Daisy Mae - our sweet Daisy has crossed The Bridge

[doxiesrock912]

Hello everyone,


Daisy Mae "monster" is a 9 yr. old, 14 lb, miniature, smooth, black and tan Dachshund.

I've suspected that Daisy may have Cushing's for almost a year now since she never fully recovered from a severe reaction to Blue Buffalo Wellness dry dog food 2 years ago, but her vet insisted that it was IBD because she had chronic diahrrea. We have since changed vets to Dr. Toby Kimm of Ragged Mountain in Plainville, CT.

Aside from the diarhhea, she has a markedly increased appetite. I've had to add water to her Royal Canin Dachshund formula to make her eat slower and avoid choking. Now she's drinking a lot of water, recovering well from her first ever bacterial skin infection, and at times seems indifferent toward me. She had luxating patella surgery in 2005 and has arthritis in that rear leg now which responds well to glucosamine chondroitin MMS? (I think those are beneficial omega 3 fatty acids.)

She's just begun 20mg, once a day of Trilostane and the vet suggests that we do some imaging because she's starting to get the pot belly.

Here are the results of her LDDS test and followed by what the vet had to say in response to my email asking for clarification.

CORTISOL SERIAL 3 (OEX)
Time 1 Pre
Time 2 Post
Time 3 Post
Cortisol Sample 1 8.8
ResuIt verified .

Cortisol Sample 2 Dex - 3.7
Result verified .

Cortisol Sample 3 Dex
Result verified . 4.5

Low-dose dexamethasone suppression test: Normal: Cortisol level less than 1.4 ug/dl 8hrs post-dex.
Hyperadrenocorticism: Cortisol level greater than 1.4 ug/dl 8hrs
post-dex.

If the 8hr post dex. cortisol level is greater than 1.4 ug/dl, the following can be used to difierentiate pituitary dependent hyperadrenocorticism (PDH) from an adrenal tumor : 1. Cortisol level less than 1.4 ug/dl 4hrs post-dex is consistent with PDH .
2. Cortisol level less than half the baseline level at either 4 or 8 hours post-dex is consistent with PDH.
(Samples taken at 2 or 6hrs are interpreted the same way as a 4hr
sample)

If neither of these criteria is met, further testing is needed to differentiate PDH from adrenal tumor Cushings.

NOTE: Approx. 5% of dogs with PDH have normal results. False positives

Vets Response to my email asking for clarification of the results:

Hi Valerie, In response to your questions, we did a dexamethosone suppression test, low dose, as opposed to an ACTH response test. The better test changes about every 4 years, and now the dex suppression test is better, according to both meetings I went to last year on Cushings. From the results, there is no doubt that Daisy has pituitary dependent hyperplasia, as a more than 50% reduction at either 4 or 8 hours from the baseline indicates PDH. As for the bloating, it is along with PU and PD, a clinical sign of the disease. That being said, an ultrasound of the abdomen is always a good idea with any Cushings suspected cases. We can also take new abdominal xrays, as we have been updated to a digital system since your last visit and the contrast is much better. I am still using Trilostane at once daily dosing, as I believe the twice daily is more prone to overdose. I have had three cases in the past month where we had to go to every other day dosing as we were causing signs of Addisons Disease (weakness, megaesophagus collapsing) on the daily dose. I will scan the bloodwork in following. - Toby Kim

What else can you tell me about the results? Is she in the beginning stages of Cushing's? The pharmacy said that the 20mg daily dose was on the low end of the spectrum.

Also, is anyone familiar with the Cornell University Veterinary Hospital in Stamford, CT? Going there is an option too.

New surgery options?

There is so much information on the internet that it became overwhelming.

Thank you in advance for your help.

Valerie

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Gracie Daisy

[Harley PoMMom]

Hi Valerie,

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

By the description of Daisy's clinical symptoms plus the positive results from the LDDS test it sure seems that Daisy does have Cushing's resulting from a tumor on the pituitary gland. Just to confirm the diagnosis of Cushing's an ACTH stim test or an ultrasound should be performed because not one test is 100% accurate at diagnosing Cushing's disease.

Although I am not a vet, with Daisy weighing 14lbs I would of liked to see her starting dose begin at 10mg instead of 20mg. Does your vet follow the proper protocols when monitoring with an ACTH stim test, such as having an ACTH stim test conducted in 10-14 days after treatment has begun? And the ACTH stim test has to be performed 4-6 hours after the dose of Vetoryl is given. Also did your vet mentioned that Vetoryl has to be given with food to be properly absorbed?

Was a chemistry/cbc blood panel done and if so could you post any abnormalities that are listed along with the reference ranges and units of measurements. Was diabetes and any thyroid problem ruled out? Is Daisy taking any other herbs/supplements/medicines? So sorry for all of these questions but the more we know about your sweet girl the better our feedback can be, ok?

Here is a handy link with info about Trilostane/Vetoryl: Trilostane/Vetoryl Information and Resources (http://www.k9cushings.com/forum/showthread.php?t=185)

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

Love and hugs,
Lori

[doxiesrock912]

Lori,

I just emailed the vet asking for the other test results that were performed the first day that I brought Daisy in. We did the LDDS on the second visit.

She seems more active already and it's only been the second day on Trilostane. Still "pigging out" and drinking a lot. I'm hoping that we caught this early.

Unless I'm told otherwise, I give Daisy all medications and supplements with her breakfast and then we go outside.

This is the most recent reply from the vet.

Valerie,
If you mean imaging, I think $350 covers an abdominal ultrasound. Abdominal radiographs are $220. We have omega 3 fatty acids or you may order them on line and i will fax a prescription. As for the food question from before, I am not sure. I like to do an ACTH response test two months into therapy as a monitor on success of therapy.


Ask away, I'm new at this and want to learn as much as I can to make informed decisions about her treatment.

Valerie

[Simba's Mom]

Hello and welcome from Simba and me! Simba is a mini Doxie, on the heavy side but every pound is loved :) he will be 11 years old on April 9, he has been on trilostane since Aug of last year. They started him at 20mg and is now on 25 mg. This forum has been awesome, knowledge is power and the encouragement is a blessed bonus. Take care, we are here for you!

[doxiesrock912]

Thank you Letti!

I read many of the threads before Daisy was diagnosed because I had suspicions.

Has Simba ever had a salivary mucuole? If so, what did the vet do for that?
Daisy has one, but because it isn't bothering her or interfering with eating, breathing, etc the vet prefers to watch it.

Did you suspect that Simba had Cushing's before vet confirmation?

Valerie

[Simba's Mom]

No, sorry I don't know what that is, what else can these poor pups have right? I actually changed vets because my old vet was saying Simba was just fat, but I knew it was more by his symptoms... He was drinking like crazy and he had some hair loss besides his pot belly....
I love the name Daisy Mae, and quick question for you, does she do well on the dashound royal canin food, and is it low fat?

[Harley PoMMom]

Lori,

I just emailed the vet asking for the other test results that were performed the first day that I brought Daisy in. We did the LDDS on the second visit.

We will definitely be looking forward to the results of those tests. ;)



She seems more active already and it's only been the second day on Trilostane. Still "pigging out" and drinking a lot. I'm hoping that we caught this early.

Cushing's is a slow progressing disease, many elder dogs can go undiagnosed for years and when treatment begins some clinical symptoms begin to abate within 2 weeks.




Unless I'm told otherwise, I give Daisy all medications and supplements with her breakfast and then we go outside.

This is the most recent reply from the vet.

Valerie,
If you mean imaging, I think $350 covers an abdominal ultrasound. Abdominal radiographs are $220. We have omega 3 fatty acids or you may order them on line and i will fax a prescription. As for the food question from before, I am not sure. I like to do an ACTH response test two months into therapy as a monitor on success of therapy.


Ask away, I'm new at this and want to learn as much as I can to make informed decisions about her treatment.

Valerie

IMO, 2 months is too long to go for an initial monitoring ACTH stim test. If a dog is doing really well in the beginning of treatment, a month is the longest that I would wait to have an initial ACTH stim test performed.

Many vets want a dog to be fasted for an ACTH stim test but a dog that is being treated with Vetoryl/Trilostane has to have some food with the dose of Vetoryl/Trilostane, even when an ACTH test is scheduled.

Please read the articles at this link: Trilostane/Vetoryl Information and Resources (http://www.k9cushings.com/forum/showthread.php?t=185)

If this were me, I would have the abdominal ultrasound done because it can give you a lot of helpful information about all of Daisy May's major organs.

Love and hugs,
Lori

[doxiesrock912]

Daisy hasn't had a single issue with Royal Canin and I'm still beating myself up for changing that one time which literally almost killed her. She was vomiting and bleeding from her rear end within a week of being on Blue Buffalo Wellness formula. BB insisted that nothing was wrong with their product and despite sending them ALL of the vet documentation, they refused to reimburse me.

I also give Daisy frozen carrots (not many because carrots contain a lot of sugar), cauliflower, green beans, and broccoli every few days in addition to the Royal Canin. She also tried Hills R/D when a previous vet thought that she had IBD.

I'll never change her food again.

She's had periodic weight issues mostly because grandpa likes to give her treats or too much food, but a week of exercise brings her right back to normal. Now she appears fat, but that is obviously only because of the recent pot belly.

Valerie

[doxiesrock912]

Thanks Lori,

Daisy has had chronic diarrhea since the incident with BB Wellness food despite being changed to Hills R/D at one point which had a minimal affect (the vet who assumed that she had IBD).

Ironically, the new vet prescribed Baytril 22.7mg to treat the bacterial skin infection and all episodes of diarrhea ceased almost immediately. I mentioned this to Dr. Kim on the second visit and the light bulb came on because according to him, if she had IBD the Baytril would've had no affect at all on the diahrrea. He said that she may have had a systemic infection all of this time from the bad dog food. I told him that the only thing ever mentioned to me before now were higher than normal liver enzymes and none of the other vets ordered more tests.

As of now, Daisy is almost done with the prescription of Baytril 22.7mg, almost done with the EFA 2N (formerly A2N) Omega 3 & 6 antioxidents (prescribed by a former vet who missed the Cushings), Osteo Pet Glucosamine Chondroitin MSM, and the Trilostane 20mg.

Dr. Kimm (current vet) said the continue all of them until they're gone. I sent an email to him asking to verify if he really meant two months or maybe should've said 2 weeks.

I'm not sure how much of the improvement in the past two days is due to the Trilostane or the Baytril.

I'll let you know the other test results and what the response is to me questioning the timeline of the ACTH stim test.

I'm unemployed and he's conservative with treatment according to my good friend Lamont who recommended Dr. Kimm. My friend did say that Dr. Kimm is honest and if he really feels that something needs to happen, he'll let me know.

Lamont has used Dr. Kimm for years, he has dogs, cats, and birds.
So far, he's done well by Daisy Mae (thank you for complimenting her name, it fits).

I never had kids, am recently engaged, so Daisy and Gracie (long haired gray cat) are my children <3

Valerie

[Harley PoMMom]

Hi Valerie,

The ACTH stim test is an expensive test because of the stimulating agent, cortrosyn. Vets will usually use a whole vial (.25 mg (250 mcg)) of cortrosyn but studies have shown that only 5 mcg per kg of weight is necessary for an accurate result. I am providing a link to an article with info on how to split, reconsititute and store cortrosyn for future use. This article is written by a renown cushing's expert, Dr Peterson: How to Extend Your Supply of Cortrosyn and Lower the Cost of ACTH Stimulation Testing (http://endocrinevet.blogspot.com/2011/03/how-to-extend-your-supply-of-cortrosyn.html)

I urge you to print this out and give it to your vet as it can save you a ton of money.

Love and hugs,
Lori

[doxiesrock912]

Lori,

thank you! I passed that onto the vet via email.
I'm so glad that I found this site!!!!!!

Valerie

[lulusmom]

Hi Valerie and welcome to you, Daisy Mae and Gracie.

I'm sure sorry for the circumstances that brought you here but I'm glad you found us. Dachshunds are definitely at the top of the list of breeds predisposed to cushing's but with only one test, the LDDS, it's difficult to say how long the disease has been progressing. Actually even if you posted numerous values that are consistent with cushing's it would be difficult to know. Both of my dogs were well into the disease by the time they were diagnosed, both peeing and drinking buckets, starving 24/7, panting like a freight train and one with severe muscle wasting. Their symptoms, blood and urine abnormalities, LDDS consistent with cushing's and abdominal ultrasound showing the usual enlarged adrenal glands and liver, pretty much cinched and open and shut case. Not all are that easy and not all are diagnosed correctly. Did Daisy Mae have an active infection when the LDDS test was done? The rest of my comments are in blue text within the body of your post below:


I've suspected that Daisy may have Cushing's for almost a year now since she never fully recovered from a severe reaction to Blue Buffalo Wellness dry dog food 2 years ago, but her vet insisted that it was IBD because she had chronic diahrrea. We have since changed vets to Dr. Toby Kimm of Ragged Mountain in Plainville, CT.

Can you think back when Daisy first got sick and tell me if she had any of the usual symptoms associated with cushing's (huge hunger, excessive peeing and drinking, panting) or did you think cushing's was the reason she nevery fully recovered from the Blue Buffalo Wellness food?

Aside from the diarhhea, she has a markedly increased appetite. I've had to add water to her Royal Canin Dachshund formula to make her eat slower and avoid choking. Now she's drinking a lot of water, recovering well from her first ever bacterial skin infection, and at times seems indifferent toward me.

Those are all definitely symptoms of cushing's.

She had luxating patella surgery in 2005 and has arthritis in that rear leg now which responds well to glucosamine chondroitin MMS? (I think those are beneficial omega 3 fatty acids.)

Dogs with uncontrolled cushing's don't usually feel the aches and pains of arthritis because they are self medicating. Cortisol is the body's natural steroidal anti-inflammatory and with cushing's, their body is floating in excess cortisol. Did your vet confirm that it was arthritis by way of imaging? It is when he treatment drops cortisol levels that arthritis is usually unmasked and becomes painful for the dog.

She's just begun 20mg, once a day of Trilostane and the vet suggests that we do some imaging because she's starting to get the pot belly.

Here are the results of her LDDS test and followed by what the vet had to say in response to my email asking for clarification.

CORTISOL SERIAL 3 (OEX)
Time 1 Pre
Time 2 Post
Time 3 Post
Cortisol Sample 1 8.8
ResuIt verified .

Cortisol Sample 2 Dex - 3.7
Result verified .

Cortisol Sample 3 Dex
Result verified . 4.5

Low-dose dexamethasone suppression test: Normal: Cortisol level less than 1.4 ug/dl 8hrs post-dex.
Hyperadrenocorticism: Cortisol level greater than 1.4 ug/dl 8hrs
post-dex.

If the 8hr post dex. cortisol level is greater than 1.4 ug/dl, the following can be used to difierentiate pituitary dependent hyperadrenocorticism (PDH) from an adrenal tumor : 1. Cortisol level less than 1.4 ug/dl 4hrs post-dex is consistent with PDH .
2. Cortisol level less than half the baseline level at either 4 or 8 hours post-dex is consistent with PDH.
(Samples taken at 2 or 6hrs are interpreted the same way as a 4hr
sample)

If neither of these criteria is met, further testing is needed to differentiate PDH from adrenal tumor Cushings.

NOTE: Approx. 5% of dogs with PDH have normal results. False positives

Vets Response to my email asking for clarification of the results:

Hi Valerie, In response to your questions, we did a dexamethosone suppression test, low dose, as opposed to an ACTH response test. The better test changes about every 4 years, and now the dex suppression test is better, according to both meetings I went to last year on Cushings.

Neither test is optimum as both can yield false positive and negative but experts pretty much agree that the LDDS is their gold standard but even then, there are exceptions. I'm not aware of any formal documentation that opinions change every four years though. The experts I follow haven't flip flopped in the last seven years.

From the results, there is no doubt that Daisy has pituitary dependent hyperplasia, as a more than 50% reduction at either 4 or 8 hours from the baseline indicates PDH.

Granted results are consistent with pituitary dependent hyperadrenocorticism but with this being the only diagnostic test your vet did, there is no way that you can eliminate doubt, especially if there was an active infection.

As for the bloating, it is along with PU and PD, a clinical sign of the disease.

The reason for the pot belly is due to many factors...enlarged liver and redistribution of fat and loss of muscle elasticity due to the catabolic effects of cortisol. A full bladder can add to it but is not the primary cause.

That being said, an ultrasound of the abdomen is always a good idea with any Cushings suspected cases.

It is a very good idea, especially before you begin treatment. Trilostane almost always causes enlargement of the adrenal glands so if done after treatment, it's a bit more difficult to determine if adrenal glands are enlarged because of the disease or the drug. An abdominal ultrasound can also give the vet a really good look at the surrounding organs. With all of the GI issues Daisy has had, did your vet never do an abdominal ultrasound to check for abnormalities?

We can also take new abdominal xrays, as we have been updated to a digital system since your last visit and the contrast is much better.

My dogs have had lots of digital xrays done, primarily by gp vets, and I've learned that I should have saved my money for an abdominal ultrasound as that's what I usually ended up having to pay for when my dogs were diagnosed with cushing's and pancreatitis by internal medicine specialists.

I am still using Trilostane at once daily dosing, as I believe the twice daily is more prone to overdose. I have had three cases in the past month where we had to go to every other day dosing as we were causing signs of Addisons Disease (weakness, megaesophagus collapsing) on the daily dose. I will scan the bloodwork in following. - Toby Kim

There is a study that showed a good many dogs on twice daily dosing needed a smaller total daily dose than those on once daily dosing; however, any dog can be overdose on either dosing regimen. Trilostane has a very short half life with it's effects waning any time after 8 or so hours. Every other day dosing is therefore not an effective approach to adequate control of cortisol. I would be very concerned about any vet's level of knowledge if he overdosed three dogs in one month and switched all of them to every other day dosing because once daily dosing was too much. It's not the frequency of the dose, it's the amount of drug you are giving once or twice a day. Some dogs do require a smaller dose and some dogs require a larger dose which is why the acth stimulation tests should be given in accordance with the published protocol. For Trilostane, the first test should be done 10 to 14 days after dosing starts, then 30 days and if no adjustment is necessary at either, every 90 days thereafter.

What else can you tell me about the results? Is she in the beginning stages of Cushing's? The pharmacy said that the 20mg daily dose was on the low end of the spectrum.

The pharmacy would be wrong. Trilostane is relatively new to the U.S. but with increasing favorability by vets, came increasing evidence that the old dosing recommendations are risky. UC Davis did their own extensive studies and they start their patients on 1mg per pound so according to them, Daisy Mae is getting more than twice their recommended dose. The manufacturer of Vetoryl has outdated dosing recommendations in their packaging inserts but have told one of our Admins by phone that they haven't changed those recommendations due to the high costs involved with making the revisions but that they are now recommending that you start with at the low end of the range which is about the same as UC Davis.

Also, is anyone familiar with the Cornell University Veterinary Hospital in Stamford, CT? Going there is an option too.

We've had members who have taken their dogs to Cornell and I believe they have a excellent internal medicine department there. That would be an excellent option.

New surgery options?

Transsphenoidal hypophysectomies are routinely done at the University of Utrecht in the Netherlands but unfortunately, it's not the case here in the states. One of our members and her dog became celebrities when Lucy Goo was accepted to participate in a clinical trial in Los Angeles. Human surgeons did this procedure on dogs with macroadenomas to study the tissue for human medicine. These human doctors taught veterinary surgeons how to perform the procedure but I'm unaware of any vet facility that is doing them. I can only imagine how expensive it would be.

Here's a link to a post by Lucy Goo's mom, Gina.
http://www.k9cushings.com/forum/showpost.php?p=75178&postcount=1


There is so much information on the internet that it became overwhelming.

Thank you in advance for your help.

Valerie

/\„,„/\ //^ ^\\
( =';'= ) (/(_•_)\)
/*♥♥*\ /''*''\
(.|.|..|.|.) (,,,)^(,,,)​
♂∞❤∞♂ ♂ ∞❤∞♂
Gracie Daisy

[doxiesrock912]

Hello, Daisy Mae had been on Baytril for the skin infection which was clearing up nicely for almost 2 weeks before doing the LDDS test. Daisy had been sick before the Blue Buffalo ( a different vet assumed IBD), but that incident sent her to Cornell on an emergency basis about 2 1/2 years ago. They didn't mention Cushing's at all that time, but I but I really believe that the Cushing's was at it's beginning stages then. just not up to the levels where they could confirm.

She has had the thirst and extreme hunger for a very long time, when I was told that she had IBD that was my biggest complaint. The extreme thirst has been present for six months, and the recent skin infection is her first ever. Dr. Kimm thinks that the salivary mucuole occured because Daisy scratched too hard in that area and the salivary gland was damaged.

I'm going to get Daisy into Cornell as soon as possible before she's been on the Trilostane for much longer. In just 2 days I see improvement as far as her energy level, having to poop less often, and the frequent urination has also slowed. She appears to be more interested in me once again as well which is another symptom of Cushing's (loss of interest in the owner).

I truly believe that Dr. Kimm is correct with his diagnosis, but I too am concerned about the dosage of Trilostane even though the pharmacy that compounded the mixture assured me that this was on the low end and I did tell them Daisy's breed and weight.

I'm wondering if Dr. Kimm also suspects that Daisy has been a cushdog for the past few years and this is why he starting with 20 mg?

I'll call Cornell on Monday.

[goldengirl88]

Valerie:
I have been wondering if my Tipper could have pharyngeal mucocele. She is always sticking her tongue out and swallowing, making a gurgling sound sometimes. I have been searching everywhere to see if I could find anything out about her symptoms. She never has this before she got Cushings. I hope all is well with your Daisy Mae. Did she have the salivary mucocele condition before the Cushings? God Bless you both.
Patti

[doxiesrock912]

Patti,

Daisy doesn't stick her tongue out but she does swallow often.
Tipper could have one inside of her mouth whereas Daisy's is on the side of her neck. They have many, many salivary glands.

No, she ddn't have it before the Cushing's, but she had a skin infection and the vet believes that she scratched so hard on the outside that she damaged the salivary gland inside.

Does Tipper's fur look dull and dry or smell like a dirty dog more often than usual? She could have a skin infection which Cushpups are prone to.

Take her to the vet, they'll aspirate the mucuole to make sure that it's benign. They can tell by looking at the liquid that comes out whether or not further testing is needed. The procedure didn't bother Daisy at all.

Good luck to you. We're just beginning our "journey" and it's scary but I've learned so much already and I'm going to call Cornell in Stamford, CT on Monday and ask to speak with one of their specialists. I'd rather not pay two places for the same tests and maybe they'll work in conjunction with our vet so that travel can be reduced.

Keep us posted on Tipper :)

Valerie

[milosmom]

hi valerie and welcome to the best forum for our pups ever !!! people here gave me strength,courage and knowledge when my doxie milo was diagnosed at 5.he lived with this for about a year but his last visit was at cornell in stamford ct which i have to say is an awesome facility !!! sparkle(receptionist)extremely loving and helpful.Dr.Alexandre Rousseau went above and beyond for my milo.unfortunately by the time we got him there(he was in crisis prior at our vet who sent us here)i can highly recommend this facility ...will be watching your story with your furbaby daisy...patty(milo)meka xoxox

[doxiesrock912]

Thank you Patti,

my fiance and I live right next door in Cos Cob and we took Daisy to Cornell once due to the incident with the Blue Buffalo food. I don't that she had Cushing's at the time but I'm positive that she suffered some permanent damage due to that or at least that is how she got what Dr. Kimm thinks was an underlying systemic infection which other vets assumed was IBD.

Daisy, Gracie and I have been staying with my father since June helping him while he recovers from stage 3B lung cancer. So, on top of job hunting, I have a lot going on and really don't want to waste anymore time on unqualified vets.

I'll keep everyone posted.

Thank you again

[goldengirl88]

Valerie:
Tippers fur is dull, but not smelly. Her skin has gotten thinner, she has black speckles on her belly as she is a Jack Russell. The black on her skin is very apparent now. She does however have trachea problems. From the fat redistribution due to Cushings a lot of fat went around her windpipe, causing her trachea problems. That is why I am wondering if she has the pharyngeal Mucocele. She does swallow a lot, and it can come from inflammation. Cushings does cause imflammation. There are many on here who say their dogs do this strange smacking of the lips and throat noises. So this could all be the caused by the Cushings. I feel she is getting some kind of drainage in her throat. It says this can cause breathing problems which she has. I am going to question the Vet about it when I see him next. I just don't even want to think of one more problem on top of what she has already! The picture of Daisy Mae is adorable. Prayers to you both.
Patti

[doxiesrock912]

I know! This is all still so very scary!

[doxiesrock912]

Hello everyone,

Daisy Mae has been on 20mg of Trilostane once a day since 3/14. Tonight, she had a bought of diarrhea that was straight liquid! Of course the vets office is closed and I can't reach anyone there. I know for a fact that she didn't eat anything odd because we go out together and when she does get into something, the stools are very loose not brown liquid.

Any advice until I call the vet in the morning?

Thank you

[lulusmom]

I have merged your new thread with Daisy Mae's original thread so that we have all of your girl's history in one place. Do not give Daisy any more Trilostane until she has completely recovered from her bout of diarrhea. This can be a sign of cortisol dropping too low so no more dosing. If she continues to have diarrhea she can dehydrate rather quickly so if she is extremely lethargic and weak, you should get her to an er clinic and not wait for your vet to open.

[doxiesrock912]

Lulusmom,

thank you for confirming what I was thinking! I'm going to check on her again right now!

Daisy wasn't too thrilled with me insisting that we go outside at 2:45am, but that's not unusual.
Once outside, she urinated only. No diahrrea and she had her usual bouncy step as we went back up the ramp into the house. Not lethargic! So I think that we can wait until the vet opens?

The diarrhea was a one time incident but it was unlike previous boughts that she had when they kept mistakenly diagnosing her with IBD.

In between postings, I found a way to contact Dr. Peterson online and I sent him the details of Daisy's case (basically, the content of my original posting here) and asking if he would work with her current vet who is good, I'm just not satisfied that he has much experience with Cushing's.

We'll also have a discussion about his office manager who I'm not sure is truly passing on my emails.

Thank you for being awake at this hour! You're a life saver and I feel that Daisy isn't in immediate danger tonight. She's definitely not lethargic.

[Squirt's Mom]

How is Daisy Mae this morning?

[doxiesrock912]

She seems fine. The vet is not in today but the tech said that he monitors his email from home so we're waiting for an official response but discontinuing the Trilostane.
They suggested that I give Daisy plain yogurt to calm her stomach.

I included Dr. Peterson's recommendations in my emails to the vet and will schedule an ultrasound.

She's not lethargic so that is a good sign.

Thank you for checking on us:-)

[lulusmom]

Hi Valerie,

I'm glad that Daisy is doing better today. I had two cushdogs treating with Trilostane and if either one looked or acted remotely ill, they were off Trilostane until I was sure they were back on track. When in doubt, do not dose.

Yogurt is not only not commonly used for stomach upset, it can cause stomach upset and diarrhea in dogs who, like a lot of people, don't handle lactose very well. A good option would be slippery elm bark, which you can buy at most health food stores. I've provided a url below so you can read up on SEB and access the very simple instructions on how to brew SEB soup. It's great for soothing the tummy, diarrhea and constipation. It was a lifesaver when my boys had pancreatitis and I'm sold on it.

http://www.holvet.net/slippery_soup.html

Keep us posted please.

Glynda

P.S. I love your personalized signature. Too cute!

[doxiesrock912]

Glynda,

I didn't give the Trilostane today and guess what? Normal poop this morning and a normal one late afternoon. Go Daisy, go Daisy :)

We happened to have a wellness physical at the vet for my father's cat this morning, I discussed the incorrect dosage issue with the vet on call and she promised to view the email that I sent to the office manager with the links from Dr. Peterson in regard to the recommended dosages of Trilostane being too high from the manufacturer. I also mentioned that Daisy's symptoms resolved much too quickly in comparison to the 7 - 14 day timelime and she was in agreement.

Due to Daisy's history, she wants to be sure that she has no food allergies and we agreed that if her stools were normal today and tomorrow, that it was definitely caused by the Trilostane. I didn't give her yogurt as I've used pumpkin in the past and that worked well. Daisy seems fine and the pumpkin was not needed.

At least now it seems that I have the vet on the same page and she couldn't understand why Dr. Kimm started out with 20mg and why he sent me to a compounding pharmacy in the first place. They have 10mg tablets on site in the office.

I'll call them tomorrow and give them the good news, plus I'll make an appointment for an ultrasound. No Trilostane until the proper dosage is determined!

I will keep the slippery elm in mind. I winder if there are natural ways to treat Cushing's?

You like my signature, thank you:)
I use one with Daisy and Gracie (long haired cat) in my emails.

[milosmom]

so wonderful to read this valerie !!! yippy for daisy mae !!! unfortunately we have all learned here that there aren't any natural ways to treat cushings.most of us here wish there was and many of us have searched and tried different things but nothing yet. will be watching you girls !!! patty(milo)meka xoxox

[doxiesrock912]

Thanks Patty!
At least I now feel that someone at the vet's office is truly listening!

Daisy is back to sleeping more so obviously the Trilostane from yesterday is out of her system. Wouldn't a spontaneous recoverbe awesome right now! Yes, I've been reading a lot:)

As you know, this is so stressful! I can't wait until she's stable, is there such a thing with Cushing's?

[molly muffin]

Wow, what an eventful evening and day you had. I'm just getting caught up and had a minor panic attack, quickly rectified with continued reading of the thread.
So glad Daisy hasn't had any more diarrhea. It's very scary when it comes out liquid like that.
Hang in there. you are doing really well. This is a real suck of a disease, and takes the most awful toll on your patience and equilibrium on some days.
I agree, love your signature!

hugs,
Sharlene and Molly Muffin

[doxiesrock912]

Panic attack! Very scary! I'm glad that you've recovered.

This is a suck of a disease and especially since Daisy has been healthy for a long time, I rarely give her scraps from the table, and now this! As many of you do, I can't help but wonder why the vets miss this so often!

While at the vet today, dad's cat ran underneath their cabinets where no one could retrieve her and we had to leave without her. Can you imagine? They've since called and she's out.We'll piuck her up tomorrow.

I need a drink) LOL.

[Simba's Mom]

Glad to hear Daisy is doing better, hugs from Sim and me.

[milosmom]

cheers ladies,having a glass of red wine...lets all try to breath,release and just be.we are always ON- it's exhausting this disease.wishing everyone here a peaceful,quiet evening.look forward to tomorrows' stories.nite nite patty(milo)meka xoxox hey valerie can you make a wine glass :)

[molly muffin]

Omg, had to leave the cat! I didn't know whether to laugh or what. I went with a laugh, probably cause I can so see that and that is exactly what my cats would have done too if they got the chance.

I agree with Pattie, we'll have just chill and have a glass of wine and calm down. What a day you had.

Sharlene and Molly Muffin

[doxiesrock912]

I'm envious Patty:)

Sharlene, if my father weren't so worried about the cat I'd be laughing too!

Thanks Letti.

[milosmom]

still looking for the wine glass valerie :).....very talented you are !!!

[doxiesrock912]

Use a paper cup, no one is watching.

[milosmom]

so impressed how you did your sign off logo (if that's what its called) would never know how to do that....impressive i must say :) <3...(those are they only ones i know lol)patty(milo)meka xoxox

[doxiesrock912]

I copied most of it from someone else and added my own touch. Shhhh.

[doxiesrock912]

Seaghost, my father's cat is home safe and sound. We should have the results of her urine test tomorrow. She urinates anywhere that she feel the urge and this includes on my father while he's sleeping!

Daisy is drinking more today and I'm going to schedule the ultrasound tomorrow. It also seems as though her salivary mucuole is larger. Does anyone have experience with salivary mucuoles?

My future mother-in-law's dog Max went in to have a tumor removed from in between his toes. Surgery went well and he was waking up from anesthesia when his heart stopped! They tried, but weren't able to revive him :(

On a positive note, I went to the dentist which happens to be on the same street where my fiance Chris works. We usually go to lunch when I'm in the area but he had meetings today. He did manage to stop by with a sweet surprise for me <3.

https://www.facebook.com/photo.php?fbid=577608388924762&set=a.105412319477707.10546.100000268197543&type=1&theater

It's been a flip/flop kind of day and I am tired.
I hope that everyone and their furbabies are doing ok.

[goldengirl88]

Valerie:
I have been reading up on them. From what I have read they have to be operated on if in the throat as they can block the airway. That is why I am so scared for Tipper, if she has this it would explain why she is having the breathing troubles. Trachea problems with the windpipe etc. were also mentioned in these articles. Tipper does have the trachea problems which could cause the mucocele in her throat. Every time I think I can stop worrying for a day, my poor Tipper gets some other issue. I think maybe since your baby has it on the outside of the jaw, it could be drained, but they said it could cause bacterial problems. I guess these things are full of bacteria??? Keep in touch and I will let you know what I am going to do about Tipper. God Bless you both.
Patti

[doxiesrock912]

Patti,
The vet tried to drain Daisy's but the saliva was too thick. Now I'm wondering if he just didn't do it correctly.

She hasn't had it for long, but it grew quickly! Doc thinks that she caused the damage by scratching too hard in that area when she had the skin infection. Now that I think of it, I do remember her working pretty hard on that spot.

Draining solves the problem temporarily as they will just grow back in a few weeks to a month. Sigh.

I would definitely get Tipper's checked out before it grows larger. Daisy's seemed to suddenly appear out of nowhere. Scared me to death!!
Our poor babies:-(

It sounds like the vet can introduce bacteria if they try to drain it.

Please keep me posted.

Xo

[goldengirl88]

Valerie:
I heard that the fluid is very thick and can sometimes contain real small stones even. I am 90% sure this is what my Tipper has. It can close her airway off at any time so I have faxed the Vet all the info. I have researched. I have told him about this issue over and over, just like I diagnosed her with the Cushings and he wouldn't listen to me. He thinks he knows it all, and it has really cost my Tipper. I will how ever wait to hear from him, since I need him for a referral. The best place I can think of is Pittsburgh. I called there and asked questions at the hospital there. I am from Pittsburgh and feel comfortable going there. They said due to her Cushings slightly enlarging her heart they can have a cardiologist on hand. They said she needs to be stable in her Cushings treatment which I feel she is. I need to find out how long she would be in there. I am worried since these dogs have compromised immune systems about the bacteria especially in her throat- it just sounds dangerous to me. But the thought of her airway being cut off from this gland is scarier at this point. I was supposed to be going for a colonoscopy, and some Dr. appts. for my lupus and depending on when they can scope her I may cancel them, as her life is more important to me. This is the reason why she keeps sticking her tongue out to clear her throat, and all the gurgling, and swallowing, I know it is. I will keep you informed on what is going on. God Bless You and precious Daisy.

[doxiesrock912]

Daisy and I are going Cornell in Stamford CT next Friday. This is where she went after she got gravely ill from the Blue Buffalo dog food. Their phone number is 1-203-595-2777 and they are open 24/7.

I believe that the Dr. Peterson that many people on this site speak of is affiliated with them somehow.

Don't wait for your vet, you don't need a referral if it's an emergency and it sounds to me like you believe that it is.

Call Pittsburgh back and tell them your concerns, they'll get you in asap.

Please don't wait for your vet! Call and leave a message that you're heading to Cornell and leave the phone number.

Daisy's mucocele is on the outside of her neck but I did mention this and we'll also address this issue on Friday. It's like they have a life of their own, the size fluctuates. It's really weird.

[molly muffin]

Happy to hear that Seaghost is home. That sounds like a kidney issue but cats can also get cushings disease.
Gosh to two, sounds horrid. Hope you can both get this issue resolved.

Sharlene and Molly Muffin

[Harley PoMMom]

Oh Valerie,

I am so sorry to hear this news about Max, my deepest sympathy to you and your future mother-in-law.

[molly muffin]

Oh geezz..I forgot I wanted to say I too am very sorry to hear what happened with Max. That is just heart breaking.

hugs,
Sharlene and Molly Muffin

[doxiesrock912]

Thank you both! Chris' mom seems to be taking it well, Max was older and she's thinking that "it was his time."

How is Tipper now?

[Simba's Mom]

Just Simba and I popping in to say hi, good luck at doctor and sorry to hear about Max...

[doxiesrock912]

Thanks Lettti and Simba.

[Trish]

Dearie me, you have had quite a week of it. Poor Max, my condolensces to your MIL.

And poor Seaghost, I did laugh when I read he found a potential hidey hole and refused to come out at the vets, smart Puss!

Hope you have a productive IMS visit this Friday and get a plan in place for Daisy, I will be looking out for the updates!

Trish :)

[doxiesrock912]

Thank you everyone!
I'll keep you posted:)

Spending the weekend with my fiance.Long overdue.

[doxiesrock912]

Hi ladies, gents, and furlets -

I might be crazy but I'm beginning to wonder how much of daisy's problems are due to Cushing's and how much were from that long standing unknown "systemic" infection that she had and was treated with Baytril for.

Interestingly, Daisy has been finished with the Baytril for more than a week now and her stools are still completely normal and much less frequent! Not a single incidence of diarrhea so I do believe that the vet was correct in his assessment that Daisy may have had an underlying infection for a very long time from the Blue Buffalo food. Knowing this makes me angry again because despite faxing them all of the vet information, they refused to accept blame or reimburse me a dime!

Also, her fur is still shiny and her energy level hasn't decreased even though we stopped the Trilostane, and she's not drinking the entire bowl of water at one sitting as before.


I'm hoping that we caught the Cushing's much earlier than I originally thought and I'm looking forward to getting on the right track with Cornell on Friday.

[milosmom]

will wait patiently valerie with you for friday to come.it sounds like your daisy mae is doing better !! woohoo !!! sending much love,support and happy xoxox.look forward to good news all this week...patty(milo)meka xoxox

[doxiesrock912]

I spoke too soon. While I was away with my fiance this weekend, our brat cat Gracie scratched Daisy's nose and it looks red today. Not swollen or leaky (I can't see a scratch), just red.

I dabbed it with peroxide and no foam, Daisy didn't like this much and licked her nose afterward. I wonder if it stung?

[molly muffin]

oh gads Valerie. I bet it did sting. My husband kind of yelps when I put peroxide on him too. :p

Hopefully it'll clear up, just keep it cleaned off. Boy the things they get up to when we aren't looking eh.

hugs,
Sharlene and Molly Muffin

[doxiesrock912]

Sharlene,

I've been doing more reading and I'm not convinced that the cat scratched Daisy. It looks as if the fur is gone from the bridge of Daisy's nose and the entire area is red. I found pictures of dogs with food allergies and they sure look like Daisy right now.

Can anyone suggest a high quality, grain free dog food with protein no higher than 30%?

If it's not one thing, it's another. Poor baby:(

[labblab]

If you are wanting grain-free kibble, Champion Petfoods has a couple of excellent lines. Orijen is their higher protein line, and Acana is their moderate protein line. I just checked, and three of the four Acana foods have a protein level of 31% (chicken, lamb, or beef). The fish food is a little higher in protein. Here's a link:

http://www.acana.com/products/regionals/

A couple of things to note about grain-free kibble, however. Most quality grain-free kibbles (including Acana) are also relatively high in fat. This may or may not be an issue for Daisy, but it can be a general concern for Cushpups since they tend to be more vulnerable to pancreatitis which itself can be aggravated by higher fat foods.

Secondly, "grain-free" does not automatically translate into "limited ingredient." For instance, these Acana foods contain a wide variety of ingredients. So if Daisy does indeed have a food allergy, it's possible that a grain-free food may still include an allergic trigger. I tell you this just because a lot of people automatically assume that switching to grain-free is going to solve any allergy issue and this is just not the case.

My non-Cushpup has suffered from allergies from the time she was a baby. In her case, I do believe they are more environmental since they are seasonal. But I still tried her on every major grain-free brand in hopes that would help. It did not, but she did develop acute pancreatitis :( ( she takes phenobarb for seizures and that drug also makes dogs more vulnerable to pancreatitis). Long story short, she is now eating a limited ingredient lowfat kibble that is largely just rice and chicken. And even with all that rice, her allergies are no worse than when she was on the grain-free food.

So the point of this saga is that unless you actually get Daisy tested to see whether/which food items are allergic triggers, switching to grain-free may not be any help. By the way, though, my younger non-Cushpup eats Acana Wild Prairie and is thriving on it.

Marianne

[doxiesrock912]

Marianne, I definitely want to avoid pancreatitis. I was trying to find a food that was grain free and low in fat. Daisy looks a bit chunkier of late but not too bad. I think that I'll wait until Friday and ask the folks at Cornell.

They should have all of Daisy's records by now.

Thank you

[molly muffin]

Strange, so no scratch. You're thinking allergy? Well, one more thing to ask Cornell about on Friday :)

You are making a list and checking it twice?
:)

hugs,
Sharlene and Molly Muffin

[doxiesrock912]

Sharlene,

I am thinking an allergy because many of the symptoms are the same as Cushing's, the LDDS test can be high if the dog is nervous at the vet and Daisy literally shakes and her skin flakes as soon as she realizes that we are at the vet, she always has crusties around her eyes which I assumed was because these little guys are so low to the ground with the dirt etc. flying in their faces, and mainly because of how many of her symptoms have improved greatly since the vet prescribed Baytril for the bacterial skin infection.

We've finished the Baytril more than a week ago and Daisy's stools have been perfect except on the sixth day of Trilostane when she had one incidence of liquid diarrhea, we stopped the medication and things went back to normal instantly. Her fur is still shiny and not smelly like it was before the Baytril, she's no longer drinking an entire bowl of water at one sitting, and she appears to be slowing down a bit while eating now (before, she didn't even chew her food and would choke), and most of all, she's happy, wagging her tail again to greet me (shows interest in me again) and walks energetically when we go outside. Her bloating appears to be going down too.

I'm not saying that she doesn't have Cushing's, but I think that many of her symptoms can be attributed to something else since they haven't come back.

All of that coupled with the fact that Dr. Kimm may be a great vet but he's already made a serious error by starting her on 20mg of Trilostane and giving me 3 months of it for a 10 - 14lb dog. His comment to my email was "based on the two Cushing's seminars that I attended a year ago....blah blah blah".
So how out dated IS his knowledge!

The final piece was when talking with the female vet who performed Seaghost's yearly physical and she asked if I thought that Daisy might have food allergies.

I am making a list because I don't want to treat her for something that she may not have or if the symptom's are making the Cushing's seem more advanced than it is.

This is ironic because I've had 8 eye surgeries back to back when I was 36 and I could probably work for any eye surgeon with the knowledge that I've gained during and since that time.

Once someone steers me wrong, I question EVERYTHING.
Especially when it comes to my fur-family. Luckily, my fiance shares my love of animals and is on the same page with me. In fat, he has Friday off and is going to Daisy's appointment with us:)

If Daisy's symptoms had returned full force after stopping the Trilostane, I wouldn't have these questions. Since they haven't, now I wonder.

Much of the information that all of you have been providing in your posts also makes me wonder because once the medication is stopped, symptoms return quickly. Am I correct?

Hopefully. we'll know more after Friday. For the first time since I've joined this board, I feel hopeful for Daisy Mae:)

[Simba's Mom]

Good luck at the vet with Daisy, poor thing with the sore nose:( sending hugs from Sim and me!!! Before I found this site, I had no idea what to ask the vet about cushings, now I go armed with questions:) keep us posted!!!

[molly muffin]

Questioning is absolutely good. You don't want to treat for cushings, if the problem is something else. It's why I have yet to start my Molly on any cushings treatment, even though my vet sold me the 30mg box of vetroyl for a 19 lb dog and was ready to go based on the ACTH test. Three negative LDDS tests and no symptoms and they are still saying, pre cushings or she could be in the 5% that test negative, but without those symptoms I'm loath to begin treating. It's touch but you really do have to learn everything you can and then question every vet and Why they think this or that and Why they want to do this or that test or treatment, and always ask about alternative possibilities. Since cushings Is so hard to diagnose, we have to be double vigilant.
I think you are absolutely doing the right thing based upon how Daisy has reacted.
Great to have both you and your fiancee on the same page. :) That definitely is a huge help.

hugs,
Sharlene and Molly Muffin

[doxiesrock912]

Thanks for confirming what I'm thinking:)

Since I've met Chris, our lives have been one big roller coaster! I'm sure that I'd be in a psych hospital by now without his support! In the past two years alone, he'sseen me through my mother's declining health from Parkinsons, dad's stage 3B lung cancer diagnosis, mom's masssive stroke exactly one week after dad's diagnosis, and her death one week after the stroke. Then I caught pneumonia and the administrative assistant at work took it upon herself to tell the temp agency that I was no longer needed simply because I was going to be out of work for two days.

Daisy Mae, Gracie, and I moved back to Bristol to help dad through radiation pnemonitis which is a complication from radiation/chemo (affects 15% of patients) in June 2012 while Chris stayed in Cos Cob. We alternate locations on the weekends so that we can spend some time together. Dad is doing much better physically, but his memory has deteriorated lately and that is worrisome.

We're anxiously waiting for the VA to approve a pension and hopefully aid and attendance pay for me taking care of dad. I'm proud to say that I did all of the paperwork and gathering of information without having to hire a lawyer:) I've also completed my associates degree, project management certificate, and associated degree during all of this with grades that were high enough to obtan grants and finish all without student loans:)

I wanted to end this post on a positive note.

[molly muffin]

Valerie! Big Hugs, to you. I'm sorry it has been a rough couple years for you, with your mom and dad. You've come through like a real trooper though and should be so proud of yourself. Even one of those events could be over whelming and here you have managed to handle them all. Congratulations on your degree and obtaining it during a tough personal time with such high grades.
You're going to feel like a vet specialist yourself after going through all this with Daisy too. :)
I think the human spirit is quite wonderful. We can put our minds to something and persevere in the face of great obstacles.
You're doing awesome and Chris sounds like a real keeper. :) Together you can do much in this world. Never doubt that. Every person can make a difference and bonded together we can do so much more.
I'm a huge fan of the positive. :)

hugs,
Sharlene and Molly Muffin

[doxiesrock912]

Daisy's nose has cleared up well.

Tonight, my father vacuumed the back room and daisy barked as always.
Her bark is not nearly as loud and I hear her breathing air in between the barks so now I'm almost sure that the salivary mucocele is partially interfering with her airway and I won't be surprised if Cornell wants to do surgery if she's healthy enough.

Sigh.........

[milosmom]

happy to read miss daisy maes' booboo is alright on her nose.just wanted to pop in to say hi valerie.....patty(milo)meka xoxox

[goldengirl88]

Valerie:
Thank you so much for all you have offered to help Tipper. I am in the midst of trying to find the best IMS for her as the hospital said she needs one to do her diagnostics. They wanted the surgeon to do her scope, but after reviewing her case they want an IMS to do it. I need to deciede if I'm going to use theirs or get another one. I will keep you posted. God Bless you and your sweet Daisey.

[doxiesrock912]

No thanks needed, that's what we're all here for. I'm glad that they referred you to an IMS instead of taking your money when they're not confident in their ability to do the test.

You're in PA, right? Call Cornell in Stamford CT and they'll probably give you a recommendarion in your area. That way, no guesswork or wasting time and money on unqualified people.

Good luck sweetie!

[Simba's Mom]

Oh Valerie, you have had a lot to deal with, lots of hills and valleys..Thankful you have a great man by your side, helps a lot I'm sure..They always say that the hills make you stronger, who said that? I would like a word with them :) anyways take care of you too, sending hugs to you and your Daisy Mae!!!

[doxiesrock912]

After you're finished with him or her (They always say that the hills make you stronger, who said that? I would like a word with them), it's my turn!

Dad and I just got back from a full day of MRIs and CT scan at Smilow Cancer Center. He's been coughing much more lately so I was glad that we had this appointment. Usually, the MRI and CT results are available by the time that we see the doctor on the same day. Only the MRIs were ready. While we were with the doc, dad had a coughing spell.

Doc prescribed Zithromax and said that he sees fluid around the outside of the lung. He'll call us if he sees something worrisome on the CT scans, but if we don't hear from him we go back in 6 weeks like always.

When it rains it pours. Where is the sun?

[milosmom]

hi there valerie just doing my usual pop in ...sorry your dad is under the weather,i will keep him in my thoughts and prayers,dealing with cancer is a very hard situation but i am so sure your dad is thankful for all that you do for him.and how is our miss daisy doing today? your in my thoughts and just wanted to send xoxox patty and meka

[molly muffin]

Sun is not here! Dratted thing, taking off just before a long weekend too. pffttt

Oh gee, hope nothing turns up on that CT and hope the meds help with your dads coughing spells. Poor guy, those coughs can really take a toll on the body.

Patti is in Ohio I think Valerie, so might be too far, maybe Cornell could give her an option in her area though. hmmm..that is a good thought.

hugs,
Sharlene and Molly Muffin

[doxiesrock912]

Thanks Sharlene,
as you can see I'm still wide awake. Everything is getting to me. Daisy's illnesses, worrying about dad, etc. I haven't stopped crying all night,

This fluid around dad's lung could be as simple as pneumonia, or it means that the lung cancer is back or congestive heart failure - so many things and none of them are good.

I've been looking at all of the pictures that I've taken over the years and I feel like i"m on the verge of losing the two beings that have been here for me all of my life it seems. Daisy and I had an immediate connection from the time that I saw her and she spent the small amount of time with me before I came back the following day and brought her home with me forever.

I feel like I should've suspected more than signs of old age and that I've failed her badly. I'm praying for a miracle on Friday because Lord knows that I can't handle anything else going wrong right now.

If we get bad news on dad, I'm not sure that he'll fight the cancer this time. He's been missing my mother so much lately and also going through that "I wish that we had done this or that" stage.

I know that everyone here wishes us well, I guess it's my night for everything to get to me.

[Harley PoMMom]

Dear Valerie,

Hoping today is better for you and sending huge and loving hugs...Lori

[molly muffin]

Hi Valerie, I hope you are feeling better today. I do understand that it is scary what you are gong through with Daisy and it is just as scary what is going on with your dad. That they are both happening at the same time can just make you feel like you are drowning in emotions sometimes.
Remember though, one day at at time with both. Tomorrow is Daisy day and I hope that you are able to get some definitive answers.
Get some rest too. Everything appears much worse when you are exhausted.

Hugs,
Sharlene and Molly Muffin

[doxiesrock912]

Thank you everyone!
Dad still sounds terrible, but Smilow hasn't called so unless they call on Monday, dad is in the clear for anothèr 6 weeks.

Daiisy Mae and I arrived in Greenwich and are chilling out in fromt of the tv waiting for "daddy" to come home from work.

I am SO tired and now I'm sick as well.

Praying for good things tomorrow!
Hoping that all of you have uneventful weekends so that everyone gets som rest.

[molly muffin]

Oh gee, sorry to hear that you are unwell too right now. Hope you get better soon and best of luck tomorrow! Enjoy a nice quiet evening and just chill. (man does that sound good~!) LOL

hugs,
Sharlene and Molly Muffin

[doxiesrock912]

Chill. Sounds great to me!

[Simba's Mom]

Sending hugs your way, no fun to cry alone, hope your daisy and kitty were with you, take take hon!

[milosmom]

hi valerie i am sure that you are snuggling with your babies and chillaxing..we will check on you in the am...pleasant dreams !!! patty(milo)meka xoxox

[doxiesrock912]

Thank you ladies.
Daisy and I are in Cos Cob with Chris. Gracie is home with grandpa. Our appointment is at 9am. I can't imagine that we'll be done and home before noon at least. I'll post updates as soon as we're home.

[milosmom]

hey valerie know that you are going to the best place in my opinion for daisies sake.i went with milo thru emergency and he received the best care possible in his condition..... wishing you peace,focus and go with your questions on paper if need be(we sometimes get so caught up and go mute when we see a new doctor)please enjoy some quiet time with chris and your most precious daisy mae.....will anxiously await your posts,gn...patty(milo)meka xoxox

[doxiesrock912]

Thank you Patty. Sleep well!

[jmac]

Hi Valerie,

Just letting you know I'm thinking of you and hoping everything goes well tomorrow...hope you'll get some sleep.

Julie & Hannah

[Trish]

Hi Valerie
Jeepers, between your Dad and pets this has been a pretty full on week for you. So hoping you get some good news tomorrow.

My Dad has been a bit under the weather too, have him booked in for scans and specialist visit as well next week. Such a worry these parents.

Fingers crossed for an excellent Daisy update later on. Hope your feeling a bit better today too. Beatiful day here, so nice and sunny it helps keep the spirits up so hopefully the sun will shine for you too :)

Trish :)

[Mel-Tia]

Hey Valerie

I hope you and Daisy have a positive, informative discussion with the new doctors

Will be thinking of you both today. Good luck

Mel
Xxxxxx

[molly muffin]

Wishing you and Daisy well today!!

hugs,
Sharlene and Molly Muffin

[goldengirl88]

Valerie:
I hope the new Dr.'s can give you some help. Hugs to you and sweet Daisey. Have a good Easter. God Bless You Both
Patti

[Trish]

Nothing yet......? hope it is good news when you get a chance to post!! Thinking of you Valerie and Daisy! :)

[doxiesrock912]

Hi everyone!
Daisy, Chris, and I met with Dr. Megan Morgan at Cornell today. I am now sure that we at least have someone who is very familiar with Cushing's, latest research etc. She knows of Dr. Peterson and everything that she discussed with us made perfect sense and is right in line with the information that I've read on this site.

That being said, Dr. Morgan acknowledged that the timing of Daisy's skin infection (Pyoderma?) and the LDDS test that the other vet took wasn't ideal, but the results indicate Cushing's to the point where she believes that the numbers wouldn't change much even if Daisy hadn't had an infection. So, she wants to start with 10mg Trilostane twice a day. She agrees with the 20mg dose, but not all at once for a dog Daisy's size (5.2kg= 11lbs). She's had only a few dogs that required the dosage of Trilostane to be lowered and that was because they had Macrodemas. (I don't know if I'm spelling that right).

The other vet had Daisy's weight at 14lbs!

Anyway, she did an ultrasound and everyone got a huge kick out of it because Daisy fell asleep during the process:) Her liver and adrenal glands are enlarged but she did NOT see any masses so she is concluding that Daisy's has pituitary Cushing's. She also mentioned the surgeries being done in the Netherlands and explained the results of those surgeries. Unless Daisy had a macrodema that wasn't responding to radiation, I wouldn't take a chance on surgery.

Not the news that I was hoping for, but Dr. Morgan was very positive and her experience with even the toughest Cushing's cases that she's had, she's been able to get them under control within a three month time frame.

On the ultrasound, she also saw that Daisy's bile duct looked a bit odd but that isn't abnormal with Cushpups and she will recheck once Daisy Cushing's is "stable". Her gallbladder also looked odd and Dr. Morgan mentioned some other "m" word that could be dangerous if it ruptures, but she's not convinced that Daisy has that problem yet. We'll do another ultrasound when Daisy's Cushing's is controlled.

Dr. Morgan is going to email me the report along with tests. She thinks that the underlying infection that Daisy had might be a form of E-coli and suspects that the incidence of diarrhhea that she had while taking the Trilostane might be a result of that infection trying to come back. Therefore, if Daisy gets diarrhea again, she wants to do another round of Baytril.

Bottom line, a medication that thins out the liquid in the bile duct that looks abnormal on the ultrasound, 10mg of Trilostane twice a day, another round of Baytril if Daisy develops diarrhea again, and an antibiotic if the urine tests come back with a UTI.

She said that the Daisy's coat although improved, is a "classic Cushdog coat."

All in all, Dr. Morgan is confident that Daisy has had Cushing's for quite some time, improperly diagnosed. She thinks that it will be fairly easy to regulate, and that her current symptoms will improve.

Now for the salivary mucocele. We watch it. She didn't hear any signs of struggle with Daisy's breathing, no fever, so for now we do nothing. When Daisy's Cushing's is under control then we'll talk surgery unless the mucocele becomes too large and bothersome or shows signs of infection. Eventually, she will want to perform surgery.

Today's initial consultation/comprehensive visit with ultrasound and urine test (possible UTI) cost $832.00.

Cornell does partial out the Cortisyn when they perform the ACTH testing which will cost $344 including discussing the results with the doctor and physical examination of Daisy and she wants to do this in 3 weeks as long as Daisy shows signs of improvement and not having Addison's symptoms.

As soon as she emails me her report and tests I will post them. She did mention numbers and what would be normal, but I honestly can't remember the details aside from something in the liver normally being 190? is in the 2,000 range with Daisy.

I asked about Macrodemas and the likelihood of Daisy's tumor growing to that extent. Dr. Morgan truly feels that Daisy has had Cushing's for quite some time and that her tumor is still small and the likelihood that it would grow to that point after all of this time is slim. Daisy had the run of the room the entire time that we were there and she saw no neurological signs at all.

This is the weird part. Every vet visit that Daisy has ever gone too results in her shaking as soon as we walk through the door and her skin flaking from nerves.
None of this happened today! She walked around investigating everything and the only time she wasn't happy was when the tech took her temp. I was amazed!!!

The cleanliness of the rooms, hallways, etc. was phenomenal! I usually don't let Daisy roam much at other vet's offices because true to Dachshund form, she will eat ANYTHING that she finds on the ground including other pets hair.
That was not a worry today.

I was impressed with everyone whom we met and thanks to all of the information that I've read on this site, I could tell that Dr. Morgan knows her stuff.

Another great point, she is available by phone or email if I have questions which is nice and it is standard practice for them to send all reports and test results to patients via email.

I am hoping that the fact that Daisy's only now beginning to have skin infections and a possible UTI after all of this time of having Cushing's that her immune system is only just now beginning to wear down and that she will respond well to the treatment.

Waiting for the test results and I will share everything with you all.

Feeling a bit more relaxed and my father said that he's feeling better today and he went out for coffee :)

Patti, I strongly urge you to consider Cornell. I know that it's a haul, but I finally feel that we have the right people treating Daisy now.

[milosmom]

valerie !!! so glad that you had a good experience at cornell(it is beautiful) and that your dr. was thorough taking her time with your daisy mae.i am happy to see that you can take a nice deep breath.glad to see dad went out for coffee today.i look forward to hearing happy times from you.patty(milo)meka xoxox

[Trish]

Wow that sounds a very informative vet visit, sounds like a great place to take your dog. I like the sound of the followup too, nice to know you can contact her via email.

When is Daisy starting the Trilostane? Only thing I can think of is it wise to wait 3 weeks for acth? I thought most here recommended 10-14 days? So hoping that all goes smoothly for Daisy!

Wondering what that GB issue is? Be interesting to hear more on that once you get the report and also about the med to treat it.

Glad you are feeling better and good to hear your Dad was out for coffee! Have a good sleep :)

[doxiesrock912]

Patty and Trish,

I was VERY impressed with Cornell and Dr. Morgan!
Actually, I think that she said 2 - 3 weeks for the ACTH. We were there for 2 1/2 hours and talked about so much. It's hard to remember it all and I think that I did quite well remembering what I did:)

I'm going to wait until I'm back in dad's area (Monday) to get the Trilostane because the other vet has 10mg tablet in 30 packs for $21 and change.
I don't think that waiting another 2 days will be a problem.

By then, we should also know if I'll need meds for a UTI and I can ask Dr. Morgan to send the scripts directly to the other vet. I'm also going to barter with them in regard to the $105 already spends on meds that I can't use.

I'm hoping that the GB issue is related to the Cushing's and everything else in the area being enlarged.

[Simba's Mom]

Hey Valerie and Daisy, glad the appt went good, its so nice when they take the time to talk with you so you understand better...what a cute thing that Daisy was not scared, way to go Daisy!! I so wish the best for your Dad too, hoping things settle down for you all!!! Sending hugs, oh from Sim too :)

[doxiesrock912]

Thanks everyone!
Daisy must be a very healthy dog to have dealt with Cushing's all of this time (vet suspects at least a year) before showing obvious symptoms.

I am worried about the 2 "abnormalities" that she mentioned with the gall bladder and bile duct. Hoping that nothing comes of it and that maybe was just made strangley:)

I spoke with dad just now and he sounds great! I don't hear any congestion etc so the Zithromax is working well. Yeah:)

[molly muffin]

I am sure that Daisy is just like her mom, tough as can be when needed.
Now don't freak out about the having cushings for a year. Cushings is Very slowly progressing. Most dogs have it for a very long time before they start to show symptoms and you don't usually start treating until you see those symptoms.
This is pretty much the norm for cushing parents. So, big hugs! Now what is this about the gall bladder and bile duct?
I'm glad the medicine is working for your dad. His cough is getting better? Going away?
Now you just enjoy the rest of your weekend! :)

hugs,
Sharlene and Molly Muffin

[doxiesrock912]

Sharlene,

I'll post the vet's report and the test result when I get them. She gave me so much information that my head was spinning and I can't remember the exact wording of what she suspects with the gall bladder and bile duct. It was something that could be a possibility and if it is, it's dangerous because it could rupture.

She's going by something that normally looks like a kiwi fruit but she seems much more "sludge" in Daisy's case. She gave us meds to loosen up the "sludge" and if that works, she does not have the other thing that could rupture and the appearance is due to Cushing's. I think that this is what she's talking about http://www.veterinarypartner.com/Content.plx?A=3402&S=1&SourceID=42

However, other than the diarrhea, Daisy has none of the other symptoms mentioned. I think maybe she's telling me all of the possibilities that could happen?

I'll share the report when I have it. Hopefully, by Monday.

One question, when the meds have Cushing's under control, will the pot belly appearance subside?

I spoke with dad twice, this morning and tonight, he didn't cough and told me that he feels much better :)

[scoora]

Valerie, I was reading about your visit with Dr. Morgan. You mentioned that she said she only had to lower trilostane dosage for macros. Did she say anything more about that? I would be interested since I know Scoop's tumor is a macro. I wonder if his dosage should be lowered. His cortisol has dropped his last couple ACTH tests without increases in his dosage. It worries me.

Have a Happy Easter
Hugs to you and Daisy Mae

Sounds like you had a great visit with Dr. Morgan. That's great.

[doxiesrock912]

Vicki,
it's rare that she's had to do that, but she has. Apparently, the dogs were heading toward Addison's and she just kept going lower and lower with their meds.

I think that she was doing her best to cover all scenarios to emphasize that this is treatable as long as you do the monitoring etc. I mentioned spontaneous remission of Cushing's and asked if she'd ever had that happen, sadly the answer to that was "no" which led to the Macro conversation.

I would ask your vet. There is a range that they like to see and if Scoop is still within that range, this could be why they haven't changed the dose.

It sounds like no change in dosage means that they have the Cushing's pretty much controlled unless the levels go below the safe range.

Dr. Morgan likes to monitor every 2 - 3 weeks and then longer when she feels that the Cushing's is stable. She has some patients that only come back once a year.

She seems extremely open to questions and I hope that your vet is the same way.

Good luck :)

[Simba's Mom]

Hey Valerie, Simba had a pot belly too and his was gone after a few weeks on the meds, he now has loose skin where is belly was and other places too...my vet told me that cush dogs weight can distribute to different places, I had to get Sim a bigger collar, but at least his belly is gone!!! Go figure, doesn't make sense to me :confused:

[scoora]

Valerie, Did she actually say that she lowered the dosage of dogs just because of a macro? Sorry, I'm a little confused. I know there's an article shows that Vetoryl makes the tumor grow faster. So I thought maybe that's why she lowerd the dosage. All vets I've asked about the Vetoryl said they never heard that.

Scoop is within that safe range but if it keeps dropping it might soon not be. When I said something to the vet she didn't seem concerned about it but if it's been dropping how do we know it won't keep going down.

Thanks

[doxiesrock912]

Letti,

it sort of does. If the Cushing's is under control and the dog gets exercise, I imagine that you can strengthen those weakened muscles to some extent as long as the Cortisol is under control and not causing any more weakness.

Just like humans who are out of shape for one reason or another, we can work to get back into shape once the things that were standing in our way are under control.

[doxiesrock912]

Vicki,

this is why it's important to test every few weeks when it looks like the Cushing's isn't stable.

It sounded to me like these few dogs appeared to be curing themselves of the Cushing's when indeed, the Cortisol was dropping too low because of the affects of the Macro pressing on certain parts of the brain so she lowered the dose to prevent them from going too low and into Addison's. She did say that this was a rare occurrence.

The point that she was trying to make is that there isn't a truly documented case of a Cushpup spontaneously being cured.

She stressed watching for symptoms. I would familiarize yourself with the symptoms of Addison's and call the vet asap. This means that the Cortisol went too low. Macro tumors can press on different parts of the brain and also cause changes.

Tell your vet your concerns. Is your vet an IMS or general practice?
I would change to an IMS. I've already experienced a VAST difference in knowledge between a general practice vet and an internal specialist. The cost between Cornell and our general vet was less than $50.00, so it was worth trading up for her expertise.

I've already spent $700 between the two previous general vets who don't have nearly the knowledge that Dr. Morgan has at Cornell and I wish that I'd started with her to begin with.

Of course Daisy is worth the money, but I'm unemployed and what I spent today was 3/4 of my tax refund check and I haven't picked up the prescriptions yet. That $700 would come in handy and Daisy will eventually need surgery on the mucocele that is on the side of her neck and another surgery if they do determine that she also has one on her gall bladder.

Good luck!

[scoora]

Valerie, So what Dr. Morgan was saying was the macro can cause the cortisol to drop. Maybe that's why Scoop's keeps dropping. I see changes in Scoop that I think the tumor is causing. His MRI report back in Nov. said if the tumor keeps growing it will press on the hypothalamus(sp?) That can affect different things. Since Scoop is blind it's hard to tell some of the things but he has done some things that I know it is affecting.
Thanks for the info.

[doxiesrock912]

You're quite welcome! Good luck to you and Scoop!

[doxiesrock912]

Hello everyone,

it is lengthy, but here is the report from Dr. Morgan at Cornell.
It's a PDF file, hopefully you can open it:)

https://docs.google.com/file/d/0B440mY1nZfEyQzNPS1J3bTFOR2c/edit?usp=sharing

[Trish]

Hmmm think you need a google account to view it, it didn't just open like a normal pdf file??

[molly muffin]

Well that Biliary Mucocoele looks a bit complicated. Interesting that cushings dogs are at a 29 times risk of getting this. Ack! Another thing to be on the look out for.

Yes, you need account permission to view that in google docs.

No way around it, cushings is an expensive disease to get. :( Wish it weren't so, that alone affects a person's ability to pursue some avenues of treatment, such as surgeries, repeated testing, etc.

hugs,
Sharlene and Molly Muffin

[labblab]

I think Trish is right, because I can't get the file to open, either...

In the meantime, I am so glad your visit with Dr. Morgan went so well! Being the Nervous Nellie that I am, though, I want to point out that the 10 mg. twice daily dosing (daily total of 20 mg.) is still double the initial starting dose recommended by Dr. Peterson and many other specialists. Here's a quote from Dr. Peterson's article that I think you already have seen:


My recommended starting dose is either 2 mg/kg given once daily or 1 mg/kg given twice daily. This is similar to the doses used in this study by Feldman (13), where the mean trilostane dose administered to his dogs was 0.86 mg/kg, twice daily (or a mean total daily dose of 1.72 mg/kg). Like Feldman, I feel that it is best to start with a daily dose that is at the low end or even lower than that recommended in the package insert. I would never start a dog on a dose at the higher end of the recommended dosage range (4-7 mg/kg), although some dogs with Cushing’s disease will eventually require daily doses that may be this high or even higher (1,14).

At her current weight of 5.2 kg, per his article, Dr. Peterson would not be dosing Daisy any higher than 10 mg. once daily or 5 mg. twice daily. I know you've had some correspondence with him. Is there something about Daisy's situation that leads him and Dr. Morgan to believe that a higher dose is warranted in her case? Or perhaps Dr. Morgan has just had different experiences with the dogs whom she has treated and prefers starting at a higher dose from the get-go. At any rate, I did just want to point out that 10 mg. twice daily remains a hefty starting dose for a dog of Daisy's size.

Also, I see that you and Vicki have been talking about possible rationales for trilostane to be lowered in dogs known to be suffering from macroadenomas. From our experiences here on the forum, I'd guess that the primary rationale is try to lessen the pressure and inflammation that the enlarging tumor is creating in the brain, rather than concern that the dog is more likely to go Addisonian. A dog with a macro may exhibit behaviors that look Addisonian such as loss of appetite and thirst, confusion, lethargy, etc. But this is caused not by low cortisol, but instead by the pressure created by the expanding tumor. So in that case, Cushing's treatment becomes a trade-off and it may be more important to let the cortisol level increase. Some specialists discontinue the trilo altogether and start dogs on supplemental predisone in order to maximize the anti-inflammatory steroidal action. Once again, Dr. Morgan may have her own reasoning about this. But in general, this has been our experience here.

Marianne

[doxiesrock912]

Ladies and gents,

I found a work around so that you can read the report from Dr. Morgan:)
It was in PDF format, but now it's a jpg attached to this posting.

Marianne, I did mention my concerns about the 20mg dosing. Dr. Morgan feels that Daisy needs the "round the clock" support right now and that is why she's suggesting 10mg twice a day so that Daisy has the benefit of the Trilostane throughout a 24 hour period. She's more than willing to lower if needed.

https://www.facebook.com/photo.php?fbid=581511101867824&set=a.105412319477707.10546.100000268197543&type=1&theater

[labblab]

Thanks for converting the pdf, Valerie! I'll take a look at it just as soon as I am able.

Also, just wanted to clarify that I am not questioning the overall decision to give the trilostane twice daily -- it's just the size of the dose. If you started with 5 mg. twice daily, though, you'd have to have the medication compounded since brandname Vetoryl is not available in capsules smaller than 10 mg. Is that maybe part of the issue for Dr. Morgan?

[doxiesrock912]

No, it's not the issue. Dr. Morgan knows that I have a compounding pharmacy nearby. I believe that she's had good experiences with splitting the 20mg dosage. She was in perfect agreement that 20mg all at once is too much.

She said the timing of the second dose does not have to be exact. I can give it 12 or even 16 hours later. I wonder if this might be similar to the loading phase of Lysodren that others go through? She is not a fan of using Lysodren because it destroys part of the adrenal gland.

Honestly, I spent at least a full hour with her discussing everything. Not one thing that she said contradicted research or the knowledge that I've gained through all of you. She truly believes that Daisy has had Cushing's for at least a year and if we need to decrease the dosage, she's more than willing to do that but she is still suggesting this as a starting point. She also stressed the fact that Trilostane doesn't remain in the system for long and I think that she wants Daisy to have more support from the meds right now especially since both adrenal glands and liver are enlarged. I told her that the pot bellied appearance just occurred within the past few weeks.

I'll give it a shot.

[Tina]

Hi Valerie,
Wow, what a great experience at Cornell! So glad to read that it went well. It sounds like that vet was very knowledgable. I am unable to open the attachment on Facebook, it says the content is no longer available? But from all that you posted it sounds like you have a great plan for your little Daisy. I have been following along on your thread, and am so happy to hear that your Dad is feeling better also. Hope you all are having a nice Easter.

Hugs,
Tina and Jasper

[doxiesrock912]

Tina, if there were a way for me to attach the document to my posting, you could read it. The PDF if protected so I can't copy and paste.

I have Adobe Writer at home and will see what I can do with that later tonight. It's important that those who have more knowledge be able to read her findings and then give me their assessment.

Happy Easter :)

[doxiesrock912]

Let's try this again.

The report is 6 pages long and includes detailed ultrasound findings.
The ACTH test was done before starting the Trilostane.

You should be able to access the document now, I had to change the permissions :)

https://docs.google.com/file/d/0B440mY1nZfEyQzNPS1J3bTFOR2c/edit?usp=sharing

[molly muffin]

I see a homework assignment in my future. :) Will try to read as soon as I get some time.

No, vetoryl doesn't have a loading phase. You start it, either once a day or twice a day and then retest after about 10 - 14 days depending up symptoms and then again at 4 weeks to see how the cortisol levels are doing.

I'll have more to say after reading the report. Thanks for changing the permissions.

hugs,
Sharlene and Molly Muffin

[doxiesrock912]

Thank you Sharlene!
We haven't started the meds yet since I now have a request into the vet asking them to pay for the meds to be recompounded into a smaller dose ($45).

Interestingly enough, Daisy is still much improved since the Baytril as far as her drinking and eating goes.

[infoviewer]

Hi Valerie: So sorry for your visit to this forum. I have been reading your posts and noticed you had trouble with BB Wellness some time ago. I have a 11-12 pound doxie diagnosed with Cushings a year ago and was started on 10 mg of Vetoryl, now on 20 mg. His worst symptom now is the hair loss and a few other things that he has caused himself. I was wondering what kind of problems Daisy was having with the Wellness food, which is what I have been feeding CoCo and he has been having loose stools off and on, but I figured it was Vetoryl or an antibiotic ointment I am using for the booboo. He has on a cone, but somehow with his long body can get around it if I do not watch him. He had eaten Eukunuba all his life, but it is not considered a good food now, so changed to the Wellness. It is so hard to figure out the best thing for these Cushing pups. I used to give him carrots and different veggies or fruit, but he had such a bad case of diarrhea that I had to take him to the vet in a towel to keep it off the car, so I stopped the veggies. Vet gave him Metronidazole at that time and said to give him Pepto Bismol. He has not had it that bad again, but does have loose stools quite often so I am wondering if it is the Wellness. Just picking your brain about the problem Daisy had with the Wellness. I know there was a recall on it at one time. I know what you mean about Daisy not having anything to do with her owners. My male dachshund is so arrogant, he has nothing to do with anyone or any pet. We love him dearly any way and just laugh at him, they are so comical. Love, JoAnne

[doxiesrock912]

JoAnne,

within a week of being on the Wellness food Daisy had diarhhea and it quickly developed into straight blood! She became listless and vomited once. They gave her Metronidazole which worked for awhile but the diarhhea came back just not in the bloody form. Her regular vet assumed IBD.

Ask your vet about a prescription for Baytril, Daisy had this for her pyoderma and it worked wonders on that and her loose stools and no more diarhhea! The vet said that Baytril would not improve diarhhea if it stemmed from IBD and believes that she may have had E-coli in her system all of this time since the Wellness incident 2 years ago! Can you imagine how angry I am that she's had this for 2 years and it could have been resolved!

If the vet gives you Baytril, don't change food yet. See if there is improvement.
Daisy also gets Osteo-Pet Glucosamine Chondroitin with MSM for arthritis and joint health. It does seem to help.

Since this issue has been going on for a long time, the same with Daisy, the IMS specialist suggested that if she gets diarhhea again to ask the vet to give another round of Baytril for a longer time. Apparently, these E-coli are stubborn. E-coli can come from many sources or something that they ate outside.

Carrots are high in sugar so we stopped giving those. Daisy likes green beans as a snack. The IMS at Cornell did not advise me to change Daisy's diet. She gets Royal Canin Dachshund 28 dry. Libbys canned pumpkin (from the baking aisle) helps her stomach too.

Baytril shouldn't cause stomach upset or anything, in fact, it helped many of Daisy's overall symptoms. Cushing's symptoms are common with many other illnesses which makes it easy to miss something else going on with our furlets.

Keep me posted!

[molly muffin]

Hi ya Valerie,

So you want to go lower than 10mg twice a day? What do you want to start Daisy on?

I'm so glad they caught the gallbladder issue. That can really make the sick, vomiting and cause some problems if any of the areas get blocked, so glad she'll be treated for that.

I really liked the sound of this specialist. She seems to be very thorough in her evaluation of Daisy and even better, sensible in her treatment plan. I really like her and I like the report she wrote too.

hugs,
Sharlene and Molly Muffin

[infoviewer]

Thanks so much Valerie. I said CoCo eats Blue Buffalo Wellness, it is actually BB Wilderness. He really never had soft stools until he started the Vetoryl. I have tried several foods and he will still have soft stools with all of them, really hard to switch foods. I will usually just give him a few pieces of the food a day until I can switch. I appreciate the tip about Baytril. I will mention that to the vet. He is on an antibiotic ointment for a booboo now and wears a cone during the day to prevent licking, but he does get to it some and I feel like that gives him soft stools. I just do poop patrol every time he goes outside. Hope Daisy Mae does okay on the Cushing medicine. CoCo was started on 10 mg to begin with and then changed to 20 mg. He weighs 11-12 pounds. One of the vets I see recommended that I give it at 10 mg twice a day, but his regular vet recommended 20 mg in the morning and that is what I do. He is doing pretty well, he has weak back legs and hair loss. His cortisol was 5.8 three months ago, so he has to be checked again in a little while. Hugs, JoAnne

[doxiesrock912]

JoAnne,

Daisy had diarhhea on the 20mg all at once and that is why we`re changing ro 10mg 2x a day. She weighs 11lbs. My vet tech jut informed me thatbshe's had a lot of recent complaints due to the way that BB is causing diarhhea in many dogs. Apparently it is cooked it 2 different waysnand many dogs can't tolerate this.

Have you seen an IMS vet yet. If niot, please do so.
The once a day dosage is sometimes hard for thensmall dogs to handle.

[molly muffin]

Valerie,
Giving one daily dose has been causing diarrhea in quite a few dogs lately?
What did she mean by cooked differently? What is cooked differently? the process of making it? How the dosages are absorbed by the body?
I'm lost. (this is not necessarily unusual)

hugs,
Sharlene and Molly Muffin

[doxiesrock912]

Sharlene
one of the techs at our vets office rescues and fosters dogs. She's extremely knowledgeable when it comes to pet food and supplements. Apparently, BB has a dual process. One batch of food has ingredients that are cooked using two different processes and they're finding that it does not agree with many dogs.

I am sure that this was the case with Daisy two years ago and at that time, the company refused to acknowledge that there was a problem.

The vet tech contacted them because multiple owners came in with the same complaint and ALL of the dogs were on BB food.

[doxiesrock912]

Thanks Sharlene,

I was super impressed with her. Not once did she argue or try to make the information that I shared seem wrong or unimportant. I read the report and was amazed that she got EVERY detail that I gave her correct.

I have to pay to get the Trilostane reformulated since it is in capsule form and I am REALLY pissed at the regular vet because he refuses to acknowledge that he made several mistakes (Ie: he has Daisy's weight listed as 14lbs, he said that it won't make a difference if we break up the 20mg to 10mg twice a day and therefore is standing by his original dose which caused liquid diarhhea within six days of starting the meds, plus he gave me a script for 3 full months).

Daisy weighs 11lbs and the pharmacy is going to reformulate the Trilostane as follows, 1/2 will be 5mg capsules, and the other half will be 10mg capsules. The shelf life on Trilostane is a little over 3 months so I would likely be out quite a bit of money depending upon how Daisy's dose needs to be adjusted.

The IMS suggests to start at 10mg twice a day. She mentioned that there are a few dogs that do well with a bit lower (7.5mg). So, that being said. If the pharmacy gives me 5 and 10mg pills, we should have all possibilities covered:)

This same pharmacy is formulating the drug for the gall bladder issue as well.

I see that some members talk about Fortiflora. What exactly does it help with?

What is your take on Daisy's ACTH test results? They were done prior to any Trilostane but she was on Baytril for the skin infection.

[molly muffin]

Hi Valerie, okay I see what you mean by the Blue Buffalo now. Well, that makes sense and I wouldn't recommend it if so many are having problems.

I didn't see an ACTH test result on the report. Did I miss it? what page? I only saw a recommendation to follow up with an ACTH after starting treatment.
I saw the LDDS result from 3/6/13
base 8.8
4 hour 3.7
8 hour 4.5
which is consistent with cushings or the body at least not suppressing cortisol production.

hugs,
Sharlene and Molly Muffin

[labblab]

The IMS suggests to start at 10mg twice a day. She mentioned that there are a few dogs that do well with a bit lower (7.5mg). So, that being said. If the pharmacy gives me 5 and 10mg pills, we should have all possibilities covered:)

Valerie, I'll bet you are sick of seeing me writing with questions about your dosing :o, but I am not seeing how a combination of 5 and 10 mg. capsules will give you an option for dosing at 7.5 mg. twice daily? Wouldn't you need to have a 2.5 mg. capsule as well, to combine with the 5? Or would you be planning to give 10 mg. at one time and 5mg. at the other?

In honesty, if it were me and the recompounding hasn't yet been completed, I'd opt for the whole order to be prepared in 5 mg. units so you would have the option of dropping clear back to a daily total of 10 mg. (5 mg. twice daily) if need be. You can always give Daisy two capsules at a time, but you can't ever cut a capsule in half. I know your IMS anticipates she'll need that higher dose, but we've seen many dogs here who really do not do well initially in terms of tolerating a daily total that exceeds that 1mg. per pound formula advocated by Dr. Peterson, Dechra, and other specialists. The dogs have needed to cut back and work up to higher doses more gradually.

Marianne

[doxiesrock912]

Marianne,

As I'm typing a response, the pharmacy called me saying that making all of the pills 5mg would be best. I was thinking of giving Daisy starting with the 10mg twice a day and seeing how she does because the IMS specialist at Cornell believes that she needs to start at this dosage. If she has diarrhea like the last time, I would drop down to 5mg after talking with the IMS doc.

Luckily, I have no problems giving Daisy pills. I put them on top of her food and she eats everything.

I know that Dr. Morgan is concerned about Daisy's kidney function being impaired. She also called me while I typed this and the UTI test came back negative, but she's got a lot of protein in her urine. Dr. Morgan hopes that treating the Cushing's will resolve this and at this time, she doesn't believe that Daisy has kidney damage.

The test results in the report are from the original LDDS test performed before Daisy took any Trilostane, my mistake:)

[labblab]

I'm really glad to hear that all the capsules will be 5 mg. This way, depending upon how Daisy responds, you'll have a maximum amount of flexibility with the dosing. :)

Marianne

[doxiesrock912]

Me too! The original vet who prescribed the high dosage refuses to pick up any of the cost to reformulate. So, in total, 3 months of Trilostane cost me $150!

I'm unemployed and very unhappy that this has happened. If it weren't for finding Cornell, I don't know what I would've done! I've gone through 3 vets prior to Cornell. To think that I could've used that money to treat Daisy the right way now really upsets me.

I would recommend to anyone who suspects that their pet has Cushing's to go straight to an IMS doc and not waste money on the general practice vets. I'm sure that some of them are good and up to date with Cushing's, but I've found that not many of them are.

[Simba's Mom]

Hey Valerie, hoping that the 5mg works for Daisy Mae, and I agree it's nice to have the option if she gets the bad poos :( Simba did great on the 20mg, but since they upped it, his tummy is gurgling more...I'm going to ask about baytril, thanku for the info, it always helps to know what others have tried and had good luck with...sending hugs to you and your girl!!

[doxiesrock912]

Awww:( Poor Simba!

How much does Simba weigh?

I asked her about Fortiflora and she said that it does help some dogs even though there are no scientific studies. I'm happy that she's open to other options too.

Hope your baby feels better soon!

[Simba's Mom]

Simba weighs 22 pounds, when he's hungry he can't get enough food, but right now his appetite is off so maybe he will loose a little...he's a savanger at nite in our back yard, eating poo sicles or whatever else he can find, so today I picked up poo ;) he will have to eat his kibble instead! Fussy little fart!

[doxiesrock912]

Wow!
Simba is 22lbs and Daisy is only 11. I wonder why she wants me to start at 10mg twice a day instead of lower? Could be because we suspect that she's had Cushing's for at least a year.

Daisy is like that. She would eat 24/7 if we let her!

[Simba's Mom]

Simba has had cushings for awhile too, my old vet said that he was just getting fat, my new vet noticed his pot belly right away and we got him tested! I prob waited a year to test him cus old vet said nothing about cushings....and yes Daisy is tiny, that does seem like alot of trilo for her...hmmmm

[molly muffin]

Molly has been on the floriflora and it has always helped her with gastro issues. I actually have some here now just in case. She's been on it a few times in her life.

Well, that 5mg was meant to be. Funny everyone immediately noticing that would be the better option. Vet, pharmacy, Marianne. :)

hugs,
Sharlene and Molly Muffin

[doxiesrock912]

Actually, Dr. Morgan from Cornell still thinks that 10mg twice a day will be fine. I'll try it and if I notice any negative changes, I'll call her asap.

Maybe she saw something in the ultrasound that makes her want to try the 10mg dose first? Anyway, so far, she's been right on with everything else.

Did I tell you that Daisy fell asleep while they did the ultrasound? I think that's hilarious:) She's never been finicky about people (except for my niece's father).

Thanks for all of the input. I'll try the 10mg twice a day and if she gets diarrhea, I'l drop it down and call the doc.

We won't have the meds for another day or two, but I started the fortiflora today to settle her stomach before we begin the rest.

[doxiesrock912]

Bravo dog food recall!
http://www.dogfoodadvisor.com/dog-food-recall/bravo-raw-frozen-dog-food-recall/

[Simba's Mom]

Hey Valerie, do you need a vets script for the floriflora stuff? And what is it exactly? Thanku

[addy]

Lettie, you do know a script for it and if I remember corretly it is "animal digest" whatever the heck that is and something else. Zoe was on it for awhile . She has now been on a probiotic from Arc Animal- Gentle Digest. Zoe's holistic vet had her on human Culturelle probiotic but it did not really work for us. The Gentle Digest has worked as well as the Forti flora for Zoe and I dont need a script and it is much cheaper.

You could try it first.

[doxiesrock912]

Lettie,

Fortiflora has probiotics in it that help maintain a healthy digestive tract and aid in the digestive process itself. It's in powder form that you sprinkle onto their food which also makes it easier to absorb.

Addy,
how do the ingredients of both products compare to each other and is the Gentle Digest also in powder form?

I was surprised that 15 days of the Fortiflora cost more than $30!!!! Definitely up for finding the same thing in a less expensive product!

[addy]

I had the name wrong, I always do that, like when I call Five Guys Three brothers, drives my daughter nuts:p:p

Arc Naturals Gentle Digest. When it comes to Probiotics and Prebiotics you may need to try different kinds, you give it about 3 weeks to see if it helps before changing. Holistic pet store gave it to me to replace the Culturelle and low and bhold it worked for Zoe.


Recommended Use:
For dogs and cats 12 weeks and older. Use to restore digestive balance interrupted as a result of antibiotic therapy, for help with diarrhea and/or constipation, to reduce gas and flatulence, and to aid digestion and absorption of critical nutrients. Beneficial for senior pets and pets under stress. Helps with yeast infections, particularly ear infections.
Under 25 lbs: 1 capsule each day
Under 50 lbs: 2 capsules each day
Over 50 lbs: 3 capsules each day
Active Ingredients:
· Bacillus Coagulans (formerly known as Lactobacillus Sporogenes)
Inactive Ingredients:
· Dicalcium phosphate
· Gelatin (capsule)
· Magnesium stearate
· Rice flour

[goldengirl88]

Valerie:
I am so sorry to hear about Daisy having troubles again with food. I was at my own Dr. yesterday because of my Lupus and was not able to reply. I just wanted to tell you that the reason Tipper only eats Newmans Own is because number 1 it has never been recalled. Number 2 is that is is organic human grade chicken. Number 3 is that is is grain free. It is also lower in fat than a lot of the other dog foods. Please be careful of the foods you are selecting. Royal Canin , and Wellness have both had recalls. I tell you this because you don't need any other problems. Many of these dog foods buy fillers etc. from China also. Wellness has been known to give many dogs diarrehea- I have read it all over the internet. So that could be the problem. This is so troubling to hear of poor Daisy going thru this. You are on top of everything so she is in excellent hands. I am going to ask if Tipper can just have the MRI and skip the other crap. Hope Daisy gets better soon.
God Bless You Both.
Patti

[doxiesrock912]

Patti,

Daisy isn't having trouble with Royal Canin right now, but I'd like to be prepared in case the IMS doc does suggest a change. Right now, she doesn't recommend it.

That's why I'm looking for recommendations. Luckily, we don't have a weight problem other than the Cushing's pot belly which has only recently appeared.

The reason that I'm starting the Fortiflora is that I want to be sure that Daisy's digestive tract is as healthy as it can be before starting Trilostane. That way, if she does have a problem we have no doubt that Trilostane was the cause.

Thank you so much for the information! I'm trying to avoid adding more symptoms or problems to Daisy's list. I love that munchkin.

[doxiesrock912]

Thank you Addy!
I'll compare the two products and wait to see if the Fortiflora helps. No diarrhea since the 6th day on the higher dose of Trilostane, but I do hear her stomach gurgling sometimes.

I'm trying to be proactive and get her GI tract as healthy as I can before starting the Trilostane again.

[Simba's Mom]

Thanku ladies, hope Daisy does good with the meds and Zoe too. Can I get that stuff online? Simba's tummy gurgles constantly, I feel so bad, I think I will call my vet today...

[addy]

Valerie, I dont blame your for wanting her digestive tract in tip top shape and it would not be good to change anything now, so best to keep with the Forti Flora. ;)

You are doing just great:):):)

[molly muffin]

Letti, The Flora one you can get from your vet and maybe you can get the one Addy mentioned online since she said she didn't need a prescription for it. Never thought about Simba not having tried it, usually vets give it pretty regular for digestive issues.

I think that is very smart Valerie. Daisy is a sweetheart, of course you want her in tip top shape before starting anything.

hugs,
Sharlene and Molly Muffin

[doxiesrock912]

Thanks everyone!

I'm paranoid since the last try with Trilostane resulted in liquid diarrhea on the 6th day. Since there is truly no way to know if it was because of the meds, the suspected underlying infection, or a little of both.

If she doesn't need the FortiFlora, it won't hurt either way.

Thanks for making me feel smart :)
This coming from a woman who five minutes ago was cutting out a mat of fur from Gracie kitty. Ooooh, she's a tad pissed. Yes, we tried the baby powder trick first, didn't work.

I've learned a lot from all of you and feel so much less stressed about Cushing's since I now have multiple sources to run things by.

We can't thank you enough.

[goldengirl88]

Valerie:
Thinking of you and Daisy and hoping this works out for her. I know what you mean about being nervous. This Cushings is certainly a bumpy road to say the least. Hugs to Daisy, and GOd Bless you both.
Patti

[doxiesrock912]

Thank you Patti,
are you feeling better?

I have to share this with you.
My fiance's mother and step mother are both named Patty!
Now I have 4 ladies named Patty to confuse me even more:-)

I love all of you, so please forgive me if I get someone confused.

[milosmom]

that is too funny valerie !!! just checking in on you and daisy,how was your day?looks like we are gonna have a great weekend with the weather.gonna get out there and do my boxes on my deck tomorrow.have a great weekend !!! patty(milo)meka xoxox :)

[molly muffin]

You're doing your boxes already Patty!!! wow, I'm impressed!
Hope you and Daisy have a good weekend.
hope we all have a good weekend. I need a nap.

hugs,
Sharlene and Molly Muffin

[milosmom]

i know sharlene !!! i am so over winter and pushing spring ahead,just gonna put some pansies to put some color out there....sending sunshine and warm wishes your way ....here's to a good weekend for all of us !!! ;) patty(milo)meka xoxox

[doxiesrock912]

I love pansies:) I planted some in a 3-side by side planter last year and then I came to dad's to help and Chris forgot about them and they died :(

Seriously? He saw them everyday as he left the house for work....men. Hmpf.

Daisy was not herself today so I'm glad that I was able to start the Trilostane tonight. I wanted to take her for a short walk and she just stared at me like "I don't think so mom."

She looks SUPER bloated too! It's strange how that comes and goes.

Have a wonderful weekend everyone with no drama or vet visits!

[doxiesrock912]

Hello everyone,

I was looking over the paperwork from Dr. Morgan at Cornell and was wondering if someone could explain these test results to me please, they were done prior to the LDDS testing:

PREVIOUS DIAGNOSTIC TESTING (2/26/13)
CBC--AII indices WNL
Chem--AST 150, ALT 514, ALP 4417, GGT 123, T bili 0.2, Ca 8.4, Cl 92, Chol 805, Triglycerides 379


Also, have any of you heard of or used the antioxident Avemar? http://www.natural-dog-health-remedies.com/herbs-for-cancer.html


Thank you

[labblab]

PREVIOUS DIAGNOSTIC TESTING (2/26/13)
CBC--AII indices WNL
Chem--AST 150, ALT 514, ALP 4417, GGT 123, T bili 0.2, Ca 8.4, Cl 92, Chol 805, Triglycerides 379

Hi Valerie,

The "CBC" stands for "Complete Blood Count" and summarizes the levels of the different types of blood cells found in a sample. In Daisy's case, all the cell counts were "within normal limits." :)

The Chem test summarizes the levels of different substances found in the blood, including the "electrolytes" that we talk about so often (most importantly, sodium and potassium) as well as such things as different kidney, liver, and pancreatic function markers. You have not given us the normal range for the items you've listed, but on the face of it, I'm guessing these were all highlighted as being abnormal and that's why you are asking about them? If so, for the most part, I believe these are all categories that can be associated with Cushing's. AST, ALT, ALP, GGT, and T bili are all related to liver function; Ca is the amount of calcium; Cl is the amount of chloride; and I'm guessing you know about cholesterol and triclycerides.

I can tell just by looking that the ALP is elevated, and that is typical of Cushing's. Without the reference ranges, I don't know how far "off" the other values are. Cushing's can cause some degree of elevation in all the liver markers, but if multiple markers are excessively high, that is the point that you wonder whether or not there is some primary liver issue at play. However, from what you've told us, it sounds as though Dr. Morgan is attributing the liver abnormalities to Cushing's at this point.

I'm afraid I don't know anything about Avemar.

Hope this helps!
Marianne

[goldengirl88]

Valerie:
Checking in to see how Daisy is this morning. Is she still looking bloated? Hope you have a good wekend with her and that the Trilostan helps her feel better. God Bless you both.
Patti

[doxiesrock912]

Marianne, yes it does! Thank you:)
Dr. Morgan explained most of it I'm sure but we spoke for almost an hour and I can't remember it all.

Patti, Daisy seems a little better this morning. Not quite to "rhino-ish". The bloating will subside soon I hope. It's been an intermittent thing with her lately but I'm hoping that the Trilostane and other things will calm her system and maybe the liver swelling will lesson too. Normal poops this morning, but a lot of them!

Neither of us was thrilled that it's less than 40 degrees out. Where is Spring?

How are you and Tipper doing?

[Squirt's Mom]

Hi Valerie,

Would you mind editing your post to include the normal ranges for the values you listed?

Thanks!
Hugs,
Leslie and the gang

[doxiesrock912]

Leslie,
I found this information.

CBC Values & CMP

Red Blood Cells (RBC) – responsible for carrying oxygen and carbon dioxide throughout the body. Iron deficiency will lower RBC count. In more reduced count, it may indicate hemorrhage, parasites, bone marrow disease, B-12 deficiency, folic acid deficiency or copper deficiency. RBC lives for 120 days so an anemia of any kind other than hemorrhage indicates a long standing problem.

Hematocrit (HCT) or Packed Cell Volume (PCV) – Provides information on the amount of red blood cells (RBC) present in the blood. Decreased levels means anemia from hemorrhage, parasites, nutritional deficiencies or chronic disease process, such as liver disease, cancer, etc. . Increased levels are often seen in dehydration.

Hemoglobin (Hb) – The essential oxygen carrier of the blood. Decreased levels indicate the presence of hemorrhage, anemia, iron deficiency. Increased levels indicate higher than normal concentrate of RBC, B-12 deficiency (because there are fewer cells).

Reticulocytes – Immature red blood cells. Decreased count is usually associate with anemia. Increased count is associated with chronic hemorrage or hemolytic anemia.

Platelets (PLT) – Play an important role in blood clotting. Decrease in number occurs in bone marrow depression, autoimmune hemolytic anemia, systemic lupus, severe hemorrhage or intravascular coagulation. Increased number may occurs with fracture or blood vessel injury, or cancer.

MCV – Measurement of the avarage size of the RBC. Elevated volumes can be due to B-12 folic acid deficiency and reduced volumes are from an iron deficiency.

White blood cells (WBC) – The body’s primary means of fighting infection. Decreased levels may indicate an overwhelming infections (viruses), or drug / chemical poisoning. Increased levels indicate bacterial infection, emotinal upsets and blood disorders.

Lymphocytes (L/M) – These smooth, round white blood cells increase in number with chronic infection, recovery from acute infection or underactive glands and decrease with stress, or treatment with steroids and chemotherapy drug.

Calcium (CA) – Blood calcium levels are influenced by diet, hormone levels and blood protein levels. Decreased levels indicate acute damage to the pancrease or undersctive parathyroid. Muscle twitches may occur in decreased level. Increased levels can be an indicator of certain types of tumors, parthyroid or kidney disease. Dr. Goldstein mentioned in his book, Nature of Animal Healing that low calcium level may indicate deficiency of pancreatic enzymes, and high calcium level may indicate poor metabolism of fats and protein.

Phosphorus (PHOS) – Affected by diet, parathormone and kidney. Decreased levels shows overactive parathyroid gland and malignancies, malnutrition and malabsorption. Increases with underactive parathyroid gland and kidney failure.

Electrolytes (Sodium, Potassium, Chloride) – The balance of these chemicals is vital to health. Abnormal levels can be life threatening. Electrolyte tests are important in evaluating vomiting, diarrhea and cardiac symptoms.

Cholesterol (CHOL) – Decreased levels are found in an overactive thyroid gland, interstinal malabsorption. Elevated levels of cholesterol are seen in a variety of disorders including hypothyroidism and diseases of the liver, kidneys, cardiovascular, diabetes, stress.

Alanine aminotransferase (ALT) – An enzyme that becomes elevated with liver disease.

Alkaline Phosphatase (ALKP) – An enzyme produced by the biliary tract (liver). High levels indicate bone disease, liver disease or bile flow blockage.

Total Billirubin (TBIL) – A component of bile, bilirubin is secreted by the liver into the intestinal tract. High levels can lead to jaundice and indicate destruction in the liver and bile duct.

Total Protein (TP) – Increases indicate dehydration or blood cancer, bone marrow cancer; decreases indicate malnutrition, poor digestion, liver or kidney disease, bleeding or burns.

Globulins (GLOB) – Decreased levels indicate problems with antibodies, immunodeficiency viruses or risk of infectious disease. Increased levels may indicate stress, dehydration or blood cancer, allergies, liver disease, heart disease, arthritis, diabetes.

Albumin (ALB) – Produced by the liver, reduced levels of this protein can point to chronic liver or kidney disease, or parasitic infections such as hookworm. High levels indicate dehydration and loss of protein.

Blood Urea Nitrogen (BUN) – BUN is produced by the liver and excreted by the kidneys. Decreased levels are seen with low protein diets, liver insufficiency, and the use of anabolic steroid drug. Increased levels indicate any condition that reduces the kidney’s ability to filter body fluids in the body or interferes with protein breakdown.

Creatinine (CREA) – Creatinine is a by-product of muscle metabolism and is excreted by the kidneys. Elevated levels can indicate kidney disease or urinary obstruction, muscle disease, arthritis, hyperthyroidism, and disbetes. An increased BUN and normal creatinine suggest an early or mild problem. An increased creatinine and increased BUN with elevated phosphorus indicate a long standing kidney disease.

Blood Glucose (GLU) – High levels can help diagnose diabetes and can indicate stress, excess of the hormone progesterone, an overactive adrenal gland. Low levels can indicate liver disease, tumors or abnormal growth on pancreas, an underactive adrenal gland.

Amylase (AMYL) – The pancreas produces and secrets amylase to aid in digestion. Elevated blood levels can indicate pancreatic and/or kidney disease.

Daisy's results:
CBC--AII indices WNL
Chem--AST 150, ALT 514, ALP 4417, GGT 123, T bili 0.2, Ca 8.4, Cl 92, Chol 805, Triglycerides 379

Normal Ranges:

Temperature, Pulse rate and Respiratory rate (TPR)

Dog/Cat
Temperature* (F) 99.5-102.5/100-103.1
(C) 37.5-39.2/37.8-39.5
Pulse rate** Young 110-120/130-140
Adult 80-120/100-140

Respiratory rate Young -- --
Adult 15-34/16-40

[doxiesrock912]

Leslie,

here is where Daisy fits in.

Conventional (USA) Units

Dog/Cat
ALT 514u/L Normal range 8.2-57/8.3-53
Alkaline phosphatase 4417u/L Normal range 1-114/3-65
AST 150 u/L Normal range 13-15/7-38
GGT* 123u/L Normal range 1.0-9.7/1.8-12
Bilirubin, total 0.2mg/dL Normal range 0.0-0.4/0.0-0.2
Calcium 8.4mg/dL Normal range 9.6-11.6/9.3-11.7
Chloride 92mEq/L Normal range 109-122/117-129
Cholesterol 805mg/dL Normal range 116-300/95-130

[doxiesrock912]

Hello everyone,

it's warmed up nicely so Daisy and I went for a short walk:)
She was sniffing around as usual, just a lot slower.

Tonight she seems to be breathing heavy, even while laying down. She's not panting, but breathing harder.
I counted her breaths, 38 in one minute. I called Cornell back and they told me that is a normal number.
I must be getting paranoid!

However, I did notice her head wobbling a bit. left and right, as she lounged on her bed and that is something that I've never seen before. I sent an email to the vet.

What are the signs if the Trilostane is too high?

[goldengirl88]

Valerie;
At times I have noticed a slight wobble to Tipper's head, at times like a slight shaking. I think it is the Vetoryl. I am so anxious about this coming week, I have hardly slept. What this disease puts people and pets through is disgusting. I am glad Daisy went for a walk. Tipper is still walking about a mile a day. Even though her cortisol has been controlled until now, I am noticing her rear leg muscles getting smaller every week. This is really scaring me because if Tipper cannot walk she will be very depressed. I just want that magic wand to make this all go away for everyone. God Bless you and sweet Daisy.
Patti

[molly muffin]

Hi Valerie,

If you have a Trilostane overdoes, you will see usually, either and/or vomiting, diarrhea, lethargic as in not wanting to get up and move, refusing food.

hugs,
Sharlene and Molly Muffin

[doxiesrock912]

Tipper walks a mile a day! That's amazing! I don't understand why the muscles continue to waste if it's under control?
Daisy has no back issues yet, but I worry about that with the pot belly.

This does SUCK:-( I was awake until 4am checking on her. I even called Cornell, that's when I realized that she had the normal number of breaths. I really thought we were making the2 hour trip to Cornwall last night.

Thanks for the info Sharlene!

Hugs and kisses

[addy]

Hi Valerie,

I hope you are remembering to breathe;);)

I know how scary it all is, you see every little twitch and wonder "what the heck is that about?". Hopefully things will go more smoothly this time. Remember too, sometimes they start feeling yucky from the cortisol dropping.

I know you are on Eagle Eye duty, I hope you both can take nap.

We are here for you. Just give a holler;););)

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

[doxiesrock912]

Hi Addy,

you have NO IDEA how thankful I am for all of you! Yes, I'm sure that you felt that way as well :)

Yes, every little thing I notice and can't remember if it's always been or not. I think I've got Cushing's senility setting in. I'm only 47 - boo hiss :)

Daisy seems much better today than last night/early this morning so I'm guessing that she might be having the beginning icks. Although, she ate a poop outside which was not one of her earlier symptoms. Blech!!! That might also be that she behaves better for me than anyone else and my sister had stopped over and took daisy out while I was getting dressed.

She didn't want to take a walk either but gets up right away to go out and do her stuff. Tomorrow will be the test, weather permitting, I plan to take her to the park instead of the boring same old neighborhood (and they say that CATS are finicky).

I'm going out with dad for awhile so she'll have the house to herself for a bit.

xoxoxoxo

[Simba's Mom]

Hey Valerie, yes this cushings sucks, I have never watched Simba closer than I do now..I watch him eat, and drink and poo and pee, it's a full time job....I just want to relax and enjoy my pup but all i do is worry...hoping little daisy does well on the meds, take care!!

[doxiesrock912]

Daisy seems to be a bit more active tonight and no diarrhea yet so maybe this time the 2x a day dosing is all that was needed. No wobbly head tonight either:)

I'll call Cornell on Monday to schedule her ACTH followup.

I hope that everyone had an uneventful weekend.

Hugs

[Wally P's Mom]

Keeping our paws crossed...

Marge

[doxiesrock912]

Thank you Marge.

Daisy seems MUCH better today! I think that her pot belly is subsiding and she had more of a spring in her step this morning <3

Quite a difference from this weekend when I contemplated a visit to the ER vet.

Thank you for the prayers everyone!

[milosmom]

happy to read this valerie :) !!! get out there and enjoy this beautiful day with your daisy mae .....Patty(milo)meka xoxox

[doxiesrock912]

Thanks Patty!
You too :)

[Simba's Mom]

So thankful no er trip for you or Daisy Mae, love that name every time I see it:) it's so weird how one day can be normal and then just when you think it's going good, something comes up...I know some of it is me with my Sim, but gee whiz when you love a pup so much, you worry:( take care Val, and Daisy Mae too!!!!

[molly muffin]

Whoo hooo, glad to hear that Daisy is having a good day!
I'm betting that means you probably are having a good day too. :)

hugs,
Sharlene and Molly Muffin

[doxiesrock912]

Thank you everyone.
Daisy went out to do what she had to, but was not interested in walking. She just plain didn't want to so tomorrow is another day :)

[molly muffin]

Hello Valerie! How is little miss Daisy doing?
Is she interested in her walks again?
Hope all is going well!

hugs,
Sharlene and Molly Muffin

[doxiesrock912]

Sharlene,
is it normal that cushpups are more sensitive to heat? She wasn't interested the other day when it was 78 degrees out, but today she was ready to go. Panting is not one of the symptoms that she's had so far, but her breathing does appear to be heavier. This could also be because of the salivary mucocele.

This coming from a dog who would lay on the pavement sunning herself on the hottest days of the year!

[molly muffin]

Hi Valerie,

Cushing dogs are more sensitive to the heat when the cortisol is higher. Daisy's should be coming down by now, so she shouldn't be having the same heat sensitive. Cortisol is like an internal combustion engine, it makes them feel warmer, so dogs will often seek out cooler places to lie.
It could be she just didn't feel like a walk that day or wasn't feeling at her best. Another thing to remember is that as the cortisol comes down, they'll feel aches and pains that they might not have even noticed before.
That cortisol can make them feel pretty good. It can take a bit of time for all of this to equalize in their bodies. Some days she might be more active than others, especially to begin with.

Hang in there momma. :)

hugs,
Sharlene and Molly Muffin

[doxiesrock912]

Sharlene,
I'm fine. I just wanted to be sure that this was the new normal.

So far, I haven't noticed much difference with the arthritis but Daisy does get 1/2 a tablet of glucosamine chondroitin with MSM and that really does seem to help.

We have an appointment with the IMS doc exactly one week from this coming Friday which would be exactly 2 weeks since starting the Trilostane.

One thing that I noticed about Cornell is that no matter who I talk with, they pull up and read Dr. Morgan's notes while we're speaking so they know exactly what is planned etc. They seem to be very careful about knowing Daisy's history which suggests that everyone there fully recognizes that each cushpup is quite different from the next one.

I'm confident that we're going to the right place!

[infoviewer]

That sounds great Valerie, so glad you are able to go to Cornell. Wish we lived closer to University of TN, but it is about 4 hours away. One of the vets CoCo sees just graduated from UT and she seems pretty knowledable. CoCo is doing pretty good, just looks worse than he is, since he has lost so much hair. He has been on 20 mg of Vetoryl about 8 months. He weighs 11-12 pounds. I suspect his cortisol is rising since he seems to be desperate for food, although he has always been greedy about food, a typical dachshund. Hope your baby is doing well. Love, JoAnne

[goldengirl88]

Valerie:
Glad to hear Daisy seems to be doing well on the meds. I wish I lived closer to Cornell. I would surely go there as it sounds awesome. That is the bad part of having an animal and not being close to a good facility, as it means a lot. Hope Daisy continues to do well. Have you noticed any bloating? Blessings
Patti

[molly muffin]

Hi Valerie,

Glad you're doing okay.
What today is a new normal may not be tomorrow. It's more a matter of adjusting to how Daisy seems to feel on any given day. Since she has just been restarted on a new therapy regime, this can change easily. As time passes and you get her cortisol stabalized, you'll see how she really feels. She should be and what we always hope for is a return to her normal self as she starts to feel better and adjust to not having the higher cortisol in her body.
I think Cornell is exactly what you needed and I'm glad you went there. Sounds like they will really Work with you. Which is key.

hugs,
Sharlene and Molly Muffin

[doxiesrock912]

Sharlene,

I agree 100%. So far, Daisy has adjusted well to the Trilostane. The true test will be Cornell next Friday.

This is a cute video, I thought that we could all use a smile :)

https://www.facebook.com/photo.php?v=116587798538641&set=vb.136336876521150&type=2&theater

[Simba's Mom]

Glad that Daisy is doing well on the meds, and thanku for sharing the video, yes we all need to laugh, take care!

[Budsters Mom]

Valerie,
YAY for Daisy! I am so glad that Trilo is helping her. It seems to really be helping Buddy too! :)

Kathy and Buddy:)

[doxiesrock912]

Thanks Kathy,
I too was afraid of the side affects, but it seems that the 10mg twice a day is a hit without stomach upset too.

Like I said, the tests on the 18th will confirm and I'm hoping to not have to increase the dosage since it seems to be working just fine.

[doxiesrock912]

Hello,

I'm in Greenwich visiting my fiance and Daisy is home with dad. He just told me that she's not interested in eating so I told him to leave the food but NOT to give her the Trilostane.

I'm waiting for the message to be relayed to an ER doc at Cornell.

[goldengirl88]

Valerie:
Poor Daisy wonder what's up with the lack of interest in food. Hope all is ok and it's just one of those things they go thru. I know you will be caring for and watching her like a hawk. Blessings
Patti

[milosmom]

oh boy...... come on daisy lets have a litl snack,maybe she misses you valerie....you never know.....sending happy thoughts patty(milo)meka xoxox

[doxiesrock912]

Patti,
I'm sure that it's the Trilostane. Daisy NEVER ignores food.
Since this is the first sign of trouble, I'm hoping that she'll just sleep it off and her cortisol will rise. The IMS doc said to call if she doesn't eat for several days, but I am not giving her the Trilostane until told otherwise.

I suspect that we'll be lowering the dose from 10mg twice a day to 5mg twice a day. Luckily, the pills are compounded to 5mg twice a day.

Still waiting for the vet to call me back.

[Trixie]

Hoping Daisy is doing okay and will want something to eat later today. Barbara

[Simba's Mom]

Oh shoot, just when everything is going good, hope she's ok!

[Budsters Mom]

Thinking of you and Daisy. :p
Hopefully is just a little bug and she just needs to rest for a day or two. Buddy just started Trilostane recently also. I've been keeping an eye on your thread And Daisy has been doing so well! Sending wellness thoughts your way.

Kathy and Buddy :)

[doxiesrock912]

Thank you everyone,
I told dad not to give Daisy the Trilostane at all today or this evening with dinner.
He said that she's back to normal tonight, ate dinner, and even tried to get at the cat's food :)

She was on 20mg of Trilostane (10mg twice a day).

Would it be reasonable to resume tomorrow with only 10mg (5mg twice a day) until I speak with the IMS specialist on Monday?

I spoke to one of the vet techs at Cornell who said that he would confer with the ER doc and get back to me.

He never called back!!!!

[Harley PoMMom]

If Daisy is feeling much more like herself, her appetite is normal and she has no diarrhea, then I would think restarting the Trilostane at 5 mg is a good idea unless you have to split the capsules yourself. Do you have the Trilostane in 5 mg capsules?

[doxiesrock912]

In anticipation of this very thing happening, I was smart enough to have them recompound the 20mg capsules into 5mg, so YES we have them :)

I'll give Daisy a break from the meds tonight and have dad give her 5mg with breakfast tomorrow.

I emailed the IMS specialist telling her what was going on and that I plan to do exactly what had been happening.

Thank you for confirming what I was already thinking.

[Harley PoMMom]

In anticipation of this very thing happening, I was smart enough to have them recompound the 20mg capsules into 5mg, so YES we have them :)



Great job, Valerie!! Does Daisy get pepcid ac 20-30 minutes before her Trilostane?

[doxiesrock912]

No, she gets Fortiflora and so far, hasn't had any stomach issues.

Before we saw the IMS doc, Daisy's general vet recommended that she take 20mg once a day (he prescribed 3 months worth_cost $105.00) and on the 6th day, she had a bought with liquid diarrhea, we stopped the Trilostane and made an appointment with Cornell.

Dr. Morgan, the IMS specialist at Cornell suggested to split the dose into twice a day which hasn't resulted in diarrhea.
It cost me an additional $45 so I decided to have them recompound it at 5mg instead of 10mg so that I hopefully wouldn't have to pay for this to be done again.

As long as Daisy is eating, she'll also eat the meds without a problem. So whether or not it's one or two capsules won't matter.

[milosmom]

hey valerie !!! glad to see that litl miss daisy mae is ok.*sighs*hopefully your evening will be relaxing.will check on you two in the am.good night...patty(milo)meka xoxox

[doxiesrock912]

Thanks Patty, I was so scared and feeling guilty for picking this weekend to leave her with my father and go to Greenwich.

Luckily, my fiance loves her too and was very understanding when I called my father at least 5 times today to check on our munchkin :)

Sleep well! I am enjoying a glass of wine since I now feel that I can relax some. SIGH!

[Harley PoMMom]

I believe Fortiflora and Pepcid ac are aids for two different issues. Pepcid ac is used to help with gastric upset, which Trilostane can cause, Fortiflora's primary job is to help restore the guts natural balance with the ingedient of a ‘good’ bacteria.

[molly muffin]

Glad to hear that you have a plan for Daisy and she is doing okay.
It doesn't matter when you want to go away, you're always going to worry. It's the nature of cushing parents. :)
It'll be okay though, you are on top of what is going on and have a plan. That makes a world of difference.

hugs,
Sharlene and Molly Muffin

[doxiesrock912]

Ladies,

the IMS vet finally responded. She thinks that 5mg twice a day is too low, but has no problem with trying this to see how it goes :)

Yippeeeee!

[SoggyDoggy]

Hey Valerie,

the only way to know for sure if a dose is too low is to try and see. Better to be too low than too high though as I'm sure you would agree.

My boy was 20lb's and was started at 60mg once a day (by reg vet). He went way too low, the IMS changed him to 10mg twice a day and now we are looking at 5-7mg twice a day. As a result, I am a big proponent of START LOW! ;) As we know, all dogs are different but better to be safe than sorry. Glad to hear that she has perked up a bit with the skipped dose, and weren't you smart to get theose caps compounded at 5mg! :D Way to go Mom!:D

[Mel-Tia]

Hello

Just checking in to see how you both are today? Hoping she polished off her breakfast

Mel
Xxxxx

[goldengirl88]

Valerie:
After my experience with Vetoryl and knowing Tipper's reaction to things, I always think it is better to start low. If I would have listened to the one vet Tipper would have more than likely had a bad reaction, as she is allergic to everything it seems. He wanted her to start on 30 and I said no only 10mg. We gradually went up from there 10mg at a time. We went from 10mg a day to 10 mg twice a day, then to 30 mg. I always feel when in doubt err on the side of caution. Hope Daisy is eating now and has a good day. It was probably good to get out and go on a little trip? Get you mind away form things for a while, even though it is in the back of your brain all the time. God Bless You and Daisy
patti

[doxiesrock912]

Hi everyone,
Daisy has been on 5mg since Monday and she's like a different dog! Eats well, leaves water in the bowl now, the pot belly has gone down A LOT, and most of all - she was her bouncy happy self and ran to greet me today!

It's been SO long since I've seen that!

The IMS specialist had me reschedule the appt from this coming Thursday to next, so crossing my fingers that her numbers have improved enough.

Dad forgot to give her the fortiflora over the weekend and she had one bought of diarrhea. Once I started giving it to her again this didn't happen so the fortiflora is definitely helping her :)

I missed my happy, wiggly doxie girl!

Hoping that all is well with each of you!

[molly muffin]

Oh yay! Looks like you've found a good dose for Daisy. 5mg not 10mg. Awesome!

Hugs,
Sharlene and Molly Muffin

[doxiesrock912]

Sharlene,

yes - I hope so!

[labblab]

I'm so glad that Daisy is doing so well! :) :)

And if the 5 mg. twice daily does turn out to be a good starting point for her, I hope you'll help us get out the word to other newbies re: that 1 mg. per pound dosing formula. Everything else about your IMS has sounded great to me, but as you know, I've been wary about her having you resume at that 20 mg. daily total regardless of it being split. Even if Daisy does ultimately end up going higher, our experience here has been that side effects are minimized when dogs start low and work their way up if need be.

Thanks for this great update and give Daisy a big hug for me!

Marianne

[goldengirl88]

Valerie:
That is great news for Daisy, I am so happy she is doing well. I too think it is so much better to start these babies out on a low dose so their bodies can adjust to it. Have a great day with Daisy. Blessings
Patti

[Budsters Mom]

Yeah for Daisy!
That is great news indeed!:)

Thanks for the great update! I love to hear happy news!
Kathy and Buddy:)

[Boriss McCall]

Yay for good news. sounds like Daisy is on her way to feeling better.

[Simba's Mom]

So glad to hear that Daisy is doing well, take care!

[doxiesrock912]

Thanks everyone!
I had my suspicions that her dose was much too high and that is why I opted to recompound to 5mg each pill.

Being that Daisy's symptoms have improved a lot, I'm hoping that the tests on the 25th indicate that we've hit it right this time.

I will gladly share this information and I think that I have in a few instances.
The change in her energy level is the most obvious improvement.

[Simba's Mom]

hey Val, do you use flora stuff and pumpkin for Daisy? And how do you give them to her? thank you!

[doxiesrock912]

Letti,

I sprinkle the Fortiflora on top of her food along with her meds and she eats all of it.
Daisy hasn't needed the pumpkin in quite some time, but if she does - I will add 2 teaspoons to her food as well.

[Simba's Mom]

Thankyou Val, Sim's tummy is gurgling away, and he has loose stools, so I will try anything!

[doxiesrock912]

Letti,

go with the Fortiflora then. 1/2 packet with breakfast and the other half with dinner.
I honestly haven't heard the gurgles since we started it :)

[Simba's Mom]

Thanku so much!!!

[doxiesrock912]

That's what we do here :)

I was surprised at how well it worked for Daisy! Especially since she's had many, many boughts of diarrhea the past two years and then add that Trilostane lists diarrhea as a possible side affect.

I was sure that we were in for more trouble but I am more than happy to have been wrong.

Hope it works for Simba!

[molly muffin]

Letti, did you order the floriflora from amazon?
Hopefully that will help out.

hugs,
Sharlene and Molly Muffin

[Simba's Mom]

Yes, should be here tomorrow, I was in the city last nite but pet stores didn't have it :(

[goldengirl88]

Valerie:
Haven't seen you post and was wondering how sweet Daisy is doing on the Trilo? Tipper has to go Wed. to get her electrolytes checked for the hospital Friday. I am a nervous wreck as the time to go nears. God Bless
Patti

[doxiesrock912]

Hi Patti,
so far so good. Our recheck appointment is on Thursday for the ACTH stim to really know how she's doing. I'm crossing my fingers for both of us!

Stools were a little loose today but I'm 99.9% sure that she got a cat poop snack yesterday while I was out with a friend. My father isn't always so good at closing the gate, sigh.

She hasn't looked bloated after eating which is GREAT!!!! I attribute most of that to the Fortiflora honestly.

Good luck on Wednesday!

[doxiesrock912]

Fed Daisy at 4am, on the road by 6:30am toward Cornell for her first ACTH test since starting Trilostane. Dr. Morgan will call with the test results tomorrow. I'm hoping that the dose stays the same or a bit lower. Daisy has improved so much that I can't imagine her wanting to increase.

Daisy met our newest family member today, Annabelle. She's a very sweet, mellow 2 year old cat that we adopted last week. Daisy sniffed all around the house. Walked by Annie who hissed twice but didn't move from her spot, then Daisy looked at her, sniffed and went to the water bowl!

Both are asleep on different pieces of furniture right now.

Not at all what I expected!


https://drive.google.com/?tab=mo&authuser=0#folders/0B440mY1nZfEycnZhOWJ5QkJUS2s

[Boriss McCall]

Good Luck with the results. Can't wait to see the numbers. :)
Hope your new family member is settling in good.

[Budsters Mom]

Hi Valerie,
A great big welcome to Annabelle:D. Not all dogs accept a kitty into the house that readily! Buddy would have had a meltdown!:eek:

I'm anxious to hear about Daisy's numbers. I have learned that what matters most is how they are actually doing with their clinical signs, even if their numbers are not quite where they should be.

Hugs to you, Daisy, and Annabelle :D

Kathy and Buddy:cool:

[molly muffin]

Crossing fingers for good results on the ACTH test!

Awww, welcome home Annabelle. That is great that Daisy doesn't seem bothered by her. That will set the tone probably for the two of them. Good for Daisy.

Hugs,
Sharlene and Molly Muffin

[Trixie]

Hi Valerie,
I hope you have a great outcome on Daisy's test. It's fantastic that she's been doing so well!! How nice that you adopted a new cat! I bet Annabelle is happy to be part of your family. :)
Barbara

[labblab]

Fed Daisy at 4am, on the road by 6:30am toward Cornell for her first ACTH test since starting Trilostane. Dr. Morgan will call with the test results tomorrow. I'm hoping that the dose stays the same or a bit lower. Daisy has improved so much that I can't imagine her wanting to increase.
Just being a mother hen :o, but wanted to double-check the timing of the test. If Daisy had her breakfast and trilostane at 4 a.m., according to Dechra that means the test should have been performed between 8:00-10:00 (4-6 hours after dosing with food). Was that the time frame you were aiming at?

Marianne

[doxiesrock912]

Yes, we arrived at the vet at 8:30am and they asked when she ate. Daisy is unaffected by Annabelle, but Annie is cautious :-) The true test will be crazy Gracie!

[labblab]

Good job, Mom!! :) :)

[doxiesrock912]

At $344, you can bet they'll be doing this test right! LOL.

[molly muffin]

At $344, you can bet they'll be doing this test right! LOL.

:D:D:D:D:D:D I have faith you'll make sure of That!
hehe
hugs,
Sharlene and Molly Muffin

[Simba's Mom]

Hey Valerie, hoping Daisy's tests come out good, sounds like she's handling the meds like a trooper, way to go Daisy!!! Thanks for your idea about the floraforta for Sim, I think it is making a difference...take care!!

[doxiesrock912]

Thanks Sharlene, I can't afford to learn the hard way anymore _ literally.
I'm so glad that the Fortiflora works for Zimbabwe!

[Trish]

Hi Valerie
I hope Daisy gets good results today, sounds like she is doing really well. What a relief for you!! Have a good weekend :)

[doxiesrock912]

Thanks Trish! I haven't heard anything yet.

[Mel-Tia]

Always waiting which is the worst!

Fingers crossed for good numbers :)

[doxiesrock912]

I know!!!! Dr. Morgan is really good about calling. Hmmm. I just realized that she doesn't work on Fridays so I'm going to call them and see if someone else can send me the results.
Stay tuned!

[doxiesrock912]

I called and Dr. Morgan will email me the full report but Daisy's post numbers are 35 when they should be 5, so she wants me to give Daisy 10mg twice a day for the Trilostane. I hope that she'll be able to tolerate this now that she's been exposed to the drug for almost a month:(

I'll post the full report once I have it.

[Mel-Tia]

Sorry to hear they haven't come down.

Big hug

Mel
Xxxxxx

[Squirt's Mom]

Just a suggestion - wait to start the higher dose until after you have posted the results here. Be sure to include the units of measurement the lab used and their normal ranges. Hopefully your vet knows the difference between the normals for a treated VS non-treated pup but let's make sure before increasing the dose, 'k? ;)

[doxiesrock912]

Sounds good! Dr. Morgan is an IMS specialist at Cornell so I'm hoping that she knows what she's doing.

So far, she the best that we've come in contact with so far.

Daisy laid on the deck in the sun for less than 10 minutes and began panting, so that is in indication that we don't quite have this under control yet.

[Budsters Mom]

Hi Valerie,:)

I'm sorry to hear that Daisy's numbers haven't come down. Other than the panting, how is she doing otherwise?

Hugs to you, Daisy, and Annabelle

Kathy and Buddy:cool:

[labblab]

Hi Valerie,

I am being very lazy here :o, but can you re-summarize for us any previous ACTH results (including at the time of diagnosis?).

Thanks so much!
Marianne

[doxiesrock912]

Marianne,
this was her first ACTH test and I'm waiting for the doctor's report via email.
Here is the information for the LDDS test that was originally done.

Previous diagnostic testing (2/26/13)
CBC - All indicates WNL

Chem - ASt 150, ALT 514, ALP 4417, GGT 123, T bili 0.2, Ca 8.4, CI 982, Chol 805, Triglycerides 379.

(3/6/13)

LDDS test - 8.8 > 3.7 > 4.5.