New to the group! Trilostane - sweet Simba has crossed The Bridge

[Simba's Mom]

Hi my name is Letti and my dog's name is SImba, he is a 10 year old mini doxie and just a few week ago got diagnosed with cushings. Even though my new vet told me everything, some things I just don't understand. Simba started with 20mg of trilostance, he was on that for 2 months or so, now they are upping it to 25mg, I'm glad they are going slow with the meds. His pot belly has disappeared and his panting and thirst have gotten better too. His back legs weakness returns sometimes, but other symptoms haven't. He has never had an ultrasound, so I might ask for one next time we go in. They have been doing regular blood checks every 6 weeks, started at 2, then 4 now 6. Its like $160.00 every time for blood work and the pills are $67.00 a month, so it's getting pretty spendy. My Simba is worth it but hope the drugs aren't hurting him in the long run! Thank you for this great site, looks like we are all in the same boat.

[mytil]

Welcome to you and Simba!

I am sorry your boy is having these troubles.

Here is a great link that describes Trilostane - http://www.k9cushings.com/forum/showthread.php?t=185. If you have not already, take a few moments to read through the brochures.

Also when you get the chance, can you post the results of the tests to diagnose Cushing's. And when was this diagnosis - several months ago? How much does your boy weigh?

If this was several months ago, let us know the results of the last ACTH stim test (monitors the cortisol levels once treatment has begun).

Also regarding the ACTH monitoring test, you can save some monies on this by asking your vet to use a portion of it (a vial contains enough for several tests). I will find the link that describes more - have to run just now.

Terry

[mytil]

Here is the link regarding reducing costs - http://endocrinevet.blogspot.com/2011/03/how-to-extend-your-supply-of-cortrosyn.html

Terry

[molly muffin]

Hello and welcome. Sorry I missed this the other day but yes, it's a big boat and we'll just move over a bit and make room for another you to squeeze in.

It does get horribly expensive and I think many of us have decided that we are just working to keep our furbabies comfy and as healthy as possible. :) Well, you do what you can for those you love so much.

Again, very happy to have you here.

Sharlene and Molly Muffin

[Simba's Mom]

Thank you for the welcome, Simba is due for his blood work soon so I will post results when I get them. I'm so happy I found this site, I feel better already!

[addy]

I have not yet had a chance to welcome you either. My Zoe is about 10 or could be 12 (she was a rescue):):) so we are not sure of her actual age. She was diagnosed almost 3 years ago.

We will be waiting for the test results so post away when you get them. We are glad you found us too! Talk away, ask questions, chime in, whatever you like.

[molly muffin]

We are very happy that you found this site too.
Each of us knows the worry, scared feelings, and loneliness that comes with your baby being not himself and getting any kind of abnormal test results. We've all walked that path and most of us still do to some degree.

hugs,
Sharlene and Molly Muffin

[Simba's Mom]

Thank you so much!

[milosmom]

hey letti and simba baby.i am also a doxie mom for a very long time and my way here is a wonderful,loving and supportive experience and will be forever thankful for finding everyone here.they all have helped me thru the most difficult times in my life with my milo and now without him.there are many watching,worrying and loving people here and i believe you have found us all here for a reason.so we are here with you on your journey with simba and there are many to answer all of your questions...welcome...patty(milo)meka xoxox

[Simba's Mom]

Thank you so much, I have so many questions, I'm still processing this all!

[Simba's Mom]

Tonite I'm sitting here and watching Simba's, he is so restless and looks around like he sees or hears things. I worry that he is not ok, he looks at me as if to say "help me" . How do I know?

[addy]

Hi,

Is Simba eating, any change in stools? Is he doing anything else differently? When did this restlessness start, just tonight? Could you tell me when Simba had his last ACTH test and what the results were? When was his last dose today? This morning? How did he act after you gave it to him? Sometimes Cush pups can get restless at night. If Simba is on once a day dosing, because Vetoryl/Trilostane peaks a few hours after administering the dose, it usually can leave the body fairly quicky so I wonder if his cortisol is rising later in the day.

Tell us more info if you can. Does he act sick to his tummy? Is he smacking his lips or licking? Is his tummy gurgling?

[Simba's Mom]

Simba's takes his med every morning after he goes outside, he seems ok after he takes it. He just started showing symptoms again, like the drinking water and attacking his food. He pants when he first gets up but stops soon after. His stomach has always gurgled, but less since I switched to blue turkey and potatoes food. Maybe I am just watching him more, not sure. I'm trying to get his tests results faxed to me, hopefully tomorrow, them I will post them.

[milosmom]

just wanted to pass by and say hi letti and simba,i also have been following your story and yes we do watch our little fur babies way to close to see if there is a change in eating,drinking,sleeping,behavior,toilet issues etc... your an excellent mom and you know your baby best,so keep a close eye and you will get some answers soon we all hope !!! patty(milo)and meka xoxox

[Squirt's Mom]

Hi Letti,

How long has it been since Simba has had an ACTH?

Hugs,
Leslie and the gang

[Simba's Mom]

Ok, got fax from vet, 10-27-12 was last ACTH test.
Cortisol pre-test. 3.0 1.0-6.5 ug/dL
Cortisol post-test 10.1 6.5-18.0 ug/dL

[molly muffin]

Okay, so Simba has been on 25mg for about a month now correct? It doesn't look like that post number has come down to what it needs to be and that could be why the restlessness, especially in the evening. Did the vet discuss upping the dose with you? You would really like that second number to be under 5, even under 9 is okay if the symptoms are controlled. I think you're looking at 30mg a day and if that doesn't help with the night time restlessness, then it oculd be that you are will want to think about the twice daily dosing.

hugs,
Sharlene and Molly Muffin

[Harley PoMMom]

Ok, got fax from vet, 10-27-12 was last ACTH test.
Cortisol pre-test. 3.0 1.0-6.5 ug/dL
Cortisol post-test 10.1 6.5-18.0 ug/dL

Hi Letti,

The reference ranges that you posted are for a dog that does not have Cushing's. When treating with Vetoryl/Trilostane one wants the pre and post to be between 1.45 ug/dl - 5.4 ug/dl with a post as high as 9.1 ug/dl as long as the clinical signs are controlled.

[Simba's Mom]

Can I email the papers to someone who can read this better then me, I'm confused by some of the notes?

[Simba's Mom]

Yes, Simba's has been on 25mg of trilostane since his last test at the end of oct. thanks for your help.

[molly muffin]

Letti, I sent you and PM.

Sharlene

[Simba's Mom]

Has everyone had a ultrasound with their diagnoses? Simba did not have one, must I ask them to do one?

[addy]

Hi Lettie,

Our IMS suggested an ultra sound to help make the diagnosis for Zoe along with an adrenal panel done at Unn. of Tenn. Knoxville after her UC:CR test showed further testing required.

Do you know what tests were done to diagnosis Simba? I am wondering what is prompting you to consider this. What I mean is, what are you thinking about? Are you worried the diagnosis is not right or do you want to see if Simba has an adrenal tumor?

Not all ultra sounds are created equal. The clinic needs a high resolution machine to get a good image.

Sorry if I am asking too many questions, just trying to find out info for Simba:):):):)

[Simba's Mom]

Hi Letti,

The reference ranges that you posted are for a dog that does not have Cushing's. When treating with Vetoryl/Trilostane one wants the pre and post to be between 1.45 ug/dl - 5.4 ug/dl with a post as high as 9.1 ug/dl as long as the clinical signs are controlled.

One of the other gals wrote this after I posted the results of Sim's tests, so am kinda confused.

[molly muffin]

ACTH - 10-27-12

Cortisol PRE 3.0ug (1.0 - 6.5ug)
Cortisol POST 10.1 (6.5 - 18.0ug)

on 25mg Trilostane

ACTH - 09-20-12

Cortisol PRE 7.2 (1.0 - 6.5ug)
Cortisol POST 8.9 (6.5 - 18.0ug)

(note on results is if under going Trilostane Therapy: If the post - ACTH cortisol is >9 ugl/dl (in October
Simba's was 10.1), incread dose if dog continues to have clinical signs of hyperadrenocoticism.
If the dog has signs of hypoadrenocorticism and the post-ACTH is <0.8 ug/dl, treatment is discontinued.

So, what is important on your test from October, is that the Cortisol has gone up POST. (when under treatment
this is the important number)

Now, it says that you called to arrange another ACTH test in December. Was that done? Do we have those results?

The range that is given on the test of 6.5 - 18.0 is a for a dog NOT being treated. When you look at the
notes (which I typed out what is revelant to you) then the range is as stated. >9 (increase if still symptoms
and below <0.8 stop medicating)

Sharlene and Molly Muffin

[Harley PoMMom]

Ok, got fax from vet, 10-27-12 was last ACTH test.
Cortisol pre-test. 3.0 1.0-6.5 ug/dLCortisol post-test 10.1 6.5-18.0 ug/dL

So sorry to confuse you...the reference ranges pre - 1.0-6.5 ug/dL and post - 6.5-18.0 ug/dL are for a dog that does not have Cushing's. When a dog has Cushing's its cortisol should be in the therapeutic ranges of the medicine it is being given. With Trilostane/Vetoryl that is 1.45 ug/dl - 5.4 ug/dl (pre and post) and a post can be as high as 9.1 ug/dl as long as clinical symptoms are controlled...am I making sense?

Lori

[SoggyDoggy]

Hi Ladies,

My interpretation of what you are saying here is that Simba's cortisol is still too high and Letti may be looking at a dose increase again. Is this correct?

In addition Letti, it might be wise to speak to your vet and mention that the cortisol ranges stated on your report may be for a dog who is not a cushings patient on Trilostane? It could be that they have not informed the lab and so the lab printed what they thought you were looking at, or that the lab screwed up and printed them wrong. This seems to be the source of confusion after all.

Anyway, good luck, Hope Simba gets sorted soon and you can settle down to many years of smooth sailing.

Naomi and Fraser

P.S. - Fraser didn't have an ultrasound. While they are wonderful at giving you a look at the other internal organs, they aren't cheap. For us it was just too expensive. Cushings diagnosis following cruciate ligament surgery for his brother meant I hit the $6000 mark in 3 months. I had to draw the line somewhere. Point is, we were diagnosed without and are now running pretty smoothly. Again, good luck.

[Simba's Mom]

I must be really dumb, I just don't understand. Simba's takes a thyroid pill too, that was started a few years ago when I brought him in for hair loss on his tail. The vet at that time never tested him for cushings, we now go to a different vet, we drive an hour to a bigger city.

[Simba's Mom]

He is going to be tested again and the end of this month, maybe I should call in and have him tested sooner?

[molly muffin]

The lab posts the range for a normal dog, but then in notes, it tells you what to look for if your dog is on Lyso therapy or Trilostane therapy, which is what I typed out in the post before. Based upon that, the lab is saying that the cortisol is not controlled at this stage, they'd like it under <9. with symptoms controlled. So, the lab results are correct since they don't post the range itself for a dog on any kind of therapy, only add it in the notes area.

Is Simba's thyroid at the appropriate level? If it isn't then I'd get that under control first and then look at increasing the dose of Trilostane. You can easily go up another 5mg at a time till it is at a good level. Currently though your Post level has increased between Sept and Oct instead of decrease, even though your Pre has decreased. Maybe twice a day dosing would be more appropriate for Simba too.
I'll let others who have much more experience with using vetroyl discuss options.

Hugs,
Sharlene and Molly Muffin

[SoggyDoggy]

So as it has been explained to me in the past, all dogs have cortisol in their system. A normal healthy dog after an ACTH test, would have cortisol in the range of 6.5-18.0 ug/dL, but when dogs are diagnosed with cushings and are treated with trilostane, this result should be different. A cushings dog on trilostane should have post ACTH test results between the range of 1.45 ug/dl - 5.4 ug/dl.

The confusion seems to be stemming from the fact that your report has the incorrect reference ranges on it - for whatever reason, who knows. This is something I suggest you speak to your vet about. Write down the ranges above and take it with you so you can ask further.

As for Simba's results, and using the treated range above, it would appear that Simba's cortisol is still too high which is why he may be appearing restless and some of the symptoms are reappearing.

I've just now read your post regarding testing at end of the month. I would speak to your vet about it, and mention the discrepancy in the ranges first. Get that issue sorted so that you don't get more confusing results. Then your test will be able to give you a more accurate indication of his results with the 25mg dosage he is currently on.

If I read above right, the vet increased Simba's dose after the last stim test? If so that would be consistent with the high readings he returned. If he hasn't been tested since dose review at end of october, then yes you could bring the test forward without any hassle (except to the wallet :p) and once the ranges are sorted on the report get a good indication.

I hope this helps and clears things up a bit. Being so new to it myself I completely understand the high level of confusion that goes with!

Naomi.

[Simba's Mom]

Thank you, starting to understand it better, thanks for your patience.

[Harley PoMMom]

Oh Letti, sweetie, trust me you are NOT dumb. This Cushing's disease is so frustrating and then all the tests, protocols, etc, it definitely can be confusing.

Hopefully I can explain better :o:confused: If a dog, that is NOT being treated for Cushing's, would have an ACTH stimulation test one would want the reference ranges that were in your lab report. When a dog is being treated for cushing's then those reference ranges are different: for dog's being treated with Lysodren the reference ranges are 1-5 ug/dl, for a dog being treated with Trilostane, the reference ranges are 1.45 - 5.4 ug/dl or as ahigh as 9.1 ug/dl.

When looking at your lab report, one might think that Simba's post # is within the normal limits because of the reference ranges that are listed, when in fact Simba's post # is not.

If I'm not making any sense, please, please let us know, ok?

Lori

[SoggyDoggy]

Ha! seems like we are all posting at the same time, no wonder it gets confusing!

[Simba's Mom]

Ok, thanks so much I am starting to get it, what bothers me is why did the lab have the range wrong and why didn't the vet catch it? I just need to know what to ask the vet about the range right? Thanks so much for helping, you have no idea how much I appreciate all of you!

[frijole]

:D We have all been there so don't worry.

On Acth tests there are two numbers. The first number is pretty much meaningless.

When we say "Pre" number we are talking the first number.

When we say "Post" number we are talking about the 2nd number.

So all you really need to know that your goal in life right now is to give a dosage of trilostane that results in an acth test with a 2nd number that is between 1 1/2 and 5 1/2. If it is as high as 9 it COULD be ok so long as the cushing's symptoms are gone.

These numbers are measurements of cortisol and too much of it is what is causing the cushings. So trilostane's goal in life is to lower cortisol. And when that happens the symptoms go away and that 2nd number on the test goes DOWN. And we all are happy then.

Make sense? ! Kim

[SoggyDoggy]

Hi Letti,

your question re ranges probably one for Sharlene to answer as she has seen a copy of the test when you sent it to her. From what she said in a post, it could be just that they have written the normal range in, but then typed notes underneath the test with further information. If this is indeed the case, use the notes to explain the report, or if the cushings range isnt mentioned there either, then copy them out from here and keep them in a file together with copies of your test results. After you get a bit more used to it, you will know the numbers and will know automatically if the results are good just by reading them.

The trick is learning to read your individual lab results and understanding their format. As I said, ask your vet about it and NEVER be afraid to question them either. (I picked my Vet up in a pretty huge mistake. My vet pathology forms are very weirdly printed, and my vet read the T4 range instead of cortisol.)

Give yourself a bit of time to get your head around it. It can be confusing as all get out to start with, but when it makes sense it just does.

Good luck!

[Simba's Mom]

So when they do the test they are actually giving him more cortisol ? Isn't that what we are trying to get less of?

[addy]

Think of it this way, when they do the ACTH test what they are trying to do is stimulate the dog to see how much more cortisol they will pump out. That is why we refer to it as a "stim". If they can stimulate the dog to pump out cortisol of appx up to 5 or even up to 9 ug/dl they consider that pup controlled even though the number is lower than a dog not being treated.

FYI- most labs list those same reference ranges, we see it all the time on reports.

You are doing just fine learning all of this. The more you know the better you can help Simba so keep asking questions.

[SoggyDoggy]

What addy said ;)

It was explained to me that, the first blood test measures how much cortisol is floating around the system naturally, but at the same time the body has storage reserves of cortisol. The ACTH stim that is used, results in the body "dumping" the stores into the blood stream, so that the 2nd test then measures how much was stored and how much is in the dogs system.

That's why they are always interested in the 2nd number, as it shows how much the body is producing and storing. If the number is too high, the body is still producing too much, therefore the trilostane dose is too low, if the 2nd number is too low, the body isn't producing enough cortisol and the trilostane is too high. (I'm guessing you knew that bit though).

I hope that makes sense. And if I have that wrong, someone PLEASE tell me, cause if so then I don't get it either :D

[Simba's Mom]

Thanks everyone!

[molly muffin]

And how is Simba today? and how did he do last night?

Sharlene and Molly Muffin

[Simba's Mom]

My vet wants. Simba to have his med, then fast and bring to vet in 3 hours for test. Does everyone have their pups fast for test?

[frijole]

I am going to reply and then I'm going to move our posts to your original thread. The reason is because I'm not sure which test you are giving and can't remember which drug your dog is on. If you had posted in your original thread I could scroll back. Lots of newbies do it so don't worry but it's hard to remember every detail on every dog so this helps us old timers :)

If you are giving trilostane you must give the drug WITH FOOD prior to the acth test or the test results won't be valid. Please read the specifics from this expert at the link. Kim

http://endocrinevet.blogspot.com/2011/03/whats-best-protocol-for-acth.html

[frijole]

Please be sure to pass this info along to your vet because withholding the food is really doing his patients a disservice as the results are invalid! He probably just doesn't know. This guy is a world renown expert on cushings so he probably will recognize the name. He'll be impressed you know this. :)

[Simba's Mom]

I will print it and fax it to her, thanks so much. I can see that we really have to be a voice for our babies!

[frijole]

Yes we do! And I've been here around 8 yrs now and things constantly change and we are always learning so don't feel bad for not knowing.. the main thing is when in doubt, ask. And you did! So you are doing a great job as Simba's voice. Keep up the good work. You'll do just fine.

Kim

[Simba's Mom]

Molly Muffin, Simba is doing ok, I tried giving his trilo at noon instead of early morning, still very restless at nite....

[Simba's Mom]

Do I always ask the questions on this thread?

[frijole]

:D If it has to do with Simba yes. That way we can go back and read if we need history in order to answer the question.

[Squirt's Mom]

Molly Muffin, Simba is doing ok, I tried giving his trilo at noon instead of early morning, still very restless at nite....

Just an FYI in case this hasn't been explained (I looked back through the thread briefly and didn't see it mentioned but that doesn't always mean much with me! I could have missed it easily. :D)

The timing of the dose of Trilostane (Vetoryl) and the timing of the ACTH is critical. The ACTH MUST be completed, not just scheduled, within a 4-6 hour time frame after the last dose. So, if you give the Trilo at noon, the ACTH must be completed between 4pm and 6pm or the test will be skewed (inaccurate).

Hugs,
Leslie and the gang

[Simba's Mom]

So today I called my vet and scheduled ACTH test for Saturday. I talked to gal at desk and she went and asked vet about fasting, anyways she said he could eat with his trilo. So at 6am he will have his med with food, then between 9&10 am he will get blood drawn, then again around noon, does that sound right?

[frijole]

Quoting Leslie from above:
The ACTH MUST be completed, not just scheduled, within a 4-6 hour time frame after the last dose

So 6 am feeding plus 6 hrs = noon latest

So yes that works perfectly. Just make sure to tell them it must be completed by noon. Sometimes they need reminding. :) Good job. Kim

[Simba's Mom]

Does anyone know what I can give Simba for the ride to the vet? It's about an hour drive and he shivers the whole time, whenever I leave town he knows something is up.

[frijole]

Melatonin - all natural you can get at any drug store. 3 mgs (one pill) it basically takes the chill off and calms dogs down so they can sleep or relax. I used it on 4th of Julys when my two dogs went crazy and it worked great. Also gave to my cush dog when restless at night. Kim

[Simba's Mom]

Thank you, that won't interfere with his test right?

[frijole]

You are smart to ask! Lots of cush dogs take it because it actually helps reduce sex hormones (affected by cushings) so I assume it does not. Hopefully if someone knows to the contrary they'll post it. I gave it to my dog daily so if it affected the results I never knew it. :o:):) Kim

[labblab]

If it were me, I don't think I'd give anything new to my dog on the morning of the test. You just don't know how it may affect them, like even the remote possibility of an allergic reaction. If it's something they're not used to or don't use consistently, I wouldn't want to try them on it for the first time that morning.

Marianne

[Simba's Mom]

Ok thank you, I gave him one tonite to help relax him he is so restless .

[addy]

So at 6am he will have his med with food, then between 9&10 am he will get blood drawn, then again around noon, does that sound right?

We always have the second draw one hour later, does anyone else have an ACTH test with a two hour second draw?

[Harley PoMMom]

If the vet is using Acthar as the stimulating agent then it is a 2 hour wait.

[addy]

Good to know, Lori, thanks!:):)

[Simba's Mom]

So tomorrow Simba will have his ACTH test, I will post results when I get them. As he lays next to me he is struggling to be comfortable, at times he is a different dog, I pray that he will be ok. Why are cushings dogs so restless, and the sex hormones up? Sometimes I wonder if he will live longer without the meds, so much goes thru my head.

[frijole]

All will be fine. Wishing you luck. Kim

[Simba's Mom]

I have to remember I still have my dog when so many don't, sorry two worry so.

[addy]

Letti, worry is a Cush mom's middle name:):):);)

You'll do fine.

[Simba's Mom]

So true, just want my pup to be ok.

[addy]

I know you do, sweetie, we all do. It is hard for us to see our pups not well, tears at our hearts with worry and wanting to make them better.

Let see what the ACTH test brings.

Holding your hand and sending hugs
((((((((((((((((((((hugs)))))))))))))))))))

[Simba's Mom]

Thank you so much for all your kind words. Today Simba has his ACTH test so hopefully by Monday I will know more. How does the vet know where the tumor is that causes the cushings?

[frijole]

You won't know with an acth test. It just tell you if the cortisol level is high enough to be considered cushing's.

There are two ways to find out what type of cushings:

1. an ultrasound where you see the adrenal glands. based on the enlargements and whether one or both are enlarged you can determine which type. if the ultrasound picks up the adrenal tumor then you know for sure it is on the adrenal gland. Pituitary tumors are itty bitty things found near the brain.

2. The LDDS test can help distinguish which type of cushings.

FWIW 85% of cases are pituitary cushings so alot of people just proceed to treat and don't worry about which type of cushings it is.

Kim

[Simba's Mom]

What is a LDDS test?

[frijole]

Low Dose Dex Suppression test is an 8 hr test used to diagnose cushings. Some do it vs the acth to diagnose, some do acth and some do both.

[addy]

The most sensitive and specific tests in the diagnosis of Cushing's in dogs are the history (most important) and physical examination (next most important). The urine cortisol-creatinine ratio is quite sensitive but not specific. The low-dose dexamethasone suppression (LDDS) test is sensitive and relatively specific if the test is performed on dogs with appropriate history and physical examination results. I do not recommend an ACTH stimulation test unless iatrogenic disease is suspected.

Per Dr. Edward Feldman

[NoonelovesmelikeNorman]

The urine cortisol-creatinine ratio is quite sensitive but not specific. The low-dose dexamethasone suppression (LDDS) test is sensitive and relatively specific if the test is performed on dogs with appropriate history and physical examination results.
Is this test cheaper than the ACTH? and can it be done to help with dosage control?

I don't know if Norman had one of those done.



I do not recommend an ACTH stimulation test unless iatrogenic disease is suspected.

I had to have one, now two done before any medication would be given. I think it is costly.

[Simba's Mom]

Thank you so much for helping me understand!

[Simba's Mom]

Also a tip for your restless cushings pups, "bully sticks" I picked some up for my squirt today and he loves them and keeps him still....:)

[frijole]

Is this test cheaper than the ACTH? and can it be done to help with dosage control?

Yes its usually cheaper but it has nothing to do with dosage control - it only tells you if a dog has cushings and what type. The acth test tells you what the cortisol is and tell you if the dog has cushings and monitors cortisol so you can tell if a dose is on track or needs to be adjusted. (Kim)

[Simba's Mom]

What type of cushings? Like I have seen some pups have atypical not sure what that means?

[Harley PoMMom]

What type of cushings?

There is PDH and ADH: PDH stands for Pituitary-Dependent Hyperadrenocorticism, where there is a small, usually non-cancerous, tumor of the pituitary gland; a tumor of the adrenal gland is called ADH adrenal dependent hyperadrenocorticism.




Like I have seen some pups have atypical not sure what that means?

Atypical Cushing's is when there is an elevation in one or more of the sex hormones but the cortisol is normal.

Hope this helps

Love and hugs,
Lori

[Simba's Mom]

With a regular ACTH test can the vet determine where the cushings is from, like the brain or the other place?

[Squirt's Mom]

The LDDS, HDDS, and ultrasound are used to determine whether it is adrenal (ADH) or pituitary (PDH) based Cushing's.

The ACTH measures how much cortisol is being stored in the adrenal glands. Someone once explained to me like this - think of a wet sponge; now squeeze all the water you can out of the sponge; that is what the ACTH does to the adrenal glands - it "squeezes" them to see how much cortisol is being held in the organs. I don't think the ACTH can tell if the cortisol is the result of an adrenal tumor (ADH) or a pituitary tumor (PDH), tho. If I am wrong about that, someone will correct me hopefully!

Hugs,
Leslie and the gang

[Simba's Mom]

Thanks I guess it really doesn't matter, just trying to learn what's going on in my little squirts body, thanks for the info. This site has taught me so much.

[Simba's Mom]

Since Simba has been on trilostane, I have noticed a few things. He stares at things, like he watches stuff but nothing is there, I wonder if he is seeing things. He has more hair loss on his tummy area and tail, he seems more boney, like his skin is lose. He has gotten more fatty tumors, but maybe that is an age thing. He doesn't want to do stairs, and used to jump off couch, now he whines till I help him up and down. He does sleep more, restless at nite. I should clarify that now I watch him like a hawk, and not saying that the bad things are from the trilostane, just stating what I have noticed since he started on it.
All the good stuff when the (dosage) is right is the water consumption is way less, so less peeing, his pot belly looks way better and he's not constantly panting. Tomorrow hopefully get results from ACTH test. This has been quite a journey, I hope it's what's best for him.

[milosmom]

hey letti just wanted to let you know i have been reading your posts about your furbaby simba and sending you xoxox patty(milo)meka

[Simba's Mom]

Thank you, trying to help others too by journaling what I notice with Simba.

[Squirt's Mom]

One of the "funny" things about Trilo is that often the pup will do what we call "blowing their coat" which means all their old hair falls out and a new, sometimes different, coat grows back. So don't worry about additional hair loss at this point...it could be simply the drug at work.

As the cortisol level become more normal the body can get back to processing fats in a more normal fashion so we sometimes see our babies body shapes change as well as treatment progresses. They lose the potbelly, fats are spread out through the body like they should instead of collecting in certain areas, they are able to burn up fats instead of storing them, so we start to see things we didn't before. My Squirt lost enough weight that I could feel her boobs for the first time in ages...and I freaked thinking they were tumors! :o:rolleyes::D

Bear in mind - our cush babies have been on sort of an extended high on speed with the excess cortisol in their bodies. As the cortisol level drops back to a more normal level, some pups go through a kind of withdrawal as their body adjusts.

You are doing a good job of observing your baby and making note of the things you see. Sharing them here is very nice...as you say, it will help others who come behind you and Simba to read about your story. That is part of the magic here - we share our journeys in the hopes it will help others. Don't forget to take a break every now and then, tho. Take some time to simply breath and enjoy your baby.

You and Simba are taking the first steps on a life-long adventure, just beginning your voyage with the dock still in plain view. There will be many changes to come, many things to talk about, as time passes. So be patient and give the drug time to work, keep observing and noting the changes you see, keep asking questions, keep reading...but above all, remember to be patient. How does that song go?... The Carpenter's maybe? "We've only just begun...." ;) Am I telling my age here?! :p

Hugs,
Leslie and the gang

[addy]

Patience is a hard thing to come by when we want our pups better right away and then we notice every little thing and worry about if it is a bad thing.;);)

Lets wait to see the numbers first. You are doing a great job, really. I remember when I first started Zoe on Trilostane - I was a wreck. You are much calmer then I was;);););););)

If you get really anxious we can have our group breathing yoga session. We all come on line and breathe in and out together:p:D;)

[Simba's Mom]

You gals are the best, seriously, the best!
I did make an album of Simba, finally figured it out!

[molly muffin]

Simba's ACTH results are as follows:

01/21/2013
ACTH

Pre 3.1ug range 1.0 - 6.5
Post 6.7 ug range 6.5 - 18.0

*Dogs on Trilostane Therapy: If the post ACTH cortisol is >9 ug, increase dose if the dog
continues to have clinical signs of hyperadronocorticism.


So, depending on if you are still seeing clinical signs, you can increase the dosage or if you are
not seeing symptoms any longer then you can leave it as is. Your call.

I think it was Addy on her thread, that mentioned that optimally you want the post to be under 5. to see
growth of hair. (Addy correct me if I'm wrong on that).

Sharlene and Molly Muffin

[Simba's Mom]

Thanku Sharlene I appreciate your help in posting the numbers for me.

[SoggyDoggy]

Can I ask what the unit measurements are for this test? Just that the ranges stated look kind of weird compared to what we normally see. Also Sharlene, if the range is 6.5-18, surely we wouldn't want to drop that below 5? Again, it depends on the units of measurement, but these results look pretty damn good to me as far as numbers within a stated range go! (Unless of course the ranges are for normal dogs not on trilo?)

Sorry to challenge this, but that's what you guys have taught me to do :D:D:D

[addy]

I think we went through this with the last ACTH test and range and the units were ug/dl. When Zoe had her stim in early October, it was confusing because her cortisol post number rose yet her symptoms improved except for her hair/coat. Dechra told us if we wanted to see improvement we need to keep going and take her down within therapeutic range of under 5 ug/dl, so yes Sharlene, you remember correctly :)

Letti, I was trying to read back through your thread but have to run as dogs need to go out. What symptoms are you still seeing that are worrisome to you?

I'll be back tomorrow I promise.

[frijole]

Can I ask what the unit measurements
Sorry to challenge this, but that's what you guys have taught me to do :D:D:D

:D:D:D:D:D:D:D:D:D:D

You are cracking me up. I can tell you are really paying attention. Keep it up and you'll be a moderator! Kim

[Simba's Mom]

I'm not sure what you mean about unit measurements, I emailed my results to Molly muffin and she posted them for me.
The symptoms are muscle weakness, panting and drinking more water, and hair loss on her tail it started about a week ago, also any of your pups eat their own poo? He gets enough to eat I promise, I have to yell his name then he stops, no way getting kisses after poo eating......

[Harley PoMMom]

I'm not sure what you mean about unit measurements, I emailed my results to Molly muffin and she posted them for me.


An unit of measurement is a specific measure of an amount. e.g. 100 U/L The U/L is the unit of measurement.

[molly muffin]

These units are all ug/dl.

01/21/2013
ACTH

Pre 3.1 ug/dl (1.0 - 6.5)
Post 6.7 ug/dl (6.5 - 18.0)

*Dogs on Trilostane Therapy: If the post ACTH cortisol is >9 ug/dl, increase dose if the dog
continues to have clinical signs of hyperadronocorticism.

This lab gives a wellness range, with qualifying statements based upon what therapy a dog is on. Simba is on Trilostane. There is a different statement if the dog was on lysodren.

I agree the numbers look good and if you aren't having any clinical symptoms then you are fine, good even. :)

Sharlene

[labblab]

Can I ask what the unit measurements are for this test? Just that the ranges stated look kind of weird compared to what we normally see. Also Sharlene, if the range is 6.5-18, surely we wouldn't want to drop that below 5? Again, it depends on the units of measurement, but these results look pretty damn good to me as far as numbers within a stated range go! (Unless of course the ranges are for normal dogs not on trilo?)

Sorry to challenge this, but that's what you guys have taught me to do :D:D:D
Hi Naomi,

Good job as far as challenging us! ;)

But you were right in thinking that perhaps the stated range was that for normal dogs not taking trilostane. Here is the complete "panel" of recommendations for dogs treated with trilostane published by Dechra, the manufacturer of brandname Vetoryl:


<1.45 ug/dl: Stop treatment. Re-start at a decreased dose.

1.45 to 5.4 ug/dl: Continue on same dose.

5.4 to 9.1 ug/dl: EITHER: Continue on current dose if clinical signs are well controlled OR: Increase dose if clinical signs of hyperadrenocorticism are still evident.

>9.1 ug/dl: Increase initial dose.

As you see, it's an entirely different range than the "standard" normal range printed on the lab report.

Marianne

[SoggyDoggy]

:D:D:D:D:D:D All good, just checking up!

Otherwise, a bump just in case it got missed.


Simba's Mom
The symptoms are muscle weakness, panting and drinking more water, and hair loss on her tail it started about a week ago, also any of your pups eat their own poo? He gets enough to eat I promise, I have to yell his name then he stops, no way getting kisses after poo eating......

And while my boys don't eat the poo, they sure try and give kisses after sniffing I'd rather not know what! So that I completely understand. Just giving your symptoms a bump in the thread in case they were missed while I hijacked it. Sorry about that, was better to be safe than sorry though.

[addy]

Okay, found all I needed, Simba's history so far, Lettie do I have this right?


Most recent test on 25 mgs

Pre 3.1ug range 1.0 - 6.5
Post 6.7 ug range 6.5 - 18.0


ACTH - 10-27-12 dose was 20mgs increased to 25mgs

Cortisol PRE 3.0ug (1.0 - 6.5ug)
Cortisol POST 10.1 (6.5 - 18.0ug)

ACTH - 09-20-12 dose was 20 mgs

Cortisol PRE 7.2 (1.0 - 6.5ug)
Cortisol POST 8.9 (6.5 - 18.0ug


Current symptoms:
The symptoms are muscle weakness, panting and drinking more water, and hair loss on her tail it started about a week ago. Simba has been on 25 mgs since the end of October.

Lettie, I wonder if with the next dose change you may find it better to switch to twice day dosing.

Thoughts anyone?

[labblab]

Since Simba has been on trilostane, I have noticed a few things. He stares at things, like he watches stuff but nothing is there, I wonder if he is seeing things. He has more hair loss on his tummy area and tail, he seems more boney, like his skin is lose. He has gotten more fatty tumors, but maybe that is an age thing. He doesn't want to do stairs, and used to jump off couch, now he whines till I help him up and down. He does sleep more, restless at nite.
All the good stuff is the water consumption is way less, so less peeing, his pot belly looks way better and he's not constantly panting. Tomorrow hopefully get results from ACTH test. This has been quite a journey, I hope it's what's best for him.
Letti, I am confused :o. The above quote is from two days ago, but this is what you wrote yesterday:


The symptoms are muscle weakness, panting and drinking more water, and hair loss on her tail it started about a week ago, also any of your pups eat their own poo? He gets enough to eat I promise, I have to yell his name then he stops, no way getting kisses after poo eating......
Is it just the hair loss that started a week ago, but Simba is truly doing better with the panting and the water issues? Or are all the symptoms getting worse again?

I think that whether or not to increase the trilostane and/or shift to twice daily dosing really does depend very specifically on the symptoms you are seeing. He has been on this same dose for three months now, so if you are still not satisfied with the symptom resolution I think a dosing increase is in order since this most recent post-ACTH result is 6.7 ug/dl. But especially if he is exhibiting the symptoms throughout the day, I would stick with once daily dosing until his post-ACTH result is lower than 5.4 ug/dl. Once at that level, I'd reassess the situation and if his symptoms still remain uncontrolled, that's the point at which I'd think about shifting to twice a day.

Just my two cents worth! ;)

Marianne

[addy]

Hope that helps, Lettie:):):):)

[Simba's Mom]

Hey Marianne, your right about what I wrote, I should've explained it better. When the dose was working all the good that comes, I will fix that in the post....but yes right now he is showing some symptoms again :( sorry to be so confusing. That's what I get for trying to help others lol and think I know it all...
Thanks again Cushing pups Moms, you all rock!!!!!!

[Simba's Mom]

Simba is doing better, he had a ear infection so I wonder if that made him hot, thus the panting and thirst. So we are staying on the 25mg tristo, and re check in May, unless symptoms come back. My vet feels Sim has the pituitary type cushings, because he doing so well on the tristo, so I decided not to do the ultrasound. I feel so blessed but yet my heart breaks for so many, so often I come on this site and another angel got their wings, my heart aches for you all, because I know how special those angels are. Take care

[Simba's Mom]

Simba is throwing up today and trembling, how do you know if it's just the flu or something worse? Before when he would throw up it would be a few times then he would be done, today is different. it seems like his stomach is never going to empty. its yellow and foamy and smells like medicine, he ate this morning as usual, this started around noon.

[frijole]

You have to call your vet. What you are describing is serious vomiting and dogs quickly can lose electrolytes and get seriously ill. Call your vet now! Take your dog in NOW.

No more trilostane. Never give trilo to a sick dog - regardless if its flu or bad food. Just want you to know.

It could be that the trilo has caused the cortisol to go too low and it could be pancreatitus. Either way your dog needs to be at the hospital and have it's electrolytes checked and perhaps be put on an IV.

Please don't wait for other responses - just call the vet or go now.

Thanks! Kim

[frijole]

The yellow is bile and that and the foam mean there is nothing left in the dog's tummy but that doesn't mean they won't continue to vomit. You must get help. Kim

[Simba's Mom]

Ok thanks, I will call in right now!

[frijole]

Great. Glad you saw this. Kim

[molly muffin]

Oh gosh, how scary Letti. Let us know how Simba is doing!

Hugs,
Sharlene and Molly Muffin

[Simba's Mom]

I called my vet, no answer, so found emergency vet care in the same city I take sim too. (We live about 45 miles away from a big city and the vet in our town is for big animals like cows and pigs.) So I talked to a gal and she asked me a few questions and said she thought Simba could wait until tomorrow to see his regular vet. So my husband who is no support says, "he's just a dog, dogs throw up" needless to say I put him in his place, seriously I need someone who understands, so frustrating..So with Simba sleeping on my lap, he hasn't thrown up for an hour, I guess I will take him in the morning to my regular vet or at least call there and let her know whats going on. I do feel better that I know where I can take him just in case, and that I did visit with someone about Sim's symptoms. However I can hardly wait until tomorrow to visit with Simba's regular vet, please say a little prayer for my Simba, thank you!

[molly muffin]

Oh dear. Has Simba had anything to drink? If you aren't taking him in till tomorrow, keep a close eye on him over night. Can you get him to the big city if he starts to throw up or isn't drinking or becomes lethargic so he can't stan?. All of these are very critical and can be life threatening.
Do you have a syringe even? If he doesn't drink then at least get some water into him using the syringe if needed. I've had to do that before.
Make sure that he goes in FIRST thing in the morning okay? I really worry for our babies on here.
The girl you spoke to was what? A receptionist? a tech? do they ever see small animals there?
It is very frustrating when you don't have the things you need like a small animal ER in close proximity.
Let us know what is going on and how Simba is doing. NO trilostane for now and not until after he is seen by a vet and they okay it.
Hang in there!
hugs,
Sharlene and Molly Muffin

[Simba's Mom]

Sharlene, Simba is drinking water, an hasn't thrown up for an hour or more, and he's resting quietly. I will take him to his regular vet tomorrow ASAP, they open at 7:30 am, hopefully the roads will be good enough we had freezing rain and fog tonite. If the roads are bad I will call in and see what my vet wants me to do. I did talk to a vet when I called the emergency vet, she asked me lots of questions, I do feel better, just hope sim is ok. He will sleep by me so I can keep an eye on him, he's my best buddy, thanks for caring. If anything changes I will take him in, no matter what.
Thank you too Kim, I called in right away, I appreciate you so much!

[molly muffin]

Okay I'm glad the person you spoke with was a vet.
I hope you don't get the freezing rain too for a long time. I'm suppose to pick up Molly in the morning and we too are expecting freezing rain, snow, more freezing rain, rain. ughhh
I just don't think I'll really relax till Simba has seen the vet. I bet you feel the same way. :)
Hang in there!
Sharlene and Molly Muffin

[Tina]

Letti, when you talked to the girl at the emergency vet, did you tell her that Simba has Cushings and is taking Trilostane? I just want to make sure that she was aware of those things and didn't just think that his vomiting was related to something else. Did she say anything about trying to give him any prednisone? I am so glad to hear that he hasn't thrown up for over an hour, and that he is drinking water, that is encouraging. One good thing about trilostane is that it goes out of their system relatively quickly. I hope he does ok through the night.

Hugs,
Tina and Jasper

[Simba's Mom]

Tina, yes I told her the meds he was on for cushings and his weight, she seemed very smart and knew what to ask me about Simba. Thank you for caring!
She did not mention prednisone but I don't have any either, something I will talk to my vet about tomorrow too.

[frijole]

I'm going to say it because I live in a town of 25000 in Nebraska and I know there is a different mentality towards treatment of animals by alot of people (including the vets that treat them).

When a dog vomits everything up like that it is a sign of something wrong - could be the trilostane, could be alot of things but you must have them check out the electrolytes tomorrow. Do NOT give any trilostane no matter what they tell you. It just isn't worth the risk. No harm will come from not giving it. Let the tummy heal.

If the roads are bad and you can't make the trek to town if you can at least get to Walmart or a store that sells Pedialyte go and get some. It helps replace electrolytes. It is bottled and in the baby department. Get the one with NO flavoring added. Mix it 1/2 water 1/2 pedialyte.

Sometimes a dog is vomiting from drinking too much. So start slow. Also you should have prednisone on hand in case of things like this. YOu live to far away and don't have access to 24 hr service - your dog could pass before you get help. So make them give you a prescription for it. You can get it done by phone and pick it up at your local pharmacy as it is also a human drug. Make sure they give you the smallest sized pill... not sure but I think it's 3 mg ( could be wrong it has been a while since I used it)

I will pray that you don't get the ice - I saw it on the forecast. Hope it is east and south of you. Hang in there and keep us posted.

If something happens during the night phone the city vet and ask them what you can do until morning. Kim

[Simba's Mom]

Thank you Kim, we own a grocery store so I can get the pedi lite as soon as I can, hope we have the no flavored one, so sim can start feeling better faster. I will not give him his meds until vet gives the ok, thanks so much for all the information. I too will not relax until sim sees vet tomorrow. I'm staying on this site because it helps me feel safe, thanks again.

[frijole]

Letti if your vet says it is ok to give trilostane tomorrow I am begging you to not give it. Not until the cause of the tummy issue is resolved. It isn't the first time and it has gotten worse. Dogs don't get sick for 1/2 a day and lose everything without a reason. It could be pancreatitis, too low of cortisol, IBD but until it resolves and you know why I wouldn't worry about the trilostane. I want to make sure it isn't the culprit. (cortisol too low) THanks. Hopefully Lori will see these posts. She has a bit of experience with tummy issues. Sending love, Kim

[Simba's Mom]

Forsure I hear you and trust you, he will not get any meds, what did you mean about how the vets treat the animals in your text before? Do I tell them to find out why he is sick and how will they do that, just by blood work?

[molly muffin]

Oh Kim is completely right. Need to figure out what is causing the tummy upset and fix that before worrying about Trilostane and cushings. This is more important at the moment.
I know what you mean. I often find comfort in just being here when in a state of worry. :) Whew, great that you have a store and crossing fingers you have the no flavor in stock.
Oh and while at it tomorrow with the vet get the kidneys checked. I'm suddenly feeling like everyone needs to have a kidney check of their dogs in addition to checking pancreas, cortisol, etc.

Hugs,
Sharlene and Molly Muffin

[Simba's Mom]

Since I am full of worry and not thinking so great plz tell me what my vet should all check for sim tomorrow, I just can't do this alone:( what would I do without you all?

[frijole]

Forsure I hear you and trust you, he will not get any meds, what did you mean about how the vets treat the animals in your text before? Do I tell them to find out why he is sick and how will they do that, just by blood work?

I had a dog named Annie and she had a very rare kind of tumor and was misdiagnosed as having cushing's. She wouldn't eat and she had these episodes that never happened at a vet's office. My vet (who has a large clientele of people who think its only a dog) didn't even try to help me figure out what was wrong. I couldn't believe it. I would come to this site and post and they would tell me what tests to ask for and then I would and we ruled out many things. He had it in his head that she had a macro tumor (cushings) and he was just going to let it go and told me to ignore it basically.

Well she didn't even have cushings. I went to K State Univ's school and those people cared. They figured it out. I spent thousands of dollars getting no where. I researched alot of other vets in my area and found that some won't ever diagnose cushing's because they don't know alot about it and so they just ignore it. (this came from someone inside their offices) So in short I grew to mistrust rural dog health care.

It's a mentality thing - heck my entire family said "she's just a dog". But what bothered me is that the vet took on the same attitude. Sorry to ramble but you asked. :D

Back to your questions. They need to inspect her and do basic blood work to figure out where the problem might be - could be the kidneys, could be low cortisol (check electrolytes), could be tummy issues.

I'm hoping Glynda or Lori who are way more experienced/knowledgeable in these matters will see this thread and comment. Hang in there, the night is young. Kim

[lulusmom]

Hi Letti,

I'm sorry that Simba is feeling under the weather today. Can you tell me if he is acting better now. Any trembling? When is the last time he vomited? Any diarrhea? You can check his gums for dehydration and anemia. Lift his lip and check out the gums. They should be pink in color. If they are white, get him in the car and drive to the nearest er. If they are normal color, take your index finger and touch the gums to see if they are tacky. Dehydrated dogs have tacky, sticky feeling gums. Then press the gum with your finger and release. The area you press should turn white but should return to pink very quickly (1 to 2 seconds max). If it doesn't, Simba is most likely dehydrated and in need of fluids.

As for what tests to ask the vet to do, it all depends on whether Simba recovers by morning. If he is still sick, the vet needs to do a blood chemistry. Most vets can do mini panels to check liver and kidney values in house as well as electrolytes. The latter is a must when a dog is being treated with Vetoryl (trilostane).

[Simba's Mom]

Thanks Kim, I going to write everything down that my vet should check for, I appreciate you. If tomorrow I'm not happy with my vet I will find one that I am happy with, but I do think that she truly cares, hope I'm right. I'm sorry u had that from your family too (it's just a dog) they just don't understand how much those pups mean to us.

[frijole]

Glynda, Glad you found us! I'll let Letti tell specifics but there has been vomiting previously (other days) but todays went from noon til around 4:30 pm and she didn't think she'd ever stop. That is what concerned me.

Yellow foamy and there was trembling at that time.

Kim

[Simba's Mom]

Just did the gum test and his look nice and pink, and I touched them and they went white and right back to pink and no tackiness. As of right now he's not trembling and hasn't thrown up since 3hours I'm thinking. He is resting quietly, I'm right by him, for the nite too.

[frijole]

When was the last vomiting episode and has the trembling subsided?

[lulusmom]

When was the last vomiting episode and has the trembling subsided?

That's good news and so is the fact that he is no longer vomiting. Did he have any diarrhea?

[frijole]

So he vomited from noon to 7 pm off and on?

[Simba's Mom]

Yes, from noon till 7, I'm so thankful he has stopped, and he is not trembling anymore either. He didn't have diarrhea that I noticed, but when he did throw up a few times he stood like he had to go.

[lulusmom]

That's a long time for Simba to be vomiting so I'm glad he appears to be hydrated. My mom's dog vomited off and on for 24 hours before she called me. I packed her up and took her to the er where she was hospitalized with pancreatitis and put on fluids. She also didn't have diarrhea. I hope he continues to improve through the night.

[Simba's Mom]

Thanks every one going to try sleep, nite

[Trish]

Hi
Hoping Simba is settled tonight, such a worry aren't they. I am not much of a help with your problems, the others have given great advice. But I wanted to tell you I always smile when I see your thread as I was a Simba's Mom too! He was a cat though.. along with his sister Nala :D So I just wanted to compliment you on your great taste in name selection and let you know I am keeping him in my thoughts, I have a soft spot for all Simba's canine or feline :) :) Hope you both get some sleep and Simba has perked up in the morning
Trish xxxxxxxxxxxxxxxxxxxxx

[molly muffin]

I'm just checking in on Simba this morning. How did the night go?

If I am remembering correctly, it seems that the vomiting episodes are having giving the Trilostane? About an hour or so later? If that is incorrect let me know. If that is true, then can you tell if it happens at any other times too? Like after eating.

Hope you had a good night and got some rest. (I know that is hard to do when you have a sick pup)

hugs,
Sharlene

[labblab]

Hi Letti,

I sure hope Simba is doing better this morning! If you do need to head it to see the vet, though, I want to tell you about one particular blood test to ask your vet about. It is the cPL blood test, and it is specific for checking canine pancreatitis. It is not part of a standard blood panel, so has to be ordered separately when the blood is drawn. But as I learned when my own dog had pancreatitis, the pancreatic enzyme levels on a standard panel can all fall within normal range even when a dog is suffering from acute pancreatitis. It takes that special test to make the diagnosis (or to rule out pancreatitis for sure).

Hope this info will be unnecessary and that Simba is looking much better. But if not, do talk it over with the vet.

Marianne

[addy]

Hi Lettie,

Hope everything is a bit better this morning. We are all surrounding you with love and prayers.

[Squirt's Mom]

Mornin' Lettie,

Hanging with the rest hoping sweet Simba is better this morning.

Hugs,
Leslie and the gang

[Simba's Mom]

Simba had a good nite no more throwing up, I made him an egg for breakfast since he was begging for food. He's drinking water too. He has appt this afternoon and I am armed with my notes, beware vet lol.
Trisha, thanks for your post, it really helped me smile too, and yes Simba is a great name, thanks for that.
Marianne, I wrote down the name of that test too, thanks so much for the info and your kindness.
Addy, thanks for your kind words and Leslie too, what would I ever do with all of you caring gals, thanks is just not enough.
I will post when I get back from appt. thanks again
No meds yet, waiting for vet appt.

[Harley PoMMom]

Hi Letti,

I sure hope Simba is doing better this morning! If you do need to head it to see the vet, though, I want to tell you about one particular blood test to ask your vet about. It is the cPL blood test, and it is specific for checking canine pancreatitis. It is not part of a standard blood panel, so has to be ordered separately when the blood is drawn. But as I learned when my own dog had pancreatitis, the pancreatic enzyme levels on a standard panel can all fall within normal range even when a dog is suffering from acute pancreatitis. It takes that special test to make the diagnosis (or to rule out pancreatitis for sure).

Hope this info will be unnecessary and that Simba is looking much better. But if not, do talk it over with the vet.

Marianne

I absolutely agree with Marianne, my boy, Harley, had normal lipase and amylase levels on the standard blood test but his spec cPL test came back high.

One additional note about the spec cPL test is that a dog has to be fasted for this test to be accurate.

Hoping Simba is feeling much better today.

Love and hugs,
Lori

[Simba's Mom]

Back from the vet, Simba is tired, 3 hours is a long time to be away from home for him. So the vet checked him out really good and did blood work, as soon as I get it I will post it, or get someone to help me;) so confusing to me. He got a cpl snap test too and that was low, but couldn't be ruled out vet said. I got some anti nausea pills and some prednisone, I really felt good about my questions, thanks to you all. The vet also gave me some low fat food sample size, and told me to keep trilo away for a few more days. She also tested thyroid, kidneys, liver, electrolytes, and other things that will show on blood work panel when I get it. Thanks so much for everyone's help, Sim is on the mend.
Could someone tell me a recipe for chicken and rice that's bland?

[Harley PoMMom]

Could someone tell me a recipe for chicken and rice that's bland?

Glad to hear Simba's feeling better!

When I used to cook for Harley, I would buy the 99% fat-free, boneless and skinless chicken breasts. I would take the breasts and put them in an roasting pan with water and add the rice too, add enough water to cover the rice/chicken, then into the oven. About every half-hour or so I would check the rice/chicken and then if needed add more water.

[molly muffin]

Super thrilled to hear Simba is doing better. I always think of a lion when I read Simba. He's like our little lion on here. Ferocious and yet cuddly, king of the forum. LOL

I hope these tests answer some questions about what is going on with him.

hugs,
Sharlene and Molly Muffin

[frijole]

I thought of you guys this morning because it was icy here. Was worried so appreciate a good update! You know me... can't wait to get the details of all those tests. We want to see them all :)

Give our Simba a big ole hug. Kim

[Trish]

Phew glad to hear he is doing better, I hope the results come back good for our Simba! Fingers and paws crossed :)
Trish xxxxxxxxxxxx

[labblab]

I sure hope Simba is doing better this morning! I just wanted to add another "bland" recipe for you. Lori's recipe sounds delicious, even for humans! But if you need something that requires less cooking time, here's a stovetop recipe. It involves cooking the chicken and rice separately. Look for ground chicken breast (not just "ground chicken" because usually that is too fatty). You can cook the ground meat quickly in a nonstick skillet with just a little cooking spray (the meat is so lean that otherwise it may stick even in a nonstick pan). In a separate pot, add together a cup of white rice and 4 cups of water. Then just stand and stir the rice (pretty much constantly) as you cook it over low-to-moderate heat. It will stick if you don't stir it, but it ends up being a totally mushy blend of the rice and water -- the individual rice kernals "melt" into a mush (kind of like a risotto if you've ever cooked that). You can even add more water as you are cooking if the rice isn't softening up enough to suit you. And then you just mix the chicken and the rice together in the dogbowl as you serve it. My dogs actually LOVE this, but I am lucky because they are Labs and will eat anything. It's funny, though, because my "pancreatitis girl" has had so much of this to eat at various times that now she expects she's going to get rice whenever I take the bag out to make rice even for my hubby and me. She comes out to the kitchen and looks up at me like, "Yum Mommy, are you making me my special rice dish?????"

Marianne

[Simba's Mom]

Thanks for caring for my Simba, it feels so good to not be alone in this journey. He's still doing ok, not quite himself yet but he's getting there. Feeling blessed to have him!
Harley's Mom, thank you for recipe I will give it a try, not with minute rice right?
Sharlene, yes Sim is my little lion with a big attitude, he thinks he's all that and then some lol...
Kim, I gave Sim a hug for you :)
Trish, thank you for the crossed paws!
Marianne, that recipe sound great too, thanks so much!
Hope to get fax tomorrow!

[Harley PoMMom]

Harley's Mom, thank you for recipe I will give it a try, not with minute rice right?


Yes, white rice and not minute rice. Since Harley had kidney disease I would use glutinous or sticky rice as this type of rice has the lowest phosphorus level.

[Trish]

Yay for good news, so pleased to hear he is improving each day! Go Simba!!! Lots of pats for the wee Doxie Lion :D

Trish xxxxxxxxxxx

[molly muffin]

So glad Simba seems to continue to be on the mend. Awful scary when they vomit like that.
You're doing awesome!

hugs,
Sharlene and Molly Muffin

[Simba's Mom]

So I got the fax today but it had no info on it, so tomorrow I will try again. It just showed the thyroid test that was ordered.. Simba is doing better, started meds today, he slept a lot, but thirst was down. He did learn a new game, he goes to the door like he has to go out, so I get up and walk to the door, and off he goes to the food bowl to beg! Oh Simba, you are too smart for me! Thanks so much for all the encouragement. Hopefully post some results tomorrow:)

[frijole]

Really looking forward to the reports - all of them. Please also share with us the meds they put Simba on. Thanks!! Glad he's taking charge of the house. :D Kim

[Simba's Mom]

Meds are the same, trilo 25 mg for the cushings and thyrosyn half tablet of 0.4 for thyroid, also gentizol for the ears.

[Trish]

That Simba is a cheeky little monkey tricking you like that, smart boy :D:D:D Hope he does good on the meds, do let us know won't you!
Trish xxxxxxx

[SoggyDoggy]

Wow! He's got you trained huh? Get Mummy up first then my chances are better! :D

Glad to hear he is on the mend though,always comforting when they start pulling these little tricks isn't it? So reassuring. :)

[molly muffin]

Hi, this report only has one result on it.

01/29/2013

TSH 0.18 Range 0.00 - 0.50 ng/ml (result within normal range)

Free T4 by Ed results are pending

Every good result is a good thing and something that can be eliminated from the list of possibilities. :)

hugs,
Sharlene

[Simba's Mom]

Just sent you new fax with more tests results, thank you!

[molly muffin]

Latest test results. I've posted only the out of range items

01/28/2013

ALP 740 (20 - 150) U/L
TBIL 0.7 (0.1 - 0.6) MG/DL
CA++ 12.8 (8.5 - 11.8) MG/DL
GLU 113 (60 - 110) MG/DL


(these I'm posting just so everyone knows they were good, not sure if part of thyroid T4 testing or what)

QC OK
HEM2+, LP 3+, ICT 0

cheers,
Sharlene

[Simba's Mom]

Thanks Sharlene, I don't know how you read those results but thanks again for always posting them for me...

[lulusmom]

With lipids of 3+ and hemolysis 2+, Simba defninitely has some high lipids (fat) in her bloodstream. Does the bloodwork show anything for tryglycerides or cholesterol? Both of these would normally be elevated with that much fat in the blood. Was Simba fasted for the blood draw? If not, did your vet talk to you about reducing the lipids via low fat diet?

[molly muffin]

I'm looking at the results nothing given for cholesterol or triglycerides on it.

[frijole]

GOod question re fasting... if my memory is working I believe Simba did finally eat some food the morning of the testing so that would certainly affect things.

[Simba's Mom]

All she was concerned about was the liver levels or billyrubin, I don't know if I spelled that right....she said kidneys were good, but said nothing about diet, just low till he felt better. I don't know what do you gals feed your crush pups?

[Simba's Mom]

Well today was eventful, after getting home from the heart hospital with my husband, I unloaded Tahoe and put bags in bedroom. Sim decided to go thru my bags and find my chocolate goodies from a friend. So after half a bag of kisses and a scotcheroo bar, he was in the er getting stomach pumped, thankful for a good friend that took him while I stayed home with my sick hubby. Sim is resting nicely as my hubby and I am too. Some days are just like that......

[Squirt's Mom]

geez, honey! What an awful weekend for you all! :( I so hope both your hubby and Simba are doing much better this morning.

What did you decided about feed? I noticed your last question wasn't answered. :o There really isn't a best food for all dogs; it's what works best for your baby in their situation. I cook for mine as well as feed kibble/moist food; Squirt eats all home cooked, Trink and Brick eat half home cooked and half kibble/moist commercial food, Sophie eats all kibble. The kibble I am feeding right now is Van Patten Natural Balance. Brick eats the fish formula and Sophie eats the duck formula. Trink is eating a new food called Freshpet Deli Fresh in the chicken formula. It is a wet food that comes in a tube that has to be refrigerated.

Let us know how your family is doing and I really do hope all is well with both of your guys.

Hugs,
Leslie and the gang

[Boriss McCall]

Oh no! so glad he is going to be okay. I am surprised my dogs have never done this. They like to snoop around in whatever bag I bring into the house.

[molly muffin]

Oh my gosh! Sick hubby, sick Simba. Wow you have had your hands full. So glad that your friend took him in to get pumped. I think it's like anything that you can't have, they want it. A neighbors dog got into a box of chocolates under the Christmas tree one year and had to go through the same thing, stomach pump. Uck, poor things.
I hope you are finding some time for yourself in the midst of the insanity.

hugs,
Sharlene and Molly Muffin

[Simba's Mom]

Well, today was better, thanks ladies. My hubby caught a virus that attacked his heart, so meds and rest and lots of prayers hope to find him better soon. It's a scary thing when they say the words, "congestive heart failure", and he is only 54, it's been a long few days, but praying for healing. He's on a low sodium diet, so it's been a learning experience, just doing the best I can, and praying his heart starts working better, right now it's working only half of what it should be, so he's on lots of meds.
Simba is doing better, but since the stomach pump he just can't seem to get enough food. He is on the Blue turkey and potato dry dog food, with canned for top since he a fussy little fur baby. Since they increased his tristo, his stomach is a little more touchy. He used to have beef or chicken treats, but now strictly turkey. He has also been jerking in his sleep, and his stomach is gurgling, hopefully this will pass, not sure whats going on with him.

[addy]

Oh Lettie, I am so sorry to hear all the issues you have had to deal with and I sure hope you are able to get off the roller coaster for awhile.

Prayers that hubby improves, I am so sorry.

Give it a bit of time, maybe Simba's tummy will calm down in a few days. Zoe has had the tummy gurgle once in awhile too after a dose change but then it calms down. Are Simba's poos okay?



BIG HUGS (((((((((((((((()))))))))))))))))))))))

[molly muffin]

Oh my gosh Lettie, that is so so scary. Did they say if the heart will be able to recover back to a 100% if it was a virus that caused the problems? I sure do hope so. 54 is just so young to deal with those kind of things.

Well, Simba did just have his stomach pumped so it might be that there is going to be some residual effects from that having to be done. I'd just give it some time and keep an eye on the little rascal.

Hang in there! You have a lot on your plate right now and we are right here any time you need to chat.

hugs,
Sharlene and Molly Muffin

[Simba's Mom]

Hey Addy, Simba's poos are ok, only problem is he wants to eat them:confused:, so I need to keep an eye on him. Hopefully his hunger will slow down, thanku for the encouraging words.
Sharlene, hopefully my hubbys heart will heal, its been a life changing experience, thanku for your kind words.
Simba is doing ok, seems like I'm a nurse for two now, and they are both pretty stubborn, I have my work cut out for me. So glad I have you all on here.....

[addy]

Nurse for hubby and Simba, Letttie, that is a hard one. I only had to do it for a week and it was hard and hubby did not have a serious illness.

Simba had a lot of stress and then his tummy being pumped, you can always try some chicken and rice rather than his food for a few days, maybe that will calm down the tummy. I'm glad his poos are good.

Food is hard because it depends whats all wrong with them. Dogaware.com has great articles and info about dog food. The thing is what works for one may not work for another.

I have to cut back on Zoe's protein intake. Both my pups are still on Honest Kitchen and it is about time to change up Koko's food again. Which is a good thing because the Honest Kitchen is pricey and I use their two most expensive foods:eek::eek: Zoe gets some commercial raw with hers and I cant change her food because of her IBD. It took me forever to get her adjusted to this food so I am going to continue to try to cut back on her raw turkey and convince hubby to cut back on her cooked turkey (he goes overboard with feeding all us, me included:rolleyes::rolleyes:)


Hugs, Lettie

[Simba's Mom]

Thanku Addy, I will check out that site right now, appreciate you so much!

[Simba's Mom]

Just wondering if the tristo helps with back leg weakness too? Sim is especially weak today and yesterday his back legs were trembling, he would look at me like he was scared poor little guy...

[addy]

The back leg weakness is a hard one. Sometimes it could be arthritis, it could be muscle wasting from their cortisol still not being controlled. It is usually one of the last things to improve. You have to build back muscle. It could be a side effect from the Trilostane. It could be other issues, neurological perhaps, another drug. Zoe cant deal with too much Tramdaol, for example, she cant walk right it affects her and cannot take Rimadyl AT ALL, she collapsed on it.

I do know Glynda has mentioned on other threads that if our pups are not well within theraputic range we may have to consider the possibility of muscle wasting for that hind leg weakness due to their cortisol.

Not sure if I helped you:o:o Half a dozen of one or another, I guess. I know watching their back legs weaken is hard.

[Simba's Mom]

Thanku Addy, do you know about the twitching in sleep at all? Sim is doing way more of that...

[NoonelovesmelikeNorman]

Hi Letti and Zimba! Just checking in from one doxie mom to another...Thinking of you and sending prayers of comfort and strength to your entire family.

(((HUGS))) and Love,

Sharon, Norman and Millie

[Simba's Mom]

Thanku Sharon, it's quite a ride, this road of cushings, wish I was off of it!

[molly muffin]

Ditto, Lettie! I know a lot of people have reported the twitching in their sleep. I'm not sure but it might be a part of the over all twitching side effects of vetroyl. Or what about dreaming?

Hope Hubs and Simba are both doing okay today.

hugs,
Sharlene and Molly Muffin

[Trish]

Hi Letti

It's time for a Simba update! Hope all going well for you and your baby and also that hubby has recovered well. Gosh, you have had your hands full lately so no wonder you have had no time to post. But you know we worry!! Hope Simmy is getting some sleep and not too twitchy, my boy does that too. Seems to worry me more than him :D

Trish xxxxxxxxxxxxxxxxxxxxxx

[Simba's Mom]

Hey Trish, thanku for the kind words...Hubby is gaining, not back to work yet but we own a grocery store in a small town so he can do lots of work from home.
Simba is doing ok, I seem to notice hair loss on his beautiful little tail, and seems like his senses are in full force, he always has his nose in the air sniffing, although he has a big head too! ;)
He sleeps alot too, but that could just be his age, he will be 11 in April.
I think since he has cushings, I watch him all the more..could be normal stuff but I'm a worrier! Sometimes when I come to check out things on this site a new fur baby has gotten cushings and I just want to scream, I really wish there was a cure for this disease. It really helps to have this site, because so many people are not understanding when it comes to sick fur babies and how much we love them... take care

[molly muffin]

You couldn't be more correct Letti. Some people don't understand, and I too wish they'd find a cure. Maybe if they can find out what causes it, they then will be closer to finding out how to cure it. One hopes anyhow.

Glad to hear that hubby is doing better. Working from home is sometimes a good thing and not working and taking it easy is even better! :)

hugs,
Sharlene and MollyMuffin

[Simba's Mom]

Simba is having a lot of gurgling sounds from his tummy, anyone know what that means?

[Harley PoMMom]

It could be gas or something has upset his tummy.

[Simba's Mom]

It's gurgling every day with every meal, and he's always begging for food. Sometimes I wonder if it's fair to him that I want him to be around longer, that I do whatever I can for him. I hate this disease, it sucks and makes me angry. I wish there was more I could do for my sweet Simba, he's just not himself....what if I don't treat him, this is so confusing...Sorry needed to vent....

[Trish]

Awww they do that sometimes, are Simba's poops OK? How's he doing generally... hate the down days so big hugs for you xxxxxxxxxxx

[addy]

Down days are bad so you need extra love and TLC. Is Simba taking any kind of tummy acid reducer? I cant remember if he is on Pepcid or not. Do you think his cortisol may be going higher if he seems hungry all the time? When was his last ACTH test?


If he is having symptoms you feel are side effects from the Trilostane/Vetoryl, you can always stop it for awhile and see if they go away.

Zoe would have on again off again tummy gurgles and I would freak out wondering if she had Pancreatitis but then it would stop. That was awhile back.

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

[molly muffin]

Every notice how the fall back is always poop partrol? :D:D

I know it sounds funny, but really, the poop tells us much, just like the urine. So I'd probably keep an eye on his poops, make sure he isn't vomiting, and is eating okay. Those are your basic standby positions and anything seems off in those areas, then you take him in to get checked out.

When was his last ACTH test? remind me again please. (the brain can be foggy)

How is your hubby doing?

hugs,
Sharlene and Molly Muffin

[Simba's Mom]

Today I took Sim for a ride, he use to love his rides, he whined the whole time and got stuck between seats cuz hes so restless, and his back legs are weak. He pooped this morning, but kept pushing and moving like he wasn't finished. I wonder about his food cuz he poops alot, but way better then on the science diet, it was usually runny.
Just when you think its going smoothly theres another bend in the road. Last nite he stared at stuff like he was seeing things moving, and up and down barking so restless. Yes, I having a down day, my best friend is sick and there's nothing I can do..His next stim test is in June, so hopefully his levels are ok. He does not take pepcid or anything for his tummy, maybe I should look into that. thank you for listening....

[Simba's Mom]

Whoa, do I sound crabby or what? My pity party is finally over, I have so much to be thankful for...
My hubby is doing better, hopefully on this week Thursday we will find out if his heart is healing..He is gaining on strength and feeling more like himself, so feeling grateful for that.
Simba is here with me yet, I'm so thankful...
And this site is amazing, I never feel alone, so thankful for that too!

[Harley PoMMom]

Letti,

From a quick scan of your thread I found that Simba's last ACTH stim test was in October, is this correct? If so, then IMO, he should have one done now and not in June. In Dechra's product insert they recommend an ACTH stim test be done every 3 months when a optimal dose has been reached.

Pepcid AC or slippery elm bark are both good products to use for a "gurgly" tummy. Hope sweet Simba is feeling more like himself very soon.

Please know we are here for your too, so please do all the venting that you want or need to do. ;):)

Love and hugs,
Lori

[Squirt's Mom]

Hi Letti,

I understand the car riding sadness. Squirt perks up at the word "ride" - she loves to ride. But in her old age she has gotten too fragile and for some reason just about refuses to sit or lay down in the seat anymore. She wants to stand the whole ride and I can't allow that with her legs. I can just see one or both of those pins snapping as she tries to maintain her balance or her falling off the seat and it horrifies me. We used to travel 100's of miles a day with ease and now a ride to the vet 30 min. away is just about too much for her - it causes her pain. :( We took our last road trip in Oct of 2011 and I know we both miss those times on the road together. Now our adventures don't involve a vehicle but rather we wander around in the field or woods by the house and she is happy for those times today. Anything that brings a bounce to her step and a shine to her eyes is joy for me. ;)

Hope you and your family have a great day!
Hugs,
Leslie and the gang

[molly muffin]

Just to refresh our memories, the last ACTH test result was on 01/21/2013

Pre - 3.1
Post 6.7

It could be that he needs to come down a tad bit more if you are still seeing worrisome symptoms.

Sharlene and Molly Muffin

[Simba's Mom]

Simba has the runs today, accident in the house, hubby not happy:( it's like Simba has to perfect then he is ok with him but we all know our dogs are not perfect, nor are those hubby's! Should I keep the trilostane away for a day or so?

[Harley PoMMom]

It is always a good idea to with-hold The Trilostane when a dog displays symptoms of being ill, and IMO, diarrhea is a sign that Simba is not feeling well. Is Simba having any other ill effects such as vomiting, lethargy, and/or inappetence?

[Simba's Mom]

He sleeps a lot but no vomiting, he did eat some of his own poo last nite so that might be the problem too, I have to get out and get it before he does ew:(

[addy]

Hi Letti,

Zoe cant do car rides much any more either which makes the vet trips hard, she is like Squirt, she wants to stand or if she will sit on my lap if hubby drives, but she cant really get comfortable. It is a loss and sad, but we adjust and try not to think about it. Someone once said aging is not for the faint of heart:(:(

Hang in there sweetie, you have had so much to deal with, a sick huby and a sick pup.

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

[molly muffin]

Hi Letti,

How is Simba doing? It could be that eating his poo made him feel sick the next day.

Sharlene and Molly Muffin

[Simba's Mom]

Simba is doing ok today, poos are still loose but he is acting fine.... I guess everything changes as they age, it's like I blame everything on cushings so I tend to get angry. I know I have to come to terms with Simba aging too, seriously I have lots to work on....:(

[molly muffin]

Seriously, we all do. It's not easy to know they are getting older, it's not easy to know that we're getting older either, but for them it's harder, because their lives are so much shorter than ours. We see the whole thing from puppyhood to old age in what seems like the blink of an hour.
Cushings doesn't help though that's for sure. Just one day at a time, or even one hour at a time on a bad day and there will be good ones and bad ones. It's unavoidable. So, deep breaths and just keep on hanging in there. You have a lot more on your plate than Simba, so don't let it all overwhelm you too much.

BIG HUGS
Sharlene and Molly Muffin

[infoviewer]

Hi Lettie: My 11 1/2 year old mini Doxie has a problem with diarrhea also. My vet told me to give him Pepto Bismol and I do occasionally and it has not seemed to hurt him. I don't think you should give it all the time since it does have some things in it that might not be good for them. I usually just give him less food and never anything from the table. I have tried to change his food to Blue Wilderness, but have not been successful with that yet. I have tried pumpkin and the slippery elm and chicken and rice, but those have not seemed to work for him either. Seems like just less food and Pepto help more than anything so far and his stool is usually only soft one day. We just do poop patrol every day. That seems to be the life of a cushing dog's mom and pop. Hugs, JoAnne

[Simba's Mom]

Thanks Sharlene and Joanne, your encouragement helps, Joanne what do you find your Doxie? Simba get a turkey frank with his meds that's the only way he will take them tried everything else, and then he gets wet food on dry, but mostly eats the wet...and then begs for more wet, I need to get him off the turkey franks and the wet food but he will not eat the dry...

[Trish]

Hi
Pleased to hear Simba is doing ok at the moment, that aging thing and coming to terms with it is so hard, seems one minute they were a puppy and the next we are dealing with all these problems. Sure is hard to get your head around sometimes. Hope your having a nice relaxing weekend :D
Trish

[molly muffin]

Hope you and Simba and hubs are having a nice, calm weekend.

hugs,
Sharlene and Molly Muffin

[addy]

Hi Lettie,

Hope poop patrol is good this weekend. LOL though, I had such a smile when I read about the turkey franks as I could so picture Simba loving them and not wanting anything else. I think Zoe's eye would pop out of her head if she were able to taste a hot dog of any kind:D

hugs to you and Simba and I understand exactly how you are feeling, girlfriend!!

[Simba's Mom]

Thanku so much ladies, you made my day! Thinking about you with your pups too, what a great support group this is!!!!

[infoviewer]

Hey Lettie: I feed CoCo Blue Wilderness, grain free, but had always feed him Eukunuba which he still likes better, but I have to watch what he eats or he gets diarrhea, never anything from the table. Seems just a bit upsets his stomach. He actually would eat anything I think, even the Hill's ID which I did not like the wet food so went back to kibble. CoCo would love a turkey hot dog, but he is so greedy he would probably get choked if i did not mash it up for him. His dog bowl is the one with post-things up in it for dogs that inhale their food. I have accidentally dropped something on the floor that he could not eat and I had to quickly get my foot on it before he got choked. It is a real zoo here. Have a good day. Love JoAnne

[Simba's Mom]

Headed to vet with Sim, he is throwing up and has the runs, plz say a prayer for him, thanks.....

[milosmom]

sending prayers and healing energy for your simba...hang in there letti ...patty(milo)meka xoxox

[Mel-Tia]

Hi Lettie

Positive mojo coming your way from the UK, hope you and Simba are ok

Mel
Xxxxx

[addy]

Lettie, please let us know when you can.

love and hugs, tons of prayers

[molly muffin]

Oh dear, just saw this. Hope Sim is doing better. Let us know when you get a chance!

hugs,
Sharlene and Molly Muffin

[Simba's Mom]

Just home with Sim, he's doing better now that he's home, all that fuss wore him out..It's about an hour drive there, and he cried and panted the whole way there, poor little man....anyways, the vet did a Giardia test which was negative, and a physical exam which she said he did well on...she did pop in the back for a minute and Sim politely tooted:p...she did say his tummy was full of air, so he's on Reglan and Metronidazole and also i/d canine canned food...the vet wasn't sure if this was a chronic issue like irritable bowels or just Sim got into something that I wasn't aware of (acute attack) so I will keep an eye on him and see how he does...thanku for all for the prayers and encouragement, I'm such a worrier I didn't know if Sim would be ok, so hard when they are sick and right away I assume it's the cushings...I appreciate you all so much!!!

[molly muffin]

Glad to hear Simba is doing better now. It could be that he does have Irritable Bowel syndrome. If so, Addy can tell you all about it. :) Her Zoe has been dealing with that for a long time.

You're doing great. :) Not everything is cushings, but cushings does lead to many other possibilities. It just affects so much of their body.

hugs,
Sharlene and Molly Muffin

[milosmom]

happy to read this letti !!! and don't you worry solo there are lots of us here to share the worrywart status,as horrific as that is, this is what most of us here do best.so i wish you a peaceful,restful easy night.pleasant dreams to you and simba...patty(milo)meka xoxox

[doxiesrock912]

Letti,

Ask the vet about the posibility of a bacterial skin infection! I just went through this with Daisy and they gave her Baytril which coincidentally eliminated the diarrhhea that she's literally had for 2 years (improperly diagnosed as IBD)!

When I mentioned this "miracle" to her newest vet, he said that Baytril would have no affect on diarrhhea due to IBD and surmised that Daisy must have had a long standing systemic infection. Most likely due to something that she ate.

Prior to the Baytril, we went through changing food to Hills I/D then R/D, the diarrhhea always came back the same or worse than before so I put her back on Royal Canin with all natural canned pumkin as a treat. Now, Daisy has normal poops without pumpkin, obviously, she did not have IBD. Needless to say, I feel like a bad fur-mom because I trusted the vets' diagnosis.

Good luck sweetie :)

[Squirt's Mom]

Hi Letti,

So good to hear your report on Simba this morning. Glad he is better and hope this isn't repeated!

Hugs,
Leslie and the gang

[addy]

Oh Lettie, big sign of relief:):):)

It seems this time of year, they find all kinds of wonderful things under the melted snow and cant resist eating the junk. I hope that is all it is.

Big hugs, sweetie

[molly muffin]

I didn't even think about it till Valerie mentioned the Bacterial skin infection, but Molly had diarrhea from a Bacterial intestine infection and had to be on antibiotics. That would be another possibility.

hugs,
Sharlene and Molly Muffin

[Simba's Mom]

Thanks everyone for all the shared info, you can never have enough!
Simba is doing ok, he still likes his own homemade poo sicicles ew :(
but his poo is getting firmer. I got him off the turkey hot dogs, he wasn't happy with me but he is adjusting...if looks could kill, oh Simba!!
He has started biting on his tail, and there is more hair loss, maybe I just haven't caught him before, hmmm...He also is very restless at night, up and down, in and out, makes for a busy nite...his water intake is down right now, and he seems less interested in eating..but still seems ok...also I'm finding more fatty tumors on his tummy area, maybe just an age thing..easier to blame cushings I guess. I started taking him on walks again, he loves the nice weather, for two days he did great, today I carried him home, he was tired, poor little man always took me for a walk before :) but I'm blessed to have him yet!
Take care everyone, hugs to your pups and you, have a blessed Easter!

[molly muffin]

Hi Letti!!! Happy Easter to you and Simba and your husband (hope he is feeling better now too)

I know exactly what you mean about biting on his tail. Molly does it too sometimes. Drives me up the wall! She's done it since she was a puppy, some sort of comfort thing I think.
Awww, poor little Simba, long walk was just too much tonight. Again, I can relate, I've had to carry Molly a few times when we went too far and she just stopped and wasn't going any further. I think that is what happens when her legs or hip is bothering though or she just doesn't feel up to par. I guess it could be she is just too tired. I never know for sure which it is.
You have a wonderful Easter weekend. Boy I could get use to have a 3 day weekend, every one! hahahaha

hugs,
Sharlene and Molly Muffin

[Simba's Mom]

Simba is having tummy issues still, as I sit here writing this I can hear his tummy :( I just called my vet and she is so helpful...she told me to try a hypo allergenic dog food, or something like ID which he has been on before...we are trying a few things to see how we can best treat him...I did ask about Baytril and she said that is for bacterial infections, and metronidazole which he is on should help with that...He's taking 250 mg, but she said we could go up on that, so do I do that or do the food change? Thanku

[addy]

Sorry to hear that, Lettie. How long has Simba been on the current food? How long has he been on the metronidazole? I assume that is 125mgs twice a day.

How are his stools? Are they ever formed and normal? Do they start out good first of the day then go down hill? Do you see mucus in the stool? How many bowel movements does he have?

Or is it just the tummy gurgles? Is he eating as usual?

Sorry for all the questions:o

[molly muffin]

Oh and ask about the digestive florafora (or however it spelled, I'm doing it phonically right now)

I haven't a clue about metronidazole, so can't comment on that. :(

Your vet does sound very helpful
hugs,
Sharlene and Molly Muffin

[doxiesrock912]

Daisy was put on metronidazole when she had the emergency illness from the Blue Buffalo food a few years ago. It worked well, but her diarrhea came back over time.

HAs the vet ruled out a bacterial infection?

[Simba's Mom]

hey gals, I changed foods about a year ago, he just wouldn't eat that id stuff, so stared him on blue buffalo turkey and potatoes for sensitive stomaches, the kibble and the canned...the only treats from that company too....he has been on the metronidazole for a little over a week......he poos almost every time he goes out, it used to be twice a day, but it has gotten worse, his poo does start out good, not great and does seem to get worse, and formed a little bit.....thanku for your help, I appreciate you all so much!!

[addy]

Have they asked for a stool sample to check?

When Zoe would have her "colitis" bouts, I would cut back on the amount of food I fed her. Sometimes it takes awhile for the metronidazole to work. You could always take Simba off the food and cook chicken and rice meal along with the metronidazole before upping the dose.

Inflammatory Bowel Disease is usually diagnosed through endescopy.

Sorry, Letti, have to run I'll be back

[addy]

It seems we dont know what is causing the tummy issues and the possible causes are many. What were the results and when was Simba's last ACTH test?

Normally, for a dog without other health issues (diabetes, etc) the first line of defense is resting their digestive tract for anywhere from 12-24 hours. I could never do a 24 hour fast with Zoe so I would opt for 12 hours. I also could not feed her a different diet so I would start increasing her normal food very gradually along with the metronidazole doses. I hate to be technical but she would have watery, squirty poos that she could not control.

If Simba does not have that and is having frequent soft serve stool and does not have a history of having problems switching foods, you could opt out of his current dog food and try cooking up soft chicken and rice after allowing his system to rest for 12 hours. You slowly increase the amount of food served. Lori has a good recipe.

Sometimes metronidazole itself can cause loose stools, I know, what the heck, right?

Since I dont know what you have already tried for Simba it is hard to have an opinion. Sometimes you need to give the metronidazole more time but you also may need to cut back a bit on how much he is eating.

With the tummy gurgles and soft stool I sometimes wonder about a mild pancreatitis attack but again, Lori can give you more input with that. The Gentle Digest helped Zoe but every dog is different. You have to give it at minimum 2 hours part from the metronidazole. Any holistic pet store should have it or you can order on line. Or you can ask you vet about Purina's Forti Flora. I think it is cheaper through Amazon verses your vet. The only reason I stopped giving it to Zoe was I just did not like that "animal digest" ingredient but that is just me and then the holistic vet pulled her off of it. I am just weird. If I dont know what an ingredient is, I dont want to give it to Zoe. I took her off her Shen Calmer for the same reason. No one could tell me the ingredients because they were written in Chinese.:rolleyes:

[goldengirl88]

Lettie:
Sorry to hear Simba has tummy issues, I know how hard it is to hear their little tummy make noises. I hope things get turned around soon. God Bless you both.
Patti

[addy]

Hi Lettie,

How is Simba doing? Just checking in on you and poop patrol.

Saying hi too:D:D:D:D:D:D:D

[molly muffin]

Hey ya from me too. :) How is Simba's tummy? Is the metronidazole helping yet?

hugs,
Sharlene and Molly Muffin

[Simba's Mom]

Simba took his last metronidazole today, still no changes so I will just keep watch for next few days see how is tummy is...I'm worried if I make him chicken and rice he will never go back to kibble, and my husband would really look at me weird if I cooked that way for Sim...the last time I took Sim to vet cuz of this tummy stuff my husband told our employees that Sim was maybe going to be put down...like what :( I was not happy, needless to say....Feeling alittle down about it but Sim is staying with me as long as he's not in pain! My husband is a pain, maybe I will take him to the vet, just kidding!!!!!!!:D:D:D
Thanks for checking how Sim is, you gals rock.....

[molly muffin]

heehehheehe Letti. Yea, he best not be making statements like that if he doesn't want to end up in the dog hours himself. :) pfffft
Hopefully Simba's tummy will calm down. He does have a very sensitive tummy and when I look back to the beginning, Simba has always had a sensitive tummy and it seems to me that anything off can send him into diarrhea and gummy gurgles, etc.
Maybe just give him very small meals, several times a day and see if that helps.
These poop patrols can be really nerve wrecking.

hugs,
Sharlene and Molly Muffin

[infoviewer]

Hey Lettie: I think it goes along with the Cushings, CoCo has it too, I have to do poop patrol every time he goes out. I just give him small meals. My vet told me to give him Pepto or Imodium when I saw the poop getting soft or change to the ID food and I do give him a little Pepto and watch his food carefully and can never give him anything except the dog food. It seems to be an all consuming job. I have to watch when the grass is first cut that he does not eat green grass, not because he is sick and eating grass, just because he likes it. Sometimes I wonder if it is the Trilostane also that causes the loose stools. I guess it is a combination of everything. We are so happy when he has a firm stool. hehe. Good luck. Love, JoAnne

[doxiesrock912]

Letti,

try the Fortiflora or something like it. I haven't heard Daisy's stomach gurgle since she's been taking it.

[Simba's Mom]

Thanku gals for the ideas, hey Val, where do I get that stuff? I think I found it on Amazon, do you do pd or chews?

[molly muffin]

Letti, with the Fortiflora what I use is a powder that you sprinkle on their food. Molly LOVES it.

http://www.amazon.com/Purina-Veterinary-Diets-Fortiflora-Sachets/dp/B001650NNW/ref=sr_1_1?ie=UTF8&qid=1365460335&sr=8-1&keywords=fortiflora+for+dogs

hugs,
Sharlene and Molly Muffin

[Simba's Mom]

Thanku Sharlene, I'm going to get some!!!

[Trixie]

Hi Lettie, I'm very new here and not versed in Cushing's so much yet but my dog Trixie has had several major diarrhea bouts over her nine years. This is all pre (possible) Cushing's for us so has nothing to do with meds but we had a really bad bout which began last June. It took until October to diagnose her with a bacterial infection called clostridium. It's a tough one to see apparently but once they finally found it Trixie was put on Tylan powder (sprinkled on her food) along with metronidazole and that finally worked.
I believe clostridium may always be present in the dogs system but there can be an overgrowth of it and it causes colitis like symptoms--we had blood and everything, it was bad. I will say that the Tylan powder is like a miracle after we went through many weeks of on and off diarrhea. Trixie had major stomach gurgles too and still does sometimes. I use Pepcid ac for that and it works. One half at night before bed usually keeps the gurgles at bay.
Anyway not sure if Tylan is something Simba needs or can have but it worked great for us. I hardly used any..1/16 of a teaspoon. Had to go find a bunch of measuring spoons that actually had that size, it's small.
Have they tested her stool for anything other than giardia? They kept doing the same giardia test for us and finally the vet decided to use her own microscope and do some checking herself and that's when she found it. What a relief when we eradicated it..didn't think we would ever see a solid poop again but we have had regular solid stuff for months now! (sorry to get a little gross!) Also they ran pancreatic panels as well that turned up normal. Those clostridium bacteria were nasty!! Hope Simba's tummy is better soon.

[doxiesrock912]

Letti,
it's very possible that Simba has some type of underlying bacterial infection. Daisy did, previous vets assumed that it was IDB! A prescription for Baytril took care of it and the Fortiflora has improved the other symptoms (I use the powered form, 1/2 packet with morning meal and dinner).

Keep us posted!

[Simba's Mom]

Happy 11th Birthday to my big boy Simba, I am blessed beyond measure to still have you!!! Love you Sim!

[Squirt's Mom]

Happy 11th Birthday, Simba!

[labblab]

Congratulations, Letti and Simba!!! :) :) :) :)

Happy Birthday, Sweet Boy!!! :D :p :D :p :D

All best wishes from me,
Marianne

(And I've taken the liberty of revising Simba's thread title to reflect this special milestone ;))

[addy]

I LOVE BIRTHDAYS:):)



Happy Birthday Simba, Happy Birthday To You

[goldengirl88]

Dear Lettie and Simba:
First of all happy birthday Simba. You are truly blessed to have you baby with you Lettie. I can tell you put your whole heart and soul into helping him. May God Bless him for many more birthdays.
Patti

[doxiesrock912]

Happy Birthday Simba!!!!

[molly muffin]

simba!!!!!!


happy birthday



Hope you have a wonderful day with your momma dear Simba!

huggies from Sharlene and Molly Muffin

[milosmom]

woohoo happy 11th birthday simba !!! congratulations lettie,may there be more healthy and happy ones ahead !!!patty(milo)meka xoxox

[infoviewer]

HAPPY BIRTHDAY SIMBA. Hope you have many more. Love, JoAnne

[Harley PoMMom]

Happy Birthday Simba!!!

[Trixie]

:D HAPPY BIRTHDAY TO SIMBA :D

from newbies, Barbara and Trixie