Quincy, 8 year old Chihuahua just diagnosed

[Jmkk]

My 8 year old Chihuahua, Quincey was diagnosed with Cushings in October. I took him to the vet for a lump on his tail that was bleeding. We got the lump removed and got him neutered while he was there. The pre op blood work showed his liver levels were high, so when I took him back 2 weeks later to get his stitches removed, they were tested again and were higher. Then of course he got the Cushing blood work done and it was positive for Cushings. He is now taking 1 10 mg of Vetoryl once a day, and every other day he get's two. 1 in the AM and another in the PM, his second ACTH test showed that once day was not enough, but twice a day every day would be too much. He is also on a liver supplement once a day. I have such mixed feelings about this disease and am so devastated. He had almost none of the Cushings symptoms before his diagnosis other than the pot belly, loss of fur on his tail, and some occasional heavy panting in hot weather. He's gained at least 3lbs since this started, he's a 12.5 lb Chihuahua. I love him dearly as we all love our babies. I am in constant fear that I am loosing him. He's such a sweet boy and he seems to feel worse now than he did before he started the meds. It's a real concern to me. Is it because of the weight gain? or the meds? the neutering? My vet assures me that this is not fatal and sometimes I wonder if he really has this disease, although again, my vet assures me that he does.... I could really use some positive comments.......

[Jmkk]

I am new here. I posted something yesterday, but can't find it and just learning how to work these message boards.
I have an 8 year old Chihuahua named Quincey. He is the love of my life. He was diagnosed in Oct. The only reason we found that he has Cushings is from pre op blood work that showed his liver levels were high. Then 2 weeks later we did more blood work and it showed they were higher. This of course led to the ACTH that showed he does have Cushings. The only symptoms he has ( other than the blood work ) was some minor hair loss on his tail, pot belly, and heave panting in the hot weather. He is on 10 mg of Vetoryl once a day, but every other day he takes one in the AM and one in the PM. He's not my same boy since he started these meds. He's gained at least 3 lbs, could that be from the neutering? meds? He's now a 12.5 Chihuahua. I'm not 100% convinced he has Cushings. Is there anything else that could cause the elevated Cortisol levels. My vet assures me that this is not fatal, and also assures me that he has Cushings. I am just devastated... I've done a lot of research to try to educate myself on this, and have seen not a whole lot of good news. I could really use some positive feedback...... Thanks

Jolene

[LauraA]

Hi Jolene and Quincy :) If you could post a copy of the ACTH test there are members that are great at interpreting the numbers and will give you some great advice. Dogs can and do live out there natural lives with Cushings so don't think it is a death sentence. I have to say I have not heard of having one dose one day and two doses the next. Does that mean he is getting 10mg one day and 20mg the next?

[Squirt's Mom]

I merged your two threads and changed the title to include Quincy's name so it will be easier for you to find. If it has been a while since you posted, you may need to scroll back a few pages to find your title again. ;)

[Jmkk]

Hi Jolene and Quincy :) If you could post a copy of the ACTH test there are members that are great at interpreting the numbers and will give you some great advice. Dogs can and do live out there natural lives with Cushings so don't think it is a death sentence. I have to say I have not heard of having one dose one day and two doses the next. Does that mean he is getting 10mg one day and 20mg the next?

Yes he is getting 10 one day and 20 the next... I will contact his vet to see if they will send me his numbers. Thanks

[Jmkk]

Thanks Squirts Mom!

[Dixie'sMom]

Hi and welcome to you and Quincey. Yes, please get copies of his Cushings testing as well as his blood work results and post the abnormal values with the reference ranges. The guru's on this forum are very good at interpreting the results and that will give them a clearer picture of Quincey's medical status.

The one thing that does jump out at me is the 10mg/day and 20 mg/day alternating day dosage prescribed by your vet. That is not a very common method of treatment with 10 mg days not being enough, and the 20 mg days being too much. A better approach would be to use a compounding pharmacy to get the dosage more in line with his weight range, e.g. 12-15mg/day. The compounding pharmacies can make the dosage any strength except for the ones that the name brand uses (Vetoryl 10, 30, 60, 120). I would discuss this with your vet and if he is agreeable there are many of us who use compounding pharmacies that can provide you with that information.

The rollercoaster dosage of high and low days could be contributing to him not feeling as well as he could be.

Does he really have Cushing's? I don't know... but the testing and blood test results will help the experts here form an opinion as to whether it is Cushing's or if something else could be going on.

Again welcome and others will be around shortly. I look forward to getting to know you and your sweet boy. :)

[Jmkk]

Thanks everyone. I have called my vet and they are faxing Quincey's results to me at work so I won't get them until tomorrow. Now that you are mentioning it, I really don't feel comfortable giving him 10 mg one day then 20 the next. Thanks for your opinions! I will post his results as soon as I can. I am working one full time job and one part time job to help pay for his meds, so I won't be back on here with his results until later tomorrow night. I wish I could have had them for tonight. How do I post a picture of Quincey?

[molly muffin]

Oh good you where able to figure out the avatar. Isn't Quincy just so cute!

If you haven't figured out the picture album yet, go to your User CP, top left corner, click on that and you'll see pictures and albums on the left hand side, click on that and it will say, add an album, click that, name it, make it public (so the rest of us can see your adorable Quincy too, and save it. Then click on your album and add photos directly from your computer, phone, tablet, etc.

[Jmkk]

Thanks Sharlene!! Molly Muffin is adorable as well!!!! It's going to take me a while to figure all of this out. I'll have to check the album out.. One thing at a time. I'm not even sure I am replying correctly. I'm too used to face book.
I am waiting for a call from the vet. I called and said that Quincey just hasn't been himself since we upped his dosage. He is just very lazy and depressed all the time. Before he was diagnosed he was full of energy, now he just wants to lay around and he has gained so, so much weight! I am really concerned.

[molly muffin]

You are doing just fine in replying. It's all good. baby steps. :)

Well no, that isn't good for him from the sounds of it. What did the vet say?

[Jmkk]

The vet just called, I have to take him in tomorrow to test his sodium, potassium and electrolytes... Any one else have to do this? He is thinking the dosage may be too high for him. He didn't seem to be too concerned about it.. I trust my vet for the most part, but thinking of getting a second opinion.

[LauraA]

Sounds like your vet thinks he may be a bit low so is testing his electrolytes - this is what should be done :) If I was you I wouldn't give 20mg a day, I would stick to just the 10mg per day. At your next stim test you can then look at increasing it slightly if needed. Then you can get it compounded to less than 20mg if you do need to increase it.

[Jmkk]

I am thinking on keeping the 10 mg a day. Today he only had the 10 and as the night goes on, he seems to be perking up a bit. Tomorrow would be the day he gets 20. I am going to suggest that to the vet tomorrow, and see what he thinks. He may suggest the compounding pharmacy and maybe try 15 a day, however we don't have any close to where I live. So I don't know what out options are going to be. Thanks Laura, I appreciate your response!!

[LauraA]

I am not sure where you live (I am in Australia) but the compounding pharmacy will send the meds to you so you don't actually have to have one close by :) You just need to make sure it is from a reputable agency. I have seen Diamondback mentioned a lot and I am sure others will give advice as to a reputable source. A stim test will tell you exactly where his cortisol is at and whether you need to tweak the dose up or down, or stay the same.

It does get a lot easier!! I think I was permanently stressed about it all till after her 2nd stim test.

[Jmkk]

What's a stim test? Is that the ACTH test? He's had 2 of them already... I am in the US Laura, and I've seen a lot about compounding pharms... I guess I will need to see what I can do. Thanks!!

[LauraA]

Yes it is the ACTH test :)

[Harley PoMMom]

Hi and welcome to you and Quincey,

Getting those test results and posting them here may help us to provide you with more meaningful feedback. A Cushing's diagnosis should not be based on high liver enzymes but on strong obvious symptoms along with multiple testing. Since there is not one test that is 100% accurate at diagnosing Cushing's more than one test is needed to validate a Cushing's diagnosis.

When treating with Trilostane/Vetoryl there are protocols that need to be followed. The Trilostane/Vetoryl has to be given with food to be properly absorbed and the monitoring ACTH stim tests have to be performed 4-6 hours after the Trilostane/Vetoryl capsule is given. Are these protocols being followed?

Also, a dog's cortisol level may continue to drift downward during the first 30 days of treatment. So unless the initial ACTH test result is either too low, or really high and the dog is not showing any symptom resolution, the recommendation is to leave the dose unchanged during the first 30 days.

Here is a link to our Resource thread where you will find information regarding Vetoryl/Trilostane: Trilostane/Vetoryl Information and Resources (http://www.k9cushings.com/forum/showthread.php?t=185)

Please feel free to print anything out and don't hesitate to ask all the questions you want.

Hugs, Lori

[Squirt's Mom]

The LDDS, one of the tests done to diagnose, is a suppression test. The ACTH, the test that monitors treatment, is a stimulation test. Took me forever to get those straight in my head! :D

[Jmkk]

Quincey's first ALT was 130 U/L. 2 weeks later they were 178 U/L. On 11/14/14 his pre ACTH Cortisol was 15.8 and post was 25.5. He was put on 10 mg a day of Vetroyl. On 12/16/14 he was retested; his pre ACTH Cortisol was 8.2 and post was 10.2. The blood work today tested for Sodium, electrolytes and potassium and all were normal. We decided to do the 20 mg ( 10 mg twice a day ) every 3rd day instead of every other day. The vet said that since his blood work came back normal today that there is no way that he could be getting too much Vetroyl. But I do notice that he is more himself on the 10 mg a day. I'm not sure what to do here. He suggested trying this and retested the ACTH test in March. He understands my financial situation and knows that I can't afford the $230 very often. I want to do what's best for Quincey, but have the gut feeling that he's getting too much Vetroyl. I am open for suggestions!!! Please feel free to suggest anything, I did mention he compounding pharmacy, but he said at this point, he wants to try this first.

[Harley PoMMom]

ACTH stim numbers are not the sole basis for a dosage adjustment, improvements in symptoms along with how the dog is feeling have to be taken in consideration too.

I really don't see how you will be able to gauge how Quincey is really doing if he is getting more Trilostane one day and less on other days, his cortisol will fluctuate with that kind of dosing. So one can compare "apples to apples" all ACTH stim monitoring test should be done at the same time frames and with uniform dosing.

I'm also including this post which can save some money with the ACTH stim tests:

We sure do understand how expensive this dratted disease is to treat, those ACTH stimulation tests are expensive and your vet can save you money by using less of the stimulating agent, cortrosyn, and storing the remainder for future tests. With Scottie weighing about 14 pounds, I suspect your vet could get more than seven acth stim tests out of one vial of stimulating agent. It is well worth your while to ask your vet if she is aware that you do not need to use the entire vial of cortrosyn. If not, provide her with a copy of Dr. Mark Peterson's blog for veterinarians where he provides instructions on how to reconstitute the agent and store for future tests. The agent should last for at least six months which amounts to hundreds and hundreds of dollars saved. You can find this information at
http://endocrinevet.blogspot.com/2011/03/how-to-extend-your-supply-of-cortrosyn.html

Hugs, Lori

[Squirt's Mom]

I'm gonna be much blunter than Lori - your vet is wrong, period. He is wasting your money on extra pills and putting Quincy on a cortisol roller coaster. The vet works for YOU. ;) You have every right, and an obligation to Quincy, to use the correct dose in the correct manner and if that means he needs a compounded med, that is what you tell the vet you want. If they won't work with you, then find another vet asap who will work with you as a team member and not as a dictator. ;)

[Jmkk]

That's what I was thinking too. He needs more of an exact dosage every day. Do you think his numbers are really high?

[Squirt's Mom]

11/14/14
pre 15.8
post was 25.5
He was put on 10 mg a day of Vetroyl.

12/16/14
pre 8.2
post was 10.2.

The post for a pup on Vetoryl can go as high as 9.1ug/dl so 10.2 isn't that far off the mark as far as the numbers go. But signs count as well and if the signs were all controlled at the time of the second ACTH, I would have left the dose where it was until the signs started increasing, if they did. So, no, the post number on 12/16 is not too high. It's not optimal but not too high especially if the signs were controlled. Ideally, you want his post number between 1.45 and 5.1ug/dl.

[Jmkk]

I just want to do the right thing for him... The vet showed me the results from another dog where his post was 1.5 and that dog was diagnosed the same time Quincey was. He did say it was a bigger dog, I guess that makes a difference?? I may have to get a second opinion. My vet is very good, and has an excellent reputation, but right now I just don't seem satisfied.....

PS when I respond, I hit the little icon, quick reply. Is that correct that I do that or should I be replying a different way?

[Squirt's Mom]

That seems to be working for you tho I've never used that feature. I always hit the blue "Reply" button! :D Whatever gets your words out here, that's what matters. ;)

[Squirt's Mom]

And tell your vet they simply cannot compare Quincy to any other dog. He is a unique biological entity - no other in the world like him. We have seen large dogs gain control on very small doses and small dogs need very large doses so you simply cannot compare pups period. ;) And to try to do so is dangerous and poses a greater risk to Quince.

[molly muffin]

I use the quick reply button, that is fine.

I think a steady does is always better, whether it is once a day or twice a day dosing, I wouldn't do, 10 one day 20 the next.

Leslie is right, it doesn't matter one bit if it is a bit what another dog does, as Quincy is his own man so to speak. Some big dogs need lower doses, some small dogs need higher, there is no way to know till you jump in and see what works. That is why we always say, start low and go up as needed.

I wouldn't change anything unless the post number was Really high in the first 30 days, just because it can continue to come down.

[Jmkk]

Thanks for your input. So do you think he's levels right now are actually fine???? Maybe a little high, but not too much to get anxious over?

[molly muffin]

Exactly. A bit high, nothing to get excited about and actually can be fairly happy that it is coming down a bit. I agree completely with Leslie with her interpretation of where you are at with the numbers. It's a combination of numbers/symptom control/life quality. All have to be factored in to get Quincy to where it is what works best for him.

[addy]

Hi, if I am following along correctly, and I may not be:o
It seems Quincy was on 10 mgs for a month, retested and his post was was 10.2. It is possible to leave him where he is on 10mgs once per day, monitor symptoms and if they rebound, retest and change the dose. It could be 20mgs is a bit much and 15 mgs may be a better dose. That would mean either compounding 15 mgs or doing 10 mgs of Vetoryl and compounding 5mgs.

Just a thought. The current dosing schedule is confusing and I wonder your vet's justification for it. How was it decided and why?

I know it is confusing. Hang in there.

[Jmkk]

:) Thanks guys, I have to say though that you are getting me a little lost... Sharlene is Molly's Mom, correct, and Leslie is Squirts Mom, correct? :)

[Squirt's Mom]

LOL Yes, and I'm sorry. I used to sign all my posts but have gotten extremely lazy lately! :o

Hugs,
Leslie and the gang

[Jmkk]

I'm sorry Addy, I didn't see your post from earlier, I am new at this and still learning how to work the message boards. I agree with the compounding suggestion, I did ask him for that but he wants to try this first. Yes you are reading correctly. Now the 10.2 was the pre number and not the post number. I am thinking when he does get the 20 mg a day ( 10 in the morn and 10 at night ) he is getting too much for that day... He told me that eventually the levels will level out.

[labblab]

He told me that eventually the levels will level out.
I'm afraid the technical information published by Vetoryl's manufacturer does not bear this out: :o


CLINICAL PHARMACOLOGY:
Trilostane absorption is enhanced by administration with food. In healthy dogs, maximal plasma levels of trilostane occur within 1.5 hours, returning to baseline levels within twelve hours, although large inter-dog variation occurs. There is no accumulation of trilostane or its metabolites over time.

http://www.dechra-us.com/files/dechraUSA/downloads/Product%20inserts/Vetoryl.pdf

Because the therapeutic action of the drug is typically effective for far less than 24 hours, this is the reason why some clinicians prefer giving half of the daily total at twelve hour intervals every single day in order to keep the drug level as consistent as possible at all times. I'd encourage you to print out this product insert if it is not already included in your box of Vetoryl, and press your vet further re: his reasoning that altering the dose every other day is a good idea. The clinical pharmacology research simply does not support this.

Marianne

[addy]

On 12/16/14 he was retested; his pre ACTH Cortisol was 8.2 and post was 10.2.

Sometimes dogs go through cortisol withdrawal and they can feel pretty cruddy as that cortisol comes down, especially if they have any arthritis or other conditions that high cortisol masks. That extra 10 mgs could be bringing his cortisol down and then Quincy rebounds up on the day he does not receive it. Makes no sense.

If it were me, I would either stick with the 10mgs once per day if symptoms are fairly controlled or re discuss the 15mg option. As everyone has already said, it is better to have consistent dosing.

Sorry if I am being repetative;):rolleyes:

[Jmkk]

Wow thanks Marianne!!! That's what I was afraid of! So the extra dosage is NOT going to help him at all. Especially if it's too much! I will definitely bring this to his attention.

No Addy, you are not being repetitive, any information is good information!!!

[Jmkk]

I think I am going to call a few other vets around here and see if any of them would be willing to give me a second opinion on the paperwork that I have from my vet without them insisting on doing their own blood work... I think it may be hard to accomplish that though.... But it can't hurt to call and find out....

[Jmkk]

I found a vet that is willing to give me a second opinion using the blood work that I already have!! I'll let you all know what I find out.

[Jmkk]

I got a second opinion today with Quinceys current blood work done and the vet is thinking he may have been misdiagnosed and he does not have Cushings. More later when I have more time....

[molly muffin]

oh my, will be interesting to hear what this vets thoughts are.

[addy]

I second that, Sharlene, let us know what the new vet thinks.

[Jmkk]

I just copied and pasted this off of my fb post:

I got a second opinion today with Quinceys blood work and results. This vet doesn't think it warrants Cushings Disease. She is actually treating other dogs that do have it and she told me their levels are extremely high. It's not that I don't trust my original vet, but I wanted a second opinion for peace of mind. She said that Quinceys ALKP results doesn't show Cushings. Now my head is really spinning.. Quincey was just doing better before he was diagnosed, now he has no energy, is depressed, and just not a happy dog. Before his diagnosis, he was a normal happy puppy. I'm not sure what's going on with him... I've even had to really convince him to go outside a few times. And it wasn't bitter cold at the time. My gut feeling from day one was that he wasn't sick..... I want to do what's best for my sweet boy, but I don't like seeing him sick now, when he wasn't before.....

[Jmkk]

To elaborate a little more, she had copies of all of Quincey's bloodwork from October, including 2 ACTH tests until now. She told me to take him off of the Vetoryl immediately but keep him on the Denamarin because there is something definitely going on, but she doesn't think it's Cushings. We made an appointment for 4 weeks from now and she wants to run more blood work and check the levels again. So my plan is to take him off the Vetoryl, and watch for changes, I am hoping he gets back to his pre diagnosis lifestyle, if not than back to square one .... I've got to see if he feels better...

[Squirt's Mom]

Would you mind posting the lab results the vet saw that makes her think something other than Cushing's is going on? I found a few lab results but nothing alarming. So if you wouldn't mind posting all abnormal results along with the normal ranges that would be great. It would look something like -

EXAMPLE
ALP – 1012 U/L Normal = 20 – 150 U/L
ALT – 205 U/L Normal = 10 – 118 U/L

Thanks!

[Jmkk]

02/18/14

ALT 134 U/L Normal 10-100
ALKP 87 U/L Normal 23-212

10/13/14
ALT 130 U/L
ALKP 159 U/L

10/28/14

ALT 178 U/L
ALKP 180 U/L

She said since his ALKP is in within normal range, she doesn't believe he has Cushings. My question almost a year ago his ALT was high, no one questioned it, then it actually went down to 130 and it's questioned.... confusing to me..

[Jmkk]

Does anyone have an opinion on his numbers above?

[Harley PoMMom]

I just scanned over your thread and noticed that you did mention that Quincey did not display some of the most common Cushing's symptoms such as a ravenous appetite and excessive drinking/urinating.

Approximately 80% or 90% of dogs have a steroid induced isoenzyme of ALKP so if one of those dogs has cushing's, you are gonna see anywhere from a mild to severe increase in ALKP and usually there are only mild elevations in the ALT. The other abnormalities generally seen on a chemistry panel are increased levels in cholesterol, triglycerides, and a low BUN, on the CBC it might show an increase in the number of red blood cells (RBC’s) and/or an increase in platelets, there is also white blood cell abnormalitie which is called a "stress leukogram", since I see none of these posted and Quincey doesn't show the obvious clinical Cushing's signs it seems that it could be unlikely that Quincy did have Cushing's.

How is Quincey feeling and doing since being off the Vetoryl?

[Jmkk]

Thank you for answering. Today was his first day off of Vetoryl, and I am noticing him actually eating and wanting his treats, he is hanging out more with us. Lately he's been laying in the corner. He appears to be more alert than yesterday too. Plus his nose isn't as dry at it has been.. All of his other blood work levels were normal...

PS I noticed you are in York PA. My daughter graduated from York college a few years ago.

[Harley PoMMom]

So glad to hear that he is doing well, he sure is a cutie pie!!

I've lived in York, PA all of my 53 years :eek: am getting to be an ole broad now!:D

[Jmkk]

I'm 51, I am right there with you....

Thanks, a lot of people thing he is a short haired Pom!! But he's a long haired Chihuahua. Some people think he is a chi/pom mix too!! Your Harley is adorable too!

I have to admit, I am a little nervous with him taking his Vetoryl.... My head is just spinning!

[Harley PoMMom]

I'm 51, I am right there with you....
I have to admit, I am a little nervous with him taking his Vetoryl.... My head is just spinning!

Is Quincey now taking Vetoryl? I thought that the Vetoryl was stopped?

[Jmkk]

Oh I'm sorry Harley PoMMom, you are correct. He STOPPED taking his Vetotyl , Tuesday was his last one. Today his tail was actually wagging and in the upright position......

[addy]

Keep in touch and let us know how you both are doing ok?

[Jmkk]

Thanks Addy, he is actually wagging his tail again, eating his treats, barking, and gets excited to go outside. The vet that diagnosed him told me about 4 years ago that he had cancer. He hurt his neck somehow, so the vet took xrays, saw a shadow and told me it was a tumor and it was cancer. I took him to Pittsburgh ( about an hour and a half from here), they drained it and luckily it wasn't cancer. They wanted to do an MRI for a few thousand dollars, which I didn't have, so I took him to a chiropractor here in Johnstown who looked at him and told me that everything in his spine was where it should be. Every so often it bothers him again, and unfortunately he took prednisone and pain pills, and was kennel bound until it healed. I am assuming he pulls a muscle . So this vet tends to over diagnose, and I may have lost all of my trust in him. But then again. he still could be correct with the Cushings. I am going to take Quincey to the new vet in 4 weeks and see what she has to say. Keeping my fingers crossed and doing lots of praying,,,, not only for Quincey, but for all of the furbabies and furmommys in this group too.

[molly muffin]

Yay for tail wags. :) It sure makes the heart soar to see that tail going.

[Jmkk]

yes it sure does!! and wet noses too!!!

[molly muffin]

Oh yes wet noses for sure! I also love it when they will play with their toys again, have a bounce and wiggle in their step.

[Jmkk]

I just came home from working a 13 1/2 hour day ( I work one full time job and 1 part time job ) and Quincey was waiting for me wagging his tail and excited. He didn't do that when he was on Vetoryl. I keep doubting myself if I am doing the right thing for him by not giving him the meds, but he is getting back to his old self before he was "diagnosed". I just hope I am doing the right thing for him. I guess I just have to put my faith in the new vet and God above... Thanks for being there for me through all of this. You guys are awesome! Yes he does have that wiggle in his step back too!
Jolene

[Dixie'sMom]

I'm so glad to hear Quincey is doing better and that you got a second opinion. It will be interesting to see what shakes out at the next vet visit. Good Job Mom!

[Jmkk]

Am I able to upload a picture on here. I took a picture of Quincey last night showing how much better he looks.

[Harley PoMMom]

Yes you can upload a pic, and from our FAQ, here's how:
As a member, you can create Albums of images that are linked to your public profile. Albums can be created by visiting the User Control Panel, and clicking on the 'Pictures & Albums' link, and then clicking on 'Add Album'.

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Public albums can be viewed by anyone
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Profile albums are viewable only by you. However, you can use the images to customize your public profile (info)

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You'll have the option to give each picture a caption, and to set one image as the Album cover, which will be displayed on the public profile. To delete an album or edit the title, description or album type, click on 'Edit Album'. To delete an image, or to edit a caption or change the album cover, click on 'Edit Pictures'.

All members who have access to your album images can comment on them, in a similar way to Visitor Messages (more info). You can delete any image comments from your albums, and report inappropriate messages to moderators.

When you have uploaded a picture, you can place it in your posts by using the BB code text that is displayed below the image when you view it at full size.

If you have trouble or questions just let us know.

Hugs, Lori

[Jmkk]

He is feeling so much better. He hasn't been up on the arm of the loveseat in months.

http://www.k9cushings.com/forum/picture.php?albumid=964&pictureid=7431

[LauraA]

Very cute photo :) It's so uplifting when we see them start to do things they haven't done in a long time :D

[Dixie'sMom]

Awww he is so cute! I'm glad you stopped the Vetoryl and have your boy back. You know, I was thinking that an ultrasound might be a good diagnostic test for Quincey. I wonder if the new vet will suggest it? If not, why not ask about it. If you can swing the cost, it may give everyone a better picture of what is going on with Quincey and maybe put to rest the Cushing's question. Let us know how he is doing. We care!

[Jmkk]

Thanks Laura and Suzie! I will definitely let you all know what the new vet says. I'm not sure what she's going to want to do, but yes if I can swing the cost......

[Jmkk]

I got my 3rd opinion from a vet today with a very good reputation here in my town. He looked over Quincey's blood work and tests and said that Quinceys results does not warrant Cushings and that he does not have it. He said he wouldn't have even suspected Cushings according to his results. I think the biggest factor was the ALKP results, as they were all normal.
Please know that I will keep you all in my prayers, you and your furrbabies both.
My vet that I have been going to for at least 10 years diagnosed him with it. I got a second opinion from my friends vet ( who said he didn't have it ) which made me need a 3rd opinion ( who also said he doesn't have it ) It's time I find a new vet, of course it's going to be one of the 2nd two vets.
Thanks for all of your advise and heartfelt knowledge helping me get through this tough time. Remember , you will ALL be in my prayers!
Jolene

[addy]

Third time was your charm then, I am so glad you sought that out.
Don't be a stranger, you can still stop in to say hi and let us know how things are going.

[Jmkk]

Will do Addy.. my heart goes out to all of you.... I'm still scared for him... I'll feel better when he see's his new vet on Feb 12th. She said she still wants to run some tests.. not sure what for. She still thinks there is something going on. The vet I talked to today I could tell was very busy and he kept it pretty short. I figure if he thought it was something serious, he would have told me. I'll just keep praying for my baby and yours too!

[Dixie'sMom]

Awwww that is great news! I'm so happy for you and Quincy. Please let us know what his new vet says about him when you go on the 12th.

Thanks for your prayers and I will definitely keep you and Quincy in mine. Please don't be a stranger. Stop in and holler!

[Jmkk]

Thanks Suzie!

[Jmkk]

Just got back from the new vet. She pretty much ruled out Cushings but is concerned about the high liver levels, so she is going to do blookwork that will give her many different things that will check on the liver function. She didn't seem to be too concerned. ( of course I am, I worry about everything and overthink everything too ). I won't get the results until Monday because she had to send them away. she did notice his heart wasn't beating normally, something my old vet never mentioned. She said it was like a "galloping " beat. She will do some research on that and call me later. She's heard it in cats but not dogs. She also said that Quincey's hair loss on his tail wasn't from Cushings, but it is common in dogs that aren't neutered and now since he's neutered that's why it's growing back. I guess I'll just have to sit tight now and wait until Monday for his liver results. She tends to specialize in Endocrine issues.

[molly muffin]

Interesting, I wonder what she'll have to say on Monday when the results are back.

I would recommend since he has had high cortisol, that you have his BP checked periodically, since high cortisol can cause hypertension, just when you are in the vets, have them do a Blood pressure monitoring. Hopefully it will never be an issue but doesn't hurt to have it checked just like in us people.
Also with the galloping heart as a factor, I don't know if that affects BP or not.

So how do you feel with this vet? Is Quincy still arm lounging on the couch? Such an adorable little guy.

[Jmkk]

Thanks I will have her check his BP next time. I'll let her know what you said. He's doing well, other than gaining weight.. I can't wait until Spring to help him lose some of that weight. We have so much snow here right now, he has no where to walk. I'll check in on Monday and let you know what the test results find. I am hoping that it is only "vet stress" causing all of this.
Yes he is still arm lounging on the couch and back to lounging with me again too!!! I just wonder what could have happened if I kept giving him meds that he didn't need...
Yes I really like this vet.. a lot! The other vet that I got the 2nd opinion on is very good too... even better, but he's 45 minutes away, and both of my dogs don't do well in the car. Quincey get's very stressed out, and my shepherd mix Kodi, gets car sick. This would make one stressed out mom as well..... and then there's the cat.......

[Jmkk]

I got great news from the vet this morning. Quincey's liver levels were perfect for his age. The galloping heart rhythm is nothing to worry about. What it all boils down to is that the levels were not high enough to warrant Cushings and the levels were risen due to what I call "vet stress". Poor little guy was just terrified to be away from me and now gets very stressed out anytime he goes to the vet. He was even shaking at the new vets office ( probably from what he smelled, I'm sure to a dog they all smell the same ) I will continue to keep you all in my prayers......

[Harley PoMMom]

So happy to hear that Quincey does not have Cushing's!!!YYAA!! And that is wonderful that his liver values have normalized. Please do keep us updated, ok ;)

Hugs, Lori

[Jmkk]

Thanks Lori!

[Squirt's Mom]

Good news! A nervous Quincy who doesn't like the vet's nor being away from his mom is good news! Drop in every now and then and let us know how the two of you are doing, ok?

Hugs,
Leslie and the gang

[molly muffin]

That's great news! So glad that you had another vet take that second/third look.

[Jmkk]

Thanks Everyone... I appreciated your help through all of this.... My boy means the world to me....

[Dixie'sMom]

Awesome news! I'm so glad his liver values returned to normal. I'm also thankful you have a new vet that you feel you can trust (Even if Quincy hates it!) Sounds like the future is looking bright for you both. I'm so happy for you.

Hugs and Love and please stop in to say hi when you can.

[Jmkk]

Thanks Suzie, Dixie and Buttons. I sent the rest of his Vetroyl to an associate at work who has been borrowing from her retirement to help pay for her dogs vet bills. She lives about 1 hour and a half from here. It feels good to help, I know how costly this disease is..... Thanks for all of your help and encouragement , I truly appreciate each and every one of you!

[molly muffin]

Aww that is very nice of you. It's true, this is a very expensive disease. sheeess. I'm sure she really appreciated you thinking of her.

Give Quincy a belly rub from us!

[Jmkk]

Just gave Quincey his belly rub. He thanks you. He loves his belly rubs!

[Jmkk]

So I called my old vet last night to have Quincey's records sent to the new vet, along with my other dogs records and our cats records. Today my old vet calls me at work and even called my new vet to discuss things. He told me that he actually talked to a specialist this morning about Quincey and his blood work. The specialist thinks Quincey has Cushings and of course my old vet still thinks so. They both agree that Quincey has no real symptoms of Cushings but the blood work says he does. This is apparently rare, but possible. So now I am a bundle of nerves again. I emailed my new vet, but have not heard back from her yet. My old vet told me that Vetoryl is a chemotherapy drug! Did any of your vets tell you that? Of course my old vet was begging me not to leave his practice, so I'm not sure how much his words are worth. I've been going to his practice for at least 20 years and we are some what friends.... but I'm still not sure what and who to believe now. I didn't personally talk to the specialist, so he may be stretching the truth a bit also. I have 2 other good vets in my area that says Quincey doesn't have it. The meds made him sick, and he's back to his normal self without them...... I am just so darn confused again..... Hopefully my new vet can shed some light on the situation for me......

[Squirt's Mom]

For me, the answer would lie in Quincy and the fact he is better off any Cushing's treatment right now. ;)

[Jmkk]

Good point Squirts Mom! Thanks

[Jmkk]

Quincey has taken a turn for the worst with this humid weather. The vet thought it was allergies, but at night he pants so hard that I have to sedate him . Last night was one of them. I don't know what's going on with him. She is still convinced that it's not Cushings, he is just miserable. It's been in the low 80's here with humidity, plus the tree pollen is extremely high. We are to get a cool down soon, so I am hoping that helps him. She gave him of all things a steroid drug for his allergies.. She said it's just a little bit, and we are weaning him off of it. Plus it has some allergy meds in it and he's also on an antibiotic. He's overweight as well. She put him on Science Diet Metabolism to help him lose some weight. He's a 13 lb Chihuahua. I am beside myself with worry. I don't know what's going on with him.... I am so scared....

[molly muffin]

Apoquel is a newer allergy medication for dogs that people have reported works really well. It is harder to come by though, but you could ask your vet about it.

[Jmkk]

Thanks for the advice. I talked to the vet today and she suggested that I also give him melatonin. She said our nerves are feeding off of eachother. If this doesn't work for him she is going to give him some Zanax. I think I need some too..... This little guy is literally my best friend.... when he feels down, I do too! I did ask about Cushings again and she is still convinced he doesn't have it.

[molly muffin]

I give molly melatonin when there are fireworks or thunderstorms. It seems to help with the nerves.