My Lucy is eating the walls - probably pituitary macro tumor

[lunalf]

Hi,

My 14-year old Scottie, Lucy, just had her birthday on April 14th. She was diagnosed with Cushing's four years ago and has been on 30mg Trilostane ever since and has done quite well.

It figures that after celebrating her 14th birthday (where I know she has already beaten the odds), just a week ago she suddenly started to literally eat the walls in our house. She walks up to the wall, sniffs, and starts in with her teeth. It's the most bizarre thing I've ever seen.

So, just this past Friday, I planned on working from home and also had a vet appt. to bring her in at 2pm. At 1:15pm the gardeners were here and since I was home I asked them to blow off the side patio. Lucy (and my other three dogs) ran to the patio sliding door to bark at them (even though I had the blinds closed) and suddenly Lucy let out this scream/wail/cry of the likes I have never heard before. I ran over to her and her front legs were out straight in front of her and it was like her body became a flat plank against the floor. Freaked me out!!!! And I was just about to get ready to take her to the vets!

So, she had a seizure. My vet (whom I have been going to for 14 years and adore) surmised that her pituitary tumor has started to expand and is causing this. She explained all the options, and at 14-years old there is no way I'm putting her through an MRI just to find out what I already know. No radiation, etc. It's now time for her quality of life to rule.

My vet gave her some downers for three days only to try an avoid another seizure - seems they happen in clusters. Xrays showed no evidence of liver or heart irregularities.

She has now produced six or seven nice holes in the wall but hey, we can fix those. I'm more concerned now about the time she has left. I took her to the park yesterday and today and she just meandered about sniffing and poking around. she is still eating well.

I don't want her to suffer at all. I don't want her to go, either. But I've been through this before, and I guess we'll know. Thanks for listening.

Linda and Lucy

[goldengirl88]

So sorry to hear about your Lucy. You do however give people like me hope that my Tipper can go on for a few more years, so it was good of you to post this. I am however sorry for what you and Lucy are going thru. I never heard of them eating anything strange, but a lot of them do excessive licking of any object near them. I hope you are given many more days with Lucy, and that she does not suffer. Blessings
Patti

[Spencersmom]

Hi Linda! So sorry to hear of Lucy's struggles! My Spencer was recently diagnosed with Cushings and about the same time started having seizures. We have him on Keppra or Levetiracetam every 8 hours for control, and Valium if he has a seizure. It has helped tremendously! He has now gone more than two weeks without one. Took time to get the right dosage, but I feel we are on the right track now! His neurologist thinks he has pituitary and secondary brain tumor. Like you, we are focusing on quality of life at this point. He is almost 12 yrs old!

You mentioned the wall chewing....that is a behavior change most likely associated to the tumor.

Are you still giving meds for Lucy's seizures?

[lunalf]

Thanks so much for your thoughtful responses.

I don't have her on any anti-seizure meds yet. I'm waiting to hear back from my vet this morning for her lab results. I have read on some of the threads that some people have given prednisone for the pituitary macro tumors which lessen the inflammation and that it helps. I am going to ask my vet about this. I know it can only be a short-term solution but I will let you know what she says.

Yes, Lucy has lived a full life and I never thought she'd make it this far. My last Scottie died at 10 years old from lymphoma and a myriad of other ailments. I am at work now and I hated to leave her this morning.

[Budsters Mom]

Prednisone therapy gave my Buddy a few more weeks of feeling well enough to do what he loved. It needs to be monitored very carefully, and administered under the advice of a qualified vet. Buddy's treatment plan was monitored by a neurosurgeon and administered through his GP vet, then relayed to me. Dosages have to be continuously adjusted depending on the symptoms being presented. Prednisone raises cortisol levels, so careful monitoring is crucial.

Kathy

[Budsters Mom]

Sorry, it posted twice. I'm bad!;)

[molly muffin]

Seizure meds, prednison, all are options that you can discuss with your vet. If your vet is unsure, he can consult with a IMS also.
The object is to have the best quality of life going forward and any good vet is going to understand this and work with you to make your baby has comfortable and doggie happy for as long as possible.

Spencer is doing very well on his seizure meds at this point, but you do sometimes need to tweak and trying different combinations to hit the one that is right.

You will have company on your journey as we are like one big family around here. :)

Sharlene and Molly muffin

[lunalf]

Hi all,

My vet called this morning with lab results. It looks like Lucy also is becoming anemic and perhaps has a stomach ulcer. She put her on phenobarbital (anti-seizure) and Carafate to help her stomach. She told me that she WILL have more seizures and that is the reason for the phenobarbital. she also said that if my Ms. Loo does not respond to these meds or appear to feel better that we can "discuss" things at the end of the week. I was at work and totally fell apart at the phone call. I am not good at this and never have been and I know you all are not either, otherwise you wouldn't be reading this.

I was worried sick about how she was doing all day. Did she have another seizure? Did she eat more of the walls? I do have three other doggies who keep her company through the day so at least she is not totally alone.

I also have theeee most wonderful boss who told me to take whatever time necessary to deal with her issue.

I get to work from home again tomorrow. Yea for me, and yea for Lucy, too. We are in for a huge heat wave here in the San Francisco Bay area, so too bad I can't take her out to the park tomorrow. She loves that.

thanks again for the support!

Linda
xo

[molly muffin]

Yay for understanding bosses. :) Working from home is great when you are worried about a furbaby.

Pheno can control the seizures, it depends a great deal on the cause, if it is a macro tumor or not.

We do know how hard this is. You just do the best you can and nope, none of us are very good and having to say goodbye.

Sharlene and molly muffin

[addy]

I hope the medication helps. I know Marianne knows quite a bit about that drug as her Peg has been taking it for quite some time.

Is Lucy still taking her Trilostane? Do you know what her ACTH tests results were and when was it done?

[molly muffin]

Has Lucy cortisol levels been checked recently? Since the wall eating began I mean? Even on the same dose after awhile, it might need to be tweaked and I just was thinking of a dog that was eating the enamel off the food bowl and the cortisol had gone up out of nowhere. Just a thought.


Sharlene and molly muffin

[Spencersmom]

So glad you will get to work from home! Awesome boss of the year! I sure hope Lucy gets some relief, and you too!!

I would certainly encourage some seizure therapy....priority! The seizures sure do a number on them. Wipes Spencer out the whole day! If Lucy does have a tumor, there will be changes that you will have to adjust to. Hubs & I are learning every day!!! First and foremost, we realize we must give Spencer stress free life, you are one up on us there!:D. From there, you will know in your heart what to do!

Give Lucy a big hug from me! Loves from Michigan!!

[lunalf]

All you guys are the best! thanks so much for all the kindness you have shown me.

It is now Tuesday night and Ms. Lucy has done pretty well today. Still eating and since I worked from home today (and tomorrow) she follows me all around the house. it's so cute.

She did show interest in more wall damage today but once I get in front of her and redirect her attention, she gives up and finds a nice place to take a nap.

she started on the phenobarbital last night.

Since she is now 14, I have not had another ACTH test done recently. She did have complete labwork done the other day and as it stands, I know (as I have already mentioned) that she has already beaten her odds of making it to 14. I am just trying to make her as comfortable as possible now. She sleeps with me and we are now ready to go to bed to face another day tomorrow.

Once again, thank you all for caring.

Linda and Lucy

[labblab]

Hi Linda,

I really hope the phenobarb will help Lucy. As Addy says, my Peg has been taking it really successfully for three years now and I hope Lucy will do well with it, too. I realize, though, that you have multiple issues to deal with if it is indeed a macrotumor that is causing the problems.

Are you still giving the trilostane? It is possible that the phenobarb may alter the effectiveness (either increase or decrease it), so if the two drugs were to end up being given together for a period of time, it would be good to consult with the manufacturer as to any suggested trilostane dosing alterations.

Marianne

[goldengirl88]

Would it be possible to put a piece of furniture in front of the wall where she is doing this to get her mind off of it? I hope you are not dealing with a macro tumor. I pray things get better for Lucy I know you both are having a hard time of it. Blessings
Patti

[lunalf]

The walls: yes, you should see my house! The inside looks like it is all boarded up. I can't cover every square inch but if I am able to redirect her attention she just walks away and lays down.

She started on the pheno last night. I took her to the park early this morning and she walked (slowly) all around and sniffed everywhere. She ate all her breakfast this morning. She is still alert, eating, and following me around the house.

If she continues to maintain this, my groomer can take her in on Friday morning at 8am and have a bath and haircut. Lucy is way overdue and is pretty shaggy and I think this will make her feel better. They know al about the brain tumor and anti-seizure meds and I will be standing by just in case.

She is 20 lbs. and still on a 30mg twice a day dosage of Trilostane which she has been on now for four years. She's never shown any side effects from it at all, unless a buildup from the drug can cause the pituitary tumor to start expanding after being on the drug so long??

[labblab]

Thanks so much for this additional info. A total of 60 mg. a day is quite a substantial dose of trilostane for a dog of Lucy's weight, and in honesty, I am quite surprised that Lucy has not needed any dosage adjustment at all during these past four years. From our experience here, that is very, very rare. Many dogs having taken the drug over an extended time period end up needing decreases so as not to become overdosed. It is possible that four years of treatment has hastened the expansion of Lucy's pituitary tumor. But I also do wonder whether perhaps she is on a higher dose of trilostane than is optimal for her at this time. Up until the wall-eating and the seizure episode this past week, had Lucy's behavior been otherwise normal -- normal appetite, thirst, activity level for her age? The wall-eating actually has me scratching my head, because I have not heard of behavior like that in connection with dogs diagnosed with macrotumors. The common behavioral issues are pacing, circling, getting "stuck" in corners, head-pressing, loss of coordination, mental dullness, lethargy, loss of appetite and inability to eat and drink.

I know your vet is labelling Lucy's collapse as a seizure, but if it has been a long time since the last ACTH test, now I'm starting to wonder whether low cortisol might be playing any role at all in Lucy's collapse. I don't see how it would account for the wall-eating, but I have also seen anemia and blood in the feces listed as possible effects of an Addisonian state. If all her other labwork was within normal limits, I may just be grasping at straws here. But now, upon more reflection, it seems to me that your vet may be jumping the gun by automatically assuming that a macrotumor is causing all these problems for Lucy, and also starting her on phenobarb after only one seizure episode. I really think you first would want to know what is going on with her cortisol level if it has been quite some time since she was last tested.

One other note in that regard: If Lucy really does have an expanding macrotumor, a decrease or cessation of the trilostane may actually help her to feel better. Steroids can decrease swelling and inflammation in the brain caused by tumor expansion, so in some cases, some Cushpups actually end up taking prednisone instead of trilostane when a macrotumor has been diagnosed.

And one final thought...is Lucy's thyroid function normal at this time, and has it been normal throughout her treatment? Low thyroid levels can trigger seizures and other abnormal behaviors, but this is an issue that can be easily remedied via inexpensive medication. Whenever I hear about dogs having seizures, that is one of the first things I ask because there is such a simple solution for it. On a basic blood chemistry, thyroid function will be noted as the "T4" level.

Marianne

[labblab]

Just wanted to add this quote from Dr. Jean Dodds re: behavioral issues that can be associated with low thyroid function:


In adult dogs, moodiness, erratic temperament, periods of hyperactivity, lack of concentration, depression, mental dullness, lethargy, malaise, fearfulness and phobias, anxiety, submissiveness, passivity, compulsiveness, and irritability may be observed. After the episodes, most of the animals behave as though they were coming out of a trance like state, and are unaware of their previous behavior.

​Another group of dogs show seizure or seizure-like disorders of sudden onset that can occur at any time from puberty to mid-life. These dogs appear perfectly healthy outwardly, have normal hair coats and energy, but suddenly seizure for no apparent reason. The seizures are often spaced several weeks to months apart, may coincide with the full moon, and can appear in brief clusters. In some cases the animals become aggressive and attack those around them shortly before or after having one of the seizures. The numbers of animals showing these various types of aberrant behavior appear to be increasing in frequency over the last decade.


http://www.k9cushings.com/forum/attachment.php?attachmentid=405&d=1263422583

[lunalf]

Oh Marianne, I am so freaking confused!!! I don't know what to do!!

Lucy was doing great! Turned 14 on April 14th and I was just so impressed with her. She could still "turn on the juice" so to speak when I took her to the park. She liked to poop and then start to run. Too funny!

Then this wall thing started out of the blue early in the week of May 4th. Friday, May 9th was when she had the seizure. I was working from home, the gardeners came, I asked them to blow off the side patio (where the kitchen sliding doors are), and when they did, my other dogs and Lucy had a fit because they could see them. Lucy ran over to the sliders barking her head off and that is when she went into this pancake-like body with her two front legs sticking straight ahead and she let out this wail/howl/cry the likes I've never heard before.

So my vet told me we could never know for sure if it was a macro tumor unless we did the MRI, which I said no way (and she agreed). So, she was very concerned that Lucy was going to have another seizure within the next 48 hours, so she put her on downers for the weekend (she was a zombie) until she got the lab results back this past Monday. I just called and they are going to send me a copy.

She said that it also looked like Lucy was becoming anemic and may have a stomach ulcer. So Lucy was started on the 16.2mg pills of pheon, but the dosage was one and a half pills every 12 hours, which is a total of 24.3mg every day. I could tell after the first dosage it was too much and I told my vet so it was decreased to the 16.2mg every 12 hours.

I am so conflicted I don't know what to do. I took her to the park this morning before coming to work and she walked around and even wagged her tail when she met some lovely pugs.

I did suggest to my vet that I wanted to decrease her Trilostane and she said, "For the Trilostane, generally I only reduce it if there are side effects and again, we run the risk of not controlling the disease process that we are trying to treat. If you would like to decrease to once daily next week, then we can see if she starts acting more Cushingoid."

What do you think? I AM SO CONFUSED!!!

[molly muffin]

I think we don't know if this behavior might not be a side effect of the trilostane. Personally, I would do an ACTH to be sure. That is just what I would do. It could be she is low, and that is causing the other things, an ulcer could be causing the anemia. Have you considered giving pepcid 30 minutes prior to medication?

That is just my thoughts on the current situation. It might not be a macro and as you said, no way to know for sure, but there are other things that Can be ruled out. A full blood test too would be a good idea. Hang with her while she is there at the vets and then go to the park. (and know that after an ACTH, for 48hours or so, they can react like they have full out noncontrolled cushings, it is a reaction to the cortisol dump, especially if it were to be high, if low the reaction wouldn't be as much or not at all)

Sharlene and molly muffin

[labblab]

Linda, I hate to put you on the spot, but can you tell us specifics about any monitoring ACTH testing that has been done for Lucy during these past four years? I am suspecting that it may have been infrequent, and perhaps not for quite some time? We are not here to judge you, but rather we are just trying to gather info to help us with our suggestions.

I may be totally wrong, but it kinda sounds to me as though your vet is trying to hold off on any in-depth testing or diagnostics and is instead letting nature run its course. At Lucy's age, I am not saying that is a bad approach. But I just want to make sure you, yourself, are comfortable as to whether or how much testing you want to pursue in order to try to get answers as to what is really going on here. Also, that you are not placing Lucy at greater risk by continuing the trilostane dosing (at any level) without knowing the status of her cortisol levels. A dog that eats the walls and has a seizure episode is not a well dog. But as it stands, we don't really know what is causing any of these problems right now. Your vet is offering treatments to try to ease symptoms, but they may or may not be targeting the genuine underlying problem/s.

I totally understand "passing" on the MRI. My own Cushpup suffered from what I assume was a macrotumor, but my husband and I also declined imaging because we knew we would not opt for radiation, either, so we never knew for certain. At Lucy's age, I can also understand not wanting to subject her to any GI scoping, either, in order to diagnose the source of any bleeding from her digestive system. There may be some other testing, though, that could be performed more easily and that could shed some light, such as at least a baseline cortisol level if not a full ACTH and also a thyroid panel. However, again, this all boils down to how much medical intervention you want for Lucy right now. There does come a time when comfort at home may supercede vet visits and diagnostics.

I'm glad Lucy seems to be brighter today. What instructions has your vet given you about monitoring her phenobarb, however? What is her dose, and has your vet talked with you about scheduling a blood draw to check her phenobarb level within the next month? That is really, really important in order to make sure that the drug level is neither too high nor too low. If too high, it can cause liver damage which would present another whole set of new problems.

And to add one more reason in favor of checking Lucy's cortisol level through a full ACTH stim test, I do want to repeat the warning that I believe there may be an interaction between phenobarb and trilostane such that the trilostane dosing needs to be adjusted and/or monitored more closely. I'd encourage you or your vet to contact Dechra, the manufacturer of brandnane Vetoryl, in order to get their input about this issue:

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

Marianne

[goldengirl88]

I was thinking the same on some of this Marianne, but just didn't want to come out and express it. I am glad you did so at least there are options open for Lucy. I think if it were me I would be having a discussion with the vet, and expressing this and see what his reasons for not doing the ACTH really are. I would need to know this in order to make a plan. I hope and pray that maybe this is not a macro. Blessings
Patti

[lunalf]

OMG - could this be it??

She has been on carprofen (aka RIMADYL) for six months for her arthritis in her right leg. I had no idea that carprofen was Rimadyl! I just looked up the Side effects, one of which is SEIZURES and ULCERS. I just sent an email to my vet. Also, she had complete bloodwork and xrays done last Friday. The xrays were all clear and her T4 result was 1.1 ug/dL (which seems in the normal range according to these results).

If all of this is from the Rimadyl I will feel so guilty. We stopped it last Saturday.

Side effects (she has had none of these except the seizure, lethargy (she's 14, so...) and now an ulcer.

A loss of appetite and unwillingness to drink
Changes in urination patterns: sweet smelling urine, blood in the urine, and/or urinating far more than usual
Diarrhea
Vomiting
Vomit or stools containing blood
Changes in skin, including scabs, redness, itching
Change in normal temperament: lethargy, drowsiness, restlessness, aggressiveness, hyperactivity
Stumbling, staggering, partial or full paralysis
Seizures
Dizziness
Jaundice: yellow whites of the eyes, skin, and mucous membranes
Death

The side effects of Rimadyl are mostly attributable to liver, kidney, and gastrointestinal problems: in some dogs, Rimadyl causes ulceration and bleeding in the gut, damage to the kidney function, and liver failure, all of which are potentially fatal.

Side effects of Rimadyl can occur with hours of taking the drug, which is why pet owners must be extremely vigilant once Rimadyl has been administered to their dog. In other dogs, adverse symptoms do not appear until a few days have passed. Initially the dog might seem a little off colour—perhaps off its food and more lethargic than normal.

[labblab]

Wow, yes, I would really wonder whether or not the Rimadyl is the problem! If so, your vet has reason to feel guilty, not you!! GI bleeding and neurological issues are well-known side effects of this drug within the veterinary community, and any vet who prescribes it ought to be well aware of these potentially serious issues.

This is the last of several serious red flags raised by your vet. Prescribing trilostane for such a lengthy time without proper monitoring tests, rushing forward to prescribe phenobarb after only a single seizure event of unknown origin (most vets take a wait-and-see approach before prescribing such a serious drug unless there is a cluster of multiple seizures or the single seizure is of long duration), and now failing to realize that the Rimadyl may be the root of Lucy's issues anyway.

Yes, I would indeed stop the Rimadyl, and I would also consider weaning Lucy off the phenobarb until/unless you know it is really necessary. In general, you can't stop phenobarb cold turkey, but I don't know if she's been on it for a long enough time to be a problem since it's been less than a week. Unfortunately, I don't have a lot of confidence that your vet knows the answer to this, either. :o

Marianne

[molly muffin]

oh my goodness. That does sound like a possibility. I agree with Marianne! What was your vet thinking of not even looking into this!

As for the arthritis, dogs with arthritis, sometimes need to have more cortisol in their bodies to off set the pain from the arthritis, it's a balancing act, and lowering (trilostane dosage) just a bit might be enough to help her legs.

Sharlene and molly muffin

[lunalf]

Yes, Marianne, I have just lost total confidence in someone who has been seeing all of my dogs for the last 12 years.

Lucy started on the pheno this past Monday night. She has been on 1 pill a day of 16.2mg twice a day. I think tonight I will start her on half a pill, and then tomorrow maybe none at all.

I have sent my vet two emails about the Rimadyl and it will be interesting to see what she says. I can't thank you guys enough for bringing up questions that I needed to think about. I had no idea that carprofen was Rimadyl. My poor Lucy! If her stomach has been eaten up no wonder she is literally eating the walls in my house.

[addy]

I dont want to pile on here but my pup was on Vetoryl for almost 3 years. The last year we had to lower her dose as her cortisol levels kept dropping . We went from a total of 50 mgs given in two doses all the way down to 20 mgs once per day and her numbers were still going down.

She too had an episode, no one was home when it happened, but my husband found her splayed out on the floor with blood on the blanket and was totally non ambulatory. She was rushed to ER. They could find nothing wrong in the ultra sound, the blood work. Their guess was she had thrown a blood clot to the brain or had a massive seizure. The seizure, they thought, seemed unlikely as they usually will urinate and/or defecate but that was not ruled out. They also thought a possibility was that Zoe might have had a macro tumor that was putting too much pressure on her brain.

No one is here to judge anyone but I will urge you for Lucy's sake to find another vet or start researching as hard as you can and be a strong voice for your pup. I know money can be an issue and I know it can be hard.

I am just glad that you found us and I think Marianne is spot on.

Big hugs to you and Lucy

[labblab]

Lucy started on the pheno this past Monday night. She has been on 1 pill a day of 16.2mg twice a day. I think tonight I will start her on half a pill, and then tomorrow maybe none at all.

If Lucy has only been taking the phenobarb for a couple of days, I would hope that you can taper it rather quickly without the danger of triggering rebounding seizures. However, since we are not vets ourselves, we cannot recommend that you make any medication changes without first consulting your own vet.

I will say that for a 20 pound dog, a dose of 16.2 mg. twice daily is a sub-therapeutic dose, anyway. The normal initial dosing range is 2.5 - 3.0 mg. per kg., which would translate into approx. 22.5 to 27 mg. twice daily for a dog weighing 20 pounds (1 pound = 2.2 kg.).

http://www.idexx.com/pubwebresources/pdf/en_us/smallanimal/diagnosticedge/de-october-2012/catalyst-phenobarbital-white-paper.pdf

Marianne

[lunalf]

She started on the pheno Monday night. The Rx on the label said,
"1 1/2 tablet every 12 hours."

I read that as one half tablet every 12 hours, but she meant it as 1.5 pills for a dosage of 24.3mg. so the first two dosages were just 1 tablet (16.2mg).

I called to make sure I was correct and they said no, it should be 1.5 tabletS.

So yay for my reading it wrong (and them writing it incorrectly).

So Lucy has had 1 pill Monday night, 1 pill Tuesday morning, and when I found out it was supposed to be 1.5 pills I gave her that much on Tuesday night and she turned into a zombie. I emailed her at 10pm and she answered "ok, then just give her 1 pill every 12 hrs."

Since today is Thursday she has not had many dosages, so the vet said just to stop it. We have scheduled a call for tomorrow as I am sure she does not want to write any real responses to my several emails of today.

I also gave her only 15mg of Trilostane tonight for a total of 45mgs for the day. I am going to do this for a week or so and then cut it down again with a vet's approval.

[lunalf]

If you all could chime in here, I'm curious: On your pet's RX labels, if you get a generic drug, does it say what it is generic for?

My husband just told me that any Rx he gets from Kaiser always states on the label what the generic drug represents.

This label only said: Carprofen - generic. No mention of Rimadyl at all.

[labblab]

Neither our human generics nor our dogs' list a brand name on the label. I don't think that is unusual, especially because sometimes there may be more than one brand name drug that contains the same active ingredient.


I also gave her only 15mg of Trilostane tonight for a total of 45mgs for the day. I am going to do this for a week or so and then cut it down again with a vet's approval.
In the absence of an ACTH test, I am not sure about your decision to lower the trilostane dosage. Since you don't know where Lucy's cortisol level is now, this is really just a craps shoot on your part :o. For instance, if she does not have a macrotumor and her Cushing's is being appropriately controlled, there may be a much better option for arthritic pain management than allowing her cortisol to spike.

Is there something about the ACTH that has both you and your vet feeling so resistant about testing Lucy? The expense is an obvious consideration, but is there anything else? The thing is, you may end up spending much more money in the long run if you remain blind as to the trilostane's effect on her cortisol level.

Marianne

[lunalf]

Hi Marianne,

Forgive me, but I work full-time and with Lucy's seizure last Friday and the ensuing events I have been a complete basket case.

I am going to get her cortisol levels rechecked asap.

[labblab]

Yes, I can surely imagine how upsetting all this has been for you and your husband! It is so hard to clear your brain when you are feeling so worried about your baby.

I am still trying to wrap my head around the wall-eating...:confused:

Aside from the seizure episode, is there anything else about Lucy's behavior that has been out if the ordinary? From our experience here, the more typical abnormal behaviors associated with macrotumors have been mental dullness and stuff like repetitive pacing. Something as "active" as eating the walls is just different from the norm. That is a reason why I am still questioning whether an enlarging tumor is the source of the problem. It will be really interesting to see whether stopping the Rimadyl will make a difference for Lucy!

Marianne

[Junior's Mom]

I can't comment on a macro tumour, because I know nothing about those.
As to the wall eating, if you are talking about drywall (gypsum board), I have a few dogs who do that. Regardless of the reasons they started, I have to keep any bare spots covered, or they will continue to chew away at it. I had a dog years ago, who also ate drywall, once he got a taste of it. Somebody told me once that it has a form of salt in it, and perhaps that is why.
Good luck with figuring things out with your pup. I hope she feels better soon.
Tracey

[lunalf]

Marianne,

1. I am having the stim test done tomorrow morning
2. I stopped the Rimadyl beginning Tuesday, so she has now been off of it for four days.
3. I took her for her bath and trim this morning. When she got home, she was more animated than I have seen her in a long time.
4. I sent my vet a very terse email this morning about the timeline with the "carprofen" and Lucy's crash. It all makes perfect sense to me. Just got off the phone with my vet who began by saying that "Rimadyl is the most widely prescribed arthritis medicine for dogs. It could be the reason for her ulcer, or something else. We don't know." She is covering her butt, I know. I'm not going to start a war with her now.
5. Yes, Lucy is eating the drywall. Does she smell the salt in it? Do you think she is craving salt for some reason??
6. As far as other odd behavior there has been nothing else.

I will have the results of the stim test back on Monday. I am going to leave her current dosage of Trilostane alone until the results come back to see what it tells us.

She looks so cute in her bandana from this morning. I am going home from work now and can't wait to see her again. BTW, I have four dogs in all. The other three were so happy to see her when she got back from her grooming this morning!

[Harley PoMMom]

The major mineral component in all drywall is gypsum, chemically known as calcium, so I am wondering if Lucy has a calcium deficiency? Just throwing that out there. :o

Hugs, Lori

[goldengirl88]

Lori might be onto something there about the gypsum.

[lunalf]

She just had labwork done and her calcium level is fine.

Junior's Mom: if you had several dogs that did this, was there any common denominator? Isn't that strange to have more than one dog do this in your lifetime?

[goldengirl88]

I guess this takes further discovery then?? I wonder if it is something used in the paper that adheres to it? Blessings
Patti

[lunalf]

Hi all,

Just an update on Lucy:

1. I had the cortisol test done over the weekend. Her level is 2.2 which from what I understand is at the "low end." Do you agree? If that is the low end, and she is taking a 30mg pill 2x/day, do you concur that this dosage should be lessened?

2. Since I stopped giving her the Rimadyl a week ago, her "mania" about the walls has lessened greatly. She is still showing some interest but nothing like before. She is more alert. She has stopped this heavy breathing at night and seems more calm. No more seizures since I stopped this drug. I have now talked to two of my friends: one swears by it and has been giving it to her Great Dane for 5 years, and my other friend said, "Don't you remember? That's what killed Bear!" So, it obviously works for some dogs and destoys others.

Thanks again for all of your input. If it were not for you guys, I never would have had the seeds of doubt planted in my mind.

I look forward to hearing your comments about the Trilostane dosage as my vet is inclined to leave it as is but she will go along with whatever I want.

Linda

[labblab]

Linda, there should be two numbers from the ACTH test: a "pre" or baseline level that was taken before injecting the stimulating agent, and then a second "post" number from blood drawn 1-2 hours later. Can you get both numbers for us, because it makes a difference if the 2.2 was before or after the stimulating agent was given.

Thanks!
Marianne

[lunalf]

This was a "post-stim" test. It was performed 3+ hours after being given her 30mg dose at 7:15am.

The 2.2 was the number AFTER the stimulating agent was given.

[molly muffin]

Right and what was her pre number? 2.2 is controlled but I still would like to know the pre level.
30mg is the dosage she has been on for a long time right? Is there where her levels normally are?

Glad to hear that her behavior is returning to more normal actions.

Drugs are like that, any dog can have a sensitivity and a reaction to any drug. What works for one might not work at all for another.

Sharlene and molly muffin

[addy]

While there is nothing wrong with a post of 2.2, it depends on how the dog is feeling and I would also like to see the pre number and where she was pre and post on her last acth test, whenever that was.

The reason I ask is my own dog was on the drug for a long time, I started seeing behavior I had never seen before; when I took her in she was about the same post 2.2. I then lowered her dose to see if her behavior improved and she still kept dropping lower even though every time I lowered her dose.


So if your pup is feeling good then no worries. If you feel Lucy is better since stopping the Rimadyl, maybe she is fine on this dose. Monitoring has to do with dose history and symptoms.:):)

That would be my input:):) Others will give theirs.

[Harley PoMMom]

On Trilostane I would prefer to see a dog's post a bit higher than 2.2 ug/dl. On Dr Peterson's blog he states that a post of 2.0 ug/dl is too low for a dog being treated with Trilostane, here's an excerpt from his blog:
When using trilostane, it has become increasing clear that we do not want the cortisol values to drop too low, because that may indicate early or mild adrenal necrosis (1,11,12). In contrast to the protocol used in this reported study, I recommend stopping the drug in all dogs that develop a ACTH-stimulated cortisol values less than 2.0 μg/dl, and repeating the ACTH stimulation test in 1- to 2-weeks in those dogs. Some of these dogs will require that the drug be restarted at a lower dosage, but others will maintain low to normal serum cortisol concentrations for prolonged periods of time. And a subset of these dogs, presumably because of mild adrenal necrosis, will never need any further trilostane treatment to control the signs of Cushing's syndrome.



Low-Dose, Twice-Daily Trilostane Treatment for Dogs with Hyperadrenocorticism (http://endocrinevet.blogspot.com/2012/12/low-dose-twice-daily-trilostane.html)

Hugs, Lori