Newbee with a lot of Questions

[rainiebo]

Hi, my dog's name is Bobo. He is a 12 year old shar-pei mix. He has been on vetoryl for about 4 months. I thought the heavy panting would go away, but it hasn't. His last ACTH, about 2 weeks ago, was said to be where the vet wanted it to be. I'm not really sure what to expect as far as they symptoms being under control. Would really like your thoughts.

[DoxieMama]

Welcome to you and Bobo! Do you have the results of the ACTH - the actual numbers? If so, could you post those? That might help provide some insight as to what's going on with your boy. What other symptoms did he have before starting treatment and have those resolved? Sorry all I have are questions for now, but the more information you can provide, the better equipped we will be to help!

[Squirt's Mom]

Hi and welcome to you and Bobo! :)

Some pups never return completely to their normal before the cortisol started to rise. My own pup panted the rest of her life, some don't regrow hair, some don't stop peeing so much. While the former state of normal may never be seen again we do typically see improvement, even a teeny bit, in those areas that remain a bit off. The goal of treatment is to bring as much relief as possible to both pup and parent. I'm not sure where you live, but if you live where summer temps are still in play, you may see a reduction in panting once the weather cools down. Our cush babies cannot tolerate heat. ;)

Does Bobo have any other health issues that you know of? Is he on any other medications? The more you can tell us about your sweet baby the better. We LOVE details! :D

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

[DoxieMama]

The ACTH results from the last test were

Cortisol Sample 1 - 2.0 1.0-5.0 ug/dL
Cortisol Sample 2 4.0 8-17 ug/dL

I agree with your vet - those great numbers!

Can you answer Leslie's questions about other health issues or medications? Maybe something else is going on to explain the panting.

[rainiebo]

Hi, thanks for the encouragement - took Bobo to vet yesterday and his results for the Cortisol Sample 1 2.0 1.0-5.0 ug/dL Cortisol Sample 2
4.0 8-17 ug dL

My vet said although the report read that 4.0 was a little low, it fell within range for post-trilostane which is between 1.5-9.1 ug/dL. This is about the third ACTH he has had done and they all pretty much show the same results.

Most of the symptoms have lessened or gone away - but the panting is still very heavy. My vet said that since he has had the panting for about three years - it is not the disease but something non-medical going on with Bobo - anxiety, etc. Most of the pain drugs and anti-anxiety drugs just increase the panting. So the vet suggested melatonin for sleeping and maybe acupuncture for anxiety. I gave him ACE last night - he's heavily sedated but at least not panting. I'll try the melatonin tonight. I'm at my wit's end. Bobo is so miserable.

[rainiebo]

Hi, he just had a benign liver tumor removed. He has had multiple conditions through out his life. Allergies, acl's, skin. Most of the conditions the Chinese Shar-pei is to have.

[rainiebo]

Hi Laura, I am really just getting the hang of the posting - but Bobo has been a pretty unwell furbaby most of his life. He is 12 going on 13 years old. I do live in Florida and it is hard knowing what to expect as far as how much exercise he can do - right now he can't even take short walks without going into a heavy pant.

[rainiebo]

Hi, again. It is so good to find y'all. It is very comforting. I've been battling his medical issues with the vet and myself for so long - just being able to talk about Bobo's condition with others whose dogs have gone through the same thing is too much to express.

[rainiebo]

Hi, not sure if you got my last post - but just wanted to add that Bobo has been on prozac, trazedone, hycodan, gabapentin, rimadyl, and allergy shot over the last month and following surgery. I took him off everything except the vetoryl and allergy shot. He started the vetoryl before surgery and the panting never improved.

[Squirt's Mom]

My vet said although the report read that 4.0 was a little low, it fell within range for post-trilostane which is between 1.5-9.1 ug/dL. This is about the third ACTH he has had done and they all pretty much show the same results.

Some education for you...and then you can help educate your vet. ;)
The 4.0 ug/dl is NOT low - it is a good number. That range of 8-17 ug/dL is for dogs who do NOT have Cushing's or who have NOT started treatment with Vetoryl or Lysodren. Once treatment with either of those drugs has started, that range no longer has any value in assessing the test results.

For a pup on Vetoryl (Trilostane) the optimal post ACTH range is 1.45 ug/dl - 5.4 ug//dl. The post # can go as high as 9.1 ug/dl if, and ONLY IF, all signs are well controlled.

Another issue - the ACE. Here is a quote from the Vetoryl (Trilostane) product insert - which surely your vet has access to, has read, and understood before prescribing this powerful drug:


Angiotensin-converting enzyme (ACE) inhibitors should be used with caution with VETORYL Capsules, as both drugs have aldosterone-lowering effects which may be additive, impairing the patient’s ability to maintain normal
electrolytes, blood volume and renal perfusion.

Here is a link from our Helpful Resource section on Vetoryl (Trilostane) that will help you learn about the medication Scooter is taking. There is a link to the product insert you can read as well as links to share with your vet if needed.

http://www.k9cushings.com/forum/showthread.php?t=185

Our babies cannot speak for themselves so it is up to us to learn all we can about this disease and the drug used to treat it. Sadly we have learned the hard way that many vet don't understand either. So we must learn then advocate on our baby's behalf to be sure their care is tops.

Hugs,
Leslie and the gang

[rainiebo]

Bobo likes to follow me around too. He tucks his tail when he's not feeling too good or his medications are too sedating. He took ACE last night to get some relief from heavy panting and his tail is dragging low today. Other newer members have said that trying to get a handle on furbaby care is exhausting and it is. Bobo is usually up 2 to 3 times a night - wheezing, hacking, heavy breathing. His cushings is under control. Does anyone else have a dog with these symptoms?

[rainiebo]

Many thanks for the information. My head is spinning. It is probably a good thing that Bobo is still alive. He is a 73 pound 12 year old Chinese Shar-pei. He has been hacking, wheezing, panting heavily for over 3 years, along with all the Cushings symptoms. His current dosage of Vetoryl is 40 mg in the a.m. and 40 in the p.m. He was started out on 10 mg a.m./p.m. - some of his symptoms have gradually disappeared but the heavy panting is still there. I won't give him any more ACE. But, I really don't know what to do at this point.

[rainiebo]

Hi, I'm sorry but I'm an exhausted 70 year old - who doesn't know where to turn - so please forgive if I'm being a pest. My vet seems to think that the best solution for Bobo and the heavy panting is to consider "the quality of life." I'm not ready to put him to sleep or to give up trying to control the panting - because in all other respects he is pretty healthy. The panting is bad - he can't sleep and I'm afraid he's going to shake himself into a heart attack.

[rainiebo]

Hi again, Bobo's panting is light during the day most of the time. But starting around 6PM - it increases to the point he can't sleep and is up and down most of the night. The vet has prescribed many medications over the years and nothing has helped. I am afraid that the panting is so severe that he will hurt himself. I don't what to do.

[DoxieMama]

You needn't apologize - you are not being a pest! It is obvious how much you care for Bobo.

The members and admins on the site visit at various times. Some are here throughout the day (like me, when I can), others once a day and still others less frequently. It just depends how much time and availability each has to stop in. I know how difficult it is to wait, but as Bobo is not in acute distress, that seems to be all that we can do now.

I do hope the melatonin helps him tonight; do you know how much to give him? I have not used it on my dog so I can't suggest the proper dose... hopefully your vet can advise you on this.

Hang in there!!!!
Shana

[labblab]

Many thanks for the information. My head is spinning. It is probably a good thing that Bobo is still alive. He is a 73 pound 12 year old Chinese Shar-pei. He has been hacking, wheezing, panting heavily for over 3 years, along with all the Cushings symptoms. His current dosage of Vetoryl is 40 mg in the a.m. and 40 in the p.m. He was started out on 10 mg a.m./p.m. - some of his symptoms have gradually disappeared but the heavy panting is still there. I won't give him any more ACE. But, I really don't know what to do at this point.
I must be missing something, but I don't see an ACE inhibitor in the meds you've listed for Bobo. Which ACE inhibitor is he taking, and for what reason?

Marianne

[dsbailey]

Hello,

My girls panting hasn't subsided either. So I'm going to give you my silly but obvious solution. I bought a $20 small box fan (about 8 x 8) from Walmart and placed it on the floor near one of her favorite sleeping spots. When she goes and lays there the panting stops. If not I move it to her. Try It!

Darrell and Lolita

[judymaggie]

I must be missing something, but I don't see an ACE inhibitor in the meds you've listed for Bobo. Which ACE inhibitor is he taking, and for what reason?

Marianne

Marianne -- I believe the reference is to acepromazine, not an ACE inhibitor.

[Squirt's Mom]

I gave him ACE last night - he's heavily sedated but at least not panting. I'll try the melatonin tonight. I'm at my wit's end. Bobo is so miserable.

I may well have misinterpreted this comment. ;)

[rainiebo]

Hi, My regular vet prescribed ACE yesterday, it knocked Bobo out, but the panting came back this morning. I took Bobo to a different vet today for a second opinion. He said to stop the ACE and prescribed a muscle relaxer for him. This second vet did not agree with my regular vet that I might want to look at putting Bobo down. He said Bobo's heart, and lungs were good. Now it's just a matter of trying this new medication. I sure hope it works.

[rainiebo]

Hi again, I'll definitely try the fan - anything to keep us both asleep and not up every hour or so. Thank you again for being here for all of us.

[rainiebo]

Hi JudyMaggie - Yep it was not an ACE inhibitor, they call it ACE in the vets office, but it is acepromazine. I took Bobo to a different vet today and he said to get off the acepromazine and he gave Bobo a muscle relaxer to try. So we'll give it a go tonight along with the fan. Thanks guys.

[MarkP]

Just a quick suggestion: If you place a bowl of ice-water or even just ice, in front of the fan, the breeze will be even cooler for Bobo. I hope it helps. Summer here has been relentless this year, and Griff's excessive panting at night worried me and kept me up too. I did not use a fan, but the basement became a new favorite place for him. Good luck.

[rainiebo]

Hi Mark, I think it does take a community to care for a cushings dog. I will definitely use ice tonight. Using the fan last night allowed us for the first time since I can't remember to sleep. He only got up once to go out. Thanks so much.

[rainiebo]

Hi, DS - the fan worked - and it was heaven for both of us to be able to sleep. Bobo only got up once last night and no heavy panting. Thank you so much.

[rainiebo]

I was reluctant to get a second opinion about some questions I had about Bobo's treatment. I felt that I owed my vet loyalty because he has taken care of Bobo and his brother since 8 weeks old. But, some of the suggestions that I got from him didn't "feel" right. So yesterday I saw a second vet. He gave me advice that made more sense to me. It's o.k. for me to get a second opinion. One that I can live with.

[Squirt's Mom]

MODERATOR NOTE: I have merged your post about seeking a second opinion into Bobo’s original thread. We like to keep all posts about each pup in a single thread as it makes it easier for members, and parents, to refer back to the pup's history when needed. Thanks!

[Squirt's Mom]

It is tough to take that step sometimes, especially when we have developed a relationship over years. But sometimes a vet who is exceptional in many areas is lost when it comes to Cushing's. So we have to take the bull by the horns and do something which is uncomfortable...but we do that because we want the very best for our babies. :) You're doing a great job on Bobo's behalf! :cool:

Hugs,
Leslie and the gang

[DoxieMama]

Oh I am so glad to learn that the fan helped him (and you!) last night. What a blessing.

[rainiebo]

Thanks Squirts Mom for moving the post, I really haven't gotten the hang of navigating around - but will soon.

[labblab]

Oh, I'm so glad the fan helped, too!!! :) :)

And yup, sometimes it really helps to get a fresh pair of eyes and a fresh set of brain cells trained on our problems...:o. Very glad to hear the new vet visit has been helpful to you guys.

Marianne

[judymaggie]

Hi, folks! I am helping Rainiebo out and posting a message that she sent to me this morning so that all of Bobo's info is in one spot:


We just slept through night 2 without the constant heavy panting and trips outside - what a blessing - the effect seems to be cumulative. Bobo is not lethargic and neither is his mom. I've had to change our lives quit a bit, but it is worth every change. We no longer go for walks. He goes for rides in the air conditioned car and he seems just as contented. He no longer sits outside, even when he wants to "sun" himself. The noise level in the house is minimum. He sits in front of the fan day and night. I just wasted more money on medications that he didn't need - a muscle relaxer, and sedative to sleep. I'm retired so the changes have been easy. Every pup is different - but Bobo is a happy dog right now.

[Squirt's Mom]

Thanks for sharing, Judy! It's good to hear Bobo is doing better.

[molly muffin]

Great to hear that Bobo is better. I love that name. It was the name of my first dog, a beloved Beagle that I had for years and years. Just love it.

Yep, a second opinion is not a bad thing if you have the least bit of doubt. You have to do what you have to do.

Wonderful that bobo like car rides and is enjoying them. I kind of like car rides too come to think of it. :) LOL

[rainiebo]

Hi, was wondering what to do when Bobo is in pain. I stopped giving him all the meds the vet prescribed because they made the panting worse. He has taken hydrocodone, gabapentin, rimadyl, and tramadol. I really don't want to make the panting worse, but would like to help his pain. He has arthritis.

[Squirt's Mom]

MODERATOR NOTE:
I moved posts about Bobo from a thread about another dog. We like to keep all the posts about each dog in their own thread, or chain of comments about that dog. That makes it easy for you as well as the rest of the members to keep up with the history for each dog. So any questions about Bobo or updates on his progress, things like that about Bobo will go here. And this is where others will come to talk to you about Bobo. ;) Thanks!

[rainiebo]

Thanks Squirts Mom - and I hope I have reached the right thread - any comments about what to do about Bobo's pain? Don't want him on pain meds - they cause him to pant.

[Harley PoMMom]

Adequan is one injectable medication that I have seen some members use for their arthritic dog, is your boy taking any type of fish oil? Fish oil, especially wild salmon oil, have anti-inflammatory properties. I found this article to be informative regarding canine arthritis and treatments: http://www.whole-dog-journal.com/issues/10_3/features/Canine-Arthritis_15910-1.html

We also have a thread where natural anti-inflammatories are discussed: Joint support supplement (http://www.k9cushings.com/forum/showthread.php?t=5005)

Here's a link with info regarding Adequan: http://www.fda.gov/AnimalVeterinary/Products/ApprovedAnimalDrugProducts/FOIADrugSummaries/ucm116139.htm

Lori

[rainiebo]

Thanks HarleyPomMom for the website - Just what I was looking for - I went to Walmart today and bought some cosequin by nutramax and plan on adding the salmon fish oil next month. I thought I would start out slow and see what might be the progress. Thanks again.

[labblab]

Hi, was wondering what to do when Bobo is in pain. I stopped giving him all the meds the vet prescribed because they made the panting worse. He has taken hydrocodone, gabapentin, rimadyl, and tramadol. I really don't want to make the panting worse, but would like to help his pain. He has arthritis.
Hello again from me! I've been following along and just want to press you for a little more info related to the pain meds and the panting. Was Bobo taking them all these meds at the same time, or in different combinations, or one at a time? The thing is, it seems very odd to me that each and every one of these meds would make him pant. They are of different drug "classes" and would act differently on his body. So if he is consistently panting while taking each and every one, that makes me think that something else altogether is more likely causing the panting.

Did he seem to have better mobility while taking any of these meds? I'm just fearful that other alternatives will not have the potential to offer the same degree of pain relief. And at his age, I'd just hate to think that you're eliminating helpful treatment options unnecessarily...

Marianne

[Squirt's Mom]

In reading back through Bobo's thread, your descriptions of his breathing reminded me of my Trinket who has COPD. Her GP vet first diagnosed her with congestive heart failure (CHF) but further testing with an IMS proved her heart was fine but her lungs diseased. She has been on meds for over a year now and is doing much better. If Bobo hasn't seen an IMS, Internal Medicine Specialist, I think I would take him to see one about the panting to rule out for sure any heart or lung problems. An IMS will have access to tests and equipment a GP vet just doesn't plus more education, training, and experience in a wider variety of things.

[rainiebo]

Hi Marianne - thanks for the post. Forgot to say that I ordered Duralactin and expect it this week. Bobo has been panting for about 3 years. I keep a journal about his symptoms and care. It has been a very long, trying and downright scary journey. He has a benign liver tumor removed in June, and was diagnosed with Cushings about 2 weeks before the surgery. The endocrinologist put Bobo on Vetoryl two weeks before the surgery. The panting didn't stop even when he was recovering at the vet's while on hydrocodone for the surgical pain. I don't know how to gauge his panting with other dogs. His is so severe and can go on through most of a day and a night. The panting is so fast and hard that I was afraid he would have a heart attack. When he came home I continued the Vetoryl and hydrocodone. My primary care vet had prescribed gabapentin, trazedone, and rimadyl to try to calm the panting and help him sleep. He was still severely panting. I tried any number of combinations of the drugs - to the point that I was a little crazy. He also had diarrhea and streaks of blood in his stools. I slowly weaned him off chicken and rice that he ate following surgery. I added rice, grain-free Wellness core, and pieces of boiled chicken. The diarrhea stopped. Before that the primary vet had prescribed Flagyl to stop the diarrhea. I googled Flagyl and found out it was just an antibiotic, so I stuck with his current diet and no diarrhea. I stopped the rimadyl and the blood in his stools went away. I slowly weaned him off the gabapentin and hydrocodone and trazedone. Then I began adding one drug at a time and monitored the results. The panting increased with the addition, one at a time and only given one of the drugs at a time, of trazedone, tramadol, and hydrocodone. So I giving him this "test." I stopped all the drugs. I went back to the surgeon who had done Bobo's surgery and told him about the meds Bobo was on. He said one of the side effects of all the drugs he was on was panting. He also added that if I couldn't get the panting under control - he could have a heart attack. He said I did the right thing by pulling all the drugs, but then he prescribed a muscle relaxer. I had seen my primary vet the day before, he suggested that I might want to put Bobo down. The surgeon said that wasn't really appropriate to put a dog down for panting. The primary vet suggested melatonin for sleeping, acupuncture for stress and prescribed acepromazine. I saw the surgeon the next day and he said acepromazine wasn't a good choice and that was when he prescribed the muscle relaxer. I keep a spread sheet of all bobo's symptoms, medicatons and surgeries he has gone through along with the dates and who treated him. I gave all three vets this information and they all had the same conclusion - pretty much all had been tried over the last 3 years and there prescriptions were a last attempt to stop the heavy panting. Putting a fan in front of him during the day and night and withdrawing and not giving him new meds has been about the only thing that has even come close to working for him. All three vets (surgeon, endocrinologist, and primary vet) just throw pills at Bobo. I threw out all the meds because I didn't want to "throw" meds at Bobo everytime it looked like he was struggling to remind myself that none of them had helped. I a lot of anecdotal information that seems to work for him - fans, no more walks, only rides in air conditioned car, very little loud noise, no more time in the yard except to do his business and only in the early a.m. and late p.m. As few trips without him as possible. Yes it does sound restrictive but it has stopped most of the panting. He is lightly panting right now, his face has that skeletal look, and he's doing a little wheezing. He's been my companion through some of the most trying times of my life. I can't really imagine life without him - so I'm trying everything I can. He has been a very expensive dog: allergy shots, special diet, two ACL surgeries, medications, and liver tumor removal. But, again to me - it has all been worth it. His quality of life for the most part is good. When the weather turns colder, he'll start his outside life again. Everyday is a battle to control the panting and keep him comfortable. I'm open to any advice for methods I haven't tried. For now I'm going with the supplements that I'm starting him on.

[rainiebo]

Hi Squirts Mom - thanks for the posting. I can't really afford another specialist right now. I'm in the financial hole so far - that digging out is going to take a long time. What meds is your pup on for COPD? Bobo since June has had ultrasounds for his lungs, abdomen, and liver. X-rays for his chest and abdomen. No one has mentioned COPD - but at this point - who knows? Thanks for the info - I'll keep it mind.

[rainiebo]

I'm sorry to say that I think I am still posting incorrectly - if I do a quick post under a message from another member? does that go to my thread or to the other members thread? I've been doing quick replies and I think that's where the posting problem lies.

[rainiebo]

Should the title read Newbee with a lot of Questions to make sure that it is posting to my thread? because if it reads another member's title - that means it goes to another members thread?

[labblab]

Hi Raina, thanks for your detailed reply to my earlier question.

Also, in order for your replies to appear in your own thread about Bobo, you always need to actually be located here in your own thread before composing a reply. You can select either the blue "Post Reply" button located immediately below the most recently posted reply in your thread, or you can select the "Quick Reply" instead. But either way, you first have to be in your own thread in order for any of your replies to be posted there.

Your replies will always end up being posted within the thread you've written them. So if you write out a reply in somebody else's thread, that's where it will stay. Apparently you were in Shana's thread when you wrote out your reply to me earlier this morning, and one of our staffers must have moved it over here for you. That's why that reply carries Shana's thread title instead of your own.

Marianne

[rainiebo]

Hi I posted to another thread if you could please move it here that would be good. I know how know. Thanks !:)

[labblab]

I just now checked, Raina, and I'm not seeing any other replies that haven't yet been moved. If you think there's still one out there, can you tell me the name of the thread and the date of your reply? Thanks! ;)

[rainiebo]

Thanks again for being so patient to read my diatribe on all Bobo's been through. Things have got to get better. There aren't anymore posts. Just still trying to navigate through.

Thanks again.:)

[molly muffin]

Hmm, have you tried melatonin? Without all the other pain/anxiety drugs? I see that it was mentioned along with some other drugs but I was wondering if you tried it at all in combination or by itself?
My dog was on it for awhile and the anxiety/panting is one of the things that it did help.

[rainiebo]

Thanks for suggesting melatonin - I wasn't really sure about its safety. Right now Bobo will be on the vetoryl, cosequin and can't remember the name of the other natural arthritis medication. Will put him on melatonin tomorrow. My primary vet suggested melatonin 6mg at night, but to make sure it was melatonin without xylitol. He said human forms of melatonin come with xylitol. I also, added Bach Stress Relief - that is a homeopathic anxiety medication. I checked with Dechra (manufactures vetoryl) for any problems with taking it and the rep said probably no - that they haven't really done any studies. I'll let you know if it works.

[Harley PoMMom]

Regarding the melatonin, you want to buy the regular kind not the fast-acting or rapid-releasing type. ;)

Lori

[rainiebo]

Thanks - will do !

[molly muffin]

Oh, this is where I ordered my melatonin from.

http://www.lignans.net/

[rainiebo]

Thanks will give it a go !

[rainiebo]

Thanks as always for your reply. I've ordered the melatonin from a website and the dose is 6mg per night. I'm going to try the rimadyl again, but have only ordered 5 chews from my vet so I can track the panting and blood steaks in stool. Most of the other medications should be out of his system by now - so hoping for the best. He is walking pretty stiffly. He'll end up being on consequin, vetoryl, Bach Stress Relief for pets, another supplement and maybe the rimadyl. I found another website that recommended a high protein, low fat diet without chicken or liver. I'm going to try the Green Cow Tripe canned dog food - it's holistic and meets the other criteria. Soooo will see how he does.

Raina

[dsbailey]

Hey Raina,

My girls been having arthritic issues since her Cortisol levels have lowered. Since NSAIDs are a bit hard on the liver I've tried to avoid them. I've lowered my girls dosage of Vetoryl from 35 mg to 30 mg (probably not an option for you at this point) but also started using Duralactin Canine Joint Plus (Duralactin with Glucoasamine, etc ...). She seems to be less creaky and sore. This may be an option instead of rimadyl, I'm not sure if you've tried or explored this yet.

[rainiebo]

[FONT="Comic Sans MS"]Hi, that's it, that's the name of the supplement I never can remember. Molly Muffin sent me info about a melatonin website Lignans.net. Another member sent me information about using a fan for Bobo and I searched google for natural arthritis cures and it listed our site and on it was the Duralactin. You all are an incredible group. Bobo is so much better and when the melatonin and duralactin get here - he'll be even better. I don't really want him on the rimadyl, but he looks so stiff and uncomfortable. I only ordered 5 from my vet. I'm trying to make him more comfortable until I get the supplements. Do you think the diet I'm going to put him on is good advice as well? It's the nuts and bolts of treating Cushings that I needed. My vet, heaven help him, is a good GP, but he's not that good at diagnostics. He's really not much help in treating the day-to-day Cushings. I don't know what I would have done if I hadn't found K-9 Cushings. I was drowning. Now I have direction. Thanks so much for the information.

[dsbailey]

Duralactin Canine Joint Plus has Microlactin, Glucosamine, MSM, Omega 3 EPA and DHA, Zinc, Manganese, and Vitamin E.

Duralactin has Microlactin.

I like the prior and don't get the sad eyes trying to cram the big Sams Glucosamine pills down their throats.

[rainiebo]

Hi thanks for the info - next time I'll definitely order the max plus.

:)

[Harley PoMMom]

I'm not sure if this was posted before so I'm providing a link to a thread where Duralactin was discussed :): http://www.k9cushings.com/forum/showthread.php?p=58306&highlight=duralactin#post58306

[rainiebo]

I think Bobo will do o.k. this go around with the supplements I've ordered. I looked at the cosequin supplement I'm giving him and it has 500 mg of glucosamine hydrochloride made from shellfish and 500 mg MSM. Other ingredients brewers yeast, magnesium stearate, microstaline, natural flavor, and silicone dioxide. Most of the extra ingredients are probably just filler. The good thing is that they look like the mini-bones I give him for treats, but the drawback is he needs three a day. Waiting for the other supplements. Thanks for helping me work through adding his supplements.

[molly muffin]

Let us know how he does with the supplements.
At least it is treat form with the supplements. He'll think he's getting extra treats. :)

[rainiebo]

Hi Sharlene - The melatonin and duralactin got here today and I gave them to Bobo along with the vetoryl and cosequin. Then I started thinking (sometimes a bad thing for me to do) will the melatonin and Vetoryl lower the cortisol so much that Bobo will go into Addisons? Appreciate your thoughts.

[Harley PoMMom]

He weighs 73 lbs and is on 40 mg of Vetoryl BID (total daily dose of 80 mg), correct? If so, that is a reasonable amount for his weight. Since he is doing well so far I wouldn't think that adding the Melatonin will aid in lowering his cortisol too much. When is his follow up ACTH stimulation test scheduled for?

Hugs, Lori

[rainiebo]

Hi Lori, his next ACTH was left kind of open-ended by my vet. He said in about 4 months. As I said before, my vet is a knuckle head. He's the one who suggested the melatonin for Bobo's sleep. Bobo did sleep better last night and didn't get that crazed look that he gets around 9 p.m. - he only got up once at 5:30 a.m. which is very good. However, he is now on vetoryl, cosequin, melatonin, and duralactin. He's had such good results from the vetoryl that I hate to mess up his cortisol numbers with the melatonin. Bobo had the typical symptoms of cushings - black skin on belly, hair loss on belly, an abscess, heavy panting, eating like a mad dog, drinking and peeing a lot. He also had swollen nipples. My vet wasn't sure it was cushings - so I asked for the test ACTH and urine tests, and they came back positive. No one, even the endocrinologist has mentioned his adrenals. He had a benign liver tumor removed and about 2 weeks prior to the surgery he was put on Vetoryl. Most of his symptoms are gone, the only one left is the panting and difficulties sleeping. His hair is mostly grown back, no more abscesses, light panting only and sleep issues almost resolved. The panting issue comes and goes. All this to say I still don't have a real good handle on his treatment. I called his vet today to try to get clarification about combining vetoryl with melatonin. From what I've read it is either vetoryl or melatonin/lignans. I'm treating Bobo's arthritis with the consequin and duralactin - he doesn't seem as stiff. Good luck to Bobo.

[Harley PoMMom]

I apologize for my laziness but could you tell me when he had his last ACTH stim test and what were the results?

My Harley was on Melatonin along with his Cushing's medication and it had no negative effect on him, it actually calmed him as he was terrified of thunderstorms and once I started the Melatonin that fearfulness went away.

Hugs, Lori

[judymaggie]

Hi! You could certainly continue to give Bobo melatonin to help him sleep. When you mention Vetoryl or melatonin/lignans in regard to Cushing's, I think you are confusing using the melatonin/lignans to treat atypical Cushing's. You would not be using the melatonin in this way.

[rainiebo]

To be honest - I don't understand half of what I read. I talked to my vet and he said it should be fine to give Bobo the melatonin with the vetoryl - so I guess we'll continue on with that. I did ask him what kind of cushings Bobo has and he said pituitary dependent. Sooooo I guess we will continue onward and upward. Thanks for all the help.

[Harley PoMMom]

To be honest - I don't understand half of what I read.

It can be confusing so if at any time there is something that just doesn't make sense come on here and we'll see if we can help. ;)

Hugs, Lori

[rainiebo]

As always thanks for all your help.

[molly muffin]

I too gave molly vetroyl and melatonin. I would give it to her about an hour before her bed time and any time there where thunderstorms coming out way.

[rainiebo]

Hi Bobo and I rode out Storm Matthew - Bobo did really well - didn't seem to faize him. We dodged a bullet -just lost a few branches. Bobo was doing fine with the panting for awhile - but it's back - not as bad as it was - but even with all the help he's getting - don't know what to do for him now. Other than that he is doing fine. Anyone with any more ideas about the panting? Thanks.

[judymaggie]

Hi! I will have to take some time to think about the panting but, in the meantime, wanted to tell you that I am so glad you guys weren't seriously impacted by Matthew. I used to live in Jacksonville and it was tough to see how high the St. John's River was rising!

[rainiebo]

Hi, Lori, Thanks for the well wishes and offer of help for Bobo. Riverside should go down pretty quick. St. Augustine and Daytona took most of the hit near us, but it was hard to watch as water came up on the river and at Atlantic Beach.

[rainiebo]

Hi Maggie - sorry for the name mix up, one of these days , I will learn how to use the system.

[rainiebo]

Well Judy, now I'm calling you your pup's name - sheesh - please chalk it up to Matthew hang over.

[judymaggie]

Not a biggie -- I still call my current dog "Maggie" even though she has been gone for 7 years! All my neighbors, friends and my vet do the same ...

[Squirt's Mom]

Glad ya'll are ok! I know folk in DeLand and am waiting to hear from them but hopefully they are ok too.

[dsbailey]

Hello Raina Bobo's mom,

I'd followed this thread for a bit but not completely. I know panting was an issue then you tried fans but became an issue again. It was posted in a facebook group (Cushing's Disease Awareness For Dog Parents) today that her pup was having some luck on cooling gel mats that she had purchased at petco. I'm not sure if someone has suggested this but thought I'd throw it into the mix if not.

Hope all is well - Darrell and Lolita

[rainiebo]

Matthew seemed to be all over the place and I hope your friends are o.k.

[rainiebo]

Cooling gel mats could do the trick. After 12 years with Bobo, I am beginning to recognize his different pants: Cushings, over-heated, excited, when he's being petted, too much noise, and when he's in pain. Guess it's about time - to finally figure out my little old man. The Vetoryl, melatonin, fan, and joint supplements are adding a lot of relief from the Cushings. I had to add Rimadyl back into the mix. He started his walks again and he's stiff and sore afterwards and the next morning. Sincerely, I couldn't have handled this alone. I was pretty crazy trying to find help for him. Everything y'all have recommended has made him more comfortable and me less anxious. The other cushings symptoms are under control for now. Thanks again :)

[rainiebo]

Hi Darrell and Lolita - thank you for the facebook info - I'm going there today sometime - I forgot to mention that some of the things that cause Bobo's panting are rimadyl, trazedone, tramadol, hydrocodone and the list goes on. He is very sensitive to meds. I'm going to pull Bobo off the rimadyl again, he's panting like a wild dog this a.m. and had trouble sleeping last night.

[molly muffin]

How is Bobo doing? Did you get the cooling mat?

[rainiebo]

Hi, Bobo is doing ok. The weather here is starting to change from scorching to mildly enjoyable, and I have limited his outdoor and walk time. This all seems to help. He's an old boy and has had a lot of losses - his litter mate passed, his human "daddy" passed, and he is in a new home all within the last three years. I'm thinking probably some of the panting might have nothing to do with the Cushings. I think I'll hold off on the mat, until I try him on lexapro - one more drug he may have a bad reaction to - but Cushings dogs, like we all know need a lot of "balancing." Hope your balancing act is going well !

[molly muffin]

Balancing is one way to describe it. ROFL :) :)

Poor Bobo, he's had a hard go of it and I do hope the cooler temperatures will make him feel a bit better.

[rainiebo]

Hi, I need your help again. Bobo's last Cortisol Serial 2 ACTH was done on September 8th. His numbers were Cortisol Sample 1 - 2.0
and Cortisol Sample 2 - 4.0 (Low).

He's not doing so good right now - his panting has increased, drinking a lot of water, and up at twice a night to go out. He's not losing or gaining weight. I feed him three small meals a day - 1/2 can Wellborn Chicken, Turkey Livers and 1/2 can Green Cow Tripe. The ACTH was done fasting, with his usual dose of Vetoryl 5 hours earlier. He takes 30 mg in the a.m. and p.m. I guess my question is since the symptoms have come back (not every day - but enough to make him uncomfortable), should I call my vet and ask for another ACTH? Yesterday was very trying for him emotionally - My daughter came over, we went to lunch, a dog from next door came over and wanted to play, but Bobo just growled at her.
He went for a very short walk and then was a mess last night - panting, etc. I guess I just need help sorting this out, is it the Cushings or he's not being monitored enough. Help !

[rainiebo]

Hi - I forgot to say that he is really jumpy and nervous. I'm giving him vetoryl, cosequin D5 (max strength, plus msm), duralactin, and melatonin. Is there anything that might help his nerves? He can't really take most meds from the vet.

Thanks again,

[DoxieMama]

Hi, I need your help again. Bobo's last Cortisol Serial 2 ACTH was done on September 8th. His numbers were Cortisol Sample 1 - 2.0
and Cortisol Sample 2 - 4.0 (Low).

<snip>
The ACTH was done fasting, with his usual dose of Vetoryl 5 hours earlier. He takes 30 mg in the a.m. and p.m.

This concerns me. Vetoryl should always be given with food and a monitoring ACTH test should never be done fasted. You should give him his normal breakfast that day, along with the Vetoryl. The timing is good, though.

That said, I would probably call and schedule an ACTH test, along with electrolytes.

[labblab]

Yes, just to elaborate further about that, trilostane needs to be given along with a meal in order to be metabolized properly. So a monitoring test performed on a fasted blood sample runs the risk of registering a higher level than is normally the case when the medication is given daily along with breakfast (and dinner). So back six weeks ago when Bobo was tested, his daily cortisol might have been running lower than the test indicated. Depending upon exactly how low it was going, a dosing decrease might even have been warranted.

I know the excessive thirst/urination/panting makes it seem as though his cortisol may be running too high right now, but ironically, symptoms of low cortisol can overlap. Since Bobo is not feeling or acting well, I would definitely request a new monitoring test, but this time discussing with your vet in advance that the ACTH must be run on a nonfasted sample. We can easily give you citations to references, or your vet can just call Dechra (maker of Vetoryl) directly for confirmation.

Marianne

[rainiebo]

As usual, thanks so much. I'll call first thing on Monday morning and get it done. Until then I'm going to keep him quiet and keep on keeping on.

Have a good weekend !

[labblab]

Yes, just to elaborate further about that, trilostane needs to be given along with a meal in order to be metabolized properly. So a monitoring test performed on a fasted blood sample runs the risk of registering a higher level than is normally the case when the medication is given daily along with breakfast (and dinner). So back six weeks ago when Bobo was tested, his daily cortisol might have been running lower than the test indicated. Depending upon exactly how low it was going, a dosing decrease might even have been warranted.

I know the excessive thirst/urination/panting makes it seem as though his cortisol may be running too high right now, but ironically, symptoms of low cortisol can overlap. Since Bobo is not feeling or acting well, I would definitely request a new monitoring test, but this time discussing with your vet in advance that the ACTH must be run on a nonfasted sample. We can easily give you citations to references, or your vet can just call Dechra (maker of Vetoryl) directly for confirmation.

Marianne
We were typing at the same time. I just want to make sure you saw my reply on the previous page. ;)

[rainiebo]

My vet doesn't seem to be too knowledgeable about Cushings. Could Bobo be in danger of something really bad happening or getting Addison's with the numbers so low. I am a worrier, and feeling pretty anxious right now. Help again !

[rainiebo]

Thanks did see it and going to schedule the test on Monday.

[labblab]

That sounds good. Had Bobo's September ACTH results been done on a nonfasted sample, I would have said they were great. Without retesting, though, it's really impossible to guess where they are now. And in fact, they may be too high now rather than too low. Or, hopefully, they may still be between approx. 1.5 and 5.5.

At this point, unless something changes, I think you're OK to keep going as you are until Monday. But it will be very good to have that ACTH performed at that time.

Marianne

[rainiebo]

Thanks, I called the vet and they are understaffed today and close at 1:00 p.m. so I couldn't get him in today. I feel less anxious, but what would be the signs if Bobo were in a crisis? our ER here is insanely expensive, and if he did go into crisis, I would feel better trying to get him into his endocrinologist today (if I could.)

[labblab]

Symptoms of Addisonian crisis include things like loss of appetite, vomiting, diarrhea, extreme lethargy, and loss of coordination. I really do expect that Bobo will be OK until Monday. If you really became worried about low cortisol over the weekend, though, and couldn't have him evaluated, the first step would be to discontinue the trilostane and the second would be to administer a low dose of prednisone to counteract possible low cortisol. I really wouldn't do either of these things prior to Monday, however, unless he really worsens and develops symptoms of crisis. This is because both of those actions will skew the ACTH testing that you're trying to have done. Hopefully, things will just remain status quo until Monday and you get the test run, and then adjust accordingly.

Marianne

[rainiebo]

Thank Goodness, Bobo doesn't have any of those symptoms. I called the vet again and scheduled the ACTH and electrolyte test for Monday. You've come through for me and Bobo again. We'll have a better weekend now. Hope all is well with you.

[labblab]

Just remember that you need to let the vet know you are feeding Bobo breakfast along with his Vetoryl, though. I don't believe that eating will skew potassium or sodium levels, which are the key electrolytes for a Cushpup. But there are other items on broader blood panels that can be affected by eating. So your vet needs to know that Bobo will not be fasted this time.

[DoxieMama]

Great plan! So glad Marianne was here to provide you with more info, and answer your questions. :)

[rainiebo]

Will do - I'll post the results when I get them to make sure you agree with the vet. I don't really have a lot of confidence in my vet. You have given me much more details on how to care for Bobo than my vet.

[molly muffin]

So test done on monday, when do you get the results? :) :) nosey buggers aren't we LOL

[rainiebo]

Hi, nope not nosey - glad you are checking up on us - Wasn't able to have his testing done until Tuesday. Silly me - they said the results would be ready on Wednesday - so I waited for a phone call. No phone call - so will call them today. Bobo was up 4 times last night to go outside. He is acting tired this a.m. - but he ate and of course went outside. Bobo's endocrinologist is expensive, but it might be worth it to take Bobo back to him. Bobo's vet is about clueless when it comes to cushings - I saw a post a couple of days ago that said the pup mom had to pretty much do all the directing and the vet just provided the tests. That's the way it is with Bobo's vet. I'll post the results shortly - I hope. Thanks again for keeping up with us - we need the encouragement !

[rainiebo]

Hi, Bobo's test results were:

Cortisol Serial 2 ACTH
Sample 1 1.3 gu/dL
Sample 2 3.4 ug/dL

The vet said that this was in a good range. He couldn't explain why Bobo was having some of the symptoms return - drinking, yard breaks, panting and up at night. He said he doubts it's the cushings because his numbers are within range and close to his last numbers. He said to try taking his water up after supper. I asked if there were other tests to try and he said no. He said it was probably Bobo getting older or maybe the symptoms were cyclic. I had a really good three weeks with Bobo, maybe will again sometime.

[judymaggie]

Hi! Those are good numbers but I definitely wouldn't want to see either number any lower. I am afraid that your vet's lack of knowledge about Cushing's is showing again with regard to his suggestion that you take up Bobo's water after supper. Here is the guidance offered to another member by one of our administrators, Leslie, in response to a similar suggestion:


Withholding water is risky in any dog but one who is in questionable health it is especially risky because some diseases, like Cushing's, effect the kidneys and those organs are going to work overtime regardless of the amount of water they drink. So withholding water can quickly lead to dehydration.

I am not sure what your vet meant by suggestion the symptoms could by "cyclic". Did he explain that? Did your vet run a blood test to assess Bobo's electrolytes? This should be done concurrently with every ACTH, especially when results have been in the low range.

[rainiebo]

Bobo will get his water tonight ! I think he meant by cyclic that Bobo would have good and bad weeks ?????? Do you think Bobo is borderline and the meds should be backed off a bit? I didn't ask for electrolytes because he had eaten. My head is spinning again. I really don't think the vet can get past Bobo's age. He seems to put all health issues as age related. Bobo is only 12 almost 13. But looks really good, his hair has come back, his eyes sparkle, no lesions, and except for this week most of his symptoms were gone. When we're out walking, people comment on what a good looking dog. I would just like to hand this whole Cushings thing over to someone else for about a week and then tackle it again. Like I said, my head is spinning.

[DoxieMama]

Hi Raina,

My vet is able to test the electrolytes for V even when he has eaten. Some tests it can cause problems, but not those, at least for my vet and his equipment. Hopefully yours is the same. (They run what they call an NSAID test, whether V has eaten or not. The lipids don't cause a problem with the result of that test for them.)

Shana

[rainiebo]

Hi, is the NSAID used for diagnosis or monitoring. Also they increased the cortisyn shot to .7 - the other ACTH tests were given with .2 - Bobo has gained about 4 lbs since last test. Could that be the reason? We had a good night last night - I took Bobo out when I got up - then we both went back to sleep. Just want to give you a heart-felt thanks for having done all this research, for Bobo, and all the other cushbabies. - If left on my own, I probably wouldn't know where to look and couldn't understand half of what I read. Hope V is feeling better and you are getting some sleep.

[DoxieMama]

The NSAID test is the bloodwork test my vet uses to check ALP, ALT, AST, Crea and BUN. I am actually not sure if that includes testing the electrolytes or not (sodium and potassium). Either way, I don't have to fast V for them to do those tests, so they can do them at any time. That's all I was trying to say... :)

I'm glad you had a good night last night and you both got some sleep. I did, too. Thanks for asking. It wasn't enough... but today's Friday so I can take naps this weekend to catch up.

[judymaggie]

Raina -- similarly to Shana's vet, my vet is able to test "ALT, GLU, BUN, CRE, NA+, K+, CL- and CO2" on what is a shortened panel. We are closely monitoring Abbie's electrolytes so these get tested every few weeks and this shortened panel saves me a lot of money. Abbie is never fasted for this panel. Here is a link to what my vet uses:

https://www.abaxis.com/veterinary/products/vetscan-vs2

He is able to this in-house and it takes 12 minutes to get results! My vet charges me $56.50.

[rainiebo]

Yep, I'll get the NSAID next time too. I'm really a coward when dealing with any medical person - vet or dr. - so I forget a lot of what I want to ask. It cost more for this ACTH and they said the reason was the first two cortizen shots were .2 and this last one was .7 - o.k. I found out the cost but didn't ask the why- sheesh. Can you think of any reason? Now I don't want to call back to find out (coward) -

[Harley PoMMom]

Also they increased the cortisyn shot to .7 - the other ACTH tests were given with .2 -

I'm a bit confused with this statement, are you saying they used more of the stimulating agent for the ACTH test this time? How much does Bobo weigh?

[rainiebo]

Exactly, the first 2 ACTH tests were .2 cortizen 25mg. Bobo weighed 74.6 at that time. This latest test was .7 of 25mg. Bobo weighs 77.2 - he's getting a little pudgy so I'm tapering off his food a little, and not so many snacks.

[rainiebo]

Sorry - I'll get this right in a minute - .7 Cortosyn 0.25mg 1ml (per cc) this ACTH test. The first two .2 Cortosyn 0.25mg 1ml(percc)

[molly muffin]

I'm terrible with the numbers for waht the cortizen should be, but I do remember that I'd take notes and go into the specialist armed with a list of questions and check them off as discussed as I too could forget to mention something at the time and in the heat of the moment.

Also eventually I just ended up with my IMS's email and was able to ask things I forgot at the time.

[rainiebo]

Appreciate all your help, and will take notes next time.

[rainiebo]

Hi - I've really appreciated your advice in the past and need it again. Bobo's ACTH on 11/1/16 was done non-fasting without labs or urine catch. The prior ACTH tests were given fasting with .2 cortisyn shot. This test was given .7 cortisyn shot. Results -

Sample 1 1.3
Sample 2 3.4

I requested the ACTH because he has started again drinking a lot of water and urinating a lot. We were up at least 4 times last night and every time - the urination was heavy.

My question is should I schedule a blood workup and urine catch? I really don't know what to do at this point. The vet just keeps saying it's his age - then he told me to withhold water from Bobo after supper. Thanks for any help.

bye,

[Squirt's Mom]

Uhmmm I don't know anything about the amount of cortrosyn used but I do have comment on a few of things you mentioned -

1) Never ever for any reason let them do an ACTH fasting. It is absolutely worthless if the dog does not eat a MEAL with the med then have the ACTH 2-6 hours after. An ACTH done on a dog that has been fasted just wasted your money and put your dog thru unnecessary stress since the test is useless. So even if the vet tells you to fast, don't and tell them to call Dechra for an education on the drug they are prescribing. If the vet won't listen, find a new vet who will work with you. ;)

2) A post, or second number, of 3.4 ug/dl is perfect so I would say the cortisol is not the problem

3) NEVER EVER withhold water from a cush pup. A cush pup does not pee so much because they drink so much. It is just the opposite. The disease causes them to pee excessively so they have to drink a lot just to stay hydrated. So NEVER take up the water. Another point your vet needs education on apparently. ;)


I would ask for a urinalysis just to be sure there is a UTI happening. Did you notice an odor to the urine or is the color darker than normal?

Hugs,
Leslie and the gang

[Harley PoMMom]

Exactly, the first 2 ACTH tests were .2 cortizen 25mg. Bobo weighed 74.6 at that time. This latest test was .7 of 25mg. Bobo weighs 77.2 - he's getting a little pudgy so I'm tapering off his food a little, and not so many snacks.

Just to clarify, are the reporting units for the .7 and .2 in mg?

[rainiebo]

Thanks Judy, I'll call my vet tomorrow, and ask for the shortened panel. As always thanks so much !

[rainiebo]

Hi, these numbers are the amount of cortisyn used when they gave Bobo the ACTH tests. I'm going to bite the bullet and call the vet tomorrow. Thanks so much

bye,

[rainiebo]

Hi Leslie, I'm glad you say the numbers are good because I don't really trust
Bobo's vet that much. I now definitely won't withhold Bobo's water. I haven't really been watching for color or odor. Mostly just monitoring how much he is drinking and I walk him on leash in the back yard so I can see that the stream of urine is really heavy. He went out 4 times last night, and each time the stream of urine was heavy. I'll watch out for color and odor. A urine test and short panel of bloodwork might be the way to go. From what you and other K9 members are saying - this would seem like the best way to go right now. As Always thanks so much !

[rainiebo]

Hi, yes they did use more of the stimulating agent on Nov. 1. The test cost more this time so I asked why and the tech said it was because they used .7 instead of .2 of the stimulating agent. I didn't ask why - sheesh - I've got to get my act together for Bobo's sake and my sanity. Bobo's weight went up from the first tests. He weighed around 72 lbs then and now he weighs around 75. I'm going to call the vet tomorrow and schedule the short blood panel, urine test, and ask why they used more stimulating agent. I'm following all the good advice from you guys - not the vet. He just keeps talking about Bobo's age.

[rainiebo]

Hi Leslie, could you please the posting I just made when I was a guest. I put my posting in the wrong place and really need to hear from you. Thanks

___________________________________________

Edited to add: Hi Raina! I'm hoping what you meant was that you wanted Leslie to add a copy of your guest message here. So that's what I'm gonna do. ;). Marianne


Hi, I'm really upset and feeling guilty and crying. I keep a journal for Bobo. I started reading the entries, realizing what I had been putting Bobo through. The vets have been treating Bobo for shar-pei fever since 2014. He's been on anti-depressants, pain pills, colcrys for shar-pei fever. He had pot belly, heavy, heavy panting, dragging back leg, several collapses, hair loss and awake most of the night. I had to insist on the cushings test. A benign liver tumor was removed in June and an endocrinologist tested him again for Cushings and began the Vetoryl. I have stopped all medications. At first in the Vetoryl he got better, but now he is panting again, and drinking a lot of water and waking up several times a night to go out, and dragging his feet again. I'm over my head in debt, and want to take him back to the endocrinologist and I will next month. No more tests with Bobo's stupid vet. I guess I'm just needing an understanding shoulder to cry on - thanks you all.

[rainiebo]

Hi Sharlene, I got some really good advice to use a fan for Bobo to cool him down during the summer. He really likes the fan and it has made his life more comfortable. Now that the days are cooler here in Florida - I'm wondering should I continue to keep him cool with the fan - or should I set the thermostat higher and no long walks in the cold? Is there an optimal way to handle the winter months?

[labblab]

Hi Raina,

As you'll see, I went ahead and added a copy of your guest note to Leslie. I am so sorry you are having such a bad day, and that Bobo is feeling poorly again. When you say you've stopped all his medications, does that include his Vetoryl? Was he still taking it at the time of his ACTH test?

Marianne

[rainiebo]

No, Bobo is taking vetoryl, cosequin, and duralactin.

Thank you,

[Squirt's Mom]

Hi Raina,

I think most of us here have felt what you are feeling at least once while dealing with our cush babies. The fact of the matter is, I happen to believe cush parents are the very best pet parents around. That means we worry and fret and have the same emotions over our babies that we would, or do, over our two-legged children. So guilt and fear and stress and anger and worry are all part and parcel of our daily lives all too often.

You are a good mom - that journal proves it. You care deeply or you wouldn't take the time and effort to keep something like that for Bobo. It is easy to look in those pages and see things that make you feel like you may not have done the best for him after all....but another time you will look at those same things and know you were doing all you could for him. And anyone else who looked thru that journal would only see evidence of a woman who loves her baby with all her heart and Soul, and who is willing to do anything to make his life better.

But the only thing that really counts is Bobo. He loves you. He loves you because of all those things you have done for him, for doing all you can to give him the best life possible regardless. He would read that journal and see only that love you have for him, nothing more, just your love. And that's all that matters. ;)

Hugs,
Leslie and the gang

[rainiebo]

Hi Leslie, this time I'm crying because your post is so beautiful. It really spoke to my heart. When I read Bobo's journal - I could only think of our website as a place of comfort because I knew I wouldn't have to explain the pain and guilt. It is very comforting to know that I'm not alone in taking care of Bobo. I can only thank you again for your gift of encouragement and understanding.

Raina

[molly muffin]

I think if the fan works for him and he likes it (I like a fan blowing on me when I sleep too and molly seemed to like the ceiling fan on too) then that is what I'd keep doing. As long as it doesn't get too cold to use it.

I agree, you're an awesome mum and I betcha Bobo Really thinks so.
We do walk that extra mile for our furbabies and do whatever they need or what we think they need, since they can't just say this hurts or that doesn't feel good or I prefer this food, please make me this tonight for dinner. We just have to figure it out and the fact you do all these things, like turn a fan on so he stays cool, and research his booboos so he'll feel better, well that makes you gold.

[rainiebo]

Hi Sharlene and Molly Muffin - I just type in a message with all Bobo's labs but had to go back and look up alkaline phos number - my post was lost I guess? Can you see if you can find it - it took a long time to enter all the data Thanks

[rainiebo]

Hi I just posted the lab and urinalysis for Bobo, but I think it is lost- I had to go to another page and look up his alkaline phos and when I cam back to post - the quick reply was gone. Anyway to find it?

[rainiebo]

Is there anyway to post his lab results from the original? I really don't want to post it again? Can I email it to either of you? Thanks

[rainiebo]

Hi Leslie My vet said he used .7 cortozyn for this test instead of the .2 because he wanted to see how his numbers responded to a higher dose.

Here are the results of his blood work. Pre-Op Surgeries

Bobo Range
Total Protein 6.6 g/dL 5.0-7.4
Albumin 3.4 g/dL 2.7-4.4
Globulin 3.2 g/dL 1.6-3.6
A/G Ration 1.1 Ratio 0.8-2.0
ALT (SGPT) 57 U/L 12-118
Alkaline Phos 862 U/L 5-31 High
Urea Nitrogen 18 mg/dL 6-31
Creatinine 1.1 mg/dL .05-1.6
BUN/Creatinine 16 Ratio 4-27
Glucose 98 mg/dL 70-138
Hemolysis 1+ no significant interference
COMPLETE BLOOD COUNT
WBC 13.8 10^3/uL 4.0-15.5
RBC 8.0 10^6/uL 4.8-9.3
Hemoglobin 18.3 g/dL 12.1-20.3
Hematocrit 53% 36-60
MCV 66 fL 58-79
MCH 22.9 pg 19-28
MCHC 34.5 g/dL 30-38
Platelet Count 299 10^3/uL 170-400
Platelet EST Adequate Adequate
DIFFERENTIAL ABSOLUTE %
Neutrophils 9,522 /uL 69 2060-10600
Bands 0/uL 0 0-300
Lymphocytes 3,450 uL 25 690-4500
Monocytes 552 uL 4 0-840
Eosinophils 276/uL 2 0-1200
Basophils 0/uL 0 0-150

ADD ON URINALYSIS
Collection at home 1st urination of the day (non-fasting)
Natural voiding
Color yellow
Appearance clear clear
Specific gravity 1.019 1.015-1.050
Protein Trace Neg
Microalbuminuria testing is recommended (if sediment is inactive) to help determine the clinical significance
Glucose Neg Neg
Ketone Neg Neg
Bilirubin Neg Neg to 1+
Blood Neg Neg
WBC 0-1 HPF 0-3
RBC None HPF 0-3
Casts None seen LPF
Crystals None seen HPF
Bacteria None Seen HPF
Epithelial Cells None seen HPF
Urine Microalbumin
(Canine Reflex ) pending

Thanks for helping decode this -

[rainiebo]

Hi I found the "lost" posting - sorry for any trouble I put you to - it's above if you wouldn't mind looking at it.

Thanks

[rainiebo]

Hi, this is a follow up to the labs - The title Should read Pre-Op Chemistries. My vet said that the alkaline phos numbers but this number was much lower than prior to his surgery to remove the benign liver tumor. Thanks again.

[molly muffin]

The only thing you need to type in is anything that is out of range. In this case, it looks like the only thing that is high/low is

Alkaline Phos 862 U/L 5-31 High

So this is after the surgery and the number has gone down significantly?

This is a really good lab report in that case.

The ALKP could even continue to go down now with that liver tumor has been removed.

[rainiebo]

Hi Sharlene, these were the labs done on Tuesday. Yep these were the post op labs and urinalysis. I was wondering would giving Bobo SAMe and milk thistle help bring down the ALK even further? My vet said it was o.k. to give Bobo these supplements. I also bought another supplement from the vet called Movoflex for his arthritis.

Bobo is very stiff and panting even after a short walk. He stumbles somewhat when walking. I take him for a ride following the walk and he settles down.

This time when talking to the vet - I felt more confident, told him about the urination cycle when he asked if I had taken up Bobo's water at night. Told him about using the fan and how much it helped. Told him I was a member of a support group and he said it sounded like a really good group.

The vet said there is new pain medication being introduced for arthritis in January that is not like rimadyl and maybe Bobo could tolerate it. We'll just to have to wait and see.

Thanks for reading all this information. I told him that with each future ACTH - we should do the short blood panel and urinalysis and he agreed to do the tests.

Bobo's schedule for nightly potty breaks seems to be working for him. He goes out after supper. Before we go to bed and when I get up for my potty break at night, I take him outside again. So far this is working. He only woke me up one time last night. What a relief. Well hope all is getting better for you and the upcoming Holiday activities. bye, Raina

[molly muffin]

Yes you could give Bobo milk thistle - sam-e. It's a liver support supplement so should be okay.

Did the vet mention the name of the new arthritis medication? There should be studies written up on it. It will be something we look into as so many older dogs have arthritis and it is often unmasked by cortisol levels going down once dogs are put onto cushing meds.

That's great that you have a routine that is working for the potty breaks!

It's still busy at our house but yes for now it feels better. Just a bit crazy. :) thanks for thinking of us

[Squirt's Mom]

I agree with Sharlene - the only thing that is abnormal is the ALK and that is not as high as some we have seen which were in the 1000's above the highest norm. Since it is already known she has had liver issues, I would think this is of no real concern on its own. If the other liver values were also out of whack, I would be more concerned. One of Squirt's vets told me he didn't worry about the ALK too much because that was just an indicator of how hard the liver was working. Many things can cause elevations that don't really mean much overall.

I also wanted to point out that the specific gravity is within normal range and in cush pups we typically see that value below normal. Bobo's is at the lower end of the norm but still normal. The color of the urine is yellow - another contrast with cush pups whose urine is usually clear or almost clear.

I was never an expert at interpreting lab results and I am starting to forget as much as I remember :D but I really don't see anything here that is alarming in the least. This looks like a good report all things considered so I would take a deep breath and say "Thanks" to whomever you believe is listening. ;) Bobo looks to be in pretty good health based on this as far as I can tell.

Hugs,
Leslie and the gang

[rainiebo]

No, but I'll call on Monday and ask. Hope it works. Thanks for reassurance on Bobo's labs. My anxiety level dropped along with Bobo's ALK level. Getting ready for the holidays and taking care of a cushionoid fur baby can be quite stressful. Last year before his care began, I gave up Thanksgiving to be home with him. It's not going to be that way this year, thank Heaven. Hope your day is good :)

[molly muffin]

I hope you and Bobo have lovely holidays. It can all be very stressful but you find yourself making the little adjustments naturally after awhile it isn't nearly as bad as it is at the beginning of the journey.

[rainiebo]

Hi Sharlene - Hope you have Happy Holidays too, filled with all the good things the holidays can bring. I'm thinking all cush baby parents are looking forward to the New Year as being a better one for us and all our cush babies. Sorting out Cushings from diagnosis to daily living has been a challenge. I can see eventually making the adjustments without thinking will really be a blessing. You've been through the journey and I'm so glad you and the gang are sharing and here to provide a "soft landing" for the rest of us.

[Squirt's Mom]

I am sharing the visitor message Raina put on my page for all to contribute to since I don't have any experience with these bleeding growths and hope someone on the forum has and can share:


Hi, Bobo is having some more problems. He can't take walks anymore, his front legs give out. He constantly licks the front legs so I THINK he is in pain, but don't know what to do. He can't take the usual doggy pain meds: tramedol, hycodan, etc. because they increase the panting. Do you know of any more pain meds that might help? I'm not giving him rimadyl because of warnings about NSIDs, and it too increases the panting. He has a tick-like growth on his anus and a little bleeding. He has these tick-like growths in different areas of his body. His vet said they are benign and not to worry. Has anyone else had problems with sores, growths, bleeding around their doggy's anus? Oh well. Thanks for all your information, as usual.

[Squirt's Mom]

As I said in our conversation on my page, I don't have any experience with the growth but the bleeding does bother me a bit. Squirt had some cysts that would rupture and bleed but they were not small, close to nickle size for the largest one. Her vet was not worried tho it bothered me a great deal! ;) She had them for years with no further issues so apparently I worried for nothing, as usual. LOL

As for the pain, I don't know relate to pain meds causing panting, that has never happened with any of my dogs. HOWEVER, I have compromised lungs and pain meds can make it harder for me to breath. Have Bobo's lungs and heart been checked out really good to make sure there are no issues there? One of my babies has COPD but has not needed pain meds so I can't tell you if she reacts the same as I do or not. Someone has posted about some new anti-inflammatories coming to the US....I will find that thread and share it here so you can read that info - it may be something that would help Bobo.

Hugs,
Leslie and the gang

[Squirt's Mom]

It was on Lola's thread - her mom is talking about these new drugs and gave a link. Here is the page on her thread for that post which is #427. You can find the post #s on the right hand side of each post.

http://www.k9cushings.com/forum/showthread.php?t=5852&page=43

[kaibosmom]

Hi there. Quickly popped on to your thread after posting. I am interested in the medications being used and followed the link. I came across something about gabapentin. Now I wonder how that has been affecting my dog. I just love this group so much! I'll pop in again to read more but for now, I am so exhausted and promised myself I would get to bed early tonight (failing so far!).

Nikki

[rainiebo]

Hi Nikki, every dog is so different, Bobo can't take much of anything. I also tried gabapentin with him. Same thing. Panting increased. I finally can tell the difference between his pants: he's happy, he's excited, the cushings, and pain. His arthritis has become so bad that he can't take his walks anymore. But that's to be expected sometimes because the cortisol levels drop with treatment. That is good to treat the cushings but bad for the arthritis. I monitor his panting - if it's just the little cushings, etc. pant, then I don't give him anything for pain. Right now he's only taking Vetoryl and some supplements for the arthritis. I feel good about the vetoryl because his fat stomach is gone, the drinking and eating are back to normal, and I only take him out to urinate at night once, when I go. He used to get up 3-4 times a night. So victory in most areas. He's almost 13 years old and so I guess he'll just have to wait for the right pain med. Best of luck - cushings has been trial and error with us.

[rainiebo]

Hi, the bleeding has stopped and the small sore along side the tick-looking thing has healed so I guess another freak-out for nothing. My vet said a new arthritis drug is coming out sometime in January - I don't know the name and I am vet shy - so probably won't call him until sometime in January to see if the drug come out. I looked on the pet info section of the Food and Drug Administration site and didn't see anything new - soooo - don't know. Oh well, have a Merry Christmas and a Happy New Year! Hoping 2017 will be good for all of us and our cush babies.

[Squirt's Mom]

Raina, talk to a lady I know who may be able to help via diet and herbs. Her name is Monica Segal. She can design a diet for Bobo (foods DO have a big effect on our bods ;) ) and perhaps recommend an herbal protocol that will help his arthritis too. Her website is - http://www.monicasegal.com/

[molly muffin]

Happy New Year!!

Yes, heard about a new arthritis medication coming out. Did you call your vet about it yet? I think another member mentioned it too.

I would panic over all kinds of things only to later either talk myself out of it or find out that it wasn't something to worry about. Problem is, you don't know if it is a worry worthy item or not, till you have worried about it. How is that for a catch 22. Dang if you do and dang if you don't. LOL
Lets face it, we are just going to worry about our furbabies, because that is who we are. :)

[rainiebo]

Hi, the only new med my vet has is a chewable called movoflex. It has not performed any miracles. It is expensive for a supplement - It costs around $40. I just bought a bottle of chewables called FlexPet - who knows - I've only had Bobo on it for about a week - no miracle yet. It costs $45.90 for a bottle of 30 but he has to take 4 a day to "load" up. While I've got you, Bobo is still panting - but the other symptoms have gone away. Here his latest ACTH tests.

Sept 8th Sample 1 2.0
Sample 2 4.0

Nov 1st Sample 1 1.3
Sample 2 3.4

I'm going to schedule him for Feb 1st for another ACTH - is this too soon and are his numbers ok? They seem to be dropping each time he has the ACTH.
His urine test was fine and the blood panel showed a still high liver enzyme but it going down since the liver tumor was removed and he has been on vetoryl.

Wish I had a miracle arthritis medication - but so far still just experimenting. I talked to a tech in the vet's office and she said that Bobo should definitely be on Denamarin chewable tabs 225 mg - 30 for $31.00. It contains silymarin and some other ingredients to support his liver. Vet never mentioned liver support. Oh well,

[Harley PoMMom]

Has adequan been mentioned for the arthritis? I do recall some of our members having success in using adequan.

I have one question regarding those ACTH stimulation results, has Bobo's Vetoryl dose remained the same? If so, than I am a bit concerned that his cortisol continues to drop and having his cortisol level checked February 1 is a good idea.

Hugs, Lori

[molly muffin]

I would go ahead and test in Feb, since he has been trending downward. I never could go longer than 3 months without checking out molly. My nerves couldn't stand it. :)

I think liver support is always good with cushings and any liver issues. Hope those liver numbers continue to come down. Good news is always well, good. :)

Can you order the movoflex and denamarin from another source? I use to order from amazon and also from thepetpharmcy here in canada. An online pharmacy that also did my compounded trilostane.

[judymaggie]

Has adequan been mentioned for the arthritis? I do recall some of our members having success in using adequan.

Hi! The beagle I had before Abbie (also a Cush pup) had severe arthritis in one of her back legs. She had a series of Adequan injections and they worked great. She never had to have an annual booster after the first series. I tried Adequan with Abbie without success as Abbie's issues are nerve based rather than arthritic.

[rainiebo]

Hi Lori, haven tried adequan. I took him off movoflex and cosequin D5. Right now he's on Flexpet, Duralactin, melatonin, and now denamarin along with the vetoryl. I'll give these supplements a trial and if they don't work - maybe give adequan. Thanks for Lola's thread - I'll give it a read. Bobo used to take phycox, deramaxx, and rimadyl - but for various reasons regarding each med - he doesn't take these anymore. Bobo is still taking 30+10 mg vetoryl a.m. and 30 + 10 mg vetoryl p.m. Bobo's vet is a fruitcake - I'm more or less working around him with you all. So will schedule the tests for Feb and get back to you. He had ACTH in Sept 16 and was given .2 of .25mg 1 ml (per cc)
He had another ACTH Nov 16 and was given .7 of .25 mg 1 ml (per cc). The vet said that Bobo's weight had increased and that was why there was a difference in the amount given. So that may have something to do with the results - who knows? Anyway when he has the ACTH test he weighs about the same for this test. So the amount should be .7 - just have to wait and see.
again and again. bye Raina

[rainiebo]

Hi Judy, I'm just shooting in the dark - chasing the arthritis "miracle" snake oil at this point. Correct me if I'm wrong, but isn't adequan really expensive? Of course, if you add all the supplements together, it would probably come out equal. Thanks for the info. Sorry it doesn't work for your other furbaby.

[rainiebo]

Hi, I'm thinking no more movoflex - going with the flexpet for awhile. I was wrong about the price for Movoflex - the vet charged $54. I'll definitely check the price for denamarin on amazon. Thanks for the info and will continue on with the search for the "holy grail" of arthritis meds. bye, Raina

[judymaggie]

Raina -- it has been such a long time since Maggie had the adequan shots, that I do not recall the cost but I think your point is a good one -- add up all the supplements and the difference might be minimal. I think it is certainly worth asking your vet about the injections. Some dogs do need monthly injections after the first round. Owners can do these at home if the vet is agreeable and the dog owner is comfortable with it.

[rainiebo]

Hi Judy, checked with petcarerx and the adequan injectable is $112 (2 vials) for members. No problem with me doing injections at home. I'll definitely keep this as an option after I have run out of all these expensive supplements if none of them work. bye, Raina

[Harley PoMMom]

I'm including a link to an article, regarding arthritis, on the Dogaware site, hopefully it'll help: http://dogaware.com/health/arthritis.html

[rainiebo]

Wow, than you so much - the picture of piglet looks just like Bobo. I am going to see how much of the recommended supplements are in the chewables that I give Bobo now and then move him onto the ones recommended. The thought that I could have Bobo beyond the 13 years he is now, has restored my hope. I don't see how any of the supplements could hurt his cushings protocol - so I'm going to work him into the arthritis program. Again, to have a workable program for him is a godsend.

[rainiebo]

Hi, it's been awhile since I posted. Bobo is going to a pain specialist who did i.v. lidocaine to determine that Bobo had neuropathic pain. The lidocaine worked, so the vet prescribed vet lidocaine patches. Went from patches (they were too hard to keep on Bobo and he licked them) to Amitriptyline (Elavil) combined with Mixiletine (pain.) This combo didn't work and made the panting worse. He's on amantidine now, but his stomach stays upset and the panting has slowed to shallow breaths. I don't think the side effects are worth the relief, but I don't want Bobo to collapse from pain again. Between the rock and hard place again, any suggestions.

[Harley PoMMom]

Gosh I am sorry to hear this latest news about Bobo. For my nerve pain the doc has me on gabapentin and it does help, on the forum I've seen veterinarians prescribe this med as well. Another medication to consider is Lyrica (pregabalin).

I'm including a link to a published article regarding neuropathy pain in dogs and medications used, titled: Managing Neuropathic Pain in Dogs; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4762016/

In the article above it references to another article which lists other non-pharmaceutical ways that are used concurrently with medication to help with the pain: https://www.ncbi.nlm.nih.gov/pubmed/25103886

Lori

[rainiebo]

Hi Lori, Well, I found out the hard way for Bobo that it was the dog food that was causing all the stomach upset. Had to switch him from Solid Gold Green Cow Tripe to Nature's Variety Instinct 95% chicken grain free. He gobbles it and no stomach upset. I guess better late than never. He is back to his old stubborn self. He is still a little stiff when he walks, but he can take short walks now. So the amantadine is doing a pretty good job. Still going to check out the links because I think the pain meds need to be tweaked a little. He goes back in for evaluation in about 5 months. The cushings is under control. So that's good. Guess we're rocking along. Bye, Raina

[Squirt's Mom]

I also take Gabapentin for neuropathy and my Sophie takes it for a tendon that got damaged when she was attacked several years ago. It helps us both a lot!

A while back fed Solid Gold and was very happy with the results. Then things started happening that concerned me - things like tummy upsets and the dogs not wanting to eat it anymore. Come to find out it is no longer made BY Solid Gold. If you read the package it says, "made for Solid Gold" - it is now made in a Diamond plant and those plants have had numerous recalls for lots of reasons. I avoid food made by Diamond or in their plants!

[rainiebo]

I'll ask Bobo's vet about gabapentin. It's really sad we can't count on a dog food to remain safe. I'll be on the lookout for diamond products. Thanks for the info. :)

[Bodhi's Mom]

Hi Raina~ My name is Stacey and I'm the mom of a 10 year old Yorkie named Bodhi. I'm sorry to just jump in but I was reading your posts about all the trouble Bobo is having with his arthritis and I wanted to throw out another option in hopes that you can find something to help him that he can tolerate. There is a new medication out called Galliprant...It is much safer for the liver and it works differently than the other meds so it may be something Bobo can tolerate. We have had much success with it where I work. I included the link for it so you can take a look and see if it might be something you are interested in trying.

https://www.elanco.us/galliprant/vet/

[rainiebo]

Hi Stacey - thanks so much for the information - I'm supposed to hear from Bobo's vet today about the amantadine and will ask him about the galliprant. Do you have any idea how much the galliprant costs? Thanks for the post.

Raina

[Bodhi's Mom]

You're welcome. It depends on his dose but it seems to run about the same as the others (Deramaxx, Rimadyl). If his dose works out to be a half a pill a day it will be a little cheaper but still not a great deal.

[molly muffin]

Hi Raina, wow, the food after all this time. Who would have thought. It really is suckee that companies don't see to take as much care with making dog food as they should. :(

I hope you can get the pain meds tweaker or one that works best for him. It is really nice that he is taking walks again. One day this winter crud is going to leave and spring will be here. Crud that it is going to be rainy this weekend.

[rainiebo]

Agreed, totally suckee ! Walking the cushings walk with Bobo is for sure one day at a time. Hope all is going well for you ! Got the fan out for Bobo again - it is indeed getting to be that time of year again.

[molly muffin]

brrr, I'm still chilled from the cold spell we had on Wednesday. LOL But yea, getting to be fan time sooner than later probably

Things are going well, exhausted, has had a 5 year old little boy in the house the past week. Boy if I had his energy, I'd be good! LOL

[rainiebo]

Hi just checking in again - it's been awhile since I posted. Bobo is not doing so well right now. He's started drinking tons of water again. His vet had increased his Vetoryl to 90 mg a day. That worked for about 4 days and then he started panting heavily. His dose is now 60 mg but the water drinking is still there and he has the "skeleton face." Here's his ACTH number:

9/8/16 Sample #1 - 2.0> Sample #2 - 4.0

11/1/16 Sample #1 -1.3> Sample #2 - 3.4

6/8/17 Sample #1 - 3.9> Sample #2 - 4.1

I have his labs but don't remember what you would need to look over. The vet keeps going back and forth between 60 and 90 mg, but Bobo is just not doing well on either dose. He'll be o.k. for a day or 2 on either dose and then the panting and drinking starts again. Any ideas would be appreciated. Thanks and have a good Fourth of July

[molly muffin]

Sorry to hear that BoBo isn't doing so well. Anything off in his regular lab work? Has he been checked recently for a UTI?