Princess 8hr testing for Cushing's today Aug 27-2014

[princessdaddy]

I am the dad of Princess Lily a Tan Chihuahua/terrier mix. Princess is a 10 year old loving girl (spayed). The apple of my eye & best friend. I noticed she started to gain weight so I cut back on raw hides and treats. I tried IAMS weight loss dog food but she continued to gain weight in her belly. I couldn't understand because I was no longer giving her treats. She has lost hair on her tail, belly and chest. I noticed she was panting a lot and drinking lots of water. I couldn't keep up with changing the emergency doggy diapers we have laid out for her in the laundry room. At first I thought it was due to the hot weather? I started getting concerned about her weight gain. This happened over a period of time. I recently did a little research and started getting very concerned. My wife & I took her to the VET last Aug. 21, 2014. The VET mentioned the now familiar word Cushing's. I didn't want to hear that come out of his mouth. They tested her blood $341.00. They sent me a PDF file and it didn't look good to me. They wanted to do an 8 hr test on her. Inject her with medicine and test her again. To confirm whether she has Cushings or not. We took her back to the VET today Aug. 27, 2014/Wed. She looked so scared when they were weighing her she defecated a little bit. She looked at me and I reassured her it was alright. It actually broke my heart. I asked the assistant Tuesday if I could bring her blanket they agreed. I made sure to rub it on Duchess Lulu (our black and tan Chi-mix with miniature pinscher) wife and myself so she could have her families scent on the blanket. We are a close family and we do everything together. She never leaves my side, so this must be a terrible but necessary experience for her. I told her what was going to happen and why. I just hope she's not too scared. We go back to pick her up in four more long hours. I just pray that she does not have this horrible disease. I've asked all friends and family members to pray for her on FB. I am kindly asking for your prayers for her as well. Having support is important. I am grateful to have found this site. I don't feel so all alone. You all sound like a very loving group. Thanks for listening Angel from the Bay. Princessdaddy

[Squirt's Mom]

Hi Dad and welcome to you and Princess...and your whole family! :)

First, take a deep breath. Cushing's is not a death sentence in spite of what you may have read on the web. Most cush pups live out their normal life span and beyond with proper treatment. AND you are now in the best of hands here at K9C. Ya'll have a brand new family and this is one heck of a family indeed.

When you pick your sweet girl up, be sure to ask for copies of the actual test results. This is a habit you will want to develop starting today. Not only will you have a file at home in case she should see a different vet for any reason, you will also be able to answer the questions we will ask of you...and there will be many. ;) So let's get started with a few, ok?

Can you tell us how much Princess weighs now?

Does she have any other health issues that you know of?

Is she taking any meds, supplements, herbs, etc?

If so, what and what for?

Is she spayed?

A hint for future testing - many of us keep our babies with us during the wait between blood draws, taking them to the park, back home if close enough, or just sitting in the parking lot or yard with them. Most vets are willing to allow you to do this so it won't hurt to ask for the next time. It sounds like she is having the ACTH today. The LDDS is an all day test so she might surely like to stay with you during that one for sure. Another test that is highly recommended is the abdominal ultrasound performed on a high resolution machine. This test has the "biggest bang for the buck" because it can not only go a long way in determining which form, pituitary or adrenal, but will also give them a good look at many other organs to make sure there is nothing going on with them.

I'm glad you found us and look forward to learning more as time goes by. Never hesitate to ask questions (it's only fair, after all! :D ) - we are all here to help each other.

Hugs,
Leslie and the gang

[princessdaddy]

Can you tell us how much Princess weighs now? Princess weighs a whooping 17.5 Far too heavy for a little dog. She shouldn't weigh more than 10lbs

Does she have any other health issues that you know of? No, other health issues that I know of.

Is she taking any meds, supplements, herbs, etc? Not taking any med, supplements or herbs.

If so, what and what for?

Is she spayed? Yes, she is spayed.

Thank you for the Tips on the testing. I would rather be with her in between times. I really appreciate that Tip. I didn't know I had options.

Regards, princessdaddy Angel from the Bay

[Harley PoMMom]

Hi and welcome to you and Princess Lily from me as well!

Leslie is right, Cushing's is not a death sentence for a dog. Cushing's is a treatable disease but success in treatment does depend on a few things; keen owner observation, a pet parent willing to educate themselves about Cushing's, and a vet/IMS that has experience treating Cushing's and is knowledgeable about the protocols for Cushing's.

Cushing's is one the most difficult diseases to get a confirmed diagnosis for, and unfortunately it is often misdiagnosed. Other non-adrenal illnesses, such as diabetes and any thyroid issue, share some of the same symptoms and should be ruled out.

Getting copies of all test/s and posting the results here along with the reference ranges and units of measurement would be great. We only need the abnormal values, e.g....ALT 150 U/L (5-50)...thanks! We are especially interested in the results of all tests for Cushing's.

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

Hugs, Lori

[Trixie]

I'm hoping to help you feel better. My dog was diagnosed in March of 2013. I was feeling then just as you are now. The 8 hour low dose dex test had me so upset too...the thought of leaving my dog at the vet all that time had me sleepless the night before the appt. It was a long day but we got through it, hope you all did too.
My dog got a positive diagnosis after that test and an ultrasound and we began medication pretty quickly afterward. I didn't want to wait and have her get worse but you do want to be sure that the diagnosis is correct before starting any medication.
I'm happy to report that my dog-Trixie, who is 10 yrs. now is doing great after almost a year and a half. It took a few months of tweaking her dose of Vetoryl but once we got the right strength for her the symptoms slowly began to subside. It didn't happen overnight but she has no more Cushings symptoms now. She continues to have her medication twice a day and she's doing great.
My advice if Princess does get a positive diagnosis is to discuss with your vet being very conservative with the dosing of the medication. My dog was about 16-17 pounds when we started and her dose was 7mg twice a day. A starting dose of 1mg per pound is a safe place to start, then adjusting the dose as needed after testing where her levels are. We increased very gradually until we hit the dose that controlled her the best which was 14mg twice a day. You are shooting for controlled symptoms on the lowest possible dose. The best way to get there is starting low and increasing slow.
The people here on this board got me through the beginning of Cushings to this point! They are extremely generous with their support and knowledge and will be a huge help to you and your dog.

Barbara

[pansywags]

I just want to say how fortunate Princess is to have such involved and caring people advocating for her.

[Dixie'sMom]

Hi Princessdaddy and welcome. I am new to this forum and to being a parent of a Cushpup also. There is tons of knowledge, support, experience and wisdom on this forum and it will help you to help your baby girl. I was also scared to death to get the diagnosis and they have helped tremendously in calming my fears. I'm still fearful, but getting better every day. My dachshund, Dixie is getting her ultrasound tomorrow so we have not begun treatment yet.The first thing I learned is that you do not have to rush into anything. You can take time to process all the information, gather some knowledge about the disease and get comfortable with a treatment plan before making decisions, and that is what I'm doing. Gathering information and proceeding slowly. Please let us know how her test went today. Hugs to you and your sweet girl.

[molly muffin]

I just want to say hello and welcome to the forum. We all walked in these doors terrified of that word, cushings. Most of us not knowing much if anything about it other than what we could quickly find on the internet. Not always the best information. Some is good info to know, some is not worth the time it took someone to type it. I'm glad you found us. We are all going through the same things you are, or have gone through, so you never walk alone.
Having a good support family is great, as at the beginning it can be so scary. I will tell you that the more you learn, the less scary it will be and the more determined you will become. Determine to get this figured out, and get your Princess back into a healthy life again.
Definitely get those test results, start your own file. I can't tell you how often I have referred back to mine. :) :)

Sharlene and molly muffin

[Squirt's Mom]

Just wanted to say that Terrier / Chi mixes are the BOMB! My Squirt was half Cairn Terrier and half Long Haired Chihuahua and was the best dog I ever met. If I were into breeding, I would be fighting to have that mix recognized as a breed all on it's own. In my experience, the blending of terrier and chi makes an unbelievable union, one of a kind, full of adventure, mischief, loyalty, and undying devotion.

[princessdaddy]

Picked up my little one Princess Lily. She looked really scared and confused with the assistant leading her on a plastic neck choke leash. (We use a halter on her) until I called her name. She looked at me like she wanted to tell me about it. I was so happy to hold her in my arms again. This test cost $444.60 Dexamethasone-Suppression. I know she was terrified because she soiled herself a little with feces. It was on her fur. She got a quick bath when she got home. She panted more all that evening and she seemed spooked at every single noise. All this was odd to me as she's a little firecracker. The large hematoma on her throat/jugular confirmed my suspicion. I don't want to think about it. After speaking to the Vet Gill Iqvinder from The Animal Clinic Santa Clara, CA I'm not comfortable with him. He puts me on the defensive. When I repeat what I "thought" he says, no. I ask him to repeat himself do to his heavy India accent. He makes me feel like I'm asking stupid questions. Princess is scared of his deep voice, rough bedside manner and the turban he wears. I did some research on him and he's only been practising here US for 10 years. I am currently looking for a female, more experienced VET or even a gentle male. I can't bare the thought that their man handling her because she is uncooperative do to fear. I can't. They sent me the results via email and confirmed that she does have Cushing's disease. I was prepared this time psychologically. The assistant called me today and asked what we wanted to do next. Ultra sound and xray. I told her to send me the estimate. She also asked if I had Care Credit because I was paying with cash. I told her I did. Princess also has Crystals Calcium Oxalate. I heard the assistant say something about surgery to remove the tumor after the ultra sound blah blah blah. To tell you the truth I didn't want to talk about any of this stuff...this evening. I put up a barrier mentally. I just need time to think, pray, research on a new Vet. I've lost sleep these past few days. I sleep lite. I'm always making sure Princess is ok and near me in the middle of the night/morning. She sleeps with us in our non-floatation waterbed along with her sister Duchess Lulu. I take her outside at all hours 1am, 3am, 5am etc. She's thirsty and also needs to urinate. She can't jump down onto her little step by the bed anymore. Her back legs seem a little weak holding all that belly weight up. It's hard for her to jump onto my recliner too. She used to jump like a little dear a couple of months ago. My baby can't dance for a frozen piece of naner either so I don't give her the command too. I'm just exhausted emotionally & physically. But I do know all this shall pass. I feel like I'm going through the eye of a storm right now, but we're going to fight it, that's for sure. Do I post her test results on a reply here or how does that work? This way you all can view them. Maybe Princess test/s can help another parent out there? Thank you for your support. Words can not express what this means to me right now. deep sigh princessdaddy Angel from the Bay

[Dixie'sMom]

I'm so sorry that you and Princess are going through this. You can post your results in the thread with just the abnormal numbers and what the high/low range is beside of it. Or you can upload a file to your pictures folder and link to it. Either way should work.

I'm so new to this myself, I wouldn't dream of trying to read the results, but others are very good at that and will be happy to help you. The one thing I wanted to say was that if you are not comfortable with this vet CHANGE. I loved my vet, but I have already changed because my vet just seemed very disconnected somehow thru this whole experience and I had doubts if he would really be available to us if we had problems or questions. So I changed because it's important to me that my little girl have someone who is interested in her and her case and willing to put up with my questions and fears. It also sounds like your current vet is charging you quite a bit. That may be the going price for tests and such in your area... I don't know. But you may even be able to see someone else and get better care for a better price. Also communication will be very important and if there is a language/accent barrier between you two, then that could also cause many problems. Others will be along to help shortly. I just wanted to say that I am praying for good things for you and your little girl, so take a few big, deep breaths and have faith that the right people will be put in place to help you, guide you, and get you to a vet you can respect and trust to treat Princess with kindness and respect and love. She's gonna be ok Papa. Keep the faith..

Suzie (and Dixie too!)

[Squirt's Mom]

Oh that bruising on the neck is so hard to see. :( So often my Squirt had to have blood drawn from her neck because her veins were so small and it always broke my heart to see the bruising.

If you are not comfortable with and do not trust this vet, then by all means find another one asap. One that Princess is ok with and one that will work with you as a team. An arrogant, uncommunicative vet is one of the last things we need when dealing with Cushing's. ;) But fair warning - it is likely that over time Princess is going to be nervous about any vet, even one she previously liked, simply because this disease often requires frequent vet visit with all the attendant pokes and prods. So make sure the new vet is one YOU can work with.

Unless they are looking for something else, I would not waste my money on an Xray - it will tell you nothing about Cushing's. An ultrasound, on the other hand, is one I strongly recommend. And FYI, one test cannot confirm Cushing's. This is one of, if not THE, most difficult canine condition to correctly diagnose because so many other conditions share the same signs and because other conditions can cause false-positives on the tests. My Squirt had 5 positive tests - LDDS, HDDS, ACTH, UTK panel, and ultrasound (2) and all said PDH but after the second US I was told about a tumor on her spleen. Once that was removed, her cortisol returned to normal. These test can only tell us that the cortisol is elelvated, not why it is elevated. And any stress internal or external can cause the cortisol to rise. So personally I am never comfortable when I see someone start treatment based on one positive test. ;)

Oxalate crystals and stones are not uncommon with cush pups and that may be why they are suggesting the xray - not sure.

Removing the tumor(s) associated with Cushing's is not something to be addressed or considered matter-of-factly - whether the tumor is on the adrenal gland(s) or the pituitary, surgery to remove them is highly risky and only the tumors on the adrenal gland(s) is done with any frequency - the pituitary tumor removal is too new in the US, and still too risky and expensive for most folk. So I would put that out of my mind today. If the tumor is on the adrenals, that is the only cure available for Cushing's, tho - removal of the tumor and gland if possible, but that is an extremely risky surgery and not undertaken by all.

Loss of muscle mass is also common in Cushing's. It's not the weight of the belly but the breakdown of the muscle mass itself due to the excess cortisol. The weight gain doesn't help the leg strength, of course, but loss of muscle mass is part of untreated Cushing's. Most pups regain that mass with proper treatment.

As for results, post them here in Princess' thread. We want to see only the abnormal values on the lab work that shows things like BUN, CHOL, ALKP, etc. (be sure to include the little letters like ug/dl, mol/l and the normal ranges for each value posted) but we want to see all the numbers on the cush tests - the LDDS will have 3 numbers, the ACTH will have 2 numbers.

Keep your chin up! You are doing good, Dad!
Hugs,
Leslie and the gang

[pansywags]

We live near each other. I sent you a PM with some vet info. Don't forget we live withing driving distance of UC Davis which houses some of the best vets on the planet and has much experience with Cushing's. It took me way too long to realize that was an option for us - if you can manage the time for the road trip it's an excellent option, though you'll still need a local vet for the treatment. Hang in there, I'm sorry for what you all are going through.

[princessdaddy]

I've been communicating with a retired SF librarian. Met her on Yelp when I was looking for another Vet for Princess. She & pansywags suggested I take her to UC Davis in their state of the art facilities/Specialist (so I started more research). She (Dorothy) assured me it would cost no more than a regular Vet. Long story short Princess Lily has an appointment Sept. 10, 2014 at UC Davis Veterinary facilities. She will be seen by a Specialist/Instructor along with students learning the field. I have been praying and have asked anyone and everyone on Facebook here there everywhere for their prayers as well. I am a firm believer in the power of prayer. I have been worried sick over all this. Dorothy (my new friend) took the time to answer all my questions. She went through the same thing, her pup being diagnosed with Cushings by a local Vet, when in fact her pup had something else. To this day she drives the 2 1/2 hr drive up to UC Davis for all her furbabies check ups etc. She says they take care of her pets so well she wished they took care of her...well, in a sense they do. It so happens we live in the same town. Santa Clara, CA how cool is this? I believe she was sent my way to console me and to put my mind at ease by divine intervention. It might sound a little strange to some but this is my belief. The icing on the cake is they do take Care Credit and this is a blessing to me also, as our finances are tight right now. I will do everything I possibly can to help make my Princess healthy once again. I wanted to FYI you all. Thank you for your support and the PM's. God bless you princessdaddy Angel from the Bay.

[princessdaddy]

@Lori I uploaded Princess test results so far in my photos. I'm not 100% sure how to link them so the group may view? or do you just go to my photos? Just wanted to FYI you all. Thanks princessdaddy Angel from the Bay

[pansywags]

princessdaddy, I'm so glad you were able to get an appointment at UC Davis. Which vet will you be seeing?

I recommend that while you wait for the appointment day to come, you get hard copes of all relevant medical records and write down a timeline of all Princess's symptoms, your concerns and questions to make sure you make the most of your visit.

If you need to burn some time while Princess is making friends with the various staff members/having tests run, Davis has a wonderful arboretum to walk through, it's very peaceful and beautiful and just a short walk from the vet buildings. If you have any interest in entomology (not everyone does, but I do!) the entomology museum is also great.

[Harley PoMMom]

I, too, am so glad that you and Princess have an appt. at UC Davis. Normally dogs with Cushing's have a high ALP and only moderate elevations are seen in the ALT, I see on Princess' lab work that her ALT and GGT are very elevated so I would definitely mention this to the vet at your UC Davis visit, in fact please do take all test results along with you to the UC Davis appoitment.

Princess's LDDS results are indicative to Cushing's, however, many things can create a false positive result on the low dose dexamethasone suppression test (LDDS), such as stress, and any other nonadrenal illness.

We are here for you and Princess, you are not alone on this journey. ;)

Please do let us know how the UC Davis appt. goes.

Hugs, Lori

[molly muffin]

Davis is very good. They should be able to get this sorted out.

Hugs
Sharlene and Molly muffin

[doxiesrock912]

If they suggest that Princess have an ultrasound, please do so. The enlarged belly with Cushings is due to organs enlarging and you want to know if any damage has been done there.

[pansywags]

Hi, when you have a chance we'd love to hear how the appointment at UC Davis went. Hoping for good things for you all.

[princessdaddy]

Hi All

I wanted to update you on my experience and what is going on with Princess Lily. We left Santa Clara at 11am and arrived at 1:30pm with a couple of bathroom breaks in between. The ride itself was not bad as far as the traffic goes. I was surprised to see so many cars going that way. I do not remember Dixon, CA being so busy (15yrs ago) My experience with UC Davis was really good. I do feel like they actually 'care' for their patients. Everything was as a member described. I appreciated the air-conditioned building as it was extremely hot that day, and we liked the comfy chairs.

It was cute to hear other doting pet parents talking to their fur babies behind us. Kind of reminded me of me. They did a urinalysis test on Princess, ultra sound and x-ray. They confirmed that she does have Cushing's along with another issue caused by this disease. Stones in her bladder, and need to be surgically removed. The Vet said it usually takes around 2 weeks for recovery; however, Cushing's patients take a little longer to heal. (not looking forward to the recovery part) It also means I will be camping out on the living room floor with her, because she's used to sleeping next to me since she was a puppy.

They ordered Princess Medication for Cushing's. The pharmacy will notify us and will be sending it through the mail. Her medication needs to be compounded. I suspect we will hear from them next week ending Sept. 21, 2014.
Her Vet said they had a Community hospital with students and a Specialist over seeing them. They can perform her surgery for a less price $600 plus dollars than the general public surgeons ($2k-$2800.00). She assured me that if it was her pet she would take her there. I told her I appreciated that statement. She was thorough with explaining everything and showing us the x-rays/ultra sound. I did not feel 'rushed'. I also liked the 'gentleness' from all three DVM and training students with Princess.

I told the Vet I felt overwhelmed by all the information and that I probably would not remember all of it. She understood that and had written everything down already. She stated that she had been doing this along time and most people only remember 5 percent of it (so I did not feel so bad)

They assured me that this Cushing's disease was not a death sentence like Cancer could be, but would need to be closely monitored and medication/labs were expensive but necessary for a better quality of life for Princess.

She gave me her card with her email on it and told me if I had any other concerns or questions to feel free to call or email her anytime. This was comforting to me. (I have not used it yet)
The bill came to $800 Thank God they took Care Credit. I was so relieved when you told me you saw a pamphlet there.

My overall experience was just as you said. Great. I did feel like they 'cared' and that is very important to me. I don't have the DVM's name right now (5:30am) I don't have her card in front of me but I do like her and trust her. Adriana (wife) and I thanked her and the others for their services and for being gentle and patient with Princess. She replied, "That's why we are in this profession, because we care" That is all I wanted to hear. It really warmed my heart and I could tell it warmed my wife Adriana's too. She made my eyes a little glossy with her warm gentle smile and understanding tone. It was probably the florescent lighting?

We left at 6pm and gave Princess her dinner we had packed. Princess was hungry because she fasted and was not allowed to eat all day. I was glad to see her eat. I know she was glad it was over with too. There was complete silence with bits of comments on the surrounding area on the 2 1/2 hr drive home. I think we were trying to soak it all in.

We arrived home at 8pm and was greeted by a very happy energetic Duchess Lulu a 4yr young black and tan little Chihuahua/Miniature Pinscher mix as she curiously sniffed Princess from head to toe for a good 5 minutes.

It was good to be home. I think I can speak for all of us.

A UC Davis student called me back Friday 9-12-14.First thing they asked was how Princess Lily was doing. That was nice & very professional. He (Student DVM) did a briefing regarding the medications and reminded me the pharmacy would be contacting us. He asked if we were interested in the surgery. I told him yes, so he will contact Community hospital and let them know. I told him, not this month (Sept.) He said that the Community hospital was pretty much booked this month and they would have openings in Oct. that's fine with me, I agreed with Oct.

My birthday is Sept. 26. I have an annual ritual for celebrating my birthday. I like to watch the sunset at Half moon Bay, CA and take photos/de-Stress. I do not want Princess to be in pain/convalescing during this time.

I have been writing down questions for the Community hospital as I think of them.

My baby still pants a lot, is very thirsty. Her coat looks dull. More loss of hair around the tail area. Her skin looks dry so I rub a small amount of pure organic coconut oil on her belly. We are also measuring her food now. I made a log to keep track of her food consumption. They used to have a food dispenser. Princess has the Cushings belly and is 7lbs over her normal weight of 10lbs which makes it difficult to jump on the couch, lazyboy chair, the podium to get to the bed. I stacked some blankets on the couch to help her reach the window so she can look out. She likes it there.

To some of the members: I appreciate your recommendation for UC Davis . We are grateful you took the time to reply.

blessings
Angel from the Bay

UPDATE: UC Davis called me last Sunday 9-14-13 they said they over charge me $186.00 and that they would be refunding it back to my card. (God is good all the time God is good)

[princessdaddy]

I forgot to mention. Princess x-ray/ultra scan showed both her adrenal glands a little bigger but not mass on them. They said most likely it's Pituitary that is affected. (I was hoping it was adrenal glands if anything) Her liver was slightly enlarged, but the DVM was not alarmed. She said it was do to the disease "Cushings". It sucks either way.

Angel from the Bay

[molly muffin]

This is an excellent report. We have always had very good reports and feed back from members who have used U of Davis.

She will be fine on medication I am sure and Davis will get the cortisol controlled. What dosage did they prescribe?

So glad to hear the trip and experience was good all around.

I always find the traffic is horrendous every time I go back to California and not at all the way it use to be back in the 80's when you could literally it seemed zip anywhere you needed to go.

Sharlene and molly muffin

[Harley PoMMom]

I am so glad that the visit with UC Davis was wonderful and it sounds like they were very thorough. And that was just admirable on their part to notify you of their billing mistake, so glad it was in your favor ;)

Is Princess going to be put on Trilostane? If so, what is the dosage, and is it going to be once or twice a day?

Hugs, Lori

[princessdaddy]

Lori, the pharmacy is suppose to call sometime this week regarding her compounded medication. Dr. Alyse Zacuto ordered 5mg capsules of Trilostane x2 a day. Dr. Zacuto said to monitor Princess for vomiting, diarrhea and blood in her stool, inappetance, sudden weight loss or dullness and to let them know right away.

Dr. Zacuto (UC Davis) said that the drug needed to be compounded to the right dose for Princess.

I am curious if any of you had to have the medications Compounded?

They have 3 days to contact me before I start emailing Princess doctor.
I just wished there was no 'guess work' in the medication dosage. But then again my doctor has done the same thing to me in the past. I use to call myself a human guinea pig and it was nothing nice. #itsapharmaceuticalworld

princessdaddy Angel from the Bay

[Squirt's Mom]

uhmmmm...am I understanding that Princess has bladder stones that are to be removed soon? AND that you are to start treating her with Trilostane now?

If that is correct, I would NOT start treatment nor would I pay for the drug until this surgery was over and Princess was fully recovered. Why? Because the presence of the stones can cause a false-positive on the cushing's testing.

My Squirt had 5 tests that were positive for the pituitary form but her cortisol returned to normal once a tumor and the spleen affected were removed - all 5 tests were false-positive due to that tumor. Because of this experience, there is no way in you know where I would start a dog on either drug for Cushing's as long as something else was going on like bladder stones. ;)

[princessdaddy]

You are correct. We are waiting for the pharmacy to call regarding her medication. (they have not yet called) I am also waiting for the Community hospital to call regarding her bladder stone removal surgery.

One of my questions is regarding Princess age and the toll all this new meds plus surgery will have on her 14 yr old body.

She has two issues 1. Cushings (symptoms) and needs medication 2. large bladder stones (on x-ray images) needs surgery.

I am confused because it does not make sense to me to start a treatment (medication) with multiple side affects. I have read that this is basically trail n error and lots of lab work to adjust dosage etc.

What I'm trying to say is how can we put her through all that PLUS a surgery and recovery?

I'm anxiously waiting for the Community hospital at UC Davis to call.

I am new to all this but if it were me. I wouldn't want to be sick and weak with perhaps side effects from the medication AND recovery from a very intrusive bladder stone removal surgery?

Who know's what can happen? leaks from a lose suture? not to mention weak from all the anesthesia and pain medication, pain etc.

This is a serious surgery...to me Any surgery at her age is serious.
big Sighs.

I know UC Davis is good at what they do. I've heard good things about them. That's why we drove hours to have her seen by them. But there's this tiny voice (its a thought, not audio) messing with me saying stuff like. "They are anxious to do this surgery because they need to get their hours in from surgeries in order to become a Certified DVM Surgeon"

I don't know if it's true or not because I have always been over protective of Princess and by me not understanding. My mind starts to wonder.

I don't want to 'wonder' I want to 'know' and be assured. This is my babygirl's life in the hands of these Vets/students and I don't want to play with it. She may be a little dog. But she's "my" little dog. That's the difference. She belongs to Angel....me. Princess daddy

#feelinganxiousoverprotectedwithmixedfeelings

Thank you for your input. I really appreciate it.

****I'm not sure what to do if it's a 'false positive'??
****How can we be 120% sure?

UC Davis doctor said do to Cushing's disease she produced these calcium deposits that formed into stones. She has multiple stones and some are large (Xray images, Ultra Sound)

UC Davis doctor also said they are too large to use a laser on them. She would be under anesthesia to long. So they have to do surgery

Regards
princessdaddy
Angel from the Bay

[lulusmom]

My first cushdog was a 4.5 lb Pomeranian. She had her second surgery for oxalate bladder stones at the time of diagnosis and before she started treatment. She was overtly symptomatic for a year before she was diagnosed but her gp vet was clueless and so was I. She had a previous surgery eleven months before the second one and she aced both of them with uncontrolled cushing's.

I've worked in rescue for decades and have had many of my rescues treated at a veterinary teaching hospital. Vet students are never unsupervised during surgery. There is always an experienced vet or surgeon looking over their shoulder with a microscope. Often times, the surgeon does the surgery while the students watch. Either way, I think Princess is in excellent hands at UC Davis.

Glynda

[princessdaddy]

Thank you Glynda. I needed to hear that. I am also really concerned with the extreme weight gain in a short amount of time. Princess is 17.5lbs (depending on scale or 17.0lbs) she should only weigh 10lbs or under. She is very bloated and her skin gets even tighter after drinking large amounts of water. Her breathing is somewhat labored and makes a snoring sound sometimes when she is awake laying on her side. I am concerned with the sutures she will have after surgery. It scares me to think they might pop and come apart because her belly skin is so tight and thin.

I say this because approx. 5 years ago Princess had surgery to remove a mass that was growing on her hind leg area. She jumped to bark at the mailman and her stitches popped open exposing her surgical wound.

I too was convalescing after having shoulder surgery during this time and managed to wrap her wound closed and put her in a carrying pet bag and rushed her to the Vet. This was a traumatic experience for us
as we were home alone. So this memory stays with me. (my phobia)

I made an Excel spreadsheet of her New Feeding Log. She does not eat a lot. 1/2 C of Iams kibble at a time. I want to keep track of how much she eats. It would be ideal if she lost some weight prior to surgery.

Just today my other one Duchess Lulu (4yr old) Min. Pin/Chi mix starting barking and startled Princess out of a deep sleep. Princess jumped from my lazy boy chair on to the floor (carpet) and landed on her tummy. All four legs gave out on her. Not just the hind. I know she's older but this has never happened before. I blame it on the extra belly weight and muscle weakness this damn disease brings.

It's hard for me to believe how in the matter of a month how weak her legs are. I know she isn't feeling good because she doesn't play with her favorite 'Coon' anymore. (Stuffed Raccoon toy)

Princess nightly ritual around 8-8:30pm was to find 'Coon' somewhere in the house and put him to bed with her. Which was usually laying next to me as I sat watching TV or studying on the PC on my lazy boy chair. She reminded me of a mother looking for her baby and tucking him to sleep. She didn't play with him at night, only put him next to her so she could clean him. Then she closed her eyes and waited for me to take her to bed, when I was ready.

I am looking forward to those days again. I really am.

I can't write anymore. It's makes me sad.

[pansywags]

I know how sad-making the whole thing can be (we all understand) but your girl is in the best hands at UC Davis.

Dr. Zacuto is really nice, she was very kind while giving me tough news about Pansy.

[princessdaddy]

I agree with you pansywags. Dr. Zacuto is very kind and thorough. She loves what she does. She gave me her personal email and that in itself said a lot to me. I've restrained myself from using it. I will give it until the end of this week before I start really using it. I will be patient until then.

Thank you pansywags
princessdaddy
Angel from the Bay

[lulusmom]

Which Iams kibble are you feeding and did Princess gain all that weight on the same amount of food? Were you open feeding prior to putting her on a strict twice a day regimen? If you are concerned about having the surgery before starting treatment, I recommend that you talk to the vet about it. If you didn't tell her about Princess' last bad experience with sutures, make sure you tell her now.

[princessdaddy]

Princess eats Iams Pro Active health small chunks. This was in a feed dispenser for both girls thus being "Open". I am blending the Pro Active health (green bag) with Iam's Natural (black bag). I want to feed them the new Iams natural. Princess eats less than a cup..it's more like 1/2 cup in the AM and 3/4 cup in the evening. She does not have that typical Cushing's ravenous appetite I've been reading about. She drinks more water than eats. We had both girls on Iams weight loss around 4 months ago but it didn't seem like it was working so we switched back to Pro Active. This was prior to being diagnosed and me knowing anything was wrong.

I stopped giving them raw hide bones to chew on and limited their treat intake. Duchess Lulu has her waist line back, but Princess still looks very bloated.

I will be emailing my concerns to Dr. Zacuto. Thanks for the suggestion. I did not tell Dr. Zacuto about that incident regarding the bad experience regarding the sutures. When I was there I just listened and only asked a few questions. There was to much information to take in. As my mind cleared I write down questions I have when the UC Davis Community hospital calls this week. I have them on my kitchen white board. I will be sure to tell them. Making a note after this message. Thank you lulusmom
princessdaddy Angel from the Bay

[lulusmom]

You should also ask the vet if obesity would place Princess at higher surgical risk. If I were you I would try to get Princess off of the Proactive Health completely. It's really inferior kibble so to call it Proactive Health is a joke. The second ingredient is cornmeal which isn't helping Princess lose weight nor get proper nutrition. Princess weighs 17.5 lbs but should weigh 10 lbs so you should be feeding a 10 lb dog. You are currently feeding her 1 1/4 cups a day, which is too much. Feeding instructions a 10 lb dog according to Iams Naturals Chicken & Barley is 1/2 to 1 cup a day. You should cut her back and no treats until you get her weight off. Most dogs love green beans so they are a great filler if she bugs you for food.

Glynda

[princessdaddy]

I received the call I was waiting for from the UC Davis Community hospital. They said that they want to wait until Princess Cushing's is under control with the medication before they perform the surgery to remove the multiple bladder stones. This was good news for me. This made more sense. Raquel said she would call back in 3-4 months. They were under the impression Princess was taking medication already. I informed them that the pharmacy had not called yet. They looked into it after we hung up and the Pharmacy (Grandpas Compounding Pharmacy) called me back within the hour. I was relived. The pharmacy said they were waiting on the Vetoryl from the doctor? I'm not sure what that meant. I paid them $58 for 30 day supply and they will be sending it via USPS snail mail. I am just grateful that they contacted me.

I am integrating Princess Lily & Duchess Lulu old Iams Pro Active to the black bag Iams® Healthy Naturals, so the girls tummy don't get upset. I mentioned what I was feeding her and the doctor said it was good food. I did some more researching and will be giving Princess only 1/2 cup twice a day. Her snacks if she gets any is a round piece of frozen banana every other day now. I'm going to Sprouts tomorrow to buy her some green beans and cut them into small pieces. Princess does not beg for food. I think small frozen piece of green bean will be nice for her to have on a hot California day.

I am doing more research on health and what to feed small breeds with bladder stones.

[princessdaddy]

Received Princess Lily compounded Trilostane (Vetoryl) 5mg which I will be giving her x2 per day with food. I fed Princess her 1/2 cup kibble Iams healthy naturals. Then I cut a small piece of banana (which she loves) and poked a hole large enough for the capsule. I gave her first capsule at 7am. I will repeat in 12 hrs.

I pray that this is the dose she stays on (5mg) x2. It would be a blessing if this strength of medication worked for her. (I know I have to be realistic) but I have 'wishful thinking'

It's been 4hrs since I gave Princess her capsule. She is not showing any negative signs of rejecting it. No vomiting, diarrhea. She's laying on her side with me on my lazy boy chair with the fan on her as usual.

I will be happy to report the day she looks for 'coon' her favorite stuffed raccoon toy and plays with him.....again. Then I know she is feeling better.

I'm also looking forward to feeling her wet nose again.

Take care of you and yours.

Angel from the Bay
princessdaddy

[Harley PoMMom]

I am doing more research on health and what to feed small breeds with bladder stones.

The first step in preventing kidney stones is to know what type of stone/s she is producing, this is usually done by sending a stone out to be analyzed. Hydration is very important, so putting water in everything she eats will help.

Hugs, Lori

[princessdaddy]

Princess Urinalysis test says Crystals: 2+Calcium Oxalate Dihydrate (3-5) They are large and will need to be removed after her Cushings disease is under control. Doctor said 3-4 months.

This is day 2 of giving compound medication 5mg Trilostane x2 per day to Princess. No ill side effects noted. No vomiting or diarrhea. She still wakes me up at 3-3:30am to go pee regardless if I took her out at bed time 10:00pm

It's still better than several times per night/morning a couple of weeks ago.

Angel princessdaddy

[Harley PoMMom]

My Bear's stones were Calcium Oxalate too :( He was put on potassium citrate made by Pala-Tech, which I found was cheaper online than at the vets and it was the exact same stuff...here's a link to it: http://www.lambertvetsupply.com/Pala-Tech-Potassium-Citrate-Plus-Cranberry-Chewable-Tablets_p_2176.html

Also you want Princess' urine specific gravity low, which means keeping her really hydrated by putting water in everything she eats, it also helps to feed them wet food instead of dry because canned/wet food contains moisture.

Here are two pretty informative articles that pertain to oxalate stones in dogs: Oxalate Bladder Stones (Canine) (http://www.veterinarypartner.com/Content.plx?A=662)

Calcium Oxalate Kidney and Bladder Stones (http://www.dogaware.com/articles/wdjcalciumoxalates.html)

Hope this helps.

Hugs, Lori

[princessdaddy]

Lori, did Bear take this before or after being diagnosed with stones in his bladder?
I ask because Princess has large stones. UC Davis wants to remove them via surgery in 3-4 months. The Vet there said the stones were to big so she is not a good candidate for laser surgery. She would be under anesthesia too long. So unfortunately she has to have the intrusive surgery after her Cushings is under control.

Princess recently started her medication today is day (3) on Trilostane 5mg. so we still have awhile until surgery.

Did the potassium citrate help Bear?
Did you give this to Bear prior or post being diagnosed?
Did Bear need surgery?

I'm going to email UC Davis Vet to see if this will help Princess feel better.

Thank you for the link princessdaddy Angel from the Bay