New to Cushings and Forum

[CeeCee]

Good Morning...My 9 year old, 5.86 lb. Chihuahua Lola has just been diagnosed with pituitary dependent Cushings after having urinalysis, LDDS test and abdominal ultrasound. She has some outward symptoms but not some of the most common ones, excessive thirst, hunger or pot belly. The specialist (Internal Medicine Vet) wants to start her on Lysodren Therapy this week - 60 mg. 2x per day for 10 days, then off for 2-3 days and then ACTH test. Unless of course she has reactions and needs to stop the Lysodren earlier. I guess what I need here is just some reassurance, and to hear from people that have gone through this. I am consumed with worry. The medicine scares me. She has never been ill before. Thank You.

[Squirt's Mom]

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[Squirt's Mom]

Hi and welcome to you and Lola! :)

Take a deep breath and try to relax a bit - you have found the very best place to be to learn and find all the support you need for the journey ahead. You and Lola are now part of our little family and we will be with you every step of the way.

It would help us a great deal if you would get the actual results of the testing done to diagnose the Cushing's and post them here. If she had lab work that shows things like BUN, CHOL, ALT, etc. all we need to see are those values that are abnormal - too low or too high. We need all the information from the LDDS plus the notes from the ultrasound. This info will help us help you. ;) I am a bit concerned by the lack of signs - most cush pups have a ravenous appetite, drink excessively and often start having accidents in the house. Can you tell us what signs she has? Here are a list of the most common ones seen in our cush babies -

• increased/excessive water consumption (polydipsia)
• increased/excessive urination (polyuria)
• urinary accidents in previously housetrained dogs
• increased/excessive appetite (polyphagia)
• appearance of food stealing/guarding, begging, trash dumping, etc.
• sagging, bloated, pot-bellied appearance
• weight gain or its appearance, due to fat redistribution
• loss of muscle mass, giving the appearance of weight loss
• bony, skull-like appearance of head
• exercise intolerance, lethargy, general or hind-leg weakness
• new reluctance to jump on furniture or people
• excess panting, seeking cool surfaces to rest on
• symmetrically thinning hair or baldness (alopecia) on torso
• other coat changes like dullness, dryness
• slow regrowth of hair after clipping
• thin, wrinkled, fragile, and/or darkly pigmented skin
• easily damaged/bruised skin that heals slowly
• hard, calcified lumps in the skin (calcinosis cutis)
• susceptibility to infections (especially skin and urinary)
• diabetes, pancreatitis, seizures

The Lysodren dose is correct - perhaps a few mg too low but that is ok - better than too high. This may mean it takes her a bit longer to load but again that is ok. Lyso is given by the formula of 50mg/kg/day, divided into AM and PM doses. At 5.86 lb Lola weighs 2.66kg (5.86 / 2.2 - 2.663636...). So her dose would be 2.66 x 50mg = 133mg per day, divided into two doses for 66.5mg AM and PM. So a tad bit low at 60mg 2x a day but ok. So that is good.

As for the directions on the length of time, don't pay too much attention to that 10-day thing. Some pups load in 3 days, some take months. The average is 7-10 days but you have to be on guard for the indications that she is loaded every single day. When you see those signs, stop the Lyso and call to set up the ACTH. Those signs can be very subtle - such as looking up from her feed bowl while eating when before she wouldn't or simply a slowing of her eating from gulping it down to chewing more normally. It is a good idea to measure her water intake each day right now before starting the treatment - that will also be a good indicator that she is loaded when her water intake drops.

BUT please don't start the Lysodren until we have had a chance to chat with you a bit and see those test results. It is much better to delay treatment than to start treatment on a pup who doesn't really need it. And the lack of signs is very concerning. So let's talk a bit then you can start treatment if needed. Our only concern is for Lola. ;)

I'm glad you found us and look forward to learning more about both of you as time passes.
Hugs,
Leslie and the gang

PS. A link from our Helpful Resource section on using Lysodren
http://www.k9cushings.com/forum/showthread.php?t=181

[CeeCee]

Thank You Leslie....As for symptoms, she has been lethargic for some time, started to have pee pee accidents in the house, some panting, was not responding to me or wanting to play or run around,staring at the walls, not wanting to snuggle up with me like she used to, - vet checked her over and did urinalysis and xray and liver enzymes were high so put her on Denamarin - and attributed some of the symptoms to CCD (Canine Cognitive Disorder). But I continued to think it might be something else as well. She isn't losing hair, but started having weird hair pattern on her tummy. The diagnosis comes mostly from all of the tests. I don't have some of the results, but this is what I do have (copying directly from paperwork from specialist)

BLOOD WORK 9/12/2016:
LDDS -
Rest 9.2
4 hour post 10.5
8 hour post 16

18/29/16
U/A Protein 1+
PH 7.5
SG 1.016
Cortisol/Crea ratio 119
Microalbuninuria 15.5

On 6//2016 Chem/CBC
GGT 35
Chol 347
PSL 22
Total T4 0.7

Ultrasound left adrenal gland is enlarged with normal shape, measuring up to 0.7 cm in height. no masses or enlarged lymph nodes are present.

Pro/Creat Ratio
9/14/2016
Total protein 88
Creatinine 50
Protein/Creat Ratio 1.8....result comment: a PCR ratio less than 0.5 is considered normal. Values over 1 are abnormal

Diagnosis: PDH with secondary proteinuria.

I do not understand alot of this - I trust the specialist, just feel overwhelmed right now. Thanks again.

[Squirt's Mom]

Hi Carol,

As you can see, I edited your lab results so they are easier to see. If you would be so kind as to edit them again and add the ranges with the little numbers after each value that would help us a lot in interpreting these results. For example -

GGT 57 12 - 32 ug/dl

I also need clarification on PSL...can you make sure that isn't a typo? It's entered as
PSL 22 and I don't recall ever seeing that on a lab report nor do I find an explanation via google, my friend. ;)

The only tests she has had done were in June then Aug?

Were they just not able to see the other adrenal gland? No other comments from the ultrasound on other organs? The signs you mention are consistent with Cushing's and the testing seems to bear that out as well...tho others with more expertise in reading results can tell you more and I'm sure they will be along soon.

9 is a bit young in a Chi for CCD I would think but I guess it's possible for dogs to have early onset like humans. Do you see anything like sundowners in humans where she starts to aimlessly roam and pace in the late afternoons? Does she get confused about which side of the door will open when she always knew before? Any loss of house training? Do you see a lost look in her eyes?

I'm sorry you felt ignored here but this is where you will get the most in-depth and trustworthy information. On FB everyone has an opinion (not always fact ;) ) and those opinions aren't always valid so that leads to more confusion. Just be patient with us....there is rarely any rush to start treatment so you can breath a bit, ok?

Hugs,
Leslie and the gang

[Squirt's Mom]

And here's that water intake spreadsheet link again....http://www.k9cushings.com/forum/showthread.php?t=3583

[judymaggie]

Hi! PSL (noted as "PrecisionPSL") is part of Antech Diagnostics' superchem panel. It is a screening test for pancreatitis. For example, Abbie's last level was 79 (range of 24-140) and the note says:

"Pancreatitis is unlikely but a normal PrecisionPSL result does not completely exclude pancreatitis as a cause for gastrointestinal signs."

I am a bit surprised that the IMS included proteinuria in the diagnosis. All the literature on proteinuria that I have read references the need to have three subsequent positive UCRs before diagnosing proteinuria. Also, Lola's result of 1.8 is not that far above the acceptable level.. As a means of comparison, Abbie's last UPC was 6.6. For Lola, this is just something to keep in mind and definitely not needing treatment at this time.

[CeeCee]

Leslie thank you so much. This is my first time on a "forum" and still trying to get used to it. I looked at the report again, and it says "Precision PSL 228". I typed what the report says, there are no little numbers (values) after the GGT.
The ultrasound says that "the liver, spleen, stomach, pancreas, small intestine, colon, kidneys, right adrenal gland and urinary bladder are unremarkable.
As for the CCD, Lola is young, but has shown some of the signs, which is why I took her to the vet originally...she did have lab, xray, Total body function in February, then total body function-Chem/CBC/T4 in June and then the T770 Urine Cort/CreatRatio and Urinalysis Antech (Add-on) in August. I am copying this from the bills, I do not have copies of the results (never thought to ask for that). She had started to have a few accidents in the house, would stare at the walls sometimes, was not responding to me when I called her, didn't want to snuggle, and yes, just seemed a little lost in the eyes. No sundowners or going to the wrong side of the door. Maybe it is a combo of both CCD and Cushings, but the vet specialist said that with meds, she is pretty sure that I will see a big difference in her.
At first we thought CCD but then after the tests it pointed to Cushings and my vet suggested that I see a specialist. She is not having a lot of accidents, and she eats the same amount of food she has for years (no begging) and drinks the same amount of water. She has never been sick! BUT, she is not the same little Chihuahua and just looks like she doesn't feel well. I am scared about the meds, but I would do ANYTHING for her and just want her to feel better. Oh, and I did not feel ignored :) I know that everyone leads a busy life and there are lots of people looking for help and advice.

[DoxieMama]

Hello and welcome to you and Lola! I'm at work and don't really have time to post much but wanted to say hi anyway. :) I hope you'll get some answers soon.

Shana

[lulusmom]

Hi Carol and welcome to you and Lola.

I have treated two cushdogs with compounded mitotane which is the active ingredient in Lysodren. I suspect that your specialist has prescribed compounded mitotane for Lola as well because of her tiny size. Both of my cushdogs were tiny, one 4.5 lbs on a good day and the other 7 lbs. Both were Pomeranians.

I am intimately familiar with o,p’-DDD which is the chemical name for mitotane. It is a derivative of DDT so that in itself is scary as heck but it performed miracles for both of my dogs who were transformed back into their former selves. I became obsessive in my research so there is little that I don't about this drug. I have cut and pasted an excerpt that I harvested from the Third Edition - Feldman and Nelson Canine and Feline Endocrinology and Reproduction veterinary teaching textbook. This can be found in Chapter 334 – Canine Hyperadrenocorticism (Cushing’s Syndrome). Once you've had a chance to read that excerpt, please let us know if you have any questions.

Now I have a few questions for you. I realize that a board certified internal medicine specialist is directing treatment so while I respect that title a great deal, I would still question the wisdom of prescribing mitotane for a dog who has a normal appetite and no increase in water intake. The reason I question this is because without either of those symptoms, there is absolutely no way for you to even know if Lola is loaded and that places her at great risk of overdose. I think your IMS has made a bad choice and if Lola were my dog, I would absolutely not agree to use mitotane, regardless of how comfortable the vet is with the drug. To be perfectly honest, your IMS shouldn't be at all comfortable with the drug in Lola's case. If I were you, I would straight out ask the IMS how in the world you are supposed know when Lola is loaded in the absence of the two most common symptoms of cushing's, which are the only symptoms you can use as a gauge for loading.

I am always wary of even starting treatment in the absence of symptoms and the only reason to consider early treatment is in the event of high blood pressure and/or chronic proteinuria. Lola has protein in her urine so I am assuming this is why the IMS is recommending treatment. My first cushdog had chronic proteinuria with 2+ protein every time we had a urinalysis done. It never resolved with treatment but her IMS kept a close eye on it and made sure there was no indications of kidney dysfunction. Chronic means that the proteinuria is monitored with no change in repeat tests. Does Lola have chronic proteinuria or was this the first time she had protein in her urine?

I apologize for all the questions but I have some very real concerns with your vet's choice of drug for Lola. I am also intimately familiar with trilostane as I switched both dogs to that drug which is a long story for another day. If you and your vet are determined to start treatment, I personally would want to treat with trilostane, starting at the recommended dose of 1 mg per lb of body weight.


CLIENT INFORMATION

o,p’-DDD Treatment of Pituitary Cushing’s

Hyperadrenocorticism (Cushing’s syndrome) refers to a clinical condition that results from having excess cortisone in the system. A minority of dogs with this disease have a tumor in one of the two glands that produce cortisone (the adrenal glands). Your dog, like more than 80% of dogs with the naturally acquired form of this disease, has a small tumor at the base of the brain in an area called the pituitary gland. The pituitary gland controls adrenal function. A tumor in the pituitary can cause excess cortisone throughout the body and results in symptoms recognized by owners (“pituitary-dependent” Cushing’s). The most common symptoms of Cushing’s syndrome in dogs include excess urination and water consumption, a voracious appetite, hair loss, muscle weakness, a “pot-bellied” appearance, panting, thin skin and lethargy. Virtually all dogs with Cushing’s syndrome have at least one or two of these signs, but it would be uncommon for a dog to have all these symptoms. By evaluating a variety of test results, your veterinary has diagnosed your dog as having pituitary-dependent Cushing’s. Now, treatment with o,p’-DDD has been recommended.

During World War II, scientists did research on the insecticide DDT in an attempt to create an extremely toxic agent. One of the forms of DDT created was o,p’-DDD (Lysodren; Mitotane), a chemical which can destroy the cortisone producing cells of adrenal glands in dogs. The drug has been used successfully in thousands of dogs with Cushing’s but you must remember that it is “poison” and that it must be respected and used appropriately. The protocol we use in treating dogs with this drug is straight-forward. A day or 2 before starting treatment, begin feeding your dog 1/3 of its normal food allotment twice daily (each 24 hours it should receive a total that equals 2/3 of the normal amount). This should make your dog even more hungry, but this is just for a brief time (we do not recommend use of this drug in dogs with a poor appetite). After 1 or 2 days of reduced feeding, begin giving the o,p’-DDD at a dose of 25mg/kg of body weight twice daily (a dog weighing 22 pounds would receive ½ tablet twice daily; the tablets contain 500mg). The drug should be given immediately after the dog eats. So feed your dog, note how long it takes to finish the meal, and then give the medication (the drug is absorbed best from a stomach containing food).

The key to treating these dogs is watching them eat and knowing when to stop giving the o,p’-DDD. As long as their appetite is ravenous, give the medication. As soon as you see any reduction in appetite, STOP giving the drug. Reduction in appetite may be noted as taking longer to finish the meal, the dog may eat ½ of the food and wander wary for a drink and then finish, the dog may simply look up at you (the owner( once or twice before finishing. In other words, we do not want your dog to stop eating entirely, we wish to see a “reduction“ in appetite as a signal to stop the medication. Other signals to stop giving the medication include reduced water intake, vomiting, diarrhea, and listlessness. But, appetite reduction usually precedes these more worrisome symptoms. Most dogs respond to this drug in 5 to 9 days, a few in as little as 1 to 3 days and some may take longer than 14 days.

No dog should receive more than 8 days of o,p’-DDD without being tested on the effect of the drug. The test is done by your veterinarian and will take 1 to 2 hours. We typically start the treatment on a Sunday, plan the recheck test 8 days later (Monday) and more than 85% of owners have stopped medication on the Thursday, Friday, Saturday or Sunday before the test performed on Monday. Once the o,p’-DDD has been demonstrated to have had effect, your dog no longer will require food restriction. Your dog will continue to receive o,p’-DDD the rest of its life. The initial maintenance dose is usually approximately 50mg/kg per week (a 22 pound dog would receive 1/2 tablet 4 times a week). That dose will likely be increased or decreased based on testing performed 1 month after maintenance treatment has been started and on testing performed every 2 to 4 months, thereafter. The average dog (11.5 years old when the syndrome is diagnosed) treated in this manner lives about 30 months (some live a few weeks and some for 6 – 10 years). The dogs with the longest survival have owners who are committed to helping their pet, diligent veterinarians, and luck. Close observation and frequent veterinary rechecks can only help in the long-term management of these dogs.

[CeeCee]

Thanks Glynda....I believe that this is the first time that there has been a diagnosis of proteinuria...IMS is also starting her on a drug called Enalapril. Quite frankly I have the same question regarding the "loading"....how will I know since she is eating and drinking the same amount as always. But she does have other symptoms (weird hair growth pattern, lethargy, staring at walls, not wanting to jump around, play with toys or with me) and all of the tests point to Cushings. The vet said that I would notice a "subtle" change, maybe not eating as fast, and being more lethargic. I am going to talk with her again tomorrow, as I will not start Lola on a drug until I am satisfied that it is the right thing to do. She is highly regarded and has a lot of experience with Cushings. And I certainly appreciate your input and the experiences that you have had with your dogs. I am a nervous wreck - but I look at my little Lola and I can just see that she is not feeling well and it breaks my heart. She has never been sick and never been on any meds (I hate meds too) but if there is a chance that this drug will help her, how can I not try it.

[lulusmom]

I've gone back through your posts and picked up some additional and pretty important information that can answer a few questions. I think the IMS is probably concerned with the proteinuria and more importantly, the high UPC which is a flag for kidney problems. Hypertension is not uncommon in cushing's and it is certainly common in renal disease which is why your IMS has prescribed enalapril. Enalapril is an ace inhibitor that will reduce the pressure on the kidneys. This drug is contraindicated for use with Vetoryl (trilostane) so that may be the reason why the IMS has chosen Lysodren as opposed to Vetoryl.

You play the most important role in Lola's treatment so the more you learn, the better advocate you will be. Working as a team with your IMS is imperative so don't be afraid to ask questions if you don't understand something. It looks like you have a great jump on things and have done a fair amount of research. You get big kudos for that. We're here to help in any way we can and when you start loading, please update us every day. I worry about every dog that loads and I will be especially worried about Lola because of her lack of symptoms. By the way, your IMS should be calling you every day for an update starting the second or third day of loading and make sure the IMS gives you prednisone before you start loading. I've only seen one vet, who was a specialist, not provide prednisone. The reason was because the member was only minutes away and the facility was open 24/7. That would be the only reason not to provide prednisone for use in the event of an emergency.

Glynda

[labblab]

Hello and welcome from me, too! I surely understand why you are so worried about your little Lola. I hate to add to your worry by adding a few questions of my own :o. But after reading through your thread, some questions do come to my mind that you may want to pursue with your vet when you talk to her today.

First, I have some questions about the diagnosis of pituitary-based Cushing's. Lola's LDDS test result could occur with either form of the disease (pituitary or adrenal), but more often with the adrenal form. Therefore, we would be looking to the ultrasound to provide more clues, and this is the part that I am wondering about. Lola's ultrasound revealed only one enlarged adrenal gland. Pituitary Cushing's typically produces enlargement in both adrenal glands. Apparently no masses or growths were seen in the one enlarged gland, but I would still ask the IMS why she thinks the other adrenal is of normal size if Lola indeed suffers from pituitary Cushing's.

Secondly, Lola does not appear to exhibit the elevations in liver enzymes that are typical of Cushing's. You have noted an elevation in her GGT, but apparently her ALKP and ALT were within normal limits. If so, this is pretty unusual for a Cushpup. It can happen, but not often. So I would ask the vet today whether she doesn't think that's also somewhat odd.

Third, I would specifically ask the vet why she is not recommending trilostane. As has already been noted, it will be especially hard to judge the loading effects of Lysodren given Lola's lack of typical symptoms. Glynda is absolutely correct that there are cautions about using ACE inhibitors alongside trilostane, but we do have several members who have successfully used both medications in tandem as long as blood chemistries are carefully monitored. Meds like enalapril can lower aldosterone levels, as can trilostane. In turn, lowered aldosterone can adversely affect the balance of potassium and sodium in the body. But as long as that balance is monitored via blood draws, there is not an absolute contraindication against using the meds together. It just seems as though trilostane might be the safer med to use in the absence of observable Cushing's symptoms. And if by any chance Lola does have an adrenal tumor rather than a pituitary tumor, trilostane is now viewed as the preferred medication for treatment of ADH by many clinicians.

Last but not least, Lola's cognitive issues do worry me a bit (staring at the walls, looking vacant, not responding). They are not really typical of Cushing's, generally. As noted above, I have some questions about the pituitary vs. adrenal diagnosis. But if Lola does suffer from pituitary Cushing's, has your vet discussed the possibility that the pituitary tumor may be large enough that it is placing pressure on other areas of her brain? Unfortunately, this does happen in a minority of Cushing's cases. And if so, it would require invasive treatment other than Lysodren or trilostane in order to reduce the cognitive symptoms. Unfortunately, expensive imaging of the head is required in order to make the diagnosis. But this is yet another reason why I am wondering about the validity of the pituitary tumor diagnosis in the first place (as opposed to an adrenal tumor). If Lola does not actually have a pituitary tumor, then possible brain involvement can be ruled out as an issue.

OK, I see I've written a book here so I'll stop! Once again, I apologize if I've created even more worries for you. But in good conscience, I feel as though I need to ask these questions since you've come to us for our help. And if Lola were mine, these are questions I would want answered before beginning Lysodren treatment. Your vet most likely has reasonable answers to them all, but I would want to know what they are.

Marianne

[CeeCee]

Thanks for your input Marianne. My head is about to explode. I will ask the specialist these questions, along with some others that I have. As for the cognitive issues, my regular vet suspects Canine Cognitive Dysfunction - and it may very well be, but some of the symptoms of CCD and Cushings ARE similar. And I understand that a tumor could be large enough to cause brain issues. My primary vet and the IMS both agree that Lola does in fact have pituitary dependent Cushings - I am anxious to begin treatment so that she will feel better, but I have left a message this morning for the IMS that I will not start the meds (which will be ready today) until I speak with her. I so appreciate all of the responses and information that I am getting here - I know that the final decision as to how I want to treat her is mine, but I think that at some point I will have to put my faith in the specialists and follow their instructions. Thanks again

[lulusmom]

Marianne, I had the same question about the right adrenal gland not being mentioned which made the PDH diagnosis questionable. However, after reading Carol's posts again, I saw that she actually mentioned in her post #5 that the right adrenal gland was normal on the ultrasound. That would definitely be consistent with PDH.

[labblab]

Glynda, I did see that the right adrenal gland was of normal size, but that's what puzzles me. With PDH, I'd expect both adrenals either to be enlarged or both closer to normal size. I wouldn't expect unilateral enlargement of one gland alone. I know that with ADH, you'd expect the remaining adrenal to be atrophied which is not the case here. And if there are no masses in the enlarged adrenal, that takes care of things anyway. But I'm just not used to seeing a large difference in the size of the two adrenals with PDH, and that's what got me wondering.

Marianne

[lulusmom]

Marianne, it's rare but there are more than a few recorded cases of dogs with both PDH and ADH so that is a possibility.

[CeeCee]

Thanks to everyone that has taken the time to respond to my post. I appreciate the care, concern, support and experience of each of you. After careful consideration, and more talk with my primary vet, the IMS, and even the compounding pharmacist, I have decided to take their advice and start Lola on 60 mg. 2 times per day of Lysodren. I have been made aware of exactly what signs to look for as far as side effects and "loading" and I will be with her all the time to make sure that she is OK. The specialty center is 15 minutes away, and open 24/7 with vets always on staff in case I do have questions or concerns. I do believe that I am making the right decision and pray that she will start to get better soon. I will come back and report to you, and again, I really do appreciate the knowledge that I have seen on this forum. Thanks again.

[labblab]

We absolutely wish you and Miss Lola the best of luck with her loading process, and we will anxiously await your updates! ;)

Marianne

[Squirt's Mom]

Stay in touch during the load and let us know how things are going. We are right by your side, sweetie! I know you will sail thru the load - you have done a good job of getting prepared. ;)

[CeeCee]

Hello everyone - just a quick update. Half way through day 5 of loading, and Lola is doing well. No bad reactions, no vomiting or diarrhea, eating and drinking the same. Takes her meds without a problem. I have relaxed a little, but still watching her like a hawk! Thanks again for all the care and support, I will check back in when we are finished with this loading phase. Prayers for all the Cushings furbabies.

[molly muffin]

Glad to hear that Lola is doing okay during her loading phase. :)

[CeeCee]

Good Afternoon.....just back from the IMS...Lola had the ACTH Stim on Saturday - results...(I am copying exactly what the paperwork said)
1.2ug/dl pre
2.5ug/dl post .....perfect!
Also....directly from the IMS..."She is doing WELL! I know she is making you nervous but I am thrilled with her response". LOL - I was a little more nervous this past week or so while she was doing the loading :)
She is going to be off the Lysodren now for one week, and then will start a maintenance dose of 60mg. two times a week.
Hoping and praying that we can keep things under control and that she starts to feel better. Thanks again for all of the information available here.

[Joan2517]

Sounds good! Good luck!

[Harley PoMMom]

Good Afternoon.....just back from the IMS...Lola had the ACTH Stim on Saturday - results...(I am copying exactly what the paperwork said)
1.2ug/dl pre
2.5ug/dl post .....perfect!

Yep, those are great stim numbers...good job Mom!!!!


She is going to be off the Lysodren now for one week, and then will start a maintenance dose of 60mg. two times a week.
Hoping and praying that we can keep things under control and that she starts to feel better. Thanks again for all of the information available here.

Her post of 5 ug/dl, although great, is on the high normal side for a dog being treated with Lysodren so I am hoping that she will not lose her load with waiting a full week to start the maintenance regimen. When does the vet want to retest her cortisol level?

Hugs, Lori

[Harley PoMMom]

Good Afternoon.....just back from the IMS...Lola had the ACTH Stim on Saturday - results...(I am copying exactly what the paperwork said)
1.2ug/dl pre
2.5ug/dl post .....perfect!


Marianne, thank goodness, corrected me on CeeCee's ACTH results so the pre was 1.2 ug/dl and the post was 2.5 ug/dl....those are perfect for Lysodren, and yep, waiting a week is the right thing to do...sorry for my goof.. :o:o

Hugs, Lori

[CeeCee]

Thanks for the encouragement everyone. As I said will start maintenance in one week, and then the IMS wants to see her one month after that - unless of course there are any issues.

[molly muffin]

Thats Great news!!!!

Right on track. :)

[judymaggie]

Excellent work making it successfully through Lysodren loading! :D Maintenance should be a little less stressful for you. Looking forward to hearing how Lola does!

[CeeCee]

Thanks again - I am hopeful that I will be less stressful - haven't slept in weeks, but that is OK, just want to make sure that she is doing well. She is a little "listless" and doesn't seem to have much of an appetite (but she is eating)...IMS said that is not THAT unusual and give it a few days - her little body has to adjust to the different levels. How long did it take before you noticed a change - FOR THE BETTER - with your babies?

[molly muffin]

That is why you give them a break of that week so their bodies can settle and they can get use to the lower cortisol.
She should perk back up by the end of the week break and then the maintenance should keep her leveled out.

[Carole Alexander]

Hi CeeCee,
I just read your thread and found it very helpful as my dog, Skippy is displaying many of the same symptoms as your dog Lola was. How is Lola doing? Is she still being treated with Lysodren?
Skippy, my dog, cannot tolerate Vetoryl and I am considering trying Lysodren. I would love to know more about your experience. I hope this finds you both well.
Best,