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

[Tina]

Hello,

I am a new member. My 8 yr old Min Schnauzer, Jasper, was diagnosed with Cushings on 6/22/12. He has the pituitary dependent type.

Let me say that I feel I have a very good vet who has experience treating dogs with Cushings, and reports having good success. We started Lysodren on 7/5. Jasper seemed to be tolerating it well, (none of the warning signs were apparent). We decided to do the ACTH stim test after he completed 5 days of treatment. He had the test on 7/11 and I got the results late in the day on Friday 7/13. The test
showed that he was too suppressed, cortisol levels were at the very low end of normal & one value was one point below normal. The Lysodren is on hold now to allow the adrenal tissue to regrow before we consider maintenance. This is what I understand at this time. I will be talking to my vet after the weekend. Jasper seems to be feeling ok currently. This has been quite stressful, especially since it is the weekend.

I found this forum right around the time we started the Lysodren, and have done a lot of reading, both from the resources and posts. Everything I have read has been so helpful.

I will be asking my vet, but I am wondering if anyone else has experienced their dog's cortisol levels going way too low with the Lysodren even though no warning signs were apparent?

I watched Jasper like a hawk once the med was started for any little change. The only thing I think he showed was some decrease in drinking, but it wasn't real dramatic. I am quite worried about the low cortisol level, even though he seems to be feeling ok now. Everything I have read about this happening scares me.

I would be most appreciative of any feedback anyone can provide. I am really trying hard to not panic over all of this, but am feeling very overwhelmed with everything.

Tina

[frijole]

Hi Tina!

Before I forget - please be sure to check and reply to the email sent to you so that future posts automatically show up.

Glad you found us - if you have read here you know we'll ask questions so we get up to speed.

First thing that comes to my mind is that perhaps the dosage is on the high side - to be loaded in 5 days.

Please tell us your dog's weight and the dose of lysodren you gave daily during the loading period.

Also please type out the two numbers from the acth test. If you don't have them , call and get them. You will need to start a file and keep them for future reference - comes in very handy. Note that a normal dog will have cortisol (2nd number on the test ) of 17 or higher. Cush dogs are ''loaded'' with lysodren with the goal of having the 2nd number be between a 1 and a 5.

IMPORTANT: Sometimes the lab messes up and is thinking they are testing a non cush dog. So an 8 would be too low for a normal dog but too high for a cush dog if you are following me. That is an example of why you must get the test results. :D

Was an acth test done before starting lysodren? If so, those numbers are helpful also.

OK... now I have to ask, are you giving your dog prednisone? It is often given when cortisol goes too low because it helps them feel better. Is your dog lethargic? Any diarrhea or vomiting? (signs of low cortisol)

You said the only change was a slight change in water consumption. FYI dogs all react differently so you must look for slight changes and assume. I am very glad you did the test at 5 days (which is actually faster than normal).

Tell us your dog's story , the symptoms, the whole saga. I know it is overwhelming at first but that is why we are here. :p You are no longer alone on this journey. Sorry I just realized you did tell us your baby's name is Jasper.

The key to using lysodren is a vet with experience, and an owner that gets involved and up to speed because you are your dog's voice. Lysodren is a wonderful med (I used it) that can make your dog well again - you just have to use it in the right dosage.

I see you are no longer giving lysodren. Hard to say how long you will need to wait. Better safe than sorry though.

Take care and again, welcome. Kim

[Tina]

Hi Kim,

Thanks so much for the quick reply and warm welcome.

I will try to answer your questions, but will tell Jasper's story on a later post. As you know, it is a little involved.

I did reply earlier to the email that was sent, just FYI.

Jasper weighs 25 lbs. The dose of the Lysodren was 250 mg twice a day.

The two numbers on the ACTH test were 15 and 14. My vet's message said that ideal is 50 to 100, and normal is 15 to 100. I understand what you are saying about the lab results. I am wondering if this lab has different reference ranges?

He did not have an ACTH test before starting the Lysodren. He had tests to rule out diabetes, thyroid problems, liver disease and kidney disease. The Cushings diagnosis was made based on a LDDS test. I'm sorry but I don't have those numbers. I know there was a 4 hr result and an 8 hr result and my vet said it was definitive that he has Cushings.

I have a prescription of prednisone on hand in case he starts not feeling well. So far he is not showing any of the signs of low cortisol. He is eating fine, no vomiting or diarrhea, and energy seems pretty normal. It has been brutally hot here (I am in Nebraska also!), so he has been a little subdued, but this is not a change.

My vet and I decided to do the ACTH test after only 5 days on the med based on the slight change in the drinking. Better safe than sorry is right, and that is always my thought. My vet said it would be at least a week before we consider restarting the Lysodren, and said it may be 10-14 days. I need to ask how that will be determined. I haven't had a chance to talk to her since it has been the weekend. She is experienced with giving Lysodren and said she has had much success.

I will tell more about Jasper in a subsequent post, kind of weary right now! Yes, it is very overwhelming, as you know.

Thank you for your questions and support!

Tina

[lulusmom]

Hi Tina and welcome to you and Jasper

I believe the unit of measurement your lab uses is nmol and if so, then yes, Jasper's pre and post stimulated cortisol is very low. One of my cushdogs loaded for 7 days and his post cortisol was almost as low as Jasper's and he never showed any sign of loading. He was perfectly fine but I gave him one dose of prednisone anyway just so I could sleep.

Most of us are more familiar with ug/dl unit of measurement so for those who may not know how to read nmol, Jasper's converted pre and post were .5 ug/dl, which is pretty scarey. The conversion for the therapeutic range your vet mentioned would be 1.8 ug/dl to 3.6 ug/dl which is definitely good. I think your vet knows what she's doing.

The weekly maintenance dose is usually equal to the daily loading dose but in Jasper's case, it may be too much for him. Jasper loaded at just under the max recommended dose of 50mg/kg so I think with him loading rather quickly and given the really low cortisol, your vet may drop the maintenance dose down to 25mg/kg, being 250mg per week. Every dog is different and my dog certainly was. His cortisol after loading was .7 so we waited two week to start maintenance. We did another stim two or three weeks later and his post stimulated cortisol was too high. That was five years ago and memory is foggy but as I recall, it was 8 ug/dl. We upped the maintenance dose a bit and that did the trick. Finding the right maintenance dose is a roll of the dice sometimes.

It sounds like you and your vet did a great job, despite the low numbers. A lot of us members have dogs who didn't read the book and sometimes they leave us scratching our heads and thanking God for dodging the bullet.

I'm glad you and Jasper found your way to us. We're here to help in any way we can. By the way, I have a little Maltese named Jasper. He's not cushingoid.

Glynda

[frijole]

Tina, Wow another Nebraskan! Just because I want to be 100% sure... please confirm the units of measure on the acth.

You have never mentioned any sort of an emergency or extreme lethargy and if Jasper's cortisol was as low as .5 we would expect him to be struggling to stand up, on prednisone, and maybe even on IVs. You have never mentioned any of this. I just want to make sure there isn't a lab mess up. I know the number of labs used in this state is very limited and the large majority use Idexx.

You are doing a great job - do you happen to have the ldds test results? Thanks! Kim

[StarDeb55]

Welcome to you & Jasper! Kim & Glynda have given you great advice, so I will try not to repeat. I have used lysodren with 2 pups quite successfully. My first boy had been loading for 8 days, showed no change in appetite or water consumption which I had been measuring on a daily basis. I took him in for an ACTH to see where we were. I get a phone call from the vet the next afternoon asking me if I had checked water yet. I said no, & was told to check water that she would wait. Low & behold, his water consumption had dropped something like 70% overnight. She said that the stim reflected that as his numbers were so low, she told me to give him 5 mg prednisone daily for the next 3 days, then bring him back in for another stim 48 hours after the last dose of pred, so we could determine, if & when maintenance could start. Unfortunately, I don't remember the exact results of the either stim & when we were able to start maintenance as this was something like 13 or 14 years ago. My point is that you absolutely can't determine if Jasper can go to maintenance without doing another ACTH. Some dogs will regenerate their adrenals almost in the blink of an eye, other pups may take months to regenerate, some may not regenerate at all. You just can't tell without the test. Please do not let your vet start maintenance dosing without confirming that Jasper is ready.

Again welcome to both of you!

Debbie

[Tina]

Glynda, Kim, and Debbie - thank you all so much for the information and reassurance. I got teary reading your responses, it is so comforting to know that you all truly understand how I am feeling because you have been there.

I talked to my vet today and have some more information based on your questions.

Kim - The units of measurement on Jasper's ACTH test is nmol, just as Glynda mentioned. My vet said that the blood is overnighted to a lab in Michigan. The results and ranges are as I posted previously.

LDDS results:

Baseline cortisol 390
4 hour 28
8 hour 54

I forgot to ask the units of measurement for this test.

And Kim, you are correct, Jasper has not exhibited any of the critical warning signs of low cortisol and we have not had an emergency. I am very thankful for that. Today my vet reassured me that the cortisol level will not continue to drop while the Lysodren is on hold.

Today she said we will recheck the levels with another ACTH test before we restart the Lysodren for maintenance. I will drop him off for that on 7/25, so that will be 2 weeks since the last test, and since stopping the Lysodren.

My vet said she has consulted with an endocrinologist just to confirm that we are doing everything properly. It sounds like he concurred with my vet's treatment plan. I really appreciate that she talked to the specialist.

That is what I have up to date.

Just a little bit about Jasper - the only sign of Cushings that he has really displayed is increased drinking and urination. I think I first noticed it around the beginning of May. It got really extreme toward the end of the month. He was drinking a ton, and I had a vet appt scheduled for him, but on the night of 5/24 he jumped down off the bed and just started peeing. He couldn't stop, it sounded like a faucet had been opened on the carpet. I grabbed a bath towel from the bathroom to hold under him and he completely soaked it. The look on his face made me cry, he was so embarrassed. He has never had an accident in the house, even when he is sick.

I took him in to the vet urgently the next day, and his urine showed some mild symptoms of a UTI, and of course low specific gravity. We treated him with antibiotics, but when the drinking did not decrease, my vet wanted to do some more tests. He has not had any further accidents in the house.

We did a liver panel, thyroid test, blood glucose, electrolytes, UA, and I'm not sure what else. He had a very elevated alk phos, and elevated LDH. All the other liver values and UA were ok. Diabetes and thyroid were ruled out, as was kidney disease. My vet was then concerned about liver disease so we did a bile acid test, which was normal. That's when she said she was suspecting Cushings, and we began the tests for that.

Jasper has not shown any of the other classic symptoms of Cushings. His appetite has not seemed to increase, no fur loss or pot belly, or leg weakness. I am wondering if maybe we caught it early so that is why he hasn't shown some of those things? He is 25 lbs but is not overweight. He is just big for a min schnauzer.

He is the sweetest and most loving dog, and is such a Mama's boy. I am hopeful that we can get him stabilized and feeling better soon.

Sorry this got so long. Please let me know if you have any more questions or feedback. I am so grateful that I found this forum. Thank you all.

Tina

[frijole]

Tina, Thank you! I just needed that confirmation... I had probably 20 acth tests done between my two dogs and the only time the units were not ug/dl was when we sent it off to the Michigan State lab (it was used because we were getting false positives from Idexx) :D Interesting your vet selected to go there.

Glad you are doing another one prior to resuming maintenance. I agree with whoever it was that said you should lower the maintenance dose! Guess that is an obvious to do but just being cautious.

Kim

[Tina]

I just want to check in real quick. As I posted previously, Jasper will be having the ACTH test re-checked next Wed 7/25 after becoming too suppressed from the Lysodren. Thankfully he has continued to feel ok and has not shown any of the critical signs of low cortisol.

I have been reading so many of the stories posted here and can't begin to express how comforting it is to know that I am not alone in this journey. There are so many kind and caring people here, and everyone's knowledge is amazing. I can't believe how much I have learned.

Thank you to those of you who have given your advice and feedback so far, I am truly grateful. I will be checking in, and will post again when I have Jasper's results and know more of what the plan will be.

This is all still very scary, but I feel so much stronger and so much more prepared to make the right treatment decisions for my precious little boy. All thanks to the help and support I have received here.

Take care,

Tina

[frijole]

Tina, You are so sweet! FYI I found these folks in a panic over 7 yrs ago because I got a diagnosis and very little information. I read and read till my brain was beyond its capacity and realized that my vet was beyond clueless. I live in a town of 25000 people and had just moved here from Omaha. I was used to having more experienced vets and it was the beginning of a journey that continued for many years. If it wasn't for the wonderful friends I met here I would have lost my sanity... We have been in your shoes, totally understand your fears, and you are so right - you are no longer alone. We will do our best to hold your hand.

Kim

[Tina]

Thanks Kim! Yes, I was in quite the panic myself when I found this forum. I was so upset at first, it took me several days to pull it together enough to register and finally post.

I am blessed in that I have a vet who has experience with Cushings and treating with Lysodren. She is very thorough and did a great job explaining everything. (She knows me well, and knows that I would need to know everything and in detail). :) I totally trust her, but it never hurts to educate yourself. And this illness is so complicated, I just needed to read as much as I could. Fortunately what I learned confirmed the information she provided!

It sounds like you moved far from Omaha?

By the way, Your Schnauzers are adorable, of course! I have a 6 month old pup in addition to Jasper. She is quite the handful, especially since all this started with him. Who would have thought...

Tina

[molly muffin]

Tina, I too was in a panic when my molly was diagnosed. I still have moments, not a great many, but a few. I can't even begin to say how much this forum has helped though. Without it, well, I don't even want to think about it.
My vet will be treating with Trilo. Not sure when, we have another test to go through and then we'll see.
Hang in there!

Hugs,
Sharlene (and Molly muffin)

[Tina]

Hi Everyone,

I want to check in with my baby's latest labwork. Just to recap, Jasper was started on Lysodren 250 mg twice a day on 7/5. After 5 days on the medication, we did the ACTH test which showed he was over suppressed with the baseline cortisol 15 nmol, and 1 hour post 14 nmol. He did not show any of the warning signs of low cortisol. The Lysodren has been on hold for 2 weeks and he had another ACTH test on 7/25 to see where we are at. We got the results late this afternoon.

Cortisol, baseline 192 nmol
Cortisol 1 hr post ACTH 186 nmol

I know you all are more familiar with the ug/dl unit of measure but are able to convert these numbers.

I talked to my vet for quite a while. We talked about maybe giving him the loading dose again for a couple of days. She said the levels are a bit higher than ideal for a Cushings dog (ideal being 50 to 100) but after discussing, said she feels that we should go straight to the maintenance dose of Lysodren since Jasper was so sensitive to the dose during the loading period, and since his symptoms are controlled currently. I felt like this was the best option also.

So he will be getting Lysodren 250 mg twice a week. I asked about the dose since several of you mentioned giving a lower dose since Jasper's levels got so scary low during loading. My vet said we will keep the dose at 250 mg twice a week since his levels are a little higher than ideal now. (His weight is 25.5 lbs).

She said to watch for a return of the excessive drinking and urinating, and of course I will still monitor for any signs of low cortisol. We discussed that if the symptoms increased that would indicate that the med isn't holding the level and we may need to put him back on the loading dose for 2 or 3 days (rather than 5 where he got over suppressed).

The plan now is to recheck the levels with another ACTH test in 4-6 weeks.

So that is where we are at now. I am so hopeful that we can get him stabilized on the meds. That was so scary when his cortisol bottomed out.

A question that I have that I forgot to ask my vet is if it is possible for the cortisol level to decrease at all when the maintenance dose is started, or does that mainly occur with the loading dose?

Please let me know your thoughts about the labwork and our course of action. I am so grateful for all of the support and advice.

Thank you,

Tina

[Squirt's Mom]

Hi Tina,

A belated welcome to you and Jasper! :)

We are a Lyso household as well but my Squirt was never loaded due to the type of Cushing's she has - Atypical. We went directly to a maintenance dose schedule when she showed signs that her cortisol was rising. Squirt weighs about 15 lbs and is taking 250 mg twice a week - this has controlled her cortisol for a year now. ;) So, yes, it is possible for a maintenance dose to lower and control the cortisol in some cases. Since Jasper did load, his adrenal glands are prepared for the maintenance dose.

What that means is this - the job of loading is to erode a miniscule layer of the outer cortex of the adrenal glands to stop the continual communication between the adrenal, the pituitary and the hypothalamus glands - the glands that dictate when and how much cortisol to release as needed. In Cushing's, this communication goes into overdrive and tells the adrenals to release cortisol all the time, flooding the body. Once the pup is loaded, this communication becomes more normal - the erosion has done its job. Then we wait for a few days for the adrenals to adjust then maintenance is started to maintain the level of erosion the load achieved. The adrenal glands can and do regenerate that eroded layer so that is the job of maintenance - to maintain what the load achieved, not further erode the cortex.

The conversion for the ACTH is - (if my math is correct! :D To convert nmol/L to ug/dl you divide the mmol/L by 27.59 )

6.96 ug/dl
6.74 ug/dl

So the post number, the number that counts, is a tad bit higher than we usually like to see after a load which would be between 1 and 5 ug/dl. Since Jasper did load so quickly and seems to be sensitive to the Lyso, I think you vet is being appropriately cautious. She seems to have a good handle on Cushing's from what I have read so far. And you are doing a superb job of being a diligent mom - the most critical factor in Cushing's. ;)

I am so glad you found us and many of us here understand how you feel. When I arrived here over four years ago, I was a total basketcase. A dear friend here later told me she envisioned a woman with her hair standing on end as if her finger were in a light socket! :D She kindly left out the part about bulging eyeballs and flying slobber! :p:D:p These wonderfully kind and knowledgeable folks took my hand and gently led me along until I could breath again...then they began to teach me - not an easy job, either! :D The more I learned the further the fear moved away from me...and I know that will be the same for you. ;) Never hesitate to ask questions; we will do our best to help you understand, or we will try to learn together if we don't already know. You and Jasper are now family here and this family sticks together through thick and thin!

Keep up the good work and know you and Jasper will never be alone. We will walk this path with you every step of the way.

Hugs,
Leslie and the gang

[Tina]

Hi Leslie,

Thanks for your feedback and all of the great information!

I restarted Jasper's Lysodren yesterday, 250 mg twice a week. I will be giving it on Sat and Tues. I am hopeful that this will control his cortisol level and even lower it a little bit since his post level was a bit higher than ideal.

I have been reading a lot of the other threads and it seems that it can pretty much be a roller coaster getting the right maintenance dose on board. Based on Jasper's most recent levels, I am a little scared that we will have to go through the loading process again, but will need to wait and see how he does with the current treatment plan. I am hoping for the best.

I am so thankful that I found this forum. I feel like I have a whole new set of friends who are just like me. All who love and care for their dogs as children. I do not have human children, so my pups are it for me. A lot of people, no matter how well meaning, do not understand that.

Did you happen to watch the Olympics opening ceremony? The Queen's Corgis were the highlight for me. They were just precious. :p

Take care,

Tina

[Squirt's Mom]

Hi Tina,

You are doing a great job with Jasper and I am sure ya'll will do just fine getting his cortisol controlled. You have that most critical factor - our diligence - down pat. ;) Plus you are reading and educating yourself on this condition our babies are plagued with and that will carry you both a very long way.

Any time you are nervous or see something you don't quite understand, ask! Trust me, you cannot ask any dumb questions - that's MY job! :p Well, that and being the Queen of Guilt and Panic! :p:D:p I panic really, really good, too. ;)

I loved the opening ceremony! When the Queen (the real one! :D) made her entrance, I fell head over heels in love with the lady. What a grand sense of humor for the leader of a world superpower to display to the whole planet! What a class act! In my opinion, the Brits have done and are doing a great job with the Games. The US has got to get busy, tho! China is taking all the metal and we just can't have that! :D

Keep in touch and remember you are never alone.
Hugs,
Leslie and the gang

[molly muffin]

Tina, you hit the nail on the head, some peeps don't get just how into our animals we are. I told my husband the other day I know more about molly's medical issues than probably my own. She certainly gets more testing done than I do. LOL

I'm enjoying the games when I get a chance to catch them, which isn't as often as i'd like.

Leslie official panic persona of the forum? *wink

Hugs,
Sharlene

[Tina]

Hi Everyone,

Leslie and Sharlene, thanks so much for your feedback and support. Jasper seems to be doing ok since we restarted the Lysodren, but it has only been a week. So far so good I guess.

I have been reading many other threads and see that several folks have their pups on milk thistle and/ or Sam-e. I have done a little bit of reading about them, but need to do more. I am wondering if I should ask my vet about starting Jasper on one or both.

His last liver panel showed an alk phos of 1127 (ref range < 95), and LDH of 564 (ref range < 175). The other values were within normal limits. I don't know if the milk thistle or Sam-e would help decrease these levels or not. I am also wondering if he should be started on them to try to prevent any adverse effects on his liver that could occur from the Lysodren. I am really worrying about that.

Thanks for any advice anyone can provide. I really don't know how I would be getting along if I hadn't found this forum. Most importantly, I feel so much better equipped to provide and advocate for the best and safest possible treatment plan for my precious little guy.

Hugs,

Tina and Jasper

[frijole]

Hi Tina! Just want to put your mind at ease... Lysodren doesn't hurt the liver. It indirectly helps it. The liver issue is caused by the cushings. When you reduce the cortisol generated by cushings using lysodren those enzymes will go down. But please know that cush dogs will have elevated liver enzymes forever. That is why alot of us use milk thistle. You can actually get with SAME in it and save yourself a pill. There is no scientific proof it helps.. I can only tell you that my Haley had levels of 2000 that went down to 1200 after using lysodren... but after using the milk thistle they went below 800 and I was thrilled. She lived to 16 1/2 yrs - she used lysodren for 4 1/2. Don't fear lysodren. :D Kim

[Tina]

Hi Kim! Thanks for responding about the Lysodren. I was thinking I had read somewhere that it was hard on the liver and could cause damage, but I could very well be mixed up. I have pretty much been spending every fee moment reading and educating myself about this illness and all that it involves. My brain is on overload, but I feel so driven to keep reading.

Thanks for sharing how long Haley was on Lysodren, that is so good to hear. And how wonderful that she lived to 16 1/2!! You obviously took such good care of her.

Did you happen to read back in my thread about the results of Jasper's most recent ACTH test and the current plan? (It is in my 7/27 post). I would be interested to know what your thoughts are about going directly to the maintenance dose even though the cortisol levels were a bit higher than ideal. Leslie provided a lot of good information that was encouraging. I am hoping we are on the right track. Thanks for the reassurance about Lysodren. I am still a little nervous about it, but I am much more scared about all of the effects that high cortisol levels would have on Jasper's precious little body.

Hugs,

Tina

[frijole]

I went back and read and that is a tad high but it's Ok to try maintenance since Jasper went low so fast - might actually lower a bit ... just keep watching for signs of either cush symptoms returning or diarrhea/vomiting (the opposite). I think I'd have the acth test closer to 4 weeks than 6 weeks just because that way you will know if this approach is working and if it isn't you can go back to loading more quickly.

Without a doubt the loading phase is the hardest part of the journey. Once that happened (Haley took FOREVER as in over 2 months of daily dosing) we were on cruise control for the rest of her life. It was really a breeze. So the disease isn't bad once you can get the symptoms under control with the right dose.

Do keep us posted and keep on asking questions. Kim

[Tina]

Thanks Kim. Yes, I had already decided that I want to re-check the levels at 4 weeks rather than 6 for the reason that you mentioned. I feel like maybe I am getting smarter about all of this with everyone's help! :rolleyes:

Tina and Jasper

[Tina]

Hi Everyone,

I just want to check in since it has been a while since I last posted. Jasper seems to be doing ok for the most part with the Lysodren at 250 mg twice a week. It will be 3 weeks on Saturday since the med was restarted. I have noticed in the last few days that he seems to be drinking a bit more than when his cortisol was bottomed out, but it's not like how it was before we started the medication. I have talked to my vet about this since his last ACTH test result was a bit higher than the ideal range. She said she recommends that we continue with the twice a week maintenance dose and repeat the ACTH test at 4 weeks like we originally planned, unless his drinking increases significantly, then we will check it sooner. Right now the plan is to recheck the last week of August. She said that we may need to do the loading dose for a few days again depending on the test results. So we are in a holding pattern at the moment.

I have literally spent hours reading other peoples threads, and their baby's stories. I have shed many tears both out of sadness and joy. I have cried along with many of you when the news has been not so good, and rejoiced with relief when there has been a positive test result, or when a sweet pup turns a corner or rallies and shows improvement.

And I have learned an incredible amount from the responses and advice provided by the administrators, moderators, forum hosts and other amazing people on this site. Thank you Leslie, Kim, Glynda, Debbie, Marianne, Sharlene, Addy, Sonja, and others. While I know you all haven't posted directly to me on my thread, I have been following along on many other threads.

I need to say that I have never seen a more supportive, compassionate, kind, or caring group of people in my life. So many times I have read where advice and support has been given while you yourselves are dealing immediately with your own pup's difficult issues. How unselfish. I hope one day to have enough knowledge and experience to be able to help others going through this and dealing with this terrible illness.

I feel that it was a blessing when I found this site and all of you. Out of utter devastation came hope, and the relief and comfort of knowing that I am not alone.

Many hugs to all of you and your sweet pups,

Tina

[frijole]

Tina, Great to hear from you. Sounds like you have a plan. If you have to do a mini load it won't be the end of the world. I would decrease the dosage though. We'll deal with that should it happen.

Reading others threads is the best way to get up to speed on this complicated disease. Yes it can be hard to read the sad stories but it truly is a remarkable group and we are here thru thick and thin no doubt about it.

Your thanks are appreciated - and I hope you do stick around and help others! We can joke and laugh and get off topic at times too. I came here just like you did - scared to death. I stayed for the same reason you mentioned.... it is a wonderful resource. I just wish I could find a group/forum this wonderful for human health issues! :D

Keep us posted! Kim

[molly muffin]

Hi Tina!!! That is really great to hear that jasper is maintaining. Even holding phase can be so calming to the nerves compared to what you go through to even reach that part. Hopefully anything future will only be minor adjustments with no big bumps.

It is reading others people threads and the advice I have received here that has given me so much hope. It truly is an awesome bunch. I check on this forum more than anywhere else on the net these days and that's saying alot!!! LOL

Hugs and belly rubs for Jasper,

Sharlene and Molly Muffin

[Tina]

Hi Kim! Yes, will definitely keep everyone posted. And I think we would be hard pressed to find a group as fine as this for human health issues, that's for sure.

I forgot to mention that Jasper's little sister will be getting spayed in the morning. I am starting to get a little nervous, always worry a bit any time anesthesia is involved. She was originally scheduled for surgery mid July, but rescheduled when all this started going on with my boy.

So if everyone could keep her in their thoughts tomorrow, I would be grateful.

Thanks, and hugs,

Tina

[molly muffin]

Of course we'll send all kinds of positive thoughts for Jaspers little sister. What is her name? Jaspers family, his sister is family, you are family! :)

Sharlene

[Tina]

Hi Sharlene!

Thanks so much for the support and positive thoughts, as always. Her name is Shelby, silly me - I forgot to mention that! She is a Min Schnauzer also, 7 1/2 months. A little hooligan, I might add. :p

How is little Molly doing? She is just adorable in your avatar photo.

Tina

[molly muffin]

Good luck to Shelby today. What a cute name. :)

Molly's doing a-okay. She doesn't have a clue it seems that anything is "off". Thanks we think she is adorable but you know prejudice and all that. :p

Hugs Sharlene

[labblab]

Thanks for the update on Jasper, and we will definitely be beaming healing thoughts to sweet Shelby tomorrow!

Thanks, also, so very much for your kind words about our forum. It means the world to hear that you have felt welcomed and supported, and it is so kind of you to take the time to speak about your thoughts and experiences. It is true that there can be discouraging times for us all, when pups or their parents have setbacks. And so your positive words are a huge morale boost and are so greatly appreciated!!!

Thank you so much, and definitely keep us updated about Shelby's surgery tomorrow, OK?

Sending many healing hugs your way,
Marianne

[molly muffin]

Hope things went well with Shelby today!

hugs,
Sharlene

[Tina]

Hi Marianne and Sharlene,

Thanks so much for keeping my little Shelby in your thoughts today. I got back from visiting her a little while ago. She was still pretty out of it, but I think she knew it was me. I got to talk to the surgeon and she said everything went fine, so that is a big relief. I can bring her home tomorrow afternoon. So Jasper and I are having a "Mother and Son night", LOL. ;)

Tina

[Squirt's Mom]

Hi Tina,

SO good to hear that Jasper is doing well on the treatment so far and hope you see more and more improvements as the days pass! :)

I understand how you felt about the spay for Shelby. My little Trinket was spayed this summer and I was absolutely terrified because she'd had trouble waking up once before. But she'd had two eye surgeries really close together when that happened. She came through with flying colors....can't say the same for her mom, tho. :o:p I'm glad Shelby will be coming home today!

Hugs,
Leslie and the gang

[Steph n' Ella]

My girl Ella got spayed last Friday at the ripe old age of 8 years. I've desided to put tank tops on her instead of doing the e coller! She looks so cute! Note to self...women's size small is perfect for a 30 lb cocker spaniel! Hope Shelby heals quickly!

[molly muffin]

glad everything went well with Shelby's surgery. Now for a nice long weekend of relaxation. (crossing fingers)

hugs,
Sharlene

[Tina]

Thanks everyone for your good wishes for Shelby! That was a great idea about using the t-shirt to keep her from messing with the sutures. I tried a little doggie shirt, but she manages to scooch it up and still lick the incision. Ugh! She is very crafty unfortunately. So the e collar is back on.

I really don't like it mainly because Jasper seems to be afraid of it. Any time she comes toward him, he kind of cowers and moves away from her as fast as he can. And he gets nervous in general any time she is on the move. He is such a sensitive little boy. But I don't have a choice, it has to stay on her.

Hope everyone is having a good weekend.

Hugs,

Tina

[molly muffin]

Hope you are surviving the e-collar. Poor Jasper. I'd be terrified too if some strange looking thing with Shelby's head sticking out of it was coming straight at me too! :p:p:p

Hope the weekend has been great.

Hugs,
Sharlene

[Tina]

Hi Everyone,

Jasper has been on the maintenance dose of Lysodren 250 mg twice a week for 4 weeks. He gets the med on Tues and Sat. He has seemed to be doing pretty good, and we had his follow up ACTH stim test scheduled for Wed 8/29. Last Saturday 8/18 when eating, he briefly walked away from the food, but came right back and continued eating until his food was gone. I monitored very closely and there was nothing else unusual all last week, he ate fine. This was the first time anything like this had happened, even when he was getting the loading dose and his cortisol went way too low, he did not show any change in his appetite.

Yesterday morning, he didn't want to eat, walked away from the bowl when I put it down and went into the other room. I coaxed him to eat a little bit here and there out of my hand, but even that was difficult. After about an hour and a half of hand feeding him off and on, I finally got him to finish what was left in the bowl by crumbling a treat in with the food. Last night he ate all his food, although he ate slower than usual.

This morning he started eating right away but about halfway through he walked away again. He resumed eating with encouragement and did finish, but slower than usual.

This morning I left a message for my vet right away. She called back late this afternoon and first said we should do the ACTH test tomorrow instead of Wednesday, and hold the Lysodren immediately. She said she also wanted to check his electrolytes, and after thinking about it, asked if I could bring him in yet today. I brought him to the hospital urgently, he had the electrolytes drawn and I left him there to get the ACTH test done also. She told me after we got home to give him a dose of the prednisone I have on hand, half a pill which is 2.5 mg. (his weight was 26 lbs tonight).

We got home about 2 1/2 hrs ago. Jasper again did not want to eat. I hand fed him a few bites and gave him the prednisone, he got it about 2 hrs ago. He has been mostly sleeping on the couch since that time. Should I expect that he will want to finish his food once it takes effect?

I have been watching him like a hawk all along, I feel like I am scrutinizing every single thing he does, and now feel that maybe I should have called the vet when he hesitated with eating the very first time a week ago and maybe he should have had the ACTH rechecked much sooner. Ugh!

I will post the results of the electrolytes, likely will have those tomorrow; and of course will post the stim test results when I get them. I just feel so upset, I feel like I messed up, even with how close I have been watching everything. I just hope his level hasn't gone critically low again.

Thanks all, and hugs,

Tina and Jasper

[molly muffin]

Don't feel like you've messed up Tina. Not at all. There are usually a few bumps in the road getting the dosage perfect and going through the loading phase with Lysodren. Has he had running stools or vomiting or anything else off other than the eating?
Lets just see what his test results show. You'll hold off on any more Lysodren until the results come back and then you'll know how he is doing. Some of the others with experience with this medicine will be by to check in and can offer their thoughts.

Hang in there
hugs,
Sharlene

[Squirt's Mom]

Hi Tina,

You did the right thing by getting Jasper on into the vets instead of waiting for a few days. You done good, Mom! ;)

If his cortisol is too low again, the pred should kick in and you should see improvement in an hour or so. He may need several doses of the pred so don't hesitate to give more as needed. If his appetite is still low, he is mopey, loose stools, or nausea are all signs he still needs the pred.

Some pups are just super sensitive to these drugs and will do better on a much lower dose than is usually given. And there are those pups who simply cannot handle one or the other and a switch is required. But that is something to look into a few days on down the road when we see these test results and see how Jasper is doing.

Please stay in touch and keep a close eye on him the next few days. Use the pred as needed and know we are always right by your side.

You are doing fine, Mom! ;)
Hugs,
Leslie and the gang

[molly muffin]

How is Jasper today?

hugs,
Sharlene

[Tina]

Hi Sharlene and Leslie,

Thanks so much for the support and for checking on my little man. I think he is doing ok for the most part. I gave him the dose of prednisone 2.5 mg on Monday night as my vet instructed after we got home from getting his labs drawn. He did finish his food a couple of hrs later. Yesterday morning he walked away from his food a couple of times while eating, but he did finish it all. The prednisone is prescribed to be given once a day as needed so I figured I would give him another dose last night if he didn't eat like normal. Well, he ate all his food with no hesitation last night so I didn't give the prednisone. This morning he walked away a couple of times briefly while chewing, but returned each time and did finish it all. He is not showing any other signs of low cortisol, no vomiting or diarrhea, and his energy seems ok. I didn't give any more prednisone this morning.

So tonight he walked away from the bowl a couple of times while chewing again. He resumed and did finish. I went ahead and gave him another dose of the prednisone, 2.5 mg.

My vet said she would call if anything was wrong with the electrolytes, otherwise would just call when the stim test results were back. I didn't hear from her yesterday or today, so I am guessing there wasn't anything significant with the lytes.

I hope I did the right thing by giving him another dose of the prednisone. I feel torn since he isn't having other symptoms. I don't think it will hurt anything, will it?

I am hoping to have the results of the ACTH test tomorrow or Friday. Will post when I get them, but I suspect he is going to be low. I will ask for the electrolyte results then too. Gosh, this is such a roller coaster. I worry about him ALL the time.

I hope your pups are feeling well this evening. :)

Hugs,

Tina and Jasper

[frijole]

Keep us posted. Don't worry too much about it. If he were really low you'd have diarrhea and lethargy to the point you thought he was dying. I'm thinking he's loaded. I hope I'm right. You are doing great. Once loaded the hard part is over. Kim

[molly muffin]

Not having lytes out of wack is a good start and no call means hopefully no problem. Kim might be on the right track and he's loaded now. That would be really good!

Hugs,
Sharlene

[Tina]

Thanks Kim! He has been on the maintenance dose for the past 4 weeks after really bottoming out while loading, where his level got down to 0.5 ug/dl. He didn't show any of those severe symptoms then, so that is why I feel worried about it now since he is showing a change with his eating. I am looking forward to the hard part being over, that's for sure!

Tina

[frijole]

Thanks for reminding me.. I remember now. Hopefully the numbers will be good. I stand by my opinion though - addisonian dogs have more extreme issues. Anything over 1.0 is good. If on the lower side you can adjust by simply waiting a week or two to commence regular dosing.

[Tina]

Yes, that's what we did the last time. If the level is low again this time, I imagine we will need to decrease the dose after waiting again to restart. I am hopeful we can get it stabilized soon, of course! He seems to be very sensitive to the drug.

Tina

[frijole]

Look at it like this - it will be cheaper to treat! Those pills aren't cheap ;) You just have to figure out the correct amount. Keep us posted!!

[Tina]

You are certainly right about that, they are not cheap! Gotta look at the positives. And from what I have read it sounds like Vetoryl is even more expensive than Lysodren.

[apollo6]

Dear Tina
Thank you for the heart felt words. Trilostane is cheaper on line than with the vets. They have a ridiculous mark up. I have bought from Dr. Foster and Smith on line. Just search trilostane and the dosage you need. Be sure the company is reputable. Other's can tell you where to buy also.
HUgs Sonja and Apollo

[Tina]

Hi Everyone,

We are still waiting for the stim test results, they were overnighted to MSU on Tues so hope for results before the weekend.

So I gave Jasper 2.5 mg of prednisone last night because he wasn't eating too well again. No other symptoms of low cortisol were apparent, but my vet told me to give him a dose Mon night for the same symptoms, so I gave it to him again. He was drinking more after it of course. Well, he had an accident real early this morning. Couldn't hold it and just started peeing. Poor little guy, he just looked pitiful afterwards. I let him out right away and he went some more. He is drinking a large amt again, and still peeing a lot. I know this is all related to the prednisone dose and am now wondering if I shouldn't have given it last night. How long until it is out of his system?

Thanks everyone,

Tina and Jasper

[frijole]

It shouldn't take too long for it to be out of the system but I'd cease the prednisone. It's OK to give on occasion to a dog that isn't addisonian but it mimics cortisol so the symptoms come back in cases where cortisol isn't too low.. so maybe you now can feel better that the numbers from the test won't be too low? :) I only used MSU 's lab one time and it took over a week.. I have no idea why but it drove me nuts. Most labs are 24 hrs. (Idexx) That said - MSU was the only lab that proved my dog was misdiagnosed so I am thankful. (false positive on all others)

Hang in there!!!! Kim

[Tina]

Hi Kim,

Yes, that's what I was thinking about his cortisol level since the Cushing symptoms came back. That didn't happen so much after the dose on Mon night. Those are the only two doses he has received. So maybe the level won't be super low like last time, but he has definitely shown some hesitation with his eating. No, I won't be giving any more prednisone unless something more is going on, or my vet says to.

The other two stim tests he has had both went to MSU and both were back in about two days. My vet did say that was faster than usual, so I guess we were lucky.

Tina and Jasper

[molly muffin]

Well it's good to that you now know he probably isn't having low cortisol. It's always iffy what to try and figure things out by, what symptoms. It might be that when the cortisol comes down, and that rush of good feelings that they have when they have high cortisol, that he just doesn't feel so awesome and not as interested in food. It will be good to get the numbers so you know whats going on.

Hang in there! Hopefully results will be in soon.
hugs,
Sharlene

[Tina]

My vet called yesterday afternoon with the results of Jssper's stim test drawn late on 8/27. It was even lower than it got after loading, and he has been on maintenance dosing for the past 4 weeks.

Baseline - 5 nmol (50-100)
1 hr post ACTH - 5 nmol (50-100)

I about died when the vet told me those numbers. (I know it is almost 0 when converted to ug/dl!!) She was surprised also. His levels when he got so low after loading were 15 and 14 nmol. And I thought that was scarey.

Let me say that he was not showing any of the critical warning signs of low cortisol, either back with the first crash, or now. He has seemed good all week except for some difficulty getting him to eat, which I have talked about in a previous post, as well as getting 2 doses of the prednisone one on 8/27 by order of my vet, and again on 8/29, when he wasn't eating so great. He got side effects from the last dose and his drinking and peeing shot up, and he had an accident in the house.

Since he didn't seem to be feeling bad and it had been 4 days since his blood was drawn, my vet recommended that I watch him and use the prednisone as needed, but didn't expect more severe symptoms to develop since we were a few days out, and no more Lysodren has been given.

Well, first thing this morning, he started vomiting. I thought I better give him a dose of the prednisone, but he continued to vomit. I know he would not be able to keep it down. Of course I called my vet right away, thank goodness she is working today, she does not work every Saturday. While I was waiting for someone to call back he vomited about 6-8 more times, and I decided he needed to be seen, and so did my vet. He is there now, they had me drop him off.

My vet called a bit ago, they did a bunch more labs. I did not get the specific results yet, but she said the CBC and WBCs are normal. He is dehydrated, sodium is now low at 133 (it was ok on 8/27), potassium is normal at 5, and the chemistry showed the kidney values were all ok and his blood sugar was normal. His alk phos is still mildly elevated and he continues to have high lipids (he has had this for a while and gets fish oil to help). Again this was all on a phone call, I will get copies of the labwork later.

She said she does not feel he is addisonian. She feels the nausea and vomiting are not related to the Cushings and mentioned pancreatitis. They are running a test for that now, but she said is not 100% conclusive. He has been started on IV fluids for the dehydration and to get the sodium level up. She will be calling back with an update soon, they close at 2:00 today. She said he may need to stay at the hospital tonight to get fluids, etc.

I am so worried and upset, I read a bit about pancreatitis and it sounds scarey. But I am SO thankful my Dr is working today, and that this happened this morning rather than midnight tonight or tomorrow with the holiday on Monday.

Any feedback or advice would be appreciated. I don't know what I would do without all of you here. Please keep my little guy in your thoughts. Sorry this is so long, I wanted to give as much info as I could.

Thanks and hugs,

Tina and Jasper

[Squirt's Mom]

Hi Tina,

I am so glad your vet was in today when you needed her, too! Please let us know how Jasper is when you learn something, as you can. Know our thoughts and prayers are with you both.

Hugs,
Leslie and the gang

[Tina]

Thanks Leslie, I am feeling scared right now. It is essentially closing time for my vet's office, and she has not called back yet. I imagine they will be keeping him now.

Hugs,

Tina

[Boriss McCall]

Hugs Tina! I know that has to be so scary. :( I hope your baby is feeling better soon.

[addy]

Tina, I am so sorry you are having such a scary time with poor Jasper.
I am so glad your vet was working today.

Please keep us updated and let us know what is happening.

I can only imagine how frightened you are feeling so I am sending huge hugs your way.

Sending prayers as well

[molly muffin]

Tina, thank god the vet was on duty today. So they are going to keep giving him fluids for the dehydration. I think we've had some people here whose pups have had some bouts with pancreatitis. It is a risk with cushings dogs from what I've read.
The good thing is that he got in right away and I would expect a phone call in the morning to tell you how he did over night. Are they normally open on Sundays? Will your vet be coming in to check on him?
Hoping to hear that Jasper is okay now and able to come home soon. I know you are just worried sick and we'll all be here with you if you need to have a chat.

hugs,
Sharlene

[Tina]

Thanks so much for all the support you guys. I heard back from my vet at about 3 or so. They are keeping Jasper in the hospital tonight. She said the test for pancreatitis was negative, which is good news. I didnt get the name of the test, she was giving me so much information, I forgot to ask. I think she said the test had 95% reliability when it is negative, but when positive can show a lot of false positives. So she feels confident that it is not pancreatitis.

She had initially said that she didn't think he was Addisonian, I think because his potassium wasn't elevated even though his sodium is low. She said she did not feel comfortable with his sodium at the level it was. She said she had consulted with all the other vets at the office today, and also did a lot of reading, and felt it would best to give Jasper Percorten. From what she explained, this is an injectable med that is given for Addison's to treat the deficiency in the mineralcorticoids which causes the electrolyte problems ( low sodium). Apparently these can also get low along with the cortisol when treating Cushings, this is why it is so important to check the electrolytes in addition to cortisol levels. Please feel free to correct any of this if I didn't understand correctly.

So he is on IV fluids over night to get him rehydrated. He had some IV medication for the nausea, an injection of cortisone, and the Percorten. Poor little guy! My vet said he is being a trooper and is handling it all well. Hasn't even messed with the IV.

She said that the vomiting had stopped thank goodness. The on call Dr was there till 6 or so, but then Jasper will be there by himself through the night. :(

The IV is on a pump so I don't have to worry about it over infusing. They are closed on Sunday's, but someone will be in to check on him and the other patients first thing in the morning. And my vet said she was going in also in the morning to check on him and wanted to recheck his hydration. She will call me then and we will see if he has responded well enough and is feeling well enough to come home.

So yes, I am very worried and scared, and worry about him being alone all night. I am wondering if all the problems today can possibly be a delayed reaction to his cortisol level being so low from Monday? Maybe his adrenals are not regrowing well this time and the level has stayed critically low for the past 5 days and now his body is showing it?

Well, I feel like I have 3 guardian angels looking after me and my baby boy. 1. The fact that my vet was working today, 2. That this didn't happen later in the weekend when my vets office was closed, and 3. All of you here to help this worried sick Mom cope with all of this.

Many hugs, and thanks,

Tina and Jasper

[Boriss McCall]

TIna I will say a prayer for Jasper & you. I know you are scared with him there alone over night. :( I hope you can get some rest & peace will wash over you till morning. He has his angels there with him too.. ;)

[molly muffin]

Hi Tina,

I know it is worrying about the over night thing but would they leave him alone if they had any concerns? Low Cortisol and low sodium could make him feel sick I would think.

We still right here with you :)

Hugs
Sharlene

[addy]

I hope you were able to get some sleep and I sure hope Jasper is feeling better this monring.

Let us know when you hear from your vet.

I am so glad it was not Pancreatitis.

((((((((((((((((((((hugs)))))))))))))))))))))0

[Squirt's Mom]

Mornin' sweetie,

How is our boy this morning? I hope his night went very well and that he will be able to come back home to your loving arms today. Bet you didn't get much sleep though, huh? :( Let us hear from you when you can and know we are all still with you!

Hugs,
Leslie and the gang

[molly muffin]

Checking in on you and Jasper! Hope he can come home today!

Hugs,
Sharlene

[Tina]

Hi All,

Waiting for a call from the vet this morning. They are closed today but she said she would be coming in herself to check on him, rather than the on call Dr. She said it would likely be between 9 & 10 that she would call.

I did get some sleep, but not a whole lot. I am sure you all know how that goes! :rolleyes: ;)

I have an 8 month old mini schnauzer pup also, so she kept me company. She is missing her brother, that's for sure!

So I am sitting here by the phone ready to go get my baby boy. I hope he did well through the night. Will keep you all posted. I hope all your pups are feeling well this morning.

Hugs to all,

Tina and Jasper

[Boriss McCall]

any word yet? jasper is feeling good today.

[Tina]

I just got Jasper home from the hospital, the Dr felt he was doing well enough to come home. Yay!!!!!!!!! :D :) :D :) :D :) :D

They said he was doing much better, hydration was much better, and his electrolytes were much improved this morning. He is drinking and they said he seemed hungry and ate a few treats. He was sent home with 2 more doses of the anti nausea medication that I am to give the next 2 mornings, and he is to continue on prednisone 1/2 tab (250 mg) daily for 3 more days starting this evening.

He seemed to have much more energy at first, but since I got him home, is somewhat subdued and seems very tired. Not too worried about that right now because I am sure he is tuckered out from everything and being in the hospital overnight.

I am a little worried because when I gave him a little food after we got home, he ate a couple bites and then walked away like he wasn't too interested. It was just half his normal portion as the vet directed, but I could barely get him to finish it with a lot of coaxing. I would think he would be hungry after no food for more than 24 hrs, and all the meds he has had. He had an injection of dexamethasone while in the hospital, you would think that would help his appetite.

So I will see how it goes. I am going to try to feed him the other half of his breakfast in about an hour.

Thanks everyone for your support and checking in on him this morning!

Hugs and sloppy dog kisses to all,

Tina and Jasper

[addy]

I am so glad he is home. Maybe Jasper needs a nice long nap and will feel like eating a bit later. He must be so exhausted, poor guy.

[Squirt's Mom]

Oh, I am so glad Jasper is back home! I know you are thrilled to have him there, too!

The meds, the experience of being in the hospital, the trauma from being sick - all that may have combined to give him more stress than he could easily handle, and coming home where he is comfortable allowed him to let go of all that and rest, which I am sure he badly needs. Hopefully, once he has rested his appetite will return as well. It could be that the meds have made his little tummy kinda blah and the idea of food isn't very appealing right now, too.

Hugs and gentle belly rubs!
Leslie and the gang

[molly muffin]

Yay so glad Jasper is home.
Maybe he feel more like eating once he's rested up from what was probably a stressful night.
Hope the rest of the weekend is more relaxing for all of you :)

Hugs
Sharlene

[labblab]

Hi Tina, I'm sooooo glad Jasper's home, too! Can you double-check that prednisone dosage, though, because a 250 mg. tablet does not sound like a dose that could possibly be correct -- maybe more like 25 mg.? In addition, with as low as his cortisol dropped, I'm feeling worried about the vet only planning for a 3-day course of supplemental prednisone. I'm assuming you'll be checking in with the vet, though, over the next couple of days in the event that Jasper does not perk up and needs a longer steroid boost.

I so hope he soon starts acting more like himself.

Many hugs,
Marianne

[Tina]

Oh my gosh Marianne, I meant 2.5 mg of prednisone daily for 3 days, beginning with this evening. It is half of a 5 mg tab. I got it confused with his Lysodren dose, which is on hold. I am not surprised, I am pretty frazzled with all that has been going on over the last day and a half!

Thank you so much for checking in on us. Yes, I will be in contact with my vet in the next couple of days, for sure. They are closed tomorrow for the holiday, which is a little anxiety producing at the moment. Jasper has been pretty much sleeping since we got home, I imagine he is pretty wiped out. But it is still making me nervous. I am constantly checking on him. He is not very perky at all. I just got him to eat the rest of his breakfast. (Yes!!) Hopefully he will eat a little more later. Can anyone tell me if it is ok to give the prednisone on an empty or nearly empty stomach, in case he won't eat any more later?

Thanks Addy, Sharlene, and Leslie for the reassurance. Leslie it makes perfect sense what you said. He has been through a lot, and of course I am watching and scrutinizing every little thing. :rolleyes: ;)

Love and hugs to you all,

Tina and Jasper

[frijole]

My gosh... just caught up... have been gone two days.. poor Jasper. He showed no signs of this really.. wow.

Yes you can give prednisone on an empty tummy. I would force it down if you have to. Even though your vet is not thinking addisonian - the cortisol is low and this is what is keeping him going right now. I agree with Marianne and find it unlikely he'll be ready to go off it completely in 3 days. From what we have seen over the years most take it very slow and wean off of it. Otherwise it is too great of a shock to the body.

The prednisone is mimicking the cortisol he's lacking so it is imperative he get it. That is probably also a part of why he is lethargic. As it kicks in he'll start to come around and be more comfy. So glad you took him in when you did and that they were there for you!

Saying prayers for your little one and sending strength and love to you. Kim

[Tina]

Oh my gosh Kim, can you believe it? What a scare this has been, especially since he didn't show signs of this, like you said. I don't think you should go out of town again!! :D ;)

I am wondering if the prednisone being prescribed for 3 more days is just until I touch bases with my vet again. She works again on Wednesday, so that would fit. Of course I can call one of the other Drs on Tuesday if needed, but I hope that won't be necessary.

Yes, I will force the prednisone down him if he won't take it in a treat. I am not messing around. ;)

I was very lucky with the timing of everything. I would have had to take him to that emergency vet clinic in Omaha if it happened last night, or today. Whew! Very scary.

Love and hugs,

Tina and Jasper

[Boriss McCall]

yay! I bet it is just him being tired. Boriss wouldn't eat after his day at the vet on Thursday. I think they have to de-funk after a day like that. Glad he is home! :)

[Squirt's Mom]

Mornin' Tina,

I hope Jasper is feeling much stronger and more like his old self today....and that you were able to rest a bit last nite.

Hugs,
Leslie and the gang

[molly muffin]

Keeping any eye on Jasper. How is he today?

hugs,
Sharlene

[Tina]

Good morning everyone,

Kind of touch and go with Jasper. Got him to eat his breakfast this morning with a lot of coaxing, but he ate it finally. Very low energy continues, he is not interested in anything and still seems very subdued. He is absolutely not interested in playing with his sister, she seems to annoy him so I am trying to keep them separated so he can rest without her pestering him. She is a typical puppy.

I got up twice during the night to let him out just in case to try to avoid any accidents. He is drinking and peeing a lot again, I am sure because of the prednisone. Just wish his appetite and energy would pick up. He got his prednisone last evening and the anti nausea med this morning. There has been no more vomiting so far thank goodness. Hopefully we are out of the woods with that!

Does it typically take several days or a week to recover from this type of thing and get back to normal?

Thanks for checking on us, and I hope everyone's babies are feeling well this morning and that you are enjoying the holiday!

Hugs,

Tina and Jasper

[frijole]

Tina, Once again Jasper has me scratching my head. Just like before when he went so low .. he wasn't eating and was lethargic which are clearly signs of low cortisol yet he's drinking and peeing alot? That isn't typical of a dog with low cortisol. If Jasper were loaded you wouldn't be seeing that still. So this is making me wonder if something else is causing the drinking and peeing.

But before I go there... please define drinking and peeing alot. Are you measuring water intake? If not, please do. A normal dog drinks an ounce of water per pound of dog. (for reference) Mark a bowl so you can easily each day fill it to that point and at the end of the day measure the difference. If you have the dogs separate is easier but I did it with my two as the other dog drank normal amounts I could tell what the 'net' intake was of my cush dog.

How frequently does Jasper go out?

I know you ruled out diabetes and think you did hypothyroidism as well.

I have to go outside and mow right now but later today I am going to re-read your entire thread to see if I am missing something. Maybe someone else w/lysodren experience will do the same. Keep a journal of everything along with dates... it comes in handy. KIm

[Tina]

Hi Kim,

I have been cleaning my carpet all afternoon and just checked and saw your post. When my vet called on Friday with the results of the stim test being so low, I asked her about Jasper drinking more and having the accident in the house the night that he got the prednisone (8/29), and why would he be having those symptoms with his cortisol being so incredibly low. She said he was having side effects from the prednisone, and made it sound like that is still possible even though his cortisol level was so low, and that is what was happening. She said he is sensitive to the prednisone also.

As far as his increased drinking and peeing, I have not been measuring his water intake as both dogs drink out of the same bowls. I didn't think to subtract what Shelby should drink in a day (~13 ounces), to get Jasper's net intake. You are so smart! I have been monitoring how often he goes to the bowl and about how long he drinks each time, and it has significantly increased. This morning he was drinking about every 20 min or so, and for about 10-15 seconds each time, sometimes longer. I do know that today, I think he had drank about 24 ounces by noon or so, just by what I know I put in his bowl, and Shelby was confined for a lot of that time so couldn't get to the bowl. He weighs about 25 lbs.

Shortly after noon I decided to get out a bigger bowl and make more of an effort to measure. I put 48 oz in the bowl and marked it like you said so I can fill it easier. I will measure what is left before we go to bed and add to what I think he drank this morning.

As far as how often he needs to go out, well today since I am home he has been going outside about every 2 hours or so, and sometimes more frequently than that. And he pees a large amount for a long time each time, at least 20 seconds or more each time.

He will get another dose of prednisone tonight, and I am worried about when I go to work tomorrow. He will not have access to water or to go outside constantly. He typically can hold it all day while I am at work, that has never been a problem. But he typically doesn't have access to water either.

Yes, diabetes and thyroid issues have been ruled out, as well as liver and kidney issues.

Thank you Kim for taking the time to re-read my thread, and for your insight and advice. I have been keeping track of things and dates, labs, behaviors, etc. It is kind of disorganized, and I had planned to work on getting it all into a notebook/journal this weekend but got sidetracked with everything that happened.

I am going to see if I can get him to eat supper now and will check back in a bit.

Hugs,

Tina and Jasper

[frijole]

Jasper's reaction to lysodren has me stumped. He went as low as 0.5 in 5 days of loading at what is a normal dosage. You stopped and it shot up to 6.74 in a short amount of time.

Then you did MAINTENANCE at 500 mg level and went to from 6.74 to 0 in 4 weeks. This is a bizarre swing for a dog on maintenance.

You started maintenance on 7/27 and on 8/15 you said the drinking had increased and you were concerned. 10 days later he isn't eating so you give him prednisone and he's at 0 on the acth.

There are too many swings going on that just don't add up. That's why I asked about the other diseases wondering if something else is causing the urination. The only remaining disease that I can think of is diabetes insipidus.

I am pretty sure they only make lysodren in 500 mg tablets so it can't be a dosing error. Either Jasper is extremely sensitive to lysodren or something else is going on.

Regarding the prednisone... I'm shocked that with practically ZERO cortisol in the system Jasper reacts so quickly to it. That would explain the urination but again... logically it shouldn't happen so quickly. And if he is peeing I would think the hunger would be back as well as the energy level.

I hope another experienced member can see this and come up with what might be going on.

In the meantime... cleaning the carpet...:( I so remember that. If he's confined you might see if these will help. I bought them for Annie and she did urinate on them (vs carpet) and these pads suck it all up and you don't smell it! You wash them and reuse them. Google: pooch pads. I bought mine from Amazon but I think Petco has them.

Sorry if I confused you more... just know this is not usual. More hugs, Kim

[labblab]

Tina, I hate to make things more difficult for you, but I am afraid it may not be safe to restrict Jasper's water tomorrow while you are at work. I think to do so may risk harm to his kidneys (I will try to come back with a better explanation later). Is there any room or area of your house where you can leave him with plenty of water, and where peeing would not do a great deal of damage? :o

Marianne

[frijole]

OMG Marianne, great catch. Tina, she's right. As much as the urination is a PITA - Jasper is drinking because he is dehydrated from urinating - not peeing from water intake. He has to have access to that water.

Kim

[Tina]

Thanks Kim and Marianne,

Yes, I am gathering that Jasper is not a usual case. My vet said that she has never had a dog where the cortisol bottomed out as low as Jasper's while on maintenance. She has said that he is showing to be extremely sensitive to the Lysodren, and still seems confident that we will get him stabilized, but on a MUCH lower maintenance dose. This conversation took place on Friday after we got the stim test results that the cortisol was soooo low. I will have to see what she thinks now that he ended up in the hospital and everything that happened Saturday.

Marianne, thank you for your advice about not restricting his water while I am at work tomorrow, I was wondering and worrying about that, and meant to ask it in my last post. You read my mind. I really don't have anywhere I could leave him unless I closed him in the bathroom that doesn't have carpet, or tried to barricade him in the kitchen. He normally stays in a wire crate when I am not home. He prefers this and tends to get anxious if he has the run of the house or if the routine changes. He is comfortable there, and automatically goes there when he knows it is almost time for me to leave for work. Do you think it would be ok to just put a water bowl in the crate with him? The only thing I don't like about that is if he pees, then it will be wet. He normally lays on a couple of thick soft folded up towels in the crate, he has never liked those sheepskin foam crate pads. At least that would be somewhat absorbent.

You know, I haven't done anything different with the water up until now, I hope I haven't hurt him! Omg. :(

And as far as cleaning the carpet, it was from all the vomiting on Saturday morning. :( He really has had only 2 accidents in the house, the one in May which prompted all the tests, and then last wednesday night after the prednisone.

Please let me know what you think about the water bowl in the crate, I think that may be my best option since he is most comfortable in there. He did eat his supper tonight with considerable coaxing, and had his prednisone tonight. He seems a little more perky, but still not back to normal.

Love and hugs,

Tina and Jasper

[frijole]

If there is room in the crate for the bowl then give it a try.

Fingers crossed - if it doesn't work then try the bathroom or kitchen. Good luck!

[labblab]

Tina, yes, I think the water bowl in the crate sounds like the best option, too. Hopefully this will just be a very temporary issue. Is there any way you might be able to check on him at lunchtime (to let him out or replace the towels), or is that just not an option? I totally understand if it is not, because I have always had really long commutes myself. :(

Marianne

[Tina]

Yes, there is room in the crate. It will make it a little more crowded of course, but he still has room to stretch out and lay down. Hopefully he won't spill it. My Lab would always spill the water in her crate. :rolleyes:

It is possible for me to take a long lunch and run home on a temporary basis, however it is not ideal. I was already considering it for tomorrow at least and maybe for a while until he is feeling better and we have things more under control. I will just need to talk to my manager about it and hopefully it won't be a big deal.

Kim, thanks for the tip on the pooch pads, I am checking them out now on Amazon. There are lots of good reviews. I think I have seen something like this at Petsmart or Petco.

Tina

[molly muffin]

What about putting the crate in the kitchen, leaving the door open so he can go in and out, and putting a couple bowls of water in the kitchen for him, with some pee pads, just in case. Try to barricade the kitchen off is possible. Otherwise, something similar in the bathroom if it is big enough?
The crate would be available for him to feel comfortable in, but being open if he wanted a drink he could get it and not risk becoming dehydrated, still have some other area than where he sleeps to pee, just in case. At this point, he is a tricky case.

Hugs,
Sharlene

[Tina]

Hi Sharlene! Yes, I am thinking about that too. My kitchen is pretty open, one side of it would be tough to barricade, but I might be able to do it. I still have some of those disposable pee pads from when Shelby wasn't house trained yet that I could put in the kitchen. I don't know if he would use them or not.

I just need to think about this, and what would cause him the least stress. I have never left him in the kitchen before, so that would be something new, and I am concerned he would be anxious about it. He is very into his routines, and gets pretty anxious with any deviation. But I would feel better if he had more room in case he does need to pee.

Hugs,

Tina

[Squirt's Mom]

Hi Tina,

They make water bowls especially for crates that hook onto the wires so the bowl is not on the floor of the crate where it can be knocked over and spilled. I have bought them at PetCo in the past.

Hugs
Leslie and the gang

[labblab]

Also, as an extension to Sharlene's suggestion, here's something we've done in the past when toilet-training puppies. Our house is mostly fully carpeted and the kitchen hard to barricade. When we wanted to leave the crate right where it is in the family room, we bought a big plastic tarp and an exercise pen. We put the tarp down on the carpet with the crate on top and the pen surrounding it. That way, there was room for a water bowl and pee pads outside the crate. When we were away from home, we left the crate door open so the puppy could go inside to sleep and rest, but the puppy was not forced to soil the inside of the crate. If the water bowl spilled or the pee pads failed, it was not a disaster because the tarp protected the carpet.

I know this set-up was too involved for you to get into last night. But it is just a thought if you have to make longer term arangements to keep Jasper comfortable. I agree with Kim, he's got me scratching my head as far as what is really going on with him and the Lysodren. It is definitely a puzzle...:confused:

Marianne

[Tina]

Great suggestions everyone. I came home for lunch to check on Jasper and let him out. I can view the forum but can't post from work. I decided to try his crate with a bowl of water. He definitely drank some while he was in there this morning, he has drank a little more than 3 cups so far today (which is about his whole day's allowance), but I would say over half of that was before I left for work. The crate was dry, but because he was holding it. He peed for over 45 seconds when I let him out, that is so long. :(

I believe he drank around 8 cups of water yesterday, which would be about 64 oz. Yikes, that is a lot! I am trying to get an exact amt of intake for this 24 hr period, so far have kept Shelby to her own water bowl.

He ate breakfast with coaxing, but did finish. As far as energy he seems about the same as yesterday. Not great yet, but better than the weekend.

Back to work, will check in later. I can't tell you how much I appreciate the support here, thank you all so much for your kindness.

Love and hugs,

Tina and Jasper

[Tina]

Well, it was a struggle to get Jasper to eat tonight, even with coaxing. He just seems uninterested in the food, and everything else for that matter. He will sniff at it, maybe eat a couple of bites and then walk away. I finally just got him to eat most of it by hand feeding a little while ago, but even that was touch and go. So frustrating. I feel kind of like we are back at square one, before we ever started the Lysodren, except his appetite and energy were good then.

I keep looking at him trying to figure out what is wrong, what could be going on with him. He is nowhere near himself and it makes me so sad and worried. I keep racking my brain trying to figure out why he is drinking and peeing so much with the prednisone, but his appetite and energy are so poor. He looks at me frequently like he is trying to tell me what is wrong but I can't figure it out.

I am trying to be positive, but I am feeling discouraged, and very worried about my little boy. Maybe I am just tired after all the stress when he was so sick over the weekend. I will be talking to my vet tomorrow, hopefully she will have some insight.

Tina

[molly muffin]

I hope your vet will have some insight too. I know you are stressed out and I am sure Jasper is stressed too. There doesn't seem to be any reason why his appetite wouldn't return, but you just never know, as any dog can react to medicine in a strange way. Some definitely go off food it seems. Are there any special things that he likes that maybe would entice him to eat? What about some chicken or something of that nature?

Hugs,
Sharlene

[labblab]

Tina, after going so very low on his cortisol, I wonder if Jasper could possibly need even more prednisone than he is currently getting. Although it does not occur as commonly, dogs who are Addisonian can also drink/pee excessively just as do dogs with Cushing's. And all the rest of Jasper's symptoms right now defintely still sound Addisonian to me.

Do you know if your vet is planning to do some more bloodwork today? I know you probably hate for Jasper to get poked again, but it might be a good idea to double-check his electrolytes. And if not another ACTH, even a resting cortisol reading might help indicate whether or not his level has rebounded to a more normal point on this current dose of prednisone.

Marianne

[Tina]

Hi Marianne, thanks for your comments and suggestions. No blood work is planned for today. I have not talked to my vet since I picked up Jasper from the hospital on Sunday, so she has not been updated as to how he is currently. Maybe she will suggest that I bring him in today for more labwork, I don't know. I will ask about the prednisone dose, and checking the electrolytes or resting cortisol. She initially prescribed that he take the prednisone 2.5 mg for 3 more days, that ended last evening, which would correspond to probable follow up today since she is in the clinic today. I am scared to stop it at this point, even with how much he is drinking and peeing. I left a message last evening for her to call me today, though I imagine that is on her list for follow up today.

This morning he would not eat anything on his own, I got him to eat only about half his breakfast by hand feeding and that took a long time. That is only about 1/4 cup. I can't get him to eat the rest. He drank a grand total of 9 cups of water in yesterday's 24 hr period, 72 oz. Energy is still low. I will see what I find out today. Thanks so much for your support, I am very worried. And now I have to head in to work. I really don't want to leave him.

Tina

[labblab]

Given your description of Jasper's behavior, I agree that it is imperative that you get additional prednisone on hand, even if in only the dose that you are currently giving him. I would be very afraid of stopping the prednisone at this point. So if you do not hear back from the vet in a timely fashion, I really do think you need to call back and insist on an extension of the prednisone until he can be thoroughly re-evaluated. What I had meant to say above (but probably was not clear about), is that I wonder if he might need even a higher dosage than he is currently getting. But even a continuation of what he's getting now would be better than nothing.

Marianne

[frijole]

Tina, I think Marianne is spot on. Prednisone is inexpensive and there is no reason for the vet not to give you a refill that includes many weeks worth of doses. I'm sure as soon as the vet knows what you have shared here that they will agree. Keep us posted. Hugs, Kim

[Squirt's Mom]

Hi Tina,

Jasper should have started rallying from his recent illness by now, I would think. So my concern is the same as Mariannes - the cortisol is not being naturally raised so he needs more pred for a longer time, his electrolytes may well be off and need to be checked. If those levels - cortisol and electrolytes - are ok, then something else may be going on and running full blood work may be in order.

Let us know how things are going...and I would keep calling the vet until I reached her. ;)

Hugs,
Leslie and the gang

[molly muffin]

How is Jasper doing?

hugs,
Sharlene

[Tina]

Hi Everyone,

I am up in the middle of the night because I can't sleep. Haven't meant to be MIA, I have just been too upset and overwhelmed to post. I did make an appt with my vet for Jasper on Wed 9/5, she kept him for the day to get more labwork and check him out. I will give specifics of all that was done later but just want to check in so you would basically know what was going on.

Within minutes of getting him home Wed evening, Jasper had diarrhea and there was blood with it. He has had colitis before, but never with blood. We went immediately back to the vet and he has been in the hospital since. He apparently has hemorrhagic gastroenteritis (HGE). This can apparently be caused by many things but most likely due to stress, which he has had an incredible amount of recently. And along with having such a low cortisol, his body just couldn't handle everything.

On the Cushings front, we did get a baseline cortisol which was still incredibly low, 0.4 ug/dl (normal is 2-6 at this lab). The electrolytes were normal. So Marianne, Kim, and Leslie, you were right of course. There is much more to all of this which I will post later when I have the energy. I just wanted to check in with a quick update. Last night when I visited Jasper in the hospital, he seemed quite a bit better, but still not great. I will be in touch with my vet this morning.

I am exhausted, overwhelmed and scared to death with this latest development. Please keep my baby in your prayers.

Tina

[Squirt's Mom]

Hi Tina,

Prayers rising and healing white light flying Jasper's way. Please let us know how he is this morning and know you are not alone, honey.

Hugs,
Leslie and the gang

PS. I know how scary that was to see the blood in the stool. My little Trinket has stress colitis and when her's first flared up, it was very bloody and very terrifying. She weighed just under 5lbs at that time and to see that blood was just awful. She is much better today, over a year later has had very few flares and no more blood, thankfully.

[labblab]

Dear Tina,

Hoping so much that you'll get good news about Jasper this morning!

Like Leslie, I'm sending huge hugs your way and keeping your sweet boy in my thoughts and prayers.

Marianne

[Bo's Mom]

((((((HUGS))))))
Hoping Jasper woke up this morning ready to come home all recovered. Prayers for everyone!! Keep us posted.

[addy]

I hope Jasper is better this morning. Colitis can be very scary when it involves blood and with everything else going on.

Sending love and hugs and prayers for some good news today.

[frijole]

Tina, Do keep us posted. I am throwing this out there just in case it is helpful. Should you feel like Jasper's situation requires the eyes of a specialist (IMS) there finally is a local option (I had to drive to K State). There is a vet clinic that has K State IMS working there. Your vet would need to refer and could work right along with them.

I don't have the name of the clinic. You can call Tonya McLinay's office in Omaha (Veterinary Eye Specialists of NE) - she is a K State grad IMS specializing in eye care that I went to. She is the one that told me of this new option.

This new clinic has access to the staff at K State without having to go there. I have never used them but since your situation is unique and sometimes a new set of eyes on the case is helpful...

Sending love and prayers, Kim

[Boriss McCall]

So sorry to hear that you & little Jasper are having such a hard time. I hope things are on the up swing today. Saying prayers for you both.

[Steph n' Ella]

Oh Jasper....hoping for a speedy recovery!

[frijole]

Just thinking of you guys. Sending love. Kim

[Squirt's Mom]

Hi Tina,

How is Jasper doing? Let us hear from you when you can, sweetie.

Hugs,
Leslie and the gang

[addy]

I'm checking in as well and wondering how you and Jasper are.

Thinking of you and sending hugs

[Tina]

Good morning All,

My precious boy is home!! :D My vet decided he was doing well enough and let him go home last evening. I was just too wiped out to post last night, I am so sorry if I caused worry. I know he is home with me now because of all the prayers that surrounded him from all of the Angels here. I don't know how to thank you all.

He is MUCH better, but still not back to normal, which would be expected after he had so much going on. He is getting Hills i/d low fat prescription diet, which he is eating!!! It is so good to see him eat what is in the bowl and not just sniff and walk away. The vet said I can start mixing in his kibble in a day or so, but I am going to wait until he has a completely normal stool before I do that.

He is still having blood, which the vet said would take a few more days to clear. I don't like that of course, but as long as it continues to improve, I will deal with it. He is on Metronidazole 250 mg 1/2 tab twice a day. He has taken this many times in the past, he used to have a problem with colitis, but had not had an episode for more than a year and a half since we switched his food to Blue Buffalo. And never had any blood before, so this was quite scary.

He had another injection of Percorten while he was in the hospital since his resting cortisol is still so low, and his prednisone has been increased from 2.5 mg to 5 mg daily. Again, Marianne, Kim and Leslie, you were spot on about that. Thank you SO much, all of your questions and suggestions prompted me to ask my vet. I asked about getting the resting cortisol to see if the current replacement dose of prednisone was enough since his cortisol had dropped so low, and she agreed it would be a good idea to check it. When it came back still so incredibly low, she said "you were right". I thought, "no, Marianne, Kim and Leslie were right!"

He is also getting Zeniquin 50 mg daily, she decided to start this in case he has a UTI, which if he did, may be contributing to his increased drinking and peeing. Since UTI's are common in Cushpups, and difficult to diagnose with the dilute urine, she just decided to treat. It was started while he was in the hospital so this morning is the third dose.

Now here is the strange thing - I have noticed that since we have been home, he seems to be not drinking very much. It is hard to tell if it is really more like normal and just seems like not enough because he was drinking SO much before, or if it is really not enough. I hope it is nothing to be concerned about, but I will be measuring today. He has only gone to the bowl once since we got up, and that was for just a very brief drink. And last night he just drank a few times. The peeing seems much more normal also. Seems odd since the prednisone was doubled, I would think those issues would be even more increased, and vet said they likely would as well.

To avoid having this post become the next installment of War and Peace, I will post a little later. I want to let you all know what all happened on Wednesday before he was hospitalized.

Again, I don't know how to thank all of you wonderful Angels for all of your love and support. I don't know what I would do without this forum.

Please keep Jasper in your prayers, he has a ways to go, but I am hopeful he will continue to stabilize from this setback and we can continue to work on treating the Cushings and get that stabilized next.

Love and Ginormous Hugs to you all,

Tina and Jasper

[frijole]

Yeah Jasper.... go boy go! Tina, we become very attached as you can tell and it is delicate at times when we have to urge people on... since we are sort of 'strangers' having never met... so we understand any hesitancy people have at taking our advice. LOL Just know our hearts are in the right place and we have seen so much over the years.

I am just so happy and relieved to hear from you... I was getting quite worried last night. I see you have been using Blue Buffalo so I assume that the fat content is fairly low on that food. I meant to mention that sometimes when dogs aren't responding to lysodren we tell people to give it with cheese or other fatty sources because fat somehow helps the lysodren absorb more quickly and be more effective. You might take a looksy at any treats you are giving just to make sure they aren't high in fat given Jasper's sensitivity to lysodren.

My Haley was a walking food machine - she lived for it. (and beer - she loved the smell of it!) Anyway over time I couldn't even give her a tiny piece of white chicken - she'd vomit it right up. It's a cushings thing. Fat intolerance.

OK... enough from me... just so very happy! Time to go put on my red for that game tonight! GBR!!! Kim

[Bo's Mom]

Great news on Jasper.....woohoo!!!

[Boriss McCall]

yay.. such good news. In fact on my bike ride this morning I said a little prayer for you & Jasper. :)

[Squirt's Mom]

Woohoo, Jasper!

So glad he is home and hope things settle down very soon!
Hugs,
Leslie and the gang

[Tina]

Thanks so much everyone for the good wishes and continued prayers. My Little Man is hanging in there today so far. He has been eating the prescription diet just fine and has kept all his meds down. Woohoo!!! You guys are so funny, I have always said Woohoo when I am really happy or excited about something, and through the years it has rubbed off on all my friends and they all say it now too. I love it that you guys say it also, it sure gets the feeling across!!

Kim, as far as Jasper's regular food, it says "crude fat 14% min". I don't know if that is necessarily low fat or not. For treats he gets Old Mother Hubbard biscuits. I don't think they are high fat, they are all natural. His soft treats, that I also use to give him his pills, are called Lean Treats. They are labeled as low fat, and I get them at my vets office.

And just so you know, I consider you and others on this site my friends, even though we have never met. The kindness, compassion, caring, and support that you and others have shown Jasper and I can only be considered friendship as far as I am concerned. Not to mention the deep level of understanding we all share when it comes to our furbabies. You guys all "get it", and that is so reassuring.

Ok, back to the game for me. Got my red on too. :D. Go Huskers!!!

Hugs,

Tina and Jasper

[Tina]

Hi Everyone,

Just want to give an update on Jasper. My little guy is hanging in there. He is still not quite back to normal, but is much much better. I got a little worried late Saturday night into Sunday morning when he started to pass more blood again. My vet said to not worry too much about that if it happened, unless it increased significantly, but it is still nerve racking. I stayed home with him all weekend so I could keep a close eye on him. Hard to leave him to go to work today. :(

He seems to be steadily improving each day and I am so thankful. He continues on the prescription food, which he is eating enthusiastically. (Yay!!). :D :) :D :). Tonight I mixed in a bit of his regular food so we will see if he tolerates it ok. His drinking and peeing have decreased to about normal, I am not sure how to explain that since he is continuing on the increased dose of prednisone. He drank an average of about 20 oz of water per day for the last 2 days. He weighed 22.6 lbs at the last check (he has lost about 3 lbs through all of this). He was drinking a whopping 64 to 72 oz per day before he was hospitalized, so I really am at a loss as to why it has decreased so much, but I feel it is a positive sign!

My vet checked in today for a report, and we are going to continue everything as is, including the prednisone at 5 mg daily. She will reassess on Friday, and right now my goal is to have him continue to stabilize and not need to call her before then! She thinks maybe he has has a UTI going on and since we are treating it with an antibiotic, his drinking is normalizing.

I think on Friday she will decide if we should taper him off the prednisone and look at scheduling another stim test to see where we are at with that. I have to be honest, I am scared to death about taking him off the prednisone. I am trying to not think about it, but he has just been through so much with his cortisol bottoming out so badly. I guess I will just have to wait and see what she says.

I appreciate everyones continued prayers for my sweet boy.

Love and Hugs,

Tina and Jasper

[frijole]

Great news! I understand fear of removing the prednisone but you wean very very slowly for that reason. He needs to adjust. You will know if it is too much too fast. Just remember that it's a steroid and you don't want him on it long term short of being addisonian ... it isn't a good thing. Great news about the water intake. Keep up the good work. Kim

[Squirt's Mom]

Mornin' Tina,

Sounds like things are progressing nicely. :) Trink's BMs would improve then start to get bad again, then improve a little more....then one more mess, then it was over. Of course, I kept letting her sleep in the bed with me during most of this while an empty crate sat within sight. :p I finally did put her in the crate for couple of nights when I ran out of clean sheets then lay in bed watching her and crying. :rolleyes: And her appetite wasn't the greatest then either - she was finicky when I first got her but she got really turned off by food during this period. I kept dark Karo syrup close at hand in case of hypoglycemia, which teeny tiny ones are prone to. ;) And then, being my Prima Dona, I had to add a drop of Karo to her food to get her to eat it for a couple of days. :D

I hope Jasper is better and better with each passing hour.
Hugs,
Leslie and the gang

[labblab]

I, too, am so glad to hear that Jasper has been improving! And I'm totally on the same page with you as far as being apprehensive about stopping the prednisone prematurely. If anything, I will say that it seems as though your vet has underestimated Jasper's need for steroid supplementation throughout this entire episode, so I would be very nervous if she were to tell you to just stop the prednisone "cold turkey" at this point. As Kim says, even if Jasper is starting to produce enough cortisol on his own, the prednisone should be tapered over a period of several days rather than suddenly halted. But since Jasper is still having abnormal stools, I'm not sure that it's even time yet to start a taper. I will be very anxious to hear what your vet recommends at the end of the week.

As far as the improvement in Jasper's thirst and urination, that may actually be due to the fact that the prednisone has rescued him from his Addisonian state. As odd as it sounds, excessive thirst/urination can be a symptom of Addison's as well as Cushing's. So perhaps the improvement you are seeing is a result of the normalization of his steroid level.

Marianne

[Tina]

Hey All,

Jasper continues to improve each day. As of his evening meal tonight his food is mixed 50/50 canned prescription food and his regular dry food. I am taking it very slow. So far so good. His stools continue to get better also, they aren't completely normal yet, but getting there. This evening I felt like I was celebrating out in the yard. I told him this was the best one yet and to keep it up. My neighbors probably think I have lost it! :p

His energy is much better also, but not quite back to normal yet. As of today, he has been drinking and urinating a bit more again. I will measure the water that is left in the morning, but I think he has drank about 32 oz so far. Marianne, what you said about his drinking improving because his steroid level may be getting more normal makes sense. I did read that increased drinking and urination can be a sign of Addison's also, so I was wondering about it actually improving some as his cortisol level came up, but didn't know if that was feasible or not.

And I agree with you completely that my vet has underestimated Jasper's need for the supplemental prednisone. I believe it may be because for a long while he wasn't showing any of the critical symptoms of low cortisol. That was puzzling to me also, and still is - I watched him like a hawk. Then when that severe vomiting started and he was hospitalized the first time, although he got the Percorten and a dexamethasone injection while in the hospital, I think the 2.5 mg daily dose of prednisone after he got home was not enough to compensate for how low his cortisol had originally dropped. He seems to have done much better on the 5 mg daily dose, which is what she sent him home on after the 2nd hospital stay. He continues on that dose now.

Back when he was getting the 2.5 mg dose, I asked her if he would need to be tapered down when it came time to take him off it, and she said no, because it was such a low dose. I hope she will view it differently now after all that has happened and he has been on the 5 mg dose since last Friday, and will plan to taper him off when the time comes. If she doesn't recommend that, I will ask about it for sure, I am too scared to have him stop cold turkey. Can anyone tell me what the normal tapering process and time frame should be? Just so I can have an idea of what to ask. She will be calling on Friday for an update and to discuss the next steps.

Thank you all so much for your continued support and prayers.

Hugs,

Tina and Jasper

[Squirt's Mom]

Hi Tina,

In humans the method is typically to start spacing the doses out over more days. In other words, if one is taking 10mg a day, when the tapering starts, the dosing would go to 10mg every other day for 2-4 days, then 10mg every third day for 2-4 days, and so on until the pred is gone. This is how I am instructed to use it anyway. ;)

Here is some info I found on VetInfo -


How to Taper Off Prednisone Dosage

When the vet establishes that the dog no longer needs prednisone treatment, the dose cannot be simply discontinued starting from the following day, because the dog can get severely ill. The prednisone should be gradually tapered off. The vet may decide to taper off prednisone by halving the daily dose or administering a normal dose every second day to the dog. After one week, the dog can get less prednisone, or get the initial dose of prednisone once every three days.

After another week, the dog may get a small dose every day or the initial dose once per week. The tapering off of prednisone treatment typically takes between two and five weeks, depending on the initial dose of the drug, the disease the dog is being treated for and the reaction of the dog when the dose is lowered. You should always follow the recommendations of the vet and never forget to administer a dose of prednisone to your pet. You should never administer prednisone to your pet when it is not recommended.

Read more: How to Taper Off Prednisone Dog Dosage - VetInfo
http://www.vetinfo.com/how-to-taper-off-prednisone-dog-dosage.html

Hope this helps!
Hugs,
Leslie and the gang

[Tina]

Happy weekend Everyone!

Thanks for the information about tapering prednisone Leslie. I did do some further reading also so I would be prepared.

I talked to my vet late yesterday and provided her with a full update on Jasper. He is continuing to hold his own! :D :D Yesterday morning I started mixing his food 1/4 canned prescription food and 3/4 his regular food, and plan to decrease the canned further tomorrow. And today I am transitioning him back to 2 meals a day rather than 3. He has been tolerating the food transition, and his stools have continued to improve, they are almost back to normal now, but not quite. He seems to have a good appetite and has been eating the mixed food just fine, but when I tried to see if he will eat his regular food by itself, he won't. He totally snubs it, turns his head and won't eat a bit. As soon as I mix it with some of the prescription canned diet, he eats it right up. Little stinker!! :rolleyes: So I don't think it is an appetite problem at this point. My vet is aware of this. I am not going to worry about it now, I may need to figure out something different with his food for the long haul.

My vet has directed that we continue with his meds the same for a bit longer. She does not feel that his adrenals would have recovered in this short of a time after his cortisol was so bottomed out, and feels he needs continued supplementation with the prednisone for now. She is continuing the dose at 5 mg daily. She said we absolutely would need to taper him when the time comes (whew, I was worrying about that!). She said the soonest she was looking at repeating the stim test was the week after next, and said that we would taper him down to the lower 2.5 mg daily dose a week before the test and then he would need to be totally off the prednisone for a couple of days before the stim test. I think this sounds reasonable. Hopefully Jasper will be able to tolerate that. He seems comfortable now on the 5 mg dose for the most part, I think.

I have noticed that his water intake and urinating have been steadily increasing again over the past few days. My vet is aware, she does not think it is because his adrenals have recovered and are producing too much cortisol again, but thinks it is probably a side effect of the prednisone. On 9/13 he drank ~ 43 oz, yesterday 9/14 ~ 67 oz. I will be measuring today and tomorrow also. So far no additional accidents in the house, but I let him out twice during the night last night.

She did mention that sometimes it can take months for the adrenals to regrow, and we talked again about how sensitive Jasper has been to the Lysodren. She also briefly mentioned the possibility that he could stay addisonian, I think she just wanted to remind me that it could happen. I imagine we won't know more about that until the next stim test, so I really am going to TRY to not worry about that. :eek::eek:

So that is where we are at. Kim, Marianne and Leslie, I feel like this is all in line with the concerns and suggestions you all mentioned. I am concerned about the increased drinking and urinating, but he is much better overall.

Your thoughts and feedback would be welcomed and appreciated. Thank you all so much.

Hugs,

Tina and Jasper

[Squirt's Mom]

Hi Tina,

Good to hear that Jasper is continuing to improve! :)

Your vet seems to be right on the mark with tapering and the testing so I feel you are in pretty good hands there. And the effects of the pred may be correct as well. I have a Boston that has to take pred and she exhibits many cush signs the days she gets her dose - she gets it every other day. She pees and drinks a great deal more on those days...but her appetite is always cushy acting! :D She was put here to EAT...a LOT...and OFTEN! :p She's a small Boston - 13lbs - but if I let her eat like she thinks she should, she'd weigh 50lbs by tomorrow. :rolleyes::D

Just so you know, many feel that Addison's is easier to treat and not as hard on the pup as Cushing's. In fact, in Europe it is fairly common to intentionally cause Addison's as the treatment for Cushing's. ;) So try not to worry overly much about the future possibility. We will always be here for you and with you.

Hugs,
Leslie and the gang

[Harley PoMMom]

Happy weekend Everyone!

She said the soonest she was looking at repeating the stim test was the week after next, and said that we would taper him down to the lower 2.5 mg daily dose a week before the test and then he would need to be totally off the prednisone for a couple of days before the stim test.

Since prednisone can interfere with stim results, you could ask your vet about giving dexamethasone instead, dexamethasone does not interfere with cortisol measurements.

[Tina]

Thank you for the information about using dexamethasone instead of prednisone, I will have to ask my vet about that when I get a chance.

Jasper has been hanging in there for the most part. Stools have continued to normalize, and he seems to be feeling better over all. Last evening (9/18) he vomited once, and seemed to have a decreased appetite again last evening and this morning. That scared me of course after all he has been through. I have him eating his regular portion of his own food mixed with about 2 tablespoons or so of the canned prescription diet. He still will not eat his regular food without mixing a bit of the canned in.

My vet had initially said to start decreasing the prednisone to half a tablet (2.5 mg) daily to get him tapered down, but since he vomited last night, we are going to wait a bit to start the taper. So far he has not had any more vomiting and he ate fine tonight, and seems to feel better tonight. I am hoping that it was a one time thing and maybe he was just nauseated. His stool has continued to be ok so far, but my vet refilled the metronidazole and had me pick that up after work tonight and told me to start it again if the stools got softer or if he is slow to eat or won't eat. Hopefully the colitis isn't trying to flare up again.

On Monday I started leaving him in the barricaded kitchen while I am at work with a couple of pooch pads and his open crate in there. He is very nervous and doesn't like it, and whines a bit when I put him in there. But I just feel it is the best option to allow him access to plenty of water while I am gone, and also so he can have space to pee since he is drinking so much. I hope he will adjust and learn to use the pooch pads and not try to hold his pee all day.

I will be talking to my vet again on Friday, so we will see what the plan is then. I imagine if he continues to eat and feel ok we will start to taper down the prednisone. I am nervous about that. Thank you all for your continued support.

Hugs,
Tina and Jasper

[frijole]

Thanks for the update. Cheering you on. Kim

[Tina]

Thanks Kim, and thanks so much for telling me about the pooch pads! Yesterday while I was at work he used them for the first time. His aim needs a bit of work, but hopefully that will improve with time! :D Today he didn't use the pooch pads but went on the blanket that I put on the floor for him. No matter, at least he is peeing instead of trying to hold it all day. I really hope that he will just get used that and learn that it is ok to use those pads while I am gone at work. So far so good, 2 days in a row.

Tina and Jasper

[frijole]

Hurray! I learned about them from someone on this forum! That is great news. Poor little guy. Great invention though huh? I had the paper like ones and didn't like using them. These are real convenient.

[Tina]

Yeah, I have some of those disposable ones left from before my puppy Shelby was house trained. I put a couple of those down the first day I tried him in the kitchen. All he did was scratch and scruff them up almost into a ball. They were useless for Shelby also, she would tear them up after just a few minutes and tried to eat them. The pooch pads are much better. I am lucky that Jasper still squats like a girl. Not sure how well anything would work if he lifted his leg like a normal boy, lol. :p. :D

Tina

[frijole]

:D:D:D:D:D Oh the visual. You'd have to tape them to the wall or furniture! :D:D:D:D:D

[Tina]

No doubt. I would have to cover a lot of area!! I have never cared that he never learned to lift his leg, it was always kind of a relief actually. And now I am really thankful! :) :)

[Tina]

I talked to my vet yesterday and gave her a full update on Jasper. He is doing pretty well overall, other than continuing with some hesitation when eating at times. Sometimes he will walk away from the bowl for a second or two but then returns and finishes. I am still mixing about 2 tablespoons or so of the canned prescription diet with his regular portion of food so he will eat. The vet doesn't seem too concerned about this for now.

I have a refill of the metronidazole on hand in case the colitis flares up, but have not needed to restart it this point. Yay!! She said we will keep things the same for the weekend and she will check in with me on Monday. If he continues to do well, the plan is to start to taper down the prednisone. She said she did not want to do that on the weekend. I told her I was nervous about that, actually I am quite scared. She reassured that we would do it slowly and said that the dose he is getting now (5mg once a day) is higher than the dose he would need if he had addisons. So I guess that is somewhat reassuring as far as trying to decrease the dose. I am still scared though because he seems to be feeling pretty good now. I think I am just gun-shy because he was so incredibly sick a couple weeks ago.

Jasper has had a pretty good day today, and I am so grateful. I would say it is the first really good day he has had since he was so sick. Hopefully we have turned the corner now!

I will update again after I find out what the plan is on Monday. I hope everyone and their pups are having a good weekend!

Hugs,

Tina and Jasper

[frijole]

Great update. Keep up the good work and know we are all behind you guys! Kim

[addy]

TIna, I am so happy to read Jasper is improving. I understand your nervousness about changing a med when you see improvement. Each time I had to finally discontinue an eye drop, I would worry so much.
Go slow and remember to breathe. If Jasper seems off at all , just call your vet and come here. :):):):)

I hope the colitis stays at bay!!!

You are doing a wonderful job. Jasper is very lucky to have you.

[molly muffin]

Yay, good news for Jasper. I'm glad he is doing better. That was so scary what he went through before. Tapering off the prednisone at a steady schedule should be okay. You are looking for him to not need it any more over all. So if he can remain in good health, without the pred that would be an optimal result. You'll be taking it really slow with the weaning and this will give his body time to adapt to not needing it and take over doing everything itself.

Hang in there.

hugs,
Sharlene

[Squirt's Mom]

Hi Tina,

Good to hear that Jasper continues to improve! :) Keep up the good work and let us know how the vet visit goes.

Hugs,
Leslie and the gang

[Tina]

Hi Everyone,

Thanks so much for the kind words. Jasper had a pretty good weekend overall. I gave my vet an update tonight, and the plan is to start tapering the prednisone on Wed 9/26 to half a tablet daily, which will be 2.5 mg daily. She said we will keep him on that dose for several days before taking him off it for a couple days to get another ACTH stim test. She will call next Monday to see how he is doing. She wanted to start the taper on Wed so that if there were any problems we would know before the weekend. She feels he will do fine on the lower dose, but I am scared of course.

My fear of course is that he is not producing any or very little cortisol on his own, and that we will get into trouble when the dose is decreased. I forgot to ask her, but if he started not feeling good on the lower dose, can I just give him another 1/2 tablet to make up the difference? And will that prevent the severe symptoms that he had before? She said that 5 mg is a high dose for him and we need to taper it down.

So that's the plan currently. I am just reluctant to do any changes because he seems to be feeling so much better now. :rolleyes:

Hugs to all,

Tina and Jasper

[Tina]

Today is day 4 on the reduced prednisone dose, Jasper has been getting 2.5 mg daily since 9/26 when we started the taper. So far so good, he seems to be feeling ok. He has been eating and hasn't had any of the scary signs of low cortisol. I am so relieved that he is tolerating the decreased dose, but I am still scared about stopping it for 48 hrs in order to do the next stim test. I am guessing my vet will be looking at that for some time next week. I will be checking in with her on Monday.

He is continuing to recover from the addisonian crisis, I have learned that this takes a while. It has been almost a month! He continues to drink and pee excessively, but other than that, seems to be getting back to his old self. I am so thankful. He has come a long way. :)

I hope you and your pups are all having a great weekend.

Hugs,

Tina and Jasper

[addy]

I am so glad Tina. It is wonderful to hear Jasper is on the mend.

[molly muffin]

I am so glad that Jasper is getting better. It does seem to take a while to recover from these addisonian crisis incidents. So no hurry in that regard.
I know you are happy to see him doing so much better.

hugs,
Sharlene

[Tina]

Hi Everyone,

I talked to my vet a few hours ago and gave her an update on Jasper. We went over everything, and she is concerned that the Percorten injection that Jasper was given when he was in his crisis is coming due in the next day or two if he is still low and needs it. Apparently it is given every 26 days, and he had it on 9/6.

She doesn't feel that he has been on the lower dose of prednisone long enough to allow his adrenals to no longer be artificially suppressed from taking the higher pred dose, so doesn't think we can do the stim test this soon. (Not to mention if they haven't regrown from being over suppressed from the lysodren). She wants to recheck his baseline cortisol to get an idea of whether he is still real low or not. This way if he is still low, she will give the Percorten, and if not, I think she said we would look at when we should do another stim test. I will hold the prednisone tomorrow morning, and drop him off for the test on Wed morning 10/3.

The results of the baseline cortisol test are sent to a lab in town, so we should get the results late the same day. Plus it is much less expensive. ;)

After talking to my vet, this seems to make sense at the present time. I know she is concerned about the timing of the Percorten, if it turns out that it is needed. He was so incredibly sick, I am sure she doesn't want to take any chances.

So this is our plan for now. I know it probably is not usual, but nothing about Jasper's response to treatment so far has been usual. He definitely has not read the textbook, and has not been following the rules at all. I have had several talks with him about this, so I am hoping he has been listening. :rolleyes:

I am nervous about him being without ANY prednisone tomorrow. I was scared to decrease the dose, and he has tolerated that so far. If he is going to get sick from holding the prednisone, how quickly would that happen? The vet said that they would give him a dose at the hospital after the baseline cortisol is drawn, so he will be without it about 48 hrs, but really just missing one dose.

Any feedback would be appreciated!

Hugs,
Tina and Jasper

[Jenny & Judi in MN]

Hi Tina: If he has been doing ok as you wean him I bet he will be ok with none. We weaned my Jenny (also overdosed with Lysodren) very slowly off the prednisone and she kept her appetite and her fiestiness.

Her cortisol is very slowly coming back. I think her baseline was something like .8 up from .4 in April and she is doing ok with nothing for the last 6 weeks or so.

No lysodren, no prednisone. She got picky so I started putting some stinky food in with her normal food and she is eating it all (knock wood)

good luck with the test! I hope Jasper is starting to produce some cortisol also. Judi

[Tina]

Hi Judi,

Thanks for letting me know about Jenny. I have been following your thread but hadn't been able to read it all from the beginning, but I had gathered that Jenny had been over suppressed from Lysodren also. Right about the time I was getting ready to ask you about it, Jasper ended up in the hospital, and it has been pretty tough since. I feel like we have finally turned the corner, and I am hoping it continues!

I am glad to see that Jenny has been doing well and that her appetite has been good for the most part. So if her cortisol is slowly coming back, does your vet think that she won't stay addisonian?

Thanks again for posting.

Tina

[Jenny & Judi in MN]

Hi. Yes, the vet thinks eventually she may need medication again but the specialist we saw in April told me not to even consider it until she is over 2 for both the pre and the post test in the ACTH

My specialist recommended doing exactly what you are doing tomorrow. He said if the baseline is super low, no need to waste time or money doing the second half of the ACTH.

The specialist also told me that if Jenny were brand new to him, he'd go with Trilostane but since we know Lysodren definitely works on her, if we get to that point again, he'd use lysodren on her at a much reduced dose. But he did tell me I could switch if I want.

It has been a nice mental health break only giving her insulin these days.

Fingers crossed for you & Jasper! Judi

[Tina]

Thanks Judi! That is good to know about Jenny and that your specialists recommendations match what we are doing. It made a lot of sense after my vet and I discussed everything.

It has been a while since she has mentioned anything about how we would handle restarting the Lysodren, but I do remember she said it would need to be at a very reduced dose, if we got back to that point. She has concluded that Jasper is highly sensitive to it. I literally watched him like a hawk while he was taking it, and he still got into a crisis. She has not mentioned switching to Trilostane at this point.

I love your avatar pic, Jenny is so cute! I wish I had a better pic of Jasper, the one I have is kind of dark. He has become afraid of the sound that my camera and phone make when taking a picture, so that is the best one I could find that would fit.

Thanks for all the feedback Judi, I appreciate it.

Tina

[Squirt's Mom]

Hi TIna,

I hope Jasper does just fine without the pred today and he can start weaning off. Some pups are just super sensitive to these meds but it sounds like your vet is handling this just right - taking her time to let Jasper's adrenal recover and aiding him meantime.

If you notice today that he is slipping without the pred on board, call her asap and make sure she knows how he is acting. He may tell you himself whether he can do without it right now or not - and don't take a chance if he needs it. ;)

I am so glad he is better than he was, tho, and continues to show signs of improving. You're a great mom, Tina!

Hugs,
Leslie and the gang

[Tina]

Thanks Leslie! I am hoping that my work load today will allow me to be able to come home at lunch to check on him. That is my plan. Unfortunately I have a meeting at 1, so that makes it a little difficult, but I am going to try, just so I can eyeball him during the day. I hope he does ok, as I really want to get the level checked to see where we are at. I am suspecting it will still be quite low, but that is just a hunch. Thank you for the ongoing support.

Hugs to you and your gang,

Tina and Jasper

[Tina]

So far so good, Jasper seems to be doing ok with the prednisone on hold. It has been about 48 hrs since his last dose and he seems to be tolerating it at this point. We are heading in to the vet shortly, I will drop him off for the baseline cortisol test and any other labs that she feels are necessary. Hopefully we will have the results later today.

Hugs,

Tina and Jasper

[frijole]

HI Tina! Great news. Fingers crossed. Let us know what you find out. KIm

[addy]

My fingers crossed too Tina

[Squirt's Mom]

Great news! So glad he seems to be holding steady without the pred! :) That's a good sign to me. ;) Let us know what you learn today.

Hugs,
Leslie and the gang

[Jenny & Judi in MN]

that is great news! now fingers crossed for today's results

[molly muffin]

Great that Jasper is doing okay without the pred. How did today go?

hugs,
Sharlene (sorry I've been missing in action for a few days) but reading, just no time to get online and respond to anything *sigh*

[Tina]

Thanks Everyone! No results yet, I imagine my vet will call with them some time today. She went ahead and gave him his prednisone dose yesterday, 2.5 mg, and I have given it this morning also. We will decide how to proceed with the taper after we see what the baseline cortisol level is. I will check in once I have the results.

Hugs to you and your pups,

Tina and Jasper

[Tina]

My vet called this morning with Jasper's baseline cortisol result, it hasn't budged, it is < 0.4 ug/dl (ref range 2-6). :eek: :( She called the lab first thing and had them run electrolytes from the blood that was drawn yesterday when she saw that the level was still so low. She called with those results this afternoon. The sodium was in the normal range and the potassium was at the highest end of normal. She said the potassium was creeping up, which was a concern, and confirmed that he needed another injection of the Percorten. She felt it would be best if I could bring him in tonight, so I did. I ran him in after work and he got the injection. He will also continue on the prednisone 2.5 mg daily for now.

She said she feels it is likely that he is going to stay permanently addisonian since his cortisol hasn't recovered at all in the 4 weeks since it was last checked. We will continue to monitor, apparently if it doesn't show some recovery within 4 months, then he will be considered to have Addisons disease. She was reassuring and said this would not be a horrible thing and that it is treatable. We talked about that a bit and went over what needs to be done in the next few weeks as far as labwork.

I have spent the last couple of hours bawling. I know I did everything exactly as I was supposed to with the Lysodren, and I couldn't have monitored him more closely for the warning signs. He didn't show any during the loading phase when he bottomed out the first time, or during the maintenance dosing. This is apparently when he got toxic and the damage was done. I just don't understand how this could have happened when I was so incredibly careful. I feel like I poisoned him. I am trying to not be so upset because I am so thankful that he is feeling better now, and he looks so much better. But I keep going back to the feeling that I did this to him and that it could be irreversible.

I am sure that part of the reason that I am not handling this well is because I am so tired. I realized that I haven't had a full night of uninterrupted sleep since some time in May when this all started. I am up 2-3 times a night to let him out, which I absolutely don't mind, but it is taking a toll. I am hoping that the drinking and urinating will somehow normalize somewhat, but I am not sure I understand why it is still so excessive since his cortisol is almost at 0. I will do anything to keep him comfortable, so I need to figure out a way to adjust to this.

Thanks so much for listening, I know you all understand.

Tina

[Jenny & Judi in MN]

((hugs))

There are a couple of people with Addisonian dogs on the K9 diabetes forum and they swear it is easier to regulate an Addison dog than a Cushing dog.

You need some rest. Jasper can certainly take some prednisone for a few more months and just be a dog!

hang in there, this is not the end of the world. Judi

[frijole]

Tina, I'm sorry. I know getting up that much during the night has to just wear you out. I know we've had this discussion before but I do not understand the urination issues. I recall having this conversation earlier and you/the vet believed it was related to the prednisone but at that time the dosage wasn't that great. Did you ever rule out diabetes insipidus? (this is not the same as diabetes mellitus). I know you ruled out thyroid issues. Sending love, Kim

[Squirt's Mom]

Mornin' Tina,

No, this is not the end of the world and NO you did not poison Jasper, honey. Some pups are just super sensitive to these meds and we have no way of knowing that going in...you did exactly as you were supposed to.

In parts of Europe, they treat Cushing's by intentionally inducing Addison's by destroying the adrenal glands because they feel Addison's is easier and less expensive to treat, and not as hard on the pup to live with. Jasper has simply gone from one end of the spectrum to the other and you can both live with this. :)

Here are some links about Addison's for you to check out and I am sure there are others out there as well that may be helpful. The next to last link is a Yahoo forum for discussion and the last one offers some other support venues.

Addison’s*

http://canineaddisonsinfo.com/

http://k9addisons.com/faqs/

http://pet-diseases.suite101.com/article.cfm/addisons_disease_in_dog

http://www.inmetrodetroit.com/pets/dachshund/frederick/addisons.htm

http://www.vetinfo.com/dencyclopedia/deaddisons.html

http://pets.groups.yahoo.com/group/AddisonDogs_/

http://canineaddisonsinfo.com/Support.html

Oddly enough, Addison's and Cushing's share some of the same signs - excess thirst and urination among them so the Addison's may be why Jasper is having to pee so much. But I would look into the Diabetes Insipidus just in case. It is a rare form of diabetes but we have seen several cases of it here. DI is not caused by sugar imbalance but rather with how water is processed in the body.

Links to DI info -

• Polyuria, Polydipsia and Diabetes Insipidus
http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2002&PID=2556

• Diabetes Insipidus
http://www.petplace.com/article-printer-friendly.aspx?id=3258

• Diabetes insipidus
http://www.provet.co.uk/health/diseases/diabetesinsipidus.htm

• Diabetes Insipidus
http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/40507.htm


Now that you have your homework assignment for the day you should have no trouble keeping your mind busy. :D But, hey, if you get bored just holler - I gots lots more links to all kinds of stuff...some are even important! :p

You are doing a great job, Mom, and you have done nothing wrong so don't let those nasty ole thoughts get you down.

Hugs,
Leslie and the gang

[Maya]

Dearest Tina, Sorry to hear about little Jasper. Bless you both.... I know it's hard and very stressful on you and I certainly understand about the lack of sleep. We have to get up every two hours to let Maya out and she still pees on the carpet. Last night she just stood up in her bed and started peeing, so that was me up at 2.45am cleaning up and getting her a fresh bed sorted out!
Now that you know that Jasper is Addisonian, things should improve, because the vet knows exactly how to treat him now. It's the not knowing which causes all the ups and downs. Addisons is a very treatable disease. I know a dog who had it since he was 4 and he's 10 now. It's a lot more common than you think. My vet was telling me that he has 17 patients on his books with Addisons and that they are all doing well. He, himself has an Addisonian poodle! He said that once they are stable it is quite easy to treat them as long as you keep them monitored. In fact, he said it's better to Addisons than Cushings and there is substantial evidence to support this if you do a bit of research on the net. I know this is very upsetting for you, sweetie, but hang on in there-you'll get things sorted...
Sending lots of hugs your way, from me and Maya

[molly muffin]

Hi Tina,

Everyone seems to say that Addisons is much easier to deal with than Cushings and is completely manageable. Dogs can live a very long time with it.
I think some sleep and getting an idea of how Addison's is treated will make you feel much better.

hugs,
Sharlene

[Tina]

Judi, Kim, Leslie, Leah, and Sharlene,

I don't know how to thank you all for your comforting words and support. I had myself a good old cry after reading your posts, and am so appreciative of all of you, your help, and your kind words.

Leslie, thank you so much for all of those links. I have done a bit of reading, but hope to hit the "homework" hard this afternoon after I get some more cleaning done.

Kim - no, we have not ruled out diabetes insipidus. This has not ever come up with my vet. I have done a bit of reading on it, and will ask about it when I talk to her next. That should be some time this coming week when we go over the current treatment plan.

Jasper's drinking continues to be excessive, along with the peeing. Other than that he really seems to be feeling pretty good now. Words cannot convey how thankful I am for that. I am seeing some glimmers of his old self come out. It has been months since I think I could say that. I am hopeful that it will continue! :D :D

Thank you all again for the encouragement. At the risk of sounding like a broken record, I don't know how I would be functioning at all without all of you and this forum. What a blessing.

Much love and giant hugs to you all and your pups from me and Jasper. xo

[Harley PoMMom]

Hi Tina,

I did a bit of research on Percorten and increased drinking/urination is listed among the side effects.


Occasionally, dogs on PERCORTEN-V therapy may develop PU/PD, which may suggest excess glucocorticoids and/or excess PERCORTEN-V. Should this occur, close monitoring and dose adjustments are required. Initially, the glucocorticoid
dose should be decreased, followed by, if necessary, a decreased PERCORTEN-V dose at unchanged intervals.
http://www.percorten.novartis.us/pdf/Percorten_V_Monograph.pdf

Hopefully only a dosing adjustment is needed, has Jasper's vet mentioned that drinking and urination could be increased by the Percorten?

Keeping you both in my thoughts and prayers.

Love and hugs,
Lori

[Maya]

Tina, I forgot to mention that excessive drinking and urination can be a side effect of the prednisone too!

Hugs from Leah and Maya:)

[Tina]

Hi Lori and Leah,

Yes, I knew that excessive drinking and urination can be a side effect of prednisone. In previous days, my vet mentioned that she thought that this may be what was happening with Jasper. But like Kim said, he was on a low dose then just as he is now (2.5 mg daily). I imagine it would still be possible. He seems to be sensitive to meds, so probably is to the prednisone too.

My vet did not mention that drinking and urination could be increased by the Percorten, but I had read that when I researched about it also. :) I will ask her about it. I have also read that they can be symptoms of Addisons as well as Cushings. Sheesh, lots of possible causes or contributing factors! :rolleyes:

My vet did mention that we will be checking Jasper's electrolytes in 2 weeks from the date of the Percorten injection, and again in 25 days to see how well it is working and how it is maintaining the levels in order to determine if a dosage or interval adjustment is needed. (I think that is what she said, I will clarify the next time I talk to her). She also said something about possibly reducing the prednisone to every other day at some point. So that might help.

Jasper has had the excessive drinking and urinating throughout this entire roller coaster ride, so I really don't know what to think about what is causing it now. It first started due to the high cortisol, but now he is bottomed out so maybe it is because of the Addison's now? Or most likely a combination of things?

Love and hugs to you both,

Tina and Jasper

[Squirt's Mom]

Hi Tina,

My little Boston is on pred. She weighed 11.5 lbs last time she was weighed, gets 1.25 mg either every other day or daily as needed and she has strong cush signs since starting the pred. Everything except hair loss and skin discoloration is present - excess urination, excess drinking, strong hunger drive, and pot-belly. She pants heavily and easily, and sleeps a lot but that is due to another reason so I can't lay that fully at the feet of the pred.

The times she has been able to manage with every other day dosing presented milder and fewer signs. The times she needs daily dosing, the signs are strong. When I reach to pet her, she has to nibble my fingers just to be sure there isn't something to eat hidden in there. :p She stands at the water bowls and drinks every drop I put in there whether 1/2 cup or a full bowl, around 3 cups...she drinks until it is gone, then usually throws it back up if I don't control her. It seems like she pees constantly. I tried diapers on her a while back and she ended up with red skin around her waist so I stopped using them and just follow her around with paper towels, rags and Nature's Miracle. :D Her skin was in bad shape when I got her and it has improved tremendously so I wasn't willing to risk that discomfort to her for my ease.

I'm not saying the pred is the whole cause behind the signs Jasper is displaying but I did want to share our experience with pred and how it has caused Tash to present as a cush pup when she isn't.

Hugs,
Leslie and the gang

[Tina]

Hi Everyone,

I have been getting caught up on some threads and just want to touch base about Jasper. I have had a lot going on unfortunately, and haven't been on the site very much in the past week and a half. :rolleyes:

Leslie, thank you for sharing all of the information about your baby on prednisone. I am hopeful that when we look at tapering the dose that we will see some improvement in the drinking and peeing.

Jasper is still hanging in there and seems to be doing well overall I think. We had originally planned to recheck the electrolytes at the 14 day mark after the Percorten injection. My vet looked over all his labs, and decided that we will wait to recheck the electrolytes at the 25 day mark when the next Percorten injection is due, since his sodium and potassium were not terribly out of line on the last check. He will get the next Percorten on 10/29 so will have blood drawn then and based on those results we will see if any adjustment in the Percorten dose can be done for the next months dose. We will also look into considering decreasing the daily prednisone dose at that time. She said we may look at checking another baseline cortisol in a month or so.

He has been doing great with everything until a few days ago when he started to have decreased interest in eating. Started eating a few bites, and then walking away from the bowl. Most of the time he would eventually finish, but not always. I picked up some Cerenia from the vet last evening and gave him a dose last night because we think he seems to be nauseated. The vet does not think it is related to the addisons. This morning he would not eat at all. He seems hungry but acts like the food in his bowl is icky or something. I talked to my vet again and she suggested getting some pepsid to give him, 5 mg daily. She also said to see if I could get him to eat a little bit of the canned prescription food he was eating after being in the hospital. She said that sometimes when they are nauseated "they hold out for the good stuff". Lol. Well, the little stinker ate the canned food right down. I will give him some more a bit later and then try mixing some with his regular food a little later tonight.

He seems good other than the eating issue. No vomiting, and his poops look good. Energy is a little decreased, but not bad. So off I go to pick up some pepsid!

I have done quite a bit of reading about Addison's , and have not seen where they have a forum like this one. If anyone knows of one, please let me know. I did see a yahoo group, but have not joined it. Does anyone know anything about it? I am hopeful that if Jasper stays with permanent Addison's that I can continue to be involved in this forum. You all feel like my family, and I want to stay here even if he ends up not having Cushings anymore.

Love and hugs to all,

Tina and Jasper

[molly muffin]

Oh gee Tina, it doesn't matter if Jasper does or does not have cushings as far as being a member of this forum. You've been a member of the family for quite awhile and we don't tend to let go of our families hands. We all hope that Jasper in fact does not go back to cushings, that he finds that happy medium once again. We have some here that have gone Addisons and are still there. It's just the nature of the beast so to speak.

Not sure what the not eating is about. The pred should be controlling the cortisol so it doesn't go to low. Maybe some of the others can give some thoughts towards that issue. At least he's not vomiting or diarrhea.

It's a good sign that he ate the canned food. If the other isn't agreeing with him tummy right now though, he probably wouldn't eat it. Molly gets like that. If her tummy is upset, or she doesn't feel so good, she won't eat her normal food. I end up having to mix in another type to get her going. Usually a bit of can on top of the dry will do the trick though. She won't necessarily eat it all once every time, but more graze at it.

Hope Jasper perks up soon.

hugs,
Sharlene

[frijole]

Thanks for the update. IMPORTANT - please tell me you bought Pepcid AC and not regular Pepcid. Don't ask me what the difference is because I cannot remember but I DO remember being told NOT to give a dog Pepcid and that only Pepcid AC is tolerated.

Hopefully someone with a better memory can elaborate but I didn't want you to give Jasper something that could hurt him.

Hugs,
Kim

PS how bout that game? geez. ;)

[Tina]

Hi Kim,

Thanks for the info about the Pepcid. I got scared for a second, because I examined all the variations of Pepcid on the shelf and dont remember seeing a regular Pepcid, only Pepcid AC and Pepcid complete. My vet said to get Pepcid AC, she said I could get the generic form, so I did because it was lots cheaper. The only active ingredient is famotidine. She said to get the 10 mg dose and give Jasper half a tab, 5 mg daily. There is a maximum strength which is 20 mg per tablet, so you have to watch the dose. Is it the Pepcid complete that you are thinking of that could be harmful? It has some other active ingredients in it in addition to the famotidine. I hope it's ok, because I already gave it to him. :o

Yeah, we sure lucked out with that game. The turnovers and muffed punt returns, sheesh! :rolleyes:

Hugs,

Tina and Jasper

[molly muffin]

Hi Tina,

What you got is the right thing, Pepcid AC. The ingredient that you are looking for is the famotidine only.
I had to look it up on a vet info site, but that is what it said.

Hope it works for Jasper and he starts to feel better.

hugs,
Sharlene

[frijole]

:D:D:D:D:D:D:D
You did good Tina! Just had to check. Thanks Sharlene for checking it out for us.

[molly muffin]

Kim, so glad you mentioned it!! I wouldn't have even known that if you hadn't.

It's all about team work! This forum is a family team. :)

hugs,
Sharlene

[Tina]

Well, Jasper has had a rough past few days. I struggled to get him to eat over the weekend. At first he would eat some canned prescription diet late Saturday and part of Sunday, mixed with a bit of his regular food. He was getting the pepcid and Cerenia for nausea. Sun evening he barely ate with much coaxing, and Mon AM he wouldnt eat at all, even the canned food by itself. My vet had said that if I couldn't get him to eat over the weekend I could drop him at the office on Mon morning and she would take a look at him. So that is what I did.

He was there all day. His physical exam was ok. They checked his urine which showed 3+ protein, which she said she was concerned about since the urine is so dilute. I don't think he has had that before, and if he did, it wasn't that much. Based on that she rechecked the kidney bloodwork and it was all normal. (I don't have copies of the labs yet). She did an abdominal X-ray to see if there was anything going on in his belly GI-wise, and it didn't show anything abnormal. She sent the urine off for a culture to see if maybe he has a UTI which could account for the protein.

She is not sure exactly what is causing him to not want to eat. She switched him to purina EN prescription diet, he was eating that right down at the vets office. Also, she thinks that maybe the decreased dose of prednisone (2.5mg) is not enough to keep him feeling comfortable. He had been on the lower dose for about 3 1/2 weeks and doing ok, and we had hoped to try to decrease it further. He started to seem less interested in his food last week. Saturday he went to the groomer. I watched him real close and he seemed ok, but then the eating went downhill over the rest of the weekend. I am thinking that this may have been enough stress to really make him not feel well. We have increased the prednisone back up to 5 mg daily. She said that he might be a dog that needs a bit higher dose to feel well. She is hoping that this is what has caused the loss of appetite.

So he was eating the new food well, seems to like it, no problems. Yesterday I came home from work and he had had a large amount of diarrhea. :( I immediately panicked, but there was no blood thank God. My vet was not in the office but I talked to another one of the Drs there. He is now on home cooked hamburger and rice diet which he is eating and tolerating, and metronidazole. The last liquid poo was about 2:30 this morning, so he is showing improvement thankfully.

So I don't know if he got diarrhea because of the new food, if it is colitis that has flared up, or of it is because of the Addison's and low cortisol. My vet is out for a couple of days, so unless she calls to check in tomorrow, we will need to discuss the plan on Friday.

I really am trying to stay positive, but it just seems like it is one thing after another for my little baby. He is such a good boy and doesn't deserve all of this. It doesn't seem like my poor Jasper can get a break. It is so hard to see him feeling so poorly.

Hugs,

Tina and Jasper

[frijole]

Dang hard to know the cause of the runs. I can share that canned pumpkin firms up the poop faster than anything I've ever seen. Get the plain pumpkin not the stuff with spices. Only give between a tsp and a TBS at a time (twice a day). What I have done is freeze the remaining pumpkin in little bags for future use if you don't feel like making pumpkin bread ;) Give Jasper a hug for me. Kim

[Boriss McCall]

Poor little Jasper..:(
I hope today is a better day for him & you.

[Maya]

Awwww Tina, sorry to hear that little Jasper hasn't been well. Leslie is right about the canned pumpkin for diarrhea- it works a treat, if you can get them to eat it. I bet you Jasper loves eating 'human food' When they stop eating like that, you try anything. Maya hardly eats any doggie food anymore!:)
I hope he feels better soon, I know how worrying it is for you. It does sound like it could be Addisons related. Those are the typical symptoms, diarrhea, lack of appetite. Lets hope Jasper benefits from this pred increase.
Thinking of you both.....
Hugs from me and Maya

[molly muffin]

oh my gosh. Poor Jasper really has been through the ringer. Well, both of you have.
Hope he is feeling better. Everyone says that Pumpkin is the thing to try for the "runs". I'd go with Kim's suggestion and try it. I wish I'd known about it back in March when molly got the runs so bad.

hugs,
Sharlene

[Tina]

Thanks Everyone! Jasper is hanging in there, again. He continues on the hamburger and rice home cooked diet, and has been eating that well. He will have that through tonight and then tomorrow I am supposed to start mixing in a bit of the canned i/d prescription food to see if he will eat that. Then gradually increase the canned food to taper him off the home cooked. Then we will look at what food he will eat for maintenance. My vet said she will be handling him with kidd gloves since all of this has happened. We will be taking it very slow. The diarrhea has resolved with the diet and metronidazole. In fact he is pooping less than normal, I hope now he isn't going the other way! He has a history of getting backed up from time to time in the past. I hope that doesn't happen now from all the rice. I have noticed that his drinking has decreased significantly over the past 4 or 5 days also. I imagine that is related to the diet.

The urine culture came back negative, so now my vet has sent urine for a urine protein creatinine ratio test (?) which she said will quantitate the amt of protein in his urine, since an infection is not the cause. (I think that is how she said it). We don't have those results yet. I am kind of worried about that.

Tomorrow he has a previously scheduled appt to have blood drawn to check the electrolytes again, as it will be 25 days since the last Percorten injection. He will also get another injection. He also continues on the prednisone at 5 mg daily.

He seems to be feeling much better overall, and I am very grateful for that. It seems that this is all very complex and it is a very fine line to keep things balanced and to keep his little body feeling good and with some level of stability. It sure doesn't take much to rock the boat anymore.

I hope everyone's pups are doing well, and you all are enjoying the weekend. :)

Hugs to all,

Tina and Jasper

[frijole]

Great update. Fingers crossed for good results on the testing and weaning. Keep us updated! Kim

[molly muffin]

Sounds like your vet is doing a good job keeping an eye on Jasper and trying to figure out what is going on with him.

Hugs,
Sharlene

[Tina]

Hi Everyone,

Sorry for being absent, I had a pretty rough time with work last week.

Jasper had his appt last Monday and had electrolytes drawn. He also had another Percorten injection. The vet decided to decrease the dose by a little, 10%. The dose he gets is 1ml, so that decreased it by 1/10 ml. She decided on the decrease since he has continued to have increased drinking and urinating, and this can be a side effect of Percorten if the dose is too high.

We got the results of the electrolytes the next day, and both his sodium and potassium were wnl. So that is great news! The results of the urine protein creatinine ratio came back at 1.27. I don't have a copy of the lab report, but my vet said < 1 is normal or a good result, > 2 indicates that further evaluation needs to be done and that treatment is needed. An in between result warrants monitoring and is kind of a gray area. She said she was a bit concerned by this result and isn't sure if the protein is increased because of the Cushings (even though it is controlled now), or if there is something else going with his kidneys, and if treatment should be considered.

We have one IMS in town (actually in the whole state, I think), and she said that she wants to work up a case study type of report on Jasper and send it to him to review to see what he thinks and maybe get some recommendations. She wants his opinion specifically regarding the amt of protein in Jasper's urine, what might be causing it, and if he feels treatment is needed. She also wants his opinion as to why Jasper has continued with such increased drinking and urinating even though his cortisol is so low. She said that he is real good about giving consultations, but that sometimes he wants to see the dog himself. Of course I will do whatever they recommend. I appreciate so much that she is willing to take the time and effort to do this for Jasper, and that she wants to make sure that she hasn't missed anything, and also that her treatment plan is the best plan. He has been through a lot, and it has been very complex. I am sure it won't be easy or quick to get it all in a report.

Jasper is now transitioned completely to the canned prescription i/d food, and beginning Tuesday, I will start mixing in a little of his regular dry food to start transitioning him back to that. His appetite has been real good while getting the canned food, I am hoping that continues once I start mixing back in his regular food. He continues on prednisone 5 mg daily. My vet said we will try to start tapering that down once we get him back on his regular food. One change at a time so we can keep a very close eye on things.

He seems to be feeling good with how we are managing things now, but I know he can't stay on that high dose of prednisone, or the canned prescription diet. He has been through so much, I just get a little anxious to start changing anything. I have noticed for about the last 10 days or so, his water intake has been decreased. Still a bit higher than normal, but much better, and some days has actually been about normal! Not sure why that would be happening now. The vet is aware and she isn't sure either. It would be nice if it would continue, I have actually gotten some sleep for a few nights!! :D :cool:

So I will wait to hear what the IMS thinks about everything. I am so grateful that my baby boy is feeling better. And fingers are crossed that he is on the road to some level of stability now!

Hugs to all,

Tina and Jasper

[frijole]

Tina, Thanks for the update. Yes, that IMS is out of Kansas State's vet hospital and if you have to go there they will work with your vet closely. I ended up going directly to K State (long story) but I was very very impressed with them. You're in good hands. Take care and keep up the good work. Kim

[molly muffin]

Hi, good to hear from you Tina. Totally sympathize with the busy work situation. I'm glad that Jasper seems to be feeling good these days. It's always so stressful when they aren't.
I think it's usually beneficial to have an IMS consulting with your vet. I love it when a vet suggests the consultation themselves too. :)

hugs,
Sharlene and molly muffin

[addy]

Hi Tina, I am not sure if this is relevant but my non CUsh pup Koko had a physical with these results- vet was mentioned could be Addisons or the start of kidney disease and that I should watch him and retest him.

Bun is marked 33 normal is 7-27
Creatinine is 1.7 normal is 0.4-1.8
Specific Gravity is 1.025
PH is 7
no protein in urine

I think consulting with an IMS is a great thing. I hope you and Jasper have a good week and work is not so hectic for you:):)

[molly muffin]

Hi Tina! Hope everything is going well with you and Jasper. Not working too hard I hope.

Hugs,
Sharlene and Molly Muffin

[Tina]

Thank you Sharlene, Kim and Addy for checking in on us and for your comments. I made it through another somewhat wicked week at work. My immediate co-worker has been out due to a family illness, and then on funeral leave :( , so it has been a little rough on the work front. Things should be improving in the coming week, I hope! Thank goodness Jasper hasn't had any emergencies or critical issues during the past couple of weeks!!

I started transitioning Jasper back to his regular dry food on the morning of 11/6, slowly mixing in a little with each meal. Well darn it, by 11/8 am, he had a loose stool. Of course I immediately feared that the colitis was going to flare again. I put him back on all canned prescription diet immediately, and he did not have any more loose stools thankfully!! Now I am thinking that maybe he is not going to be able to tolerate going back to his Blue Buffalo food, even though he had not had any problems with it before (other than not wanting to eat it!). Talked to my vet, and she recommended that we transition him to the dry version of his prescription canned food and see if that will work to get him off the canned. It is Hills prescription diet i/d low fat GI restore dry food. I am not too thrilled about it, and I know how some of you here feel about Hills/Science Diet and I can't say I disagree, but I am going to try it. I talked to my vet about it and she understands my feelings but said that she really does like their prescription diets. So far he is willing to eat it (yesss!!), and tolerating it just fine. I started mixing it in yesterday morning. My vet said we don't need to keep him on it forever hopefully, but need to get him off the canned food for a time, and then can think about trying the BB again.

We also discussed the consult with the IMS and his feedback and recommendations. She asked him about two issues, the protein in Jasper's urine, and his continued increased drinking and urinating.

1. Protein in the urine: The IMS suspects that it is caused by a combination of Cushings and the steroids and is not an indicator of another problem. (Yay!!) He suggests to monitor it for now, and recheck the protein-creatinine ratio in a month or two. He said that frequently the urine protein will stay high in dogs with Cushings, even once the Cushings is controlled. He also said as long as the steroid dose is high, protein will continue to spill in the urine, so it may be related to the increased steroid dose.

2. Increased drinking and urinating: The IMS felt it could be related to the Percorten injections. He said some dogs are sensitive, that it is not common but is possible. He also said it could be the steroid since Jasper is on an increased dose. He feels that the 5 mg dose is above a physiological dose for Jasper, which could be causing the increase in symptoms. He suspects that is not a function of underlying disease but a function of one of his meds. (Another yay!!)

He said that he is not convinced that Jasper needs the Percorten injections since his electrolytes have not been really highly abnormal other than the time he was in the crisis and was so dehydrated. He wonders if Jasper has a glucocorticoid deficiency but not a mineralocorticoid deficiency.

The only way to determine this is to not give the Percorten injection when it is next due, but check the electrolytes at that time and then again in 10 days, and then in another 10 days. We would need to watch for Addison like symptoms to return.

He also said that we should try to decrease the prednisone and see if Jasper continues to feel well. (This was already in the plan). If he can't tolerate that, then the IMS said to consider another steroid such as dexamethasone. He suggests to see if we can decrease it to the 2.5 mg daily dose. (This was the dose he was on for about 3 1/2 weeks before he had the last episode of not wanting to eat and the colitis flare).

Conclusion: My vet and I were very relieved that he didn't identify a bunch of things that should have been done differently, or that were missed. :) ;) And also relieved with his opinions that he didn't think there were additional problems going on that were causing either issue.

The plan is still to get him transitioned to a dry kibble diet, and once that is stable, consider trying to decrease the prednisone dose if everything is going ok. We will discuss whether to give the next Percorten injection or not, depending on where we are at with tapering the prednisone. Right now, his next injection is due the day after Thanksgiving, so I don't know if I want to try to rock the boat then. Plus, we haven't been able to try to decrease the prednisone yet because we have had set backs with getting the diet stabilized. Of course, it won't be any more convenient in a month, closer to Christmas. We will be discussing it to see what we feel is best.

So that is where we are at. SO sorry this is so long, but it helps me to get everything documented in once place for my records also!! I don't know how many times I have gone back to my posts to see when something happened, or a timeline for something, so that I could report accurately to my vet.

Jasper seems to be feeling pretty good overall. I am keeping my fingers crossed. Thank you all SO MUCH, and hugs to anyone who takes the time to read all of this!! As always, I greatly appreciate any feedback, comments or suggestions! :)

Love and hugs to all,

Tina and Jasper

[frijole]

Tina, I am impressed! It is so nice to have an IMS in our state now and they seem to be on top of things as is your vet! Overall great news and a solid plan. Keep us posted.

I know what you mean about using your thread as a timeline/reference - it is really easy to go back. You might want to periodically save the thread to your pc for safe keeping. (just as a backup)

Good job mom! Thanks for the update. Kim

[Tina]

Thanks so much Kim! Yes, it is a blessing that we have an IMS in Nebraska now. I forgot to say in my last post that my vet sent Jasper's complete report of everything that has gone on from the beginning, with dates, etc, but she just focused her questions on the two issues I listed. So he is aware of everything. I am sure it took her quite a while to get that all together. I appreciate her so much and feel very lucky.

At the risk of sounding stupid, how do I save a copy of my thread to my pc? I have often thought that I would like to save it somewhere just in case.

Hugs, and thank you again for your ongoing support,

Tina and Jasper

[jmac]

Hi Tina-

I'm so glad to hear Jasper is in a good place and that you got lots of good news after your vet appointments. I'm glad you saw the IMS and that he and your vet are in contact and in agreement. That is always helpful! It sounds like the food transition is going well too! Hopefully someday you can take him off the Hills diet altogether, but at least for now the diarrhea is under control and Jasper is willing to eat the dry food.

As for coming back to the forum to check on what was going on/keeping a record/I do the same thing! It is a wonderful place to come to refresh my memory if needed!

I hope that work will calm down for you soon and that Jasper continues to do well!

Julie & Hannah

[frijole]

There might be an easier way but I go to "thread tools" upper right side and select "printable version" - you get the page of the thread. I copy and paste that into a word doc. 20 pages means you do it that many times but you have it.

If someone has an easier method I'm all ears! :D

[addy]

Tina, thank you for stopping by and checking on me and Zoe. I alway check on you and Jasper too. I am glad things are working out with the IMS and with the colitis. It is sogood to have that under control. When I had to transition Zoe from her prescription diet, I had to go very slowly, one teaspoon a meal sometimes.

Thank you for the tip about Zoe standing next time for her blood pressure. It is a life saver for sure:):):) She gets so stressed but I cant say I blame her with all the poking, etc and frequent visits.




(((((((Hugs))))))))))))))))

[molly muffin]

Tina! omg! A Plan!! We have a plan. LOL Doesn't it feel good to at least have a plan in place and know what you are aiming for in the coming weeks, months ahead. Something has simple as making the diet change, deciding on the injections, it all gives one a sense of at least semi control of a situation which has waaayyy too many days of out of control stress. You have had plenty of those. You and Jasper both really deserve to have a controlled, relaxing holiday season. :)

Thanks for stopping by and saying hi to Molly's thread. People here are so great!

hugs,
Sharlene and Molly Muffin

[Boriss McCall]

Yay Jasper & Tina!! sounds like things are moving in the right direction. I am like you. I like to document everything here. Anyway else in my house & there is a good chance it will get lost. :rolleyes:

Glad things are flowing smooth for you.

[Tina]

Thanks for the kind words everyone. We are continuing the food transition and so far so good. Jasper is continuing to eat well, and his poops look good. I am going to decrease the canned food again tomorrow. My vet called last evening for a report and feels he is doing well enough to start tapering the prednisone again. :eek:

He started with the decreased dose this morning. It is now 2.5 mg daily, down from 5 mg which he has been on for the past 3 weeks after he stopped eating and broke with colitis. Even though he did well on this lower dose for over 3 weeks when we tapered him the last time, I am a bit worried about decreasing it. Logically I know it should be ok, but I just get scared to rock the boat because he has been feeling so much better.

My vet plans to check in again in a week, and if he is continuing to feel good, we will need to discuss whether or not he will get his next injection of Percorten, which is due 11/23.

I have noticed that his drinking and peeing have increased again over the past week or so. :( It had been better for about 10 days, but now is increasing again, and we are back to going out at least once during the night again. I can't really explain either the decrease or now the increase as no meds had been changed during those times.

So my goal is to not have a need to call the vet for anything for the next 7 days. That would be a record at this point! :D :cool: :rolleyes:

Hugs,

Tina and Jasper

[Tina]

Happy weekend Everyone!

I have Jasper completely transitioned to the dry prescription low fat i/d diet as of last evening. He had his second full dry meal this morning and he is eating it all. A bit less enthusiasm than with the canned food, but he finishes. Hope that will continue. Poops have been good so he seems to be tolerating it well! :)

We started tapering the prednisone again and decreased the dose to 2.5 mg daily starting 11/13. I think he is doing well with that also, although seems to maybe feel not quite as perky as on the higher dose, but I will keep an eye on that.

Last week I noticed that his water intake was trending up again. It started a few days before we decreased the prednisone, but after looking at my journal this morning and comparing dates, it significantly increased beginning on 11/13, the day we decreased the prednisone. On 11/13 and 11/14 he was back up to drinking 7 cups (56 oz) per 24 hr period. He had been drinking around 35-40 oz/day for about the week prior, then kind of crept up to 48 oz for two days, then the 56 oz like I mentioned. Well, for 11/15 and yesterday 11/16 he drank a whopping 72 oz per day! I was off work yesterday and I was literally letting him out every 1.5-2 hrs. We are back to getting up at least twice or more during the night again to go out. Ugh! :eek: :eek:

Looking at the dates, it seems to correlate a lot with decreasing the prednisone, but this does not make sense to me. The IMS felt that his increased drinking and peeing was likely medication related and recommended decreasing the prednisone, which we had in the plan anyway. I would think the water intake should be trending downward with the decrease. I realize that Jasper has not followed the rules for anything else through this journey, so maybe this is another example of that. :confused:

He had a period from about 10/24 to 11/10 where the intake was consistently about 40 oz per day or less, and some days it was even normal. He had a colitis flare during that time, and was on the higher 5 mg prednisone dose during that time, so I don't know the explanation for the more normalized water intake. Now I really don't know what to think. Today he seems to be almost constantly at the water bowl.

Thank you all for any opinions or feedback.

Hugs,

Tina and Jasper

[molly muffin]

Hi Tina,
Yay on a successful transition back to dry food for Jasper.
I'll let others comment on possible reasons for the water intake changes and prednison. I'd just be guessing. My thought is that the prednisone maybe makes him feel better, but not as thirsty, whereas when the pred is lowered that changes somehow. Remember pred is addictive and they have to be weaned off of it, so how the body reacts to that lowering could manifest in different ways and Jasper has shown himself to be pretty sensitive to medications.

Anyway, hopefully someone else has experience and a better explanation. I'm just guessing.

hugs,
Sharlene

[Tina]

Jasper has continued to drink (and pee) a ton throughout the weekend. He has been eating the dry low fat i/d food, but is not as enthused about it as the canned. For every meal both Saturday and Sunday he would walk away briefly from the bowl at least once, but then return on his own and finish everything. Now this morning he walked away a couple of times, has eaten about half and now will not finish. I am wondering if his appetite isn't so good because we have tapered the prednisone dose.

He has been getting the decreased dose of 2.5 mg daily since 11/13. Maybe since it has been 7 days, it is catching up and affecting his appetite? He seems a bit less perky since the decrease also. Maybe it is my imagination, but I don't think so. My vet and the IMS feel 5 mg daily is too high of a dose for him to continue on long term. I am wondering if maybe he won't be able to tolerate the lower dose? I will be talking to my vet today, she is supposed to be calling to check in, so of course I will see what she has to say.

Tina and Jasper

[Squirt's Mom]

Hi Tina,

I hope the vet has some answers for you today. Tasha takes 1.25mg of pred daily and she weighs 13 lbs...and acts just like one would expect with a pup on daily pred - lots of drinking and peeing and always starving. Sounds familiar, huh? ;)

It's not uncommon to see a slight increase in water intake when a pup goes from wet to dry feed because of the higher moisture content in the wet feeds...nor is it uncommon to see a pup prefer wet to dry feed as it tastes so much better. :D Not that I've tried either one, nooooo, not me! :D

Hang in there and let us know what you learn. You're doing a great job, Mom!
Hugs,
Leslie and the gang

[Bo's Mom]

Tina,
I hope you find the answers from your vet. Please let us know what he/she has to say.

BTW: Leslie, you made me laugh when you were talking about "NOT" trying the wet/dry dog food. Hmmm, I have to wonder. :confused::confused::p:p
It reminds me of a few months back when I was trying anything to get Bo to drink water by even getting down on all fours near his water bowl and showing him what he needed to do. Not that I really drank any. LOL We do it all. :D:D

[molly muffin]

Tina, Happy Thanksgiving to you and Jasper. Crossing fingers for answers.
The thing with Jasper is that he seems to react to any and every little change in a big way. That makes it hard to tell what is going on with him. :( Interested to see what your vet has to say.

hugs,
Sharlene and Molly Muffin

[Tina]

Thanks Leslie, Belinda and Sharlene for the support. Jasper ate just a few bites of his dinner tonight and then walked away from the bowl. He almost acts like maybe the food doesn't smell good. I just left the food there and each time he went to get a drink, which is quite often, I could hear him eating a few bites. He managed to finish it over about an hour or so. This is totally unlike him. His whole life before Cushings he would always finish his whole meal, no problem.

I just got done talking to my vet a bit ago. We discussed all that is going on. She was disappointed and concerned to hear about the appetite issue, and the excessive drinking. She agreed that the increased drinking makes no sense since the prednisone has been decreased. This makes her think that maybe it is not a side effect from the prednisone, but really is a manifestation of the Addison's. She also pointed out that we are at the tail end of the Percorten also, so it doubly doesn't make sense. The IMS felt that his symptoms were due to side effects from the meds, but now she isn't too sure since the drinking is so excessive now. His intake has been 72 oz daily for the past 4 days, and he is on track for that today also.

She recommended that I see if Jasper will eat a small amt of the canned food tonight, and if so, start mixing in a small amt with the dry food for tomorrow. Well, he did eat it right down. So that is good, the last time he stopped eating he wouldn't even eat the canned food.

We discussed that maybe his cortisol is going back up on its own. We both don't really think so, but we are going to check a baseline cortisol after work tomorrow just to see where we are at with that. I will hold the prednisone tomorrow until after the test, and then we are going to increase it back to 5 mg daily to see if it will boost his appetite. And I think she is a little concerned about him maybe starting to head toward a crisis again. I did tell her that he seemed to really feel better when he was on the 5 mg dose. She is thinking he might not be able to tolerate the lower dose. We should have the cortisol result back on Wednesday, I will talk to my vet again then.

Sharlene, you hit the nail on the head - it is hard to figure out what is going on with him when he reacts so much to every little thing.

Ok, now for something funny. Well, it's funny now that it is all cleaned up. While I was talking to the vet about Jasper and taking notes on everything, my puppy proceeded to have diarrhea poo right in the middle if the living room. :eek: :eek: Where is the Calgon when you need it?!! My vet said I could give her a couple of half doses of Jasper's emergency metronidazole. We just had to laugh so I didn't cry, literally. I guess it was handy that I had my vet on the phone! :rolleyes:

Hugs,

Tina and Jasper

[addy]

When it rains it pours -Calgon take me a way or Chocovino works quite well:D:D

Since he ate the wet willingly, could it be you may have to keep mixing wet in to the dry? They cultivate a taste for wet pretty fast;) The dry doesnt smell nearly as good:):) Oh the pups and food.

I hope things get figured out for Jasper, you have been trying so hard with him.

I hope you have a good turkey day!!!!!!!! AND I hope puppy feels better as well.

[Squirt's Mom]

Hi Tina,

Something else to talk to the vet about today is the possibility of diabetes insipidus. This is a rare form of diabetes in which the body cannot process water normally and has nothing to do with blood sugars like diabetes mellitus, the common form. The testing for DI is risky so many vets simply start treatment to see if it helps. If it does, the diagnosis is confirmed and treatment continues. We have had several cases of DI here so it's certainly worth asking about. ;) Excessive drinking and urination are hallmarks of DI.

Let us know what you learn today and how this sweet boy is doing.
Hugs,
Leslie and the gang

[molly muffin]

Oh Tina. Poor Jasper. He's had a hard road lately. You are both due for some smooth sailing.
I certainly hope they can get this figured out so that you can find some sort of normalcy again.

hugs,

Sharlene and Molly Muffin

[Tina]

Thanks Everyone. Yes, things have been a bit discouraging, but I am trying to stay positive. Jasper is eating his dry food with about 1/4 can of the canned food mixed in. I am hoping that continues, tonight he hesitated a bit but did finish. I took him in after work and he had a resting cortisol drawn. I am anticipating that it will still be way low, but who knows. I gave him a dose of prednisone 5 mg after we got home per my vets direction, as the pred was held this morning. We did not see the vet tonight, the blood was drawn by a tech.

Leslie, thank you for your comments about diabetes insipidus. Kim had also mentioned this to me a while back as something to look into. I think you may have even mentioned it before also. I remember I started to research it, and then Jasper got sick with colitis, wouldn't eat, etc. If I asked my vet about it then, I don't remember what she said. I did some reading about it while I was at work today, and will definitely be mentioning it to her and asking about it when we talk tomorrow.

A couple of the resources that I read mentioned that the nephrogenic type of DI can be caused by adrenal disorders such as Cushings, due to the effects on the kidneys. I searched and searched but wasn't able to find much information about that specifically. It sounds like this type is the more difficult to treat. The other type is called central DI which is more successfully treated, and is treated by desmopressin drops. It sounds like this treatment is not effective for the nephrogenic type.

So, I will see what I can find out from my vet when we talk tomorrow. She mentioned that she would have the cortisol results by then, it must go out to a lab in town.

I am struggling to stay positive about things and not get really discouraged. I know that being sleep deprived is contributing to this. Getting up every couple of hours during the night to let Jasper out continues to take its toll. I am praying that somehow we can get this under some control. And at the same time I know we have much to be thankful for this Thanksgiving season. We are so incredibly grateful for all the dear friends we have made on this forum, I can't thank you all enough.

Love and hugs from me and Jasper

[frijole]

Tina, Hang in there. Couple of thoughts - first off Glynda posted an article written by a well known specialist and it talked about schnauzers and how prone they are to get certain diseases and both types of diabetes were mentioned. I think it's worth checking out.

Also was wondering if the change in food and change in prednisone at sort of the same time didn't make things harder to figure out. Give Jasper a big hug from us and have a great thanksgiving ok? Kim

[Tina]

Hi Kim! Yes, I have thought the same thing about the change over to the dry food and decreasing the pred at about the same time also. :rolleyes: I remember I even asked my vet about it because I thought the initial plan was to wait until he was all the way transitioned to the dry food before doing anything with the prednisone. She said to go ahead and decrease it. I think the reason for this is that she was hoping to try to have Jasper go without the Percorten injection this month as the IMS had suggested as a possibility to try. We are on kind of a timeline with that as it is due 11/23. She wanted him on the lower pred dose for a while before we tried that. Right now, the plan is that he will get the injection on Friday, because he is not stable with the prednisone and other things right now. Of course that will also depend on the cortisol result from yesterday. Ugh, it is so complicated! :o

How do I find Glynda's post, is it under the resources section?

Tina and Jasper

[frijole]

I have a few minutes to search the forum... if i don't post it, it's because i had to go to work. lol. We'll find it.

[frijole]

I found the article and the focus is on diabetes mellitus - skimmed it as I have to go... could have sworn it discussed DI but I don't have time to read the whole thing right now... if it is meaningless... forgive me! :o

http://endocrinevet.blogspot.com/2012/11/association-of-hypertriglyceridemia.html

[lulusmom]

Hi Tina,

When was the last time your vet did a full blood chemistry or even an in-house mini chemistry which includes kidney values, at least one (ALT) liver enzyme and glucose. Can you get a copy and post the results here? I would be most interested in the glucose.

Glynda

[Tina]

Thanks for the link to the article Kim, it was not meaningless at all. It related to diabetes mellitus, but I read it anyway because it pertained to mini schnauzers with high triglycerides, which Jasper has also. :rolleyes: It was interesting, I love reading Dr Peterson's articles.

I talked to my vet today and the resting cortisol drawn yesterday was still < 0.4 ug/dL, so it has not come up at all. :( I think the lab must not be able to measure a value lower than this because the result always says < 0.4.

Glynda, I verbally obtained the lab results you were asking about. My vet said the last blood chemistry was done on 10/22 and it was all normal except for an elevated Alk Phos which was 1869. This was higher than the last check, she said it had increased due to the prednisone. The ALT was 53, and glucose was 110, which said were both normal. I will get a copy of all of the labs I am missing when we go in Friday for the Percorten, and can post the complete report with reference ranges then.

I asked about diabetes insipidus, and we discussed that. She basically said that she had been considering that as a possibility more about a month ago, before Jasper had those 2 1/2 weeks where the drinking and peeing had significantly decreased and some days it was even normal. She said that you don't see that happen with DI, that usually it is progressive, so she feels it is less likely since he had a period where his drinking was better. She is really wondering if the increase in the drinking/peeing isn't a function of the Addison's, and we see it start to go up when he is getting ready to get into trouble with the Addison's.

She said she has not completely ruled out the possibility of DI, but said it is very rare. She said she has only seen one case in 15 years. She wants to give the higher dose of Prednisone a chance again and see how he does. He will also get the Percorten injection on Friday 11/23 as scheduled.

So that is where we are at with things now. He ate pretty good tonight with some canned food mixed in. Thank you all so much for all the kindness and support extended to me and Jasper.

Happy Thanksgiving to everyone and their pups. :)

Love and hugs,

Tina and Jasper

[frijole]

Thanks for the update. Your vet sounds on top of things as always. FYI the other reason I brought up DI is because we've seen it here a bit and the ones I can remember were all schnauzers. Kim

Happy Turkey Day and GO BIG RED! ;)

[Tina]

OMG, GO BIG RED is right, how did I not mention that?!! :D ;)

Thanks for the compliment toward my vet, that really means a lot coming from you. When I asked about DI, she paused and then said "I wasn't going to mention anything about that". She knows how I am about details and didn't want me to worry more than I already am. We both kind of laughed about it. She was very open about her thoughts once I asked. She even said that the diagnostic water deprivation test is very risky and she doesn't do it, just like Leslie mentioned. Sometimes I think I drive her nuts with all my questions, but she is always very patient. I appreciate her so much.

Hugs from me and Jasper

[Tina]

Jasper had his Percorten injection today. My vet decreased the dose by another 10%, so he received 0.8 ml. It has been 5 days since the prednisone was increased back up to 5 mg daily. He has been eating good with a bit of canned food still mixed in, and seems to feel much better again overall, I'm sure due to the higher pred. His drinking and peeing continue to be excessive, but are a little less over the last day or so. Hopefully it will continue to trend downward! My vet is going to call in a week to check in and get an update.

I got printouts of a bunch of labwork. I need to go through it and will post his last chemistry results that Glynda was asking about a bit later.

Hugs to all,

Tina and Jasper

[molly muffin]

Well, it might not be the best suggestion for clear thinking when reading lab results but the first time I brought molly's home to go over, I sat down at the table with the results a piece of paper and a great big glass of red wine.
It took a while to get through. The bottle moved to the table nearer to the glass, the papers were all over the place and I was a mess over all. Of course by the end of it, I had what I needed to know and didn't really care that the table was a complete paper zoo. (probably the wine thinking there)
LOL

Good luck!
Sharlene and Molly Muffin

[Maya]

Hiya Tina, I am so pleased to read that little Jasper starting to feel better. That pred is amazing stuff!:) I believe Addisons like Cushings takes a bit of playing around with until you get the right dosage. Some dogs need more-some less. Sounds like you're on the right track with Jasper, now.
Hugs to you and your little man
Leah

[Tina]

Thanks Leah, so good to hear from you. How are you doing? I think of you often and hope you are hanging in and healing. Yes, I am finding that lots of adjustments are needed to manage Addison's also. Jasper's last resting cortisol was still < 0.4 ug/dl which is practically 0. So it looks like he is going to likely stay permanently Addison's. I think my vet wants to wait another month to make the definitive diagnosis, she said something about the adrenals not recovering for a period of 4 months, and then they consider that it is permanent Addison's.

I feel that Jasper is going to need to stay on the 5mg daily dose of prednisone. It seems that every time we try to decrease it to 2.5 mg (which is the dose that my vet and the IMS say is what he should be on), he starts to not feel well and have problems. So I guess we will see. I worry about the effects of the higher dose on his liver. He continues to drink and pee a ton, otherwise seems to be feeling pretty good. Thanks so much for checking in on us Leah.

Hugs,

Tina and Jasper

[Tina]

Ok, I am finally getting back to post the lab results that Glynda asked about a while back. I got a verbal report for some of the values from my vet and posted those previously, but here is the complete report. This is a Mini (in house) CHEM blood panel, drawn on 10/22/12. This is the last time it was checked.

ALP 1869 U/L (20-150)
ALT 53 U/L (10-118)
BUN 5.0 mg/dL (7-25)
CRE 0.9 mg/dL (0.3-1.4)
GLU 110 mg/dL (60-110)
TP 7.9 g/dL (5.4-8.2)

It looks pretty good except for the ALP, which has been high, but has gone up quite a bit since the last time it was checked. My vet said it has increased due to the prednisone. Should I be worried about that? He has to be on the prednisone, but as I mentioned before, I am worried about the higher dose.

He had gone in on this day due to not eating. He broke with colitis the next day, went back on bland rice and hamburger diet, and a course of metronidazole. The pred was also increased back to 5 mg daily.

Tina and Jasper

[Trish]

HI Tina and cute Jasper!

I am not much help with the numbers or his condition, but wanted to pop in and say hello and wish Jasper a happy day :) and thanks for your support with my journey too, it is so appreciated
Trish and Flynn xx

[addy]

I'm sure someone will be along to check the numbers for you.

Just wanted to say hi and hugs

[Bo's Mom]

Just wanted to send (((((HUGS)))) also.

[molly muffin]

I'll let the numbers people talk about that too. The only other thing I see is that the Glucose is at the high end of the normal range, but I'm not sure what that means...maybe something to keep an eye on?

So many of our babies here have the really high ALP values. It seems to go along with cushings and now with the prednisone might be a part of Addisons too. So, again something for those who have been through this part of the journey to comment on.

Okay, so I know nothing! ROFL But hey, Big super duper Hugs to you and belly rubs to Jasper and a tickle to Shelby too. :) It's friendly Wednesday!

hugs,
Sharlene

[Maya]

Hiya Tina! I'm doing quite well thanks, considering.... The pain is starting to ease and my heart is beginning to heal. Things get a little better as the days go by. The photos and canvas we ordered arrived yesterday. We totally overdid it by ordering too many:o, but I don't care, they are beautiful! I have her up on the wall in every room of the house, so I can see her precious little face every time I walk through the door.:)
Regarding Jasper's ALP, it's bound to be high due to the prednisone and unfortunately not much can be done about it. If it's any consolation, Maya's ALP was over 3000 for at least a year! The specialist said, "Yep, it's high, but no dog ever died because of a high ALP." The best thing you can do is carry on giving him milk thistle or some kind of liver support.The peeing and drinking are probably also side effects of pred, so you'll just have to keep those rags handy!:p
I know it's hard, but try not to worry about something you have no control over. You are doing a great job! You said yourself, he needs the prednisone, so your main concern right now is helping him feel better and if 5mgs does the trick....so be it!:) Maybe some time in the future he'll be able to come down a bit. Just make sure you give Jasper his pred on a full stomach. That way there is less chance of it irritating or causing ulcers in his digestive tract -which seems to be one of the main concerns about prednisone.
I'm glad he's feeling better!:)
Love n hugs, Leah

[cheydogger]

Tina-

I just read through your whole thread. Holy heck!!!!!! You and Jasper have been through a lot. I am so sorry your little buddy has had so many highs and lows. Geez! I sure hope he stabilizes soon. How in the world have you been emotionally? I would be a total wreck. You are a good Momma. Give that baby a big belly rub from me.

Hugs,

Ro

[Tina]

Hi Everyone,

Finally getting some time to get a little caught up on the site. Thank you Leah and Ro for the posts of support.

Leah, glad to hear you received the photos and canvas of sweet Maya. I bet the canvas is just beautiful. You can never have too many photos as far as I'm concerned. :) I think of you every day and hope that things continue to get better and you continue to heal. Hugs....

Ro, yes, my Little Man has been through quite a bit, and there have been many times where I have just been a wreck. The worst I think was when he was hospitalized for the second time in a week due to an addisonian crisis and also had HGE. He was so sick and it just seemed like a downward spiral was happening. I was terrified and had a pretty big meltdown then. There have been a few setbacks since then. I somehow force myself to be strong for him. He is very sensitive and knows right away if I am upset, so I have to hide a lot from him because I don't want him to sense that and worry. I always hide my crying because I don't want him to get upset. It is not easy. The belly rub was given and enjoyed, Jasper thanks you! :D

Last Friday 11/30 my vet checked in. Since Jasper was overall hanging in there and doing about the same, she wanted to give it another week on the higher prednisone dose to see if the drinking and peeing would decrease at all. He has been feeling comfortable on that dose, but the drinking and peeing have continued to be excessive and she wondered if it might still be a manifestation of the Addison's.

She called for an update on Friday 12/7. Jasper continues to seem to feel good, appetite is good, etc. but the excessive drinking and peeing continue. It has not decreased at all. My vet is not sure, but thinks it may be side effects from the prednisone and is recommending that we switch the prednisone to dexamethasone. (this was part of the plan after she consulted with the IMS if the symptoms didn't improve). She said some dogs that can be sensitive to prednisone and have sides effects sometimes do better on dexamethasone. She said the dex is more potent than the prednisone, so the dose will be quite small. Jasper's pred dose of 5 mg translates to about 0.5 mg of dexamethasone so that will be the dose that we start with daily. It is longer acting than prednisone so she is hoping that we will be able to decrease the dose after a few days, as long as Jasper continues to feel well. And of course hoping the drinking and peeing decrease. :rolleyes:

So I will start the dex tomorrow. The plan was to start it yesterday, but Jasper had an appt with the groomer and I didn't want to start a different med the same day. He got sick and stopped eating a few days after he was groomed the last time, but was on the lower pred dose then. Now he is on the higher dose and I gave him an extra dose last evening and his regular dose this morning, so I hope this is enough to counteract the stress from the grooming. Oy, it is so much to think about! :eek:

So that is the plan now. If anyone has any information, feedback, or experience with dexamethasone, I would greatly appreciate it. I have done some reading, but I am still a little nervous to do any kind of change. From what my vet has said and what I have read, it shouldn't be a big deal. But then again, we know that my little guy doesn't follow the rules, so I am a bit leery.

Hugs to all,

Tina and Jasper

[Tina]

Today is Jasper's second day on dexamethasone rather than prednisone. It may be my imagination, but he seems a little less perky than he was. His appetite is still good and he ate well tonight. That seems to be the first thing to go when he starts not feeling well, so I guess I will just keep an eye on things.

My vet prescribed the dexamethasone at 0.5 mg daily for 4 days, then decrease to 0.25 mg daily for 6 days, then decrease to 0.25 mg every other day for long term. I was originally supposed to start the dex on Saturday but delayed it because he was getting groomed on that day. Now this will put us starting the decreased dose on Friday, just before then weekend. I am a little nervous about that, I think I will call my vet tomorrow to see if she wants me to stick to the taper schedule since I started it later than we had originally planned.

I understand that dexamethasone is longer acting than prednisone, but does it start working just as quickly after each dose? I have searched on the internet but can't seem to find any information about this. So far there hasn't been a change in his water intake, but it has only been a couple of days. I am praying this med change helps with this.

Tina and Jasper

[Trish]

Hi Tina
Hope Jasper does well on the Dex, hopefully you will see an improvement in his symptoms. Not much help on the speed of it working, but praying alongside you that it does work better than the Prednisome!
Trish xx

[Trish]

How is Jasper doing today with the Dex Tina?? Hope all going well and just checking in on you :)

Trish and Flynn

[cheydogger]

Just stopping in to say hi and check on Jasper. I am no help with the meds, but I can send a big belly rub to jasper:D.

[molly muffin]

Hey there, hope all is going well with you and Jasper and Shelby!

hugs,
Sharlene and Molly Muffin

[Tina]

Hi Everyone,

Thanks for checking in on Jasper. He seems to be doing ok on the Dex. I decreased the dose to 1/2 tab (0.25 mg) daily starting Saturday 12/15, and so far so good. The vet said to give this dose for 6 days, then decrease to 1/2 tab every other day. I am not sure I want to do that going into the weekend or the holiday, so I may delay that decrease. I am kind of scared to go to every other day, but the vet said her goal is to get the dose down to 1/4 tab every other day for long term as long as he can tolerate it. I guess the dose he is on now is still higher than the physiological dose needed for Addison's, so that could be why we haven't seen any consistent decrease in his drinking and peeing. (That's why I'm up now, to let him out!).

We are still hopeful that we will see a decrease in these symptoms as we get the Dex dose lower, but my vet did mention that Jasper may be showing signs of very early kidney disease, before it shows up in the blood or urine tests. She is on the fence with that thought right now, but did put it out there since he continues with the excessive drinking and peeing. I am seriously trying to not think about that possibility now.

He has an appt for tonight (12/19) for his Percorten injection and to have electrolytes drawn. We are expecting a winter storm to begin here later today, and they are saying that they are expecting near blizzard conditions by the evening rush, so I am a bit worried I may need to reschedule him. I hope it will be ok if I do, the injection is given every 26 days, so not sure if it can be a little late or not. Hopefully we will be able to make it. :rolleyes:

Hugs,

Tina and Jasper

[Boriss McCall]

I am going to hope for the best & pray that Jasper's little kidneys stay clean. ;) I don't want you to have to worry about anything else. :(

Sounds like winter is heading your way... burrr!!
Keep warm & I hope you & Jasper have a Merry Christmas. :)

[addy]

Well, we will cross the kidney problem when we have to right?
Hunker down for the storm, hope you can stay warm and cozy INSIDE:D

I looped Zoe's leash through her mini harness and it works quite well for now. I'll look on line as you suggested since I at least have some breathing room and can use this contraption I rigged up in the meantime:D:D:D

Cush moms have to be creative:):):):):)

[cheydogger]

I hope the weather holds out long enough for Jasper to get his shot. Drive safely.

Hugs,

Ro and Chey

[Trish]

Hi Tina
Hope Jasper's decreased Dex dose is still going ok :) I know what you mean about not wanting to alter things too much over the holidays. Seems to be much less help available then, at least I have my vet's cellphone numbers (think they feel guilty with the whole swab debacle) so I can contact them if I need to!
Stay warm you guys, hope the appointment goes well on Monday!
Trish and Flynn xx

[addy]

Hoping things are okay with you and Jasper

[frijole]

Me too! Also hope you aren't one of those in Omaha stuck without power after the storm. Stay warm!

Let us know how our little guy is doing. Kim

[Tina]

Hello Dear Friends,

Thank you all for checking in on us. There have been some Internet problems in my area due to the blizzard, so my connection has been intermittent at best for the past couple of days. All fixed now I think. And no Kim, I am not in the areas of town that had been without power, thank God. And I mean that literally, I thanked Him out loud because I don't know what I would do with Jasper in that situation if I couldn't find a motel available that allowed pets. There is not much flexibility there due to the inability of his body to handle stress. No way could he go to the pet shelter, he would not be able to handle that. So I am blessed we did not have to deal with that. And my street was finally plowed last night, yay!!! :D

We did make it to the vet for Jasper's injection and electrolytes on Wed 12/19. It was a 3 1/2 hour round trip of driving due to the roads :eek: , but we were careful and made it home by about 9:30 pm. Even though it was pretty dicey, I am glad I decided to chance it, because the roads were worse on Thursday after snowing and blowing all night, so that would have been even more difficult to get him there. His Percorten dose was decreased by another 0.1 ml, so he got 0.7 ml. My vet called late on Friday and his electrolytes were all normal. I don't have the numbers, but she said they were all in the middle of the normal range. So that is good news! :D :D I think she is hoping that we may be able to stop the Pecorten at some point if things stay in the normal range. The IMS mentioned this to her a while back when they consulted.

She will check in next either next Wed or Fri. I am supposed to decrease the Dex to 0.25 mg every other day any time. I made an executive decision to continue him on daily dose through 12/25 and then skip a day 12/26 to start the every other day dosing. I just don't feel comfortable trying that when the vets office will be closed for the Holiday or have decreased hours. I am very nervous to make this change since he seems to be feeling pretty good. But I am hopeful he will be able to tolerate it and that we will get some normalization of the excessive drinking and peeing.

And yes Addy and Amy, I am putting any possibility that there are kidney issues out of my mind. :o

Love and hugs,

Tina and Jasper

[molly muffin]

Merry Christmas Tina to you and Jasper and Shelby!

Have a safe and wonderful Holiday,

hugs,
Sharlene and Molly Muffin

[Tina]

Merry Christmas to all the dear friends I have met on this forum over the past 5 months. To say I don't know what I would have done without you all is an understatement. It was a blessing the day I found this site, and I don't know how to thank you all for the knowledge, kindness, love, and support you have given me and Jasper (and continue to give) throughout our journey with this complex illness. I truly feel like we are family and I love you all.

Merry Christmas to you and your pups. I wish you all a blessed day with your families. Much health and happiness, and many many Blessings in the New Year.

Love and hugs,

Tina and Jasper (and Shelby) xx

[Trish]

Merry Christmas Tina, Jasper and Shelby!

Have a great day and hope your not still in that blizzard, that sounds most not fun! Wishing you the best Christmas ever!

Trish and Flynn xx

[Trish]

HI Tina and Jasper

Hope the reduced Dex dose is going OK! Happy New Year, have a great night and year!

xx

[molly muffin]

Happy New Year, Tina, Jasper and Shelby!

Hope this is going to be a really good year for all of you.

Cheers,
Sharlene and Molly Muffin

[Tina]

Thanks everyone for checking in on us. Jasper seems to be feeling well, and we have had good holidays! He is now getting Dex 0.25 mg every other day since 12/26, and seems to be tolerating it well. Dexamethasone is much longer acting than prednisone, so that helps him stay stable on every other day dosing.

There has been no change in the drinking or urinating, even on the days he doesn't get the Dex, but my vet said she is not surprised by that since it is longer acting. I will say that on most nights, I can work it out to where he only has to go out once during the night, but that involves going to bed later. My vet wants to cut the dose in half again, and hopes that will make a differences with the drinking and peeing. She said the dose he is getting now is still higher than the physiologic dose needed for his body, so the plan is to decrease. She plans to check in again next Monday 1/7 and I imagine we will decrease it again then, as long as he continues to do well in the meantime.

I am just so happy that he is feeling better now, and I pray it will continue. It is such a joy to see him eating, and playing with his toys, and having enough energy to rough house with his sister, and sleeping peacefully, and just being a dog. Everything. I get teary eyed just watching him, he has been through so much. And I love that little guy so so much. He is my heart.

Happy New Year to all my dear friends here. Wishing good health for all our pups, and many blessings to you in the coming year.

Love and hugs,

Tina, Jasper and Shelby

[molly muffin]

Tina, that is such fabulous news about Jasper. It must be wonderful to feel like you have him back with you being normal acting and you are finally able to get some sort of life and schedule worked out again. Shelby is probably thrilled to have her play mate back too.
That would be really good if he can take a decrease of the Dex and that help the urinating frequency. If not, you seem to have it worked out pretty well now to only once a night.

So glad you have had good holidays! Lets have a fabulous year too!

hugs,
Sharlene and Molly Muffin

[Boriss McCall]

Tina,
Happy New Year to you & Jasper!! So glad things are going good for you & Jasper.
May the new year bring only good things. ;)