Just diagnosed 6 year old Boston Terrier "Freckles"

[FrecklesMom]

Yesterday my faithful best friend Freckles was diagnosed with Cushings. One of the saddest days in my life when I looked it up and realized the implications. Unfortunately one of the first things I read was the statement that whether an animal had medicine or not they would not live more than 2 years from diagnosis. It had already been about a year since I noticed the first symptoms so did that mean I would only have another year with Freckles? Just devastating to think about.

I noticed Freckles started to pant frequently doing hardly anything, drink and go outside to pee constantly about 10 months ago. She seemed starving to death all the time too and slept alot more. I thought being she was 5 at the time and a little overweight this was all a natural progression of age/weight. In the meantime our house went up for sale and everyones focus was on the showings, sale, packing and moving. When we got to the new home it seemed at night (her bed is on the floor beside my bed) I would hear her randomly at night making a noise like someone with a dry mouth, smacking as she opened and closed her mouth, licking her lips or whatever. Then this week she started limping on her back leg and panting even when just sitting there so I decided time to take her in to see if she had arthritis. My vet suspected cushings and kept her at the office for 10 hours to do tests which came back positive. I happened upon your forum doing an internet search for dosage and side effects of the medicine vet suggested, Lysodren. I can't tell you how fortunate I feel to have found this group. I have been so fearful of not knowing enough and making a wrong decision. I've read the information here you have on Lysodren therapy and it was very helpful to get the whole picture of how this works. Freckles weighs 33 lbs and the doctor wants to start her on 750mg Lysodren a day for the initiating phase. She has a very sensitive stomach, can only eat ibs prescription dry dog food since a puppy and takes a pepsid daily so not sure how this will work out if its hard on the stomach. Her vet wanted me to read all the literature, research over the weekend and talk to him Monday to decide what we wanted to do. At first as I read things on the internet I was thinking I don't want to do this but after getting more detailed information here I think If I monitor closely we can do this. Just wish I had known to take her in sooner.

Thanks to all who set up and run this forum, I am so very thankful it is here and we are not alone. Freckles and Diane

[addy]

Hi and Welcome,

It is so scary to hear the diagnosis. We have all been there and understand how your world comes crashing down on your head. Things get less scary, the more you learn and deep breaths are also important.:) It took me awhile to remember to breathe.

Could you post the results of the LDDS test ( I assume from the time frame that was the test).

Others will be along soon, so please be patient.:) They can give you meaninginful feedback as you have already given quite a bit of good information. I wont have to put you through our ususal drill. I use Trilostane so I can comment on Lysodren but we have many experienced members using it.

Take a deep breath, slow down. Cushings is usually not an emergency to treat, so you have time to ask questions, think and learn. As for that 2 year life limit, my Zoe's was diagnosed 2 1/2 years ago. I have been treating her for a little over one year.

She is still here, chewing on a Kong at the moment.:D:D:D

The best part is you are no longer alone.

[Harley PoMMom]

Hi Diane,

Welcome to you and Freckles, so sorry for the reasons that brought you here but glad you found us.

As Addy has mentioned, getting copies of all tests that were done on Freckles and posting the results here will really help us to provide you with more meaningful feedback. If a senior wellness blood panel was done, posting the abnormal levels with their units of measurements and reference ranges is what we need to see, as an example: ALT 110U/L (28-100).

Cushing's is not a death sentence, so that statement about a dog living only 2 years after the diagnosis is just not true. Cushing’s is a treatable disease, with proper medical management, close monitoring and owner observation, most Cushingoid pets can live to their full life expectancy, with complete or partial resolution of clinical signs, and good quality of life!

Cushing's is one of the most difficult diseases to get a confirmed diagnosis for because not one test can confirm cushings, and other non-adrenal illnesses share the same symptoms as Cushing's, thats why one needs a qualified GP or IMS for this disease.

Lysodren is known to cause gastric upset in dogs, so if Freckles is prone to this, maybe ask your vet about using Vetoryl/Trilostane instead...just a thought.

Please know we will help in any way we can so do not hesitate to ask any and all questions.

Love and hugs,
Lori

[Nikki]

Welcome!!
I don't have much useful knowledge, but I wanted to stop by and say hi to a fellow Boston Terrier owner :).
My dog was diagnosed in February, and when I really think about it he was suffering from symptoms at least a year before hand. I wouldn't worry too much about the "only survive 2 years after diagnosed" thing. From what I understand that's not correct, and a lot of times it is older dogs with many other health problems that are diagnosed with Cushings.
Anyways, I'm glad you found us! :)

-Nikki&Max

[Squirt's Mom]

Hi Diane and welcome to you and Freckles! :)

Lysodren is a wonderful drug for our cush babies! Yes, reading about it will scare you to pieces but handled correctly, it is no more dangerous than aspirin...which can be fatal as well if mishandled. ;) I am glad you found and read about Lysodren in our Helpful Resource section - good tips, huh? The key today is to take your time. As Lori said, Cushing's is not a death sentence. It is a condition that moves very, very slowly, allowing us parents time to learn all we can before diving in...and you are off to a great start in that area, Mom.

The loading dose is exactly correct! At 33 lbs, Freckles weighs 15 kgs. The loading dose is calculated at 50mg/kg of body weight. So 15kg x 50mg = 750mg. BUT this should be divided into two doses per day - AM and PM, not given in one single dose.

Feed Freckles her meal as usual along with Pepcid AC or Tagament, THEN give the Lyso with peanut butter, cream cheese - something rather fatty/oily. (Be sure the Pepcid is the AC form only - no other.) This will let you know that she got the med for sure and help with any digestive upsets that may occur. If she is used to eating one meal a day, by dividing her meals that should also help with digestive issues.

Now, about this 2-year myth. It is just that, Diane - a myth. Our family here has proven that over and over and over. We had one member who's baby lived 12 years after diagnosis! At the age of 6, Freckles can have many more years with you. Here's why....1) those statistics include those folks who bring their dog in, get a diagnosis of Cushing's then either don't treat or simply don't come back until the pup is in the very late stages with multiple complications as a result; 2) most pups are diagnosed in their senior/geriatric years and actually do live out the remainder of their lives; 3) unfortunately, many vets do not understand Cushing's nor the treatments available, do not educate the parents, and complications can be laid directly at the vet's feet - not the disease nor the drugs; 4) even when the pup passes from something other than Cushing's, that diagnosis remains part of the history, taking part of the blame. Then the primary reason our family, and others like us, can prove this myth incorrect is the care our babies receive over all. We ARE the exception to the rule and we ARE the ones who will fight for our babies, sacrificing when needed, going to extremes for them...and the statistics don't include folks like us. ;) And...many vets are unprepared for parents like us. :D Not many of their clients will tell them they are wrong, why, and be able to prove it - but we can and do when needed. ;) We do not blindly follow their advice, we research, talk to others, learn all we can, THEN take action as required. We are the FEW, the PROUD...oh, wait, that's something else...but you get the idea. :p

I'm really glad you found us and look forward to learning more about you and Freckles as time passes. The most important thing I can tell you today is this - you are no longer alone. Ya'll now have a family that will walk with you every step of the way.

Hugs,
Leslie and the gang

[3bostons]

Hi Diane, from another boston lover :D
Im not an expert here either but my 10 yo boston girl was diagnosed this July also. She too was on pepcid ac and did the lip smacking thing too, and she has a very sensitive tummy and I was worried about the meds. Well she is taking the other cush med, vetoryl, but I will say since being on it now for almost a full month, we dont need the pepcid anymore and she doesnt do the lip smacking thing either. The best part was no tummy upset AT ALL, yeah :D So, just to let you know that these meds do seem to really help them. Now I wonder if the whole acid upset and lip smacking had anything to do with cushings ?? Dont know, but I know its gone now.
Hugs, Kona and deb

[Boriss McCall]

Hi Diane & Freckles,

Welcome!! I was just like you VERY scared. I am a BT lover as well. They are just the sweetest most entertaining dogs. I am finally starting to see my Boriss light up again. He started Trilostane 8 days ago.

I wish we could erase all that stuff on the web about 2 years... I sometimes venture out off this forum & read some of that stuff & get scared all over again. I have now learned my lesson to Not READ that crap anymore. :eek:

I have talked to several people with Boston's on my BT websites now who said they treated their babies for many many years with the meds & lived a healthy life. Also you will find on here many people who can prove that theory wrong with their own experience. :D

Everyone is here to help! Glad you found us.:)

[Boriss McCall]

oh yeah.. I have a lip smacker as well. :rolleyes:

[FrecklesMom]

Hi everyone and thank you, thank you for ALL your Encouraging words!

Deb, especially interesting that treatment ended up helping Kona with the sensitive stomach too. Makes me wonder if freckles sensitive stomach could have been the very first sign of cushings now?

Addy, I'll see about getting a copy of the test results to post. On the phone the doctor read off what the ranges were and what freckles results were and she was way higher than the top number on the range for each test he talked about. Unfortunately He was going through them so fast I didn't write down that part.

I can't tell you how happy to read all of your comments that survival rate can be many more than two years. Leslie, your explanation all the things that go could go into those survival statistics makes it understandable now that you can't necessarily rely on their study. :))

Lori, I think I will bring up freckles sensitive stomach and ask about
Vetoryl/trilostane. I was thinking that the lysodren was the only medicine availabe that actually reduces the size of the growth (like chemo)and the others were maintenance after it got reduced? I'll go to the information area and look those up too.

Nikki, Deb and Borris, I'm so glad you posted about your boston terriers. I love bostons and have always had one in the house since I was a girl. Freckles is happy to hear she is not the only boston lip smacker. LOL

Hugs! Freckles and Diane

[Squirt's Mom]

Hi Diane,

There are two main drugs used to treat Cushing's - Lysodren (Mitotane) and Trilostane (Vetoryl). Both are very effective but work in different ways. NEITHER is safer than the other no matter what you will read on the web. Folks were led to believe that Trilo was safer than Lyso but that is not true. Both have the very same risks but what makes Trilo seem safer is the short life in the body. Trilo is leaving the system in 2-8 hours while Lyso is just reaching it's peak at 48 hours. Some pups do better on one over the other. If you start with one and need to switch to the other, it is recommended that you wait at least 30 days, ESPECIALLY when going from Lysodren to Trilostane.

There is no loading phase nor maintenance phase with Trilo - you simply start giving it and once the dose is dialed in correctly (determined via signs and ACTHs), you will give that dose daily. With Lysodren there is a loading phase were the drug is given twice a day until signs are seen that indicate the cortisol has dropped and the ACTH post number is within range. Then a maintenance dose is given 2-4 times a week.

In the Helpful Resource section you will find some links about Trilo (Vetoryl) where you can read about the benefits and risks associated with it as well as info on Lysodren. If you have any questions, please ask and we will do our best to help you understand.

Hugs,
Leslie and the gang

[FrecklesMom]

Hi Leslie, thank you for the explanation on the meds! I went to the reference area again and read about all of these. In the comparison literature I read that lysodren doesnt actually reduce the size of the tumor either which I didn't understand before. So after successfully using either treatment for cushings are there other problems seen frequently by everyone as time goes by because the tumor continues to grow on the pituitary? After not realizing the increased hunger, panting and drinking was a problem for so long I'm afraid I will miss something else.

Hugs, freckles and Diane

[Squirt's Mom]

Mornin' Diane,

The pituitary tumor typically remains microscopic and causes no further problems other than the signs seen with Cushing's. The tumor is what is causing hormones to be out of whack in Cushing's. In some cases, the pituitary tumor will start to grow and become what is referred to as a macroadenoma, or macro for short.

Neither drug reduces the size of the tumor on the pituitary gland but treatment can shrink the tumors on the adrenal glands. (Just FYI, the pituitary gland is in the skull, the adrenal glands sit on top of the kidneys in the abdomen.) I think once we each understood that Cushing's means tumors and usually in the head, we all became very nervous, worrying about a macro. But the majority of cush pups never develop a macro and resume their more normal life with treatment.

There are signs associated with the macros - confusion, getting stuck in corners or behind things, circling, head pressing to name the most obvious. Fortunately, there are treatments for the macros - radiation and a surgery called Hypophysectomy, which is relatively new in the US but performed in The Netherlands often. One of our members was among the first in the US to have this type surgery - she was a pioneer in Cushing's, blazing a path for others to follow, a hero to her family here and to all cush pups who face these tumors. Her name was Lucy Goo and you can read her story here - http://www.k9cushings.com/forum/showthread.php?t=534.

I want to repeat - the majority of cush pups do NOT develop a macro but live out their lives happy and healthy with treatment. ;)

Hugs,
Leslie and the gang

[Steph n' Ella]

Diane- Glad you found this forum too! I just want to add that you should not feel any guilt about not noticing symptoms or feel like you should have gotten Freckles to the vet sooner. Cushings creeps up on most owners very slowly so it is hard to notice the difference in behavior. Also, there is no need to rush in to treatment. It is safer for your pet to check and double check the diagnosis and then proceed with medication than it is to rush in to using these powerful meds!

[FrecklesMom]

Hi Leslie, thanks so much for the Information on macros and tumors. Very reassuring. I followed the link to Lucy Goo and read through the story, what a brave women and amazing story! I would have done the same and tried the surgery given her choices at the time. But it definitely was not an easy thing to go through for them. I
Also found another article in the reference area on macros so I feel well equipped with information now. . The only thing I have noticed is freckles does seem more subdued recently and very tired not sure if its because she feels bad. Sometimes she just sits up at night in her bed and stares at me instead of laying down and sleeping. I end up getting up and laying her down. She is also very nervous when I need to run an errand. Today she started to tremble really hard and I had to sit back down and stay to calm her down. But she doesnt do any of the things described for macro so guessing its just her not feeling too well? Just don't know. Going to be picking up a copy of the test results tomorrow so will post when I get back. Hopefully they will give some additional information.

Hi Steph, thanks for the encouraging words. I am trying to come to terms with the guilt by working hard on Learning everything I can so we can turn this around for freckle bug. :)

Hugs, freckles and diane

[frijole]

Hi. Just wanted to say my dog Haley was like that at night and it is common - not a sign of a macro. It is a sign of cushings. Cortisol is high and causes cushings. Cortisol is like adrenaline. So until it is controlled by meds cush dogs tend to be like that at night and pace sometimes. With treatment that can go away. Kim

[Squirt's Mom]

Mornin' Diane,

Kim is right - in a normal body, the cortisol levels cycle - higher during the day, dropping at nite. But in our cush babies, that level doesn't drop at nite so they are often restless, don't rest well, and that results in extra nervousness and sleeping at times they used to be awake. Getting the cortisol under control usually helps this behavior a great deal.

Hugs,
Leslie and the gang

[Boriss McCall]

My Boriss is the same way. But, getting better with the meds. He was way more nervous & just acting weird before the meds kicked in. He would even go lay way across the room facing the other way from my husband & I. Which is SO not normal. He is usually in our faces 24/7. That really scared me..

But, now he has been on Trilo for 11 days & is starting to act like himself again.
Don't worry it does get better. ;)

[FrecklesMom]

I just got back with a copy of a dexamethasone suppression test. Doesn't seem to have anything but results of this on the sheet. Not sure if there is another page I am missing with other tests.

Pre-dexamethasone results: 12.1 (H) Reference range : 1.0-6.0 ug/dL
Post 4 Hr dex. Results: 5.1. Reference range. Less than 1.5 ug/dL
Post 8 Hr dex. Results. 2.8. Reference range. Less than 1.5. ug/dL

Results

<1.5 or < 50% of baseline. Consistent with pituitary- dependent hyperadrenocorticism (PDH)

[FrecklesMom]

Thanks Kim, Leslie and Borris for explaining about the behavior. Makes me feel better :) funny Borris but freckles has been doing the very same thing laying on the floor with behind facing us. I started asking my husband okay did you not play with her today, forget her snack ....and she's mad at you or what.

[FrecklesMom]

Sorry Boriss for misspelling your name :(

[Boriss McCall]

: ) His name is spelled a little different than the usual Boriss. I think my husband liked the double SS. :p

When Boriss started turning his butt to us is when I got really sad. You know how Boston's like to pout.:rolleyes: I was so afraid his fun personality was going to be gone forever.

I am just glad he is hanging with us again. I feel like I have been on emotional roller coaster the last couple of months. I can't tell you how many times I have cried myself to sleep. I am glad to finally get him on the meds.

Don't worry you will get your sweet little Freckles all better.;)

[Steph n' Ella]

Going in for Ella's LDDS tomorrow. I’m so nervous! Hopefully someone with more experience reading results will be by soon.

Have you had any other blood work that shows abnormalities? For example many times a blood panel will show elevated liver enzymes. You should be able to request these tests from your vet and you can post the ones that are outside the normal range (high or low) here. Other things to check in the blood work are the thyroid levels (T4) and blood sugar levels (can show diabetes). Diabetes and thyroid problems mimic cushings symptoms so it is important to rule them out.

Also, usually a high resolution ultra sound of the abdomen will show if the adrenal glands are enlarged (both = pituitary cushings; one larger than the other = adrenal cushings). If you’ve had one done, your vet or a specialist who viewed the images should have written a report that describes all the organs viewed and detailed notes on each one…especially important here are any abnormalities that they might see. Type out the notes and post them in your tread here too!

All these tests are important b/c you want to be tripple-ly sure everything points to cushings before you start on the meds! I wouldn't risk these meds on my dog unless I were 100% sure!

[FrecklesMom]

I'm so glad Boriss and so many of the other dogs I am reading about are doing better. I love your avatar picture he is so cute! I know what you mean about wanting to keep the personality intact. Each dog has its own wonderfully unique personality and its hard to see it drift away. This whole thing makes me nervous but I am ready to get started. Doctor still hasn't called back yet to figure out treatment etc. He returns to office tomorrow. In the meantime I have been watching freckles eat her meals so I know what she normally does. Good thing because she normally looks up every so often but is chewing not stopping eating. Then head is right back in dish. Don't want to mistake that for one of the signs I'm looking for.

[FrecklesMom]

Steph, hope your LDDS tests go well tomorrow! I just called the vets office and evidently they did no bloodwork at all on Freckles. Just the Dexamethasone Suppression test. Not sure why, maybe because it was so obvious, don't know. She not only displays symptoms but her mouth smells funny which I assume is the cushings. It sound like an important next step from what you are saying. Would be nice to know that cushings is our only problem to resolve.

[molly muffin]

Sorry I'm so late in saying welcome to the board. It's a real roller coaster trying to figure out cushings. It's always good to have initial blood work tests prior to starting medications if for no other reason than having a baseline of "before" for everything. I think our vet is sick of me calling and saying I want another alp and alt test or urine test or this or that. LOL

Hugs,
Sharlene and Molly muffin

[Boriss McCall]

Thanks! I think Freckels is pretty adorable. She has such pretty markings.
Hopefully your vet will do the full blood panel before you start the meds just in case.
I did the same thing you are doing now. I took notice of everything Boriss was doing pre-meds so I could compare things once he started. I also take notes everyday. It helps a lot!:)

[Harley PoMMom]

I just got back with a copy of a dexamethasone suppression test. Doesn't seem to have anything but results of this on the sheet. Not sure if there is another page I am missing with other tests.

Pre-dexamethasone results: 12.1 (H) Reference range : 1.0-6.0 ug/dL
Post 4 Hr dex. Results: 5.1. Reference range. Less than 1.5 ug/dL
Post 8 Hr dex. Results. 2.8. Reference range. Less than 1.5. ug/dL

Results

<1.5 or < 50% of baseline. Consistent with pituitary- dependent hyperadrenocorticism (PDH)

Hi Diane,

I believe these LDDS test results point to PDH. I was wondering if any senior wellness blood panel was done on Freckles, if so, could you post any abnormailities that are listed...Thanks! Has your vet mentioned having an ultrasound done on Freckles? Also, could you remind us of Freckles symptoms...Thanks again!

Love and hugs,
Lori

[FrecklesMom]

Hi Sharlene, thanks for the suggestion, a number of people mentioned getting blood tests so I decided to call vet back yesterday about getting bloodwork done. I can see I need to pester the vet too! LOL The bloodwork was done early this morning. He said everything was normal but I'll be posting results next. Some of the categories on my copy show they are high.

[FrecklesMom]

Boriss mom, I got a little notebook to keep track to things too after reading others were doing that. I tend to forget things anyway and I like the idea of being able to show it to the vet during visits as I read others are doing.

[FrecklesMom]

Hi Lori, thanks for looking at the test results, she got blood tests this morning so will be posting them shortly. He said they were normal but I do see some numbers in the high category. He didn't seem to think we needed an ultrasound when I talked to him after the bloodwork was complete. Current symptoms are alot of panting even when she does nothing, alot of drinking and needing to go out. Always starving to death. You cant open anything crinkly in the kitchen without her rushing to see if she gets something. She Limps and cant jump up onto couch or chairs anymore (weak hind legs), sleeps alot more and more subdued, breath smells sick, more anxious when I leave her. We start Lysodren on Sunday. I'm very anxious to get started!

Hugs, freckles and diane

[FrecklesMom]

Here are bloodwork results for Freckles taken today sept. 20, 2012 prior to treatment

Items in High category:

Test. Results Reference

RETIC 141.1 K/ul. 10.0 - 110.0
BASO 0.18 K/ul. 0.00 - .10
ALB 4.1 g/dL. 2.3. - 4.0
ALT 117 U/L. 10. - 100
ALKP. 1941 U/L. 23 - 212
Cl. 125 mmol/L. 109 - 122


Items in Normal category ProCyte Dx


RBC. 8.71. 5.65 - 8.87
HCT. 60.2%. 37.3 - 61.7
HGB. 19.9 g/dL. 13.1 - 20.5
MCV. 69.1 fl. 61.6 - 73.5
MCH. 22.8 pg. 21.2 - 25.9
MCHC. 33.1 g/dL. 32.0 - 37.9
RDW. 20.3%. 13.6 - 21.7
% RETIC. 1.6%.
WBC. 8.32 K/uL. 5.05 - 16.76
%NEU. 63.7%
%LYM. 20.9%
%MONO. 7.7%.
%EOS. 5.05%
%BASO. 2.2%
NEU. 5.30 K/uL. 2.95 - 11.64
LYM. 1.74 K/uL. 1.05 - 5.10
MONO. .64. K/uL 0.16 - 1.12
EOS. 0.46 K/uL. 0.06 - 1.23
PLT. 376 K/uL. 148 - 484
MPV. 11.1 fl. 8.7 - 13.2
PDW. 13.9 fl. 9.1 - 19.4
PCT. 0.42%. 0.14 - 0.46

Catalyst Dx

GLU. 126mg/dL. 74 - 143
BUN. 16 mg/dL. 7 - 27
CREA. 0.9 mg/dL. 0.5 - 1.8
BUN/CREA. 18.
PHOS. 4.5. mg/dL. 2.5 - 6.8
CA. 10.2 mg/dL. 7.9 - 12.0
TP. 7.2 g/dL. 5.2 - 8.2
GLOB. 3.1 g/dL. 2.5 - 4.5
ALB/GLOB. 1.3
GGT. < 0 U/L. 0 - 7
TBIL. 0.7 mg/dL. 0.0 - 0.9
CHOL. 226 mg/dL. 110 - 320
Na. 155 mmol/L. 144 - 160
K. 3.8 mmol/L. 3.5 - 5.8
Na/K. 41.
Osm Calc. 308 mmol/kg

[Steph n' Ella]

Well your liver values are high, which is consistent with Cushings. Most people start their Cushings journey with either symptoms that you described (excessive hunger/thirst and/or house training issues) or with having routine blood work done that shows high liver enzymes (ALT and/or ALKP). I am a bit nervous that your vet didn't point this out to you. I am also nervous that he doesn't seem interested in doing an ultra sound. If you are going to spend lots of money on drugs and periodic testing, why wouldn't you shell out the $ to get a peek inside at those adrenals?

Ella had a great day at the vets yesterday! She is a bit of an odd ball in that she loves going to the vet! All the techs are in love with her and by the end of the day Ella has them wrapped around her little finger! They haven't called me yet, but her internist tends to make phone calls on blood work in the evening after all of her scheduled patients have had their appointments and those in for testing have been discharged… so waiting… arg!

I am sure others with more experience will be by to give you advice on starting meds on Sunday.

[FrecklesMom]

Hi Steph, i hope Ella's blood test results turned out well yesterday! I think mostly the blood test was done to make sure freckles didn't have something else like diabetes so him saying it was normal was referring to other diseases he would watch for. I did ask him about an ultrasound but he talked in relation to the pituitary area. Never mentioned the adrenal gland. I assumed it was because the test ruled adrenal tumor out so I will speak to him again. Could be I dont ask all the questions I need to.

Lysedren Question...

I picked up the lysedren in tablet form thinking it would be easier to hide it in cheese. I'm getting more nervous as sunday approaches. Hopefully freckles isn't like me and will eat even when she isn't hungry. Does that even happen? I would think that would be the first sign she has enough medicine. I'm also not clear if you have prednisone on hand to stop vomiting do you still take them to the vet ofc immediately after you give them the pill?

I will be so glad when we get to maintenance phase.

Hugs, freckles and diane

[Maya]

Hello and welcome!:) Wow another Boston terrier! You lot seem to be taking over the board lately!:p I have to agree with the others. I can't understand why your vet doesn't want to do an ultra sound! An ACTH test is also a good one have done too. You really want have a correct diagnosis before embarking on any treatment.
Leah and Maya

[Steph n' Ella]

Just to be clear, even if it is pituitary-based, the adrenal glands will be enlarged b/c of the increased cortisol. So an ultrasound is still an important test that will, in the end, add up to a Cushings dx.

Yes, if you need to administer the pred, you should go to the vet immediately!!!! They will to an ACTH test to see exactly how low the cortisol is so that you know how much and how long to administer the prednisone. They will also check your pup's electrolytes. I suggest that you read some of the posts in which owners have had to use the prednisone. It is nothing to fool around with. You will think your dog is at deaths door! Again, I am nervous about you starting meds if all this wasn't really explained to you.

Maybe check out Bo's thread:
http://www.k9cushings.com/forum/showthread.php?t=3925

[frijole]

.

Lysedren Question...

I picked up the lysedren in tablet form thinking it would be easier to hide it in cheese. I'm getting more nervous as sunday approaches. Hopefully freckles isn't like me and will eat even when she isn't hungry. Does that even happen? I would think that would be the first sign she has enough medicine. I'm also not clear if you have prednisone on hand to stop vomiting do you still take them to the vet ofc immediately after you give them the pill?

I will be so glad when we get to maintenance phase.

Hugs, freckles and diane
I used lysodren for 4 1/2 yrs. It is a bit strange that your vet didn't go over this with you but I will give it my best shot. :D

Before you start lysodren i want you to print this document. I used it myself and read it every day until I had it down. You never know what will be your sign to stop. It could be the water, it could be Freckles pauses between bites (like a normal dog). It is ANY sign of change - not that they stop eating. So before you start you need to measure how much water she drinks. Put tape on a bowl and fill it to the same point every day. At the end of the day measure how much is left and you'll know how much she's currently drinking. That way you will know when it drops off.

As I mentioned with food - it could be minor changes. When in doubt do NOT give lysodren because it continues to work for two days after the last dose. You cannot take it back once you give it. So never give it until AFTER she's eaten her meal. That way you can decide if you think she's loaded. DON"T give it if you are concerned. Better safe than sorry. Wrap it in cheese or cream cheese as it helps coat the tummy. She might get gas from the drug and sleep a bit at first but this is normal. Don't worry about that.

I want to make sure the dose is right. What is the amount you are giving each day? What instructions did your vet give you. How much does she weigh?

If you were not given prednisone call the vet and DEMAND it. If they have any experience with this drug at all they know you must have it on hand. If your dog gets too much lysodren this pill can save her life. It always happens on a weekend and you just cannot get to the vet and get the drug quickly. The pills are cheap. You won't need them on day one but get them please! Better safe than sorry.

The reason your dog eats so much is that the pituitary tumor (near the brain) is sending messages and messing with hormones. Too much cortisol is created and your dog thinks she's starving even though she isn't. This drug erodes the adrenal cortex where this cortisol is generated. This reduces the cortisol and once it gets to a certain level your dog no longer is getting those messages and eating and drinking return to normal levels. (This is a laymans' version ;) Following is a good overview of what cushings is:

http://www.2ndchance.info/cushings.htm

Following is the link on how to use lysodren:
http://www.k9cushings.com/forum/showthread.php?t=181

This drug saved my dog's life and so it is wonderful. But like any drug you have to understand what is does and how to use it. Really your vet should have covered all of this. You NEVER give lysodren to a sick dog. Signs that your dog has had too much are diarrhea and vomiting. They also become lethargic to the point you think they are dying. That is when you give prednisone.

Your goal in giving it is to reduce the cortisol. You know how you are doing by having acth tests done. The goal is for the last number which measures cortisol to be between a 1 and a 5.

That's enough for tonight! HOpe it helps. Kim

PS We were all nervous. Key is to have an experienced vet who COMMUNICATES WELL and an engaged parent that is up to speed and pays attention to the dog while on the drug and know what to do.

[FrecklesMom]

Hi Kim, my vet did go over things but I am also fighting bronchitis and a sinus infection last few days so Im not remembering a couple things because I'm not feeling too great. . I do have the prednesone and he told me when to use it, just couldn't remember what he said to do after that especially if its the weekend. I went to the lysedren dosing link and decided to take screen shots of all the instructions and will read them every day until I know them forward and backwards. Also will get info for pet emergency hospital incase of an emergency. I have been measuring water intake for last four days so i will know immediately if she drinks less. She weighed in at 33 pounds so he said to give 3/4 of a 500mg pill twice a day after meals. That totals 750mg day.

[3bostons]

Hi Diane, it is scary to start these meds, I watched and followed Kona around like a hawk after giving her the first dose, I think she wondered what the heck I was doing :p But I was just that worried too. Konas alkp numbers were some of the highest my vet had ever seen they were in the 7000 ! but now after a month on the vetoryl her numbers are down in the 3000 range so it is helping.
I too am now facing another worry because they need me to increase her dose and they had to compound the meds so I am waiting to get them in the mail should be today. If I do get them today, with tomorrow being Sunday, I will probably wait till Sunday or even Monday to start the new dose just because I want the vet to be available if I have to call. My vet at least understands my concerns and tends to err on the side of low dose increments too which helps. So I am going to only do her increase 1 x day to start and see how it goes.
Hang in there, I know how scary this all is. I also cant believe how many little bostons are on this site, its heart breaking for any animal to have to go thru this but bostons have a special place in my heart.
hugs, kona and deb

[FrecklesMom]

Hi Leah, Steph and Deb,

I can't tell you how much I appreciate everyones hello's and help in turning me in the right direction for freckles treatment.

Steph, I was thinking it was either pituitary or adrenal, didn't really Understand it could be both. I will be calling the vet to see about the ultrasound monday. Also I understand now what you are saying happens after you administer the prednesone and how important the testing is afterword. I've decided I'm going to do screen shots of all the information everyone is giving me to also read during my daily review of things so I won't forget anything. Even when I'm not sick when I'm stressed I sometimes forget things. Wish it wasn't like that but seems worse as I get older. :(

Deb, I know I am surprised at all the Bostons here too. My family and my parents have always had bostons for years and never even heard of this. Such a sad thing to see any dog go through. I think I would want to go with lowest possible dose during maintenace too. i hope the new Vetoryl dosage works really well. We actually have a pet pharmacy 3 minutes from me and dispensed freckles medicine. I did the tablet for this loading period but will have them do compounding when we get to maintenance.

[Squirt's Mom]

Hi,

I wanted to clarify something for you about the ultrasound and its ability to aid in the diagnostic phase. With PDH, the pituitary form, the adrenal glands are typically both enlarged. With ADH, the adrenal form, one of the adrenal glands is usually very large while the other is much smaller or even atrophied (withered up). While it IS possible for a cush pup to have both a pituitary and an adrenal tumor, this is extremely rare. FYI, the adrenal glands are always involved in Cushing'e even when the tumor is on the pituitary.

The ultrasound can help diagnose and determine which form of Cushing's is in play PLUS let them get a look at many other organs and their health status to boot. This is how a tumor on my Squirt's spleen was found - after removal, her cortisol returned to normal and remained in range until last summer. The tumor was causing the positives on all her cushing's testing - five in all. So the value of an ultrasound in Cushing's cannot be stressed enough in my experience. ;)

Hugs,
Leslie and the gang

[FrecklesMom]

Hi Leslie, None of the literature talked about spleen tumors causing cushings so I'm glad you mentioned your situation. I'm so glad they found the tumor for your little fur baby. Makes me very anxious now to get freckles in for an ultrasound asap. I did some checking and his office doesn't have ultrasound equipment so may be why he didn't mention doing one. Thanks so much for sharing this information.
Hugs, diane and freckles

[molly muffin]

Hi Diane,

My vet didn't have the ultrasound equipment either. I just asked for a referral to get one done and they sat me up with a consult to an Internal Medicine Specialist and the ultrasound at the local Vet ER hospital. That worked out to our benefit in that the IMS ordered an LDDS test (after a positive ACTH, and blood work showing higher ALP and ALT). The LDDS test came back negative for cushings at this time. The ultrasond did show mildly enlarged liver and adrenal glands and lymph nodes, so she might be on her way to cushings but my vet had wanted to start her immediately on 30mg Vetoryl, which would have not been good since she is still suppressing fine.

Just ask your vet for a referral. They should have some place that they send the pups to that need an ultrasound locally. (well, one hopes locally)

hugs,
Sharlene

[frijole]

Hello! I had one dog that had cushings and one that was misdiagnosed. It wasn't pieced together until almost a year later when we did a 2nd ultrasound (the first one they missed the tumor) when they determined there was a non cushings adrenal tumor. We even had a cat scan done to rule out pituitary tumor as she tested positive for pit cushings so many times.

This isn't a rare thing. Dogs are misdiagnosed alot. Hope this helps. Kim

[Squirt's Mom]

None of the literature talked about spleen tumors causing cushings so I'm glad you mentioned your situation.

Hi Diane,

I don't know what happened but I replied to this earlier today....it ain't here! :confused: More than likely operator error. :p

Squirt's tumor didn't cause the Cushing's - it caused false-positives on the Cushing's tests. The tests can only tell us if the cortisol is elevated, not WHY it's elevated. Cortisol is one of the bodies natural defenses against stress and it is released any time the system is under stress of any kind. This response is absolutely normal and happens in human bodies as well. Anytime you are sick or under pressure, the odds are you would test positive on a Cushing's test. This is why it is important to do as much testing as you can before starting any treatment and why we should never have the testing done while or just after a pup is ill.

Removing the tumor removed the stressor which meant Squirt's cortisol level was able to return to a normal level since the body was no longer fighting that stress. In a cush pup, their body cannot return to normal and does not need a stressor to cause the cortisol to elevate. It is a miscommunication problem between the hypothalmus, pituitary and adrenal glands that causes the cortisol to elevate in Cushing's. We do not know what causes this miscommunication to start. But there are many things that can cause the cortisol to rise that are completely unconnected to Cushing's. ;)

I hope this helps! If I've made the waters even muddier, just let me know and I'll stir them up some more for you! :D

Hugs,
Leslie and the gang

[Steph n' Ella]

Diane and Freckles, So glad you got some good advice over the weekend! Hopefully all this info isn't overwhelming you too much :/ Pretty soon you'll feel like you went to vet school or something :p

[FrecklesMom]

Thanks everyone : ). Overwhelmed but grateful you are all so willing to share what you know! You are all sweethearts. Yes, I just might be ready for vet school soon. LOL. So we go in first thing tomorrow for an ultrasound. He has someone who comes to them to do it, equipment and all. He also said I could be present and It takes 24 hours to get report so we won't know anything until Wednesday.

Hugs, freckles and diane

[Steph n' Ella]

Yes...freckles will be glad to have you back there with him during the ultrasound. The tech might even point out some of the organs for you. Of course you'll have to wait for the official report...but techs generally have a good idea what they are looking at too!

[Boriss McCall]

So glad you are getting the ultrasound. You will learn so much about what is going on with little Freckles. :)

[molly muffin]

Yay for the ultrasound. You'll feel so much better being able to know what things look like.

Sharlene

[FrecklesMom]

Ultrasound is done and I was surprised to get a copy of the written report before I left since I was standing there. Everything was normal with the exception of Adrenals.

Abnormal:
Left Adrenal - Adrenalmegaly (7.8 mm caudal pole), normal shape
Right Adrenal - Adrenalmegaly (8.1mm cranial pole)' normal shape

Diagnostic Interpretation: compatible with pituitary-dependent Cushing's disease

So I am so very VERY relieved no other problems were discovered. She was fully awake for ultrasound but held in place and is walking like her back side is sore now. I am feeding her in a little plastic dish on the couch so she can just sit and eat. She thinks thats pretty cool. Now we continue to move forward with the Lysedren.

[Boriss McCall]

What good news!!! yay!!

I am so glad all her other organs look great. You must have a very good Boston if she will lay still for an ultra sound. We had to sedate Boriss & he was still a little bit squirmy during it.

Good luck with starting treatment on Freckles. I am sure she will do just fine.:)

[molly muffin]

I'm happy to hear that all other organs are normal. That is the best news. :)

So, now on to the loading phase. Some of the others who have been through that will be by to comment soon I hope.

hugs,
Sharlene

[frijole]

Please let us know your dog's weight and the dosing your vet is prescribing so we can check it ok? Just want to be safe is all. Kim

[FrecklesMom]

Thanks everyone : ). She weights 33lbs and prescribed 750mg per day dosed half After morning meal and half after evening meal. I have been reading the dosing instructions from the reference section here every day so I'll know everything forwards and backwards. I didn't give anything to her at dinner because the poor thing was still walking around like it was very painful. Hopefully she will feel better tomorrow.

[frijole]

The dosage is perfect at 50 mgs per kg of weight. Give after eating, wrap in cheese or cream cheese. Never give if you see any hesitation when she eats.

There's no rush to start so if you are worried she's sick or hurting just wait a few days. No more stress needed for you. ;)

Any questions whatsoever just post 'em. You are doing great. Kim

[Squirt's Mom]

WOOHOO! Great ultrasound report and I KNOW how relieved you were to see such a good report! :):)

Now you are ready to start treatment and you are doing a great job of being prepared, Mom! We are here any time you have a question or get a bit nervous about something so don't hesitate to speak.

Hugs,
Leslie and the gang

[3bostons]

That is good news on the ultra sound. WIth Kona her ultrasound was a major indication of cushings, not because of the report, the report was ok it was the fact that she turned black and blue after the ultrasound, I posted pics on my homepage. I was horrified when it happened, needless to say, I still dont know why she would bruise that bad, they shouldnt push that hard right? But the bruising they considered immediately to be cushings related, plus now 8 months later, she still has no hair regrowth, another sign. So, needless to say from there we pursued the other tests and confirmed the cushings.

I can relate to the worry of starting the meds, but you have lots of people here to be with you as you and freckles go !

hugs kona and deb

[FrecklesMom]

Med update, I ended up starting Lysodren Tuesday. Gave her the half pepsid before food, food, then 3/4 pill wrapped in cheese. First two days nothing unusual. Third day this breakfast meal she ate about 2/3 of her meal stopped eating and looked up at me for about 20 seconds then walked away from food. I was shocked. I didnt give her any Lysodren and called vet. He is going to do ACTH test to check numbers. He said it was very unusual to load in two days but some dogs more sensitive to meds and he has had another dog do this in three days. Does this happen very often? Lunch meal her appetite is less too so no doubt there is an appetite change.

Thank you all so much for being so caring and help me do this right even as you are busy taking care of your own cushings Pups. Such a special group here. With all the information everyone has shared (even with my massive fear ) I had no doubt how to give medicine and when not to give it.

Deb, I would have freaked out too if I saw freckles black and blue. When freckles had hers I did notice they had two people holding her on the cushion very tight so she wouldn't move. No bruising but she couldn't walk right for a few hours.

So on to the acth..

Hugs, freckles and diane

[3bostons]

Diane, sounds like one of the symptoms they tell us about with these drugs being too much, the not eating thing. Hopefully they find thats what it is and reduce the meds for freckles so he can eat again. I know they repeated to me if there is any change in appetite like that to stop meds immed and call them, so you are on the right track now. I will be looking to see what his test results show later.

You know, after the whole bruising thing with Kona, the vet no longer takes her away from me to do the tests, I stay with her and honestly she is such a good girl she never squirms or fights it so it works out good with me holding her. They are surprised how calm she is even when they take blood from her neck, while I hold her. It makes me feel better too, and I think it really helps Kona.

Good luck and let us know how it goes !
hugs, kona and deb

[Squirt's Mom]

Hi Diane,

You done good! I'm glad the ACTH is scheduled and you will know for sure but it definitely sounds like Freckles is loaded. Let us know what you learn and way to go, Mom!

Hugs,
Leslie and the gang

PS Freckles and Kona are on different meds and Kona will not go through a loading like Freckles did.

[Squirt's Mom]

To hijack -

Debbie - Kona is taking Trilostane (Vetoryl) which does not have a loading phase - yo simply start and keep going. With Lysodren, what Freckles is taking, there is an induction, or loading, phase. It is correct to stop the med when certain signs are seen, among them hesitation in eating. At that time an ACTH is performed to see exactly where the numbers are and if they are in range, the pup waits a bit then starts the maintenance phase. Two different drugs that work in different ways and are handled differently. ;)

[Boriss McCall]

wow.. that was fast! :)

[3bostons]

Yes I know they are on different meds but from what I have read, loss of appetite is still a concern no matter which med they are on. I was simply letting her know, good reason to contact her vet, definately not medical advice.

[frijole]

You did great! It sounds like a load to me. Can't wait to see the results! Kim

[molly muffin]

Yep, you are right, loss of appetite, trembling, vomiting and diarrhea are all symptoms that a vet should be contacted and an ACTH test done immediately for either drug.

It's good advice. Always better safe than sorry! :)

Sharlene

[FrecklesMom]

ACTH test is done. Does what they inject them with for the test make them not feel good? She is just laying here not wanting to even look at me and limping again when she walks. Not interested in food at all. I'm thinking maybe her back hurts from being lifted in and out of the vets cages but don't know about the other. Maybe she is just really upset because I keep taking her down there, do you think? Poor little thing.

[Boriss McCall]

we all now how moody/sensitive to situations a Boston can be.;) Or at least my little guy is.

Boriss was VERY tired after the test & didn't seem to feel 100% until the next day. He was not happy about going to the vet the morning of his test.

[Boriss McCall]

Also I can't wait to here how good the numbers are. :D
You and Freckles have done such a good job.

[molly muffin]

Yea, I think getting an ACTH test or an LDDS test just wears them out. Give it some time, a day or even two to see how she is doing. When do you get the results?

Sharlene

[frijole]

ACTH test is done. Does what they inject them with for the test make them not feel good? She is just laying here not wanting to even look at me and limping again when she walks. Not interested in food at all. I'm thinking maybe her back hurts from being lifted in and out of the vets cages but don't know about the other. Maybe she is just really upset because I keep taking her down there, do you think? Poor little thing.

Lysodren keeps working for 48 hrs after the last dose. Not sure when your last dose was but it could be that the cortisol is a bit low. That makes them lethargic. That would also explain the lack of appetite. If cortisol is low it is the opposite of cushings (no hunger vs ravenous)

Regarding the limping - cortisol is used to treat pain. Previously Freckles was producing her own pain pills and it helped treat arthritis and other issues. Once you treat the cushings and reduce the cortisol we often see this. Options are: glucosamine, duralactin, adequan shots.

Anxious to hear the test results. Keep us posted! Kim

[FrecklesMom]

Things are looking up this evening, freckles finally looked at me.LOL just a tad bit sensitive like Boriss! They will call me tomorrow with the results, will be hard to sleep tonight. I wondered how long each pill kept working after she takes it. Last pill was wednesday dinner and I add 48 hours so it will just be wearing off right now. I'm glad you mentioned about the arthritis too kim, vet had told me previously she had the start of arthritis in one knee. I will be very interested to hear what everyone thinks tomorrow of results. My vet went on vacation thursday for a week and one of the junior vets will be advising me on results and what maintenance dosage Should be. I'm a little nervous because she didn't seem to know as much when I asked questions today. If freckles is dosed In two days i wouldnt think a dog that sensitive should get a very high maintenance dose as normally given. We will check in tomorrow when I get numbers.

Hugs, freckles and diane

[frijole]

Diane, Normally maintenance dose starts one week from the date you gave it last UNLESS the cortisol is real low in which case you wait a while before starting. Maintenance is usually the same amount on a weekly basis that you were giving daily. HOWEVER since she loaded so quickly (assuming she is loaded) I would LOWER that amount.

Just write it all down and post it here and we'll help you with it. If the 'jr' vet is confused we'll help you thru it! Don't fret. Kim

[Boriss McCall]

yay Freckles! When Boriss gets in trouble (if you want to call it that) He will run back to the bed & hide out pouting forever. It is so funny.. He won't look at us either.

I am curious Freckles is so young. How old are dogs when they start getting arthritis? I haven't noticed anything in Boriss yet & am very curious if I will. Do they just walk slower or with a limp?
I just assumed it would come when he is older or if there was a past injury. I do have a 2 1/2 year old Bulldog who limps when she wakes up in the morning on one leg. She was injured as a baby & has some hereditary joint issues. I am wondering if at almost 3 years she already has arthritis? :(

I am glad things are running so smooth for Freckles. I love to hear the success stories. Have a great weekend!

[FrecklesMom]

ACTH tests are in. Dr. Said if she had taken one more pill we would be talking addisons. The only reason we are not talking Addisons is because of this group, your helping and kind comments here. I have tears in my eyes as I write this, I can't tell you how thankful I am to all of you for your help! This is all so scary to me.

Great numbers but results are after only two days of medication at 750mg per day.

ACTH
Baseline 1.9
2hrs. 2.0

Her dex test the previous week was:
Baseline. 12.1
4hr. 5.1
8hr. 2.8

Thats a huge drop per dose in a couple days, like 5.0 per pill. The vet said pretty much what you mentioned Kim, giving her same 750mg dose once per week. When I asked her if we should be giving her that much since she is so sensitive she thought for a minute and said I should try 500mg a week. I don't fully understand how medically all this works with the pituitary gland regrowing back. But at such a low baseline I'm concerned there is a real risk of going addisons with just one pill if its too much considering how sensitive she is. Her appetite has decreased now to where she doesnt finish any meal right now, so thinking this is going to be trickier to figure out. I'm feeling more than a little panicked. Any thoughts?

Hugs, freckles and diane

[FrecklesMom]

BorissMom, we lived in a two story house up until about a month ago. I think freckles running up and down stairs like a mad dog for 6 years was the cause of of arthitis on her knee although I never asked. Problems started when she was five but she was constantly running up and down stairs her whole life. That is the main reason we sold the house a couple months ago. Have never had problems with any of our other bostons when we were living on a single level...so tell Boriss and your little frenchie no stairs. :)

[frijole]

ACTH tests are in. Dr. Said if she had taken one more pill we would be talking addisons. The only reason we are not talking Addisons is because of this group, your helping and kind comments here. I have tears in my eyes as I write this, I can't tell you how thankful I am to all of you for your help! This is all so scary to me.

Great numbers but results are after only two days of medication at 750mg per day.

ACTH
Baseline 1.9
2hrs. 2.0

Her dex test the previous week was:
Baseline. 12.1
4hr. 5.1
8hr. 2.8

Thats a huge drop per dose in a couple days, like 5.0 per pill. The vet said pretty much what you mentioned Kim, giving her same 750mg dose once per week. When I asked her if we should be giving her that much since she is so sensitive she thought for a minute and said I should try 500mg a week. I don't fully understand how medically all this works with the pituitary gland regrowing back. But at such a low baseline I'm concerned there is a real risk of going addisons with just one pill if its too much considering how sensitive she is. Her appetite has decreased now to where she doesnt finish any meal right now, so thinking this is going to be trickier to figure out. I'm feeling more than a little panicked. Any thoughts?

Hugs, freckles and diane

Yeah - I wouldn't start giving maintenance until the appetite has returned to a more normal level.

You compared two different tests so there was no huge drop as you mentioned. :) If you didn't do an acth test prior to starting the load you don't have anything to compare. You compared yesterday's acth test to the 8 hr ldds test. That test was used to diagnose the cushings. The acth test measures cortisol levels.

Normally the maintenance dose is NOT given all in one day. It is preferred that you give it 3 to 4 times a week. So if you went with the 500 mg per week (one pill) simply cut it into 4 pcs using a pill cutter if you have one and give 1/4 of a pill 4 times a week. What this does is it keeps the cortisol in check but it also spreads the drug out so you reduce the risk of going too low.

The test number of 2.0 is really not that low but probably she went slightly lower after the test since I think you did it right away. I would consider waiting two weeks from the last dose before starting the maintenance dosage. In that time the hunger should be ok and you should also be seeing some improvements in the symptoms (eating/thirst etc)

Just keep a close eye on her and watch the poops for diarrhea ok? she is obviously sensitive to lysodren and I want to make sure she didn't go too low. If no diarrhea or vomit you should be ok. Probably just lowered her cortisol levels real fast so her body is adjusting.

Sorry to ramble. Keep on posting and we'll keep on reading. :) I'm glad you found us too. YOu are doing just great. Kim

[FrecklesMom]

Thanks kim :) I feel better after hearing the numbers don't correlate. I thought it was just two different methods of testing the exact same thing. I would definitely feel better waiting a couple weeks then splitting the lysodren in smaller doses during maintenance to keep a better handle on this. I'm assuming that I will watch for exactly the same things as I did with loading. For that reason I'll try going to two meals a day and dropping the lunch meal altogether since she isn't hungry then. She probably should be given less food for her age and weight anyway. I think frecklemom will need a looooong vacation when this is all over..

[molly muffin]

So glad Freckles is doing so well.

I think it's a perfect excuse for everyone to take a vacation! :)

hugs,
Sharlene

[frijole]

:) You are welcome! I remember feeling the same way so dont' worry about it. One day at a time. If her appetite returns to normal in a week you can always start before two weeks... normally it's a week after the last dose but given how very fast she loaded and the lack of appetite - I wouldn't rush it. Just pay attention, report in and we'll help you. Kim

[FrecklesMom]

Kim, it seems everything is going to be tied to her appetite. I have actually had to hand feed her on the couch to coax her to eat up until yesterday. This morning was first meal she ate in kitchen on her own. I think you are right I am going to start maintenance next monday after her appetite straightens out. Her vet will be back by then too. Will make me breathe easier having him here if we run into problems.

Sharlene, I think you are right. Everyone here needs a vacation after going through all this worry. :-)

Hugs, freckles and diane

[frijole]

Diane, and next week if the appetite isn't there - don't start. Better safe... xoxo, Kim

[molly muffin]

How is the appetite doing?

hugs,
Sharlene

[FrecklesMom]

Sorry, handling some pressing needs with college daughter too so haven't had time to get over here. Freckles appetite came back and yesterday she was drinking and panting a little more. I decided to start her 1/4 lysodren maintenance tablet early this morning and will give the other 1/4 Tomorrow. No tummy upset noise with this smaller amount which I like. She seems like she feels better these days and moving about more. I do notice a litlle pot belly now which I was thinking she wouldn't get after starting medicines. So anyway I'm back to watching her carefully. I have been keeping a little notebook journal every day of everything and that has been immensely helpful so I can look back and refresh my memory.

Hugs, freckles and diane

[Boriss McCall]

Sounds like Freckles is doing great! :) I would be lost without my notes. I am so glad that Shannon (Sunshine's mom) told me to make a daily notebook. It truly helps! Good luck with the maintenance. Sounds like things are moving along smoothly.

[FrecklesMom]

I guess freckles will be everyones example of a dog supersensitive to Lysodren. On her first maintenance pill I gave her yesterday which was 1/4 of a 500mg tablet she woke up with no appetite for breakfast this morning. Sooo I'm not going to give her the other 1/4 tablet today. Will watch the appetite and water intake again like you said Kim. Other than the no appetite again she seems fine. Could be she needs only a 1/4 tablet per week. She is do for her shots so will talk to her regular vet now that he is back to see what he thinks.

[frijole]

Good move mom. I think rather than wait until her hunger is 'normal' I'd shoot for when it is more like it was before starting on lysodren. It is pretty strange that 1/4 of a pill would instantly have that effect. Certainly talk to your vet about this. Kim

[lulusmom]

The number one side effect listed for Lysodren (Mitotane) is GI upset so it could be that the drug is simply not sitting well on Freckles' stomach. A number of our members give their dogs Pepcid AC to counter the effects. My dogs never had that problem so I am not sure of the dosing. I hope other members will drop by to share their experience.

Glynda

[3bostons]

How is Freckles today? Hope the appetite is coming back and things are somewhat back to normal for you both. I know I worry about any change to these guys cause like Freckles, it seems they are ultra sensitive to meds, diets or anything changed.
Hugs, kona and deb

[FrecklesMom]

Hi :)

I know Kim it is strange but when I think back over the years she has always been sensitive to everything going in her mouth. Has been especially difficult when kids drop a cherrio or animal cracker on the floor. Next thing I know she is sick and won't eat anything for a day. Difference with this is if its an upset stomach I always hear the stomach grumbling and she won't touch food at all. No stomach grumbling with this medicine. She has been on prescription id dry dog food her whole life because everything else makes her sick.

Glynda, I give freckles 1/2 of a pepsid before breakfast and dinner already. Fortunately she didn't get any stomach grumbles which she always gets when something is really upsetting her stomach. I am thinking for some reason she assimilates things faster causing her to be more sensitive to dosage? That could be a variable with all of the cushings dogs which explains why there could be such a wide range of loading days experienced.

Deb, freckles appetite is getting better with each meal but I'm still seeing things I don't usually see like stopping in the middle of eating to get a drink...that never would have happened a month ago. So I'm fairly comfortable watching for general appetite changes to decide next day to dose. I'm thinking maybe Monday for the the second 1/4 pill but will see. I definitely won't go above 1/2 a tablet per week these first four weeks until I get the next test done to be on the safe side.

So far I'm happy with Lysodren and how it has helped her already but definitely requires careful monitoring like you all said. The real story will be told with the next test that is done as to whether I'm reading all the signs right now so i'll be anxious to see what it says. But I'm feel so much better seeing her more playful and not panting all the time. :)

Hugs, freckles and diane

[FrecklesMom]

Lysodren maintenance update. For first week of maintenance I am ending up giving freckles a total of 375mg of Lysodren, Split up two or three days apart. Yesterday was the last 1/4 tablet and this morning she wasn't hungry at all so I won't give any more for this first week. Her loading dose was 750mg for two days and this amount is exactly half that. She is doing great, still has weakness in back legs, and sleeps alot. It hasn't been easy figuring this out thats for sure. She hasn't wanted to eat anything without a little bit of cheese in her meals now so sometimes wasn't sure if she was eating just to get the cheese. In the end when appetite went down she would eat all the cheese and not all the kibbles and/or I would see a big jump in thirst and hunger. This morning food is still sitting there so I know this is it for weekly dosage. Wish they would develop an at home test you could check things daily like for diabetes.

Hugs, freckles and diane

[molly muffin]

I'm so happy to hear that freckles is doing so well. We always need some good news around here. It'll be good to see what the numbers show on the next test. I am hoping they are really good.

hugs,
Sharlene