the IMS is that there would be no difference.
The next option is to add on an ARB - Losartan. There isn't a lot of studies in dogs on this. In the US they have seen good results, and my IMS has one dog on it here that is responding. There aren't too many choices left in the protein losing kidney medication area though.

So, I don't have the pre number but she told me over the phone the post numbers for the ACTH.

20/22/2015 (2 weeks ago)
pre - 166
1 hr post - 339
2 hr post - 389

03/18/2015
pre
1 hr post - 326
2 hr post - 356

So a small drop this time but not much. The drop after 30 days on the first dose was greater than this one of an increase of 3 mg.

So, for the moment she is staying on 11mg, because with the wedding and company at the house and boarding during different events that require a lot of people at the house, we'll keep her on current dose, then increase to 15mg and see if bringing down the cortisol more, might help the kidneys as we are running low on options there.

That is the current plan.

So, two things I need to find out, would switching from benazepril to enalapril make a difference in the UPC.
Anything at all about dog reaction on kidney protein loss using Losartan in addition to benazepril

got to run back to work.
hugs all

[judymaggie]

Sharlene -- I've done some research on using ARBs in conjunction with ACE inhibitors. I came across one article that seems to answer some aspects of your questions -- caveat is that it is very, very technical, having been written by and for vets. Here is the link for the article:

http://veterinarymedicine.dvm360.com/practical-guide-antiproteinuric-drugs-dogs

What I can glean from this 2013 article is that the preferred ACE inhibitor is enalapril and that losartan can be used with it if the enalapril does not lower levels on its own. I would need to spend some more time reading the article to discern why the enalapril is preferred.

I'll do some more research on enalapril vs. benazepril and will let you know what I find.

I know the UPC numbers were not what you were hoping for but it does sound like a difficult issue to treat. A big hug for Molly and you!

[molly muffin]

Thanks Judi. I read that one and a couple others. Enalapril is the choice drug in the USA while benazepril is the choice drug in Canada. There is no difference really in how they will affect the UPC. Those are the top 2 choices.

Now dang if I didn't find another article about Losartan raising potassium in when used in conjuncture with an ACE inhibitor like banazepril. Well, that's not good, as on her renal profile last week, this is her potassium level currently:

6.0 mmol range 3.6 - 6.0 mmol dang it.
Because there is a risk of the banazepril raising the potassium too. In fact she is right at the highest end already, so how can I add something that will maybe help with the protein loss but raise her into dangerous levels of potassium.
This just seems impossible sometimes, the more I read!

I just don't really know what to do at this point.

We'll try to get the cortisol down lower and hope that helps I guess. Then I'll have to talk to the IMS about that potassium issue too.

If you find anything, holler. I'm game to read anything at this point. Though I admit my head hurts from all of it. LOL

[judymaggie]

I looked at some more articles about losartan and several of them referred to losartan as "losartan potassium"!

[molly muffin]

That doesn't sound very promising does it. Grrrr.

Thanks. I'm going to look up that phrase tomorrow.

[Harley PoMMom]

Hey Sharlene,

When I get home I will search and see what I can find, I thought :confused::eek: that one of the difference between the two is how they are metabolized/excreted, one is by the liver and the other through the kidneys.

[molly muffin]

From what I read Lori I think that is one of the differences.

I'll have to see f I can find the article that talked about it. I know the first was human patients given both had increased potassium. The other article talked about two different arb that ended up increasing potassium in dogs.

[molly muffin]

This is interesting. Last slide a bit scary

http://www.canwestconference.ca/PDF/speakers/Companion%20Animal%20Sessions/Dr.%20Barrak%20Pressler/Evidence-based%20treatment%20of%20proteinuria_Slides.pdf

[Harley PoMMom]

Great find! According to that the side effects of ARB and ACEi are the same. It's good to know that if the ACEi does not reduce the Proteinuria than Losartan can be used along with the ACEi.

[molly muffin]

The issue is going to be the potassium. If it causes potassium to raise I don't think we will be able to use it.

[beaglemom3]

Hi Sharlene,
I am not sure if this is helpful but my boys are both on enalapril and their kidney values became elevated, not terribly elevated but over the normal range.

We had their US yesterday for their tumors and heart disease and blood work to check their kidneys etc and will have the results later today and will let you know if their potassium and kidney values if this will help you.

[molly muffin]

Thanks Vicki! I appreciate that!

[Budsters Mom]

So how is our little diva?

[molly muffin]

Molly is...you know..molly. :)

She is doing okay. Loves that the weather is nice. I have to really watch her with the luxating patella though, as she can lose her balance easily. The other day she just went over and rolled onto her back (she was on the grass and playing with a fur friend) and she just lay there legs in the air with a what the heck look on her face. I picked her up, set her to rights, brushed her off and she didn't miss a beat, off to play some more, but this time on the sidewalk, where she has more stability. That girl!! She has a spirit that just won't quit.

I'll be signing the release tomorrow for the pharmacy I am switching too and around the third week of april I hope to have things in place to increase her dosage and start the cycle of testing all over again. We have to get her to a good place so the other things are easier to control.

I'm still fighting sinus problems left over from the whole bronchitis thing in February. Now on some different meds. Man this thing sucks, it's not in my lungs any more, just my head. (well they always say it's just in your head right. hahahahah)

We're swamped literally with wedding and family stuff. Family starts arriving this friday and the wedding isn't till the 11th, so I know I've been scarce around here, but bear with me awhile longer.

Work too takes a lot of time and energy as things have changed and I've picked up even more daily jobs, which just leaves me wanting a nap most days. I crash when I am home. LOL Not as young as I use to be obviously. Not even sure when that happened.

LOL

hugs all!

[Blues people]

hi Sharlene,
Seems you are having as hectic a time as we...
I hope all goes well w Molly. Seems like she is a little trooper.
Your energy and optimism is refreshing and strengthening . I wish I could be as so.
No ,matter what tomorrow brings for us, I wish you both good outcomes and more happy times.

[mcdavis]

Sorry to hear you're feeling under the weather, especially with everything that you have going on. Fingers crossed that everything goes well for Miss Molly when you increase the dose - I'll be thinking of her even if I don't get a chance to drop by.

[molly muffin]

Well the wedding is over and I am trying to get back into the swing of normal after wedding life again. :) At least until the honeymoon in a couple weeks when we'll be taking care of two cats. LOL

The wedding was beautiful, bride gorgeous and groom handsome, it all went off perfectly, but oh my gosh, exhausting! I think we all slept our way through sunday evening and monday, as much as possible at least between ferrying people to the airport at various times.

Molly is home, yay! I hate when she is away but as much as we loved the wedding, she would have hated it. It took her awhile to get settled this time when she got home. She would be up and down, and not really rest for quite a while, moving from spot to spot. She wouldn't let me out of her sight either, just wanted to be where ever I was. Not her normal thing after being boarded, and I wonder if maybe it is that so many of the staff have changed and not as many of her normal regular people any more. She is much more comfortable it now seems going to the vet hospital where her specialist are and seeing the regular vet techs there. Even though it is huge and she shakes on the way and when we first get there, she always comes out happy as a clam and settled with her regular vet techs who take care of her and do the blood draws and blood pressure. She loves those people. Normally that is how she is after boarding but not this time.

We'll be raising her trilostane dose soon. I have them already from the new pharmacy I'm using.

Well back to sleep. I am trying to catch up on the forum as much as possible. I'm sorry for those I have missed, as I am sure there must be more than a few.

hugs all

[molly muffin]

Molly will be going back to the specialist for ACTH/UPC this thursday. We increased the dosage of trilostane to 15mg tuesday, 2 weeks ago so it's time to check again.

I've noticed a couple things lately. Eye sight, even though the vet said she her cataracts remain small, she had a couple more retinal bleeds that have now likely scared over as she has real difficulties at night seeing or in low light and shadows become threats and make her very skittish for night walks. She also hasn't walked around the pool outside once since we opened it this year. She just seems to not feel comfortable exploring all the way around. Hopefully as she is out more, she will get more comfortable with her territory and feel safe to explore and enjoy her yard again.

Kidneys, I'm noticing that she has to go out more lately. No accidents, but definitely wants out more often, and gets the tremors in the morning until she can get outside. So we are trying to get her out earlier now. I don't know if that is a sign of the protein loss and kidney issues or not or if she has something else going on. She will have a urinalyis when they do the UPC Thursday so if something is going on, I hope it shows up so we can address it.

Luxating patellas are definitely worse. She wants to walk on the grass but sometimes it is almost impossible for her to remain stable. She doesn't appear to be in any pain, but I keep the halter tight enough that if she loses balance I can support her till she gets back on the sidewalk. The hardest thing is that today, we have a cushy mat in front of the kitchen sink and I saw her hind quarters just drop when she was walking on it at one point this evening. I think it was the leg, but definitely a symptom of worsening, and I hope it isn't anything else. I haven't seen her do it since, so don't think it is a return of the back issue.

It is hard to see their bodies failing them and try to remain positive. Some days it's harder than others I guess.

Over all though, she is still happy, I think. Wants attention, not really playing with her toys as much but sometimes, that comes and goes. She will lay on her back and kick and play with us when we tickle or kiss her tummy. She is always available for treats. :)

hugs all

[judymaggie]

Sharlene--sure do hope Molly's cortisol and UPC numbers come down! Curious how often you are checking her potassium levels ...

[molly muffin]

We hadn't done them for awhile prior to the increase in the benazepril and then we did a full renal panel.

So I don't check them every time, but if I see something trending upwards, then I tend to start checking it more often.

[kaibosmom]

I agree. It is very hard to watch their little bodies get more frail. I'm experiencing that with my Molly. Cuddling is fine. It's other activities that are difficult. Some days are better than others. I know there will come a day when we need to decide how her quality of life is. I dread the day. She will be 14 in September. The IMS commented on Thursday how cute they are in the kennel together. She said Kaibo was wrapped right around Molly as if to be protecting her and comforting her. Ummm. Excuse me!? I said I need a picture of that! Then, as if on cue, as I put them both down on the floor, Molly barked at him and told him right off. Omg.

[molly muffin]

So for the first time in forever, molly's cortisol levels are controlled.

7 May, 2015
pre 44nmol (1.59ug)
post 103nmol (3.8ug)

This is after an increase to 15mg trilostane from 11mg trilostane. 2 weeks, so I expect it will go down more, but hopefully not too much. She will be retested the end of june to make sure. I can't do anything sooner as I can't miss work, we are all on no time off orders starting beginning of june to mid june. It did drop over 200 points though, so I will watch her closely.

Her kidney levels are all within range and she is concentrating urine still
Even potassium is down to 5.1, and within range.

Her UPC remains at 2.7 and we're just going to monitor that.

Her ALT is raised to 224 from 163 in Sept, 2014
Her ALKP is raised 1742 from 1400 in Sept, 2014

I don't have the ranges as I got this all over the phone from the IMS and she'll be emailing me copies of the reports later.

Ultrasound shows no major changes. Adrenals still bilaterally enlarged, no change in the nodule, liver shows normal expectations of high cortisol.

So, it's a good report. I just have to watch for any adverse reactions that might indicate she has gone too low on the trilostane. If she does we'll have to back off to 14mg.

hugs

[judymaggie]

Fabulous report!! :D Keep up the good work, Sharlene & Molly!!

[Squirt's Mom]

Sounds like a good report, Sharlene! You deserve a pat on the back at the very least (maybe it's lobster time now? ya know, as in someone drives you to the lobster and cooks it and cleans up after? :D ).

[Robert]

Could be lobster for lunch and dinner time!!!!!! Great news...

[Budsters Mom]

Yes, terrific well-deserved news indeed!:p

[flynnandian]

good news for you and molly!

[molly muffin]

I am thinking about this and need to decide today.

Before we keep molly at 15mg, maybe I should have another test in 2 weeks to see if she has dropped further or too much.

Looking at this history, I have some concerns:

on 8mg trilostane

ACTH Oct 17, 2014

Pre 74 nmol 2.68ug
1hr 858 nmol 31.09ug
2hr 1024 nmol 37.11ug

ACTH Nov 07, 2014

Pre 102 nmol 3.69ug
1hr 582 nmol 21.09ug
2 hr 608 nmol 22.03ug


01/18/2015

Pre - 89
1 hr post - 378
2 hr post - 499


increased to 11mg

20/22/2015 (2 weeks ago)
pre - 166
1 hr post - 339
2 hr post - 389

03/18/2015
pre (?)
1 hr post - 326
2 hr post - 356



increased to 15mg -2 weeks ago

05/07/2015
Pre 44
Post 103


Any thoughts? I'm wondering if maybe she will continue to drop too much on the 15mg and needs to be a 14mg or 13mg instead.

I just don't know, but since I can't get off for a test till later in June, I don't want to take any risks..arghh

My IMS said she would order in 40pills of 15mg for monday. So, I'd have to send an email saying not to place that order today.

[Harley PoMMom]

What a drop in that post number! which is good!

She was increased to the 15 mg after that March stim test? If so that I think the 15 mg should be fine. You could always get the Trilo compounded in a few 2 mg and 10 mg capsules if you decide to decrease her 15 mg dose, although that would probably be a pain in the butt.

How does she seem to be feeling?

[molly muffin]

We didn't increase the dosage until 2 weeks ago as I didn't want to have an increase during the whole wedding stuff going on. So she stayed on 11 mg until 2 weeks ago when we increased to 15 mg It scares me that she dropped that much that fast.

I think she is okay at this level. It is going lower that worries me.

[judymaggie]

Sharlene -- I'm trying to follow the numbers you posted but am confused. Why are there three numbers for all the tests except for the 5/7 test rather than just pre & post numbers?

[molly muffin]

In canada we used the same stimulating agent uses in the UK Australia Europe. That company was sold and it is no longer available to be used for "pets". This last test was done using the same stimulating agent used in the US and follows its protocol of only doing one post draw.

[judymaggie]

Sharlene -- Not sure how to correlate the results between the two different tests but Molly definitely has a history of continuing to drop the longer she is on a particular dose. That said, since the trilostane has such a short life and you definitely know what to look for with regard to negative effects, you would be able to stop the trilostane immediately if need be. Would it be more expensive if your vet orders a week's worth at a time? I would hate for you to have to pay for 40 pills and then have to go change doses before you use them all.

[molly muffin]

I've decided to do a test in two weeks as yes her history shows she willcontinue to drop. I have enough of the 15mg to get through that time period and a bit past so we can decide if it is safe to keep her at 15 mg or not.

With Molly's lack of symptoms that are typical of Cushing's. She shows no different at this cortisol level than previous higher levels I worry that she would have to go very low before we caught her using symptoms. Even diarrhea is in her history so not a true indicator. She doesn't drink as much as she should and never has. So that too is a problem area. And food she has never been a big dry food eater either. Sigh.

There is nothing typical about Molly and her diagnosis.

I will only do the ACTH test in two weeks so cost shouldn't be too bad. Cross fingers.

It is definitely a balancing act and fine line with her. If I could know she would stay where she is I'd be very happy indeed.

[judymaggie]

Sharlene -- your plan sounds like the most sensible (albeit, expensive) thing to do. Hopefully, Molly can maintain the good numbers and not go any lower!

(I think Molly and Abbie conspire together somehow to keep us on our toes! :rolleyes:)

[molly muffin]

I didn't want to have to spend the money right away but I've seen how quickly things can go wrong. A drop of 200nmol or 0ver 7ug in two weeks. Knowing she has continued to go down without a change has me wary. Better safe than sorry. I hope.

I think that even after all these years and the knowledge I've gained. ( never enough). I still am afraid of the what ifs.

[Harley PoMMom]

WOW, in only 2 weeks with the 15mg and she dropped that much. I believe your plan to test in 2 weeks in a very good idea, glad to hear that Miss Molly :) is doing well with her Trilostane.

Sending positive energy along with love to you and Molly, Lori

[labblab]

You know, one more variable in all this is that the stimulating agent had changed for this most recent test. I know that, theoretically, that should not make any difference in the results. But perhaps that introduced some change in Molly's test numbers in addition to the change in dosage. I agree, it will be really interesting to see if there is any further variation in two weeks.

Marianne

[molly muffin]

I wondered about that too Marianne. The other variable is that I had changed pharmacies. I just don't know but it is worrying.

We went up 4 mg on the increase and I was hoping to be around 200 or 180 nmol when the results came back. Dropping that much definitely is more than I think either myself or the IMS expected.

[labblab]

Hmmm...the pharmacy change raises even a few more questions, then. Are you going to be sticking with this pharmacy from now on? You know I always worry when we see unexpected results with compounded meds. Especially when dealing with dosing totals and changes that are incrementally rather small, I always wonder how accurate the changes really are from batch to batch, even using the same compounder. But now I'm really wondering whether the pharmacy change may account for a difference in absorption or actual accuracy/comparability of dose. :o :o

[molly muffin]

I don't know. It depends on what the next test shows I guess. I did cancel the order for more of the 15 mg pills today and we will see how things go till next week.

If she continues to drop a lot them will probably go back to getting from the vet school pharmacy. I just don't know why she dropped so much.

I know what you mean. Is it the stimulating agent. Is it the pills. Is it just Molly. Argh. So frustrating.

[labblab]

Sharlene, why did you decide to change pharmacies? One probably very goofy thought that occurs to me is that you could order some 15 mg. capsules from the vet school and give them for two weeks before retesting. It would be interesting to compare the results between the two sources. But that would only really make sense if you wanted to return to them, anyway, which you may not.

If you want to stick with the new compounder, we'll just figure this is a baseline for the way in which their dosage affects Molly and judge future changes accordingly. Plus, we're kind of overlooking the fact that she is finally in well-controlled therapeutic range -- and that is really a good thing! :) :)

[molly muffin]

Hi Marianne. One factor as always was cost. To get it through the vets compounder was more expensive and I have to go to the IMS to pick it up. Not the closest option by any means. And I had no contact with the compounding pharmacy myself. This was recommended by someone else who uses them for trilostane for their dog. It's a human pharmacy who has a pet pharmacy section too. So I like the options available and they send it straight to my door.
Since my IMS is not in till Wednesday I think, I haven't been able to discuss any of this with her yet. So couldn't get the vets pharmacy to make pills to compare till the end of the week. Then under a time crunch of when I can get the testing done.
I love that she is controlled now and hope it makes a difference with the kidney and bp issues. I really just want her to stay right where she is now. My fear is that she won't and will drop some more. Not tons of wiggle room.

I am probably being a worrier is all. I do tend to do that. Lol. Last year was a real kick in the pants. Things just changed and went downhill so fast. Good one minute and not the next. It makes me gun shy for sure.

[kaibosmom]

You want to be between 42 and 152, right? I would keep her on dose she is at longer and retest. I think that's what you decided to do. I'm not sure if our IMS is being conservative or not with Kaibo but she wanted him to stay on 5mg twice a day for another month because she said he may still drop...and that was after a month being on that dose. I guess we will see in a couple of weeks. Im not sure if I posted on our page but Kaibo's down to one insulin instead of two! He's doing really well 😃

[molly muffin]

Yes. They can go put to 250 nmol. That would be 9 ug. That she dropped so much so fast and because she usually continues to drop for even copper 30 days worried me. We have an appt for next Thursday to retest. I am a worrier I know. But we have seen it happen so easily on the forum where things can go low quickly. I like nice and slow.

That is great about kaibos insulin. Congratulations.

[Trish]

Hmmm well it is past Thursday.... we need an update!! I now you're a worrier, we all are... that's why we here :D dog worrier's united! Hopefully the IMS calls to let you (and us) know all is well!

[molly muffin]

Nothing yet and whatever the verdict we won't be able to order till Monday, and so I will run out of 15mg on Tuesday and will have to use some 11mg I had left to carry her through. ARgggghhhh

Usually have a call next day at around 5pm. Guessing there must have been emergencies today and they take priority, which is understandable, it is a VET ER hospital first and foremost where her specialist is.

[Trish]

Stink! I still have hope she will call!! **fingers crossed**

[molly muffin]

So I was right, emergencies all over the place today and my IMS was the only internal medicine specialist on duty. She called me around 9pm.

I don't even begin to know what to think about these results. Molly continues to be... well molly.

On the same dosage of 15mg:

Pre 29 = 1.05 ug
post 243 = 8.8 ug

She said she wasn't worried about the pre being that low, as that can fluctuate during the day due to different factors that if the post had also been low then we'd worry, but instead, mollys post went up by 140 nmol points.

She dropped 234 points from her post of 334 nmol I think it was in the previous test in April initially on the 15mg and now back up.

If I hadn't just had an ultrasound 2 weeks ago, I'd think she had an adrenal tumor, but then this is the dog who tested negative on every LDDS test too.

So what the heck molly! You are confounding me.

If any of you have any thoughts I'd love to hear because I swear this dog is absolutely one of the most confounding cases I have seen and just figures she is mine.

She is doing everything normal molly. Eating, drinking, playing. No diarrhea, poops have in fact been great.

sigh


2 weeks ago, she was on 15mg and results were:

pre 44
post 103

We talked about was it the compounding pharmacy, was is the test..what.

I think it is higher though, this past week, she has had less problems with the back left leg than the previous 2 weeks and here is the kicker, she hasn't had the tremors for the past week.

The ultrasound showed no change in the adrenal glands, still enlarged bilaterally. The nodule hasn't changed a bit. The liver is still enlarged and the only thing we noted on the tests is that her liver values have increases (ALT and ALKP) GGT fine. Which is also baffeling a bit as we'd hoped those would either come down or stabilize.

I asked if we should try going back to the other pharmacy but she said, no since I am on lock down at work, and can't get off for a test, then we'll keep her on the same pharmacy's compound and she'll order 8 weeks worth of trilostane 15mg and we'll retest when I can and see how she is.

[judymaggie]

Ah, Molly, Molly ... you sure do keep your Mom's brain cells on high alert! Sharlene, since Molly is feeling so good, maybe just shift focus away from test results/patterns. The improved leg and lack of tremors are definitely good signs. I know how hard it is to just accept what is and not wait for the "other shoe to drop". Give Molly and yourself hugs from Abbie and I!

[molly muffin]

That is the idea just accept and go with the flow for a bit.

Today though is not a good Molly day. Started last night with her very jumpy on a late night walk. Them stopped and wouldn't go up the step. Fine this Morning. Then this afternoon was behind couch and had diarrhea on her walk around 4pm. Is still jumpy but did the step okay. Not sure is this is cortisol or eyesight.

Since Molly often has diarrhea I can't say that it is related to cortisol levels which should be fine as the test Thursday was higher anyhow.

Maybe just am off day for her. Hard to,say. I don't like it though.

[molly muffin]

And now she just ate all her dinner and is bopping around like no problem. We will see how she does on her walk later on. Still think she has lost more sight I. The right eye especially

[judymaggie]

Another day when we wish our dogs could talk!! I was thinking that it was more than likely Molly's vision issues. Abbie has cysts almost completely covering her corneas and she startles often.

[molly muffin]

I tend to think it is eye issues too.

[mommyslittlegirl]

Hello,was reading a little about your baby Molly.I have also read about others on the site.All these sweet babies.But I noticed they all are lucky they have such loving mommies.

[Budsters Mom]

Maybe just am off day for her. Hard to,say. I don't like it though.

Yes, I somehow managed to handle the continuing problems as they arose, but the off days now and then were tough. I totally get it. For me, it was that knawing feeling that something wasn't quite right, but not knowing what it was or how to fix it.:o

I had a dog as a child who went deaf and blind as he aged. He was my little brother who grew up with me. We were inseparable for 15 years. It was a minor detail that he actually happened to be a dog. He started as my protector, but toward the end, I ended up having to protect him. He managed very well for a long time in his sound and sightless world. He was truly loved and that was all he needed. Molly may be losing her sight, but she has all she needs too! She is dearly loved!

Hugs,
Kathy

[Harley PoMMom]

Hey Sharlene,

Were the 03/18/2015 ACTH stim numbers (1 hr post - 326 (11.8 ug/dl)); 2 hr post - 356 (12.9 ug/dl)) from the former compounding pharmacy, and were her recent ACTH stim results 05/07/2015 (Pre 44 (1.5 ug/dl); Post 103 (3.7 ug/dl)) from the other compounding pharmacy that you switched to? If so, then what Marianne has mentioned before with regard to the pharmacy change, could be the culprit for those conflicting stim results. :confused: How is she doing now?

Hugs, Lori

[molly muffin]

Only these last two where from the new compounding pharmacy.

I mentioned that I want to go back to the other pharmacy and compare but the IMS said she didn't want any change while I wasn't in a position to do a test.

So this next batch of meds will be from the new compounding pharmacy and then when we test next the order will go to the other compounding pharmacy from at the vet university. That is the long term plan.

She is sleeping now. Was okay last night but not as playful.

[molly muffin]

Dawn. Yes we all try so very hard to do the best we can for our much loved furbabies.

Kathy you are right we know when they are off. I am sure Molly can adapt if she does end up blind. I worry more about figuring out the medical issues she has going on and trying to keep those stable. Cortisol liver kidneys and bp.
They said her liver just keeps going up and there is no reason they can see for it to be doing so and are hoping that is she is controlled maybe that too may adjust with time just as they hope the kidney and bp will adjust. We are putting am awful lot of hope I to this one area helping all the others.

Molly is doing okay this evening. She seems to bounce back and forth i. How she reacts on Any give day or even hour.

[Budsters Mom]

Oh Dear Sharlene,

We love our little muffin too and know how worried you are.:o They have our hearts wrapped around those furry little paws of theirs and we desperately want to fix everything for them and make them okay forever. It's the feeling of helplessness that sucks!:o :( Okay, not the best choice of words but they work. Molly has always been somewhat of an enigma. She loves to keep you guessing and on your toes.

It finally got to the point with Buddy that I had to Face the fact that I could not fix him anymore. Although that was devastatingly difficult to face, it was also freeing because my focus had to change to enjoying every precious moment I had left with him and letting the rest go because nothing else mattered anymore. I pray that you are still a long way from that point with our little muffin and she will once again bounce back from all these little setbacks. It's really easy to get so wrapped up in all the diagnostics and lose sight of the precious little baby right in front of your eyes. I spent way too much time frantically googling, searching for a miracle cure that could save Buddy, when I could have doing belly rubs and butt scratches. Try not to make the same mistake I did.

Breathe Sharlene, you'll get it all figured out.
Hugs,
Kathy

[addy]

Hi Sharlene, I just skimmed a few posts and sure hope Molly is having a break and a better day. I need to go back in your thread, I remember the last updates I read, her numbers had come down but sounds like her eyes are troubling?

Thinking of you as we cleaned our pool this morning, water is still cold, we have not had the heater on much as the pool has only been open for a week.

I hope you and Molly are ok

Love
Addy

[apollo6]

Dear sweet Sharlene.
Will be praying for our sweet little Molly. Hope she feels better.
Love Sonja ,Apollo

[molly muffin]

Addy, Sonja, so great to see you both here. :)

What a busy spring you have had Addy. I can't even imagine doing all you have done while also not feeling the best in the world.

Sonja dear, so good to see you. I know things are very hectic for you too these days. Hope that little Ariel is keeping you smiling though. That's important through all the rough times.

Molly is being molly. a bit demanding and seems to be feeling better than she has for the last couple weeks. Lower cortisol might not make her feel so good, but who knows.

She'll be going a bit higher in her cortisol as i ran out of the 15mg and playing phone tag with the pharmaist since monday. It will be sent out tomorrow and hopefully I'll have it friday (if the post feels like it) or if not will be next week.
Since I'm out of 15mg pills, she'll have the pills I have left, not sure if they are 11mg or 8mg, but better than nothing. Then we'll have about 6 or so weeks on 15mg till her next test.

She is currently barking at me because she wants her veggie treat. She pulled a toy out of her box last night to play, which she hasn't done for a couple weeks at least. When she does that I know she is feeling good.

Also continues to NOT have the tremors and leg is acting better too. No slipping out causing the hop. Gads. What a twist this girl is.

hugs all!

[spdd]

I don't post much anymore, but you can bet I check up on "our" Molly almost every day. Glad to see she is feeling better. My stomach still flips when I do come here, and I find it still very hard, but all the pups I knew get a regular visit on their threads just so I know how everyone is doing. So... sweet Molly, you just keep your momma happy and continue to feel well.

[doxiesrock912]

Go Molly!!!!!!

[Budsters Mom]

How is our little muffin doing today?

[kaibosmom]

Sounds like she's feeling better! Kaibo has been getting toys out too so it looks like lower cortisol is good for both of them! Yay.

[mcdavis]

I haven't posted because I don't really have anything to offer but I am following Molly's journey and thinking of you all throughout. I was so pleased to read that she's playing with toys - that's always a good sign :)

[Budsters Mom]

Where is that update on our little muffin?

[molly muffin]

Molly is doing good. Which is always nice to say. Her leg is holding up fine, I don't think she has dropped down any in her cortisol as she has trouble with her leg when she does, plus a couple other things I know now to watch for. (not that she ever went too low, she didn't, but when she is around that 100nmol range, I should know it)

She is playing and active, all normal molly things. Probably not as happy with me as she could be as I am working so much these days that she doesn't get that extra time we normally have had. Just been a rough year for that.

And my home computer has been contrary, so not been around as much. It freezes so much it makes typing a post a real painful experience. Tonight it seems to be (at the moment) on it's best behavior. LOL I do read on my ipad but I find typing on that a real trial and I'm just not great at the voice stuff, although I know you tried to teach me Kathy. I keep forgetting to say period, comma, etc.

Anyway, molly is okay.

One thing. I haven't started her on her heartworm, tick, flea med this year. She has been on revolution for years with no problem, but then I was looking into it some more and they where talking about it affecting the liver and that made me a bit wary as molly's liver enzymes keep going up, and I hate to think I might be doing something to make it worse on her liver. So not sure what I'm going to do about that.

That is my latest thing I guess and really the only thing going on. :) so can't complain.

Thanks for checking in on us!

[mcdavis]

So pleased to hear Miss Molly is feeling good at the moment, although sounds like Mom needs a rest ;)

but I'm horrified to read about Revolution affecting the liver. There are so many nasties we have to protect our pups from here (rabies, ticks, ...) and I do worry about the effects of all of the chemicals :(

[addy]

Sharlene, had to stop by to check on Molly, glad things are stable and also to say

TRIPLE CROWN. OMG, can't believe it:D

[judymaggie]

Have to second the OMG!! :D It was so exciting.

[molly muffin]

That was very exciting. I didn't see it, but very glad that he won.

I hope they put him out to stud now and he can live a happy life just frolicking with the ladies. :) :)

[molly muffin]

I had to bite the bullet and go with revolution for molly. I'm taking her with me this weekend out to the lake in the woods and no way I want to risk, tickets and mosquitos and fleas out there with her.

She has always tolerated the revolution well (as in didn't even notice it went on), but I'm more leery of everything these days. LOL

She still appears to be happy, hmmm, make that bossy little diva. She is currently barking and prancing at me for her treat, she had some broccoli and rice last night and I think she thought she had found nirvana the way she licked that bowl clean.
She really could care less about her dry kibble and most days she doesn't finish a bowl for the whole day. I have to add some wet food to get her to eat so her trilostane will be absorbed properly.
She doesn't drink worth a hoot either the little minx. She never had been a big drinker, and it's not changed at all.
The only time she drank appropriate amounts was when she was on the SO food.

Oh well, if I don't get a chance to check back in, I'll see you all next week. :)

huggers

[judymaggie]

Have a great vacation! I bet Miss Diva will love checking out the new sights and sounds.

[mcdavis]

Hope you all have a lovely trip.

We're currently in NH with Henry - in addition to the Revolution I'm spraying him with Sentry Natural Defense then wiping him down with some lavender grooming wipes I found - I think he smells good :D
He doesn't agree, and fingers crossed neither do the ticks!! although I just took him for a short walk before dinner and he came back with one on his nose :eek:

[apollo6]

Have a great trip
Sonja,Apollo,Ariel

[mommyslittlegirl]

Sharlene and Muffin,hope you had a fun trip .Well,its back to work.

[molly muffin]

We're back. I am so glad I gave Molly the revolution. I have only seen mosquitoes that bad, one other place in my life. If you went out at night, or morning, or during the day when it was rainy, you would be covered in less than a minute. I wore a light colored hoody every time I went out, except for Saturday during the day, when the sun was out and a bit of a breeze. Then it was okay as long as you stayed by the lake, not in the woods. Molly was limited to going out, peeing and getting inside as quick as possible. I still have bites all over me.

I gave molly a bath with oatmeal soon as we got home and she seems to be okay. I didn't find any ticks at least, hope I didn't miss any.

hugs all

[doxiesrock912]

Mosquitoes Rae the worst! I would rather be in pain than itch. Aveeno oatmeal bath helps alot.

[judymaggie]

Hi, Sharlene! Just checking in to make sure you and hubby and Molly are okay -- it's been a few days since you got back from your trip. Hope all is well!

[molly muffin]

Hi Judi, yea we just got busy with fathers day weekend stuff, swim parties and kids, which was all great.

Then yesterday I got sick. :( sore throat, coughing, chills, can't stay awake, drat it. I have till Friday to beat this. Which is our anniversary and we have plans all weekend. I refuse to be down and out for that.

Have you ever heard of Buckley's? Its a cough, cold, flu medicine, who actually advertises that "it taste awful but it works". I'll be taking that tonight before bed. gads, must be desperate.

Hope everything is going well with all of you.
Molly had the runs on Saturday so, checked her poop sunday morning and it was fine, but still withheld the trilostane for Sunday, back to regular dosing on monday.

This happened at the cottage too, and I didn't give her trilostane on the sunday, after hubby said her stools where a bit looser than we like.

I am putting both of these episodes down to stress. The travel to the cottage and then this weekend the pool party with kids. She always reacts to stress with 'the runs'

[mommyslittlegirl]

Hey Sharlene,hope you are feeling a little better. I started to get worried about you.

[apollo6]

Sharlene hope you start feeling better and little Molly.
Sonja,Apollo ,Ariel

[Squirt's Mom]

Take care of yourself, Sharlene!

[Budsters Mom]

Okay Sharlene, you are sick and need to take care of yourself.:o

It is time for an intervention. It is obvious that you can not do this on your own, so you need our help. Put your devices down and back away ever so sloooooowly. Okay, obviously that did not work, so try again....

It will be hard, but we will survive without you until you're feeling better. Well, at least most of us!;) Our little diva needs her mama in tiptop shape and so do we! Soooooo rest Sharlene and PUT YOU DEVICE DOWN!!!! Don't make me come there and take it from you!

[Budsters Mom]

Okay Sharlene, your light is on! Don't think I don't know! I am watching you!!!! :eek::eek::eek::eek:

Why aren't you resting!!!!!!!

[molly muffin]

I am behaving myself. But reading isn't that hard to do. Still coughing but my throat isn't sore any longer and head only sometimes feels basketball size. A couple people have suggested allergies and it does all seem to be around head and stuffiness so maybe. Did have the chills though at first.

Anyway. No time. I am going to take some sinus meds today because today is our anniversary and we are going out to dinner tonight that will be very long 3-4 hours tasting menu and wine pairing about 18 - 20 courses and I will enjoy it darn it!

Tomorrow we are doing the. VIP theatre to see Jurassic world. And Sunday we are going to a film premiere documentary. So really. No time for sick.

Molly at least is being great. Just needs hair trimmed out of eyes. But very much her Molly self doe which I am every grateful.

Hugs

[Budsters Mom]

happy anniversary Sharlene! Pace yourself!!!!!!!

So happy to hear that Molly is doing well!:p

[mcdavis]

Happy Anniversary Sharlene - I hope you feel better and are able to enjoy the weekend activities.

[Harley PoMMom]

Happy Anniversary Sharlene!!

[judymaggie]

Hope you are feeling well enough to enjoy all your festivities this weekend! A big hug for Molly!

[molly muffin]

Everything is going good here. I'm swamped at work but nothing new there.

I am trying a switch of food with molly. I currently have her off her LP kidney food and I'm trying a canadian brand, nutram, that is turkey, chicken and duck, low phosphorus, and even lower fat content than the LP food and about the same protein. It also has a low glycemic index, grain free. So no potatoes, corn, etc.
I notice she seems to pee even less (and no her glucose wasn't high, but with certain foods it can spike of course) Also isn't as hungry, and sometimes doesn't even want her canned food for her pills. Energy level is the same and she seems to be doing okay. I wouldn't mind it if she lost a bit of weight to try and help her back legs (the patella), but not too much. Anyway, I'm giving this a go as I really don't care for the high fat content in the prescription kidney diets.

That's about it for us.

hugs

[molly muffin]

Molly didn't want to eat her breakfast this morning, even the wet food on top of the dry. Normally she'll scarf that down even if she just picks around the dry for the rest of the day (she has always been a grazer). She took her meds in her food ball, but then was uninterested in the rest of it and walked away. Finally I got her to eat some by hand and she ate the rest of it and did her normally picking at the dry. Now she has gone behind the french door in the corner and laid down. I've never seen her go there before. She was at my feet but then I kept reaching down to pet her and she didn't seem to want to be bothered by that, which is also normal, but going behind the french door is a new one. It's close to me though but not in hand reach.
She had her walk this morning and was totally normal on it. Barked at another dog, normal bowel movement (solid).
Just not sure what it means and I'll withhold tomorrow mornings pill just to be on the safe side.

sigh, never easy with cush pups

[judymaggie]

Hi, Sharlene! Hopefully, Molly is just having an "off" day -- good that she had a walk with normal poop. I can't remember if you give her pepcid before her morning meal. If not, maybe you could try that for a couple of days and see if her enthusiasm for breakfast improves.

[Squirt's Mom]

Any chance she is hearing fireworks or thunder and it's making her a bit off? Canada Day was yesterday (maybe? :)) and not sure how it is up there but down here idiots shoot fireworks for weeks before and after the actual holiday - in spite of laws against them. :mad::rolleyes:

[apollo6]

Just dropped by to say hi. We cushing parents get so worried about ever move,sometimes as Addy would say put cushing in the drawer for the day and take a break.
Sonja,Apollo and Ariel

[molly muffin]

Molly is acting better this evening. Interested in her food ball of meds and her treat after walking and when hubby came home. Nibbled at her food.

So, maybe this morning was an off morning, but I will hold the trilostane tomorrow morning, see how she does and then resume if she acts fine on Sunday. She didn't act really interested in food a couple mornings lately but never walked away like this morning.

Energy level as still a bit down on her afternoon walk, so have to gauge that too, but definitely wanted a piece of shredded cheese. Is currently trying to convince me she needs her dental treat or maybe chicken and squash..hmm..yea definitely the chicken she wants.

I have always had to combine a couple different kinds of food with her, and I wonder if trying to just give her this one kind of food isn't working for her. She would just not eat over having just one type of food. Since she has never been a really big eater, I guess that is a possibility.

She seems to have low energy and food drive in the morning and then perks up as the day goes on.

I gave her melatonin for the fireworks on Wednesday, probably will be some this weekend too. She didn't like the noise at all, but finally went to sleep and then was fine on Thursday.

I don't give her pepcid right now, but that could be a possibility. Would that only bother her in the mornings though?

[judymaggie]

Sharlene -- when I was only feeding Abbie once a day, my vet explained to me that acid build up could occur more in the mornings because her stomach had less food in it than any other point in the day. I then went to feeding her twice a day and it helped a lot. Since there aren't any downsides to trying the pepcid, maybe you could do that for a few days and see if it helps.

Hugs to Molly from Abbie!

[molly muffin]

Molly gets fed twice a day. Morning and evening although she usually has dry kibble in her bowl all day as she is a grazer. She gets topped with wet though twice a day as she has pills to take at those times and needs food.
I skipped the trilostane yesterday and she was fine all day. Gave her the trilostane this morning again and she is back to normal eating habit so guess Friday was just an off day for her.

Maybe had some acid buildup or something. She gets her joint and milk thistle treat style just before bed so never has a completely empty tummy over night.

I just worry about her I guess. I'd like her to be around for a lot longer and what ever I can do to help make that happen and keep her quality of life good for her I will do.

We are having some nice weather her finally this weekend. No rain! Lol. So she is getting some out door play time too which she loves.

Hugs all.

[Budsters Mom]

I totally get it Sharlene. This disease takes a toll on all of us. We worry about things we should never have to worry about because our babies are fragile. It's not fair, but we adapt because we love them so much and will do whatever we can to make life better for them.


I just worry about her I guess. I'd like her to be around for a lot longer and what ever I can do to help make that happen and keep her quality of life good for her I will do

[doxiesrock912]

Sharlene,
I was told to give a small snack before the morning meal to dilute the acid content. Sometimes a big meal with all of the acid do not mix well.

[molly muffin]

I am not sure if molly has ever eaten a big meal in her life. She just never had the cushings appetite. The problem seems to have resolved itself and she is back to where she was prior to not wanting to eat.
Usually the wet food stimulates her appetite enough to want to eat. Without it, she wouldn't eat enough at all, and just sort of randomly pick during the day. This was true even before starting trilostane.
Since my IMS is going to be going on vacation for a couple weeks, I'll be taking molly in next thursday for an ACTH and UPC test. We'll see where she is at that point.

hugs

[Harley PoMMom]

I posted this in Judy/Abbie's thread and wanted to post this here too.


Hey Judy,

I came across this study published in 2014, this dog's proteinuria did not respond well to the benazepril/amlodipine treatment, then a drug known as Telmisartan was started along with lowering the doses of the benazepril/amlodipine. After 5 weeks of using the Telmisartan (and adjusting up the dose) the dog's UPC of 4.0ish went down to .33, they then upped the dose of Telmisartan and reduced the benazepril dose, one month later this dog's UPC was .14!

Article can be found here: http://onlinelibrary.wiley.com/doi/10.1111/jvim.12471/pdf


At most recent recheck, 31 weeks after the discontinuation of benazepril and on 10 mg (0.9 mg/kg) of telmisartan once daily, UPC remains reduced (0.33)

Hugs, Lori

[molly muffin]

We are heading to the IMS office to have an ACTH and UPC done today. I needed to get it done before she (my IMS) leaves for vacation for the next few weeks.

Cross fingers that we are controlled with cortisol and UPC at the very least, remains steady and no worse.

hugs all

[judymaggie]

Thinking good thoughts for Molly and you! "Steady" is definitely what we want.

[Bailey's Mom]

Hi Sharlene-
I hope you and Molly get a good report. We'll be looking for the results!
Love,
Susan

[Budsters Mom]

Waiting with you Sharlene.;)

[Harley PoMMom]

Me waiting too! :D

[Budsters Mom]

Tap, tap, tap,....... Any news yet? Inquiring minds need to know.;)

[molly muffin]

Hi, sorry it has taken so long for me to update the test results.

So, ACTH:

07/16/2015
Pre 34 nmol = 1.23 ug
Post 221nmol = 8.01ug

05/21/2015
Pre 29 = 1.05 ug
post 243 = 8.8 ug

05/07/2015
Pre 44
Post 103

I'm inclined to think that test on 05/07/2015 where the cortisol was post 103 nmol was an error somewhere as these last two are more consistent with what we see historically molly react to trilostane.

We don't retest for 6 week, due to my IMS being away and just maintaining for a bit, but will likely raise her trilostane from 15mg to 17mg. I am personally okay with the present level, as she is asymptomatic anyway, but the IMS wants a tad lower. We'll see and I'll give it some thought.

Her UPC has gone up to 3.1 from 2.4 - 2.7. So the IMS thinks this might be a daily fluctuation but could be her trending upwards. We are discussing, depending on her next UPC result, to remove her from the benazepril entirely and go with an ARB. I mentioned the article that Lori posted a link to me and Judi about. My IMS currently has a dog on solo ARB and one on joint ARB and Benazepril, another IMS in the same hospital has a dog on solo ARB. These are all new so we will have time to see how they respond before we move Molly that way.

She is still concentrating with specific gravity of 1.035, everything except the protein is good.

Abnormal on the chemistry test are as follows:

Calcium - 2.90 (2.20 - 2.80 mmol) We will check ionized calcium next round of testing. If high will look into parathyroid as she has been up and down on this.

Chloride - 105mmol (108 - 119 mmol)
The IMS wasn't concerned about it as other electroyltes where within normal range, although I notice the sodium - 145 (142mmol - 152) potassium was good though 4.8 mmol (4.0 - 5.4 mmol.
BUN - 11. mmol (3.2 - 11. mmol) (so have to watch that)

ALT 199 (18 - 121 iu/l) This is actually down from 224 previouosly (YAY)
ALKP 1769 (5 - 160 iu/l) this is up as last time was 1742 (BOO)

So, that was on thursday, friday it was raining here and molly wouldn't go for a long walk so didn't poop at all. Saturday she went into full out diarrhea, really bad ones too and it has continues, even though I added in a sensitive stomach dry food and a pro-biotic.
We just got back from the vet, as the diarrhea has continued and have the probiotic that we have used before, but I was out of (florifora), and metronidazole. (might be a touch of colitis but did a poop smear to eliminate any parasite possibilities)

So that is what is going on with molly. I have to say though, Molly continues to be molly, she had a grand time at the vet on thursday, is very comfortable there, so much she ran up the IMS, jumped on her to say hello, loves her vet and her vet tech. They said she was very excitable there on Thursday, not scared at all, and as a result her BP was around 180. (not optimal at all!!)
She also had a great time at the vets this afternoon and isn't running a fever, very engaged and active, bright eyed even for a dog that has lost a lot of sight. LOL

So whatever it is, it doesn't make anything but her tummy feel bad I guess and she doesn't seem to react to that other than having some wicked gas. (clear the room)

She is also on chicken and rice now.

hugs all, thanks for checking on us. Love you guys! You're the best!

[Budsters Mom]

Ahhh poor Molly. Tummy issues are no fun for either of you.:o

All in all, a good report though. :p

Our happy engaged little diva. Go Molly!!! :p

[judymaggie]

Hi! Overall, results look pretty darn good! Sure wish Molly would communicate with Abbie and tell her that she should enjoy all the attention she gets at the vet. ;) I do hope the diarrhea gets under control quickly although I bet Molly is enjoying the chicken and rice!

[Harley PoMMom]

Oh my, our dear Molly saga goes on :( I agree with Judy, all in all, a pretty good report. Hoping that diarrhea subsides soon, sending huge loving hugs to you both, Lori

[molly muffin]

Chicken and rice is her favourite meal. She will eat that when nothing else does it for her. I think this started the day of 03 July when she refused her food. She never usually turns down the wet food. We thought an off day. But it was the first sign I think now. It's been a trial to get her to eat properly since that day. So hoping this turns things around for her.
At least she kept her attitude.

[kaibosmom]

Poor Molly! Tummy issues are no fun. Kaibo must be eating for her since he's gaining weight! It's funny how every IMS is different. Kaibo post was 162 and no one wanted to touch his dose. Two months later is is 116 post and all good. Finally in therapeutic range. Anyway I hope Molly feels better soon.

[molly muffin]

My IMS would be happy to have molly in the 100's post. I guess I would be too, but I know that she'll have more leg problems when she goes lower. sigh

On antibiotic now but today, still diarrhea. Sigh. I know too soon to expect miracles.

[Harley PoMMom]

Awww :( poor Molly, diarrhea is definitely no fun. Sending healing energy along with loving hugs, Lori

[Budsters Mom]

Hmmmm.... Our little Diva keeps getting to eat her favorite chicken and rice while she has diarrhea. Once it stops, she's back on the food that she's not crazy about. Maybe she's in no hurry to get it under control.;) Seriously, I know it's worrisome. I hope her tummy settles soon.

Buddy lived for food. Rosie is picky like Molly. She can take it or leave it, often waiting most of the day to eat much of anything. She will not eat unless she is hungry regardless of what she is given. She is generally better about soft food being mixed in, but doesn't always even want that. It is hard when they are picky and need medication.:o I understand.

[kaibosmom]

How is the little miss doing?

[apollo6]

Hope sweet Molly gets better.
Sonja

[molly muffin]

Molly still has diarrhea but her appetite is back. While she ate,the chicken and rice she wanted some of her kibble tonight. Acted like she was having the best treats ever when I gave her some. She also,isn't being finicky about her wet food any more. I hope that means we are on the up swing and the diarrhea will clear up soon. Cross fingers. That has to be hard on her. We still don't know exactly what causing it. No fever. She just had blood test and as I gave the results previously. Nothing bad there. So weird.

[mcdavis]

It's great that Molly's appetite is back but not good about the runny poops. Have you tried a tiny bit of pure pumpkin to see if that helps - I always use it when I transition Henry's food and it helped when Hamish had his tummy problems.

[Squirt's Mom]

Hope Molly is feeling more like herself by now!

[sandi and bugsy]

Sending healing thoughts for Miss Molly and hoping the diarhea clears up soon! Great shes eating better!

[molly muffin]

Well she is probably eating a bit better as I'm not giving her trilostane while she has this awful diarrhea. It unfortunately hasn't gotten any better. The gp vet will let me know tomorrow what our next steps will be. The poop smear came back. No parasites. Maybe a CBC next to check white and red blood cells?

She continues to eat, To be lively and playful. Especially in The evenings. Her habit is to sleep most of the day while I work. She does turn her nose up sometimes to the wet food with her pills in it but she is eating her regular meals. Breakfast and dinner well. The chicken and rice didn't make a difference we either and she is now back on her regular food after a week of special meals.

This is really frustrating as normally the antibiotic would do the trick. I think I will run up and see if I can find some plain pumpkin. Anyone remember how much you start out giving of that? Can't remember is if it is a teaspoon or less for an 18 pound dog.

Luckily she also continues to drink so not getting dehydrated but she must have sore bum by now. Poor little girl

[mcdavis]

Start with a very tiny amount of pumpkin - my understanding is a small amount firms things whilst a large amount softens......
I used to give Hamish (around 16lbs) a 1/4 teaspoon 3 times a day.

[judymaggie]

So sorry that Molly's diarrhea hasn't cleared up yet but it certainly sounds like she isn't letting it bother her. If her "bum" is visibly irritated, you can rub a bit of diaper rash cream on it--I use Dr. Smith's which is quickly absorbed and not greasy.

Will be interested in what remedies your vet suggests. Abbie remains on metronidazole but it does not seem to be helping her loose stools. She doesn't go in the house but has little control outside--ended up pooping in the middle of the road today. Fortunately, we are having torrential rains which washed away what I couldn't pick up!

[Squirt's Mom]

Squirt got about 1/2 tsp and she weighed an average of 15lbs.

[molly muffin]

Her poop was a bit better this morning. Started out formed anyhow, but didn't stay that way by the end, still it is progress. She is off the metronidzole now. They did an xray to check and make sure it wasn't the chicken she got into a week ago, and it wasn't her tummy is clear, the big enlarged liver, which we knew from cushing, otherwise she is good.
They went ahead and gave her a barium (sp?) which they said sometimes, will grab hold of everything inside and help to clear it out. She'll pass it in about 2 poops. They said it is used therapeutically sometimes.

So, here is hoping we're on the upswing of things.

[molly muffin]

First solid poop!!! Finally. Yay!!!

Although still limping on the right front paw. I can't find anything to cause it, took her to the vet, who manipulated all 4 legs, they found nothing either except for the back luxuriating patella. We are stumped but she has been limping since the Saturday that she started the diarrhea. SIGH. At least that (diarrhea) is gone, she has to feel a bit better.

[judymaggie]

Hooray!! :D:D:D (Not too many places we can celebrate poop!)

Curious about the timing of the limp -- hopefully, it will disappear soon.

[molly muffin]

Yea I thought that curious too. I thought it was getting better. Now I think is worse again. All I can think is that she might have hurt it with all the jumping around off the couches she does. Vet did say she was showing sensitivity at her back injury area. Swear if it's not one thing it is another

But yay for poops. Lol. You're right. Not many places we'd say That

[molly muffin]

So, how about this. Took molly for grooming today, now that the poop situation has cleared up and I had my groomer look at mollys nails since I said, I think she is displaying sensitivity there and she said, yep, someone clipped these too shorts, this is probably why she is limping now. arggghhh, I haven't asked anyone to clip her nails, my groomer always does it, but guess at the hospital someone must have done it and not told me they went too short. Anyway, we will monitor her, not let her jump for awhile till her nails are not so sensitive and see if that helps. We've already had all her joints looked at by vets, but I didn't think of her nails since I knew I hadn't had them done. I should have thought of that first though. I knew they weren't split as I looked at the joints. I feel like a bad mommy.
I'll be telling them no clipping her nails. I have someone who does that!!

Would that have caused stress colitis maybe too? from pain?
My initial thought is that it could. Maybe.

[judymaggie]

Sharlene--don't beat yourself up! You had absolutely no reason to think there was an issue with Molly's nails. I would think the stress of getting her nails clipped combined with the pain could certainly cause her diarrhea. The timing certainly works.

[Budsters Mom]

You are a wonderful Mommy Sharlene. :pDo you want to be mine? I could use one. ;):D

None of us, even supermoms like you, can control/know EVERYTHING. Yes, it does all fit together. Front paws are particularly sensitive and that could explain the limping. Anything can set off diarrhea, so it's all possible.

Tell them to keep their mitts off of our little diva!

[mcdavis]

Don't you just hate it when people do stuff that they're not asked to do and cause problems :mad: You really shouldn't beat yourself up.
There are times when I think we have to be detectives to work out what's going on with our pups.

Hopefully you've identified the problem - it's certainly plausible, so keeping everything crossed that the nails grow quickly and she's feeling much better soon.

[molly muffin]

Thankfully the limping is getting better every day, so that is a plus.

She continues to do well as far as her tummy goes too, so Yay.

[kaibosmom]

Yay! Good news!

[molly muffin]

Molly seems to have recovered completely now from the sensitive toe nail clipping. grrrrrr

She does have times when her back legs bother her and you can tell as she'll climb a step instead of bouncing up it, or just wait for a lift. It isn't all the time, just some days are rougher than others.

poops are soft form to solid, but nowhere near what it was before, so I'm just hoping that time will help with that.

Hope you are all doing really well!!!

Life is a bit crazy these days. Paternity leave is the bane of my year. Everyone is working extra due to summer vacations (we miss one person and things get backed up) and then have a paternity leave for one of our team for all of November/December, so definitely crazy. Add in some personal stuff and well I'm not here nearly as much as I'd like to be but do try to pop in as much as I can.

I don't want anyone to think I've forgotten about you. I definitely haven't.

I hope everyone is having a good summer and your furbabies are doing well.

hugs

[mommyslittlegirl]

Hey Sharlene,you are amazing. You always answer each and everyones question. Thank you

[judymaggie]

Sharlene--thanks for Molly update. Had you tried the pumpkin? I do think it is helping Abbie.

I was part of a small team (before I retired :D) and can totally relate to how hard it is to cover for co-workers and still do your own workload. From my perspective, you do a great job juggling all that goes on in your life!

Give Molly a hug from us!

[Bailey's Mom]

Hi Sharlene!

I've not forgotten you even though I, too, have not been able to spend the time on this site for awhile now. I do read the posts as I get the emails. I'm glad Molly is doing pretty ok.

I once dropped Palmer off for a grooming and they took him in the back while I was still there and started on him right away. Nail clipping was first. I heard some yelps from the back and looked at the gal who was still in front. I forget what excuse she gave me, but I was VERY unhappy. All 3 of our dogs have had black nails and it's almost impossible to know where the quick begins......consequently I leave it to the groomers.

Love,
Sus

[molly muffin]

Susan! So great to see you online. You little whipper snapper, been staying busy I bet.

Oh yea, my groomer is the only one I usually have do molly's nails, which is why I was surprised to find they'd been cut already.

I have to say, molly is a little bundle of energy in the evenings lately. Playing with her ball, running around, wants to sit outside with me and bark at dogs in the neighborhood who walk by. Just enjoying life. I love to see her like this. Hope it continues for a very long time.

[Budsters Mom]

You and me both sister!!! :p Go Molly!!! :D:D:D

Keep those nail clipping fiends away from our little Diva!!!!;):eek:


I have to say, molly is a little bundle of energy in the evenings lately. Playing with her ball, running around, wants to sit outside with me and bark at dogs in the neighborhood who walk by. Just enjoying life. I love to see her like this. Hope it continues for a very long time.

[mcdavis]

Pleased to hear that Molly's feeling better and recovering from the nail clipping. Do you know who actually did it so you can ensure it doesn't happen again?

[molly muffin]

I haven't been back over to the IMS, we are actually on a bit of a break from testing in that I don't have to go back till September, but no fear, I will find them. I have an idea it might have been Chris, but I think he would have said something to me, we'll see. He is the lab tech, but could have been anyone. So I'll have a word with him and the IMS and say, yo, knock off the grooming with the little miss. Gawd, wonder if it was because it was before she went to the groomer and they thought she looked a mess!!!!!!!! (she did, she always does when she reaches that stage of either groom her or loose her under all the hair)

[molly muffin]

Quick update. Molly has diarrhea again. I just can't figure out what the cause is. I'll start her on some pumpkin tomorrow. The last place I checked didn't have the plain pumpkin only the can lpie filling which won't work.

[Greybeard]

Quick update. Molly has diarrhea again. I just can't figure out what the cause is. I'll start her on some pumpkin tomorrow. The last place I checked didn't have the plain pumpkin only the can lpie filling which won't work.

Kitana had her first normal poo in almost 3 weeks today after finally giving her pumpkin! :D I had tried EVERYthing including syringe-ing the bland diet in her since she wouldn't touch it herself, and I've been using slippery elm too. I gave her 1 tbs in the morning and one in the evening with her food (she's 40-ish lbs) She went from watery poo to totally normal within 2 days. I hope it works for Molly too!

[Budsters Mom]

Hi Sharlene,

So sorry to hear that Molly has diarrhea again.

I have a trick to keep the pumpkin purée from going bad, since you use so little of it. It's always ready when you need it, but you don't end up having to throw any away. ;)

I open both ends of a can and put the pumpkin into a Ziploc quart plastic bag. A heavier variety is best. Make sure you get a name brand that zips tightly and stays closed. I use two cans at a time because I use it in my breakfast shakes also. For Molly, you would would want to fix one can at a time.

After getting the pumpkin in the bag, squeeze it all the way down and squeeze as much air out as possible, then zip it shut.

Get a flat pan, such as the cookie sheet and put wax paper on it.

Cut a very small hole on one bottom corner of the Ziploc bag.
You are going to use it like a pastry bag and squeeze out very small portions of about 1 teaspoon or so.

It is OK if they touch each other on the cookie sheet because they break apart easily once frozen. Stick them in the freezer overnight.

Take them out the next morning and break them up. You can then put them in another ziploc in the freezer. They are now ready when you need them. Take out only the portion you need and defrost it.

Easy, simple solution. Always ready....

I hope this helps!

[judymaggie]

Poor Molly! Another suggestion re pumpkin--start with just a little bit and gradually increase until you see firmer stools. Abbie, at 24 lbs., now gets a little over 2 teaspoons, spread out over the day in each of her three meals.

Are you still giving Molly metronidazole? I tried to go from once a day to once every other day but loose stools returned.

Curious--are you giving Molly pepcid before her Vetoryl meal? If not, that might help quiet things down.

[apollo6]

So sorry to hear about Molly. You can get canned pumpkin in the supermarket under the cake section. Also some specialty pet shops carry pumpkin. Pray she starts feeling better. Also you can add a little baby electrolytes to her water if she gets dehydrated.
Sonja, Angel Apollo

[mcdavis]

Sorry to hear that. Is it possible that Molly has developed an allergy to something in her food?

Or maybe they've have changed the recipe? I was feeding Henry Annamaet and was about to order a new bag when I discovered they'd changed the recipe and added lamb which I think was what caused him to chew his paws when I tried the Fromm lamb food - fortunately I had enough of the old stuff to transition him to something different. Not to get off the subject but I did read that you should treat each new bag of food as if it was a totally different food in case the recipe has changed :confused:

You could ask the vet about Zantac - after the problems caused by the recalled Blue Buffalo we gave Hamish Zantac (I can't recall the dose but I did split the pills) and pure pumpkin and it really helped.

[Harley PoMMom]

Oh poor Molly :( I believe Squash (baby food kind) can be used for diarrhea when pumpkin is not available, hmmm, I wonder if there is plain pumpkin baby food?

[molly muffin]

I found plain pumpkin finally. Not every grocery has it I guess. Or maybe they where just out. But anyway I didn't give it to her as she is back to a normal poop again.

Man this girl just likes to keep me on my toes!!!!

She acts like she feels fine. I'm also giving her probiotic again. Just in case.

Food is all the same. So maybe just a flare up of something her tummy didn't like. Hard to say. She has displayed any other allergy type symptoms. No chewing anywhere or licking. I'm keeping an eye on her. Lol. She is not to be trusted.

[Jenny & Judi in MN]

glad she is feeling better! I remember having a hard time finding the pumpkin too.

Barb from the diabetes forum had a dog who would run under the bird feeders and eat the dropped bird seed.

[mcdavis]

The stores should start stocking it soon (ready for Thanksgiving ;)). I remember having to search the first time I looked, then being overwhelmed with choice the second time.

I gave it to Hamish every day so it's hard to be 100% sure if it was helping or he would have been fine without it, but things were definitely better once he had that and the Zantac. It might be worth trying it for a few weeks to see how things go, especially if she likes it - Hamish loved it.

[mommyslittlegirl]

Hi Sharlene, I always get pure organic pumpkin for Kiki at a health food store.

[molly muffin]

I did find the pumpkin and she got some today. Loves it in fact.

It has not been a good day at all. :( So, molly does Not like to be carried down stairs. She will run to try and escape you and sometimes she succeeds like today. She didn't run straight down the stairs, but half, then half again, then at the last to the landing she either missed gauged where she was or her front legs didn't hold her up, but she missed and rolled onto her back, looking back up the stairs at me, like she was saying "what the hell mom" and then bounced up and ran down two more steps and into living room. I was scared to death!! She seems fine from that mishap though.

Then I go to the office but a really lousy monday at work. Sometimes Mondays are just like that. Stopped by grocery on the way home, thinking finally this day is over. Nope, it isn't.

When I got home, molly had blood on the right side of her face. That dang skin tag or mole by her eye, she had scratched or something and torn it open and it was bleeding all down her face, matted by her eye. On a white dog, red blood, well, felt like it was a horror movie set. So, into the kitchen for warm water and compresses to the area to loosen the mat and then cut the hair away and clean up her face. It took about a good 30 minutes of non stop, press, wash gently, pull away hair to get it all cleaned up and the bleeding to stop.

Then off for walkies, where she has mucusy diarrhea, which I get partly picked up in a big plastic grocery bag and then a bee decides the smell is interesting, so I am swinging this bag of poop over my head at this bee that will not go away and was way to interested trying to land on me. I was thinking if this poop goes flying I am Not going to be a happy camper. Finally the bee gave up, the poop got picked up and off we went for home.

One more time tonight, she managed to get the mole bleeding again and I cleaned her up.

It has been a Very long night and day. Molly's eyesight is so much worse.
She can't track anything close up by sight, only by smell and it is making for some challenges to get her to eat anything as it is all smell I think. She can see there is a dog across the street but not a piece of food right in front of her unless she gets her nose right on it.

She was on the couch earlier tonight and when she wanted down she whimpered to get my attention and I went and got her and put her down. She was fine with that. She is not though consistent and sometimes will try to jump down on her own.

I'm just tired tonight I think. Molly hasn't left my side since i got home today. She is currently laying at my feet and will get up and follow me to any room I go to and stay by my feet.

[judymaggie]

Sharlene--reaching out to give you a big hug! Tomorrow has to be better. :)

So glad Molly likes the pumpkin--maybe that will encourage her to eat as well as help with the diarrhea. Remember that you should increase the daily amount until you see results.

Hopefully, the bleeding site will dry up on its own. Abbie has an increasingly large lipoma behind one ear--I think the vet is going to have to aspirate it tomorrow (for the third time) when we go in for an ACTH as I have seen Abbie scratch that area and I am afraid she will open it up. Don't think I could handle the blood as well as you!

[Budsters Mom]

Ahhhh Sharlene, I'm joining Judy in that great big hug! Yes, some days just kick the crud out of us!

As much as you don't want to hear this, you might want to think about gating that stairwell, so Molly can't go down on her own. Yes, she hates it, but it's not safe with her vision deficits. I am concerned that she may not be able to judge them carefully when she's running down and could get seriously injured. Major worry wart here!!!!:o

[molly muffin]

Yes I kept gate up and carried her down this morning.

[Jed's Mom]

Wow Sharlene, when you explain Molly's vision troubles its like you are talking about Jed. Everything you say is spot on. He can track me from far away but up close, he is bumping right into me. And he too is starting to miss some stairs. He will circle the coffee table at night looking for a spot to lay down, last night he took it too close and hit the sharp corner around his ribs..he let out a cry that broke my heart. :(

Is Molly on any drops or medicine? We see the Dr today. I'm trying to prepare for the worst but praying we can do something to help him.

xoxo
Lisa and Jed

[molly muffin]

Molly is on amoldipine for the high blood pressure and benazepril for protein in her urine.

The high blood pressure causes retinal bleeds. The retinal bleeds heal and then scare over and where ever they have scarred at, the sight is lost.

The dog ophthalmologist can tell you more about what is happening to cause Jeb's problems.

[Bailey's Mom]

Wow Sharlene! You have your hands full! Poor Molly.
Please do use the gate at all times. We went visiting for Thanksgiving one year and the family there wasn't used to having pets around. Especially ones that did not see well at all. Someone left the door to the basement open and poor little Peaches did not see that was where she was going. She rolled all the way down the stairs. Fortunately she was not injured but I felt AWFUL that it had happened. With her we got to where we had to carry her over the stairs.
Any time I approached her to pick her up to move her, I had to simultaneously tell her "It's alright. It's just me." She adapted to that pretty well. I'm sorry for your struggles.Hang in there!
love,
Sus

[mcdavis]

Pleased to hear that Molly likes the pumpkin - it's great when they like something which is good for them.
However so sorry to hear about the her sight, and the need to carry her downstairs. We've always carried the dogs downstairs as our staircase is dangerous (wood, curved, tall!), so we have a gate at the top.

[addy]

I'm sending big hugs too sweetie. Sorry to hear about the troubles. I understand how it all weighs on your shoulders. When our little ones are having a bad day, we do as well.

Besides, Monday's are always kind of yucky in my opinion :)
The last time I had checked up on you and Molly, things seemed to be pretty good so I am hoping our sweet girl will be off and running and fine soon.

My love to you both

[molly muffin]

So great to see you Addy.

I'm sure Molly will adjust, now I just have to adjust with her. :)

huggers

[molly muffin]

This is ACTH test week. :)

We go on Wednesday for ACTH, UPC, urinaylsis, probably blood work too. She will also be seeing the eye doctor while she is there.

She has a few accidents in the house this past week and was drinking a lot more water, now sure if it is cortisol going up or kidneys or a UTI. So many options eh.

It's weird, as her cortisol has come down, she really looks more like a cushings dog. Begs at night for food (treats, she'll leave her kibble still), hair is thin, tail thin, pot belly has never gone away (enlarged liver).

Well, she still acts like molly though, except for the off days but we all have those as we get older, so I don't read too much into that as long as the attitude is good still.

Oh did find a nice pumpkin product, pure pumpkin puree in a little packets. Love them!

I've been sick too again. So seems like either me or molly in and out to doctors lately. Not a trend I want to continue that's for sure!

[judymaggie]

So sorry to hear that you have sick--I hope Molly gave you some good snuggles to make you feel better! Will be thinking good thoughts for Molly's round of tests.

[Bailey's Mom]

Hey Sharlene!
I'm down in FL just checking on things and getting a break from everyday life. I was relieved to see the family of 3 Sandhill cranes walking around. There is not. Nearly as much wildlife at this time of year. Guess they all went north in
May, too!
I'm sorry you're not feeling well-but as always, you seem to be taking it all in stride.
Bailey is not along for this one week trip. I sure do miss her.
Please give
Molly a belly rub from us and feel well soon.
Love,
Sus

[mcdavis]

So sorry to hear you've been ill. I hope you're feeling better now.

Interesting about the pumpkin pouches as I've only ever seen it in tins - will have to take a look.

Fingers crossed for Molly's tests - I hope they go well. Give her big hugs from us, and look after yourself.

[Budsters Mom]

Well, it seems you need a belly rub too. :o You'd better talk to hubby about that one. There's only so much we can do! Lol:D Rest when you can sweetie. I know it's hard.

As for our little muffin, all in all, not a bad report. She still pretty much herself, which is a good sign. I love that you don't stress over every little thing beyond your control. I wish I could've been more like that with Buddy. Rosie is much more a free spirit. I am much more laid-back with her.

Bigs hugs,
Kathy

[molly muffin]

Well, good and not so good.
So, lets get the not so good out of the way first. :)

BP was at 200 so amoldipine has been increased to address that hopefully
BUN is above normal range - that thought can be affected by many things including diet
Creatinine is increased to high of normal range - that is a worry as is kidney specific and even a small increase is not something you want to see.
ACTH - pre 52 Post 406 - she is no longer controlled at a below 9.0ug so trilostane is increased to 19mg from 15mg daily

So for the good :)
Her cataracts are worse than a year ago but not as bad as they could be, a lot of snow in the back of the retinae, which makes it like she sees everything through fuzz, along with some new retinal bleeds from the hypertension.
Her UPC dropped from 3.1 to 2.2 back where it was prior so we are maintaining the same dose of benazepril and not moving her to the ARB at this time.

Plan is in 2 weeks after starting the 19mg of trilostane we will retest ACTH, UPC, recheck ultrasound, and run a mini renal panel

Wasn't terribly happy when the ophamologist said that I don't need to worry about her eyes as much since her health problems are more concerning and it isn't probably something (glaucoma) that I will have to deal with due to those other issues. My hubby said she is being realistic but still is hard to hear that.

My IMS is pregnant and due in November ,not sure she'll make it to her due date and will be away for 4 months, so I need to get molly sorted out before she leaves and I also let her know that November and December are out for me as far as testing goes. I'm covering a parental leave person at work plus my normal job and so not allowed to take time off till January. We need this figured out by the end of October. Lets hope that 19 will get her back down.

Now as to why it went back up. Trilostane compounded, adrenal tumor secreting could be a factor (we'll check that on the ultrasound), some dogs do need an increase after awhile, and some need a decrease. Molly could be one that only holds steady for some long and then has to be changed on dosage.

I can't believe I am up now working, but alas I am. We were out tonight, then home to walk molly and then do some work, then working again tomorrow. With low B12 and all the working, I'm exhausted all the time. Molly doesn't care about any of that though, and is still in the ACTH spaz zone, so is jumping around begging for treats. Think I'll cave in and give her some. She is good at getting what she wants. LOL

hugs

[tyry]

Sharlene, I truly hope you can get all sorted out in the next month and get Molly back to where she needs to be! Lots of hugs and good thoughts coming your way from me and Jen!

[mypuppy]

Thinking of you Sharlene and your precious little girl. My prayers she is feeling better soon. I love and miss you both hugely.

Tight ones

Xo Jeanette

[Squirt's Mom]

Molly is in the best of all hands and I know you will always make things as good as you possibly can for her. Now, do the same for yourself and get well, woman!

[judymaggie]

Sharlene -- why can't we get an "all good" just once to know what it feels like! :( I sure hope the higher dose of amlodipine will get Molly's BP under control. Great news about the UPC!

I had to get B12 shots for quite a while so definitely know how draggy you can feel before your levels go back up. I wish your work wasn't so demanding.

Take care and give a big hug to Molly!

[molly muffin]

So we have the more recent ACTH history in one spot:

So, ACTH:

09/23/2015
Pre 52 = 1.88 ug
Post 406 = 14.7ug

07/16/2015
Pre 34 nmol = 1.23 ug
Post 221nmol = 8.01ug

05/21/2015
Pre 29 = 1.05 ug
post 243 = 8.8 ug

05/07/2015
Pre 44
Post 103

I don't like the jump up of 6 points since the last test. grrrrrr
I think that the cortisol increase has probably made the BP go up and that also affects eyes and kidneys. Or the kidney problem (creatinine going up has affected the cortisol, which effects the BP and and eyes also)

IMS thinks kidneys might be driving force. I don't know which it is.

I guess I had all is normal for so long back in the day, however many years ago that was, that I used up all our "normal" and now just get Ucky yucky.

[apollo6]

Just dropped by to see how you and Molly are doing. Take care of yourself.
Sonja,Apollo, Karma and Ariel.

[molly muffin]

Thanks Sonja. :)
We are just carrying on.
The weather is cooler and molly has moments of pure energy. :) Isn't that always such fun to see.
We'll go next week for a recheck on her levels and kidneys. Yesterday we tried to do a BP check, and only got one before the cuff went kaput and they didn't have another. It was good though, although just hope it is accurate, it was 112, which is down from the 200's it was last on the 23 Sept.

Getting ready for Canadian thanksgiving here and have company arriving tomorrow. I'm just glad to get a break from work finally. hahahaha

Hope all is going well with you.

hugs

[addy]

I have to ask, what foods are usually served for Canadian Thanksgiving?

It is so nice to take a break from work, what is that old saying all work and no play makes Jill something?

Give big hugs to Molly.

[molly muffin]

Hi Addy. We have the same food for thanksgiving that they do in the US. For us it is a celebration of the harvest. So turkey ham potatoes etc. Although most Italians will add in a pasta dish.

We are also having a mixed evening of tapas and some Eastern European items this week with some friends. Canada is a bit of a mish mash heritage wise so we try to do it all. Lol. It can get even crazier at Christmas where our Portuguese family will be starving cod and our Swedish friends will be having a drop in on Christmas Eve where various seafood is served everything from pickled herring ( gag) to lobster and of course a soup with mussels.

My food,experiences have expanded a great deal since I left the US and moved to canada.

I found a low,protein canned food that Molly seems to love. Even better for it perhaps than the vets medical moderate protein. It's a Halo brand chicken food. She has become very picky lately.

Wednesday we go back for ACTH to see if the increase dosage is helping lower her cortisol back down and an ultrasound to check if adrenal tumor is increased ormwhatmidmgoing on with that. Renal panel, UPC, and BP check too. I am a bit nervous. One cause we don't know why her cortisol went up on last test. I am hoping was just something involved with compounding. The other reason is her IMS is on bed rest and out till about March on maternity leave so a new IMS that I haven't seen before. Hate to see new vets when we worked so hard to get everyone on board already and tuned into miss Molly's care. I'll be a basket case I'm sure. Lol.

Molly is getting lots of attention right now. She is particularly glued to our daughter who is pregnant right now. Life is both exciting and nerve wrecking. My MIL says Molly is the queen of the house and we are her hand maidens. There to do her bidding. I'm like. Yea and?! Lol. She deserves it. She has almost made it to 13 and with the potential health issues we will take every day we get with her. I am still amazed sometimes that people see her no think she is a young dog. We just love the little munchkin.

I'll post a picture from the other night.

Hugs all.

[addy]

Awww, Molly is queen for sure. Hard to say about the cortisol but I too hope it is a compounding issue. If she is feeling good, take it:)

Nice to hear about your soon to be Nana status! That is an exciting time. We were just commenting on how we wish we could "borrow" a little one for a special Christmas show our symphony is having.

I hope you have a wonderful Thanksgiving!

I've just picked up some new samples of Honest Kitchen for Koko. They have a new fish diet without the sweet potatoes. I'll have to check out Halo too!

[molly muffin]

We will know more tomorrow when the ACTH results come back, but the adrenal nodule hasn't changed, so most likely is still not secreting that is not the problem that caused her cortisol to go. Possible it is a compounding issue. As I said we'll know more when her results come back tomorrow. IM will be speaking with the compounding pharmacist about it when they call in the prescription refill.

Her blood pressure was 136, the best it has been since we started down this road of the high blood pressure. So that is good, we had increased her amolodipine and hopefully this is the best dose for her.

We still are waiting on the renal panel results too which should be back tomorrow.

I'm thrilled about the adrenal gland, that is a huge relief. If everything is okay on tomorrows results we won't retest till January. (we didn't redo the UPC as she had just had that a couple weeks ago and it was back down to where it was prior at 2.1)

So, not a bad day, hope tomorrow is also good.

[judymaggie]

Hooray for lower BP & no growth with the adrenal nodule!! :D Will think good thoughts for the rest of the results.

Curious what Molly's amlodipine dose is ...

[molly muffin]

Judy, she gets 2 x .625mg amoldipine pills per day. I give them in the evening with dinner. We increased that from 1.5 pills per day.

[spdd]

Really hoping those test results tomorrow are good.... I check up on your little doll all the time.

[Harley PoMMom]

Man, what a fantastic BP number!!!! And I am so glad to hear that the nodule hasn't grown...YAAA!!!! Crossing all fingers and toes for great renal results.

Hugs, Lori

[molly muffin]

14 Oct, 2015 on 19mg trilostane
ACTH
pre 60nmol = 2.1ug
post 270nmol = 9.7ug

So, ACTH:

09/23/2015 on 15mg trilostane
Pre 52 = 1.88 ug
Post 406 = 14.7ug

07/16/2015
Pre 34 nmol = 1.23 ug
Post 221nmol = 8.01ug

05/21/2015
Pre 29 = 1.05 ug
post 243 = 8.8 ug

05/07/2015
Pre 44
Post 103

Since we expect the post to only go down maybe up to 50 points on the last 2 weeks, we are upping her dose to 21mg in 2 weeks and then a retest at the 2 week mark after the increase. Hoping to get her post to about 150. Her pre always runs a tad lower than the post for whatever reason, probably why she is so jumpy all the time, she runs low regularly and then when it dumps it's at any stimulation or excitement she reacts like crazy. So a more steady might be helpful to her and help with the protein loss and the BP.

Kidneys are good, this result the BUN was still a bit higher but the creatinine was 14.4 with a high end range up to 30, so that is fine too. YAY!

Overall I'd say this is a good report and a good plan for going forward. We'll see how it works out. I've had to make some arrangements for having the ACTH done at the local vet, who said that yes they use the freezing method, due to not being able to get off work to go to the specialist for these test till at least January. (work issues). Of course anything worrying, you know I'll stop meds and get her in sooner. I don't take chances with my baby. :)

Hugs all, it has been a heck of a journey hasn't it :)

[Harley PoMMom]

I agree, all in all a good report!

[molly muffin]

Oh I forgot to mention that they did a SDMA test on her. Which is a kidney test, the newer one and can determine kidney deterioration now when it is at 20 - 40% even, it use to be that kidney failure didn't show up till 60% of kidney had failed, so this is good to have a test that can show it sooner. Anyway, Molly's test came back in the normal range, which is another huge relief for us.

:)

[judymaggie]

So glad that SDMA results were good! I will definitely add this to my list of tests for Abbie at the end of the month.

[spdd]

Yay !!!!!!!!

[addy]

Well that is great news for our little miss.

What a journey indeed, Sharlene and you are doing an extraordinary job!

[FemaleK9]

Good news is so nice to hear! I'm happy for you and Molly!

[apollo6]

Ya:p for Molly and you
Sonja,Apollo,Karma and Ariel

[molly muffin]

I got molly's results back from the last ACTH, and even though we went up 2mg, and it's been 3 weeks since the last test there has been virtually no real change in her numbers.

Since my works is absolutely crazy and I can't get off to go do tests till at least January, we are going to stick with this dosage until I am able to start back in with adjusting dose. This was discussed with her current internist. We dont' want to make any changes during a time when I can't be doing tests regularly. So, we'll resume early next year.

Her adrenal glands sure are stubborn!

06 Nov, 2015 - 21mg trilostane
ACTH
pre 53 = 1.9ug
post 273 = 9.8ug

14 Oct, 2015 on 19mg trilostane
ACTH
pre 60nmol = 2.1ug
post 270nmol = 9.7ug

So, ACTH:

09/23/2015 on 15mg trilostane
Pre 52 = 1.88 ug
Post 406 = 14.7ug

07/16/2015
Pre 34 nmol = 1.23 ug
Post 221nmol = 8.01ug

05/21/2015
Pre 29 = 1.05 ug
post 243 = 8.8 ug

05/07/2015
Pre 44
Post 103

[Budsters Mom]

Try pilling Rosie!:eek::eek::eek: Now that's STUBBORN!!! Wiry little minx!!!:o

Yes Sharlene, I totally agree. I wouldn't want to be increasing any dosages when I wouldn't be available to monitor closely and test either. ;) No point in taking any chances. Even though you haven't seen the numbers you'd like to see, Molly remain stable. ;)


Her adrenal glands sure are stubborn!

[addy]

Sorry work is do crazy for you, that makes it hard. How is Molly feeling? How is her hair, coat, any other Cushing symptoms of concern?

It sure can get frustrating so Big hugs (())

[Harley PoMMom]

Oh phooey, sorry about Molly's numbers, them darn adrenals!! :mad:

Love and hugs, Lori