Thank you from Day 1 (9 y/o poodle/terrier mix)

[Henrietta]

Hi there,

My dog Molly (9 yrs old poodle/terrier mix) and I are brand new here. We got the results of the Cushings time test today which confirmed what I feared. We will begin the next step, I'm guessing, on Tuesday. I'll explain more about Molly later, but I just needed to thank you all for helping me so much in the last few hours. I was freaking out reading things on the web (I have not yet spoken to the vet, just got the voice mail that she was positive for Cushings) and then I found a link to one of your posts, started looking around, and burst into more tears, but these were of relief. I can already tell that I have found a place of deep knowledge, straight talk, and great comfort. THANK YOU for making this difficult day sooo much better. I'll post Molly's story later.

[addy]

That first phone call, that new given, I remember only too well my reaction, I think we all do.
I am so glad you found your way here and we welcome you and your pup with open arms, love and understanding.
When you can, tell us more about your pup. What prompted the vet to look for Cushings, list any abnormal test results, and certainly list the test results from that phone call. Always make sure to get copies of any tests done and don’t be shy to ask your vet for them.
Sorry, this is short, I’m still at work

[Budsters Mom]

Hello and welcome from me too,:)
I am sorry for the reason that brought you here, but so glad you found us.
You have come to the right place! There are many K9Cushing's angels standing by to help and stay with you every step of the way. They love details, test results, any information you can get your hands on. The more the better. We will do all we can to help.
So again welcome to you and Molly,

Hugs,
Kathy and Buddy:cool:

[Roxee's Dad]

Welcome to you and your Molly :)

Just reading your first post gave me chills and brought a tear to my eyes... both of happiness that you found us and that you and Molly are not alone in this and one of sadness for another cush pup in our family.

We are looking forward to learning more about you and Molly.

[molly muffin]

Hi and welcome from me too. I have a molly also :)
Addy asked the pertinent questions to get us started, so that is your homework for now.
If there is one thing to take away from your initial conversation here, it is that this isn't a death sentence. With proper treatment, a good vet and vigilant momma/poppa, they can live out their normal life span.

The first order of business is to make sure this is really cushings. Sometimes it is and sometimes it isn't, so we'll want to see anything abnormal high/low with range from any and all blood tests. You want to rule out diabetes, thyroid issues, UTI's, etc, They have the same sort of symptoms and can cause false positives on tests.

Welcome again!
Sharlene and Molly Muffin

[Henrietta]

Hi There.

I posted a thank you a few days ago, and while I still don't have the reports with the numbers, here is what I do have as far as Molly's story and where we are. She is 9 and has been my baby for 5 years, was my mom's baby for 2 years before that, and had a rough first 2 years of life. The humane society where my mom adopted her said she was probably a breeder dog who was then dumped. We have rehabilitated her to be unafraid of people (men can pet her now) but she still hates garden tools, aluminum foil boxes, boots, and girl dogs who are bigger than she is. She LOVES little boy dogs. She is sweet, smart as a whip, and has our entire household wrapped around her paw.

Five months ago she went off her food, was lethargic, had loud tummy noises and was mouthing a lot. We did the UCCR test which came back on the high side of normal, followed by ACTH Stim test which came back normal. A full blood panel showed that her liver levels were a little up, so they went with a mild pancreatitis diagnosis. We switched her food to low-fat, gave her Denamarin and famatodine and she got a lot better. She wasn't 100% better, so when we went for her regular check up I took in another urine sample and asked for the UCCR. The vet did a full blood panel, and we did a biopsy of this tumor on her leg which she has had for years. The panel came back with off the chart liver levels and the tumor is mast cell. The next day we did X-rays that were clean, was referred to IMS, who did an ultra sound where we saw that the liver was enlarged and the gall bladder was very sick. The mast cell tumor is on her leg and the surgeon said it can't be removed because there is not enough flesh there, so we are just leaving it and hoping for the best. They removed the gall bladder Tuesday May 7, biopsied the liver and looked around. Everything looked great (mind you we were afraid they would find all kinds of tumors.) Other than the gall bladder needing removal and flushing, all looked fine. Molly recovered from the surgery like a champ. The liver biopsy came back with nothing major, just a bit of an infection (we finish up Clavamox for that in 4 more days) and one other elevated number. So the IMS said we needed to do ACTH Stim test. On Friday I got the call that it came back clearly positive for Cushings. This morning we started 30mg of Trilostane once a day and are watching her like a hawk. From reading here I realize that maybe we could have started her on a lower dose.

Molly weighs 17 lbs, most of that weight just coming on in the last year, regardless of us cutting back on her food and treats. Her belly shape has changed and is pot-like. She would eat all day long if we let her, and gets very hungry in the evenings, water consumption is up, and she goes out to potty at least once an hour many days, a few times at night, has had some accidents. She has some days that aren't that way, but they are getting more and more rare. I'm not noticing hair loss, but it is coarser than in the past. She doesn't pant, but also doesn't want to exercise. This is a little dog who needed 3 walks a day 6 months ago. She is also bruising. She had a huge bruise from the ultrasound and then a smaller one from where they took blood in her neck.

I've put in a request for all of her test results, starting with the ones from 5 months ago, and I should get them by the end of next week. As far as I can tell there isn't a Cushings specialist in my area (Atlanta, GA), but I'm going to keep looking. I love my vet and the IMS, but I know we are in this for the long haul. I am so grateful for this site, and I have a lot more learning to do. This is long, sorry, and thanks if you are still reading.

Moderator's Note: I have merged your update on Molly into Molly's original thread. We, normally, like to keep all posts on a pup in a single thread as it makes it easier for other members to refer back to the pup's history, if needed.

[Harley PoMMom]

Hi and a belated welcome from me to you and Molly. Bless both you and your mom for giving Molly a loving and forever home.

Sorry to hear that Molly has a mast cell tumor on her leg. My boy, Bear, had a malignant nerve sheath tumor on his left front leg. The surgeon also told me that it would be difficult to get clean margins so I opted to have his leg amputated. It was a hard decision to make but Bear is doing wonderfully on 3 legs.

Strong symptoms make up a huge part in the diagnosis for Cushing's, and it does seem that Molly does display many of the clinical signs of Cushing's. But, it can be challenging to get a confirmed diagnosis for Cushing's because not one test is 100% accurate at diagnosing it and other non-adrenal illnesses can create false positive results on all tests for Cushing's.

Getting copies of all tests that were done on Molly and posting any abnormalities that are listed will help us to provide you with more meaningful feedback. When the ultrasound was performed was there any mention of the adrenal glands?

When a dog is being treated with Trilostane/Vetoryl we have seen that adverse effects are minimal when they are started at the lower end of the dosage scale. 30mg for a 17lb dog is a bit high so just watch out for any ill effects such as vomiting, diarrhea, lethargy, or Molly just not acting herself. Since Trilostane has a short half-life, if any of these are noted simply stopping the Trilostane should make her feel better and if she doesn't perk up than a visit to the vet is warranted.

We are here to help in any way we can so do not hesitate to ask all the questions you want. ;)

Love and hugs, Lori

[molly muffin]

I love your avatar of Molly. She is a real little darlin. I love it when they roll around on their backs, it just makes me think they are very happy.

Poor little dear, she has had some issues going on with her lately. It really sounds like you are doing a good job. Just keep an eye on her with the 30mg, diarrhea, vomiting, lethargy, not eating, can all be signs of going to low cortisol. (just so you know what to keep an eye out for)

You're doing great!
Sharlene and Molly Muffin

[Budsters Mom]

Just popped in to say that your avatar of Molly is absolutely adorable!;). That is a photo of true bliss! :). I am so sorry that she's having so many issues lately. We are here for you!

Hugs,
Kathy and Buddy:cool:

[Henrietta]

Thanks for your responses. Molly has tolerated her first day on 30mgs fine so far. She seems just about the same. Still very hungry. I'm very interested in the lower dosages, cause I always think less medicine is the way to go, and I'll check with my vet about it when I can.

Adrenals were fine during ultrasound as far as I know. They checked her out really thoroughly (even her bladder, which was also biopsied during surgery and turned out to be nothing) so if there was anything up with the adrenal glands, they would have noted it.

Question: Molly is very "mouthy" like she has peanut butter stuck in her mouth and has to keep licking or moving her tongue. She was doing this before and we thought it was linked to a bit of high stomach acid and were treating with famodadine, but we stopped after surgery, because without a gall bladder stomach acid shouldn't be problem. Is this common in dogs with Cushings?

[Roxee's Dad]

Could possibly be a bad tooth or something else in her mouth that may be bothering her. Our Rozee actually had a cracked root that was never detected until she had x-rays.

[Henrietta]

Day 2 of 30mg Trilostane at 8:30am, and I'm noticing that around 4:30pm she takes a big energy dive. I can rouse her, and if I get her on her feet she will walk or do what I ask, but she moans a little bit as I pick her up and if left alone would immediately lay back down. It lasts until about 6:30, and then she seems okay, not as perky as she is earlier in the day, but okay. She is eating great and not vomiting or anything. Is this just the beginning of a reaction that will get worse each day or could this be the meds wearing off and her cortisone going back up, or is it too soon for that? I have to leave her to go to work tomorrow, and my Dad will be with her in the afternoon, so I would love to tell him what might be going on. If the meds are out of her system in 8 - 12 hours, is she yo-yoing cortisone levels, or do they automatically calm down while sleeping in the night? Thanks for any help.

[molly muffin]

Keep an eye on her. If she is having too much trouble, it could be even that her cortisol is going too low and if so, withhold of the trilostane to see if that makes any difference. Also call your vet and advises of the adverse reaction. They do have a bit of cortisol withdrawal too when it starts to come down, if it comes down really fast, then they can feel pretty awful. I'm concerned about the moaning when you pick her up.

Sharlene and Molly Muffin

[Simba's Mom]

Hello and welcome to you and Molly, so glad you found us, settle in and take care, we are here for you....

[Henrietta]

Picked up reports from the IMS

Pre ACTH cortisol was 5.7 ug/dl
Post ACTH cortisol was 32.5 ug/dl

The biopsy of her liver came back with glycogen hepatopathy which is what led them to do the ACTH.

I'm guessing diabetes has been ruled out because of her earlier blood work. We are going to do a full blood chemistry again in 10 days.

I've decided to stay with the IMS until we get this all figured out rather than going back to my regular vet, who is wonderful, but the IMS is treating Molly's liver, so best to stay with one doc for now.

All fine so far today. Watching to see if she has an energy dive this afternoon. It is tough to know because she is already low energy and it is now hot, which makes her even slower. My work today was cancelled, so at least I can be here instead of my Dad all by himself.

[molly muffin]

I'd stay with the IMS too for now.

Hope the energy levels out so that she doesn't crash in the late afternoons.
It doesn't seem to be low cortisol that would be the problem though based on that post number.

Sharlene and Molly Muffin

[Henrietta]

Molly made it through the whole day without a major energy dive! No walk today, but it was hot. Also, her poop, which has been like Nutella because of the antibiotic, was much firmer thanks to the Flora stuff I'm giving her with lunch. Oh, how I am longing for the day when I am not checking out the quality of every poo. I know, never gonna happen. :)
Thanks again for all your comments and encouragement. They are such a comfort.

[molly muffin]

Oh good! Glad she had a good day :)I
am sorry to have to be the one to break the news but ..... welcome to the poop patrol lol
It's amazing how obsessed we can become with dog poop :) If it is any consellation you are in good company here
Hugs
Sharlene and molly muffin

[Henrietta]

Molly threw up bright neon yellow liquid this afternoon. Her energy was fine, and 90 minutes later she ate her lunch, only about 2.5 hours later than usual. I'm watching her closely, and of course I immediately called the vet, but had to leave a message. Molly is not a dog that throws up easily, even when we are giving her meds to make her throw up. I'm guessing we will continue watching and see if the vet wants us to give the dosage in the morning or hold off. If she had any other symptoms I was ready to take her in for a prednisone shot.

I got the blood test results. These were the numbers from 4/30/13, before gall bladder was removed.

All numbers were high, except where noted.

Total Protein. 8.5
Albumin. 5.3
AST (SGOT) 67
ALT (SGPT) 479
ALK Phosphatase 2460 (Results verified)
GGTP 323 (results verified)
Creatinine. 0.4 low
BUN/Creatinine Ratio. 43
Glucose 40. Low
Potassium. 6.0
Chloride 100 low
Cholesterol 580
Triglycerides. 450

Platelet Count. 554

Urinalysis
Protein. 1+

Microalbuminuria. 5.2

I have no idea what any of the numbers mean and hope the gall bladder removal and antibiotics have helped them get back to normal. We do the whole test again when we do her next Cushings test.

[molly muffin]

Yes, the numbers will likely change since the gall bladder removal.
Neon yellow sounds like bile to me. Any diarrhea? You said she is still eating fine. So this doesn't sound like a cortisol too low issue.
Did your vet get back to you?

Sharlene and Molly Muffin

[Henrietta]

Yes, we talked this evening. She said to watch her and if nothing else happens then to give her the dose in the morning. If she throws up tomorrow, then to bring her in and they would do oral prednisone and a stim test. She has been fine all evening.
It just occurred to me that the throwing up may have something to do with her not having a gall bladder (although that should mean less bile in her stomach) more than with Cushings. I'm just so hyper-vigilant about the Cushings side effects, that I'm forgetting that she is still adjusting to a organ removal.

[molly muffin]

You are quite correct, it could have something to do with the gall bladder surgery. Throwing up neon yellow isn't what we normally see with cushings cortisol drop.
It can take awhile to recover from the surgeries too.
We totally get that you worry about everything when anything is wrong with our furbabies. It's the nature of caring for them so much. Doesn't make it easy though.
hugs,
Sharlene and Molly Muffin

[Harley PoMMom]

Sometimes Trilostane can cause gastric upset in a dog, Pepcid AC may help with that.

[Henrietta]

Thanks Sharlene and Lori.
I just gave her Famotidine cause she is obviously having tummy and reflux issues. The noises are so loud they are keeping me up. I'm also researching even lower fat treats and ways to get her to take pills. I've been using skinny cow low fat soft cheese, but now I want to cut even that out and see if she will take the pills in pumpkin or something else. I'm having to give her so many pills that I may be inadvertently giving her too much fat.:(

[Henrietta]

Hi. We seem much more stable here. Molly is on day 9 of Trilostane and is noticeably livelier. She is done with all the other meds, and only gets Denamarin in addition to T, so we are down to two pills a day. Finishing the antibiotics and switching to pumpkin for treats has helped her tummy, so she is much less mouthy and hasn't needed Famotidine in a few days. We go in for the second ACTH test at the end of this week. Hopeful that June will be much easier than May.

[Henrietta]

Scheduled for the second ACTH test on Thursday. I am wondering about the timing, and I know I don't quite understand how it works. Molly takes her Trilostane at 9am. They told us to drop her off at 2:00pm. That is hour 5, so that means the first blood draw will be within but near the end of the 4 - 6 hour window and the second blood draw will most likely be after hour 6, is that okay? I thought the whole test had to be done within 4 - 6 hours. Do I have it all wrong? Apparently the vet also said she wasn't sure exactly what she would give her. Do they have a choice of what shot of cortisone to give? This is the IMS and not my regular vet. Thanks for any clarification you can give.

[lulusmom]

I too would be concerned with the timing. The easiest thing to do is to give Molly her breakfast and dose of Trilostane at 10:00 am. The stimulating agent most vets use is called cortrosyn and it is very expensive. Other vets use a compounded acth gel as it is less expensive.

[molly muffin]

Molly is usually the queen of figuring out how not to take a pill. I have started making a ball of wet food around the pill, just a little and giving that to her, and have a back up little bit of the wet food on my figure for a follow up, which encourages her to swallow the first bite, so she can get the second. I actually got this tip from the office manager at my vet, who gives molly her pills when she is there.
I have the pill popper syringe and have tried most things. This so far works the most consistently.
Yea, I'd want the test done within that window, so Glynda has an good idea of giving her med later.

hugs,
Sharlene and Molly Muffin

[Henrietta]

Thanks Glynda and Sharlene. I will wait and give her the meds at 10 that morning as you suggest. Great idea for pills. Luckily so far my Molly has been a pill champ, if she can't taste it. So we smothered them in cheese orpeanut butter. Both are no go's now, so I'm glad she likes the pumpkin.

[Trixie]

Like Sharlene, I also have great luck giving pills in wet dog food. I use some saran wrap and put some wet food down...put the pill in and then wrap and pack it like a little sausage. Trixie swallows it in one bite...been working like a charm. Her wet food molds pretty easily around the pill with the help of the saran wrap-which of course I remove before she eats! :)
Hope your little pup is feeling better! :)
Barbara

[Budsters Mom]

I use a small piece of a hypoallergenic Pill Pocket ( Duck and Pea) to wrap Buddy's pills. He gobbles them up! All I have to do is call "pill time" and he comes running! Loves those pockets!:D

Hugs,
Kathy

[Henrietta]

Thanks for all the pill ideas. Since medicine will now be a daily part of life, I'll try them all so Molly doesn't get sick of pumpkin all the time. Had the 2nd ACTH test today, should know the results tomorrow or Monday.

My husband took Molly to the IMS today and apparently she walked in, walked right past the front desk, through the door, and headed down the hall to the break room. All the nurses and techs recognized her and got a kick out of it. She isn't scared of the IMS office at all! This is a dog who shakes at the regular vet and even the groomers. Maybe she knows that they have helped her, maybe even saved her life.

[Budsters Mom]

Yes, pills for our fur babies, are a daily part of life for most of us. If you find something Molly likes to hide the pill in, she'll get excited thinking that she's getting a treat. Pill time is a highlight of my Buddy's day. A positive attitude helps. If you act excited, Molly will be too.:) Please post those ACTH numbers when you have them.

Hugs,
Kathy

[Henrietta]

Results of Molly's ACTH test after being on Trilostane for 12 days.

Pre. .8
Post. 2.7

The vet called while I was driving home, so I couldn't see the paperwork. The vet was very happy with those numbers and said we will continue on the 30mg for another month and then do another ACTH and full blood work at that time to check out the liver levels.

On the paperwork I have from the first test it says the reference ranges are:

Pre: 2 - 6
Post: 6 - 18
<2 Post ACTH cortisol consistent with hypoandrenocoeticism

Molly was only 2.7, so does this mean that she is now close to the low side? She looks and acts like she feels good, but I certainly don't want to over medicate her. I'm planning on writing an email to the vet so she will get it on Monday with these questions and telling her that I don't mind paying for a lower dosage if that might be even better for her.

Thanks is for any guidance and wisdom.

[Henrietta]

Just looked at the information from Dechra, and they use 1.45 as the bottom range and say if the post number is above 1.45 to keep at the same dosage. Why is their number lower than the lab report's number?

[labblab]

Hi,

The ACTH is used both to diagnose Cushing's initially, and additionally as a monitoring test after a dog has started treatment. The reference range on your lab sheet refers to the diagnostic norms, NOT the treatment goals. As you have already seen, the therapeutic range for a dog taking Vetoryl is much lower than the diagnostic reference range.

As far as Molly's dose, if she were my dog, I would want to talk further with the vet about lowering the dose. Normally, it is largely the post-ACTH result that is important in decisions about dosing changes. But Molly's pre-ACTH of .8 is really low, and even though her post-ACTH result is higher than 1.45 ug/dl right now, we would expect that her cortisol level will continue to drop down further during the first month of treatment. So if her dose remains unchanged, we would expect her level to go even lower.

With results such as this, I'd encourage you to contact Dechra's Kansas office so as to talk with a technical representative. They can better advise you as to whether they would feel concerned about continuing Molly on this same dose. Here's contact info:

http://www.k9cushings.com/forum/showthread.php?t=185

I doubt that they will have reps available over the weekend, but I'd try to get in touch with them first thing on Monday so that you can discuss Molly's test results in advance of discussing them further with your vet.

Marianne

[molly muffin]

I agree with Marianne to give Dechra a call. Cortisol can continue to drop the first 30 days and beyond on the same dose. Because the pre number is already Very close to too low, it wouldn't hurt to have their input at all.

I like the post number though. Just don't want her to continue to drop too much. Remember, the first number is what is circulating currently and the second number (post) is like how much they have in reserve to dump out.

hugs,
Sharlene and Molly Muffin

[Henrietta]

THANK YOU!!!! It is so good to have a better understanding of those numbers. I will call Dechra on Monday to ask about the .8 pre number. Molly is also a very allergic dog, and I wonder if the super low cortisol will end up causing allergies to flair. I've been noticing how much she is scratching lately.

I wish they had a 20mg pill, but I guess they figure you can do two 10mgs, although that is more expensive. I wonder if one of the reasons the vets stick with 30mg is because they are aware of the cost burden. I know some vets do compounding, but neither of mine have mentioned it. Marianne, since you are also in Georgia, do you know of a vet that deals with compounding Trilostane , in case I get to that point? Thanks again for all the info. and comfort!

[molly muffin]

Yep, it can cause allergies to flair up when the cortisol lowers. Can't win some days eh. :) Most vets can give you a prescription and then you can order the compounded trilostane online, from like Diamondback drugs in Arizona (several of our members have used them and recommend them). As long as it is not for a mg that Dechra makes (10, 30, 60, etc) the pharmacies can do it. So, instead of 30, say 29 for example.
You would need to ask your vet about it specifically, but Marianne might have some ideas too. Vetoryl is also known for not just being a brand name, but a consistency in the dosage that is in their medication and is why some prefer to use it over trilostane, while others due to cost factors and/or needing specific dosages not made by Dechra, will use compounding pharmacies.

Hope that helps. :)

hugs,
Sharlene and Molly Muffin

[labblab]

As Sharlene has said, we have a number of members here who are using Diamondback Drugs for their compounded trilostane and have been very satisfied with their services. Even though they undoubtedly exist, I'm afraid I can't name any Georgia compounders that handle veterinary drugs.

Marianne

[lisamak]

Another option for compounding (soft chewables) is SVP Pharmacies (Sugarland, TX). I've used them for about a year for Vince's selegeline (for his alzheimer's) and just ordered his first batch of trilostane (10 mg). Drs. Foster and Smith sell the brand name Vetoryl but it turned out to be cheaper ($25.28 for 30/10 mg) to go with the compounded (and I've been very happy with the selegeline quality as well as the customer service from SVP).

Here's contact info:
SVPmeds.net
877-673-3705

Also, I called Dechra last week (before ordering) and they were happy to help me...knowing I hadn't even started the meds yet, and they didn't ask if I was using name brand/compounded generic/etc.

~~Lisa and Vince

[Henrietta]

Thank you all for the pharmacy ideas. I called Dechra on Monday, and the representative said they didn't like to see either the pre or post ACTH number below 1.5, so Molly's pre number of .8 was a concern. The rep said that she needed my vet to call her. I got the case number and emailed my vet as diplomatically as I could. I haven't heard anything back yet, and I'm going to give her a follow-up call tomorrow. It is scary asking a vet to call a drug company, but I'll continue to do it if it is what Molly needs. I just wish Dechra would change their literature, because it says a pre number below .5 is an issue. I clarified with the Dechra rep, and she said 1.5 is the limit. I didn't ask her why the literature says differently because I figured she has no say on that anyway, and she was super nice and helpful. Molly seems fine -- a little slow in the afternoons sometimes, but it is 90 degrees, so we are all slow.

[Henrietta]

Called the IMS vet this morning and very quickly received an email response. She is focusing on the post number of 2.7 and not worried about the .8 because Molly is doing well. To my knowledge, she did not talk to anyone at Dechra. I don't want to make her mad, so I thanked her, said my concern continues because of Molly's energy dips and the fact that she has had major allergy issues in the past. I'm going to my regular vet today to pick up more Denamarin, and will stay there as a drop-in patient and will talk to her for a second opinion.

[Budsters Mom]

It never hurts to get a second opinion. ;) The docs just don't see what we see!:( We know when our babes are not quite right.;)

Hugs,
Kathy

[molly muffin]

Just keep an eye on her and if it looks like those energy dips are happening too often, or if she experiences any other adverse symptoms get her back in for another ACTH to make sure that she didn't drop too much.

Sharlene and Molly Muffin

[Henrietta]

My regular vet rocks! I waited to talk to her, and she understood my concerns. Also expressed the wish to balance the cortisone carefully since Molly is very allergic to the world. I got some more Fortaflora to give to Molly to see if that helps with the very soft stool to that may just be lingering from the antibiotics. If there is no change by Monday, then she thinks we should do another ACTH and most likely drop her to 20mg. If it clears up the stool then she says let's stay where we are and decide about dropping after the 30 days test. I'm cool with that. That test will include a full blood panel, so we can see the results of the removed gall bladder and Cushings treatment on her liver levels.
I spoke again with a Dechra rep today (they also rock!) and she said if I felt she was dipping in energy too much, then to just stop giving her the medicine. Since I am going to visit relatives out of state and taking Molly with me next week, I feel good knowing that is possible. I realize it is what you wise folks have advised others to do as well.

[Budsters Mom]

You are doing a great job following up with it all! :)Buddy is allergic to the world also, so I know how hard that is!:( It does limit us as to what we are able to do for our babies. I'm glad that you called Dechra again. I called them too, when I had questions early on. Yes, they are very helpful!:) Have a wonderful trip! I bet Molly will love being the center of attention!;)

Hugs,
Kathy

[molly muffin]

Yay for vets who understand our concerns. :) Absolutely you can stop and restart the medications . Plus you can lower it if need be too. I wouldn't hesitate a bit to do so either if the stools don't become firmer. It's a fine balance sometimes. :)

hugs,
Sharlene and Molly Muffin

[Henrietta]

Hi. Been gone for awhile, but thought of you all. Molly did great on our trip out of state. Even handled the 18 hour car ride like a champ.
We just did the one month ACTHtest and pre was .7 (yikes!) post was 2.9. I hate the pre number, but tell myself that it doesn't stay that low all the time. Dechra says that many vets don't even look at the pre-number. So, we are staying with 30mgs for now, because we have other issues.

We also did a full blood work up and, happily, most of the numbers that were waaaaaay out of whack before her gallbladder removal are now back in the normal range. Yippee!! However, AKL phosphate was 1,358 (10 -150 is normal) and ALT (SGPT) was 254 (5 - 107 is normal). Although those numbers are much improved, they say that all is not well. So today Molly started treatment for cholestasis - the bile isn't flowing properly through her liver into her digestive tract. The symptoms line up because she has been very itchy and had some white streaks in her poo. White poo is a very strange sight! So, she started on 125mg of Ursodiol this afternoon, and so far so good.

Overall we can tell that Molly is much healthier. She is peppy, her eyes are clearer and she "talks" to us so much more. Fingers crossed we can get her liver/bile situation fixed.

[Trixie]

It's so nice to read your good news on Molly. Despite a few kinks with the liver numbers it sounds like she's really doing well. Her demeanor and peppy behavior is a good barometer and hopefully the new medication for her liver will help get that in line. Glad she's feeling so much better. :)
Barbara

[molly muffin]

That is a pretty good report considering where she Was at. So hopefully the improvements will continue and the numbers will come down for the liver too.
I know that pre can be scary, but it's true, some vets don't pay attention to the pre, only the post. The post is pretty important, but you always keep an eye on them. :)
I think you are doing a great job. yay mom
Awesome that she did good on the long car ride. :)

hugs,
Sharlene and Molly Muffin

[Budsters Mom]

I am so glad that Molly is doing so well! :)What a trooper! An 18 hour car trip! :eek:You sure as heck would have heard me whining!:D big hugs to you both,