My Cheza Bean (7 y/o Husky) - Cheza has passed away

[lexiek13]

7 year old Husky. Diagnosed in March 2013. Up and down with Trilostane started at 120, was fine. 180 put the levels to a norm but made her lethargic and blah (laid on the ground and only moved to pee or eat), back to 120 and then quit eating....Last weekish. I've taken to pureeing food in the blender babyfood style and she'll eat but it has to be elevated. Her head shakes (seizure-like but its not a seizure). Her legs seem to not be strong enough to support her....she used the wall in the back yard to support herself as she went to urinate.
I'm calling the specialist tomorrow but our regular dr thinks its a macrotumor thats getting so large its affecting neurological stuff. (Nursing student...and all I can come up with is "stuff" I'm just crying and typing is hard).
I don't know what I should do. I dont know if I'm hurting her by keeping her, or if she has a shot. I don't know what to do and...well...Help? Please?
I love her more than my life but I cannot put her through this if its just about me. If I'm just being really paranoid and fatalistic tell me....if I'm hoping something will get better and prolonging her distress...tell me.
.....I'm dying inside because I'm watching my baby die.
Lex

[labblab]

My first and immediate worry is that Cheza may be overdosed on the trilostane and consequently suffering from Addisonian symptoms. Please tell us the exact dates and numbers for her monitoring ACTH results. Current recommended dosing is to start a dog off using a formula no higher than 1 mg. per pound and then slowly working upward as needed based on monitoring tests. It sounds as though Cheza has been taking rather high doses and even though the amount has been lowered somewhat, her adrenal function may remain oversuppressed even with the decrease back to 120 mg. Have her cortisol level and blood chemistries been retested recently? Even when cortisol levels appear OK, electrolyte levels can become unbalanced due to oversuppression of aldosterone by the trilostane, and either/both issues can be responsible for Addisonian symptoms.

In this situation, if Cheza were mine, I would definitely witthold any further trilostane until you've consulted with the specialist. And if she is indeed oversuppressed, she may need predisone and/or additional supplemental medication to normalize any electrolyte imbalance. In order to determine if this is the issue, she will need bloodwork performed ASAP -- which I hope your specialist will recommend. But for our benefit here, please do give us those monitoring test results. They should have been done two weeks after the start of treatment and after any dosing change. And then again at the 30-day mark.

Thanks so much!
Marianne

[frijole]

Agree with everything Marianne said. Most important - no more trilostane. It does sound like the cortisol has gone too low. Do get help right away. Keep us posted. Kim

[spdd]

Do not give up. I am having issues with my dog and have for weeks. It will all work out. The advice here is absolutely wonderful. Please do all the things they ask you here to do. They have read my dogs charts, analyzed situations I have been in and haven't steered me wrong yet. Keep you chin up. Your dog is young and it's just working on and tweaking a few things that will make your baby feel better again.

[Squirt's Mom]

Hi Lex and welcome to you and Cheza! :)

Marianne is right on the mark so please listen to what she had to say and stop the Trilo for now. What you are describing could easily be due to an overdose and NOT a macro tumor. ;) So just put that thought out of your mind for today, ok? If your vet hasn't done an ACTH in the last few days, I would insist one be done today AND have her electrolytes checked at the same time. The electrolytes are as important as the cortisol when we suspect the cortisol has gone too low with a Trilo pup. So no more Trilo for now and try to get an ACTH asap to see where her cortisol is now. This is the easy-peasey part. ;)

Now for the more difficult part. Calming our minds and hearts. I remember when I first heard the word Cushing's - I thought my world was ending. Squirt is my heart and soul dog, I cannot imagine a day without her by my side. I cried for months, totally terrified, frustrated, angry and filled with guilt. In the last five years since, we have been through several scary things unrelated to Cushing's when I feared losing her. Honey, from day one to today, the folks here have held my hand, help me up, given me strength and hope and courage to keep fighting for her. I don't know how we would have faced all we have without our family here. This is now yours and Cheza's family as well. And we are here for you anytime for any reason. You can cry, scream, laugh, worry, fret, vent, whatever and you will find soft shoulders, strong arms, caring hearts, and ears to hear. So you can relax a little bit and take a deep breath - you are home at last among family who cares a great deal about you both and will do anything we can to help. We will be right by your side regardless of what the future may bring. Therefore, the most important thing I have to tell you today is this - you are no longer alone.

Hugs,
Leslie and the gang

[lexiek13]

Thank you! I will let you all know what happens with the specialist. Las Vegas has an amazing animal center that supposedly works miracles so fingers crossed.

[knitbunnie]

Welcome. I'm pretty new here, too, and my French Bulldog, Pia, has had some terrible ups and downs as we struggle with Cushings and all sorts of things that have come along with it - pancreatitis, UTI, not eating (how weird for a dog with Cushings!), the medications, the shakiness and weakness, the endless 240 miles round trips to our specialists, and worst of all Pia's sad little face.

The people here in this forum have been my rock. My strength. Stay with us. I don't know how I'd cope without this forum. Hopefully, your Las Vegas specialists will have some answers for you and Cheza. Stay strong, stay here, and you and Cheza will get great support and amazingly good advice.

P. S. - I'm a nurse, too, so I know how our minds work, thinking of every dark corner, every terrible scenario. It's hard to turn that off. I wish I knew how.

[Budsters Mom]

Hello and welcome from me too. :)
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, but be ready for lots of questions! So again, welcome Lex and Cheza. Xxxxxxx

[lexiek13]

Update:
shes like night and day different for the better today. No Veteryl either. I took her to see the super emergency room today and they said she is stable and set an appointment for next friday with the internal medicine specialist. They did not charge me either and said she isnt going anywhere soon.

[Squirt's Mom]

Oh, good news! :cool: Did they tell you to continue to withhold the Trilo or restart it? Did they do an ACTH and if so, would you mind posting the results here in her thread?

Keep in touch and let us know how things are going!
Hugs,
Leslie and the gang

[Trixie]

sounds like maybe just too much vetoryl?? Hope you can get some answers next Friday. Are you keeping her off the medication for now?
So happy for you that your Cheza is feeling better now!! What a relief!
Barbara

[molly muffin]

Hello and welcome from me too. It really does sound like too much vetoryl. Even good vets can get that one wrong, as they can get the range wrong of what is needed.

One thing that we always recommend to our members is to get copies of all lab work from your vet and keep your own file. Everything leading up to the diagnosis and since. This can be invaluable when you have to go to a Vet ER, see the specialist, etc, so you don't have to repeat test and the specialist or ER can look over what has been done and what results are. Very handy. I'd get that as soon as possible.
Do you know if they thought it was a pituitary or adrenal tumor when cushings was first diagnosed? Was glucose normal? How about the T4? These are two areas that can mimic cushings symptoms, as can renal issues. So everything needs to be ruled out.

That she is doing good now without the medication, seems to signify that her cortisol might have gone low.

Sharlene and Molly Muffin

[knitbunnie]

Such good news! It's wonderful that you've seen a change for the better in your Cheza Bean. Keep us updated on how Cheza is doing this week:)

[doxiesrock912]

I think that you've escaped a major crisis! Thankfully!
My Daisy Mae is the prime example of a dog who began Trilostane at the recommended dosage for her size but it was too high.

There is no such thing as a one size fits all dose because every dog responds differently. It's trial and error with a lot of close monitoring until you find the balance.

I'm glad that Cheza Bean is doing well!

[lexiek13]

Update:
She's able to go out to the yard and do her business without shaking or leaning on walls. There hasn't been a limp since Friday. Saturday we had 2 shaking head incidents but none since. The appetite stimulant is doing a great job, she still wont "chew" but she's going to the fridge and staring at me for food. We went for a walk yesterday and she almost dragged me around the one mile circle. She is drinking A TON again but I just leave her out of her crate with access to the dog door and back yard. However because of the water, there is more drooling (for her thats not a normal) and her mouth is a little brown but her eye discharge has stopped. She's still not Wooing at me, and I wonder if I'll ever hear her voice again. But she's got energy and doesnt look like she's going to collapse under her own weight. I see the internal medicine doc on Friday but am grateful that my microbiology teacher is a DVM and specifically lab researcher/drug tester and genetics genius. She, along with all of you have reassured me that I can actually sleep and not have a panic attack. I did find another cyst on her today. She had one early in the diagnosis....smaller than the size of a pea. I had that one drained and analyzed and it was just a cyst. Are cysts something I need to be expecting or are they something I need to worry about?
Thank you all for your support, you've really made quite a difference.

[labblab]

That's great that Cheza is doing better! While you're awaiting her appointment on Friday, can you go ahead and fill us in re: more specifics about her diagnostic and treatment history -- how much she weighs, what symptoms led to her initial testing, what tests were performed, and also info about any monitoring ACTH tests since starting the trilostane? You may not know the actual test numbers right now, but if you tell us more about Cheza's overall history, we can help coach you as to questions you may wish to ask on Friday.

Marianne

[lexiek13]

Right before xmas 2012 we noticed she was drinking excessively and constantly begging for food/treats. I thought it was just her being more active because I live in the desert and my huskaroos are more active in winter. Then we came home to a dog sitting in a crate full of urine. Huskies are clean space lovers, very proud and Cheza especially so. She hadnt had an indoor accident since she was 3 months old. I took her in thinking diabetes. Vet tested for diabetes, negative. Pancreatitis...negative but liver enzymes were off so xray which showed the liver was slightly enlarged. The next day we got her into the internal specialist for an ultrasound. No tumors in abdomen but he said her thirst, polyurea and extreme hunger were flags for cushings. Back to reg vet for acth stim test that determined yes...hyperadrenocorticism. she was put on 120mg of veterol once daily for 15 days. A second acth test apparently revealed that level was not where it needed to be but was getting better. 3 weeks after we did another stim and the levels were still off so upped to 180. 15 days ...another test...results good. so she was on that for 4 or so weeks but just laid on her side,drooling, eyes leaking grossness and face turning brown. I took her in and was told the tumor may be getting larger causing neurological issues. She started bumping into stuff, tripping, having head tremors and walking in circles. Then she refused to eat. I decided that Cheza at 120 beat Cheza at 180 and we bumped her down and split the dose to one in am and one in pm. Then I took her in last weds and got told her weakness and non appetite and refusal to chew were neuro signs of a big tumor and i should prepare for a few weeks to two months. I flipped out...which is when I found you and made an appt for internal specialist for this week. Ive requested a copy of her file and will get it tomorrow
or thursday.
This morning she ate for the dad...and it was all kibble. This is the first time since July 10 that she touched anything she couldnt lap at like water, and the first time she ate without me sitting with her coaxing her to finish.

[lexiek13]

Oh! She weighed 52lbs in Jan 2012. Jan 2013 when this mess started she was 62lbs. shes dropped to 54 as of last weds but is eating again so unsure right now.

[labblab]

Well, all of the testing, etc. certainly seems to have proceeded per standard protocol. The initial dose is consistent with Dechra's publshed dosing chart, although higher than we would have recommended here based on our group's experience (we lobby for an initial dose no greater than 1 mg. per pound). Having said that, though, the proof of the pudding always resides in the subsequent monitoring tests and the resolution of clinical symptoms, and it sounds as though Cheza's test results must have pointed to a higher dose. The actual numbers, themselves, will still be really interesting to see.

The fact that she's rebounding now, though, definitely points to an overdose or a negative sensitivity to the medication. So we will be really, really interested in the outcome of your appointment on Friday!

Marianne

[molly muffin]

The thing is that every dog is different and reacts different to medications. So, if symptoms are fine, even if the cortisol number is a bit higher, like up to 9. post, then that is fine. The main thing is the symptoms and quality of life. Where she is good at is where she should be. This was obviously not good and when cortisol does start to drop, it can continue up to and even past 30 days.

I agree with Mariann, it will be good to see the numbers and where she is/was at.

Sharlene and Molly Muffin

[lexiek13]

8-3-13
We met with the specialist. He had all of the acth test results. He agreed with my other vet's choices per the numbers and the literature that comes with the Vetoryl. He said the recommended dose is 1-3mg per pound. He errs to the side of low though because he deals with this alot where my vet went with 2 because it was the middleman. He said that my diary of Cheza's behavior since he first diagnosed her was quite helpful. He said dogs behaviors and reactions to medications are not always matching with the numbers and that he would take good results with less than desirable numbers over right numbers and personality change any day. He asked me to rate Cheza today vs what she was when I first took her in because of the urination/drinking. I said that since last week when I took her off the Vetoryl she's probably 75% of who she was 5 months ago. He said lets keep her off the drug until we hit 100% and reanalyze then. If she needs it (the urination is uncontrollable) he'd start her at 1 60mg a day or every other day and see how it goes. But not to even think about it until we get her back to herself. She's so much stronger now...in just 7 days its almost magic. Her tail is up, her face is fluffing out and her undercoat is blowing. She was the only of my 3 girls who didnt blow this summer, her poor body has been holding onto all that hair all summer (In Vegas). He also told me to halt the stimulant for appetite because her lack of one COULD (but prob wasnt) a sign of something more serious like spleen cancer or something. 30 hours after her last pill she's eaten 3 meals uncoaxed. The Dr thinks all of this was a hypersensitive reaction to the medication and we'll revisit the medical options when we recover her from the damage done.
Also for those of you who have pets with more serious brain tumors: The Netherlands right now has the most successful treatments for brain surgery however, it is not without its problems. The risk vs reward isnt high enough. Yes they get rid of the tumor causing Cushings but in doing so they can cause thyroid issues or other brain trauma. Essentially we treat the symptoms and watch closely for comorbidities.

Thank you all for your support and caring, I plan on keeping you posted and keeping up on the research but am no longer looking at this as a death sentence.
Lexie...and her Bean

[doxiesrock912]

Lexie,

it's not a death sentence :) I thought the same thing when Daisy was first diagnosed. I'm so glad that the specialist is starting low. Getting the dosage right is tricky and then it often changes anyway. I can't tell you how many times I've adjusted Daisy's meds and had to stop them for a day, two, or even a week.

Sounds like Bean is in good hands and that is HUGE!

[addy]

It sounds like you are starting to sort things out. I do want to assure anyone else reading along, Cushings is not a death sentence, the drugs we use to control symptoms may need adjustments along the way, Lysodren might work better than Trilostane for some dogs, other health issues can crop up but if you work together as a team with a knowledgeable vet and learn all you can, it is not as frightening.

I am a bit concerned about the vet suggesting to dose every other day. Since Trilostane leaves the body quickly, it peaks at about 2 hours and is usually cleared the body by eighteen hours or less, it is hard for me to see the point in dosing very other day. Just something to keep in mind, if you resume dosing.


Whether to start with once- or twice-daily trilostane administration is controversial (1,2). Although most dogs are controlled clinically with once-daily dosing, trilostane may begin to lose its effectiveness 8-10 hours after administration, so twice daily dosing may be necessary in a subset of dogs (1,4).


the quote in in this article

http://endocrinevet.blogspot.com/2012/12/low-dose-twice-daily-trilostane.html

Hang in there

[lexiek13]

I will likely go back to 60mg once daily but only after she recovers. At the moment the only thing left of the "scary" effects is her head trembling. Its lessening in occurrence and duration though. Is this considered a symptom of the disease or do I need to start considering MRI and other diagnostics?

[lexiek13]

Update 9/1/13
Cheza is eating and has more energy. Her hair started to release (huskies shed like mad) but because she didnt shed in spring there were horrible mats. I had her groomed and got her a "potty patch" because huskies HAAATE being dirty. She perked up a bit afterwards. She's still lower energy but her weight is slowly starting to come back. I've noticed at least 2 more cysts though and I'm kind of being the helicopter mom and spazzing over the cysts. I'm going to talk to the specialist this week about vitamin supplements and perhaps something to help the cysts because they cannot be comfortable. She also has two ulcers on her lips because they get stuck in her teeth when eating. I was using vaseline but decided to try the Kanka medicine for kanker sores and so far its working well. She isnt happy about it at first but after the numbness hits she's happy.

[lexiek13]

Cheza (7yo Husky) just started the Vetoryl 30mg last Thursday. I've noticed her head trembling 2 times but otherwise she's been much more alert. Because the panting has diminished her lip sores are healing. My only concern right now is that she keeps pacing restlessly. I want to *silverlinings* think she's finally exercising herself because she feels better. I'm afraid though that its another horrible side effect and that I wont be able to have her on the trilostane anymore. She's at least moving around though which is good because she was getting so weak. Now she's greeted me at the door the last 3 days.

[Squirt's Mom]

I'm glad you are seeing some improvements and bet you will see more as time passes. The trembling could be from the Trilo - that is one of the side effects mentioned. The pacing could be as you say - she is feeling good enough to move a bit more now or it could be a reaction to the suddenly lower cortisol (Trilo works pretty fast and some pups have a period of adjustment as the cortisol level drops) but if it continues or worsens, let your vet know asap.

Let us know how things are going!
Hugs,
Leslie and the gang

[Harley PoMMom]

Has an ACTH stim test been done recently? If so, could you post those results? Thanks!

Hugs, Lori

[Trixie]

Have you noticed any changes in her symptoms?
Drinking/peeing/eating? Any decrease/increase?
Maybe the pacing is still some Cushing's like behavior. Restlessness can be a symptom of Cushings more than it would be from the medication.


Barbara

[frijole]

I'd like to know the last acth test results and the date it was done. Thanks, kim

[Squirt's Mom]

Cheza (7yo Husky) just started the Vetoryl 30mg last Thursday.

Cheza hasn't been on the Vetoryl long enough for the first ACTH yet, ya'll. She's only been taking it a week. ;)

[lexiek13]

My dog seems to have developed incontinence and her hind legs are weak and shake. My husband is convinced she is dying and i need to make "the decision". I dont know what to do or think. Any advice is welcome

[frijole]

The incontinence and the hind leg weakness are simply signs of the cushings which I understand you have not been treating that long right? How long have you been treating? Trilostane right? (also known as vetoryl) I am going to merge this thread with your other one so that your whole story is in one place and we can follow along.

You must give the medicine time to work and you must do acth testing to measure how it is going. That is why we are asking about the dose, how long you've given it and the acth test results. Thanks, Kim

[Trixie]

Cheza was on Vetoryl which was too high, then off for awhile and then back on again with a lower dose, right?
It sounds like the cortisol is back up causing the back leg weakness and the incontinence as Kim said.
If it were my dog I would not think about the decision but instead try to get the proper dosage of Vetoryl and see if there is a positive change. It just seems like the dosing has been really high and really low...maybe in between is the answer and will help control Cheza's cortisol level.
When is your next acth test?

Barbara

[doxiesrock912]

Also, dosing twice a day works best for many dogs.

[lexiek13]

The specialist took her off when she started showing the hypersensitivity last week. He said we can try lysodren, two other medicinal treatments or even holistic meds but that the vetoryl was doing her way more harm than good. The limping I have now discovered is due to some sores on the pads of her front legs which she uses more to compensate for the weakness of her back legs.

[frijole]

Just so you know you cannot switch to lysodren without a wash out period. Please I feel like we don't have the whole story. Can you give us more details from start to current about your baby? I'd like to know symptoms, tests done to confirm the diagnosis, results of those tests, amount of trilostane you were giving and if any followup tests were done. How long were you on the drug and when did the symptoms come on. As much detail as you can provide please. Thanks. Kim

[Squirt's Mom]

The specialist took her off when she started showing the hypersensitivity last week. He said we can try lysodren, two other medicinal treatments or even holistic meds but that the vetoryl was doing her way more harm than good.

The only "two other medicinal treatments" I can think of would be Ketachonozole and Anipryl (generic is Selegiline). I wouldn't use the Keto unless it was life or death - it is and anti-fungal and extremely hard on the liver and does very little to control cortisol. Anipryl can be effective but the pup MUST have the pituitary form of Cushing's and the pituitary tumor MUST be in the pars intermedia portion of the gland. Even then it is only effective about 25% of the time.

As Kim said, she will have to go at least 30 days without any cushing's meds on board if you decide to switch to Lysodren. However, I am leery of offering any suggestions as to whether switching would be a good idea or not since we have seen no test results at all for Cheza. So we are flying blind here. ;)

The brain surgery you mentioned a few posts ago is called a Hypophysectomy and they are being performed in the US now. In fact, one of our members was the first pup to have that done in the US. The procedure is far from perfected, is very expensive, and leaves behind problems....but it can buy a little more life and for some pups who are having many issues from a macro, a better life. Most PDH pups never have to face this as the tumor stays microscopic (a micro) all their lives - very rarely does it start to grow and become a macro. ;)

I'll make the request for all the test results that Cheza has had so far, both to diagnose and to monitor since starting treatment. That would help us help you a great deal. ;)

Hugs,
Leslie and the gang

[lexiek13]

I will contact our doctor and request a copy of her records. I know that both of them said that at 120mg her acth test was perfect. Cheza's quality of life at that point was not. The specialist felt that although her levels were imperfect on low or no doses, the reaction she had to the vetoryl was not worth the perfect acth levels. He felt that if she was too weak to even go to the bathroom and did nothing but walk in circles and bump into objects that the quality was just not there.
I know its a numbers game but she gets like every horrible reaction possible when on that drug.

[frijole]

Based on your last comment I would agree that you need to wash out and try something else. It's important that you share as much info as possible and that quote from a specialist was very telling because he/she's right - it isn't just about the numbers. Some dogs just can't handle certain drugs. Bless you! Kim

[lexiek13]

Okay I have her records...all 23 pages of them and they are filled with some things I understand and others I dont. I'm wondering if scanning them and putting a doc folder up would be the best idea for viewing.

[molly muffin]

Hello, gosh, sorry we missed your last post. You can scan the results and put them as a jpg in your folder, but the best idea is usually go go through and by date write out just the abnormal results. So, it would look like this:

09/28/2012
ALT 65ug range (65 - 110ug) as an example.

ACTH - pre 4.0 post 8.0

How are things going? How is Chez?

Sharlene and Molly Muffin

[lexiek13]

Wow....all hell broke loose after I posted this. We started physical therapy with an underwater treadmill. Four days after the first treatment she got a hotspot. Talk about gruesome. Three weeks later on antibiotics, medical creams and a biopsy (for lupus specifically which is a death sentence or calcinosis cutis) it came back positive for calcinosis. Tomorrow we are doing a baseline acth test, and we're gonna start mitotane. I am petrified but the alternatives are surgery for dramatic resection of the adrenal glands or death. In retrospect its better than lupus. If this works, I'll have her. She isnt done. She turns 8 on the 17th of this month.
Trying to stay positive. I'll sendyou guys the acth test report that I receive after the tests tomorrow.

[goldengirl88]

Just read your post, sorry your baby is having so many problems. I will say a prayer for you both. Blessings
Patti

[molly muffin]

We'll be right here, waiting with you. Yes I agree, much better than Lupus and treatment can at least help to resolve these symptoms. Remember that the cc can be one of the later symptoms to clear up. So, don't despair. Just hang in there!

hugs,
Sharlene and Molly Muffin

[lexiek13]

Test results:
ACTH Stim Pre:6.4%
ACTH Stim Post:9.8%
CBC: Liver Enz elevated
Hematocrit 31%
Platelets elevated but assumed due to open wound on shoulder (WBC stress)

We decided to add chicken livers to her food for the anemia and we are starting lysodren as soon as I can afford it (tomorrow). I'm also giving her four drops of Yuccare serum, Glucosamine/Chondroiton, and a Pet tab daily as well as 9mg of Melatonin, and 2 antibiotics we will continue to keep her on during the Lysodren initial stages.
I'm petrified, this drug scares the crap out of me. I want it to work because if it doesnt, I've lost her. I've about run out of any hope I had, and it kind of sucks.
Keep your fingers crossed. Our doctor is amazing, she's on this around the clock in case of an Addison's crisis and it helps that I'm pre nursing and know what to look for. Just scared though.

Lex

[Squirt's Mom]

Hi Lex,

No need to be afraid of Lysodren. It is a life-saver for our babies and handled correctly, it is no more dangerous than aspirin when it is handled correctly. ;)

What does Chez weigh these days? I'll help you check the loading dose so we can be sure things are off to a good start. And here is a link from the Helpful Resource section on Lysodren. It has some great tips for the loading phase and many folks print this out so it is handy.

http://www.k9cushings.com/forum/showthread.php?t=181

Hang in there, Mom! You're doing a fine job!
Hugs,
Leslie and the gang

[lexiek13]

A depressing forty eight lbs. She started at sixty.

[Squirt's Mom]

Ok, at 48lbs. the dose works out to 1090.90mg a day. Since the tablets come in 500mg doses, she will take 1000mg a day, divided and given twice a day - so one pill am and one pill pm. Here is the link to some great tips, ect. on Lyso that you can print out and keep handy. It tells what to look for that could mean Chez is loaded as well as what to look for that could mean a crisis.

http://www.k9cushings.com/forum/showthread.php?t=181

I think I would talk to the vet about starting the load while she's still on the ABs. It might be better to wait until she has finished them before adding the Lyso to the mix. Both ABs and Lyso can be irritating to the digestive system so I would talk to her about maybe waiting.

Just take a deep breath....you are a great mom, you know Chez well, you already watch her like a hawk, and do your best for her all the time. Those things are just as important as your vet's knowledge and experience....if not more so. See? You have a critical half+ of this mastered already! :) And you are not alone. We will be here to help you in any way we can.

Three things to remember - 1) it is messy and sometimes difficult to take back the pill once it is given. So if you have any doubts, withhold the dose, call the vet, and come talk to us in that order. ;)
2) Insist that the vet give you some pred if she hasn't already. This is NOT an option with Lysodren. Should a crisis arise you have the means to correct it in hand and when this does happen with either drug, it seems to be on a weekend, holiday, or other time the vet is not readily available. These pups seem to do the utmost at times to keep OUR cortisol levels high! :D
3) Ask the vet for a phone number that she can be reached at 24/7 during the load. That way, you have access if you have concerns or should there be a problem.

Breath...you will do just fine. Read the link I gave you, ask any questions you wish before starting that may help you understand and feel more confident, and breath, breath, breath. You will be a pro in no time!

Hugs,
Leslie and the gang

[Harley PoMMom]

Is Chez displaying any symptoms?

[lexiek13]

The vet wants to keep her on the AB's because of the calcium deposits and thick skin. Its why she got a hot spot and there are quite a few of them on her body.
I have the phone number, I don't have any prednisone though so I'll get that, thank you.
Symptoms: Polydyspia, Polyuria, her back legs have lost so much muscle that she has trouble standing, skeletal head, the belly, hair loss.
And she does not seem to have a voice anymore which is heartbreaking.


Thank you all!

[Harley PoMMom]

Please do not start the Lysodren until you get some prednisone to have on hand, this is very important.

Also, here's a handy link with info about Lysodren: Lysodren loading Instructions and related tips (http://www.k9cushings.com/forum/showthread.php?t=181) Feel free to print anything out. ;) If you have any questions, just ask away.

Hugs, Lori

[goldengirl88]

Probably the reason for the loss of voice is the pharyngeal nerve. It may be compromised if you say the trachea is. I hope all goes well for you and your baby. My Tipper has tracheal issues and I know it is a hard road to go. Blessings
Patti

[lexiek13]

Okay, Lysodren will be here tomorrow or Monday. I have Keflex and Amoxicillin for the skin infection and Prednisone in case of an emergency. I'm going to keep a paper and video diary of this process. Our doctor saw her today for a bath, a sanitary shave and nail trim and she said Cheza looks much stronger than last week and last week she looked stronger than two weeks ago. Doctor feels that we have a good chance with this.

[spdd]

Just popping in to wish you luck with all the loading and monitoring. I wouldn't worry too much about the loss of voice. "Mah boy" lost his voice too a few months ago. Once in awhile he actually will let out a bark, but he loved to howl when he was happy, now it's just a hoarse almost squeek. That made me sad too, but all part of the aging process possibly.

Good luck to you.

[lexiek13]

And she broke her tail this morning. I cant catch a break...no pun intended

[Squirt's Mom]

Oh my word....how did she do that? Bless both your hearts. If a broken tail feels anything like a broken tailbone in humans, OUCH!

[molly muffin]

Oh my gosh!!! Poor thing! Poor You!

hugs,
Sharlene and Molly Muffin

[goldengirl88]

Sorry to hear about the tail breaking. How did that happen? Just know we are all thinking of you and praying all goes well. Blessings
Patti

[lexiek13]

Okay: Day II on tail. She lifted it (in the splint I gave her) and is no longer screaming, squealing or crying. I think maybe it got bruised when she flopped weird in my car. I buckled her in and she sat funny and cried. I'm going with bruise because I can deal with that. We have a new skin irritation being treated with the silver sulfadiazine and bactine spray. Drugs here tomorrow. I almost cant wait, but I'm petrified that they wont work. If they dont work the only other answer is surgery and ..... she's been through too much already.
With hope....wishing for the angels on her collar to work their miracles.
Lexie and her Cheza (who turned 8 today)

[Tina]

Lexie,
Years ago my lab sprained her tail playing wild dog in the back yard. I'm not exactly sure how it happened, she was racing around and rough housing and wrestling with my friend's dog and I think she landed on her bum in a goofy way and sprained it. It was quite painful for several days but was not broken. I kept her on a leash for a few days so she couldn't play rough or anything, and I think my vet prescribed deramaxx for her at that time for the pain and inflammation. It was tough because she was a happy dog that was constantly wagging not just her tail, but her whole body. Maybe Cheza has sprained hers also, hopefully it is not broken.

I wish you the best of luck with starting Lysodren. Just remember to watch her closely for any subtle changes with eating or water intake. Have you measured her water intake so you have a baseline?

And happy birthday to your sweet girl. We love birthdays around here! :)

HAPPY BIRTHDAY CHEZA!!!

Hugs,
Tina and Jasper

[molly muffin]

Happy Birthday Cheza!!!

Hope that tail starts to get better soon. Maybe something for the pain, as Tina mentioned?

hugs,
Sharlene and Molly Muffin

[Squirt's Mom]

Happy 8th Birthday, Cheza Bean!

[lexiek13]

Lysodren starts at 5am tomorrow. We have tramadol but I unsplinted the tail today and she didnt cry, yell, scream, try to eat me or jerk away. She's elevating it somewhat too so no more peeing on her tail tip. The hardest part of this is going to be keeping the other two crated for most of the day so I can monitor chezas water, or I'm going to have to sequester cheza and let her pee all over the floor in the kitchen. Not sure which would be more traumatic. I fill her two bowls with a 3 liter water pitcher (measurements on it) about four times a day right now, but sometimes the other two drink out of them and she drinks out of theirs..hence possibly crating two and leaving chez out.
Thanks all I'll keep you posted. Cross your fingers that this works.

[Squirt's Mom]

Here is a link to a water intake spreadsheet one of our members built for us -

http://www.k9cushings.com/forum/showthread.php?t=3583

[goldengirl88]

CHEZA WISHING YOU A HAPPY BIRTHDAY AND MANY MORE. Blessings
Patti

[lexiek13]

Okay...day six little to no appetite, water intake is under five cups vs one and a half gallons, shes running into things and falling down though. I stopped the eds after this morning because of the water/food/attitude. We will be consulting with her dr tomorrow morning. She is biting me if I try to help her stand or give meds/food. Thats worrying me. I had a panic attack when she collapsed in the rain at two this morning and tried biting me when I helped her. That was followed by omg shes dying dreams and a fitful day.
More to come
Lex

[frijole]

What you have described has me concerned. I fear she might have gone too low. Falling down and running into things is not a good sign. Not eating and drinking are also signs of loading/low cortisol.

Do you have prednisone on hand to give in case of emergency? If not you need to get some as soon as possible. The drug continues to work at lowering the cortisol for TWO DAYS from the last dose.

Have you phoned your vet? You need to. Also be prepared to go to the ER vet/hospital if this keeps up. Dogs need cortisol to live. Please keep us posted with updates and also answer the question do you have prednisone on hand? Do you know how much to give if you need to?

Thanks Kim

[frijole]

Wow I just reread your thread and see you were on trilostane so the starting point from the last acth test was around 9? That meant you really didn't need to load very long. Please take your dog to the vet tomorrow for an acth test. Don't wait.

That said - if something were to happen this evening - just to be safe I looked up and your dog weighed 48 lbs I believe and the rescue dose of prednisone is 5.5 mgs. Boy I can't remember how big the pills are but err on the side of caution and give more and not less.

It works within a few hours and would give comfort if she's in distress. Sending warm thoughts. Kim

[lexiek13]

Prednisone administered. She did eat tonight though onlyba little and is still very wobbly although less aggressive. Vet was called today we go in tomorrow unless she has an emergency

[frijole]

Sorry I was headed to bed and wanted to give you instructions in case you needed to give it - I didn't mean to give it to her unless you feel she is distressed. I was worried from what you wrote but not sure how serious it is. Oh well.. be sure to let the vet know tomorrow morning how much you gave. Prednisone mimics cortisol and so while giving it gives relief it also skews the test results. So you have to wait (I believe it's 24 hrs from giving it) to do the acth test. If you do the acth test the results won't be accurate.

Regardless do keep us posted on how your baby is doing (and you as well!). Kim

[molly muffin]

I want to be sure I am reading this right. She went out at 2am, fell over, tried to bite you when you went to help her, wouldn't eat her breakfast, and then she had her last dose of lysodren?

I want to get the timeline right in my head, because this doesn't sound good. Her cortisol will continue to drop for 2 more days after the last dose of lysodren, as Kim just said. It is seriously dangerous for her cortisol to go too low, as in life threatening. You are taking her to the vet in the morning?
If she continues to do badly today/tonight, then she will need the emergency dose of prednisone most likely. Also make sure the vet checks the electrolytes as those often go out of balance also, if the cortisol goes too low.
This really needs to be addressed immediately.

Let us know how things are going.
hugs,
Sharlene and Molly Muffin

[molly muffin]

Okay I see that you have already given her the prednisone. So hopefully that will get her through the night alright, but she does need to see the vet in the morning and give the vet the entire timeline and what time you gave the prednisone. As Kim stated you need to wait to do the ACTH most likely as the prednison will skewer that result, but the pred is necessary due to the symptoms of going too low.

Hang in there!
hugs,
Sharlene and Molly Muffin

[molly muffin]

Okay I have reviewed your entire thread and I am going to put a synopsis up for ease of finding.
let me know if something is wrong and needs to be changed.

Las Vegas

Husky 8 years - weight 52lbs - Jan 2012, 62lbs - jan 2013 - July 2013 54lbs - Nov 2013 48lbs

diagnosed March 2013 - diabetes ruled out, pancreatitis okay, liver enlarged

trilostane 120mg - fine
test 15 day - level getting better but not there per vet
3 weeks after 15 day test, another ACTH, not yet there for levels dose increased

Trilostane 180mg - levels normal but reaction, lethargic

trilostane 120mg - quit eating (last week 07-19-2013 approx date)
head sahkes has to be elevated to eat, legs not strong

(discussions of possible macro tumor, not confirmed)

07-26-2013 - no - vetroyl, doing better

07-30-2013 - no shaking, no leaning on wals ,no limp since last friday
saturday two head shaking incidents, none since.

09-01-2013 - eating, has energy

10-03-2013 - 30mg vetroyl started a week ago, head now trembling, but still alert,
pacing restlessly
(mentioned she had gotten weak - while off vetroyl?)

10-07-2013 - now has incontinence and hind legs weak and shake was removed from vetroyl
last week (around the 3rd?)
specialist suggests trying lysodren

11-08-2013 - developed hot spots after undersater treadmill, antibiotics, etc,
confirmed calcinosis from biopsy

11-13-2013 - ACTH Pre 6.4 Post 9.8 (now at 48lbs)

11-16-2013 - broken tail?

11-20-2013 - starting lysodren

11-24-2013 - little to no appetite, water under 5 cups, running into things falling down.
gave lysoren this morning. prednisone administered

Sharlene and Molly Muffin

[lexiek13]

Vet confirmed decision for 5mg of Pred. 3 hours later she ate a bowl of watered down food and applesauce, drank, let me tend to her open sores and allowed me to assist her. Not aggressive, crying or biting. She took her antibiotics without a problem. The only caveat was that she had a tremor incident for about 35 to 35 seconds. It was not a seizure. She's now resting, I have been checking on her every ten to fifteen, listening to heart and lung sounds...steady and regular. She is also much more alert to sound and movement around her. Continuing to monitor. She and I will be at the vet at 8am for a CBC and ACTH stim.
(while i try not to have a friggen nervous break down and feel like a cruel human for doing this to her...which is really hard right now)

[lexiek13]

At what point do I need to realize that I'm torturing her? Granted, I havent slept in 50 hours, I just wonder, when I look at her, if it is my will keeping her with me or hers. I am distraught and don't know what to do. I apologize, but atm, I'm kind of falling apart.

[thecoz]

I'm sorry for this tough time you're going through right now. You are doing awesome though. I'm very new to all this...but I can already see how difficult it can be to manage at times.
KJ & Cosmo

[Squirt's Mom]

Hang in there, sweetie. It sounds as if Cheza's cortisol went way to low. Please do not wait to get her in this morning asap for the ACTH. When there is indication the pup is in crisis, we do not worry about waiting 24 hours from the pred - we need to know NOW what those numbers are. This cannot wait - she MUST be seen asap this morning. Ideally someone could have seen her when you saw those signs last nite - loss of appetite, falling over, aggression. Make SURE her electrolytes are checked this morning as well as the ACTH.

Let us know how she's doing! I'm glad she perked up with the pred.
Hugs,
Leslie and the gang

[frijole]

Good morning. Glad the prednisone perked her up that quickly and that she ate - all very good signs. Also glad you phoned your vet and have an appt this morning.

They should check electrolytes and potassium levels this morning in addition to doing the acth test.

Hang in there and be strong for your baby. We are here to help so you aren't alone. You are doing just fine. Kim

[molly muffin]

Good morning. I know you are completely exhausted. Hang in there. Lets see what the numbers show this morning. When she crashes it seems to come on very fast and go from fine to not fine quickly. Even when she is not on any medication she will be okay for a few days to a week and then the same symptoms of a crash come back. Legs wobbly, falling over, etc. So, it is very hard to know when it is a crash vs when it isn't with her.
The only way to confirm a macro tumor would be to have an MRI or CT scan, both of which are expensive.
Talk to the specialist this morning and see what he thinks about this.

hugs,
Sharlene and Molly Muffin

[frijole]

Wanted to reinforce this:

They should check electrolytes and potassium levels this morning in addition to doing the acth test.

Everything you have described is normal behavior for low cortisol. The prednisone will give her relief she needs so you are not torturing her. The tremors you describe are also signs of low cortisol so don't torture yourself with negative thoughts right now. We will all be with you in spirit. Kim

[addy]

I dont know if this helps at all and every dog is different, but my Zoe has been on Trilostane for 2.5 years now, she was having head shakes and falling over, weakness in her back legs, we had to help her up out of her bed, these symptoms just showed up one day; her stim was post 1.9, electrolytes were fine. I just cut back her dose of Trilostane. Zoe's symptoms did not get as severe as your pup's sound but her numbers were not super low, maybe low for her, I am hoping.

Dont give up yet. I know it so hard and so much pressure.
Let's see what the numbers say, as Sharlene already said.:)

[spdd]

Wishing you all the best this morning!!

[molly muffin]

Checking in to see how things went today with Chez. How is she doing? How are YOU doing?

hugs,
Sharlene and Molly Muffin

[frijole]

Just getting home. Any update? Sending love, Kim

[Squirt's Mom]

Mornin',

Popping in to see how things are going for you and Cheza Bean.

[frijole]

Checking in this am because I am in meetings all day. Do check in when you can as we worry. Continued warm thoughts, Kim

[lexiek13]

Just got results. Before: 0.7 After: 0.7
I am elated. And relaxing. She may need pred therapy weekly but atm....dont care!

[labblab]

Hi, I have only a moment to post right now, but those results are too low, especially since there is no difference between the "pre" and the "post." And they are truly way too low if the ACTH was performed within 24 hours of the prednisone dosing, because the prednisone will artifically increase the result. Her natural cortisol production would be even lower in that event.

At the moment, there is no way of knowing when, if ever, Cheza's cortisol prodution will rebound back within normal range. Cheza needs supplemental prednisone on a daily basis right now, not weekly. And are you certain that her blood chemistries (especially sodium and potassium) are within normal range? If not, she may need an additional supplemental drug for the time being (because aldosterone, the hormone that regulates those levels, also can be oversuppressed along with the cortisol).

What instructions has your vet given you? I am so sorry to be the bearer of worrisome tidings, but these results are definitely lower than you would wish to see, especially soon after having given Cheza prednisone.

Marianne

[lexiek13]

Shes consulting with the specialist. I was instructed to give her a pred this morning. Shes doing better than sunday. Im not happy about Addisons but it is somewhat easier to treat than the Cushings so Ill take it. Had her levels still been too high we were at the end of the road with adrenal removal our only other option.

[labblab]

OK, I have a better understanding now as to your perspective on all this. I was just afraid that you might not realize that the supplementation of the low cortisol (and possibly low aldosterone) may be an ongoing need from here on out.

Marianne

[Jenny & Judi in MN]

I almost killed off my Jenny's levels with Lysodren. Her post was .2

she did prednisone for 6 months and has been off all cushings related meds for over a year.

It has been a nice mental break not stressing over Lysodren and ACTH tests.

Her cortisol is slowly slowly moving up. Her specialist said as long as she wasn't showing symptoms we could periodically do the pre part of the ACTH just to check and see where she is at.

Good Luck!

[frijole]

Like Marianne suggested those numbers just mean Addisons but they really are no indication of how low Cheza really is because you had given prednisone within 24 hrs of the test. Plus the test was done the day following the last dose so lysodren will continue working for two whole more days from that point... point being no one really knows how low the cortisol went or is right now.

Your comment about weekly dosing scared me as well as I'm not sure your vet is real up to speed on this stuff. Remember when we mentioned getting the electrolytes checked and the potassium/sodium checked during the visit? I didn't see that mentioned. If you don't know please call and find out. This is real important stuff or we wouldn't be harping on it. Please let us know asap. Really appreciate it.

Yes it could work out to be easier but it isn't an easy journey - especially right now as you have to figure out if your dog is OK. I'm glad your vet is consulting with an IMS but does that mean the IMS is talking to him/her by phone or can you actually take your dog there to be seen. I'd feel much better if it were the latter. Thanks, Kim

[lexiek13]

My ims moved to oklahoma. We didnt do a cbc yesterday but will soon. I realize it isnt a miracle but after everything else didnt work I was expecting a call with news that it was time to let her go.

[frijole]

Nope you giving her the prednisone could have saved her life. It is real important that you get the sodium and potassium and the electrolytes checked. I'm not going to quit asking because it is that important. Did your vet do that? I don't mean to nag but I am concerned and want to make sure your dog is in good hands. Thanks. Kim

[Tina]

Cheza needs supplemental prednisone on a daily basis right now, not weekly. And are you certain that her blood chemistries (especially sodium and potassium) are within normal range? If not, she may need an additional supplemental drug for the time being (because aldosterone, the hormone that regulates those levels, also can be oversuppressed along with the cortisol).

Marianne


Hi, I have been following along and just have a second to post as I am still at work. You mentioned that a CBC wasn't done yesterday, but what Marianne and Kim are asking about are electrolytes, which may be included on a chemistry panel. Do you know if these were done? Specifically the sodium and potassium levels as these can become imbalanced during an addisons crisis or episode and this alone can cause very serious issues.

If this happens a separate medication is needed to replace the aldosterone, in addition to prednisone that you are giving to stabilize the cortisol. Please call your vet and ask if the sodium and potassium were checked and if they were within normal range. This is totally treatable, but the right bloodwork needs to be checked and the right medication needs to be given in order to stabilize both the cortisol and electrolytes. I hope Cheza is feeling better now. I will check in when I get home.

Tina

[lexiek13]

Specialist says electrolytes and potassium are normal but we are rechecking next monday. Ten mg of pred one five twice a day till friday. They think the adrenals may be fried though hence the test again in a week.

[frijole]

Specialist says electrolytes and potassium are normal but we are rechecking next monday. Ten mg of pred one five twice a day till friday. They think the adrenals may be fried though hence the test again in a week.

Thanks for update on electrolytes/potassium. I didn't follow your comment above in red - please advise.

Hard for them to really know status of adrenals. Sometimes they grow back sometimes they don't. I've never heard a vet say they think they are 'fried'. Wow.

How is Cheza feeling and acting today? Thanks. Kim

[labblab]

I'm guessing you mean one 5 mg. tablet of prednisone twice daily (for a total of 10 mg.)?

If you are stopping the pred on Friday, I'm guessing it's because you want her to be steroid-free for the 48 hours prior to the ACTH? But she may not be able to tolerate that long a time without supplementation. I believe in that situation, dogs can be given dexamethasone instead of prednisone prior to the testing because it doesn't skew the ACTH in the same way as does prednisone. Since this is going to be a holiday weekend, I'd definitely ask your vet as to the gameplan if Cheza looks as though she needs a steroid over the weekend.

Marianne

[molly muffin]

Hi! So glad that her electrolytes are good and yea, it is good to recheck them to make sure.

Addisons is treatable too, and you won't really know till sometime in the future if they will start back up or not, if not, then she'll be on medication to keep the cortisol high enough.

I hope she continues to do good and that you get your baby back.

We have another active member whose dog also went to low and is still Addison. He is doing fine, some up and downs but over all good.
Tina and Jaspers thread is here if I haven't posted it to you previously:

http://www.k9cushings.com/forum/showthread.php?t=4372

hugs,
Sharlene and Molly Muffin

[frijole]

Thanks Marianne - that makes sense and I agree ... I would be afraid that Cheza might not be able to tolerate not having any prednisone over the weekend. Finding a vet this weekend might be tough. Good thinking as always Marianne. Kim

[lexiek13]

1 5mg x 2 a day, total 10. I was on my phone stuck in class so I was being lazy and short. On Friday if better I will dial back and only give her one Saturday so that she can get 24 hours free by Monday.

[frijole]

That is a large dose of prednisone and under the circumstances your vet must feel it is warranted. To just stop can be very serious and you could be stuck with a very very ill dog on a holiday weekend and no way to get more pills. I agree with Marianne - you need a backup plan with your vet. Please find out if he or someone will be available should your dog need these meds. It always seems to happen on the weekends and better safe than sorry.

[lexiek13]

She notified me that she's on call through the holiday and if I need her all I have to do is dial. Chez was totally lethargic yesterday, now she's pacing, and I'm at OMG SLEEP WHAT ... but its better than lethargy :)

[lexiek13]

Fortunately I am in Las Vegas and my vet clinic has an emergency hotline and my vet is amazing. She has my number and it will go to her if I call. She is concerned for us and will answer no matter what.

[frijole]

She notified me that she's on call through the holiday and if I need her all I have to do is dial. Chez was totally lethargic yesterday, now she's pacing, and I'm at OMG SLEEP WHAT ... but its better than lethargy :)

This is 100% due to the prednisone. It mimics cortisol. You might want to discuss the pacing with the vet as it could mean the dose is too high and can be reduced. Yes much better than the lethargy. That said without the prednisone she would immediately go back to being lethargic and suffer so that is why we were so concerned about your vet's availability. Great to hear she is on call and available - that is exactly what you need.

That prednisone is her lifeline that is keeping her system in check right now so just keep an eye on her and if you fear she's reverting let your vet know. Have a great holiday despite. At least this didn't happen this weekend right? Kim

[Tina]

That is great that your vet is available over the holiday and weekend. Glad to read that Cheza is doing better. How is her appetite, is she eating?

Tina

[lexiek13]

The team agrees that one dose of five mg every twenty-four hours is best after my observations last night and today. Thank all of you for being so helpful, I appreciate it so very much.

[frijole]

:D That worked out good because you should have enough pills to make it thru the weekend now if you need to right? Hopefully Cheza can munch on a piece of turkey too! Take care, Kim

[molly muffin]

Happy Thanksgiving!

So glad to hear that your vet is on call for you if needed.

Very happy that she is doing so much better too. :) YAY

hugs,
Sharlene and molly muffin

[lexiek13]

Update: she walks into corners and stands there. She has difficulty getting up and walking. Seriously decreased appetite. Another test Monday but...she really doesnt look good. End of the road?

[labblab]

What dose of prednisone is she taking and how often (and can you remind us as to her weight?). Given her behavior, you are still dosing her this weekend, right?

Marianne

[lexiek13]

Weight: 48. Pred until this afternoon was five mg once. Today we did five twice.

[molly muffin]

How is Chez doing now? Did the two doses of pred help?

hugs,
Sharlene and Molly Muffin

[Squirt's Mom]

Mornin',

How is Chez this morning? Is there any chance her vision is failing enough to cause confusion about where she is (like corners) and maybe some depression about losing the sight?

Standing in corners and staring is one of the signs of CCD but she is awful young for that I would think - it is usually an old dog condition (doggy Alzheimer's). But that is also one of the signs of a macro. Do you see any other signs like aimless circling? We have a thread in the Everything Else section on Macros where members have shared their experiences so others can compare. You can find that thread here - http://www.k9cushings.com/forum/showthread.php?t=3567

I hope this is just her cortisol still being too low and the electrolytes being out of balance and nothing more. Do you have an ER facility you could take her to today and have those checked (cortisol and electrolytes)? I know she is slated for them tomorrow but if she is struggling today, I would want them done now if at all possible.

Let us know how she is doing and know we are with you both.
Hugs,
Leslie and the gang

[frijole]

Is she on any pain meds? My Haley walked into a corner and stood there after giving her tramadol - the dose was too high. Just checking.

7 yrs old is too young for dementia. :( Kim

[Junior's Mom]

How is Cheza Bean today? I have a dog that will often stand in strange places and stare, but it's because she is obsessed with shadows and flashes of light. As others have mentioned, it could be her eyes.

[lexiek13]

Shes still not interested in food but is relaxing and resting at last.

[lexiek13]

Id think macro but this crap only happens when shes on meds to suppress the cortisol.

[molly muffin]

Checking in to see how Cheza is doing? Any interest in food yet?

hugs,
Sharlene and Molly Muffin

[Squirt's Mom]

If she is only "off" while on the cortisol suppressing drugs then I'd stop giving them to her. I don't remember what testing she had done to diagnose the Cushing's but is there any chance this is a misdiagnosis? Or maybe she is one of those pups who need their cortisol to run a little higher than the recommended norms? Did she have an ultrasound as part of the testing phase? Has she had labs lately?

How is she doing today?
Hang in there. I know this is so frustrating.
Hugs,
Leslie and the gang

[lexiek13]

Potassium level good. Sodium slightly high. Acth pre less than one. Acth post still less than one. Course of action: .5mg pred x two a day. Next acth is on Monday to be super sure. She is eating and drinking mostly from a bottle but is interested. Still very weak but we will get her in pt when she gains a little weight.

[Squirt's Mom]

ooooo...no wonder she's not feeling well! Cortisol is toooo low and the pred should help that a great deal. I hope her appetite is back today and you see a bit more energy with the pred on board. They did tell you to stop the Lyso? (:o Had to ask, ya know!)

[frijole]

Wow still that low after a week of prednisone - bless her heart. Keep doing your best to give her water and food. I am curious what the purpose is of checking levels again on Monday. I think you said to be super sure. Sure that she is addisonian?

From what I've read from other cases over the last 9 years it will take a long time before the adrenals heal - if they ever do. You won't know for sure on Monday if she's addisonian as some dogs actually do bounce back over the course of time. Could be they never grow back but I wouldn't expect any answers next Monday.

Forgive me if I misunderstood - frankly I was trying to save you the cost of an acth test if that is what they are doing. They are so dang expensive.

Hang in there and hopefully Tina and others who have dealt with addisons can offer advice. Hugs to Cheza. Kim

[Harley PoMMom]

Potassium level good. Sodium slightly high. Acth pre less than one. Acth post still less than one. Course of action: .5mg pred x two a day. Next acth is on Monday to be super sure. She is eating and drinking mostly from a bottle but is interested. Still very weak but we will get her in pt when she gains a little weight.

If Cheza weighs around 50lbs then the .5mg of prednisone may not be enough for her. The usual rescue dose of prednisone is 0.25 mg/kg, and a kg equals 2.2 pounds, with a 50lb dog that would equal 5 mg of prednisone (50/2.2 = 22.73 * .25 = 5.68mg).

[frijole]

Good catch Lori.. I was thinking that is a typo because she was on 5 mgs 2 x a day before but maybe it was lowered... ?? Hope not to that level. At 10 mgs a day Cheza was pacing and had cush symptoms if I recall. Kim

[Jenny & Judi in MN]

just to back up what Kim said, when my Jenny's cortisol was this low her IMS said if we wanted to spot check where she was at we could just do the first part of the ACTH which is way cheaper. Odds are good that if that number is still very very low so is the post #.

Just a thought

[lexiek13]

Sorry about that, I meant half of her 5mg so 2.5. This is what five nursing classes, and two masters classes at two different colleges during study week does to the brain. Oh and no sleep...cause there's no sleep.

I cut the tip off of a nipple of a baby bottle and she's eating and drinking from that, drinking now from her bowl, and able to walk for more of a duration. Our doc said it'll be a slow recovery.
Do any of you have ideas for helping me feed her to gain weight? Once she gains some back I can get her into physical therapy and start recovery.

Clarifying, she gets 5mg pred a day split into two 2.5mg doses on the 12 hr mark. We are retesting acth next monday to make triply sure that this is accurate.
Thank you! I'm thinking I may just have a Merry xMas

[Squirt's Mom]

I have some recipes for Satin Balls that help pups gain weight if you are interested. They are fairly easy to make and most dogs seem to love the ones I've tried. They are rather high in fat, tho.

[frijole]

I did the Satin Balls for my Annie who was skeletal from not eating. This recipe is used by people who show their dogs and need to gain weight quickly. My vet thought it sounded like a good option for Annie and she ate them but only if I cooked the hamburger - the recipe called for raw. This recipe is huge so cut it back to test it! :)

Satin Balls
More Satin Ball Recipes
Husky Howllow's Satin Ball Recipe



A Reader's Recipe:

5 pounds ground meat
5 cups Total whole grain cereal
5 cups oats (slow cooking type)
2½ cups raw wheat germ
¾ cup oil
¾ cup molasses
6 egg yolks
5 packets gelatin
2 ½ tablespoons Solid Gold Seameal supplement

Mix up, form balls, freeze, feed as treats or food supplement.

Mix all ingredients together thoroughly like you would a meatloaf.
Roll into balls no larger than 1 inch diameter.
Divide into at least 6 separate containers or bags. Freeze. Thaw as needed for feeding.

I take a frozen pack to dogs shows with me, kept on ice, and never have had any trouble with it spoiling, even in the heat of Texas summers...
All my dogs go crazy over this stuff...but you have to be careful, it will put wt on the dogs pretty fast if you feed enough....I feed a pack a day...half in am , half in pm.
When I want to increase the weight on a dog, I feed more; so far I haven't got to the point where they won't eat anymore, and believe me, Satin has eaten a lot at one setting. It will put on the weight, make the coats soft and blue black (on black dogs at least, that's all I have).
The dogs stop all the itching and chewing at their coats/skin, their eyes get this bright look and the energy level goes out the roof(not that Belgians need any more energy).
The bitch that I got this recipe for is a picky eater, but when this in on the food (I long ago stopped trying to "bury" it in the other food; they just hunt it down to eat first, and making a mess trying) she eats much better. It seems to whet her appetite.


More Satin Ball Recipes

Comments:

Per the information received after having the Satin Balls recipe checked by several vets/labs:

Satin Balls is a total canine diet. It can be fed by itself or as a supplement, for however long you wish. My dogs have been on Satin Balls for over a year; the only time that I have fed it alone is when I had a sick dog needing to be built up or an underweight dog that I plan on showing.
The only problem with feeding it by itself is figuring out the amount. It will put weight on a dog in a few days...that's why it is so great to feed just before a show. If you have a dog that is in good weight, but you just want to build coat/endurance, you would have to figure out how much to feed (cal per kg), or you would end up with a fat dog in a very short time. At one point, I let Satin eat as much as she wanted, just to see how much she would consume. I never got to that point! After a pound pack, she was still looking for more, so I stopped. I have been told a dog will stop eating when full on it, and that you can then gauge the amount needed to maintain weight!
I just find that per the pocketbook and ease, my dogs do very well on it as a supplement. I give about a 1/4 pound each night to maintain beautiful coats, energy level, and a full appetite...no picky eaters here.
Just don't try to hide it in the kibble...they will make a mess throwing out the kibble, digging for the Satin Balls! My dogs have never gotten sick on Satin balls...not even when I am at a show and feed only that. I feed less kibble, so I saves money there. There is also less stool to pick up as the dogs are able to digest all of the Satin Balls.
I have been playing with the recipe. I now use the Knox Joint Gelatin instead of the plain Knox unflavored gelatin. Since this is high in vit C and protein, and is good for the joints, it would be good for the dogs. They don't seem to mind the added flavor.
I am also adding Flaxseed oil. They probably don't need the added oil, but so far I have not seen it hurt anything.
Fix some up and let your dogs enjoy. They will love you forever and forever!

[labblab]

Just want to add a cautionary note about perhaps watching the fat content of any dietary shift. Although not yet proven beyond question, it is thought that Cushpups may be more vulnerable to pancreatitis, and that pancreatitis attacks may be triggered by abrupt introduction of high-fat food. So just to be on the safe side, you may want to be fairly careful about calculating and monitoring the fat content of any new diet.

Marianne

[frijole]

:D Yes you should pass this recipe by your vet for comment!!! Kim

[Harley PoMMom]

Sorry about that, I meant half of her 5mg so 2.5. This is what five nursing classes, and two masters classes at two different colleges during study week does to the brain. Oh and no sleep...cause there's no sleep.

Clarifying, she gets 5mg pred a day split into two 2.5mg doses on the 12 hr mark. We are retesting acth next monday to make triply sure that this is accurate.
Thank you! I'm thinking I may just have a Merry xMas

I was worried so Thank you for clarifing that for us. ;)


just to back up what Kim said, when my Jenny's cortisol was this low her IMS said if we wanted to spot check where she was at we could just do the first part of the ACTH which is way cheaper. Odds are good that if that number is still very very low so is the post #.

Just a thought

I agree with Jenny here, a pre test for cortisol would probably be adequate.

[lexiek13]

I will definitely run this by her. I'm pretty strict with what my girls get to eat and what they don't. Chez has got the hang of the modified bottle, and today she was walking much steadier than yesterday. She wouldn't let me take the bottle out of her mouth tonight until all the food was gone. There has been NO head shaking in a week and she is responding to my commands (albeit less than I'd like....especially when I can tell she's just ignoring me).

[doxiesrock912]

Good to hear! Keep improving Cheza Bean.
Selective hearing, not just for men _ lol.

[molly muffin]

Sounds like Cheza is doing better! Yay! That is good news indeed. I know you will get this sorted out for Cheza. Sounds like you are swamped currently with school too. I'm sure this is all very hard to deal with on top of everything else.

hugs,
Sharlene and Molly Muffin

[lexiek13]

Oh yeah. I have two finals down, one almost finished and three left after.
Cheza stood up, on the tile, by herself today. She only needed help up three times over the afternoon. She's drinking from the bowl again, and she ate a bit from it this evening.
There's a bit of a bounce to her gait today too...makes my heart happy.
Hope everyone is having an excellent week!

[molly muffin]

Excellent news!!

hugs,
Sharlene and Molly Muffin

[lexiek13]

ACTH test...same as last week. Cushings is officially history. Cheza is to stay on 2.5mg preds twice A day and her antibiotics for the skin infections until further notice. In 3 weeks we will reassess her electrolytes and potassium levels. She had a not so great day friday but since has been walking on her own. Today she actually stood up all by herself. She has some spring to her gait as well. The ONLY downside is she has a new infection. Friday (the bad day) she was rubbing on and leaning on the outside house walls too much. Her hair and skin peeled off....thus the infection. I've been icing and cleaning it and its getting better. Her fur is regaining luster and softness and she does not whine and cry as much.

[doxiesrock912]

Great news!!!! It's horrible when they don't feel well.

[molly muffin]

It sure can be a delicate balancing act. I'm happy to hear that Cheza is doing better over all though. :)

hugs,
Sharlene and Molly Muffin

[lexiek13]

Alrighty...Her levels were higher than last week to start, but not "high" just not at almost 0. After the ACTH gel injection there was no elevation. So sticking to the same meds: antibiotics until the calcinosis dissipates and her open sores are fully healed and 2.5mg pred two times a day. She's drinking normally, she ate from her bowl tonight (still liquified), she was grooming her face this morning..something I havent seen her do in over a year, and she's able to get up all by herself and there's little to no balance issue. I'm working on getting food into her. Her kidneys and liver levels are good as is her pancreas so we can increase fat a bit, but in the form of puppy food not fatty meats. I swapped out the chicken livers for raw eggs because she hated the livers and just sucks up the eggs. I'm hoping we're on the climb back up.

[lexiek13]

I took Chez in for a bath and a checkup because of some sores I've noticed that are a combination of the calcinosis and falling. Her back had to be totally shaved. There were more sores...possible hot spot starts and she looks ...bad. Really bad. Because of the success I had with her last sores the doctor told me to take five days, keep her on anti biotics and clean/care for the wounds and we will reassess. If they arent healing its time to let her go. If they are, we'll go another week. She isnt gaining weight and is practically skeletal although she eats, drinks, and goes to the bathroom.
I'm devastated.
Oh, and my birthday is coming up. Happy birthday to me.

[frijole]

I am hoping those with experience with Addisons can chime in and help you out. You mentioned a couple weeks ago that "in 3 weeks we will reassess her electrolytes and potassium levels". Has that been done and what can you tell us?

This is real important when treating Addisons. Sometimes additional injections are required besides the prednisone. Are you giving any other meds?

A dog with cortisol can seem near the end and then with the right amount of cortisol (increase due to meds) they perk right up. So don't give up yet.

I promise you we will all put on our angel wings and surround you and dear Cheza with positive thoughts, strength and love. Hang in there and yes - happy birthday to you. Hugs, Kim

[molly muffin]

Oh no, I'm so sorry. I thought she had been improving on the pred and was starting to eat again. :(

I know you are just heart broken by this turn of events. :( And a birthday too. :( She is so young to have this happen to her. It's true sometimes you just take things day by day and when you realize the time has come to make that decision, then you do it for her, because it is that time, knowing it will hurt your heart something awful. I hope that time hasn't come yet.

sending you hugs and support. We are here whenever you need/want us.
Sharlene and Molly Muffin

[lexiek13]

She isnt in pain. She is eating/drinking. She hates being still. I'm hoping the lack of weight gain is because of her body fighting these skin infections. The last time I did this with her there was a marked improvement early. We will test the electrolytes this thursday on our checkup. Part of the problem is my doctor doesnt have experience with pet parents who are hypervigilant like I've been. I've been on top of everything, followed every direction and researched above those directions. She's not telling me its "time" because she knows how dedicated I am and thinks there's a small chance I can fix her.

[Tina]

Lexie,
I'm so sorry to read the latest about Cheza. What were the results of her last electrolytes check? Were the sodium and potassium WNL? And has she been checked for diabetes? I know diabetes can cause weight loss. I'm not sure I understand the reason for the skin infections. Sorry for all the questions, I am just trying to understand what is going on with your sweet girl in case I can help. My baby became Addisonian from Lysodren.

Hugs,
Tina and Jasper

[lexiek13]

Today Cheza passed away. She fought so hard but her poor little body couldnt take anymore. I got her eight years ago as a puppy on Jan sixth...the day after my birthday. She will always be the best thing thats ever happened to me. I want to thank you all for your support, knowledge and advice. I will alwaya be grateful.

[doxiesrock912]

Oh no Lexie!
I'm so sorry to hear this!
My sincere condolences dear!

[Renee]

So very sorry. My thoughts are with you and Cheza Bean. Rest in peace Cheza.

[goldengirl88]

I am so sorry to see that your sweet Chez has passed away. The other will greet her at the bridge. She is running and playing now free of pain. God Bless you Both
Patti

[molly muffin]

Lexie, I am so very sorry to hear that Cheza has passed away. You both fought long and hard.
My sincerest condolences.

hugs,
Sharlene

[Bo's Mom]

I am so terribly sorry to read this tonight. May you rest in peace and run free sweet Cheza. I know the other Angels will guide you to all the best places to hang out at the Rainbow Bridge. Your spirit and memory will live on forever in the hearts of those lucky enough to have met you.

[Roxee's Dad]

I am so very sorry for your loss. Rest in Peace sweet Cheza.... tonight you are among our newest and brightest stars in the night sky....

[Budsters Mom]

I am so sorry to hear of sweet Cheza's passing. She has been welcomed at the rainbow bridge by many of our other fur angels. Run free sweet girl, run free! Xxxx

[frijole]

RIP sweet Cheza Bean - run free of all pain and know that you were loved.

To mom - I'm so sorry and hope that memories of all the good times helps get you through the sad days ahead. Let us know if we can help in any way. Kim

[Woodydog]

I am so sorry to hear of Cheza passing. Run Free little one :)