New to Cushings

[Katy1]

Hi everyone...our Annie, miniature schnauzer was just diagnosed with cushings and she is also diabetic. Anyone out their who has a pup with a dual diagnosis?

[Squirt's Mom]

Hi and welcome to you and your sweet Annie! :)

First thing I want to do is send you to our sister site, K9Diabetes. They are the experts on canine diabetes. Once you are registered there, come back and talk to us more about the Cushing's...but diabetes will always take precedence since it is immediately life-threatening and Cushing's is not. So go register with them then come back here and talk to us, ok?

https://www.k9cushings.com/forum/showthread.php?9174-New-to-Cushings

Hugs,
Leslie

[Katy1]

Thanks Leslie, I'll do that and come back.

[Katy1]

Hi again... just an update on Annie. The hubby and I had a consult with the vet today and she may have been cushinoid for several years which triggered the diabetes. Her glucose has been very high and was considered insulin dependent. This is day 3 for her on 3/4 of a 500mg tablet of Lysodryn. She had been at their boarding facility because we had to be out of town last week and that's when they did all the testing for Cushings. Anyway, the doc told us he checked her fasting glucose this am before her feeding and it was down to 179--she weighs 18.3lbs, has been diabetic for almost a year and has shown no real physical symptoms of Cushings except for some weight gain and needing to go outside at night. He told us to leave her there another day and will check her glucose again tomorrow. They were not going to give any insulin today. He said once the Cushings is under control, that may keep her glucose down low enough that we might be able to get her off the insulin at some point. I realize this is the Cushings site and not the Diabetes site but they are so entwined it's hard for me to wrap my head around it all. Then to top it off, she had developed cataracts in both eyes several months ago and we were scheduled for surgery to remove those on the 25th. We've been advised to postpone that until she is stabilized. I'm just grasping for straws and reaching for moral support. I've had schnauzers for over 45 years but never have experienced Cushings so I will read all I can and check out the resources available here. Thanks.

[Squirt's Mom]

I'm glad she is with her vet and pray they can get things under control and help teach you how to manage both conditions. We are here to help with the Cushing's and K9diabetes will be with you for the diabetes. If you have any questions about Cushing's don't hesitate to ask and we will do our best to answer. The two conditions are definitely a handful together but I have full faith you will learn what is needed to give your sweet Annie the best life possible.

Hugs,
Leslie

[Katy1]

Hi All—Annie’s mom here with an update. After 3 weeks at the vet the drug finally kicked in. Her latest stim test was great and she is officially “loaded” on Lysodren at 500mg divided into two doses a week. Oh, sorry—still new to this, Annie is a 10 yr mini-schnauzer and also diabetic. Her coat is good and pretty good muscle strength. She’s drinking much less but her diabetes is also better. I’m going to start her on milk thistle to help her liver deal with the Lysodren. Any other suggestions for helpful supplements? Thanks for being here!

[labblab]

This is great news! You’ll see that I’ve moved your post over here to your original thread about Annie. This way, we can more easily track her entire diagnostic and treatment history. Because we are a nosy bunch, we’d love to see the actual numbers for her most recent ACTH stimulation test. However, just knowing that she’s looking and behaving a lot better is a huge relief.

I don’t have additional suggestions for liver support myself, but perhaps some of our other readers will have some thoughts. Thank you so much, though, for updating us. And we’ll remain anxious to hear how things are going for you guys.

Best wishes,
Marianne

[Katy1]

Her stim test #was down to 2 from 17:5 last week. I am concerned that it might be too low and push her into Addisons. I will give her Lysodren myself for the first time tomorrow and she will have another stim on Thursday. She never refused food to give them the signal that she was fully dosed, the little pig, so I’m sure there will be extra stims in our future and I ‘m ok with that.

Doc originally started her out at 375mg per week and then upped it to 500 when she wasn’t responding. He mentioned a target stim of 5 when we began so that’s why I ‘m worried that 2 is too low. I know from reading the literature that this stuff can build up in the body. Any comments would be appreciated and thanks Marianne for guiding me through this forum. Wish us luck for tomorrow. I just have fears she’s going to have a bad reaction to the pill. She eats a half a can of Glycobalance 2x a day and I will give her pill in a little “meatball” of her food first then let her finish. I know I over think everything and am a worrier by nature. Can’t help it—she’s my baby just like yours are to you all. Take care. Karen

[labblab]

Hi Karen, thanks so much for this additional information! I just have a couple of questions that’ll help clarify things. When dogs go through the loading phase for Lysodren, they are dosed daily, but this is what you wrote:


Doc originally started her out at 375mg per week and then upped it to 500 when she wasn’t responding.

I’m guessing you meant to say that, while loading, she was given 500 mg. per DAY. And now, she has shifted to receiving 500 as a weekly total, divided into two doses. For dogs taking Lysodren, the target post-ACTH result is between 1-5 ug/dL. So even though she falls within the lower part of the range, Annie’s indeed within the desired target. So that’s good. We’ll hope that the 500 mg. weekly total turns out to be the perfect maintenance dose for her, but that’s good that you’ll have the added reassurance of another test this week.

I have not used Lysodren personally, but one suggestion that occurs to me is that you may want to make sure that Annie finishes her normal meal before giving her the Lysodren dose tomorrow. If for some reason she is picky about eating, that may be a signal to hold off on the Lysodren dose. I know that this is an instruction that is typically given during the loading phase, but it makes sense to me to still follow it even after shifting to the maintenance phase. Hopefully some of our members who have had direct experience with Lysodren will add their thoughts about this.

Thanks again for returning to update us, and we’ll be anxious to hear how things continue to go.
Marianne

[Katy1]

Marianne, Thank you for the voice of reason and the ability to enunciate my garbled words which then made sense to me. I have no pride left at age 67 and need any advice I can gain from this forum of learned pup cusings parents. I feel much better with your affirmation of #2 as OK. This is my first pup developing cushings after 45 years of pups and I feel like a first time parent of a human infant in the ER because she/he vomited and I panicked. I am prepared to give Annie her first dose at home in the morning. Your feeding suggestions make perfect sense. I will let you know how the morning goes. Take care, Karen 0

[Squirt's Mom]

Hi Karen,

What is the dose of Lyso you are going to give her...or have already given her? How long ago did she have a dose at the vet's office? Typically there are a few days between achieving the load and starting maintenance. So if she had a dose at the vet's on Monday you would wait a few days then give the maintenance dose. The maintenance dose is not the same daily as was give at the vet's but rather that dose is divided. So if she was getting 500mg a day for the load from the vet then that would be divided into several doses over the week - ie 250mg twice a week or 125mg 4 times a week. In other words do not give her 500mg today.

You say she vomited....was that after she came home from the vet's? If so has she vomited again? How is her appetite this morning? Have you noticed any loose stools or diarrhea?

[Katy1]

Good Morning Everyone,

Just the basics first for anyone new to this thread. Annie is fully loaded on Lysodren and yesterday was the first time I gave the maintenance dose of 250 mg. since she came home from three weeks at the vet hospital. I gave it to her in a little meatball of her Glycobalance and then she gobbled down the rest of her breakfast. I was so concerned that she might have a reaction but all went well. I did notice that she drank more water than usual and she acted like she didn't feel comfortable lying down as she kept moving from spot to spot all morning. That made me wonder if her stomach might have been upset. My husband thought I was just imagining things. I thought Annie was going in for a stim test today but they are just doing a glucose curve as she is also diabetic. Not sure when the next stim will be but I'll be sure to ask later this afternoon when we pick her up. Sorry Leslie about all the confusion in my last post.

Now I have a question regarding the forum and what a "junior member" means. Do I need to pay a fee to be a regular member? If so, that's ok, and perfectly understandable in keeping this forum up and running. I only ask because I've tried to access the reading material and was told as a junior member I didn't have access to that as well as other information. I'm hoping someone will clarify this issue for me. My sincere thanks to everyone rooting us on and helping me keep my calm through the initial storm. Our journey has just begun and I know I can't do it without you all and your vast experience and knowledge. Take care. Karen

[labblab]

Hi again, Karen! The “Junior” vs. “Senior” designation stems solely from the number of times that a member has posted on the forum. I forget what the magic number is that triggers the changeover, but there should be no difference at all in your ability to access the material on the forum. It is free of charge to all members. So I’m concerned that we may have a glitch going on with the website, and appreciate you letting us know!

If you could possibly copy and paste the exact language of the warning message you’re receiving, that’ll help us figure out what’s going on. I’m so sorry about any problems, and we’ll try to get this straightened out ASAP.

Marianne

[Katy1]

Hi Marianne...the following is a direct copy/paste of what I'm getting. Thanks for the help. Karen

Katy1, you do not have permission to access this page. This could be due to one of several reasons:

Your user account may not have sufficient privileges to access this page. Are you trying to edit someone else's post, access administrative features or some other privileged system?
If you are trying to post, the administrator may have disabled your account, or it may be awaiting activation.
Log Out Home

[labblab]

Thanks Karen! We’ll definitely look into this!

[Budsters Mom]

I seem to recall the magic number which will change a member from junior to senior status is 100 posts. It's been a while, so I could be completely wrong. All posts count, whether you post on your own thread or respond to another member on their thread. You don't get a prize or any special link to material that the junior members cannot access. I have over 4000 posts over almost 6 years. I am still waiting for my PRIZE, it hasn't happened. LOL I think my prize is the fact that our administrators are still putting up with me for so long. So seriously, your status as a junior member shouldn't affect your ability to access anything.

[Budsters Mom]

I just read your update Karen. I have gotten that message many times. If your are on an IPad, clear Safar in settlings and close all open apps, which will remove all of those nasty cookies and restart. Do the same on a computer, except clear whatever browser you are accessing the forum from, then restart. Hopefully that will help.

Glitches pop up on this site from time to time. It has been touchy lately. Good luck!

[Katy1]

Thanks for the tech help and suggestions. I'll work on it tomorrow when I'm not so brain dead. Karen, Annie's Mom

[labblab]

Many thanks to Kathy for these suggestions. If they don’t help, though, let us know and there are a couple of other things we might try...

[Katy1]

I did everything Kathy suggested, cleared the cache, dumped the cookies, etc. then restarted my laptop and still no luck. It must be something on my end because it's happening on both my hp and ipad. I'm lost at this point. What else can I try? Thanks, Karen

[labblab]

OK Karen, I’m going to send you a private message to talk about another problem-solving option. We’re determined to get this figured out!

[Katy1]

Just a quick update. Tried to feed Annie her breakfast this am and she refused to eat—I mean flat out refused to even get close to the plate. She has only had two doses of her maintenance Lysodren so I called the vet. They said to bring her in so I quickly made her a day pack of all her supplies and off we went. She was also very lethargic and urinated a lot before we loaded her up. Her last dose of Lysodren was on Sunday and she ate okay last night. I’m scared and don’ know what to think or feel given my mindset of late. I have to take off for a Dr’s appt. this afternoon and it’s over an hour away so we won’t know anything until we get home later. My dread is taking over. Will update you later. Karen

[Squirt's Mom]

Let us know what you learn. We are right beside you even tho you can see us!
Hugs,
Leslie

[labblab]

Thanks so much for letting us know. I surely understand your worry, but you’re doing exactly the right thing by taking her in. If, by chance, her adrenal function has truly dipped too low, the vet will be able to immediately start giving her any needed steroid supplementation. So she’s right where she needs to be right now. And we’ll be waiting right here beside you for the next update!

Marianne

[labblab]

Still right here, awaiting word about little Annie. Hang in there, Karen!

[Katy1]

BIG UPDATE :o

For those of “our family” who are crying, or tearing up—that was me two nights ago---or those of our family who are rejoicing in a good day and crying tears of joy….let me recount the trials and tribulations of a day worth living with a newly diagnosed Cush pup—and a MOM who didn’t know any better. I laughed all afternoon at myself and I know my Gracie (departed 1-11-19) and big sis to Annie, was barking with laughter after a great 14 year run. I also saw this as a sign from Gracie to pull myself away from grieving her death and focus on her baby sis’s health and well-being. Bear with me as I recount the day to remember.

When I posted this morning, I was in process of rushing my newly diagnosed pup to the vet because she REFUSED her breakfast…Annie has never refused food--- including post HGE events and flu. At 8am, she presented as a sick dog who I feared was in some kind of “collapse”—(I don’t even have my terminology yet correct. My Hubby, Jerry and I took off and left Annie at the vet with her dog pack of food, insulin, eye drops, leash, water bowl, and blanket. After handing over my limp, quivering pup to the vet tech, giving her all meds taken “forever”, and becoming semi-hysterical, she said they would take good care of my baby. ( Now is the time when all of you have my permission to moan a collective, OMG—how pathetic).

Now, I digress to this past weekend. Wherever you are in the world, especially in North America, the weather has been horrible. The POLAR VORTEX hit us in Illinois, USA in early January. I digress further if you will forgive me. My little baby Annie, 10 yr. old newly diagnosed Cush pup has always been a snow dog. She is a beautiful black and silver miniature schnauzer being born and bred south of Tacoma, Washington. When I describe her as black and silver, I mean black as tar and her silver markings are as white as snow---when she’s clean. At diagnosis, her coat was as thick as a rug and still is. I’m thankful for that. Because of her thick coat, she has always loved snow---and as of this weekend, I can also add mud to her repertoire. I know many, many, many of our beloved pups love snow to some degree, but my Annie has always taken it to epic levels. This year after a record snowfall, brought her to the back door after she had figured out how to fully face plant her head in a bank of dripping wet snow. At this point I wish I could upload a photo right here, but I can’t, so just use your imaginations. Close your eyes, focus on a solid double pane glass door…then all of a sudden; a small black creature with a solid white, snow crusted face appears. You take a step back, then two steps forward and laugh until you cry. That was my Annie, the day after we put our Gracie down. I know that Gracie had all fours in that prank. On with this apparent never-ending-story. Annie’s face was so packed with wet snow that I just plopped her in my big pup-friendly single big kitchen sink and hosed her down with warm water until all the snowballs were melted. I also noticed that she had snow packed in her nostrils and I was able to easily remove that with warm water with the aid of a couple of baby cue-tip swabs.

Fast forward to this past weekend. Lots of rain, lots of mud on Saturday. For some unknown reason Annie decided to pretend the mud was snow and did another full-on, full throttle face plant head down in the mud. When I saw her at the glass door, I loved her more than life itself and I wanted to kill her at the same time. I let her stand outside while I started her bath, gathered up as many dog towels I could find, some shampoo and all the courage I could muster. At this point, one must understand that bathing a black dog covered in thick black mud is no easy task. Finally, it was over, and I could see her eyes again, however, I neglected to really look at her nostrils. Her wet black dog hair was partially covering her nose---that’s my story and I’m sticking to it, motherly guilt after the fact—and all.

Now it’s Sunday, her Lysodren pill day. This was the second maintenance pill I had given her at home. Everything went ok but I also noticed that she had mud stuck in her nostrils, mostly in the left one. Fortunately, our vet is open from 10-3 on Sundays, so I called and asked the safest way to remove the mud plug. This was totally different from the snow plug. At this point the mud had hardened and I didn’t want to shove a cue-tip up there and potentially cause more problems. They told me what to do and how to do it---but I didn’t, because I had been hit with the memory of Gracie’s death just two months prior. I spent Sunday night crying for my lost Gracie while watching a hockey game and reading through all the grief help I could on this site. It was very therapeutic--but not for Annie.

Now it’s Monday. I have a slight burst of energy and spent the day taking care of household business long neglected. Annie still has the mud plug in her nose and I am oblivious. She ate her supper, no problems.

Now it’s today, .. I worked hard on Monday around the house, Daylight Savings Time is NOT my friend, and I’m a tad late getting around to feeding Annie.
It was a little before 8am cst and Annie did not want to get out of bed. Her dad had let her out to potty about 5am. I fixed her breakfast and she did NOT want anything to do with food—not even the plate. She was lethargic, hubby told me that she had urinated a lot when he let her out and all I could think of was the totally irrational, “MY BABY IS GOING TO DIE NOW! I called the vet right away and asked if I should give her a Pred. tab and was told to bring her right in.

If you are still with me at this point in this saga, Bless You! The best is yet to come. I promise you will laugh.

At 8:53am this Tues. Hubby carried our limp baby girl into the vet’s office with me following in tears carrying her day bag. They knew we were coming and our favorite person in the office personally grabbed me for info to relay to the techs and the Doc. SPOILER ALERT!

She took one look at Annie and said to me…and this is a direct quote, “It’s her nose”—Did you look at her nose—it’s plugged with mud?” “She’s probably not getting enough oxygen.”

I didn’t know what to say, had no reply, no excuse, no nothing. All I could do was hand her the bag of stuff and off to my medical appointment over an hour away. My appt. wasn’t until 1:45 so we took care of some chores at home before we officially hit the road. At 12:03pm, (Hubby was a math major and can do quantum physics in his sleep but doesn’t have a clue how to operate the washing machine) Jerry suggested we call and check on Annie and see what her treatment plan for the day looked like. At this point, I can’t repeat the words to which I replied after I asked the question…”How is Annie doing?”(Too much silent profanity). The reply was from my favorite person at the vet clinic was, “I WON! It was her nose. The techs were very careful in removing the large plugs of dried mud from her nostrils and she is doing very well. Shortly after they finished, she ate her breakfast, her insulin shot was given and she has a wiggly tail whenever anyone walks by her special crate.”

At this point in the conversation, I’m filled with a combination of horrible guilt, the ultimate in embarrassment, and the biggest sense of relief that a human being is capable of. I’m now crying tears of joy that my little baby Annie did not suffer a life threatening event and laughing so hard at the same time because of my own “blindness in grief”. Then, in his own way, my loving spouse, now driving me down a semi-truck filled highway turned to me and said, “Don’t get so worked up about this, Annie’s fine, maybe sometime she won’t be, but now she is. Smile.” Some of the most profound words ever spoken to me. I love this man and I love you all for sticking with me through this long-winded saga.

On a technical note: while Annie was at the hospital today, I asked them to check her teeth, run some necessary bloodwork to see if she could have her teeth cleaned with anesthesia and the answer came back YES. She is due for a glucose curve on Thursday then we will make the appt. I also contacted her veterinary ophthalmologist and she is on the books for cataract surgery on May 17, 2019. Remember, I said, on the books….it will depend on her combined health at the time.

Today was a HUGE revelation to me as a new mom of a Cush pup, a renewed sense of hope…. the longest laugh at myself I’ve had in years and a very, very subtle—but paw firm message from my angle Gracie to keep vigilant eyes-on her baby sis. Message heard loud and clear Gracie—thank you.

Long story short---eyes, ears, heart on call 24/7/365. To everyone of all ages living with a Cush pup or any pup with issues or not. If you "see something, say something" to the person in charge of care. Wow, what a day, thanks for listening universe. Blessings to all, Karen

[Joan2517]

A great story, Karen! Part of being a mom to a cushpup is the , how shall I say it, completely irrational paranoia. Because we are always watching for signs, any little things will become HUGE. I can't tell you how many times I run to the vet now and am told there is nothing wrong. But after losing Lena, I don't take any chances with any of them. Poor Lee never saw the vet as many times as she did after she was diagnosed and on Vetoryl.

After we got Sibbie, which was so soon after Lee passed, if she burped I was at the vet. A few months ago our 15 year old teacup chihuahua, Doree would not eat. She threw up and had diarrhea. I told my boss I had to work from home because I was pretty sure she was going to die. Ran to the vet, they did blood work, xrays, full exam, meds for the diarrhea and vomiting. $660 dollars later it turned out to be just a stomachache. Everything came back perfect. But I figured the money was well spent because we knew she was in great shape for her age. The next time it happened I knew not to panic.

But that is the new norm for us. Watching, worrying, panicking! On the upside it means plenty of funny, embarrassing stories! Enjoying the everyday things! And being happy with a good day!

[labblab]

All I can say is, WHEW!!!! :):):):):):)

What a relief, and as Joan says, what a great story!

If you’re anywhere near as old as me and remember Joni Mitchell’s classic song, “Woodstock,” my favorite line (which I quote often) is, “Life is for learning.” And that it is, a thousand-fold. No matter what mistake I make, I try to tell myself that there was value to it, because now I learned something that I didn’t know before — and that’s one mistake I won’t ever make again! :rolleyes:

Please give Annie a big hug for us, and give yourself a “virtual” hug, too. Here’s hoping that today is a much calmer and happier day, all the way around!

[Katy1]

Greetings All,

I wanted to post earlier but my paranoia after our escapades of yesterday prevented me from doing so. However, enough of this day has passed that I feel comfortable in making this announcement: WE HAD A GOOD DAY! NOTHING HAPPENED! In fact, it was so good that I made a call to our vet clinic and told them. I could hear the laughter in the background but with my infamous reputation down there, I expected nothing less.

I think we are still fighting with Daylight Savings Time and it took Annie a little while to get herself going this morning but she finally plodded her way into the kitchen after I let the can opener on her dog food make a few extra laps. Today was her Lyso med day and of course my anxiety was running high. I did my best to pretend that nothing was different and she licked her plate clean and didn't even detect the pill hidden a a little meatball of dog food. I walked over to the calendar and drew a little heart.

Maybe it's my imagination, but it has seemed to me that on her Lyso med days, she seems to drink a little more water and requires a little more food. She also sleeps more. Is there anything to that?

As I close out the day, I just wanted to let you know that nothing bad happened at our house today---and I just know that you all understand how good that feels. Blessings and be well. Karen

[Squirt's Mom]

I don't remember Squirt having that reaction on her Lyso days but it could be my memory. :rolleyes::o I would think that is certainly possible however. When it's time for a dose the adrenals have already started to regenerate a bit which could cause a reccurence of the signs to a small degree. Then when the maintenance dose is in the system those adrenals calm down once again and those little signs disappear. So I wouldn't worry overly much about that...but GREAT JOB, mom, in picking up on that change! That is the sign of an observant pet parent which is the most crucial part of dealing with Cushing's.

Your story brought laughter to me and a memory of ONE of my own panics with Squirt. We were laying in bed one evening and I started rubbing her belly. I felt lumps up and down her belly where her teats were. It scared me to pieces! By midnight I had diagnosed breast cancer and was hysterical. I cried uncontrollably and hugged on her all night long so neither of us got any rest. I was at the vet's office as soon as they opened and a complete basket case as I told her vet, with whom I have a great relationship, she had breast cancer. He carefully examined her while I sobbed on the other side of the exam table then looked at me and said, "Those are her boobs, you big booby!" :D She had lost her pot belly and for the first time in years I could feel her mammary glands! Perfectly normal but we hadn't had "normal" in quite some time so I was not prepared for it at all! :D:D:D So, yes, I could SO relate to your adventure the other day....that is perfectly NORMAL for us cush parents and don't let anyone tell you differently. LOL For a long time I referred to these episodes as twitching and those of us who experienced them twitchers. So welcome to the Twitcher Team!

Hugs,
Leslie

[Katy1]

Leslie,

I am honored beyond belief to be invited into the “Twitcher Team”. I will wear my button with pride in the secure knowledge that I indeed am not alone in my eccentricities and total obsession with my fur baby and her total well being over my own. This will make me smile all day. Thanks for that. Karen

[Katy1]

Greetings to All,
Now we have a new problem. For the past two days, Annie has not wanted to eat her breakfast. She is on Glycobalance, one can a day divided between her two meals. Yesterday, I ended up sprinkling some ground up freeze dried chicken breast on top, and this morning, I used just a little bit of baby food turkey in broth and she picked around at that for awhile and finally ate everything. I'm scared to death for tomorrow though because it's her Lyso med day. I feel a call to the vet coming on as I type. My double concern is that she has been a diabetic for over a year. I’ve already left a post over on the k9Diabetes site.

My big fear is that she may be getting a bit too much Lyso and it has really suppressed her food drive. Annie has never missed a meal in her life, even after bouts of HGE earlier in her life.

Take care everyone and wish us luck. Karen

[Squirt's Mom]

I'm glad you have posted on the diabetes forum. Sometimes once the cortisol comes back to a more normal range the insulin needs to be decreased but I will leave that to the experts on our sister site. I wouldn't expect the cortisol to have dropped too low in the last few days since she saw the vet but that is always a possibility so keep an eye out for other signs such as loose stools/diarrhea or nausea/vomiting. Let us know how things are going when you can!
Hugs
Leslie

[Katy1]

Hi Leslie,

Well, I cried all the way to the vets office at 3 o’clock this afternoon. I cried the whole time doc was telling me that Annie was doing ok. He ran a bg quick test and an electrolyte panel. He told me he could tell that she was not overdosed on Lysodren and totally understood my concern and tears. Doc knows I’m a crier and mostly a hot mess if I feel my baby is having a crisis or not. He gave me a hug, told me I was doing more for my baby than most of his parents would( still not sure how I feel about that ). Anyway, Sunday is her med day, and doc said if she doesn’ want to eat—don’t stress, just let her plate sit for an hour or so, if she doesn’t eat, no Lysodren or insulin and. she will still be alive at the end of the day and to call him whenever I needed to. I do not abuse that privilege. Thanks for listening, Blessings to you all and your pups. Karen

[Joan2517]

I'm a crier too, Karen. Sometimes when I get there I am totally incoherent and can't even tell them what's wrong! They are used to it....the fear of not knowing what is wrong, even if you KNOW something is wrong is frightening. If only they could let us know so we don't have to guess.

The first night Lena was in the ER, I couldn't speak at all. I just sobbed through the whole evaluation with the doctor. I sobbed when I told her goodnight and left her. I screamed and cried the whole way home. The next day when I picked her up, I didn't have a voice and my eyes were so swollen from crying that I was afraid she wouldn't recognize me. Then when it happened again that night I couldn't even cry. I was totally in shock.

Some people are better at handling these situations. I don't happen to be one of them...

[Squirt's Mom]

You're doing really well, Karen. Our "breast cancer" scare was nearly 4 years into Squirt's diagnosis and you have just started this journey so don't feel bad at all for the twitching or tears...they are perfectly normal! :)

[Katy1]

Ok, I know it’s early this am where I am and I’m a basket case because my sweet little Annie is going in today for a dental cleaning under anesthesia. I’m so paranoid over this little pup, my hubby is about ready to put me out of my misery. Is this the twitcher team i’m speaking to? Between the Cushings and the diabetes forums, I’ve gotten lost, mis-placed my brain or lost it altogether. Blessings to you all and your brains. Crazy Karen

[labblab]

Yep, this is the twitcher team, alright! I’m up early, too, although you’ve got me beat by a couple of hours... I’ve got to take my senior nonCushpup Lab girl in to be seen first thing this morning for a weird growth on her eyelid that we just spotted this weekend. I know it will need to come off, and I’m just hoping it’s nothing bad. They’ll probably want to schedule a dental at the same time. They won’t do it today — this will just be the assessment. But I hate to even take her in for this part, because it’ll get the ball rolling. And just like you, I hate to think of her going under anesthesia and having anything done at all :-((((((.

So I’ll surely be thinking of you girls today and wishing you well. I know what a long day this will be for you. Come back any time to update us, OK??? We’ll be watching for you!

Big twitchy hugs coming across the miles to you,
Matianne

[Harley PoMMom]

Huge loving and calming hugs from me as well! I know how worried you must be about sweet Annie and we are here for you.

More (((Hugs))) Lori

[Joan2517]

Me too! I always get worried when they need anesthesia. I obsess over it for days! Lena and Doree went in at the same time when Lena was 14 and Doree was 11. Lena was getting dental work and Doree was finally being spayed. I went to work and was very unproductive. I was sure Lena would not do well because of her age, this was before we even knew she had Cushing's. My husband picked them up and when I got home from work I was sure Lena would be curled up in one of the beds totally out of it. Well, she didn't even come to greet me, she was so busy eating even though she had 11 teeth removed. She handled it just fine.

Turned out that Doree needed me more. I spent two days on the couch with her trying to keep her comfortable.

I'll be waiting for your news too!

[Katy1]

Thanks to all for the virtual hugs and well wishes for our dental day. I called the clinic to let them know she was on her way, reminded them that Annie needed her eye drops and salves administered during the day. and asked what time she was scheduled for her procedure. I should not have done that because I was told the staff was having a “career” day this morning and Doc wouldn’t get to Annie until this afternoon.

So now I have a big blanket piled on top of me while I think of my little baby stuck in the cage without any water or food, and no one around for company except her lamb chop snuggle toy. I think I really need to consider therapy again. I’m sure she will be fine—and I’ll keep that mantra going until she’s home. Hugs and blessings to all.Karen

[Katy1]

Oh Marianne, Gracie had one of those eyelid cysts a couple of years ago. I let it go too long and it finally popped on it’s own and bled all night. Of course, the hubby was on a fishing trip at the time, so I sat up with Gracie all night holding a hand towel over her eye. We have no ER vet here so Gracie and I, Annie rode shotgun, were at the vet office to help them open up at 7:30 that morning. Doc took her right into surgery and was able to remove it. I don’t remember what he called it just that it was benign. You and your pup will be in my thoughts today. Let us all know how it went. Karen

[labblab]

OK, Karen, counting the hours right alongside you! We’re back home, and yes it sounds like this is the same kind of eyelid thing as Gracie’s. Vet said it’s a benign plugged-up eyelid gland thingy (of course he gave a genuine technical name, but I’ve already forgotten it ;-). He said it may possibly shrivel back up on its own, especially after we treat it with some eye drops. But if not, it will need to come off if it starts irritating her eye at all. And he also said for us not to poke at it or else it’ll bleed all over — just like Gracie’s. So we’ll try the drops, but if that doesn’t help, it’ll be a removal and also a dental for our Luna. At least I can relax for today, though, and focus my attention on you guys! So keep the updates coming...

[Katy1]

Annie is home and is currently snoozing on the couch! I was thrown for a small loop. When the office called and said she was ready to be picked up, I grilled the poor new receptionist, who obviously hadn't been warned about me, about Annie's dental procedure and she told me that everything went well. Not good enough for me, so as I am in the middle of a little fit of a thousand and one questions, she said "i'll let you talk to one of the techs". Bless my hubby's head today in spite of his non-comforting comment this morning, he told them to call me at home and give me all the info. They called right away after he left with Annie and told me she was having some diarrhea and I asked about feeding, her insulin and if I should give her the Lysodren tomorrow am. She answered all my questions. And now the bombshell. When my little baby wobbled in followed by the hubby, he handed me the report sheet along with a copy of her dental x-rays which said: EXTRACTION At this point I'm thinking WTH? Nobody told me she had to have a tooth pulled, does she need to be on an antibiotic? I tried to call back an no one answered. so I left a message for someone to call me whenever they could. Hubby told me the tooth basically fell out on it's own during the procedure---just why could no one tell me after i asked an was told no teeth removed, everything was fine, yada,yada,yada.......Yes i'm ranting right now, but this is a safe place to do that, i'm asking for your patience as I dial myself down. ok big deep breath.....

[Joan2517]

Hahaha! You sound just like me! Only I would've called the emergency number and insisted on a call back. They must hate me...who cares. I spend thousands of dollars there and I expect them to respond to me whether I am being a nervous Nellie or a normal person. If not I will find one who will. I have four dogs, and will probably always have dogs...they won't want to lose my money.

[Katy1]

Hey Marianne, I'm very thankful for your news and you are such great parents to get on top of this right away. Gracie's happened like overnight, but in reality and hindsight being 20/20 LIFE got in the way of me taking excellent care of my forever Gracie. Doc did an excellent job with her surgery. I was so terrified she might loose one of her beautiful eyes--but it worked out well and she eventually grew back her long eyelashes. I hope the eye drops work for your big girl. Geez-- I miss our lab right now. Sable was my hubby's first experience into dogdome and she was a challenge until I came along and eventually got him on track. Now, you couldn't find a better pup pop anywhere. Luna is so loved. Blessings to all. Karen It's been a really long day.

[Katy1]

Hi Joan, I just typed something and then it just disappeared. Annie is still sleeping off her anesthesia, still has a little diarrhea but is drinking from her water bowl when awake. I don't think she is going to eat tonight and I don't know what to do about her insulin. Maybe nothing? Any suggestions from anyone out there? I know this is not the diabetes forum but I'm too tired to switch over. Such is the life with a dual diagnosis pup.

[Joan2517]

I am not knowledgeable about Diabetes, Karen (at least not yet). Someone will point you to the right direction.

[Squirt's Mom]

How is Annie doing today? It's not uncommon for them to have a bit of diarrhea after a dental...some of mine had it every time! It must have something to do with the anesthesia. I'm sorry no one got back to you about the insulin question but most of us don't have that experience so we are hesitant to offer input on things like that. We got your back on Cushing's tho! ;)

Hugs,
Leslie

[Katy1]

Hi All, sorry to bother you earlier but I was in my usual ”what do I do now” mode. Annie was supposed to get groomed today, but after her stress from the dental yesterday, compounded by the fact that today was her Lysodren day, I called early and rescheduled her for next week. She is so woolly and doesn’t even look like a miniature schnauzer anymore. But I didn't want her stressed any more then necessary. Sorry this is short--I'm just exhausted and need to figure out how to take care of myself.

[Squirt's Mom]

I hope you've had some time to rest and that Annie is feeling less stressed today. I also want to repeat what Marianne said on Jackson's thread - please keep talking not only on Annie's thread here but on threads for other dogs as well. It is the community feel that keeps this forum alive and we ALL learn by talking to each other and reading on the many threads open here. So don't worry about not knowing enough yet to talk....just keep your open and caring heart going for everyone here by sharing with others, ok?

Hugs,
Leslie

[Katy1]

Hi Leslie,

I’m doing better today and I really bless and thank you for the support and encouragement. I haven’t been MIA on purpose—just been spending most of my time over on the k9D site. Annie is scheduled for double cataract surgery with new lens implants on May 17th., so I’ve been trying to gear myself up for this next round. It was originally scheduled for the 24th of February, then everything fell apart with the new cushings diagnosis, and everything else. I do plan on posting about her surgery for anyone else with a dual-diagnosis pup, maybe in the “Anything Else” category or wherever you think might be more appropriate or helpful. The following actually needs to go there too but I need to vent now!

I have to tell you what happened to us last night. At about 9pm the doorbell rang, Jerry went to the door and two of our finest policemen were standing there with guns, badges and everything. I dropped my iPad and jumped to my feet thinking someone in the family had died and they couldn’t find us for some reason. Jerry invited them in and they informed us that the people who live behind us had accused us of poisoning one of their dogs! Annie was standing right by me, tail wagging and being a perfect hostess. I just burst into tears and said. “ How can they even think that? We Had to put OUR other dog down in January and now this little one has just been diagnosed with cushings disease plus she’s diabetic!” I think the older officer knew what cushings was because he told us he was sorry we were having to go through that. Both officers told us they knew we didn’t have anything to do the poisoning just because of the slope of the properties. If we has dumped anything into their backyard, it would have just drained downhill into ours putting our own dog at risk.

Now about the neighbor dogs. They have two beautiful dobermans and a darling long haired dachshund, who loves to run the fence with Annie. The dobermans, unfortunately have been trained as attack animals. Last summer, they also accused us of trying to poison their dogs with anti-freeze. Without being too graphic, I have reported them three times during the past two years for animal neglect and so has another neighbor. I know this is just payback but very upset and I was so scared that they might retaliate and try to poison Annie, I called them back over at 11:15 to check the fenced in part of the yard ( because I could see people peering out a window) and they didn’t find anything.

Anyway, I’m trying to focus on Annie and her needs. I did find out that the neighbor dog will be fine, for which I’m glad. I may not agree with the neighbors dog training choices, but I will never wish ill on anyone’s pet. They don’t train themselves—Blessings to all of you and your cushpups today. I’m especially thankful for this site as well as the k9D site today. Karen

[Katy1]

Well, I’m crossing my fingers, legs and toes before I key this in...but Annie has survived through another Lysodren day—so far anyway. Me, maybe not so much because my anxiety over giving her this drug starts running in hi gear the night before. To help soothe the soul. after she successfully eats her Lyso-laden breakfast, I’ve been playing a couple of my favorite tunes, Through the Rain—Barry Manilow and my all time favorite by Queen, Another One Bites The Dust. I can already hear the collective “groan” out there! I know I’m old and I have been blessed with a Cushpup in my care.

I do have a legitimate concern/question to throw out into the universe today. A couple of days ago, I was giving Annie a nose to tail check and noticed her nose seemed to be dry and cracked. I called docs office and they had a gel for that so now I ‘m trying to get her nose back in shape. Is this a cushings thing because of inflammation or is this a diabetic thing. I know I’ve crossed over to the k9D forum, but with a dual diagnosis pup, there are some days I don’t know where to turn. Can anyone give me some advice please. Blessings to you all and your pups. Karen

[labblab]

Hi Karen! Your question about the dry, cracked nose is a good one. I don’t have any research to cite, but anecdotally, other members have complained about dry noses in their Cushpups. My own Lab boy definitely suffered from a dry, crusty nose and he also developed very crusty pressure calluses on his elbows where they came into contact with the floor when he was laying down. I would put Vaseline on his nose, and tried to cushion his elbows with the tube part of tube socks.

Again, I haven’t seen dry nose specifically commented on in the literature, but hopefully other folks may share comments or similar issues if they’ve seen them in their dogs.

Marianne

[Joan2517]

Lena had the dry nose too, Karen.

[Squirt's Mom]

Several of my pups have had that dry nose and I use either coconut oil (which usually gets promptly licked off! LOL) or a salve I make olive oil and bees wax that has chickweed and calendula in it.

As for your music choices...."Another One Bites the Dust" is what I want played at my funeral! :D Everyone knows that plus it's written on my addendum sheets for my will along with my other song choices. LOL

[Budsters Mom]

Bag Balm works on dry noses also. It is safe if licked and has antibiotic properties to help guard against infection. You only need a very small amount a couple times a day.

[labblab]

Hmmm...Kathy’s reply made me scratch my head and delve deeper into my use of Vaseline. As it turns out, it probably was not a great choice on my part. Even though I’m unaware that it caused any problem for my dog, it’s not a good thing for a dog to be ingesting. So “nix” the Vaseline idea (and see, here I am correcting some misinformation of my own only a coupla days after our earlier conversation...;-)).

[jaxr0806]

Oh my gosh Karen, what horrible neighbors. Glad Annie is doing well. I know we are giving our pups different meds but I stress out every morning and I talk to myself while putting it into his food-hoping and praying the dose isn’t too much. Jackson has a very dry nose and some recent elbow calluses. I ordered nose butter and elbow butter which I think are supposed to be all natural. We have a really hard time getting it on his nose though.

[Katy1]

Hi All,
I decided to post here instead of posting on Simba’s Mom’s thread. After reading all the info there, I did take Annie to the vet to have her voice checked. I made a recording of her raspy bark and vocals with my phone that morning. After checking her out, the only information he could offer was perhaps some neuropathy starting in the muscles around her vocal cords because of her diabetes. He also reassured me that Lysodren would not cause LP and that was a condition seen mostly in larger breed dogs.

I also wanted to say “HI” to all my new friends here. You all have become a very special group of people to me and Annie. We will be facing some serious challenges in May, if all continues well. She is scheduled to have double cataract surgery with lens replacement on May 17th. My doc has worked with this ophthalmologist for years and thinks Annie will do well because her cataracts are not fully developed. I’ll be posting on the k9D site as well.

Because today was Annie’s Lyso day, I haven’t gotten anything done except dose in my chair and keep watch over my pup. She is sleeping peacefully in her bed with her head hanging over the side, her new favorite position, so my rational mind is telling me that she is just fine. I wish my rational mind would show up more often. Blessings to all today. Karen

[labblab]

Karen, thanks so much for your update about Annie. I was thinking about you guys heading in to the vet, and am relieved to hear that there doesn’t seem to be an acute issue going on with her throat. I hope everything remained calm and peaceful for you girls after you posted your note yesterday. “Calm and peaceful” is such a blessing for us all!

Hugs all the way around,
Marianne

[Katy1]

Thanks everyone for your suggestions on stuff for her nose. I finally found a nose/paw butter that is totally non-toxic and has no sugar in it. It’s called “4 Legger”. So far I ‘m pleased with the results. I also figured out a trick I’d like to share. Right after I apply it to her nose and she starts to lick it off, I put a little dab on each paw. This seems to refocus her and she starts licking it off her paws. By the time she’s done with her paws, the stuff has had time to absorb into her nose.

I’ve seen a big change in her nose. It’s still a bit rough, but the cracks are gone and we’ve had no more facials in the mud. I honestly think that was her way of taking care of a sore nose. Blessings, Karen

[Katy1]

Marianne,

I copied the following portion over here when I realized I had rambled on in the wrong thread. Sorry, I'm a bit scattered today.

I do have a concern regarding Annie—the past several days, her appetite has increased but so has her energy level. She has turned into this little creature that her dad and I don’t even recognize! I don’t know whether to be excited, scared, prepare for another panic attack or something else.

Do Cush pups return to a better version of their former selves once the meds are working? She’s on Lysodren 250mg twice a week and I can actually see what appears to be her waist. Should I ask to have her ACTH run earlier rather than wait until June? She just seems so “normal” and I’m almost afraid to breath. She even grabbed her favorite toy this morning after her Lysodren-laden breakfast and bounded up on the bed wanting her dad to play with her.

As always, Blessings to all and your pups. Karen

[labblab]

Hey Karen, good girl for copying your questions about Annie over here to her thread!

First off, I think it sounds great that Annie is rebounding with so much energy. Cushing’s can be such an insidious disease. The ill effects can accumulate slowly and incrementally, such that we almost forget what was once “normal,” or how our pups were behaving months and even years beforehand. So hopefully this will be a new, happily energetic normal for your little girl!

As far as the monitoring tests, I have never used Lysodren myself. However, in looking back through your thread, it’s not clear to me exactly when previous ACTH testing was done. One test was done to mark the end of the loading phase and the transition to the weekly maintenance dosing. But has any additional testing ever been done? If not, I think I’d rather test at least once again before June in order to have more peace of mind that this maintenance dose is really optimal. From the sound of things, Annie is doing great now with little worry that she’s dropping too low. But you also don’t want to let the cortisol start creeping steadily higher, either, such that you’d have to reload again.

Again, I am no expert on this. Leslie has had tons of Lysodren experience, so hopefully she’ll soon be stopping back by. But in the meantime, those are my two cents worth ;-),

Marianne

[Katy1]

Annie has never been tested since she hit her loading/maintenance dose back in February. At that time, Doc said he would want to test her again in three months which would put us in May. She is having cataract surgery on May 17th so when I talked to him before she was boarded last week, he suggested waiting until after her surgery and do it in June. I really don’t want to wait that long, especially in light of her newly found zest and zeal for food.

I’m just afraid to get too excited about anything that even remotely appears normal. I don’t want to jinx anything!

[labblab]

Again, I don’t have personal experience with Lysodren. But I think the general recommendation is that at least one monitoring ACTH test should performed within the first month or so of maintenance dosing. Here’s a quote from a classic textbook reference:


The recommended target range for good control of the cortisol production is a result of 1-5 ug/dl for both the pre and post ACTH stimulation test numbers. An ACTH stimulation test is done as soon as it is suspected that the dog is loaded, to confirm if a successful loading has been achieved. An ACTH stim test is done again after a month of giving the weekly maintenance dose and another ACTH stim test is performed after three months of maintenance therapy, to be sure that the weekly maintenance dose of Lysodren is correct for the individual dog. An ACTH stim test should then be performed every 4 to 6 months to monitor the cortisol production and to determine if any dose changes may be needed along the way. Any changes in the dog's eating or drinking habits or behavior should be reported to the Vet immediately and an ACTH stim test will likely be needed to check the dog's cortisol levels and to see if the dose needs adjusting.

https://www.k9cushings.com/forum/showthread.php?181-Lysodren-loading-Instructions-and-related-tips

If it was me, I’d actually want to have her cortisol level checked prior to the cataract surgery so that I’d have enough time to make any needed dosing changes beforehand. Regardless of the surgery, waiting a full four months prior to doing any retesting at all would make me very uncomfortable.

Marianne

[Katy1]

Yea—I’m pretty uncomfortable myself so I made a management decision to call the vet office tomorrow and ask for an appointment for a stim test. I appreciate your time in looking up that information for me!

[Katy1]

I knew this past weekend was too good to be true. I had just finished making the appointment for Annie to have a stim test tomorrow when no more than five seconds later, she pukes up a bucket os bile. Jerry had just started to prepare some ribs to go on the grill later and with Annie’s newly acquired increase in appetite, she was in the kitchen when she got sick. I told Jerry he needed too take her to the vet. She had her Lysodren yesterday and I remember watching her pawing at the snow ( we had about 5 inches of snow yesterday) and trying to nibble at some grass.

She was panting this morning and also wolfed down her breakfast. I’m in the middle of a semi-meltdown. I was told she has also lost a pound over the past week and a half. I really don’t know what to think. I now have the phone—actually both the cell and our land line as I keep an eye on hubby’s ribs. Will post any news later.

[labblab]

Aww gosh, Karen, I’m sure sorry about this setback. Of course, it’s always possible that Annie’s episode was unrelated to the Lysodren or her cortisol. My nonCush Lab has had a couple of massive vomiting episodes within the last month, for reasons that are a mystery. But I know you’re feeling worried and we’ll be anxious to get an update as soon as you know more yourself.

Hugs!
Marianne

[Katy1]

Well, doc did blood work which came back better than even normal She told me over a "three way phone call"--me hubby and doc that her sodium phosphorus or sodium something indicated that her cortisol was not too low----not what I'm worrying about right now!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Sorry for yelling. She puked again in the doc's office and they decided to keep her overnight not only to monitor her, but they can keep tabs on her glucose then run her stim test first thing in the morning. It's been years since Annie puked. She hasn't been in the trash, not been anywhere unusual---like out of my sight.

I knew this weekend was too good to be true. Well, my baby is in good hands now and believe it or not, I have calmed down. When Jerry came home he told me that the entire staff was asking how I was doing. They all know how I fall apart at a hangnail...let alone my little cushpup. I feel very pathetic at times. I love those people dearly.

I have no numbers to post yet but will do so when they become available to me. Blessing to you all and your pups. Karen

[Katy1]

I need your thoughts and prayers today. Annie took a big turn for the worse overnight. Doc called this morning and told me that she has developed not only pancreatitis but her gall bladder is twice the normal size and she has a full blown mucoscele(sp?) or a complete blockage of the bile duct.

How can this happen overnight? Her blood work looked good yesterday and this morning her liver enzymes were over 1000! If she doesn’t make some improvement in 24 hrs. He told me we might have some tough decisions to make—and we all know what that means. I’m just beside myself! I’m so scared I’m going to loose my little baby. There is a specialty clinic in Chicago we will take her to if she rallies enough that we can make a 2 hour drive with her. Blessings to you all and your pups. Please give everyone you love an extra hug today. Life is so fleeting.

[labblab]

Oh Karen, I just got home and am speeding healing prayers your way! I’m so sorry!! I’ll keep checking all day for more updates. No matter what, please don’t blame yourself in any way. I doubt that this is Lysodren related at all. Cushing’s dogs do seem to be more vulnerable to the development of mucoceles, and it’s nobody’s fault. It just happens :-((((.

Whenever you have a chance to check in, please do, OK? Your K9C Family is right here alongside you. If you do head to Chicago, drive safely! I know how hard it is to try to calm yourself in a situation like this. But you and hubby need to stay safe, too.

Hugs, hugs, and more hugs,
Marianne

[jaxr0806]

Oh Karen...I am so sorry to hear of the new obstacles you guys are facing. I am definitely sending healing prayers and all good thoughts your way.

Where is the specialty clinic? I live in the Chicago suburbs and am curious where you might be taking her.

Like Marianne said, please update us when you can.

[Joan2517]

Oh poor Annie and poor you, Karen...Cushing's is such a roller-coaster. We're up, then we're down. Just when you think things are going good, it changes. I'm praying for you and dear, sweet Annie that this is just one of those drops that will climb back up quickly. We are all with you...

[Katy1]

Well, Doc finally called me back at a little past 9:30 this evening. He told me that Annie did not vomit today. I should hope not because she has no access to water or food. Plus they've had her on Cerenia which is a wonder drug to me for tummy troubles. Any way, the goal for tomorrow is to see if she will drink on her own. If she does, they will offer food. They did not give her any insulin today and hopefully, she will eat a little something tomorrow so they can give her insulin. Doc said his goal is just to let everything settle down. That also means no lysodren tomorrow and I forgot to ask him about that but if she misses a dose, I don't think it's going to matter.

I'm just dumbfounded how my little happy pup could act so healthy and fine one day and be on death's door the next. Is this how Cushings acts? Oh, Julie, the ER Clinic we use in Chicago is Blue Pearl in Northfield. We had Gracie there for a consult on her gallbladder several years ago. When we lived in Kansas City, I swear we either bought them a new wing to their building, or at the very least added a bathroom after spending close to a b-zillon $ over the course of three non cushpups. But they were the best...anytime day or night and I spent plenty of nights dosing on their couches. I'm exhausted but please give a hug or a kiss to those you love. for or no for. Life is so fleeting.

My big worry now is Annie's gallbladder. It's twice the normal size and I'm just praying it doesn't rupture during the night. She is so sick and we miss her so much. The tears are streaming down my face right now...I hope I don't short out the keyboard. I just don't want her to die without me there with her. I know she has her favorite snuggle fur toy but it's not me. I just want to be with her curled around her keeping her warm and safe.

This is just not fair and I'm very angry right now at the universe. Have I not been tested enough when I had no choice in January but to put Annie's big sis Gracie down. I'm still grieving her passing. Now I'm facing the reality that we may loose Annie.

If the worst happens, I will be pup-less, I just can't imagine my life without a pup. I've had pups for over 45 years and I don't know how to live without a pup. My pups have kept me alive when I didn't think I would make it. I'm just a hot mess right now. Again, I please ask you all to give everyone uou love, especially your pups a big hug or kiss' Life is so fleeting. Blessings to you all and your pups. Karen

[Katy1]

Oh, I meant to say through the tears how much I appreciate you all hanging with me even though I'm a "newbie". I feel so surrounded with sincere concern and support it's such a blessing. As always, Blessings to you all and your pups. Karen

[labblab]

Oh Karen, I’m up now too and awaiting your morning vet update right alongside you. I’ve got all fingers crossed, that’s for sure. Just remember, no matter what, you’re not alone, OK? Annie’s in the skilled hands of the vet and we’re right here with you, our prayers continue to flow...

[Katy1]

Marianne,

Thanks for being there with me... I’ts only 6:39 am here in Illinois and I’m just praying that they find Annie alive when they open at 7::00. I have all phones on board but I do not want any phone to ring until about 10:00am. I wish that I had some more numbers to post for anything. All of you are so good at interpreting for those of us ( I’m just referring to me right now because I’m such a mess ), who are new to cushings. I’m so appreciative for your collective knowledge and support.

How could happen so quickly? Doc can’t even answer that question for me and he’s had much experience with cushpups over his 35+ years of being a vet.

I have so much anxiety right now and so much I neeed to get done around the house today. All I can see right now are Annie’s toys on the floor from her big energy surge over last weekend and all I want to do is sit in my chair with a blanket over my head and cry. Blessings to you all. Karen

[Katy1]

You all know that I should be “committed “ into some kind of mental facility about now—It’ 7:28 right now and at 7:33 I’‘m calling the the clinic. From what I ‘ve read about mucocels, the the ABVS __american board of Veterinary surgeons recommendes surgery at the first sign of blockage.

All I want to do now is throw her in the car and make a mad dash for Chicago for surgery. I know I can’t do that yet because she’s not stable enough to travel. I have turned into the “Straw Man” from the Wizard of Oz—-if I only had a brain. Ok now,it’s 7:42 and no phone calls yet.

My sincere apologies to all the rational out their in the world today. Blessings, Karen

[labblab]

I totally understand. My husband can successfully compartmentalize. I cannot. At all. When I’m anxious and worried and sad, my feelings bleed all over anything I try to think about or accomplish and can totally paralyze me. I wish I had some great suggestions to help soothe you, but as you can see, I’m pretty hopeless in that department myself. But if there’s any truth to thinking that misery loves company, at least you’ve got me here for company. 100%!

[Squirt's Mom]

Hi Karen,
I'm just catching up with everything going on with Annie. My goodness! I would be a basket case myself by now so to me your reaction is perfectly normal. Prayers rising for the very best news this morning. Please let us know when you can.

Oh! I wrote a post to you about Lyso usage and it's not here...or anywhere else that I can find on the forum. So apparently I did that while my mind was not with me but off on its own somewhere. I'm glad Marianne gave you the pertinent info!

Hugs,
Leslie

[Budsters Mom]

Hi Karen,

From experience… If you think that you're going crazy and should be committed, you are most likely perfectly fine and are acting entirely normal. The ones that are truly mentally ill, ofen believe they are perfectly normal. Weird huh? You are distraught to the point where it's hard to function, which is totally understandable under the situation.

Many of us understand the waiting and feeling helpless, with regard to our fur babies. Know that you are not alone. Please update us when you can.

[Katy1]

Just a quick update on Annie. We are on the road to Chicago to hand the baby over for potential surgery tomorrow Will keep you posted. Please keep those positive vibes coming our way. We really need it now. Blessings to you all and your beloved pups. Karen

[labblab]

For sure, a multitude of positive vibes being sent! Drive safely, and know that we’ll be sitting right beside you the entire way...

[Katy1]

We made it through the horrible Chicago traffic to the Blue Pearl specialty clinic in just a little over two hours. Annie slept all the way and we got her checked in but we won’t see the surgeon until tomorrow. They will do another ultrasound and all the blood work in the morning.

It absolutely killed me leave to her there. I just felt like my heart was being ripped out. Our regular doc at home did go ahead with the stim test but we were in and out of there so fast I grabbed the printouts and didn’t even try to look at them so I have no numbers to share. The clinic here in Chicago has copies of everything they need so I’ll ask the dr. tomorrow if I remember.

Oh, Julie....we are up here in Northbrook or maybe it’s Northfield. Jerry told me we are about a mile or so from Lake Michigan. You probably know where we are—I don’t have a clue.

The doctor we saw this afternoon told us all the bad stuff that could go wrong with this gallbladder surgery and displayed absolutely NO compassion for us whatsoever. Oh man, I thought I was going to come unglued! At some point, I will be having a serious discussion with whoever she reports to. We have worked with the surgeon before when we needed a consult for Gracie about 4 years ago and he a great guy with a lot of heart.Well, I ‘m exhausted and my feet hurt. Thanks for being here for us and our little pup. Blessings to you all. Karen

[jaxr0806]

My heart is hurting for you guys but try to stay positive. I know...easy for me to say but Annie will need your calm energy today. I do know where the clinic is. If I didn’t have to go to work today I would head that way to lend some support and distract you for a bit. Sending hugs and prayers!

[labblab]

Thank goodness you’ve already met the surgeon! My heart will be with you guys all day today. When you see Annie today, please give her a gentle hug from all her family here. We’ll surely be awaiting your news.

Marianne

[Squirt's Mom]

Sending prayers, hugs, and gentle belly rubs your way! Hang in there even tho I know how scary it is. You are doing the best you can for your precious girl and she knows it....as do we. Let us know when you can.

Hugs,
Leslie

[Harley PoMMom]

Positive thoughts and healing prayers coming from my home too...sending love and hugs, Lori

[Katy1]

Annie went in for surgery about noon today. She’s been in for about 30min and so far so good. No news is good news. Met with the surgeon earlier and he was very confident for her outcome but was also very realistic because she is such a high risk patient. I’m so grateful for all your thoughts today. Go hug a pup from me and Annie. Blessings to you all. Karen

[Katy1]

Annie was out of surgery about one and visited with the surgeon. He was pleased with how everything went but reminded us that the real work was just beginning. We are now on guard for the next 72 hours. He was very glad that we got her here when we did. Evidently. Her little gallbladder had ballooned to the size of a small grapefruit and could have burst at any time.

We were able to go back into the ICU right away and she was already starting to regain her bearings. She has a special warmer in her cage, a feeding tube so they can get groceries in her as soon as they feel she’s ready. She recognized my voice and looked up at me. Tears of joy have been flowing all afternoon! We just gave her a quick pat on the head and then got out of everybody’s way so the techs could do their job. I ‘ve never seen that many people fuss over a pup. There had to be six people assigned to her at that time. We will have to mortgage the 4 grandkids to pay for this one but knowing that we were able give her a new lease on life was worth every penny. The alternative was not acceptable.

That’s the update. We’ll stay over one more night, go home late tomorrow and come back for the day on Sunday. Blessings to you all and your pups. Karen

[Joan2517]

I'm so relieved that she made it through the surgery. I have been trying to distract myself all day. Praying that she will continue to recover....

[Budsters Mom]

So glad to hear that Annie pulled throught the surgery. You are doing all you can for her. Baby steps now. Many of us have spent our family's inheritance and then some, on our fur babies. We do what we can.

Hanging with you as Annie continues to fight.

[labblab]

Thank goodness!!!!!! And now we take things one step at a time, but the first milestone is now behind us.

[Katy1]

Oh, I also was able to visit with an internist today who was assigned to Annie’s case. She was supposed to get her Lysodren on Wednesday but that didn’t happen and she told me not to worry about missing the one dose and she will monitor Annie very carefully and may readjust her Lysodren days depending on when she starts eating on her own. She “promised me that I would not have to suffer a “reload” again, at least not on her watch. That made me feel much better. She also told me to ignore the stim test that was on Monday before she got sick because her numbers would have been all over the place.She did suggest that we have it repeated as soon as the rest of her numbers look normal.

Jerry and I got to visit her in their ICU this evening. We we able to get down on the floor and through all her drugs, she recognized our voices and stood up on wobbly legs and the vet tech said that was a very good sign. Once again, the tears of joy are flowing freely. We’ll spend some time with her, only if it’s for five minutes , before we head home tomorrow. Everyone enjoy a blessed weekend. Karen

[jaxr0806]

Such good news! It sounds like she is in great hands and will be back home recovering soon. One day at a time...I have to keep reminding myself that I just need to tackle one day at a time.

[labblab]

Oh that is indeed such good news! And the internist is spot-on re: that ACTH test — the numbers will likely be quite unreliable given how ill Annie was at the time. So don’t even give them any thought at all. It’s great that the internist is on Annie’s case. That gives us all so much more peace of mind!

Marianne

[Squirt's Mom]

What great news this morning!! Way to go, Annie girl! (and mom and dad!) The IMS is spot on....that ACTH is worthless and she doens't need the Lyso right now anyway...it might make her sick at her tummy and that is not what she needs at all right now. So waiting is good. Even if her cortisol does elevate a bit that can be gotten back under control pretty easily most of the time so don't worry about that. I am just so happy to read your updates. YAY!!! :cool::cool::cool::cool::cool:

[Katy1]

Hi, Just a quick update on Annie. We visited her at the specialty clinic in Chicago this morning before making the two hour drive home. We expected to be taken back to the ICU to see her but low and behold, they led us into an exam room and shortly after, in waddles Annie on all fours lugging her little heart monitor power pack on her back and still sporting the feeding tube in her nose. We just cried for joy and spent a few minutes loving all over her on the floor before she was led back to her special cage. They are weaning her off the heavy duty IV pain meds and keeping all fluids and blood pressure in check.

She is starting to eat baby food and a few small bites of chicken. They are going to let her eat anything she wants and regulate her insulin as needed. Not sure when she’ll receive her next dose of lyso. I’m sure I ‘ll be given a boatload of instructions regarding her insulin and any changes in regulation of the Lysodren when she is released.

She will need to be on a very low fat diet once she is home. The doc said she eventually wanted her back on the Glycobalance which I was glad to hear.

Annie may be well enough to come home on Sunday or Monday. She has had no complications so far but I think we got her there in time and were very lucky. So far, she is our little miracle pup in spite of all the strikes against her. Blessings to you all and your pups. Karen

[Joan2517]

That is such good news, Karen. This is hitting so close to home for me that I am hyperventilating.

[Budsters Mom]

Great news indeed!

[Katy1]

Oh Leslie, the surgeon told us yesterday after her surgery that he would be giving her something to actually give her a boost of cortisol to help her along. I’m just amazed at the level of care our little Annie is receiving. Yes, for many people it’s very expensive and I make no judgements on choices that have to be made—because whatever choice we make for our pups will always be the right one for you you’re pup and your family. I’ve been forced to make the tough decisions in my past and it’s gut wrenching hard. I just feel so blessed right now that she is recovering and if we should have her for only a short time post all this, it was still worth it. No regrets. Blessings to you all and your pups.Karen
I


I just want you all out there in whatever part of the world you reside, we all understand, their are no judgements and you will do the best for pups however you can.

I will be very honest about Annie’s surgery. Yes, it was very risky and very expensive. Most people would have elected to put their pup down. We have never had official pet insurance but we always put money away in case we needed it—and wow, three angel pups later,we exceeded our limit. Annie may be our last pup,which is very sad for us, but somehow we were able to pull out all the stops for our little one and give her a second chance at life, for as long as we have her.

,

[labblab]

So, so, so grateful to read your updates, Karen! As soon as my eyes open each morning, I grab my iPad and rush here to see what’s happening. I pray that Annie will continue to grow stronger today, and that tomorrow you’ll be bringing her back home again. I’m guessing today may crawl by way too slowly for you, but we’ll be trusting that each hour that passes will continue to fuel your baby’s recovery.

Hugs of healing comfort being sent to you all three!
Marianne

[labblab]

Been thinking of you guys all day, and surely hoping that things are going as smoothly as possible.

Continuing hugs and prayers heading your way...

[Katy1]

Greetings to all and good news to share. Our little Annie is finally home! The surgeon released her this morning and we drove to Chicago to pick her up and we were home by four this afternoon. We also came home with a full pharmacopoeia of goodies.

I was really worried because I was instructed to give her the Lysodren when I fed her this evening. She was also supposed to have a pain med, an antibiotic, and now I can't remember the last one....all with her food. She wobbled out soon after she heard the can opener. I started her out with just a quarter of what she normally eats and she basically inhaled it along with a couple of the pills. When she finished, she looked at her empty plate--looked up at me---looked at her empty plate, then looked up at me. Well, she got a second course along with her lysodren and that other pill. After she snarfed the second helping, her eyes looked up at me and said, "more mom". Well, I didn't want to overdo a good thing but she did get a small third helping and then I could tell she was done. I got her outside and she did her business, got her back inside before the pain med hit her and knocked her out for the evening.

She will have the staples out in 10-14 days by our regular doc so we don't have to go back to the clinic in Chicago unless something happens that he can't handle. We are not out of the woods yet but we're off to a very hopeful start. I don't think I could have made it through this without my new cushpup family. Blessings to you all and your pups. Karen.

[labblab]

Awww, what great, great news for sure!! ;):):):):)

Surely hoping that things just get better and better from this point onward. Please give our brave little girl some big pats from her family here!

[Joan2517]

That's such good news, Karen! I'm so happy for you!

[Squirt's Mom]

Oh YAY!!! I was so hoping to hear from you today and the news is just wonderful! :cool::cool::cool: A healthy appetite after surgery is a good thing in my mind and I pray her recover is swift and uneventful from here on out.

Hugs,
Leslie

[Katy1]

Oh, Leslie, I ‘ve been thinking about you. I think you are one of a handful of people on this forum who has experience with Lysodren. It seems like everyone else has their pup or pups on trilostaine(sp?). In fact, the internist at the specialty clinic in Chicago was trying to talk me into switching Annie to trilostaine. I was paying for her advice by the second so I didn’t get into it with her. So far and #1—- I’m just thankful that I could bring Annie home alive. This may sound morbid, but we took a large cooler with us in case she didn’t make it through the surgery and we would have to pack her in ice to bring her home for cremation. I know that sounds so morbid, but she was so sick and I was just planning for the worst

Basically, she seems to be tolerating the Lysodren ok and my vet is not comfortable with trilostaine. Any advice on the topic? Blessings to you and your pups. Karen

[Katy1]

Hi Everyone,

I almost hate to say this but we’re having another good day. I felt so overwhelmed with all the drugs the clinic sent home with Annie, I wasn’t sure I could figure it all out.

The hubby had to go fishing this week and I’m sincerely happy that he finally got to do something for himself. He is the best doggie dad ever and doesn’t even blink an eye when I say the dreaded words,”we need to go to the vet”.

My little patient Annie is currently out cold on the Lazy Boy couch beside me. She has just been so good and seems to even understand her restrictions—-like no jumping, no running...the usual post surgery stuff. If she needs a drink of water and she’s on the couch, she will just sit up and look at me. That is my cue to gently lift her off and after her drink, if she wants back on the couch, she will walk toward it but not even attempt to jump and wait for me to lift her back up.

I hate e-collars but Annie has needed a soft one to keep her from licking her line of staples. She is slowly adapting to that. Before this emergency surgery, we had been preparing her for cataract surgery on May 17th. You won’t believe the phone call I received yesterday afternoon.

The call was from Annie’s ophthalmologist’s office. We have had to postpone this surgery twice and now I was going to have to do it again. The universe always has it’s own plans.

The Doc had to have foot surgery last week and had run into some complications. I told the receptionist what had happened with Annie and she almost couldn’t believe it because the specialty clinic where Annie was and the hospital where her eye doctor is are jut a few miles from each other. Anyway, we will tackle the cataracts in the future.

This morning, after Annie’s breakfast, She had to go outside. I carried her down the one step and placed her paws on the wet grass. She didn’t move for probably 3 minutes as. I shivered in my bathrobe watching her. It rained last night and I’m just guessing that the cool damp grass felt good on her feet.

Joan and I have a discussion going on my gratitude thread regarding the value of a really good poop in a pup so I won’t rehash that here. Anyway, after Annie did her business, I got my phone and went out to take a pic to show the vet on Thursday.

We have been through some major struggles lately, but I can’t help but think that our angel Gracie has had a paw in the extraordinary recovery of her baby sis.

I’m getting ready to call the specialty clinic in Chicago to see if they have any results from the biopsies they took during the surgery. Thank you all again for keeping us in your thoughts. You have no idea how much it means—-well, I take that back because you do know. Blessings to you all and your pups. Karen

[Squirt's Mom]

Sorry for the delay in replying and I don't have long now sadly but I am among the oddballs that prefers Lysodren to Vetoryl and don't see anything changing my mind. I have used it in both my dogs even tho the second one didn't actually have Cushing's as proven by her necropsy (autopsy for animals). Lysodren works ONLY on the adrenal glands while Vetoryl (Trilostane) works on the axis, or loop, between the pituitary, hypothalamus, and adrenal glands...and many other things operate along that axis such as those that have to do with stress responses, glucocorticoid responses (in addition to cortisol), and hormones for example. Since Annie's vet is more comfortable with Lysodren that is the drug you want her to have - the vet's comfort level is very very important. When I moved back home and started looking for a new vet for my Squirt every single vet told me they would switch her to Trilostane and I walked out the door. She was doing very well on Lyso and I was not changing her for anyone or anything. I ended up choosing a vet who knew nothing about Cushing's, educated him with the little I knew and told him where to find the rest of the information he needed to learn about Lyso and Vetoryl as well as the disease itself. He now has many cush babies and uses both drugs. Some vets still fall for the hype that Vetoryl is "safer" than Lyso - it is not. Both have the exact same risk factors up to and including death if not properly prescribed and monitored. But both are life savers in the right hands. Annie's vet is comfortable using Lyso so that is where I would stay no matter what anyone had to say. You are a great mom and I know you watch her like a hawk -which is a critical factor when using either drug so I have complete faith you will do just fine with the Lyso.

Hugs,
Leslie

[Katy1]

First of all, Leslie I totally agree with you on everything.

Now for my update on Annie......she’s doing too well but I wouldn’t have it any other way! I think she has eaten enough at home and she has more energy and thinks she can leap tall buildings in a single bound. I could not even take a bathroom break today without worrying where I would find her when I came out.. She has jumped, barked at the neighbors, tried to play with her favorite toy, jumped in her favorite chair.....the list goes on and on all with her e-collar on, and I’ve had very little sleep in 48 hours. Her dad is fishing the Detroit river this week for Walleye....so I’ve been here with my post-op baby by myself.

Actually this is much better for me because now I only have one “Baby” to care for instead of two. I love the hub but sometimes I need a break and he needs to go fishing. End of story.

Thursday is Annie’s Lysodren day so I’m already a mess and trying how to figure this in with all of her other meds.

I can do it, i’m her mom. Blessings to you all and your pups. Karen

[Katy1]

Annie and I both overslept this morning. She inhaled her Lysodren along with all her other drugs while I was standing in a corner of the kitchen holding my breath. I really hate Sundays and Thursdays. I gave her a pain pill about 30 minutes ago and she is passed out cold in her bed where I can see her. We have an appointment with doc’s other doc this afternoon at 4pm for a check up. I’m just glad the Lysodren is over until Sunday. Blessings to you all and your pups. Karen

[Harley PoMMom]

Good luck with the doc appointment, let us know how it goes, please!

You're doing a great job!!!!

[Katy1]

Well I had the experience of a lifetime this afternoon when I took Annie in for her check up. I have non-diabetic peripheral neuropathy in my feet, so just to be on the safe side, I called the desk to let them know we were there and all of a sudden three of Annie’s favorite people were at my car to help me in but most importantly to carry Annie inside. Jerry is on his way home from fishing and I know Annie is going to rejoice in her dad being home.

Back to my story, once she was weighed and we were in an exam room, all of a sudden everyone in the clinic was there to greet Annie and welcome her back. There were probably 25 people in this small exam room—- and then they brought in her boarder buddies— there was cupcake and all her small dog friends. Even dr, Elizabeth’s pup was there to greet Annie. I was surrounded by people and pups who truly cared about my little miracle. Poor Annie was overwhelmed and spent her welcoming by my legs.

Everyone there thought she was a dead dog when they handed her off to us last week.for our 2hr race to the specialty clinic in Chicago.

Finally ,the results of the check up........she is OK...........and is the proud owner of 33 staples! A new record for our local clinic. She is a small pup who has also lost weight and could be a poster child for starving refugees The doc and I looked at her diet and decided to double her grocery basket and she was a happy hungry baby tonight.

I have to say right here right now, never give up on your pup until he/she gives you that look (we’ve all been there before
that tells you it’s their time. Annie at age 10 now has a second chance to chase robins and to live her complete life, however long that may be. I just feel blessed for our local clinic—she’s a celebrity in our little town. More than that she is my hero....she never gave up on herself and we never gave up on her because she never gave me the “look”. Blessings to you all and your pups.

[Joan2517]

What a sweet story! That's the way it should be.

It reminds me of when our six year old Saluki, Isis, who had canine lymphoma, had to stay over at Manhasset Animal Hospital way back in 1996. She had gone into remission after the first round of chemo, but it came back a few months later and she was severely dehydrated and needed to be hospitalized. She had been getting the chemo there so everyone knew her. They wanted to know what she would eat. Now my Isis was very spoiled, did not like dog food at all. The one thing she especially loved was roast pork fried rice. Her vet, Dr. Hendrickson went out and got Chinese food for dinner that night and got Isis her fried rice and sat with her and ate his dinner. Now that's what I call excellent service. Isis died a few months later, one week before she turned seven, and they were all devastated.

When we moved away, we started using the vet we have now, and I don't get that level of care. They are good, but that personal touch is just not there. Sometimes I wish I had continued to use my other vet. They are like a half hour away, instead of 10 minutes down the road. I wonder if Lee would have lived a little bit longer. He always met me at the office, no matter what time or day it was, and he had someone living upstairs so I wasn't afraid to leave them. This vet has no one there at night and I would never leave any of them there.

There are times that I wonder if I should go back to them....

Your vet sounds wonderful and you are lucky to have them.

[Squirt's Mom]

What a great story! I love it and love how everyone rallied around our sweet Annie! (and came to help you!) A compassionate, caring staff like that is hard to find and a true treasure when one does find them. What a blessing to Annie and to you. I am so glad she got a good report and KNOW she is gonna enjoy that increased food!!! What cush pup doesn't DREAM of that?! LOL :D:D:D

Continued prayers for sweet Annie and her mom and dad!
Hugs,
Leslie

PS I hope hubby brought home a lot of good CLEANED fish ready for the freezer! :D

[Katy1]

Oh my gosh...I need to send instant hugs out to ,Marianne, Joan and Leslie. I know you take your responsibility as a moderator seriously. You have been there for me and my little baby,Annie from the be beginning of our journey. And you all are still here,not only for me and Annie but for everyone who has a pup in need. I’m personally grateful for your collective knowledge and dedication to this forum.

To everyone else who is watching, reading learning....you have come to the best place on the internet. No question Is a ‘stupid’ question....ask away and you will learn. Blessings to you all. Karen

[Harley PoMMom]

So glad to read that Annie's check-up went well! And WOW, 33 staples!!!!

[Katy1]

Hey everyone out there, it’s just me having a little panic attack. It is cool outside, it’s cool in the house and Annie is panting up a storm. I have given up on trying to keep her from jumping on or off anything....but right now she just had a big drink of water and she is sleeping beside her water bowl. What am I supposed to think, what do I need to do? Now she just flopped over on her side which tells me she is comfortable. She is due for a pain pill in about 40 minutes—does panting in a Cushpup indicate pain? Help somebody! Blessings as always. Karen

[labblab]

Hi Karen. Excessive thirst and panting are common symptoms of elevated cortisol levels associated with Cushing’s. I don’t believe the panting reflects pain, per se, but instead is a response to the body being in a consistently “stressed” state due to high circulating cortisol.

In Annie’s situation, however, it’s hard to know exactly what may be triggering the panting. It’s possible that her cortisol level has indeed been creeping up during the course of her illness. Or it may be a side effect of some of her medication. Or it could be pain still related to the surgery. If she’s sleeping comfortably, pain seems less likely. However, if the panting subsides subsequent to taking the pain pill, then discomfort does seem to be a more likely cause. Perhaps her higher degree of activity and jumping around is making her feel more sore or irritating her staples. Was the surgeon pretty insistent about keeping her as still as possible right now? If so, maybe you could set up a temporary pen within which to confine her for the time being. It sounds like it’s pretty hard to keep her quiet right now, but putting strain on her incision could definitely cause pain and set up additional problems for her. I’m guessing she won’t be very happy to be confined, but it might be necessary to allow that incision to fully heal.

[Katy1]

Well, I talked myself off the mountain and called the clinic in Chicago where Annie had her surgery. They immediately put me through to a tech who helped take care of my baby and she told me that panting is an indicator of pain. I feel so guilty because I had cut her pain meds down from 3 a day to two because she was so groggy. Welll, when I dumped out the remaining Tramadol, I was in shock to see I only had enough left for one day. So, there I am back on the phone with the specialty clinic in Chicago and I was told to take a big deep breath..........why do people keep telling me that?

Anyway, they said they would work with my doc at home and if he did not have it in stock, they could call a local pharmacy so we could have it on board tomorrow.

I sincerely appreciate the universe for letting me vent, screem cry,sob, whatever I need for my little miracle pup. Right now I have no numbers on anything...... I ‘m just glad my little baby is alive with her 33 staples. I need to send out special blessings to all of you out there who may have been cheering us on....remember this, I hold your pups in my thoughts and prayers every day. We are a family here and you all have taken care of me and somehow, I hope to pass it forward . Blessings to you all and your pups. Karen

[Katy1]

Oh Marianne, you are correct on all levels. She was so sedate until her dad got back from his fishing trip. She’s always been a daddy’s girl—can’t blame her for that. The pain pill helped her a lot and i’m going to add that third pain pill back on th list for tomorrow. I had taken one out—probably too soon, hence the extra activity, etc. In almost 50 years of pups I ‘ve never had to deal with anything like this. My little Annie is the engine that could and she won’t take NO for an answer! Would I have it any other way? No! Just please don’t tell me to get over myself and “breathe “.

I am concerned about her cortisol and bg levels, but nobody else is right now. So maybe I just need to breathe. Blessings, Karen

[Budsters Mom]

Yes, panting may very well be the result of pain. I am with Marianne on this one. Allowing Annie to jump, even once, is dangerous. It's not about what Annie wants at this point. They don't know their limitations, so you have to set them. Pain meds are a double edge sword. They help and are needed, but can also help the pup feel like they can do more than they should. Pen her as soon as possible and keep her penned for the duration. I have a soft sided play yard. It works great for when I have to curtail my pup's activity. it is almost impossible to be right there with our babies every minute, while they heal. Penning will force her to rest, while giving you a much-needed break, knowing that she's safe . If I had just spent thousands of dollars on surgery, my dog wouldn't be jumping at all! It is the middle the night here on the West Coast, I apologize if this message does not come across as sensitive as it should. Penning is a must at this point.

[Katy1]

Oh my gosh—when two of the most respected people on this forum tell me the same thing, it’s time for me to listen and send the hubby to Petsmart when they open this morning. The surgeon did stress the no jumping low level activity stuff but I guess I really wasn’t able to translate the information into reality at the time. I have no problem with penning her her up for a few days until the staples come out....it’s her dad that’s going to be the problem.

[labblab]

I’m really glad you were able to make contact with the surgical practice. And I’m totally in favor of sending hubby off to buy that pen first thing today. He needs to understand how risky it is for Annie if that incision is compromised or if an incisional hernia were to develop. The last thing you want is the need for another surgical repair. So you’re going to have to draw the line with them both — no jumping until the surgeon gives the OK. I know it may be hard, but it’s necessary. Good luck with them both!

[Joan2517]

Keeping them from doing what they usually do is really hard, especially when they seem to be able to. I have a hard time doing it, too, but you really don't want that incision to open up. When Sibbie was spayed I didn't put a collar on her because I didn't want to see her uncomfortable, and she didn't seem to be bothering it. Then I noticed she was licking at the stitches the minute I wasn't watching. I ran right out and got a soft collar.

Annie will get used to being penned. Put her toys in and some special treats, and it's probably movable so you can put it wherever you are. The pills will help to make her sleepy. And like Kathy said, it will give you a break too. It's exhausting watching them all the time...

[Katy1]

Miss Annie is now the not so proud owner of her own personal play pen/jail cell plus she has her soft e-collar on all the time except when she eats. Now here is what she is doing. She has been been constantly standing up on her little thin back legs ,grabbing the netting with her toes saying “Get me outta here! “. Now I’m worried she’s going to stretch her little tummy and pop something doing that. She has her favorite two toys, access to fresh water, and she can see us wherever we go. Now what do I do?

I keep going over to her and placing her feet on the carpet and she just gets right back up on her hind legs wanting out. This is actually turning out to be more work then when she had free range. She would jump on the couch or chair and she would stay there for hours. Help from anyone will be appreciated. Blessings to you all and your pups. Karen


,

[Budsters Mom]

She's pulling at your heart strings, which is exactly her goal. Standing up is not as dangerous as jumping. When she does it, she's getting attention, so she'll keep it up as long as it's working. I would try another route, by acting like you don't see her standing and fussing. Reward her with attention when she's down and quiet. This is new for her. She doesn't like it, but will eventually adjust once she realizes that this is the new norm for now. In order to make this work, Everyone around Annie (Particularly Dad), need to hang tough and follow the same plan. If Annie senses that someone is about to cave under the pressure, than it's all over. You can do this!

Another option would be to leash her, keeping her with someone ALL the time. I would not personally choose that option. Pet parents need breaks too. Surgeons/Vets often recommend crating/penning, knowing that the pup will most likely fight it at first. That means standing, whining, crying, pawing and even trying to chew their way out. If you hang tough, it'll get easier. This is more about you and hubby and less about Annie's reaction. Many of us have had to pen our pups. Newsflash!!!, Not many are happy about it.

So to recoup.... My opinion is to tough it out with the pen! Good luck!!

STOP THINKING ABOUT THE PLAYPEN AS A JAIL CELL!!! This is a good thing for Annie!!!

[Squirt's Mom]

I'm going to tell you a true story that will scare you :( but also make you understand how important it is for Annie to be limited in her movements right now. One of our Admins had her new rescue dog spayed. Simple, ordinary operation that happens at least a thousand times a year. Nothing as serious as what Annie has been thru. Her baby decided to tackle the steps soon after and before her mom could stop her, she had done just that...apparently with no harm done. However that night her mom heard her whimpering in her bed so she got up to check on her....and to her horror found her baby covered in blood because the incision had burst open and several of the organs were outside the body. They rushed her baby to the ER and thankfully the dog survived. But it was not an easy go for either of them. And her baby only did that ONE time, once. But once was all it took for the stitches both internal and external to come undone. Please steel your heart and protect your precious baby girl from herself. If necessary get a carry case which won't allow much movement at all. Annie will be fine....pissed maybe but alive and unharmed. And you won't have to face the nightmare our Admin did with her baby girl. This time will pass much more quickly than you think and soon she will be able to run and jump and carry on to her heart's content....but for now she must be protected. :)

Hugs,
Leslie

[Katy1]

Thank you everyone for your help advice and support. If I could teach middle school/junior high kids for 18 years one little bitty pup is just going to have to tow the line too. Blessings to you all. Karen

[molly muffin]

When my molly hurt her back, she wasn't allowed to jump or do stairs for 6 weeks. Talk about trying to keep a good dog down. It was impossible and we too invested in a doggie playpen for her and it helped a good deal. She wasn't thrilled but she did much better because of it. Then we got stairs to the window seat so she wouldn't jump up there either. The stairs really came in handy when she could no longer jump due to the cushings and still wanted in Her window seat. So you never know how things will work out. I also loaned that playpen to a friend when she got her new pup.

Hopefully she will be feeling better and healing well in no time at all.

[Budsters Mom]

I work in a SDC (Special Day Class). I have worked in my local school district for 27 years. I have had classes ranging from preschool through 8th grade. I am now in a 4/5/6 combo. Having said that, dealing with my own family, and fur child, is tons harder. As much as I care about my students, I don't take them home with me. So, I do understand how this is difficult for you.

Hang tough and know that you are doing the right thing for your sweet girl.

[Katy1]

Hi Kathy, I just don’t know how you all work and have families plus everything else it take just to manage daily life and then add a Cushpup into the mix it is just mind boggling to me. I loved teaching but I ‘m very thankful to be retired. Both Gracie and Annie were a handful even before they got sick. Blessings to you all.

[Katy1]

Annie has finally given up the whining, crying, climbing, barking and anything else she could think of to just hack me and the hubby off to no end. The first night, Jerry slept on the floor next to her play pen and I slept in the recliner. Last night he said he couldn’t take it, so he moved the recliner next to the pen and I slept out here in the living room by myself next to the baby. She whined a little because she’s such a daddy’s girl, but finally gave up. I can be the bad cop when I have to be. Thursday can’t come soon enough!!! That’s when the stitches come out. Blessings to you all and your pups. Karen

[Budsters Mom]

Could you possibly move the playpen into the bedroom at night so that both you and hubby could get some sleep?

[Katy1]

We thought about it but decided that a consistent spot would work better for her. Plus she’s used to sleeping on the bed with us, pre-surgery, and thought that might be harder on her. Last fall, I had to have two spinal surgeries within five weeks and had to wear a neck brace for two months—basically my own e-collar and had to sleep in the recliner so a couple more days are no big deal. Thanks for thinking of us though! Blessings, Karen

[Squirt's Mom]

I'm glad she is accepting her limitations and hope you and hubby can find a way to be comfortable while watching over her. I bought an air mattress after Squirt had her surgery and slept on the living room floor with her so I would be close so I understand the need to be with her very well. Soon this will be in the past and she will return to her normal routines...and so can ya'll! You're great parents and she is so lucky to have you both!

Hugs,
Leslie

[Joan2517]

I have been sleeping on the couch since Gable started showing symptoms and was diagnosed so that I hear him get up when he needs to go....over a year now...I miss my nice, comfy bed. Hopefully after we see the specialist next week we will all be more comfortable!

[Katy1]

I've been thinking about you and Gable and was glad to see your post. Is his appointment on the 6th or 9th? At any rate, Annie and I have been counting down the days with you. At one time or another, I think we all have spent nights sleeping on something other than our beds for either kids, grandkids or pups. But in this case, you need a big trophy for first place couch mom:o! Blessings to you, your pups and your couch. I'll be thinking of you and Gable from my recliner tonight. Karen

[Joan2517]

LOL! It's the 9th, and a recliner sounds awesome...I've got Sibbie on one side, Cooper on the other, Gable next to us either on the floor or ottoman, and Doree on her chair with the space heater on to keep her warm. I need a full night's sleep!

[labblab]

Surely thinking about you guys today and hoping that those staples will soon be out with no problems!! (And that now everybody will be able to get back to a good night’s sleep ;-))))))

[Katy1]

OMG—I couldn’t decide whether to post this update here or on my gratitude thread. THE STAPLES ARE OUT!!!!!!!!!! Unfortunately, ����������, there were only 32 instead of 33��. Most important, the baby is out of her play pen. I apologize for the sarcasm and the fact that I figured out how to use the smileys—just can’t help myself.

Now for the official update...saw Doc this afternoon and the techs removed her 32 staples and I made sure that I received all of them. ( I’m thinking about making them into some kind of necklace or bracelet ). Annie was also supposed to have a complete CBC done, but after Doc looked at it he came in the exam room with the sample and told me he couldn’t even spin it because of hyperlipidemia(sp?). She had not eaten anything since her breakfast at 8:00am this morning and he drew blood about 4:15 this afternoon cst. It really did look like a pink milkshake. Anyway, her dad will take her in tomorrow morning early for a fasted blood test and hopefully it will be ok. The plan is to take her back in next Tuesday for a glucose curve and a stim test. He was asking me about her eating,drinking....yadayadayada...telling me that she was doing ok and could probably wait on the stim test. I said “Hey Doc, remember who you are talking to—-can we get a stim test done—I really don’t care what your schedule says how this should be done, I need to know what her numbers are if it’s feasible at this point”. He just took a step back and said, OK.

Moving forward with our visit. By now, Annie is at the exam room door wanting out—I would want out too at this point, but once again, we had drawn a small crowd from the office in addition to a vet intern from Germany working with doc for a few months. So Annie gave up and found solace near my right leg as I sat on a hard bench in the corner. I flat out asked him in over his 25 years as a veterinarian if he had ever had a success case like hers. He was actually quiet for almost a second, and all he could do was shake his head no. He told me with everything against her, cushings, diabetes, pancreatitis, he would have told me to put her down. My reply was, “Doc, I looked in her eyes and I knew it wasn’t her time.” I think he got it. The problem is he deals with people all the time who just give up on their pets, dogs or cats and has never run into a “me”. Please don’t misunderstand, I’m a retired teacher, grandmother—nobody special. I don’t dress up or down, I just throw on whatever feels comfortable for the day and I gave up social circles with the first husband.

Continuing on...Doc’s intern from Germany was asking me questions about Annie’s prior health and she didn’t have much knowledge about cushings but I don’t know exactly how far she is in her vet school. Back to my discussion with doc...the man finally admitted that Annie was a one in a million miracle. Truth be told, Doc is an excellent vet, but he also knows and admits his limitations. I’m hoping that from this experience with Annie, he will tell other patient parents that there is a specialty clinic in Chicago that may be able to help if he can’t but it may be expensive. He had never heard of this clinic until we came along. I’d like to hope that a little learning was filtered his way as I learn everyday on this site from all of you.

Now about Annie’s physical appearance. I know this is so stupid but she’s just gone to ‘hell in a hand basket’ as fas her appearance. I can already hear the yelling at me through cyberspace right now—“Karen,get a grip, her appearance doesn’t matter, she’s alive.” I know, I know, I know. However, any of you out there who have ever been a parent to a miniature schnauzer should know the breed is a very proud breed, especially when it comes to their grooming. Gracie was the most prissy schnauzer I’ve ever had. If she had a whisker out of place and couldn’t get it back herself, she would sit and bark at me until I would get the brush and fix it. Thankfully, Annie’s a little more laid back, but I haven’t been able to brush her for two weeks. Tonight, she was rolling all over the floor to our delight but tomorrow morning I ‘m calling her groomer for an appointment ASAP. After Annie is groomed, she prances around the house like a diva. I can’t wait and tomorrow she will be brushed

Thank you �� for putting up with all this verbiage but it is what it is. Blessings to you all and your pups, here and beyond. Karen

[Katy1]

I’m awake so early this morning with such a new found hope for Annie’s future no matter what happens from here on out. I’m almost giddy with excitement! In fact, as I sit here I’m imagining having a spa day with her. I think this afternoon I’ ll give her a nice warm bubble bath in my big kitchen sink and just clean her up a little. I also think the warm water might feel good on her tummy where her big scar is. When she’s dry then I’ll gently brush all her little tangles out. She also has a tuft of hair on the top of her head that makes her look like a quail but I’ll let the groomer take care of that next week.

I hope we get the results from her blood work today. I’m hoping her liver enzymes are in the normal range. Blessings to you all and have a great weekend. Karen

[Squirt's Mom]

I am so very glad her staples are out and she is acting more like her old self! I know she is thrilled to have her freedom back again...as are you. ;)

[labblab]

I’ve been in and out all day so didn’t have a chance to write before this. But I’m soooooooo glad to read your news, and hope both you girls are thoroughly enjoying your spa day :-))))))))))

[Katy1]

Well, what can I say, other than the euphoria of having a spa day with my little baby boiled down to Annie's thought process of "GET ME OUTA HERE". I had the nice safe paw protector in the sink, the water was perfect in temperature, I had plenty of towels on hand, and all the safest suds that a pup could want plus conditioner.

My hubby is a retired--semi-retired-home contractor. When we build a house, it's truly a dog house, but more important, a home where pups don't have struggle with anything, nor do we.

Back to the reality of spa day. Basically it just boiled down to a little girl who did not want to be in water, for whatever reason. After about 3 minutes, I called it quits, plucked her out of the drink and got her dried off. Thankfully, it was warmer outside today and when she was dry I put her out. Well, does anyone want to venture a guess what happened next? You probably already know,...................she rolled, and rolled and rolled in the grass. Well, at that point, I'm dripping in sudsy water, holding a a damp towel and calling her to come in. Then I just stopped....and I realized all this fluff didn't matter, my miracle baby was alive, her staples were out, and at that very moment, I once again realized what a gift had been entrusted to us. This little life, now my cush pup, but she is still here with us.

Fast forward to early this evening. Annie started to pant...which to me she was having some pain so I gave her a pain med as a part of a treat. It took a couple of hours but I think she's ok for now.

For those of you who actually read my ramblings, next week I'm going to dredge up a topic that has been buried for about 5 years and I have just learned about this info. I know I'm a a newbie to cushings but what I dug out of the graveyard was very thought provoking. Please stay tuned. Blessings to all. Karen

[labblab]

Hi Karen, and thanks for the update — I’ve sure had you guys on my mind and hoped that your day would go well. But here’s a question for you — did the surgeon give you instructions about any continued restrictions or care after the staples came out? Perhaps I’m just being a nervous Nellie, but giving Annie free rein to run and roll in the yard with abandon does worry me at this still early stage in her recuperation. If the surgeon said it was fine to resume all normal activity just as soon as the staples were out, you can totally ignore me. But when my dogs have had surgical procedures, I’ve been told to keep them on leashes whenever outside for a fair piece of time, so as to restrict them from running and contorting too aggressively for a while. As I say, this may not be considered an issue for Annie. And of course, you can’t keep her swaddled in bubble wrap. To some extent, she’s gonna do what she’s gonna do. But I don’t like hearing that she started panting again :-(. With a surgery this extensive and an incision this large, it just seems to me that it would be best to remain somewhat restrictive re: aggressive physical activity for a while longer. If your surgeon didn’t give specific instructions in this regard, you may want to double-check. And if they say that a return to full activity is now fine, then you can just ignore everything I’ve written above and carry on as normal ;-).

Marianne

[Katy1]

Marianne, you have raised some excellent questions. I was given no post staple removal instructions from anyone. However the top part of her incision is bright pink and that tells me it’s healthy tissue.

Ok Marianne, since it appears you are on board today,, I’Ll just unleash the “blast from the past” on this site regarding early spay/neuter and cushings. I found Dr.Deckers info...but it just seemed to me that she is just in it for the money. I did more recearch on my own through the AKC you really have to spend hours sifting through their stuff. But at one point I was sent in a diffferent direction to another Doc/researcher who qualified dr. Becker’s info. I’m not going to post any sites without permission plus you’ve probably already read them.

The only reason I’m dredging this stuff up again is because Jerry and I are thinking about a baby sister for Annie. I know that she is getting older and we are getting older by the minute, but we have always had at at least two pups in our home. Gracie’s bark in my head says Annie needs a baby to take care of.

Back to the dredge, I have also found a site which lists docs state by state who perform vasectomys, ovary sparing spays for females......and the list goes on. Annie is the only pup after having pups for over 45 years who has had cushings. But if I can prevent a future pup from any hormone related disease I’m all in.

This little rant probably makes no sense to anybody but me.....but we had no sleep last night. As I stated before, she goes in on Tuesday for a stim test plus a bg curve, so I can post numbers after that.

Blessings to you all for putting up with me. I love you all and bless your pups,here and departed. Karen

[labblab]

Karen, I’m so glad to hear that Annie’s incision looks to be healing nicely. As I said, I am probably just being hyper-nervous, so take my suggestions for the two cents that they’re probably worth. :)

As for Dr. Becker — I am not a fan of her conclusions about Atypical Cushing’s, and I’m assuming that’s what you’re talking about. It’s been quite a while since I’ve read any of her articles, but I believe she has tried to link early spay/neuter with the development of Atypical Cushing’s. This is a condition about which there remains a great deal of uncertainty within the endocrinological community. It refers to a situation where dogs exhibit elevated adrenal hormones other than cortisol. Causes for this condition are uncertain, and even the ramifications of these hormonal elevations are uncertain. The University of Tennesse at Knoxville has done a fair amount of research re: this condition in recent years; I really don’t know whether they have hypothesized any linkages with spay/neuter.

However, this is not Annie’s problem. She has elevated cortisol associated with traditional Cushing’s of which the two possible causes are known: development of pituitary or adrenal tumors. I am unaware of any research that links spay/neuter with the development of these tumors, and I don’t think even Dr. Becker is making that claim.

It’s been so many years since I’ve had a puppy that I have not sought out research about the pros-and-cons of spay/neuter and other types of conditions, and there may be other issues to consider besides Cushing’s. But I don’t think traditional Cushing’s has been implicated as a related problem. Here’s a quote from a 2016 Q & A with noted endocrinologist Dr. David Bruyette:


Wooten: Have there been any studies comparing the incidence of Cushing’s disease in our spayed and neutered population vs. our intact population?

Bruyette: Yes, it has been looked at. Unlike the problem we see in ferrets with adrenal disease that are spayed or neutered, we really haven’t seen any difference in the frequency of Cushing’s among spayed or neutered dogs.

http://veterinarymedicine.dvm360.com/cushings-rise-expert-observations-disease

If there are other specific articles you’d like to discuss, though, you can go ahead and reference them here.

Marianne

[Budsters Mom]

Talk about a nervous Nellie, I would have kept Annie in the pen for a few weeks longer. It's easiler to keep them there, than starting all over if the need should arise. However, I do tend to be overcautious.

Regarding spa day.....Was Annie cleared for a bath? It's possible that her incision is still very tender and trying to bathe her might have smarted a little. If you are going to check with the vets about activity restrictions, you might want to ask about bathing also.

[Katy1]

Kathy, Annie was totally cleared for bathing and anything else. I know, totally understand and appreciate your train of thought. Been there myself over the years, I check her tummy scar about 3 times a day—it’s still sloughing off dead tissue. I’ve always been of a medical mindset and I gently cleanse her incision with CVS wound wash. I’m such a germ-a- phobe by nature nothing gets past me if I can help it. Just drives my husband nuts because he was raised in a totally different environment. Right now, my concern with her is her occasional panting. She is scheduled for a stim test on Tuesday. BLessing’s to you for your concern and input. Karen

[Budsters Mom]

A stim test would help you sort out Annie's panting. Is it pain related, uncontrolled cushings, or both?



Kathy, Right now, my concern with her is her occasional panting. She is scheduled for a stim test on Tuesday.

[labblab]

Karen, I just want to make sure you saw the reply I posted to you yesterday re: your question about a possible connection between spay/neuter and Cushing’s. It ended up at the bottom of the preceding page of your thread here, so you may not have noticed it ;-). If you want to discuss the issue further, we can certainly do so.

Marianne

[Katy1]

Marianne, yes, I did read your reply but I still have more questions. We can forget about the Becker article because she really only addresses the atypical cushings which has nothing to do with Annie at all. We are now moving forward towards a possible new baby sister for Annie and as I mentioned before, there is a site that lists vets state by state who are now performing alternative sterilization surgeries which leaves the pup intact with all their hormones but cannot reproduce. wish I could have had that choice at age 40 when I had to have a complete hysterectomy and had to take HRT for years!

I ‘ll just restate my main question for anyone thinking about adopting another pup. Does this approach to partial sterilization really make a difference in the long run? Just throwing this out into the universe because I’ve never heard of this before. Blessings to you all. Karen

I know adopting from a shelter or rescue is totally different because of laws which they must follow.

[labblab]

I’ll be interested in hearing feedback from others, too, Karen. I vacillate between feeling like I’m too old for another puppy and fantasizing about life with a new little guy or girl — I guess only time will tell which side wins out! But as I wrote before, I’ve been out of the puppy loop for so long that I have no idea as to current thinking about spay/neuter options or recommendations. So I’ll be watching for any related comments here, too.

Marianne

[Joan2517]

It's hard work, but worth it! I love Sibbie with all my heart and just wish I had had more time grieving so I could have paid more attention to her. It hurts me sometimes to think that here was this little baby, who managed to keep herself busy while I cried on the couch for weeks.

[Katy1]

Oh Joan, I don't think I had the time I needed to really grieve Gracie before we had the cushings bomb drop on us with Annie and then the double 1-2 punch with Annie's gallbladder surgery. One of these days, I'll get back on my grief thread and unleash a river! I think the puppy thoughts have been a self made diversion, although it has made me smile to think of the possibilities. The reality is, and I have to echo Marianne's comments regarding feeling like I have been out of the puppy business for too long to start over. We are also seriously considering a move back to Kansas City where the four grandchildren are. I miss them so much and only get to see them once or twice a year. It just wouldn't be prudent to bring a new pup into an unstable environment. Moving on to other stuff, Annie did have a stim test this morning but I don't have any results yet. Tomorrow, she goes in all day for a BG curve. We are slowly getting back on track with this little baby. Blessings to you all and your pups. Karen

[Katy1]

I got the results of Annie's stim test this afternoon and here are the numbers. Doc said she was doing ok and he seemed a bit miffed that he had to pull up her file and print the results out for me...but hey, I really don't care.

The following is what was printed out and the labeling doesn't make sense to me so maybe someone can help me interrupt these numbers and provide some feedback.

Cortisol Sample 1 0.6 1.0--5.0 mg/dL Low

Cortisol Sample 2 6.4 8.0--17.0 mg/dL Low

It's obvious to me that she is under the normal range but I really don't understand how low a pup has to be before one needs to panic. I asked him about the low range and he told me she was where she needed to be and didn't seem to be concerned. Her first stim way back in March after she was "loaded" on Lysodren was 1.something, sorry, can't remember and don't know where the paper is right now.

I know most of you don't have experience with Lysodren however I'll accept any and all comments. She is slowly gaining weight since her surgery so that's good and most importantly, she has a good attitude toward everything. Friday, she goes in for a much needed grooming and I know that she will be prancing around the house after that. Blessings to you all. Karen

[Harley PoMMom]

A dog being treated with Lysodren the ideal range is 1 ug/dl-5 ug/dl, so her post of 6.4 ug/dl is a little high BUT since she is recovering from surgery her body probably needs that extra bit cortisol, at least for right now. How is her appetite and drinking?

Lori

[labblab]

Lori is exactly right about the desired therapeutic range for a dog taking Lysodren. The ranges that the lab printed out are the normal ranges for a dog who has neither Cushing’s nor Addison’s Disease when the ACTH is being used diagnostically before any treatment has begun.

I also agree with Lori that, under the circumstances, this is probably an acceptable reading for Annie. However, I might be inclined to repeat the ACTH in another month, once things have really calmed down for a while. Her post-ACTH reading is not too far above 5.0, but it does represent a significant increase from the March reading of 1-2. You don’t want it to consistently continue to increase further over time, or else you will be risking losing the load. So I would want to retest again, sooner rather than later, so as to increase her maintenance dose if the cortisol rise continues. And especially so if her symptoms start to rebound.

[Katy1]

Now I’m really confused because the graph on her report had her marked in the low range at 0.6 with norms of 1.0-5.0, and then “sample 2” had a reading of 6.4 with norms of 8.0-17.0. Are these numbers backwards on the report?

I do understand that the important crucial control number should fall within that 1.0-5.0 range but doesn’t that 0.6 fall under that? Maybe I’m just totally loosing it. Blessings to you all and thanks for your help. Karen

[labblab]

Nope, the reference ranges printed on the lab report are not backwards -- it's just that they are the reference ranges for the ACTH when it is being used diagnostically. They are basically irrelevant when it comes to monitoring the appropriate dose of Lysodren for a dog under treatment.

As you can see, there are two numbers associated with the test. The first is for the "resting" or baseline cortisol level. The second reading is taken an hour after a stimulating agent (ACTH) has been injected. This post-ACTH reading is usually the more important of the two when evaluating the appropriateness of the current dose of Lysodren (or trilostane, too, for that matter). In looking back through your thread, I had assumed that the number you had given us back in March was for Annie's first monitoring post-ACTH test result at the completion of her load (as opposed to the baseline cortisol level drawn on that same day). That's because the post-ACTH result is the one that is commonly evaluated in terms of treatment effectiveness. This is what you told us back then:


Her stim test #was down to 2 from 17:5 last week. I am concerned that it might be too low and push her into Addisons.

So I was assuming that you meant that her original diagnostic post-ACTH result was 17.5 (which you'll see was slightly above the normal post-ACTH range on a diagnostic test and thus mildly "positive" for Cushing's), and that her post-ACTH at the end of her loading phase had dropped down to 2 (which is good for a monitoring result after starting Lysodren). Since you only gave us one number, I was assuming it was the post-ACTH result. But there should also have been a baseline reading taken at both times, as well. For comparison purposes with this week's test, it will be especially interesting if you can dig out the March report. That way, we can see what her baseline level was at that time, too.

So fast forwarding back to the present time. For a dog taking Lysodren, the desired ranges for both the resting cortisol and the post-ACTH reading are 1-5 ug/dL. It's true that, at 0.6, Annie's resting cortisol level is lower than the desired range for that value. If she was showing signs of being Addisonian, that resting cortisol level would be a concern. But if her electrolytes and behavior are all normal, then I'd guess that you'd mainly be focusing your attention on that post-ACTH level of 6.4. That reading is a little higher than the optimal therapeutic range for Lysodren, and reflects an increase from March. Combined with the lower baseline reading and all the medical stresses she's been under, if it were me, I wouldn't be increasing her maintenance Lysodren dose at this time. But all of this combined information is the reason why I'd retest her in another month of so, in order to see what her cortisol level is doing under more normal circumstances.

Hope this makes some sense rather than making everything more confusing!

[Katy1]

Thanks Marianne for the clarification. I understand finally! I’m one of those people who has to read something at least three times before it sinks in.

When she was first diagnosed, Jerry and I were in Maui, in fact we were there the week it snowed over six inches on Mt. Haleakala, so I was having to absorb all the preliminary information over the phone which was horrible for me because I am not an “auditory learner”. Then when we got home she had to stay in the hospital for another two weeks and I was still trying to absorb all the information from doc over the phone or in person. It’s all such a blur at this point.

I will never increase her dose of Lysodren unless I absolutely have to. That stuff still makes me shiver with fear. Your suggestion to retest in another month was my thought too. Doc perceives me as being “over zealous” in my approach to this medical situation with Annie but I don’t care. I have been this way with all my pups over all these years and I’m too old to change now. Anyway, thanks for the validation. Blessings, Karen

[Katy1]

Hi everyone,

An update on Annie and I’m once again in all out panic-paranoia mode. Last week Annie had her first groom since way before her surgery. We were busy all that day and I really didn’t put serious “hands on” until the next day, but when I did I just freaked out. I discovered she has two small hard lumps on the right side of her head between the middle of her right eyebrow and her right ear. The largest is the size of a frozen pea and the other is about 1/3 the size. They are definitely under the skin and flesh colored. I do know they were not there the last week in March. I’m also surprised her groomer didn’t say anything.

She was already scheduled for a bg curve tomorrow so I will ask doc to check them out and either aspirate the large one or do a biopsy or whatever he needs to do. I know they are not lipomas. They also don’t move, so yes, I’m scared.

I won’t be able to pick her up until five or six so we’ll see what doc says.

Today was also her Lysodren day and late in the afternoon I was in the kitchen with her. All I was doing was emptying some trash. I happened to look down at her just for a quick chat and I noticed her back right leg quivering. I bent over and gently touched her leg and it stopped after a few seconds. Do I need to be concerned about this too?

I was almost ready to start thinking that maybe we could catch our breath for a bit. I’ll post what I find out tomorrow. Blessings to you all. Karen

[labblab]

Aww Karen, it does seem like it’s always something coming up, doesn’t it :-((((((

By now, I’m guessing Annie is with the vet. I know the day will crawl by for you until she’s home again and you have some answers. Waiting right here alongside you, and surely hoping that there’s nothing serious going on. I know you’ll let us know as soon as you can.

Hugs, hugs, hugs!

[Katy1]

Here’s the update on Annie…first of all nobody died, except the garage door and that will be part II of our today.

First and foremost, those hard lumps on her head turned out to be a pimple and a separate sebaceous cyst which doc took care of and was actually glad that I had him look at them. Her little immune system can’t tolerate any kind of infection right now. For once, I didn’t feel like he dreaded me being there. Maybe, my little baby has taught him something. She was actually there for a BG curve which I will post later on the K9D site, but for anyone here with a dual diagnosis pup, he upped her insulin from 8 units to 9 keeping her food intake the same.

I told him about the trembling in her leg and he really didn’t have an answer for me and I really hate it when I get that answer. I asked him if she should be on ursodiol since her last ALP was 874, but he said we’ll check it again in another month. He reminded me that even though she’s leaping tall buildings in a single bound, she still has a way to go in her recovery and her body is still readjusting itself to having no gallbladder. I really think at some point, he will publish something about Annie in one of the vet journals. He’s big into strange things that happen, and even though we as her parents made it happen…he’s never seen a case like hers. Plus, he likes research. Ok, enough of part I.

Part II……

I got the call about 5:30pm cst that I could pick up Annie, so I grabbed my purse, phone and car keys and headed for the garage. I had been to the grocery store earlier and everything worked fine. I pushed the garage door button…and nothing happened. I pushed it again…nothing happens…now I push the other garage door button and it opens. But that won’t do me any good because that’s where the boat is, not my car.

Now, I’m in a huge PANIC because Jerry drove to Kansas City for business this morning and won’t be back until very late tomorrow night. I called him immediately and he had no idea what was wrong. We have 11ft ceilings in the garage and there is no way I can reach that emergency pull cord to release the garage door and raise it—even with a ladder. All the neighbors are older than I and the only neighbor who could have helped was gone. I finally called 911 and they patched me through to our local police. I explained my situation to them and the dispatcher was very nice and within five minutes, one of our local town protectors was there to rescue me so I could go rescue Annie before they closed. In the meantime, Jerry had alerted the vet office of my situation and they assured him that someone would be there until I could get there. When my hero arrived, he assessed the situation, jumped up and grabbed that cord and pulled that big heavy garage door up. I opened up the side door so I could get back in the garage, closed the second garage door, jumped in my car, buckled up…..my hero dropped my dead garage door. I gave him a big “thumbs up” and away I went. At this point, I’m over an hour behind and I called the clinic to let them know I was on my way. They told me not to worry that doc was still there and would wait until I got there.

I arrived at five minutes before their closing time of 7:00pm and doc had an emergency come in so he was tied up for awhile before I could even talk to him. In the meantime, they brought in my bouncing baby girl, barking, tail wagging and wanting out. I noticed her head right away and was grateful those lumps were gone. Finally, doc came in, we talked, I payed and we were out of there and home in the driveway by 7:40. I fed her right away, she was really hungry then made myself a peanut butter, jelly and bacon sandwich. Don’t judge—it’s a really good sandwich in a pinch.

We are now settled in. Annie is sleeping in her dad’s chair, she’s such a daddy’s girl. I’m keeping tabs on a baseball game for Jerry so I can tell him the score. We’re having bad storms in our area tonight and there was a game delay. My car is sitting out in the elements for the first time in it’s life with me. I don’t care, my little brave baby is home and we are safe. I look at her sleeping and I’m just amazed at her tenacity and zest for life.
First thing in the morning, I’m calling the Overhead Door Co. for an emergency repair. Blessings to you and all your pups. Karen

[labblab]

Soooooo glad to get the update on Annie this morning, and surely hoping your car survived the storm! Hopefully a more peaceful weekend will be in store, all the way around!

[Budsters Mom]

FYI......
Since your garage door disengage handle is too high to reach, that's easily remedied. Have someone tie a rope to it, so it hangs down to where you can reach it easily in an emergency. Pulling the handle will disengage the lock and allow you to manually slide the door open by pushing it. I have had to do this several times due to power outages and a malfunctioning garage door. It won't fix the problem, but will allow you to get your car out when needed.

[Katy1]

Hi Kathy, I have been after my husband for years to do this very thing...add an extension. Now I think it may finally happen. Blessings, Karen

[Katy1]

Kathy. I showed your post to the hubby this am and he is out running errands, including going to get some Cosequin for Annie and and some extension rope foe my garage. I think the universe has put a curse on us sometimes because every time Jerry leaves for a fishing trip or just an overnight quick business trip, something goes wrong! I’m not kidding...either the pups were sick or the power went out because our line was cut from building behind us.....you name it it’s happened and I always collapse in a pile of tears first, dry my face and then I call him.

Anyway, the garage door is fixed. Today was Annie’s Lysodren day, and I’m always hyper-vigilante as far as reactions. She always seems to drink more, sleep more, move move more to to stretch out, like she’s uncomfortable. But no tummy upsets or diarrhea. I just hover—can’t help it. Blessings to you all and your pups. Karen

[Budsters Mom]

Glad it worked out! My local fire department/ police never would've responded for something like that. I would have been told to call a cab or an Uber.

[Katy1]

Hi Kathy, all I can say is we live in a smaller community and I am on a first name basis with our local police because of the people who live behind us. I have had to report them for pet neglect three times in the past two years. It has just been a nightmare.

Anyway, the hubby added an extension to the garage door cord and for right now, all is well. I do have a question for you on behalf of your late great Buddy. What species of lizards was he after. I ask because I ‘ve always had a side profession in herpetology and spent many of my younger years taking my son and his two best buddies on field trips all over the state of Kansas looking for toads, turtles,lizards,skinks,snakes and anything else in the creepy crawly world. Anything but spiders——they scare me to death! Your Buddy must have been quite the guy and I could have utilized his talents on our field trips. In my imagination right now I can see him leading us up a south facing rocky hillside, then suddenly stopping and barking to signal a lizard under a rock. You did have the best of the best. Blessing, Karen

[Katy1]

Here’s the latest since her stim test. Doc is trying to balance out her insulin with her food intake and has had two bg curves in the past two weeks and they were both basically the same. The big difference is she has gained a pound in the last week. I’ve already posted this info on the k9D site but wanted to post it here too.

If doc was going to raise her insulin, which he didn’t, I was going to ask for another stim test. He had an emergency so I didn’t have a chance to visit with him. My next thought was maybe it’s time to cut back her food intake and leave the insulin dose the same. Instead of one can of Glycobalance 2x a day I’m going to split 1.5 cans between her two feedings.

It’s been really strange though because she has been acting hungry all the time. Water intake is ok and no other symptoms. She has been a “chow hound” ever since she was a real puppy so maybe I’m once again seeing shades of the original,but new and improved Annie.

Blessings to you all and your pups. Karen

[Budsters Mom]

Buddy has been gone almost 6 years. We have many lizards species and they are EVERYWHERE, year round! He was kept very busy. His lizard of choice is the Alligator Lizard because they are bigger and slower than the smaller ones. Buddy didn't just locate the lizards, he went in after them and pulled them out of their hidey holes. In the bushes, under the bricks, or fence. He would dig until his paws were raw if I let him. It was not unusual for him to catch several in one day.



I do have a question for you on behalf of your late great Buddy. What species of lizards was he after.

[Katy1]

Oh Kathy, that memory of your Buddy just made my whole day better!!!:). Blessings, Karen

[Katy1]

Everyone please excuse me for asking, but why is Trilostaine preferred over Lysodren? Is it safer, less expensive—- except for Leslie, I feel like I ‘m the “Lysodren loaner”.

I’ve looked online for answers but not much help there. I just notice that about 4 hours after Annie ingests the Lysodren with her breakfast, she seems slightly uncomfortable. She changes her resting spots more frequently and she drinks more as well as stretches out more to make herself more comfortable.

I’m such a hyper-worrier anyway....do I need to add this to my growing list or just accept this as part of her med day response? Blessings to you all, my worrier warriors!

[labblab]

Hey Karen, no need to apologize at all about this question — it’s perfectly reasonable to ask.

Here are my personal short answers to your questions, with a couple of links to give you more in-depth information. Historically, Lysodren (mitotane) has probably been less expensive than trilostane. Once you got past the daily loading phase of Lysodren, the monthly cost for maintenance doses of the drug were probably less than the monthly cost of trilostane taken daily. However, that may be changing now that the manufacture of Lysodren has been taken over by a new company with what appears to be a significant cost increase per pill. Aside from the cost of the drug itself, trilostane may typically require more dosage adjustments over time, necessitating a higher number of expensive monitoring ACTH tests. However, as is the case with many aspects of Cushing’s, there’s a lot of variability from dog to dog. Some dogs taking trilostane stabilize quickly and require few monitoring retests, while some of our Lysodren pups have needed repeated ACTH tests throughout extended loading periods or when maintenance levels have been erratic. Plus, data that I saw today suggests that fully half of dogs treated with Lysodren experience cortisol rebound that requires a full reload within one year of initial treatment. Less favorable Lysodren results may be associated with treatment overseen by GP vets, because they may tend to be more fearful than specialists of using truly therapeutic doses of the drug.

However, from the studies I’ve seen, generally both medications can provide effective symptom control, with little difference in terms of life expectancy. So the preference for trilostane simply seems to boil down to this: many clinicians who treat a lot of Cushing’s dogs report fewer and milder side effects among their trilostane patients.

Both medications can cause serious side effects, including adrenal damage resulting in a permanent Addisonian condition. For this reason, both medications must be monitored equally carefully. The risk of irreversible adrenal damage is apparently quite low with both medications, but it is higher with Lysodren: the figures cited in the article I’m giving you by Dr. David Bruyette state a 5% risk of complete Addison’s with Lysodren as opposed to 0.10% risk with trilostane. And apparently side effects, in general, are less commonly seen with trilostane. This differential is especially cited in relation to treatment of dogs with adrenal tumors. Especially high doses of Lysodren may be required to control symptoms of dogs with adrenal tumors, with an associated higher incidence of side effects. For this reason, trilostane now seems to be especially favored for adrenal vs. pituitary Cushing’s.

I’m going to give you links to two different articles that I think may be helpful. The first is a 2018 review of trilostane treatment studies accumulated over the past twenty years. I found it very interesting, and highlights both what we know and what we still don’t know about best practices with this medication. The second is a 2016 article by noted endocrinologist, Dr. David Bruyette, that provides some of the statistics I’ve included here. In the interest of full disclosure, he’d be the first to let you know that he has provided direct consultation to Dechra, the company that makes Vetoryl, the brand name version of trilostane.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855282/

http://veterinarymedicine.dvm360.com/canine-hyperadrenocorticism-which-treatment-should-i-turn

As for Annie’s possible discomfort after taking her Lysodren, it may be the case that it’s mildly upsetting her stomach. However, at least it sounds as though it is transitory and not especially severe. You might ask your vet about giving her some type of stomach-soother on her Lysodren days. Otherwise, she seems to be tolerating the medication well, so I’d see no need to make a switch just so long as the Lysodren is truly doing its job as far as providing consistent control of her cortisol. But that’s why I keep sounding like a nag in terms of monitoring her cortisol level. I just want to keep you guys from joining the statistic of those folks who have to turn around and reload again after just a few months of treatment ;-).

Marianne

[Budsters Mom]

Hi Karen,

I will not pretend to know a fraction of the science behind all of this. I chose trilostane because it leaves the system within 12 hours, or so. The idea of Lysodren loading terrified me. This is probably because I didn't know much about either of these very dangerous medications. Vetroyl (brand name for trilostane) was more expensive than Lysodren, but that wasn't the reason I chose Trilostane. Trilostane was very hard on Buddy's stomach, so it may not be much better than Lysodren in that regard. Lysodren prices have signifantly risen, so I have no idea which medication would cost less now.

Again, others have more facts and science behind their posts regarding this issue.

[Katy1]

Well, one would think that after 6 months of researching, reading, reading some more, and listening that I would have a clue about Cushings. NOT SO!!!!!!

I think that I feel somewhat comfortable with the whole "lysodren thing" a little bit---I'm not sure I'll ever get there. I look at my little Annie sleeping peacefully on the floor, sometimes with all fours in the air as she sleeps on her back----oh yea, I have plenty of photos! The hubby and I feel so grateful to have her with us each and every day.

Now for the hard questions....What can we expect as we go forward with Annie and her Cushings? I need to know the down and dirty, the worst that could happen, and anything else that could go wrong, also factor in that she is also diabetic. My life has taught me to always be on guard and that's probably not a healthy perspective on life, but I have a real need to be prepared for whatever.

After all my little baby has been through I need a a realistic view of what to look for, what to expect and what to ignore become I'm so obsessive. Blessings to everyone here and thanks for putting up with me. Karen

[labblab]

Hi Karen,

Being pretty OCD myself ;-), I surely understand your search for some definitive answers. However, I'm afraid that Cushing's is about as far as you can get from being a cookie-cutter type of disorder. It's labeled as being a "syndrome," meaning there's a whole big basket of *possible* symptoms or complications. But as far as predicting the actual road map for any individual dog -- that's pretty much impossible.

In my own personal opinion, probably the most difficult possibilities are these. First, for dogs suffering from pituitary tumors, I think the possibility of enlargement into macrotumors is one of the most unwanted outcomes. If the tumors enlarge enough, they can invade brain tissue and create neurological changes that can seriously jeopardize quality of life and even become life-threatening. As you probably know, that's what happened to my own Cushpup, Barkis. So I'm especially sensitive re: that risk. However, it's a minority of pituitary tumors that enlarge to that extent.

The development of the skin disorder, Calcinosis cutis, can also seriously affect quality of life. A couple of the other most serious complications from Cushing's would include high blood pressure (with the associated risk to vision, kidney function, etc.), and also an increased risk of creating/throwing blood clots. The article that I linked to in my previous reply noted that therapeutic trilostane treatment does appear to help lower liver enzymes and cholesterol levels, reduce proteinuria, normalize specific gravity of the urine, and ease calcinosis cutis. However, apparently it does not necessarily lower blood pressure or reduce the risk of clots. Whether or not Lysodren treatment is more successful in this regard, I do not know. But I'm thinking the general take-away is that some aspects of Cushing's indeed benefit from treatment, but some risks do remain since the disease is not actually curable. However, it is highly variable as to exactly how problematic those risks become for any given dog.

So I'm afraid I can't provide the specific roadmap that you're seeking. From my experience here throughout the years, every dog's path is different. Some take dramatic twists as did my Barkis. But for other dogs, Cushing's proceeds as more of a back-burner type of issue. Once the overt symptoms come under control, life goes on pretty much as normal and it may be some other unrelated health condition, or just old age, that ends up being the over-arching issue. In Annie's case, for instance, it may be the diabetes that provides more challenges than the Cushing's. So in honesty, I don't think there's any way to prepare in advance for what a new day may bring. The best any of us can do, whether dealing with Cushing's or not, is to rejoice in the good days, and then on the not-so-good days, bring any worrisome changes to the attention of our vets.

If you're born to worry -- like you and me -- Cushing's is just one more thing to worry about! I don't say that to be flip, but I've actually had just as much to worry about with my non-Cush dogs as I did with Barkis, and no better ability to predict what the next challenge was going to be. I would love to tell you what you can and cannot ignore, but in reality, worriers like us will never be able to ignore *anything.* The trick, I think, is just to go ahead and ask about anything that is bothering you, rather than fretting all alone and letting your worry overtake you.

I'm sure this was not the answer you were hoping for...but I'm trying to be as honest as I can. That's what we're here for, and we intend to stay right by your side ;-).

Marianne

[labblab]

Hi Karen! Just stopping by again to say “hi” and hoping that things are still going OK for you girls. Do let us know when you get the chance.

Marianne

[Katy1]

IiHi Everyone….and a special thanks to Marianne for checking in on us. To begin, so no one has to worry, Annie is doing GREAT!!!! I was the one who was out of action last week with some bug. To make it worse, the hubby was in North Dakota on a fishing trip…I know, I know…who leaves a sick wife home alone with a “sick pup”? Well, all I can say is he needed to get away and now we have two “pay back Mom” trips in the works.

But first and foremost,…our little Annie. I’m almost afraid to say the words, but here I go once again…she is doing great! She had been scheduled for cataract surgery way back in February, then all heck broke loose with her Cushings..then her gallbladder surgery in April. Anyway, on Monday of this week, we made the two hour trek to her ophthalmologist to have her cataracts re-checked and evaluated. Well low and behold, the universe was smiling on our little baby and her eyes have actually improved as far as her dry eye condition and the doc also said her cataracts had not gotten worse. Her recommendation was that we just stay on her eye meds and re-check in three months. She also said that her little body is probably still healing from the surgery not to mention her “new and improved self” is still readjusting to life with Cushings and diabetes to boot.

When we checked in for her eye check, it was like a moment from the past. When we were in the exam room, the staff that I have talked to over the past months came in to greet Annie and they even took her in to the back, wherever that was to say HI to everyone back there. Jerry and I were dumbfounded because we had only seen this eye doc once before and she just couldn’t believe how well Annie was doing. Of course, like any proud pup mom, I had to whip out my phone and show off her latest healthy poop. The clouds of laughter are still probably hanging over her office. I know I’m just rambling but hang with me.

Now I want to update you on our plans. Tomorrow I’m going to make an appointment with her regular doc for her semi-annual senior check-up and set up some kind of schedule for complete blood work, the next stim test and whatever else needs to be done.

Jerry and I love to fish, and Annie has been with us on several fishing trips in her younger years to Northern Minnesota with her “angel sisters”. If doc gives us the ok, we are going to take her fishing with us, probably for the last time, in late July. We went to Petsmart yesterday and bought her a new life jacket. Needless to say, she did not appreciate me trying several sizes on her. But, in the end, she ended up with not only a new life jacket, but also a new toy.

When I was under the weather last week, I did spend a lot of time reading through the threads and tried to get caught up on what I could.
I have nothing else to add at this point so I offer my Blessings to all of you and your pups. Karen

[Katy1]

Hi everyone,

I just wanted to touch base before things get more crazy then they already are. Annie had her semi-annual senior check up last Friday. Doc still can’t believe that she’s still alive let alone the fact that she has transformed herself into a little “super pup” complete with a big bark fest when doc walked in——I couldn’t believe it either. She has found her voice and is using it!

I grilled him about any bloodwork or stim test that might need to be done and basically he told me to quit worrying—which will never happen, and just to take a good look at her behavior. At this point, she acts like a normal pup. We had such a good report from her eye doc and regular doc that we are going to take her on what will probably be her last big road trip this month. The hubby an I love to fish in northern Minnesota for walleye and got the green light that she could go with us.

We will take three days to get up there so we can keep Annie on her schedule as a dual diagnosis pup. I know I’ve already posted our outing to get her a new life vest so I ‘m sorry if this is a repeat.

We have all her papers in case we decide to travel in to Canada for a day. She is such a good traveler but we will take no chances. I’ve already made a list of every vet clinic on our route between here and International Fallls, Mn. After that it gets a little “iffy” so if she does get sick, we may have at least an hour drive or more to the nearest care.

Well, I’ll sign off for now. I wish you all a happy and healthy 4th for your families and your pups. Blessings, Karen

[Squirt's Mom]

I hope you are enjoying your trip! Fishing or doing anything in a northern clime sounds WONDERFUL to me down here in Arkansas! :D I swear I am a misplaced Siberian citizen. LOL Be careful and let us know how things went when you get back home.

Hugs,
Leslie

[Katy1]

Oh, man what a day! I knew when I posted that Annie was doing great that I probably shouldn’t have done that.

Forward a week. We woke up this morning to our normal routine, but no such luck. Annie did not want to eat! She has always been my little chow hound and if she turns her nose up to food, something is wrong.

The cst is now 8:10 and she is asking to go outside, so I throw on a robe and follow her. We had a torrential thunderous night last night, so while Annie was strolling amidst the ruins, I was picking up lawn furniture, etc…..then I noted her classic poop walk. I was sitting on the deck letting her do her thing and she pooped, checked her poop and it was totally normal looking so we went inside. She still had NO interest in food so I called the clinic.

Our favorite tech was on duty and said Doc would not be in the office until 11:30….. I said we would be there. A brief digression, the hubby had made plans weeks ago to play golf with out of town buddies for this morning so he is out of the picture at this point. I’m on my own.

Annie had a normal poop at 8:30am cst but she still did not want to eat. 15 minutes later she wanted out again, so I followed her and she had the runs. I called the clinic again.

Our appointment was for 11:30, so of course, we are there at 11:15. In the meantime, Annie had the runs again outside the clinic, so someone went out and gathered a sample.

Finally, Doc is here and is poking and prodding all over Annie. I told him that since she was totally fasted, it might be a good idea to do whatever he wanted to do with her diagnostically. He said he would run a complete blood panel.

These are the critical numbers we are looking at right now:
In May, 4 weeks post gallbladder surgery:
ALP…852
ALT….87
Today:
ALP: 1336
ALT: 420

Everything else was in normal range. Doc said these increases indicated something going on with her liver so he put her on Amoxicillin, Ursodiol and Denamarin. They gave her first dose of Ammox. and denamarin in the office plus some sub-q fluids. The time now is 1:00cst

Now Annie is snoozing on the couch and after an hour, I decided to leave my watch post and go to the kitchen to unload the dishwasher. After the first few dishes, I hear the classic sounds of pup puking and I see my poor baby puking up bile on the couch. Thankfully, it was covered with a sheet. Another call to the vet, another drive to the vet, another wait at the vet. He thought it may have been a reaction to the meds they gave her on an empty stomach. He gave her a shot of Cerenea and another load of sub-q H20 and we were home by 4:45. Annie slept until about 9:00 and then was giving me the hungry look.

Well, I thought what the heck, if she’s hungry, she’s hungry……even though doc said to fast her for 24 hrs…..not happening on my watch. I fed her the usual amount and she gulped it down. I also gave her the night dose of Amoxicillin and waited for an hour to make sure everything maintained it’s proper place. Then I gave the rest of her insulin dosage for the day.

Today was also supposed to be her Lysodren day so my question is how long do I wait for the next dose?

I wasn’t even thinking about that when I was in doc’s office this afternoon. He told me to wait until tomorrow, but she is now on so many other drugs, I’m wondering if I can just wait until our next scheduled dose which will be on Saturday. I want her little tummy to get used to all the new stuff.

People often wonder why I worry so much………I rest my case.
I’m so tired at this point. Blessing to you all and a happy and safe 4th tomorrow. Karen

[Squirt's Mom]

I'm glad the vet was in and you were able to get Annie in to see him! As for the Lyso dose, the first thing I would do is some serious research on drug interactions with the meds, and class of meds, the vet has already given her. It may be that is the reason he said to wait a bit - to give the meds time to get out of her body to lessen the chances of a bad reaction. Here is a link that will get you started:

https://www.drugs.com/drug-interactions/mitotane,lysodren.html

Generally, we say never give Lyso or Trilo to a dog who is sick with something else. Let the other acute condition improve then start back on the treatment. So if I were you I would definitely wait at least 1 day if not a day or two more depending on how Annie is then. So Sat sounds pretty good to me. If she is still having digestive upsets I would talk to her vet about how long you can wait. We don't want to reload but neither do we want to put too much on her system if we can help it.

I fully understand the worrying part! My new little rescue girl, Tilly, had what seems to be a seizure late yesterday afternoon and we can't get in to see a vet until Mon morn due to the holiday. She hasn't had another episode of whatever that was but if she does we will be driving to the next town over for a veterinary ER! So as you worry about Annie know another twitcher mom is worrying with you. :D

Hugs,
Leslie

[labblab]

Gosh Karen, I’m so sorry about this setback and I’m really hoping that Annie is feeling much better this morning! I also can’t argue against delaying her Lysodren until her tummy is settled, although on the flip side, we really don’t know whether delaying is a good or not-so-good thing to do in terms of her cortisol level. Since we don’t have a monitoring reading, I think you’ll have to trust your “mom instinct” on this one.

As you know, diarrhea and vomiting can be symptoms of a cortisol level that’s gone too low. But if Annie’s potassium and sodium levels were normal on the chemistry panel, that makes overdosing far less likely. On the other hand, elevated ALP and ALT are classic symptoms of elevated cortisol, so it’s possible that she’s losing ground in terms of cortisol control. Have her glucose levels been more consistent lately, or have they remained higher than you’d like?

Of course, this episode may have nothing to do with Cushing’s at all. However, I remain puzzled by your vet’s reluctance to monitor Annie’s cortisol. If Annie otherwise was not going in to the vet regularly and having blood drawn, I might more easily understand his decision to not stress you guys with added testing. But you do go in regularly, and it seems as though there are several occasions now when he could easily have performed an ACTH, especially since the time of day that the test is run does not matter for dogs taking Lysodren. Outward appearance tells you some things, but far from everything. It’s not uncommon for a Cushpup under treatment to “look” fine up until the moment when they don’t — when they start barfing or having diarrhea, for instance. It seems to me that it would be better to check the internal lab status so that medication adjustments can be made in order to avoid behavioral disturbance or abnormality.

Right in the middle of an acute episode that is not Cushing’s related is not the best time to monitor cortisol because cortisol is likely to be elevated at least temporarily by whatever else is going on. So if your vet is convinced this has nothing to do with Cushing’s, I guess I would hold off until she’s recovered. And I really, really hope you guys are still able to take your trip. But as soon as you return and at a time when she’s stable, if it were me, I’d really want that ACTH to finally be performed, especially in light of the new elevations in Annie’s liver enzymes. Just sayin’...

Marianne

[Squirt's Mom]

Oh! I have completely missed that she is not being monitored!!! :eek::eek::eek::eek: That is extremely risky on either of these drugs so I do not at all understand her vet's stance UNLESS the vet does not understand the drug that they prescribed to Annie or Cushing's. If that is the case I would RUN and find another vet asap. These drugs are very very powerful and should not be given unless the dog is monitored regularly. I do realize it is more difficult with a dual diagnosis pup but doing an ACTH simply cannot be put on a shelf when a pup is on Lysodren (or Vetoryl). Please, for Annie's sake, insist that her vet run the ACTH asap.

Hugs,
Leslie

[Katy1]

Ok, everyone just take a deep breath. Annie is doing so much better and if anyone wants to rant on her vet, you need to rant on me first because i’m her first line of defense.

The amoxicillin and ursodiol seems to be making a positive difference. Last night I gave Annie a Cerenia tablet because today was her scheduled Lysodren day. I’m happy to report that all food and meds stayed in place.

When she is fully recovered we will be doing further testing on everything. Blessings to you all. Karen

[Katy1]

Hi everyone,

I apologize for my little rant—I have been so stressed lately with all the meds I have to put into my little baby’s body.

In fact, since she is still on amoxicillin for her liver I just called doc to ask him if it would be ok to give Annie a cerenea tab at midnight again because Wednesday is her her Lysodren day and that might give her some extra tummy protection. He gave me the ok so that’s what we will do until she’s off the amoxicillin.

Plans forward, the hubby and I have a fishing trip planned to leave on the 18th of July. We had hoped we could take Annie with us. Well, as a mostly hysterical pup mom we decided to board her at our vet. I was assured they would be all over her, which I know to be true, but I will also be asking for a stim test plus complete bloodwork since her recent liver episode. If I need to ask for anything else,please come forward. Blessings to you all. Karen

[labblab]

Hey Karen, we all have “those” days — we know where you’re at ;-)

After me harping about getting a stim test done ASAP, you’ll probably be stunned to hear me suggest that if you cannot proceed with the ACTH before you leave, you might best wait until after Annie has returned home again subsequent to your trip. You can go forward with the other bloodwork if you like while she’s boarded, but at this point, I’d wait on the ACTH until Annie has both fully recovered from this GI episode and is also back home in as stress-free an environment as possible. Both physical illness and emotional stress have the potential to elevate cortisol levels and skew test results for both the ACTH and the LDDS. As we’ve probably already discussed, in the effort to reduce stress on their dogs in conjunction with the test, some of our members even opt out of leaving their dogs caged at the vet during just the intervening hour between the test draws. Unlike most other dogs, Annie may be exceptionally calm while she’s boarded at the vet, but I just want to mention this consideration.

Having said that, I forget how long you’ll be away. If it’s for a really lengthy time, then maybe your vet will want to proceed in your absence. But I just want to mention the pros-and-cons so that you can make the most informed decision.

Marianne

[Katy1]

Hi Marianne,

I always appreciate your input! We decided it would be in Annie’s best interest to board her at the vet while we are gone. There are so many things that could go wrong I won’t even mention them.

Everyone at the clinic knows her so well and the other vet takes her small dog to work with her everyday. There are also a couple of employees in their boarding section who also take their pups to work. Annie has made friends with all of them and on the occasional slow day, they will let Annie out for a free run around the whole office with the office “pack”.

After the first day or so I’ve been told she settles right in. I’m still going to ask for a stim test and a redo of her liver values at doc’s discretion. She’s almost done with the amoxicillin. We won’t leave until the 18th and we will be gone about eight or nine days. If you have any other suggestions please let me know. Blessings, Karen

[Katy1]

Hey Everyone,

Now I’m in panic mode, not because Annie is sick, but because she’s ok and now I’m just waiting for the next “shoe to fall”,. I really try to be a positive person, but the minute I even try to feel comfortable, we have a set back—either human or other.

Today I checked her in for boarding at the vet for a week starting on the 18th-26th. We have been waffling between taking her with us or leaving her here. With the severe heat even where we’re going in way northern Minnesota, it’s supposed to be hot up there too. I decided it’s not worth taking any chances, and now she has become somewhat of a celebrity at the clinic, so she will be staying home.

I can guarantee you I’ll cry all th way to Madison, Wisconsin because I will feel guilty for leaving her and also just missing her. I’m such a mess.

I did emphasize the need to do a stim test and recheck her liver panel. She has shown some minor symptoms of the cushings. Panting, even when she’s been in a very cool environment most of the day. Her scull feels more boney and she has more strange bumps on her head and back. She has also has had to to outside during the night.

I will try to send updates on Annie as receive word on any labs run. Blessings to you all. Karen

[labblab]

We’ll be watching for those updates, Karen, and hoping that all goes well for all three of you! I know it’ll be hard to leave Annie behind, but we caregivers do need moments of respite in order to strengthen ourselves for all the challenges that inevitably arise once we return home once again. Travel safely, and good luck with the fishing!

[jaxr0806]

Hi Karen,
It’s been a while since I’ve been out here but I just got caught up on Annie’s status. Annie is in good hands at the vet so I hope you are able to enjoy your fishing trip.

[Katy1]

We are home from our fishing adventure and it’s taken me 4 days to recover! I know this is not the “fishing channel”, but for anyone who has ever fished the Lake of The Woods in either the US or Canada, it’s not a vacation—it’s work. However, my hubby caught and released a 31 inch walleye which equates to 11 pounds—his lifetime record for a walleye.

I’m so thankful that we decided to leave Annie home. It was so hot and the closest vet was a 2hr. drive. While Annie was boarded I asked that they run another stim test and a follow-up liver panel......and I also asked for a skin scrape because I had been feeling bumps and lumps along her spine and I was so scared she was developing CC.

Before I post the important stuff, I have to admit the joke was on me ....again!!!!!!! Doc did not do a skin scrape because the lumps and bumps I felt on her spine was pine tree sap. I felt so stupid. We have three big white pines in the backyard and Annie is always sniffing underneath the branches for bunnies. I spent all my away time worrying for nothing.

Ok, stim test results: pre—4.1. Range 1.0-5.0
Post—9.1. Range. 8.o—17.0

Her liver results were still high which really concerns me. When we picked Annie up I couldn’t talk to anyone about the test results because the clinic had been slammed with emergencies and doc was in surgery with all his techs.

After Annie’s past bout with whatever, we put her on 250mg of ursodiol once a day and I was praying that would make a difference. Her recent ALP was 1134, GGT-13, and everything else on her panel was in the high range.

I found an internist about an hour away and I want a second evaluation. She is part of another specialty clinic but we would not have to fight the Chicago traffic. I don’t know what’s normal anymore.

Annie acts fine, she is actually a brand new pup since her gallbladder surgery but..............

Help! Blessings, Karen

[labblab]

Hello, Karen, and welcome home to everybody :-))))))). Even though it wasn’t necessarily relaxing, I’m so glad you and hubby were able to take this trip together. It sounds like a much needed break from the routine. And I’m especially glad to hear that Annie is generally doing well, too!

But getting back to business ;-), here’s a couple of thoughts on the Cushing’s/liver front. Annie’s cortisol level continues to elevate, and is now even more highly out of therapeutic range for a Cushpup being treated with Lysodren. The range that you cited with her ACTH result is the normal range for a dog who does not have Cushing’s when the test is being used for diagnostic purposes. It is not relevant to Annie’s situation. For a dog taking Lysodren, you want both the pre-ACTH and post-ACTH levels to range between 1.0 - 5.0. Annie’s post-ACTH result is now almost two times higher than is desired. To the best of my recollection, here’s her ACTH testing history:

Pre-treatment diagnostic post-ACTH level: 17.2

Post-ACTH result at the end of her loading phase and the switch to maintenance: 2.0

May monitoring test: Pre-ACTH of 0.6; Post-ACTH of 6.4

Current result: Pre-ACTH of 4.1; Post-ACTH of 9.1

Since her cortisol level has consistently been rising, we’d conclude that her maintenance Lysodren dose has been too low. Whether or not you could get it back down into therapeutic range simply by increasing the maintenance dose or whether you’d need to reload, I do not know. But if you do nothing and let the current pattern progress, I’m guessing that her cortisol will just keep on increasing unchecked as her adrenal tissue continues to regrow.

This elevating cortisol level could explain both the return of some Cushing’s symptoms and also the lack of improvement of her liver values. Those liver elevations are classic Cushing’s symptoms. Even when cortisol levels are well-controlled, liver elevations don’t necessarily ever return to normal. But when cortisol is not well-controlled, improvement is really unlikely. The good news is that if those elevations are indeed the result of Cushing’s, they may not ever be particularly sinister in terms of actual liver damage, but instead may largely just be “markers” as to the presence of higher levels of circulating steroids.

How have Annie’s glucose levels been trending? Have they remained hard to regulate, or have you achieved some consistent control? If her diabetes has remained under better control and you’re not noticing a strong rebound in Cushing’s symptoms, maybe just increasing her maintenance Lysodren dose will continue to buy you some more time before you’d have to consider reloading. I just don’t know, and I think it may indeed be a wise idea to consult with a specialist who has more experience with the management of complicated cases such as this.

But the bottom line is that I’m really glad to hear that, right now, Annie is doing well. Every single good day is a special gift, that’s for sure!

Marianne

[Katy1]

Marianne and anyone else out there in cushings land. I guess the only positive thing I can offer with regard to Annie is that her glucose level is stable for the time being. Doc ran a fructoseomine test before we left on our trip and it was good. I don’t have any numbers but this is just an FYI.

I just watch her behavior and she seems so normal. Tomorrow, I'm going to try to talk to doc—and have a serious discussion about his comfort level in treating her. All of a sudden, I feel like we have been shoved off to the side. I realize he has the pressures of managing vet offices in two small towns 25 miles apart. I’m not making excuses for him, but now I’m faced with the realization that Annie’s tri-conditions are more than he can deal with.

I think when we grabbed Annie and rushed her to Chicago for her gallbladder surgery, doc thought his job was done. Maybe I’m wrong because he has taken such good care of our girls over the the past five years, but maybe Annie is just too much.

Marianne, thank you so much for putting all of the numbers in perspective for me. Math and numbers are my mental enemy! If anyone has any other suggestions, please chime in—-I’m always open for opinions, suggestions, anything...... you all are the best people on the planet! Blessings, Karen

[Budsters Mom]

This is whay I choose to focus on today. Do with it as you wish. My time with my little Buddy is gone. He's not coming back. I spent so much of my time worrying over the tomorrows, that I lost all of my todays and I can't ever get them back. Annie is acting fine. Take the time to rejoice in that, before it's too late!

Annie acts fine, she is actually a brand new pup since her gallbladder surgery[/QUOTE]

[Katy1]

I appreciate the reality check.......but i’m Still unglued from what Marianne spellled out to me as far as her stim numbers are concerned. My main doc is on vacation but I have an appointment with his other doc on Friday afternoon, with the baby in tow.

Actually. Dr. Elizabeth is much easier for me to discuss these issues with. Doc takes things personally even though I try to soften the blow. Dr.Elizabeth is the one who helped my beloved Gracie cross the bridge. She is very soft spoken but is able to get her the main point across. I’m looking forward to Friday for answers. I’ll let you know the outcome of our consultation. Blessings to you all. Karen

[labblab]

Karen, I hope you have a really fruitful conversation with Dr. Elizabeth tomorrow. And although I know it’s hard, try not to fret unduly about the stim numbers. You’ve reported that Annie is outwardly looking good and behaving normally, so this is not an emergency situation. One way or the other, you can once again reduce the level of circulating cortisol. Perhaps just increasing her maintenance dose will do the job, and that would be an easy “fix.”

Hoping today is another good day for you two and, again, wishing you well tomorrow.

Marianne

[Katy1]

Marianne, et all..

Dr. Elizabeth and I had a great discussion this afternoon. She spent almost 45 minutes with us. She had to get caught up on Annie’s everything plus today is Annie’s 11th birthday— she couldn’t have any treats but everyone came through to give her an ear scratch or a paw shake or a head pat. It was was a quiet day in the office and I was grateful.

We went through her stim test history and Elizabeth agreed that Annie probably could use a “Lysodren booster” to get her numbers back in control. She decided to add an additional 125mg to her regimen which will now change from twice a week administration to three.

Her last Lysodren pill was on Wednesday of this week. Tomorrow we will start a new schedule. Tomorrow, she will get the quarter tablet of 125mg., then Monday and Wednesday of next week she will get her reg. dose of 250 mg.

Annie will be boarded with them at the end of the month and they will run another stim test at that time to see if there is improvement. I really hope we caught this little “flair” in time to make a difference.

I also had her check her blood pressure and heart murmur. The murmur has changed sounds to both doc’s but they both tell me that it’s not bad just a different sound.

I feel like I paid for some peace of mind today. I also asked dr Elizabeth how many cushings pups they were monitoring. I got the biggest eye rolls from both Elizabeth and the tech in the room with us. Thay both told me they had many,many cushings patients on meds but many more pups they knew were positive for cushings but their parents did not want to pay for the testing so they were on just “supportive” therapy.

It was a relief to know that Annie is not the only one and for now, we will maintain the status quo and see what happens with the increase in Lysodren. I also know where I can receive higher level help if need be.

My baby turned 11 today and I rejoice in the fact she is still with us. Blessings to you all. Karen

[Harley PoMMom]

Happy 11th Birthday, Annie!!!

[Katy1]

Annie says Thank you for thinking of her on her special day! Blessings, Karen

[Joan2517]

Happy birthday, Annie!

[Squirt's Mom]

HAPPY 11th BIRTHDAY, ANNIE!!
AND MANY MORE!!

[Katy1]

Hi everyone! Annie and her dad and I have been mia for a few weeks because everything was going ok. Now I’m not sure it is.

She was boarded at her vets for a few days and during that time, she had a stim test done because we upped her Lysodren the first week of August. I called doc’s office today and was told that her her pre test number was 3 and her post was 12.3. I made an appointment with doc for next Thursday afternoon.

It’s evident to me that her minor increase of Lysodren at 125mg was not enough. The only thing is she is acting so normal in her new normal world.

Marianne, please advise if you’re home from your trip. I also invite any and all advice from anyone out there. Blessings to you all. Karen

[Budsters Mom]

This is EVERYTHING!!! I am by no means an expert. I have lost beLoved fur babies and have had my heart shattered. If I were you, I wouldn't change a thing, and would ride out the ACTING NORMAL coaster for as long as the ride lasts. I would be ever so grateful to stay on that ride FOREVER!

So, to sum it up, the numbers would be meaningless to me. Our pups are ill. There is no cure for Cushings, except for surgery in rare cases. So acting normal would be a true blessing.



The only thing is she is acting so normal in her new normal.

[labblab]

Hi Karen, I’m not really “back” yet, and unfortunately I only have a few minutes to write tonight. But in my opinion, whether or not Annie’s rising cortisol needs to be addressed more aggressively probably depends on two questions: has her glucose level stabilized at an acceptable level, and are her Cushing’s symptoms being adequately controlled? If the answer to both those questions is “yes,” then it seems to me there is less urgency in aggressively reducing her cortisol level. However, the wild card is that if you don’t intervene in any manner to put a lid on the rejuvenation of her adrenal tissue, a reload at some point in the future may be inevitable. However, “some point in the future” may not necessarily be right now if she’s otherwise doing well.

Marianne

[Squirt's Mom]

I second what Marianne had to say - IF the BG is well controlled *and* her signs are well controlled I'd leave things as they are for now. But I do have a question - while she was in boarding did the vet/techs make sure her Lyso was given with food? If not, then it wasn't absorbed well enough to work on the cortisol and in that case I certainly would not increase right now. I would make sure the med was given with food then retest in a few more weeks.

[Katy1]

Oh wow, It just seems like forever since I’ve posted here. Update on Annie—we are still juggling about 5 ballls in the air but non have yet dropped. Doc increased her Lysodren to 250mg three times per week and we will do another stim test in a month plus a glucose curve. Her cataracts are still at stable status for which I’m thankful. I don’t remember who yelled at me and told me to just go with the flow if she was showing no symptoms. Thank you—I think it was you Kathy.

Leslie to answer your question regarding boarding feeding. Yes, they always make Annie a dog food ball with her Lysodren inside and she just snarf’s it up with the rest of her food.

I do have a serious question—-why has the price of Lysodren doubled in the past few months? I’m having trouble finding it for less than $15.00 per pill. Can anyone chime in on that. With her increased dose now I just can’t believe the cost. I think Annie is the only active Cush pup on Lysodren here as far as I know, but If anyone has a reference to a less expensive supplier, I would really appreciate the information. When I’ve looked myself most other sites other than Chewyk are sold out and chewy is the most expensive. Ugh! Well, anyway, I offer blessings to you all and your pups for a safe weekend. Karen

[labblab]

Hi Karen, and thanks for the update. In answer to your question about Lysodren, here’s a link to a thread that Leslie posted last year re: Bristol-Myers-Squibb’s divestiture of the manufacture of Lysodren. Direct Success Pharmacy is now the sole U.S. distributor of brand name Lysodren. If you’re still able to purchase from Chewy, you must be getting some leftover batches of previous BMS product runs. Presumably due to the lack of competition, the price may continue to increase even further. One alternative that Leslie discusses is switching to a compounded version of the medication. Take a look at what she has written here:

https://www.k9cushings.com/forum/showthread.php?9111-Lysodren-shortage

https://www.directsuccessinc.com/direct-success-pharmacy

Marianne

[Katy1]

Ok, we for found an on -line set called allivet that was selling Lysodren for 6.50 per tablet so we ordered 60 and our vet authorized the purchase. Who knows, Annie might make inti the record books, we just take a bard at a time and feel so blessed that she is still with us —- and I know that her older sis Gracie would approve..

[labblab]

Hi again, Karen, and that’s great that you’ve found a less expensive supply. Here’s one cautionary note, though — do check the expiration date of the medication when it arrives to make sure it is still “good.” At that price, I’m guessing that it must still be left over from an original Bristol-Myers-Squibb production run, so it may be approaching the end of its expiration period. I know that the effectiveness of many medications far exceed the listed expiration date, but still, you will want to make sure that you’re within at least a reasonable time frame.

Marianne

[Katy1]

Hi Marianne, Actually, that’s the first question I asked when I ordered ...you know the old saying......anyway we received it yesterday and the expiration date is a year and god willing, Annie will still be with us. Blessings to you all. Karen

[Katy1]

Just a quick update on our Annie, doing fine outwardly but she is scheduled for a glucose curve tomorrow and a stim test on Wednesday——will update when I have numbers. I’m always waiting for the next iceberg to fall. That’s my problem not her’s. Since her gallbladder was removed in April, she is a totally different dog. I don’t know how the cushings plays into this,which is probably nothing—-but for right now, she acts like she’s 5 instead of 11. We are so blessed. Blessings to you all....it’s been long. Karen

[labblab]

Hi Karen! How nice to see you girls back again, and with such a good update :-). Of course we’ll be anxious to review Annie’s test results with you, but especially at her age, her outward appearance and behavior are hugely important, as well. I’m so glad to hear she’s doing good! Thanks for stopping by this morning, and we’ll be watching for further info.

Marianne

[Squirt's Mom]

Hi Karen,

What a great update on Annie! Acting 6 years younger is a real blessing and one I hope continues for some time to come. That gall bladder must have been making her feel pretty rotten and I'm glad she has perked up.

Hugs,
Leslie

[Katy1]

Last week Annie had both a stim test and a glucose curve done. Her stim test results were: prre 1.something and her post was 11. Now to many of you that would look like a train wreck! Well her last post stim was 17 and I was scared so we added another half tablet of Lysodren to her regimen. Now she on 1/2 tab three times a week.

Now here’s the kicker. Her glucose curve was the most stable it’s ever been since we started this journey. I won’’t post all the numbers but when I talked with doc she said that even though her post stim is high, Annie has finally reached a balance between her Lysodren and her insulin. She is also maintaining a healthy weight of 16.5 lbs. for a miniature schnauzer.

The most important thing is how she is acting. She is a completely new pup! She runs, jumps,�� barks and wants to play. I really think getting her gallbladder out was the key to the puzzle. Don’t forget the little girl is 11 years old. Oh I forgot to mention that her cataracts are stable and we have her on eye drops and a salve twice a day. She is physically a hot mess now under control.

Annie has never really acted like a “typical “ cushings pup with the exception of the initial typical symptoms. I just feel. So blessed that she is still with us. That’s the news for now. Blessings to you all and your pups. Karen

[labblab]

Awww Karen, I think this is great news and I wouldn’t change a thing now, either! “Stable” can be the most beautiful word in the whole wide world. The new Lysodren dose has stopped the increase in her cortisol level and even dropped it somewhat. So in combo with the good glucose curve, I think you girls are doing really well :-). I wish you a lovely holiday season, with your happy little Annie right by your side ;-).

Thanks so much for this update — it raises all our spirits to share in the happy news!
Marianne