Fritz and Recent Updates - Fritz has Passed

[Wally P's Mom]

Hello All:

I thought that I would start a new thread. I took Fritz to the vets two days ago and his ALP was elevated, more so than last year. It is the only thing that is high in his blood panel and no other symptoms exist. Fritz just turned 13 and I am think more age than Cushings. However, when I get a copy of his report, I will post his values.

I just read a post in my Wally's memorial that Wally is looking down on me. Wally has led another little dog into our lives. Believe it or not, Lucky showed up on our doorstep exactly 1 year and 3 days since Wally's passing. I named him Lucky because he was lucky to have found us and we are lucky that he decided to stay. I have been told that it was fate that he is with us. When I have more time, I will share what little I know about him.

Fritz has taken to him just fine. At night they lay side by side in bed. When I work from home, they both sit with me. Good thing I got a new sofa that fits all of us.

Marge, Fritz and Lucky (and Wally in my heart)

[Harley PoMMom]

Oh Marge!

A new addition to the family! I am so happy for you and sweet Lucky.

I think you are right at assuming that Fritz's ALP is increasing due to age. Big hugs to you and all of your furbabies...Lori

[mytil]

Marge,

So glad to hear from you. I think Lucky knew exactly what doorstep to come to. :)

With no other symptoms, I too would think the elevation is due to age. Keep us posted
Terry

[Wally P's Mom]

Hello All:

For as quickly as Lucky came into to our lives, he left. Long story short, he is with his family.

The period of time that we had him, we learned that we could open our hearts and love again. I never fully stopped mourning the loss of Wally. Little Lucky helped me move on and am truly thankful to that little dog.

Marge

[Wally P's Mom]

Hello:

Fritz was diagnosed with diabetes today. His blood sugar level was 343. In August, it was 98.

He went to the vet because he was vomiting. (5 times this afternoon).

There was much discussion about him having Cushings. His ALP values could not be measured by the vet because they were so high.

He had a US done back in August. There was nothing abnormal about the adrenals or the liver.

Tomorrow, we check his blood sugar levels and go from there. We have insulin, just in case.

Marge and Fritz

[Wally P's Mom]

Forgot to add:

The vet has been very careful with us. She knows what we went through with Wally.

If his blood sugar is still elevated with insulin, would you do the Tennessee panel or just the stim test? I always thought you got more bang for your buck doing the UTK panel.

Currently, he is not presenting any of the typical Cushing symptoms.

Marge

[Squirt's Mom]

Hi Marge,

The UTK panel will tell you not only about the cortisol but the intermediates as well. Some don't give much, if any, weight to the import of the intermediates. I am one who wants to know so I would do the UTK if I could, However, the intermediates are apt to be elevated anytime a pup has conventional Cushing's. I think if you are looking at the possibility of Cushing's in Fritz, I would start with the UC:CR. This test can rule out Cushing's but not diagnose it.

With diabetes in the picture now, it can get very confusing between diabetes and Cushing's. I think I would concentrate on the diabetes first then if he displays cush signs, start the testing for that. Are you on our sister site for diabetes? Here is their link just in case (they are the experts on diabetes and can offer you some great help! ;)) - http://k9diabetes.com/forum

Hugs,
Leslie

[Harley PoMMom]

Hi Marge,

So sorry to hear that Fritz is not feeling well and was dx'd with diabetes. Leslie has provided a link to our sister site that deals with canine diabetes and I strongly urge you to join there, the members have a wealth of knowledge regarding canine diabetes and can surely help you.

Has Fritz been checked for ketones? Ketoacidosis can be life threatening and one of the symptoms is vomiting. I believe ketones can be detected with a urine test using a test strip.

Sending hugs and love, Lori

[Wally P's Mom]

Thanks. I did stumble across the diabetes site in my reading and googling last night. It did get me up to speed and started me on the right foot this morning.

I don't think he was tested for ketones last night. He was checked for pancreatitis and that was negative.

I did get a canine glucose meter this morning and was ready for this next adventure.

I think we caught this early as he was not displaying symptoms of a diabetic dog. His last blood test was back in August. My vet said that he has a well documented history, so the change was easy to detect.

I do have corn syrup on hand just like I had pred for Wally.

I worry about the side effects of all of this. Yes, cushings does rear it's ugly head in the back of my mind.

It is good to once again be surrounded by old friends.

Marge

[molly muffin]

Hi Marge and welcome back, although, really sorry it is because Fritz is now having problems. Poor guy.

I went back and read Lady's thread and Wally's. What a journey you have been on these last years.

hugs,
Sharlene and Molly Muffin

[Wally P's Mom]

Hello:

Looks like I am coming back to you all for some help. The last month we have been on a roller coaster ride with Fritz. Blood Glucose is all over the map. As soon as we use the stable, he either tanks or rockets off to the moon.

My friends on the sister site are telling me that he could be honeymooning. I bought that for a while as the amount of insulin needed was quite low. As for his diet, it is very strict and regulated. When I go back to work at the end of the month, it will take me an hour to pack and label his meals.

We have checked his pancreas and did all the blood work for that. Everything came back normal.

So the vet is recommending that we test him for Cushings. Some days he drinks like fool and others not so. But he does urinate quite frequently on the nicer to be outside days and not so when it is cold. (imagine that). His loss of hair and this elevated ALP are the only cushing symptoms present. No pot belly or weight gain. In fact, he has lost weight in the past month.

I am all for doing the UTenn panel. What I think could be going on is that his estradiol levels are high and that could be interfering with the insulin. Insulin and Estrogen do have contraindications.

Any opinions?

I know, please post his results back here when we get them.

Thanks for your help.

[molly muffin]

You could do the UofT panel to check those levels, but you probably aren't going to want to treat for cushings or even pursue that until the glucose is under control. So if you do any testing, do it during a controlled period, not during off period. Otherwise you could get some invalid results. Good that everything else is checking out okay though.
I'll let some of the more experienced members chime in with their thoughts though as they have much more knowledge than I do.

Sharlene and Molly Muffin

[frijole]

Alot of vets jump to the 'cushing's conclusion' when dogs are hard to regulate... sometimes it's cushing's but often it isn't. To be honest I'd probably skip the traditional testing and go directly to an ultrasound and have them look at the adrenal glands. If they are normal size then it's probably not cushings... if one is larger or both are enlarged chances are it's cushings.

No fat tummy and huge appetite makes me question cushings. Kim

[Wally P's Mom]

We had a US done in August, but his BG was normal back then too. The hair loss and elevated ALP is what is making them think Cushings.

Fritz lost some weight. He went from 25lbs down to 23.7lbs in a month. Very strict diet.

With what I went through with Wally, I am happy to rule this either in or out with the UTenn panel.

Fritz has BG tonight of 144 at 5:30pm. This is pretty good and we need to keep him there. With him, it will either be either up or down. Careful monitoring.

[frijole]

Do you have a copy of the US from August? I'd be interested in what they wrote about the adrenal glands. It could be very telling. I feel it is more accurate than the cushings tests with dogs that have other ailments. Trust me - I've been here 8 yrs now - lots and lots of false positives. (I lived it with a dog that had 5 false positives on the acth test and 2 on the LDDS test) The adrenal gland description could give you quick answers. lf normal - it isn't cushings. Weight loss isn't common with cush dogs either.

I understand if you want to do the UTK panel for purposes of measuring the sex hormones.

Kim

[Wally P's Mom]

Just looked at the report:

Both adrenals are normal in size and appearance.

This was from a US from August 21, 2012.

It was done by the same Dr that found the adrenal tumors invading the vena cava of Wally's Heart. I trust her implicitly.

I ,too have been the victim of false negatives and positives. Wally taught me a lot in his life. Right now, this panel is what must be done. The cortisol and hormones influence the production of insulin. If another US needs to be done afterwards, I will do it.

Any thoughts on the estradiol levels and insulin?

My personal opinion (and Kim, I think has confirmed it) is that the hormones are elevated making the sugar hard to regulate. Elevated estradiol levels also leads to hair loss and elevated ALP.

ALP at the end of November was >2400.

Do you think I am on to something?

[molly muffin]

I think it is a definite possibility that estradiol could be making it difficult to keep the insulin under better control. I am however, only repeating the things that I have read so probably not the best source of info. You are probably twice as smart about this as me.
I'll cheer you on though!! :) Go girl, go girl!
But with the normal size adrenal glands in August, they probably haven't suddenly ballooned, so it could be the other hormones.
Sharlene

[labblab]

Dear Marge,

Gosh, I am so sorry that you and Fritz are facing all these challenges. If you are willing to pay the price to have it done, I see nothing to be lost by proceeding with the UTK panel. As Leslie suggested earlier, you could always start the Cushing's testing with a simple UC:CR urinalysis, and that may still be a good "first step." But as you already know, if steroids other than elevated cortisol are the culprit, the UTK test is the only way to identify those issues.

For what it's worth, my own thought is that adrenal Cushing's has been effectively ruled out by the ultrasound report (no obvious masses or tumors). However, my understanding is that around 30% of dogs with pituitary Cushing's do not exhibit enlarged adrenal glands, especially in the early phase. Also, like Fritz, my own Cushpup actually lost weight rather than gained weight prior to diagnosis and had no pot belly. So I've learned from my own experience that there can be variability in the symptom profile.

So, bottom line, I don't think there's anything to be lost by doing the UTK panel and you may get some helpful information to work with. Just my own 2 cents, but there you have it!

Marianne

[Wally P's Mom]

Yes, you are right, a simple urinalysis would definitely rule out Cushings. Right now, I am trying to get the most complete picture possible.

Fritz has an insulin adjustment every 5 injections. I was looking at his trends today. Either up or down. Today we went down.

I am so frustrated just like I was with Wally. These two grew up together and I think Fritz learned all the tricks. No they were not litter mates.

Marge

PS Thanks for the two cents. It definitely gave me more to think about.

[Wally P's Mom]

Hello Friends:

The samples was sent over night today and UTK should have it by morning. The waiting game begins.

I forgot how expensive it is to ship those little tubes. Yikes.

Poor Fritz never had so much blood removed from him. It makes his daily prick look like nothing.

Anyway, keep us in your thoughts and we will post his results as soon as we know them.

Marge

[Harley PoMMom]

Will be checking for those results and will definitely be keeping you and Fritz in my thoughts and prayers.

Love and hugs,
Lori

[Wally P's Mom]

Fritz has been diagnosed with Cushings. Results from UTK are in. Pre was 21.1 (2.0-56.5) and post was 292.7 (70.6-151.2). All the other hormones tested were elevated (both pre and post).

I went out tonight to pick up the lysodren and the pred. We begin to load tomorrow and have him scheduled for a recheck next Tuesday. At a weight of 23.7lbs, Fritz will take 1/2 500mg tablet, twice a day.

I have never loaded before, any advice? Wally just went straight to maintenance as he was his own dog.

I am hoping that his coat will come back quickly and his sugar levels are much better regulated.

Marge

[frijole]

I checked the dosage amount and it is spot on at just under 50 mgs/kg . I'll post a link that I used while loading. Meanwhile the following tips from the top of my head:

Never give lysodren to a sick dog - vomit, diarrhea etc.

Signs of loading are ANY changes no matter how subtle in eating and/or drinking. So before you start loading watch how Fritz eats and measure daily water intake. I marked a bowl with average consumption and marked it with tape. Every day I filled it to that mark and at the end of the day I knew how much water she drank. Most cush dogs inhale food so it could be that the dog hesitates when eating or actually breaths or chews food that is your sign.

No matter what the vet tells you about when to come in for an acth test - if there are signs before then you stop giving lysodren. Lysodren works for 48 hrs from the last dose so never ever give it if you have any doubts because you can't take the pill back and that 2 days could cause the dog to go low if you give it. If you think your dog has loaded call to set up an appt for 2 days from the last dose so you have the most accurate possible acth.

Always give lysodren AFTER your dog has eaten their food because you can withold it if the dog hesitates /is loaded. Wrap the lysodren in cream cheese. It forms perfectly around the pill and you don't need much. It coats the tummy and helps prevent gas that dogs on lysodren can get.

I watched my dog every time she went out to pee/poo because a sign of loading is diarrhea.

I'm sure there's more but this is a good start. :) Any questions just ask us and always remember - when in doubt do not give it. Come on line and ask questions if you need to!! Good luck, Kim
http://www.k9cushings.com/forum/showthread.php?t=181

[Wally P's Mom]

Good advice about the water consumption. I have a scale, so I can measure that too.

With the diabetes, all his food is carefully weighed and accounted for. We have a diary that tracks his BG, units of insulin and exactly what is eaten.

There is good communication between the vet and myself. Depending on his BG, I e-mail her 2-3 times a day with his BG results so his insulin can adjusted. If issues arise during loading, I know she is a phone call away.

His appetite is goofy and if his BG is off so is his appetite. With Wally, he ate everything. Fritz is fussy which does not help.

I am hoping to see a more regulated BG values. In the past day, we went as high as 505 and down as low as 167 with really no change in insulin.

Thanks Kim for the advice.

Marge

[Wally P's Mom]

Just a quick post,

We began lysodren yesterday. The first dose wiped him out. The second one, Fritz did better with.

This morning about 2hours after the first dose, Fritz had the squirts.

Not giving him any Lysodren tonight after consulting with the vet.

BG was down to 171 about 4:00pm and needing to check him now.

I am hoping we are doing things right.

Marge

[frijole]

Wow - squirts could mean a quick load. Is he eating ok? Any vomit? You did cease giving lysodren right? Please do if you didn't. Hold off and keep us posted in great detail ok? Kim

[Wally P's Mom]

Yep, squirts.

Fritz ate OK. No vomit. No lysodren tonight.

The vets are not playing it as a load, yet. I am hoping it is. But, Fritz also has had loose stool issues.

Marge

[Wally P's Mom]

Good morning:

Stools are still loose. BG is 193. Water consumption is 370ml on Friday in comparison to the 604ml on Thursday. Food consumption is slightly reduced. No vomiting.

Called the office this morning and sent an e-mail of all of this information with stool pictures.

I am wondering if Fritz is loaded and that quickly or if it is something else.

Marge

[Jenny & Judi in MN]

my Jenny loaded that quickly on Lysodren. So, hopefully that is the trick. She also has diabetes and cushings. Hope things start to stable out here for you guys!

[Squirt's Mom]

Hi Marge,

It is possible that Fritz could be one of these pups who is very sensitive to the Lyso and he has loaded quickly. You did the right thing in stopping the med and letting the vet know what you are seeing. An ACTH will tell the tale, however, so I hope that will be scheduled soon. Let us know how he is doing and what the vet has to say. Did they give you any pred? If not, insist they give you some to have on hand just in case. ;)

Keep up the good work, Mom!
Hugs,
Leslie and the gang

[Wally P's Mom]

Thanks. I am waiting to news on whether or not to do an ACTH this morning. I did read your thread and am very hopeful for Fritz. You guys are an inspiration.

[frijole]

Marge, I'll tell you up front that vets will often say NO WAY they can be loaded yet but we have seen it and we've seen what happens when people continue to load at the vets instructions. Please insist on having the acth test. What convinced me is not just the diarrhea but the large reduction in water consumption.

Worse thing that happens is she's close but not quite there and you load another day or so and pay for an extra acth test. If you keep loading and go low... you risk much more.

Go with your gut always. Kim

[Wally P's Mom]

Thanks Leslie.

I do have pred. I learned that one with Wally. Trying to get an ACTH done today.

Marge

[Squirt's Mom]

Marge, I am moving this thread into the Question and Discussion board now that Fritz is loading. ;)

[Squirt's Mom]

And here you are! :D

[frijole]

If you can't get an acth test done today that is OK. The ideal time for it is 48 hrs after the last dose because lysodren continues to work for 2 days from the last dose. So if you have a test done before then the cortisol is probably a bit LOWER than the results will show. Good luck! Kim

[Wally P's Mom]

Hello All:

I have to agree with what you are telling me. I've never loaded before because Wally went straight to maintenance and his cortisol values, hormones for the most part were higher than Fritz. But Fritz was being loaded due to his diabetes.

I did insist on an ACTH test today because it was Saturday and with tomorrow being Sunday, waiting til them would not happen. The ACTH test today, I am looking at as a security blanket, a safety net. Much better being safe than sorry. The only thing it hurts is my wallet.

It was suggested that the diarrhea could be a side effect of the lysodren. So if he is not loaded, we will continue to loaded, but at a lower dose.

When one of his Drs saw him today. He remarked that his coat looked a little better and his morning BG is much lower. So the little bit of lysodren is having some effect.

I should have the results sometime tomorrow and Dr told me that we would hear back then.

Until then, no lysodren. We continue to pray for some type of news.

Thanks.

Marge

[frijole]

Marge, There is a rule to never give a dog with diarrhea lysodren (or one that is vomiting). You mentioned him having issues before so the vet could be right but remember the water intake was so much lower. If the lysodren caused diarrhea it is due to loading imho. Some dogs get gas and give it with Pepcid AC (must be AC variety) to reduce gas but I don't recall ever seeing a dog who just got the runs from lysodren EVER in my 8 yrs here.

I say that because if he isn't loaded I would not lower the dose. All that will do is make loading longer (stressful) and increase the likelihood that sometime during that load he'll have diarrhea again. Better to get the load done and over with.

I'm hoping this chat is for not because Fritz is loaded. If diarrhea becomes an issue you might have been better off with trilostane. Kind of surprised the vet didn't go that route.

Fingers and toes crossed, Kim

[Wally P's Mom]

Hello Kim:

I am suspecting that the diarrhea is from him being loaded. Yes, from August through October we had on and off issues with vomiting and diarrhea. I suspected then he was a little off and only his ALP was elevated back then. I was guessing it was because of his age.

In November, we had an afternoon of vomiting. This lead to his diabetes diagnosis and some more talk of Cushings. Two weeks ago, I saw the vet for a follow up and to discuss the issues with his coat. This lead to the UTK panel.

When the results came back, I was given a choice of drugs. I choose the lysodren because of my experience with Wally. Although, I questioned my choice, I was told that for the hormones being elevated and the diabetes, my choice was correct. As for the Pepcid, he gets it. I give it to him prior to his breakfast so it is in his system prior to the lysodren.

You don't know how much I am praying that you are correct in saying he is loaded. I just want to get the cortisol down to get his BG down and stable. I go back to work on Thursday, so it would be nice if I did not have to leave him while he is being loaded. I have been with him every day since this has happened. My work day is from 9am-9:30pm with an hour commute each way. Although my parents watch him on Thursday, I don't want to have them to watch him as he loads.

I am just hoping Fritz is as subtle as Wally was.

Marge

[Wally P's Mom]

Hello.

Just saw his test results. I don't have the ranges or hard copy yet. Pre was 4.4 and the post was 16.6. Fritz will start maintenance and let that finish the job of regulating.

His insulin dose was also dropped 1unit based upon his BG this morning of a 243.

Almost there, but things are looking (Wait. Don't say the word because as soon as we do, we know what happens ....)

Marge

[Jenny & Judi in MN]

Hi Marge, I won't say the word either. Lets hope this does the trick! Jenny's insulin needs dropped from 7 units to 3.5 units once her cushings got regulated.

I hope Fritz is feeling better already! Judi

[Wally P's Mom]

Hello:

Began maintenance today with Fritz, he puked 11 hours after the pill and slept most of today. (No further lysodren was given.)

Maintenance was to be 1/2 a tablet, twice on Tuesday's. Now it will be divided up over 2 days.

BG slowly has crept up since the lysodren was stopped on Friday. I guess that was to be expected. I am hoping that the dose is split so the BG will be easier to control.

Just a thought....

Anyway, we did a trial run with how Fritz will do at my parent's home on Thursday. They needed to learn his schedule and how he eats, plus giving shots. Going back to work this week, and I am going to miss him something awful.

Marge

[frijole]

Marge don't have time to read back... you were loading originally at the same dose as the mini load right? If not then the puke after a single dose is strange. If the original dose was lower then I'd worry the miniload dose is too high. Could something else have caused the vomit? Just asking questions... thanks Kim

[Wally P's Mom]

Fritz was taking the same dose as his load. After puking on Tuesday, diarrhea on Wednesday and more puking today.

His water consumption was high today( about 500ml) today and held off on his insulin til tonight.

Do you think he is crashing or just stressed because of my return back to work today? I have been home since November 30, 2012,

Marge

[frijole]

Impossible to say but I would withhold lysodren. When in doubt you never ever ever give lysodren to a sick dog (vomit or diarrhea). Remember it keeps working for 2 full days after the last dose. I'd call the vet and discuss but I would not give the drug even if the vet told me to and I'd tell him that - you do not want to go too low. Better safe than sorry.

Hoping mom's to diabetic dogs will chime in here! Kim

[Jenny & Judi in MN]

how is he today?

[Squirt's Mom]

Hi Marge,

How is Fritz today? Has the vomiting stopped? If not, take him to the vet if you can. This may be an Addisonian crisis or it could be something like pancreatitis. Regardless, if he is still vomiting, he needs to be checked out. They do an ACTH be sure they check the electrolytes, too.

And as Kim said - no more Lyso, none, for now. ;)

I hope he is better this morning and we are all worried for nothing.

Hugs,
Leslie and the gang

[Wally P's Mom]

Sorry for neglecting to follow up with the posts.

The vomiting ceased after Fritz realized that I was not coming home. He ate his chicken. When I came home, his BG was checked and he inhaled his evening meal of chicken. Mom and Dad said he watched the door most of the time I was gone.

Friday morning, we went to the vet to make sure there was not a crisis. He was examined and his lytes were checked. Low, but the ratio was perfect. Not Addison's. Nothing was out of sorts, so not pancreatitis.

Yesterday, he resumed his normal activities. No issues. His Lysodren dose was split between the AM and PM. Easier on the tummy even with the Pepcid he takes.

Water consumption has been high for the last 2 days. Makes sense considering what he has gone through.

Vet wants to take a week off the lysodren to give a chance for hs system to settle down.

I bought him a thunder shirt to help him with the stress and we are going out to dinner tonight so he gets used to me being gone.

The thought is that this is stress because we have not been apart since he has been sick.

Today has been #*. Can't say it. You know how these things go....

Marge

[frijole]

Marge, Glad you are back and Fritz is ok. If the electrolytes were low I am concerned the cortisol was also low. Not necessarily addisons but tell me - did he do an acth test? HE can't just say "take a break"! You need to know what the last dose was doing. Where was Fritz cortisol wise. You need an acth test if you are going to change doses, hold off dosing whatever.

Frankly it could be that Fritz's cortisol is perfect at 1.5 and if it is you don't continue loading. YOu wait one week from the last dose and you switch to weekly doses that are equivalent of what you were giving daily. You could actually be there!

Please find out if one was done and if so what the numbers are. If not I'd have one done asap because Fritz could actually be loaded.

If I'm missing something let me know!! Kim

[Wally P's Mom]

Hello Kim:

We did an ACTH last week and STOPPED loading.Results were posted on 1/20/13. We began maintenance on Tuesday. His daily loading dose was 1/2 tablet twice a day. So the plan was 1/2 tablet twice on Tuesday. He vomited on Tuesday prior to receiving the second 1/2 tablet. This was put off til Friday. After the issues the days before with the vomit and diareeha, we checked his electrolytes and made sure he did not go in the wrong direction.

So the new plan was 1/4 tablet twice daily, twice a week. This does work out to be the exact amount that he would of received as one days loading dose.

The vet wants to stop maintenance for a week to allow his bowels to correct themselves. I am not sure about the starting and stopping if he is functioning just fine.

[frijole]

Thanks for clarifying and setting me straight. :)

Maintenance dosage is NOT twice a day and all in one day which is probably why you had the vomiting. Maintenance is the same amount given over a week's span PREFERABLY in 4 doses (different days)

So in your case you'd take that pill (500 mgs) and split it into quarters (like he told you to) but you wouldn't give it on one day or on two days. You give 1/4 of a pill on 4 different days of the week. The reason for this is to keep the lysodren working evenly in order to keep the load. This isn't my protocol - it is what has been recommended by specialists worldwide. Perhaps your vet changed it due to the diabetes but I'd also think this approach would be easier on the diabetes.

I just know that the more days you can give it the more effective it is at maintaining the load. Kim

[Wally P's Mom]

Thanks Kim. That is the type of answer I am looking for. It is what I was thinking of on Friday on my own without knowing that it would of been proper to do so.

Could you please provide me a link so I can share this with my vet?

Thanks again.

Marge

[frijole]

While I search for an article for your vet could you please share what the results of that last acth test were? (where your vet said to go on maintenance now?) I went back but did not see where it was posted. It's important. Thanks. Kim

[frijole]

I am searching for the actual article where Feldman said this but to prove I'm not making it up :) read this link where Deb is explaining Feldman's thoughts and her vet's experiences.

It used to be that dogs got maintenance dose 1 -2 times a week but over the years they are recommending greater frequency, especially if the load results (last acth done prior to maintenance) is on the high side where you really want to make sure that you can maintain the load. If I find the whole article I will post it. If not you can use this and just say the name Feldman - if your vet follows cushing's at all he'll know that name.


http://www.k9cushings.com/forum/showthread.php?p=65089&highlight=feldman+lysodren+maintenance#post65089

[frijole]

Here's another reference. To be honest I think so long as you do dosing on more than one day you will be fine :) Also remember to get another acth test done after 4 weeks on maintenance so you can monitor if you are maintaining that load. This is critical because you really don't want to start over again with a load.

Dr. Edward Feldman has changed his protocol for maintenance dosing. He now lectures his students to never give a once weekly maintenance dose but rather to spread it out over the week, preferrably in three doses. This allows for more consistent maintenance of the erosion achieved with loading as well as allows for easier adjustments in dosing. Both of my dogs have been on 3 x weekly maintenance for quite some time now.

Glynda

[frijole]

As you can tell this has been discussed frequently here :) Feldman talks about on page 1570 of his protocol so here you go:

Protocol. Page 1570

Maintenance therapy involves choosing a regimen and altering that regimen as required. Dogs that respond to daily o,p' -DDD therapy within 9 days or that have a post-ACTH plasma cortisol concentration less than 2 ug/dl are classified as sensitive and begin a maintenance schedule of 25 mg/kg of o,p' -DDD every 7 days. Those that initially require more than 10 days of therapy or with a post-ACTH plasma cortisol concentration greater than 5 ug/dl are classified as resistant and recieve 50 mg/kg every 7 days. In either situation, the dosage is divided into two to four treatments per week.

[Wally P's Mom]

Hello Kim:

Results were posted on the 20th. I understand Dr Feldman's work. I would really like to read the protocol or have a link to it. Yes, the quotes are great. However, without an article, it is hard to tell the vet to consider it.

I did find this:

http://veterinarynews.dvm360.com/dvm/article/articleDetail.jsp?id=460965&sk=&date=&%0A%09%09%09&pageID=2

which does say the same thing you are telling me.

Thanks.

Marge

[Harley PoMMom]

What about this one: http://books.google.com/books?id=elPuvsucuY8C&pg=PA335&lpg=PA335&dq=lysodren,feldman&source=bl&ots=gp-C0eUB7I&sig=7SPyfrNWqfz0EkW3e3oKUUlj5gs&hl=en#v=onepage&q=lysodren%2Cfeldman&f=false

Page 343 Maintenance Therapy with o,p'-DDD

[Wally P's Mom]

Hello:

We have been administering his maintenance dose across 4 days. I have tried giving it in the morning, but he is a better eater at night. So I give him his lysodren at night. I do watch over him for several hours before I fall asleep.

Monday, we go for a recheck ACTH and hopefully we are well on our way.

His insulin dose has gone up to 7 units, but his BG is a little lower than what it was 4 weeks ago without the big peaks and valleys. 4 weeks ago we were averaging about 270 and now on his good days average about 220.

His coat is still yucky, but I would rather have a dog with a yucky coat than no dog at all. Fritz is loved.

If all goes well, he will take his lysodren at night and alternate days being on and off. I would of made the change by now, but with his blood work on Monday and reading that the most accurate read is two days away. Fritz would of have no lysodren since Saturday prior to the test.

Today, a BG curve and holding 230 206 228 ... and so it goes.

Thanks for his help.

Marge

[Wally P's Mom]

Hello:

Not sure how to read this:

ACTH: Pre 4 Post 21.5

Post has increased in the past 30 days as it was a 16.6.

His BUN is also up to 47 when previously it was a 17. Creatine values are good.

Diabetes is being well managed.

Is the diabetes effecting his BUN values? or is the start of something else?

For the most part Fritz is feeling great.

Marge

[lulusmom]

Hi Marge,

I hate to be the bearer of bad news but it is apparent from the results of the stim test, that Fritz' cortisol is way too high. You are probably back at square one and will have to reload at some point. What I don't understand is why it is not affecting the diabetes. When cortisol is that high, you would expect to see some problems in regulating the diabetes. Have you tested the bg lately?

Is BUN the only abnormal value on the most recent bloodwork? If everything else is normal, it couild be due to dehydration or even a recent meal. Was Fritz fasted for the test?

You have had a devil of a time getting Fritz' stabilized on Lysodren. Why did your vet withhold the lysodren for so long? Was feeling poorly? I haven't gone back to refresh my memory so can you tell me if he is treating with a general practitioner vet or an internal medicine specialist (IMS). If not an IMS, you may want to consider a consult with one.

Glynda

[Wally P's Mom]

Hello:

A lot going on here at home, so I have not been able to post.

His blood work looks like this:

pre ACTH 4, post ACTH was 21.3
ALP 2405 (10-150)
ALT 312 (5-107)
BUN 47 (7-27)

Glucose 104

So, I know that the ACTH looks terrible and if it was any other dog, he would need to be reloaded. Fritz does not tolerate the loading very well. So, we are giving 1/4 of a 500mg tablet once every other day instead of the crazy way he had been taking it (T,W,F,Sa) By keeping the lysodren constant in his body, we are hoping for better control of his diabetes.

The vets are attributing his BUN to the cortisol being off and slightly dehydrated. I am not sure. I just read consumer affairs about the food Fritz has been eating since this has started. One dog has suffered kidney failure as a result of eating this food and a number of others have had issues that I have seen occasionally in Fritz.

I am open to food suggestions and will to take them in a private e-mail sent to me to avoid a list of product endorsements.

Fritz goes back in 2 weeks to be rechecked. His sugar and water consumption are stable for the time being.

Our vet is a GP, but worked with us through all the Wally stuff, so I trust her beyond belief. An internist would be good if I have not seen physical improvements in Fritz. Today, he went for a long walk and one he may not of done so well at a couple of months ago. For a guy his age, he still has a get up and go. The balding is being filled in with fine hair, but again could it be the dog food?

We celebrate having him in our lives for 14 years on Sunday and we mourn Wally's passing 2 years ago on Friday.

Marge and Fritz

[Squirt's Mom]

What is Fritz eating, Marge? There have been lots of recalls on feed that have connections to China which are causing some serious health issues so please check out that feed and change it immediately if needed.

[Wally P's Mom]

Fritz is eating Blue Buffalo.

[lulusmom]

Yes, for a dog with diabetes, those acth stim test results would be a serious problem, so I'm wondering why it isn't a serious problem for Fritz? :confused: With cortisol that high, you would expect a very difficult time of regulating the bg. At this point in time, I believe your vet's dosing recommendation is a real crap shoot. Lysodren's efficacy is contingent upon the level of erosion achieved by heavy and cumulative doses so unless the every other day dosing erodes the adrenal tissue enough to stim the flow of cortisol, you very well could be wasting money on Lysodren and stim tests. You also can probably look forward to more not so desirable stim results.

[Squirt's Mom]

Marge, I don't find any recalls on Blue other than for excess Vit D in 2010. Nothing connected to China and the kidney issues from their involvement. So that is a good thing!

[Wally P's Mom]

I switched him over to Wellness, to be cautious. Fritz is eating better and not as finicky.

Something is happening with him. Not necessarily bad, his blood sugar has dropped significantly on the day after he take his lysodren. All this begun after the change in food.

I doubt if it is the food. But it has been 3 weeks since his lysodren has been given every other day, wondering if his cortisol levels are dropping.

We will see as he gets rechecked next week on Monday.

Marge

[Jenny & Judi in MN]

One of Jenny's signs of her cortisol dropping was really really low blood sugar. glad you are getting him checked out!

[molly muffin]

How is Fritz acting, is he acting like he feels good? Is he lethargic at all? Diarrhea?

Sharlene and Molly Muffin

[Wally P's Mom]

Thanks Judi, I needed to hear that. It is going to make me even more vigilant in watching him. I am on Spring Break this week, so I am home. If I run a few errands, Fritz usually goes with, unless it is too cold. Spring Break here in Chicago:)

As far as behavior goes, NORMAL. You would never know that this is going on by the way he acts. Only the prick of a paw...

My vet is always a phone call or an e-mail away. My emergency kit has both pred and corn syrup in it. Luckily, we have not needed either. When his BG dropped to 60 on Sunday, a quick trip to McDonald's for a hamburger took care of his low sugar levels. Never did I imagine how much sugar is in one of those things.

Marge

[lulusmom]

Lysodren is more readily absorbed into the GI tract if given with a bit of fat so if the food you switched to is higher in fat, it very well could make a difference.

[Wally P's Mom]

You are on to something...

Wellness 14% vs Blue Buffalo 9% fat.

That is the difference!!! Cortisol must be dropping and so is his blood sugar.

I will know on Monday. I hate to bring him in early for a blood test as long as all is going OK and Fritz is not crashing. Monday will be 30 days since his last ACTH test.

Marge

[molly muffin]

Glynda is pretty smart, so I'd bet she is onto something too. :)

Just keep an eye on Fritz until then. As long as he doesn't show signs of going too low it should be okay.

Sharlene and Molly Muffin

[Squirt's Mom]

Hi Marge,

When you said you went to MacDonalds for a burger for Fritz, my stomach dropped. :eek: When I first got Trink, that was one of the very few things she would eat period so I found out real quick if there were onion and/or garlic in their "meat" - and yes there is onion. So this is not the best idea when his sugar is low as the burgers may open up a whole 'nother can of worms you do not want to have to deal with. Every fast-food joint I asked has onion in their meats - including the chicken.

Fast-foods are killing the humans in this country and certainly are not good for our babies. Which is not easy to accept as I love most fast-food joints! :p I have been appalled at the crap they put in our food since I started paying attention. It is difficult around here to find chicken the grocery stores that doesn't come from China or that hasn't been injected with "flavorings" or fed GMO feeds. And when I do, it wipes out my food budget. Only one store carries fish that doesn't come from China....anything they have touched scares me to pieces and I flat refuse to support China after all they have done to food sources.

OFF-TRACK! :D Anywho - make up some beef balls and freeze them for Fritz in the future instead of a burger from fast-foods.

Hugs,
Leslie and the gang

[Wally P's Mom]

I do know about the junk that goes into and on the "burgers". Even though there may be some onion in the burger, the other stuff that they sprinkle and add to it went down the drain as I washed it for him.

Believe it or not, he does not like home cooked burgers, especially when mixed with rice. We have tried.

Maybe if I pulled out the grill, that would help. But there are issues with eating grilled meat also.

[Wally P's Mom]

Test results from Monday are pre 5 and post 24. A little worse than last month. Do we reload or switch to Vetroly?

Marge

[Wally P's Mom]

I think we are going to reload instead of waiting 30 days for the lysodren gets completely out of his system and to keep his hormones in check.

Is the reload protocol the same as the initial load?

Thanks.

Marge

[molly muffin]

I think it depends if you are doing a full reload, if so, then yes it is the same. There is also a mini load, but I'm not sure how that works. One of the others who has used lysodren will know though.
I hope that this one stays with him.
hugs,
Sharlene and Molly Muffin

[frijole]

I'm curious what dosage your vet has suggested for the reload.

If a dog isn't maintaining a load it usually means that the dosage was not high enough. Forgive me for not remembering all of Fritz's loading numbers but you need to look at every acth test and the dosing amount and length of time. Based on this you select the dose (normally you would raise it) and you load the same as you did the last time. Test same as last time. Not sure how long you waited after the last load to do the acth test but if you see the numbers headed upward you either up the dosage or periodically give a wee bit more lysodren in a week in order to maintain that hard earned load.

If you have time to write up the loading history we could throw out some ideas. I wouldn't load at the same amount this time as I'd suspect the same results. Kim

[Wally P's Mom]

His load began on Jan 17 and retested on the 19th because of diarrhea. It was determined then he was close enough to a load and maintenance should take care of the rest.

From January,
Fritz has been diagnosed with Cushings. Results from UTK are in. Pre was 21.1 (2.0-56.5) and post was 292.7 (70.6-151.2). All the other hormones tested were elevated (both pre and post).

I went out tonight to pick up the lysodren and the pred. We begin to load tomorrow and have him scheduled for a recheck next Tuesday. At a weight of 23.7lbs, Fritz will take 1/2 500mg tablet, twice a day.

Fritz is now about 22.5lbs. His pre was 5 and post was 24. He could hardly stomach the first load, and I am not sure how he will tolerate this one. So far I have not received that information about dosage.

Any advice would be helpful as we intend to reload after Easter.

Marge

[molly muffin]

Hi, did the vet say anything yet about the reload dosage and if they wanted to up it?
I know you said you wanted to start after Easter.

Sharlene and Molly Muffin

[Wally P's Mom]

It is the same dose we initially loaded with. 1/2 500mg tablet, twice a day.

We begun loading last night.

His blood sugar has dropped tremendously. Saturday night, his blood sugar was 490 and tonight, it was 135.

I have been tracking his water for months, so a drop in his consumption will be easily detected.

So this concludes day one, and in the morning, I will know about his water. It is weighed every morning.

[Jenny & Judi in MN]

are you going to reduce his insulin? I think I would. hugs, Judi

[Wally P's Mom]

Hello All:

His insulin is adjusted with his BG readings. The vet is e-mailed to at least twice a day unless there are problems.

We have hit that wall again. 3-4doses into loading and Fritz has the squirts again. He began to load Sunday night (OK), yesterday (Both doses OK) and after this mornings dose. I don't think I need to describe what happens next.

Water on Sunday was 704mL and yesterday was 768mL. His water consumption should be less than 600mL per day.

Yes, Lysodren has been stopped.

I will measure his water tomorrow morning and see where that is at. Appetite is a poor measure for Fritz as he is a poor eater anyway. Fritz has never been one to gorge himself at the food bowl and walks away when he is full or not interested.

Marge and Fritz

[Simba's Mom]

Sending healing hugs to Fritz and an encouraging hug to Mama of Fritz, take care!

[molly muffin]

Oh geeez, sorry to hear this is happening again. :( I wonder if he just doesn't tolerate lysodren well? It doesn't seem to ever really control his cortisol and he has such a reaction as soon as you are into the load.
I'll let some of the others with experience with lysodren comment, maybe they have some ideas.

Hang in there!

hugs,
Sharlene and Molly Muffin

[Wally P's Mom]

At 6:30, his BG was 127 and he drank 651mL of water. We are close, if not there. This information has been sent to the vet and awaiting her reply.

Keep your paws crossed.

Marge and Fritz

[molly muffin]

That is good. Fingers crossed!

Sharlene and Molly Muffin

[Squirt's Mom]

You have to wonder if just passing the bottle of Lyso under Fritz's nose wouldn't be enough for him! :D He is super sensitive it seems and loads so quickly. Now if he will just hold on to it this time. Keeping our fingers and paws crossed that this is the one that does the trick and it won't have to be repeated.

Hugs,
Leslie and the gang

[Wally P's Mom]

Boy, my wallet would really like that.

We did an ACTH test this morning. I expected to do one tomorrow, but why not today.

The vet had us give him a 1/2 tablet of lysodren after the ACHT test and after his morning bowel movement.

5 units of insulin this morning, too.

Now, we wait. Fritz is sacked out in the big bed. Waiting seems to tire him out.

My parents are planning a trip to Branson and their request is that Fritz travels with them. I just accompany Fritz for medical support.

Marge and Fritz

[molly muffin]

That's pretty spiffy that Fritz gets to travel with his own medical nurse. :) It sounds like fun for all.

Crossing fingers for a good test result. Hold that load Fritz!

Sharlene and Molly Muffin

[Wally P's Mom]

Fritz also travels with his own first aid bag with stuff in it for most any occasion. We used it for Wally and now with Fritz. Some habits are hard to break.

Good news, lab results are in and we are officially induced. Let the games begin...

Marge and Fritz.

[molly muffin]

Ready, set, GO! Hope this time is better and he holds the load. Come on Fritz you can do it!
I'll cheer you on Marge :)

Sharlene and Molly Muffin

[Wally P's Mom]

Thanks Sharlene.

We almost can't believe it. Fritz had a special dinner tonight and tomorrow, it is back to business. Don't worry, it was not McDonald's. Nothing like a home cooked meal.

Fritz will be closely monitored for his BG as it should begin to tumble.

One chapter ends and another begins....

Marge

[doxiesrock912]

Marge,

I'm wondering why the vet insists on using Lysodren? I ask this because Daisy's IMS specialist at Cornell refuses to use it because it destroys part of the adrenal gland and she doesn't believe in doing this.

[Jenny & Judi in MN]

this is excellent news! have a great trip!

Jenny was similarly sensitive to lysodren but her IMS said if she ever needs cushings meds again he'd consider lysodren for her as it obviously works. we just overmedicated her

[Wally P's Mom]

I was told when we were treating Wally, that before Trilostane, some vets would destroy the adrenal and have a dog intentional go Addison's.

I think my vet has more experience with lysodren than Trilostane. Also, with the increased hormones that Fritz has, lysodren would work better than Trilostane.

Trust me, none of these were easy decisions. They were made with the doctors and my opinion.

The last 2 days, his BG has been spiking at night, before dinner. His diet has been very restricted since results were returned. I am waiting for that big drop, it does and shoots right back up.

I knew we were going on in this journey, but not on a roller coaster ride.

Our paws are definitely crossed for some stability soon.

Marge and Fritz

[frijole]

Marge,

I'm wondering why the vet insists on using Lysodren? I ask this because Daisy's IMS specialist at Cornell refuses to use it because it destroys part of the adrenal gland and she doesn't believe in doing this.

Marge has done a good job of responding and I want to add a bit more simply because others read this thread and might have the same question. Your vet is correct in that part of the adrenal gland is eroded when using lysodren. This is how this drug works. It has been effectively treating cush dogs for gosh I don't know 30+ years. Trilostane is much newer to the market.

Other drugs have come and gone - all expected to be the miracle drug but they didn't live up to the hype. Trilostane works differently. While it may be easier to administer, it is about the same in it's effectiveness. And it also has pitfalls - trouble getting the doses right, dogs can overdose on it etc.

In short both drugs work differently but have about the same level of success. Both drugs can be hard to figure out dosing and can have side effects. Dogs can overdose on both. In short the thing that is most important in my opinion is the experience of the vet and the alertness of the owner.

I hope this helps. Kim

[Squirt's Mom]

To add to what Kim has said - Lysodren only erodes, not destroys, a miniscule layer of the outer cortex of the adrenal glands during the loading phase which can regenerate rather quickly which is why the dog goes on to a maintenance dose after the load - to maintain that teensy erosion on the glands. It does NOT destroy the glands most of the time and when it does it is typically due to misuse by the vet.

Understand - Trilostane has the same potential to "destroy" the adrenals. Read the insert and you will find the word "necrosis" of the adrenals as a possible side effect.

Edited to add:

In Europe Lysodren is often used to cause permanent Addison's as they feel Addison's is easier on both the dog and the parent. Some vets in the US feel the same way. But that is not the way it is most often used here. But again, Trilostane can also permanently destroy adrenals. Both are life savers - both can cause permanent damage even death.

[Tina]

Kim and Leslie, thank you SO much for your posts with additional clarification about the choice to use Lysodren rather than Trilostane. I am always hesitant to post on other members threads since Jasper's outcome with Lysodren was not ideal, even though my vet is experienced and I followed her orders and instructions regarding loading to a tee and watched him like a hawk. We have since learned that Jasper was abnormally sensitive to the Lysodren, (and other medications), and nothing about his treatment has followed the normal expected course. There was obviously no way to know this ahead of time.

My vet recommended treatment with Lysodren because she was more experienced with it, and she and the other vets in the clinic have had more long term success using it, rather than Trilostane. She discussed that there was the potential for severe risks with both meds. So I chose to treat with Lysodren based on detailed discussion and recommendations from my vet, and like Marge said, it was not an easy decision.

Kim and Leslie, I appreciate you chiming in with expert clarification, because my guilt feelings always resurface whenever I read things that either say or imply that treating with Lysodren is less safe than treating with Trilostane. While logically I know that I did everything right with Jasper (thanks in large part to all of your feedback on this forum), it doesn't take much for my heart to kick in and worry about my treatment choices all over again.

Again, I am always hesitant to post comments to others who are going through this, since things with Jasper did not turn out as we had hoped and planned. I would never want to scare anyone, or cause additional worries. But even though he is likely now permanently Addisonian (we will know for sure in about a month when we check his cortisol again), right now, and I stress right now, we seem to have things under control, and he seems to be feeling good for the most part and is a happy boy. So even though some things went wrong and we now have additional issues to deal with, it is possible to come out on the other side. Thank you again Kim and Leslie, love you both. And hang in there Marge. I am hoping you get some stability soon for your precious boy.

Hugs,
Tina and Jasper

[Wally P's Mom]

Hello Tina:

This is sadly not my first time here with a cushpup. My Wally was a cushpup, also. He was a hard diagnosis and did not follow the textbook when it came to Cushings.

We, too, followed the rules and watch him like a hawk with the lysodren. Within a matter of months, Wally went Addison's. We, too, were told that he could revert back to Cushings, but it never happened. Never did I doubt the treatment that I followed with him with either Cushings or Addison's diseases.

My vet did caution me that an excess of trilostane could lead to Addison's just like lysodren. I think the main reason I did not switch for the second load for Fritz was because I could not treat Cushings for a month. His diabetes would go crazy amongst other things.

Honestly, having been on both sides of this fence (now more than once), I could not tell you which side I had rather be on. Personally, neither. With both conditions, you are dealing with the possibility of sudden death. But, the support that you get here when you need some one to understand and get you through the ugly stuff is amazing. We learn and support each other. You should never be afraid to share what you know.

My vet is terrific and has been in constant (7 days a week, 24 hours a day) communication with me. Yes, holidays included. Being the team that we are, we both have been open and willing to learn from each other. Not always can you have this type of relationship with your vet.

Hang in there Tina, I know exactly what you are going through and where you have been.

Marge

[doxiesrock912]

Marge,
where is your vet? He/she sounds priceless!

[Wally P's Mom]

I live in the southern suburbs in the Chicago area. If this is close to where you live, I will be happy to send you contact information.

[Wally P's Mom]

Hello All:

Struggling to get Fritz to eat which is really important with his diabetes. Any ideas?

Forget the rice and hamburger, he won't touch it. Nor steak and eggs...

We have tried almost everything.

[Budsters Mom]

Have you tried baby food chicken, beef etc. in the jars? It is easily digestible and doesn't have to be chewed. You can put a little bit at a time on his tongue and he can lick it off. I am so sorry to here that Fritz isn't feeling well. My thoughts and prayers are with you and your precious boy.

By the way, do you want to loan out your vet to someone in California? He/she sounds like a gem! I could desperately use a really good vet! Ha!

Kathy and Buddy:)

[doxiesrock912]

Thank you, but I'm in Connecticut.

[Harley PoMMom]

Baby food is a good idea but make sure it contains no onions. Usually, when it comes to food a dog will follow there noses, so the stinkier one can make their food the better chance the dog will eat. Adding one of these on top of his food might entice him: Parmesan cheese, tuna water, sardines water, a bit of tuna or sardines or just warming his food in the microwave. Hope Fritz is eating better real soon.

[frijole]

I had a dog that refused to eat every day for over a year so I know how tough it is. Alot of the things I used had too much sugar/corn syrup for a diabetic but someone told me to take the dog food (canned) and put it in the oven and heat it up. (sliced) It did seem to work as the flavors were more vibrant. But if he's refusing steak I'm not sure how to top that.

Do you think he has tummy issues? Have you tried giving him pepcid ac? Again check with your vet because of the diabetes. Have you tried tripe dog food? It is a disgusting smelling fishy thing but most dogs love it.

Have you tried cooking some white rice and simply putting chicken broth on it? Perhaps if the tummy is upset it is looking for something easy to digest? Gosh I wish I could give you a magical cure. Kim

[molly muffin]

Oh gee, poor Fritz. Well, he has to eat, so those stinky things might work and anything that you can smear on his tongue. I've also tried making a game of the food. Throwing a piece that she'll attack and eat and then once she's done this with a few pieces her appetite seems to kick in and then she'll go to her bowl.
Hope Fritze starts to eat soon.

hugs,
Sharlene and Molly Muffin

[Wally P's Mom]

I got him to eat some Blue Buffalo Beef Stew and some turkey from Boston Market. The Blue Buffalo was eaten only after I told him Maria said to eat it. (That's his doctor. He listens to her.)

I like the idea of the Parmesan cheese. Do you use the dry stuff or the stuff in the cheese section?

Tuna is not a bad idea either. Baby food, I am not sure about. We might have tried that before.

His BG right now is through the roof, but slowly coming down. Last night he had the "chills". No temp, but we were told to give some pred in case his cortisol dropped to low. Today, Fritz was better, played. No appetite, but he played.

He is not your typical daschund. A food hoarder.

Thanks for your help.

Marge

[Wally P's Mom]

I am sure they both would love to travel to sunny California. It's a husband and wife team. But, Fritz needs them too much.

[Jenny & Judi in MN]

I'm glad you got him to eat. When Jenny's cortisol got low and she didn't want to eat I bought some of the Wellness canned grain free stuff and would put half an ounce of that on top of her better-for-a diabetic food. That worked with her.

[Mel-Tia]

Hey Marge

Just wondering how you and Fritz are doing? Hoping he is tucking into that steak (lucky fella)

Big hug

Mel
Xxxxxx

[Wally P's Mom]

Hello All:

I thought I would update you on how Fritz is doing. We went to the vets last Wednesday to have him checked over.

We had a chem panel done and a UA done. His BUN is still high and now his creatine levels are now slightly elevated. The UA showed some bacteria growth, so we are hoping with antibiotics things will go back to normal. I am really afraid of the fact that his kidneys could be starting to fail. The vet does not think that is the case.

I was worried about his cortisol levels dropping too much. However, his Na/K ratio was good. It helped having experience on the Addison's side of the fence with Wally. ACTH in about a week.

The good news is that his ALP has decreased by half.

Fritz is taking an appetite enhancer to get him to eat. He takes 1/2 tablet every three days for 5 doses.

He is still not eating dog food. Last night it was a chicken shish ka bab and rice. This morning it was lowfat salami. Whatever I can get him to eat is what he is eating. I told the vet that he only eats what I do and I must eat it first before he does. I think he was royalty in a previous life.

His blood sugar throughout this ordeal has been pretty good. This morning it was 166.

His weight is holding.

In this case, you celebrate as much good news as you can. When you need to worry, then you do. I don't want to waste any time that I have with him worrying about what could happen or eventually will. At his age (14), we live each day to its fullest.

Marge

[Wally P's Mom]

Judi:

We have tried the Wellness, canned and dry grain free foods.

No. He ain't touching it.

I ,too, have thought about his cortisol dropping low.

Marge

[Boriss McCall]

Yay Fritz.. Glad you & your mama are living every day to the fullest. That is so much more fun than worrying.

[Simba's Mom]

Just one day at a time is all we can do, hope Fritz starts eating better, sending hugs!

[Harley PoMMom]

Hello All:

We had a chem panel done and a UA done. His BUN is still high and now his creatine levels are now slightly elevated. The UA showed some bacteria growth, so we are hoping with antibiotics things will go back to normal. I am really afraid of the fact that his kidneys could be starting to fail. The vet does not think that is the case.



Since bacteria did show up in the UA, this could be the reason for the elevation in the creatinine.

Hope the sweet boy starts eating normally soon.

Sending love and hugs,
Lori

[molly muffin]

Well, you know that isn't all that bad from the sounds of it. A very bumps maybe but the major stuff seems to be doing okay.
Maybe he just decided that when it came right down to it, your food taste better than his and he can pretty much guarantee that if you eat it, then it's going to be good :) At 14, who wants to argue about it, LOL
I think that is a fine philosophy, just enjoy each day to the fullest. Something we all should try to do no matter what.

hugs,
Sharlene and Molly Muffin

[Wally P's Mom]

Hello All:

Happy Memorial Day to all that has served and to all that has had a loved one serve and was lost.

Quick question:

Fritz is currently battling dry flaking skin and the loss of fur. His coat is brittle to touch.

He is taking Flax Seed Oil, Fish Oil, Free Fatty Acids and using a spray bath with fatty acids in it.

The medicated shampoo that the vet has prescribed is not helping, but making matters worse.

He bathes about once a month, typically.

The thought is the medicine could be doing this to his coat.

I know this is the least of my worries, but any ideas on how to stop the flaking. The vet did not like my "Head and Shoulders " suggestion. The pH is off for a canine.

Thanks for your help.

Marge

[doxiesrock912]

Daisy had a bacterial skin infection which caused the same symptoms. She needed antibiotics (Baytril worked great) and I shampooed her twice a week for the first 4 weeks, then once every week.

Could be the problem with Fritz?

[Jenny & Judi in MN]

I'm glad you are getting his royal highness to eat something! good luck with the skin

[addy]

I know that feeling, we are dealing with seborrah (oily and dry) with hair loss and minor yeast and bacteria which is still surface not deep with in the skin. I had a scraping done.

When you say the medicated shampoo is making it worse- which shampoo and how is it making it worse?

[lisamak]

Sorry that your Fritz isn't a big eater these days. Here's some recommendations for "tempt to eat" that I use for just about any inappetance cause:

Weruva Paw-Lickin' Chicken - just gravy and shredded chicken, generally you can get the dog (or cat) to drink enough gravy to kind of prime the pump and get things going

Evanger's Whole Chicken Thighs and/or Hunk of Beef - again, just meat in gravy...if the belly is rumbling because its empty (therefore acidic) then water down the gravy a bit and try it first

Honest Kitchen's Ice Pups - a powdered broth you make fresh, with a little bit of warm water (I serve it in miso soup bowls)...its chicken + turkey + asparagus + herbs and I've not seen a dog or cat refuse it (you can also freeze it in ice cube trays and add to water to get animals to drink more on hot days, when they're dehydrated, etc.).

As for the skin issue, are you using Malaseb/Malaket or a similar anti-fungal shampoo? Sometimes they can be too strong depending on what the problem is. A skin scrape is probably in order to see if its an infection or if its just a side effect of meds. A soothing shampoo/spray I like for skin issues is Ark Natural's Neem products. Neem is a natural anti-fungal and is also soothing to skin/coat (and its good against flea and ticks).

Also about the oils you're giving, I use Ultra Oil (hemp-seed primarily but has fish oil, other oils added) and prefer it to use a fish oil and and a bunch of others. Its a balanced 3-6-9 so means you get it all in one bottle. I also use coconut oil (I use Cocotherapy but you can use any human-grade, extra virgin, organic coconut oil from market/health food store). My youngest gets oily and flaky on his back end for no good reason and the Ultra Oil (and previous oils) weren't doing enough...adding the Coconut Oil definitely helped (it also tastes delish and may help with Fritz's appetite issues). Its great 'cuz I can then rub any leftover oil on the spoon into my hands or directly on their fur if anybody's itching at a particular spot.

~~Lisa and Vince

[Wally P's Mom]

Hello:

Thank you for all your suggestions.

We were using Malaseb and that was drying his skin even more. The vet says it is not a bacterial infection.

We have been using a bath spray and shampooing him with Alveeno Baby Shampoo. (all natural and hypoallergenic). The flakiness has ceased. The shedding continues, but we are also seeing new hair growth.

We went through something like this with Wally, but he was more gooey, tar-like and shedding.

After that, Wally grew hair like he had never had hair.

Hoping the same thing happens for Fritz.

Marge

[Wally P's Mom]

Hello Gang:

I come to the well of knowledge here again.

Fritz has finally become more stable with his water consumption, eating and insulin.

He drinks about a 1/3 of what he used to and his insulin has dropped that much.

His eyesight is still there, but he does have some crystals.

Last night I lowered Fritz off the bed and as gently as I placed him on the floor, he went splat. Back legs gave out and walked wobbly. His head is tilted. I checked his BG and it was high about 338.

We went in to see the vet. His regular is on vacation so we saw Fritz's back up. He was checked over for acid ketosis, vestibular syndrome, and of course his back and neck. No on the first two conditions. No ketones in his urine, no rapid eye movement. He had deep pain feeling in his hind legs and his right front leg was slow to respond. With the tilt to his head, the thought is neck issues. He is taking tramodol and previcox. I sent a picture of Fritz to his Dr on vacation and she is thinking that the lack of appetite and the tilt head could be the start of vestibular syndrome.

Since last night, Fritz walks much better and the head is tilted unless distracted. His appetite is in the toliet again. Tonight he was offered chicken, steak, brisket, cat food and cheese. He ate some cheese.

I am worried. So I am willing to entertain all suggestions and words of support. We need it and I go back to work on Monday. Ugh.

Marge

[Harley PoMMom]

Oh Marge, I am so sorry to hear that sweet Fritz is not feeling well.

If it is vestibular syndrome, I believe dramamine can be given to help with the motion sickness.

Does Fritz like tuna? If so, I am wondering if he would eat some now or even try just drizzling some of the tuna water in his food and then warming it in the microwave.

I do hope his appetite picks up real soon, sending huge hugs to you both, Lori

[Budsters Mom]

Marge,
Sending you an Fritz mass hugs and healing energy. It makes it that much harder when you have to go to work knowing that your baby's not feeling well. Have you tried strained baby food like chicken or beef? Sometimes they can be enticed to lick it off your fingers. Just a thought.
Kathy

[Wally P's Mom]

Thank you all for your support.

I did try the baby food. If anything, it was an enticement to eat something else. We are still struggling to get him to eat. Fritz is currently eating about half of what he used to and that is even using meds to get him to eat.

Starting last Monday, he developed a bad dose of the shakes. They come and go. Last night, the shakes came when I was trying to get him to eat and did not leave until mid-morning. While not constant, they did disturb his sleep last night and he tossed and turned all night. It is like he is restless. The shakes are like a frightened dog at a vets office and teeth are chattering. No, the AC is not cranked because I am sweating thinking he had the chills.

I asked his vet and she is unsure of what is going on. She is thinking that his cortisol levels are dropping effecting his appetite and his shaking.

Water consumption is averaging about 440mL per day.

His mobility is good and better than the neighbors dogs. His head tilt is straightened up. Vet thinks it was just a pinched nerve. Both ends are working as they should.

Any thoughts?

We are doing an ACTH on Thursday. Work prevents me from doing it tomorrow.

As Fritz and I journey together, he is taking his own path and not one that I am familiar with.

Thanks.

Marge

[molly muffin]

My thought would be that the cortisol could have dropped. I would get a blood test though and have kidney's looked at too, for any problems there. Make sure his electrolytes are good.
Those are the things that come to mind off the top of my head. Without the tests there is no way to know for sure and just guessing.

I hope that you can get this figured out. Fritz is a lucky guy to have you working so hard for him. :)

hugs,
Sharlene and Molly muffin

[Wally P's Mom]

Kidney values are slightly off, as well as his Potassium. But nothing dramatic to cause these problems. Sodium/Potassium ratio was OK, so not Addison's. ACTH on Thursday.

[Wally P's Mom]

ACTH was moved to this morning due to his shaking last night. His vet thinks he could be Addison's based upon physical symptoms and food/water consumption. Fritz has lost 1.5lbs since last Monday. Waiting for his results, the hard part.

Marge

[molly muffin]

Oh my gosh. Did they give you any prednisone just in case?

Sharlene and Molly Muffin

[Budsters Mom]

That is so scary! I am so sorry to hear that. :o I certainly hope he feels better very soon and they get a handle on that! Big hugs to you both!

[doxiesrock912]

That's scary. Daisy was close a few times , but I recognized that she was off right away. Hoping that he does better soon!

[Wally P's Mom]

With all the trouble he has had eating, bacterial infections and a tilted head, diabetes, it was hard to see the forest in the trees. So many meds.

A good journal helps. I actually reviewed it with one if his Drs. today.

Yes, I do have pred on hand. I have had it from day one.

I will let you know what his results are.

Keep us in your good thoughts.

Marge

[Wally P's Mom]

Hello All:

If this don't beat all. I am really hoping that Judi chimes in and helps with this one.

Fritz's labs came back this morning:

Pre 1.0 Post 1.1
K 6.3 (4-5.5)
Na 144 (141-156)
Na/K ratio 22 (>25)

Conclusion: His Cushings is being well controlled as it is flatlined. However, his Na/K ratio indicates that he is trending towards Addison's.

Diabetes has been steady with his AM read averaging about 325 and his PM read about 270, with 2 units of insulin given.

Last night was another restless night, back up at 3:00AM. This time he was uncomfortable and his color was a little off. At midnight when I got him out from under the bed, he was like a wet dish rag. After reading Judi's comments and the rest of the groups and replaying the talks that I had with one of his vets, I dug out the pred and gave him 1.25mg. He slept soundly and calmly the rest of the night. Color was better in the morning and a second dose was ordered by his vet.

His appetite and activity was better today than it has been in weeks. I wonder where my Fritz has been.

His current treatment plan is stopping the lysodren and giving 1.25mg of pred daily for the next week and rechecking his ACTH and electrolytes to see if they have improved or decline.

As I explained to my husband, it is like we are trapped between 2 diseases, Cushings and Addison's.

Has anybody been here before?

Fritz is marching to his own drummer.

Marge

[Budsters Mom]

I am so sorry that I can't help you with these numbers. I just wanted to pop in and give both you and Fritz great big hugs. You're doing a great job Marge. Doesn't this Cushing's thing suck? Xxxxx

[molly muffin]

Wow, it does sound like he was trending towards Addisons, if the prednisone has made that big of a difference.
Hopefully yes, Judi will see this too. Did you also post this over at k9diabetes in case she sees it there before here?
I'd see how the diabetes does while on the pred if it stays okay or you might need to adjust up a bit on the insulin, then his numbers need to be higher than lower for cortisol. Not high, just higher than it currently is for him to feel good.

hugs,
Sharlene and Molly Muffin

[Wally P's Mom]

Yes, it does suck having Cushings even if it is your second time around. My Wally also had Cushings. He passed away 1 year and 4 months ago. It seems like a lifetime ago considering all that I am going through with Fritz.

No, I did not post to K9 Diabetes because I forgot my username and password.

All I was told was that if it is Addison's, life would be easier.

Marge

[doxiesrock912]

Marge,
we came close to Addisons a few times with Daisy. Luckily, she lost her appetite immediately when things weren't right so I knew to stop the Trilo until she regained her appetite. I have no experience with Lysodren, but other health conditions certainly factor into this. Daisy had an underlying infection that was also playing a part in her adverse reaction to Trilo.

It's a seesaw until you find the right match.
You know Fritz well and that will be your best indication of what is working and what isn't.

It sounds like the Prednisone is helping. That is good news!

[Tina]

Hi Marge,

I just saw the latest on Fritz, and I am sorry you are both going through this. My Jasper became over suppressed on Lysodren last August and had an Addisonian crisis which resulted in 2 hospitalizations. It seemed to happen suddenly a few days after his stim test results came back really low. I think his pre and post levels were both 0.5, which are lower than Fritz's results. But Fritz's are on the low end of the desired range of 1-5 ug/dL for treatment with Lysodren.

Great job with giving the prednisone. I am concerned with the Na/K ratio being so low and the elevated K. Your vet is obviously aware of these values, and didn't think that IV fluids were warranted to try to get the potassium down? When over suppression due to Lysodren occurs, aldosterone can become over suppressed in addition to cortisol, which causes the electrolyte imbalance. Sometimes the Na goes low also in addition to the K being elevated. It looks like Fritz's Na is in the normal range, but getting down to the lower end. IV fluids and medication can be needed to stabilize the electrolytes, along with prednisone which supplements the low cortisol.

He needs to be monitored closely for the usual symptoms of decreased appetite, vomiting, diarrhea, low energy or lethargy. And with diabetes in the mix also, his food intake and insulin will need to be watched even more closely. I don't have experience with how diabetes affects all of this, so I can't comment on that.

How much does Fritz weigh? If he doesn't bounce back pretty good, he may need more of a prednisone boost and the 1.25 mg daily may not be enough. You will need to evaluate that and check with your vet.

When Jasper's crisis happened, he seemed to be doing fine even with the low cortisol, I didn't see any warning signs. He suddenly seemed to crash, with uncontrolled vomiting. I was lucky and was able to get him to the vet within a couple of hours and that is when the electrolyte imbalance was found. He was hospitalized and given IV fluids, dexamethasone injection, and a Percorten injection to correct the aldosterone over suppression.

Your treatment plan sounds good, just monitor to see if a bit higher dose of pred might be needed. And for sure, no more Lysodren for now. I hope Fritz is stabilizing for you, and he will continue to improve with the prednisone. Hang in there Marge, we made it and so will you and Fritz.

Hugs,
Tina and Jasper

[Wally P's Mom]

Thanks Tina for your encouragement.

We made it through last night with just a trip outside. We froze in bed while keeping Fritz comfortable.

He had a few tremors this morning while I was checking his BG, but he was also due for his pred. And a few again tonight while he ate his dinner.

His appetite tonight was half way decent. His BG was high, but that could be due to the pred. Somewhere there is going to be a happy medium.

His "crash" was a decrease in appetite and water consumption. Considering how picky of an eater he is, we all assumed it was something else.

When my other doxie crashed, Wally , he puked every time I got ready to leave to go to work.

With Fritz, both ends are functioning properly.

In a week, we will retest him and check his lytes and his cortisol levels. Then a decision will be made about the DOCP (percorton) injections. So it was good that you commented about the aldosterone levels and that injection. When Fritz was diagnosed, we did the UTenn panel and that hormone was also elevated.

Fritz weighs 19# and if I remember correctly I calculated that he needed 1.29mg of pred. The vet wanted him to have 1mg of pred. I have 5mg tablets at home and quarter them.

Fritz is well documented. He has a calendar that tracks his BG, units of insulin, what he eats and how much and what he drinks and how much. Plus test results and changes in meds. This calendar goes with him to the vets office all the time. No need to be worried about not being watch. In fact I timed the whole start of his crash when his vet left the country for vacation. (Wally crashed about the same time in the year also.)

I am hoping that with each day, Fritz will improve.

He marches to his own drummer.

Marge

[Squirt's Mom]

I love folks who march to their own drummer! :)

Hang in there, Fritz! We're all pulling for you and know you have a super Mom by your side.
Hugs,
Leslie and the gang

[molly muffin]

Fritz is just Fritz, his own unique little self. :) Hopefully he'll continue to do good on the pred in combination with this insulin and who knows, it might even up being an easier time of it to keep the BG at even levels.

hugs,
Sharlene and Molly Muffin

[Wally P's Mom]

Hello All:

I think we took a step backwards last night to move forward.

Fritz had the trots last night and of course it was in the middle of the night. His high BG (about 480) and pred explains this.

I think we are almost back to square one and trying to get his BG regulated.

Appetite is not so good today with his problems last night.

Fritz rests comfortably today.

Keep your fingers crossed.

Marge

[doxiesrock912]

Awww. Trots are no fun for anyone. Hoping that things improve soon!
Hugs to you and Fritz.

[Wally P's Mom]

Hello All:

Fritz went back in for his recheck ACTH and lytes yesterday and his appetite has tanked.

His lyte ratio was 24 and his pre and post ACTH were 0.2.

He is on the Addison's path now and begins DOCP today.

Wish us luck. We begin again.

Thanks for all your help over the past weeks and months. I know that we always have friends and a home here.

Marge

[Bo's Mom]

Healing thoughts going to Fritz. Please keep us updated.

[Trixie]

Hoping Fritz gets leveled asap. Sending positive thoughts that he feels more himself soon, with appetite back too.
Barbara

[Harley PoMMom]

Hello All:

Fritz went back in for his recheck ACTH and lytes yesterday and his appetite has tanked.

His lyte ratio was 24 and his pre and post ACTH were 0.2.

He is on the Addison's path now and begins DOCP today.

Wish us luck. We begin again.

Thanks for all your help over the past weeks and months. I know that we always have friends and a home here.

Marge

Hi Marge,

Gosh, I am sorry to hear this latest issue with Fritz. :(

Has the vet started him on prednisone along with the DOCP?

[molly muffin]

The prednison and Docp will help. We've had other members go through this. Tina's Jasper is currently Addison too.

Her thread is here: http://www.k9cushings.com/forum/showthread.php?t=4372

if you want to give it a browse through and you can see what their treatment steps were.

Hang in there! :)
Sharlene and Molly Muffin

[doxiesrock912]

Marge,
now Fritz is on the opposite end of the spectrum. Poor guy.

Prayers coming for you and Fritz.

[Wally P's Mom]

Yes, Fritz is taking pred and getting his DOCP every 28 days from here on out.

Fritz began his pred last week and hoping that we would see a change in his cortisol levels. Last week's ACTH test came back as a well controlled Cush pup. This week's test was definite for Addision's.

It was hell being between diseases.

Addision's is not a new road for me, we went down it with Wally. I just hope Fritz's path is not identical.

Marge

[Wally P's Mom]

Hello All:

Fritz and I are still here. Fritz was diagnosed with Addison's last June. His diabetes is considered to be well managed. With the warmer weather, we can go out an walk. His monthly BG average has dropped 30 points since last month. We are a little lower now than we were in January.

His eye sight is fading. We think he can only see shadows now, if that.

His Addison's is in check. I give him his DOCP injection here at home. When I need a vial,Fritz gets a check up.

In March, we celebrated his 15th birthday. Every day that I spend with him is a gift.

Hoping all is well with you.

Marge

[doxiesrock912]

Marge,
15! That's wonderful! Happy belated birthday Fritz.

[Wally P's Mom]

Thank you.

We celebrated with corned beef (a St Patricks day birthday) and passing out bones to his bow wow buddies. Since Fritz needed his annual check up, we made breakfast for the vet's office.

[goldengirl88]

Wishing Fritz a happy birthday. You have a great system for keeping track of all his results. I am sure that played a part in him turning 15. Blessings
Patti

[Squirt's Mom]

Happy Belated 15th Birthday, Fritz!

[molly muffin]

Marge! So great to hear from you and major whoo hooo for Fritz!!


HAPPY BIRTHDAY 15TH FRITZ!!!!!!

So good that his BP is doing well and his diabetes is under control.
He sounds like a happy camper. :)

Sharlene and molly muffin

[Wally P's Mom]

Hello Friends:

I know it has been a while. Fritz and I have been doing our thing. Diabetes has been well managed. He went blind about 6 months ago. Nothing I could have done would of stopped that. But we have managed. His Addison's disease has been OK. Some stomach issues, but tweaking his diet has helped. New problem crept up on us this morning, I think he now has back issues. Trouble walking and a slow response on the left side to deep pain. There is one, but it takes a while. He saw a Sunday vet this morning that prescribed some tramodol and he sees his vet tomorrow. His vet knows as she saw the videos of him trying to move.

I know I have been blessed to have him by my side for close to 16yrs. I also know that back issues take time to heal. Not sure what tomorrow brings, but I am not ready to send him to Wally just yet.

Keep us in your prayers.
Marge and Fritz

[molly muffin]

Limit his movements, no going up or down steps, no jumping on furniture or anything that can aggravate his back. It took my molly about 6 weeks to recover from a back issue last winter.
An xray will show what sort of damage you might be dealing with.

[Harley PoMMom]

Oh Marge, I am sorry to hear that dear Fritz is having some issues :( and I hope the tramadol will alleviate that pain. I am sending some healing white light and soothing hugs, keep us updated.

Hugs, Lori

[Wally P's Mom]

We saw the vet on Monday. He is about 90% back to where he was. A little PT, good meds and a pack n play to keep him confined.

Keep him in your thoughts as next week will be difficult as his vet is going out of town. But made a follow up appt just in case.

Marge and Fritz

[Squirt's Mom]

90% recovery sounds good! Keep up the good work Mom and Fritz! I hope the week goes by swiftly and with no events to report. ;)

[Wally P's Mom]

A small set back over the weekend, but shows signs of progress as the day went along today. We go back to the vet tomorrow and hoping for good things.

[molly muffin]

oh hoping for good results. Small set backs happen. It's the larger picture that counts. Crossing fingers.

[Wally P's Mom]

Hello Friends:

Just a quick check in. Neck is better. Left leg may always be weak. We just completed his laser treatments. Fritz is much better now than when things started 6 weeks ago. We have tapered the pred back to his daily dosage and keeping him on the tramodol. (Pred for Fritz is a good thing because he is Addision's. For the rest of you, it is a dirty word.)

Because of his failing eyesight, I bought him a pair of sunglasses. Bright light bothers him. He will wear them without a fight while being held. Walking and wearing them is a different story. The tech at the clinic said he looked like a pilot.

On the 17th of March, we celebrated his sweet 16. He had corned beef. We passed out bones to all of his canine friends.

Keeping all of you in our thoughts and prayers.
Marge and Fritz

[Squirt's Mom]

Happy 17th Birthday, Fritz!

[molly muffin]

Happy Birthday Fritz!!

whoo hooo 17!

Well it does sound like he is doing better now and that is a good thing.
Poor guy, just going to have to take it easy on that leg from the sounds of it. It might strengthen a bit though with the gentle exercise routine or hydrotherapy even. Hope so.

It's hard to keep a good dog down, so the saying goes. I believe it!

[Harley PoMMom]

Happy Birthday, dear Fritz!!!

[Wally P's Mom]

Thanks for his birthday wishes. He celebrated his 16th birthday this year on St Patrick's Day, the 17th. This year we are working on getting him to his golden birthday, his 17th. So we are celebrating that birthday all year long, so I guess you could wish him a happy 17th, if you desire.

Marge and the birthday boy, Fritz.

[doxiesrock912]

Happy Birthday Frtiz!
I have a friend who has several Pekingese. Poor breed is plagued with back issues. Once they start to feel better they will test and likely overdue it so setbacks can occur.

It's hard to keep them still as I'm sure that it is with Fritz. They probably think their being grounded and can't understand why.

[judymaggie]

HAPPY BIRTHDAY, FRITZ!!

Abbie hopes you get lots of yummy treats and gentle hugs! :D

[Wally P's Mom]

Hello All:

I have come to this family for many years when I need some support. Here I am again...

Fritz went down with a pinched nerve in his neck last week. I know the recovery takes time. The vet had said that he moves which is a good thing. Yesterday after his laser treatment, he stopped walking in the yard and urinating laying on his side. He still walks in the house on both carpet and tile. He eats and drinks. 95% of the time, he makes it outside.

His diabetes and Addisons is well managed.

I don't know if this is his way of telling me that he is done with all of it or just to have faith and in time, all will be OK.


Thanks for letting me vent. I just don't know what to do.

Marge

[addy]

Oh Marge, I am so sorry to read this. Pain can take its toll.if the pinched nerve takes time, it just may be about the pain. I know it is hard to see Fritz laying down like that.
Sending huge hugs and hope that things are better.
Without knowing more, I would hope you will see improvement. Dogs can get depressed and I would not go to those other thoughts just yet.

[Wally P's Mom]

Thanks for the words of inspiration. The vet said his left side was weak still after watching his video. I gave him a little of tramodol and it helped perk him up.

Fritz just needs time.

[Squirt's Mom]

How is Fritz this morning? Did he rest well last nite? Bless his heart...and yours, too, Marge. I hope the Tramadol helps and he bounces back soon. You know we are by your side all the way.

Hugs and gentle belly rubs,
Leslie and the gang

[Wally P's Mom]

Thanks again for your support.

Last night Fritz got up around 3:00am and was up until 4:30am. He stood as he urinated. He paced the house. I fed him and gave him his meds and finally off to sleep he went.

This morning, Fritz was moving around better. I gave him his midday tramodol. In a little while, he goes back to the vets for a laser treatment.

Fritz was supposed to go on vacation next week. It is postponed until spring. It's hard to be 10 hours away from his medical team.

Keep us in your thoughts and prayers. Fritz is fighting and so must I.

Marge

[molly muffin]

I'm really glad to see that Fritz is doing better. Those pinched nerves really do take a while to get through, so this may just be all part of the recovery period since everything else is well controlled.
When molly had a problem with her back, it was about 6 weeks of minimal activity and she wasn't nearly as bad as Fritz was, still it just takes a bit.
You're doing great though. Fritz has always had excellent care with you and the family.

hugs

[Harley PoMMom]

I, too, am glad to hear that Fritz is feeling better. Since the pain meds seem to make him more perky I wonder if giving him more doses throughout the day would be beneficial?

Keep us updated! You and Fritz are in my thoughts and prayers.

Hugs, Lori

[Wally P's Mom]

Hello All:

Fritz saw his GP on Monday for laser. With his blood sugar rising to the point the meter no longer reads, his pred was lowered by 1mg and suggested that we see a neurologist and get a MRI. I agreed to see the neurologist, but no MRI. I didn't want put him under to do a MRI at his age.

What we did find out was that not only is it a neck issue, but also some soreness in his spine.

With left with a script for gabapentin that because it was such a low dose required to be compounded. We started it this evening and need to wait a couple of days to see if it works.

There are days where it looks like things are better and others that don't. We may have to accept that this maybe the best he can be, but he is in better shape than other dogs I know.

Keeping hopes high,
Marge

[Wally P's Mom]

It's working and working very well!!!:)
The tapering of the pred has begun and I have taken him off the Tramodol.

It's nice, no great, to have my pup back.

[Squirt's Mom]

YAY! Wonderful news!

[molly muffin]

This is great news!! Glad he is on the mend. :)

[Wally P's Mom]

Hello All:

It is with great sadness that I post that my best buddy, Fritz, has passed and joined his friend, Wally at the bridge. Fritz was 16 1/2 years young. He bravely battled diabetes, and Cushings and Addison's, and most recently Cervical neck disease. It was not any of these that took him down but a primary brain issue. My husband and I could no longer see him suffer with the neck and brain issues so we gave him one last gift. We let him cross peacefully and pain free over to the rainbow bridge.

Godspeed my boy, Fritz.

Marge

[Harley PoMMom]

Oh Marge,

I am so so sorry and my heart just breaks with yours. Fritz sure was a fighter and with your deep love and devotion he was able to overcome many obstacles, and it is with this same deep love and devotion that the painful decision was made to let him go. It is very difficult losing our beloved furbabies so please know we are here for you.

With Heartfelt Sympathy, Lori

[SuperCupcake64]

Wow, what a great long life he had with you, and how strong he was! I lost my own boy Saturday morning. Loving our pets enough to let them go is incredibly difficult. I empathize, sympathize, and hope each day is a little bit better for your family.

Jen (and Maizie, and Sammy in heaven)

[Squirt's Mom]

Oh Marge, I am so so sorry to hear about our sweet Fritz. He was such a trooper and fought with all he had, as did you. I know Wally is thrilled to be running and playing with Fritz again but I also know your heart is shattered, missing them both so badly. You are a great mom, Marge, both your boys so blessed to have you.

Our thoughts and prayers are with you as are our deepest condolences,
Leslie, Trinket, Brick, Sophie, Fox, Redd, and all our Angels.

[judymaggie]

Marge -- my sincere condolences to you and your husband for the loss of your dear Fritz.

[molly muffin]

I am so sorry. :( My sincerest condolences. I know it is the greatest gift to them, to take away the pain, but it sure is hard on those of us who are left behind.
Take care of yourself during this heart breaking time.

[Wally P's Mom]

Thank you, all, for your thoughts and kind words during this difficult time.

I think, in hind sight, I may have figured out exactly what had happened to Fritz. Every symptom that he had could very well be explained away by something else, except his head tilt. I am truly grateful that his vets and myself never figured it out. As cruel and as selfish this sounds, Fritz enjoyed an extra couple of years with us living a relatively good life. Knowing now what I do, I would of released him much earlier because his age would of made surgery or treatment difficult. Throughout all of this, he was never in an ounce of pain or suffering. The last 12 hours of his life was the worst for us to watch, but never once did he cry or whimper in pain. For the most part, Fritz slept as if nothing was ever wrong. Only when he got up, it was difficult for us to watch.

Sunday was a day of sadness and heartbreak. Monday was a day of gratitude. Gratitude for having Fritz as long as I did. Gratitude for his vets, vets techs, pharmacist, support groups and anyone else that came into our lives.

I don't know what today will bring. It will be my first day at home without him and alone. Sunday, my husband was home and yesterday, I kept busy away from home. Time will help establish a new normal.

Even though, Fritz never barked much, the house is so quiet without him.

Much gratitude to each of you for your advice, support and love over the years.

Marge

[mytil]

Oh Marge, I am so incredibly sorry! My heart is with you all!!!!
((((hugs))))
Terry

[Wally P's Mom]

I never thought I would be one here posting a week after the fact, but here I am. In my heart, it seems like it has been forever.

Fritz passed one week ago and even though I know what caused his death, doesn't make the heart ache less. Yes, I am filled with gratitude knowing we didn't find it sooner, but I am still filled with an ache in my heart. I was told these are normal signs of grief.

During the passed week, I shopped (I hadn't bought groceries in almost a month. I couldn't leave him.); baked cookies; had the carpets cleaned (His own scent trail.); and I picked up my Fritz's cremains. It honestly felt good to hold him again even if it was only his ashes. This week, I have plans to go out and give back to the community that I live in. Book clubs, bible study and packing care packages. I promised Fritz that I would keep busy while he was gone and I would be just fine. I intend to keep my promise to him.

The strangeness of not having him here was meant not clock watching, watching where I walked to avoid tripping over him, and not vacuuming his paw prints off the carpet. Who knew these are the things I would miss besides him sitting by me and listening to ever word I said and snuggling in the middle of the night and the 3:00AM potty trips.

I doubt if the ache completely goes away, but with playing with the neighbors' daughter's new dog, there is room for one more. Not now, my heart needs to mend some, but when it's time.

Thanks for reading, I just needed someone to listen to me.

Marge

[molly muffin]

They sure do have big personalities don't they. Then when they are not there the silence and emptiness just seems vast.

It's the little noises and things that says, I'm here with you that really is a kick when it's not there.

Big hugs!!

[SuperCupcake64]

Hi, Marge.

I can relate so much to the feelings you describe. I think the thing that has helped me the most is to believe that as one door closes, another opens. After the loss of my dog in August 2013 in a tragic, horrific accident, I didn't think I'd ever get over it. I felt like I had PTSD and was walking around in a fog. Once I felt a little better, I decided to make her loss a gain for other dogs who needed help. I adopted my Sammy, who was not a great adoption candidate due to his untreated Cushings and advanced age, and my Maizie, who was a stray in Puerto Rico. I felt so much better knowing that life's unfairness had benefited other living creatures. When your heart is ready, I wholeheartedly encourage it. :-)

Jen (and Maizie, and Sammy in heaven)

[Wally P's Mom]

Hello All:

Thanks for your words of encouragement. We are looking into a puppy for the Spring. Meanwhile, my husband and I booked a cruise for January.

With all of this to look forward to, I just broke down and cried last night. 2 weeks out. I know the wound is fresh, and time will take the sting away. But I cried as if I just lost Fritz. I still walk the house at 2am which was his potty time and when I get up, I still tell him I will be right back. Over time, I know this will cease.

The holidays are coming and my Fritz was our kid. My dad passed away 2 days before last Christmas. I am just not motivated to do Christmas this year. Last year, most of Christmas stuff was done as we were finding out about my dad's illness. Not too hard to do Christmas when it's already done. But I promised my husband 20 years ago, there will always be Christmas. And Fritz loved Christmas...

I am rambling. Bottom line, I miss my pup. I know his prognosis was bad and releasing him was right. But we had each other for soooo long.

Marge

[labblab]

Oh Marge, you are not rambling at all. The hurt you are feeling and the words you are writing make perfect sense. Every day is a day of loss. Some days are harder than others, and I think holidays without loved ones can be the hardest days of all...by far. Entering this holiday season without both your dad and Fritz surely does change everything forever, and my heart goes out to you.

I think it may be a matter of just facing each day one at a time. It may be really impossible to know in advance which traditions may still bring comfort, and which ones are now too painful. As each day dawns, I hope you will allow yourself to follow your heart and your instincts in doing, or not doing, things in a way that brings you the greatest comfort. Life has a way of surprising us, both for the bad but also for the good. So who knows, in the midst of your sorrow, there may yet be a new little tradition to be born that will warm both your heart and your spirit.

Throughout it all, please know that we are here to share your thoughts and feelings. We are family, Marge, and we are here to share the days to come.

Sending tons of hugs across the miles!
Marianne

[labblab]

Marge, just wanted to add that in addition to your thread here, we also have a communal thread on our "In Loving Memory" forum where you can come and post at any time during the holidays. The "door" there is always open. :o

http://www.k9cushings.com/forum/showthread.php?t=3790

[Wally P's Mom]

Missing Fritz, 1 year later. Enough said.

[DoxieMama]

Many hugs your way. My baby joined yours yesterday. I pray they are now both the happiest and healthiest they can be....

[Squirt's Mom]

awwww big ole hugs, Marge. It's never easy, these dates. We know they are coming and try to prepare but still are never quite ready. I know your sweet boys are watching over you with so much pride and love.

Hugs,
Leslie

[molly muffin]

Hugs Marge.

I think you said it all. We always miss them. :(

[rainiebo]

I am so sorry to hear of Fritz's passing. What impresses me about your posting is that you have done so many wonderful things to "celebrate" his passing. Your big heart has found good ways to express it's grief.