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

[molly muffin]

Hi everyone, I'm Sharlene and my lovely dog Molly has been diagnosed with Cushings for 5 days now.
I've been reading over the site and I've cried many tears while reading the various posts. Some tears for you and your loving companions, some for Molly, some if I am honest, for myself.

Molly weights 19.2lbs. She has in the past been prone to crystals forming, so she has been on SO dog food for years. She takes Glucosimine because she has a hip joint that isn't grooved really deep enough and she's had some issues with that in the past. In fact, it was a sore leg and a pot belly that causes her to be tested for cushings 2 years ago, results of which were negative, from a DEXA test. Hence the glucosimine. Her ALP's have been high consistently and we try to balance that using the SO food, that encourages her to drink more water and the crystals not to form. She only had them once, that was enough.

This morning I went and picked up copies of her lab tests going back 2 years.
I'll post any that were off with the appropriate ranges:

2010 physical
ALP 518 (20 - 150)
everything else within normal ranges

2011 physical
Albumin 46.7 (26 - 44)
Protein 78 (51 - 72)
ALP 764 (5 - 151)

2011 DEXA
Cortisol (Base) 82.2 (20 - 300)
Cortisol (DEXA) - 4 hours 28.7
Cortisol (DEXA) - 8 hours 35.1

Not Cushings

2012 March physical
Albumin 44.1 (26 - 44) (barely out of range)
Protein 76 (51 - 72)
ALP 1121 (5 - 141)
ALT 139 (6 - 118)

At my request we redid the ALP and ALT along with the ACTH test a week ago

2012 June tests
ALP 1003 (5 - 141) (this has actually decreased a bit since March)
ALT 152 (6 - 118) (while this has gone up a bit since March)

Cor1 - Cortisol (base) 172 (30 - 300)
Cor 21 - Cortisol (ACTH) - 1 hour 924
Cor 22 - Cortisol (ACTH) - 2 hour 1014

Lab states, that in a normal animal Cortisol will increase above 250 but not above 600.
The results are consistent with Cushings Disease; Pituitary-Dependent Hyperadrenocorticism

okay, so now that is out of the way, my vet, who has been Molly's vet since we brought her home as a rescue baby at 11 months, feels that this has been caught at the very earliest of stages. Her recommendation is to begin treatment with Vetoryl 30 mg. In fact, it is sitting here on my desk right now. It is the monster in the closet, under the bed, or in my case, in front of this computer monitor.

So I asked her why begin treatment now,( actually she has called me once since they told me on Wednesday, to discuss and then we spoke again today, when I went to pick up copies of lab results) and she said, that although it is not clinically necessary to start right now and we can decide when we would want to start medications for the cushings, that her experience is that when treatment is not started, the risk increases greatly for dog to develop diabetes and/or pancreatitis. That she feels and she has had good results with early treatment. I asked also about the Davis study suggesting a lower dose and she said that the Davis study is already out dated compared to more recent studies, from universities around the world. That she has had good luck with this dose for Molly's size. Starting the medicine she said would be followed up with tests at day 10 - 14 (she suggested day 12) after starting treatment and then based upon how molly is doing, either 4 weeks or sooner if she feels that it is needed.

So, that is where we stand. She didn't say start right now, because as she mentioned we might not have tested at all and it wouldn't have been caught until some other time, when I brought her in for a problem of some sort. True enough I suppose. She thinks it is an opportunity to prevent any further complications and to get her sorted out and on the road to a "maintenance" life, which would hopefully be a long one. She also said, that it is possible that once the cortisol levels go down, that we will see some arthritic issues since she had a spell with joint pain last year. She outlined what we'd use to treat that if it does occur, which would be Glucosomine first, pain meds possibly, laser and finally injections if none of the other options work.

I find myself second guessing how well I thought molly was/is. She does lay around more, but has a great time playing when she wants to. She doesn't eat all at once every day, usually she eats maybe half or even less, and then later will finish off (around dinner time). She drinks, but not overly so and we in fact try to encourage her to drink since she had issues with the crystals forming. She does have some times when she doesn't want to jump up or she has to make a running leap for that window seat she loves. And yes, there is the pot belly. (we thought she just really loved those treats a tad bit too much and that is probably still true)

Have I been in denial? Maybe. Yet people on the street can't believe she is 9 years old, thinking her much younger.

Will starting her on the medications sooner rather than later lead to less complications and a better over all life? I don't know that either.

Really, I know a lot and I know nothing. That about sums up the gist of it.

[Roxee's Dad]

Hi Sharlene and welcome to you and Molly:)

There will be plenty of more knowledgeable members stopping by to say hi and help in any way they can. My confusion or concern is the lack of appetite and thirst. Usually a dog with cushings has a very healthy appetite and can never seem to get enough water to drink.

It is possible to get a false reading on cushings test if the pup is experiencing any other health problems. Has an ACTH stim test been performed, The way I have always understood cushings diagnosis is that no one test is conclusive and cushings can be somewhat difficult to diagnose at times.

Hang in there and check back often, things can be kind of slow on the weekends and close to the holidays.

Oops I see the ACTH has been done so maybe a Low Dex test to confirm.

[molly muffin]

Hi John,

Yes the ACTH was done, results in first post. Appetite depends, she would woof down a bag of treats like there is no tomorrow if you let her, she loves her can food, but the dry food, some days she will graze at it and others she'll eat it all at breakfast. Water, yea, same concern here, she doesn't overly drink, although she has a bowl of water in the bedroom at night, because she will get up and get drinks during the night most of the time.
I actually had the same concerns and mentioned them today to the vet. She said that not all dogs display the same symptons but that she does feel that the cushings diagnosis is correct.
I don't know if it is or not and that is why I haven't jumped on starting her on medicine. The liver is high, the cortisol is definitely there in the ACTH test.
Weekends are for good times, relaxing and enjoying not having to do the work thing. I hope everyone is enjoying this one. For us, it's a long weekend too. :) Love it!

[Roxee's Dad]

Hi Sharlene :)

Did they determine which type of cushings it may be? One thing to be aware of, in most cases, treatment is usually used to treat the symptoms, such as excessive hunger, excessive thirst and frequent urination.

In some cases where it's adrenal based, surgery may be possible thereby a cure. The medications Lysodren and Trilostane do not cure cushings, only treats the symptoms.

[frijole]

I am headed out the door so don't have long to post but your dog doesn't have typical cushing's symptoms. A cush dog is ravenous and would eat anything and never leave a kibble EVER. I'm glad you did not start any meds. The world experts all agree you do not treat until there are symptoms even if the dog has cushings. You are right - UC Davis does recommend lower dosing and we have found over the years and experience from many hundreds of people who have come here that starting low is the ONLY way to go.

I want to convert your test results when I return. Are you from outside the US? The numbers are higher than normal and I think it is the unit of measure used by the lab. I'll check in later.

Hang in there and don't fret this diagnosis - Molly will be fine. Kim

[molly muffin]

John,

The lab said Pituitary-Dependent Cushings, not adrenal based. And they think that the symptoms will start to show that literally it has been caught very early. That the excessive food and thirst will probably be some of the first symptoms that she develops. She has had accidents in the house, but not consistently, so I wouldn't attribute them to cushings.

Kim, I'm in Canada. Not sure what the conversions would be, but have included the lab ranges as given. Yes, my vet acknowledges that there is no cure, only symptom treatment. Her concern is the other possible illness that could occur and might be preventable such as diabetes, which molly currently has no signs of. In fact, molly other than the liver and the cortisol and belly has no signs of cushings. In most cases she wouldn't have probably been tested at all.

Sharlene.

[Roxee's Dad]

Thanks Sharlene, :)
I am very interested in following yours and Molly's thread.

Shih Tzu's hold a very special place in my heart.;)

[molly muffin]

I am curious. If this is not cushings, and my vet is adamant that it is, what tests should I ask for? What else could it be. The sudden increase in the ALT's is what is worrying, along with the cortisol going up.

I want to take care of whatever the problem is, I just don't know what to do. Another talk with the vet and she is definite that starting early prior to typical cushings symptoms can help to prevent other organ problems from developing.

I don't know what to do.

The ALT only results are:

54 (10 - 118) 2010
110 (6 - 118) 2011
139 (6 - 118) March 2012
152 (6 - 118) June 2012

As you can see, those numbers are just going up like crazy and pretty quickly too. I was told they really get worried once the number hits (double normal results, which would be 236. Vet thinks Vetoryl will get the cortisol under control so that she won't end up with any major organ damage.

Thoughts?

[Roxee's Dad]

Hi again Sharlene,

I was just wondering, was a High resolution ultra sound performed? Usually to take a look at the adrenals and other important organs. In many cases one or both adrenals may be enlarged due to the cushings. This is because they are working overtime to produce the cortisol.

I do remember Leslie's story about Squirt and the ultra sound found something wrong with her spleen which in turned caused a high cortisol count. She will probably be around soon to elaborate.

Another question, I see the ACTH test was performed, was there another test like the LDDS, performed after the ACTH test to determine if it is indeed pituitary based.

[jmac]

Hi Sharlene,

I wanted to offer you a belated welcome from me. I also have two Shih Tzus and love the breed!

First, Molly sure is a cutie! My dog, Hannah, also had crystals in her urine and has been on Royal Canin SO food for 8 years. It has helped her out a lot!

Hannah was diagnosed in March of 2011 after routine blood work before a dental. Her Alk Phos level was high and my vet asked about Cushing's symptoms (water increase, urinating more, ravenous eater, etc.) She was drinking and urinating a bit more, but I don't know that I would have contacted the vet about it. He did a LDDS test that day and she did test positive for pituitary Cushing's. We had an ultrasound done a few weeks later just to be sure things were normal there and they were. My vet also felt that we caught it very early and said that for many dogs it takes years for things to progress.

I still have not started treatment on Hannah over a year later. We did try Anipryl for a few months because I knew it worked in some dogs and had basically no side effects and didn't have to be carefully monitored. Her ALKP level did drop, but I didn't notice much of a difference otherwise so we decided to stop the Anipryl. She has now been taking Denamarin, a liver supplement, for about 6 months and her ALKP level returned to normal. It was over 800 when we started and was about 200 a few months ago.

Since I know the main way to determine how she is doing is by monitoring her eating and drinking, I don't feel comfortable starting her on a stronger drug unless I am sure I will be able to see a difference. She definitely gets several drinks a day, but she is not emptying a water bowl and she is not peeing constantly. She does LOVE to eat and does beg me for food sometimes, but it isn't out of control. She has a full coat, no pot belly, no skin issues...just some hind leg weakness. I have decided that until she has more significant symptoms I don't want to treat. My vet strongly supports this, as did the IM vet we saw. I know there could be some damage being done, but I don't feel comfortable risking it with powerful drugs.

I am glad you are taking the time to think about what is best for Molly. I know others will be by to offer more "expert" opinions on what is best for her. I would definitely take some time to think, read, and educate yourself before jumping into anything.

Also, I know ALT and ALKP are different liver enzymes, but the high normal end for ALKP here is 212 and Hannah's was over 1700 when she was diagnosed. I definitely understand your concern, but I don't want you to panic. I wonder if a liver supplement would help Molly as well. I know many people on this forum use one, so that might be something to look into.

Please keep us updated on what you decide and always feel free to ask questions. You have found a wonderful place of helpful, knowledgeable, caring and supportive people!

Julie & Hannah

[Squirt's Mom]

Hi Sharlene,

Welcome to you and Molly! :)

My Squirt is another one who currently has very high ALP, but her vets aren't worried about it. However, she is actively cushionoid and Molly isn't so that may be why your vet is concerned. It takes more than just the ALP elevation to indicate a real problem - that would show as elevations just about across the board via the liver enzymes. The liver is an amazing organ that can take a whole lot of punishment before it rebels. If you are really concerned about the liver function, a bile acid test may be worth discussing with your vet.

You are wise to wait on treatment as signs are a critical part of not only diagnosing but monitoring treatment. Without strong signs, handling this disease is much more difficult and risky. So take your time - it sounds as it you have plenty of it to learn a lot before you start treatment. ;)

I started to tell you about Squirt's story but since you have been reading for two years I didn't want to repeat something you may well be familiar with. :D If you aren't and would like to hear it, I will be happy to share! In a nutshell, she was diagnosed in '08 and is doing great today at the ripe old age of 14! :):cool:

I'm glad you found us and look forward to learning more as time passes!

Hugs,
Leslie and the gang

PS. On the normal ranges you added for the LDDS...(20 - 300)...is that the range for all three values - base, 4, and 8 hour?

[lulusmom]

Hi Sharlene.

I’ve fallen behind in reading everybody’s threads so I apologize for just now getting around to welcoming you and your precious Molly Muffin. I’d like to make some observations and maybe ask some more questions and the easiest way tie my questions to the information you’ve provided is to type my stuff in blue text within the body of your post. Please see below.


Her ALP's have been high consistently and we try to balance that using the SO food, that encourages her to drink more water and the crystals not to form. She only had them once, that was enough.

If Molly has cushing’s, it is highly unlikely that prescription or nonprescription food will have any effect on ALP.

2012 June tests
ALP 1003 (5 - 141) (this has actually decreased a bit since March)
ALT 152 (6 - 118) (while this has gone up a bit since March)

In subsequent posts I noted that you are very concerned about the progressive increase in ALT. 152 would be considered a mild elevation, which is the norm for a dog with cushing’s. This doesn’t mean a dog’s liver is being damaged but rather is being overworked from the effects of high cortisol. It also should not be the primary factor in determining whether a dog should start treatment.

Cor1 - Cortisol (base) 172 (30 - 300)
Cor 21 - Cortisol (ACTH) - 1 hour 924
Cor 22 - Cortisol (ACTH) - 2 hour 1014

Lab states, that in a normal animal Cortisol will increase above 250 but not above 600.
The results are consistent with Cushings Disease; Pituitary-Dependent Hyperadrenocorticism

This appears to be an acth stimulation test, probably using an acthar gel, with peak concentration occurings two hours after stimulation, thus the two post blood draws. Here in the states most vets prefer to use cortrosyn as the stimulating agent, with peak concentrations occurring 1 hour after stimulation, requiring only one post blood draw. Regardless of which stimulating agent is used, an acth stimulation test does not differentiate between pituitary and adrenal based disease. Could you please recheck your paperwork to make sure you aren’t missing some text.

okay, so now that is out of the way, my vet, who has been Molly's vet since we brought her home as a rescue baby at 11 months, feels that this has been caught at the very earliest of stages. Her recommendation is to begin treatment with Vetoryl 30 mg. In fact, it is sitting here on my desk right now. It is the monster in the closet, under the bed, or in my case, in front of this computer monitor.

So I asked her why begin treatment now,( actually she has called me once since they told me on Wednesday, to discuss and then we spoke again today, when I went to pick up copies of lab results) and she said, that although it is not clinically necessary to start right now and we can decide when we would want to start medications for the cushings, that her experience is that when treatment is not started, the risk increases greatly for dog to develop diabetes and/or pancreatitis. That she feels and she has had good results with early treatment.

Symptoms are a big components of a diagnosis and a cushing’s savvy vet would not confirm a diagnosis and launch into treatment in the absence of overt symptoms. The primary goal of treatment is not to cure the disease but rather to eliminate clinical signs. If there are no overt clinical signs, there is no need to jump into treatment. As a matter of fact, I would be hesitant to start treatment without validating the ACTH stimulation test and determining which form of the disease Molly has.

I asked also about the Davis study suggesting a lower dose and she said that the Davis study is already out dated compared to more recent studies, from universities around the world.

The UC Davis protocol was established as a result of their extensive experience with Trilostane. Based on the 100’s of threads here, I believe UC Davis protocol is much safer than the dosing recommended by Dechra, the manufacturer of Vetoryl. One of our administrators was actually told by an internal medicine specialist on staff with Dechra that they are verbally recommending to vets that they use the very lowest end of the range for dosing but they have not yet published a revision to packaging inserts.

That she has had good luck with this dose for Molly's size. Starting the medicine she said would be followed up with tests at day 10 - 14 (she suggested day 12) after starting treatment and then based upon how molly is doing, either 4 weeks or sooner if she feels that it is needed.

Proper protocol dictates that an acth stimulation test be done at 10 to 14 days and again at 30 days. I would recommend that if and when you start treatment, your vet should follow proper protocol, especially in the first 30 days of treatment.

I find myself second guessing how well I thought molly was/is. She does lay around more, but has a great time playing when she wants to. She doesn't eat all at once every day, usually she eats maybe half or even less, and then later will finish off (around dinner time). She drinks, but not overly so and we in fact try to encourage her to drink since she had issues with the crystals forming. She does have some times when she doesn't want to jump up or she has to make a running leap for that window seat she loves. And yes, there is the pot belly. (we thought she just really loved those treats a tad bit too much and that is probably still true)

With symptoms being limited to a pot belly, I absolutely would not start treatment until symptoms became apparent. I would, however, want an abdominal ultrasound done to make sure there is not some other problem going on. A very small number of dogs have cushing’s caused by tumors outside the pituitary and adrenal glands that secrete acth, so having a look at internal organs is a really good idea. In these cases the treatment of choice would be to remove the tumor. One of our moderators has a dog who had elevated cortisol but it was later discovered, via an abdominal ultrasound and subsequent surgery, that the cause for the elevated cortisol was a tumor on the spleen. Once removed, cortisol levels fell. Oddly enough, these dogs usually have higher levels of circulating cortisol, like Molly. With just an acth stimulation test and no symptoms, how does your vet know what she is truly dealing with?



I actually had the same concerns and mentioned them today to the vet. She said that not all dogs display the same symptons but that she does feel that the cushings diagnosis is correct. I don't know if it is or not and that is why I haven't jumped on starting her on medicine. The liver is high, the cortisol is definitely there in the ACTH test.

For what it’s worth, you’re conclusion is the same as mine so I’m glad you have not rushed into treatment. Based on the information you have provided thus far, your vet has determined that Molly has elevated cortisol via an acth stimulation test. Absent further testing to validate and differentiate, I personally wouldn’t assume the diagnosis is correct.


John,

The lab said Pituitary-Dependent Cushings, not adrenal based.

As I mentioned previously, I have no idea how the lab can make this determination.
And they think that the symptoms will start to show that literally it has been caught very early.

That’s possible but I’m not sure what constitutes catching the disease early with no clinical signs of the disease.

Kim, I'm in Canada. Not sure what the conversions would be, but have included the lab ranges as given.

If the acth stimulation test is in nmol, you would convert to ug/dl by dividing the results of each draw by 27.59. Conversion of Molly’s acth stim test is

Cor1 - Cortisol (base) 6.23
Cor 21 - Cortisol (ACTH) - 1 hour 33.4
Cor 22 - Cortisol (ACTH) - 2 hour 36.75


Vet thinks Vetoryl will get the cortisol under control so that she won't end up with any major organ damage.

Cushing’s is a very graded disease, progressing at a snail’s pace and it takes a very, very long time to do any internal organ damage. Thanks to my ignorant gp vet, my dog was overtly symptomatic for almost two years before an internal medicine specialist finally diagnosed her. If any dog with cushing’s was going to have internal organ damage from long term excess cortisol, it would have been my Lulu but she is fine. I just had a senior panel done and her kidney levels and liver enzymes are perfectly normal.

Just to validate what I have been saying about not treating in the absence of symptoms, here are some excerpts from reference material published by renown and well published endocrine specialists as well as a much utilized veterinary text book. You should share these with your vet and ask her why she disagrees with the experts.

Excerpt from reference paper written by Dr. Mark Peterson, entitled Cushing’s Disease in Dogs: Recommended Diagnostic Protocol and Treatment Options.

False positive results are common in dogs suffering from non adrenal disease. Because such false-positive test results occur for all of the commonly employed screening tests (ACTH stimulation), low-dose dexamethasone suppression, urinary cortisol: creatinine ratio), the definitive diagnosis of hyperadrenocorticism should never be made purely on the basis of results of one or more of these screening tests, especially in dogs without classic signs of hyperadrenocorticism or in dogs with known non-adrenal disease. If a dog has no clinical signs of Cushing’s syndrome, we do not recommend treatment.

Excerpt from Dr. Rhett Nichols, entitled Canine Cushing’s Syndrome: Diagnosis and Treatment (Part 1: Typical, Atypical, and Pseudo-Cushing’s Disease.


Based on the lab tests, does the dog have Cushing’s syndrome:

The most important criteria for making a diagnosis of Cushing’s syndrome or hyperadrenocorticism (HAC) is the patient must have signs and symptoms consistent with the disorder. The importance of signalment, history, and physical examination finding cannot be overstated.

Excerpt from Merck Veterinary Manual:


Diagnosis can be challenging; it should be based on clinical signs and laboratory abnormalities and confirmed via an appropriate screening test for hyperadrenocorticism. If results of screening tests are inconclusive or if laboratory abnormalities associated with hyperadrenocorticism are noted in a dog without clinical signs, the dog should be retested 3-6 mo later.



Whew, that was a novel and I commend you if you are still with me. I've been typing this off and on since early this morning but have been interrupted a number of times. I hate it when work gets in the way. :D I see that others have posted since I started this epic saga so please excuse any duplication.

Glynda

[molly muffin]

I am absolutely with you still! Thank you all so much for your very informative information and for calming my up and down panic attacks.

Okay, to answer John, no they didn't do the LDDS after the ACTH test. That is the one with DEXA right? They did this 2 years ago in May 2010, with negative results.

So it sounds like a high density ultrasound is the best option at the moment. It is possible that a liver supplement might help her liver values come down. I'll ask the vet about that. Also, a confirmation with a follow up Low Dose DEXA test.

I have asked the vet about these tests since her determination that Molly had Cushings and she said that I pay her to know what tests are needed and what are not. She didn't feel a follow up is needed, that I'd be wasting money.

Her values from this lab are in nmol/L for the ACTH test.

Glynda I am going to type out exactly what it says within the text for results on the ACTH test. Keeping in mind that their text recommendations will be based upon the nmol/L ratios.
(thank you for taking the time to type all that out btw! wow!)

Cor1 - Cortisol (base) 172 (30 - 300)
Cor 21 - Cortisol (ACTH) - 1 hour 924
Cor 22 - Cortisol (ACTH) - 2 hour 1014

TEXT: RESULT INTERPRETATIONS

Normal animals: Cortisol will increase above 250nmol/L, but not above 600nmol/l.

Primary Hypoadrenocorticism (Addisons disease; Adrenocortical insufficiency); Pre-ACTH concentration is below the reference value (often undetectable) or low normal. Post-ACTH concentration does not differ from the pre-ACTH concentration or changes very little.

Secondary Hypoadrenocorticism: Pre-ACTH concentration of cortisol is below the reference value (sometimes undetectable) or low normal. Post-ACTH concentration is elevated 3 to 5 times above the Pre-ACTH concentration.

Primary Hyperadrenocorticism (Adrencortical tumor); Pre-ACTH concentration of cortisol is usually above the reference value . However, because of the sporadic pattern of cortisol secretion, it's concentration may be within the reference value, even low. Post-ACTH concentration may be within the reference value, above the reference value, or unchanged from pre-ACTH conecntration. No change from pre-ACTH concentration is an excellent indication of a tumor. If the post-ACTH concentration is within or above the reference falue, additional testing (e.g., dexamethason suppression) is recommended.

Secondary Hyperadrenocorticism (Cushings disease; Pitutary-Dependent Hyperadrenocorticism): Pre-ACTH concentration of cortisol is usually above the reference value. However, because of the sporadic pattern of cortisol secretion, its concentration may be within the reference value, even low. Post-ACTH concentration of cortisol usually is far above the reference value because of functional adrenocortical hyperplasia: serum cortisol will increase to >600 nmol/L. (This is the one I typed out earlier as it seems to be consistent with Molly's results)

latrogenic Cushings Syndrome: Pre_ACTH concentration of cortisol is below the reference value (often undetectable) or low normal. After long-term treatement with corticosteroids, post-ACTH concentration does not differ from pre_ACTH concentration or changes very little.

I've been watching Molly like a hawk the last couple days. (poor thing probably has a complex by now!) and to me, she seems a bit more lethargic than normal, but it is hot out, although not inside. She isn't panting at all (unless out in the heat, then we both pant together). She is drinking her normal amount of water, not exceslys (even with the heat) and eating the same, (when she wants but not all at once). I think she is above the same as Hannah. I know the vet goes on about the pot belly, but Molly has had that belly since she was about 5 maybe. I'm telling you she gets Good treats! So I'm not convinced about that either.

I do adore out little molly. Before her I had a golden retreiver that I'd had since a baby. She was on prednisone from the time she was 2 for severe allergies. I am convinced that she died due to not being diagnosed with lastogenic Cushings. She had the severe hair loss, horrible skin condition, went to the bathroom in the house, drank as much as she could, weakness in her hind legs especially and yet, I never heard a word about cushings or that she could be treated for what she did have. That just makes me ticked off big time.

Molly was the rescue baby I got a year after Tasha (my golden) when I could no longer stand the silence in the house. We lost one of our cats that had been Tashas constant companion since babyhood 3 months before we lost Tasha. The silence was unbearable. Molly was meant to be in our home and I want to shake my fist at fate and say, how dare you give Molly a disease of any kind.

Okay I too cannot keep things short it seems. Sorry.

No I haven't been on here for 2 years, that was one of the other newbies. I have however, been reading through everyone's threads, at least some of them, there are a lot more to still get through. I found this actually as a link under VeterinaryPartner.com as a recommended link. That link I got from a friend who is a vet in Maine.

Hugs to everyone. Some moments I feel fine, and others I feel like crying and panicing a the mere thought of anything happening to molly.

HUGS and Belly rubs to all those faithful companions of ours.

[molly muffin]

I'm going to throw this out there because it really is upsetting me and I feel totally disloyal for these thoughts. I admit that I thought them as soon as my vet said she wanted to test for Cushings bakc in March when we got the first high ALT results.

Why the heck does she keep pushing cushings disease, when all molly had was a pot belly 2 years ago, she pushed this and the results were negative. This time it was because of the liver and I feel like, gee she finally got the results she's been looking for. It kind of pissed me off at the time. Now I feel the same about pushing meds that I don't want to have her on yet if not needed.

It makes me wonder how many dogs she has put on these meds and do they really need them, what are their life expectancies with the meds. Would I be in fact hurting molly to put her on them now or would I be hurting her more if I don't put her on them and the vet is right and she wouldn't develop diabetes or some other disease.

The vet even told me I shouldn't be reading so much stuff on the internet, it would just confuse me. (again, way to piss me off)

I do try to remember that she is the only vet that has ever treated molly in her life and that I know she loves her too. (molly boards with the vet and often hangs out in the vets office with her instead of in the "cage" area) So I don't doubt that she cares for her, but it still is bothering me. I just want to scream sometimes in frustration. :(

Okay so got that out of my system. Thanks for letting me rant. I guess I'm like the angry mom whose kid had been diagnosed with some horrible, non-curable disease and want to blame someone for it. :(

[jmac]

Hi there,

I would be upset if that was the response I got from my vet as well. I understand that they are the experts, yes, but they don't know everything and they certainly aren't experts in everything. My vet thought it was good that I was reading about Cushing's and also felt good about me wanting to take her to an IM specialist; he gave me a recommendation for who to see.

Also, reading and researching is what a GOOD owner WOULD and SHOULD do, so that would tick me off too! You should be sure you know what you are dealing with before you give your dog any medication, and many, many, many vets would recommend against treating when you aren't seeing symptoms. How does she expect you to know how Molly is doing if the main thing you are supposed to watch for is a decrease in drinking and ravenous eating?! That is the main reason I will not treat Hannah yet. It would be too hard to watch for.

I am glad you are not giving meds yet. If I were you, I would push for the LDDS test and the ultrasound, if you can afford it. I would also see if there is an internal medicine specialist vet you could see in your area for a second opinion. I think your vet needs to understand that you are a concerned and proactive pet owner, who loves her pet deeply. She should not be making you feel this way.

Keep us updated on what you decide!

Julie & Hannah

[Squirt's Mom]

Hi Sharlene,

My HUGE mistake....:o:o:o:o

I'm glad you are considering an ultrasound, tho. I am also very glad that you are not letting your vet push anything on you or Molly until you are ready. That pressure can make us feel like CRAP! I know....I refused to be pushed and was told point blank I was killing my dog because I didn't start treatment immediately (not here, on another cushing's forum)...and that was the mildest thing they said. :mad:

When Squirt was first diagnosed, we had a great vet who took a very conservative and thorough approach to testing. Squirt had the LDDS, HDDS, ACTH, UTK panel and two ultrasounds - all positive for PDH. After the second U/S, they told me about a tumor on her spleen. In Sept of '08 that tumor and half her spleen were removed. Her cortisol returned to normal as a result. That tumor was causing her internal stress and her body responded just as it was supposed to - by releasing excess hormones including cortisol which caused all those test to be positive when they really weren't. They were all false-positive because of that tumor.

This sort of experience like Squirt had is only one of the reasons Cushing's is so very hard to diagnose. Cortisol is one of the bodies natural responses to stress of any kind - internal or external. So just because one or even two of the cush test come back positive, that does not mean you have a confirmed diagnosis in every case - like Squirt's. FIVE tests said she had PDH in 2008 - all five were wrong. In addition, the cush signs are shared with many other conditions like liver or kidney diseases, hypothyroidism, diabetes to name a few. Diagnosing Cushing's is as much a process of ruling out all other possibilities as it is getting positives on the testing. ;)

So if your vet isn't willing to listen to you, to work with you as a team, then it may be worth looking into a different vet to handle the Cushing's - an IMS is a good idea. For one thing, they have more education and experience in things like Cushing's and for another, you vet might not feel as slighted if you see someone who specializes VS another GP vet. ;) They may even be willing to work with an IMS.

Hugs,
Leslie and the gang

[molly muffin]

Just a quick note. I emailed using the "contact us" Dechra site, to try to get something in writing about going with a lower dose in dogs vs the higher one in their insert and got the response that they cannot give advice to pet owners, but if you send them your vets info, they will contact That vet.

Well, I already gave my Vet a speech about drug representatives vs other clinical studies, so I know she is in contact with the drug rep already. She told me she was. Anyway, this is just to let you know, emailing them using the form doesn't appear to do any good.

grrrrrrr

[AimesFarm1]

Just like in human medicine, a doctor should NEVER bully a client. You have a right and responsibility to be an informed client. I am currently in the process of trying to get my fur baby into a specialist at Cornell for a second opinion because I think my vet is rushing into Cushings and ignoring the fact that the testing is negative and he is asymptomatic.

You should not feel bad for questioning your doctor's opinion. You are protecting your loved one and seeking the best possible treatment. I say a good doctor empowers you to have confidence in a diagnosis by supporting thier hypothesis with clinical symptoms and solid conclusive diagnostic testing. Good for you for loving Molly so much and wanting the best for her! Are there other vets near you that you could take her to for a second opinion?

[molly muffin]

what are some good omega 3 supplements or treats/food to give molly? I read that omega 3 is good for helping to naturally lower cortisol levels? Not sure if that is true or what, but figured this is the group to ask.

I think my next course of action will be getting the ultrasound done. After that, we'll see, but I'm think about the 1st part of August to ask for an LDDS test too.

Thoughts? I did have a couple things I thought of over the last couple days. On the morning of her test I actually gave her the revolution skin treatment. I didn't get the phone message that she should be fasting either, so she did have breakfast that morning. She does exhibit stress when going anywhere, but especially vet. She was being boarded and I asked them to do the test that day and they said they did.
I don't know if any of this would actually affect the ACTH test or not of course. Probably and most likely, not, but still...
So for the moment, my thought is what about the supplement idea. I spoke with a friend who is involved in pet rescue, and she suggested 2 other vets in the area, if I want a second opinion. My main thing right now, is that I want any other possibilities ruled out. It may turn out that my vet is correct and she does have Cushings, but I want to eliminate liver disease, thyroid, etc. Diabetes has already been ruled out. Anything else that would cause her cortisols to rise, other than cushings?

Thanks Sharlene and Molly

[Squirt's Mom]

Hi Sharlene,

Yes, stress will affect the cush tests. Cortisol will naturally rise in the body, human and canine, when it is under any sort of stress, whether that stress comes from the outside - as a vet visit or change in their environment, or from the inside - as in as illness. So there are literally millions of things that can cause the cortisol to rise that have absolutely nothing to do with Cushing's. Elevated cortisol in an of itself is not a problem nor considered an illness/disease/condition. It is when the body is not able to stop releasing the cortisol even when there are no stressors in play that Cushing's becomes a possiblity.

Hope this helps you understand a bit better. We have members who will take their babies in for the testing but not leave them between blood draws. They will take them home if they live close enough, out to a park, or just sit in the car with them to try to lower the natural stress of being at the vets. Not all pups have a problem going to the vet and do just fine being left for the duration of the test. We each have to decide what is best for our baby and what will provide the most accurate results on the tests.

Hugs,
Leslie and the gang

[addy]

Hi Sharlene,

Just stopping by to say thank you for always checking in on us.

It took me a year to start Zoe on treatment. Her symptoms were not that strong. Take a day at a time. Enojy your Molly. Your avatar is so beautiful of that little girl:):):)

[molly muffin]

I think my vet has scared the bejebees out of me. She is basically saying that if we don't start treatment that the other cushings symptoms are going to show up and by the time they do that she will have other problems. She is very much an advocate of starting medication early to bring the cortisol levels under control and prevent them from causing any other organ damage. She thinks that this is the best option for giving molly as normal of a life span as possible and said that yes she would always be under treatment for the cortisol.

Gee Addy, look whose talking Zoe and Kodo are freakin adorable. :) :) So many absolutely darlin companions on this site and so sad to think of even one of them having health problems to deal with.
I'll add some pictures of molly to an album when I get a chance.

I'm still not sure when I'll start molly on treatment or when I'll get the ultrasound done. I'm just not ready to have another chat with the vet and molly is okay for the moment.

Hope Zoe's eyes start to get better soon! Poor baby.

[Squirt's Mom]

Hi Sharlene,

Is Molly showing more or stronger signs lately? I am just really, really uncomfortable treating a pup who isn't showing pretty strong signs since the signs are critical, vital, to monitoring treatment. If there are no signs, how will you know if it is even working much less have any indication that she is over dosed?

And I would want the U/S before starting as well...but that's just me. ;)

You are doing a great job of educating yourself and keeping a hawk's eye on your sweet Molly girl!

Hugs,
Leslie and the gang

[lulusmom]

I think my vet has scared the bejebees out of me. She is basically saying that if we don't start treatment that the other cushings symptoms are going to show up and by the time they do that she will have other problems. She is very much an advocate of starting medication early to bring the cortisol levels under control and prevent them from causing any other organ damage. She thinks that this is the best option for giving molly as normal of a life span as possible and said that yes she would always be under treatment for the cortisol.

Your vet sure scares the bejebees out of me too. I don't want to sound like a broken record but the goal of treatment is to remedy symptoms and if a dog is asymptomatic, treatment should not be prescribed. I believe I provided you with some validating excerpts from some of the worlds most noted endocrine experts. Did you share these with your vet and ask her why her opinion is in direct conflict with them?

If what your vet says is true, almost every dog here would be diabetic and would have suffered with pancreatitis because they were not diagnosed and treated until they were overtly symptomatic. The majority of dogs diagnosed with cushing's are not diabetic nor have they had chronic pancreatitis. The only thing I can figure is that your vet has had minimal exposure to cushing's and the cases she's had were complicated by companion conditions such as diabetes. :confused:

I am pretty sure that you are feeling torn right now because your vet is telling you one thing and we're telling you another. My best advice to you is to not place your faith in anybody to know what is best for Molly. The best and only way you can do that is by educating yourself. We can only provide you with our own experience and point you to excellent reading material. You are Molly's only voice so make it heard. If you have questions, ask them and we'll try to answer as best we can, as well as provide you with links to reading material on the subject.

[molly muffin]

I don't think Molly is showing any more signs of cushings than she ever has.

It's like my vet could Hear us talking about Molly today. I got a call from the vet's office this morning after I posted here actually, asking how she was doing. I said, fine and that I hadn't started her on the Vetoryl yet. Which seemed to surprise them but I'm not sure why since I said I hadn't decided anything yet.

So I reiterated that point and said I won't do anything till she has an ultrasound to rule out tumors or any other disease. Since they don't do that at the vets office, she has to be referred to the Vet Emergency Hospital, so that is what they have done. Wow, 75 bucks for the referral.

So, Molly is booked to see an Internal Medicine Specialist and have an Ultrasound Friday morning.
I just spoke with the Vet Hospital and confirmed that this specialist has lots of experience with dogs with cushings or maybe having cushings and told them I'd bring her test results with me and that I'm concerned because of no real clinical signs of cushings. I want all other possibilities to be ruled out.

We'll see what happens on Friday and what the specialist says.

I did tell my vet about other findings, and the response was that I shouldn't be reading so much on the internet (that is the short basic version anyway).

I certainly appreciate all the valuable information that you are all willing to share with me. If not for this forum I probably would have just started her on the meds without any further testing or the ultrasound, thinking I was doing what was best for her and not even realizing the possibilities of something else. :(

[frijole]

:D Don't worry... many of us have been down this same path with vets. There is garbage on the web no doubt... but if you go to the links that Glynda referred to you will find that we are providing you with info that vets pay MONEY to learn in classes! These are the recommendations of world renown specialists in treating Cushing's.

Tell the IMS (or your regular vet) you have been reading articles written by Dr Feldman. If they have never heard of him then they know very little about cushings (its a way to screen ;0) Feldman (among other specialists) makes it very clear that we should not treat until there are symptoms.

Like I said - many of us have been in the same boat - myself included. You want to trust your vet because you have to be able to trust them... then along comes this site with conflicting info. It happened to me 7+ yrs ago. Obviously I stuck with the site and canned the vet. :D And I have no regrets. These people saved my dog's life and my sanity.

Hang in there and all will be just fine. Kim

[lulusmom]

I did tell my vet about other findings, and the response was that I shouldn't be reading so much on the internet (that is the short basic version anyway).

Oh my gosh, deja vu. The new gp vet I took my Lulu 10 days ago too told me exactly the same thing and that I shouldn't believe everything I read on the internet. I asked her if I should disregard all those peer reviewed studies in the veterinary journals and clinical trials submitted to the FDA for drug approval or the numerous audios of lectures I've purchased on how to diagnose and treat cushing's given by Dr. Edward Feldman, Dr. Mark Peterson, Dr. David Tweedt or Dr. David Bruyette, all considered experts in their field. I then told her that in my experience, more than few general practitioner vets need to sit their butts in front of a computer and start educating themselves. Keep in mind, this is the same woman who thought a dog diagnosed 7 years ago should have an ldds test done to obtain a baseline cortisol and that a post stimulated cortisol of 8.4 ug/dl is not only acceptable but normal for a cushdog being treated with Lysodren. The vet literally stammered then and I suspect she'll do the same when we finally connect to discuss Lulu's stim test, hopefully today. I will be offering up a copy of the Lysodren Loading Instructions and related tips in our Helpful Resources forum. These instructions are taken directly from a chapter in a veterinary textbook contributed by Drs. Steven Ettinger and Edward Feldman. I hope she won't be insulted because it will help her treat future patients effectively. Besides, I certainly wasn't insulted when she immediately assumed that I am an ignorant layperson who believes everything I read on the internet. :D

[Roxee's Dad]

Hi Sharlene,
Just wanted to add that I have had the same experiences. Some with cushings and with ear medications. My vet at the time applied Gentamicin Otic ear drops in Rozee's ears before I could tell him no. I explained that one of the side effects is loss of hearing. He told me I read too much on the internet. I insisted he change medications while he was insisting that is what he used on the local police dept canines. He went back and read the warning lables then came back and apologized, adding that he was going to change the meds for the police canines. Rozee did lose her hearing, but I'll never know if that was the reason.

I was new to the site and with the wonderful help of the members here, I was able to have a knowledgeable discussion on cushings and the treatment with our vet at the time.... we didn't always agree, but I insisted to go with the successful and cautious experiences I have gained here.

[molly muffin]

Thanks everyone.

It is hearing of your experiences on the board, that makes all the difference in the world when it comes to these one on ones with the vets. Peterson and Feldman are now staples of conversations involving cushings treatments with the vet. To think I'd never heard of either prior to this.

Wow John. You made a difference in a whole community of canines! Way to go! I couldn't be more proud.

Glynda, had to laugh at the thought of you marching in to the new GP vet armed with reams of material to explain very calmly how the vet is wrong. Road trip to Canada? :)

Interesting. I'm speaking with an acquaintance in Penn, who was told her dog must have cushings because the liver enzymes went up. Turned out after an ultrasound to be a large tumor on the liver, which was benign, has now been removed and her dog is fine.

[apollo6]

Dear Sharlene
Thank you for the kind words.
I am originally from Toronto, Ontario, Canada. Now in San Diego , Ca.
I tried a lot of things for almost a year, and waited a few months after Apollo's diagnos to research what treatment to do. Apollo is 4.9 kilos(10.75lb) and is on 10 mg. Trilostane. I started very low with him. I listened to my instincts and not the vets often. Question everything if you are not sure. Keep copies of all of Molly's lab's , take notes and write it down for future reference.
Each dog is different and treatment is different.
Below are some links about cushing and some references.
http://www.kateconnick.com/library/cushingsdisease.htm
references to internal medicine vets, just pu in the city and province.
http://www.acvim.org/websites/acvim/index.php?p=3
http://www.acvim.org/websites/acvim/index.php?p=3
You are not alone.
You and your sweet Molly are in our thoughts.
HUgs Sonja and Apollo

[molly muffin]

We are back from having the ultrasound today and meeting with the Internal Medicine Specialist.

Good news is that she doesn't have any tumors anywhere. Her adrenal glands are slightly on the large size, and liver a tad large. No sign of liver disease, gall bladder, anything that I asked would cause her ALP's and ALT's to be raised. The IMS, told me that looking at the results and all her other tests (that I have posted here) that Molly does indeed have cushings.

Her recommendation is that another LDDS test (we had the last one two years ago, negative) and see what those results are. If they clearly show cushings, on top of the ACTH showing cushings, then we would start her on low dose, 5 or 10 mg of trilostane. She said that was the low end, and that she is of the mindset that you start low and go up, rather than high and go down and that is what she would advise my vet. (I'll be returning the 30mg box of vetoryl)

If the LDDS is low, borderline, not clearly showing cushings, we'd wait and then retest in about 3 months. She also recommended another full blood panel workup and urine workup, prior to starting molly on any medication. So, if the LDDS is high, we'll move to doing the full blood and urine panels.

I am so much more comfortable with this IMS. I did say I was fine with the vet doing the LDDS, as long as she (the IMS) is consulted. If I feel at any time that my vet isn't on board with the treatment, then I'd rather see her directly. She was fine with whatever I decide.

Interesting, my vet told her in her faxed notes, that I had "read on the internet, much information, that made me wary of treatment" pffffft and hmmmmph

This doctor was fine with my reading up and had just recently attended a conference by the vet association. She said, they compile information from all studies done in the US and I want to say UK too, and then issue statements regarding treatment based upon these findings. She said there would be either a statement or a paper issued soon, a new one I mean, she doesn't think it's been released yet, regarding Cushings treatment. One thing will be not waiting for clinical signs to start low dose treatment if all testing indicates cushings and all other diseases or possible issues ruled out.

She has heard Feldman speak several times she said, after I mentioned papers written by Feldman and Peterson. (she said on you are familiar with the big names in this area and laughed) She said they both are doing excellent work, along with U of Tenn regarding this disease that is so hard to diagnose and hard to treat.

So, in essence, I feel comfortable with her prognosis and her plan at this point and hope my vet can get on board with what we want to do.

[molly muffin]

Sonja, I'm in Mississauga, but only a stones throw across the creek into Toronto. :)

I've been reading up as much as I can on Cushings, Medicine, treatments, when to treat, when not to treat. It's a big swirly mass of information right now, that doesn't always make much sense. Thanks for the links :)

[lulusmom]

This doctor was fine with my reading up and had just recently attended a conference by the vet association. She said, they compile information from all studies done in the US and I want to say UK too, and then issue statements regarding treatment based upon these findings. She said there would be either a statement or a paper issued soon, a new one I mean, she doesn't think it's been released yet, regarding Cushings treatment. One thing will be not waiting for clinical signs to start low dose treatment if all testing indicates cushings and all other diseases or possible issues ruled out.

Wow, this is huge news and I'm dying of curosity. Is there any way you could find out who the speaker was?

[jmac]

Hi there!

I'm so glad your visit went well today and that you like this vet. Certainly that is a good feeling after your recent experiences with your other vet.

I don't have any input or advice to offer you, but I'm glad you have a vet that respects your thoughts and supports you educating yourself. :)

Julie & Hannah

[molly muffin]

I don't know who the speaker was, if I missed her saying or what. She seemed to be saying that this would be a new release based upon the compilation of many studies that have been conducted over the last 2 years. (she was explicit that it was based upon many peoples research, mentioned west coast specifically also) She said she had heard Feldman speak a couple times, but didn't say if he is who presented this or if it was a panel discussion or what. She did take one look at molly and say 5 - 10mg to start we can adjust up if it is needed and not risk overdosing, which she felt would be a more dangerous situation.

She said, that she was aware of only 2 cases of adrenal damage to the point of Addisons caused by Trisolane, and that neither had occurred under her or at this hospital. Not 2 world wide or ever, just two that she had been aware of personally.

I looked to see if her email was on her business card but it wasn't, only the general hospital's email.

Next I speak to her I will ask her about who the speaker was. I did mention this board and that everyone here has in the past or is now dealing with Cushings and that all official release of statements or papers are followed carefully so that we will all be watching for that release.

[addy]

It sounds like you are in good hands and the important thing is you feel you can relate to her and she has experience.

I am so glad you had the appointment!!!!

[Squirt's Mom]

Oh, this is exciting! New research on our babies disease! I am sure Glynda will be all over this release and bring us all up to date. It is nice to have a resident Cushing's Guru! :D And now they are thinking to start low-dose treatment even with no signs, or mild signs, present, huh? Interesting....

It sounds like you have found a great IMS! I remember how wonderful it felt to find Dr. S in TN after our run in with an IMS or two who were awful so I am very happy for you.

Let us know how things go and what you decide to do!
Hugs,
Leslie and the gang

[molly muffin]

Thanks gang. I do feel good with this IMS who not only seems to be on board with the same things that I am, low dosing and exhaustive testing to verify results and rule out other possibilities.

Early treatment but Only if positive this what is causing the problems and the levels of all testing should be showing on the high side of cortisol rising, then treatment. At least that is what I understood her to be saying. I wish I knew who was issuing and when and where the statement/report. I'm sure when it does come out, Glynda will be all over it. :)

[lulusmom]

I found an upcoming continuing education lecture being offered by Dechra that may cover the information on treating without symptoms. This lecture is given by a veterinary dermatologist husband and an IMS wife team, entitled Cushing's Disease: Inside and Out. It's not available to us laymen and I can't see the five modules but they are entitled, 1) Perspectives, 2) Diagnostic Considerations 3) Treatment Options - What We Knew Then 4) Treatment Options - What We Know Now and 5) An Option for Managing Canine Hyperadrenocorticism. The what we knew then and what we know now sounds very interesting. The fact that a dermatologist is contributing is interesting because a lot of dogs with cushing's have severe skin and coat issues with few other symptoms. Even more interesting is that the husband dermatologist's practice is in Pasadena, CA. I had a little Shih Tzu foster dog who had horrific skin problems and few other symptoms, who was ultimately diagnosed and prescribed Vetoryl by another derm vet in that practice. Hmmm?

I have been able to find some of the older Dechra continuing educational material sessions so hopefully, I can find this one at some point. It'll drive me crazy until I find it and I suspect Marianne will be very interested too. Oh how I wish I had a veterinary friend. :(

Glynda

P.S. Sharlene, ask your vet if the names Rhonda Schulman, DVM, DACVIM and/or John Angus, DVM, DACVD sound familiar. One or both may have lectured at the veterinary conference your vet attended.

[molly muffin]

I'll make a note of that Glynda. I'm not sure when I'll be seeing the specialist again that I had this discussion with. Next I see my regular vet who will be the one to administer the LDDS test and follow up. She is suppose to consult with the specialist at this point. Well, unless she gives me any grief about starting Molly at the lower dose of Trilo, in which case, we could be seeing that specialist a lot sooner than expected. LOL

I'm thinking maybe keep an eye on that Journal of Vet Internal Medicine for any articles too.

I wonder about asking Dr. Peterson or Feldman if they know of anything coming out that will be different than their original recommendations of waiting on treatment. Have you emailed either of them before? Peterson I think has a web blog, not positive.

Sharlene

Sharlene

[lulusmom]

Dr. Feldman isn't receptive to answering questions for us pet owners without an appointment so writing to him is usually a waste of time. Dr. Peterson has a blog and if I can find the time tomorrow, I'll drop him a line. Hopefully he'll think my question is worth answering. It is Dr. Peterson's paper that I refer members to whenever there is a question about starting treatment in the absence of symptoms. He does not treat patients who are not symptomatic. I believe he is, however, open to treating an asymptomatic dog if the dog has an underlying condition that might require that high cortisol levels be addressed.

Glynda

[StarDeb55]

I don't want to rain on anyone's parade about trying to contact Dr. P, but I actually did e-mail him about 8-9 months ago, to which he did respond. I was politely, but firmly told that he did not answer e-mails directly from owners as he did not have the time. If his website for owners will allow questions to be posted, you might have better luck doing that.

Debbie

[molly muffin]

Well, fooey!

I got the same response from Dechra when I contacted them about body weight and starting dosage. *no talk to pet owners, only the vet in charge. :(

Sharlene

[lulusmom]

I am planning on posting to his blog and as I recall, he has a page for vets and one page for pet owners. It won't hurt to try. Too bad none of the experts give so freely of their time to us pet owners like Dr. Oliver did. I miss him.

[apollo6]

Sharlene
from one canadian to another.
thank you for checking in on me. Canada might have some different options on cushing treatment than the states.
Hugs Sonja and Apollo

[molly muffin]

Hey Sonja and Apollo.
So far I haven't found anything particularly different in Canada.
Now I'm worried about Trilo causing the rear leg weakness. :(

I'm made an appointment for Molly to have an LDDS test on 3 August. She'll be staying that weekend at the vets (boarding) so might as well do it all at once. She'll also have her yearly vaccines after the LDDS test. Maybe the next day.

Not sure but also might have the urine test done too. As long as I'm going to have a huge vet bill that weekend anyway, might as well go all out.

Sharlene and the Molly Muffin!

[Skye]

well this has me very curious, so since i just saw IMS, had loads of labs done and tests, what do you think if i ask if he has heard any news on this? all he can really say is no or wont reply, or doesnt apply to my situaition. if you think i should as i will be hearing from them tomorrow.....let me know...and let me know how i should word my questions........i am cst, usa.

[molly muffin]

That would be so awesome! Maybe just a question of whether or not they are aware of any connection cause and effect between taking Trilo and weakness in the rear legs. If so, is there any correlation between dosage amount, length of time on the medicine, etc.
Something like that maybe.

I didn't think about that a possible cause, although I notice so many of the dogs with cushings seem to also have this rear leg weakness and I thought, well, the cortisol has been covering up the arthritis. Now I'm wondering since Sonja made a note of it. And the skin issues. It's all very strange.

Like you said, it might not be relevant to you or he might not know or maybe he will. Either way, I appreciate it!

thanks, thanks, thanks.

Sharlene and Molly muffin

[Skye]

okay will make note of that!
i thought my understanding was rear wasting was likely and the cortisal does cover up alot of discomfort....then when that level does change often other areas that are problematic appear.
but treating cushings with meds before symptoms are severe is what is new to me and was wondering if i should ask about that???

[molly muffin]

Oh sure! Feel free to mention what my IMS told me. That from a conference she had recently attended, based upon a compilation of studies, that a new report was to be issued, about treatment of cushings in dogs, after tests have ruled out other possibilities for the high cortisol levels themselves prior to symptoms occurring. I'd be interesting if others have heard of this or if it was just something that those at that particular convention are aware of, when and what it will say. My IMS didn't know when it would be coming out, only that she didn't think it had yet, but she seemed pretty assured that a statement would be released.

Thanks again. Sorry I misunderstood. I didn't realize that Trilo would cause the wasting, only that the higher levels of cortisol could cover up other problems, none of which I am aware of molly having currently.

[Skye]

not sure that trilo causes wasteing......but it that was also a symptom of cushings......BUT i am not as knowledgeable as the angels here......they will be more certain of that. always trust the flight of them angels. :)
my little one had the tumor on adrenal gland, so that area i have some experience on and some of the other pet parents here have seen their little ones through that. One of the angels is all over the labs, and others have helpful experience and compounded knowledge that is endless. Truly amazing place. Life long friends for certain!
Reading over your thread......so much of what you express and how you express it reminds me of myself. Especially when you type out "grrrrrr" LOL made me smile and chuckle......ohhhhhh how i understand grrrrrrr. lol

[molly muffin]

Molly had a horrible night with the thunderstorms we had here. Panting in fear, wanting on the bed, off the bed, under the bed, me on the floor with her, just on and on all night long. I wonder if the elevated cortisol anyway, if any sort of fear is even more exaggerated than before. Has anyone else noticed that their cushings dogs, without treatment, seem to react more to the things that scared them before?
I ended up working from home today I was so exhausted I couldn't even think of driving to work and Molly has slept most of the day.

[addy]

Zoe was afraid of thunderstorms and funny thing, when I first started to treat her I only used melatonin and lignans. The melatonin calmed that fear away.

Poor Molly, thunderstorms can be hard, I know.

[Squirt's Mom]

Hi Sharlene,

Our camper got struck by lightening last summer while Squirt was inside alone. No one was hurt, thankfully, but it has had a negative effect on her. She was never nervous in storms unless they were really bad and loud, then we were both nervous. :p But since that incident, she doesn't like them and is getting worse since we moved into the trailer. Her hearing is going so I'm not real sure what she actually hears but she picks up on something and has a hard time relaxing now. We had a very mild thunderstorm last nite - the thunder was distant and just gently rumbling. But she wanted on the bed and right next to me, something she no longer does for the most part.

She was really anxious last nite and she had already had her melatonin dose. I could have given her another dose with no problem but decided to try something else. Several friends have pups who don't handle noises well at all and they have bought Thundershirts for their babies with varying degrees of effectiveness for their babies. Not having a Thundershirt, I took a corner of the sheet and wrapped it around her belly and chest fairly snug then tucked the corner in so it would stay. She looked like a huge cotton sausage! :p But she calmed down, settled next to me and started dozing. After a bit, when it was just raining, she started wiggling to get free; I unwrapped her and she made her nest and went to sleep. Seeing how the snug wrap seems to calm her, I may well invest in a Thundershirt. ;)

http://www.thundershirt.com/

Hugs,
Leslie and the gang

[apollo6]

Sharlene
HOpe Molly is feeling better.
thank you for your posts.
There are natural remedies you can give Molly for fear and they also have a calming vest you can buy if it gets real bad. Andy would be able to tell you more, since Zoe is afraid of thunder also. Heck so am I.
Hugs Sonja and Apollo

[jmac]

Hi Sharlene,

Izzy, my non-Cush dog, is terrified of storms and loud noises, and has been since we got her. We have the Thundershirt, which helps a little, but doesn't totally stop her. Many people have complete success with that, however.

After she destroyed a door frame by chewing/scratching one day when my husband and I were at work, my vet finally suggested Xanax. It is much better. It works best if you know it's going to storm (I know, not the easiest, right? :)), but even if I give it when it starts or when she is already shaking, panting, standing on my body, etc., it kicks in between 30 and 60 min. and she is MUCH calmer.

There is another drug...ace something that some people use, but my vet said all it does is drug them, but the anxiety is still there. A woman I work with used it on her dog and the dog acted drunk. With Xanax they actually feel calmer. Izzy is only 7 lbs. and takes .25 mg at a time, but the vet said she could take more if needed, and it seems to do the trick--usually. My mom uses it on her Shi Tzu and it really helps her too. I highly recommend it.

They say dogs sense the pressure change, so Izzy usually is acting weird before it even starts thundering. My parents have a blind, one-eyed dog, and he senses storms too, so they definitely know. The lightning terrifies Izzy too.

We spent lots of nights with the t.v. on or a radio and a light, and without getting much sleep. We're both teachers and I can only imagine our teaching the next day! :) My students love hearing stories about my girls though, so they always knew when I was sleep deprived. :D The Xanax makes it so I have to deal with no more than an hour of a totally anxious dog. It's wonderful!

Whether it's the Thundershirt, Xanax, both, or something else, I hope you figure something out soon!

Julie & Hannah

[molly muffin]

Hey gang! Thanks for all the awesome suggestions. It just breaks my heart to see her so scared and not be able to sooth her. Hopefully we can figure out something that will work with Molly. I'll try a tightish blanket first, if that works, get the Thundershirt. If that doesn't work, then go to meds, but everyone probably by now knows that giving molly any medicine is ridiculously difficult.

Thanks so much. LDDS test this friday!

hugs,
Sharlene

[molly muffin]

ugh, the double post gremlins! Wasn't sure how to delete so just edit.

[molly muffin]

Quick question. LDDS test, fasting right? They told me to not give molly her breakfast and then they'd feed her after the last blood draw.

She gets the LDDS tomorrow, when she is also going to be boarding at the vets till Monday, as we are going to be out of town for the weekend.
She'll get her yearly vaccinations on Saturday.

Depending on what the LDDS shows (I am thinking it's going to show that she needs to start the meds) we'll decide when to start her, or wait and have another ACTH in 3 months to check her and see how it's progressing.

[frijole]

Yes - here's a link from Dr. Bruyette, a world renowned specialists where he mentions it.

http://veterinarymedicine.dvm360.com/vetmed/ArticleStandard/Article/detail/580093

[molly muffin]

Thanks, looks like 8 hours fasting.

[Jenny & Judi in MN]

good luck to Molly tomorrow!

[lulusmom]

Hi Sharlene,

I just wanted to mention that unless you are forced by law to vaccinate annually, there is absolutely no reason to put a dog at risk, no matter how small the risk, by giving annual rabies. Vaccine guidelines were revised years ago to three years for most vaccines. I'm providing a url below so you can read up on the recommendations. I parted ways with my old vet for demanding that my dogs be vaccinated or risk their refusal to admit my dogs if an emergency arose. We had a knock down drag out in the waiting room when they told me this. A vet who insists on annual vaccines is well aware of the new guidelines but they ignore them to get the dogs into the office every year.

http://www.aahanet.org/PublicDocuments/CanineVaccineGuidelines.pdf

I also heartily recommend that you watch Dr. Karen Becker's four part video of discussions with Dr. Ronald Schultz, one of, if not the world's expert on immunology. It was Dr. Schultz who was the driving force behind these revised guidelines. He and Dr. Jean Dodds are in their fifth year of a seven year USDA sanctioned study to prove that rabies vaccines are good for at least seven years. Dr. Schultz already knows this but the government won't look at any supporting evidence that isn't part of a study that has been approved and conducted in strict compliance with USDA guidelines.

http://www.youtube.com/watch?v=xC--bGthNN8
http://www.youtube.com/watch?v=0_Zvg8tIxeY
http://www.youtube.com/watch?v=Fc-6exZcbJ4
http://www.youtube.com/watch?v=sdPhj8Vq9ck

Even if it had been three years since Molly has been immunized, I personally would not risk giving her a vaccine until you are sure she doesn't have cushing's (normal cortisol) or 2) if she is diagnosed with cushing's, she should be stabilized on treatment before vaccines are given.

[addy]

I'll chime in with an observation. I had to give Koko my non Cush pup his 3 year rabies shot and I titered him for the rest. He was low on distemper. I also started him on his heartworm meds.

Since giving him these 3 things- even though I spaced them apart 3 weeks, I noticed not too long after that, hair has been coming out of his tail , not a lot but strands here and there.

Maybe it is just a coincidence- but makes me nervous. Sharlene, sometimes your vet will give you a rabies waiver due to health reasons. Zoe does not get any vaccines any more.

You have to way the risks your dog may have regarding possible exposure to rabies.

I second Gylnda in thanking you for helping. It has been a difficult few months for a lot of us and we really appreciate your help.

[molly muffin]

Molly is at the vet. She is scheduled to get her rabies vaccine on Saturday after the LDDS testing today. Here we are required by law to get the rabies shots every 3 years.

I'm also having a full blood panel and the regular urinalysis done while she is there. I just want baselines on everything again since her last Full panel was in March. (I had the ALP and ALT redone in June) So far molly hasn't had any problems with any of her vaccines. No hair loss, upset stomach or anything. She has more issues when she takes pills with upset tummy issues. Which sort of worries me starting her on something that will be life long.

They are treating quite a few dogs there for cushings with success, which makes me feel better. Some have multiple problems, like diabetes and pancreatis. (This by the way was the lab tech I was talking to this morning)

I have an hour to get ready to head to the airport. I spent an hour at the vets before I would leave her this morning.

So for the morning molly funny. I have to walk molly around the corner at the vets, then sort of jump back around the corner out of sight or she tries to dig in and not move. Now she knows that I am going to disappear at that corner, so at the corner, she did a quick maneuver around my legs with her leash and stayed on the side that made it so I couldn't escape her without tripping over her. Even when I tried to dodge into an exam room, she moved into the room with me, keeping her effectively behind me instead of beside or in front. Everyone was laughing and saying she was smart and certainly knew how to keep me with her. She also went straight over to the scale to get weighed, since that too has to be done each trip. She walked onto the scale, sat down and waited for us to acknowledge that she had done and awesome thing on her own.

See you all when I get back. Vet knows to call me if anything comes up on the tests.

[Jenny & Judi in MN]

she is one smart pup! enjoy your weekend, sounds like Molly is in good hands

[Tina]

Hi Sharlene,

How did Molly do over the weekend while you were gone? I bet she is glad you are back. I hope you had a nice weekend! :)

I want to thank you for posting on my thread with your kind words and support. I really appreciate it, and so does Jasper. There are such good people on this site, it feels kind of like a lifeline when things are so scary and overwhelming.

Hugs to you and Molly,

Tina and Jasper

[molly muffin]

Hi Tina,

I got home too late to be able to pick molly up tonight from the vets where she boarded and had tons of tests.
I Hate the house without her in it. It feels so empty and quiet. I can't wait till I can pick her up at 11 tomorrow. It's a holiday so they are only open from 11 - 12 for pickups, etc.
You know I'll be waiting for them to open though.
We are all in the same scary boat that seems to rock constantly from the cushing waves. How is that for an analogy. ;) I feel sea sick just thinking about it.

Hugs to you and Jasper too.

Sharlene and molly muffin

[Squirt's Mom]

Hi Sharlene,

I just wanted to say that you are doing a fine job of navigating that ship of yours. You are a good Captain! :D

Hugs,
Leslie and the gang

[molly muffin]

Had this whole long thing typed out, somehow hit the "back" button on my mouse and lost it all, so here we go again.

LDDS Test results

Cor1 - Cortisol (base) 79 30 - 300 range nmol/L
Cor34 - Cortisol (DEXA) - 4 hrs <27.59
Cor38 - Cortisol (DEXA) - 8 hrs <27.59

Interpretation for low-dose DEXA:

Normal dogs: Serum cortisol suppresses to <40 nmol/L for the 8-h interval.
Adrenocortical hyperfunction: dogs with HAC do not suppress to <40nmol/L for the full 8 hours. In ~60% of dogs with pituitary tumores, there is suppression to <50% baseline values or <40 nmol/L at 3 or 4 hours.

converted to ug/dl division by 27.59

Cor1 - Cortisol (base) 1.051
Cor34 - Cortisol - 4hrs <1
Cor38 - 8hrs <1

Urine Gravity - 1.038
trace Protein
blood ca. 250 ery/ut
We're still waiting on sensitivity/culture to come back, I don't see anything on this that says cortisol/creatine

Abnormals on blood work as follows:

Albumin 46.8 26-44 range g/L
Protein 74 51-72 range g/L
ALP 1054 4-141 U/L
ALT 144 6-118 U/L

Thoughts anyone?

I'm going to type out her ultrasound results too:

Physical exam, Mild dental tarter. heart no murmur or arrhythmia. Lungs NAF. Abdomen mild distension, tense, no obvious pain. M/S good body condition.

Ultrasound:

Liver mildly enlarged, diffusely hyperechoic and the margins are rounded. The gall bladder has a moderate amount of echogenic debris present. Bile duct normal. Stomach wall measures from .25cm and there is moderate gas present. The spleen is normal. Left kidney measure 4.86cm, there is hyperchoic speckling in the cortex and there is a mild decrease in corticomedullary definition. Left adrenal gland measure .80cm and .68cm and is mildly enlarged with the caudal pole larger than the crnial pole. Urinary bladder wall is mildly thickened at the apex from .32cm to .43cm, although the lumen is not fully distended. Mucosa is mildly hyperechoic and irregular, and there are two small calculi presnet measuring .18cm and .24 cm. Colon is normal. right Kidney is similiar in appearance to left kidney. There is a small non-obstructive calculi present, measuring .28cm. Right adrenal gland measure .56cm and .74cm. and is the upper reference of size to mildly enlarged. Pancreas is normal. Small intestine is normal. Mesenteric lymph nodes are mildly enlarged with one measuring .33cm by 1.97cm. There is no free fluid present in the abdomen.

Thanks,
Sharlene

[labblab]

LDDS Test results

Cor1 - Cortisol (base) 79 30 - 300 range nmol/L
Cor34 - Cortisol (DEXA) - 4 hrs <27.59
Cor38 - Cortisol (DEXA) - 8 hrs <27.59

Interpretation for low-dose DEXA:

Normal dogs: Serum cortisol suppresses to <40 nmol/L for the 8-h interval.
Adrenocortical hyperfunction: dogs with HAC do not suppress to <40nmol/L for the full 8 hours. In ~60% of dogs with pituitary tumores, there is suppression to <50% baseline values or <40 nmol/L at 3 or 4 hours.

converted to ug/dl division by 27.59

Cor1 - Cortisol (base) 1.051
Cor34 - Cortisol - 4hrs <1
Cor38 - 8hrs <1

Sharlene
Sharlene, can you double-check the lab report for Molly's LDDS? It looks like she had 79 nmol/L for the baseline cortisol, but I'm confused by the "Cor34" and "Cor38" lines. I'm assuming those reflect the 4-hour and 8-hour results, but I'm thrown somewhat by the notation. If the lab did not not give specific numbers for her 4-hour and 8-hour results, but instead the report is just indicating that they were both less that 27.59 nmol/L (or less than 1 ug/dl), then those results are not consistent with Cushing's. I just want to double-check that I am interpreting the report correctly.

Marianne

[molly muffin]

Yes I think you are interpreting that correctly Marianne.
The cor34 = 4 hour, cor38 = 8 hour (I don't now what they actually mean other than the 4 and 8 hours draw)

and yes the number on the result is is is <27.59 or as I did the conversion <1

I didn't think it looked like cushings on that result either. Yes, the ultrasound shows results which could be consistent with cushings (liver, adrnal gland slight enlargement) and the ACTH results are consistent with cushings. This one is not. What about the urine gravity, that doesn't appear to be diluted to me either.

I find this just very weird and confusing.

:( Sharlene, whose boat is acting a bit tipsy right now.

[lulusmom]

I received a response from Dr. Peterson on his blog and if there are any new studies that show it may be beneficial to treat asymptomatic dogs, Dr. Peterson isn't aware of them. Because we've had so many members with dogs who are asymptomatic but have high alkp, I included a question about that as well: Hopefully his response will set some minds at ease.


I am not a proponent of treating dogs with asymtomatic Cushing's disease, unless they have secondary hypertension or proteinuria.

Low dose trilostane may be helpful, but I am not aware of any studies that even suggest that, let alone prove that to be the case. With any drug, we have to weight the concerns of side effects.

In general, most dogs with Cushing's syndrome develop a high alkaline phosphatase, with is "induced" to rise because of the cortisol excess. In other words, the fact that this liver (and bone) enzyme is high only means that it is a marker for Cushing's and does not reflect liver damage. So to me, that is not a reason to treat, especially since this value rarely normalizes after successful treatment with trilostane or mitotane.

[labblab]

Glynda, I'm confused by Dr. Peterson's comment that elevated ALKP is only a "marker" in Cushpups. Just as is the case for Molly, we've repeatedly seen ultrasound reports that note liver enlargement and hyperechoic (fatty) changes in dogs suspected of Cushing's. It seems to me that these represent genuine physical abnormalities resulting from the disease. But not life-threatening, so maybe that is what he means -- that generally there are no serious changes to the liver?

And Sharlene, I am totally stumped right alongside you. I am baffled by Molly's contradictory test results -- especially the conflicting ACTH and LDDS results. In an article discussing interpretation of LDDS results, Dr. Peterson tells us that a "negative" LDDS is very reliable. Only a very small percentage of Cushpups do not return a positive result:


When interpreting LDDS test results, first evaluate the eight-hour postdexamethasone administration cortisol concentration. If it is above the reference range, the dog probably has hyperadrenocorticism (false positive results may occur in dogs with nonadrenal illness). If it is within the reference range, either the dog does not have hyperadrenocorticism or there is a 5% to 10% chance that the dog has PDH. (The dog may have early pituitary disease and the pituitary gland is still responding to a pharmacologic dose of dexamethasone by decreasing ACTH production, thereby reducing serum cortisol concentrations.) In those cases, an ACTH stimulation test is warranted.
As you can see, he does suggest moving on to an ACTH for a symptomatic dog who has a negative LDDS, but a positive ACTH would then result from a scenario where the dog is suffering from PDH. So what do we do with the finding that Molly may have only one mildly enlarged adrenal? Is the ultrasound missing enlargement in the other gland, too?

It does seem to me that there are still enough remaining question marks that I would be hesitant to start treating. A trace amount of protein was noted in Molly's urinalysis, but I don't believe that would yet constitute "proteinuria" that would warrant immediate Cushing's treatment with so many questions left unanswered.

Sorry that I am not providing any answers here :o. Like you, I am baffled for the moment...

Marianne

[frijole]

Well include me as stumped. :o

Just to cover all the bases - can you confirm that the ultrasound of the adrenals was done on a high resolution machine and that they were able to view both adrenals?

I ask this because my Annie had 2 false positive ldds tests and a host of false pos. acth tests as a result of an adrenal tumor that was not caught on the first ultrasound we did. Her urine was concentrated as well.

Not sure if this helps but at least you know you aren't alone! Kim

[addy]

Didnt Dr. Peterson have a case study where he said non adrenal disease can also enlarge the adrenal glands? It was the case study of the young collie. I remember being upset because I wondered if Zoe's colitis flare was responsible for her enlarged adrenals.

[labblab]

Addy, I think it's true that the adrenals can enlarge in the presence of any chronic condition that stimulates excess pumping of cortisol. That's why the symptom profile is so critical when arriving at a Cushing's diagnosis. If Cushing's sympoms are absent and/or symptoms are present that are inconsistent with Cushing's, you'd want to do further investigation.

Marianne

[molly muffin]

Thanks everyone for answering and posting your thoughts. It's a confusing
situtation that's for sure.

I asked about the High Density ultrasound. They said they didn't know what I meant by that
but that their machine could see everything. They did present sizes in cm for all the organs
so I am assuming they were able to see enough to measure.


I'll post her abnormal ultrasound results (abnormal only) and test histories
again, so noone has to go scrolling through pages to find the
information.

Ultrasound July 2012:

Liver: mildly enlarged, diffusely hyperechoic and margins rounded
gall bladder: moderate amount of echogenic debris present
stomach: moderate gas
left kidney: hyperechoic speckling in the cortex and mild derease in corticomedullary definition
left adrenal gland: mildly enlarged with caudal pole larger than the cranial pole
Urinary bladder wall: mildly thickened at the apex, although lumen is not fully distended.
Mucosa: mildly hyperchoic and irregular and two small calculi present
right kidney: similar in apperearance to the left kidney - small non obstructive calculi present
right adrenal gland: upper reference of size to mildly enlarged
lymph nodes: mildly enlarged

Test Histories:


ALT - 54 (10 - 118) May 2010
ALP - 518 (20 - 150) May 2010

Albumin 46.7 (26 - 44) April 2011
Protein 78 (51 - 72) April 2011
ALT - 110 (6 - 118) April 2011
ALP - 764 (5 - 141) April 2011


Albumin 44.1 (26 - 44) (barely out of range) March 2012
Protein 76 (51 - 72) March 2012
ALT - 139 (6 - 118) March 2012
ALP - 1121 (5 - 141)

ALT - 152 (6 - 118) June 2012
ALP - 1003 (5 - 141) June 2012

Albumin 46.8 (26 - 44) August 2012
Protein 74 (51 - 72)
ALT - 144 (6 - 118) August 2012
ALP - 1054 (5 - 141) August 2012

and finally Urine gravity 1.038 August 2012

this could be because I couldn't get her to drink much that morning
after not eating.
trace protein
small amount blood

I think she might have a UTI and we're still waiting on the results of the
culture/sensitivity test to come back.

So, what could be making her ACTH go up like a cushings dog and her LDDS show
normal dog results. I'm rather worried about something like liver disease, but I
thought I read somewhere that any joint issue could also cause high cortisol results.
Does anyone know if that is true? Not sure it would show high on ACTH though.

Her abnormal values seem to be up and down too.

I'm stumped. The good thing is that Molly doesn't know a thing about this
and is running around the house with a shoe in her mouth, which I need to
go retreive. She won't chew it but she will try to fit her entire
body inside of it. (this does not by the way, work).

Hugs everyone and thanks so much,

Sharlene and Molly Muffin

[jmac]

Hi Sharlene,

Thanks for always checking in on my little Hannah. I appreciate your kind words and encouragement.

I have no advice for you, unfortunately. Hannah has never had an ACTH test, but my IMS does not recommend them unless she is using a drug to treat Cushing's. She doesn't feel that there is enough valuable information.

Hannah has had really high ALKP levels in the past and they dropped dramatically after taking Denamarin. She has been on it for about 6 months now. Her ALT has never been high though. I think that infection can cause liver values to be high, but I don't know if that is just ALKP or also ALT. I know sometimes if a dog has a dental infection and gets it taken care of, the liver values can return to normal. Again, not sure if this is one or both.

I'm sure others will be along to help you out soon though. I love the story about Molly with the shoe. So funny! I love that she tries to get in it. What a little cutie! Sounds like she is quite happy too, and that certainly is most important! :)

Julie & Hannah

[Roxee's Dad]

Hi Sharlene,


So, what could be making her ACTH go up like a cushings dog and her LDDS show normal dog results.


I think she might have a UTI and we're still waiting on the results of the culture/sensitivity test to come back.


May be the answer. Sometimes infections or other abnormalities can cause a higher than normal Cortisol reading.

[labblab]

Hi again, Sharlene.

John is so right, nonadrenal issues can certainly increase cortisol readings. But the LDDS is more vulnerable to "false positives" than is the ACTH. So if it was something other than Cushing's that was causing the elevation, you'd expect Molly's results to be reversed. It would be the LDDS that would be elevated, but the ACTH less likely. :confused:

You mentioned that the specialist who reviewed the ultrasound and labwork does think that the results all point to Cushing's. Did he/she have any explanation for the discrepancy between these two tests?

Marianne

[molly muffin]

I can see where a UTI would cause cortisol levels to rise, but the ACTH/LDDS situation is strange. I don't have my papers handy at the moment, but in the consult follow up to my vet, the IMS said that if LDDS test does not support ACTH, to wait and retest in 3 - 4 months. If it Does support ACTH, then to begin with 5 - 10 mg Trilostane.
That makes me wonder if perhaps it isn't quite as unusual as I thought. I have not yet had a call from my vet who did the testing and when I called last night, I was told that they were waiting on the culture/sensitivity test results. I did ask if they did a cortisol/creatine ratio or not, but the girl I spoke to didn't know and the vet had already left for the day. (that was around 6pm)
I think it is strange that the vet hasn't called since normally she would have. I wonder if she is still miffed about my questioning her and going to the IMS. I don't know if they forwarded the results to the IMS or not. The IMS is at an emergency vet hospital.
I think it is strange about the results, but no one else seems to be acting very concerned.

Thanks for the support!
Hugs,
Sharlene

[labblab]

I can see where a UTI would cause cortisol levels to rise, but the ACTH/LDDS situation is strange. I don't have my papers handy at the moment, but in the consult follow up to my vet, the IMS said that if LDDS test does not support ACTH, to wait and retest in 3 - 4 months. If it Does support ACTH, then to begin with 5 - 10 mg Trilostane.

Given all the circumstances surrounding Molly's symptoms (or lack therof) and testing, I think the recommendation of the IMS to wait a little while and then repeat the LDDS is a very reasonable one. :)

It does not seem to me as though there is any need to rush into treatment until the puzzle pieces show greater clarity. And in the meantime, it sounds as though Molly remains a happy, beautiful little girl. ;)

Marianne

[jmac]

Congrats on becoming a forum host, Sharlene!

I just sent you a message too, but I wanted to publicly thank you for accepting. I was hoping they were going to ask you because you have done such a wonderful job welcoming people, supporting them, and offering encouraging words. You are perfect for this role!

Julie

[molly muffin]

Hi Julie,
I got your message and responded. Thanks for the welcome. I'll try to live up the great job that you and Addy are doing. You know the bar is high right. :) :) :)
I guess being talkative can be a good thing!

I'm going to try calling the vet again tomorrow. So far I've had no luck catching her. I find it strange that she hasn't called me yet, normally she does call as soon as test results come in yet nothing about the LDDS. I think she might still be miffed that I opted for the specialist consult.

I agree we are holding off for now on the Trilostane. I wonder if the tumor is very small if it can still put out the signals to suppress. Her labs only went wonky in March, so perhaps they are thinking that in 3 - 4 months, there will have been cortisol in her system long enough that it will no longer suppress. Man I hate second guessing. Either way Molly is still happy for now, so I'm okay with that.

Thanks all!
Sharlene

[addy]

Hi Sharlene,

A belated congrats from me. You have been terrific and with so many new members we need all the help we can get:D:D

You are doing an awesome job and we are so very thankful.

hugs

[Jenny & Judi in MN]

thanks for being a host! I read Molly's thread but your questions for her are out of my realm but wanted to say hi!

[molly muffin]

Thats okay, they are out of my realm too! :)

Sharlene

[molly muffin]

Whoooo Hoooooo! I just spoke with the lab tech at my vets and the prognosis for now, based upon the LDDS is that it is not Cushings at this time. Not to say it won't go that way. We'll retest her in 3 - 4 months for cushings and we'll keep an eye on her liver with some regular blood tests too. I'll always want to keep an eye on the protein.
I've asked the vet to get back to me by early next week on liver supplement ideas or what we can do for that.
She also does not have a UTI. They think that the small trace amount of blood was from the 2 small crystals, that might be aggravating but are not large enough to be life threatening.
So for us this is a good day. I hope that everyone else is getting good news today too. We're calling this Good News Friday!

Hugs,
Sharlene

[jmac]

Hi Sharlene,

That is certainly good news! I'm all for Good News Friday!

I'm glad you didn't decide to treat even before this, because it just didn't sound like Molly had enough symptoms. Sort of like Hannah. Watching and waiting and retesting sounds like a good plan.

Have you heard of or talked about Denamarin as a liver supplement? Hannah has been on it for about 6 months. When she was diagnosed with Cushing's, her ALKP was 1770. She tried Anipryl for a few months and it did drop the ALKP, but her behavior was the same. We then stopped the Anipryl and did nothing. Her ALKP creeped back to 800 in a few months. That's when we started the Denamarin. Three months later it was 186 (normal!) and a couple of days ago it was 250, so a little high, but not terrible. I am a big fan of the Denamarin. :D

I hope they'll find something that will work for Molly. But at least you can have a happy and relaxing weekend!

[molly muffin]

Hi Julie,
I'm glad that I came here and found out that I should be having other tests before starting treatment.
It is her ALT's that I need to go down in addition to her ALP. I'm going to ask about the Denamarin.

I think it sounds like Molly and Hannah are both in the waiting stages, retest, retest, retest.

Hugs,
Sharlene

[apollo6]

Dear Sharlene
Thank you for being so great with support for so many of us.
Don't rush into anything with Molly. Read all you can about cushing , and give the results on any tests they do. We have some great techs who can interrupt them for you. And always get a copy of the tests for future comparison. Never be afraid to ask questions of your vet. If you don't feel good with their decision listen to your gut.
Hugs Sonja and Apollo

[molly muffin]

Hi Sonja, absolutely not rushing into anything. Her last test, LDDS, returning a noncushings results, we will be waiting and retesting her in 3 - 4 months for cushings. In the meantime, I am getting recommendations on supplements for Liver (her ALT's are a tad on the high side and of course her ALP's are high) and I have had excellent suggestions from members of which supplements to look into for that.

I've added some pictures of molly to a folder, so peeps can get to know her. She's my adorable little rescue baby. It to this day breaks my heart that someone did not want her. We got her when she as 11 months old.

http://www.k9cushings.com/forum/album.php?u=2360

She also, only understood French, when we got her. How funny is that and them telling me her name was "lady" well, she didn't respond to lady, nor did she respond to Madame, mademoiselle, or any other combination i could think of. Hence, the doggie discussion of "now you're name is molly, end of this silliness, you have a name now" LOL
She still though will sit at the feet and gaze adoringly at anyone willing to speak french to her.
Je m'appelle Molly et j'aime la langue française.

Hugs all,
Sharlene

[addy]

Bonjour, je peux parler seulement un petit français.

That is too precious, Molly loving french:D:D:D:D:D:D

Okay, start saving the pennies. There are no quarantine laws in France. She can go into the country, no problemo and the French LOVE dogs. Dogs can even eat in restaurants with you.

Mon ami, Molly can you say "a baguette, please at an outdoor cafe on Rue St Dominique?


Love it:D:D:D:D:D

My favorite dog book, Lauren's Story, an American dog in Paris by Kay Pfaltz

[infoviewer]

How precious is that, a dog that understands French. Hope you are doing ok today Sharlene. Love, JoAnne

[molly muffin]

Hey gang, I'm fabulous today. :) Molly is fabuleux. LOL

It is true, the French, do love their dogs. We were in France a couple years ago and one of the things I noticed in Nice is that all along the streets, you will have metal waste containers mounted on poles, that have doggies poopie bags so you can pick up and then dispose of waste in a sanitary manner. No poop all over the streets for the French. There is no excuse as everything you need is provided for you. Love it!

She actually came to us from the northern part of Quebec and a high kill area for dogs turned into the shelters. :( We have or had, a rescue group that specialized in saving this dogs and brought them down to Toronto, where groups of people already screened for adoption would then go pick up their new babies. When we walked in the door, our molly was in a cage, practically shaved down to the skin because her mats had been so bad, just a baby really and she looked sad and forlorn. Hubby took one look at her, picked her up and said, she needs us, lets go. That was that, we took the little shaved, shaking, frightened sweetheart home, only to discover we had brought home the queen of the pack, a princess waiting to be crowned. She was so crowned and we still live to serve.

I totally have to read that book addy!

LOL
Sharlene

[apollo6]

Dear Sharlene
Thinking about you and Molly.
Know what you mean about the French. About 30 years ago we were in France flying from Cain to Paris and we say dogs in the plane just sitting with their dogs. Back then it was fun to fly, real food, utensils,and the blankets and pills and snacks were free. What a concept.:eek:
Is it true you are from Canada? I was born in Toronto. Lived on I think it was Young Street right beside the the Maple Leaf Garden. the moved to Rexdale, Ontario, the township of Etopica( forgot the spelling). Still have a few friends in Scarborough . Miss a lot about Canada, but not the cold.
Hugs Sonja and Apollo

[molly muffin]

Hi Sonja, Yes I live in Mississauga and work in Etobicoke. The area that Rexdal is in. Small world.
Those were the good days of flying. Not it's here is a bag of nut, enjoy your flight. LOL Not quite the same. I love how the french adore their dogs. I haven't flown with Molly, I don't think she would like it since everything scares her and she doesn't do good with change. If you are flown since you are a puppy though I guess they are use to it. I have a friend who flies her dogs with her when they go from Alaska to Arizona for the winter months and she says it's no big deal. I don't necessarily believe her. :)
Yea, the cold is not fun. That's why we have so many snowbirds that take off in the winter. :)

Hugs,
Sharlene

[jmac]

Hi Sharlene,

I checked out Molly's pictures. She sure is a cutie! She is very lucky that she found such a wonderful, loving home to live her life! I'm sure you feel pretty lucky too because she's a pretty special girl. I love that she enjoys being spoken to in French. And that she tries to get in shoes. What a funny girl!

I added more pictures of Hannah yesterday too. I put all of the pictures I had of her on my computer in one folder yesterday so I had them all in one place. I was thinking about how lucky I was to find her. We adopted her when she was four. She had never been on a leash, been in a car, walked on grass, seen stairs, etc. She was a pretty strange little dog. She learned so much and is the most sweet, loving dog I've ever met. She loves everyone and lives to be around people.

Hannah's happily chewing on a bone right now...she is pretty happy about it. Thanks again for checking in on us. I hope her laser treatment provides some relief tomorrow too.

Julie & Hannah

[molly muffin]

Hannah is adorable Julie. I love all those pictures of her. That is hearbreaking that she had never walked on grass, seen stairs, or anything. I'm so glad you found her and showed her what true love is.

I'm don't know why I have such head banging impulses after any talk with my vet but I do. Today we discussed liver supplements. I'm going to start her on a liver supplement called hepato supplement. Basically a milk thistle supplement. They have one called Zenotil which is sort of like the Denamarin, but doesn't have the milk thistle in it, so you have to take both together if needed.

She hasn't heard of Denamarin. (hence the head banging) No UTI. So, anyway, I'll start that when I return from Montreal. I have a work thing I have to do this weekend and not starting anything new if I can't be close by to keep an eye on her myself.

We'll keep an eye on her liver and protein results going forward. Retest now is looking to be end of November/December. As long as she doesn't start displaying any symptoms of the cushings that is.
With the ultrasound results we can't rule out that she might be headed in that direction.
*sigh*

At least Molly is happy, she just had a tickle session with the hubby, (she is ticklish under her front legs especially) so he tickles, she growls and then they are both exhausted. I just found the shoe in front of the front door, so she must have run over there right after he tickled her to try to bury her face inside of it. Revenge shoe? hmmm.. Now they both are ready for bed. ROFL!

hugs,
Sharlene

[infoviewer]

Sharlene: That is so cute, a revenge shoe, my dachshund would have it torn to shreds when he was younger. Does not play much now. I hope you find out for sure Molly's diagnosis. Hopefully it will not be Cushings, but I know you will handle whatever it is with love. Hugs, JoAnne

[Tina]

Hey Sharlene, thanks for the good wishes about Shelby. She is doing ok, and we are ALL adjusting to the e collar!

I hope you and Molly are having a good weekend!

Hugs,

Tina and Jasper (and Shelby)

[molly muffin]

Thanks Tina, we had a good weekend in Montreal.
Molly stayed over at the vets. Strange though. She was 19.6 lbs in June for the ACTH test. She was 19lbs at the LDDS test in August, this time when I took her in Saturday she was 18.6. Trying to figure that out.
She also came home with diarrhea today. She doesn't Always have stomach issues from staying at the vet. The last couple time they only gave her dry dog food, no treats or wet food when she was there and she did fine. This time though sure enough, upset tummy. I think it is because she gets a lot of separation anxiety when she is away from us, or at least when she is staying at the vet.

Hugs,
Sharlene

[Jenny & Judi in MN]

I hope Molly's tummy settles down and am glad she made it through staying at the vet's.

[molly muffin]

Molly's tummy was fine by the evening and I started her on her Hepato support supplement today. She seems to be doing fine. She certainly had a lot of energy when I got home today! hahaha

hugs,
Sharlene

[Bo's Mom]

Lots of energy is a good thing. I am so glad to hear that Molly is doing better with her tummy issues.

[infoviewer]

Sharlene: So glad Molly is better with the diarrhea. If CoCo eats more than usual he will get diarrhea. Glad to see you on again and hope you have a good week. Love JoAnne

[molly muffin]

Well the diarrhea was just based upon anxiety from being at the vets it looks like. I hate that she gets so upset but there is no one else that can take care of her really when we are away. We have a trip coming up where she is going to be boarded for 10 - 11 days, so I have a case of nerves before even leaving her.

Last night I gave her green beans for the first time. I'd never even Heard of this for a dog treat. Now, are they suppose to be just given raw, cooked, canned from the grocery or what? I gave her a few because we were having some with dinner and thought, why not. A friend tells me her dog also eats cauliflower. Carrots cooked or raw? I'm sort of new to this whole idea of veggies as dog treats.

Hugs,
Sharlene

[infoviewer]

Hey Sharlene: I did give CoCo lots of vegetables as treats before he started having so much trouble with diarrhea and he really loves them, especially the baby tomatoes and apples, but now they seem to upset his stomach. I have tried the pumpkin, but he still gets the upset stomach. I think the cushings causes it or the Trilostane, so I just watch everything I feed him now. I know you are going to miss Molly Muffin on your long trip. I am so glad we can take CoCo with us when we are going to be out of town. We are watching the track of the hurricane this morning and hoping it is gone before our trip on Friday. Of course Tunica is on the Mississippi river so just depends on what is going on Friday. Have a good week. Love JoAnne

[Jenny & Judi in MN]

Sharlene I've done frozen green beans or cooked and chopped up.

when I tried broccoli that wasn't chopped as well she picked every single piece of it out and laid it aside LOL

[Squirt's Mom]

Hi Sharlene,

Yes, dogs can eat just about everything we do. The thing to be aware of is this - vets say not to feed table scrapes and they are absolutely correct in this. However, table scrapes and human food are not the same things. Table scrapes will contain things that we humans use to make the food taste better - seasonings, fats and oils, etc. and those are the things that are not good for our babies. So fresh, unseasoned, human foods are good but what comes off of our plates and our of our pots and pans usually isn't.

Use raw, frozen, or home cooked fresh veggies. Canned veggies often contain things like onion which are toxic to our babies. Green beans, carrots, broccoli, cauliflower, sweet potatoes, squashes, white potatoes...the list is quite long. Be sure to google to learn what food NOT to feed and give each new food one at a time with plenty of time to see how Molly handles it. ie Don't give green beans this morning then broccoli tonite - if she were to have an upset you couldn't know which it was. Give each new one a day or two to make sure it is ok with her system. ;) Be cautious with the Brassicaceae family of veggie as they can and do affect thyroid function. Pups who are already hypothyroid do not need these veggies at all. This family includes broccoli, cauliflower, kale, mustards and others.

Hugs,
Leslie and the gang

[Squirt's Mom]

OH! Also pay attention to the nightshade family of veggies - white potatoes and tomatoes to name a couple. This family of veggies can aggravate arthritis and other skeletal inflammatory conditions. I love white potatoes but have to eat them sparingly as they do make me hurt worse afterwards. ;)

[addy]

My Koko LOVES organic blueberries. I think he is addicted to them;):D We use them as a treat. The first time I gave him one, he spit it out and looked at me like I was crazy. Then he saw Zoe gobble one up (back in the day when she could eat stuff like that) so he decided to try again and he has been loving them ever since. Will stand at the frig waiting for one:rolleyes::rolleyes:

[molly muffin]

Hi all, I'm going to be away for awhile. We're leaving for Barcelona and won't be back for a couple weeks. I hate leaving molly at the vets, but this is the best option for her since we don't have anyone who can take her and I'm so very picky about who has her, and what she can do, can't do, can eat, can't eat, etc, etc. She doesn't like people she doesn't know, she will attack any dog she doesn't Know or consider a friend. (yea, she is the little short one that will go for the leg of the big one) If I am there then I don't worry, but if I'm not I do.

I find though that my biggest concerns are all of you. My dear friends who are going through so much yourselves and just worrying that everyone is going to be okay. Not being here if needed, bothers me. I don't know what kind of internet abilities I'll have available in Spain, maybe wifi at our hotel. I'll take my tablet just in case. :) If I can buy a sim card to use there, then even better!

Just in case though I might be missing in action for awhile. Everyone take care and I'd say behave, but heck, that's no fun!

hugs,
Sharlene and Molly Muffin

[frijole]

Have a great time! You will be missed around here. I'm sure the vet's will spoil Molly rotten. Kim

[Jenny & Judi in MN]

have a fabulous time! We chaperoned a bunch of high school kids to Europe a couple of years ago and only got to spend 2 days in Barcelona. Always wished we'd had a bit longer, I'm sure Molly will be fine!

[Maya]

Have a great time! Barcelona is absolutely beautiful!
Hugs Maya and Leah:)

[infoviewer]

Wow Sharlene, Tunica is no match for Barcelona. Have a great time and I will miss your posts. Molly will be fine. Love JoAnne

[Squirt's Mom]

Tunica - Barcelona - front porch....hummmmm, something is wrong here. :confused: JoAnne, Sharlene - ya'll aren't spending enough money at the vet's or something! :p

Have fun and miss us terribly, as we will miss you!

Hugs,
Leslie and the gang

[labblab]

Sharlene, hope you have a wonderful trip! :) :) :)

Marianne

[Bo's Mom]

I don't know if I am late posting...but have a wonderful time. Molly will miss you but I am sure her vet will spoil her. Take bunches of pictures and post when you return.

[addy]

Bon Voyage


:D:D:D:D:D:D:D:D:D:D:D:D:D:D:D:D:D:D:D:D:D:D:D:D:D :D

tapis are a good thing:):):):):):)

[Boriss McCall]

Have FUN! we will miss you.

[lulusmom]

Hi Sharlene,

You will be sorely missed but you just have a good time and don't worry about things here. We've got you covered.

I was ecstatic to hear that the new bull fighting ban took effect in Catalonia recently so you won't be seeing any of those going on during your trip. Now if the rest of the country and others will follow suit. It is truly a despicable, inhumane sport that should be outlawed in all countries.

[molly muffin]

Holy Cow. I was so busy when on here checking out everyone else threads that I forgot to update mine. You guys probably already figured out that we're home from vacation. ROFL!!

Molly is alright. She wasn't thrilled to stay at the vets place, so they told me that they kept her up at the front desk with everyone during the days and she did fine. They made her a bed and she just hung out and was basically spoiled rotten by everyone. A couple accidents in the house since she came home but she always has those after staying away from home, till she can get back onto her normal potty schedule. (that and the pissed off irritated pee which she did do once) That girl has some serious attitude sometimes.

We've had quite the adventure tonight. A neighbor lady discovered a small white shih tzu in her yard and we have been in search of it's parents all evening. Since about 5pm I guess, maybe a bit earlier. Took it to the vet to be checked for a chip. I called my neighborhood groomer, but she didn't know whose it could be (she did volunteer to adopt it if no one claimed her) Then we walked the neighborhood asking every person we saw if they knew who she belonged to. No luck. Went to our local pet store, to see if they knew her and no luck there either.
I don't get it. She is recently groomed, looks to be in fine health and taken care of. Not a bit skinny or grungy, but yet no one out combing the streets for her. The lady whose yard she appeared in, said she would keep her if no one claimed her too. Everyone just falls in love with this little thing, she is so adorable and friendly. Obviously used to riding in cars too.
Tomorrow we'll be putting up flyers and notifying animal control in case someone called them to report her lost. Also contacting various vets office, etc.
Interesting too, is the lady I met tonight through this adventure, said she had also had a dog with cushings, and said it was just a horrible disease. I didn't get to ask her too much about her experience with it, but I am guessing it didn't go well. I will try to follow that up though because I am curious.

Well, that's it for me at the moment.

hugs all
Sharlene and Molly Muffin

[infoviewer]

Wow Sharlene, you came home to a great adventure, a sweet furbaby, thank goodness a good person found it, now she will still have a good home if her owners are not found. I cannot imagine. My dog hardly ever gets 2' away from me. He is protecting me I guess. I know your Molly was glad to get home. Hugs, JoAnne

[Boriss McCall]

Sounds like Molly got lots of love while you were gone.

I hope that little pup finds her family. She is lucky you found her.

[Steph n' Ella]

Awe Sharlene...I hope you find cute-little-white-furball's owners because it does seem like she is lost. Ella and I were on a walk last night and I saw a cat that had a collar and tags wandering around the park. I was trying to scoop it up but it was afraid of Ella. I'm worried b/c it's really unsual for owners to let their cats outdoors in the city!

I hear you, JoAnne, as you say your dog is never far from you. We call Ella "Under Foot" because she is literally always under our feet! This leads to us accidentally steping on her...but she doesn't seem to mind as long as she gets to be close by! Oh well! It is good b/c I know when she isn't around she is proly off in another room going potty!

[molly muffin]

The little furballs name is Loki and she has been reunited with her owners, who were just worried sick. It seems that we all went down the same main streets but missed each other and then for whatever reason, we both missed going down the others side street that they lived on. But happy ending and we've encouraged the owner to get her microchipped in case of future escapes.

Sharlene

[Squirt's Mom]

Wonderful, Sharlene! You helped make a really great day for humans and furbabies alike. I bet Molly is so proud of her mom!

Hugs,
Leslie and the gang

[molly muffin]

Thanks Leslie, it felt good to have her home with her mom and dad, but boy was it hard to give her up, she was such a sweetheart. :)

Molly was probably just happy that we didn't end up with another dog in our house. LOL She is a bit of a jealous one. Her mommy and daddy and not sharing. Her toys you can have but not us. :)

A good start to the weekend! Have a wonderful one yourself!

hugs,
Sharlene

[Boriss McCall]

yay! happy ending are the best.

[Tina]

Hi Sharlene, and a very belated welcome back from your vacation. I hope you had a wonderful time. I bet Molly is sure glad you are home! I sure missed you around here. Hope you and Molly are having a good weekend.

Hugs,

Tina and Jasper

[infoviewer]

Sharlene: So glad the little dog got back to where it belongs. It is so sad to see a lost dog and know someone is heartbroken. Dogs are so fast they can disappear in a flash. My CoCo is so slow now since he is 11 and has Cushing's, but I am slower myself or at least I should be. Hope everyone is having a good weekend. Love JoAnne

[molly muffin]

It's good to be back. I love traveling, but it's always nice to be back home. :)

It's true some of those little dogs can really move. This one, Loki, was only 3 years old and moved like a bat outta hell. A true "loki". She was here, there and everywhere, even on a leash. No wonder she was so exhausted by the time we were done looking for the night. Her owner and his neices and nephews and family were so excited to have her back home. I know they were terrified something had happened to her. You don't want a dog or cat or other little one to get into the woods where there are coyotes and other things that could attack them. (not exactly what one expects in a good size city, but true).

hugs,
Sharlene

[Steph n' Ella]

In Bawlmer we have rats the size of coyotes! It seems where ever you are in the world, pets belong inside with their owners...to be loved and pampered! So gland you got Loki back to her family!

[molly muffin]

One of Molly's ears is really red inside and has probably some sort of infection. I know there is a type of drug that we have to stay away from because it causes deafness. Is there anything I can do here at home to help her? It's Sunday night and a holiday monday with everything closed. Any thoughts or ideas are appreciated? She has been shaking her head alot and scratching at it, couldn't get comfortable this morning, but it wasn't red like this.

help
Sharlene

[molly muffin]

taking her to ER. Will be back

[frijole]

Just seeing this - it is any drug in the 'myacin' family. Hope you get some answers at the ER. Sending love, Kim

[molly muffin]

Will not use anyuacin drugs. Will be home soon. Waiting on we bet to talk to us

[frijole]

good luck!

[molly muffin]

We're home. Boy typing on the iphone sure throws up a lot of bad spelling on my part. Sorry about that.
Okay, so yep, ear infection, they prescribed Surolan. It's a topical anti-fungal, antibacterial and anti-inflammatory drops, twice a day, also slather on the inside ear flap due to it being red.
If needed, original benedryl 25 mg tabliets with the only medicinal ingredient being Diphenhydramine. She can half 1/2 a tablet, 12.5mg, every 8 hours for 2-3 days. This is if she is uncomforable and her ear is bothering her.
This is Molly's first ear infection and all I could think of is that there is one that they shouldn't give her that could damage her hearing and to run on here to find out what it was. We asked before they did anything that they not give her anything in that family of drugs.
They also asked me if she was cushings and I told them she had the LDDS and suppressed for the full 8 hours below 1. The vet said, oh good, not cushings. Whew.
I did say, yea, not cushings but still high ALP and ALT and told them about what we are giving her, the Hepato Support Supplement, which she said would is good for molly to be taking right now.
So that is the latest update on Molly.
Thanks Kim, so much for the fast answer. It got me through the ER experience feeling better to know what Not to let them give her and that I walked in knowing that information.

Hugs all,
Sharlene and Molly Muffin

[frijole]

No problem. Glad I checked in. Just in case - I did a search on the forum and typed in ear infection deafness and every thread where it was discussed was brought up :_) Cumbersome but when you gotta know you gotta know!

Hope Molly gets immediate relief from the drops. Kim

[infoviewer]

Sharlene: So sorry for Molly's ear infection, but glad you caught it early, that is awesome, you are so good. She will be good as new in a day or two. Glad to know the myacins could cause deafness also. This is such a great forum with such good people. Love JoAnne

[Boriss McCall]

Hope Molly's ear is feeling better today.

[3bostons]

Hope Mollys ear is feeling better today. It is one of the many health issues I deal with on my little guy too, he is the only one who gets them and the slightest thing can set one off for him. I carry the liquid benadryl with me every where cause it will give him pretty quick relief, and he likes the cherry flavor so he takes it easily :p
Hope Molly is feeling better !

hugs kona and deb

[addy]

I hope you both are better today. I cant help with ears, ironically, it is the one thing so far Zoe has not had.:rolleyes::rolleyes:

I know Molly is in the best hands ever!!!!!

hugs

[molly muffin]

Hi all, thanks for the kind words.
This is molly's first ear infection. She was shaking her head and really bothered yesterday morning, but I checked and both just looked pink. So I thought, well, if she keeps this up I'll take her to the vet on Tuesday. Last night when I was combing her ears, she was sensitive on the left side and when I looked at it, it was flaming red. To the ER we go after a quick check in here. It scared me how fast it changed.
She seems much more comfortable today with the medication. Expect 7 days for it to be completely cleared up. She'll be fine. No damage to ear drums, the vet said we got it very early on.

whew
Thank god Zoe doesn't have That to deal with too Addy!

hugs, all,
Sharlene and Molly muffin

[Maya]

Awwwww poor Molly! The meds willl kick in soon and she be feeling a lot better, bless her! I've noticed that about dogs. Any ailment they seem to get can escalate from almost nothing to severe in a matter of hours. That's why we have to be on the ball at noticing these things as soon as they start to happen. Good thing that you are!:)
Have a great day and give a good belly rub to Molly for me!
Hugs from Leah and Maya

[Cocoa's Mom]

Sharlene, how is Molly's ear doing? Hope she is doing better :)

[molly muffin]

Hi, thanks for asking about Molly. I think her ear is better, it seems just pink now, not red.
However, Molly does not care for the ear drops or specifically, the bottle with the tip that has to go into her ear canal. So, now if she see's me shaking the bottle, she is off as fast as she can go, and we do circles through the house. Last night, she ended up under my Mother in laws legs (safety she thought) and I got her there. This morning, it was endless circles until my husband put a block on her. Then of course she acts like you have committed, not a crime, oh no, she goes for full out guilt. You have betrayed her in the worse way possible and she is disappointed in you.

She is feeling better though. Early this morning it was full speed down the upstairs hallway, a skidding turn, back towards the bedroom door, around the corner and down the stairs, to a running stop (involving another skid) to the front door, where she just sat and looked Very proud of herself. Of course then I had grabbed a robe and came downstairs, and said, molly, back yard and off she went, full out to the sliding glass door to the back yard, skidding stop (I think she must have just figured out skidding or something). So finally I got a cup of coffee and out we went. She did the full sniff around, scout out where the squirrels had been and not been, made sure everything was fine as I barely had my eyes open. A quick pee, back inside and a run to the front door, because she was Determined to get a walk in and was not satisfied with the backyard excursion. Yes, I went and got dressed, put on the leash and took her for a walk, which she does every morning before her breakfast.
I think she is feeling pretty darn good.

HUGS,
Sharlene

[Cocoa's Mom]

Well I'm glad to hear that the ear infection isn't slowing her down at all! Sounds like maybe you need a good pair of running shoes just to keep up :D

[Boriss McCall]

Molly is so funny! Sounds like my Pearl. She can run like mad when necessary. Glad she is feeling better.

[molly muffin]

I spoke with the vet clinic this morning and the consensus is that I'm bringing Molly in this afternoon to have her ear looked at. I'm not sure that it is cleared up yet. She isn't scratching at it or shaking her head, but it's still reddish rather than normal, which I admit could be from having the med put in. Hopefully it's all cleared up. She doesn't Act like there is anything wrong, but better safe than sorry. :)

hugs,
Sharlene

[molly muffin]

So, not completely cleared up. She'll stay on the meds for another week with only a drop or two into the canal and then rub some into her ear flap, twice a day. They think it is a an allergy problem since the vet said she doesn't see anything in the canal that would make her think fungus or bacterial infections. This medicine has a mixture to cover all 3 though, including anti inflammatory, so should work. I don't know what her allergy would be. She has never had an ear infection before.

sharlene

[Boriss McCall]

Poor Molly :(
sounds like you will be chasing her around the house with the ear dropper for a little while longer. Hope she is feeling better soon!

[molly muffin]

Thanks. If you ask Molly she feels just fine and doesn't any need for anything to be stuck down her ear. My hubs was saying that of course they don't see anything like fungus or bacteria at this point, she's been on the meds for a week and it's just at the final clearing stage at this point. He thinks it was fungal.
I don't know but I'm not taking any chances either way, so the circus continues. :) I think molly thinks I am the clown.

hugs,
Sharlene

[apollo6]

thinking about you and Molly. HOpe she is feeling better.
Hugs Sonja and Angel Apollo

[infoviewer]

Sharlene: So glad Molly is better and doing her sprints every mornng. Hope you can keep up. It is so wonderful when they are feeling good. Hugs, JoAnne

[Tina]

Hi Sharlene,

I am trying to get caught up on some threads and read about Molly's ear infection. How is she doing now? My Lab years ago got her first ear infection at about age 5, and it was a stubborn one. She too needed a mixture of meds that included the antibiotic, anti fungal and anti inflammatory. They mixed it up special in the office because the regular ear meds at the time would not ever clear it up completely. We learned through the years that her infections were apparently triggered by allergies (that she had never had before) also. She would get frequent infections in the spring and summer, they would go back and forth between one ear and the other. The ears would be clear in the cold weather months. But as I got smarter, I would catch them pretty early, so they were easier to kick then. Just keep an eye on Molly for this type of pattern, she sounds a lot like my girl!

Hope you and Molly are having a good weekend.

Hugs,

Tina and Jasper

[molly muffin]

Hi Tina,

Good points. I'll have to keep an eye on her. I didn't give her any medicine in her ear today. It always seems to be clearer in the mornings before I put the drops in and then seems more reddish afterwards. I think she messes with it because it tickets or aggravates her. So I'm going to try to go a couple days and see how she does. She's been on this medicine for almost 2 weeks. The vet said last visit that there wasn't any signs of infection, so I'm hoping that her ear will be fine in a day or so. We'll see and I'll keep an eye on it.
She hasn't ever been diagnosed with allergies, but has a "habit" licking of her paws. She has done this since we have had her, but she has never scratched in a way that suggested she had any sort of allergy, skin irritations. We'll see though, because now she is almost 10 and might be developing some.

I do hope Jasper's tummy starts to feel better. Poor guy has been through so much. (you both have)

hugs,
Sharlene

[Boriss McCall]

How is Molly doing? I hope her ear is feeling better. :)

[molly muffin]

Hi Amy,

Molly's ear did clear up, but I'm watching her for every itch and scratch and I worry it will come back. I'm still dealing with the after affects of having to give her that ear medicine. It got to where I could only corral her at walkies time at the door. So, now she'll run to the door, but then circle away till she is use that medicine bottle won't appear again. Everything else seems to be fine with her. I'm going to wait till this bottle of Liver supplement is gone, and then have another ALP/ALT test done, maybe a full blood panel, just because, not sure yet. I am dreading doing another LDDS test and will see how the blood work comes back first probably.
I've been trying to go through and update threads tonight. I feel bad if I don't get to answer as much as I'd like to and while I read every day sometimes I'm time short. LOL My MIL just left and we have a few days, about 10 till the next guest shows up. Then we're into the Holiday season and it gets crazy!

Molly is currently chasing an ice cube and seems pretty happy about it. I do worry though. I find I check every poop, every pee, every belly rub for anything 'off'. I probably drive her nuts sometimes. LOL

Still all is well for now and that's a good thing. Hope Boriss is behaving himself, well, not really. I hope he's giving you a run for your money cause I know that is when you are both happiest! :)

hugs,
Sharlene and Molly Muffin

[Boriss McCall]

ha.. Molly isn't going to trust you with that bottle for a long time. She is giving you one of these...:p catch me if you can.

Boriss hates the drops. but, he will pretty much let me do anything to him except clip his toe nails. That is when he turns crazy!!

Every time I go for a test I get my nerves all in a knot.. I hope when Molly gets hers they all come back golden! It is hard to keep up with everyone time wise & emotionally. Some days I am too scared to open the forum cause I want everyone to have good news.

Boriss was running around here like a crazy man earlier this evening. So, he is now down for the night snoring away...
I am trying to keep him calm because of his eye. It's not so easy. It isn't red anymore he just seems to have trouble in the morning he squints. I hope it gets all healed soon.

Have fun during your little break before the holidays! The busy season at work & with family is coming for me as well.

[infoviewer]

Hey Sharlene: Glad Molly Muffin is doing so well. Maybe when you have her tested everything will be fine. I am the same with my CoCo, I watch every body part to make sure he is okay. Now his eyes seem to have a lot of gunk in them. I haven't taken him to the vet for it yet since it is not bad yet. I just use a soft wet cloth and wipe his eyes every morning. Some of the furbabies have so many problems I feel lucky that CoCo still seems to be doing pretty well on 10 mg of Vetoryl and his thyroid medicine. Molly is so smart, runs when she sees the bottle with her ear medicine. Holidays are the same here in Tennessee, lots of family, which I love, but it is a lot of work. My granddaughter is staying with me while she does her student teaching, but that is over the end of this month and then she has to look for a teaching job. My grandson graduated from nursing school about a month ago and has talked to several hospitals in this area. We have lots of hospitals in the Nashville and surrounding areas, so I am sure he will find something soon. Wish he had gone to school to be a vet, since my whole family seems to stay at the vet office with dogs or cats. Hope you and your family and all the furbabies have a good holiday season and get through the rest of the year healthy and safe. Praying for all the families in New York and New Jersey, so sad. Love JoAnne

[apollo6]

Dear Sharlene and sweet Molly
You are a devoted mom and dad like we all are. It is normal to watch every move, anything unusual. Don't forget to enjoy the precious good times. Try to be in the moment with your sweet angel. We get so wrapped up in the disease we too often overlook the good times.
Hugs Sonja and Angel Apollo.

[Trish]

Hi Sharlene and Molly

Molly is such a sweet little bundle of fluff... gooooorgeous! I want to say a big thank you for all the time and knowledge you share with us newbies! I seem to spend quite a big portion of my spare time on here reading up as much as I can and all of everyones tips and advice is golden to me.

Hope you have a fantastic day with your sweetie :D
Thank you
Trish xx

[molly muffin]

Awww, thanks Trish.

This forum is addictive. :) Be warned now. hahaha Everyone here is so wonderful, there is just something about people who have pets and love them, that is very special. This place, the people and the furbabies are very near and dear to my heart. I remember exactly how it felt when I was told Molly had cushings and all I could do is look at her and think 'I'm not ready to lose her yet' and bawl my eyes out.

The people here helped so much to make me see that 1) it may not be cushings 2) if it is I'll deal with it along with help from those here 3)it's not a definite good bye today. I can't imagine anyone else not finding out those things as soon as possible. It helps to be able to get that grip on what is reality and what is just plain fear. It helps to know what you need to do, what tests to get done and what treatments are options and what to expect going through those treatments.

I hope you can find that same peace of having a shoulder any time you want it. :)

Sonja, love, thank you for stopping by. I'm heading over to thread to find out how you are doing. You know you are in my thoughts and heart.

JoAnne! You're right. We need some family vets. hmmph, both of ours love animals something fierce, yet neither chose being a vet as a career. Sounds like you have a lot of family stuff going on too. I'm so glad that CoCo is doing so well with treatment! Hugs!

hugs to all,
Sharlene

[Tina]

Hi Sharlene!

Gosh Lady, what did you do, go and post on every thread in the forum?! Your kindness is amazing, I don't know how you stay caught up on everyone!! Thanks for checking on Jasper and me, I will post an update on him in a bit. I want to get a little caught up on a bunch of threads and see how everyone is doing.

So glad to read that Molly's ear has cleared up. Those infections can be buggers sometimes. And I can totally just picture her avoiding you with the ear med bottle. My Lab that had the chronic ear infections was exactly the same. If I even went anywhere near the cupboard where the medicine was kept, she would go on alert and start watching my every move to determine if she had anything to worry about. It was too funny. :D

I wish I didn't have so much housework to do, I could easily be on the forum all day getting caught up on all those I care so much about, and there are a few new folks that I want to post on as well, not to mention updating everyone on my Little Man. I really could spend all of my free time on here!!

Hope you are enjoying your weekend Sharlene. Belly rubs for Molly from me and Jasper.

Love and Hugs,

Tina and Jasper

[jmac]

Hi Sharlene!

So glad to hear Molly's ear is finally better. I know that chase with the ear drops bottle! They sure do figure out our patterns, huh? Hannah now doesn't like her ears looked at because she is waiting for me to put something in there!

Like Sonja said, it is so easy for us to get wrapped up in anything that could be wrong. Sometimes we search for it. Remember to take time to just enjoy Molly feeling and acting healthy. You will know when something is wrong without having to search for it because you are such a good mom.

I am also amazed at how you stay caught up on every thread. It is so kind of you. I read a little every day, but I've had such a busy school year that I am having a difficult time posting, so I sincerely appreciate you doing such a fabulous job! I don't know where we'd be without you! Thanks for always checking in on us. I truly appreciate it. I'm going to just wait and see how Hannah's ALKP and ALT look in a couple of weeks and then we'll go from there. As for me, I love my 3rd grade class dearly, which is wonderful, but it has been a busy year. I feel like it should be getting easier after 10 years, but I find myself putting in 10-12 hours almost every day! I'm working on a more "balanced" approach between work and life, so I hope you'll all be hearing just a little more from me around here. I'm also trying to make some time for me, to do more of the things that make me happy.

I sure do hope that you'll have good results with Molly's next blood work, and I hope that the ear is clear for good! :)

Take care!
Julie & Hannah

[molly muffin]

Hi Julie and Tina :)

I dedicated one full evening to going through and updating, finding out what is going on with people. I know it is so easy to get caught up in what is going on here and lose track of time. I have to make a real effort to limit myself some days or I'd spend the rest of the week chasing dust bunnies everywhere. :) I do have it a bit easy in that 2 days of the week I work from my home office. That gives me some leeway in my online time, and catching up on things around here.

I'll go check out Jasper's thread this evening. Hope he is doing well!

I'm with you Julie, just wait and see what the next tests show and enjoy them right now as much as possible. Worry I'm sure will come in it's own time. At the moment Molly is pulling out every toy in her basket, throwing them in the air and then attacking them when they land.

Oh I do understand what you mean about the work days for teachers Julie. I have several family members and friends that are teachers. Always something to do after and before the school day begins. It seems never ending.

Hugs gang!

Sharlene

[mypuppy]

Hi Sharlene,

I have to second to what Tina, Jaspers mom, stated " your dedication and sweetness on the forum shine through for all us. You as so many other of our members are truly a Godsend. We would all be lost without one another. keep up the great work, although I know from experience, as much as we would love to dedicate every waking hour to this purpose, it is impossible to keep up at times.

Glad Molly's ears have cleared up by now. my girl used to get frequent ear infections and after switching her to a no grain diet it made a world of difference in that department. As for ear, eye drops, I gotta brag--she sits still for all of them--she's such a good girl.

take care of you and much love to you and Molly girl.

Tight hugs too. Xo Jeanettw

[molly muffin]

Awww, thanks jeanett. We have to stick together on here. Everyone is in the same boat and we all have to paddle together. :)

I'd love to switch molly to some other diet but I'm terrified of taking her off the S/O food, it has kept the crystals at bay and her drinking water in the right amounts for years now and I worry that if I change that, then we'll be back to the crystal problem. Although I did become a bit nervous over the possibility that being on that diet long term could cause pancreatic issues. I'm actually a bit concerned that might be what happened to her back in March with the awful diarrhea and she wouldn't eat and I had her on a very bland diet and antibiotics for a long time because the vet swore it must be something bacterial in her stomach.

Now reading here, I realize the symptoms were the same as pancreatis. I just never seem to know what to think and they didn't do any testing for that. I want to say, why on earth wouldn't they!

Anyway, that is me being a worry wart, but I do wonder if maybe it didn't cause the lymph nodes to be swollen (as seen on ultrasound) and the liver value to go up, although I'm not sure if they were connected or not.

I don't know what to make of the ear infection coming out of nowhere for the first time in her life.
Guess I've picked up the worry bug. LOL Still we're all okay here now and I'm probably more on pins and needles waiting on results to come in for others on the forum. Test days and now a surgery on the radar today has me in full worry mode. So far everything seems to be going well and everyone getting good news, including solid poops and Princess being herself. :)

HUGS, Sharlene and Molly Muffin

[apollo6]

Dear Sharlene
You are indeed one of the angels on this forum.Always trying to say a kind and helping word. Thank you.
Will be praying for you and Molly. Glad the ear infection has improved.
Hugs Sonja and Angel Apollo

[Trish]

So cute to hear Molly is having fun tossing her toys about! Love it when they are playing and being silly!
xx

[molly muffin]

I'm just going to say this on Molly's thread....

Happy Thanksgiving Each and Every One

You are all such special, wonderful people that I can't thank all of you enough for being on the other end of a computer for everyone who comes here, so scared, so worried for their precious furbabies. You give the gift of yourselves, every day. Thank you!

hugs,
Sharlene and Molly Muffin

[Bo's Mom]

I want to 2nd what you wrote in your post. We are all fortunate to have each other in our lives and for that I give many many thanks. Wishing you and your family the happiest of Thanksgiving and go ahead and let Ms. Molly clean some plates this Thanksgiving.

[addy]

DITTO, sweetie and a special thanks to you

I hope Molly too has a happy turkey day, sleeps late, barks at the stove for turkey and happily demands lots of cuddles:D:D:D

[Jenny & Judi in MN]

I hope Molly's ear is better and a Happy Thanksgiving to you Sharlene!

I used Zymox on Jenny for a week before her dental procedure. I was hoping her deafness was due to inflammation or infection or something but the vet checked her while she was knocked out and said her ears were squeaky clean. So it works.

Judi

[mypuppy]

Awwww Sharlene,

happy turkey day to you and Molly and your family. You too are pretty special and dear to all of us here.

We sure do love ya sweet thing.

Xo Jeanette and the Princess

[jmac]

Sharlene,

I hope you, your hubby, and Molly also have a wonderful Thanksgiving. I also am very thankful for this forum, and for the many caring and wonderful people like you, who help support me and keep me sane. :p

Have a wonderful Thanksgiving!

Julie & Hannah

[Boriss McCall]

Happy Thanksgiving Sharlene!! I am so glad you are on this board. Thanks for all the support you give me & everyone.
xo

[Tina]

Hi Sharlene,

I just want to stop in and wish you, Molly, and the rest of your family a Happy Thanksgiving! I also want to thank you for always checking in on me and Jasper and all the support you constantly offer. I am so grateful to you and this forum, I don't know where we would be without all the special people here.

I am not sure that Thanksgiving is observed in Canada, but I wish you a wonderful day today! :D

Love and hugs,

Tina and Jasper

[molly muffin]

Thanks Everyone! We do celebrate Thanksgiving, it's just in October. Think of a Harvest Festival time.
I think the sentiments though are great, no matter when or where you live. :)

mucho love!
hugs all,
Sharlene and Molly Muffin

[jmac]

Sharlene,

I have celebrated Canadian Thanksgiving with some Canadian friends for the past few years. Good times! :)

Julie & Hannah

[Maya]

I have to agree with everyone! What would we do without you??;)
God bless you and that little dog of yours!
Love 'n' hugs, Leah

[molly muffin]

Thanks gang, you are all such sweethearts. I think we're just a very giving community and that probably has much to do with being animal lovers. :) In the human/animal relationship, we always seem to get back 10 times whatever we give. This community just follows the rule of interactions. :)

love to you all!

Now off to fix yet another family dinner. Did I mention I have company this week from out of town! LOL Crazy around here.

hugs,
Sharlene

[molly muffin]

I posted a couple more pictures of Molly today. I think it is fair to say that hair growth is not a problem for her. She was groomed and her hair cut when we came back form Spain, so around Sept 17th. The first picture which is actual the last, was taken yesterday Nov 28th and she looks like a fluff muffin again. Although one badly in need of a bath. Her hair was over one eye today, like a puppy Marilyn Monroe.

She will be going to stay at the vets again on Dec 12th, and I am going to order a blood panel to be done then to see how her liver values are. Anything else specifically I should ask them to check blood wise?
To recap, she has high ACTH, high ALP, high ALT and as perfect of an LDDS as one could ask for. (baffling)

Sharlene and Molly Muffin

[Bo's Mom]

Awww, she is so beautiful!!!

[labblab]

I found an upcoming continuing education lecture being offered by Dechra that may cover the information on treating without symptoms. This lecture is given by a veterinary dermatologist husband and an IMS wife team, entitled Cushing's Disease: Inside and Out. It's not available to us laymen and I can't see the five modules but they are entitled, 1) Perspectives, 2) Diagnostic Considerations 3) Treatment Options - What We Knew Then 4) Treatment Options - What We Know Now and 5) An Option for Managing Canine Hyperadrenocorticism. The what we knew then and what we know now sounds very interesting. The fact that a dermatologist is contributing is interesting because a lot of dogs with cushing's have severe skin and coat issues with few other symptoms. Even more interesting is that the husband dermatologist's practice is in Pasadena, CA. I had a little Shih Tzu foster dog who had horrific skin problems and few other symptoms, who was ultimately diagnosed and prescribed Vetoryl by another derm vet in that practice. Hmmm?...

...P.S. Sharlene, ask your vet if the names Rhonda Schulman, DVM, DACVIM and/or John Angus, DVM, DACVD sound familiar. One or both may have lectured at the veterinary conference your vet attended.
Hey Sharlene,

First off, Molly is such a sweetheart! It always brightens my day to see your photos of her. :) :)

Since I felt lazy this morning and wanted to postpone taking the girls for their walk :o, I started back at the beginning of your thread to refresh my recollection about Molly's history. I only made it part-way through, but ended up with these preliminary thoughts.

First off, the continuing ed lectures that Glynda found earlier are now mobilized for public viewing. You must have Adobe Flash installed to view them, but here they are:

http://www.cliniciansbrief.com/webrief/cushings-disease-inside-and-out

I've only had time to listen to two of the modules, but it is the first one ("Perspectives") that does indeed offer out the suggestion that it may be time to establish a new treatment paradigm for Cushing's, and not wait until dogs exhibit full-blown symptoms prior to intervening. I don't know that this lecture is what your IMS was talking about, but it is consistent with the notion that earlier intervention may preclude the development of more serious issues such as hypertension, proteinuria, cruciate damage, etc. Both of the specialists (dermatologist and internist) also stress that they have diagnosed lots of dogs that do not present with a full profile of classic Cushing's symptoms. For instance, the internist says that, surprisingly, many of her Cushpups do not exhibit ravenous appetites. And the dermatologist says that many of his patients exhibit little other than just skin/coat abnormalities. Of course, my first thought, is "Then how do you know they really have Cushing's?" But they both seem to be confident about their diagnostic accuracy. And in the case of dermatology issues, I guess it is true that there are certain disorders (like calcinosis cutis) that basically only manifest with Cushing's.

As far as Molly's upcoming retesting, have you decided to postpone the followup LDDS? I noticed that back in the summer, the IMS recommended a retest in about three months time. To me, it does make sense to first start out with a general lab/urinalysis panel in order to see whether there have been changes in the liver studies and proteinuria. Because if everything has normalized, then you're be off the hook altogether! But if those values have worsened, I'm thinking you would want to revisit another LDDS. Also, has Molly's blood pressure ever been checked? That might be another test that would be wise to perform. Because even Dr. Peterson seems to endorse advancing to treating an otherwise largely asymptomatic dog in the presence of unresolved proteinuria and/or hypertension.

I'll have my fingers crossed that you'll see improvement in Molly's labwork this time around. But if not, perhaps this is a bit more food for thought.

Marianne

[molly muffin]

I think you are right Marianne. I didn't plan to do another LDDS until I had her blood work rechecked to see what that is doing. I don't expect the ALP's to go down as they have been high for about 4 or more years. I think they went up or started to go up about the time that she started to get crystals forming and we put her on the SO formula dog food.

This last time the only thing that became different was the ALT's went up. It seemed to me that this went up after in March she had a horrible case of diarrhea (she'd never had anything like that before) and her one week of antibiotics became 2 weeks and she was on floraflora for about a month. I am thinking it might have been pancreatis, but no one mentioned this to me at the time and I was quite unaware of it until joining this forum. I did the bland food for about a week before gradually reintroducing her to her food again.

I'll try to listen to the modules this weekend if I get a chance. That does sound like what my IMS was talking about. She said it would be written up in a journal though and I've never seen it, or maybe it is Just for vets, I don't know.

Thanks for your input. I got a bit worried that dogs like Chey also had the high ACTH and normal LDDS and it turns out to be an adrenal tumor, but the ultrasound didn't sound show that.

Molly hasn't so far had any skin problems, coat problems, excessive hunger or thirst (I still have to give her the SO food or she doesn't drink enough) She periodically has had hind leg weakness but we have thought this is due to arthritis that is the result of a groove not cut deep enough for her joint and subsequent small injuries when she was younger. (verified via xrays) (this has Never stopped her jumping for a treat though) She last had a bout of the leg problem 2 years ago, which interestingly enough is also the first time they did an LDDS test. I said she yelped, so I thought it was an injury, but my vet wanted the LDDS test. (I really think she's a cushings pusher). Anyway, most of the time she is fine and a few times she is a bit ginger with it, but there hasn't been any wasting of the hind leg area that I can tell and no trembling.

I guess my worry, is that if this is not Pituitary Cushings, then what is causing the cortisol to be so very high. That is sort of scary. Liver disease or something else worries me and if anything else is going on inside her that would cause the cortisol to rise if it's been rising for a long time, then it could be affecting her adrenal glands (making them just slightly on the enlarged size as per the ultrasound).

Well, this is long enough! I have to remember, not writing a book here. :)

LOL we think she is pretty darn cute too, but I know we are prejudiced parents. hahaha

Thanks again,
hugs,
Sharlene and Molly Muffin



Sharlene and Molly Muffin

[addy]

Hi Sharlene,

Hard to say what may be making that cortisol go up if it is not Cushings. I am afraid I cant offer any advice but I can stop in and tell you, yup, that Molly Girl is one cute little bug:D:D:D:D

Have a great weekend!!!

[Trish]

Hi Sharlene and Ms Molly

I hope you get to the bottom of that beautiful little girl's problems! She wounds pretty happy though, so pleased to hear that :)

Have a nice weekend you two and to all those that love you :D
Trish xx

[cheydogger]

Sharlene-

I sure hope you get lil Molly Muffin figured out. It is stressful wondering what is ailing your baby.

As for Chey, her ultrasound report did state a right adrenal neoplasia, however, the radiologist didn't elaborate on the tumor. Maybe he couldn't tell, but he didn't say if it looked to start in the cortex, medulla.....nothing. Also, you have to look at the size of her right adrenal. It is huge, 3.27 c.m. and it's hyperechoic to the retro peritoneal fat. I know, however, her results are very mixed. I probably wouldn't compare any of Chey's findings to Molly. Don't go there;)

As Marianne said, a blood pressure check wouldn't be a bad idea. Matter in fact, I think all dogs should have a BP check at their annual well visit screenings:rolleyes: it will be interesting to see what Molly's new blood work shows.

Give that cutie patootie a big belly rub:D

Lastly, I wanted to say thank you for all the time you put into checking in on everyone. You are very kind:D

Hugs,

Ro and Chey

[molly muffin]

hi gang and thanks.

I'm not really spazzing out about molly, except in my head, sometimes. :)

The comparison I was making was an adrenal tumor type of problem showing positive ACTH and negative LDDS. Specifically Molly's ultrasound did not show a tumor on the adrenal, so that just makes it more strange. It showed, everything that would be consistent with cushings Pituitary tumor and yet, suppress she did, just like if it were an adrenal tumor. She's never been on steroids, so that shouldn't be it. So, you know, I just rack my brain trying to figure it out.

I learn something all the time on this forum from seeing what others are going through, what test they did, what results mean, etc. I hate that Anyone has to go through this with their precious furbabies.

We'll just wait and see what the next results show. Blood tests it is. :) I think a full panel and we'll just see where she is at and go from there. :)

We had snow last night!!! It melted. whew. Not really ready for the winter thing, even though molly thinks snow is a blast and a half. Something to run and jump in and have good times.

Hugs,
Sharlene and Molly Muffin

[Bo's Mom]

Awww, Molly playing in the snow sounds like a great time. Here in Texas (deep south), we NEVER get snow. Right now, we are planning a trip to the beach to enjoy the 80 plus degrees. Our sand is your snow I guess. It is just hard to make snowmen with sand. But, we get some mighty great castles. :D:D:D

[apollo6]

Dear Sharlene
Tried to read a little of your last post. You may want to have a thyroid test. If I am correct it has similar symptons to Cushings. Apollo was on thyroid medication. Also hair loss, etc can some times be attributed to elevated hormones, that test is down at the university of Tennessee. Not saying you need to go there. You might ask Addy. Apollo had elevated hormones also. try to stay positive.
Hugs Sonja and Angel Apollo

[molly muffin]

Hi Sonja,
Yes I want to have a thyroid test done, T4 right? Glucose has always been normal, but that should be on the panel too.
We haven't had any problems with hair loss, so far. As you can see by the pictures I posted, she had a hair cut in mid September and is now another little fluff muffin badly in need of another hair cut.
I feel lucky that we haven't had skin problems yet, but I worry that this is all new and that the day could be coming. That with high cortisol levels comes the very real risk of this.

Thanks for your input Sonja. We'll definitely want the thyroid test too.

Belinda, our snow melted and today all I needed was a jacket. I'm much better with warmer weather, unlike Molly who loves the snow.

hugs,
Sharlene and Molly Muffin

[molly muffin]

Just wanted to let everyone know that I am going to be away till next week. We're off to visit Snow and celebrate grandson's 1st bday. (still sort of in shock that we're grandparents, I'm pretty sure I'm only 34 now and forever) hahahaha
I know, I'm on here so often, someone would probably send the police to the house to check on me if I didn't show up and didn't say anything. (just kidding)
I've booked Molly in to have blood tests to include thyroid, a complete blood workup and a urinalysis.

We'll see how things are when we get the results.

hugs all, catch ya laters,
Sharlene and Molly Muffin

[labblab]

Sharlene, hope you have a wonderful trip! We will miss you very much, but this sounds like a very special visit and celebration! ;)

Travel safely!

Marianne

[milosmom]

enjoy your babyboy and try not to worry about your little cuty patooty molly...patty and milo xoxox

[Trish]

Have a fabulous time with your family Sharlene, how exciting to go and spend time with them. I will miss you terribly of course but hopefully I will have a healthy Flynn to present on your return... lots of hugs for Molly too xxxxxxxxxxxxxxxxxxxxxx

[Harley PoMMom]

Sharlene, have a wonderful time with your family, and yes, your family here will sure miss you!

Love and hugs,
Lori

[Tina]

Hey Sharlene,
Have a great time and safe trip. Jasper and I will miss you too, of course! Hugs to you and Molly.

[mypuppy]

Sharlene, so sorry I missed you before saying "have a great time" with your little potato and family. Have a lovely and fun time. I gather you must from that spunk of yours. :D

Sorry Molly is hard to figure out, hate it when that happens...:mad: Hope someone figures it out soon.

Love ya and looking forward to some good stories upon your return.

xo Jeanette

[mypuppy]

ps. Missed something else here too. so, am I to understand that now the veterinary field feel it is wiser to still treat a dog with cushings although they are not symptomatic, in order to prevent all the potential complications of cushings? :confused: this has always been a concern for me with my girl when she takes her trilo breaks, and it brings me back to a very old post wherein we were breaking our minds wondering if "we treat the numbers or symptoms"?

Golly!:confused:

[mypuppy]

Belinda,
Sorry, had to say you made me LOL with your sand comment. haaaaaabaaahaaaaa...Come up north anytime and build all the snowmen you'd like in my yard, and bring a dump truck while you're at it too...we have snow coming out of our ears, and one can't be so selfish...:D

xo Jeanette



Awww, Molly playing in the snow sounds like a great time. Here in Texas (deep south), we NEVER get snow. Right now, we are planning a trip to the beach to enjoy the 80 plus degrees. Our sand is your snow I guess. It is just hard to make snowmen with sand. But, we get some mighty great castles. :D:D:D

[mytil]

Have a great time Sharlene with your family.

Safe travels and have a great Holiday!

Terry

[infoviewer]

Missing you aleady Sharlene, but what a treat, a one year old grandson in the snow, hope Molly gets to go with you and play in the snow. That would really be a hoot, a one year old and Molly in the snow, beautiful pictures. I can hear the happy laughter already. Have fun. Love, JoAnne

[Boriss McCall]

Have a fun & safe trip! we will miss you.

[apollo6]

Dear Sharlene
Enjoy your baby grandchild, and as Addy would say put the Cushings in the drawer and shut it closed for know.
Hugs Sonja, Angel Apollo and Arion, his little brother
Maybe this might help. Apollo was on allergy medicines for years unfortunately, which often times have steroids in them and so do other medications which can cause the cortisol to go up,also stress.


http://www.vetinfo.com/elevated-cortisol-levels-in-dogs.html


Sent from my iPad

[molly muffin]

I'm baaaccckk!

Wow, you guys were busy on here! I've been typing my fingers off since getting home. :) Lots of snow, grandson was a hoot! Gosh they grow so much, he's got the cutest smile. I started calling him sunshine since his smile just lights up a room. :)

I can't pick Molly up till tomorrow. :( Our plane got in too late tonight. I Hate the silence in the house when she's not in it. So, not thrilled about that, but I'll live.
So, I get to the vets to drop her off and went over what I wanted to done. Lord have mercy, as they say, in for a penny, in a pound. I must have gone nuts and went for several pounds.
So, Molly is having complete blood work done, and a T4 panel . (might as well eliminate things)
A urinalysis. She's prone to crystals and I check for infections any chance I get.
Also she has had some small stones before (no need for surgery thank god) so she gets an xray thingee, to check for any stones, which they said, also shows organs. So, I'm like, yes, check it all. She gets these about once a year or year and a half I guess.
Now for the extra pound part. I went ahead and said they should do the LDDS now after all. I know I said I was gong to wait but with boarding, grooming, all the other tests, I figured, what the heck, lets go for the whole kit n' kabodle.
I don't know if I've left off anything else that I had done or not. The list seemed to be a mile long, or it could have just been price shock at the time. LOL Anything is possible. I'm pretty sure I left in a daze.

Anyway, not sure what results I'll have when but you can be they will be posted when I get them. Cross fingers that we are good on the test results!

Hugs all. Thanks for the well wishes. You guys are all just awesome! I'd be three sheets to the wind and bat crazy if not for everyone here. :)

Sharlene and Molly Muffin

[Trish]

Yay welcome back Sharlene and a welcome home for Molly tomorrow, she will be so pleased to get back to her Mum and home!! xx

[infoviewer]

Hey Sharlene: So glad you are back. I know Molly will be so glad to get home. Hope all her testing is normal and you don't have a bill shock. Your baby grandson sounds so precious, human babies and dog babies just make us smile, not comparing the two, just loving the good feeling we get with all babies. Love, JoAnne

[Bo's Mom]

Welcome back!!!

[Boriss McCall]

Welcome back!
I think Molly is going to be giving you the ole stink eye after all those tests. lol:p

I am keeping my fingers crossed that everything comes back good & you can enjoy your holidays.

We missed seeing your happy post while you were away. Glad you got to have fun with your family.

[cheydogger]

Hoping for good test results!!!! I bet Molly was so happy to see you and go home!!

[molly muffin]

Well, test results are back and guess what, we are still baffled. LDDS, continues to suppress wonderfully. ALP continues to go up, ALT has gone down. Urine Gravity is good, concentrated.
So, I'll do the run down, because even I hate going through pages of this thread looking for past results.
Ready? Set. Go!

Ultrasound July 2012:

Liver: mildly enlarged, diffusely hyperechoic and margins rounded
gall bladder: moderate amount of echogenic debris present
stomach: moderate gas
left kidney: hyperechoic speckling in the cortex and mild derease in corticomedullary definition
left adrenal gland: mildly enlarged with caudal pole larger than the cranial pole
Urinary bladder wall: mildly thickened at the apex, although lumen is not fully distended.
Mucosa: mildly hyperchoic and irregular and two small calculi present
right kidney: similar in apperearance to the left kidney - small non obstructive calculi present
right adrenal gland: upper reference of size to mildly enlarged
lymph nodes: mildly enlarged

Test Histories:


ALT - 54 (10 - 118) May 2010
ALP - 518 (20 - 150) May 2010


Albumin 46.7 (26 - 44) April 2011
Protein 78 (51 - 72) April 2011
ALT - 110 (6 - 118) April 2011
ALP - 764 (5 - 141) April 2011



DEXA (LDDS) May 2011
Cortisol (Base) 82.2 (20 - 300)nmol 2.97ug
Cortisol (DEXA) - 4 hours 28.7nmol 1.04ug
Cortisol (DEXA) - 8 hours 35.1 nmol 1.27ug



Albumin 44.1 (26 - 44) (barely out of range) March 2012
Protein 76 (51 - 72) March 2012
ALT - 139 (6 - 118) March 2012
ALP - 1121 (5 - 141) March 2012


ALT - 152 (6 - 118) June 2012
ALP - 1003 (5 - 141) June 2012


ACTH (2 draws - this is due to the agent used by the vet) June 2012
Cortisol (base) 172 (30 - 300) 6.23 ug
Cortisol - 1 hour 924 33.49 ug
Cortisol - 2 hour 1014 36.75 ug

Lab states, that in a normal animal Cortisol will increase above 250 but not above 600.
The results are consistent with Cushings Disease; Pituitary-Dependent Hyperadrenocorticism

Albumin 46.8 (26 - 44) August 2012
Protein 74 (51 - 72) August 2012
ALT - 144 (6 - 118) August 2012
ALP - 1054 (5 - 141) August 2012


LDDS - August 2012
Cor1 - Cortisol (base) 30 - 300 nmol/L 2.86 ug
Cor34 - Cortisol - 4hrs < 27.59 nmol < 1 ug
Cor38 - Cortisol - 8hrs <27.59 nmol < 1ug

and finally Urine gravity 1.038 August 2012


LDDS - December 2012
Cortisol Base 87.2 nmol (30 - 300) 3.16 ug
Cortisol 4 hr <27.59 < 1 ug
Cortisol 8 hr <27.59 < 1 ug


Thyroid Mini Profile - all within normal ranges December 2012

Albumin 47.3 (26 - 44) - December 2012
Protein 73 (51 - 72) - December 2012
ALT 125 (6 - 118) - December 2012
ALP 1229 (5 - 141) - December 2012
Cholesterol 10.39 (2.50 - 9.90) - December 2012 (I was told to ignore this due to possible sm amount food in the AM)

Urinalysis all normal, no crystals
gravity - 1.035 (clear, dark yellow, concentrated) - December 2012

I notice I didn't receive a copy of any report on the xray for stones, etc that they did, but I was told, no stones (i only notice there wasn't a written report in my papers when I got home)

Vet is to call me later this week, she wasn't in today and she'll have a hard time reaching me
until maybe Thursday or Friday by my schedule. I was told, nothing was urgent, so don't worry, but
that we should go over where we are at with the blood work.

Basically the ALP continues to rise. We think the ALT might be going down in reaction to the
Heppato Support supplement.

I asked about doing a bile acid test, but was told that none of her other liver values have gone
out of range, as would normally be seen in a dog with liver cancer.

I asked about Kidneys, and they said they are fine.

Next stop? I don't know. Didn't show an adrenal tumor on the ultrasound. Something made her ACTH have
high results though and is keeping her liver and adrenal glands working. It just isn't a pituitary
tumor from the sounds of it. I don't think anyway.

I'll see what the vet has to say when we finally get together via phone. I already told the front desk that I'll be asking for all test results to be sent over to the IMS so that we can brain storm
and see if we can figure this out.

It is frustrating, that I can research and know the things I should know about cushings, the basics anyhow, but then when it comes to Molly I find myself clueless.

Thanks for listening and reading all. Yes, molly was very glad to come home and be with her pack. :) She is clipped down poor thing. Going to be a chilly month or so till that coat grows back in. Bit of miscommunication there.

Yep, there was definitely some sticker shock when I went to pick her up. But it's molly and we all know I work for her. :) ROFL!

hugs,
Sharlene

[molly muffin]

Just spoke to vet. As long as molly isn't showing any cushing symptoms we aren't going to do anything else. Just monitor her. At some point we might go with a full liver panel (bile acid, etc) to see how that is functioning, but right now the ALT is coming down on the Heppato Support. She said that it could be a very small, almost nonactive pituitary tumor, or not very active and that could cause the high ACTH and still suppress on the LDDS. So, again, monitor. She said that would also cause the liver to react as we are seeing with the higher ALT's, but they aren't alarming highs yet and she has always had a bit of a pot belly too, so we are just in further wait and see mode I guess. She said nothing showed abnormal on the xrays too.

Sharlene and Molly Muffin

[Boriss McCall]

Yay Molly.. I hope she never ends up with "full blown" cushings. I know you feel the same way. You are such a good mommy. I know it is probably frustrating not knowing the exact reason why things are off. :confused:

[milosmom]

sharlene you are such a good mommy and i was happy to read about molly.i am so happy she is not diagnosed with cushings.i pray she will be keeping you busy playing and snuggling.keeping an eye on you two.patty(milo)and meka xoxox:)

[infoviewer]

Sharlene: That is woderful that Molly does not have full blown Cushings. She may never get it, you are so good to monitor everything. That makes for a very Merry Christmas for you and your whole family. Give Molly lots of belly rubs and hugs for me and CoCo. Love, JoAnne

[molly muffin]

I hope not too. The vet keeps talking about a small pituitary tumor or an not always active small pituitary tumor. The cortisol is high, so we have to consider that something is causing it be that way. At the moment the plan is to continue to monitor her for symptoms. Which of course just makes me watch her like a hawk and doubt what I am seeing.

I know she sometimes grazes her food, eating some of a bowl in the morning and finishing later, other times she eats all in the morning and then wants more at night. The dog has Never said no to a treat, so no way to tell with that, although I'd like to move her to green beans and carrots, etc, solely. (hard to do when everyone wants to give her something and people come by with Christmas gift treats for her along with the toys) Yes it's true, we get drop offs just for molly.

If she doesn't have her SO food, she doesn't drink enough water. I've tried to see and sure enough, she won't drink as much as she does on the SO food, which has her at just where she should be. So that is very Non-cushings. She pees like a million times outside, but she's always done that since puppyhood, as she's an alpha marker dog. (or with her, more likely a prima donna marker)

She doesn't want to jump up because she knows if she looks cute and longingly she'll be lifted. Same thing at night if she is asleep before bed, then she has to be carried up, but if she's not she'll run up those stairs like her tail is on fire. So, it's hard to tell with her, she's such a little prima donna princess personality. (our fault I'm sure).

We'll just see what happens and what future tests look like. In the mean time, here I am :) LOLOL

hugs all,
Sharlene and Molly Muffin

[addy]

In the mean time, here I am LOLOL

and we are all glad of that no matter what;):D:D:D:D

[Trish]

Gosh that Molly is a mystery girl... hate not knowing what is causing her trouble though. When Flynn had all the cushings tests initially, they could not pinpoint anything and I remember his IMS saying often they have to wait for symptoms to really declare themselves before they can a reach final diagnosis. Soooo frustrating when you know your baby is not right, but things are just not adding up with the investigations. Good to hear she is having fun with her toys! Watch all that slippery ice outside you two!
Trish and Flynn xx

[molly muffin]

I remember that several others seem to have gone through a long period before a full diagnosis of cushings was made. It could be that at some point in the future, she'll stop being able to suppress, but until then I hate the thought of starting her on meds for cushings. Till then a mystery molly remains. A happy one at least :)

Right now she is having a blast, we just put the tree up and she's periodically wondering if she should attack it or take a nap under. *I vote for a nap.
Plus I just brought home groceries to make dinner tonight (Jambalaya and jalapeno bread) The smells of sausage, etc have her nose twitching like a runaway train, so fast I don't see how she can breath and sniff at the same time. I imagine it's going to kill her when I really get in there and start full out cooking. This btw, is suppose to inspire me to get motivated to decorate the tree, wrap gifts and in general be a merry elf. :)

It's a happy dappy merry holiday sort of day!

Happy Holidays
Sharlene and Molly Muffin

[mcdavis]

Right now she is having a blast, we just put the tree up and she's periodically wondering if she should attack it or take a nap under. *I vote for a nap.


It's great news about Molly's test results and also that she's doing well.
however attacking the tree gets my vote!!

[molly muffin]

however attacking the tree gets my vote!!

uh oh, sounds like Molly has a partner in crime!!!

ROFL

Sharlene

[mcdavis]

uh oh, sounds like Molly has a partner in crime!!!

ROFL

Sharlene

Absolutely ;)

If a dog's getting up to mischief it usually means it's feeling well - the worst day of my life was when Hamish's arthritis got so bad that he refused to move, eat or misbehave.

[molly muffin]

You are absolutely right! A mischievous dog is a happy dog. Molly isn't quite as mischievous all the time as she use to be, now she has more like, spurts of trouble making. Then she needs the nap afterwards. :)

Well, tree is up and decorated!!
Molly seems to have a lot of presents this year. :eek::eek:
She can open her gifts, but she can only have 1 treat on Christmas morning (after a very reduced breakfast to take her Heppato pill). We learned that the hard way after her very fist Christmas with us, she nipped the daughter, and later we realized she was completely over stimulated after only being with us for about a month. Now she is limited on Christmas morning and we've never had another issues in all those years.

I swear her belly looks bigger. She's put on .4 of a lb between Sept and Dec. That's a lot for her. I thinks she is getting cataracts too. :( The vet didn't mention it when we picked her up after the last stay, but she goes back the end of January and I think I'll have them take a look at her.

After so many incidents of eye issues, I'm becoming paranoid!!

Okay, recap, good thing - Tree is up and decorated! Xmas shopping is completed!
We have to go out for a dinner, but wrapping to commence upon return!
No ice!

Happy Holidays
Sharlene and Molly Muffin

[apollo6]

Sending you happy wishes and a blessed Christmas
Hugs Sonja and Angel Apollo

[Bailey's Mom]

Merry Christmas and the happiest of New Years!!!!!!!
May all of your Christmas wishes come true...
May we all stay away from any and all cliffs,
Peace and Joy to all!
-Susan

[addy]

Ho, Ho, Ho Sharlene and Molly

[Boriss McCall]

Merry Christmas!!

[molly muffin]

Merry Christmas all you wonderful people and furry friends (that's the animals you guys!!)

hahahahhaha

Have a wonderful Christmas!

Sharlene and Molly Muffin

[labblab]

And a very Merry Christmas to you and Molly and your whole family, Sharlene!!! :) :) :)

[Trish]

My word, 2 1/2 pages of Molly Muffin posts!!! Such a good Christmas effort from you Sharlene, how lovely you are to everyone :D:D I am sending you some pavlova for your pudding :D:D Best you go to bed or you might stop Santa from landing on your roof and then Molly will be upset :D

You are just a treasure, the shiniest star on the tree! xxxxx

[Tina]

Merry Christmas to you and Molly. Have a wonderful day with your family!

Love and hugs from me, Jasper and Shelby

[molly muffin]

hahahah, Trish! We went to a Christmas Eve party at a friends house, then when we came home I started baking, so you guys all got me while I was making pecan tarts at midnight. LOL You know that wait between batches in the oven can be pretty long and I didn't want to miss anyone, although I'm sure I did. If so, know I wish you all a merry christmas. :)
Right now I'm here as we await cinnamon rolls, which is a holiday morning (although it's closer to noon but no one got up early today) tradition here. Then we'll all start cooking together for a family dinner this evening. Love the holidays!!

Oh yes, later on there Will be pictures of us and molly.

hugs all,
Sharlene and Molly Muffin

[molly muffin]

And Molly's Xmas pics are up!

Sharlene

[Trish]

Pics are totally adorable Sharlene, what a good looking family you all are :D:D

[molly muffin]

UCK, have the moon boots out and in the backyard making paths through the snow for molly to a final cleared spot for the potty break. I have to take her out on a leash even in the backyard because of the pool. I won't let her wonder back there with snow on the ground without a leash and me on the other end. :) We look like a funny pair but she knew when it was snow on her walks this morning that we'd be making the snow paths and she went right downstairs to the outside door, ready to go. And yes, she finally could go. The sidewalk cleared path just doesn't do it for her in the winter with snow on the ground. Too much snow to get to trees and no grass. :( she really dislikes it, but loves her backyard play area.

hugs,
Sharlene and Molly Muffin

[Trish]

Gosh Sharlene, that sounds fun... NOT!!!! :D:D Train her to use to loo inside :D:D I am going to stop complaining about the heat, because the opposite does not sound very pleasant at all! I can just imagine Molly disappearing under a mound of snow and you having to pull her out by her leash :eek::eek: Keep dry girls!
xx

[infoviewer]

Oh Sharlene what we do for these furbabies. CoCo wakes us up at 3 every morning to go out. So here I am with a flashlight trying to keep him quiet so he does not wake up the whole neighborhood. My husband and myself race to see who can get their clothes on first to take him out (NOT). I usually win or shall we say lose since I am faster and it is cold in Nashville this week, down in the 20s and 30s, but no snow. Moon boots sound like a good thing in this cold weather. Have a good New Year. Love, JoAnne

[addy]

Totally relate, I was outside at 5am putting down plastic where we still had a wee bit of grass showing, not sure it will work with the new snowstorm, I'll let you know:rolleyes::rolleyes:

Bermuda sounds good right about now, :D:D:D:D:D:D

[Trish]

Noooooo, you got to all come visit me!! No snow here ladies! I woke up to foghorns this morning, Flynn thought it very strange and so did I! Very thick dense fog had come in from the sea, most unusual. Lifted now and its going to be another hot day, think the walk will have to be postponed until this evening when it cools down.

[Boriss McCall]

Burr... I am so glad we aren't clearing snow for our dogs. I feel for ya'll. I don't think Boriss would ever go outside.

We did have a white Christmas which was nice. But, it all melted away by yesterday.

I hope you are staying warm. :)

[Trish]

Happy New Year Sharlene and Miss Molly! Hope you keeping your feet dry! xx

[molly muffin]

Happy New Years Everyone!!


I hope everyone has a wonderful new year in 2013, with many good things and happy, healthy pups in their lives. Love long lasting.

Cheers,

Sharlene and Molly Muffin

[Tina]

Happy New Year to you, Molly and your family. I sure enjoyed your Christmas pics. Molly is so photogenic! And obviously she will ALLOW you to take her picture, how nice! :D. Wishing you many blessings in the new year.

Hugs,

Tina and Jasper