Jasper (12 yr old Mini Schnauzer) is now at peace

[Trish]

Yay so pleased to hear Jasper is feeling well, great news! Long may it continue :D
Trish xx

[Trish]

Hi Tina
I hope no news is good news and your having a great week!
Trish xx

[molly muffin]

Yep, Ditto what Trish said! Hope you and Jasper and Shelby are doing really well.

hugs,
Sharlene and Molly Muffin

[addy]

Hoping everything is okay and you are not sick in bed with the flu.

We miss you:):):):) Maybe you all missed the cabin and decided to go back. It did sound lovely. What a wonderful escape.

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

[Tina]

Hi Everyone!

Thanks so much for checking in on me and Jasper. I haven't meant to be absent, the past week has been so tough for many reasons. Wicked busy, stressful, and long hours at my job, and then so much sadness on the site. I have been reading and keeping up for the most part and have been crying every night for our members and their pups. I can't seem to shake it. I was absolutely heartbroken at the losses of Maximus and Baxter, and couldn't stop crying. Still crying actually. You would think they were my own dogs. And poor Scoop, and Tipper, and Casey, worrying so much about them. And others too. I have been so upset that I haven't even been able to post on their threads. Every time I started, I just couldn't find the words and was just bawling. I am hoping to do some posting a bit later.

There has been a bit of a setback with Jasper also. I feel guilty even posting about it with everything that others are going through. Last Friday he started hesitating and walking away from his food at times again. This had not happened for a while. On Monday 1/7 when I talked to my vet, she thought it was probably related to the decreased Dex dose - he has been on 1/2 tab (0.25) mg every other day since 12/26. She felt this was a sign that he was not tolerating the decreased dose so said to increase back up to 1/2 tab daily for 4 days to see if it would boost his appetite and then decrease to 1/4 tab but give daily rather than every other day. Today is the first day of 1/4 tab. I don't think I noticed a big difference over the past 4 days. Some meals he will eat like normal, others he will do the walking away business. So far he has always returned to the bowl fairly quickly and finished. In the past, this behavior seemed to be the first sign that his body wasn't feeling so good with the steroid dose and that the dose was too low for his body.

I was so upset about this, because even at the every other day dose, it is still higher than the physiologic dose recommended for his weight. It seems like very time we get close to trying to decrease the Dex to the dose my vet recommends (1/4 tab every other day), he starts not feeling well again. We have never been able to get it down to the recommended lower dose, so have not been able to evaluate whether the increased drinking and peeing are side effects from the Dex, or something else.

I know my vet is thinking more and more that it might be early kidney disease because the drinking and peeing have not decreased at all. We have an appt on Mon evening 1/14 for his Percorten injection, and my vet said she wants to see him then. Usually this is a tech appt so I am glad she will be checking him. I told her his tummy seems bigger, I imagine this is from the steroids. I worry so much about the long term effects of the steroid dose being higher than it should be, specifically the effects on his liver.

Also, for about the past couple of months or so, his nose has been kind of crusty. He has always had kind a of dry rough nose, but this is worse, and a couple of times there has even been a crack that looks sore. I have been putting pure vitamin e oil on it daily and that healed the cracks. It helps with the crustiness also, but it is still a problem. It also seems like he has some gunky stuff in his nostrils. I have been cleaning that carefully with moist q-tips, and started with saline drops in each nostril about a week ago. Unbelievable that he lets me do all of this, but so far so good. So I will have the vet check that too. I hope that isn't something else going on.

Any feedback or thoughts would be appreciated. Again, I feel guilty even talking about all of this with all that others are dealing with. And I need to somehow get perspective on things. I just care so much about everyone's babes, I can't help the sadness.

Thanks for listening, and as always, for the support.

Hugs,

Tina and Jasper

[Harley PoMMom]

My boy, Harley had a dry, crusty nose. I believe his high blood pressure attributed to his nose appearance. When we were able to get his high blood pressure under control, his nose cleared up.

Has Jasper's BP been checked?

[molly muffin]

Oh Tina {{HUGS}}.

It is hard sometimes to read things that are sad. This past week or so has had too many on here and we have all spent so much time in tears.

However, that being said, never feel bad about posting anything going on. We worry about you guys if we don't hear you know. :) Even in the midst of other things, you and Jasper are important to all of us.

Jasper, jasper, jasper. He really doesn't like those lowered doses does he.
My golden was on prednisone for years and I could never get her decreased to where she should have been.
I'm glad the vet is seeing him though and maybe can make some determination about how he is doing. You just never know with Jasper, he seems to react differently to every medicine than expected.
Do let us know what the vet says and I'm sure others will jump in with their comments too.

And don't be scarce! Sometimes when you feel down the best thing in the world is share it and get through it with friends. That is what we are all here for, to support each other. That means supporting you too!

hugs,
Sharlene and Molly Muffin

[frijole]

My Haley got a very crusty scabby nose to the point I had the vet check it out and I can't forget what he said it was but he gave her an ointment that I believe was an antibiotic but it has been years so I'm not sure.

Hang in there and know that we have all been thinking about you and worrying so when you don't feel like posting just write HI we are ok and we'll get the message. :D

Sending love and hugs,
Kim

[addy]

Oh Tina,
((((((((((((((((BIG HUGS))))))))))))))))))))))))

Sometimes a break is exactly what is needed so no worries, we dont want you to be in tears.

I hate the fact that I have to continue Zoe's metronidazole, I worry about her liver and the side effects but I cant seem to get her off that last little bit so sometimes we have to weigh the good with the bad.

I am really glad your vet is seeing him and hope there is some insight for his poor nose.

Just know we are always here for you and we understand. I know it is hard to read about all the pups and wonder if yours is next. You end up feeling all kinds of emotions.


(((((((((((((((((((((((((((MORE HUGS)))))))))))))))))))))))))))

[Boriss McCall]

Hi Tina,
I know what you mean.. It has been hard to see all the suffering. :(

I wish you didn't feel guilty. But, I do know what you are saying. I hate to post things about Boriss when I see so much sadness going on. But, everyone is here to help no matter how big or small you feel your problems are. We are all here to support each other in good times & bad.

I wish I could give you some feed back on what is happening with Jasper. But, since I have no experience with those things I can't give any advice.
I just wanted to pop in to let you know we care about you & Jasper & your worries big or small.

hugs

[addy]

We are all here to support each other in good times & bad.

Oh Amy, that is so true and think of the people who are afraid to post, not sure if they should, everyone needs to know yes, post, it is okay to give us good news, we need to honor those we have lost but also support those still in need and give them courage and support and hope. It is a fine balance to be found but we must try to find that balance.

I always worry about that. I know how I felt in the beginning. I worry that you all are afraid to share a good thing or ask a question, no matter what it may be. We need to hear good things too. Never forget that.:):):):)

[molly muffin]

We Love good thing! We worry when we don't hear. We support no matter what. I think that pretty much sums it up. :)

Sharlene and Molly Muffin (unofficial K9cushing cheerleader member)

[Tina]

Thank you all for the encouragement and support, and HUGE HUGS to you. Love you all so much, I don't know what I would do without all your kind words. To know that you all totally understand is such a relief. You guys get it more than my own family or friends.

Lori - Jasper has not had his blood pressure checked recently, I think the last time was maybe in October or November, and it was normal at that time. It was normal the only other time he had it checked also, that was around the time he was first diagnosed with Cushings, last summer. We have a vet appt tomorrow for his Percorten injection, do you think I should ask to have it checked?

As far as his nose, I have told my vet over the phone about it , so she is aware, however, I don't think she has seen it since I noticed the gunky stuff in his nostrils. I have told her about it, she recommended the saline drops. She also said a while back that I could put a little neosporin ointment on it if the vitamin e oil did not help the cracks. I have used it a couple of times, and he didn't seem to really lick it much, so that was good, but I prefer the vit e oil.

Amy, so are so right, we are all here to support each other no matter what is going on. I love it when I read that Boriss is doing well, and when anyone's pup is doing well for that matter. It gives a sense of hope.

I have always been an emotional girl, and the losses and other difficulties that others are facing recently have hit me hard. Also, the anniversary of the loss of my Angel lab Dakota is approaching, and I know that is weighing on me and makes me even more sensitive. I wrote a bit about her in Jill's thread about preparing to say goodbye to Casey. I still miss her so much and this time of year is always hard. So many times I have wished that I had a support group like this forum when she got sick. Losing her was the most horrible thing I have gone through in my life, and the feelings come rushing back so easily it seems.

Jasper doesn't have a stim test tomorrow, but he does have a vet appt and is getting an injection in a show of solidarity for Zoe, Boriss and Coco's stim tests! :D :D We are hoping for good results for all.

Love and hugs from me and Jasper

[addy]

Jasper doesn't have a stim test tomorrow, but he does have a vet appt and is getting an injection in a show of solidarity for Zoe, Boriss and Coco's stim tests! We are hoping for good results for all.

Thats my girl:D:D:D:D:D You are doing just fine and hey we love emotional, wear your heart on your sleeves kind of girls:D:D:D

[Harley PoMMom]

Lori - Jasper has not had his blood pressure checked recently, I think the last time was maybe in October or November, and it was normal at that time. It was normal the only other time he had it checked also, that was around the time he was first diagnosed with Cushings, last summer. We have a vet appt tomorrow for his Percorten injection, do you think I should ask to have it checked?



I believe I would ask to have it checked especially if your vet feels that Jasper might have early kidney disease. Elevated blood pressure is hard on a dog's kidneys.

[Tina]

Thanks Lori, I will ask to have his BP checked. The reason my vet is suspecting that he may have very early kidney disease is because his excessive drinking and peeing has continued throughout everything that he has been through. I think she is still on the fence that it may be side effects from the steroids - he is on Dexamethasone now - because we have never been able to get the dose low enough to see if that would resolve. The IMS that she consulted with mentioned that he could be showing very early kidney disease, before it shows up in any of the blood tests.

[Boriss McCall]

Tina,
I completely agree. I am here to help support & help carry the burden of those suffering. But, we need to hear the good stuff to for HOPE! ;)

Specially for the new comers. I was so terrified the first time I found this forum. It really made me feel good when I could read post from people who's dogs were responding to treatment & doing great.

Good luck tomorrow at the vets office. :)

[addy]

Good luck with your vet appointment today!!!

[labblab]

Tina, I wish you good luck, too!!!!

Also, I have been very touched reading about your sweet Dakota, and if you should ever wish to do so, please know that we would welcome a thread of her very own on our "In Loving Memory" forum. Our family embraces many beloved "honorary" Cushpups, and Dakota surely falls within that category! I know you are coming up on the anniversary of her passing, and it would be our privilege to read anything that you might care to write in these coming days.

Sending many hugs,
Marianne

[molly muffin]

Hey Tina,

How did it go with Jasper today? What did the vet have to say?
Hope it wasn't a bad day at work for you.

hugs,
Sharlene and Molly Muffin

[addy]

Me too, saying hi. Mondays at work YUCK;)

[Trish]

Hi Tina and Jasper

How did the jab go?? I can't help it but I get worried with our doggies vet visits and no report so I will be checking tomorrow for the good news. I am a glass half full kinda girl, but I read something that made me laugh.. whether your glass if half full, or half empty they both still need wine.. so that will help stop the worrying anyway :D:D:D (or something like that :) )

Trish and Flynn xx

[Tina]

Up to let Jasper out in this bitter cold and just wanted to do a quick post to say that the vet appt went pretty well. Don't want anyone worrying here. ;) We had a 7 pm appt and things were running late. By the time we got home and everyone was fed, I crashed out on the couch. I am so tired all the time with this wacky sleep schedule. And here I am up in the middle of the night posting. Lol. I will fill you all in tomorrow after I get home from work, mostly good news from the vet.

Sounds like everyone's stim tests were done and we are waiting on results. Keeping my fingers crossed for all. Trish, just read your post and I love the glass half full comment, so true! Thanks everyone for thinking about us and checking in. Back to bed we go. :)

Hugs,
Tina and Jasper

[Trish]

Oh no, sounds chilly, freezing in fact... I would be happy with a permanent spring or even autumn would be nice! Glad to hear all went pretty good today, will be checking in for the finer details tomorrow :) I am so bad the next day if I do not get a good sleep, so I will be going there soon too. Sweet dreams Tina and Jasper xxxxx

[molly muffin]

ohhh, good news from the vet! Can't wait to hear all about it!

Get some rest! Smiley, snuggling, good rest!

hugs,
Sharlene and Molly Muffin

[Boriss McCall]

yay for good news!

[addy]

Good news? Did I miss good news? Dang, I hate it when that happens

[molly muffin]

Haven't missed it yet, we're still waiting for Tina to tell us!!!

Anticipation builds! LOL

Sharlene and Molly Muffin

[Tina]

Lol you guys. Had to work late and then wanted to check real quick on everyone's stim results. It sounds like it was a good day for all! So happy to read everyone's numbers, I was thinking about it all day. :) Will read more in a bit.

Here's our update. Jasper got his Percorten injection, my vet decreased the dose by another 0.1 ml, so he got 0.6 ml. She is thinking we may be able to stop the injections, but doesn't want to do that yet until we are sure he is stable on the Dex. (Yes, I still have hope that it will happen :rolleyes: ). She feels he has atypical Addison's which is where only glucocorticoid (prednisone, dexamethasone, etc) support is needed due to lack of cortisol, and the mineralocorticoids are still produced by his adrenals, so his electrolytes are not affected for the most part. This is not a common type of Addison's, but it wouldn't surprise me - nothing about Jasper's journey so far has been common! We are going to keep the Dex dose at 1/4 tab daily for another week, and if he is doing well on all fronts, will try to go to 1/4 tab every other day. This is the dose that she wants him at for long term, we just have never been able to get it down there. So fingers crossed for that. She hopes that at this dose we would be most likely to see some decrease in the drinking and peeing.

She looked at his nose real good and took some swabs of the junk in his nostrils. She was not real concerned with any of it. She said his nose is extremely dry, not sure why, and the gunky stuff is apparently the usual stuff that gets in dog noses, but when the nose is normal and moist, it gets flushed away. She said to continue with the saline drops, vitamin e oil on the outside, and she recommends I run a humidifier during the day where he stays and in the bedroom at night. So that was good news. I asked about checking his BP, she looked at his last two, they were 148 and 150. She said that she was not concerned about high BP since he has Addison's now rather than Cushings.

Ok, now for the not so good part. His tummy is big because his liver is enlarged from the steroids. She said that was all she could feel when she checked his tummy, she didn't think anything else was abnormal. I know that steroids cause the liver to enlarge, and I am trying to not worry about that. She kind of acted like it wasn't a big deal, but that might be because she didn't want me to worry. I thought about it later and should have asked if it will continue to get bigger, and also if this will affect the functioning and cause damage, and if his enzymes will continue to go up now. Does anyone know about these things? I can't believe I didn't ask, I think I was on information overload by that time.

I asked about checking his urine again since it has been about 3 months or so since he had a bit of protein. We did get urine for a protein:creatinine ratio test like he had last time. Those results will be in tomorrow. I am praying my little heart out that it doesn't show more protein than last time. We talked a little about early kidney disease, I told her I am terrified of that. She said she was scared too. That makes me nervous. So that is another not so good thing. Trying to not worry about that too until we get the results tomorrow.

I will make a list of questions for her for tomorrow also. So - a couple of worries, but she said overall she thought he was doing well and looked good. She said we have come a long way, but still have a ways to go. Please keep him in your prayers that the urine test isn't worse than last time. Well, I've written another book, I suppose none of you are surprised. :rolleyes::rolleyes:

Hugs,
Tina and Jasper

[Trish]

Hi Tina

Good to hear his nose is OK and the Dex ok, be so good to get that down again!

I most certainly will have fingers crossed for good urine, stay away protein!! I am not sure about the liver, I am wondering if an ultrasound would give any further info? Maybe could add that to your list of questions!

Being a novel writer myself, it is good to read your post, it is not too long at all. Us enquiring minds like to hear all the in's and out's of it all :D:D

Hope i don't catch you two up in the middle of the night again!!

Trish xx

[Boriss McCall]

Morning Tina,

I will be thinking nothing but good thoughts today for Jasper's liver & kidneys. I know that is a scary thing.

I am not sure about the liver continuing to enlarge. I am sure someone with experience will come by with answers for that. I worry about Boriss & his liver too. Sometimes his feels large to me. I will probably have all the levels tested next month.

I am glad his nose is going to be okay. I had a bulldog in the past who always had a dry crusty nose. We just used the vitamin e oil to help the crusty stuff to go away. It didn't seem to bother him.

[molly muffin]

Yay on things in general being good and hopefully that no protein increase in the urine.
I did read that their can be a relation between the Percorten and urine/water consumption. So that is a possibility, and if that is, then maybe Dex too. So, don't panic yet on the kidneys.

Crossing fingers for todays results!

hugs,
Sharlene and Molly Muffin

[Tina]

Hi Everyone, thanks for all the good thoughts sent Jasper's way. I anxiously waited all day for my vet to call, but didn't hear from her. She usually calls me at work but sometimes will call after I am home right before the clinic closes. When I got home I saw there was a vm message from her and I was so relieved, I thought "the results must be good news, or she would have called me at work".

Well, unfortunately the news is not good. His protein:creatinine ratio has more than doubled from 3 months ago. Then it was 1.27, on 1/14 it was 3.57. She said this is a significant elevation and indicates that he is losing a lot more protein from his kidneys. She did not mention a reference range, so I called and had a tech check the report. She said it didn't list the reference range so will need to have my vet call to clarify that. I checked on line and it shows a couple of different reference values, depending on if the BUN is within normal limits. But values above 2.0 indicates there is medically significant protein loss through the kidneys even if the BUN is within normal limits. His BUN was not checked this time but it has always been normal.

She said she doesn't know if it is a primary kidney issue, associated with his medication, or a function of the Cushings or Addison's, but that we need to look into it. She didn't feel he needed his BP checked the other night, but now feels like it needs to be checked to make sure that hypertension isn't contributing to the value going up. I will take him in tomorrow after work to have a tech check it. I am worried about it being inaccurately high due to the stress of being at the vet. On Monday it was very busy and chaotic there, and he was very anxious.

She said she will be getting another consult with the one and only IMS we have in the state, fortunately he is in town. She has already consulted with him about Jasper once, and he was very helpful. She said she wants to talk to him to help determine the next step. She said she would be calling in a few days as soon as she gets the consult.

So we will get his BP checked tomorrow and then wait. I will need to wait till then to ask all my questions about his enlarged liver. I am trying really hard to not panic over this, but I am pretty upset. I turned the radio up loud, went into the bathroom, and had a 20 minute crying jag. I didn't want Jasper to see or hear me. Well, he was laying outside the closed door when I came out of course, and just looked up at me with the most innocent and wise look on his face, as if to say "I know Mama, I know". I had to fight so hard to not start bawling again, and just picked him up and held him tight.

You guys, I am trying with all my might to stay positive and not get discouraged, but I can't help but feel that he just can't get a break. I feel so weary and I am absolutely terrified of what all this liver and kidney stuff will mean for him.

My mind wanders back to when all of this first started. He was drinking and peeing alot, had an accident in the house, and all the testing started. He has been through the wringer with all the tests that arrived at the Cushings diagnosis, getting toxic on the Lysodren twice, the Addison's crisis, two hospitalizations, hemorrhagic gastroenteritis from all the stress, now the Addisons diagnosis, all of the ups and downs with trying to stabilize him on the steroids. Through all of this he is still drinking and peeing too much, except now his adrenals are fried from the Lysodren, he has to take steroids that are causing his liver to enlarge, and now the kidney stuff. I feel like I have done all of this to him, and if we would have just left everything alone, he would be better off. After all, I am adjusting to all the drinking and peeing. I am so upset I don't know what to feel. I know I have been doing what I thought was best for him at the time, but that is not helping me feel any better. I am sick with worry for him. He just innocently trusts, and doesn't deserve any of this.

Thanks for listening, and sorry if this seems like whining, I don't mean to. I am just feeling so down right now.

Hugs,
Tina and Jasper

[frijole]

Ah Tina, I'm reaching out with a huge hug for you both. I don't know what to say because I don't have any advice. I know your vet is on top of things and smart enough to seek help when it's needed so I'll pray that they come up with something to give you both relief.

Everything you have done for your baby has been out of love. Do not question yourself or your actions one little bit. I've been here 8 yrs and I have read your thread multiple times and I simply cannot explain what happened with Jasper while on the lysodren. I understand hindsight and all but just remember what you did was the right thing at the time and you have done nothing wrong whatsoever.

I wish I could wave a magic wand! Instead I send love and prayers. Kim

[molly muffin]

Oh sweetie of course you are. This is a perfectly normal reaction to constant worry and the up and downs that you have been through. You and Jasper have certainly been through more than most have.

However, you did do everything that you are suppose to do in these cases. You had symptoms, you tried to find out what was wrong. You did and then you followed a prescribed treatment plan. The same one that is recommended for all dogs, either lysodren or trilostane. Jasper just had a very instant sensitivity to the treatment. You couldn't know that.

It's great that your vet is consulting with the specialist and I certainly hope that there will be a path forward that won't be overly strenuous for Jasper.

We aim for stabilization and a good quality of life. Jasper has that and he can go on having that.

You are of course worried and I hope that some of the others who Way more knowledge about the urine protein issue will be by to give their opinion.

I though will give you a big hug and lend you a shoulder to cry on any time you want it.

hugs,
Sharlene and molly muffin

[Skye]

Tina and Jasper.......the not knowing.....ugh...it is horrible. You know when those times happen....where you just break...it is because of immense love....if your baby is near and you hold him tight think those words over and over and he will feel that through you and know where this emotion is coming from. And you focusing on those words will keep you focused as well. Dont stop saying them...not even for a second. over and over and over, otherwise the doubt (which is NOT our friend) creeps in and weakens your amazing strength. I know you love your baby so so so much. My heart hurts for you, what your experiencing right now wish i was actually there to just hold you!!!! And you got to let all that out.....its just not healthy to hold it in. Sending you love and hugs sweetheart. The answer will come and action plan will come into place. kiss on snout to jasper.

[Trish]

Hi Tina

We all know this stage is the worse, you find out something is wrong then and feel so awful but once you get to talk to the specialist and get a plan in place you know where you are working towards. So you are allowed a bit to feel upset right now, but back on the horse you go Tina!!

Flynn has an enlarged liver too, they see it on ultrasound and also during surgery. He also has protein in his urine. Both things I am going to followup up once he is recovered more, so they are kinda parked at the moment until he gets more strength back.

Take heart from the normal BUN and hopefully that is still where it is that. One day at a time, you have had good news this week too, so lets hold onto that until you can speak to specialist.

Still, we all know totally how you are feeling, it is so stink when you want everything to go good but we are here to help you through it!

Paw's up Tina and Jasper!!!!

Trish and Flynn xx

[addy]

Well, everyone else has said everything I want to say to you.:(:(

I know this is hard and you want to hide in the closet or under the covers and boy you and Jasper sure deserve a break. So I am here to tell you, go ahead and cry and scream and just release it all, have a total meltdown. Sometimes it is the best thing to do and then we start again.

I cant offer you medical advice only emotional support Tina but one thing I do know is you did nothing to Jasper. You are not responsible. Something was wrong and you tried to help him out of love and caring and things turned out differently but it is not your fault. Honey, sometimes life just is not fair and good people and good dogs get hurt and suffer.

Somehow, I am determined to drill into your head you have done nothing wrong so just watch out because I just might show up everyday to remind you of that;)

Now, go find a drawer and promise me you are going to scream all that guilt into the dang drawer, slam it shut and keep it shut for awhile.

We are always here for you and I totally know how scared you were waiting for that call. Yesterday by 2pm I felt like an overwound grandfather clock about to burst its springs.:eek::eek::eek:

Man, it was hard to pull it together when I finally got home but I did and you will to because Jasper is looking at your beautiful face and he is worried because mom is scared.


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

[Boriss McCall]

Oh no Tina.. I am so upset for you & Jasper. I totally understand It is so hard to stay positive. You have been on a roller coaster of emotions.

You are doing everything in your power to make things good for Jasper. You are the best mom he could ever have.

I will be saving a prayer for you & Jasper. I know the waiting part is going to be hard.

big hugs..

[Tina]

Kim, Sharlene, Trish, Skye, Addy, Amy, thank you all for the support, hugs and pep talks. Huge hugs to you all. I have spent the last day or so pulling myself up by the bootstraps. It has not been an easy task.

Jasper had his BP check on 1/16 pm. I decided to take him about 20 min early or so, so we could just quietly sit in an exam room for a while so he could be more relaxed when it was checked. The tech did 3 readings and said it was 150, which is the same as it was a few months ago. She said this is at the higher end of normal, they like it to be under 160. He seemed pretty calm so I feel this is accurate. His heart rate was 80, which she said was good also. So, it doesn't look like his BP is the cause for the increased protein in his urine. The tech spent quite a bit of time with us, she was as reassuring as she could be. She was very validating with all my concerns, nice to know I haven't been over reacting I guess. She said she knows it is hard, she was very knowledgeable with all the details of Jaspers case. I was kind of surprised because there a lot of techs at the office, and Jasper has seen many of them at different times since all of this started. Then she said Jasper is one of her favorites. That explains that. ;) She is one of my favorites also, very smart, calm and patient.

So my plan was to just wait until my vet contacted me with what she learned from the IMS consult. Yesterday at work, I started feeling kind of panicky about things, started worrying that we should have checked the urine sooner before the level got this high because if treatment is needed we could have started that sooner; worried that a urine culture wasn't done before the test, as I read that if an infection is present it can cause a falsely high reading in the protein:creatine ratio; and also worried that it had been a while since he had bloodwork done to check the kidney values, and maybe his BUN and creatine weren't normal anymore as they had been. ( Addy and Leslie, I am giving you a run for your money as the forum's worst worrier :p ).

So I left a message at the office for my vet, just wanted to run my questions by her so I didn't dwell on them all weekend. She called as I was leaving work, and answered/reassured me on all my concerns. She said it is a good thing that his BP was ok so we know it is not contributing to the problem, so we don't have to worry about treating that. She sent the consult off to the IMS, so thinks we might hear back as early as Monday. She also answered my questions about the enlarged liver, the main one being if it is being damaged due to the enlargement. She said no, that the function is not affected, however the ALP could continue to increase due to the steroids. I asked her about Denamarin, she said she thought that might be a good idea, so we are going to talk about that also after we get the kidney stuff figured out.

We discussed quite a bit, she was very supportive on all fronts, said she totally understood how frustrating this has all been, and said that she feels frustrated too. I told her I am more scared than frustrated. She said Jasper's "multi-dimensional presentation and issues" has been one of her biggest challenges since she started practicing. I thought "well, that's my Boy". :rolleyes:

Trish, thanks for mentioning that Flynn has an enlarged liver and protein in his urine. It is reassuring to see how well he is doing even though he has those issue also. I had been telling Jasper all about his surgery and all that he went through day by day so Jasper could help keep Flynn in our prayers. He is Jasper's role model. And I totally admire how positive you have been throughout, I am going to try to make you my role model! :D

So that is where we are at. I am still pretty scared, but don't feel that panic in my gut right now. I'll take that. Thanks again for all the kind words.

Love and hugs,

Tina and "multi-dimensional" Jasper :)

[Squirt's Mom]

Hi Tina,


( Addy and Leslie, I am giving you a run for your money as the forum's worst worrier :p).

Don't know about Addy, but I guard my throne as the Queen of Worry most jealously! :p:D Beside, you have a loooong way to go before you are in the running with this batty old broad! ;):p You do remember the boob story? ;)

You are doing a great job, Mom. I know it's hard to keep a level head (HA! look who's talking!) but you seem to be on top of things like a pro. It sounds like you have a great vet as well and that has to help you feel better. Let us know what the IMS has to say when you learn, and know you and Jasper have a whole host of folk behind you pulling those bootstraps with you.

Hugs,
Leslie and the gang

[Tina]

Thanks Leslie! It is so hard to keep a level head, I was glad to hear the tech didn't think I was over reacting at all. And please, no worries about your throne, I have no intent of taking it over!! I just hope I don't legitimately earn it one day!! :eek:

You know, I am not sure I know about the boob story, is it in Squirt's thread? Let me know and I will go read it. And by the way, I love your latest avatar pic, so cute. :)

Hugs,
Tina and Jasper

[Squirt's Mom]

To save you a read through the morass :D, here is a link -

http://www.k9cushings.com/forum/showthread.php?p=55225&highlight=boobies#post55225

[Tina]

Oh Leslie, LMAO! I am literally laughing out loud and both dogs are on alert looking at me like I am crazy. That is so funny, so glad Squirt was ok. That occurred before I joined the forum, so that explains why I didn't know about it. Thanks, I needed a laugh like that. :D :D :D

[molly muffin]

OMG Leslie, I didn't know that story either!! I'm with Tina now just cracking up laughing out loud!!

Tina, You are doing so good! We all Try to stay on top of things and cover all our basis, but "multi-dimensional" Jasper has really taught you well. I think it's awesome that you have such a good vet that will work with you no matter where the road leads.!!

Boots are looking Just fine!

Hugs,
Sharlene and Molly Muffin

[addy]

Well, so far I cant top the boob story so Leslie still has her throne:D:D:D

Tina, we love you and Jasper dearly and we are here for you in good times and bad. We are here to support you and Jasper anyway we can.
Gosh, how many times have I logged on crying because I was having a total meltdown thinking I was responsible for Zoe having Cushings?:o

When you are a caregiver to someone you love dearly and who is ill, dang it is really easy to get overwhelmed and down. Which is why God gave us Chocovino, bubble baths and ITunes:D:D:D:D:D And this forum, except that was given to us by some pretty amazing people, not really God:D:D:D:D:D

It sounds like you are in good hands and your vet and staff are on top of things and even better sympathetic and kind. That is a hard to beat combo;)


((((((((((((((((((((((((((((((((((((HUGS)))))))))) ))))))))))))))))))))))))))

[Tina]

Big ((((((HUGS)))))) Addy, Sharlene and Leslie. Yes, I am so fortunate to have such a wonderful vet. We are truly blessed.

On Friday evening when we were talking over all that is going on with Jasper, and the reasons she is consulting again with the IMS, she mentioned that a couple of times she has thought to just refer me and Jasper there. She said he is a very good Dr, but she has found that sometimes he isn't always great with follow up. She said "and I know you need that".

She went on to say that she knows I need detailed explanations and to be involved at all levels, and said she was concerned about a potential lack of that with the IMS. She also mentioned the expense, which I appreciated. However, I made sure that if she felt that was what Jasper truly needed that she would send us there. She said yes, of course, and she did mention that there are some tests that they can do there that can't be done at her office. I just wanted to make sure that she knew that what is most important to me is that we do what is the absolute best for Jasper, and that I would figure out the money somehow.

Hugs,
Tina and Jasper

[milosmom]

just popping in tina to let you know that i am keeping an eye on your updates.sending love,light,peace and xoxox patty(milo)meka

[Tina]

Also, I have been very touched reading about your sweet Dakota, and if you should ever wish to do so, please know that we would welcome a thread of her very own on our "In Loving Memory" forum. Our family embraces many beloved "honorary" Cushpups, and Dakota surely falls within that category! I know you are coming up on the anniversary of her passing, and it would be our privilege to read anything that you might care to write in these coming days.

Sending many hugs,
Marianne

Marianne, I have been a bit involved with Jasper's ongoing issues, but I keep meaning to thank you so much for your post about my precious Angel Baby Dakota. I will certainly think about starting a thread for her as you mentioned. The upcoming anniversary is so difficult every year, maybe that would be just the thing to help me deal with it better, and more importantly to honor her and her memory. I am teary just thinking about it. I miss her so. She always hated being left home alone, and I think she would be overjoyed to be included in this wonderful family as an "honorary" member. Thank you for your kindness Marianne.

Love and hugs,
Tina

[Tina]

Ok, today is a week since the vet said to give Dex 1/4 tab daily for a week and then try to decrease to every other day if he was doing ok on all fronts. I skipped his dose this morning, so today is the first day of the every other day dosing. This is the first time we have been able to try every other day at the lower 1/4 tab dose. (Yay!)

He ate his dinner ok. He has seemed pretty subdued and not too peppy all evening. Not much spring in his step. He seems like maybe he doesn't feel the best, and of course I wonder if that is due to no Dex today. But no severe signs. I am hoping that maybe it will just take a period of time for his body to adjust to the lower dose. I just let him out and we are off to bed. (Had a little snooze on the couch, that's why it's so late :rolleyes: ). I wanted to wait all evening to see how he did before I posted. So we will see how his eating is for breakfast in the morning, usually decreased appetite or trying to not eat is the first sign of trouble. He will get his Dex after breakfast. No word from my vet regarding the IMS consult yet, but i wasn't really expecting to hear today. Nite. :)

Hugs,
Tina and Jasper

[Trish]

Ohhh good luck Jasper!! Hope all goes well tomorrow, I guess it will take a little while for him to get used to lower dose. Hope he perks up again tomorrow Tina. I know you have your eagle Mummy eye on him :D:D Now you behave yourself Jasper and eat all your brekky in the morning!

Trish and Flynn xx

[Squirt's Mom]

Hi Tina,

How is Jasper this morning? I hope the decrease works just fine for him this time. Let us hear from you when you can.

Hugs,
Leslie and the gang

[addy]

Hoping Jasper perked up a bit

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

[molly muffin]

Hey Tina :) How did Jasper do with the every other day dosage?

hugs,
Sharlene and Molly Muffin

[Boriss McCall]

Can't wait to hear how Jasper is doing. HOpe today is a good day!

[Tina]

Hi Everyone, thanks so much for all the good wishes!

Jasper has continue to eat fine so far. He got his Dex yesterday morning. He has perked up some, but still seems a bit subdued to me. Last night he rough housed with Shelby for a while, but then for the rest of the evening, seemed pretty tuckered out. Hard to tell if it is decreased energy overall, or if he was just tired for some reason. Seems kind of tired this morning also. So today is a skip day, no Dex. Will see how he does.

I was home Monday to monitor him on the first skip day, but I have to work today. Hopefully it will all be ok. I am just a little nervous because this is the first time we have tried the every other day thing with the lower Dex dose, and I do worry about the off days. Also hoping to maybe hear from my vet today regarding the IMS consult.

Gotta head to work, have a good day all!

Hugs,
Tina and Jasper :)

[molly muffin]

Hope everything goes good with his off day today.
Any word on the consult today?

hugs,
Sharlene and Molly Muffin

[Tina]

My vet talked to the IMS, she called this evening to discuss his comments and recommendations. The news is not wonderful. After reviewing all the latest information on Jasper, he feels the next step is to check his renal function as he thinks it is a primary kidney issue due to the protein loss. I don't want to forget to mention that my vet asked him about Diabetes Insipidus, and he said he didn't think it was likely because there is not usually protein loss with DI. She asked about a trial of the Desmopressin drops to be sure, and he said that it could actually make things worse if the kidneys aren't happy. So I guess I am glad we didn't try that a while back.

The immediate plan is to recheck his kidney values and blood protein level with a chem panel, and to get a sterile urine specimen for culture to make sure there isn't a UTI going on. I will take him in after work tomorrow to get that done. The blood results should be back Friday, and urine culture back Saturday.

If the kidney values are still normal (BUN and creatinine have been normal on previous checks, last one in October), then there is another blood test specific to kidney function that the IMS is recommending, it is called an iohexol clearance test. It can apparently check for early kidney disease before the usual abnormalities show up in the blood.

I will post more tomorrow about all that she said, I am pretty wiped out right now from researching stuff on line and worrying. Again, I am trying to not panic, but I am very scared and can't seem to stop crying. I am just praying that the disease is in a very early stage so that we have a good chance that the progression can be stopped with treatment. I am not sure what else to think right now, just scared to death for my baby. :( Please keep him in your prayers.

If anyone here knows anything about this test, or kidney disease, I would welcome the information. Thanks.

Tina and Jasper

[Trish]

Hi Tina

Well I am glad your IMS rung back to get this process underway! Jasper is such a trooper with all these tests, just like Flynny... they keep on going and we keep on worrying, thank goodness they don't know about all the stress their problems cause us. It is so not fair, but I am still very hopeful this is early stages and we all know they can do such wonderful things for our furry friends :) Sitting here with you in support tonight Tina, so if you have to get up to let Jasper out and want to vent come find me. I am sitting up watching the Aussie Open tennis and one of my favourite players is coming up soon! In between that, I am writing my letter to the IMS about Flynn :rolleyes:
Trish xxxxxxxxxxxxxxxxxxxxxxxxx

[Tina]

Thanks so much for your post Trish. I have been up for a bit to let Jasper out and also to do a little research on kidney diets. I took him in for his chem panel, and the sterile urine for culture, and my vet had a couple of sample bags of prescription kidney diets to send home with us. One is Hills k/d, the other is labeled CNM K-9 NF, which I think is a Purina product, not sure. She said to do some trials to see if he likes one more than the other, and the plan is to switch him over to a prescription kidney diet, which I guess makes sense. He has been doing so well on the Hills low fat i/d diet, I hate to mess with that, but I guess we must. :rolleyes:

We should have the chem panel results back sometime today. Like you said, I am hopeful that it is early stages so we will have good treatment options. But I am still quite scared. Well, back to bed we go, not that I am getting much sleep. I am exhausted, but my mind won't let me rest. I will post the lab results when we get them.

Again, if anyone has any input, I would appreciate it.

Tina and Jasper

[Trish]

Hi Tina
We are googling the same thing at the same time! Flynn still has proteinuria 3+ on dipstick, so I have to take in another sample to check the protein:creatinine ratio. His has been high for a year, but normal blood creatinine and BUN and that was done a month back. So we will be waiting for that urine result next week. Get some sleep Tina, I have been reading up on kidney stuff after reading about Jasper, time to take it a bit more seriously I think!
Trish xxxxx

[Tina]

Hi Trish, just posted on Flynn's thread. Yes, it looks like we were googling things at the same time. ;) I have done quite a bit of internet research in the past couple of days about kidney disease, it is quite overwhelming.

Ok everyone, I got the results of Jasper's chem panel, and the BUN and creatinine were in the normal range, which is great news! This is so scary to me, but my vet told me that the kidney has to have lost 2/3 of it's function before those values will show abnormalities. 2/3??!! Has anyone else ever heard that? I guess I don't understand why there aren't tests that would detect problems sooner. I need to add that to my list of questions for her on our next call.

Here are the chem panel results, drawn on 1/24/13:

Glucose 90 (70-12) mg/dL
Urea Nitrogen Serum 12 (10-28) mg/dL
Creatinine Serum 0.69 (0.50-1.50) mg/dL
BUN/Creat Ratio 17 (no reference range given)
Bilirubin Total 0.1 (<0.6) mg/dL
Bilirubin Direct 0.0 (<0.3) mg/dL
Bilirubin Indirect 0.1 (no reference range given) mg/dL
ALT 133 *H (<100) IU/L
Alk Phos 2782 *H (<95) IU/L
AST 17 (<65) IU/L
Cholesterol 283 *H (125-260) mg/dL
Triglycerides 154 *H (41-115) mg/dL
Calcium 10.9 (8.3-12.0) mg/dL
Phosphorus 4.5 (2.8-5.7) mg/dL
Sodium 149 (138-154) nmol/L
Potassium 4.8 (3.7-5.8) nmol/L
Chloride 106 (104-118) nmol/L
Protein Serum 6.8 (5.4-7.5) g/dL
Albumin 3.4 (2.5-3.9) g/dL
Globulin 3.4 (no reference range given) g/dL
Osmolality Calculated 295 (280-310) mOsm/Kg


I was happy to see that the electrolytes were all in the normal range from the cushings/addison's perspective! The Alk Phos has increased significantly since the last time I could find a result, it was 1869 on 10/22/12. The ALT is now elevated and it has always been in the normal range before. When my vet phoned the results, she mentioned that the liver enzymes were up due to the steroids. I will ask further about it now that I have the specific results. His triglycerides have been elevated in the past, it is a bit lower than the last time, maybe due to the low fat i/d diet, however the cholesterol is now elevated. Overall, I think these are good results considering everything. Any feedback on the lab results would be appreciated!

My vet was pleased that the BUN and creatinine were within the normal range, but said that he has protein losing kidney disease. I think she called it Protein Losing Nephropathy. I need to clarify that this is the diagnosis for sure. I was on information overload so forgot to ask a few things. She said it was caused from the Cushings.

The plan for treatment is to change him over to a kidney diet, Hills prescription k/d, I started the slow transition last evening. In a few days after we see that he is tolerating the food, she will start him on either enapranil or benzapril. These are both cardiac/BP meds but are used for kidney disease also. I did some reading, but need to research further. My vet said his kidney values have to be rechecked 5-7 days after starting the med because sometimes the med itself can cause the kidneys to be unhappy. But she said it is necessary to slow the progression of the disease in the long run. So I am a bit worried about that, as I did read that the meds can cause kidney problems/damage themselves. Yikes! :eek:

I am guessing from the lack of previous responses from the wonderful experts around here, that nobody has much experience with any kidney issues. PLEASE HELP if you do!!!

I searched for a Kidney Disease forum like this one, all I found was a yahoo group called K9Kidneys. I did register for it, but within minutes I had about 20 automated emails with instructions etc. I checked it out a little but it is not set up like this forum. I have not posted anything there yet, I am not real sure how to do it. It seems a bit confusing how it is set up. Has anyone here ever belonged to a yahoo group? How do you enter posts, is it by emailing?? Well, that might have to wait, I am feeling quite overwhelmed and not sure I have the energy to tackle figuring that out at the moment. And I am scared. Of course some of the things I read on the internet paint a pretty dismal picture, but I am trying to not think about that right now.

Thanks for reading all of this and for any help/advice anyone can provide.

Hugs,
Tina and Jasper

[Harley PoMMom]

Hi Tina,

My boy, Harley, had kidney disease. It is true that it is not noticeable on the blood panel until at least 50%-75% of kidney function has been lost.

Has Jasper had an UPC done?

The Yahoo K9kidney forum is a great site, which I did belong to, the members there have a wealth of knowledge about canine kidney disease so I do urge you to join there. You do post to that site through your own e-mail account.

Two of the supplements that I gave to Harley for his kidney issue were CoQ10 and wild salmon oil. Harley was on enalapril and benazepril and these may elevate the creatinine and BUN but these values should level out.

It is also a good idea to give something to help coat the stomach lining such as Pepcid AC or slippery elm bark. Both of these aid to eliminate ulcers which are prone in dogs with kidney disease. These products can make the absorption of some meds/vits/supplements more difficult which is why it is recommended not giving any of these for at least 1 hour before or 2 hours after giving the Pepcid AC or SEB.

Along with the creatinine and BUN, the phosphorus and potassium levels need to be watched for elevations. If phosphorus levels begin to climb then a binder is needed.

Feeding a moderate-protein diet is now what is recommended, here is a site with info about diet: http://dogaware.com/health/kidneyprotein.html

If I can be of help in any way, please do let me know.

Love and hugs,
Lori

[addy]

Hi Tina,

I am sure someone will be along to read through your labs:D;)

I know Lori will be more than happy to answer any of your questions, as she offered, so take her up on it, okay?

I belong to a Yahoo group for Zoe's IBD. I am not on it much anymore, no time, but if I remember right you have the choice of getting posts from your group (updates) via email or just logging in to the group so I could ask a question either just being logged in to the group via email or via from the updates I received via my email. It depends on how much you want to read via emails. I eventually changed my setting to not getting updates via email, I could not keep up.

We adjust and learn with each new challenge we face. I know you are on info overload so I'm sending you a ((((((((((((((((hug))))))))))). Sorry I cant be of more help today, have had a horrible headache since last night.:( I have not yet heard of Protein Losing Nephropathy so I'll learn about it with you:)

[Squirt's Mom]

Hi Tina,

Yahoo! groups are a bit of a hassle in my book. ;) You can, like Addy said, reply either from the digest in your email or by signing into the group. If you are signed in and reading a post, you will see a blue "reply" button in the upper RH corner of the text box. From there it's much like any other forum to send/submit. Your post may be immediately visible or it may take a bit to hit the board, it depends on how the group is set up.

The thing I really, really dislike about Yahoo! groups is that you can't keep info in one place like the threads in this type format. Each post on Yahoo! just sorta hangs there and to read the "conversation" you have to click each reply that is under the original post. I get lost as to which ones I've read and haven't! :D The email digests come across looking more like this format but the board is not at all.

There are some good groups on Yahoo!, tho, so don't give up. The kidney group is supposed to be a great one. ;)
Hugs,
Leslie and the gang

PS. Wish I could help with the labs but alas, no....

[molly muffin]

Tina! Hugs.

I know this is extra scary on top of everything else that you have gone through with Jasper and continue to deal with. I do think you have a good vet who is very caring and patient. It's great to have a vet that will work with you.

I wish I could tell you all about Kidney Disease and alleviate your worries. Alas I don't know and have no experience with anything other than crystals.

I will google for you though till the cows come home as they say. :)

This is one paper I found on Protein Losing Nephropathy.
http://www.vimpva.com/articles/Protein-Losing%20Nephropathy%20in%20Dogs.pdf

hugs,
Sharlene and Molly Muffin

[Tina]

Thanks so much for the replies everyone.

Lori - thank you for all of your information, and the offer to help. I can't tell you how appreciative I am. I'm sure I will have some questions, I just can't get it together right now. My head is spinning with all the reading I have done today, and I can't seem to really focus very well. But I wanted to answer your question about whether Jasper had a UPC done. Is this a urine protein:creatinine ratio? If so, yes, he has had this test done twice. I had posted them a while back. The results are as follows:

10/22/12:

Protein, Random Urine 138.9 mg/dL (no reference range given)
Creatinine, Random Urine 110 mg/dL (no reference range given)
Protein/Creat Ratio 1.27 (no reference range given)

1/14/13:

Protein, Random Urine 73.3 mg/dL (no reference range given)
Creatinine, Random Urine 21 mg/dL (no reference range given)
Protein/Creat Ratio 3.57 (no reference range given)

The increase in the ratio from 1/14 is what made my vet say that we needed to start treatment now, she said it was a pretty significant elevation in that value and indicated that he is losing a lot more protein from his kidneys.

I went to the site you gave and read all the diet information. I am a bit anxious about that now, because the Hills k/d is the food my vet has me switching Jasper over to. She also mentioned Purina and Royal Canin kidney diets as possibilities also. She said she didn't have a preference. I brought a sample of the k/d home to see if he liked it. It seemed ok so figured we would go with that. Should I ask my vet about it? I don't know what else she would prescribe. The k/d does have a bit higher protein content than the Purina. I couldn't access the nutritional info on the Royal Canin website.

As far as the yahoo group, I did join and complete my registration. I am going to need to tackle that another time, they have a lot of questions and lab results that they request for the first post. And I need to figure out how their site works when I am not so over loaded. I am glad to know it is a good site to join.

Thank you again for the help.

Hugs,
Tina and Jasper

[Tina]

You guys, thanks for the hugs. I sure need them. Sharlene, I am so scared I can't think straight. I calm down for a while and for a short time feel that it will be alright, but then the fear creeps back in. I haven't gotten anything done the whole weekend except research all of this stuff. I can't stop, I just feel so anxious.

Now it is almost time to face another work week and I don't even have laundry done. And the next 2 weeks are going to be tough at my job, someone is on vacation. I have to figure out how to function somehow. I am starting to second guess my vet after reading all the kidney diet info at that link that Lori provided. My friend keeps telling me to take things one day at a time. I know she is right, but I am not able to do that very well right now. I know you all understand, and I am so thankful that I can vent here. I have a headache from crying so much and I want this sick feeling in my stomach to go away. I feel like kind of a wreck.

[molly muffin]

It's okay, of course you can't concentrate on anything else other than this at the moment. Remember when cushings came up the first time? And then Lysodren, then the crisis, etc, etc, etc. You handled all of that so well, really proud of you.

However, YOU have to learn as much as you can before you start to take it in and feel calm, so finding out what you need to know is your way of coping. Once you have a better handle on it, things will seem more manageable. Your friend is right too, one day at a time and right now, this time, is that you need to step back away from the reading for a bit. You are starting to overwhelm yourself it sounds like and that doesn't let you fully just digest the information. So, calm, step back, do the laundry, do anything else, but try to just not look up new info till you can really wrap your mind around what you have already read.

Just deep breathes. Think calmly, make your notes to talk to vet and go from there.
Big Hugs,
Sharlene and Molly muffin

[Tina]

You are starting to overwhelm yourself it sounds like and that doesn't let you fully just digest the information.

You are so right Sharlene, as usual!! ;) I have actually stopped researching and reading as of a couple of hours ago. I am wiped out. Now I need to stop ruminating over everything!! :eek:

How was your weekend? I hope you had some fun for the both of us!

Love and hugs from me and Jasper

[frijole]

I feel useless because I really don't know anything about kidneys. :( I can tell you however that I have found that nutrition is not something that is focused on at vet school and that the stuff they sell is a revenue stream so they tend to push it. I know you will question your vet and you have the relationship to do it without offending if need be.

Sending strength and love. Kim

[molly muffin]

Good Tina. I'm glad to hear that you are giving yourself a break. That is essential. I bet I spent days and days reading about cushings when I first heard it in relation to Molly. It consumes you until you can figure it out. I totally get that. :)

The weekend, whew. It was good, it was fun, I didn't get to bed till 4am and then awake at 7:30. It was a work function, a big one and wow, I am so not the girl I was in my 20s that could do that and then keep going the next day!!!!! I tried though :D:D Poor husband, was not feeling 100% and he just gave up on trying to keep up with me at one point, only to find his energy later. (text to me at 3am, "I'm in our room, where are you?" My reply "Room xxx, after party party, come on up, gangs all here") I thought he was going to die but he came up and it was another hour before got back to our room finally and bed. Now..I am going to just curl up and become a vegetable till I can go get Molly and cross fingers that we don't get that nasty freezing rain they are calling for!

Only thing I am doing is checking on here tonight. :)

You hang in there and try to get some good sleep tonight!!

HUGGERS Tina, Belly rubs Jasper!
Sharlene and Molly Muffin

[Tina]

Oh Kim, don't ever feel useless. You have been and are so much help and support to me and Jasper. And I know what you mean about the vets selling Hills. My vet has never really pushed it until Jasper needed prescription diet. When she prescribed the i/d, I questioned her about it because I didn't like the ingredients as Jasper had been eating Blue Buffalo. She said she really didn't like Hills, but that she really believed in the science behind their prescription diets and highly recommended them.

A couple of other times I mentioned not liking the ingredients, but had to shut up because Jasper really did much better after we switched him to the low fat i/d, and he tolerated it well. I hate to have to switch him again, but hopefully it will go well with the k/d. I will probably ask her a bit about what I read, but feel I need to be careful since she has already said at least twice that that she feels strongly about the prescription diets.

Sharlene - glad you had a fun weekend. I know what you mean, this old gal ain't what she used to be either, lol!! I love the text from your husband at 3 am, too funny. I hope you don't get that freezing rain either. We lucked out here, it stayed just above freezing here all day so we just got rain and fog. The freezing stuff went just north and east, so we were very lucky. I hope you can get Molly tomorrow as planned, I am sure she misses her Mommy.

Hugs, and Jasper says thank you for the belly rubs. :p

Tina and Jasper

[Harley PoMMom]

But I wanted to answer your question about whether Jasper had a UPC done. Is this a urine protein:creatinine ratio? If so, yes, he has had this test done twice. I had posted them a while back. The results are as follows:

10/22/12:

Protein, Random Urine 138.9 mg/dL (no reference range given)
Creatinine, Random Urine 110 mg/dL (no reference range given)
Protein/Creat Ratio 1.27 (no reference range given)

1/14/13:

Protein, Random Urine 73.3 mg/dL (no reference range given)
Creatinine, Random Urine 21 mg/dL (no reference range given)
Protein/Creat Ratio 3.57 (no reference range given)

The increase in the ratio from 1/14 is what made my vet say that we needed to start treatment now, she said it was a pretty significant elevation in that value and indicated that he is losing a lot more protein from his kidneys.

The usual reference range for the UPC is =<5, so I understand your vets concern. My non-cush dog, Bear, has Protein-Losing Nephropathy (PLN) and is on enalapril. The enalapril has really worked well for him as there has been no protein loss since being on this medicine.



I went to the site you gave and read all the diet information. I am a bit anxious about that now, because the Hills k/d is the food my vet has me switching Jasper over to. She also mentioned Purina and Royal Canin kidney diets as possibilities also. She said she didn't have a preference. I brought a sample of the k/d home to see if he liked it. It seemed ok so figured we would go with that. Should I ask my vet about it? I don't know what else she would prescribe. The k/d does have a bit higher protein content than the Purina. I couldn't access the nutritional info on the Royal Canin website.

My vet also suggested the Hill k/d but since Bear is doing well on his current dog food, I declined. I believe one has to feed their dog a food that the dog does well on and that the dog will eat, so if Jasper eats the Hill k/d and does well on it then I truly think this is the right thing to feed him.



As far as the yahoo group, I did join and complete my registration. I am going to need to tackle that another time, they have a lot of questions and lab results that they request for the first post. And I need to figure out how their site works when I am not so over loaded. I am glad to know it is a good site to join.

Thank you again for the help.

Hugs,
Tina and Jasper

The main reason that I joined the Yahoo group was to have access to their files. They have a wealth of information concerning canine kidney disease and I have learned a lot from reading their files.

Anything I can do to help, please do not hesitate to ask, ok?

Love and hugs,
Lori

[Trish]

HI Tina

It is so not fair we have to be worried about kidney problems after all our babies have been through. I am so glad our boy's do not realise the stress they cause their Mum's! Although I am very heartened to read that many dog's do very well once they get on treatment, so remember that when doing the googling!! Sometimes it pays to step away from the computer. I swear I would not have gone ahead with Flynn's surgery if I had relied on all the doom and gloom I read online about adrenalectomy.

Flynn's kidney test is also still high, UPCR 1.5, (meant to be less than 0.5) on Saturday but I was relieved to see only very slight rise from November last year. When I spoke to vet tonight, he said he does not need any treatment until >2.0 but he is going to speak to IMS to confirm this recommendation. I am thinking maybe he should go on something now to prevent it getting worse but will wait and hear the IMS thoughts on this.

I am glad to hear Jasper is going to start something to get it under control and lower your stress levels too :) When is he starting, or did I miss that bit? Flynn took the Benzapril for a bit for his surgery before swapping to phenoxybenzamine, it was only for a week or so but he tolerated it well.

I keep waiting to see if your wee green light comes on as it does sometimes at this time of night when your up to let Jasper out, I was going to tell you my new Motto... "Keep Calm and Carry on" haha I think we could both do with doing that, not that I am any good at it either :):)

Monday was busy as heck here, but one day closer to the weekend :D your work sounds like it is going to take a lot of your energy this week, so try and get enough rest and look after yourself Missy!!

Thoughts are most definitely with you, we will get though this!!

Trish xxxxxxxxxxxxxxxx

[addy]

Im up early sending more hugs because it is important to start your Monday with a hug;););););):D:D:D Info overload can be a not so great state of mind and the vets no nothing about nutrition use to push the prescription diets. For now if Jasper eats the food, maybe leave it as is and deal with the food a bit later. Otherwise you'll be overwhelmed with finding a different food now too.

Baby steps, sweetie, we are holding your hand.

[molly muffin]

Yay, how about late evening HUGS!! LOL I missed the morning huggies. :)

Yep, awful weather here this morning, but never fear, hubby pulled out the big 4x4 and off through slush, snow and frozen rain we went to get our muffin.
She is just happy as can be to be at home. Didn't seem to miss us so much this time and I think one difference is the new play time they have there. She seemed to really enjoy it, or so I was told. LOL

How are things going today?

hugs,
Sharlene and Molly Muffin (back in the saddle again)

[Trish]

How is Jasper and his Mom doing? Hope you got some sleep last night and work wasn't too crazy for you today, plus did you find some clean clothes to wear?? :D:D:D

Thinking of you Tina and hope your feeling a bit calmer about your baby :)
Trish xxxxxxxxxxxx

[Tina]

Thanks for the hugs guys, keep 'em coming! :) Just a quick post since I am up to let Jasper out. Had to work a bit late, and gave the research a rest. The overwhelming feelings of worry come and go. I think I am just overloaded, so really am trying to give it a rest. I have continued to transition him to the Hills k/d diet, he is now on 50/50, so will continue with that for a couple days before advancing it more. Addy, I agree, I am just going to get him transitioned to the kidney diet for now, hope he continues to eat and tolerate it, and worry about that piece later.

Sharlene, glad you got Molly home safely. We had horrible fog here all day and night, and freezing fog in places, but for the most part our temps stayed above freezing. The drive home was a bit dicey, literally couldn't see more than about a car length in front of me, pretty scary.

Yes Trish, I found some clean clothes, Lol!! I did just enough laundry to get by for a couple of days, so will be in trouble again after tomorrow! :rolleyes:

Holy cow, now it is almost 4 am here, better try to get a bit more sleep! I will check in after work. Thanks for the kind words and support, it means a lot.

Tina and Jasper

[Trish]

Awww I was hoping to see you on tonight, glad Jasper likes the food so far. Flynn never used to eat his biscuits on their own, I used to have to put some wet food on it to make it more palatable for him. But he seems to like these new ones so thats good. Also happy you are giving the researching a rest for a bit. I know knowledge is power, but we also have to take time to chill out and just be happy with our babies in the here and now and keep our worrying minds off what the future may bring because who knows really!! Those numbers they quote in the studies are just that, numbers, we have the warm furry friends in our lives and there are many many stories on this board alone of dogs who have beaten the odds and ours are going to join them Tina :D:D:D

Crikey, those weather and driving conditions sound dicey, be safe girls!! So now if I do not hear from you I will worry you have skidded off the road into a ditch or something :eek::eek::eek: See you at the next 4am pitstop :D

Trish xxxxxxxxxxxxxxx

[molly muffin]

It is so funny. I wake up and come on here and wonder what you two have been up to in the middle of the night. You just would not believe the big smile it puts on my face to read you two chattering away at 4am!!!! :D:D

Crimey, horrid fog here to last night and this morning. Hope it clears up some before I have to head to the office. It's wet out there with the snow at that should I freeze or melt stage, so you don't know if you are stepping on wet or ice. I no likeee.
At least it isn't a cyclone!!

Have a great day. No ditch jaunts!

hugs,
Sharlene

[SoggyDoggy]

Or sea foam! Check these two out!
http://www.youtube.com/watch?v=8HyZzpnAZ7c and http://www.youtube.com/watch?v=quw64ULTohk

This is all foam kicked up by the sea during the storms in Queensland over the last couple of days.

But on a more serious note, Tina, do take some time out from the worry and enjoy some cuddles with Jasper. No point in worrying yourself sick with too much research, I've come to realise that with so many things in life, you only ever hear about what's gone wrong, rarely the successes as we are usually too busy enjoying them to post about it. So give yourself a break, grab a blankie and snuggle on the sofa for a while. :D

[molly muffin]

Wow Naomi!! You guys have to watch those videos! That car! Holy cow, I had to replay it like 3 times, just came out of no where.

Naomi is right, enjoy some snuggle time! Makes the world seem all better. :)

hugs,
Sharlene

[addy]

I saw the sea foam video, wow!!!!!!!!!!!!!!!!

You guys are having crazy weather!!!!:D:D:D:D

[SoggyDoggy]

Not on the west coast, here it is just hot (93 today, but 100 again by weekend - Fahrenheit that is) and with bush fires. All the wild weather at the moment is in Queensland and New South Wales, I'm beginning to think I would never live on the east coast! The worst part though is some of the floods that have been happeining over there. We get images of people being rescued from roof tops as the flood waters are lapping at the gutters - yep the floods have completely swallowed some of the houses, others with rivers flowing so fast people are being washed away or boats being ripped form moorings. It's a bit scary.
But Alas, I don't want to hijack Tina's thread.

Hos'w Jasper this morning/evening? (Must remember you are opposite to me :D) And how's Mum?

[Trish]

Isn't that sea foam freaky, never seen anything like that here! Wonder what is in the water to make it foam up like that. We saw the car in the foam on the news last night, so bizarre. NZ is the place to be, we are not getting the terrible heat/fires/floods you are in Australia or the freezeing cold storms of North America. So you are all welcome to come for a visit!!! All we have to watch out for are earthquakes and volcanic eruptions.... but it's hard to find the perfect country :D

Now back to you Tina, sorry to chat about the weather but your thread is such a nice friendly place for a catchup!! Hope your day was good, you must be just about due to wake up for Jasper! Hope he still liking his new food, give him some tripe!! :D See you soon xx

[Tina]

Well, Sharlene, here I am at 4 am again! Shoot, meant to be back in bed by now, but have been getting caught up on a few threads. I have been working a lot of extra hours, (poor Jasper and Shelby :( ), and have been wiped out by the time I get home, so haven't posted for a couple of days. But I have been reading along when I can. It is finally Friday, and then one more week with someone else on vacation and then hopefully things will slow down a bit at work!

You guys can talk about the weather anytime on my thread. :D Holy smokes, those sea foam videos were pretty freaky. I have never seen anything like that either. Some similar footage even made our local news here!

Jasper is hanging in there. He was just out a bit ago for his middle of the night potty break. He was pretty speedy due to the frigid temps, and is now wrapped up in a blanket snoring next to me on the couch!

He got his first dose of Enalapril last night, so I have been keeping a close eye on him. I talked to my vet a bit more yesterday, I will post more about that later.

Lori - thank you so much for all of your information and support. I am sure I will have some questions for you in the coming days. I am sorry you have had to go through these issues also. I appreciate your experience, and any help or tips you can offer. I am hoping to have some time to read some of the files on the canine kidney group this weekend.

Hugs,
Tina and Jasper

[Trish]

Hi Tina

You poor thing, working so hard on top of all the Jasper worries, I am pleased to hear he is OK though, and omg those trips outside in the middle of the night in the cold, do you have little shoes for him to wear so he does not get frostbite?? :D

I am sure he will handle the Enalopril well, I think Ro's dog Chey is taking that too, more for BP I think. Looking forward to hearing what else your vet had to say.

Jeepers hope you got a couple more hours solid sleep before work today!

Trish xx

[Boriss McCall]

HI Tina,
Glad the first day on the new meds went well. I can relate to busy at work.. I am hoping Feb. things will get a little better.. busy busy!!

[molly muffin]

Tina!!! It's the weekend!!!! Yay!!!!

They asked me if I could stay late tonight and after the week this has been there was just no way I was interested in doing that, even for over time.

I need a long soak in a hot bath. So, girls, its the weekend, wine and hot soaks sounds like a plan?

The furbabies can have some good yummy treats while we soak. (I just got molly a local made one, cranberry chia, no wheat, corn or by products, the cinnamon makes it smell so good too)

Hugs all around,
Sharlene and Molly Muffin

[Tina]

Hi Everyone, and happy Superbowl Sunday!! I just spent the last hour or so reading and getting caught up on everyone's threads. I will have to do some posting later as I have TONS of chores to try to get done before the game.

Jasper has been fully transitioned to the kidney diet Hills k/d since the dinner meal on Friday, and appears to be tolerating it. He had one really soft poop yesterday (got a little nervous :eek: ), but it seems that may have been a one time thing. I am on tight poop patrol now, LOL! He did so well on the low fat GI diet, I am hoping we don't get any problems since the fat content of the k/d is quite a bit more than that was.

As I said he started the Enalapril on 1/31 pm. He is getting 2.5 mg (1/2 tab) once daily for a week, then we will recheck a kidney panel. This dose is half of the dose he will be getting if all goes well. My vet said she wanted to start slow to make sure his kidneys can handle it. The med itself can apparently cause problems with the kidneys, so she is being ultra cautious since Jasper has been so sensitive to everything else. If the kidney bloodwork is still ok after a week on the half dose, then we will double the dose to where it should be.

She said that if the medication makes his kidneys unhappy, then he won't be able to take it and treatment will then be with diet and the fish oil supplement only. (I haven't started that yet, one thing at a time). She said the Enalapril is key to slowing the progression of the disease, and from what I have read, it is our best hope. She said she has had good luck with it with other dogs, so I am hoping for the best even though my Jazzy one has proven to not read the textbooks!

So I am asking for everyone's prayers and positive thoughts that he will be able to tolerate this medication, and that he will be able to continue on it long term to slow the progression of the damage to his poor little kidneys. Thank you everyone, I believe in the power of prayer and positive vibes, and we truly need it now. ;)

My vet said that while this is a progressive disease and can progress quickly :eek:, she has several dogs that she has been treating long term, and one for a couple of years. Although none of those dogs have all the issues that Jasper has had, that gave me a lot of hope. He is certainly due for a break I think! :p

I have not even had a chance to do any reading in the k9 kidneys group, but certainly plan to. I think I have just needed to give my mind a rest, and to be honest, I am a little afraid of what I might read there.

Today he seems to be feeling good, and I am appreciating that. Last night we snuggled in a blanket while watching TV. He wanted to be on my lap most of the night, so that is why there are no posts from me on my usual Saturday night rounds! :D

Thank you everyone, and please keep the prayers coming about the medicine. He goes in on 2/7 for the follow up bloodwork.

Love and hugs,
Tina and Jasper

[molly muffin]

Yay Tina! Glad to hear from you. I thought you were probably swamped again at work and maybe, just maybe actually getting to enjoy your down time. Wouldn't that be a treat!!

Totally sending you all the good vibes and prayers I can for Jasper to tolerate the kidney medicine well and for it to slow the progression. Now do they look for the numbers to actually decrease while on this med? The ones that sent the world into a tailspin when they came back as high, over 2.0 I believe was when they looked at treatment options.
Jasper is really due for break and so are you. So hoping for great blood work results on 2/7.
How is Shelby doing btw? We'll be needing an update on her thread too. :) :)
Enjoy the super bowl.
hugs,
Sharlene and Molly Muffin

[NoonelovesmelikeNorman]

Hi Tina,

Certainly will be praying for your Jasper...to tolerate the meds and that the blood work comes back good and to have Jasper Healthier and Happier.

Sending Healing vibes of Love and Hugs,

Sharon and Norman

[Harley PoMMom]

Hi Tina,

Sometimes a dog may do better on a different ACE Inhibitor, maybe ask your vet about Benazepril if the Enalapril doesn't work out.

You and Jasper are in my thoughts and prayers.

Love and hugs,
Lori

[addy]

Im saying prayers too and hope it will be as Lori said that if one does not work maybe the other med will.

Holding you close, sweetie, as always.

[Trish]

Yay it's Tina!! Always happy when I read your posts to let us know what is going on. I am not paying any attention to that bit about how it can progress quickly la la la la la la fingers in ears! That is not going to happen to our babies!! I have always think a bit of healthy denial can be a good thing!! As long as you are treating appropriately of course :)

Jasper is going to do well on his new enalopril, his new diet and soon his new fish oil pills! That's what I shall be concentrating on and sending a million good kiwi vibes up to you!!! I like the vet is being cautious, I also like the stories about her long term successes!!

So pleased to hear of the snuggle fest on the couch, you so need that with all the hard work you have been doing!

I had a bit of a moment tonight, Dad is laid up with some gout in his foot... gone out in sympathy with his cat who lost her claw I think :D:D so he could not take Flynn for their usual walk today. So when I got home tonight I was a bit knackered and thought it won't hurt for him not to have a walk for a day :rolleyes: But he kept giving me the look and if I walked anywhere near his leash he would get so excited thinking we were about to go, so I had to take him, sigh... so off we went up the beach AND it was so beautiful. Warm night, sun setting and giving off this gorgeous light through some sun showers with a little sprinkle of rain, rainbow out over the ocean. We were walking along and this guy says "Oi you got Basil's (my Dad) dog!" So I replied that actually he is my dog haha. Turned out he was Dad's reflexologist and they also meet up quite often on their walks! So we had quite a chat while his dog who was a young 1 yo and Flynny played. Flynn and Luca romped and chased and rolled and wrestled and were just having the best time, the guy could not believe he was 11 and been through so much lately. I watched them playing with Flynn so happy and thought this is exactly why I fought so hard to get him the treatment and it was totally worth going through what we have to see him enjoying his life like this...so there you are that is my long winded moment Tina! I guess what I am trying to say is to totally enjoy the happy times and try to clear your head from the worry to allow yourself to do that and hopefully we will have many many more moments with our babies to share :D

xxxxxxxxxxxxxxxxxx for your 4am pitstop

[SoggyDoggy]

She said she has had good luck with it with other dogs, so I am hoping for the best even though my Jazzy one has proven to not read the textbooks!

I can tell you right now, you don't have to read the text book to fluke the exam! :D I have enough kids in my classes that will tell you that, so like Trish, I will stick my fingers in my ears while loudly singing Lalalalalalalala! :D Jasper will do brilliantly, how can he not with all of these good vibes going out to the heavens :)

[Bo's Mom]

Tina,
Positive thoughts and prayers sent to Jasper from Texas!!!

[mcdavis]

Positive thoughts and prayers coming your way from me too

[Tina]

Hi All,

Thank you for all the prayers and positive thoughts. Please keep them coming. :) I just have a minute to post, I haven't meant to be absent, work has just been horridly busy as I expected, but I am on the downhill side now!

We have had a few somewhat minor (I hope) issues with Jasper over the past couple of days. A bit of soft poo, and intermittent poor appetite. The vet said to hold his Enalapril last night, though not sure that is the problem. He goes tonight after work to get his blood drawn for the kidney panel re-check. I hope holding the med won't affect the accuracy of that, the vet said it wouldn't, but my vet was out yesterday so this was a back up vet who doesn't know Jasper. He gets the med in the evening so by time he gets the blood drawn tonight, it will essentially be 2 days without the Enalapril. Hopefully that won't affect the results.

I will post more tonight, just wanted to check in so no one would be worrying. ;)

Hugs,

Tina and Jasper

[molly muffin]

Still sending out the positive vibes Tina for you and Jasper. Hoepfully it wasn't anything serious causing the poor appetite and soft poos. Molly has that off and on, so maybe it's not the medicine.
Cross fingers for good results on the kidney panel!
yay!! on the downside of the horrid work stuff! Good, maybe you'll get a chance to breath now.

hugs,
Sharlene and Molly Muffin

[Harley PoMMom]

Hoping Jasper's appetite improves along with his loose bowels.

Another thing I did to help with Harley's kidney disease is that I only let him drink distilled water because tap water may contain impurities that might be hard on the kidneys.

Sending healing thoughts, prayers, and love...Lori

[molly muffin]

Hoping for good tests today!

hugs,
Sharlene and Molly Muffin

[addy]

Hoping for a good day for you and Jasper!!!

[Trish]

Hi Tina and Jasper
Hope you got a good result from his tests! Lots of hugs for you two xxxxxxxxxxxxxxxxxxxxxxxxxxxxx

[Boriss McCall]

HI Tina,
I have been super busy at work all week too. I am so going to enjoy this weekend.
I am sending positive vibes your way as well. We will keep the bad juju away from little Jasper. :D

Amy

[Tina]

Thank you everyone for all the prayers, positive thoughts and hugs, I appreciate it so much! And I feel like it worked because Jasper's kidney values were all in the normal range on his bloodwork from Thursday pm!!! :D :D :D The vet said that the missed doses of the Enalapril would not alter the accuracy of the results. I don't have the numbers because she called with the results, but she said the BUN, creatinine and phosphorous were all in the normal range. I am so relieved, and she seemed pleased also. FINALLY something went the right way for my boy! So the Enalapril is now increased to 1 tablet daily, which is 5 mg daily. At first she said to give it all at once, once a day, but then said to split it and give half a tab bid on the slim chance that it could cause some stomach upset. He will go in to get a follow up renal profile in about a week, on 2/14, to make sure he is tolerating the increased dose.

The labwork he had done on 2/7 was a full chemistry profile and included liver values also, which my vet said were still elevated due to taking the dexamethasone. The concern is that his triglycerides were sky high, she said they were 1735, the normal range according to other lab reports that I have is 41-115 mg/dL, so this is way high. We discussed that he was previously on the low fat i/d food, and the kidney diet he is eating now is significantly higher in fat, so she feels that is causing it to be so high. Jasper has always had elevated triglycerides, even prior to Cushings, I think it is a Schnauzer thing unfortunately. But the highest I think it ever was in the past was 828, so this new value is extremely high. He was on Welactin fish oil supplement in the past to help lower it, and it did make an impact. The Welactin is part of the kidney treatment plan, so hopefully it will help lower the triglycerides this time also. I started him back on that Friday night. And he has to stay on the kidney diet, I just wish it was lower in fat.

Another labwork abnormality that my vet mentioned was his bilirubin was a bit elevated this time. She said she feels it is because the triglycerides were so high. She said that when the sample is lipemic, that this can affect the bilirubin results. So she didn't sound too worried about that.

He still has intermittent decreased appetite or something, walking away from his food a few times while eating, but so far has finished each meal. The poo seems to have normalized for now.

So all in all I am very happy with the kidney lab results, of course. :D My prayers were answered about that. I am not thrilled with the triglycerides as I know that this can lead to pancreatitis, so I just have to pray that this doesn't happen and that they will come down after he has been on the fish oil for a while. I will post the lab values when I get them all.

Ok, so now prayers are focused on tolerating the higher Enalapril dose, I have already started with that. I don't know how to thank you all for your continued support, prayers and love. I believe the power that all of that has is immeasurable. Please keep the prayers coming, I don't want to let my guard down yet!

Love and huge hugs,
Tina and Jasper

[Harley PoMMom]

So happy for you and sweet Jasper!!!! YAAA!!!

Hypothyroidism can cause elevations in the triglycerides, usually in a blood panel the thyroid level is checked, it is called a T4, what is Jasper's T4 level?

Harley would get an upset tummy from his BP meds so I gave him slippery elm bark to help with that.

You're doing a fantastic job, Tina!!

Love and hugs,
Lori

[frijole]

That was a pretty good report girl!!! Hurray! Yep that is a schnauzer thing but you are all over it so keep doing what you're doing mom! Awesome job - awesome update. Hugs to dear Jasper.. Kim

[Boriss McCall]

Tina... I am so HAPPY for you & Jasper. :D:D:D:D:D
Such good news. Enjoy this week & I hope you can rest a little easier. You deserve some worry free time.
YAY!!!!!

Amy

[molly muffin]

This is fabulous news Tina!!!! yay to both you and Jasper!

Now, you can hopefully breathe again. :)

hugs, have a good week,
Sharlene and Molly Muffin

[Trish]

Hooray for the kidney test, so pleased to hear that Tina!!!!! Booooo for the cholesterol/triglycerides! Had Jasper fasted for that? Not sure if it makes a difference but humans need to fast for 12 hrs for that test. Might pay to check?!? I guess they will redo those and his liver tests/bili when they recheck his renal function in a week? Are they checking his BP with the enalopril to make sure he is not going too low?

He probably just walking away from food as it is a change from his usual diet, picky pups :D He must be hungry as he goes back for the rest!

But all in all, I think that calls for a high paws five!! :D:D

Trish xxxxxxxxxxxxxxxxxxxxxxxxxxx

[addy]

High five paws from me too, you needed some good news!!!

[Squirt's Mom]

WOOHOO!! Way to go Jasper and Mom! :cool::cool::cool: That's a great report, Tina, even with the little "glitches". Keep up the good work you two!

Hugs,
Leslie and the gang

[Tina]

Thanks everyone! Yes, I have been pretty happy. I almost hugged the little guy to death the day we got the results back! ;)

Lori - his thyroid level has always been normal in the past. It was last checked when we were ruling out things before he was diagnosed with Cushings. On 5/25/12 the T4 was 1.5, ref range 0.4-4.0 ug/dL. I looked through all the labwork that I have and I don't see that it has been checked since that time. Do you think I should ask about re-checking it?

Trish - yes, Jasper was fasted for a little over 12 hrs for the chem profile, thanks for asking about that. It was the first thing that my vet verified when she called with the results. So the triglycerides were that high on a fasted sample. :( Tomorrow he will just be getting a renal profile drawn rather than a full chem panel. My vet said that it would be too soon to see any changes in the triglycerides or bilirubin yet. His Alk phos and ALT have been elevated due to the Cushings and now due to taking the Dex. She said taking steroids causes the liver enzymes to be elevated. So I am not sure that we will see much improvement there. I am hoping once we get the kidney stuff under control, we can talk about maybe starting him on Denamarin to help with that. I don't know how that will affect his kidney issues, it may be contraindicated. I will need to find out about that. And as far as the blood pressure, before he started on the Enalapril I asked my vet about that. She said it would have minimal effects on his BP, could maybe lower it by only 10 points, so she said that would be ok. I probably should ask what the signs of low BP would be, just in case. Thanks for mentioning that also. :)

I will get a copy of the chem profile from 2/7 tomorrow when I take him in, so I can see the specific results and post the numbers.

Jasper seems to be doing pretty good I think. (Do I dare say it?). He is still doing the walking away from his food while eating thing at most meals. I don't know if this is due to poor appetite, or what. He acts hungry when I put the food down, but after eating about half of it, he walks away a few times while chewing. So far he has always gone back and finished, but just eats kind of slow. This morning was the worst, I had to encourage him to finish, but he did thank goodness.

So he is hanging in there. He has been getting the full dose of Enalapril since last Friday, so it will be almost a full week when he gets the renal values re-checked. So all fingers and paws crossed that they will all still be good!

Hugs to all,
Tina and Jasper

[Harley PoMMom]

Lori - his thyroid level has always been normal in the past. It was last checked when we were ruling out things before he was diagnosed with Cushings. On 5/25/12 the T4 was 1.5, ref range 0.4-4.0 ug/dL. I looked through all the labwork that I have and I don't see that it has been checked since that time. Do you think I should ask about re-checking it?



Since it has been normal in the past I would probably just keep an eye on it. My feeble mind forgot that Jasper is a mini schnauzer and this breed is prone to elevations in the triglycerides.

You're doing a great job, Tina!!!

[SoggyDoggy]

Hi Tina,

Just wanted to comment on the food and walking away while eating. I'm not sure if this is a huge change or not for Jasper, but Fraser has pretty much done that his entire life! He is not exactly what one would call "motivated" by food, and often has to be encouraged to finish. In fact, it was when he needed no encouragement for a few months that i realised something was actually going on - this was the early cushiness rearing it's head. Now that he is right again, he will find the perfect bit of food in his bowl, pick it out and chew it up properly before swallowing, then i his own time return to his bowl to hunt up the next "perfect" morsel. Dinner can take 20-30 minutes sometimes! (or even longer if he gets a sense I might be trying to rush him or go out somewhere)

Might it be now that Jasper is not ravenously hungry, that he is instead savouring his food? or perhaps even that he just doesn't like it and only is eating it grudgingly to please you? Just some thoughts, but I would think that even if it is taking time, as long as he is not off food completely he should be fine. Just watch out for the pancreatitis with the higher fat kidney food.

Glad about those kidney results though!

[Trish]

Hi Tina

So pleased Jasper is still doing well!! I will be waiting for the news on the latest blood tests with fingers crossed.

Flynn can be slow sometimes too when he eats, especially if it is food he is not that keen on like his bisuits. He will eat all the good part of the meal, ie meat and leave some of the biscuits but goes back and eats them later. I know he is off colour when he does not even want the meat!

Hope your day goes well!
Trish xxxxxxxxxxxxxxxxxxxxxx

[Squirt's Mom]

Hi Tina,

I'm so glad the report is as good as it is! YAY, Jasper and Mom! :cool::cool::cool:

Just navel gazing and found this tidbit so I thought I'd share. Is it possible that something is affecting Jasper's sense of taste? Maybe the meds? It could be that he eats until he no longer feels really hungry but the food itself has little taste to him so he isn't motivated to finish it - kind of like chewing cardboard. ;)

Hugs,
Leslie and the gang

[Tina]

Jasper had his blood drawn for the renal profile tonight as scheduled. We should have the results late tomorrow. Everyone at the office said that they thought he was looking good, and seemed to be feeling good. :)

When we got home I figured he would be pretty hungry since it was later than he usually eats. He seemed hungry but when I put the bowl down he just looked at it and stepped back. He wouldn't even start eating. He took a few morsels from my hand but that was it. He wouldn't even eat with encouragement this time. Over the next half hour I heard him go and eat maybe 3 or 4 bites, maybe about 1/4 of what I put in his bowl. I wondered if the fish oil that I mix with his food was possibly causing him to not want to eat, even though he has always liked it before. I got him to eat about 1/4 cup of the food with no fish oil, but then he wouldn't eat any more of that either. The rest of the food is sitting in his dish, and it has been over 2 hrs now. He is sleeping on the couch.

I held the Enalapril tonight. I am not sure if it can be given on an empty or mostly empty stomach. Also, before we started it, my vet said that if he had any drop in appetite to stop the medication. She said that decreased appetite is a sign that the kidneys aren't happy. So I don't know if that is what is going on now or not. It's hard to say, because the Addison's and cortisol issues can cause loss of appetite also. We had so much trouble with that before. He was doing so well on the low fat i/d food before, I am just worried it is the k/d food, and the novelty is wearing off.

Leslie, it does seem like maybe the food doesn't taste good to him now. And Naomi, this is a change for him. When he is feeling good and all is normal with his eating, he usually eats steadily and enthusiastically until the meal is gone. He has never been ravenous or snarfing down his food, but he always finished all at once.

So I guess I will go and pick up the food dish for tonight, it doesn't look like he is going to eat any more. Poor Shelby has been confined to the living room this whole time so she doesn't eat it. :( If I can't get him to eat in the morning, I am going to hold the Enalapril then also. I will talk to my vet tomorrow. I don't know what she will say because I don't think we have much flexibility with his food, and that is a big concern.

I will keep you all posted. Thanks so much for all the positive words and support, it means a lot.

Hugs,
Tina and Jasper

[Trish]

Hi Tina
Has Jasper's appetitie gone off only since the enalopril started? I wonder if that is making him a bit queasy? Is he doing any lip smacking that could indicate nausea? Maybe it is the pill upsetting him. Be good to hear what your vet says tomorrow about this, can you try putting something nice and smelly on it to make it more tasty for him, like tuna juice? Or on second thoughts that could be too salty.

Jasper, now you be a good boy and go eat your dinner!!!

Have a good night you two!

Trish xxxxxxxxxxxxxxxxxxx

[Tina]

Well this morning now he won't eat at all. Took a couple of kibbles from my hand and that is it. :(

Trish, yes, it seems that his appetite issues this go around have started since we started the Enalapril, but he was switched to the prescription k/d kidney diet around the same time also. He started the Enalapril at half dose on 1/31, and was transitioned to the k/d beginning 1/26 and was on full k/d diet by 2/1 pm meal. He first started acting finicky with the food on 2/5, with the walking away behavior. It has been intermittent since that time, where some meals he will eat normally, but even when hesitating, etc., he would always finish. The last couple of days the problems have increased, and now this morning won't eat at all. He has not been doing any lip smacking that I have noticed.

When he went out this morning, he had a poo that was partially weird looking with some mucous. So I wonder if he is starting with colitis. I think that would surely affect the appetite. I gave him a dose of metronidazole that I have on hand, and will talk to the vet today to see what she thinks. I sure don't want him to break with full on colitis. I held the Enalapril this morning also, not sure if I can give it on an empty stomach. Thank goodness he isn't scheduled for his Dex today. He seems to be drinking ok.

Thanks for your feedback Trish. I will check in later after I talk to my vet.

Tina and Jasper

[addy]

Tina, will Jasper eat other foods? If you cooked up some chicken and rice would he eat that? Is it just his the kibble or all food?

[SoggyDoggy]

Wondering the same thing now too. is it maybe just that he hates the K/D? especially if he is drinking fine. Sometimes the mucousy stools can be just not enough food/bulk in the system. A bit of chicken breast might be worth trying.

[Harley PoMMom]

I would definitely try the chicken/rice mixture or any other foods that you think he will eat.

Hoping Jasper's appetite picks up real soon.

[lulusmom]

Hi Tina,

I have been so out of the loop here, I had to go back and refresh my memory on what's been going on with Jasper. So much has happened that I'm still not sure I understand everything, like why is Jasper taking Enalapril and why is he on a seriously protein restricted diet? It looks like Jasper has normal, normal BUN, creatinine and phosphorus levels but because the protein creatinine ratio was much higher in January, she put Jasper on K/D food which he doesn't seem to like too much. I can't say that I blame him. I'd be very concerned about putting my dog on such a very low protein diet without knowing that his kidney function is seriously impaired and if I were at that point with one of my dogs, I'd try to make my own food as opposed to the crappy quality ingredients Hills uses. Please check out these excerpts as well as others on the Dogaware site. Lots of excellent information there.


Pet Food Safety: Dietary Protein by Dorothy LaFlamme, DVM, PhD, Dipl ACVN
"Summary and Conclusions: Based on a comprehensive review, there remains no evidence that dietary protein causes kidney damage, or any other adverse effects, in healthy dogs. Even in dogs with chronic kidney disease, dietary protein does not appear to contribute to kidney damage. However, in chronic kidney disease, there can be an accumulation of byproducts of protein metabolism, which may contribute to uremic signs. Hence, in those patients, dietary protein restriction may be of benefit. On the other hand, dietary protein is important to support normal protein turnover and maintain lean body mass. Healthy, aging dogs have an increased requirement for dietary protein. When insufficient protein is provided it can aggravate the age-associated loss of lean body mass and may contribute to earlier mortality. Unless medicatlly indicated, intake of dietary protein should not be restricted."


The Mythology of Protein Restriction for Dogs with Reduced Renal Function by Kenneth C. Bovee, DVM, MMedSc
"Morris subsequently developed, produced, and sold a low-protein diet, KD, for dogs with renal failure. He and others were influenced by the erroneous work hypertrophy concept for urea excretion advanced by Addis. While experimental or clinical data were never published to support the value of this or other diets, the concept was broadly accepted without challenge in the veterinary literature." This article talks about the history of protein restriction, and about 10 recent experimental studies that have failed to provide evidence of the benefit of reduced dietary protein to influence the course of renal failure.
Also see Influence of Dietary Protein on Renal Function in Dogs by the same author, which concludes, "These results do not support the hypothesis that feeding a high protein diet had a significant adverse effect on renal function or morphology."

http://www.dogaware.com/health/kidneyprotein.html

You mentioned that a urine culture was done on January 25th which was several days after the protein creatinine ratio was done. This is a bit ass backwards since you want to make sure there is no active urinary inflammation/infection before doing a UPC as that would falsely elevate the ratio and I'm not talking small numbers. Unless I missed it, and that's completely possible, I don't see where you ever posted the results of the urine culture. Can you post those results now? If there was any blood/bacteria identified in Jasper's urine, you might as well throw out the last UPC and maybe even ask for your money back.

Glynda

[Trish]

Darl what has the vet said? Hopefully they will allow you to give her some tastier food. Mr Flynn would turn his nose up at a kibble diet too! Fingers crossed to hear good results tonight xxxxxxxxxxxxxxxxxxxxxxxxx

[Tina]

Hi Everyone,

Sorry to follow up so late, the evening got away from me. I forgot to say in my last post that I considered giving Jasper the bland hamburger or chicken and rice diet, but wanted to check with my vet first to make sure it was ok with the kidney issues. I figured he would probably eat that. She verified tonight that it was ok.

We had a long talk after I got home from work. Before I even mentioned that he had an episode of mucous in his poo, she questioned whether he might be getting ready to break with colitis, as poor appetite and going off his food has happened in the past before colitis has reared its ugly head. After I told her about the icky poo, she immediately agreed that this was what was likely causing the lack of appetite (rather than the Enalapril or something else), since it has happened before. She said it was perfect that I started the metronidazole this morning, that is exactly what she would recommend. (Yay, I made the right decision after I debated about it this morning!). She also said to give him a dose of Cerenia to help with the nausea and then feed him the bland diet for a couple of days.

His follow up kidney profile was all within normal limits, which was a relief. So we will continue the Enalapril at 1/2 tab twice a day.

So I ran out to the store to get some chicken breasts to cook up for his dinner. In the past I have always fed him hamburger/rice mixture, but since everyone on the site has mentioned chicken, I figured I would try that. My vet said either would be ok. It was snowing here during the evening, and in the few minutes that I was in the store, my whole vehicle was covered and the roads got a little dicey!

He ate the chicken and rice just fine tonight, so hopefully we have nipped the colitis in the bud.

Glynda, thank you so much for your post and all of your information and feedback. I will need to do some checking and try to answer your specific questions/concerns tomorrow, I am pretty tired right now. I will say that the urine culture was negative, I probably just forgot to post that. The k/d food and the Enalapril were prescribed in agreement with and based on the recommendations of the IMS that my vet has been consulting with. They have diagnosed Jasper with PLN, protein losing nephropathy.

I had read a bit about the diet recommendations that you posted from the dogaware site, I believe Lori provided the link previously. I got pretty overwhelmed reading everything, along with trying to understand all that is going on with Jasper now. The excerpts that you have posted have made me feel quite worried about it all now. I agree, I don't like the ingredients in Hills and have told my vet that on more than one occasion. She said she doesn't necessarily like Science Diet, but said she feels strongly about the science behind their prescription diets. She has been pretty firm about that.

Again, I will do the best I can to answer the rest of your questions and clarify things better tomorrow. Things have been quite complicated for Jasper, there has been a lot going on. Thank you all for the support!

Tina and Jasper

[labblab]

Hi Tina,

I'm so glad that Jasper is eating again, and hopefully things will remain settled down for you and your little guy!

Boy, the topic of canine renal management is definitely a contradictory one. And one of the chief difficulties is the lack of controlled experimentation. There have been lots of studies on humans and rats, but not so many on dogs and cats. So it is difficult to find substantiated evidence. However, here are some links that I had found a couple of years ago and kept bookmarked. I do think the sources are quite credible. And if I'm understanding the discussion correctly, the opinion among many specialists is that from a physiological standpoint, treatment (dietary and/or drug) really does seem warranted for dogs exhibiting persistent levels of high proteinuria on the basis of UPC results, regardless of whether or not they show other symptoms of renal disease. The first link is to a "2004 Concensus Statement of the American College of Veterinary Internal Medicine: Assessment and Management of Proteinuria in Dogs and Cats." Even though this statement is now almost a decade old, I still see reference made to the recommendations:

http://cms.evsrl.it/SocSpec/SiteTailorCommon/ShowBinary.aspx?id=2200

The second is a round-table discussion among veterinary renal experts ("Proteinura and Renal Disease") sponsored and published in 2005 by IDEXX Laboratories. This is a most informative "read," and further endorses the basic recommendations of the ACVIM Concensus Statement. It has an especially interesting section re: the advisability and degree of dietary changes depending upon patient symptomology.

http://www.idexx.com/pubwebresources/pdf/en_us/smallanimal/education/proteinuria-round-table.pdf

Lastly, here's a 2009 article from the "DVM360" magazine that discusses diagnostic and treatment issues associated with hypertension and proteinuria in dogs with renal disease:

http://veterinarynews.dvm360.com/dvm/Medicine/Diagnosis-management-of-hypertension-proteinuria-i/ArticleStandard/Article/detail/591639

Here's a quote from this last article that is a pretty good summary of the train of thought represented in all of these links, and I will look for even more recent articles when I get the chance. But for what it's worth, I think your IMS has a significant amount of professional support regarding the advisability of dietary and/or drug intervention in the face of persistent proteinuria to the extent that Jasper has exhibited. However, I don't know the specific profile of the food you're giving Jasper. As Glynda says, it may be that it is more severely protein-restricted than these panels would recommend in his situation. I especially encourage you to read the IDEXX round-table discussion in that regard, because I believe they suggest only mild/moderate protein restriction early on for a dog without other symptoms of renal disease. It's a fine line because you want to keep up with the protein that is being lost, but you don't want to cause additional renal damage from excessive protein leakage into the kidneys.



In addition to being a diagnostic marker of the severity of renal disease, renal proteinuria may be a mediator of glomerular and tubular injury. Recent findings have demonstrated that proteinuria is associated with increased risk of developing progressive CKD in dogs.

In addition, studies have shown that therapies that reduce the magnitude of proteinuria often are renoprotective. Proteinuric renal disease is often associated with systemic hypertension, which can conversely exacerbate renal proteinuria and therefore, it is difficult at times to separate the effects of high systemic and intraglomerular pressures and proteinuria.

Marianne

[addy]

Sweetie, you have a lot on your plate and I dont want you to now get stressed out about having to think about cooking every day for Jasper. So maybe we can find a different solution for you.

I do know that when Zoe first had her outbreak of colitis years ago, we tried the dry prescription ID kibble. She hated it and it made everything worse. The ingredients in the canned ID were a tiny bit better so I switched to the canned and she did better on it, not perfect but much better.


So my question is, does the KD come in canned food? If not is there another kidney type food that might come in canned?

So, I am off to check out that old website of Hills and I'll be back:D

[addy]

Canned KD:


Water, Egg White, Corn Starch, Pork Liver, Chicken Fat (preserved with mixed tocopherols, and citric acid), Sucrose, Flaxseed, Dried Whey, Chicken Liver Flavor, Calcium Carbonate, Calcium Sulfate, Caramel Color, Choline Chloride, Vitamin E Supplement, Potassium Chloride, Magnesium Oxide, Iodized Salt, Taurine, Ferrous Sulfate, Ascorbic Acid (source of vitamin C), Zinc Oxide, Thiamine Mononitrate, Beta-Carotene, Niacin, Calcium Pantothenate, Vitamin B12 Supplement, Manganous Oxide, Copper Sulfate, Pyridoxine Hydrochloride, Biotin, Vitamin D3 Supplement, Riboflavin, Calcium Iodate, Folic Acid, Sodium Selenite.

Dry KD:


Ingredients
Brewers Rice, Pork Fat (preserved with mixed tocopherols and citric acid), Dried Egg Product, Flaxseed, Corn Gluten Meal, Chicken Liver Flavor, Powdered Cellulose, Lactic Acid, Calcium Carbonate, Dried Beet Pulp, L-Lysine, Potassium Chloride, Potassium Citrate, Choline Chloride, Iodized Salt, Calcium Sulfate, vitamins (L-Ascorbyl-2-Polyphosphate (source of vitamin C), Vitamin E Supplement, Niacin, Thiamine Mononitrate, Vitamin A Supplement, Calcium Pantothenate, Biotin, Vitamin B12 Supplement, Pyridoxine Hydrochloride, Riboflavin, Folic Acid, Vitamin D3 Supplement), Vitamin E Supplement, L-Threonine, Taurine, minerals (Ferrous Sulfate, Zinc Oxide, Copper Sulfate, Manganous Oxide, Calcium Iodate, Sodium Selenite), L-Tryptophan, Magnesium Oxide, preserved with Mixed Tocopherols & Citric Acid, Phosphoric Acid, Beta-Carotene, Rosemary Extract.

IMO -If I had to choose between the dry and wet, I'd choose the wet. I would also ask your vet what is plan B if the KD continues to aggrevate and flare Jasper's colitis because I think that could be a distinct possibilty.

Hang in there sweetie, we are all here to help and support:):):)

[labblab]

Wow, gag-city!!! Those ingredients do sound awful! :eek: :(

FWIW, that IDEXX round-table article suggested that wet food is better than dry for dogs with renal issues, if it is affordabe to the owner. If not, they suggested adding extra liquid to the dry food.

I just checked the analysis for the Hills dry, and it seems like it has a really high fat content. That might be aggravating Jasper's GI tract, too. I just took a quick glance at the Royal Canin ingredients and they seemed a bit more palatable, and also had a lower fat content. Still awfully low protein, though. Maybe you could augment these low-protein diets with a bit of lean, high-quality homecooked protein (like chicken breast). Of course, the ratio would be very important and would probably take a nutritionist to figure out so as not to be overdoing the protein. Maybe some other folks here with renal experience will have some more thoughts.

Marianne

Edited to add that I now see Royal Canin has at least two renal diets: one ("LP") for later-stage, and one ("MP") that is labelled for treatment of early-stage renal issues in small and medium breed dogs. The MP has a higher protein content, so that sounds as though it might be the ticket for Jasper. Here's a link with nutritional info for the kibble: http://www.petfooddirect.com/product/6111/Royal-Canin-Veterinary-Diet-Renal-MP-Modified-Dry-Dog-Food. It also comes in a canned form with very different ingredients: http://www.petfooddirect.com/Product/6112/Royal-Canin-Veterinary-Diet-Renal-MP-Modified-Canned-Dog-Food.

[addy]

That is great news on the Royal Canine Marianne. :):) The only problem I found for me with the RC prescription foods when I considered them for Zoe was that the vets did not carry them in Milw so I would have to order on line. Hopefully that is not the case anymore or for Tina's area. That was five years ago so I know things can change:):):):):):)

Tina was stressed out about having to research a different food for Jasper along with everything else she is worrying about so she was hoping the KD would work temporarily until things calmed down for both of them. I am concerned though that it already flared his colitis.

We're trying to give you options, sweetie:):):):):) Aren't you glad you dont have to work today?

You are doing great, Tina. Believe in yourself:):):):)

[Tina]

Marianne and Addy, (((((((Hugs)))))), and a million more. I am sitting here with tears of gratitude. You guys read my mind. I don't know how to thank you for all the information, links, resources, feedback, suggestions and support.

I just scanned all of the information and wanted to post real quick to let you know that I will be back on a bit later to give it a more thorough read and check out all the links. My Grandmother is in assisted living and they called this morning, so I need to run out there for a bit and see what is going on with her. Hopefully it won't be anything major. I wanted you both to know that I had seen the information, and am so grateful. Yes, Addy, very glad to be off today so I can do some research on this. Again, I don't know how to thank you, I am so worried about all of this. :confused:

Jasper ate his chicken and rice just fine this morning. Just gave him all his meds. :)

So I will be back in a little while, hopefully a short while.

Love and hugs from me and Jasper

[labblab]

Tina, I hope everything is OK with your grandmother! Good grief, but you have a lot on your plate right now!!

Just wanted to pop back to say that I hadn't noticed earlier that Glynda's Dogaware article also contains a section with a table comparing ingredients of different commercial Rx renal diets, including the Hills and the two Royal Canins. In this portion of the article, Mary Strauss (the author) does address the probable need for moderate protein restriction for dogs exhibiting significant proteinuria. You may already have seen this portion of the article, Tina, but I'll give you the specific link for it here:

http://dogaware.com/health/kidneyprescription.html

The question I have, though, is what actually constitutes "mild" or "moderate" protein restriction?? I dunno what the actual numbers should be. As far as the Royal Canin foods, I got all excited because I saw that a number of them are actually carried in-store in Petsmart, including the more highly restricted LP versions. However, it doesn't look as though they carry the MP version. But the other interesting thing is that according to Mary Strauss' chart, the "LP" canned food (which apparently Petsmart carries) actually has a higher protein level than the MP dry food. So go figure. Maybe you can mix-and-match foods in order to come up with a combo that is palatable and healthier for Jasper.

Don't worry, Tina! We'll keep working on this and come up with a good answer!

[Boriss McCall]

Tina.. I hope your weekend gets better... too much stress for one girl to handle!! :(

[Squirt's Mom]

Hope your Grandmother is alright, sweetie. Let us know!

[Trish]

Hi Tina

Hope the day has improved and your Grandmother is OK. So happy Jasper ate his chicken, good boy!! Yay about the results too :D:D so hard trying to figure out dietary stuff, I am reading these links with interest too, so thanks girls for digging them out.

xxxxx

[Tina]

Hi Everyone,

Thank you all for the concern and good wishes for my Grandmother. She is fine, thankfully. She lives in a very nice assisted living facility, and does well there for the most part. Lately she has been out of touch with reality quite a bit, and today was a bit more agitated than usual about things. I spent a few hours there with her, she was able to calm down and is fine now. So relieved, as I don't need something else to worry about right now!

Marianne, yes, I had briefly looked at that table in the article, but need to take a closer look, as well as checking out all of the links you provided. And what constitutes mild, moderate or extreme protein restriction is a question I have as well. Without numbers to go by, I am not sure I know what I am looking for.

Back when my vet said we needed to start Jasper on a kidney diet, she offered the Hills k/d, Purina NF and Royal Canin as options. She said she didn't have a preference, and that we would need to see if Jasper liked one more than another. (She didn't have a sample of Royal Canin, and he didn't show a preference between the other two). When I did a bit of research at that time, I tried several times to read about the Royal Canin but the website wasn't working properly and I couldn't access the veterinary diets for some reason. From the link you provided today, it does look like the ingredients are better in their kidney diets. And I think they were lower in fat than the k/d if I remember correctly. I need to check that more carefully.

I also need to go back through Glynda's post to see what other questions or concerns she mentioned that I need to address.

My little guy ate his chicken and rice again tonight. I wish it contained everything needed to feed all the time, and my worries would be over!

I think I am going to work on the reading tomorrow when my mind is a bit more refreshed. Thank you again for all of the help, I am so worried, and all of the support is so comforting. I have said it before, but I don't know what I would be doing without all of you.

Love and hugs,

Tina and Jasper

[labblab]

Tina, I'm so relieved to hear that your Grandmother seems to be settled down again. It's clear that you are just as kind and good to her as you are to Jasper!!

One thought that's come to me about our dietary questions is that if you wished, you could email Mary Strauss directly to ask her opinion as to what percentage of dietary protein would constitute a mildly or moderately reduced intake. She has written a similar article regarding lowfat diets for dogs prone to pancreatitis, and I emailed her directly with some questions about fish oil supplementation for my Peg (her email address is at the botton of the articles). To my surprise, she responded promptly! She openly admits she is not a vet, but as we all can see, she does cull the research in order to arrive at her recommendations. It is just a thought, but if you tell her Jasper's UPC result and situation, she might have some specific comments about percentages and also even fresh food additives that would be good in the event you stick with a highly restricted commercial food. If what she says makes sense to you, then you can run the recommendations past your own vet as you make your decisions.

Also, as you wade through the research links, bear in mind that I believe the recommendations re: protein restriction for dogs experiencing renal dysfunction are different depending upon the presence or absence of proteinuria. So even though protein restriction is no longer thought to be necessary or helpful in some situations, the recommendations are different when a dog is spilling a significant amount of protein in his/her urine.

My continuing best wishes to you!!
Marianne

[Trish]

Yay your Grandmother is ok and double YAY for Jasper eating his chicken!! Hopefully this means this week is going to be a good one for you two!! xxxxxxxxxxxxxxxxxxxxx

[addy]

Mary Strauss will for sure answer you. She has always promptly answered my questions over the years even when we first were not sure of Zoe's diagnosis, she tried to help me. She has always been great about that.:):):):):)

Marianne, that is a wonderful suggestion. I have also read the protein in urine can be from a high protein diet and changing the diet will help lower the protein, depends on how high it is and what the other kidney values are. I have to address that with Zoe now, we have to cut back on her protein (hubby has been overly generous with the chicken)

Gotta run, my hours are all messed up this week so I can come home early for Zoe, I wont even get lunch:(:( I'm hungry already ust thinking about it;)

[molly muffin]

Hi Tina, I'm getting caught up on what is going on with Jasper and you . Wow, such a lot to take in. I really do think that people on here should just be given a degree in all things dog related. LOL Amazing the amount of research one has to do to figure out the most ordinary of things.
I'm glad to hear that your grandmother has settled down. I know how hard that is since my dad was in an assisted living with much the same issues, except his was alzheimers that got him going on bad days. Some days were better than others, but it's all emotionally exhausting.
You're doing so awesome with Jasper. Just remember to take a few moments and enjoy Jasper and Shelby. Give yourself those moments to sort of regroup.

hugs,
Sharlene and Molly muffin

[Trish]

Tina!!!!!!!!!!!!!!!!!!!!! I see you online :D, hows it all going, is Jasper behaving and eating his dinner? So nice to see you, but I guess with you online at this time of night you are doing a potty break?!

[Tina]

Hi Everyone,

Holy smokes, I had to go to page 3 to find our thread! Looks like lots of new posts and new members, will need to try to get caught up over the next couple of days, I hope.

I just want to check in since it has been a while since I posted last. I have done some research on the food issue, called both Royal Canin and Hills. Will have to let you know what they said later, but talked to my vet at length and we decided to switch Jasper to the Royal Canin Renal MP food. Since he was already off the Hills k/d and on the chicken and rice, I thought it would be a good time if we were going to switch. Started mixing in 25/75 kibble/chicken rice mixture yesterday pm. I am praying he tolerates it. I have done tons of reading at all the links that were provided. (Thank you guys!). I have not had a chance to email Mary Strauss, but that is a great idea, although I think I got some of the food questions answered between the tech at Royal Canin and my vet. Again, will go into that on a later post when I have more time.

The latest with Jasper is that his water intake has decreased significantly. At first I was relieved, he had gone down to about 4 cups/day from 6, but now 2 days ago he only drank 2 cups in 24 hrs, then yesterday drank only 1 cup! Today it looks like he is on track for maybe 1 or 1 1/2 cups. I measure from am to am. I called my vet earlier today (wednesday) to let her know because I am worried about that now, due to the kidney issues. She was not real concerned at this point, said if it continues till the end of the week to call her back, and I guess she will probably want to see him. I don't know why his intake would have decreased so dramatically, from about 6 cups a day to this, that is a big difference. I can't imagine it would be only diet related. His pooping has also decreased, he is pooing only about once a day now, and not a very big amount. :( I am hoping it is because of the chicken and rice diet and will increase once I get him eating more renal diet, but she said to monitor that also. Overall he seems to be feeling ok for the most part, but not as perky as usual. Gosh, it is always something.

We are under another blasted winter storm warning, and I am up late working on a project for work. It is supposed to start snowing 2 inches per hour about mid morning, so wanted to get on top of things so I can leave work early if needed so I don't get stuck there!

Will post more later, hopefully will have some unplanned free time tomorrow afternoon. I guess I should say this afternoon now. Yikes, better try to get a few hours of shut eye. :o

Hugs to all,
Tina and Jasper

[Tina]

Hi Trish!!!!! Looks like you have signed off now, but yes, had a potty break about an hour and a half ago and decided to work for a bit on some work that I brought home. I posted an update in my last post, and am going to try to get some sleep now. I read your update on Flynn, I think it sounds great overall!! I will post on your thread when I get a chance. Hugs to you and Flynn. :p

[labblab]

Tina, thanks so much for this update. And I just wanted to tell you that my Peg's pooping decreased substantially (both amount and frequency) when she was on the homemade chicken/rice after her acute pancreatitis attack. So I think that part of things is to be expected and nothing to worry about.

Marianne

[Squirt's Mom]

A decrease in the number of times a pup poops can be a good sign. The more filler, or useless stuff in feed, the more they are going to poop because their bodies can't use the things in the feed - they are only fillers. The higher the quality of ingredients the more they are apt to actually be absorbed and used by the body so there is less waste to get rid off. If you feed twice a day and your pup poops 4 times a day, they are not keeping much of that feed inside - it is all useless, a waste for the system so it is eliminated. If we were to eat a diet of pine bark, peanut hulls, and chicken fat we would poop a whole lot more than we would on a diet of pine nuts, peanuts, and chicken. ;)

[molly muffin]

Ugh, hope you didn't get hit too hard with that winter storm!

How is Jasper's water intake today?

Take care, hugs,
Sharlene and Molly Muffin

[Tina]

Hi Everyone,

Wow, this sure has been a busy place. It will take me all evening to get caught up on everyone!

I will stop back later to post an update on Jasper, right now I want to post a very belated response to Glynda's questions about Jasper's urine UPCR and culture done in January. I wanted to make sure I had everything straight.




You mentioned that a urine culture was done on January 25th which was several days after the protein creatinine ratio was done. This is a bit ass backwards since you want to make sure there is no active urinary inflammation/infection before doing a UPC as that would falsely elevate the ratio and I'm not talking small numbers. Unless I missed it, and that's completely possible, I don't see where you ever posted the results of the urine culture. Can you post those results now? If there was any blood/bacteria identified in Jasper's urine, you might as well throw out the last UPC and maybe even ask for your money back.

Glynda

Yes, the urine culture was done on 1/24 after the UPCR which was done on 1/16. I had read that a culture should be done first to make sure there is not a UTI present, just like you mentioned Glynda. I remember asking my vet about this because I was concerned about the results being affected, and she did say that before she she sent in the urine for the UPCR, she spun it down and there was no blood or wbc's present.

We got a sterile urine sample for culture after the results of the UPCR came back elevated to make sure there was no infection. I believe she realized this should have been done first, but also said that since there was no blood or wbc's present in the UPCR sample, she felt an infection was not likely. The culture was negative. I am thinking we can feel safe that he didn't have an infection at the time of the UPCR if the urine culture from a sterile sample was negative a week later. Does anyone think there should be any concerns about that?? I am just thinking that if he had a UTI, it would not have cleared up on its own.

Glynda, I think I addressed your other questions in a previous post. Thank you so much for your feedback and concern for my boy, I really appreciate it! Please let me know if you have additional thoughts.

I will be back a bit later to post an update on Jasper and what I found out from my research about the renal prescription diets on my calls to Hills and Royal Canin.

Tina and Jasper

[Tina]

Hi All, I hope everyone is having a good weekend!

Marianne and Leslie, thank you for the feedback about the decreased poo issue. The only reason I was concerned at all is because along with having a history of colitis, Jasper has also gotten backed up before, and that is worrisome also. He has had to have an enema in the past based on an xray that showed he was totally backed up. Of course he got a pretty severe case of colitis after the enema, I guess from all the irritation. So of course I want to avoid him needing that again!!

On the food front, I called both Hills and Royal Canin and got more information about their renal diets. I am really trying hard to not be biased here given how I feel about Hills foods in general, but I have to be honest. The two people that I talked to at Hills were absolutely not as well versed or knowledgeable about their k/d diet as the person at Royal Canin was about their kidney diets.

Royal Canin staffs their customer line with vet techs, so the person I talked to there was an actual vet tech and it showed. I am not sure if the folks at Hills were techs, but it didn't seem like it. The tech at RC was very sharp. She explained that when comparing foods, you apparently can't go by the % dry matter numbers listed on the bag for protein, fat, etc. She said that all the nutrients need to be converted to grams per 1000 calories (or 100 calories) in order to make an accurate comparison. She was able to calculate this conversion easily for both of the kidney diets that RC offers, I am sure she must have had a formula that she used.

I told her that I was specifically interested in the Renal MP diet as it had a higher protein level than the LP. She asked quite a few questions about Jasper, what was going on with him kidney wise, his history, lab results, etc. She absolutely agreed that the MP diet is what would be recommended for Jasper (versus the Renal LP which is lower in protein). Of course I told her I would need to run everything by my vet, but I was hoping she would agree. She said to have my vet call if she had any questions, that she had entered all of Jasper's info in the computer. She said that if she couldn't answer my vets questions she would connect her to one of their vets that are on staff there.

She said that the Renal MP diet is considered moderate protein restricted rather than extreme. (The bag also says "moderately restricted level of high biological level protein"). With all the info she was providing, I forgot to ask what numbers constitute mild, moderate or severe dietary protein restriction, but I know I can call her back and ask that another time. I left the paper with all the numbers on it at work, but I think it ended up being maybe 5 or 6 grams/1000 cal higher in protein than the Hills. My vet felt that was good, but did not feel that was as significant as the difference in the fat content. I think the RC was about 9 or 10 grams/1000 cal lower in fat, my vet felt that was more significant for Jasper. (I will need to verify those number when I have them in front of me, sometimes the memory is not so good). My vet felt that it would be great to switch Jasper to this food, and agreed with all the info the tech at RC had provided. (Whew!!). :rolleyes:

So we started the transition on 2/19 pm, he is currently eating about 75% MP diet/25% chicken and rice mixture. He has been doing well with the transition for the most part, decided to go very slow. He seems to like it, and the poo amount has increased as I have increased the kibble, which I would expect. There have been a couple of softer poos here and there, but now today it was pretty soft formed, with a bit of mucous. The color has been lighter than normal but this food is an orangish brown color, so would account for that. He is still on the metronidazole so I am concerned about the mucous and softer consistency. He will finish the metronidazole after the pm dose tomorrow. I hope he is not going to be intolerant of the food. I was planning to have him transitioned to 100% Renal MP by tomorrow, but not sure now, maybe I should add more chicken and rice back in?

I feel like he has to adjust to this food as it is our best option to treat his kidney issues and urine protein loss. I don't think I have ever seen him have mucous in the poo this late in a course of metronidazole, so I am a little worried.

His water intake has gone back up a bit thankfully, he is back to drinking between 2 and 3 cups per day for the past 3 days, so that is better. Overall he seems to be feeling pretty good for the most part. Still seems not quite as perky at times but more energetic at other times.

I would appreciate any feedback on the food transition and poo issues. And please keep him in your prayers that he is able to adjust to and tolerate this new food.

Hugs,
Tina and Jasper

[addy]

Tina, just my opinion from what I went through with Zoe's colitis but I would keep Jasper on the metronidazole durring the transition. Maybe discuss with your vet. One thing I learned about colitis and metronidazole is these 5-7 day courses may work for an acute case but if a dog is prone to colitis or has a history of it, weaning them off of it rather than taking it for 5 days then just stopping it is much better. It was the one really good thing a vet taught me. She was holistic based vet as well as using western medicine.

[Tina]

Thanks Addy, I agree completely. Initially when he broke with the colitis, my vet said to give the metronidazole for a couple of days beyond him having a normal poo. We decided to complete the full course instead since we are transitioning him to a new diet. She always prescribes a 10 day course rather than 5 or 7 days, so tomorrow will be day 10. Maybe I should ask about keeping him on it even longer due to the symptoms today and the new food? I think I have a back up prescription here that I keep on hand for emergencies. I have never needed to give it to him for longer than 10 days. Your thoughts?

[addy]

Yes, I think he should be on it until he is fully transitioned and it may be you have to back up a bit and go slower with the transition if he has having softer stools. You would go back to the food ratio where he did not have mucus stools and then leave him for a few days and add much smaller amounts for the next increase of food ratio. Once he is fully transitioned with good poos, you can wean him off the metronidazole, so if he is getting two doses a day, cut him back to one dose a day for 4-5 days, if stool remains good, cut back to one dose every other day for 4-5 days, then one dose every two days, then 3 days and then off.

If that weaning does not work you have to start making the one dose smaller in size. I just use my clean finger nails to shave some off until the pill is so small I cant shave any more off.

I've done it both ways but the vet taught me the first way. Sas taught me option two:):):) They both worked for Zoe.

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

[Tina]

Well, I miscalculated, Jasper was done with the 10 day course of metronidazole with the pm dose last pm. He has not had another poo since the one in question late yesterday morning, so maybe things are trying to correct themselves. He may still go when I let him out one last time before I head to work. I have continued him on the 75/25 mix of kibble/chicken and rice since he has been on that ratio since 2/22 and was doing ok before yesterday. His appetite seems good right now. I will leave a message for my vet to see if she thinks he should be on the metronidazole longer.

Hugs,
Tina and Jasper

[Mel-Tia]

Fingers crossed for a decent poo

Am sure if outsiders stumbled on this site they would wonder why we analyse these things!:D

Mel and Tia x x

[molly muffin]

Hi Tina, poo status report please.

ROFL myself silly.

hugs,
Sharlene and Molly Muffin

[Tina]

LOL Sharlene, literally. You crack me up. I know, so funny with all this poop talk!! :p

Well things are a bit better here for now, but we are going to keep mixing in the bland diet 25% for a couple of more days, and also continue the metronidazole for now. We have switched to hamburger and rice for the bland diet part. He has always done well on that before, so we switched on the slim chance that the chicken was affecting anything. This was the first time I gave him chicken and rice for colitis, before we always used beef. Unlikely that the chicken should cause problems, but we all know that Jasper goes his own way on things. :rolleyes:

The vet said it was too soon to know of he was going to be intolerant of the RC renal MP, but it entered her mind too. I pray pray pray that he will adjust.

Off to work, will check in later.

Hugs,
Tina and Jasper

[molly muffin]

Hi Tina,

I think I missed it, poo's okay now? :)

I think that we just Have to find the humor anywhere we can in these kinds of situations where it is high level stress constantly and worry, worry, worry. Laughter for me is the best medicine. :)

Molly Loves the chicken, but I put hamburger in one night, that I had cooked and rinsed, and no fat practically at all, and the little witch turned her nose up at it!!!!! Shocking. Of course she did finally eat it but not till she let me know that she preferred grilled chicken. Our little princess.
Does Jasper prefer the beef over the chicken or just do better on beef usually?

Did you guys get whalloped by that snow storm? It's suppose to be here tonight. Lots of heavy white (hhahaha I meant to say Wet) snow. Yea, I'm working from home the rest of the week. :) So glad my job lets me do that.

Huggers Tina and Jasper and Shelby,

Sharlene and Princess Molly Muffin

[addy]

I think I missed the poo report too. heck, I talked poo for 3 years straight no break:D:D neighbors thought I was nuts out there very day examining her poo:rolleyes::rolleyes::rolleyes:

what's a little poo between friends anyway?:D:D:D:D:D:D:D

[Trish]

HI Tina and Jasper, glad to hear the tummy issue is settling. My vet said not to change his food yet and we need to check another urine next week and if it is getting worse I will bring it up again. He has so enjoyed his venison, possum and tripe I would hate to change it again. He does not like kibble much and he always leaves it in preference to the protein part of his meal, so will see what he says next week. You are so good researching his food and ringing the companies, I will take your lead if/when I have to :D:D Flynn never drinks more than a 1-2 cups a day never has done, vet seemed quite happy and unconcerned with that. Have not seen you online for a while, so hope you getting some good nights sleep :D

Trish xxxxxxxxxxxxxxxxxxxxx

[Trish]

I <o> <o> you!!! Hope you got good news :)

[Tina]

Lol you guys! I was trying to be more subtle with the poop report by saying "things are a bit better here for now..." I will make sure I spell it out better next time! :D :D

Yes, the poops are better for now, but I wouldn't say they are totally normal, for whatever reason. Still a bit softer than I would like to see. Even when he was on all chicken and rice, they didn't firm up like they normally do. That is why I thought I would switch to hamburger and rice, which is what I have always given him in the past for colitis. He is getting less than 25% mixed in now, so not sure it will make a big difference now. We went to chicken and rice this time because it seems like that is what everyone here recommends and feeds their dogs, so I felt it might be a better choice as lower in fat. My vet said either was ok as long as I used very lean ground beef and rinsed it or boiled it.

Today (2/27) when I got home from work it looked like there were traces on one of the pooch pads that Jasper had thrown up. :( That scared me a bit because he has not vomited through all of this, that part has been pretty good. But he ate fine tonight and nothing further, so I will monitor. Before work he seemed a little off, maybe his tummy was upset. I hate it when things happen when I am gone, then I don't really know what went on. And he HAS to adjust to and tolerate this food, I just keep praying for that. He seems to be drinking a bit more again also, so will monitor that too. I still measure his water every day, but sometimes it gets tough with Shelby drinking also, and sometimes he will drink a bit out of her little water bowl too.

Sharlene, that big snow storm on Mon and Tues went just to the South of us thank goodness. We got the one last Thursday/Friday with 9" of snow. I spent a good part of Friday night and Saturday shoveling, ugh! Hope you didn't get hit too hard.

Hi Trish! Just posted on Flynn's thread. :)

Hugs,

Tina and Jasper

[Trish]

It's funny as Flynn LOVES chicken, gobbles it down. But I always find it makes his poop a little loose, some of the pups just tolerate things differently I guess. I also find chicken gives him stink breath too. So I have not been giving it to him lately. My vet recommended the leaner meats hence the venison and possum and I add the ziwi peak food which seems to be suiting him for now. He did a vomit a couple weekends ago too, worried me as well but so far no more evidence of that. I dread having to change his diet again as he seems to go off the prescription diets pretty quick, plus I think the poor wee man, one of his great loves is food so I hate to deprive him of his tasty meals! Still, if it is better for them so be it. Hope that wind is easing for you guys, stay safe and warm!! Summer is a coming :D:D (well spring at least!)

xxxxxxxxxxxxxxxxxxxxxxx

[addy]

Dang, I couldnt find you:rolleyes::rolleyes:

http://www.vetcontact.com/en/art.php?a=685


http://www.ncbi.nlm.nih.gov/pubmed/15954557

second paper is older 2004/2005 but has some good info nonetheless.

I'm on thread poop patrol this morning, just checked on Coco and now checking out Jasper's poos:D:D:D:D:D LOL!!!!

[Tina]

Hi All,

Well, my Little Man is hanging in there. I have had him on full RC Renal MP diet since the evening meal on 2/28, and he is adjusting. We continued the metronidazole for a few additional days, he got the last dose of that yesterday morning. I decided to taper it down to once daily for 2 days rather than just stop it after Saturday evenings dose. So hopefully the poops will stay somewhat ok with no metronidazole on board. The weird thing is that he is pooping only about once a day now, he always went twice a day before, like clockwork. My vet said it is ok if he goes only once a day, so I am not going to worry about it at this point I guess.

As far as the food, he does not eat it as enthusiastically as the hamburger/rice, but so far he has finished each meal within about 10 or 15 minutes, so I will take that. My fingers are still crossed, but so far so good with the food. Hoping it continues so I can get him started back on the fish oil in a few days.

He goes in for his monthly Percorten injection today after work. The vet has been decreasing the dose by 10% each month so this time he will get 0.45 ml. The starting dose was 1 ml for the first few months. So far he is tolerating the decrease each month. My vet is hoping to try to get him off the injection once we can get him stable on everything else, which has been a challenge.

My vet said we need to give it a month or two of Jasper being on the prescription food, Enalapril and Welactin (fish oil) before we recheck the UPC. And we need a good month of treatment with diet and Welactin before rechecking the bloodwork. She said we wouldn't see a difference in the triglycerides any sooner than that. The Welactin is key for lowering the triglycerides, and also important in decreasing the protein loss from the kidneys.

So as long as Jasper continues to stabilize and tolerate things, this is the plan:

Percorten injection 0.45 ml today 3/5
Recheck a chem panel in 1 month
Recheck the UPC in 1-2 months
Recheck the electrolytes when we decide to stop the Percorten
Continue on Enalapril 5 mg 1/2 tablet twice daily
Continue on Dexamethasone 0.5 mg 1/4 tablet every other day
Restart Welactin fish oil supplement 1/2 spoonful on food twice daily, restart in a couple of days if colitis continues to stabilize
Continue on Royal Canin Renal MP modified protein diet
Continue to measure water intake
Recheck baseline cortisol or ACTH stim test at some point to see if there has been any recovery of the adrenal glands


So that is the plan. I'm like Trish, I like a specific plan all spelled out letter by letter. Just a little type A, I think. :rolleyes: ;)

He seems to be feeling pretty good overall, and I am so grateful for that. I treasure every day with him. I actually went out to a concert with a friend on Sunday night and didn't obsessively worry the whole time. :)

I continue to pray like crazy that he tolerates this new food long term, and the Enalapril, renal diet, and fish oil halt the progression of the kidney disease. Please keep him in your prayers for these things also. Thank you everyone for your ongoing caring and support.

Love and many hugs,
Tina and Jasper

[labblab]

Good job, Tina!!!! I'm so proud of you and your Brave Boy!!!!!!!!! :) :) :) :)

Marianne

[Skye]

i have thought about getting a little web cam or something of the sort so i can click in from device and check on shysie when i am away. i know a lady that can check her pups when she is away from them. she has puter set up in room and it has web cam i am guessing and she has it where she can check on them through her phone.

[molly muffin]

A plan!!! I love a plan! If you weren't an A personality prior to having a sick pup, you sure would be afterwards.
It sounds like a really good plan too. Nice short term and long term elements, goals at different stages. Yep, it's a winner.

You are awesome Tina!!!

hugs,
Sharlene and Molly Muffin

[Trish]

Oh my, that is an A+++++ plan! I love it :D:D

He sounds like he is doing good Tina, stablised on that lower Dex dose too. YAY! Once Flynny has settled BP and UPC I will go back to monthly checks too, seems safe to me. So good to see your vet thinks the same.

I had that outage on here too last night, I had come over here to your thread and had typed a message, then nothing... kept saying internet connection problem here. But rest of my internet pages were working, so must have just been a K9 problem?? I fiddled about half an hour or so before I gave up and went to bed myself!

Hope his tummy has remained settled with the Metronidazole stopping. I have noticed Flynny is pooping less with his changed diet too. We all deserve a rest from kidney worries :D:D SEe you soon no doubt, its getting up to your pit stop time :eek: How did it go at the vet tonight, he get his jab?

xxxxxxxxxxxxxxxxxxxxxxxxx

[Trish]

Hmmm Tina, what happened at the vet's the other night, you haven't posted since and now I am a tad worried, hope all good you guys!! See you soon no doubt! :)

[Tina]

Thanks you guys, glad you like the plan. Trish - didn't mean to worry you, I have just had a lot going on the past few days and didn't get a chance to post. Jasper's "jab" went just fine Tues night, LOL. :) So are you saying that you missed me on Jasper's middle of the night potty breaks? :D

Well, things have been going well for most part. Then on Friday morning before work, colitis reared it's ugly head again. Jasper had a large very loose poo with lots of mucous. :mad: :mad:

His poos had never really firmed up to what I would call normal since the last colitis break a few weeks ago, but they weren't getting any worse either, so I figured he was holding his own. Fortunately, his appetite has not seemed to be affected. I immediately restarted him on the metronidazole before I went to work yesterday.

My immediate fear is that he isn't tolerating the renal MP diet, of course. I talked to my vet yesterday. (Gee, can we maybe go more than 48 hrs without needing to talk to the vet about something?) :rolleyes:

She said we are going to keep him on the metronidazole for 2 solid weeks this time even if the poops get back to normal before that time. She said at this time of year in our area, for some reason there are lots of problems with colitis. She said she had seen 6 dogs with it on Friday alone. She is not sure if this is part of the reason Jasper has it again or not, but also feels that it may be that we didn't totally kick it from the last round. She said it may very well be related to the food, but didn't want to blame the food just yet.

She is also starting him on a probiotic - Fortiflora - we started it this morning. It is a small packet of powder that gets sprinkled in with his food once a day for 30 days. She thinks since he has been on the antibiotics so much that it may have messed up the normal bacteria in his gut. He has had the Fortiflora one time before many years ago when he had a tough bout of colitis, and it worked like a charm then. But he was fully healthy then. Hopefully it will make a difference now. Fingers still crossed that it IS NOT the food!

So the metronidazole has kicked in, and he does not seem to be feeling bad today. He has continued to eat ok, so no bland diet for now! I had planned to restart the Welactin this morning but now need to hold off on that again until the poo is normal for a few days. I am anxious to get that restarted since it is such an important part of the treatment for both the kidneys and to lower the triglycerides.

So a bit of a setback, but hopefully we will be back on course quickly.

It has been rainy today, and the forecast was for a couple of inches of wet snow tomorrow, supposedly no big deal. Now I see that we have been placed under a winter weather advisory and there are blizzard warnings a bit to the West. Sheesh, will it ever end?! :rolleyes:

Hope everyone is enjoying the weekend.

Hugs,
Tina and Jasper

[molly muffin]

Molly loves that Fortiflora powder. I sprinkle it on a bit of wet food and she gobbles it up. I last had to use it last march when she had that awful problem with the diarrhea. It seems to work pretty well if the stomach bacteria is all messed up.

I hope it isn't the food too, but there is a chance it isn't if dogs in the area are getting colitis. I wonder why that would be. A seasonal issue? hmm :confused:

Hopefully this is just going to be a small bump on the path to getting the kidneys in a good place. Heck with Jasper, it isn't really Jasper if there isn't a bump somewhere. I'm convinced he is rewriting the medical books in secret at night while you sleep and then while you are at work. All of the stuff is probably just his lab work to verify his findings so he can put them in the book. ;) I wonder if he has his own group here on the forum and they are all collaborating while we think we are being the smart ones and looking at them!! :eek:

oh no, not another winter advisory! *sigh* That is a bummer. :mad:

Have a good rest of the weekend!
hugs,
Sharlene and Molly Muffin

[Skye]

that is what Shysie uses in her diet. 1/2 packet twice daily. has helped her a great deal. i keep her on it year round. good stuff. :)

[Skye]

i know the ims mentioned fish oil to me as well and we use one though i am wondering if it wont be increased....
next step would be ACEI
i think i am going to start adding more water to her food. If jasper eats kibble....to help him digest it....put it in blender and it will turn to near powder, then you can add water to it and it is like soft food. great way to help keep them hydrated.
I am also bothered that her BUN was at 28
i have a spread sheet of all her labs and different test. some tests (each listed seperately) have same things as some others but i still listed them seperately......listed by test and date. if would like i can email you her spread sheet and you can see if something like that would help you track all his inclines declines and stables readings.
Jasper losing protein through urine?
kidney is very confusing as it can be blood, then branches out from there, or it can urine and branches out from there. and from each branch is 5 stages. ugh.
Girlfriend.......hope you got a hold of my hand in all this............scary stuff. Lets keep our babies strong and stable and not let this stuff go any further at all. :)
i got yours and i am not letting go!

[Trish]

Yes, I do miss your potty breaks!!! :D:D:D Glad the jab went ok, they should show you how to do it. I gave Flynn his 4th Pentosan injection last night, it is real easy and saves a trip to the vet to have it done. :D

Hope the probiotic and antibiotic sort the poopy butt reall soon for Jasper, so typical you have to use one thing to fix up the damage the other does :eek::eek: Still, it sounds like it is working good already and you will get back on the Welactin asap.

xxx

[Squirt's Mom]

Hi Tina,

Glad things seem to be looking up for Jasper and hope the trend continues!

I used the Welactin with Squirt's first home-made diet and she couldn't handle it - it gave her diarrhea. After trying many different fish oils, both capsules (which are a HUGE mess :D) and liquid, I found one that she doesn't have any problems with and that offers high levels of DHA and EPA - the Omegas that help their systems. I am using Only Natural Pet's Salmon Oil and have been for several years now. I don't know what the difference is that makes this one alright (haven't really looked at it, truthfully) but I'll take it whatever it is! ;)

You might compare the ingredients and analysis between the Welactin and other oils if Jasper continues having loose stools on the oil and find one that you and the vet agree on. There are a lot of good fish oils available to us so we don't have to be locked into one brand or the other.

Hope ya'll have a good day!
Hugs,
Leslie and the gang

http://www.onlynaturalpet.com/products/Only-Natural-Pet-Pure-Salmon-Oil/999060.aspx

[Tina]

Hi everyone, thanks for the feedback and support.

Sharlene - Lol (not really) about Jasper rewriting the textbooks. Maybe that is what he is doing, it sure would explain why he can't seem to follow any expected pattern or response to anything. I understand that being a trailblazer can be a good thing in some situations, but I think it's time he gives it a rest. I keep telling him it is ok to be a follower, that is why the vet makes the big bucks!! :D :D

As far as the colitis, my vet has told me before that for some reason, she and all the vets at the clinic see a lot of it in the spring months here, usually beginning in March. (Although it certainly isn't spring here today, have already shoveled twice, and expecting more snow :eek: ). I remember back a few years when Jasper had a really bad case, I think it was during March then. He did not have Cushings or Addison's then.

Skye - yes, Jasper has been losing protein through his urine, his serum protein and albumin levels have been ok so far. His UPC was quite high, so my vet started treatment with prescription renal diet, Enalapril, and Welactin. I am not sure about the 5 stages that you mentioned. Yes, I would be very interested in seeing what type of spread sheet you use to record all of Shysie's information! I am not good with spreadsheets, and have been recording everything for Jasper, but it would be nice to have everything in one place and easily retrievable. So please let me know about that. And yes, I've got your hand also and won't be letting go. We have to stick together and support each other through all of this!

Trish - the plan is to hopefully get Jasper off the Percorten injections soon. If we aren't able to do that, I will look into giving it myself, my vet has mentioned that before. It seems easy at the clinic, and I have given injections to people, but I don't know about jabbing my baby, that might be a different story. :rolleyes:

Hi Leslie, thanks for the information and link for the salmon oil, I will definitely check it out. As far as the Welactin, Jasper actually has been off it since Feb 15th when he got colitis at that time. I haven't restarted it, so it is not the culprit this time. Jasper was on Welactin for probably a couple of years before he got Cushings to treat high triglycerides which he has had in the past, but the level has not been as elevated as it is now. He tolerated it just fine before, but will have to see now. I will ask my vet about the Only Natural Pets Salmon Oil if he continues to have problems when we restart the Welactin.

Hugs,
Tina and Jasper

[Mel-Tia]

Hi Tina

I just wanted to pop on here and say thanks for your kind words on Tia's memory thread in case you didn't see my response there

I read through your thread yesterday and you guys have certainly been through it.... Been a rollercoaster and a half for you two :eek:

Hope you and Jasper are having a good day and little miss Shelby is behaving herself?

Mel
Xxxx

[Squirt's Mom]

When we lived in TN the dogs would get diarrhea every spring and our vet told us that was common because that was the rainy season. Our yard was at the botton of the hill from several others who had dogs and their bugs would wash down into our yard and our dogs would pick them up then get sick, usually with Giardia. Once it got good and hot and things dried out, they didn't get sick any more - until the next spring. When she first told me that, tho, I thought she was a bit off, ya know? Blame diarrhea on the season of the year? But she was apparently right on the mark!

[addy]

Spring and fall can be hard, some people will automaticially dose with panacur in Spring and Fall. Zoe used to do fine in the winter and once spring came, it was all over.:rolleyes:

Hi Tina,

popping in to see how things are going with you and Jasper:)

[Skye]

how is pooh patrol going? and the kidneys? the stages is on that iris link. it is really a interesting site. feel like i am getting secrete look at how vets compile information....lol and thus creating scrolls of my own questions. lol! like i am squeezing in at the round table. lol
if you are comfortable pm me your email and i will send you the spread sheet i have done so far. i am wanting to redo it and have it different. one LONG line of all blood.......not seperated out in title of tests.......and then months and reference ranges and results. so this one has been going for 16 plus months so it isnt as attractive as it was...lol.........but it still helps me track. But maybe together we can give each other ideas on how to create one that would be perfect.
holding on tight to you and furbaby..........as i know you are as well. Onward we go......why do i think we are skipping on a yellow brick road and sometimes dodging flying monkeys...........(quiver....i am still scared of flying monkeys to this very day) lets skip over to lollipop land. okay? seems like a happy little area.

[molly muffin]

Hi Tina, just checking in on you and Jasper to see how things are going?

hugs,
Sharlene and Molly Muffin

[addy]

Me too Tina, hope you guys are okay!!!

[Trish]

Eek, nothing for over a week!! Not to worry anyone of course... Tina said she was busy! I hope all going well with you and Jasper!! I have missed our late night catchups! xxxxxxxxxxxxx

[Mel-Tia]

The calendar tells me it's Jaspers birthday

Have a great day little fella, am sure you will be spoilt rotten

Mel
Xxxxxxx

[Tina]

Hi Everyone,

Thanks so much for checking in on us! I totally apologize for not posting for so long, normally I would never go this long without at least checking in real quick, things just got away from me. I have just been so exhausted, not really sure exactly why. No worries though, I am happy to report that Jasper is hanging in there. And...... Today is his 9th Birthday!!! (Thanks Mel, you are correct!). I have taken the day off work to spend with him and just hang out at home, so I am going to take some time now to get caught up on everyone. I will post an update on him in a bit.

:D :D :D HAPPY 9TH BIRTHDAY JASPER!!! :D :D :D

Mommy loves you so much!!!

We have sure had a lot of ups and downs this past year, and he has been through so incredibly much. I am so thankful to be able to celebrate this Birthday, and grateful to share my happiness this day with his (and my) wonderful family here, who we cannot live without! We love you all. ((((Hugs))))

I will be back later to post an update.

Birthday hugs from me and Jasper :)

[labblab]

Oh, and so many birthday hugs right back atcha!!!!!!!!!!!!!

:) :) :) :) :) :) :) :) :) :) :) :) :)

And I'm gonna go right now and revise your thread title to reflect Jasper's big day today! :p :D

Marianne

[addy]

Happy Birthday Dear Jasper

[Squirt's Mom]

Happy 9th Birthday, Jasper!!

[Nika'sMom]

I know we haven't met, but, I want to wish your Jasper a very Happy 9th Birthday :D

[Trish]

happy birthday jasper boy, have a fantastic day with mom!!

[molly muffin]

Happy Birthday Jasper!!!!

Wow, 9 already. Hope you both had a good day :)

Super big hugs and a belly scritch for Jasper

Sharlene and Molly Muffin

[Harley PoMMom]

Happy 9th Birthday, Jasper!!

[lulusmom]

Happy Birthday Jasper!

[milosmom]

i also want to stop by to wish jasper a very happy,healthy,fun filled birthday !!! patty(milo)meka xoxox

[Boriss McCall]

Dang I missed it..

HAPPY BIRTHDAY JASPER!!

[Skye]

ugh!!!! were LATE!!!!!!
however.............

HAPPY BIRTHDAY!!!!!!!!!!!!! WOOFWOOF PAWS IN THE AIR PARTY IN THE HOUSE................LOL!!!!! GET YOUR SWAG GOING!!!!!

[Simba's Mom]

Happy Birthday Jasper, just keep celebrating the whole year!

[doxiesrock912]

Hippo birdie two ewes...hippo birdie two ewes...hippo birdie dear Jasper...hippo birdie two ewes!

[Trish]

TINA!!!!!!!!!!!!!! WHERE ARE YOU!!!!!!!!!!!!!!!!!!!!! Hope all going well and your just having a wee break and good on you for doing that! I remember you said life was pretty hectic recently.

Love to hear how Jasper is doing though, have not even seen you pop in the middle of the night.

Hope all good in your household
Trish xxxx

[Tina]

Thank you everyone for all of the wonderful birthday wishes for Jasper. We had a great day, so glad I took it off to spend with him. The only thing I am sad about is that he didn't get any special treats or things to eat, because I just didn't want to take a chance with all that has been going on. He was still on the metronidazole at that time to treat the last bout of colitis, so I didn't want to rock the boat by feeding him anything out of the ordinary. :( But we spent lots of quality snuggle time. :D

Jasper is hanging in there. He finished the 2 week course of metronidazole on 3/21 pm. He continues on the FortiFlora one packet daily. I finally restarted the Welactin fish oil on 3/19 (Happy Birthday poor boy :rolleyes: ), because I wanted to restart it while he still had a couple of days left of the antibiotic. Only one change at a time so I can monitor the poops. It has only been 3 days since he finished the metronidazole, but so far so good. The poops have been ok for the most part. And he seems to be tolerating the Welactin, thank the Lord. This is a very important part of the treatment plan, for both the kidneys, and to help lower his triglycerides. He continues on the RC renal MP diet, and on Enalapril 5 mg 1/2 tab twice a day. His appetite has been good. The drinking and peeing are still more than normal, but have decreased a bit. Some days he is not too perky, but he seems to be feeling good overall for the most part.

We had what I would call a milestone of sorts on Friday 3/22. It marked a full 2 weeks since I have needed to call the vet for anything. This is the first time we have been able to go for this long since all of the problems started, so about 10 months or so!! We have made it 1 week a couple of times, and 10 days on one occasion, but never a full 2 weeks. So I feel this is important to note!! :p

I did have to call on Friday to get a refill on his Enalapril and found out that my vet is on vacation for 2 weeks! She will be back on 3/29. At first I was glad I didn't know she was gone, but then felt a little panicky. You know, "what if something happens?!" But later I started feeling like my vet should have at least left me a message that she was going to be gone for that long, especially with all that has happened with Jasper. I don't know, I imagine she felt it was ok since she hadn't heard from us for a week before she left. Actually, she was probably celebrating that she was going to be away from us for a bit, Lol!! I do know who to see in the office in her place. But I guess I still wish she would have let me know. After all, I am pretty sure Jasper is her most complex patient. Just being picky I guess. It's not the first time, and I'm sure it won't be the last. :rolleyes: :rolleyes: :D

I left a message for her to call me once she is back, just so we can touch bases and I can give a report on Jasper, and clarify when we will be rechecking labwork, UPC, Percorten injection, etc. Sheesh, if we don't need anything in the meantime, by the time she calls, it will be 3 weeks since we have talked! Fingers and paws crossed. I had to joke with the receptionist that I was glad to see they were keeping their doors open without our once or twice a week visits!

Hugs,
Tina and Jasper

[addy]

That sounds like a pretty darn good report, Tina.:):):)

I have my fingers crossed you make it another two weeks:):):)

I'm really glad to here Jasper is tolerating the fish oil. I have nightmares about trying to give that to Zoe:rolleyes::rolleyes:

One second, one minute, one hour at a time, then 1 day at a time, one week at a time, hey we are up to two weeks at a time:D:D:D

LOVING IT:D:D:D:D:D:D

gotta run, Koko is LOCO, flying around the house and the rugs are flying every which way and poor little Zoe is trying to trot after him:rolleyes:

I think they are needing my attention:D:D:o

[molly muffin]

Sounds like a good Jasper report! Yaaayyyy!!!!
2 weeks, you can do it. Hopefully nothing will come up and you won't even notice she is away.

Addy, hope you have your running shoes on, sounds like Koko is having fun. :0

hugs,
Sharlene and Molly Muffin

[Simba's Mom]

Woot Woot, for good reports, sending happy hugs from Sim and me....

[Trish]

Very weird, my vet is away for a holiday too, without checking in with me either.. . what are they thinking having a life without notifying us :D:D:D Eek, we haven't driven them away have we :D:D:D

Hope Jasper is behaving himself till the vet gets back. Flynny is doing pretty good, I have him booked in on 9th April for his next BP and UPC checks, thats a couple of days before I go to Australia. So hope he does good while I am away.

See you soon
Trish xxxx

PS Koko is Loco made me laugh Addy :)

[Tina]

Hi Everyone,
My vet got back from vacation last Friday, and I have checked in with her. I will post an update on Jasper in the morning. I just want to post real quick to say that we will be trying a mobile dog groomer for the first time in the morning. I kind of freaked out a couple of months ago after reading that horribly sad grooming tragedy post and the feedback from others about that.

Since Jasper got sick, I have become more and more concerned about leaving him at the groomers for his bath and haircut. I don't know why exactly, I am just nervous leaving him somewhere now. He has gone to this groomer since he was born, and I have worked with her to decrease the amount of time that he spends there. But even with dropping him off first thing and her taking care of him first in the day, he is usually there about 2 hrs or so. He used to be there about 4 hours total, so it is better, but I still don't like it. Just a feeling in my gut I guess.

So I called a mobile groomer and scheduled an appt for tomorrow. I am a little nervous just because it is someone new. Like I said, Jasper has gone to my regular groomer since he was born, and I have known her for about 20 years. So this will be a big change. But I like the idea that it will take much less time, and she said I can sit in the front of the van if I want to while she grooms him, if it doesn't make Jasper anxious.

I started looking into this based on the feedback of others on the forum. We only have 2 mobile dog groomers in town. It is quite a bit more expensive, but it will be worth it if it is less stressful for Jasper and he is more comfortable. I have to give him extra dexamethasone to compensate for the increased stress on his body. He got his regular every other day dose today, and I will give him a dose tomorrow morning also to help with the stress.

So wish us luck. I really hope I like this lady, because I really like the idea of him just being out in the driveway in her van rather than having to leave him somewhere. I can keep an eye on things this way. ;) She will be here first thing in the morning. I will let everyone know how it went.

Hugs,
Tina and Jasper

[addy]

Will be thinking of Jasper and you. He might like a personal spa day in his driveway;););)

I feel so bad Zoe cant really do the groomer anymore. Iwas trying to give her a haircut on her face, trying to match it to Koko.
Did you ever give a snapping alligator a new do:rolleyes::rolleyes::rolleyes:

I'm sure it will go just fine. If only we lived near John we would not have to worry!!!!!!:):):)

[Tina]

Hi Addy. Lol, spa day in the driveway. Yes, I have often wished that I lived near John, and my grooming worries would be over!! And so sorry that Zoe wont let you trim her face, that would be tough if she was snippy. I would not want to approach with scissors. :eek:

Well the appt with the mobile groomer went well. She was very nice and calm, seemed very gentle, soft spoken, and seemed genuinely concerned to know all about Jasper's health issues. She did pretty well with the haircut. There are a few minor adjustments that will need to be done with his beard and face, but this was the first appt, I am sure we can improve the next time. For now, I am going to try to do a few snips here and there to adjust. I am not good with eyebrows, so wish me luck! Jasper had an extra dose of dexamethasone to counteract the stress from being groomed and so far is doing ok. And what a huge relief to not have to leave him anywhere for a few hours. Not to mention that he won't be exposed to other dogs with his compromised immune system.

I gave my vet an update on Jasper last Friday 3/29, and we talked again briefly this past Friday. Jasper had his monthly Percorten injection on 4/1. The dose was lowered by 10% again, so he got 0.4 ml. We are still looking to wean him off it in the future. We need to recheck electrolytes to see how those are doing, which is included in his plan.

Here is the current plan:


Continue on Enalapril 5 mg, 1/2 tab twice a day
Continue on Dexamethasone 0.5 mg, 1/4 tab every other day Continue on FortiFlora one packet sprinkled on food once daily for 30 days (he will be done with this after supper tonight)
Continue on Royal Canin Renal MP prescription diet
Recheck a chemistry profile around the beginning of May, to include kidney and liver values, and electrolytes
Recheck UPC at the beginning of May
We may recheck the triglycerides at the same time, although preferably we want him on the Welactin for a 3 full months before rechecking (Welactin was restarted on 3/19)
We will probably get a baseline cortisol at the same time also, just to verify that he is likely permanently Addisonian
Continue to measure water intake

I asked about rechecking the UPC sooner, and she said that it is slow to show improvement with treatment, and she has found that it can be discouraging to recheck it sooner (i.e. monthly), because it may not show any improvement that soon. I guess that makes sense. I am anxious to see what it is now, but sure don't need any more discouragement! My vet said we are doing everything we can as far as treatment for the kidney issues, there aren't other options, so I continue to pray that the treatment will stop the progression of the proteinuria and kidney disease.

I am worried about him finishing the course of FortiFlora. His poos have been much better, and I would say they have been mostly normal for the last week and a half or so (Yay!! :D). I asked my vet about continuing the FortiFlora. She said it wouldn't be a bad thing, but she prefers to stop it after the 30 day course. She said if his poops get soft again, we can start him back on it. She seemed to think that he didn't need to be on it all the time at this point. It will be done tonight, so I guess we will see. I am just hesitant to change anything that seems to be working!

He is eating well on the prescription diet with the Welactin added. His drinking and peeing are about the same - less than it was when he was drinking up a storm, but still more than normal. He is drinking about 3 1/2 to 5 cups a day, it should be right around 3-3 1/4 cups per day according to his weight.

It seems to me that his abdomen isn't as large as before. I am hoping that this means his enlarged liver has decreased in size now that we have been able to get the Dex dose down to a physiologic dose. I am hoping his liver enzymes will go down also, but I am not sure if that is realistic or not.

He seems to be feeling pretty good and is happy. I am so thankful for that. I will just feel better once we have some labwork to validate that his little body is indeed doing better. I am still scared to death about the kidney stuff and am praying hard about that. I treasure every day with my precious boy. Thank you all for your continued support.

I hope everyone and their babies are having a peaceful weekend.

Hugs,
Tina and Jasper

[molly muffin]

So glad to hear that the mobile groomer worked out. I think any time you change groomers, there are a few adjustments to be made. Perhaps next time, now that you know what was done differently you can talk to her about how you would like those areas to be trimmed to.
I know for Molly we can go with a shaped beard, face area, or we clip it down to a puppy cut, where they trim the beard off. I admit this does keep her cleaner for longer. Somehow she always manages to look like a slob with the long beard. Puts her whole face into her water bowl, then into her food bowl and well you can just imagine. Still I do sometimes have the shaped beard cause it's cute. Thank god I don't have to worry about eyebrows! I do have to worry about bangs in her eyes and her eye lashes grow like you wouldn't believe, very long. I've hard this is actually a disease, but it never seems to have affected anything other than just being long and having to be trimmed.

Hopefully Jasper will be fine without the FortiFlora. However, if not, he could always go back onto it if needed. Jasper as we have said many times writes his own book.

hugs,
Sharlene and Molly Muffin

[frijole]

Glad the groomer worked out. I tried one many years ago in Omaha (he passed away) and it was a disaster. It was winter, very very cold and he had my girls in his van trying to groom with the door open. I about crapped my pants. Only tried it once because of that. I saw a metal table, no padding and thought they must have been freezing their buns off. :eek::D:D:eek:

[molly muffin]

Hi Tina, checking in on you and jasper and shelby.
Hope everything is going okay and all is well and you aren't being over worked too much!

hugs,
Sharlene and Molly Muffin

[Trish]

Hi Tina
How are things going with Jasper? Miss you popping in the middle of the night for a quick chat, hope all well with you guys and you are starting to get some nice sunshine for some walks!
Trish xx

[molly muffin]

Hi Tina,
Sorry to hear that your mom and grandmother have both had medical issues lately (from Flynns thread) and I hope that they are both doing okay now.

hugs,
Sharlene and Molly Muffin

[Tina]

Hi Everyone,
Just wanted to pop in and finally give an update on Jasper. Thank you Sharlene and Trish for checking on us! I haven't been on the forum much lately as both my Mom and Grandmother ended up in the hospital during the past couple of weeks. :eek:

Thank you Sharlene, everything is ok now and they both seem to be doing fine. My Mom lives in San Antonio, so that was quite worrisome that I could not be there. Thank goodness my brother lives nearby so he could be there to keep on top of things and fill me in by phone. It was kind of touch and go for about a day or so as to whether I needed to urgently go down there, but fortunately it was not necessary. My Grandmother is here in town and lives in assisted living, so that was a bit easier to manage.

It all just brought to the forefront my fear about needing to leave Jasper for any reason. I have a wonderful pet sitter that we have used several times before, but I have not gone anywhere since Jasper got sick, so have not needed her. I need to get ahold of her and talk to her about all that is going on with Jasper so she can be up to speed. I am hoping that she will not feel that he is too much to handle. Also, she needs to meet my unfriendly little hooligan Shelby to see how that goes. Hopefully Shelby wouldn't be too much for her to manage behaviorally. So - lots of issues that all need to be addressed sooner rather than later. I would be up a crick right now if I needed to go away for an emergency, and that is a very scary feeling.

Jasper has been doing pretty well I think. He has been off the FortiFlora since 4/8 and no further diarrhea. (Yay!!) His poops have been multi colored however, just like some of the pics that Julie posted of Hannah's poo. They go from lighter to darker and back again, and sometimes are lighter on the inside and dark on the outside, or marbled looking. I don't know if this is anything to worry about or not. The variability in the color is very odd. Something I will be talking to my vet about when we see her, I guess.

He continues on the RC renal MP diet, Welactin fish oil, Enalapril and dexamethasone as I previously noted. We have an appt on 5/4 for follow up on all his labs, UPC, and his yearly wellness check. I am anxious to get some follow up on things, I won't feel secure until I see that the labs validate that the treatment is working, especially regarding the proteinuria and kidney values, as well as hopefully some improvement in the ALP and triglycerides.

I posted earlier on Addy and Zoe's thread that Jasper seems a little off lately, but I can't identify any glaring things that seem specifically wrong right now. I guess he just seems overall more subdued. Jasper has never had an ultrasound, it was not something my vet recommended during the Cushings diagnostic process, in fact I think it was only mentioned as possibly the next step if the LDDS test was not conclusive. I found this forum after Jasper had already started on Lysodren and got over suppressed during the load, so didn't even know that most dogs going through this have an ultrasound. I have often wondered, especially recently, about whether or not I should ask if he should have one. I don't know. I would welcome your thoughts or advice about this.

I thought of something else just a couple of days ago after reading about all the pups that are scared of storms or thunder. Jasper is afraid of storms also, mostly the sound of high wind. He doesn't like thunder either, gets quite restless, but it seems to be the sound of high wind that scares him the most. Knowing what I now know about how cortisol functions in the body during times of stress, I wonder if maybe he would need an extra dose of Dex during the times that we are getting severe storms?

Since his poor little body hasn't been able to produce ANY cortisol for quite some time, that only seems reasonable. I can't believe it didn't occur to me before! :o So far he has not gotten sick after any storms, but if the last couple of weeks are any indication, we are in for a bad weather spring. I give him extra Dex before he gets groomed to help counteract that stress, so wonder if I should do the same for storms. The only problem is that a lot of times severe storms come up while I am at work so I wouldn't always be able to know when it is going to happen. I will be asking my vet about this. Your thoughts??

Thank you all for reading and your feedback. I know this is a Cushings website, but I am forever grateful that you all have allowed Jasper and I to stay and continue to be a part of this forum even though he is now likely permanently Addison's. And also now with kidney issues. I really don't know how to thank you all. :)

Love and hugs,
Tina and Jasper

[frijole]

Tina, Great update. I can help with the thunderstorms... My girls were afraid as well - that and 4th of July (until their hearing went :-> ) I gave them melatonin - just one pill and it chilled them enough they didn't shake all over. It is all natural and doesn't affect the cortisol. One 3 mg tablet should do it. Buy at any drug store. Kim

[Squirt's Mom]

Hi Tina,

I hope your mom and Grandmother continue to improve and no emergency trips are required. I'm in the same shoes - no one I could count on to take care of my babies if I had to leave them and it is scary to think about. I hope you have no need to leave.

Here is some info I posted earlier on Tipper and Patti's thread -


A friend told me about the TTouch Body Wrap as an alternative and it works much better for Squirt than the Shirt does - and it does not interfere with her ancient body movements. I use an ACE bandage that is about 3" wide and has a Velcro end. Here is how to put it on - http://www.crvetcenter.com/ttouch.php

One of the tricks to handling storm fear with either the wrap or the Shirt is to start using it when there is no need for it so the pup associates it with happy, calm times. Wrap them or put the Shirt on then go to the park, or for a walk, something they enjoy while wearing the wrap/Shirt. Once they are comfortable in the wrap/Shirt, you then make sure it is put on long before the storm actually begins - which means you have to watch the weather predictions like a hawk. If it is supposed to storm this afternoon, you wrap or put the shirt on in the morning - hours before the activity starts so they immediately associate the wearing of it with those good times they have experienced earlier while wearing it. I have a narrower ACE bandage that I use on Brick but Sophie will not tolerate either the Shirt nor the wrap. She basically attacks it until either she has ripped it off or I take it off. She has the mildest reaction to storms of the three so I let her be as the wrap/Shirt makes her more upset.

I also use the melatonin for Squirt as well as Brick and Sophie. In addition to the melatonin, I use the dried herbs Passionflower and Skullcap made into a tea. Squirt gets 2ml, Sophie gets 4ml, and Brick gets 1ml.

Hope this helps!
Hugs,
Leslie and the gang

[addy]

Hey Tina,

I wanted to keep Zoe on her melatonin and lignans when we first started Vetoryl and our IMS was adamant that we could not as she claims melatonin can affect cortisol. So maybe check with your vet before trying melatonin. She was so adamant about it, just got me thinking today when I read this. Maybe she is wrong.

[NoonelovesmelikeNorman]

Hi Tina, Good to hear things have stabilized with your mom and grandmother. So much to Handle at one time. Maybe turning on a fan or a radio would help drown out the noise of thunder??? Just a thought. I hope your dog sitter can get acquainted with your other pup in case you need to travel.

Praying things calm down in all areas of your life. Peace and blessings,

Sharon, Norman (cushings doxie) and Millie (mini -yorkie pooh)

[molly muffin]

Tina, super big hugs girl! You know we love you and Jasper! Cushings is what might bring us in the door here, it isn't necessarily what keeps us here. Just walking in that door, makes you a part of the family of k9cushings, whatever may be going on, cushings or not.
I'd get the pet sitter on board and acquainted, just in case of an emergency in the future. Let her get familiar with Jaspers issues and meet little miss Shelby. :)
Ultrasound, if you feel something is off with Jasper, and you would know better than anyone else, then you could get one. You after all know Jasper best. Something to put on your list to talk to your vet about.
Hoping things continue to go well with your mom and grandmother.

hugs,
Sharlene and Molly Muffin♦

[Trish]

I think I would ask for an ultrasound, it could show something in his kidneys that may be treatable? I know Flynn had a few stones there, I must ask about that again.

I also read the kidney dogs could benefit from aspirin, another thing to check with my vet about as well as fish oil.

Flynn sleeps through storms without a peep out of him, plus I think I could take him for a walk with all the fireworks going off on Guy Fawkes and he would look at all the pretty colours :eek::eek:

I agree with the getting the petsitter up to speed, always handy to have that up your sleeve if you do need to head off anywhere quickly. So pleased to hear your Mom and Grandmother are doing better, they are such a worry aren't they. At work today, I ran into Dad's physician and also Mum's Dr from last week and had a chat to them both and gave them updates and asked a few more questions. So now instead of just having a plan for Flynn I have to worry about plans for Mum and Dad too!!!! :eek::eek: Getting hard to keep things straight with all the various illnesses!! I need an app :eek::eek:

Jasper sound like he is generally doing ok, so hoping we get good results on your little man next week, I will be waiting with baited breath to hear!!

Have a good week!
xxx

[Simba's Mom]

Just checking in on you and your furbabies, sending hugs too!

[addy]

Hi Tina,

I happened to come across an article by Dr. Peterson which included this quote:


Melantonin
Melatonin can inhibit the activities of both 21-hydroxylase and aromatase enzymes within the adrenal cortex. Inhibition of the 21-hydroxylase enzymes could potentially lower serum cortisol concentrations, whereas inhibition of the aromatase enzyme could potentially lower circulating estradiol levels.


I thought of you so am sharing it.

[Trish]

Hi Tina and Jasper - just wondering how you are both doing, hopefully having a good week with no dramas from your family either, these parents and grandparents can be such a worry. So hoping your stress levels have gone down and everyone is behaving!

Love to hear and update on the boy when you find time :D xx

[Fellasmom]

Hi Tina
Just wanted to thank you for your kindness.Losing Fella has been so heartbreaking but I am so grateful to all of you.Just started reading about all of your furbabies and look forward to reading your thread on your baby Japser.So thankful to all of you for being there and helping me through this!Hugs to you and Jasper!
Love,
Patty

[Skye]

stopping by to see how things are going......hope to hear from you soon.

[molly muffin]

Hi Tina,

Hope all is okay with mom and grandmother and Jasper and Shelby.
Are they over working you again at the office?
Hope you have a good relaxing weekend.

hugs,
Sharlene and Molly Muffin

[Tina]

Hi Everyone,

Thank you all so much for checking in on me and Jasper! Things have been crazy at work again, and I haven't been able to be on the forum much lately but have been reading along as much as I can.

I just want to post real quick to say that Jasper's follow up appt is this morning. He will have his yearly "physical" , heartworm check, etc. He is not due for any vaccinations this year except for bordetella, which is given orally now. So I am thankful I won't have to deal with decisions regarding all of that this year. He will also get all his bloodwork rechecked, liver and kidney profile, chem profile, electrolytes. And of course we will be rechecking the dreaded UPC. We may also recheck a baseline cortisol, and the triglycerides/ cholesterol, but not sure about that, it may be too soon for those.

I am up at the butt crack of dawn to get my notes and list of questions together before his appt. I am feeling a bit anxious as this is our first check on things since Jasper started treatment for the proteinuria. He has been on the prescription kidney diet fully since 2/28, the Enalapril since 1/31, and the Welactin since 3/19.

I will be back on later. My goal today is to get caught up on everyone and do some posting. I feel so out of the loop and miss talking to all my wonderful friends here. I hate to feel so out of touch. Thanks again for checking on us.

I am asking for everyone's prayers and positive thoughts for good results for my boy today. Please keep us in your thoughts.

Love and hugs,
Tina and Jasper

[Trish]

Ohhhh ask about the benefit of having ultrasound too....


GOOD LUCK JASPER AND TINA!! XXX

[Tina]

Awww, thank you Trish!!! Yes, I have added the ultrasound to my list, thank you!! A while back I think you mentioned that you had read something about giving aspirin for kidney issues. I remember way back my vet saying that in doing all my reading I would probably see aspirin mentioned as part of the treatment for PLN, but that she does not recommend it. She explained why at the time, but for the life of me I don't remember. I will ask about that again also.

Gosh, my list is getting pretty lengthy. I feel like I am always grilling her with tons of questions. I guess it won't be any different this time! :D

I'm feeling kind of scared, and it will be torture waiting for the results. I have told Jasper how good Flynn's results were, and to be just like him! :p

(((Hugs)))

[Squirt's Mom]

Hope all goes well today for Jasper! Let us know what you learn!

Hugs,
Leslie and the gang

[molly muffin]

Crossing fingers and paws (molly is) for Jasper and you today and some awesome good results on all the tests.

hugs,
Sharlene and Molly muffin

[Harley PoMMom]

Keeping you and Jasper in my thoughts and prayers, and wishing you both the best of luck with the vet visit.

Love and hugs, Lori

[SoggyDoggy]

Hey Tina,

I hope all goes well with the checkup and that it stays routine with no surprises (unless they are good ones - good ones are always welcome). Fingers crossed for you and please give Jasper an extra smooch from us too! :D

[addy]

me too, Tina, Zoe and I are cheering for you and Jasper

[Trish]

Ohhh no news yet?? I am up early to check on you two! Hope it went well today xx

[Tina]

Thank you all so much for keeping Jasper in your thoughts today and for all the good wishes. I feel like the appt went pretty well. My vet thought Jasper looked good overall. His weight is holding steady at 25 lbs, I was a little worried about that with the lower protein food. When she examined his abdomen she said everything felt ok in there, and she said his liver margins were much more normal than the last check a few months ago. I was so worried then, his tummy was so big, and when she felt around she said it was because his liver was so enlarged from the steroids. Now that he is on a physiologic dose of the Dex, his liver size has decreased. That is great news, although it didn't sound like we could expect the ALP to improve because of the Dex.

He had blood drawn for a chem profile which includes a liver and kidney panel, and triglycerides. Also a baseline cortisol. The last cortisol check was done in November, and it was less than 0.4 ug/dL then, ref range 2-6 ug/dL. If it comes back still this low, my vet said he will be considered permanently Addison's. She also sent off urine for a UPC. We did not check the electrolytes since he just got the Percorten injection last Saturday, so they would likely be normal from that.

She didn't feel that having an abdominal ultrasound would be of great benefit now since he is finally showing some stability. I had forgotten that my vet had done a couple of what she called "targeted ultrasounds" back when Jasper was so sick and ended up in the hospital with the Addison's crisis. His pancreas and liver were looked at then, and a targeted ultrasound of his kidneys was done when his drinking and peeing had not shown any improvement and the protein showed up in his urine. She said the liver and pancreas looked ok, and there were no cysts or abnormalities of his kidneys. I don't have reports for any of these, and I now am remembering that I wasn't charged for them. I think they were done when he didn't seem to be responding normally to anything and she was struggling to figure out what was going on with him and wanted to cover all the bases. I didn't even think to ask about reports, maybe I should inquire about that?

The lab results will be back Monday or Tuesday and she said she will call when they are back. So the torture of waiting has started. I feel like there just has to be some improvement since he seems to be feeling better, but I won't feel secure until the numbers validate that. I am thinking positive but still feel scared, especially about the kidney profile and UPC. I have been telling him all day about what good results Flynn had this last time, and so he can do it too!! ;)

Shelby had her yearly check last weekend, I need to post an update on her thread in the everything else section. She has a couple of things going on also, never a dull moment around here!

Thanks again for thinking of my boy today, I knew you all were with us in that room. I had so many questions for my vet, I am sure she felt tag teamed. And she was, because you were all there with us! :D

Hugs,
Tina and Jasper

[Boriss McCall]

Hi Tina,
I know what you are talking about with work. I have been so slammed myself.
I will be keeping my fingers crossed waiting for the test results. Sounds like he is doing good! :D

[Trish]

Hi Tina

So pleased to hear the appointment went well today, with all those positive signs we surely have to get good news!! Will keep everything crossed just in case though.

I just caught the end of a show on tv, one of those crime programmes, and it was in Omaha!! So I was checking out the scenery of your city, it was about a whole lot of kids who murdered the father for sleeping with the son's girlfriend and the mother knew and gave the ok so she could collect the insurance money?!? :eek::eek: You live in a lovely place Tina :)

Hope you enjoy the rest of the weekend now the appointment is over xx

[addy]

waiting is hard, sweetie, so we will all wait with you:):):)

I am pleased that everything went well and it sounds like your vet is doing a great monitoring job:):):)

That, dear friend, is half the battle:):):):)

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

[Squirt's Mom]

Sounds like a good report to me so far, Tina! YAY, Jasper and Mom! :cool::):cool::)

[molly muffin]

Hoping for good news this week!!

hugs,
Sharlene and Molly Muffin

[Trish]

Still got everything crossed for you Tina, I hope you hear tomorrow to put you out of the misery of waiting waiting waiting!! xx

[Trixie]

Tina,
I hope your wait will be over very soon (waiting is the worst!) and that you get some great results from Jaspers tests!! Thinking positive thoughts for your little schnauzer! :)
Barbara

[molly muffin]

Soooo Tina. Any word today????

hugs,
Sharlene and Molly Muffin

[Tina]

Hi Everyone,

Well, all your prayers, positive thinking and good wishes worked. My vet called late today with Jasper's lab results and there has been a lot of improvement!! I was so pleasantly surprised I could hardly speak!! :D She emailed the reports so here is what we have:


GLUCOSE 81 (70-120) mg/dL
UREA NITROGEN SERUM L 8 (10-28) mg/dL
CREATININE SERUM 0.77 (0.50-1.50) mg/dL
BUN/CREAT 10 Ratio (no ref range given)
BILIRUBIN TOTAL 0.2 (<0.6) mg/dL
BILIRUBIN DIRECT 0.0 (<0.3) mg/dL
BILIRUBIN INDIRECT 0.2 mg/dL (no ref range given)
ALT (SGPT) H 145 (<100) IU/L
ALKALINE PHOSPHATASE H 1562 (<95) IU/L
LACTIC DEHYDROGENASE(LD) H 323 (<175) IU/L
AST (SGOT) 24 (<65) IU/L
CHOLESTEROL H 306 (125-260) mg/dL
TRIGLYCERIDES H 198 (41-115) mg/dL
CALCIUM 11.3 (8.3-12.0) mg/dL
PHOSPHORUS 4.0 (2.8-5.7) mg/dL
SODIUM 143 (138-154) mmol/L
POTASSIUM 5.2 (3.7-5.8) mmol/L
CHLORIDE 104 (104-118) mmol/L
PROTEIN SERUM 7.2 (5.4-7.5) g/dL
ALBUMIN 3.7 (2.5-3.9) g/dL
GLOBULIN 3.5 g/dL (no ref range given)
OSMOLALITY CALCULATED 282 (280-310) mOsm/Kg

CORTISOL-RANDOM <0.4 (2.0-6.0) ug/dL

PROTEIN, RANDOM URINE 93.6 mg/dL
CREATININE, RANDOM URINE 63 mg/dL
PROTEIN/CREAT, URINE 1.49 Ratio
*END OF REPORT*

The UPC has improved significantly, (normal is < 0.5)
3.57 on 01/14/13
1.49 now :D :cool: :D :cool: :D

It is still not normal, but tons better. Going in the right direction!! I feel like I can breathe a bit now after seeing that, I was so afraid that it would be the same or even worse.

Also very relieved to see that the BUN and creatinine had not gone up, phosphorus was ok, and also that the serum protein and albumin were still WNL with the moderate protein diet and urine protein loss.

The cholesterol and triglycerides are still a bit high, but the triglycerides have come way down,
1735 on 02/07/13 :eek:
198 now

Alk Phos still elevated but better,
2170 on 02/07/13
1562 now

The LD and ALT are a bit elevated now where they were WNL on 2/7. She didn't mention any concern about that when she called, I will have to ask.

The baseline cortisol hasn't budged. I don't think the lab can register anything lower than <0.4 so that is what it always shows. She said that we can consider him permanently Addison's now, as enough time has lapsed with no adrenal regeneration that we can make the diagnosis. :( I have some mixed feelings about it, but am so thankful that my boy is feeling better, that I am not going to dwell on that now.

My vet was VERY pleased with all of the improvements, and for now we are going to keep the plan the same. Continue with the Renal MP diet, Enalapril, Welactin, Percorten injection every 26 days, and the Dex every other day. She didn't mention when we would follow up again, I think she was just so happy with things, and probably glad that she may get me out of her hair for a while!

I have nearly hugged Jasper to death since I got home, he keeps looking at me like "Mom, what is wrong with you, settle down". Thank you so much everyone for all the crossed fingers, toes, paws, tails and everything else. I am so grateful that the treatment appears to be working, and I pray that it continues.

Before I had received any results today, I was sitting at my office and thinking about everything that has happened since we started this journey. (My day was not very productive today). I didn't realize it but it has been almost exactly a year since everything started. And actually it has probably been a little more than a year since I first noticed that he was drinking and peeing too much, we just hadn't started looking into it yet. It was either 5/23 or 5/24 last year that he had an accident in the house during the night and we went in for an urgent vet visit the next day, and all the evaluating and testing started.

After his horrible cortisol crashes at the end of August/beginning of September, the subsequent hospitalizations and all that happened then, the unspeakable thoughts crept in about whether he was going to make it through or not. My boy is still with me now and words can't adequately express how grateful I am. I am bawling now just thinking about all of it, and also because if all of this wouldn't have happened, I wouldn't know any of you. It is because of you, my dear friends, that I was able to get out of bed every day when things were at their worst. It was you that were there with me during the middle of the night when I sat up crying and scared out of my mind. It is because of you that I gained the right knowledge and learned the right questions to ask of my vet in order to always, always do what is best for Jasper. And for that I thank you all so very much.

Love and huge hugs,

Tina and Jasper

[doxiesrock912]

Congratulations!!!!!!

[Trish]

OMG Tina I am just elated for you and Jasper, what a relief!!!!!!!!! :D:D:D:D:D




I'm feeling kind of scared, and it will be torture waiting for the results. I have told Jasper how good Flynn's results were, and to be just like him! :p



Now, it is kinda prophetic you said that! Did you realise both Jasper and Flynn's highest UPC were exactly 3.57 and now both their latest are 1.49!!!!!!!!!!!!!!!! Both exactly the same, what are the chances of that!! I went back and checked Flynn's because I thought, hang on here those numbers sound very familiar LOLOL! We should go buy a lotto ticket!! Now you gotta go find a real healthy dog and tell BOTH Flynn and Jasper they have to be just like him and we will all liver happily ever after :D:):D:)

His liver tests are so much better too.... Wow I bet you sleep better tonight, about time we had a breather. Now if Flynny's tummy would settle down we would have a house of harmony for a while!

This has brought a tear to my eye Tina!! So, so happy!

Trish xxxxxxxxxxxxxxxxxxxxxxxxxxxx :D

[Squirt's Mom]

Oh, YAY! Jasper and Mom! What great news! :):):cool::cool: I am so glad to see these improvements!

Now, remember, in Europe it isn't uncommon to treat Cushing's by intentionally inducing Addison's because they believe Addison's is easier to treat and easier on the pup than Cushing's. So don't be sad or afraid - Jasper just decided to join the other side. ;) BUT you make it perfectly clear to our boy that he is just that - OUR boy so you have to keep coming here and letting us know how he is doing. :)

Hugs,
Leslie and the gang

[addy]

Wonderful news, sweetie, now you can breathe:):):):):)