14 year old Bichon with Cushing's PDH (Maggie)

[Cris]

Hello everyone! I have a 14 1/2 year old Bichon, Maggie, who was just recently diagnosed with Cushings. I know very little of this disease, but I have been reading articles and joining support groups to learn more of it. Today, Maggie went to an oncologist/internist to have an ultrasound. She was recommended by our vet (of 25 years) after determining from the low Dex suppression test that she definitely had Cushings. Form the ultrasound results today, Maggie's Cushings has been determined to be "pituitary dependent". Tomorrow, her prescription for Lysodren (500 mg) will be ready for her to take. The oncologist/internist also gave me two prednisone pills, with strict instructions, and a list of behaviors that would indicate a "rapid decline" and what to look for while Maggie is on Lysodren. If all goes well while on the Lysodren, Maggie is to return to her vet for an ACTH stim in 5-7 days. If the test is normal, Lysodren will be given every 3-4 days as a maintenance therapy. Maggie's has had elevated liver enyzmes since 2010. She has been on Denamarin since that time and has gone for yearly ultrasounds to check for any changes. Maggie also has arthritis. Rather than medication, she receives weekly laser treatments. This has been ongoing for the last year. Thank you all for letting me join this group. I'm looking forward to learn about Cushings from all of you!

[mytil]

Hi and welcome to our site. I am sorry you and your Maggie are dealing with Cushing's. I am glad to hear you are working with a specialist.

When you get the chance post the results of the LDDS so we can all see the levels of cortisol prior to treatment. Also post the ACTH test that will be performed within the next 5-7 days.

Here is a good link for those using Lysodren - http://www.k9cushings.com/forum/showthread.php?t=181. Please especially read about signs to watch for during this loading period.

How much Lysodren was prescribed?

One thing to keep in mind regarding arthritis is that as the cortisol levels are lowered, the arthritis problems may increase. Cortisol being a steroid does help with the pain and mobility of arthritis.

Keep us posted
Terry

PS - I have taken the liberty of starting a new thread for you and Maggie

[judymaggie]

Welcome to you and Maggie! My Abbie is also on Lysodren. Do print out the post from the link that Terry provided and keep it very close during loading. Be sure to give Maggie her pill (wrapped in cheese or peanut butter--or canned food which is what I do) after feeding. That way you would know to withhold the Lysodren if Maggie shows any change in her eating habit.

Signs of loading can be very subtle. I would suggest that you measure her water intake today so you have a baseline and then measure every day during loading. Abbie's first change was decreased drinking followed by walking away from her food bowl for the first time ever. Her first ACTH was on day 8.

Although your vet wants to do the ACTH on day 5-7, Maggie may not be loaded by then. I would suggest you talk to your vet about having it done on day 8 (per the guidelines by Dr. Feldman, the Cushing's expert in the link) if Maggie is not loaded before then. You wouldn't give any Lysodren on the day of the test. My vet likes to do ACTH 24 hours after the last dose--other vets prefer 48 hours. Whatever path your vet takes, make sure that future ACTH tests are done with the same time frame so test results can be compared.

[Cris]

Thank you for assisting me in setting up a thread. :-) As far as the level of cortisol that have been assessed for Maggie… I don't have those values. All I know is that all values are "off the chart"… "across the board". I will ask for the specific values when I check in with the vet. It will be good for me to keep a record so that I can compare progression before and after she starts her meds. It was thought to be a good idea to begin Maggie on the Lysodren early Monday morning, as oppose to the end of the week, when the prescription is available. That way, the vet clinic will be open and the medical team can be available should any complications arise….even though I do have the oncologist's instructions and prednisone available should anything arise. I would prefer that Maggie's vet is available for even telephone consultation, should I need assistance. As far as the Lysodren dosage…. the instructions are 1/2 tablet (500 mg) , once a day for 7 days. And, then following with an ACTH stim. It's interesting that prior to referring Maggie to an internist/oncologist for an ultrasound (who prescribed Lysodren), Maggie's vet was thinking that she would be prescribed Trilostane. Although they work at different clinics, both vets collaborate and work very well together. But, I was curious as to the difference between the two drugs.

[Squirt's Mom]

Hi and welcome to you and Maggie! :)

How much does Maggie weigh?

And can you verify that you are to give 250mg only ONCE a day? Loading is typically done via 2 dose per day, am and pm.

Glad you both are here!
Hugs,
Leslie and the gang

[Cris]

Thank you for the warm welcome!! Yep…. that's the instruction left by the internist/oncologist: "Please give Lysodren 500 mg, 1/2 tablets once a day for 7 days". She also noted that "some dogs take only 3 days for this drug to have normal cortisol, whereas some dogs take up to 21 days. The average time is 6-7 days." This is from her written instructions.
Maggie weighs 17 lbs. and is currently also taking Denamarin to control her liver enzymes, which apparently is good while taking Lysodren which I understand is a VERY strong (and toxic) for the liver. Apparently, milk thistle has been recommended while taking Lysodern. and the active ingredient in milk thistle is also in Denamarin.

[Harley PoMMom]

Hi and welcome to you and Maggie,

The way Lysodren works is that it physically erodes the outer layer of the adrenal cortex, this is where that extra cortisol is being produced. What you want to happen while a dog is in the loading phase is for the Lysodren to erode enough of the adrenal cortex to bring that cortisol down to the therapeutic range. Generally those adrenal glands can regenerate rather quickly so that is why during the loading phase the dog is given Lysodren twice a day, to keep those adrenal glands from rejuvenating back so fast.

Here are links to a couple articles where Lysodren is discussed and the protocols that should be followed: Lysodren loading Instructions and related tips (http://www.k9cushings.com/forum/showthread.php?t=181)

Hyperadrenocorticism (Textbook of Veterinary Internal Medicine, Chapter 118) (http://www.k9cushings.com/forum/showthread.php?t=199)

If you have any questions at all please do not hesitate to ask. ;)

Hugs, Lori

[Squirt's Mom]

Before starting the Lyso, call and insist that you speak to the vet, not a tech, and again verify that dose of once a day. Loading is done TWICE a day, maintenance is done once a day after the load is achieved. So make sure this is how she wants it done and if she says yes, ask why she is not loading your pup with twice a day dosing as recommended. With once a day dosing, it may take much longer to load. ;)

[Cris]

Initially, when Maggie began her tests and before going to the internist/oncologist for an ultrasound…Maggie's vet said that should she have PDH, he would recommend the medication, Trilostane. After the results of the ultrasound, the internist/oncologist prescribed Lysodren. Although my vet and the internist/oncologist are not in the same clinic, they have mutual respect for one another and work very well together in providing health care to pets in my area. That being said…. I am wondering why prescribe Lysodren, instead of Trilostane. I have not started Maggie on the Lysodren. I'm waiting to start on Monday, when I know the medical staff at the vet clinic will be available for any emergencies. I have placed a call to Maggie's vet to discuss the two drugs and if he would still prefer Maggie to take Trilostane. Can anyone provide me with info regarding the difference of the two drugs. And, why prescribe Lysodren over Trilostane.

[Squirt's Mom]

I would ask the oncologist but it may simply be that Lyso is the drug they are most familiar with and have had the most success with. That is often a key factor in deciding which drug to use. ;) Both work equally well on PDH while many vets prefer Trilo for ADH since the adrenal based form often requires higher and higher doses to maintain control. Lyso is a bit harder on the digestive system for many pups. From observation, Lyso is less expensive to use because fewer dose adjustments are needed and therefore fewer monitoring tests are needed. (With every dose change, the testing schedule starts all over at 2 weeks.) Both have the same risk factors but Trilo has a shorter life in the body than Lyso, leading some to feel it is safer, but it is not. IF the pup should have a crash, the Trilo is leaving the system quicker than Lyso will.

Did you verify that once a day dosing with the oncologist directly? And ask why they chose once a day instead of the recommended twice a day for the loading dose?

[Cris]

The instructions for the daily dose was given to me in writing by the oncologist. I haven't been able to reach her, as she lives 3 hours from my home in Naples. She comes down to the Naples, FL area for appointments. I'm still waiting for Maggie's vet to call me about his thoughts regardinging Trilo versus the Lysodren. Maggie also has arthritis and she receives weekly laser treatments, which seem to help a good deal. I've read that the medication for Cushing's PDH can unmask possible serious arthritis, by surpressing Cortisol. :-(

[Squirt's Mom]

Yes, the cortisol sort of "treats" inflammatory conditions like arthritis and when the cortisol is lowered the inflammation increases. There are things you can do to help so talk to the vet now about the options. That may be what the doc is thinking in doing the load this way, too.

[Cris]

ahhhhh… that does make sense. I will bring it up to the vet when he calls me today. Thanks so much for your advice!

[Cris]

Does anyone have experience with their dog developing Cushing's, taking medication while having arthritis? My 14 1/2 old bichon, Maggie, was just diagnosed with Cushing's PDH. She also has arthritis and receives weekly laser treatment. she is on Denamarin to control her high liver enzymes, which limits any pain control meds she could take for arthritis. Sometimes, her hind legs get very wobbly. But, I read somewhere that it could be characteristic of Cushing's. She hasn't yet started her meds for Cushing's … but I've read that medication for Cushing's can make the arthritis worse, by unmasking what the overproduction of cortisol was doing. Any thoughts?

[Squirt's Mom]

MODERATOR NOTE: I have merged your post about arthritis in cush pups into Maggie’s original thread. We normally like to keep all posts about each pup in a single thread as it makes it easier for members to refer back to the pup's history when needed. Thanks!

[flynnandian]

yes the meds [vetoryl] unmasked my flynn's arthritis very badly.
his front legs were twice as big and his wrist even bigger.
this happened overnight after the first dose.
it never healed so i had to put him down.
he was a retired working dog [bordercollie].
ian my other cush dog walks much stiffer since on vetoryl.
so i would start on a very low dosage and watch what happens.
arthritic dogs do need a higher level of cortisol in their blood.
like they always say on this forum; start low and slow.

[Cris]

thanks for your response flynnandian… I'm very sorry to hear about Flynn. I will definitely keep your advice in mind.

[Harley PoMMom]

Unfortunately that excess cortisol can mask the symptoms of arthritis. From what I have read glucosamine/chondroitin are two supplements that are usually given for dogs with arthritis, another medication that some members have used is called Adequan, which is an injectable medication.

As far as the NSAIDs, Rimadyl is one that I'm not fond of because it can cause liver damage in some dogs. I have used Tramadol in the past for my dogs and it has helped.

Hugs, Lori

[Cris]

Hi, I have been so busy reading all the threads on this site. And, I am learning so much about Cushing's. There is SO much to learn! And, this is such a wonderful resource. You guys are such a wonderful support group! I started Maggie on her Lysodren medication this morning at 9 a.m. As prescribed, she is taking one 1/2 tablet (500 mg tablet) daily. Maggie weighs 17 and a half lbs. The internist/oncologist prefers to start her on this light dose. Maggie's vet has scheduled an ACTH test on the 7th day of starting the Lysodren. I've scheduled an appointment at the vet for Maggie's laser treatment (arthritis). I thought will she was there they can check her blood pressure. I've also read that a healthy meal should be given prior to taking the medication Lysodren. Maggie is on Science Hill i/d which is low in fat
. Do you think that would be sufficient to deter any stomach ailments as a result of taking such a strong/toxic medication?

[addy]

Hi,

Lysodren needs to be given with fat to properly absorb, wrapped in a piece of cheese would work. The id food, is it canned or dry? The canned isn't so horrible, my Zoe was on it for awhile because of inflammatory bowel disease.

You would not want to change food now so keep the ID. changing food now would not be good, try to keep all foods and treats the same so you know cause and effect.:)

[Harley PoMMom]

Many members do give their dog Pepcid AC 20-30 minutes before the Cushing's medication is given to help alleviate gastric upset, I would ask the vet about this.

Hugs, Lori

[Cris]

Well, Maggie had her 3rd dose of Lysodren today, (250 mg a day). She was scheduled for her laser therapy at the vet this afternoon, but rather than taking her for the laser treatment, I had her see the vet. I had noticed that her hind legs were more "wobbly" than usual, due to her arthritis. Thinking that the arthritis was getting worse, I wanted to have her checked out by the vet. The vet took her blood (blood stat test) and came back with the news that she was "pre" addisonian….. "very close to getting there". Forgive me, but I don't have any test numbers to share with you. But, he said that her potassium was very high and he advised me to give her a predinsone pill (when I got home, which the internist/oncologist had prescribed) (5 mg.) and stop the lysodren. Maggie is scheduled tomorrow morning for an ACTH test. Other than her more than usual "wobbly" behavior (which I attributed to her arthritis), Maggie is eating fine, happy as a lark (she was never lethargic). And, when I took her outside to play in the yard, she would fall, but get right back up, and her tail was wagging. I honestly didn't think it was the lysodren. I took her to the vet, thinking her arthritis was getting worse. So MUCH to learn!! But, I'm glad I acted on my instincts.

[Harley PoMMom]

I would love to see those test results, and if you could get copies and post the results here that would be great. If her potassium was elevated, which is part of the electrolytes, was the sodium in the normal range? Also, prednisone is given when the cortisol is too low because it mimics cortisol in a dog's body, when the electrolytes are unbalanced mineralocorticoids are needed.

Prednisone given 24 hours before an ACTH stim test will skew those results, so the vet will need to take this in consideration when evaluating the ACTH stim results.

Good eye on Maggie, and I sure hope she is feeling her normal self real soon, keep us updated.

Hugs, Lori

[molly muffin]

Oh my gosh, I'm so glad you did take her into the vet. Sometimes you just don't know with these pups, what the sign will be. Usually there is one and for a third dose, wow, quick.
So really glad you took her in.
Get copies of her tests from today and also the ACTH from tomorrow. Make sure the IMS knows what happened too. This will affect any maintenance dosing.

[Dixie'sMom]

WOW... good catch! Even and tho you didn't know what you were catching. :) It shows you are very observant and on top of things. That will serve you and Maggie very well throughout her treatment. I'll be watching and cheering you both along! :)

[judymaggie]

Keep on trusting your instincts--no one knows Maggie better than you do! It will be very interesting to see the test results from today and tomorrow's ACTH numbers.

[Squirt's Mom]

Please do get copies of those test results from when the vet said to stop the Lyso and use the pred as well as the ACTH that follows. You are doing a great job of observing - and that is half the battle in this disease. ;)

[Cris]

Hi there,

I picked up Maggie's test results this morning from her vet. She took the Low Dose Dex Suppression test (LDDS) on 01/02/15. The results were:

Cortisol Sample 1: 3.3
Cortisol Sample 2 Dex: 7.0
Cortisol Sample 3 Dex: 8.9

From there, we had an ultrasound done of the adrenal glands and liver on 01/07/15, by an internist/oncologist. She was referred there by her vet. The results showed Maggie's Cushing's is PDH.

Maggie started Lysodren on 01/14/15, which was prescribed by the internist/oncologist. (from this point, she will be monitored by her vet, and the vet would consult with the internist/oncologist on a need basis). Maggie is 17.5 lbs and was prescribed 1/2 tablet (of a 500 mg tablet) once, daily (250 mg daily). And, she was scheduled to return the following Wednesday (01/21) for an ACTH stim test.

On her 3rd day of being on Lysodren, however, I took Maggie to have her arthritis checked because her hind legs were very weak and wobbly. Thinking that Maggie's difficulty in walking may be related to the Lysodren medication, her vet took a blood test and based on the results, he recommended to stop giving her the Lysodren and to give her 5 mg. of Prednisone. (Sorry…I don't have the results of that test).
He also scheduled her to return the next morning (after overnight fasting), for an ACTH stim test.

We returned the following morning (01/17) for the ACTH stim test. Here are the results:

Time 1 8:22 a.m.
Cortisol Sample 1: 7.3 (HIGH)
Time 2 9:22
Cortisol Sample 2: 15.3

Maggie was to refrain from taking the Lysodren until (1/19) where we were instructed to administer the drug (1/2 of the 500 mg tablet), 250 mg., every 3 days, and to give her 5 mg. of prednisone if deemed necessary.

Maggie is now on her 2nd administration of the drug and so far no problems, no side effects, no prednisone.

She is scheduled for an ACTH stim test, two weeks from the day she started back on Lysodren. That would be 02/02/15.

That's where we're at for the moment. I have seen a decline in the manner in which she eats her food, since starting back on Lysodren. She doesn't "inhale" her food as she use to, but she does finish her bowl. Her appetitite is good.

[Harley PoMMom]

Hi there,

I picked up Maggie's test results this morning from her vet. She took the Low Dose Dex Suppression test (LDDS) on 01/02/15. The results were:

Cortisol Sample 1: 3.3
Cortisol Sample 2 Dex: 7.0
Cortisol Sample 3 Dex: 8.9

From there, we had an ultrasound done of the adrenal glands and liver on 01/07/15, by an internist/oncologist. She was referred there by her vet. The results showed Maggie's Cushing's is PDH.


We returned the following morning (01/17) for the ACTH stim test. Here are the results:

Time 1 8:22 a.m.
Cortisol Sample 1: 7.3 (HIGH)
Time 2 9:22
Cortisol Sample 2: 15.3

Those ACTH stimulation results are not within the therapeutic range for a dog on Lysodren. The therapeutic ranges for Lysodren are for the pre and post to be between 1 ug/dl - 5 ug/dl.


Maggie was to refrain from taking the Lysodren until (1/19) where we were instructed to administer the drug (1/2 of the 500 mg tablet), 250 mg., every 3 days, and to give her 5 mg. of prednisone if deemed necessary.



The protocol for Lysodren therapy is to administer a dose of 50mg per kg of a dog's weight being split and given twice a day. It will be a real challenge to load Maggie when she is getting the Lysodren every 3 days.

Keep us updated ;)

Hugs, Lori

[Cris]

Hi! I haven't posted much but I've been learning a great deal by reading what everyone else has written regarding their experience with Cushing's. I'm no "expert" on the subject…just "beginning" to understand it. I was going to wait until Monday so that I can post Maggie's ACTH test results since she started Lysodren (again), on 1/19, 250 mg every 3 days. So far so good. We'll see what the tests show on Monday. In the meantime…… I requested that Casey, my soon to be 14 year old maltipoo, take a blood test and urine analysis to see if she has Cushing's. I have noticed, lately, that she's been panting a great deal. And, has an insatiable appetite. We received the results of the initial tests and they "suggest" Cushing's. On Monday, I take Maggie for her ACTH test and Casey for an LDDS test. Poor Casey, a little over a year ago, she suffered an FCE (Fibrocartilaginous Embolism), which left her paralyzed from the neck down. For 12 days she couldn't move any of her limbs. With the grace of God…. and the medical attention of a canine neurologist, PLUS months of physical therapy (inlcuding hydrotherapy) Casey regained the ability to walk, run and jump. She is a little weak on the right side and falls from time to time, but she is in good shape. Last November, I took Casey to the vet on a day I thought she was acting very "odd"…a little "disoriented". I thought it could have been CCD (Canine Cognitive Disorder). Instead, the vet found that her spleen had ruptured and she was bleeding internally. Emergency surgery saved her. Had I not acted on my instinct, she would not have survived. A few weeks later, she developed pancreatitis. She managed to pull out of that one, too. Now… is it possible my intuition is right… which is why I suggested that we test her for Cushing's? I always like to rule on the side of error and have my pets tested when I have doubts. I prefer that than to wait until a condition gets worse. I'll let you all know what I find out on Monday. Two dogs with Cushing's??? I think I need a drink! :eek:

[flynnandian]

i have [had] 3 so cheers! [2 are still alive]

[Cris]

WOW!! 3!!!! That is amazing! And, I bet they kept you busy! Just when I was getting comfortable with the behaviors to look for, in Maggie, that would suggest her cortisol levels are off while being on Lysodren…. now, to learn to focus on Casey's behavior. It wouldn't be so difficult if the behaviors suggesting a problem were consistent with ALL dogs. I'll have to be more vigilant as I keep a watchful eye over my pups and recognize their individual behaviors that may indicate a problem! Oh well, the tests will be conducted on Monday. We shall see! :rolleyes:

[flynnandian]

i hope the test on monday says no cushing's for casey.
but with those golden oldies we never know.......

[ShibaMom]

Crossing fingers and toes for no Cushing's for Casey!!!

Way to go Cris, with all you've caught.
And, if it's not Cushing's, I hope it's nothing serious!

Cheers,
Samantha

[Cris]

Thanks for the good thoughts! I'm just glad that if it is Cushing's, at least we know it….and we can go from there. From what I'm reading on other sites, it seems that Cushing's is often times the last to be diagnosed. And, that it usually takes some medical condition to exist (that may have been the result of untreated Cushing's) before it is diagnosed. And, it just seems that the behavioral characteristics that is suggested as Cushing's isn't always consistent. That is what makes this disease (at least to me) as being so confusing and often undetected. :confused:

[Squirt's Mom]

But you know what, Chris? Canine Cushing's is being recognized and diagnosed more and more often now. Why? One reason is parents like you and everyone here - we DEMAND our vets be up to speed because we have done our research and want the best for our babies...and know when they are getting just that. ;) Thanks to the speed of communication via the web, we can reach out to each other, share our experiences and first-hand knowledge, and awareness grows. I think we parents have done as much, if not more, for this attention to canine Cushing's than anything else. The veterinary community was not prepared for us, a group of pup parents who love our babies to no end and who are willing to go to great lengths to make sure their lives are as rich as possible. That includes digging into the vet's studies and their texts and their conventions and learning all we can about this disease...then requiring that they live up to our expectations. You are a part of this great machine, this movement of awareness, this work of combined love. So don't be discouraged, be proud you are a cush parent! :)

[Cris]

Thanks "Squirt's Mom"! And, you are absolutely right about the resources and support groups available for pet owners. You wouldn't believe the information I've downloaded on Cushing's! I don't want to become an "expert" on the subject… I just wanted to be "familiar" with the language used when discussing Cushing's. And, the "experiences" that so many have shared here and other support groups online, allows me to bring up questions to the vet… the "what-if's" and it allows me to be vigilant regarding adverse behaviors associated with the medications used, such as Lysodren. A "list" of behaviors just doesn't really help me if my pet doesn't necessarily "fit" the behavior. But, when members of groups share their experiences…. ahhhhh.. that is priceless, for me. It connects! I'm grateful to have a vet who I've been with, for 25+ years and who is, in my opinion.. "ego-free" to ask the opinions of internists and other medical experts. My vet has a wonderful relationship with an internist/oncologist that frequents the Naples, Florida area, from Sarasota on a weekly basis. It is the internist who did the ultrasound and prescribed Lysodren. So, when I asked my vet, "why Lysodren and not Vetoryl as you first recommended"? He responded… "I'm not sure, let me check with her". And, he did call me back and told me why she "preferred" the Lysodren. I respect that kind of relationship between medical professionals. And, I appreciate all the support this network has to offer.:D:D

[Cris]

Well, folks… it's official. my 14 year old Maltipoo, Casey also has Cushing's. I'll make sure to get the LDDS results to share with all of you. Casey will now see an internist/oncologist (Dr. Ward) on Wednesday for an ultrasound and consultation. Maggie, the bichon, who was diagnosed with Cushing's in mid January will have her medication (Lysodren), adjusted. My vet is in agreement with Dr. Ward, that we will take the start-low-go-slow protocol. Maggie's ACTH results indicate that we haven't gotten where her levels need to be. Again, I'll also have the results from her test soon, to share with you all. We will increase her Lysodren from one 1/2 pill (250 mg) every 3 days, to one 1/2 pill (250 mg) every two days. Is it happy hour yet??????:eek:

[Dixie'sMom]

Oh honey, that really stinks. Of course we are here for sweet Casey too. It sounds like you have a good plan in place so that is a blessing and hopefully you were getting more comfortable with the Cushing's symptoms so it wasn't a shock to you. You know what to look for. You got this!

Its happy hour somewhere so go ahead! Cheers!

[Harley PoMMom]

So we don't get Casey's and Maggie's treatments confused, a new thread can be started for Casey, believe me, I can get confused real fast!!

Regarding Maggie's Lysodren loading regimen, the appropriate loading dose is 50mg/kg of a dog's weight, being split and given twice a day. For the loading phase you want to hit them adrenal glands kinda hard, they can be tough and that is why that loading dose protocol is recommeneded.

I'm afraid with the loading phase Maggie is following that she may never load or that it will take forever.

Hugs, Lori

[judymaggie]

Hi -- I just wanted to add to Lori's post that it sounds as though your vet and/or the internist (I can't tell from your post who decided on the dosing) is somehow confusing the Lysodren loading protocol with treatment with Vetoryl. The "start low, go slow" protocol is for Vetoryl, not Lysodren.

[Cris]

Both seem to agree that slow is best…even with Lysodren. Maggie started on Lysodren, one 1/2 pill (of a 500 mg tablet) every day. I have to trust what they tell me. I will bring it up to the oncologist/internist on Wednesday, when Casey goes for her ultrasound to determine if it is PDH or ADH.

[Harley PoMMom]

It's not that uncommon for general practioner vets and even IMS' to lack the knowledge and experience with the proper protocols in treating Cushing's. Many of us have learned this the hard way, our dogs pay the price for placing blind trust in our gp vet. We pay the price too on an emotional and financial level.

[Cris]

Thanks so much for the heads up! I am feeling a little more comfortable in addressing issues and questions when talking with both vets. Reading the info and the shared experiences offered on sites such as this, has given me the confidence to do so…as I learn the language associated with this disease. I'm making a list of questions to ask the internist/oncologist. ;)

[molly muffin]

We all had to learn as much as we could it seems as fast as we could and go in armed with our new found knowledge.
My vet and I had our moments that for sure, but in the end the IMS agreed with me and by extension the forum, as that is where I learned so much and so my vet agreed too. Now we just all have nice friendly chats and "discuss" our options. That makes things so much easier. We all know what we are comfortable with, slow and low is our motto to and my IMS says quite clearly and even has it on her wall, "Do NO Harm" she said it's better to tiptoe in and find out everything than jump in with both feet, head first and drown. Makes sense to me. :)

[Cris]

I'll need to start another thread for Casey, the 14 year old maltipoo, and Maggie's companion, who was just recently diagnosed with Cushing's. Tomorrow, she has her ultrasound. The vet did say to fast 12 hours prior to the ultrasound…. but I neglected to ask if she can have water. Does anyone know whether water is allowed prior to an ultrasound?:confused:

[judymaggie]

Hi--water was permitted before Abbie's ultrasound.

[ShibaMom]

Water is actually good - it helps them visualize the bladder better. I was told to try not to let her pee for a bit before coming in. So don't withhold water. (Especially for a cushingoid dog, too, since their kidneys are producing the urine with or without the water intake. A common misconception is that they pee a lot because they're drinking a lot, but it's actually the opposite.)

Good luck tomorrow!!
Samantha
Zanya, Chip, Tux, Weasley and our angel Gingus