Confused about my vet's instructions-can anyone help

[Izzy and Jasper]

Izzy is 7 yr old miniature schnauzer. we noticed her heavy drinking. then one night whilst asleep she unkowingly wet herself.

We took her to our vets who ran a dexamethasone suppression blood test.

Is there anyone on here who can understand the results, we were assured that this test would confirm a diagnosis but they want us to run another blood test - an ACTH test.

Dexamethasone Suppression Test
Cortisol Basal 150.0 nmol/l 50.0 - 250.0

Cortisol 3 hr post Dex 42.8 nmol/l

Cortisol 8 hr post Dex H 43.0 nmol/l 0.0 - 40.0


A few days before, we had a normal blood sample taken, can anyone also make sense of this:

Canine Standard Profile
Full Blood Count
WBC L 5.3 x109/L 6.0 - 15.0
RBC 6.43 x1012/L 5.00 - 8.50
Haemoglobin 15.3 g/dl 12.0 - 18.0
PCV 46.7 % 37.0 - 55.0
MCV 72.6 fl 60.0 - 80.0
MCH H 23.8 pg 19.0 - 23.0
MCHC 32.8 g/dl 31.0 - 34.0
Platelets 428 x109/L 200 - 500


Differential % Abs Interval

Neutrophils 74 % 3.9 x109/L 3.0 - 11.5

Bd Neutrophils 0 % 0.0 x109/L 0.0 - 0.3

Lymphocytes L 17 % 0.9 x109/L 1.0 - 4.8

Monocytes 7 % 0.4 x109/L 0.0 - 1.3

Eosinophils 2 % 0.1 x109/L 0.1 - 1.2

Basophils 0 % 0.0 x109/L


Film :
Occasional reactive lymphocyte seen
Platelet count appears normal in film


Total Protein 74.0 g/l 54.0 - 77.0
Albumin H 37.3 g/l 25.0 - 37.0
Total Globulin 36.7 g/l 23.0 - 52.0
Sodium 147 mmol/l 139 - 1


:) WE LOVE OUR LITTLE IZZY. AND WOULD APPRECIATE SOME ADVICE FROM THE BRILLIANT MEMBERS OF THIS GREAT SITE :)

[Squirt's Mom]

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[Izzy and Jasper]

Please can someone help - feeling desperate. Does Izzy have Cushings as per her readings on the dex test. Why another test ACTH??? Is my vet just trying to make money out of me??? :( Love Izzy with all my heart what is going on?

[frijole]

I don't have time to check the LDDS test results to make sure it is indicative of cushings but I will tell you in my opinion your vet is NOT trying to rip you off by doing an acth test. This disease is tough to diagnose and you do NOT want to start treating until you know for sure it is cushings. The LDDS test can have false positives so doing the acth test helps assure your dog truly has cushings prior to starting on treatment. I see it as a good thing - hope that helps. Sorry but I have to get ready for work so can't post more now. Kim

[labblab]

Welcome to you and Izzy, and I'm so sorry that nobody had a chance to respond to you yesterday! I'm certain you'll be getting more "welcomes" today. :)

If Izzy's symptom profile is pointing towards Cushing's, then I think your vet's suggestion to perform an ACTH is a reasonable one. You have not given us the "normal" range for her LDDS test, but usually it is in the neighborhood of 1.4 or 1.5 ug/dl (these units are the ones with which we are most familiar here in the U.S.). What this means is that if a dog's 8-hour LDDS result is higher than that "normal" cut-off point, the test is consistent with Cushing's. When I convert Izzy's 8-hour result, it turns out to be 1.5+ ug/dl. So that means it is probably right at the cut-off or a little above -- so truly a "borderline" result. A small percentage of dogs who suffer from early pituitary Cushing's will not yet test "positive" on the LDDS. For those dogs, an alternative blood test -- the ACTH -- may instead pick up a positive result. So I am guessing this is why your vet is recommending that testing. Here's a link that more fully explains this testing:

http://veterinarymedicine.dvm360.com/vetmed/Medicine/ClinQuiz-Interpreting-low-dose-dexamethasone-suppr/ArticleStandard/Article/detail/580093

Backing up a bit, though, can you tell us whether Izzy has other abnormal symptoms besides the thirst and urination issues? Also, at the time her blood was tested, did you also get blood chemistry results in addition to blood cell counts (which you've given us here?). The blood chemistries give values associated with such things as kidney function, liver function, thyroid function, and blood sugar level. Also, has she had a urinalysis performed recently? If so, it will help us a lot if you can list any results that are either too high or too low on either the blood chemistries or the urinalysis.

Once again, welcome to you both. We are so glad you've found us and we will be here to help you as much as we can!

Marianne

[goldengirl88]

Welcome to the forum. Marianne has already gone over the things that need checked on your baby. Just know that your dog can live out their lifespan with this disease. I know it is scary and everyone that finds this forum is scared to death. I cried for weeks on end. If you get a diagnosis of cushings and you choose treatment you must be vigilant about watching your dog for any signs of problems. If you do that your dog will do well. Once you get into the routine of this it will be less stressful. You must educate yourself on this disease as you are the only advocate your dog has. Do not put blind faith in anyone even your vet. It is important to have an experienced person who had a good knowledge of this disease, it will save you time, money and heartache. Start a doggie diary with the things going on with your dog every day, you will need it to reference. Blessings
Patti

[molly muffin]

Hello and welcome to you and Izzy.

Marianne, is correct, these are quite borderline results on the ACTH.

Conversion as follows for other to see:

Dexamethasone Suppression Test
Cortisol Basal 150.0 nmol/l 50.0 - 250.0 - 5.4ug base
Cortisol 3 hr post Dex 42.8 nmol/l - 1.5ug 3 hr
Cortisol 8 hr post Dex H 43.0 nmol/l 0.0 - 40.0 - 1.5ug 8 hr

so I can understand why your vet wants to verify with a follow up ACTH test. You want to be sure before starting any treatment.

As Marianne asked, can you tell us what symptoms led you to the cushings testing? Were there any results for ALKP or AST on the blood panel that was done? Typically these can be higher in cushings dogs. What about glucose. You want to rule anything else out before going with the cushing diagnosis.

That will get us started. :)
welcome again
Sharlene and Molly Muffin

[Izzy and Jasper]

Sorry for the late response had to get the rest of the results from vets here they are. The original reason Izzy went to vets was because she had some puddles in the house, drinking lots and she unknowingly wet herself (poor baby). By the way I have Jasper a Tibetan Terrier with Cushings too!!!!! he has had many bad reactions to Vetoryl so I am very concerned. So it looks like I both my babies have it could there be a connection?

The rest of the test results are below:

Film :
Occasional reactive lymphocyte seen
Platelet count appears normal in film


Total Protein 74.0 g/l 54.0 - 77.0
Albumin H 37.3 g/l 25.0 - 37.0
Total Globulin 36.7 g/l 23.0 - 52.0
Sodium 147 mmol/l 139 - 154
Potassium H 5.70 mmol/l 3.60 - 5.60
Sodium : Potassium L 25.75 27.00 - 38.00
Chloride L 104 mmol/l 105 - 122
Calcium H 3.19 mmol/l 2.30 - 3.00
Phosphate 1.23 mmol/l 0.80 - 1.60
Urea 4.7 mmol/l 1.7 - 7.4
Creatinine 52 umol/l 20 - 100
Total Bilirubin 1.1 umol/l 0.0 - 16.0
ALP H 1394 u/l@37C 16 - 55
ALT H 202 u/l@37C 18 - 56
Gamma GT 1.0 u/l@37C 0.0 - 6.0
GLDH H 100.0 u/l@37C 2.0 - 6.0
Bile Acids H 19.1 umol/l 0.0 - 10.0
CK H 1445 u/l@37C 50 - 230
Cholesterol H 18.0 mmol/l 3.8 - 7.0
Triglycerides H 6.42 mmol/l 0.56 - 1.69


Glucose Random 5.3 mmol/l 2.0 - 5.5


Amylase H 1053 u/l@37 100 - 900
Lipase 173 u/l@37 0 - 250


THANKS SUE AND IZZY :confused::)

[molly muffin]

hmmm, looks like the electrolytes are off a bit in this results. Did the vet address these results at all with you?

Oh wow, two babies, one with cushings could be exhausting. Usually the thing to remember with vetroyl is to start off at no more than 1mb/1lb, and if once a day dosing isn't working to control symptoms fulling all day and night, then split the dosage to twice a day dosing.

I am a bit concerned about the elctrolytes and what might be going on with Izzy. Was the LDDS test done at the same time as this test? LDDS could be false, if there is something else going on. So I'd want to be very sure of the diagnosis before starting any meds.

Sharlene and Molly Muffin

[Izzy and Jasper]

thanks everyone who has gave advice:) The Dex Suppression test was done 4 days after the blood test. Izzy wet herself unknowingly again yesterday evenining, she blew up like a big balloon aswell with a big swollen tummy??? And she has been sick twice with what looks like water where she just cant take any more on. My little princess is worrying me we have already gone through so much with Jasper. Thanks again :)

[labblab]

Total Protein 74.0 g/l 54.0 - 77.0
Albumin H 37.3 g/l 25.0 - 37.0
Total Globulin 36.7 g/l 23.0 - 52.0
Sodium 147 mmol/l 139 - 154
Potassium H 5.70 mmol/l 3.60 - 5.60
Sodium : Potassium L 25.75 27.00 - 38.00
Chloride L 104 mmol/l 105 - 122
Calcium H 3.19 mmol/l 2.30 - 3.00
Phosphate 1.23 mmol/l 0.80 - 1.60
Urea 4.7 mmol/l 1.7 - 7.4
Creatinine 52 umol/l 20 - 100
Total Bilirubin 1.1 umol/l 0.0 - 16.0
ALP H 1394 u/l@37C 16 - 55
ALT H 202 u/l@37C 18 - 56
Gamma GT 1.0 u/l@37C 0.0 - 6.0
GLDH H 100.0 u/l@37C 2.0 - 6.0
Bile Acids H 19.1 umol/l 0.0 - 10.0
CK H 1445 u/l@37C 50 - 230
Cholesterol H 18.0 mmol/l 3.8 - 7.0
Triglycerides H 6.42 mmol/l 0.56 - 1.69

Glucose Random 5.3 mmol/l 2.0 - 5.5

Amylase H 1053 u/l@37 100 - 900
Lipase 173 u/l@37 0 - 250

thanks everyone who has gave advice:) The Dex Suppression test was done 4 days after the blood test. Izzy wet herself unknowingly again yesterday evenining, she blew up like a big balloon aswell with a big swollen tummy??? And she has been sick twice with what looks like water where she just cant take any more on. My little princess is worrying me we have already gone through so much with Jasper. Thanks again :)

I am so sorry to add to your worries, but I am very concerned about the many abnormalities in Izzy's bloodwork that relate especially to her liver. We are used to Cushpup's exhibiting some abnormalities with liver enzymes, but Izzy has a whole range of elevations that are severe, with some uncommonly seen here. For instance, I did not even know what "GLDH" was until I just now read about it and discovered it is a marker that is very specific to liver damage. Given what you are describing, I am very, very worried that Izzy's main problem is with her liver. That would account for many of these lab abnormalities and also a swollen belly too -- from something that is called "ascites," or internal fluid build-up when the liver is not working properly. In view of the other elevations, I am surprised that her bilirubin is so low (bilirubin is another liver marker). But I am not well-versed in the ins-and-outs of liver problems, so I am not sure as to what different abnormal profiles may mean.

Regardless, I am so sad to say that she sounds like a very sick girl to me, and depending on how she is today, she may need emergency attention. Do you have access to any veterinary care during the weekend if she worsens?

Marianne

[Izzy and Jasper]

Thanks for your reply. Yes we do have access to a vet on the weekend I am going to call them now!!!! Will keep you informed.
Many Thanks
Sue and Izzy:mad:

[Mel-Tia]

Hi Sue

Just wanted you to know that you aren't on your own right now. I haven't posted to you before but have read along. Hope that you can get some answers as it's so scary when you don't know what's going on

Hope they get back to you soon. Big hug

Mel
Xxxxx

[labblab]

Here's a couple of links that may help make some sense of those elevated values:

http://www.2ndchance.info/dxme-GDH.htm

http://www.cpdsolutions.co.za/Publications/article_uploads/Liver_Tests.pdf?PHPSESSID=g55tg32191tvbd2tf682ibct 03

And here's an explanation as to causes of ascites, or fluid buid-up, in the abdomen:

http://www.petmd.com/dog/conditions/cardiovascular/c_multi_ascites#.Un4oyLK9KSM

This info may make it easier for you to ask your vet questions about what is going on with Izzy.

[labblab]

Is it possible that Izzy ate anything toxic recently, or has any new drug just been started?

[Izzy and Jasper]

Thanks for the links I have read these very helpful cheers:) I am waiting a call from the vet still, but I am more educated to what the blood tests say and will ask some more questions. As to whether she has ate anything bad I dont think so we do walk in the woods and she drinks from the puddles she is on no medication at present. I will let you know what the vet says.
Thanks
Izzy and Sue

[labblab]

I am so relieved you'll be able to consult with the vet. As you saw in that article, if Izzy truly is suffering from ascites, they may need to go ahead and drain some of the fluid off in order to make her more comfortable and also to help with further diagnostics.

We'll be very anxious to hear what they say!

[Squirt's Mom]

Hi Sue,

Please let us know what the vet has to say. I'm so glad Marianne spoke up - I was still trying to figure some of this out! ;):D Izzy has several abnormalities that I would want to completely understand before I spent another penny on Cushing's testing. SO many things can cause false positives on these tests and so many other conditions mimic Cushing's signs.

Puddles - make sure, as sure as you possibly can be, that no one has been spraying anything like RoundUp or other herbicides or pesticides that could run off and collect in areas where water will pool. If you are in a farming community, be extra cautious about allowing her to drink from puddles. When I was young (more years ago than we are going to talk about! :p), a puddle was just water but with all the chemicals we use these days, even rain isn't just rain any more. So we have to think about what could be in that puddle our baby is drinking from. ;)

Looking forward to your report from the vet.
Hugs,
Leslie and the gang

[labblab]

I absolutely agree with Leslie that before proceeding with any more Cushing's testing (like the ACTH), I think the liver diagnostics take top priority. If you have access to a vet who is able to perform abdominal ultrasounds, that may be the best "next step." That type of imaging will allow the liver, adrenal glands, and other internal organs to be viewed and assessed. And actually, you would want that imaging done as part of a thorough Cushing's work-up, anyway. So you are taking care of many questions with that single diagnostic.

[Izzy and Jasper]

Have just spoke to vet they have booked her in for scan on Tuesday, and call them if she gets any worse. So I think that will be the best thing to do.

[molly muffin]

Oh good Marianne, so glad you were able to go through the test results.

I absolutely agree I would not pursue cushings testing while anything is going on with the liver, as appears to be, the cushing tests would likely be invalid.

Hopefully she'll go fine over the rest of the weekend till Tuesday.

hugs,
Sharlene and Molly Muffin

[lulusmom]

Hi Sue,

Has Izzy been diagnosed with heart disease and is she on medication for it? If not, has your vet ever mentioned a heart murmur? Is she coughing? Has Izzie ever had pancreatitis and does she have a history of high triglycerides? Can you check the test results and let us know if the lab mentions anything about hemolysis?

Glynda

[Izzy and Jasper]

There has been no mention of any heart condition with Izzy, and she does not have a cough. back in March she had a small tumour removed from her leg and the infection after was severe with septic complications and the prospect of her losing her leg, she overcome this but now looking back she had 8 weeks of antibiotics could this have had an effect. Then in the summer her nose swelled up an went crusty and she had very sore eyes they tested this and found no cancer cells although it was a problem for 2 months with her restricted breathing in the end we used Piriton which seemed to help where more antibiotics didnt. Hope a bit more of her background helps. Do you know what they look for in an ultrasound? She is such a princess and a world without her is not conceivable.
Thanks loads
Sue and Izzy:confused:

[Squirt's Mom]

Hi Sue,

An ultrasound will look at many organs - the adrenal glands, the kidneys, liver, stomach, intestines, gall bladder, ect. This is a test that one of our members says gives "the biggest bang for the buck" - meaning for what this test costs, you learn so very much, more than any other test out there. ;) A good look at the adrenal glands goes a loooong way toward a diagnosis of Cushing's and determining if it is pituitary or adrenal based. An ultrasound saved my Squirt's life by finding a tumor on her spleen that would have ruptured and and more than likely killed her. The ultrasound is one test I cannot recommend strongly enough since it saved my Sweet Bebe. :) It is non-invasive tho they will shave her belly and Izzy may need a sedative to keep her still on the table. So a bald-bellied, groggy baby is usually the worst effect from this test - no big deal at all. ;)

You're doing a great job of watching Izzy, Mom! That is half the battle right there.
Hugs,
Leslie and the gang

[Izzy and Jasper]

Thanks for your comments and support, you have made me feel easier about the scan, and I know a bald bellied Izzy will still be a cutie:)

[lulusmom]

Hi Sue,

I only had a minute when I posted last night so didn't have time to tell you why I was asking about heart disease. Both of my boys with congestive heart failure have had high GLDH and CK. I don't remember how high the numbers were but the vet explained to me that these respond to muscle injury and the heart is one big muscle. I had never seen GLDH on any bloodwork before that, nor did I know it was liver specific until Marianne posted her concerns. I've done a lot of research on liver disease and I don't recall reading about GLDH or hearing it referred to in the veterinary audios I've listened to. These blood values can change on a dime but based on what you told us about Izzie's symptoms and the results you posted, I didn't automatically think liver disease. You would not see low normal bilirubin, you would see much higher elevation in ALT, you would see elevations in another liver isoenzyme, AST, which I don't see on your test results at all. I believe you would definitely see low albumin if a dog had ascites.

Does Izzie have a history of high triglycerides and can you check the bloodwork and let us know if there is any mention of hemolysis?

Glynda

[Izzy and Jasper]

Hi there, to let you know her Triglycerides reading was 6.42, her ALP was 1394 and ALT 202 does this help. The first reading I sent was not complete the full bloods I have are further in the thread. Hope this helps you to help me further.
Many thanks
Love Sue and Izzy

[Squirt's Mom]

Would you mind posting the normal ranges for those values? It's those that are too high or too low that we are interested in seeing. ;)

[lulusmom]

Hi again.

Sorry for the confusion. I did notice that the results you posted showed high triglycerides and cholesterol. This is not an odd finding in a dog with cushing's but is also not an odd finding in and otherwise healthy mini schnauzer, as this breed is genetically predisposed to hyperlipidemia. I was more interested in whether Izzie had high triglycerides on older bloodwork, perhaps done on annual senior panels in the last few years. I'm also still interested to know if the current lab results say anything about "hemolysis"

[lulusmom]

Leslie, she already posted those results with the normal reference ranges. All were elevated and consistent with what we see in a cushdog. Here they are:

ALP H 1394 u/l@37C 16 - 55
ALT H 202 u/l@37C 18 - 56
Triglycerides H 6.42 mmol/l 0.56 - 1.69

[Squirt's Mom]

:o:o:o oops! :o:o:o

[Izzy and Jasper]

Ive not heard of Hemolysis before I dont think they are on her blood results. I will look up what Hyperlipidemia as I have not heard of this either. I cant thank you all enough for you help.
Thanks loads
Sue and Izzy :)

[lulusmom]

Hyperlipidemia is a condition where a dog has high levels of lipids (fat) in the bloodstream. Hemolysis can occur with too much fat in the blood or from improper handling by the lab. Depending on level of hemolysis, it can have minimal to great impact on increase and decrease in values on blood chemistry.

[labblab]

Just wanted to stop back to add that I most definitely am not a liver expert, and nobody will be happier than I if it turns out that Izzy doesn't have specific liver issues!

What I found especially worrying, though, were these two values since they do not commonly appear on reports of blood chemistries:

GLDH H 100.0 u/l@37C 2.0 - 6.0

Practically liver specific, this enzyme is localised almost exclusively in the mitochondria of hepatocytes. It is generally considered that a severe insult is required to bring about its release and it is therefore not a sensitive general marker for hepatic disease (but see below): GLDH has been demonstrated to be a sensitive marker of hepatocellular necrosis in the dog irrespective of its severity. It is considered to be at least as specific as ALT as a marker of hepatic disease in the dog.

Bile Acids H 19.1 umol/l 0.0 - 10.0

The measurement of fasting bile acid levels is at least as sensitive as either the bromsulphthalein clearance test or the ammonium tolerance test as a measure ofr hepatic function.

We've already mentioned the GLDH, and as I say, I'd never heard of it before. But everything I find on Google describes it as a liver-specific marker that often accompanies acute liver assault. Since Izzy's value is astromonically higher than the reference range, it definitely caught my attention.

As far as bile acids, I know they are also a diagnostic related to liver function. However, I believe they are often tested within very careful parameters, first on a fasting basis and then also again later after a meal. Since there is only one result given for Izzy, I assume this is a fasting level. But I don't know any specifics as to how the test was conducted, and as a result, I'm really not sure how to interpret it. But since Izzy's is almost twice the reference range, again, it stood out to me as a red flag. If it *was* a fasted sample, per the quote above, it seems that an elevated result can be an indicator of liver dysfunction.

The thing is, since neither of these values appear frequently on lab results, it made me wonder whether Izzy's vet specifically requested some "extra" liver analysis out of a related concern. It's true that Izzy's ALKP is not unusual for a Cushpup, but at almost a four-fold increase, the ALT seems awfully high. Yes, the low bilirubin is a puzzle as is the lack of elevation in AST and GGT. But from the little I have read, it sounded to me as though elevations in different combinations of liver markers could point towards different types of issues. So that has been the source of my concern here. But I may be absolutely off-base, no question about it.

As I said earlier, though, I think the ultrasound remains a great "next" diagnostic, no matter what. So I don't think anything is being lost in pursuing that imaging, and there may be a lot to gain.

Marianne

[lulusmom]

Marianne, I definitely did not mean to infer that you were off base in any way. As I said, I had no idea GLDH was even a marker for primary liver disease. Bile acids are commonly elevated in cushdogs and according to either Dr. David Bruyette or Mark Peterson, while not the norm, they can be as high as 75 umol/l but anything over 50 umol/l would be suspicious for primary liver disease. I get my experts on audios mixed up sometimes. :o

[labblab]

Glynda, no offense taken at all! I truly only know bits and pieces when it comes to liver function, and definitely didn't know that bile acids are often elevated in Cushpups. I don't think that's anything that we've ever talked about here on the forum. I know we've recommended that people pursue bile acid testing if there is concern about evaluating liver dysfunction. But from what you are saying, the result is really not diagnostic in a Cushpup unless it is WAY elevated?

Marianne

[Izzy and Jasper]

Izzy had her ultrasound scan yesterday. It all seemed pretty scary, her adrenal glands were enlarged her right one being the most, her pancreas was enlarged with cysts, her liver was enlarged and discolouration patches, her bladder was described as a deflated balloon, her kidneys looked very pale. They also found a lymph node with a cyst so she then had a aspiration taken from her liver. The vet and ultrasound consultant said it is Cushings and she will need to go on Vetoryl but we will discuss further when the liver test results come back on Thursday. I just did not expect such a mixture of abnormalities in my princess. I am scared about Vetoryl as Jasper (my other baby) has had so many side effects from it that we have decided not to give it him anymore.
I am so confused, upset and overwhelmed.
Sue, Izzy and Jasper :(

[doxiesrock912]

Sue,

every dog responds completely differently. The Vetoryl might work for Izzy and you know what to look for from experience and can alert the vet as soon as you spot trouble.

[labblab]

Sue, can you ask whether there is a written report of the ultrasound exam and the results of the aspiration of the lymph node and liver? With so many abnormalities, it would be really helpful to see the actual descriptions and accompanying professional commentary.

Also, can you tell us a bit more about Jasper, his diagnosis, and the problems he had with Vetoryl?

Marianne

[Izzy and Jasper]

Hi, as to the ultrasound written results I will ask my vet when I speak to them next. The aspiration was only taken from her liver as they could not get to the lymph node but the result of this test is due tomorrow. When they did the scan my vet said that it showed that Izzy had Cushings?
As to Jasper he has had a host of problems in the last 11 months- he went Addison had pancreatitis and lots of colitis. He has tried various amounts of Vetoryl (I have a cupboard full of different dosages) and my vet has even spoke to Dechra who did say that there are cases of dogs not responding well to treatment. He has been of it now for 3 weeks and is much happier in his self, although he has Cushings. His hair is falling out he has blackening skin and wees for England but he is just more alert and content without the drugs.

Thanks so much for all you do
Sue, Izzy and Jasper

[goldengirl88]

Sue:
I agree every one of these dogs reacts differently to this drug in their systems. I thank God my Tipper was able to take it as her symptoms were so bad she was feeling horrible. Blessings
Patti

[molly muffin]

I agree with Marianne it would be good to see the actual ultrasound report.

As for him being on vetroyl and then he went Addisons while on it? This is something we see happen, when they give too much and don't do follow up testing per protocol usually. For instance, staring dosage should be 1mg/1lb according to more recent studies than Dechras original ones. Then if you need to you do small dosage increases until you get it to what is right for that particular dog. We've seen that doing it this way, which might take longer over all, to hit the right dosage, does in fact, allow their bodies to get use to it much better than other wise. Less chances of Addison crashes, or them reacting to sudden drops in cortisol, which can make them feel awful. Give vetroyl with a bit of food, some of it a bit fat soluable (this enables better absorption of the medicine), testing to be done after the morning dose which is given with a bit of food, approximately 4 hours after the dose. Completed testing 4 - 6 hours after dosing.

I'm not sure if that information helps you at all, but maybe it will.

So, lets see what the test results say tomorrow and exactly what that ultrasound says and take it from there.

hugs,
Sharlene and Molly Muffin

[labblab]

Just checking in on you, Sue, and hoping to hear whether you've gotten Izzy's reports back yet?

Marianne

[goldengirl88]

Sue:
Checking in to see if anything came back on your baby yet?? Blessings
Patti

[goldengirl88]

Just read you post to Barbara and heard the fish oil worked for Jasper. I was glad to read that as I just started Tipper on it Saturday.