Honee's Story

[Sooty]

Hi, Just want to introduce myself. My name is Bella an I have a 8 yr
Old Chihuahua that is 16lbs.My girls name is HONEE ,diagnosed with Cushing's. I've been taking her to a GP who in my opinion doesn't know Cushing's. I have an appointment for her to go to a specialist on April
20th. As soon as Honee see new Dr. I will inform the group on the situation from beginning, an try to give some help through my experience that we are going through. Bless you all. :)

[wendyweneki]

Hi Bella,

Wishing you and Honee the very best. Looking forward to hearing your story. We (my 30 yr old daughter) and myself are leaving in about 30 minutes to go and talk to the Dr. for the first time since we got the diagnosis.

I have learned SO MUCH from this group - still confused and overwhelmed, but I feel more competent to ask the right questions.

Wendy

[molly muffin]

Welcome to the group Honee and Bella. So glad you found us.

Is Honee currently under treatment or are you still in the trying to figure things out stage?

[lulusmom]

Sharlene, Bella came here from the facebook group at my suggestion. Her vet is less than learned on the subject of cushing's which she now realizes and has made an appointment to see an internal medicine specialist. While we wait for Honee to present all the facts after the consult, I can clue everybody in on a few things, or at least those things that I remember.

Honee weighs 16 pounds and is quite overweight which is contributing to her noisy snoring and weakness in her hindquarters. Treatment was started at 30mg once daily and the results of the first acth stim test showed that levels were too low so she was taken off Vetoryl and was again stimmed 30 days later. Post stimulated cortisol was 25 ug/dl. Treatment was restarted at 10mg compounded liquid trilostane once daily. The next post stim done at least two weeks later showed post stimulated cortisol at 19 ug/dl which the vet was very happy with and instructed Bella to continue with the current dose and come back in three months for another stim. :eek::confused: But wait, there's more. The vet never gave Bella correct dosing or acth stim test instructions and as a result, Honee had always been dosed in the evening and all of her stim tests were done no less than 16 to 18 hours post dose. Honee was due for her scheduled acth stim test which I suggested that she cancel as she would be flushing more money down the toilet. Honee was switched to morning dosing and the acht stim test was rescheduled for a week later. That test was done very recently and the post stim cortisol was 7.9 ug/dl. Bella made sure that she maintained dosing at the same time every morning and that the test was done within 6 hours of dosing.

So that's Honee's dosing history and it makes me cringe to think about just how low her first post stim would have been had she been tested according to protocol. I don't recall what the original stim result was but I'm sure Bella can share that info with us. Honee currently remains on 10 mg trilostane. I will be anxious to see how the IMS consult goes.

Glynda

[molly muffin]

Thank you Glynda for filling us in.

Oh my goodness. What a tangled web indeed. Well, good news is she'll be seeing an IMS who is Hopefully well versed in cushings and the medication protocols and can make life much easier for both Bella and Honee.

[Sooty]

Should Cushing dogs get Annual Vaccines

[Budsters Mom]

Hi,

Wow!!! You have chosen probably the subject with the most controversy in this entire form! There are definitely varied opinions here.

Personally, I feel that Cushings alone should not keep a dog from receiving annual vaccines. Total health and other medical issues need to be considered. I do feel that puppy shots are necessary.

I personally have had (and do have) an allergy dog who have reacted to various vaccines. If you chose not to immunize further, you need to be diligent to protect them. That means NO dog parks or greeting unfamiar dogs on walks, or out and about. The only dogs that my Rosie is allowed to be around are friend's dogs who I know are current with all their shots. They need to be okay with the fact that you no longer vaccinate. You need to politely turn down requests from other walkers to, "say hi". I walk Rosie daily. She NEVER gets to greet other dogs, only people. I feel that socialization is important, but safety is even more crucial.

As for Rabies boosters. They are required by law within the US. Many states do accept medical exemptions, but actually getting one may be difficult. If you do not vaccinate and your dog bites someone, you are liable! They are taken from you and quarantined for 10 day, or longer. You are billed for their entire stay. Not even mentioning the stress on the dog. If there is even a remote chance they could get out and bite someone, it's best to protect them and youself by vaccinating. Same applies here as other vaccines. You need to weigh the risks considering their general health and other medical conditions.

I am definitely not pro vaccines and have made that obvious on this forum, but for most dogs they are okay.

I'm sure others will pop up to have a say also. I hope it helps.

Kathy

[judymaggie]

Hi! I wanted to add that it is possible to get vaccine titers for everything except rabies. Here is an explanation of titers in an article from Bark magazine:

http://thebark.com/content/titer-testing

My current Cushing's beagle, Abbie, gets all basic vaccines and has had no negative reactions. My previous Cush pup, Maggie, had a very bad allergic reaction to vaccines when she was very young. We tried pre-treating her with benedryl (both oral and injectable) -- that diminished her reaction but didn't eliminate it. When she was older, we started doing annual titers and, after the age of 8, she no longer needed any vaccines (other than rabies).

The titers were quite expensive when Maggie got them but I understand that the cost has come down.

[lulusmom]

Vaccines can be a contentious subject and you probably won't find 100% agreement in this group. Some vets believe that if a cushdog is well controlled, vaccines should be fine. Other vets, like my own cushdogs' internal medicine specialist, do not agree. I was given a waiver by my IMS for my animal control agency which I never used because I had already made the decision based on my own research that my senior dogs would never be vaccinated again. Even if they were healthy, I would not have revaccinated them after years and years of annual boosters. Just to be on the safe side though I did titers, which showed they had full immunity.

Cushing's aside, unless a dog has not yet received core vaccine boosters at one year old, the only core vaccine that is required to be given annually is rabies but only in those municipalities who still require proof of annual rabies vaccines. Most states, counties and cities are now accepting three year rabies vaccines so if you are inclined to continue to give your cushdog vaccines, make sure that your animal control agency requires annual rabies and if not, make absolutely certain that your vet uses a three year vaccine. There are a lot of vets who, despite the AAHA science based vaccine guidelines, continue to buy one year vaccines, forcing naive clients to over-vaccinate their pets. I find that unconscionable and unfortunately, it happens way too often. Two rescue vets I dealt with in CA as well as a mobile vet in my new state of TN were guilty and I called them out on it. Where I live in TN, there is no animal control agency that requires registration or proof of vaccine, yet the mobile vet I called would have given my dog and my sister's dogs a one year vaccine if I had not asked him which vaccine he was ready to load. It was a one year vaccine. He never asked me how old my dogs were and what their vaccines histories were. He had three year vaccines but asked me to keep it quiet so that his other clients don't ask for them. I was livid and he was stunned that I was so confrontational. I carry the AAHA vaccine guidelines in my car to educate people and vets. I gave him a copy and suggested that he educate himself so that he quits placing dogs at risk for no good reason. What is really sad is that there is no difference between the one year and three year rabies vaccine except for the label so these unscrupulous vets purposely buy one year vaccines. Some may consider the risks to be minimal but I know first hand that if it's your dog that suffers greatly from an adverse reaction, that small percentage doesn't mean squat. Rule of thumb is trust no vet to act in your dog's best interest whether it be cushing's or vaccines. My best friend's nine year old cushdog who had received annual rabies shots all of her life went into anaphylactic shock the last time she got the vaccine. If my friend had not hung around the vet's office chit chatting, she may not have been able to get her dog back to the vet's office in time to save her. It was a horrific experience, one that should never have happened.

My mantra is educate yourself so that whatever decisions you make for your dog are educated ones. I've included a link below of a good summary that explains core vs non-core including frequency. If you want to learn everything there is to know about canine vaccines and you have the time, you can learn from the world premier immunologist, Dr. Ronald Schultz, who headed the task force who developed the canine vaccine guidelines that have been adopted by all veterinary teaching hospitals in North America. Dr. Schultz did a four part interview with Dr. Karen Becker and I've included the url to that site as well.

http://todaysveterinarypractice.navc.com/canine-vaccination-guidelines-key-points-for-veterinary-practice/

http://healthypets.mercola.com/sites/healthypets/archive/2011/06/21/expert-proof-most-pets-are-vaccinated-way-too-often.aspx

[labblab]

Hello Bella, welcome back to you and Honee. You'll see that I've merged your question about vaccination into your original thread. This way, people will be able to read about Honee's overall history and tailor their replies to Honee's specific situation.

In general, though, here are some of my own thoughts. As Kathy has said, there are certainly a lot of different opinions about this subject! What I can offer you is simply my own opinion. I don't believe vaccinations should be given to anybody, human nor dog, during a time period of acute illness. However, dogs with Cushing's cover a broad spectrum, from those who are newly diagnosed with highly elevated cortisol and concurrent infections or vulnerabilities, to dogs who have been stabilized with treatment and enjoy controlled cortisol and are otherwise doing well. In the former situation, I would want to withhold vaccination until a time when my dog's health was more stable. In the latter case, I would indeed opt to vaccinate based upon the advice of my vet and the individual risk factors that are pertinent for my dog (prior vaccination history, age, lifestyle, geographics, liklihood of exposure, etc.).

For vaccines that seem appropriate for my dog, I would definitely try to obtain the longest-acting version that is available and that is allowed where you live -- for instance, 3-year rabies and 3-year distemper/parvo combos. And finally, humans and animals with compromised immune systems may be advised not to be injected with any "live" virus vaccines. Since the elevated cortisol of Cushing's does suppress the immune system, this can be another issue or consideration to discuss with your vet.

As I say, this is only my personal opinion based on my own reading and conversations with my vets, and you may hear from others here who feel differently. By the way, how are things going for Honee? Were you able to consult with the specialist?

Marianne

[lulusmom]

Hi Bella. I got your visitor message asking me about supplements for home cooked diets that you obtained from youtube. Anybody can post a video and since I have never home cooked, I would not really trust them to know which supplements and in what amounts should be added. There are commercial products that you can buy to add that has it all. When I was doing research, I ran across some recommendations for a product called Balance IT. The Balance IT site was founded by a board certified veterinary nutritionist who also developed the product used to supplement home diets. You can find recipes for obesity on the site as well. https://secure.balanceit.com

I know that bad weather prevents you from walking Honee outdoors on those days but if you can get her to exercise in the house by walking her from room to room or up and down stairs, you will help her greatly in losing weight.

I found some additional references on vaccines that are probably a bit easier to understand. Dr. Hines' 2ndchance.info page is definitely easier to grasp and it also includes information on anaphylaxis which is the most common side effect. I also included his page on rabies that is helpful in understanding a lot more about rabies which can aid in helping weigh risks vs benefit.

For those members who are familiar with Dr. Jean Dodds for her expertise in canine thyroid disorders and her heavy involvement in the Rabies Challenge Fund, she feels that titers, whenever possible, be done in lieu of core vaccines for cushingoid dogs. If you read Dr. Hines page, he said antihistamine injections don't offer full protection for a dog with a history of adverse reaction but it can lesson the effects. I personally would do a titer, if at all possible, before taking that chance again.

http://www.2ndchance.info/anaphylaxis.htm
http://2ndchance.info/rabies.htm
http://news.wisc.edu/schultz-dog-vaccines-may-not-be-necessary/