Question about Lysodren

[jsmith]

My dog, Montana, has been diagnosed with Cushings. He is 15 1/2 years old. I have a couple of questions about Lysodren and was hoping someone would know the answer. How fast does it work? Immediately or for some hours after administration. How many hours? My vet gave me Presidone in case he has a reaction. Do I have to worry about a reaction all the time or just for a period of time after giving Lysodren? Knowing the answers to these questions will really help me ease my mind.

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[Jenny & Judi in MN]

here is a link to the tips on Lysodren loading. It is really helpful

http://www.k9cushings.com/forum/showthread.php?t=181

every dog is massively different when it comes to "loading" that is the initial dose. some load in 2 days some load in 10 days, that is why it is so important to watch for symptoms.

I was too blase about it with my Jenny. On her second day of Lysodren she threw up water. I decided that didn't count as throwing up and gave her her dose. On the 3rd day she had runny diarrhea and threw up more water. I stopped the Lysodren but since she wasn't lethargic or anything I didn't give the prednisone.

The ER vet was worthless when I was panicking thinking I'd killed her. The folks here walked me through and she is fine now. We got her in for an ACTH to see where she was.

Usually they want to start the lysodren on a weekend because most dogs won't show signs of being loaded for 4 days or more and in theory that would get you to a weekday where you could call your vet.

My Jenny sucks at following the theories so it is good you are aware, alert and can keep an eye on your dog.

Judi

[frijole]

I am very glad you found us because you should have very specific instructions regarding using lysodren. I am attaching a link that I want you to read and print if you can. It helped me load my dog.

First - please tell us how much your dog weighs and exactly what dosage you are giving and the frequency. I just want to check to make sure the dosage is within protocol.

Give lysodren with food and give it AFTER the meal has been eaten. Wrap it in cream cheese, peanut butter etc. as it will help coat the stomach as some dogs get gas as they adjust to the drug.

Different dogs react differently to the drug so the how long question I can't answer. It depends on the dose and the dog. We have seen dogs 'load' in a day and my dog holds the record at several months. Most are a week to 10 days. Large dogs seem to load faster than small dogs. But you must monitor your dog very closely as you can't simply rely on averages. YOu look for changes in appetite or water consumption.

Tell us about your dog, the symptoms, the weight and dosage. Read this sheet and do ask us questions ok? Kim

http://www.k9cushings.com/forum/showthread.php?t=181
http://www.k9cushings.com/forum/showthread.php?t=180

[jsmith]

Thank you for your responses. Montana weighs about 50 pounds and the vet has him on 500 mg of Lysodren twice a day one day week on maintenance after loading. I just don't know if he could colaspe at any time or if there is a timeframe after giving the medication that I really have to watch. It scares me to death.

[frijole]

OK I checked the dosage and it is within range. Sometimes vets who are afraid of the drug start too low and then all you do is waste time, money and STRESS. With lysodren it is better to start out where you are and let the drug work.

There is no set timeframe. Read the link I sent. Re read it. I was petrified too. Key is the drug worked and it saved my girls' life... she led a normal life for 4 1/2 yrs on lysodren. I had ZERO problems after loading.

Where you are at is the hardest part. And that is getting the dose right and cortisol lower. YOur dog won't hurt at all unless overdosed. That's where you come in. You monitor like a hawk. You stop if there is a change - even small - in eating or drinking behavior. Measure water intake BEFORE starting lysodren so you can know if it is reduced. Watch how your dog eats so you can know if there is a change (slower) in how they eat.

When in doubt you never ever give a pill. YOu cannot take it back and it works for 2 days after the last dose. So don't forget that. Don't let it scare you... just get up to speed and you will be just fine. Kim

[jsmith]

Thanks it's good to know how long it works after the last dose.

[jsmith]

I have read the loading instructions time and time again. He was showing so many neurological symptoms before he was diagnosed, it's hard to tell when improvement is happening. Like I've read so many times, I thought he was getting dementia. It's when he had an accident inside that I began to think something was wrong. He did not gain weight, lose his hair or get a pot belly. In fact, he lost weight. It's when he starting panting and waking me at night to frantically go out that I noticed he was drinking a lot of water. If I understand the instructions correctly, the neurological symptoms will improve in time but not immediately.

[frijole]

OK... so your last post has me scratching my head and wanting to confirm that your baby has cushings and not something else. It is quite frequently misdiagnosed.

That and the fact that your dog is 15 1/2... i want to be absolutely sure we are dealing with cushings.

Cush dogs live to eat - as in they inhale food without chewing it, they walk around the house looking for food, they sometimes have insatiable thirst as in they drink buckets of water - not just alot of water but buckets. I don't remember a time when a dog didn't have a rounded belly that had cushings... I guess if caught early it could be but...

Please tell us the whole story including all symptoms even if you think they might mean nothing. Then tell us what tests have been done. Include blood panel results that are out of range. Nonadrenal illnesses can cause false positives on cushings test so it is important the multiple tests are done to confirm the dx.

Most often we see diabetes and hypothyroidism that is misdiagnosed as cushings. But any non adrenal illness can cause an increase in cortisol production as the body is fighting it and skew test results. I had it happen (I had one dog with cushings and one that was misdiagnosed with it)... so better safe than sorry.

I don't mean to scare you but let's just make sure ok? There is no rush to treat cushings other than the peeing is a pain in the butt.

FYI I am headed out of town in an hour but am sure others will help where I leave off and I'll check in later tonight. Hang in there! Kim

[jsmith]

Montana has had hypothyroidism for several years. Cushings was suspected when I requested routine blood work. His liver enzines were high. Then the vet ran the 8 hour test that confirmed Cushings. I did not get the results but can if needed. We also did a 24 hour water test and he was drinking about 14 cups of water a day. After loading, the water consumption went down to 7 or 8 cups. But now he is drinking more so we are loading again. The vet says every now and then a dog requires more loading. I have had this vet forever and trust him so I hope he is treating Montana correctly. Let me know what you think.

[frijole]

OK... it helps to know that you aren't just starting out loading but instead are doing a reload.... big difference.

Are you loading at the same dosage as the last time or did you increase it slightly? That would be helpful.

Also, when you did the original load how long did you go and what was the result of the acth test? (we need the 2 nos on the test)

As I mentioned my dog took about 4 mos to load - that is 2 1/2 months of the daily lysodren with the waiting periods between acth tests ...we had to increase the dose to way above what is ever recommended because my girl was unique ;)

If you post the acth test results after the load that would help. Also I assume you did another one prior to this mini load to confirm that cortisol has risen?

You get the gist :D of my questions.

Since Montana is an older dog are you doing anything to help with arthritis that might currently be aided by his cortisol production?

Take care!!! Kim

[Steph n' Ella]

Your vet does sound good! Good luck to you and Montana! Keep reading around here when you have the time...maybe a thread where another poster loaded their dog on lyso. You'll see you are not alone! You will also see what behavior made them stop or give pred...then what the results were when they went to the vet the next day. Never under estimate the power of others experiences!

[jsmith]

Well, we haven't had any subsequent testing. I am laid off and husband has cancer so we wouldn't be able to afford all the tests that everyone on this forum is getting, I'm afraid. My vet is using he expertise and what I tell him about Montana's behavior to try to help me. He is on medication for hypothyroidism and arthritis. I wish I had more financial resources, but I just don't.

[Squirt's Mom]

Hi j,

Treating without testing is extremely risky and I hope your vet is truly on top of educating you so the risk is as low as possible. If they have not told you exactly what to expect when it works and what to expect when there is a problem, please let us know and we will do all we can to help you understand. To answer your original question - you will always have to watch for signs of the cortisol going too low and stop the treatment immediately. Do you have prednisone? If not, INSIST your vet give you some - it is fairly inexpensive and can save your baby's life if it is needed. Without testing, you have no idea where you are so the signs will be your only clue.

Here are some links that may help -

Financial resources
http://www.k9cushings.com/forum/showthread.php?t=212

How to Extend Your Supply of Cortrosyn and Lower the Cost of ACTH Stimulation Testing
http://endocrinevet.blogspot.com/2012/03/how-to-dilute-and-store-cortrosyn-for.html

Hang in there!
Hugs,
Leslie and the gang

[jsmith]

Yes I have presidone and I watch Montana very carefully and do not hesitate to contact my vet with questions.

[molly muffin]

Hello and Welcome. This is a good board to be on for information and people to help if you need to know anything. One way or another you'll find some experience here.

How is Montana doing? Hopefully he'll reload just find and all will be well and just keep an eye out for any problems as I'm sure you're already doing. :)

Hang in there!
hugs,
Sharlene

[mytil]

Hi and a belated welcome from me too.

I just wanted to add, remember that Lysodren continues to work within the system for several days after the last dose in case your vet never mentioned this.

Please do check out the link Leslie gave about reducing the cost of an ACTH by taking only the second reading - ask your vet about this and he/she should cooperate.

I agree with the others, testing is very important! It would be like a diabetic monitoring results of insulin meds just by how they feel and not checking the blood levels.

Terry

[marie adams]

Welcome to you and Montana,

I used Lysodren with my Maddie Girl--we loaded the first time about 6 or 7 days--can't remember exactly. What I noticed was a slight look away from her food and I was right--test with ACTH the next day or day after that--she was good to go. Not to scare you but the first vet said he knew what he was doing, but this wonderful forum knew far more than he did--in fact I learned so much here I knew more than the second vet we went to.

I have a question: You said this is your second loading, but after the first one, did you then go on a maintenance dose which would have been ex. 500mg twice a week? I might have missed that part of your post that the maintenance dose was too low so you are reloading.

Maddie had no side effects from this drug--so I was happy with giving this to her--at least happy that it helped her.

Some of her symptoms were: lost all her under fur, weakness in her hind legs with shaking, lethargic, ravenous appetite, water consumption, went potty a lot--clear not yellow, her facial features changed I think because the muscle wasn't as good, panting of course, potty belly, and I would guess she had gained weight. She was doing great on lysodren:), but cancer got her in the end.:(

Take care you will figure this all out with the help of the experts here at the forum. :):)

[jsmith]

I'm not sure it's a real reloading - he went on maintenance for only two weeks and seemed to be doing really well. Then he started the water drinking again so the vet said give him extra Lysodren until it stopped. I only gave him 2 more doses. Noticed a change in things and stopped. He seems very calm and settled right now.

[molly muffin]

Glad to hear that Montana seems to be doing well right now. All you can do is be vigilant and keep doing what you are doing.

Hugs,
Sharlene