New Here - Honey has crossed the bridge

[belfastgirl1943]

We live in Australia and just recently our little rescued dog Honey was diagnosed with Cushings. We have had her for six and a half years and we think she is about 8 years old. We started on Trilosane on the lowest dose for her weight and it did not help her symptoms in fact it made her ill.
She has had a lot of health problems - she had her spleen removed as it had a tumour - for about the last three years she has had a form of colitis which was painful for her but now we have that reasonably under control. We sound after trying every medication there is for the colitis that she responds better to natural medications.
We are now trying the Cushex drops. After two weeks there is no noticeable change. We really don't know what to do next.
Any advice would be appreciated especially if someone has had success with natural treatments.

[LauraA]

Hi belfastgirl1943, I am a West Aussie :)
The Cushex drops will not help I am afraid. What is her weight and what was the trilostane dose you started out at? It may be that a lower dose would work better. Does Honey have many symptoms of Cushings, usually it there is no outward symptoms then treatment is delayed till when they do show them. Most people will start their dogs on a liver supplement though to help with the raised liver numbers.

Did they do a ACTH Stim test when she was ill to see if her cortisol was too low? If so get a copy of the test results and post if you can :)

[Harley PoMMom]

Hi and welcome to you and Honey from me as well. Cushing's is one the most difficult endocrine diseases to get a confirmed diagnosis for because not one test is 100% accurate at diagnosing it and other non-adrenal illnesses can create false positive results on tests for Cushing's.

Dog's with Cushing's usually have a ravenous appetite, drink buckets of water and pee rivers, they also tend to have some hair loss and skin problems, does Honey have any of these clinical symptoms?

What medications is she taking? How much does she weigh? And what is the dose of Trilostane she was/is on? Was she getting her Trilostane with food?

It would help us if you could post the results from all test/s that were done on Honey, we only need to see those abnormal values, as an example: ALT 150 U/L (5-50). We are especially interested in the test results that were performed to diagnose her Cushing's.

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

Hugs, Lori

[belfastgirl1943]

I don't have Honeys test results. Would need to access from Vet. She weighs 8.5 kilos and was prescribed Trilostane 30 mg once per day. This was in the form of a compounded capsule and was to be given in the morning before any food.
Honey has all the standard symptoms. Panting, drinking large amounts. peeing very often and sometimes incontinent, over heats easily, enlarged liver. no energy, sleeps a lot, always hungry and searching for food etc.
She has ongoing gut problems - has seen a specialist and has also had her spleen removed. After a week on the Trilostane she became very lethargic, with a droopy tail, and looked just miserable and unhappy, restless and very uncomfortable all the time. We stopped the Trilostane ande decided to try the Cushex drops.
She is on a prescribed hypo allergic diet and no other medication at present (except the Cushex Drops) and has been on so many drugs for her gut over the years including prednisolone that she is now sensitive to most medications.
Looking back she had some early Cushings symptoms about 2 years ago which worsened in the past 6-8 months - finally we saw a different Vet in the same practise who had her in for half a day and ran all the tests and diagnosed Cushings. That was about a month ago.
We just want her to have a better quality of life as she has had so many health problems and deserves better.

[Harley PoMMom]

A starting dose of 30 mg of Trilostane for a dog weighing 8.5 kg is a bit high. Dechra' the makers of Vetoryl (which the active ingredient is Trilostane) are now recommending a starting dose of 1mg per pound of a dog's weight, so for Honey's weight of 18.7 pounds her startimg dose should of been no more than 18 mg.

Dr. Mark E. Peterson, who is a world-renowned veterinarian specializing in endocrinology, has written in his blog that dogs being treated with Trilostane must have this medication with food.
With trilostane, it’s extremely important to give the morning medication with food, and then start the ACTH stimulation test 3 to 4 hours later.

Fasting these dogs on the morning in which the ACTH stimulation test is scheduled should be avoided since it invalidates the test results.

When a dog ‘s food is withheld, the absorption of trilostane from the gastrointestinal tract is decreased. This leads to low circulating levels of trilostane, resulting in little to no inhibition of adrenocortical synthesis. Therefore, serum cortisol values will higher when the drug is given in a fasted state than when it is given with food.

http://endocrinevet.blogspot.com/2011/03/whats-best-protocol-for-acth.html

If she was receiving her Trilostane without food then her system was not absorbing the Trilostane properly.

How is Honey doing now? Did she have any monitoring ACTH stimulation tests performed? And if so, could you post those results here....thanks

Lori

[belfastgirl1943]

Thank you for your quick reply. I will contact our Vet tomorrow and ask for the initial test results on which she based her diagnosis. Honey was only on the Trilostane for 2 weeks when we stopped them. When prescribing the Vet said this was the very lowest dose. she ahs not had any further monitoring tests.

I will have to make another appointment with the Vet to discuss lowering the dose and to get new capsules as the capsules we have were made up at 30 mg. Pity as we have 16 capsules left.

Thanks again for the info. I will arm myself with this for the next Vets visit.
Honey has improved in herself after coming of the Trilostane - she is happier and more comfortable but her Cushings symptoms are still the same.
I will keep in touch. Thank you for being so caring.x

[LtlBtyRam]

I hope you can find out what is causing the symptoms. Everyone has what works for them. When I first started here I was unsure and scared. We've been going down this path for a couple of years now.

What works for us is a special compounded dose of Trilostane (since she is between brand doses) twice a day with supportive acupuncture appointments every 2 weeks along with a couple of different tea pills and another supplement.

The folks here are great and a huge help. Let us know how your journey is going.
Angela

[Harley PoMMom]

When prescribing the Vet said this was the very lowest dose. she ahs not had any further monitoring tests.



Since the brand-name, Vetoryl, only makes certain dosages, when other doses are needed a compounding pharmacy can provide any dosages that Dechra does not manufacture in their brand-name Vetoryl. Many members successfully use Diamondback Drugs as their compounding pharmacy. Here's a link to their website: http://www.diamondbackdrugs.com/home-mobile/

[belfastgirl1943]

Here are Honeys test results. Done to see if she had Cushings.

ACTH stimulation test 3/3/2015

Cortisol resting 190 high nmol/L 15 -170

Cortisol 1st post 1139 nmol/L

I am not sure if this is what you want. Let me know. Thanks x

[Harley PoMMom]

Those ACTH stimulation results are high, converting to ug/dl which are the units we are used to seeing, that comes out to a pre of 6.9 ug/dl and a post of 41.3 ug/dl.

I've been wanting to ask, how was the tumor on her spleen found, was an ultrasound performed?

Did she have a CBC/chemistry blood panel done recently? And how about an urinalysis? If she has could you post anything on there that is marked abnormal...thanks!

And it is just wonderful that you have given Honey a loving forever home, Bless you.

Hugs, Lori

[belfastgirl1943]

Hi Lori, Yes Honey did have an ultrasound and they found a ? dead spot on her spleen. Vet recommended to remove it in case it was malignant. This was a few years ago
Has had some in house blood tests done a couple of months ago and we took some urine in late last year some time which was also tested in the Vets.
Perhaps it is best if we go back to the Vet and request the tests you suggest and just start afresh?
Honey is having a not so good day today. Do you think we can do something to help her? She is such a dear little girl. She was found roaming the streets and had been mistreated before we rescued her just over 6 years ago. We love her to bits.
Margaret xx

[Harley PoMMom]

Hi Margaret,

Oh my, poor sweet Honey, I just don't understand how a person can abuse such a dear girl, I am so glad Honey has you to love and dote on her.

If this were me I would have a CBC/chemistry blood panel and an urinalysis done just to see if there are any new abnormalities that show up.

Some dogs are sensitive to Trilostane and maybe Honey is one of them, and if so, than starting out at a lower dose would be better. I believe I mentioned before that Dechra recommends a starting dose of 1mg per pound of a dog's weight. We have seen that when a dog is started out at that dose of 1mg/lb that it minimizes the risk of unwanted side effects. Also, since Trilostane can cause gastric upset giving Pepcid AC 20-30 minutes before the Trilostane dose may help with that. Did the vet give you prescription for prednisone? Prednisone is given when it is suspected that a dog's cortisol has dropped too low, it mimics cortisol in a dog's system.

Cushing's sure is a difficult disease to diagnose, and treating it can be challenging too. Our experience here is that many dogs do take a fair amount of "tweaking" in order to arrive at their ideal Trilostane dose. And their dosing needs can change over time.

We all know how stressful times like this can be so please know that we are here to help you in any way we can. Please be sure to check out our Helpful Resource section. There is a ton of information there, including a great thread for folks new to the disease. Here's a handy link: Helpful Resources for Owners of Cushing's Dogs (http://www.k9cushings.com/forum/forumdisplay.php?f=10) and Trilostane/Vetoryl Information and Resources (http://www.k9cushings.com/forum/showthread.php?t=185) Feel free to print anything out and do not hesitate to ask all the questions you want.

Lori

[SuperCupcake64]

Hello! I'm not nearly as experienced as a lot of the people on this forum, but for what it's worth, I adopted a senior dog with untreated Cushings who after a year and a half has responded only moderately to trilostane. My vet uses using a compounded liquid form because it's easier to adjust the dose up incrementally. I recently took Sammy to an internal medicine specialist who recommended that I use the brand name version (Vetoryl). He said there are studies that show it's absorbed better. So if the compounded drug doesn't work as well as you would like, switching to the brand name might be one (unfortunately more expensive) option.

Best of luck to you. I know how confusing this can be! :)

[molly muffin]

You can definitely get a lower dose compounded of trilostane in Australia. The does of 30mg being the lowest for her weight is out dated information.

So, 18mg, but I would probably start even lower. Honey is about the same weight as my molly and we started very low, 8mg once per day and are slowly moving up, now going to 15mg, and she has tolerated it very well. If she exhibits a lot of symptoms in the evening, then a split dose, 1/2 and 1/2 given WITH food, the morning and evening meal, might work. As littlybit suggested also you can try acupuncture which works for some dogs and laser therapy to go along with a low dose of trilostane.

Once you have a cbc, urinalysis done that is probably the treatment plan I would follow as you want to lower that high post cortisol, but you don't want her to feel awful while on it or respond badly to it.

Welcome to the forum!

[belfastgirl1943]

Thank you everyone for your support and replies. I m so thankful to have found this forum.
Yes the prednisone was prescribed by the Vet at the time when Honeys Gut problem was at its worst - but it didn't help. She saw an internal specialist at the time.
We will take Honey to the Vet again and talk things through and see about getting her started on a lower dose of Trilosane. I believe it is possible to get this compounded into a paste which would work better for her as the capsules stick in her throat and she coughs them up.
We have always had a problem giving her medication unless it can be dissolved and squirted down her throat or can be made into a paste.

Thank you all again for caring. I will stay in touch. Margaret xx

[molly muffin]

They can do a liquid suspension too as another possibility.

[belfastgirl1943]

I finally managed to source the Trilostane in liquid form from a compounding chemist. I had to try a few via email but in the end a local one got advice and is happy to make it up for us in an oil suspension.
Our Vet also spoke with them - although he appears to have reservations - he thinks the capsules are safer for both the dog and for us handling them.
Any way we finally got him to agree to a lower dosage and he gave us a script which is is being made up for collection tomorrow.
Honey is very miserable and sad except when there is food on offer. I am not holding my breath for a brilliant result as her lymph glands are up and there may be other things going on - but her temperature is normal - so not an infection.
The trauma of taking her to the Vet who is only ten minutes drive away was dreadful for her. Now we are trying to find a vet who does home visits.
Wish us luck.
Margaret

[Harley PoMMom]

Hi Margaret,

I've merged your new post into your original thread about Honey. This way, we will be able to keep track of her entire health and treatment history all in one place.

Oh poor Honey, those vet visits can really bother our pups :( Glad to hear that you can get the Trilostane in a liquid suspension. Hopefully with the lower dose of Trilostane Honey will start feeling more like herself. Wishing you and Honey the best of luck.

Hugs, Lori

[molly muffin]

I'm glad you are able to get the lower dose of trilostane. I think that is much safer to start with.
Hopefully honey will start to feel better and be happy again.

[belfastgirl1943]

We just got the liquid Trilostane and it says give with food. To make sure she gets it all can I just put the drops on a small amount of food and then give her the rest of her breakfast.

[labblab]

We just got the liquid Trilostane and it says give with food. To make sure she gets it all can I just put the drops on a small amount of food and then give her the rest of her breakfast.
I would call the pharmacy that prepared the trilostane and ask them. The manner in which you give the med may definitely affect how well it is absorbed in the body, and the pharmacist should be able to guide you best in that regard.

Marianne

[belfastgirl1943]

My husband asked them when he picked it up - they said check with the Vet. We rang the Vet straight away and he was to ring us back - it was just before the practice closed. He didn't ring. So this morning I just put the drops on a small piece of soft food which she ate first and then gave the rest of her breakfast.

Has anyone here used the liquid Trilostane?
Can anyone here advise on this?

[molly muffin]

Hello. I haven't used the liquid trilostane but trilostane in general needs to be given with food, so putting some on her food and then her having her breakfast immediately should work.

In a way that is how I do it with the pill form. I wrap it in some wet food and give it to her and then give her the rest of her breakfast.

[belfastgirl1943]

Many thanks Charlene.

[belfastgirl1943]

Honey has been on the liquid Trilostane now for several days. She had 5 days on 2.5mls once per day in the morning and then this was increased to 5 mls .

On the third day on the low dose she seemed a little brighter - but since then she shows no improvement and had a really miserable day yesterday. When she went out to pee she hardly had the energy to walk the few steps back indoors again.

She is no better than when we tried the Cushex drops.
Do we have to be patient? I hate to see her like this.

[molly muffin]

Why was she raised to 5ml? Cortisol will continue to go down on the same dosage for 30 days or so. Usually don't increase unless the ACTH test shows she is very high until after the 30 days. By raising you risk her cortisol going too low. Which one sign can be lethargy. You have to be careful with the meds they can be pretty powerful.
I've noticed that it can take sometimes around 10 days to see initial changes on the original dose. That is just a trend I've seen on the forum. Every dog is different of course in how they respond to the drugs. I wouldn't have increase though.

I'd have a test done to see how she is now cortisol level.

[belfastgirl1943]

We are following the Vets instructions. This is what it says on the bottle.

Trilostane 20mg/ml fixed oil suspension 50ml: give 0.25ml once a day for 5 days then 0.5ml once a day.

They gave us a marked oral syringe dispenser.

Now I am looking at the syringe there are two sets of markings. When I give it I have giving the smaller amount which looks less. I saw my husband draw it up and I think he may give her the larger amount.

Now I am worried and upset!

My husband is out so I cant check.
The smaller marking is a half of the larger marking. The larger amount seems to be the correct dose.
Poor Honey!
Do you think we should start over?

[labblab]

We are following the Vets instructions. This is what it says on the bottle.

Trilostane 20mg/ml fixed oil suspension 50ml: give 0.25ml once a day for 5 days then 0.5ml once a day.

They gave us a marked oral syringe dispenser.

Now I am looking at the syringe there are two sets of markings. When I give it I have giving the smaller amount which looks less. I saw my husband draw it up and I think he may give her the larger amount.

Given the info on the bottle, it seems as though 0.25 ml per day would equal 5 mg. of trilo, and 0.5 ml would equal 10 mg. Even the higher dose is still a low amount for a dog of Honey's weight (8.5 kg. or nearly 19 pounds). So I have to assume that your vet was just planning to introduce the medication very slowly by starting out super-low for a few days before moving on to the intended 10 mg. daily dose.

Given those instructions, I would think that the two marks on the syringe correspond to those two different amounts, since one is half of the other. So do you mean you and your husband have unknowingly been switching back-and-forth between the two doses rather than starting out at one level and then shifting to the other after the five days? Either way, since both doses are relatively low, I would be surprised if Honey's cortisol has dropped too low. It's possible that it may even be the reverse: if you have unintentionally been giving her only the 5 mg. for an extended time, that may just be too low a dose to be making much difference for her.

I would think you could consistently just stay on the 10 mg. at this point. But if Honey continues to remain unwell, I would contact the vet to let them know she is doing poorly. Perhaps they will want to reevaluate her before proceeding further.

Keep us updated, OK?
Marianne

[molly muffin]

Okay based on what the bottle says as dosage Marianne is right she is at 10 mg with the higher dosage which shouldn't be too much and that is what the higher markings is for. So now shouldn't be too low.
I forgot what is her weight?
How is she doing today?
They can also go through cortisol withdrawal as the cortisol in their bodies goes down and feel yucky for a few days which is another possibility. Cortisol makes them feel pretty good and can mask the aches and pains. Then suddenly it is gone and ouch they feel those things again.

[belfastgirl1943]

Honey was started by the Vet on a 30 mg capsule once per day. This was making her very miserable and the capsule difficult to administer.
Someone on this forum suggested this was too high and to go back to the Vet and start on a much lower dose and build up. We decided also to chang to the liquid as giving the capsules was too difficult.
So we went back to the Vet and asked for a prescription for the liquid and a lower dosage as suggested here on the forum.
The Vet did what we asked.
Now I am confused. It was suggested on the forum to start around 10 mls or even 8mls.
Honey was miserable and droopy initially on the 30 mls, and still the same on the 5 mls and 10 mls.
My husband normally gives her this so we have now worked out it was only on 2 occasions that she got the incorrect dose

[Squirt's Mom]

I want to catch you right quick and hopefully help you understand how liquid meds work. You use the term "mls" which mean milliliters and that is how liquids are measured. BUT that is not how the medicine in the liquid is measured. It is measured in mg or milligrams. So on a bottle of liquid medicine you will see the dose listed as ___mg/ml which means there are X # of mg (milligrams) of the medicine in each ml (milliliter) of liquid. The liquid is a carrier for the medicine and is not the medicine itself. So when you give 1ml your are not giving 1ml of medicine - you are giving 1ml of liquid with ___mg of medicine in it. It's easy to get confused with how much medicine you are actually giving when using liquids. ;)

Your bottle says Trilostane 20mg/ml so that means in every ml there are 20mg of Trilostane. If you are giving 1ml you are giving 20mg of Trilo with each dose. 1/2ml would be 10mg of Trilostane and so on.

[belfastgirl1943]

Honey is still not improving - so sad. I have organised for a Mobile Vet to come and see her tomorrow. To get a second opinion and to save Honey the distress of going out.
It is heart breaking to watch her hoping for some improvement and seeing none. Our own Vet misdiagnosed her for about 8 months putting it down to her gut problems. Even though what we kept describing we now know were the classic symptoms of Cushings.
She was a rescue dog - found on the streets covered in prickles and starving in a small country town. We got her 7 years ago. She has a lovely nature and is such a little sweetheart and has had a lot of ill health to contend with.
It seems so unfair! I just a better quality of life for her - she deserves it.

[belfastgirl1943]

I forgot to say thanks to everyone we did figure out how the dosage worked.

[molly muffin]

Let us know what the mobile vet says.

Poor Honey, we all hope that she can get to a better place with this and enjoy herself once again. She sure has been though a lot, but gosh, what a great home to end up in. :)

[belfastgirl1943]

Unfortunately the Mobile Vet has the Flu and cancelled yesterday so we have to wait until next Thursday now.
On another subject we bought a dog toilet for Honey as she now has the occasional accident indoors. (We live in a ground floor apartment which opens on to expansive gardens.)
We were hoping to get her to use the toilet when we go out or during the night or at other times if she needs it. We have tried everything but she will not use it. I have put pee soaked paper on it, put the grass mat on the lawn and tried to get her to go on that to get her scent on it but she just jumps off.
We never leave her for more than 2 hours, we take her out every hour and most morning she needs out around 5am.
It would make life so much easier if Honey would use this toilet. Any suggestions?

[Harley PoMMom]

I must confess, I did not know they made toilets for dogs, had to google it!!

I wonder if you would put another dog's urine on it, maybe then she would go on it to mark her territory???

I've believe some members use belly bands for their pup, and I see that they do make doggie diapers. :)

Hugs, Lori

[molly muffin]

Doggie toilet was a new one for me. I've heard of pee pads of course, but not the same thing. Interesting concept. I don't know what would entice her to use it.

Drat on the mobile vet having to reschedule.

[belfastgirl1943]

Would you believe it the Mobile Vet (Dr Ken)got called away on an emergency before he got to us. He did a free phone consult from his car. He had read all Honeys medical info from our other Vet.

He asked an awful lot of questions and gave me excellent information support and advice. I really felt like he cared and was experienced with Cushings.

We had increased the liquid Trilostane from .25mls to .5mls after 7 days as instructed and Honey was almost unable to function so for two days prior to speaking to the Mobile Vet we reduced it again to .25mls and she had a little more energy and was a little brighter.

Based on my observations of Honey on the Trilostane he suggested we keep her on the lower dose for a week and then increase to .3mls for a week and then .35mls for a week and so on.

I feel more confident now and prepared to be patient and hope to see some improvement. I can ring Dr. Ken at any time.

[belfastgirl1943]

Honey is doing better on the lower dosage. She is more lethargic in the mornings after her Trilostane but seems not to be peeing just as much and looks a tiny bit less miserable. However, her bowel movements have altered. She does a normal movement followed immediately by two smaller softer ones. I don't know if this is related to the Trilostane. She does have an ongoing gut problem that had been much improved for the last 6 months. Any thoughts?

[molly muffin]

Hi, so glad to hear that Honey is doing better on the lower dose.
Yes sometimes they will be lethargic in the mornings after trilsotane. My molly is too.

However, you will want to have a follow up ACTH done to see where her levels are with the lower dose. It's the only way to know for sure how she is handling it, if it is too much still, and if it is the cause of the loose stools.

You can try adding in a bit of fiber to her diet to help with that also.

[belfastgirl1943]

The last couple of days Honey seems to be having a problem with her front left leg. She seems as if it is not able to bear her weight and sometimes holds it up and just stands there. It seems worse today.
Does this mean the Cushings is progressing?
She is still on the Trilostane and we are very gradually increasing the dosage as recommended by the Vet.
This is very worrying for us. She is still eating well and not quite as thirsty or peeing as much but mostly just sleeps or lies around.
Any advice?

[Squirt's Mom]

I would have the vet check her out to make sure she doesn't have an injury or bite of any kind. It is common for inflammatory processes like arthritis, allergies, etc. to come to the forefront as the cortisol is lowered. The excess cortisol acts as an anti-inflammatory and when it is brought back to normal levels, those things it was holding at bay come forward. So I would have the vet check and go from there.

[belfastgirl1943]

Honey has no sign of an injury or bite. We live in an apartment and she never goes out unattended. She can no longer jump up or down on to furniture she sleeps or lies around most of the time.
The problem with her front leg has been gradually appearing and she also get little spasms in her leg when she is sleeping.
I read on other sites that leg weakness either front or rear can be a symptom of Cushings and I was hoping someone on this forum may have experience with this.
The other problem is Honey gets too distressed to take to the local Vet and it would be a couple of weeks until the mobile Vet can see her.
Our worry is that this means her Cushings is getting worse.
Can anyone advise if this is the case?

[belfastgirl1943]

Just reposting and hoping for a reply.

[Wrighton]

My.dog tore her CCL when she was chasing a deer and fell through the ice, so we knew why she couldn't put her leg down, but once it had happened she held up her leg,but I could not see any injury to it nor did she react when I touched it. We took her to the vet immediately, but after the fall, her leg "shivered" when she slept. In that you are with your dog at all times outside, I guess it is unlikely it is an injury. Moreover, it certainly did not come on gradually.

On the other hand, lameness occurred when she had anaplasmosis, a tick borne disease, which if left untreated can cause very serious and permanent injury or death. A simple blood test showed it in minutes and with antibiotics, she completely recovered. Early diagnosis and treatment was critical. We live in an area with lots of ticks.

Hope someone who is more knowledgeable can help. After two surgeries in eight weeks this year, I understand how much your dog reacts to a visit to the vet. Mine shivers the whole time, but it is a necessary evil for us.

[molly muffin]

I don't think there is any way to know for sure what is causing the problem without the vet checking her out for the front leg. Did the mobile vet ever come over?

Rear leg weakness not being able to jump is common with Cush pups though. Lowering the cortisol often also uncovers problems like arthritis in the legs.

[belfastgirl1943]

Thanks for your thoughts re Honeys leg weakness. It is still the same so I am inclined to think like it said on a website that it is probably related to her Cushings. It does not seem to worry her except that it does not bear her weight as well any more.

We are still ever so slowly increasing the Trilostane. But there is very little noticeable improvement in her overall condition. Her belly is still very swollen and she is lethargic and often unhappy looking. She sleeps a lot and is a little brighter in the afternoons but is eating well and not weeing just quite as often. She doesn't want to walk only the few metres to the lawn to do what she has to do.

We have given up hoping that the Trilostane was going to be the answer.

[Squirt's Mom]

Can you tell us how much Honey weighs? And what dose of Trilo she is taking?

[My sweet Ginger]

Based on my observations of Honey on the Trilostane he suggested we keep her on the lower dose for a week and then increase to .3mls for a week and then .35mls for a week and so on.

Hi, quickly reding through Honey's thread I didn't see her monitoring ACTH stim test results. I only saw the diagnostic ones before the trilo treatment. Was there one done after trilo and what were the results of the pre and post numbers of the latest ACTH?

Leslie, Honey weighs 8.5kg.

[Squirt's Mom]

Thanks, Song! I guess I was being lazy. :o

[belfastgirl1943]

Honey is now on 8mls of Trilostane per day.
She has not had any repeat tests as the last time we took her to the Vet she became so distressed that we thought her heart would stop beating. In the end I had to carry her outside after the Vet examined her whilst my husband spoke to the Vet and she hardly moved for a few days afterwards.
She just starts shaking all over as soon as we get in the car and it gets worse when we get into the Vets so we are too frightened to take her or leave her for tests.
She is a rescue dog and has always had some anxiety.We have tried sedatives in the past but she struggles to stay alert and fights against them.
We love her to bits. She is such a dear little dog and we just want whatever time she has left to be comfortable and stress free.

[molly muffin]

Have you ever considered having a home visit vet? They aren't always easy to find but some areas do have vets that make house calls for dogs that become very stressed.
It's something to think about, and maybe your vet would be willing to do so or know another vet that could do a house call.

Just something to think about.

[belfastgirl1943]

I found a mobile Vet - who let us down twice. Once he was sick and the second time got called away just before he got to us. He only visits our area once per week. He did ring me and did a phone consult. I am now trying to find another one.

[belfastgirl1943]

We are struggling with how to decide when enough is enough for our dear Honey. I have located a lovely female Vet who will come to our home but really do not know how to decide. Can anyone who has made this decision please help?

[Budsters Mom]

;)For me, it helped to have a plan. My Buddy had a suspected macro tumor. I knew that he would not recover and he was slowly dying before my eyes. It was very hard for him to settle at night and he was very restless. As long as I was able to manage his pain and he was not suffering, it wasn't his time. He was still able at that time, to do everything that he loved. He could still hunt and chase lizards, although his front legs would give out without warning and he would do a face plant. He could still run along the fence and bark at the birds who had the nerve to invade his airspace and he could still guard his family like he always had. Except he could no longer jump up into the window seat to look out anymore and the ramp was too hard for him to climb up. My plan was to let him continue as long as he could happily continue to do everything he loved. However, the first time that that he looked like he was suffering and could no longer enjoy his days doing what he loved, then it was time to free him. Making a plan is easy. It is very hard to actually carry it out.

That day came much too soon. He was lying in his bed one morning and could not get up. He looked through me with his big brown eyes. He was ready to fly. I had to carry out my plan and I did. After lying down and cuddling with him for about a half an hour, I got dressed and we took our last car ride together. It was one of the hardest things I've ever done, but it wasn't about me. It was about the right thing for him and I owed him that.

I cannot tell you when the right time is for your baby. I can only share my story with you and hope it helps.

Someone will be by shortly to merge your threads. It's much easier to us to follow along when all the facts concerning each fur baby are all together. Do not worry though. Others will still see and respond to your request for help. ;)

Big hugs,
Kathy

[Squirt's Mom]

Hi sweetie,

Tough place to be, huh? I know. :( Squirt has been gone over a year but I think I lived with anticipatory grief as long as I have lived with realize grief. And I'm not sure which is worse. There were so many times I thought she was done, that she had had enough - then she would rally and I would feel like a heel for giving up on her. But that time finally came when she couldn't fight back. Her body shut down. She stopped eating and drinking and that was my sign. There was a look in her eye that said she was seeing somewhere else already.

There are no set rules or aspects of when it is time - we know our babies best of all and know best when their lives have lost meaning. Here are some good links that tell us things to look for -

http://pets.webmd.com/features/put-pet-to-sleep

http://www.petmd.com/blogs/fullyvetted/2009/march/ten-ways-you-know-its-time-euthanize-your-pet-6745

http://www.vetstreet.com/our-pet-experts/how-to-say-goodbye

Know you are not alone. We are here if you need to talk - and we do understand only too well.
Hugs,
Leslie and the gang

[Jenny & Judi in MN]

You may want to consider loading up on some pain meds since you are so far away from a vets office. I thought of 3 things my Jenny enjoyed. It got so that she was down to 1, she didn't even really want to walk in the yard any more, so I knew it was time.

Because my vet hunts deer and it was the opener we had a last weekend with her. She was hurting somewhere so I gave her tramadol every 3 hours, fixed some of her favorite foods. Carried her outside and enjoyed our final weekend.

If I hadn't had the tramadol we'd have had to go to the emergency vet and I was glad we were able to go to the office she was familiar with.

hugs, Judi

[belfastgirl1943]

Thank you everyone. We are only 5 minutes drive from our own Vet but we want Honey to pass at home in her own surroundings with us holding her - if at all possible as taking her to the Vet now traumatises her.

[belfastgirl1943]

Today is our Golden Wedding Anniversary - but we cant celebrate things are just too sad with Honey.
We do have a plan for her - as we had with our last dear Oscar - Oscar had cancer - one morning he stopped eating and seemed confused and had some sort of a little turn and we knew it was time. We took him to our Vet and they said they were just taking him to prepare him but brought him back already unconscious. Which was the last thing we wanted - we wanted to hold him whist he was still conscious.
This is why we have found a vet who specialises in helping pets to pass at home. She is only a few suburbs away and on call over 7 days including holidays. So hopefully we will know when its time and Honey can pass peacefully at home.

[molly muffin]

Congratulations on your Golden Wedding Anniversary, that is definitely something to stand up and take notice of, even if you aren't in a celebratory mood with Honey having such a time.
I think the plan to pass at home is a good one. That is what I would want to have happen to and I'd want to be with her.
Actually with my golden we did take her in to the vets and I was with her the entire time, petting her and looking into her eyes even though I couldn't see her very well through my tears.

My thoughts and heart is with you.

[belfastgirl1943]

We are having difficulty knowing when "enough is enough" for dear little Honey. Today for the first time she refused food. A little later she ate a few mouthfuls.
She can still stand up on her own and walks slowly short distances about the house. We take her outside every hour or so. She is panting more and wants to be near me all the time.
I have contacted a Vet who will come to our home when its time to let her go.
Any advice would be so welcome.

[Budsters Mom]

Quality-of-life was always first and foremost in my mind when I had to consider the right time to release my Buddy. He had a great deal of difficulty settling to sleep at night. As long as he was still able to do what he loved during the day, which was guard duty and lizard hunting, and I was able to control his pain to keep him comfortable, I let him continue on. However, the first time he was not able to get up and function during the day, was when I released him. I could tell that he was miserable and ready and I had plan in place. However, it came much too quickly and it's always too soon whenever It happens. So for me, it was all about quality of life and making sure Buddy did not suffer. He had always done so much for me, I needed to do that one thing for him, so I did. My heart is still broken.:o

We remain here for you. You and Honey are forever family.

Big hugs,
Kathy

[Budsters Mom]

I am so sorry. :o I just realized that I pretty much posted my last post on your other thread last month. Someone will be around to merge your threads shortly so others don't get confused like I did. We like to keep all the information concerning one fur baby together. It makes it easier to follow along that way, particularly when we want to go back and recheck some information. ;)

Kathy

[labblab]

The two threads have now been merged. Thanks for pointing that out, Kathy.

Marianne

[belfastgirl1943]

Thank you Budsters Mum. Thank you for reminding me that its something we will be doing "for" Honey.
So many tears have flowed already for her. Its heartbreaking! But the time is getting closer and we need to be strong and do the right thing for her.
She is only eight and a half was rescued by us about seven years ago. She has had a lot of ill health but we have had a lot of happy times too. We have taken her with us all over Australia. She had a bad start in life but we have loved her dearly.

[Budsters Mom]

Yes, releasing a fur baby to fly, particularly a heart dog such as Buddy, is the ultimate act of love. When the time finally comes that you've done all that you can and know that you can no longer make it better for them, then it's time. We have the power to assure that our babies do not linger and suffer. Many will hold on much longer for us and suffer in silence. We need to be strong for them, knowing that our hearts will be shattered. It sucks!!! :o

[belfastgirl1943]

Our hearts are breaking. Honey has crossed the bridge to doggy heaven. We knew it was time to let her go and she passed peacefully at home. We found a service called "Let me Go" and a wonderful Vet came to our home and she passed on my bed where she was content and relaxed.

[Budsters Mom]

I am sorry for your loss.:o

Honey has been welcomed by many furry friends at the Bridge. She is now happily running with them free of pain.

Although her pain has ended, yours has just begun. You performed the ultimate act of love. Many of us have been where you are now and will remain here to support you and your family. Talking with those who understand, does help.

Big hugs,
Kathy

[molly muffin]

I am so sorry. :( My sincerest condolences to you and your family for the loss of dear Honey.

[judymaggie]

I am so sorry for the loss of your Honey. It is so very hard to let them go, especially when they have not lived out what we think should be their full life. Take care of yourself and focus on those good times!

[belfastgirl1943]

Thank you everyone for your love and support. We are heartbroken. My eyes are red raw and the tears just keep falling.

[spdd]

I am so sorry to read this, but I know exactly how you feel. It's almost a year, and I still haven't straightened myself out. If you need to vent, cry, or just talk.. feel free to p.m. me. It's a terrible loss and they take not just a piece but a lot of our heart with them.

[FemaleK9]

I'm so sorry for your misery. I understand so well I am crying as I type this, as I'm sure others are, too. Hugs all around.

[LtlBtyRam]

I am sorry to hear about the loss of your dear Honey. Me and my family will keep you in our thoughts.