Daisy Mae, diagnosed with Cushings and high bp 12/5/14

[samba7282]

Hello everyone! My name is Sarah, and our 11 yr old chi mix, Daisy, has just been diagnosed with cushings 12/5 and high blood pressure this week 12/26... she is on once daily dose of Trilostane(Vetoryl) 10mg, and now Enalapril 2.5mg once daily, and Denamarin to help her liver... She is having trouble seeing this last week, the vet says it is due to the high bp. She had ACTH check 12/22, and her body is responding to the meds and cortisol levels are lowering, the vet says her levels are where they should be for treatment thus far, but not normal yet, but not warranting changing her dose either... her urination and water intake have greatly improved, but her never ending desire for food has not changed at all.... all she wants to do is eat... She is just not our happy, energetic full-of-life little "poot" (as we affectionately call her) :)... and now with her having trouble seeing it is just breaking my heart... I have changed her diet to a low fat and low carb, high protein kibble called Instinct (chicken kind) to hopefully help her liver not have to process as much.... I know we are only 3 weeks into treatment, and I don't know if I am just being impatient or too hopeful right off the bat, but should I expect to see her want to eat everything drop off to normal or does this remain even with treatment? And will she possibly go blind from her blood pressure, or can the meds drop it and reverse it slowly? I am so worried about her, she is our special little girl :) Any help or advice would be so gratefully appreciated!

[molly muffin]

Hello and welcome to the forum. Quick question, how is the protein in her urine?

High blood pressure can cause retinal bleeds, where there are retinal bleeds, as they heal, sight is lost. Usually focal point sight. Get the blood pressure down, have this checked regularly and hopefully some of the eye sight will be saved.

I ask about the protein in the urine because I am in the exact same sort of situation you are. My molly has lost significant focal point sight, due to the retinal bleeds (we saw a doggy ophamologist) and it is because of the high bp. Our high BP is due to not only high cortisol that was uncontrolled but also, protein loss, which shows up in the urine, if you see a +2 or +3 in urine, have a UPC done. This is a urine protein creatinine ratio.

Do you have the numbers from the follow up ACTH test? You want the post number to be under 9ug at least with controlled symptoms and if symptoms aren't controlled (like the hunger) bring it down to under 5ug post number on the ACTH.

On our test we are steadily dropping even at day 30 so I haven't increased her dosage and I am hopeful that we can get everything under control.

You're on track, doing what you need to do.

The eyesight while it might freak them out at first, is not nearly as important to dogs as it is to us humans. With even a little sight they will run through the house like a crazy dog playing chase (my dog does this, although she'll bark at my husband and me through the window as she doesn't know it is us till we come in and she smells that it is us) They are very smell oriented.
They might not play with toys as much as it is harder for them without the focal sight to see well, but they will usually eventually on their own terms return to the toys. My molly for instance may not play with us and her toys, but she'll pounce and attack them on her bed.

How much does your little poot, Daisy Mae, weigh currently? I see she is on 10mg of vetroyl.

Welcome again to the forum.

[samba7282]

Hello, and thank you! I am so glad you responded! Daisy is currently 12.2 lbs on 12/26... that is so reassuring about her sight:) I have been reading about blindness in dogs and how well they adjust. I take care of a few pets that have gone blind from diabetes(I am a pet stylist for almost 12 yrs now) and they did great also after they adjusted. She had a U/A on 12/5 and the vet said it was normal, but it has not been re-checked since and I don't have the print out with the numbers.. I need to get that, her LDDS test and her ACTH test results printed off from them and I will post them for you :) Th vet said that her eyes upon exam Friday showed retinal sclerosis, and that she can see, but it is cloudy.. this makes sense since she can see what is far away, but the closer something gets to her face she loses focus and has to sniff it out.

[samba7282]

I wanted to post the lab results and weight history I have so far for you: her weight 4/8/13 10.6 lbs, 12/1/14-12 lbs, 12/3-11.5lbs, 12/4-11.9lbs, 12/22-12.5lbs, 12/26-12.2lbs. Throid test was normal, and her CBC showed the following as high or low, all other values were in normal range: LYM(low)0.74, LY%(low) 7.3, HGB(high) 20.1, MCH(high)37.4, GLU(high) 115.

[molly muffin]

It's good to get the test results and start your own folder of all test results. Believe me with cushings we seem to be referring back to them all the time, it will guide you in making dosage adjustments etc going forward.

Oh there will a bunch more along to, just hit and miss sometimes as to when people are online. Especially with the holidays we pop in whenever we can.

Good to hear the ratio, 12.2lbs and 10mg of vetroyl, excellent starting dosage.

As for food, try things like cooked green beans as a filler/treat. It's low cal and we often use it to tide over those hunger pains.

I throw molly a piece of dry kibble and she can get to it no problem. If she doesn't "spot" it I will point to it with my finger and tap and she'll get it. Even with the sight problem, she Loves this game and wants to play it every night.

[samba7282]

Do you think I should have the vet check her urine tomorrow just to make sure? He did not detect bleeding in her eyes, but I want to do everything I can for her:o

[molly muffin]

Can you edit your post with the results for the CBC and post the range next to them?

Like this for example:
LYM(low)0.74 - range
LY%(low) 7.3 - range
HGB(high) 20.1 - range
MCH(high)37.4 - range
GLU(high) 115. - range

So the ALT and the ALKP where within normal ranges?

[molly muffin]

You don't have to have it checked tomorrow but I would have a UPC done If there is any protein in her urine, your vet has lab results and might know if this is an issue or not.

What I can also tell you is that if there is any protein problems, then it would be treated probably first off with the Enalapril so that is why I said no need to rush right out tomorrow and get it done.

[samba7282]

Thank you so much Sharlene! She loves boiled chicken, so we have been shredding it and giving her a few nibbles here tnad there through the day to try and tide her over as well;) We have to do the same thing with pointing sometimes if she doesn't see it when we toss it to her, that's a good idea about making it a game for her, especially since she doesn't much want to play at all anymore. I will try the green beans...im leary of adding salt so I want to stay away from canned...think I might try steaming them with some carrots too. let me know if that's not a good idea:)

[samba7282]

You are the best! I cannot thank you enough for your help, it is so nice to know we are not alone :) I will be praying for you and molly on your journey as well;)

[samba7282]

LYM 0.74- 1.00-4.80
LY% 7.3- 12.0-30.0%
HGB 20.1- 12.0-18.0 g/dl
MCH 26.0- 19.5-24.5 pg
MCHC 37.4- 31.0-34.0 g/dl
GLU 115- 60-110 mg/dL

[molly muffin]

Steaming is a great idea. I do that. Carrots are good, just make sure they are cut small, as they tend to scarf them down.

Yea, I do whatever I can to make things fun for molly and that one seems to work. Although be ware, as molly has been known to go to her bowl and bark incessantly, to play the game. LOL

There will be others along too that will pop in with their thoughts. Thanks for the well wishes, same to you too. It does help to have others along with for the journey. :)

[samba7282]

you're welcome :) thank you for the tips :)

[Dixie'sMom]

Hi and welcome to you and Daisy. I see that Sharlene is taking very good care of you. I can't add anything to all that she has said, but I did want to say Hello. I look forward to getting to know you and Daisy. :)

[samba7282]

Hello! Thank you for your warm welcome! :)

[flynnandian]

welcome from us too!

[samba7282]

Thank you! :) I am glad to report that today is the first day since our journey in this began that Daisy's abdomen is much less swollen! She almost looks normal!:)

[molly muffin]

Aww that is great to hear. Always so nice when they start becoming, looking, acting like they normally do. There is nothing so wonderful as a happy dog in the house.

[samba7282]

Thank you! I couldn't agree more, it is such a very slow road, but any little light that shines is so comforting! I have noticed she has not been drinking very much water at all today, and yesterday too, but significantly declined today...I thought about adding water to her dry food, but am afraid it will make her bloat? Im calling the vet in the a.m....is that much decrease in water consumption normal or is this a sign of going in the wrong direction?

[molly muffin]

Is eating fine? Not wobbly on feet etc. No vomiting? You don't want them to get dehydrated though. It us hard to know without numbers of ACTH exactly how the cortisol is doing. Can you get that result?
Not drinking can be a sign of going low. It can also be a sign they feel yucky from cortisol dropping in their body.
Any significant change I would tell the vet about.

[samba7282]

Hello! Sorry I have not been on in a while.. I took her in to the vet Tuesday, the 30th, and he said she is well hydrated, and she has been drinking a normal amount since, I guess its just that she was drinking so much water before, this seemed like nothing at all, but the vet said 2/3 - 1 cup is all she needs a day, so she is good! She was acting as normal as can be just not drinking. I got her ACTH test results, and are as follows:
Cortisol sample 1(pre) 3.5 - (1.0-5.0 mg/dL)
Cortisol sample 2(post) 7.7 - (8.0-17.0 mg/dL)
Happy New Year!

[molly muffin]

Those are good results. You can have up to 9.0 ug if the symptoms are controlled or bring down to under 5.0ug if they are not.

Sounds like the water is fine. It's always a bit nerve wrecking when you start new medications. You are doing good though.

hugs

[samba7282]

Thank you Sharlene, that is so good to hear! I just wish she was more like herself, she just walks around looking for food or sleeps... she hasn't wanted to play, and she was SOOO active before...I wonder if this is due to her feeling ill or to her losing her vision? it is weird to me that literally overnight this started.....she was fine one day bouncing around, and the next completely bloated and miserable with a cushings diagnosis 2 days later....

[samba7282]

One more question, sorry! On the ACTH test results, the 'pre' number is without being given ACTH right? and this shows us that it is under control? I'm a little unsure about the 'pre' and 'post' results and what they really mean?

[molly muffin]

Pre is taken before injection. Then the post is after injection. Post is very important. So think of it like this. The pre is what is circulating I their body them when the injection is given the adrenal glands dump what they have into the body. Now who pith the post number you know how the adrenal glands are functioning and if they are still being told to over produce cortisol. With trilostane you are creating an interruption from the pituitary gland to the adrenal gland because the pituitary is stuck in an on position. Pituitary is the most common reason for Cushing's.

Hope that helps. We tend to think it is overnight but in reality Cushing's is very slow progression. However the bp going up causing blindness retinal bleeds that happens fast. My Molly went from fine to significant sight loss. In months. I didn't realize my vet said her eyes aged. It took a special eye doctor to explain what happened. The eye sight changes their comfort level until they adapt to it Some more easily than others. I think our job is to make their areas safe. Change nothing in furniture placement and build their confidence that everything is fine and normal still.
You'll get through this fine and so will Daisy Mae.

Hugs

[samba7282]

Thank you so much Sharlene, that makes a lot more sense about the ACTH! You are a blessing ;) I thank you for all your help and advice, and support! It makes a world of difference! I have done a lot of reading about helping your furbaby deal with vision loss, and she is doing well with the around the house and outside stuff. We have not and wont change anything around the house (just like you said ;) ), its amazing how well she can navigate it! It's just not seeing her play and be happy go lucky that is so hard for us right now...we give her all the love we have, and pray that she feels truly happy again like she used to be! p.s. she loves to play find the food... I will call her to me and have little pieces of kibble, beans or peas, and teaching her up, down, right, left, and step to help her with the vision thing too. Thanks again! Hugs to u and Molly!:D