Spencer - Ready to start trilo, now three seizures in an hour (Spencer has passed)

[Spencersmom]

:confused:

Hello everyone. First of all, I would like to think you for this website and the resources/support that comes with it. I will try to provide as much info as I can.

Currently, I am waiting on results from Cushings screening that were performed last friday, 3/7/14. Bloodwork has been sent to University of Michigan so I won't have numbers back until probably the end of this week.

Why was the test run? Spencer is exibiting a lot of symptoms as follows:

Very bloated belly
Thin skin with little to no hair on his abdomen
Enlarged liver
Elevated liver enzyme - one was very high (will provide later today or tomorrow)
Thyroid slightly low
Thick waxy coating on his penile shaft under the foreskin (His Dr had never seen this but researched and found Cushings can be a cause)
Very lethargic
Low body temp
VERY hungry

One symptom he does not show is extreme thirst.

I was concerned last November about the swollen belly, thinking he was gaining weight and he was having incontenence issues in the house. Blood panel was run for baseline and showed some elevation in liver enzymes. That's when the Dr ran an xray and found his liver was enlarged. Current tests run last week show a marked increase in liver and his Dr feels it is really being stressed.

I have an appointment this afternoon, as I suspect he is having seizures. Three times now in the past 2 weeks, he has cried out in the middle of the night. He doesn't move, just cries until I stroke him. Last night was his latest episode and because the TV was on and the room illuminated, I was able to see him. As he cried out the two times, his head had a slight tremor. The cries and tremor only lasts a matter of seconds, but afterwards he doesn't move or respond for a minute or so. His eyes are open, but he just lays very still on his side until I physically move him.

My concern is how much his condition is changing. For historical purposes, he is 11 1/2 years old. He is a Chihuahua, normally around 6-7 lbs but now weighs 9 1/2 lbs. January 2013, he was neutered due to enlarged testicle suspected with cancer. His Dr felt they removed it all. Is it possible that there might have been some cancer that could have spread, causing the Cushings? All of this has come on since his surgery.

We just lost our other Chihuahua a month ago to liver failure. My heart is being ripped out right now. I'm worried sick and don't know what to do!!

[Squirt's Mom]

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[labblab]

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Marianne

[Spencersmom]

Additional observations I forgot to mention. Spencer has noticible and marked weakness in his hind quarters and I recently noticed a pivot to his rear legs when walking. He has a hard time walking on the laminate floor in the kitchen.

Last friday, when I brought him home from the testing, his right front leg would drag and knuckle under completely causing him to fall. At one point, he tried to poop, fell over on his stool and couldn't get back up. Later he was able to walk but still had a slight drag to the right front paw.

He looks sad all the time, unless he thinks there is food around. He begs like crazy and gobbles anything we offer him. He doesn't clean out his kibble bowl though. We have him on weight maintenance Organix.

I have an appt with his Vet this afternoon over the seizure concerns. I hope to get copies of his current blood panel to post here.

Thank you again for any insight you may be able to provide and any questions I should prepare to bring with me.

[Harley PoMMom]

When a dog has Cushing's their body is producing excess amounts of cortisol. This increased cortisol level makes the kidney work harder and thus the dog has to drink a lot more water to keep up with the high urine output from the kidneys.

I believe most of Spencer's symptoms can be attributed to Hypothyroidism instead of Cushing's, even the seizures. The buckling or knuckling sounds more like a neurological issue.

Getting copies of Spencer test results and posting them here would be great...Thanks!

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

Hugs, Lori

[Spencersmom]

i hope to have Cushings results soon! Thyroid is definitely not the issue based on his other results. Panel results below are in house Vet screened broad blood panel, only elevated or low results shown. Normal will not be included.

ALP - 1227 ( normal 5-160). nov 2013 was 217
ALT - 280 (normal 18-121)
GGT -36 (normal 0-13)
BUN -33 (normal 9-31)
Cholesterol -722 (normal 131-345)
glucose 133 (normal 63-114)
Phosphorus 7.5 (normal 2.5-6.1)
Chloride 103 (normal 108-119)
potassium 7.5 (normal 4.0-5.4)
Auto Platelet 853 (normal 143-448)

Will post the other results when they come in. dr plans to discuss his case with UofM endocrinologist with all symptoms he has displayed!

[Spencersmom]

i apologize....so focused on the issues, I left out my manners!!! My name is Terry, I'm originally from Texas but now live in Michigan. (Still buried in snow). i've had Spencer since he was 8 wks old. He had a LOT of personality, spit and vinegar! So much of his decline I thought at first was from late age neutering due to incision of Inguinal cryptorchid. He was never the same after surgery, but lately has declined markedly in the past 6 months.

Before joining i took time to read threads and as much info as my brain could absorb. It's really overwhelming and i've not even gotten to the treatment phase with my pup!

Raising my kids was so much easier, and one had severe allergies and asthma!

[Harley PoMMom]

With the phosphorus, potassium, and Chloride being elevated, these point to a kidney issue. When the phosphorus is high a binder might be needed, high phosphorus levels can cause inappetence in a dog.

[Harley PoMMom]

Hi Terry!

It seems that I've also lost my manners. :o

I want to tell you how sorry I am for the loss of your dear Chihuahua furbaby. Loving them comes so easy but losing them is so very hard. My heart goes out to you, and I'm sending huge comforting hugs, Lori

[Spencersmom]

Thank you!! Lexi was 14 1/2 years old and was suffering liver failure. After spending 4 days in the hospital, and giving us hope that she would pull through, she started crashing. Liver enzymes went thru the roof. One that was normal below 200 shot up to 15,998, and biliruben went to 5.7 when normal is under 0.9. She was turning yellow and her Dr felt she was suffering, so we had to make that dreadful decision all furparents hate facing. It broke my heart to let her go, so the problems we are now facing with Spencer are almost more than I can handle. I've cried more tears than I knew I had. Right now, I know he is uncomfortable and not enjoying life. I keep asking myself if it's worth putting him thru more, will he be able to handle the medication if Cushings is positive, what is the best decision for him, what should I expect long term.

Too much to think about!!!:(

[Harley PoMMom]

Cushing's is a treatable disease, really it is. Some dogs go undiagnosed for years and once treatment is started and they are stablized they go on to live their normal life span and usually with complete resolution of symptoms.

Left untreated, the dog usually develops internal organ damage due to high cortisol production, in addition to all of the symptoms that you can actually see. It's the organ damage that is very important to try to prevent by treating with a proven to be effective cortisol-lowering drug, such as Trilostane or Lysodren. We have folks here treating for years with one drug or the other, and whose dogs are doing really well.

[Spencersmom]

I really appreciate the reassurance! I've read other comments that Cushings is such a horrible disease, etc...it has really had me worried. How long does it take for organ damage to happen? I'm concerned that may have already started happening. His Dr is totally perplexed at some of his symptoms, such as his crying out at night while he is asleep. Once she gets his results back, her plan is to speak to the endocronologist at University of Michigan to discuss his case. I hope they have some answers and a successful treatment plan to put in place.

[molly muffin]

Hello Terry and welcome to you and Spencer. I'm very sorry for the loss of your dear Lexi. :( My condolences.

Hmm, I see the glucose is also very high. With so much having gone on with Spencer's blood work, I'm really happy that your vet is consulting with an experienced IMS. If I had an option, I'd probably get an ultrasound if possible, and look at all the internal organs, not just liver, but also gall bladder, kidneys, spleen, pancrease, everything. I'm not sure that I think this is cushings right now. I'd definitely look at the kidneys I think.

These are some options that you can discuss with your vet too. Poor Spencer, you and he have had a rough time lately. It certainly isn't easy, not cushings, not anything else that make us worry for our furbabies.

Again welcome to the forum
Sharlene and molly muffin

[Spencersmom]

Spoke with the Dr yesterday evening and she is almost 100% certain he has Cushings, just waiting on the last result to confirm. Her preferred course of treatment is to use trilostane. Most of what I've read, this is second choice after Lysodren. Will discuss in more detail when all final results are in and we go back for determining a treatment plan.

[molly muffin]

Vets can use either lysodren or trilostane, it depends on what they are most comfortable with, have used the most and/or think would work best for your furbaby.

Sharlene and Molly Muffin

[Spencersmom]

I must say, coming to this forum has helped my nerves tremendously. My Vet has ordered meds and I will be going tomorrow to pick them up and have the big discussion regarding everything concerning his treatment plan.

If there are any suggestions for questions I need to ask, based on what has been covered so far, I could certainly use the input and respectfully appreciate any and all advice given. Not sure I know what all I should be asking!!

I'm anxious to have my little guy back to his normal little self. You would be amazed at how much he has changed in the past 9 months!!!

[molly muffin]

What medicine was decided on? If trilostane, keep the dosage very low to start out. (did they say what the dosage would be) Also find out when they will want to do the first follow up test.

The vet should go over all the signs of an overdose and things to watch out for and what to do if you see any of those signs.

The forum is a great place. :) Others will be stopping by to give their thoughts too.

hugs
Sharlene and molly muffin

[Harley PoMMom]

I would first ask the vet how many dogs with Cushing's has s/he treated sucessfully. If the vet is more comfortable with Trilostane, I would want to know if the vet uses the UC Davis protocol or Dechra's.

Dechra is the maker of brandname Vetoryl and in their product insert they recommend a starting dose of 1-3 mg per pound of a dog's weight.

UC Davis, on the other hand, recommends initiating Trilostane therapy at 1 mg per kg of a dog's weight once daily.

Here are the links to the articles that have this information:

Dechra: Dechra's U.S. Product Insert ( http://www.dechra-us.com/files/dechraUSA/downloads/Product%20inserts/Vetoryl.pdf)


UC Davis: Comparing therapies for canine hyperadrenocorticism (http://veterinarynews.dvm360.com/dvm/article/articleDetail.jsp?id=460965&sk=&date=&pageID=1)

I would ask the vet what their protocols are regarding monitoring ACTH stimulation test and if they follow Dechra's. According to Dechra, Trilostane must be given with food to be properly absorbed. Also, the timing of the ACTH stim test is very important too, as it should be done 4-6 hours after the dose of Trilostane is given.

These are just some of my thoughts! ;)

Hugs, Lori

[Squirt's Mom]

Lori's questions will guide you well! You don't want a vet who has had poor luck with one drug or the other, OR is new to using the drug. Experience and successful experience! ;)

Bear in mind your financial situation as well. Trilostane (Vetoryl) can be more expensive to use because this drug often requires frequent dose changes and with each dose change the ACTH monitoring schedule starts all over again.

[Spencersmom]

He woke me up at 2:08 am crying out from the first mild seizure, then the next one came at 2:50 am, then just 10 minutes later the worst! He was visibly seizing, crying out and ended up peeing uncontrollably. The last one took at least 5 minutes or more to recover from! We have an emergency hospital close by, so we took him there, where he is staying until his regular clinic opens!

Spencer is supposed to start his cushings treatments today, but I don't know what to expect now or what to do! Can cushings cause seizures????

This mornings episode is the 4th one in 3 weeks, at least that we know of, and the seizures seem to be getting worse!

[Trish]

Oh my gosh, so sorry to hear this. What an awful scary night for you all. I hope he is feeling better in the morning and you can come up with a plan with the vets. I am sure those that have dealt with seizures will be on a bit later and will be able to help with your questions. I just want to let you know I am thinking of you and Spencer.

[labblab]

I'm so sorry to hear about Spencer's seizures. I am guessing that starting treatment for the seizures will take precedence today over the Cushing's. Three within the space of an hour is indeed considered an emergency situation, so you did the right thing by taking him in.

Cushing's, per se, does not usually cause seizures. One exception can be if the Cushing's is caused by a pituitary tumor that is rapidly enlarging and placing pressure on other areas of the brain. Seizures can occur in this situation, but they are not the most common symptom. It sounds as though Spencer has been having some other neurological issues, too. So you may be well served by consulting with a vet specialized in neurology at this point in time, both to try to get a clearer diagnosis and also to oversee the coordination of medication in the event that Spencer moves forward on both an anticonvulsant as well as the trilostane.

I hope it is OK, but I have merged your new post into your original thread and I have taken the liberty of revising your thread title to reflect these new developments. Please do keep us updated!

Marianne

[goldengirl88]

So sorry to hear about the seizures. That is indeed very troubling. There have been several people on here who have dogs that have been treated for seizures, so I hope you are able to get a plan worked out for your baby. Blessings
Patti

[Spencersmom]

Marianne, thank you for merging the two threads. I wasn't sure how to handle Spencers' new development.

He certainly has refused to stay within the norm regarding symptoms. When the vet tech checked his temp, thinking it would be elevated from the seizures, it was actually 98.6 which is pretty much where his temp has been lately. Don't dogs normally have body temp in the 101 range? They set his crate up with a warm water pad to lay on.

We go to get him in an hour, then straight to his regular Dr. We have a lot to discuss!

[goldengirl88]

Yes a dogs temperature ranges from 101 to 102.5

[Spencersmom]

spencer's results from the low dose dex test were:

Baseline - 238 (ref range 15-110)
6 hrs - 58 (ref range - 0-30)
8 hrs - 104 (ref range 0 - 30)

finding is likely pituitary dependent cushings, per MSU. I thought it was U of M doing the test, but it was Mi State.

Dr has started him on Vetoryl, 1 10 mg capsule per day, testing on day 12. He has developed a runny nose so we have a course of antibiotics. For the seizures, she wants to see if he has another episode like this morning. if so, I have some Valium, and emergency within 5 mins of my house. She wants to get the cushings addressed first.

So I hope this is a good course to take! Dr. was very happy I found this support group too!!

[Spencersmom]

Spencer is having seizures at more frequency. Woke me up again this morning at 5:20 having another Grand Mal!! So far it has only occurred during sleep. At least as far as we know! It worries me if he has any during the day while we are at work.

[labblab]

This is just my layperson's opinion, but having had both a Cushpup and a dog with seizure disorder, I do believe the seizure management takes far greater precedence over the Cushing's treatment right now. From the things I have read, seizures of this frequency (three within an hour) really do constitute an emergent situation. And from what you have written, Spencer has now had seven seizures within 2-3 weeks. There is nothing about Cushing's, per se, that would commonly be causing seizures other than the possibility of a pituitary macrotumor. And in that event, the better choice may be to not treat the Cushing's at all so as to facilitate the anti-inflammatory benefit gained from steroids.

There are still lots of question marks about seizure disorder, but one school of thought worries that allowing seizures to continue and worsen can lead to brain changes and greater difficulty in ultimately gaining good control. Since Spencer has already had another grand mal seizure so soon after the triplet, if he were my dog, I would not want to wait any longer to be discussing treatment.

As I wrote earlier, you really may benefit from a consultation with a neurologist at this stage. The knuckling and paw-dragging that you are describing are additional neurological symptoms that bear assessment. Please bear in mind that the LDDS test can return "false positives" for Cushing's in the presence of other, nonadrenal illness. The runny nose raises a little bit of a red flag for me. What does the vet think that's about? Could he have some kind of infectious process going on that might be related to the seizures? Also, I remain curious about Spencer's thyroid results since hypothyroidism is a known cause of seizures and so many of his other symptoms are also consistent with low thyroid. It is true that low thyroid levels are often secondary to Cushing's with spontaneous resolution once the Cushing's is controlled. But some Cushpups additionally suffer from primary hypothyroidism that requires treatment in it's own right. Michigan State is well known for their expertise in assessing thyroid function. By any chance, did they analyze Spencer's thyroid panel as well as the LDDS?

If you do opt to continue with the Cushing's treatment right now, your vet can talk directly to Dechra, the manufacturers of brandname Vetoryl, in order to see whether they have any helpful feedback re: trilostane/anticonvulsant combinations. But if it were me right now, I would focus my attention on exploring the cause and treating the seizures.

Marianne

[Spencersmom]

Marianne, one thing his vet mentioned that could be related to the seizures is his high cholesterol. Is there any other way to diagnose seizures other than doing a MRI? We can't afford that kind of expense right now

Do you think valium will help? Also, should he have it after just one seizure? I didn't dose him with valium this morning, as he recovered quickly and was alert, hungry and able to walk around ok.

He is also taking antibiotics as a precaution, his Dr said cushings can suppress his autoimmune system and the runny nose could be the start of something. Drainage is clear at this point.

His thyroid is a little bit low, but only by a small margin. I think I included it earlier in the thread. With all the symptoms he has that are common to cushings, his Dr feels pretty certain that is what he has. She is concerned about the seizures and was back & forth what to address first, and I won't be surprised if she changes course if the seizures continue to worsen.

[goldengirl88]

The only help I can offer you is this: I read an article written by Dr. Jean Dodds stating that when a dog is having seizures the first thing she looks at is their thyroid, so that goes with what Marianne's said. Also you can send your results to her for 100.00 and she will advise you what is going on and what you need to
do. my Tipper had thyroid problems, I could recognize the symptoms, and my vet did not want to treat her. She is now on thyroid medication and doing better
with everything associated with it. If feaseable maybe you could get a consult with Jean. I do know for a fact the neurologist I took Tipper to said most seizures happen at nite when the brain is sleeping. I have seen several members on here with dogs having seizures. I am with Marianne in saying this needs attention immediately. Blessings
Patti

[labblab]

Hi again, Terry. Sorry that I have only a moment to post right now and will be gone for the rest of the day. But I did want to quickly mention these things.

Yes, I do believe that high cholesterol and/or high triglycerides can cause seizures in dogs. I can't remember the specifics re: the exact mechanism, but you can research this further on the internet. It is also true that Cushing's can be associated with high cholesterol. So if Spencer does have Cushing's, over the long run, control of the Cushing's can also be helpful in reducing the issues with high blood fat, too. So I am not saying the Cushing's should never be addressed -- I'm just talking about which pot of water would be boiling on my front burner right now.

You're right that an MRI would be very costly. But in terms of exploring the cause of the seizure, I'm talking about more specialized labwork and/or a physical assessment by a neurologist. For instance, a more complete thyroid panel may be helpful (more than just looking at a single T4 result on a general blood panel). As Patti says, Dr. Dodds performs this type of analysis. My own personal preference would be to submit a complete thyroid panel to Michigan State University with a request for endocrinological interpretation. There are thyroid issues that can reveal themselves on a complete panel of which you'd be unaware just by looking at a single T4 value. There are also other types of labwork that can be performed to try to search for the cause of seizures. Again, if you search the interet under "diagnosing canine seizures," you'll get a lot of information.

Lastly, I'd have to defer to your vet's instructions as to when and how to use the valium. My understanding is that it is a short-acting drug that is given more on an emergency basis when you are trying to interrupt a cluster of seizures or an especially long-lasting seizure. It is not given on a daily basis to prevent seizures in the future. For that, you'd have to switch to a different type of anticonvulsant medication.

Marianne

[goldengirl88]

Just checking in to see how things are going today.Hope you got enough information to have some options. Blessings
Patri

[Spencersmom]

Hi everyone! Update on Spencer. Spoke with another Dr today who is one of the Senior Vets where I go and she feels, based on Spencer's symptoms and test results that he has a tumor in his brain. I've picked up Levetiracetam today and have started him on it to see if we can get the seizures under control. He had another one saturday morning about 5:30am and again this morning around 1:30am.

Looks like our treatment options are to try to control his disease as best as possible and give him as much quality of life as we can for as long as we can.

She agreed with me that an MRI would be expensive and while it would certainly answer questions, it wouldn't provide a cure if it is a tumor.

Right now we are going to see if the meds provide the control we desire and then go from there as far as any additional tests are concerned.

Today he was more alert and interactive than what he had been. He even barked at me this morning because I wasn't getting his breakfast ready fast enough.

[goldengirl88]

I am so sorry to hear this. Do you mean a separate tumor from the pituitary, or do you mean a pituitary tumor? I too would want to see if the seizure medication will help. I am hoping it stops the seizures, and like you said a better quality of life. God Bless you and Spencer, I wish I had a magic wand to make it all better.
Patti

[Spencersmom]

There was no distinction as to what kind of tumor, just that her experience with his onset of symptoms and tests indicate neurological disease, most likely tumor. His progression has been rapid, she feels too much so to point towards anything cushings or thyroid related in regards to the seizures. I just hope the meds help him and he gets relief!

[molly muffin]

awww, poor boy. What a tough time and seizures are very scary to watch. You feel so helpless during them.
Sending you big hugs and hope that this helps

hugs
Sharlene and molly muffin

[labblab]

Terry, I am very relieved to hear that Spencer has started taking the seizure medication, and I will cross all my fingers that he quickly benefits. It's interesting that he is already looking a bit "brighter" to you. My seizure dog, Peg, takes phenobarb and with some patients, that drug leaves them somewhat dulled. But after she got over the initial side effects, she seemed a lot perkier than she had in a long time. We now suspect she had probably been living under sort of a neurological cloud for quite some time before she actually started having the grand mal seizures. Even though we still don't know the cause (we didn't opt for an MRI, either) and it could well be a tumor of some type for her, too, she's done very well for three years now. I surely hope you have the same good fortune with Spencer!

Marianne

[goldengirl88]

Just checking in to see how Spencer is doing today. I hope no seizures over nite.
Blessings
Patti

[Spencersmom]

Morning all. I just wanted to report in that Spencer did have a seizure this morning at 12:45am, however it was a small one. No grand mal this time. He only cried out once and the tremors were not as intense and only lasted a few seconds. Possible improvement, maybe??? I'm keeping my fingers crossed!

Marianne, I'm hoping we have the same good results that you've experienced. The medication he's on is relatively new from what I've researched and has less side effects. Also, it's not as hard on the liver as other meds, and can be taken in conjunction with the cushings treatment.

We are giving him a few days to see how he responds and will revisit with his Vet and go from there.

Please keep him in your thoughts and prayers that he gets relief....and nights of great rest and no seizures!!! He's been through a lot in the past 2 months, loosing his companion while dealing with his own illness.

[labblab]

Terry, for what it is worth, you are proceeding just as I would be doing, and I am so glad your vet has researched a medication that is a better combo with the trilostane. I'm not familiar with this drug, so I don't know whether it takes some time to get to full therapeutic level, but that is often the case with anticonvulsants. Plus we realize we've been unusually lucky that Peg has been totally controlled; it's to be expected that occasional seizures may still occur even with treatment.

All in all, I just want you to know I think you're handling a really tough situation really well. Hang in there, OK?!! And absolutely, Spencer will be in my prayers!

[Squirt's Mom]

All in all, I just want you to know I think you're handling a really tough situation really well. Hang in there, OK?!! And absolutely, Spencer will be in my prayers!

DITTO to what Marianne said! DITTO TWICE! :)

[goldengirl88]

You are doing a wonderful job, I know this has to be horrible to watch, but just pray that the seizures lessen like Marianne said. My heart goes out to you. Blessings
Patti

[molly muffin]

Just checking in on you and Spencer today.

Glad the seizure was a small one. Maybe on the road to none at all?? :)

Sharlene and molly muffin

[Spencersmom]

I can't thank y'all enough for the words of encouragement as well as all the helpful advice. Knowing what kinds of questions to ask has been huge. We also took advice provided to get copies of all test results and created a binder that I am logging his meds, and seizures as well as how many ounces of water he is drinking per day. We have a scale that we are using to accurately track his consumption.

With your help, our Vet as well as the techs have been impressed with our "thoroughness"! I really can't take credit, and I've let them know of your forum. You are such a wonderful resource and your concern for Spencer has brought me a tremendous amount of comfort!!!

[goldengirl88]

Again, you are doing an excellent job. You Spencer is lucky to have you.

[doxiesrock912]

Knowledge is power and Cushings has shown us that we HAVE to know what we're talking about because too many vets don't know enough.

Praying that Spencer improves soon!

[My sweet Ginger]

Hi, how often is spencer getting Levetiracetam in a day?
My Ginger's been on this drug for about 3 months for focal seizures and the whole body and leg tremor and I have to give it to her three times a day because of it's short half life. Although I read or hear that focal seizures and tremor are two different things it somehow keeps Ginger's condition under control tho not completely.
I actually saw the difference almost immediately the very first time and I thought it was amazing. I didn't really see any side effects from this drug and I make sure she takes it with food even though her neurologist said that's not necessary.;)
After three months on this med we are about to switch to Zonisamide with twice a day dosing.
Although we've come to manage the three time dosing schedule (7 am, 3pm and 11pm) the late night @11pm dosing has become a big ordeal for Ginger who's almost always sound asleep by then and I pretty much have to force her to take it and often times it becomes a battle of will between us:o and I don't think that's any kind of comfort for her.:rolleyes: Another reason for switch is I think this drug was losing it's effectiveness gradually as I see seizures and tremors are coming back more quickly now like only a few hrs after she takes it.
We will try Zonisamide for two weeks and evaluate and decide.

I hope Spencer will be helped with this drug because it makes a big difference not just to the dog but even to the owner who has to helplessly watch your dog suffer and that's just the worst feeling.

I apologize this got a little long I but was just wondering about the dosing frequency.:) Take care. Song.

[molly muffin]

Terry, it is to Your credit that you have taken in so much information about cushings and testing and seizures and everything else in order to work with your vet team to do the best that can be done for Spencer.

You are the best advocate and only advocate/voice that Spencer has and you are doing a wonderful job of it :)

hugs to you,
Sharlene and molly muffin

[Spencersmom]

You all have really humbled me!! My hubs and I have done what we have done only because we love our furbabies and feel that we assumed a responsibility to see to their care and wellbeing from the time they came into our lives, until the time they leave us. I don't feel we are doing anything special.....we are doing what's responsible!!! We have given them nothing less than we would give our child, because after all, that's what they became!

Spencer had a good evening. Came to meet me when I came home, and followed me around in the house. With his swollen belly and hind quarter weakness, this is a challenge, but we try to encourage him to walk as much as possible without exhausting him during this phase.

He's still really hungry so he will continue to receive the cushings meds once a day. Seizure meds are 2X per day, since we can't manage 3X's a day with our work schedule. Keeping hopes up he sleeps well all night tonight!

I haven't mentioned the personal stress because I've tried to keep this about Spencer, but the physical and emotional toll has been enormous! Not sleeping at nights waiting for him to seize, checking on him constantly.... It's really overwhelming! Sorry if I sound like I'm whining....just venting a little! My hubs on the other hand has been so sweet!! Last two weekends, he has handled all household chores so I could just spend the whole time holding Spencer!

[molly muffin]

oh my gosh Terry, we support Spencer And you! So don't worry about saying anything at all.

Of course this takes a toll, ask anyone on here, they'll all agree, it's a nightmare at times and very little sleep is almost a norm for some. You're in good company. :)

Awww, your husband is a real sweetheart to jump in and take on some of the chores so you can be with Spencer. That is very sweet. We have some good furbaby mums and dads around here. :)

I know, we just all worry so much about them, and there isn't any way to Not worry. Having a cushings dog or any sick animal is all consuming. You just try so hard to always make sure they are comfortable and that all is the best it can be and sometimes that comes at a very heavy personal expense. Grab naps with Spencer when you have the chance. :)

hugs
Sharlene and Molly muffin

[My sweet Ginger]

What I forgot to mention in my last post was that we could've gotten Levetiracetam extended-released formulation tabs which come in 500mg, twice a day option but since you must not break these tabs and Ginger only weighs 10 lbs we couldn't. If Spencer weighs more than Ginger maybe you can look into it.

[goldengirl88]

Just stopping in to check in on Spencer. Hoping to hear he was seizure free for the nite. You feel the same way about Spencer as all of us do about pour babies, they are like our children. Blessings
Patti

[Squirt's Mom]

Awww, Terry. You don't even have to say a word - we know the toll this is taking on you and your hubby. One of my family members told me several years ago that I spend too much money on my dogs. If I didn't do that, I could have _______. Funny....but the ________s just don't mean much in the grand scheme of things in my world. And the money is the least of it.

My beloved family member just didn't get the fact that these babies are our children just as you said. As such, we give them our all - financial, emotional, mental, physical, spiritual. When they are sick or aged, we become care takers who bear no less a burden than those who care for sick or aged human family members. And the whys are the same - because they deserve no less and because we love them from the depths of our being.

Never hesitate to vent to us - you are part of our family and this family sticks together. You always have a safe, soft spot to fall here with us.

Hugs,
Leslie and the gang

[Spencersmom]

Spencer had a good night last night. No Grand Mal, no crying out he slept really well. He did wake me up at 4:00am lifting his head up and taking a breath and when he layed his head down, there was a little twitching to his upper lip. Maybe still a slight seizure?? If so, still a big improvement. He did that a few times, and each time it only lasted seconds. (I slept with my hand next to him so I would wake up any time he moved)

He is still a ravenous eater, and is consuming 6 to 6 1/2 oz of water each day. We are monitoring him closely for any signs of being fully loaded.

His current weight right now is 9 lbs. His normal weight is around 6 lbs, so he is really bloated. The time release seizure meds were not an option, so we have to make the best with the liquid every 12 hours.

I feel better today, having been able to get a little more sleep last night. Looks like we are making good progress!!!

[labblab]

I'm so glad to hear that you all had a better night!! YAY!!! :)

Also, you mentioned monitoring Spencer for "loading" in relation to his trilostane. I just want to make sure you realize that there is no loading phase with trilostane in the same way there is with Lysodren. You will always be dosing daily with the trilostane; the monitoring just relates to whether or not the daily dose needs to be increased or decreased depending upon symptom resolution along with blood testing. Unless there is reason to believe the dose is too high, currently the general consensus among clinicians is to leave the initial dose unchanged for approx. the first month. At that time, if symptoms remain and the bloodwork supports it, an increase will be made.

So you are definitely doing the right thing by monitoring Spencer's thirst and appetite. But unlike with Lysodren, you do not halt the daily treatment when you see a decrease. Instead, you celebrate because the drug is doing its daily job! :)

Marianne

[Spencersmom]

Marianne, I am so glad you clarified the difference!! I thought we would need to handle the same!! Well, that certainly makes it easier for us!!!

He is scheduled to be tested again on March 27th, so I'm hoping we have better values by then.

[goldengirl88]

Great to hear that there were no seizures last nite. Hope it continues that way. Blessings
Patti

[labblab]

Yes, we will all be anxious to see those test results on the 27th! If Spencer's cortisol level is still really high and you are not seeing any symptom improvement at all by then, there is a chance your vet may want to bump up the dose a little. But the increasingly common procedure is to leave the dose alone during the first month because we now know that cortisol levels often continue to drift downward during the initial weeks of treatment even when the dose is unchanged.

Another option that your vet may end up considering is twice daily dosing of the trilostane. When making that shift, you split the daily total in half rather than doubling it. Since the anticonvulsant is being given multiple times daily, your vet may decide it is better to also keep Spencer's cortisol level maintained at a more consistent level throughout the duration of a 24-hour time period.

And one last thing, do let your vet know you are not able to maintain the 3x daily dosing schedule for the anticonvulsant. I surely understand why it's a problem for you, so it may be the case that a different drug choice will end up being better for Spencer -- one that only requires dosing once or twice daily. Even twice daily at precise 12-hour intervals can be hard enough, as I know only too well with my Peg and her phenobarb. :o

[Spencersmom]

I created an album with a picture of Spencer and Lexi, if anyone wants to check them out. I miss Lexi so very much.

Both pictures were taken in good times when they were happy and healthy doing what they loved the most.....camping!!!

[molly muffin]

They are both adorable as can be. Just too cute and huggable. :)

Sharlene and molly muffin

[doxiesrock912]

What a major improvement!
Go Spencer!

[goldengirl88]

What cute pictures of your babies. Hope Spencer had no seizures last nite. He is so tiny and adorable it is hard to comprehend him going thru all this. Blessings
Patti

[Spencersmom]

Well, Spencer didn't have any Grand Mal seizures last night, but starting around 1:00am, he got very restless. He kept trying to lay in different directions as if he was uncomfortable, kept sitting up, then he started panting which he never does. We took him out at 1:30 to see if he needed to potty, then he drank water several times. He still couldn't get settled so finally around 2:00 I got up with him. He tried walking around the kitchen, but just seemed to have no energy, then he went into his crate, drank more water and then layed down. He never sleeps in his crate at night, so this was really odd behaviour. He stayed there until 5:00 when he woke me up. I tried taking him back to bed, but he became restless again, so a little after 6:00, hubs got him up so I could get another 30 mins of sleep. (was awake much of the night)

Once he got up, he seemed ok. Ate his breakfast and seemed alert.

Could this just be some of the meds causing this? I have valium as well as tramadol and gabepantin. If he gets restless again, would it be a good idea to give him something to help settle him down?

[Harley PoMMom]

It could be that Spencer's cortisol is rising in the evening, and as Marianne has mentioned, that he may need twice a day dosing.

When treatment with Trilostane is started a dog's cortisol can continue to drop until that 30 day mark, and since an ACTH stimulation test is due at that 30 day period I would wait until then to do any dose adjustment.

If Spencer is getting really restless at night, I would ask the vet about giving him something to clam him down, possibly the valium.

Hugs, Lori

[Spencersmom]

Lori, you and I are thinking alike, I just spoke to his Dr and she said I could dose him with Gabepantin as needed if he is restless. He goes thursday (3/27) for the next test to check cortisol levels! Just trying to get him thru this next week, and hope he is strong enough to get thru this!

[goldengirl88]

Terry:
My Tipper often becomes restless in bed at night if her cortisol is high. Some have gone to split doses to try and stop the cortisol from rising at night. I hope you get it worked out. Praying these seizures go away from your sweet boy. Blessings
Patti

[molly muffin]

Hope Spencer and you both have a better night and more sleep. :) Crossing fingers and paws.

hugs
Sharlene and molly muffin

[goldengirl88]

Terry:
Hoping to hear that all went well last nite. Tipper has some really bad tremors
last nite. Blessings
Patti

[Spencersmom]

Good news, and a happy friday it is!!!! Spencer slept ALL NIGHT!! He woke up this morning with a little sparkle in his eyes too!!

I woke up around 4:00 and couldn't believe my eyes when I saw that he was sound asleep, snoring a little and comfortable as could be!

I will take that blessing and carry it with me all day today!!!:D

[Spencersmom]

Oh, Patti..... I was so excited to post my good news, I didn't see yours. I'm so sorry about the tremors!!! How is your baby doing this morning?

[Squirt's Mom]

WOOHOO!!! Way to go Spencer and Mom! I can only imagine what joy that brought you to see him sleeping soundly! :cool::cool::cool:

[molly muffin]

That is so wonderful!! So glad you both finally got a good nights sleep and a great start to the day too. And it's a friday! hahahaha

Enjoy,
hugs
sharlene and molly muffin

[goldengirl88]

Yeah!!!!!!!!!!!! Go Spencer!!!!!!!!!!!!!!!!!!!!!! Atta Boy!!!!!!!!!!!!!!!!!!

[Spencersmom]

:(:(:( he had two seizures during the night! The first, mild one was at 10:29, and the he woke me at 4:30 having a grand mal. I am so disappointed! After the mild one, i just couldn't go to sleep....and when I did doze off, he'd raise his head and take what seemed like a gasp of air and then lay back down after 10 seconds or so. He did this every 10-15 minutes most of the night!

I'm wondering if we are dealing with something that we won't be able to get a handle on, and if it's going to get worse! How long do we allow him to go thru this? I'll post a recent pic so you can see how much he has changed! Wish I could post a video, so you could see how hard it is for him to walk, poor lil fella!

I was so happy and optimistic yesterday....and so sad today!

[labblab]

Oh Terry, I am so sorry to read this news. My heart just aches for you. You are faced with such a painful situation and no clear answers. The biggest concrete suggestion I can make, though, is to talk to the vet about switching to a different anticonvulsant that does not require 3x daily dosing. Since your schedule does not permit you to give the three doses, Spencer cannot be maximally benefiting from the seizure control. If a therapeutic level is not maintained consistently in the bloodstream throughout a 24-hour time period, I believe you will always be risking break-through seizures.

Controlling Spencer's seizures is seemingly your #1 quality of life issue right now. So if it were me, I'd even forego the trilostane right now if it stands in the way (due to interactions) with an anticonvulsant that would otherwise be a good choice for Spencer. As we've talked about earlier, if the seizures are indeed being caused by a pituitary macrotumor, you probably wouldn't want to be giving him trilostane, anyway. If you can just get the seizures under control, then you can start thinking about other options. This could even include later weaning him onto yet another anticonvulsant that might be a better fit with the trilostane.

Having said all this, I can only imagine how downhearted you are feeling, and I know you don't want Spencer to suffer. So no matter what you decide or how you proceed, please know that we are always here to support you.

Marianne

[My sweet Ginger]

Marianne, thank you for saying what I've been wanting to say about the importance of being on schedule with anticonvulsant medications.
I just couldn't articulate it as well as you did so well why it is so important. It is so much easier with twice daily dosing schedule it almost makes me think I'm forgetting something.:rolleyes:
Can you ask the vet and make a switch to twice daily dosing and keep the schedule? That way if it doesn't work you will know that's not from not following the schedule. I really hope little Spencer gets some help from some medication. I was told I will not see a complete control and so far that's been the case but they are a lot less.

[Spencersmom]

Marianne, thank you so much! I do plan on discussing seizure meds again. The one prescribed did not conflict with the vitoryl, which he definitely needs to be on. His belly is so big, combined with the hind quarter wasting, he has difficulty walking. It's really a struggle for him....he falls or will just give up and lay down.

He can't continue with the seizures that's a definite.

[Spencersmom]

Spoke with Dr, we will give seizure meds 3x on weekends & twice daily when at work, and upping the dose from 0.8 ml to 0.9 ml. Lets hope this works!

[molly muffin]

Oh Terry, I'm so sorry Spencer had another seizure last night. :( two even. So they didn't change the medication, just up the dose a bit? Then go to the 3 times on just weekends?
I'm not really sure I understand that thought process. Does the dose decrease on weekends then when you are doing 3 times a day?

hugs
Sharlene and molly muffin

[Spencersmom]

Sharlene, dose stays the same regardless of times per day, i made sure to ask! We're going to see how his test results come back, and if this change in meds helps! This next week is going to be an important one .... He's got to get thru this!!!

I posted another pic that I took this morning. You can see how big his belly is.

[labblab]

Terry, I apologize for harping on this because the last thing I want to do is make an already stressful situation even worse for you. :o

But I am not understanding how increasing the dose is going to change the speed with which the drug exits Spencer's system. If the therapeutic effect only lasts for around eight hours, during the week he is still going to experience a "trough" twice daily that lasts for four hours until he gets the next dose, no matter what size the dose is. And when you test his blood level for this drug, unless you test outside of the eight-hour dosing window, you will not be getting a true picture as to what his level is for a full 30% of the day. (One source I read said you test the blood level after about two weeks to measure the drug's concentration?)

Now, I am the first to say that I am not familiar with the ins and outs of this drug. So perhaps your vet has specialized information that the pharmacologic effect actually lasts longer than eight hours. But all I can say is that all the general dosing material I've read about this drug says that it needs to be given every eight hours and if that can't be done, a different drug should be prescribed.

I am wondering whether zonisamide, the drug that Song's Ginger is switching to, would be an option for Spencer. Apparently it also has a very safe profile in terms of not adversely affecting a dog's organs. Of course, whether or not it causes some other problem with trilostane, I cannot tell you.

Perhaps your vet has already done this, but if not, a great option would be for him to call Dechra directly to get their feedback about anticonvulsant options in combination with Vetoryl. If you even had to remporarily fall back to phenobarbital, for instance, in order to gain control of Spencer's seizures, I'm hoping they could pass along some Vetoryl dosing/monitoring tips. Here's their contact info:

http://www.dechra-us.com/Default.aspx?ID=365

As I say, you can just ignore what I've written if it makes you feel even crazier about things. But in good conscience, I just feel as though I need to state my concerns for you to consider in the event that this medication does not provide sufficient control of Spencer's seizures.

Marianne

[Spencersmom]

Gave him his afternoon meds for the seizures and he is out!! Hubs & I have eaten a snack & he's not even waking up. Ugh.....maybe he's just exhausted from last night & finally able to sleep?

[Spencersmom]

Marianne, gave him his meds before your post showed up!

I'm so confused what to do! The Vet clinic has multiple Dr's and they have varying experience in pet care, not making excuses, just have been with them since 1998 and they have always provided excellent care! If there is ever a question, they will immediately consult with a specialist or send us to one. I've always trusted their care...now I have doubts.

Yes, I am stressed....lack of sleep does that! I'm scared too! Scared beyond belief that I will not make the right choice for him....scared because I see my precious little man go from this vibrant and attitude filled little chihuahua to a pet existing!

[labblab]

Terry, I am sorry to be creating doubt for you, especially since I am not a vet myself and far from knowledgeable about this specific drug. It sounds as though your vet is really hoping this will work for Spencer because there are reasons why it would be a good choice in his situation. Since you have the plan in place, I see no reason not to give it a try. But if it doesn't control Spencer's seizures, I just wanted to give you hope that using a different drug may produce a better outcome for him.

So let's shift this from a negative to a positive and just think of it in terms of you having options if you need them. :)

Marianne

[Spencersmom]

Marianne, it's really ok! I know that everyone here is trying to offer the best support, and I value that beyond measure! I'm just so worried about him! I want him to get well and live many more years, but i'm so worried that this is not his plan! Hubby keeps trying to hang onto anything positive, even if it makes no sense! He keeps telling me that I'm just being negative....I'm just trying to be realistic!

I got my hopes up with Lexi and her illness was not survivable....is this the one two punch?

[goldengirl88]

I know things are so rough for you right now. I just wanted to tell you I feel your pain and wish I could make it better. Blessings
Patri

[flynnandian]

in the netherlands if seizure meds alone don't work they add kaliumbromide. i don't know if they do this in the usa. most of the time it works great. [ it is an old fashioned seizure med.]

[goldengirl88]

This sounds like something that could help Spencer. Maybe you could ask the vet about it?? I am hoping Spencer had a good nite. Blessings
Patti

[labblab]

The bromides (potassium and sodium) are used here in the U.S., too, either as stand-alone anticonvulsants or in addition to others. One initial drawback to bromide is that it can take quite some time (weeks) to get to therapeutic level. Bromide use has also been linked to an increased incidence of pancreatitis. But it has been used here successfully for a long time.

Marianne

[Spencersmom]

In spite of the increase in dosage, he had two seizures again last night! First was at 12:30 and second at 2:20.

I'm so frustrated, I just want to cry!!!

i think tonight I am going to try to capture what he is doing during sleep to show his Dr., then discuss what y'all have suggested. Poor Spencer hates taking the liquid meds, he tries to get away from me! I hate so much all that he is going thru!

[My sweet Ginger]

Since it's the weekend I assume Spencer was on 3x dosing schedule yesterday and he still had more seizures last night. I don't remember our neurologist telling me there is a loading period with Levetiracetam and also I saw an improvement right after the very first dose. Maybe this drug isn't working for him then?
Also, if his appetite is healthy enough try tablets instead of liquid form with a syringe which I had to force on her in the back of her throat but found rather easy on my part without a battle of will which could go on and on with a tab wrapped in foods with her poor appetite.:mad:
With Zonisamide capsules it's much easier, I mix it with flavored food and dim the kitchen light so she won't see it in clear view:p and it's gone as long as she eats her food. I had harder time with Levetiracetam because it was broken in half and so soluble in any amount of moisture and she detected it way too fast.:o
I just don't know how well Zonisamide works for her yet today being only the 3rd day and until yesterday she wasn't doing so well.
I hope you will find a drug that works for him very soon but I think some drugs need a few days until you see improvements.

[molly muffin]

Oh I am so sorry, seizures are so frustrating to try and get a handle on. :(
That is a good idea about videoing the event and showing the vet.

Hang in there. Maybe it will just take more time and figuring out the best medicine.

Sharlene and molly muffin

[flynnandian]

there is also a new medicine called pexion in my country. [ i am still on a forum about epilepsy because i used to have a dog with this disease].

[Spencersmom]

Today I was able to record what happens when he sleeps. It's definitely abnormal sleep activity. I wish there was some way to post videos here so you could see and comment.

I know his seizure activity needs to be controlled.....I get that! I also know there is definite seizure activity, as evidenced by his obvious signs. What I question from observations are his sleep patterns and if they are pre seizure or sleep apneia (sp?) related.

[Spencersmom]

Is there any way to tell?

[molly muffin]

I don't know if there is any way to tell or not.

You can upload to youtube and then post link here, or to photobucket, etc.

hugs
Sharlene and molly muffin

[goldengirl88]

Please upload the video to a site and post the link here as I am wanting to see this because of my Tipper's activity at nite. I definitely want to see the video. Blessings
Patti

[Spencersmom]

Couldn't get the video upload figured out.....i'm sorry! Did stop by to show one of his dr's and she doesn't think it's seizure related! Could be all the pressure from his swollen belly and organs making it hard to breath. I will take him in wed so two of his vets can check him together and see how his heart and lungs are holding up.

The Sr Vet I showed his videos to thinks we are dealing with brain tumor....I think I mentioned that before. I will be staying up to give him a midnight dose of his seizure meds, since 12 hr dose isn't working. We upped his meds over the weekend and last night was seizure free! So, whatever it takes to get him under control and comfy, that's what we will do!

Keep fingers, toes and paws crossed! Oh, thurs is testing day too!

[Spencersmom]

Two nights in a row with no seizure activity. Hope this means giving him his meds 3x per day is going to hold!

[labblab]

Oh Terry, I'm so happy to hear this!! All fingers crossed this will continue! :) :)

Marisnne

[goldengirl88]

If you can get some video of this I really want to see it. My Tipper has problems like this at nite and it was thought to be seizures, but the neurologist is leaning to tremors. Tipper's whole body shakes now. If we can make a comparison maybe we can figure this out. Blessings
Patti

[Spencersmom]

Tipper's Mom.....the video I got of Spencer is while he is sleeping. He doesn't have tremors, except during a seizure episode and then it's the typical symptoms. What he has been doing during sleep, is start breathing shallow and pausing, which then causes him to raise his head and gasp for air. I will see if my hubs can help me tonight figure out how to upload from my ipad. (it's new, just got it for Christmas so I don't know how to do everything on it yet)

I hope Tipper is doing better. It's so unnerving to watch them go thru these things, not knowing if they are suffering or not. Has your Vet said anything as far as prognosis if it is in fact a tumor?

[Spencersmom]

Oh sorry....my brain is still trying to wake up!! I read tremors to be tumors!!!

What kind of tremors does Tipper display? Is it like muscle twitching or is it like her body is stiffening up and shaking?

[goldengirl88]

It is both, that is why we need to see if your dog is doing the same thing. I hope you can get the video uploaded. Blessings
Patti

[Spencersmom]

Tippers Mom.....still trying to figure out! I am soooo very sorry for my lack of tech skills!

If i can describe what is happening....he falls asleep, and as his slumber deepens, his breathing slows and appears to "skip"... Then he raises his head up to gasp for a breath.

[Iraklis]

Originally Posted by pansywags View Post
I'm so glad you found an IMS who can see Cooper quickly. Please let us know how it goes.

This morning I uploaded a video of Pansy shivering when she inhales, is this similar to what you see with Cooper? https://www.youtube.com/watch?v=YV7mc78B1UM

Do the tremors look like this?^^^

Does the ''lifting his head'' look like this, but more ''extremely distorting'' for lack of better words?
http://www.k9cushings.com/forum/picture.php?albumid=864&pictureid=6524

[goldengirl88]

I am still holding out hope that you can get this video up online. I had some footage of Tipper on my IPhone, but was unable to get it onto my computer too. From looking at Pansy's video Tipper does similar shaking. Blessings
Patti

[Spencersmom]

I finally got his video published on You Tube.

https://www.youtube.com/watch?v=WX7QLXE27QY&feature=youtu.be

We have had three nights in a row now with no seizure activity. He is on the seizure meds 3X's a day, which means I stay up until 11:00pm to give him his night dose.....but it seems to be working!!

In the video, if you watch closely it looks like Spencer's breathing slows down and he seems to hold it until finally has to gasp for air. Afterwards, his breathing looks a little more labored. His vet is puzzled by this. He does this any time he goes to sleep during the day or at night. He will repeat this pattern about every 10 minutes for about an hour or more.

Tomorrow he goes in to have his cortisol levels checked. Praying for improvements!!!

[goldengirl88]

Terry:
I see what you mean about the breathing. Tipper does this also. When I showed it to the IMS she let everyone of the Dr.s in the hospital see it. The conclusion they came up with is it is a variance in her sleep pattern. I do not agree with that conclusion. Tipper starts jerking and twitching when she first starts sleeping is when it is the worst. She will seem like she is holding her breath and then finally
take a big breath. Sometimes I shake her when she does this to make her breathe. Her jerking and jumping started in her leg. It is all over her body now and she shakes violently. It has gotten progressively worse, and is scaring me. When does Spencer start with the seizure activity? Can you tell when he is aboutto do it? This disease is terrible. Blessings
Patti

[labblab]

I haven't had a chance to look at the video, but what you are describing sounds like sleep apnea in humans. I just Googled it and sure, enough, dogs can have it, too (not that you need yet another thing to worry about :o :o). But here's a link that you might talk over with your vet tomorrow.

http://www.vetinfo.com/sleep-apnea-in-dogs.html#b

Marianne

[molly muffin]

Oh poor Spencer, he does look like he is having a hard time breathing doesn't he. :( He appears to be awake through this, is that right?
hmm, did they do any testing to see if the liver being enlarged is encroaching on the heart, putting pressure on it?
I'm really glad that there hasn't been any further seizure activity.
It sounds like he needs a stable dose in his system at all times to control it. (late nights for sure)

hugs
Sharlene and Molly muffin

[Renee]

I haven't had a chance to look at the video, but what you are describing sounds like sleep apnea in humans. I just Googled it and sure, enough, dogs can have it, too (not that you need yet another thing to worry about :o :o). But here's a link that you might talk over with your vet tomorrow.

http://www.vetinfo.com/sleep-apnea-in-dogs.html#b

Marianne

My pugs get sleep apnea, especially my Ichiro. I'm a light sleeper, so I wake up often throughout the night and check on him.

[Spencersmom]

Met with two of his Vets this evening. They checked his last series of xrays and are treating him with the lowest dosage of lasiks, as there seems to be some heart enlargement and possibly slight fluid in his lungs.

He doesn't drink an excessive amount of water nor does he have to potty frequently. We measure his fluid intake daily on a scale so we know exactly what he is consuming. I expect the lasiks to increase his output and his need to potty.

Does anyone have any experience with lasik drugs and cushings, as well as his seizures?

This little man is just a puzzle for us all!

[goldengirl88]

Are you describing congestive heart failure to me?? Has Spencer been checked by a cardiologist? Does he have any history of heart problems. You and he surely did not need this on top of what you are already dealing with. He is so tiny and cute, it is hard to think of him having so many issues. My Tipper has a heart murmur, which is ever so slight. I have no experience with the lasix sorry. You just can't catch a break. I am praying for you and your baby. Blessings
Patti

[Squirt's Mom]

I've had several babies on Lasix. Most handled it just fine - but one gets horrible diarrhea from it. Tasha, one who did well on it, took it for the whole time she was her, about 9 months, and she was also on Pred so the peeing was astronomical! :eek::p Tash had cancer and CHF. The others all had some sort of heart or lung disease with fluid present and they all did well with it.

Grace is the only one who has had a bad reaction to Lasix. She has cancer and right side heart failure. She can't take any of the meds for this - they make her worse. So she is on an herbal protocol that seems to be working for her as her heart held up well during the surgery and Doc says it sounds better than it did. Grace isn't coughing like she was and doesn't have the diarrhea as often as she did.

[Spencersmom]

Yeah, his Vet thinks he could be in the very early stages of congestive heart failure. No murmer, so that's good!!! Thank you for the positive feedback regarding the lasix. He's on minimal dose to start just to see how he reacts.

Last night was the fourth night with no seizure activity and no sleep apnea that I am aware of. We all had a fabulous night of much needed sleep!!!! I'm glad for him especially, since we dropped him off this morning to have his ACTH Stimulation test done.

I'm anxious to find out how he's doing since he's been on vetoryl now for 12 days. Wow...it seems like a life time ago!!!

[molly muffin]

Glad to hear another night seizure free, but poor Spencer, to have more problems. He's just such a little guy too. :( :(
hugs
Sharlene and molly muffin

[goldengirl88]

Terry:
I am so glad to hear you all got some much needed rest. Is the enlargement of the heart causing the CHF?. I hope the stim test results are good, and all of this bad stuff is over for Spencers sake. Blessings
Patti

[Spencersmom]

Has anyone's pet ever had problems with the stim test? We picked Spencer up and he acted like his front legs were numb. He couldn't walk, kept knuckling under and falling over. He reacted the same way when he had the original test done.

[molly muffin]

Some dogs have a reaction to all the cortisol being dumped into their bodies from the stim test, it usually goes away within 48 hours. I'm a little concerned though that his symptoms seem to revolve around the neurological aspects rather than the cushings aspect of more drinking, humger, urination. This is usually a result of the tumor affecting the brain, and there could have been some swelling.
Have you mentioned this to the vets? If not I think it would be good to have a chat with them about how Spencer reacts to each ACTH test.

Poor little guy is sure having a rough go of it.

hugs
Sharlene and molly muffin

[goldengirl88]

Tipper had reactions to her first 2 tests. She went into vestibular episodes after both. It really made her act crazy and scared like she thought something was going to get her. It really makes them act funny for a while. I am praying Spencer can get past all this and start to feel better. Blessings
Patti

[Spencersmom]

Sharlene, I did mention it to his Vet that he had issues after the first test. He did the same thing again yesterday and she got to see first hand. We still brought him home, and he was able to walk after a while, tho wobbly and a bit weak.....even this morning.

He had his breathing episodes again last night, but no seizures.

His symptoms have really perplexed the Dr's at his clinic as they have not been typical!! They have been his Dr's his whole life, in fact I started going to this clinic when I had my first Chihuahua, so they know him very well. LOL....in fact, I can ask him if he wants to go see Dr. Murphy and he will growl!!!

I have a dear friend who has been praying for him and tells me to keep professing to him that he is healed, and I really want to claim that but my gut feeling is telling me otherwise. I feel guilty that I don't have enough faith, but I'm just afraid to get my hopes up too much.

I know I keep saying this, but it's just too soon after loosing Lexi!!!

[goldengirl88]

Terry:
Positive thoughts and prayers coming your way. Pray for a miracle. Blessings
Patti

[goldengirl88]

Tipper is the dog you have to think outside the box for also. She is not your typical cush dog either. She always has or does something that stumps everyone. I am hoping you all had a good nite and Spencer had no seizures. Blessings
Patti

[molly muffin]

Okay, they think Spencer has a tumor correct?

And the tumor is what they think is causing the neurological issues? I know there is a protocol for macro tumors, where you give both vetroyl and prednisone together. I think though that this is something you go to when you are looking at palliative care and keeping them as comfortable as possible and having a bit more time together. I don't know that Spencer is at that point though.
Still it is something you could discuss with your vet team and they could discuss with the specialist for a going forward option if needed perhaps.

Hope you guys made it through the night okay
hugs
sharlene and molly muffin

[Spencersmom]

Spencer had another seizure free night!! It looks like the meds are working to keep them under control! He still has the gasping episodes, so we'll see if the lasix helps. I know it is ridding fluid, because he woke me up at 4:00am needing to potty.

He's such a sweet boy! He still seems tired today, not sure if it's still residual effects from the test or from all the drugs he's on.

[molly muffin]

Lets see how he is in a week of being on the lasix if it clears the fluid enough that his breathing problems go away.

Sounds positive though, so remember, baby steps. :)

hugs
Sharlene and molly muffin

[Spencersmom]

Sharlene, I am taking every little victory to heart! Getting the seizures under control has been huge! He still has a long way to go, his battle is going to be a tough one and y'all have really helped me more than you know! Being prepared when speaking to his Dr's, asking questions based on the advice provided here, as well as printing literature to share with them has given me a stronger level of confidence that I am hopefully being a better advocate for his care.

Praying for another good night!!

[doxiesrock912]

Terry,

Daisy had diarrhea for 48 hours after her first ACTH test. I gave her canned pumpkin with meals for three days before the next test and she was fine.

She just had another ACTH yesterday, no pumpkin needed and no diarrhea but she is noticeably weaker and slept a lot yesterday and today. Tonight she's much improved.

[goldengirl88]

Valerie:
It seems this testing really messes with some of these babies. Tipper acts really wonky for a while afterwards. She had bad reactions the first two times, but some 16 times later she just gets really weird and seems scared and confused afterwards. I wish there was an easier way of doing this, it has been a hard road for Tipper too. Blessings
Patti

[goldengirl88]

Sorry for hijacking your thread. I am so happy to hear that Spencer had no seizures. I would say that was a really good nite by all accounts. I hope he is breathing easier on the lasix. I guess he has to pee more as the fluid has to get out of his body. Hope he continues to improve. Blessings
Participation

[Spencersmom]

Oh honey, you didn't hijack my thread! This is what I am looking for, other's experiences with their babies.

What is in the canned pumpkin that helps? Was it for the diahrea? Is it possible to treat the cushings without putting Spencer thru the tests? The second time seemed to take longer for him to recover from, so I feel a little reluctant to put him thru any more!

I really appreciate everyone's input!

[Harley PoMMom]

The fiber in the pumpkin, plain (no spices) is what helps with diarrhea or constipation, so it may be used for both issues.

Regarding the cortisol testing, Dr. Audrey K. Cook and another colleague performed a study to see whether a baseline test could be used to monitor dogs being treated with Trilostane. Here are a few excerpts from her article:
During trilostane treatment, baseline cortisol concentrations between 1.3 and either 2.9 μg/dL or ≤ 50% of the pretreatment baseline cortisol concentration correctly predicted acceptable control of adrenal gland function in 147 of 168 (88%) dogs...

...In addition, a baseline cortisol concentration ≥ 1.3 μg/dL could reliably exclude the possibility of an overdose of trilostane in an ill patient or when a patient is reevaluated following a reduction in the dose of trilostane...

...Therefore, measurement of a timed baseline cortisol concentration may be regarded as a screening test for acceptable control of adrenal gland function; a result within the target range would preclude the need for an ACTH stimulation test in a substantial proportion of patients. For those dogs with baseline cortisol concentrations outside the defined target range, an ACTH stimulation test may still be necessary before appropriate adjustments in the dose of trilostane are made...

...However, it is important to regard measurement of baseline cortisol concentrations as a screening test for adequate control of adrenal gland function in clinically stable patients; this technique is not designed to replace the criterion-referenced standard of an ACTH stimulation test when a more detailed evaluation of adrenal gland function is needed. Limitations of the use of baseline cortisol concentrations to monitor treatment should be carefully weighed by both pet owners and clinicians, and this option should possibly be reserved for patients in which the cost of an ACTH stimulation test is an issue for the owners.

Full article can be found here: Evaluation of the use of baseline cortisol concentrationas a monitoring tool for dogs receiving trilostane as a treatment for hyperadrenocorticism ( http://www.2ndchance.info/cushings-monitorcortisollevel.pdf)

Hugs, Lori

[goldengirl88]

I am hoping to see you post that there were no seizures again. How is Spencer holding up? Are you noticing any difference in his breathing since the Lasix? Blessings
Patti

[Spencersmom]

Hi Patti! Thank you for checking in on Spencer! He is still sleeping thru the night with no seizures! YAY!! I wish I could say the same about his breathing, as he's still having episodes. Temps finally warmed up enough to let him wander around outside, which he seemed to enjoy! He still tires easily, and doesn't have any of his old spunk, but we're just going to let him enjoy what life he has left and love him as much as possible!

[molly muffin]

Hi Terry, glad to hear he isn't having any more seizures. Everything counts and that is a good thing. If the lasix works and reduces fluid build up then he'll probably breath better. I don' t know how long that takes or what the success rate is with that. :(

That is great that he was able to get out for a bit. Even when Molly is feeling off, she loves to be outside (unless it's real hot or rainy, then forget it LOL )

hugs
Sharlene and molly muffin

[goldengirl88]

Terry:
So glad for no seizures!! You are doing a wonderful job with that little love bug. Hope he gets to breathing easier. Blessings
Patti

[Spencersmom]

spencer had a better night! No seizures and improvement in his breathing! Had to take him out to potty @ 2:00am (yawn) but he settled in to sleep very soundly afterward!

Now just waiting to hear about last week's test results! Will share when they come in!!

[molly muffin]

Crossing fingers!!!

yay for a good night and better breathing! :)

nap time?
hugs
Sharlene and molly muffin

[goldengirl88]

I am so happy for you. I hope Spencer can continue to improve. You are probably getting some much needed rest since Spencer is doing well at nite. Blessings
Patti

[Little CoCo Puff]

Glad to hear Spencer is doing better - hugs to you.

[Spencersmom]

Thank you all!!!! Still lacking sleep as I have to stay up till midnight to give him his night dose of his seizure meds, and if the lasix's works on him then I have to take him him during the early morning hours. Then I go to work for a full day. I'm really exhausted but will do what he needs!!!

I celebrate the smallest milestone....no seizures....sleeping better....reduced gasping for air....feeling more alert....walking around the yard enjoying the sunshine finding objects to mark.......those are the simple doggy pleasures I treasure! Spencer is no where near where he was..but those pleasures for him are enough to keep me fighting on his behalf!

[Spencersmom]

Spencer is definitely starting to feel better!!! He's becoming more conversational again.....almost got up to a trot to get a treat this morning and seems more alert and bright eyed!!!

He had a great night last night!! Slept so soundly I don't think he even moved. He was in the same position this morning as he was when he fell asleep!!!

Looks like we are getting a handle on things!!!! Keep up the good work, my little man!!!

[Squirt's Mom]

:cool::cool::cool: Woohoo!!!! Way to go Spencer and Mom!!! :cool::cool::cool:

[labblab]

Terry, I am so happy for you guys!! :) :)

Marianne

[My sweet Ginger]

Terry, I'm so happy to read that your little man is doing better each day as I know how hard it is for us parents to watch our innocent babies suffer with this complex disease. I hope he will continue to do better and you get an A+ for administering his midnight dose because I know too well it's such an ordeal for both you and Spencer but I'm very happy that he's finally getting the help he needs.:)

[goldengirl88]

Terry:
I am so glad you are able to celebrate Spencer's continual improvement. The best part is you probably got a little more sleep, and your little man is doing good. Blessings
Patti

[Spencersmom]

Funny story to share with y'all about Spencer. When he was a young dog, he was obsessed with his.....boyhood! One day I told him..."Spencer, if you don't leave your weiner alone, i'm gonna get it"!! When I said that, he got the most defiant look on his face and started growling. Well....hahaha....that was a challenge I wasn't about to back down from, and neither was he!!

Well, after that every time I told him, "I'm gonna get your weiner" he would run up to me, growling ever so fiercely. If I put my hand down by his side, he would get very protective of his manliness, and then if I said.. "fine, I don't want it you can keep it" he would immediately check it to make sure it was still there!!! Funniest thing ever!!!

A dog that that is totally aware of his anatomy!!! True story! :D

[Squirt's Mom]

LMAO! Now that is funny! :p:p:p

[molly muffin]

That is so hilarious! I don't think I've ever heard of dog quite "that" aware. hahaha

So glad that Spencer is feeling better. When he feels good the world looks a little bit brighter.

hugs
Sharlene and molly muffin

[goldengirl88]

Terry:
You definitely provided the humor I so desperately needed today. That weiner story is too funny. I am so glad Spencer is improving, he is too cute. Blessings
Patti

[goldengirl88]

Terry:
Just checking in to see how the nite went?? Hope all is well and that Spencer had another good nite. Blessings
Patti

[Spencersmom]

Hi Tippers Mom......welll, we didn't have such a good night. Spencer had a mild seizure at 11:20 and then around 3:00am he woke me up with his breathing again. About every 5 minutes he would raise his head for air and this lasted for over an hour. Then at 4:30 he needed to go outside and from then until about 5:30, he was restless.

I got his results back from last weeks test and his resting rate was actually higher than before he started on the Vetoryl. After the low dose stimulation, his cortisol dropped within normal ranges, tho a little on the high side. The endocrinologist wants him tested again in a few weeks to see how his resting rate is, but my hubs doesn't want to put him thru that again since we feel he had the neurological reactions both times.

My little guy is just having a hard time!!! We're going to stay on the current protocol for the next 3 weeks and then revisit and go from there.

[molly muffin]

You can get the resting rate done without giving the stimulating agent that causes all the cortisol to dump into his body. It is the dump that causes the problems. The resting would just be a normal blood draw.

I'm so sorry that you guys had a bad night again. I'd hoped they were over and done with and he was on the road to recovery. *sigh* Some days are just harder than others and so we'll hope tonight will be better.

hugs
Sharlene and Molly muffin

[goldengirl88]

Terry :
I am sorry to hear Spencer did not have a good nite. You can get his resting cortisol like Sharlene said. I hope this turns around, and I pray Spencer has no more nites like this. Blessings
Patti

[Spencersmom]

I think next test will just be resting rate 4 hrs after meds, with no stim done. I'm thinking we can monitor how he's responding well enough doing that. Am I just having wishful thinking or is this a plausable option?

There has got to be some way to monitor his levels to understandably a lesser degree without stim, but still enough to treat!

What are your suggestions/ thoughts?

[Renee]

I personally question how accurate testing just the resting rate is... I know that some have suggested it as an option, but, I do not feel it is a replacement for the real thing. My girl's resting rate has always (even before treatment) been relatively low, with her highest resting rate ever being just 3.9.

But, that is just my experience, and while Tobey has reacted to the stimulating agent, never as much as your pup.... so, please do not feel I am criticizing.

[molly muffin]

In Europe where they had a shortage of the stimulating agent and where unable to do ACTH for quite awhile. I'm still not sure if it is readily available. They are using the resting plus electrolytes to monitor.
It isn't optimal, but I can see that you and your vet might not want to risk too many ACTH tests until Spencer is more stabilized. That is something I think that you'll have to work out with your vet.
I know there is a link somewhere on the forum put up by Eva, from the German group.
http://tinyurl.com/pej75uo found it :)
Maybe you could take that to your vet and see what they think.
hugs,
Sharlene and molly muffin

[Spencersmom]

Spencer had yet another mild seizure last night! Wasn't Grand Mal, but still two nights in a row seizing again. Also having the breathing issues. Another developement we are monitoring is muscle quivering in his hind quarters. I first noticed it a couple days ago and thought he was cold. Have seen this more frequently, at sleep, awake and even standing so I don't think it is due to being chilled. Any thoughts? Is this part of the cushings?

He had a really off day today....I was away for a few hours and hubs said he was just not even his lately normal self. His ears are layed back, his expression looks sad .... I just don't know what to make of it.

[molly muffin]

oh dear. :(
Yes tremors seem to come with treatment with vetroyl. It is listed as one of the side effects possible. :(

Sometimes they have off days but that doesn't sound so great about the breathing problems continuing.

Is it only one seizure during the night? I wonder if the breathing problems are contributing, causing stress.

hugs
Sharlene and molly muffin

[Iraklis]

I may be seeing enlarging tumors everywhere...but...
doesn't a higher resting cortisol level (tumor trying to ''adjust'' the lower cortisol levels producing more endocrine ACTH?) and seizures point to that?

Don't want to scare you spencersmom!
But...Judging from my experience...No question sounds stupid to me now...

[Squirt's Mom]

I may be seeing enlarging tumors everywhere...but...
doesn't a higher resting cortisol level (tumor trying to ''adjust'' the lower cortisol levels producing more endocrine ACTH?) and seizures point to that?

The thing to remember is that not all seizures, even in a cush pup with PDH, have anything to do with Cushing's. The pituitary tumor can remain microscopic and the pup still have seizures from an entirely unrelated cause. Seizures in dogs are often idiopathic - meaning we never know the cause.

My own pup had a seizure a year ago (from a certain med she was on) and has neurological signs (from doggy Alzheimer's) and she does have PDH, but she does not have a macro tumor that we are aware of nor does she display those signs. ;) Not all PDH tumors cause any problems beyond the usual cush signs...in fact, most do not.

[goldengirl88]

Terry:
I am not sure what you are describing is tremoring or not. I did research these tremors and this is one of the things I read.
Tremoring releases stored glycogen/glucose to permit continued muscle contractions.
Tipper has terrible tremors that started in her rear legs. They have now progressed to her whole body jumping at nite including her mouth and eye twitching. I hope Spencer has a better day today. This little boy needs a lot break the poor baby. Blessings
Patti

[Spencersmom]

Hubs took over Spencer care for me last night after I stayed up to give him his night dose. i slept 12 hours and still had to be awakened!!! Spencer was restless, could be because he wasn't in bed with me, but since he didn't sleep well, no seizure activity!

[goldengirl88]

Just checking in to see how the nite went. I have lost so much sleep since Tipper started with this a year and a half ago that it has aged me 10 years. Try and rest whenever you can. Great that hubby is pitching in to help. Hope Spencer is doing well. Blessings
Patti

[Spencersmom]

Hi Patti!! Thank you for checking in on my lil man! He is laying next to me sound asleep right now! He had two seizure free nights.
We had to take him out to potty at 2:30 this morning, and he was restless for a little while, so I just put him down and let him wander around until he was ready to come back to bed. Seemed to work, as he slept very well the remainder of the night. Might be our new night schedule, we'll see. He still gasps for air, so I'm not sure if the lasix is doing any good.

Boy, what a roller coaster ride we are on with this sweet boy!

[goldengirl88]

Yeah for no seizures, way to go Spencer!!!!!

[molly muffin]

Oh I really hope that the lasix is helping. I'd love to have him able to breath okay.
That is great though about 2 seizure free nights.

So, when he doesn't sleep All through the night but is either restless away or up and walking around awake, then no seizures those nights. Interesting and if that continues, then something to chat with the vet about.

hugs
Sharlene and molly muffin

[Spencersmom]

Sharlene, I called and asked for his Dr to call tomorrow to chat about his tremors and night time restlessness. Also want to discuss his behavior today.....he just acted like he didn't feel good. Several times when I put him down on the floor, he sat with his head hanging very low, and he has been very lethargic.....even hubby noticed and agreed.

One thing I have noticed is he is loosing more fur, now on his chest and anywhere that touches .... Such as under his arm pits, etc.... Not sure how to describe.....but even on top of his little nose. I was told it could take some time for the Vetoryl to work...but i'm concerned especially with recent resting rates higher than pre meds!

[labblab]

Terry, can you get us the actual numbers for all of Spencer's cortisol levels, both baseline (resting) and also the full ACTH results? That will allow us to offer more meaningful feedback. Thanks so much!

Marianne

[goldengirl88]

Terry:
Is he still lethargic? Do you think his cortisol is going too low? Watch him like a hawk. I am curious what the Dr. will say about the tremors and moving about the bed being restless as Tipper also does that. Could it be that from the fat in his body shifting to different areas especially the abdomen, and it is pressing on something making him uncomfortable?? Hope you get some answers. Blessings
Patti

[Spencersmom]

Morning Patti! I didn't think about associating his being lethargic with low cortisol. Will keep an eye on that, for sure! He slept really well last night and was very vocal at hubs this morning when he only got canned food for breakfast, no chicken. I have noticed a shift in food preference, as last night and this morning he want nothing to do with his canned food. Before, he would devour any and everything and beg for more. He didn't finish everything for two feedings now. Will see how he's doing this evening, hopefully we are finally making good progress. Will let you know how the Dr chat goes.

Thank you so much for checking on him like you do!

[goldengirl88]

Please do let us know how the talk with the Dr. goes. I am praying for you and Spencer .
Patti

[labblab]

Terry, can you get us the actual numbers for all of Spencer's cortisol levels, both baseline (resting) and also the full ACTH results? That will allow us to offer more meaningful feedback. Thanks so much!

Marianne
Terry, I am betting that you may not have seen my question on the bottom of the preceding page. If you did, just ignore the repeat, OK?

[Little CoCo Puff]

Terry, I read your post about Spencer taking a shift in his food. That is exactly what CoCo did too. She always ate her canned food with gusto - cleaned up the plate and looking for more. The last two weeks before she passed she didn't want that food anymore. Oh my, what a variety I had here and at one point I didn't care whether it was urinary SO we were supposed to be feeding her as long as she would eat...something. It only got worse to the point she was not interested in food. I hope this is not Spencer's case...please keep us posted.

[doxiesrock912]

Terry,
as their cortsol drops, many dogs become picky eaters since they're no longer suffering from the extreme hunger symptom.

[Spencersmom]

Ok....here are the two comparative test results.

First: baseline - 238 (H) Ref range 15 - 110
Cortisol low dose dex 6h -58 (H) Ref range 0 -30
Cortisol low dose dex 8h - 104 (H) Ref range 0 -30

Second: baseline - 242 (H) Ref range 15 - 110
Cortisol 1h post ACTH - 536 Ref range 220 - 550

Endocrinologist suggested retesting in a few weeks to see if baseline shows improvement in trilostane therapy levels, and decide then about dosage, whether to change or not.

Vet recommends possibly seeing a neurologist. He was more alert yesterday and this morning, had a good appetite and barked for his chicken. I just never know what to expect from him! From one day to the next, he can be doing pretty good or acting like he's miserable!

The breathing issues continue, and we are going to try to record some of the tremors, if I can capture it in progress. Hopefully these recordings will assist any neurological evaluations.

[goldengirl88]

Terry:
Good idea to film the tremors. I took my IPhone and showed Tipper's neurologist and he was really excited to know he could see what was happening, and said very few people think of doing this. I hope you can get his dosage straightened out so he feels better most of the time. Has the vet said anything about the alqsix not working to relieve his breathing? Are they able to increase it or change to another med? I would like to see these tremors myself as I am curious if they are what Tipper has been doing. Hope you and Spencer have a good day. Blessings
Patti

[goldengirl88]

HiTerry:
How is the baby today? Hope he had am quiet nite. I am wanting to see his tremors. Is he still eating ok? It is already nice here and Tipper has walked once already. Blessings
Patti

[molly muffin]

How is Spencer today? Hope you guys had a good night and he is having a chipper day. :)

hugs
Sharlene and molly muffin

[goldengirl88]

Terry:
I am hoping to hear that Spencer did well the last two days, and was seizure free. Blessings
Patti

[Spencersmom]

Hi sweet Patti! You are so faithful, checking on my little man!! Last night no seizure, but he did have one night before. I have an appt with the neurologist in Ann Arbor, MI on wednesday. One of their specialties is seizure management, so I'm hopeful they will be able to come up with a better plan for controlling them! I also hope they can explain some of his other symptoms, and together with our regular vet get a handle on his health issues so he will feel better and return to a more normal state!

His gasping for breath when he sleeps still continues in spite of the Lasix therapy.

I hope that at some point my body can adjust to only 5-6 hours of sleep. Lol....I'm one of those ppl who need LOTS of beauty rest!

[molly muffin]

Oh Terry, I'm so glad you got an appointment with the neurologist. I really hope they can help Spencer. A good over all plan that your vet can implement.

Oh boy, do I hear ya, I'm a person who enjoys her sleep too, so I don't know how you are doing it on 5 - 6 hours a night.

Hang in there. Wed will be here in no time.
hugs
Sharlene and molly muffin
I really had hoped that the lasix would help Spencer with his being able to breath. :(

[goldengirl88]

Terry:
That is definitely a good idea to see the neurologist. It is also good to take any video you have of what is happening to Spencer. I took video to Tipper's neurologist and he was thrilled to get it and see things first hand. A plan is always a good thing with these Cush dogs. Hope you both have a good weekend, and that you get some much needed rest. Blessings
Patti

[Spencersmom]

I'm hoping I have some good news!! Spencer doesn't seem to be having the tremors like he was. I'm thinking that was a side effect of his meds and he is adjusting. He is becoming more and more vocal and interactive, barking to let us know he wants food or to be held or go outside. It seems there is a little spark of the old Spencer still there!

[molly muffin]

Wow. Go Spencer. I really hope that you get some good news too. He does seem to be better which is really great!

Hugs
Sharlene and Molly muffin

[goldengirl88]

Yeah Spencer!!!!!!!!!!!!!!!!

[goldengirl88]

Terry:
Hoping for another yeah day for Spencer. Hope you got some rest. Blessings
Patti

[Spencersmom]

We had another night with no seizures. We do get up during the night with him, so I wonder if it helps to break up his sleep cycle a bit. Hubs has been awesome this weekend, letting me sleep.....ALOT!

Noticed a few mild tremors, but they were so brief i wasn't able to capture them. i would describe them as looking like he was shaking from cold. Just isolated to his hind legs and very brief and mild, yet enough that I noticed.

Other than that, he has times when he is alert and "talking" and then he is asleep when I have him laying next to me, all cuddled and content. He is such a sweetheart!!! i just want him to be compfy and as happy and pain free as possible!

[goldengirl88]

Terry:
Good to hear no seizures. I am hoping the neurologist can get him straightened out so this no longer happens at nite. I bet you are happy with all the sleep!! Blessings
Patti

[molly muffin]

Any night without seizures is a good night.

Really that is what we all want, them to be comfortable and doggie happy. It sounds like Spencer is having some good days.

hugs
Sharlene and molly muffin

[Spencersmom]

Ok....i've got another question. Tonight (for the second time this week) I picked Spencer up and his belly was all wet. Couldn't smell any urine, thought maybe first time he spilled his water bowl on himself. Well tonight i found the source of his being wet....he peed on the rug in front of his crate and must have fallen in it......but there was absolutely no smell to it. Is that normal? Just wondering if I should mention it wed when I take him to the specialist!

[goldengirl88]

Terry:
If his urine is dilute there will be little smell to it. Has he had accidents previously? This poor little guy, he is to cute to have all this going on! Blessings
Patti

[flynnandian]

dogs with cushing do have diluted urine which smells less like urine is my experience with it.
since my dog is on vetoryl it smells more like urine again. [more concentrated again]

[Spencersmom]

He's been on Vetoryl for a several weeks now and this past week seems to be having to urinate more often. His urine has zero smell to it! If he has anything going on, what would make him need to go out with frequency and his pee to be neutral in odor?

[Spencersmom]

Just to clarify...hubs took him out after work at 4:45, Spencer peed on the rug around 6:30 and I just took him out at 9:15 and he really peed big time. We realized this afternoon that he has had numerous accidents that we were not aware of in front of his crate, so of course I'm concerned if this is of concern!

You know, i've told both of my sisters about not only Spencer but our little Lexi whom we recently lost.....and I was amazed that both said they would never spend the $$! It floors me that they could possibly deny care. I can understand if it involved thousands that one doesn't have...we all have limits, but to refuse even what we've incurred...$100 per month for meds and additional for tests and vet office calls? Thank the wonderful Lord we've been able to do what Spencer needs, but it upsets me to think they have pets who will someday get old! What if they get sick? I know that's off topic, but it really is unsettling!

[doxiesrock912]

Terry,

has the vet checked whether or not Spencer has a UTI or other issue that might cause this? Daisy started having accidents just before she was diagnosed. Once we started treatment, the accidents stopped fairly quickly.

[Harley PoMMom]

An UTI can cause a dog to drink and urinate more. Most dogs with Cushing's disease have diluted urine, which generally is colorless and odorless. Since their urine is diluted a regular urinalysis doesn't always pick up an infection, so an urine culture and sensitivity test should be done so the exact bacteria can be known and the proper antibiotic can be prescribed.

Dogs with Cushing's can be prone to diabetes, diabetes will also cause an increase in drinking and urinating. Diabetes can be ruled out with a blood test.

Hugs, Lori

[Spencersmom]

Well, tomorrow is the big day! The morning is not going to be fun, as we are to fast him after midnight for any pending tests they may decide to run. He is NOT going to be happy when we tell him he can't have his boiled chicken for breakfast, let alone minimal amount of water! His appt isn't until 11:30, so I just can't see not letting him have a little treat and small amount of water around his normal 5:00am wake up!! Not a full meal tho!

I just hope I remember everything to tell them! I pray we get some answers as to his future prognosis and treatment plan!

Please say a little prayer for my precious man!

[Spencersmom]

Forgot to mention that I plan on asking for another complete blood panel to compare with his last one, just to see where his liver, kidneys and thyroid are as well as sugar! Anything else we should have them check? Maybe xray too?

The doctors I'm taking him to are among the best! They diagnosed Lexi with canine meningitis, and were the main reason we were able to keep her healthy as long as we did! They worked with our regular vet as well as other specialists we took her to, making sure she received no treatment that could possibly throw her out of remission. i really hope they are as instrumental in Spencer's well being!

[molly muffin]

Talk to them and see if there are any tests that They want to do to help you get answers. They should have some ideas of what they need to see.

Well, my molly and your Spencer can keep each other company in their agony of not getting breakfast. She is getting an ultrasound tomorrow and yep, fasting. I'm sure they will both being giving us doggie stink eyes. LOL

Crossing fingers for answers!
hugs
Sharlene and molly muffin

[Harley PoMMom]

Wishing you and Spencer the best of luck with the doctor visit tomorrow and will be anxiously waiting to hear what they have to say.

You and Spencer are in my thoughts and prayers.

Hugs, Lori

[Squirt's Mom]

Keeping you and Spencer in my thoughts and prayers! Let us know when you can.

[molly muffin]

Checking in on you and Spencer!

hugs
Sharlene and molly muffin

[Spencersmom]

Well....where do I begin! spencer had two seizures this morning. Went for his appt, and the neuroligist thinks he has a right forebrain tumor! Other posibilities are hydrocephalus or other inflamatory disease. He's leaning more towards tumor. MRI would confirm, but is not an option for us to pursue.

Showed the clip of his sleep, and he thinks that those episodes are focal seizures.

Because of the cushings, he can't be treated with steroids and in fact he thinks the cushings was actually holding the seizures at bay, so now we're in a catch 22! Treat the cushings, which lowers the cortisol will allow more swelling in the brain. We're in essence putting a bandaid on the problem, which is most likely going to get worse.

At some point, he said we have to not only consider his quality of life but ours as well. The sleep depravation as well as other life changes need to weighed in determining how far to allow this to continue.

Needless to say, I'm pretty sad right now. Tears flow as I type!!

[labblab]

Oh Terry, I am so sorry to read this news. I wish I was right there to give you a big hug, and to give sweet Spencer a gentle little hug. I know you are in a really tough spot right now, trying to decide which step to take next. We are always here for you to talk to, OK?

Holding you all in my thoughts and heart,
Marianne

[goldengirl88]

Terry:
I am so sorry about this news. Spencer is like your child and I know how hard the decision of what to do will be. I was not prepared or expecting this kind of news, I am just so sorry. I will continue to pray for sweet Spencer to get a miracle. Blessings
Patti

[molly muffin]

Big, big hugs Terry. I'm with Marianne, I wish I could give you a great bit hug for real. Right about now you probably need more than a few of those.

I really am sorry that this was the diagnosis. So, okay, don't treat the cushings and let the cortisol raise or treat the cushings and deal with the seizures. I guess my question would be, is there a medium in there anywhere? Can you do a lower dose of cushing treatment and would that be enough to help control the seizures. If the answer to that is no, then the next thing to think about, is which gives Spencer the better quality of life and yes, you and your hubby too.
I guess these are the questions that you have to decide on. Just know that whatever you decide, we are here and we aren't going anywhere, so we'll walk with you, side by side through this journey and if you need a lift over some rough spots, well, we can do that too.

HUGS
Sharlene and molly muffin

[Iraklis]

I would suggest an MRI ,knowing all the guilt of unanswered questions that come after everything is said & done...

On the other hand between treating Cushings or the suspected tumor...the tumor for sure.

One option would be to give Vetoryl and cortisol medication at the same time (because circadian rythms dictating body cortisol rise&drop uncontrolled) so as to have more control of what is going on in the body.
Second (cheaper but less affective) would be to just leave the body produce its own cortisol.

It is much easier to deal with the symptoms of Cushings than neurological symptoms resulting from a brain tumor!
You can aid the function of the liver and kidneys with ex.SAM-e, milk thistle (I used Liver Guard by Source naturals...many helpful ingredients in that one).
You can also give some cinnamon for the elevated blood sugar.
Omega-3 and curcumin/turmeric, I4P and/or K9 immunity also help keep the tumor in check.
High quality protein food like chicken breast and/or sardines plus spinach juice also help a lot.

My baby lived for 4 months with some of these ,and would probably live more had i not started him on Vetoryl again...

I hope you make the best possible decision!!!
And more importantly I hope ALL goes well!!!

[Squirt's Mom]

aw, Terry, not the news any of us wanted to hear, honey. :( I am so sorry. :(

Know this - Spencer trusts you completely; he knows you have always done your best for him and that you will do your best for him now. We know the same. And we will be with you all the way, no matter what.

Hugs,
Leslie and the gang

[goldengirl88]

Terry:
I have to admit opening up your thread today is difficult for me. I thought about you and Spencer last nite when I lay there awake. This is just so unfair, and I am sorry you are facing this as I feel your pain. Blessings
Patti

[molly muffin]

Hope you had a good night Terry and Spencer.

Thinking of you both
hugs
Sharlene and molly muffin

[Spencersmom]

Y'all make me cry with your sweet encouragement and understanding! The stress has been taking a real toll on both me and hubs, and yesterday certainly confirmed our worst fears. We can't afford the MRI! We've sacrificed so much already and hubs has said enough! We spend thousands of $$$ on the test to confirm....then what? Yes they could radiate, but that puts us even farther in debt! All of my family, kids, and grandkids are thousands of miles away! I have to choose between being able to see them or treat Spencer and hope it's successful! Trust me....i've been tormented by the position i'm in! It's like choosing one child over another and it's literally making me physically illl!

And to top it off, yesterday after leaving from his appt, I'm driving along the interstate, lost in thought not paying attention and get nailed by a cop in a speed trap! Did he care that I just found out my pet is sick? NO....writes me a fricken ticket anyways for speeding! What next!

[goldengirl88]

Terry:
So distressing to hear you got a ticket too on top of all the other issues. I really know how you feel, and everyone on here just prays not to have to face this with their babies. One thing though, is you do have an understanding husband, and that support really has to help. Where is the pet fund that helps out in situations lime this??? No one should!d have to make this choice. I am praying for all of you, and a miracle for sweet Spencer. Blessings
Patti

[molly muffin]

Oh Terry, it is a horrible position to be in. I am right there with you, holding your hand.

But right now, lets think about quality of life and just getting on with things. You do the best you can and that is all you can do. The MRI is very expensive, thousands and my IMS just said, there are not guarantees that something will show up, even with all that.

Hang in there!!
hugs
Sharlene and molly muffin

[Spencersmom]

I read everyone's posts to my hubs.... And he just cried and cried!!! He couldn't believe the outpouring of support and love from all of you!!!

How can we ever say thank you enough to all of you!

The journey continues, we will do everything medically possible within our means to give our lil man the time he deserves to be loved and spoiled and be comfortable!

My prayer is that we can get a handle on his physical needs, let him enjoy each blessed day...his boiled chicken...his home made jerky...laying next to mom or dad..sleeping cuddled close at night...rides in the truck to where ever...camping...just anything that makes him happy!

Thank you for sharing the ride with us!

[molly muffin]

Oh your husband is a sweetie.

We Know how hard this is, and it sucks to be in the position you are in, it is where most people end up. The bills are outrageous but sometimes what you have to do is just take that step back and say that you are doing the best you can and that is all you can do.

hugs
Sharlene and Molly Muffin

[doxiesrock912]

Terry,
virtual hugs from here too for you, hubs, and Spencer.

Have you looked into Care Credit? They have a credit card specifically for vet bills and often have an introductory period with little or no interest. Sometimes, it's for as long as 18 months.

It's worth a try and you can apply online and it allows you to pay the bills off in smaller increments. http://www.carecredit.com/vetmed/

Praying for all of you!

[goldengirl88]

Great idea Valerie, I forgot all about it. Hope Spencer had a better nite last nite. Blessings
Patti

[Spencersmom]

Spencer has diarrea this morning for the past 2 hours! He's pretty mopy right now! Poor thing, he had to go and his hind quarters are weak, so he fell over in his poo!!!

Normally I space his meds out but hubs gave him everything at once. Could that have been too much for his system? I gave him some flagyl, hope it helps!

My poor little boy!

[Iraklis]

Could that have been too much for his system?

Yes!
What does he eat?

[My sweet Ginger]

Oh, poor Spencer. If that's been the only change this morning, probably that is most likely. Go back to spacing out and see if that stops diarrhea. How many kind of meds is he on these days?

[molly muffin]

Yep, sometimes too much into the system is just that too much and they always seem to react in the gastrointestinal system when that happens, hence diarrhea or vomiting. He's such a little guy too. See how he does today and tomorrow go back to spacing things out and see if that doesn't work better for him.

hugs
sharlene and molly muffin

[Squirt's Mom]

Terry, when you say "everything", what all is he taking now? Did you opt to continue the Trilo? Had you or hubby noticed anything different last nite or prior to the meds this morning? Did the vet give you any idea of how rapidly the tumor was growing?

How is he now?

[Spencersmom]

He had his chicken and canned weight control, which he gets every morning. Normally we'll give him the Vetoryl with his food, and wait about an hour or so before giving the seizure meds. Hubs decided to give him both around 6:00am, and the diarrhea started between 7:30 and 8:00.

[goldengirl88]

Ugh oh, I am so sorry to hear this. Do you think it was the change in giving the meds together? When I pill Tipper ( many times a day) I never give her anything with the Vetoryl and wait about 2 hours before I give her anything. How did he do at nite, any seizures? I hope you and sweet Spencer have a blessed Easter, and that there is a miracle for Spencer.
Patti

[Spencersmom]

Talked to my Vet this afternoon...she called after hours to check on Spencer (she's that awesome).....which gave me the chance to let her know about the diarrhea! We will have him on chicken & rice until his tummy settles down. If still an issue on monday, she wants to know!

She thinks it could be the meds, or something else. Just have to monitor him tomorrow, and give him another dose of flagyl tonight!

Right now he is enjoying laying outside in the sunshine, sleeping in the warmth and waking up to watch any activity around him.

Sure do love this sweet boy!!

[molly muffin]

Oh our precious Spencer, catching some rays. Hope his tummy is feeling better.

hugs
Sharlene and molly muffin

[goldengirl88]

Terry:
Hope Spencer is doing better today. So nice of your vet to call about him. Watch out for that Easter bunny Spencer!
Patti

[Spencersmom]

No more tummy troubles! Definitely will space his meds out from now on!

He had 2 seizures within 30 mins early this morning so I'll be calling the neurologist tomorrow. Gave him valium after the second one, so he's been a sleepy boy today!

I hope everyone has had a blessed Easter!

[molly muffin]

Where they long ones or smaller focal seizures?

Hope you had a good day today. Happy Easter
hugs
Sharlene and molly muffin

[goldengirl88]

Terry:
Were you meaning like grand mal seizures ?? I am hoping that Spencer gets to a good place and this stops. I know you love him, and how worried you must be. It is so hard to watch these babies struggle. Hoping for a good week for Spencer.
Blessings
Patti

[Spencersmom]

So far, Spencer hasn't had a grand mal seizure since right after starting on the seizure meds, he does continue to have what they call petite mal, where he cries out and his head and front legs jerk. Thank goodness those are brief, but still hard to deal with as it always occurs in the middle of the night, jolting us out of sleep!

And because he does the other thing the Dr said was focal seizures, i wake up from those afraid he will have a petite or grand mal. It causes alot of anxiety attacks and loss of sleep!

Mt son was here visiting for the weekend and he admitted to me saturday night that he felt Spencer has declined tremendously and his quality of life is drastically deminished.

This morning, however my sweet boy did have a good start to his day and was more his little annimated self!! It's so hard to know what to do for him...what is best!!

[goldengirl88]

Terry:
It can change from minute to minute sometimes driving you crazy. One minute you think they are down and out, then they start playing and make a fool out of you. Spencer has not been on the seizure meds all that long, and maybe it will even take switching to another drug or adding something else to get him in a better place. I know how you must feel with this startling you in the middle of the nite. I pray for all of you he gets a miracle. What a cute baby he is. Blessings
Patti

[goldengirl88]

Terry:
Just popping in go check on that baby of yours. I am hoping Spencer can turn this thing sound. We are having a lazy day today, and I am resting. All this can really wear on you. Hope you had some sleep. Blessings
Patti

[Spencersmom]

Talked to the Neurologist today and he upped the seizure meds. Gave him the increased dose and tonight he seems to have loose stools again. Gave him Flagyl and hope it keeps his tummy in check!

Poor little baby...just so much to put him thru! He looks at me with these sad eyes and I just wonder if i'm doing this for him or for me & hubs!

[My sweet Ginger]

Oh, poor little Spencer. I hope he will feel better tomorrow.

He is on liquid Levetiracetam, right? What's his dosage? It gave my pup loose stools too but she was fine on tablets.:rolleyes:

[goldengirl88]

Terry:
This poor baby cannot catch a break here. Do you think the upping of the dosage caused the loose stools? I sure hope not as it may control these seizures and he would need it. Maybe the neurologist could advise if it would do that?? Praying for Spencer to be well again. Blessings
Patti

[molly muffin]

Did the increase dosage help Spencer?

Hoping today is a better day.

hugs
Sharlene and molly muffin

[goldengirl88]

Terry:
Hoping Spencer had a better nite on the new dosage. Blessings
Patti

[goldengirl88]

Just wanted to know if there is any update on the baby? I truly hope this increase helped. Blessings
Patti

[Spencersmom]

Hi everyone!!! With the holiday and two busy weekends it's been a while since I've provided an update! I think the additional seizure meds are starting to help! He went a week with none and the one he had sunday morning was very brief! We gave him valium right away and that prevented any additional cluster attacks. Since his seizures are reduced, he seems more alert and has become quite the vocal chatterbox! He has no problem telling us he wants some chicken, or barking at me to wake up in the morning or even telling us...hey, pick me up!!!

We were supposed to volunteer this coming weekend at our annual Relay for Life event for Cancer research, but have cancelled this year to avoid putting Spencer thru any unnecessary stress! My team captain was very understanding and agreed that sometimes there are more important priorities....and this year, I agree!

I hope all of you had a very blessed Easter!

[goldengirl88]

Terry:
I am so relieved to hear from you. I am so happy your boy us feeling better. This is really good news that the extra meds are controlling his seizures better. I totally agree about not doing the race, Spencer is more important and needs you
now. Blessings
Patti

[molly muffin]

What a great update! So glad that Spencer seems to be doing better and has found his voice again. Always a good sign when they become chatterboxes. :)

Yea, that might have been a bit much for Spencer this year.

Hope you are getting some sleep now too. :)_

hugs
Sharlene and molly muffin

[Spencersmom]

I hope I don't sound neglectful, but Spencer hasn't had a bath in a while with all of his issues and to tell you the truth, I'm afraid because of his paper thin skin!!! Will it be ok to give him a bath and do I need to use any kind of special shampoo??? I would think he would enjoy getting all clean, but with his skin so fragile, I don't want to chance causing an infection or discomfort in any way!

[Iraklis]

I used baby wipes or a towel ''watered'' with vinegar.
Gently!

P.s. Husko wasn't bathed since last May...cause later all hell broke loose...

[doxiesrock912]

Terry, I wonder if just a really good rinse with warm water would suffice if you're worried about breaking skin or irritation?

Great news that the meds are working! Seizures are so scary to watch.

[Squirt's Mom]

Good to hear that Spencer is doing well and chatting with you! :D

I'm not a big one for frequent bathing - I think the natural oils can be better for the skin than the chemicals in the shampoos most of the time. The same as washing our hair every day strips the oils, making our hair brittle and the scalp dry. Mine don't spend much time outside usually and they get baths only when they are really needed. Brushing helps keep them clean and I use baby wipes for minor clean-up like muddy feet....or I'll dunk them in a bowl of water. :D So unless there is a real need, I wouldn't worry about bathing him. Dogs don't worry about BO like we do. :p

[Harley PoMMom]

I, too, think it is fine to skip the bath right now, but when you do decide to give Spencer his bath I would try to find a dog shampoo for delicate skin.

Hugs, Lori

[Spencersmom]

Thank you all for the bath input. For now, I think I will just spot treat any area's that need attention.

He slept really good last night.....so did I, for that matter!!!:D I'll try to get a video of him "talking" to us and post a link so y'all can see how much he has improved. He is walking better, even tries to get into a bit of a gallup at times. Not having the seizures has really made him feel better. I can see now how much of a toll it takes on him when he has them, especially if more than one.

Your input and encouragement have meant the world to me and my hubs....and Spencer too!!! To each and every one....thank you for being on this forum and offering your wonderful support!!!

You all ROCK!!!:D:D:D